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Type or print in Ink. - <br />497 Contribution Report Amounts may be rounded to whole dollars. <br />T C,9.14TRIBLITION REPORT <br />NAME OF FILER bl Iliel 19t"11111"' """'61mQ <br />Date of 77' <br />14 CPLIFORNIA <br />09/21/2015 rY- FORry <br />Alicia Aguirre This Filing RE 11 N, 497 <br />AREA CODEIPHONE NUMBER I.D. NUMBER (if applirable) 2 <br />(650) 366-9058 11276471 Report No. SEP 21 20111:: <br />STREETADDRESS, 0 Amendment <br />CITY OF <br />867 Edgewood Road to Report No. <br />CITY STATE ZIP CODE (explain below) CITY CLERK <br />Redwood City CA 94062 No. of Pages 2 <br />1. Contribution(s) Received <br />DATE <br />RECEIVED <br />FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR <br />(IF COMMITTEE, ALSO ENTER I.D. NUMBER) <br />CONTRIBUTOR <br />CODE <br />AN <br />ENTER OCCUPATION IFINDIVIDUAL, <br />AND EMPLOYER AMOUNT <br />(IF SELF-EMPLOYED, ENTER NAME OF BUSINESS) RECEIVED <br />Jesus Lopez <br />IND <br />President <br />09/18/2015 <br /> <br />❑ Com <br />Mi Rancho Super Market 3000.00 <br />Atherton, CA 94027 <br />❑ OTH <br />0 Check if Loan <br />❑ PTY <br />0 SCC <br />% <br />Provide interest rate <br />CAA Tri County <br />El IND <br />09/18/2015 <br />980 Ninth Street # 1430 <br />N1 com <br />1000.00 <br />Sacramento, CA 95814 <br />0 OTH <br />0 Check if Loan <br />PTY <br />❑ SCC <br />% <br />Provide interest rate <br />California Real Estate Political Action Committee <br />0 IND <br />09/18/2015 <br />525 S. Virgil Avenue <br />X com <br />3500.00 <br />Los Angeles, CA 90020 <br />Fj OTH <br />0 Check if Loan <br />D PTY <br />El SCC <br />% <br />Provide interest rate <br />"Contributor Codes <br />IND - Individual <br />COM — Recipient Committee (other than PTY or SCC) <br />OTH - Other (e.g., business entity) <br />Reason for Amendment- <br />PTY — Political Party <br />SCC — Small Contributor Committee <br />FPPC Form 497 (Marchf 2011) <br />FPPC Toll -Free Helpline: 866/ASK-FPPC (866/275-3772) <br />