Laserfiche WebLink
Schedule A Type or pdnt in ink. SCHEDULE A <br />Amounts may be rounded Statement covers period <br />Monetary Contributions Received to wholedollar~. <br />SEE INSTRUCTIONS ON REVERSE through <br />NAME .OF OFFICEHOLDER OR CANDIDATE AND CONTROLLED COMMITT~EE/ I.D. NUMBER <br /> <br /> FULL NAME AND ADDRESS OF CONTRIBUTOR OCCUPATION AND EMPLOYER AMOUNT CUMULATIVE TO DATE CUMULATIVE TO DATE <br /> ' DATE (if COMMITI'EE, IN ADDmON TO COMMITI'EE'$ NAME AND ADDRESS, ENTER I.D. NUMBER (If SELf-EM~tOYED, EmER RECEIVED THIS CALENDAR YEAR OTH ER <br /> RECEIVED OR. If NO I.D. NUMBER HAS BEEN ASSIGNED, EmEB TREASUREA~ NAME AND ADDRESS) NAME M BUSe~$$! PERIOD (JAN. 1 - DEC. 31) (IF APPLICABLE) <br /> SUBTOTAL <br /> <br />Monetary Contributions Summary <br />1. Amount received this period -- contributions of $100 or more. <br />(Include all Schedule A subtotals.) .................................................................................................... $ <br />2. Amount received this period -- contributions of less than $100. <br />(Do not itemize.) ....................................................................................................................... <br />3. Total monetary contributions received this period. <br />(Add Lines l and 2. Enter here and on the Summary Page, ColumnA, Line 1.) .......... . ............................... TOTAL $ ,,~'~ C~ C~ <br /> <br /> <br />