497 Pena 2018 Report 1 - 10/16497 Contribution Report Amounts may be rounded to whole dollars.
NAME OF FILER
COMMITTEE TO ELECT JOHN PENA CITY COUNCIL 2018
AREACODE/PHONE NUMBER I.D. NUMBER (Wapplicable)
11370057
STREETADDRESS
CITY STATE ZIP CODE
LA QUINTA CA 92253
1. Contribution(s) Received
Date of
This Filing
I Report No.
10/16/2018
❑ Amendment
to Report No.
(explain below)
No. of Pages 1
Date Stamp
RECEIVED
OCT 16 X018
CITY OF ISA QUINTA
CITY CLERIC DEPARTUY
DATE
FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR
CONTRIBUTORIF
AN INDIVIDUAL,
ENTER OCCUPATION AND EMPLOYER
AMOUNT
RECEIVED
(IF COMMITTEE, ALSO ENTER D NUMBER)
CODE *
(IF SELF-EMPLOYED, ENTER NAME OF BUSINESS)
RECEIVED
FORTUN'S KITCHEN + BAR LLC
❑ IND
1,000
10/16/18
KIRKLAND, WA 98033
❑ coM
❑X OTH
❑ Check if Loan
❑ PTY
❑ SCC
0°
Provide interest rate
❑ IND
❑ COM
❑ OTH
❑ Check if Loan
❑ PTY
❑ SCC
°'
Provide interest rate
❑ IND
❑ COM
❑ OTH
❑ Check if Loan
❑ 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
497 Contribution Report
Amounts may be rounded to whole dollars.
NAME OF FILER Date of
10/16/2018
Date Stamp
,
•0:1
COMMITTEE TO ELECT JOHN PENA CITY COUNCIL 2018 This Filing
AMOUNT
RECEIVED
AREA CODE/PHONE NUMBER 1. D. NUMBER (if applicable)
RECEIVED
or Otticial Use Only
760-564-4184 1370057 Report No.
CA REAL ESTATE PAC
STREETADDRESS
OCT 16 2018
El Amendment
CA ASSOCIATION OF REALTORS
❑ IND
51405 CALLE HUENEME 1 to Report No.
1,000
10/16/18
CITY STATE ZIP CODE (explain below)
CITYO F LAA
OQUINTA
NT
1
CITY DEQUI TCA
LOS ANGELES, CA 90020
LA QUINTA CA 92253 No. of Pages
❑Check if Loan
1. Contribution(s) Received
DATE
RECEIVED
FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR
(IF COMMITTEE, ALSO ENTER LD NUMBER)CODE
CONTRIBUTOR
*
IF AN INDIVIDUAL,
ENTER OCCUPATION AND EMPLOYER
AMOUNT
RECEIVED
(IF SELF-EMPLOYED, ENTER NAME OF BUSINESS)
CA REAL ESTATE PAC
CA ASSOCIATION OF REALTORS
❑ IND
1,000
10/16/18
525 S. VIRGIL AVENUE
❑ coM
LOS ANGELES, CA 90020
N OTH
❑Check if Loan
❑ PTY
❑ SCC
Provide interest rate
❑ IND
❑ COM
❑ OTH
❑ Check if Loan
❑ PTY
❑ SCC
Provide interest rate
❑ IND
❑ COM
❑ OTH
❑ Check if Loan
❑ 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