Bury 01-01-1991 thru 06-30-1991 Semi-Annual 490

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SCHEDULE D ENFORCEABLE PROMISES RECEIVED (Other Than Loan Guarantees, Loan Endorsements and Loan Security) FORM 490 PAGE NOTE: Loan guarantees, loan endorsements and loan security are 'enforceable promises, h However, such promises must be reported on Schedule B, NOT Schedule D. STATEMENT COVERS PERIOD FROM I r~ROU~ (Amounts May 8e Rounded To Whole Dollars) !/j / FULL NAME AND ADDRESS ' OCCUPATION AMOUNT I CUMU- DATE OF CONTRIBUTOR AMOUNT REC'D. PAID (If COMMI~EE, IN ADDITION TO COMMI~EE'S EMPLOYER PROMISED ~TIVE NAME AND ADDRESS. ENTE~ I.O NUMa(~ THIS PERIOD THIS PERIOD AMOUNT OR, iF NO IQ. NUMBER HAS BEEN ASSIGNED, (1~ SEL~-EM~OYEO, ENTER (ALSO ENTER ON ~ UNPAID ENTER THE TREASURER'S NAME AND ADDRESS) NAME Of BUSINESS) SCHEDULE A) Occupation: , Employer: ~F$1S~L YEAR: Occupation: Employer: IFS~S~LYEAR: Occupation: Employer: ~IS~L ~R: Occu~ti°n: Employer: I F$1S~L YEAR: ;Occu pa~on: I ~LENOAR YEAR: (a) (b) SUBTOTAL ~ $_ _ SUMMARY 1. PROMISES RECEIVED OF $100 OR MORE THIS PERIOD (Column (a)) ................... $ 2. PROMISES RECEIVED UNDER $100 THIS PERIOD (Not itemize) ...................... 3. TOTAL PROMISES RECEIVED THIS PERIOD (Line 1 + 2) ............................. 4. PAYMEN~ ON PROMISES OF $100 OR MORE RECEIVED THIS PERIOD (C~umn (b)) ............................................................ 5. PAYMENTS ON PROMISES UNDER $100 RECEIVED THIS PERIOD (Not itemize) .......................................................... (AI~ enter on Line 2 of the summa~ se~ion of Sch~ule A) 6. TOTAL PAYMEN~ ON PROMISES RECEIVED (~ne 4 + 5) ........................... 7. NET CHANGE THIS PERIOD (Subtra~ Line 6 from Line 3) Enter the difference here and on Line 6, Column 8 of Summa~ Page ................ (May ~e neg- ative TIgure)