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Schedule C Type or print in ink. SCHEDULE <br /> Nonm( netary Contributions Received Amounts may be rounded Statement covers period · · <br /> ,owholedollars. from ~'~l /(~ ~ i~ ~I~~ <br /> S~EI~STRI T,GNSON~EYERSE t.~ou~.C~ [ 30/0-0 .a.e of_ <br /> NAME OF FILl R ID. NUMBER <br /> <br /> IF AN INDIVIDUAL, ENTER AMOUNT/ CUMULATIVE TO <br /> DATE FULLNAME, MAILINGADDRESSAND CONTRIBUTOR OCCUPATIONANDEMPLOYER DESCRIPTION OF FAIRMARKET DATE CUMULATIVE TO <br /> ZIP CODE OF CONTRIBUTOR CODE * GOODS OR SERVICES CALENDAR YEAR DATE OTHER <br /> NAME OF BUSINEsS) (JAN 1 - DEC 31 ) <br /> [] cou 7-o ~ ~ o'~-O~ <br /> [] IND <br /> [] COM <br /> [] OTH <br /> [] IND <br /> [] COM <br /> [] OTH <br /> I~tND <br /> [] COM <br /> [] OTH <br /> <br />Attach additional information on appropriately labeled continuation sheets. SUBTOTAL $ / 3 3 3 <br />Schedule C Summa~ <br />~. Amount recoiYed this period - nonmonetary contributions o[ $~00 or more. I 'Con~dbutor Codes <br />(Include all Schedule C subtotals.) ................................................................................................................... $ [ ~ ~ ''~ IND-Individual <br />2. Amount received this period - uaitem[zed nonmonetary contributions of loss than $100 ................................ $ r(~[ OlHCOM-RedPi°nt Commiiloe_ Other <br />3. Total nonmonetary contributions received this period. <br />(Add kines ~ an0 2. Fnter here and on the Summary ~a~e, Column A, kines 4 and 10.) ................... IOIAL $ [ ~ '~ ~ <br />FPPC Form 460 (8199) <br />For Techoical Assistance: 9161322-5660 <br /> <br /> <br />