2017-12-04 Form 497 - Middleton497 Contribution Report Amounts may be rounded to whole dollars.
NAME OF FILER
Lisa Middleton for Palm Springs City Council 2017
Date of
This Filing
"'tt>~e:o 12/04/201 7 ~ I ( r 0 F P A L H S r• I{ I I'-: CALIFORNIA 497
FORM
AREACODE/PHONENUMBER
1.0. NUMBER (lfapp/lcBble)
1394265 Report No. __ 1 __ 2 17 DEC .. 4 AM IQ: 4 t " I • y
STREET ADDRESS •Amendment • r r ICE L f' ·1 HE Cl Ii' CLt
to Report No. ----.i_-++
-c1=TY-,-------------------=s=TAc:::r=-E--=z1=p-::-c-=-oo~E~----1 (explain below)
1
fl.~
Palm Springs CA 9 2--i..& ::> No. of Pages
1. Contribution(s) Received
DATE FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR
RECEIVED (IF COMMITTEE, ALSO ENTER 1.0. NUMBER) CODE*
Coachella -Imperial Valleys Strategies 0 IND
11 /29/2017 75100 Mediterrainean 0 COM
Palm Desert, C A 92211 0 0TH
0 PTY
~ sec
0 IND
0 COM
0 0TH
0 PTY • sec
0 IND
0 COM
0 0TH
0 PTY • sec
Reason for Amendment:-------------------------------
IF AN INDIVIDUAL,
ENTER OCCUPATION AND EMPLOYER
(IF SELF-cMPLOYED, ENTER NAME OF BUSINESS)
-eontributor Codes
IND -Individual
AMOUNT
RECEIVED
$2000.00
D Check if Loan
%
Provide interest rate
D Check if Loan
%
Provide Interest rate
0 Check if Loan
%
Provide Interest rale
COM -Recipient Committee (other than PTY or SCC)
0TH -Other (e.g., business entity)
PTY -Political Party
sec -Small Contributor Committee
FPPC Form 497 (Jul/2016)
FPPC Advice: advlce@fppc.ca.gov (866/275-3772)
www.fppc.ca.gov