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497 Pena 2018 Reports 2 & 3 - 10/16 (2 forms)497 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 (if applicable) STREETADDRESS 11370057 CITY LA QUINTA STATE ZIP CODE CA 92253 Date of This Filing 10/16/2018 l Report No ❑ Amendment to Report No (explain below) No. of Pages 1 Date Stamp 1 CITY OF IAA OUINTA CITY CLERK DEPARTME�JT RECEIVED OCT 16 Bois 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 UAPT ONAND INDIVIDUAL, ENTER OCCUPATION ENTE NAMEM EMPLOYER (IF SELF-EMPLOYED, ENTER OF BUSINESS) AMOUNT RECEIVED FORTUN'S KITCHEN + BAR LLC ❑IND ❑ coM 1,000 10/16/18 KIRKLAND, WA 98033 0 Check if Loan X OTH ■ PTY ❑ SCC % Provide interest rate ❑ IND ❑ COM ❑ OTH ❑ Check if Loan ❑ PTY ❑ SCC °' Provide interest rate ❑ IND ❑ COM ❑ OTH 0 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 COMMITTEE TO ELECT JOHN PENA CITY COUNCIL 2018 Date of This Filing 10/16/2018 Date Stamp CALIFORNIA FORM 497 or ■ -Icia Ise ■ny RECEIVED OCT 16 2018 CITY OF LA OUINTA CITY CLERVEF'ARTl41EN AREA CODE/PHONE NUMBER I.D. NUMBER (if applicable) Report No 1370057 STREET ADDRESS ■Amendment to Report No CITY STATE ZIP CODE (explain below) 1 LA QUINTA No. of Pages 4 CA 92253 1. Contribution(s) Received DATE RECEIVED FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR (IF COMMITTEE, ALSO ENTER I.D NUMBER) CONTRIBUTOR CODE * IFANT ON AND E ENTER OCCUPATION ENTER NAMEM EMPLOYER (IF SELF-EMPLOYED, OF BUSINESS) AMOUNT RECEIVED 10/16/18 CA REAL ESTATE PAC CA ASSOCIATION OF REALTORS 525 ANGELES, CA 90020 ❑IND ❑ coM 1,000 ❑Check if Loan °' X OTH ❑ PTY ❑ SCC Provide interest rate ❑ IND ❑ COM ❑ Check if Loan % • OTH ❑ PTY ❑ SCC Provide interest rate ❑ IND ❑ COM • OTH ❑ PTY ❑ SCC ❑ Check if Loan % 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 (.1ul/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov