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Amounts may be rounded Statement covers period <br />Loans Made to Others towhdedollars. <br /> <br /> SE E I NSTR(~i~TIONS ON REVERSE Ethr°ugh~ PIge <br /> NAM E O; OFFICEHOLDER OR CANDIDATE AND CONTROLLED COMMITTEE I.D. NUMBER <br /> <br /> FULL NAME AND ADDRESS OF RECIPtENT <br /> DATE OF LOAN ~ c~at~r~E, m ~ TO C~.~ NAM! ~ ~ss, lk'~l~.D, minks INTEREST RATE DUE DATE AMOUNT <br /> <br /> SUBTOTAL <br /> i <br />Loans Made to Others -Part I Summary <br />!. Loans of $100 or more made this period. <br /> · (Include all Loans Made - Port I subtotals.) ............................................................ <br />2. Loans under $100 made this period. <br /> (Do not itemize.) .................................................................................... <br />3. Total loans mode this period. <br /> (Add Lines 1 and 2.) .......................................................................... TOTAL $ <br /> <br />Loans Repayments Received - Part II Summary <br />4. Payments received on loans of SI00 or more. (Include all loan payments received and all loans of $100 or more <br />which have been for~livefl by this officeholder, candidate, or committee - Part II Ca) subtotals. <br />If forgiven, also itemize on ~chedule E.) ................................................................ <br />5. Payments received on loans under S 100. <br />(including a forgiveness. Do not itemize.) .............................................................. <br />6. Total loan payments received this period. T <br /> (Add Lines4and 5.) .......................................................................... OTAL $ ( <br />7. Net change this period. (Subtract Line 6 from Line 3. <br /> Enter the net here and on the Summary Page, Column A, Line 9.) .................................... NET S <br /> <br /> <br />