HomeMy Public PortalAboutForm 497 Report No. 20
° 497 Contribution Report
Amounts may be rounded to whole dollars.
NAME OF FILER
Partners for a Safe Claremont
Date of
4-9-2018
Date Stamp
o
This Filing
AREA CODE/PHONE NUMBER
I.D. NUMBER da licable
909 262-9922
1403060
Report No. 2
For O icial Use Only
( ('Jt .,�)
STREETADDRESS},I�p�
2058 N Mills Ave Suite 430
❑ Amendment
to Report No.
(explain below)
C17 7 CLE
CITY STATE ZIP CODE
Claremont CA 91711
No. of Pages 2
.. vv..L .6J4AL1v11j X1 CI.CIVIYCI
DATE FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR
RECEIVED (IF COMMITTEE, ALSO ENTER I.D. NUMBER)
Nationwide Environmental Services
11914 Front Street
4-8-2018 Norwalk, CA 90650
Reason for Amendment:
CONTRIBUTOR
CODE '
❑ IND
❑ COM
X OTH
❑ PTY
El SCC
❑ IND
❑ COM
❑ OTH
❑ PTY
❑ SCC
❑ IND
❑ COM
❑ OTH
❑ PTY
❑ SCC
IF AN INDIVIDUAL,
ENTER OCCUPATION AND EMPLOYER AMOUNT
(IF SELF-EMPLOYED, ENTER NAME OF BUSINESS) RECEIVED
1,500.00
❑ Check if Loan
i
Provide interest rate
❑ Check if Loan
r
Provide interest rate
❑ Check if Loan
�r
Provide interest rate
**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 (Jul/2016)
FPPC Advice: advice@fppc.ca.gov (866/275-3772)
www.fppc.ca.gov
497 Contribution .Report
NAME OF FILER
Partners for a Safe Claremont
AREA CODE/PHONE NUMBER
909 262-9922
STREETADDRESS
2058 N Mills Ave Suite 430
CITY
Claremont
2. Contribution(s) Made
Amounts may be rounded to whole dollars.
Date of 4_g-2018
This Filing
I.D. NUMBER (if applicable)
1403060
Report No. 2
❑ Amendment
to Report No.
STATE ZIP CODE (explain below)
CA 91711 No. of Pages 2
mp
DATE FULL NAME, STREETADDRESS AND ZIP CODE OF RECIPIENT CANDIDATE AND OFFICE
MADE (IF COMMITTEE, ALSO ENTER I.D. NUMBER) OR AMOUNT OF DATE OF ELECTION
MEASURE AND JURISDICTION CONTRIBUTION (IFAPPLICABLE)
N/A
Reason for Amendment: FPPC Form 497 (Jul/2016)
FPPC Advice: advice@fppc.ca.gov (866/275-3772)
www.fppc.ca.gov