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,ScheduleC Typeor print in ink. SCHEDULE C <br /> Amounts may be rounded Statement covers period '~ <br />Non-Monetary Contributions Received to whole dollars, from q l' ( ~ ~ <br /> <br />SEE INSTRUCTIONS ON REVERSE /~J/~ through ~jl~ /~ Page /~ of~:7~'~ <br />NAME OF OFFICEHOLDER OR CANDIDATE AND CONTROLLED COMMITTEE I.D. NUMBER <br /> <br /> FULL NAME AND ADDRESS OF CONTRIBUTOR OCCUPATION AND EMPLOYER CUMULATIVE TO CUMULATIVE TO <br />t DATE (IF COMMITTEE, IN ADDITION TO COMMITTEE'S NAME AND ADDRESS, (IF SELF-EMPLOYED, ENTER NAME Of DESCRIPTION OF FAIR MARKET DATE DATE OTHER <br /> GOODS OR SERVICES VALUE CALENDAR YEAR (IF APPLICABLE) <br />RECEIVE D ENTER I.O. NUMBER O~ IF NO I.D. NUMBER HAS BEEN ASSIGNED, BUSINESS) (JAN. 1 - DEC. 31 ) <br /> ENTER TREASURER'S NAME AND ADDRESS) <br /> <br />!Attach additional information on appropriately labeled continuation sheets. SUBTOTAL $ <br />Non-Monetar~ Contributions Summar~ <br />1. Amount received this period-- non-monetary contributions of $100 or more. <br />{Include all Schedule ¢ subtotals.) .................................................................................... <br />2. Amount received this period -- non-monetary contributions of less than $100. <br />(Do not itemize.) ........................................................................................................ $ <br />3. Total non-monetary contributions received this period. <br />(Add Lines 1 and 2. Enter here and on the Summary Page, Column A, Line 4.) ....................... TOTAL $ <br /> <br /> <br />