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SCHEDULE B -- Part I Schedule B -- Part I Type or Print in Ink. Statement coven period Amounts may be rounded Loans Received lo whole dollars. from SEE INSTRUCTIONS ON REVERSE through Pago.__ NAME OF OFFICEHOLDER OR CANDIDATE AND CONTROLLED COMMIV[EE: I.D. NUMBER LENDER OR GUARANTOR'S FULL NAME AND ADDRESS LENDER / GUARANTOR'S LENDER INFORMATION GUARANTOR INFORMATION DATE (iF COK#dlrI-EE, ENTER FULL NAME, A[~SS AND I.D. NUMBER IF NO I D. OCCUPATION AND EMPLOYER (IF SELl:- DU~ DATE/ AMOUNT CUMULATIVE AMOUNT CUMULATIVE RECEIVED NUMBER HAS BEEN ASSJGNED. ENTER TREASURER'S NAME & ADDRESS) -EMPLOYED ENTER ~USINESS NAME) NTEREST RATE~ OF LOAN TO DATE GUARANTEED TO DATE DUE DATE CALENDAR YEAR CALENDAR YEAR INTEREST RATE OTHER OTHER [] Lender [] Guarantor* DUE DATE CALENDAR YEAR CALENDAR YEAR iNTEREST RATE OTHER OTHER [] Lender [-] Guammor* DUE DATE CALENDAR YEAR CALENDAR YEAR INTEREST RATE OTHER OTHER [] Lender [-I Guatanlor* * See important instructions on reverse. SUBTOTAL S $ Summary Page. ~:~:~:i:~:i:~i:~:i:i:~:i:i:~:::~.~:~:~:i:i:i:~:~: Lme t8 only. Loans Received B Part I Summary 1. Loans of $100 or mom received Ihis period. (Include all Loans Received -- Part I (a) subtotals.) ....................... $ 2. Loans under $100 received Ihis period. (Do nm itemize.) ...................................................................................... 3. Total loans received this period. (Add Lines 1 and 2.) .......................................................................... TOTAL $ Loans Received ~ Part II Summary 4. Loans of $100 or mom repaid, forgiven, or paid by a third party this period. (Include all Part 11 (c) subtotals. If forgiven or paid by a third paly, also itemize thc wansacdon on Schedule A.) ................ $ 5. Loans under $100 repaid, forgiven, or paid by a third party. (Do not itemize.) If forgiven or paid by a third party, include this amount on Schedule A Summary, Line 2 ................................................................. $ 6. Total loans repaid, forgiven, or paid by a third party this period. (Add Lines 4 + 5.) .................................................................................................................................. TOTAL 7. Net change this period. (Sublract Line 6 from Line 3.) Enter the riel here and on the Summary Page, Column A, Line 2 ......................................................... ' ..... NET $ May be a negalive number.