HomeMy Public PortalAboutForm 497 Ted Mertens 2022 (5)497 Contribution Report
Amounts may be rounded to whole dollars,
NAME OF FILER
Elect Ted Mertens IW City Council 2022
Date of 10/31/2022
This Filing
Date Stamp CALIFORNIA
OLr
-i' 2
CAFORM 497
Report No. $
AREA CODE/PHONE NUMBER
760-776-8186
I.D. NUMBER Of applrcable)
1453220
For Official Use Only
to Report Nont
STREET ADDRESS
74972 Saguaro Lane
(explain below)
No, of Pages
CITY STATE
Indian Wells CA
ZIP CODE
92210
1. Contribution(s) Received
DATE
RECEIVED
FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR
(IF COMMITTEE, ALSO ENTER I.D. NUMBER p
CONTRIBUTOR
CODE`
IF AN INDIVIDUAL,
ENTER OCCUPATION AND EMPLOYER
(IF SELF-EMPLOYED, ENTER NAME OF BUSINESS)
AMOUNT
RECEIVED
10/31/2022
CREPAC #890106
c/o Reed & Davidson LLP
515 S. Figueroa St, Ste 110
Los Angeles, CA 90071
❑ IND
■ COM
1 OTH
■PTY
rA SCC
1000.00
• Check if Loan
%
Provide interest rate
❑ IND
D COM
❑ OTH
0 Check if Loan
• PTY
0 SCC
Provide interest rate
❑ Check if Loan
%
• IND
❑ COM
❑ OTH
■ PTY
li• 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.gav