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HomeMy WebLinkAbout497 08/31/2016 Contribution Report Schelly Sustarsic497 Contribution Report NAME OF FILER Schelly Sustarsic AREA CODEIPHONE NUMBER I.D. NUMBER (Inapplicable) ( CITY Seal Beach 1. Contribution(s) Received Amounts may be rounded to whole dollars. STATE ZIP CODE CA 90740 Date of g/31/2016 This Filing Report No. 1 ❑ Amendment to Report No (explain below) No. of Pages HEMMED AUG 3 12016 CITY CLERK CITY OF SEAL BEACH DATE RECEIVED FULL NAME, STREETADDRESS 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 8/10/2016 Schelly Sustarsic X IND ❑ coM ❑ OTH None $3,000 p Check if Loan ❑ PTV El scc 0.0 % 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) PTV — Political Party SCC — Small Contributor Committee FPPC Form 497 (Jul /2016) FPPC Advice: advice @fppc.ca.gov (866/275 -3772) www.fppc.ca.gov