Laserfiche WebLink
Schedule C Type o~ pdnt in ink, SCHEDULE C <br /> Amounts rely be foufld~d Stltement covers period <br /> Non-Monetary Contributions Received towh~, ~,,~ <br /> from <br /> SEE INSTRUCTIONS ON REVERSE through <br /> NAME~OF OFFICEHOLDER OR CANDIDATE AND CONTROLLED COMMII'rEE I.D. NUMBER <br /> FULL NAME AND ADDRESS OF CONTRIBUTOR <br /> OCCUPATION AND EMPLOYER CUMULATIVE TO CUMULATIVE TO <br /> DATE M COMMITI'E [. k~l ADD~T )ON ~O C(]MMITfEE'$ NAME ANO ADDRESS, DESCRIPTION OF FAIR MARKET DATE <br /> RECEIVED (w BELF~M~tOYED. EmER f~aaE M DATE OTHER <br /> EMTER I,D. NUMBER Ol~ I~ MO I.O. NUMBER HAS BEEN ASMG~D, IU~S$) GOODS OR SERVICES VALUE CALENDAR YEAR <br /> E ~TE R lgEASUgER'S NAM~ Mm AiX)~E$$) (JAN 1- DEC. 31) (IF APPLICABLE) <br /> <br />Attachadditionalinformationonappropriatelylabeledcontinuationsheels. SUBTOTAL $ <br />Non-Monetary Contributions Summary <br />1. Amount received this period-- non-monetary contributions of $100 or more. <br />~lncI ud~ ~11Sch~lul~ C subtotals.} .................................................................................... <br />:L Amoun! r~¢~i¥~d this l~riod-- non-mon~t~r~ contributions of I~ss th~n $!00. <br />{Do not it~mi~.} .................................................................................................. $ <br />i. Tot~,l non-mon~t~ contributions r~¢~i¥~d this ~riod. <br />{Add I.in~ ! ~nd :~. Enter h~r~ Rnd on Ih~ Summ~ P~gR, Column A, Lin~ ~.} ....................... IOIA[ $ <br /> <br /> <br />