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S;ched ule C TV~, or print in ink. SCHEDUL.E C <br />Amounts mey be rounded Statement covers period <br />Non-Monetary Contributions Received towholedolle., <br />SEE INSTRUCTIONS ON REVERSE throogh <br />NAME OF OFFICEHOLDER OR CANDIDATE AND CONTROLLED COMMITTEE JMBER <br /> <br /> FULL NAME AND ADDRESS OF CONTRIBUTOR ~CUPATION AND EMPLOYER CUMU~TIV~ TO CUMU~TIVE TO <br /> RECEIVED EmEg I.D. ~MBER ~ If ~ I.D. NUMBER ~S ~EN ASM~ED, I~NESS) G~DS OR SERVICES VALUE ~LENDAR YEAR <br /> ENTEa T~ASU~R'S ~ME A~D A~S$) (JAN. 1 - DEC. 31 ) (IF APPLI~BLE) <br /> <br />~Attacha~itionalinfo~ationonappropriatelyla~l~continuationshee~. SUBTOTAL $ <br />Non-Moneta~ Contributions Summa~ <br />1. Amount received this ~ri~-- non-monetary contrlbutions of $100 or more. <br />(Include all ~hedule C subtotals.) .................................................................................... $ <br />2. Amount receiv~ this ~ri~-- non-monetary contributions of less than $100. <br />(Do not itemize.) . <br />3. Total non-moneta~ contributions received this peri~. <br />(Add Unes 1 and 2. Enter here and on the Summary Page, Column A, Line 4.) ....................... TOTAL $ <br /> <br /> <br />