Form 460 - Recipient Committee Campaign Statement Cover Page Page 20

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Schedule A (Continuation Sheet)
SCHEDULE A (CONT.)
Monetary Contributions Received
Amounts may be rounded
Statement covers period
CALIFORNIA
460
to whole dollars.
FORM
07/01/2016
from
12/31/2016
through
20
50
Page
of
I.D. NUMBER
NAME OF FILER
Lisa Bartlett for Supervisor 2018
1359658
AMOUNT
PER ELECTION
IF AN INDIVIDUAL, ENTER
CUMULATIVE TO DATE
FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR
CONTRIBUTOR
DATE
RECEIVED THIS
TO DATE
OCCUPATION AND EMPLOYER
CALENDAR YEAR
(IF COMMITTEE, ALSO ENTER I.D. NUMBER)
CODE
*
RECEIVED
PERIOD
(IF REQUIRED)
(IF SELF-EMPLOYED, ENTER NAME
(JAN. 1 - DEC. 31)
OF BUSINESS)
12/28/2016
Gayle G. Roski
Artist
1,900.00
1,900.00 P2018
$1,900.00
IND
X
Gayle G. Roski
COM
OTH
PTY
SCC
12/28/2016
Edward P. Roski, Jr
President
1,900.00
1,900.00 P2018
$1,900.00
X
IND
Majestic Realty Co
COM
OTH
PTY
SCC
12/29/2016
Laura Matsutsuyu
Homemaker
1,000.00
1,000.00 P2018
$1,000.00
IND
X
None
COM
OTH
PTY
SCC
12/30/2016
HDR, Inc
249.00
249.00 P2018
$498.00
IND
COM
X
OTH
PTY
SCC
12/31/2016
Carla D. Meberg
Artist
100.00
100.00 P2018
$100.00
X
IND
Carla D. Meberg
COM
OTH
PTY
SCC
SUBTOTAL $
5,149.00
*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 460 (Jan/2016)
FPPC Advice: advice@fppc.ca.gov (866/275-3772)

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