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$CIIEI)IJI.E <br />Schedule CJ Typo or Prinl in Ink. <br /> Amounts my be rounded Slolomont covers poriod <br />Payments Made by an Agent or Independent to.hob, do.ers. <br />Contractor (on Behalf of an Officeholder or <br />Candidate) <br />SEE INSTI~TIONS ON REVERSE through Page of __ <br /> <br />NAME OF OFFICEHOLDER OR CA/'W(]4DATE AND CONTROLLED COMIdlTTEE: ID. NUIvIBER <br /> <br />NAME OF AGENT OR INDEPENC~NT CONTRACTOR: <br /> <br /> NAME AND A[X:)RESS OF PAYEE OR CREDITOR <br /> (iF COkldlflEE. IN A[X)IIION IO COI~flEE'S ~ AM) ADDRESS. ENIER I O NtAABER OR. <br /> f NO I D NUMOER HAS BEEN A,~IGNED. EN1ER TREASUREK$ NAME & A[X~ESS) CO[]E OR E~SCRIPTION OF PAYMENT AMOUNT PAID <br /> <br />Attach additional information on appropriately labeled continuation sheets. <br /> TOTAL* $ <br /> <br />* l)o not Iran.~fer to any other schedule or to the Sum,nary Page. 'l'l,s total nm), tuft equal the atru>u,I paid to the ageta or itutependent contrm:tor a.~ reported on Schedule E by the can,lidate. <br /> <br /> <br />