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Non-Moneta Contributions Received <br /> SEE INSTR~NSON REVERE <br /> ~E OF OFF~EHOL~R OR ~NDIDATE ~D CONT~LLED COMMI~EE I.D. NUMBER <br /> FULL NAME ~D ~D~SS OF CONTRIBUTOR <br /> DATE ~CUPAT~N ~D EMPLOYER CUMU~TIVE TO CUMU~TIVE TO <br /> RECEIVED ~ C~EE, m A~O C~E~ ~m ~ ~SS, ff ~LF~M~OYED, ~ ~ m DESCRIPT~N OF F~R M~KET DATE DATE OTHER <br /> E~. ~IE~ ~ w ~l.D. ~R ~S KEN AS~O. * ~SS) ~ OR SERV~ES V~UE ~LENDAR YEAR (IF ~PL~LE) <br /> <br />Attach~itio~ifl~atiofloflapp~riat~yla~l~cofltifluation~ SUBTOTAL S <br />Non-Moneta~ Contributions Summ~ <br />1. Amount r~eiv~ this ~ri~-- non-moneta~ contributions of S 1 ~ or more. <br />(l~lude all ~ule C ~bto~ls.) .................................................................................... <br />2. Amount receiv~ this ~ri~-- non-moneta~ contributions of less than S 100. <br />(Do not itemize.) ....................................................................................................... S <br />3. Total nofl-mone~ contributions received this ~ri~. <br />(Add Lines 1 a~ 2. Enter here and on the Summa~ Page, Column A, Line 4.} ....................... TOTAL $ <br /> <br /> <br />