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· $chedule A Typ, m print In Ink. SCHEDULE A <br />Monetary Contributions Received Amounts may b~ rounded <br /> to whole dollar~. $~;~,;;;,.: ~.) <br /> ,_ <br /> SEE INSTRUCTIONS ON REVERSE through 6/~/~ Page <br /> · ~'.,~.' %:" OF OFF)CEHOLDER OR CANDIDATE AND CONTI~,OLLED COMMII'rEE I.D. NUMBER <br /> <br /> FULL NAME AND ~L;AE~$ OF CONTRIBUTOR OCCUPATION AND EMPLOYER AMOUNT CUMULATIVE TO DATE CUMULATIVE TO DATE <br /> DATE (s COMNI~E. m ADomofl TO COMMitS NAM! ANO AOORESS, imE# tO. NUMIE~ (1~ SELI~..EMFtOYEOo ENI~E# RECEIVE D THIS CAkE NDAR YEAR OTHER <br /> RECEIVED o~. IF NO I.O, NUMIER HAS II~EN ASSIGNED, IENTER TREASURER'S 14AME A~D ADDRESS) NAME O~ m,'S~SS) PERIOD (JAN. 1 - DEC. 31 ) (IF APPLICABLE) <br /> <br />Monetary Contributions Summary <br />1. Amount received this period -- contributions of $100 or more. <br />(include oil Schedule A subtotals.) .................................................................................................... S <br />2. Amount received this period -- contributions of less than $100. //~ O <br />(Do not itemize.) ....................................................................................................................... <br />3. Total monetary contrlbutlons received this period. <br />(Add Unes l and 2. Enter here and on the Summary Page, ColumnA, Linel.) ...................................... TOTAl ~ <br /> <br /> <br />