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Committee to Revitalize Our School 2014-10-13 - 3497 Contribution Report 1027817 NAME OF FILER Committee to Revitalize Our School AREA CODE /PHONE NUMBER (510)759 -3236 STREET ADDRESS 1520 Central Ave CITY Alameda 1. Contribution(s) Received DATE RECEIVED 10/09/2014 10/09/2014 I.D. NUMBER (if applicable) 1364294 STATE CA ZIP CODE 94501 Type or print in ink. Amounts may be rounded to whole dollars. Date of This Filing 10/10/2014rm. Report No. 497-3 ❑ Amendment to Report No. (explain below) No. of Pages FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR (IF COMMITTEE, ALSO ENTER I.D. NUMBER) Northern California Carpenters Regional Council Issues PAC Committee ID # 1219354 Sheet Metal Workers International Association Local 104 San Ramon, CA 94583 Reason for Amendment: www.netfile.com 1 CONTRIBUTOR CODE * ❑ IND COM ❑ OTH ❑ PTY ❑ SCC ❑ IND ❑ COM OTH ❑ PTY ❑ SCC ❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC Date Stamp 497 CONTRIBUTION REPORT CALIFORNIA! FORM �} 201' Ci T'( OF AL._ MED/ In( CLERK'S OFFU: ;E For Official Use Only IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER (IF SELF - EMPLOYED, ENTER NAME OF BUSINESS) AMOUNT RECEIVED 5,000.00 ❑ Check if Loan r Provide interest rate 5,000.00 ❑ Check if Loan 00 Provide interest rate ❑ Check if Loan o� 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 (March /2011) FPPC Toll -Free Helpline: 866 /ASK -FPPC (866/275 -3772)