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SCttEDUI.E B .... Part I '-' Schedule B -- Part I TypeorP,4ntlnlnk. Statement covara period Amounts may be rounded Loans Received to whole dollaro. fro~t SEE INSTRUCTIONS ON REVERSE through Page__ of __ NAME OF OFFICEHOLDER OR CANDIDATE NxlD CONTROLLED COMMITTEE: ID, NUMBER LENDER OR GUARANTOR'S FULL NAME AND ADDRESS LENDER / GUARANTOR'S .ENOER INFORMATION GUARANTOR INFORMATION DATE (IF COMMII~EE, ENTER FUtJ~ NAMe, A[N~RESS AND I D NUMUER IF NO I D. OCCUPAIION AND EMI~_OYER (IF SELF- DUE DATE/ AMOUNT CUMULATNE AMOUNT CUMULATIVE RECEIVED NUMBER HAS BEEN ASSIGNED, ENTER IREASUI~R'$ NAME & ADDRESS) -EMPLOYED ENTER BUSINESS NAME) INTEREST RATE OF LOAN TO DATE GUARANTEED TO DATE DUE DATE CALENDAR YEAR CALENDAR YEAR INTEREST RATE OTHER OTHER [] Lendm' [] Gua~anlor* DUE DATE CALENDAR YEAR CALENDAR YEAR INTEREST RATE OTHER OTHER [] Lencle~ [] Guaramof* DUE DATE CALENDAR YEAR CALENDAR YEAR INTEREST RATE OTHER OTHER [] Lender [] Guaranlor* * See important in~truclions on reverse. SUBTOTAL $ ~ ~::~ ~:!~: ~,: .,:, ! :~ ~::~.:.[~ ~ ::::::::::::::::::::::::::::::::::::::::: ~ !8 o~ly Loans Reoeived -- Part ! Summaq~ !. Loans of $100 or mom received this period. (Include all Loans Received -- Part I (a) subtolals.) ....................... 2. Loans under $100 received this period. (Do not itemize.) ...................................................................................... $ 3. Total loans received this period. (Add Lines 1 and 2.) .......................................................................... TOTAL $ Loans Re©aired -- Pad II Summa~ 4. Loans of $100 or mor~ repaid, forgiven, or paid by a third party this period. (Include all Part 1I (c) subtotals, if forgiven or paid by a third party, al~o itemize the Iransaclion on Schedule A.) ................ $ 5. Loans under $100 repaid, forgiven, or paid by a third party. (Do not ilemize.) if forgiven or paid by a third party, include this amount on Schedule A Summary, Line 2 ................................................................. $ 6. Total loans repaid, I'orgiven, or paid by a third party this period. (Add Lines 4 + 5.) .................................................................................................................................. TOTAL $ 7. Net change this period. (Subtract Line 6 I'rom Line 3.) Enlcr Ihe nel heEe and on the Summary Page, Column A, Line 2 .............................................................. NET $ uay ~ a ,ooa~vo nutone,.