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- ~ SCHEDULE A <br /> Schedule A Type or Pt4nt in Ink. Statement coven poflod <br /> Amounts may bo rounded <br /> Monetary Contributions Received to whole dollars. <br /> from <br /> <br /> SEE INSTRUCTIONS ON REVERSE through Page of__ <br /> NAME OF OFFICEHOLDER OR CANDIDATE AND CONTROLLED COMMITI'EE: I.D. NUMBER <br /> <br /> FULL NAME AND AD(3RESS OF CONTRIBUTOR <br /> DATE (IF COMk41I~EE. IN ADOITION TO COMMIrfEE'S NAME ANt) N[~)RES$. OCCUPATION AND EMPLOYER AMOUNT RECEIVED CUMULATIVE TO DATE CUMULATIVE TO DATE <br /> RECEIVED ENTER I.D. NUMBER OR. If: NO I.D. NUMBER I4A$ BEEN ASSIGNED. (IF S~LF-EMI~OYED ENTER THIS PERIOD CALENDAR YEAR OTHER <br /> ENTER TREASURER~ NAM~ & ADDRESS) NAME O~ BUSINESS) (JAN ! - DEC 3 t) (IF APPLICABLE) <br /> <br /> SUBTOTAL $ <br /> <br /> Moneta~ Contributions Summar~ <br /> 1. Amount received this period -- contributions of $100 or more. <br /> (Include all Schedule A sublolals.) ........................................................................................................... $ <br /> 2. Amount received Ibis period -- contributions of less than $100. <br /> (Do not ilemize.) ...................................................................................................................................... $ <br /> 3. Tolal monelary contributions received this period. <br /> (Add Lines i and 2. Enter here and on Ihe Summary Page, Column A, Line l.) ....................... TOTAL $ <br /> <br /> <br />