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Schedule A Type or print in ink. SCHEDULE A <br /> Monetary Contributions Received Amounts may be rounded Statement covers period <br /> to whole dollars. <br /> from <br /> SEEINSTR, IS ON REVERSE through ~.~ll~ <br /> NAME OF OFFICEHOLDER OR ~NDIDATE AND CONTROLLED COMMITTEE I.D. NUMBER <br /> FULL NAME AND ADDRESS OF CONTRIBUTOR <br /> ~ DATE 0F C~M~.tL ~ AOOa~ TO COMM~EE'S a*ME ~ND AOD~SS, ENTER ~.O. NUUSEa OCCUPATION AND EMPLOYER AMOUNT CUMU~TIVE TO DATE CUMU~TIVE TO DATE <br /> RECEIVE D ~ ~F ~O LD. NUMaEa ~S area ASSiGnED, ENTER T~ASU~R'S NAME AND ADDRESS) 0F SELF-EMPLOYED, E~ER RECEIVED THIS ~LENDAR YEAR OTH E R <br /> NAME OF .OS~tSS) PERIOD (JAN. 1 - DEC. 31 ) (IF APPLI~BLE) <br /> SUBTOTAL $ <br />Monetary ~o.tribution~ $.~mary <br />1. Amount received this period -- ~ontributions of $100 or more. <br />(Include all $~hedule A ~ubtot~l~.} .................................................................................................... <br />2. Amount re~ei~ed thi~ period -- ~ontribution~ of I~ than $100. <br />(Do not itemize.) $ <br />3. Total moneta~ contributions received this peri~. <br />(Ad~ Lines.1 and 2. Enter here and on the Summary Page, Column A, Line 1.) .......... . ............................... TOTAL $ <br /> <br /> <br />