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Schedule B -- Part I Type o, print in ink. SCHEDULE B- Part I <br />Amounts may be rounded Statement covers period <br />Loans Received to whole clollars. ---~ <br />from ~ <br />SEE INSTRUCTIONS ON REVERSE through , <br />NAME OF OFFICEHOLDER OR CANDIDATE AND CONTROLLED COMMITTEE I.D. NUMBER <br /> <br /> i ~' <br /> DATE LENDER OR GUARANTOR'S FUUL NAME AND ADDRESS - LENDER/GUARANTOR'S LENDER INFORMAT~ON i! -- GUARANTOR INFORMaTiON <br /> Bct'l:nJl:r~ (if COMMITTEE, ENTER FULL NAME, ADDI~ESS AND I.D. NUMKR. If MO I.D. OCCUPATION AND EMPLOYER (If ~LE- · ' <br /> ......... NUMMR HAS BEEN AsSiGNeD ENTER THE TREAI4JI~R'S NAME AND ADO~SS) EMPLOYED. ENTER BUSINESS NAME ) DUE DATE/ MOUNT CUMULATIVE I AMouNT CUMULATIVE <br /> GUARANTEED <br /> · NJTEREST KATE Of LOAN TO DATE I TO DATE <br /> ~' DUE DATE CALENDAR YEAR I CALENDAR YEAR <br /> ~1 Lender ' I'! Guarantor* ~, <br /> DUE DATE 7ENDAR YEAR J SCALENDAR YEAR <br /> , N~TEREST RATE <br /> , ~ OTHER I OTI~R <br /> I <br /> I-J Lender I~] Guarantor* ~* <br /> I <br /> [-I Lender I~1 Guarantor* ~ '~ <br />'See important instructions on .reverse. SUBTOTAL $ #, $ e~ tm ~e o~. <br />Loans Received - Part I Summary <br />1. Loans of $100 or more received this period. (Include all Loans Received - Part I Ca) subtotals.) .......... <br />2. Loans under $100 received this period. (Do not itemize.) ........................................... <br />3. Total loans received this period. (Add Lines 1 and 2.) ....................................... TOTAL $ <br />Loans Received - Part II Summary <br />4. Loans of $100 or more repaid, forgiven, or paid by a third party this period. (Include all Part II Cc) <br />subtotals. If forgiven or paid by a third party, also itemize the transaction on Schedule A.) .............. $ <br />5. Loans under $100 repaid, forgiven, or paid by a third party. (Do no itemize.) If forgiven or <br />paid by a third party, include this amount on Schedule A Summary, Line 2 ............................ $ <br />6. Total loans repaid, forgiven, or paid by a third party this period. <br />(Add Lines4 + $.) ....................................................................... TOTAL $ ( <br />7. Net change this period. (Subtract Line 6 from Line 3.) NET $ <br /> <br /> <br />