Committee to Revitalize Our School 2014-10-20497 Contribution Report
1028190
NAME OF FILER
Committee to Revitalize Our School
AREA CODE/PHONE NUMBER
(510)759-3236
STREET ADDRESS
CITY
Alameda
1. Contribution(s) Received
DATE
RECEIVED
10/14/2014
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 10/16/201
Report No. 497-5
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)
Victor Jin
Alameda, CA 94501
Reason for Amendment:
www.netfile.com
Date Stamp
497 CONTRIBUTION REPORT
CALIFORNIA A4017
FORM
T2 g 2014
CITY OF ALAMEDA
CITY CLERK'S OFFICE:
CONTRIBUTOR
CODE *
For Official Use Only
IF AN INDIVIDUAL,
ENTER OCCUPATION AND EMPLOYER
(IF SELF-EMPLOYED, ENTER NAME OF BUSINESS)
Real Estate Broker
IND Self
• COM
D OTH
• PTY
SCC
O IND
El COM
OTH
111 PTY
O SCC
EI IND
COM
11] OTH
• PTY
D SCC
AMOUNT
RECEIVED
1, 000 . 00
0 Check if Loan
Provide interest rate
• Check if Loan
Provide interest rate
O Check if Loan
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)