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Schedule C Typeorprint in ink. SCHEDULE C <br />Amounts may be rounded S~&~,,~,,~ covers period <br />Non-Monetary COntributions Received towholedollars, fr°m .~ -~/_ <br />SE E INSTRUCTIONS ON REVERSE thr°ugh / ~" ~/' ~'~' Page <br />NAME OF OFFICEHOLDER OR CANDIDATE AND CONTROLLED COMMITTEE I.D. NUMBER <br /> <br /> FULL NAME AND ADDRESS OF CONTRIBUTOR OCCUPATION AND EMPLOYER CUMU~TIVE TO CUMU~TIVE TO <br /> ~ DATE 0~ C~MInEE, IN ADD~ TO C~M~EE'S ~ME A~ ~D~$S, (IF ~LF-EM~ED, EmER ~ME ~ DESCRIPTION OF FAIR MARKET DATE DATE OTHER <br /> G~DS OR SERVICES VALUE ~LENDAR YEAR <br /> RECEIVE O EmER I.D, NUMBER ~ IF NO I.D. NUMAR ~S BEEN ASS~NED. B~NESS) (IF APPLI~LE) <br /> imie ~ASU~a'S ~ME A~ ~ss) (JAN. 1 - DEC. 31) <br /> <br />~ttacha~itionalin~ationOnappropriatelyla~l~continuationshee~. SUBTOTAL $ ~ <br />Non-Moneta~ Contributions Summa~ <br />1. Amount r~eived this ~ri~ -- non-monetary contributions of $100 or more. <br />(Include all Schedule C subtotals.) .................................................................................... <br />2. Amount received ~his ~ri~-- non-mone~ry contributions of less than $100. <br />(Do not itemize.) ........................................................................................................ <br />3. Total non-moneta~ contributions received this peri~. <br />(Add Lines 1 and 2. Enter here and on the Summary Page, Column A, Line 4.) ....................... TOTAL $ <br /> <br /> <br />