HomeMy Public PortalAboutForm 497 Ted Mertens 2022 (3)497 Contribution Report
Amounts may be rounded to whole dollars.
NAME OF FILER
Elect Ted Mertens IW City council 2022
Date of 9/26/22
This Filing
Date Stamp
S P 2 6 20l
CALIFORNIA 497
FORM
For Official Use Only
Report No.
AREA CODE/PHONE NUMBER
760-776-8186
I.D. NUMBER (it applicable)
1453220
to Reportp Nont
STREET ADDRESS
74972 Saguaro In
(explain below)
No. of Pages 1
CITY STATE ZIP CODE
Indian Wells CA 92210
1. Contribution(s) Received
DATE
RECEIVED
FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR
(IF COMMITTEE, ALSO ENTER I.D. NUMBER)
CONTRIBUTOR
CODE`
IF AN INDIVIDUAL,
ENTER OCCUPATION AND EMPLOYER
(IF SELF-EMPLOYED. ENTER NAME OF BUSINESS)
AMOUNT
RECEIVED
Ted Mertens
retired
1500.00
t'I IND
■ COM
9/26/22
74972 Saguaro Ln
Indian Wells, CA 92210
IZI Check if Loan
■ OTH
• PTY
0
■ SCC
Provide interest rate
■ IND
• COM
■ OTH
0 Check if Loan
■ PTY
■ SCC
Provide Interest rate
■ IND
• COM
• OTH
• Check if Loan
• PTY
■ SCC
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@fppc.ca.gov (866/275-3772)
www.fppc.ca.gov