497 Late Contribution (2)
LATE CONTRIBUTION REPORT
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lYpe or print In Ink.
Amounts rnIIY be rounded to who" dol......
11107,
2
01
Filing
Da"
This
.D. NUMBER (ifappNc4'"
1279538
Late Contribution Report
2005
CUPERTINO CITY CLE
7
NOV
1
Report No.
o Amendment
to Report No.
(explain below)
No. 01 pagee
ZIP CODe
95014
STATE
CA
NAME OF FILER
CitizBns lor Orrin Mahoney
AREACOOBPHQNENUMBER
408-725-1767
STREET ADDRESS
10940 Miramonte Road
CITY
Cupertino
Received
CONTRIBUTOR IF AN INDIVIDUAL, AMOUNT
DATE FULL NAME, STREET ADDRESS AND ZIP CODe OF CONTRIBUTOR ENTER OCCUPATION AND EMPLOYER
RECEIVED (F COMMITTEE, ALSO ENTER I.C. NlIMBER) CODE * (IF SELF-EMPLOYED, ENTER twIiIE OF BUSINESS) RECEIVED
IXI IND
Orrin Mahoney oeOM Retired 2,000.00
11/07/2005 10940 Miramonte Road o OTH
Cupertino, CA 95014 o PlY
osee III Chock If Loan
o IND
o eOM
o OTH
o PlY
osee o Chock If Loan
o IND
o COM
o OTH
o PlY
osee o Chock If Loan
Late Contrlbutlon(s)
·Contributor Codas
IND -Individual PTY - PoIijical Party
COM - Recipiant Committee (other than PTY or SCC) SCC - Small Contributor Committee
OTH - Other (e.g" business entity)
Reason for Amendment:
FPPC Form 497 (JanuaryI05)
FPPC Tol~F... Helpline: 8861ASK-FPPC (8661276-3772)