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SCHEDULE H <br /> Schedule H Type or print in ink Statement ove period � �_ <br /> Loans Made to Others* Am to hole dollarsnded from � � '�4 •- , � ' <br /> SEE INSTRUCTIONS ON REVERSE through v • �` `�i3 Page� of �� <br /> NAME OF FILER I.D.NUMBER <br /> �C���3 �Z`��-���=�c ��ur►c5 ( �4�� l 2��32 <br /> IF AN INDIVIDUAt,ENTER (a) �b► (�) (d� �e) (f� �g) <br /> FULL NAME,STREET ADDRESS AND ZIP CODE OUTSTANDING AMOUNT OUTSTA DING �NTEREST ORIGINAL CUMULATIVE <br /> OCCUPATION AND EMPLOYER REPAYMENT OR <br /> OF RECIPIENT BALANCE LOANED THIS BA�NCE AT RECEIVED AMOUNT OF LOANS <br /> (IF COMMITTEE,ALSO ENTER I.D.NUMBER) (IF SELF-EMPLOYED,ENTER BEGINNING THIS FORGIVENESS CLOSE OF THIS <br /> NAME OF BUSINESS) PERIOD PERIOD THIS PERIOD' PERIOD LOAN TO DATE <br /> � PAID CALENDAR YEAR <br /> s s � a s <br /> � FORGIVEN �� PERELECTION** <br /> a s a a a <br /> DATE DUE DATE INCURREO <br /> � PAID CALENDAR YEAR <br /> a a % a a <br /> � FORGIVEN �TE PER ELECTION"* <br /> s a a a a <br /> DATE DUE DATEINCURRED <br /> "Loans that are contributions to another candidate or committee <br /> must also be summarized on Schedule D. loans forgiven must SUBTOTALS $ a � � ��F�t � � � � -�'�� <br /> also be reported on Schedule E. �P�. <br /> (Enter(e)on <br /> Schedule I,�ine 3) <br /> Schedule H Summary O <br /> 1. Loans made this period ..................................................................................................................................................$ .,If Required <br /> (Total Column(b)plus unitemized loans of less than$100.) � <br /> 2. Payments received on loans ...........................................................................................................................................$ <br /> (Total Column(c)plus unitemized payments of less than$100.) Q <br /> 3. Net change this period. (Subtract Line 2 from Line 1.).......................................................................................... NET $ <br /> (Enter the net here and on the Summary Page, Column A, Line 7.) (May be a negative number) <br /> FPPC Form 460(January/05) <br /> FPPC Toll-Free Helpline:866/ASK-FPPC(866/275-3772) <br />