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Save Our City 497-549 7 C o n t r i b u t i o n R e p o r t Am o u n t s m a y b e r o u n d e d t o w h o l e d o l l a r s . AMOUNT RECEIVED IF A N I N D I V I D U A L , EN T E R O C C U P A T I O N A N D E M P L O Y E R (I F S E L F - E M P L O Y E D , E N T E R N A M E O F B U S I N E S S ) DA T E RE C E I V E D 497 CONTRIBUTION REPORT CALIFORNIA FORM Da t e S t a m p FU L L N A M E , S T R E E T A D D R E S S A N D Z I P C O D E O F C O N T R I B U T O R (I F C O M M I T T E E , A L S O E N T E R I . D . N U M B E R ) CO N T R I B U T O R CO D E * For Official Use Only497 NA M E O F F I L E R AR E A C O D E / P H O N E N U M B E R ST R E E T A D D R E S S CI T Y S T A T E Z I P C O D E I. D . N U M B E R (i f a p p l i c a b l e ) 1. C o n t r i b u t i o n ( s ) R e c e i v e d IN D CO M OT H PT Y SC C Da t e o f Th i s F i l i n g Re p o r t N o . Am e n d m e n t to R e p o r t N o . No . o f P a g e s IN D CO M OT H PT Y SC C IN D CO M OT H PT Y SC C *C o n t r i b u t o r C o d e s IN D – I n d i v i d u a l CO M – R e c i p i e n t C o m m i t t e e ( o t h e r t h a n P T Y o r S C C ) OT H – O t h e r ( e . g . , b u s i n e s s e n t i t y ) PT Y – P o l i t i c a l P a r t y SC C – S m a l l C o n t r i b u t o r C o m m i t t e e (e x p l a i n b e l o w ) Re a s o n f o r A m e n d m e n t : Check if Loan %Provide interest rate Check if Loan %Provide interest rate Check if Loan %Provide interest rate ww w . n e t f i l e . c o m FPPC Form 497 (Jan/2016) FP P C A d v i c e : a d v i c e @ f p p c . c a . g o v ( 8 6 6 / 2 7 5 - 3 7 7 2 ) www.fppc.ca.gov Sa v e O u r C i t y ! A l a m e d a N o o n B 1 2 0 1 6 (5 1 0 ) 5 2 2 - 0 2 3 1 13 5 0 2 3 5 Al a m e d a CA 94 5 0 1 11 / 0 2 / 2 0 1 6 21 2 5 2 2 - K C 1 10 / 3 1 / 2 0 1 6 Ca l i f o r n i a C h a r t e r S c h o o l s A s s o c i a t i o n A d v o c a t e s I s s u e s C o m m i t t e e Sa c r a m e n t o , C A 9 5 8 1 4 Co m m i t t e e I D # 1 3 4 3 0 6 2 In - K i n d C o n t r i b u t i o n X 613.89 E- F i l e d 11 / 0 2 / 2 0 1 6 17 : 5 2 : 3 4 Fi l i n g I D : 16 2 2 1 3 2 9 5