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Type m ixint in ink. SCHEDULE C <br /> chedule C Amountl rely be ,ounded Statlmlat cover, pe,tod <br />Non-Monetary Contributions Received <br />SEE INSTRUCTIONS ON REVERSE through / - <br />iD COMMITTEE I.D. NUMBER <br />CUMULATIVE TO O <br /> FULL NAME DRESS OF CONTRIBUTOR OCCUPATION AND EMPLOYER DESCRIPTION OF FAJR MARKET DATE ~,,O'ATEOTHER <br />~ DATE I~ coemmneL m ADOelIO. 10 COodMn~iI'S mUde AND ~OI~SS. ~ SlUaM~LOVED. l,Til ~ O~ GOODS OR SERVICES VAI.UE CALENDAR YEAR <br />RECEIVE D fmflt LO. NUMM n Od. w No i.D. NUMIftl HAS Of~Jd ASSIGmD. OUSlmSt) / (IFAPPLICABLE) <br /> (JAN. I - DEC. 31 <br /> <br />~AI! labeledconlinuation sheels. SUBTOTAL $ <br />Jtions Summary <br />1. period-- nOn-monetary contributions of $100 or more. <br />all Schedule C subtotals.) .................................................................................... <br />2. received this period-- non-monetary contributions of less than S 100. <br />(Do not itemize.) ........................................................................................................ $ <br />3. Total non-monetary contributions received this period. <br />(Add Lines 1 and 2. Enter here and on the Summary Page, Column A, Line 4.) ....................... TOTAL <br /> <br /> <br />