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, I <br /> <br />Schedule A Type or print in ink. SCHEDULE A <br /> Amounts may be rounded Statement covers period <br /> Monetary Contributions Received to whole dollars. <br /> from L- I- ~ S~- <br /> SEE INSTRt IS ON REVERSE through (~ ' ~30 - q~- Page <br /> NAME OF OFFI{ HOLDER OR ~NDIDATE AND CONTROLLED COMMITTEE I.D. NUMBER <br /> <br /> FULL NAME AND ADDRESS OF CONTRIBUTOR OCCUPATION AND EMPLOYER AMOUNT CUMU~TIVE TO DATE CUMU~TIVE TO DATE <br /> ~ DATE (~ C~MI~EE, IN AoDn~N ~O COMM~E['S NR~E AND ADD, SS, ENTER LD. NUMBER (IF SELF-EM~OYED, EmER RECEIVE D THIS ~LE NDAR YEAR OTH ER <br /> RECEIVE D ~ If NO I.D. NUMBER ~S BEEN ASSIGNED, ENTER TREASURER'S ~ME AND ADDRESS) NAME OF IUS~SS) PERIOD (JAN. 1 - DEC. 31 ) (IF APPLI~BLE) <br /> too /0o <br /> <br />Moneta~ Contributions $umma~ <br />1. Amount re¢eived this period ~ contributions of $100 or more. <br />(Include all S(heduleA subtotals.) ................................................................................................... $ ! <br />2. Amount reCeived this period -- (ontributions of less than $100. <br />(Do not itemize.) .................................................................................................................... <br />3. Total moneta~ ¢ontributions reCeived this peri~. <br />(Add Lines 1 and 2. Enter here and on the Summary Page, Column A, Line 1.) ......................................... TOTAL S I.~GI.2 ~ <br /> <br /> <br />