HomeMy Public PortalAboutForm 497 Ted Mertens 2022NON
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497 Contribution Report AMObnta maybe rounded to whole dollars
NAME OF FILER
Elect Ted Mertens I.W. City Council 2022
AREA CODE/PHONE: NUMBER I.D. NUMBER IV appal*
760-776-6186 Pending
STREET ADDRESS
74972 Saguaro Lane
CfTY
Indian Wells
STATE ZP CODE
CA 92210
Date of 8/26/2022
This Filing
Date Stamp
Report No.
❑ Amendment
to Report No
(explain bebw) 1
No. of Pages
1. Contribution(s) Received
DATE
RECEIVED
FULL NAME. STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR
OF COMATTEE.A<a0 ENTER tn.NumaERI
CONTRIBUTOR
CODE'
IF AN INDIVIDUAL.
ENTER OCCUPATION AND EMPLOYER
(F sELFk)LOTED, ENTER NLUE OF ousit cse)
AMOUNT
RECEIVED
8/25/2022
Ted Mertens
0IND
❑ COM
0 OTH
❑ PTY
❑ SCC
Retired
1500.00
® Check If Loan
0.0
Provide Interest We
❑ IND
❑ COM
❑ OTH
❑ PTY
❑ SCC
❑ Check if Loan
Provide Mterest role
❑ IND
❑ COM
❑ OTH
❑ PTY
❑ SCC
❑ Check If Loan
Y.
Provide Interest rate
Reason for Amendment
" Contributor Codes
IND - Individual
COM - Recipient Committee (other than PTY or SCC)
OTH - Other (e.g., business entity)
PTY - Political Party
SCC - Small Contributor Committee
FPPC Form 497 (Feb/2019)
FPPC Advice: advIce&ofppc.ca.gov (866/275-3772)
www.fppc.ce.gov
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