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SCHEDULE A
<br />Schedule A Type or Print in Ink. Statement covers period
<br /> Amounts may be rounded
<br />Monetary Contributions Received ,owho,edo,,,rs. from !/1 /
<br /> ?/
<br /> ,',r,..,,', o' q
<br />NAME OF OFFICEHOLDER OR CANDIDATE AND CONTROLLED COMMITI-EE: ID NUMBER
<br /> ~f 5-'/(,,"/,::,
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<br /> FULL NAME AND ADDRESS OF CON IRIBUTOR
<br /> DATE 0F COMMIrIEE. IN ADDITION TO COMMII let'S NAME AND ADORESS, OCCUPATION AND EMPLOYER AMOUNT RECEIVED CUMULATIVE TO DATE CUMULATIVE TO DATE
<br /> RECEIVED ENTER I D NUMBER OR, IF NO ID NU/,a~ER ItAS BEEN ASSIGNED. (IF SELF-EMPLOYED ENTER THIS PERIOD CALENDAR YEAR OTHER
<br /> ENTER TREASURER'S NAME & ADDRESS) NAME OF BUSINESS) (JAN I - DEC 31 ) (IF APPLICABLE)
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<br /> SUBTOTAL
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<br />Monetary Contributions Summary
<br />1. Amount received this period -- contributions of $100 or more.
<br />o.ci~¢ a. Sched,,~e A s,,b~o~s.) ...........................................................................................................
<br />2. Amount received this period -- contributions of less than $100.
<br />(Do not itemize.) ......................................................................................................................................
<br />3. Total monetary contributions received this peri~xi.
<br />(add u.e.~, :,,,d 2. n,,,~,,,ere :,.d ,,,, ,,e S,,,,,,,,,~ry P~ge. C,,I,,,,,. A. Li,,e ~.) ....................... XOXAL
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