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Schedule C <br /> Nonmonetary Contributions Received <br /> SEE INST <br /> NAMEOF <br /> DATE <br /> RECEIVED <br /> F <br /> Type or print in ink. <br /> Amounts may be rounded <br /> to whole dollars. <br /> � ( ���o� D� ������ C�Ty �� <br /> FULL NAME,STREET ADDRESS AND CONTRIBUTOR IFAN INDIVIDUAL,ENTER <br /> ZIP CODE OF CONTRIBUTOR CODE * �CCUPATIONAND EMPLOYER <br /> (IF COMMITTEE,ALSO ENTER I.D.NUMBER) (IF SELF-EMPLOYED,ENTER <br /> NAME OF BUSINESS) <br /> ❑IND <br /> ❑CAM <br /> ❑OTH <br /> ❑PTY <br /> ❑SCC <br /> ❑IND <br /> ❑� <br /> ❑OTH <br /> ❑PTY <br /> ❑SCC <br /> ❑IND <br /> ❑COM <br /> ❑OTH <br /> ❑PTY <br /> ❑SCC <br /> ❑IND <br /> ❑COM <br /> ❑OTH <br /> ❑P1Y <br /> ❑SCC <br /> Attach additional information on appropriately labeled continuation sheets. <br /> Schedule C Summary <br /> 1. Amount received this period—itemized nonmonetary contributions. <br /> (Include all Schedule C subtotals.)............................................................... <br /> 2. Amount received this period—unitemized nonmonetary contributions of less than$100 .. <br /> 3. Total nonmonetary contributions received this period. <br /> (Add Lines 1 and 2. Enter here and on the Summary Page,Column A, Lines 4 and 10.} . <br /> Statement covers period <br /> from � — <br /> through <br /> DESCRIPTION OF ( AMOUNT/ <br /> GOODS OR SERVICES FAIR MARKET <br /> VALUE <br /> SUBTOTAL$ <br /> ..............................$ � <br /> ..............................$ <br /> ................. TOTAL $ � <br /> Page� of� <br /> �.D.NUMBER <br /> ; ������ <br /> CUMUTATIVE TO pER ELECTION <br /> DATE TO DATE <br /> CALENDAR YEAR (IF REQUIRED) <br /> (JAN 1-DEC 31) <br /> 'Contributor Codes <br /> IND-Individual <br /> COM-Reapient Committee <br /> (other than PTY or SCC) <br /> OTH-Other(e.g., business entity) <br /> PTY-Political Party <br /> SCC-Small Contributor Committee <br /> FPPC Form 460(January105) <br /> FPPC Totl-Free Helpline:866IASK-FPPC(8661275-3772) <br />