Form 497 Contribution Report m
497 Contribution Report
Amounts maybe rounded to whole dollars.
487 0ONTRIBifil{7NREPORT
Ld NAMEOFFTLER Date of
L7 09/22(2016 r I
d Gaspar for mayor awls This Filing ! ii •'
AREACODEfPHONENUMBER I.D.14UMBER(varM.Mj For Official UseOnly
Report No.zD]6-1 I SE - PH (,;
1760)6]2-3600
5 FETADDRESS
[]Amendment
to Report No.
CITY STATE ZIP CODE (e>;dan aelari
No.of Pages '
6ncivitas CA 92D24
1. Contribution(s)Received
z
IF AN INDIVIDUAL,
p DATE fULL NAME,STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR ENTER OCCUPATION AND EMPLOYER AMOUNT
K RECEIVED mcounvTTE><.MSOENtEAto.N.tua6w CODE" DECEIVED
V AF aEtF{MPLOYED,fN1ER NN.IE OF M151aESSy
q De/22/2016 Paul Gaspar Physical Therap LSt/Owner 9,225.00
Q48 ❑7f IND Gaspar Doctors of Physical
Encinitas, [A 92024 I-I roM Therapy
L❑l OTH ❑Check if Loan
O ❑ PTY
❑ SCC %
Provide W.St[ale
❑ IND
❑ COM
❑ OTH ❑Check if Loan
❑ PTY
❑ SGC x
Provide imerest rate
L] IND
m
❑ COM
m
N
m OTH ❑Check If l.cen
m
❑ PTY
0 ❑ SCC x
r-
y Provide nlareal rate
`ContribtAor Codes
m
N IND-Individual
COM-Recipient Committee(other than PTY or SCC)
•+ - OTH-Other(e.g,business entity)
Reason for Amendment PTY-Political Party
SOC-Small ContributorCOmmidee
m
N
N FPPC Form 497(JaN2016)
m FPPC Advice:advica@fppc.ca.gov(866f275-3772)
m wmv.fPPC.ca.Bov
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