Ruben Tibs 496(\)
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Late Independent Expenditure Report Type or print In lnk.
Amounts may be rounded to whole dollars.
Date of 10~
This Filing __ I_"'.....,.._
1.0. NUMBEFI f~spp1lt:.llbls>
Report No. __ 1_--"-'---
STATE C'flf~D[
list Only One Canc:Hdate or Ballot Measure
NAME OFb;DIDA~PPORTEDOR OPPOSED ~u. ~ \ ~loS
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DATE
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ZIP CODE
SUPPORT OPPOSE
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O Amendment k' Off toReportNo. ___ (,.....ityi-'111' Cler S ic
(explain below) 't
No. of Pages........,_ ___ _
NAME OF BAU.OT MEASURE SUPPORTED OR OPPOSED
BALLOT N0.11.ETTE.R JURISDICTION
DESCRIPTION OF EXPENDITURE
SUPPORT OPPOSE
AMOUNT
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:>J Reason for Amendment:----------------------------------~---
FPPC Form 496 (June/OJ)
FPPC Toll•free Helpline: 866/ASK.f PPC
late Independent Expenditure Rep,ort LATEINDEPENDENTEXPENDITUREREPOR'f
CALIFORNIA 49 O FORM \(')
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~k&vl \,lo~ ___ .::.,,_ ___ .:._ ___________________________________ -! 1.D. NUMBER (lf~J
NAME OF ALER
3. Contributions of $100 or More Received*
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DATE RECBVED
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FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRISUTOR
(!¥ COMNITl'EE. ALSO EHtal-l.D, HUMlleR)
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••Contributor Codes
IND-lndMdual
CONTRIBUTOR IF AN INDIVIDUAL, ENTER OCCUPATION
COOEH AND EMPLOYER.
~F SEIJ'.EMl'LOYEI>, ENTER NAME OF l!USINESS)
nd1ND ?e-+~d OcoM
OoTH
0PTV
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[Y'INO nlla~' ~~41-0COM
OoTH
OPTV nscc
DINO
OcoM
DOTH
QPTY oscc
LJIND
QCOM
OoTH
QPTY oscc
DINO
QCOM
DOTH
QPTY oscc
DINO
QCOM
QOTH
QPTY
oscc
:\J *Maier donor and Independent expendi!ure
:i comnlttaes that do not receive contributions
:::) are not required to complete Part 3. COM-Aeeipient Committee (other than PTY or SCC)
OTH-Other
PTY -Political Party sec-Small Contributor Committee
AMOUNT INTERESTRATCS RECEIVED
If loan, ~ ';JOO.OD enter interest rate, ii any
-%
l 15.0D If loan,
enter interest rate, if any
0 %
If loan,
enter Interest rate, if any
'¥o
If loan,
enter interest rate, if any
%
If loan,
enter interest rate, if any
%
If loan,
enter interest rate, if any
%
FPPC Form 496 (June/Of)
FPPC Toll-Free Helpline: 866/ASK-fPPC
8661275-3772