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Schedule A Typ, o, print in Ink. <br />Amounts may be rounded Statement ~overs <br />Monetary Contributions Received to whMe dolla,s. <br />SEE INSTRU~IONS ON REVERSEthrough~ ' ~' (~/~ ' <br />NAME OF OFFICEHOLDER OR ~NOIOATE AND CONTROLLED COMMITTEE I.~UMBER <br /> <br /> FULL NAME AND ADDRESS O~ CONTRIBUTOR OCCUPAT~N AND EMPLOYER AMOUNT CUMU~TIVE TO ~ATE CUMU~TIVE TO DATE <br /> ' DATE (,, CMMI~EE, m ADDn~ 10 C~M~E['S ~MI A~ A~SS. E~ERI D NUMBER M SELF~M~OYED, linen RECEIVED THIS ~LENDAR YEAR OTHER <br /> RECEIVED ~ ~ K i.D. NUMI[A ~S liEN ASS~NiD, lml~ ~mA~'S GM[ AND A~[SS) NAME M I~SS) PE ReD (JAN. 1 - DEC. ~ 1) (IF APPLI~BLE) <br /> I <br /> '.~ <br /> SUBTOTAL $ <br /> <br />Monetary Contributions Summa~ <br />1. Amount received this ~riod -- contributions of S 100 or more. <br />(Include all Sch~ule A subtotals.) .................................................................................................. <br />2. Amount received this period -- contributions of less than $100. <br />(Do not itemize.) ........................................................................................................... ...... $ <br />3. Total moneta~ contributions received this peri~. <br />(AddLines 1 and2. Enter here and on the Summary Page, ColumnA, Line 1.) ...................................... TOTAL $ <br /> <br /> <br />