Roloff 497-1497 Contribution Report
Amounts may be rounded to whole dollars.
NAME OF FILER
Jennifer Roloff City Council 2016
AREA CODE/PHONE NUMBER
415-999-4395
I.D. NUMBER (if applicable)
1385651
STREET ADDRESS
CITY
Alameda
STATE ZIP CODE
CA 94501
Date of
This Filing
Report No.
10/11/2016
497-01
0 Amendment
to Report No
(explain below)
No. of Pages
1
111 e S
OCT 1 1 2016
CALii-ORINIIA
FORM 497
For 13"Icial Use Only
CITY OF AL/2\1\4E DA
CITY CLERK'S OFFICE
1. Contribution(s) Received
DATE
RECEIVED
FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR
(IF COMMITTEE, ALSO ENTER I.D. NUMBER)
CONTRIBUTOR
CODE *
IF AN INDIVIDUAL,
ENTER OCCUPATION AND EMPLOYER
(IF SELF-EMPLOYED, ENTER NAME OF BUSINESS)
AMOUNT
RECEIVED
10/10/2016
Christopher and Trudi Seiwald
Alameda, CA 94501
Retired
Retired
1,000.00
0 Check if Loan
%
x IND
MI com
U OTH
PTY
•SCC
Provide interest rate
El IND
0 COM
0 OTH
ID PTY
III SCC
0 Check if Loan
%
Provide interest rate
0 Check if Loan
%
• IND
0 COM
0 OTH
• PTY
•SCC
Provide interest rate
Reason for Amendment-
**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