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I <br /> Type or print in ink. SCHEDULE <br />Schedule C Amounts may be rounded Statement covers period <br />Non-Monetary Contributions Receivedto whole dollars. J~7 / /~' <br />from <br />through :c~f: '3~/~ I~*~ Page <br />SEE INSTRUOIONS ON .EVERSE <br />I.D. NUMBER <br />NA~E OF OFFICEHOLDE~ OR ~NDIDATE AND CONTROLLED COmmITTEE <br /> <br /> CUMU~TIVE TO CUMU~TIVE TO <br /> FULL NAME AND ADDRESS OF CONTRIBUTOR OCCUPATION AND EMPLOYER DESCRIPTION OF FAIR MARKET DATE DATE OTHER <br />~ DATE (~ c~n~. ~ AOmlma~o co~n~*s ~ A~D ADD.SS. (~ S~Lr*~PLO~ED. ~m~a aA~E ~ G~DS OR SERVICES VALUE CALENDAR YEAR <br />RE CEIVE D EN~Ea ~.~. NUMaEa ~ ~ ~O tO. NUMerR ~S eEEN ASS~aNEO. ~US~NESS) (JAN. 1 - DEC. 31) (IF APPLI~BLE) <br /> ENIER TREASU~R'S NAME AND ADDRESS) <br />I <br /> I <br /> I, <br /> <br />(A(~acha~itionalinfo~ationonappropriatelyla~l~c°ntinuati°nshee~' SUBTOTAL $ ~ <br />~on-~oneta~ Contribution~ Summa~ <br />~. ~mount mreived thi~ period-- non-monetary ~ontribution~ o[ $100 or more. $ ~ ~ <br />0ndude all Srhedule C ~ubtotal~.} .................................................................................... <br />2. Amount received this peri~-- non-monetary contributions of less than $100. $ <br />(Do not itemize.) ........................................................................................................ <br />3. Total non-moneta~ contributions received this period. <br />(~dd Line~ 1 and 2. Inter here and on the Summar~ Page, Column A, Line 4.) ....................... IOIAL $ ~ ~ ~ <br /> <br /> <br />