Laserfiche WebLink
Schedule A Typ~ or print in ink. SCHEDULE A <br />Moneta~ Contributions Received to~oledollars. ~om <br />SEE iNSTRUCTiONS ON REVERSE <br />IF AN INDIVIDUAL, ENTER AMOUNT CUMU~TIVE TO DATE CUM U ~TiVE TO DATE <br /> DATE FULL NAME, MAILING ~DRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR OCCUPATION AND EMPLOYER RECEIVED THIS CALENDAR YEAR OTHER <br /> RECEIVED (IF COMMI~EE, ~SO ENTER I.D. NUMBER) CODE * (iF SELF-EMPLO~D, EN~R N~E PERIOD (JAN. 1 - DEC. 31 ) (IF APPLICABLE) <br /> OF BUSINESS) <br /> ~ IND <br /> ~ COM <br /> ~ OTH <br /> ~ [ND <br /> ~ COM <br /> ~ OTH <br /> ~IND <br /> ~ COM <br /> ~ OTH <br /> ~ IND <br /> ~ COM <br /> ~ OTH <br /> SUBTOTAL $ <br /> <br />8~hedulo ~ Summa~ <br />~. ~mount mcoived this po~o0 - cont~butioas of $~ 00 or moro. <br />2. Amount roceivo0 this poriod - unitemized contributions of loss than $~ 00 ......................................... $ <br />3. Total moneta~ contributions received this period. ~ OlH-Other <br />(~dd kines ~ and 2. ~nter bore and on the Summa~ ~a~e, Column A, I_ine ~.) ................... 101~ $ <br /> <br /> <br />