Form 497 Contribution Report (3) m
497 Contribution Report Amourris may berounded to whole dollars.
W i"(`� 497CONTRIBL)TION REPORT
Ld NAMEOFFILER Date L Stamp •. , •
dCaspar for Rayor 2016 This Piling IO/1312_01� _ e
AREACODEPNONENUr.BER LD.NUMBER m .l
�� 3
�.�,+ aN C{ Ij t i � Foro61a L>Beonly
12$pOrt .2016-1013
(760]632-3600
STREET ADDRESS
❑Amendment
to Report No.
CITY STATE ZIPCODE (exoaln below)
No.of Pages 3
Encinitas G 92024
1.Contribution(s)Received
z
IFANINDIVLOUAL,
DAIS FULL NAME,STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR ENTEROCCUPATI001ANO EMPLOYER AMOUNT
RECEIVED IFC0MMITIEE.MSOINTPRID.NOMBIR7 CODE a RECENED
V (¢BELFEMPLOYEO.ENn:0.NAfIEGFN13NE33I
Cz 10/13/2016 Paul Gaspar Physi^at Therapist/Owner 10,000.00
zz i] IND Gaspar Doctors of Physical
Encinitas, G 92024 COM Therapy
o ❑ OTH �j Check If Loan
N El Fr
SCC M
Pmride interest rate
[j IND
p Dona
0 OTN ❑Check if Loan
❑ FrY
El SCC x
PmAde iMereet Dole
❑ IND
W ❑ com
m
❑ OTH
m ❑Check 6Loan
m
❑ PTY
❑ SCC x
� ProvNe Inkrest late
'Comribulor Codes
I0II IND—EndHldual
;D COM—Recipient Committee(otherthan PTY orSCC)
-+
OTH—Other(e.g..tushass enft
Reason for Amendment:
PTY—Political Party
,o
� SCC—Small Cantrlbufortbmmelee
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f, FPPC Fonn 497(Jani7At6)
m F"C Advice:advice@(ppeea.gov(6681175.3772)
r, www.fppe.a.goV
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