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SCllEI)IJI.E (? <br />Amoun.. mayb. rounded ~~~~., · <br />Idnn Ur~n~f=fu.........._.._._.. Contributions Received to whole dollaro. <br /> from <br />SEE INSTRUCTIONS ON REVERSE through Page.__ of <br />NAME OF OFFICEHOLDER OR CANOIDATE AND CONTROLLED COMMIT[El=: ID. NUMBER <br />FULL NAME ARe ADORESS OF coNq'RlflLrI'oR <br /> DATE (IF COI/MIllEE. IN A[XNTION 1'O COMMIIIEE'S NAME AND OCCUPATION AND EMPLOYER DESCRIPTION OF FAIR MARKET CCg,,'KJLATIVE TO DATE CUMULATIVE TO DATE <br /> RECEIVED ADORESS, ENTER I D NUMBER OR. IF NO I D NUMBER HAS (IF S£LF-[MPLOYED ENTER GOODS OR SERVICES VALUE CALENDAR YEAR OTHER <br /> BEEN ASSIGNED, ENTER TREASURER'S NAME & ADORES.S) NAME Ot: BUS4NESS] (JAN I - DEC 31 ) (IF APPLICABLE) <br />' <br /> <br /> SUBTOTAL $ <br /> <br />Non-Monetary Contributions Summary Attach additional information on oppropriately <br /> labeled continuation sheets. <br />i. Amount received Ibis period -- non-monelary conlribulions of $100 or mo~e. <br />(include all Schedule C sublotals.) ................................................................................................................ $ <br />2. Amount received Ihis period -- non-monetary cona'ibulions of less Ihan $100. <br />(Do not itemize.) ........................................................................................................................................... $ <br />3. Tolal non-moneta~ conltibutions received Ibis period. <br />(Add Lines I and 2. Enler here and on Ihe Swnmary Page, Column A, Line 4.) ............................ TOTAL <br /> <br /> <br />