Gilmore 2014-10-28= = .......... = = p.... _.. _.. en en en en i:o O"") = z >< < =. :>.... c: ltl 0.. E 0 u ~ <!) c: ltl <!) Cl ;::.;: p.... LC) LC) = = = e-.......... _.. = C'l .......... = C'l .......... e-t_:) = 497 Contribution Report Type or print in ink. Amounts may be rounded to whole dollars. NAME OF FILER Date of Gilmore for Mayor 2014 This Filing 1012012014 AREA CODE/PHONE NUMBER l.D . NUMBER (if applicable} (916)285-5733 1323448 Report No. 7767513-ko STREET ADDRESS D Amendment to Report No.-----=c=n:-:Y-------------------5-TA_J_E ___ zl_P_c_o_D_E ____ _jl (explalnbelow) 1787 Tribute Road, Suite K Sacramento CA 95815 No . of Pages 1 1. Contribution(s) Received DATE FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR RECEIVED (IF COMMITTEE.ALSO ENTER l.D. NUMBER) CODE* 10/28/2014 ~dam Elsesser 1351 Harbor Bay Parkway [!] IND ~lameda, CA 94502 D COM DOTH D PTY D sec D IND D COM DOTH D PTY D sec D IND D COM 0 OTH D PTY D sec Reason for Amendment: __________________________________ _ www.netfile.com ClT V Ofl; ALAMEDA crrv C LER K~s o~r=~r r-: IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER (IF SELF-EMPLOYED, ENTER NAME OF BUSINESS) Chief Executive Officer Penumbra Inc . •contributor Codes IND-Individual AMOUNT RECEIVED 2 ,500.00 D Check if Loan % Provide inte1est rate D Check if loan % Provide inlel'esl rate D Check if Loan % Provide lnte1 est rate COM -Recipient Committee (other than PTY or SCC) OTH -Other (e.g ., business entity) PTY -Political Party SCC -Small Contributor Committee FPPC Form 497 (Marc h/2011) FPPC Toll-Free Helpline: 866/ASK-FPPC (866/275-3772)