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Schedule B - Part 1 Type or print in ink. SCHEDULE B- PAR} 1 <br /> Amounts may be rounded Stateme,~t ?vers period <br /> Loans Received to whole dollars, from <br /> <br /> SEE INSTRUCTIONS ON REVERSE through ~::~'~/~O Page ~'--of~::~' <br /> NAME OF FILER I.D. NUMBER <br /> <br /> IF AN INDIVIDUAL, ENTER LENDER INFORMATION GUARANTOR INFORMATION <br /> DATE FULL NAME, MAILING ADDRESS AND ZIP CODE CONTRIBUTOR OCCUPATION AND EMPLOYER (a) (bi <br /> OF LENDER OR GUARANTOR CODE * (IF SELF-EMPLOYED, EH[ER DUE DATE/ AMOUNT CUMULATIVE AMOUNT CUMULATIVE <br /> RECEIVED t~r COMMIT TEE, ALSO EH] ER I D NUMBER) NAME OF BUSINESS) INTEREST RATE OF LOAN TO DATE GUARANTEED TO DATE <br /> <br /> DUE DATE CALENDAR YEAR CALENDAR YEAR <br /> []IND <br /> $ $ <br /> [] GeM INTEREST RATE <br /> [] OTH OTHER OTHER <br /> [] Lender [] Guarantor -- % $ $ <br /> <br /> DUE DATE CALENDAR YEAR CALENDAR YEAR <br /> [] INn <br /> $ $ <br /> []COM INTERESTRATE <br /> []OTH OTHER OTHER <br /> [] Lender [] Guarantor --% $ $ <br /> <br /> DUE DATE CALENDAR YEAR CALENDAR YEAR <br /> []IND <br /> $ <br /> [] GeM INTEREST RATE <br /> [] OTH OTHER OTHER <br /> [] Lender [] Guarantor -- % $ <br /> <br /> Enter (b) on <br /> Summary Page. <br /> SUBTOTAL $ $ Line 17 only. <br /> <br />Schedule B - Part 1 Summary <br />1. Loans of $100 or more received this period. (Include all Loans Received - Part 1 (a) subtotals.) ................... $ <br />2. Amount received this period - unitemized loans of less than $100 ................................................................... $ <br /> <br />3. Total loans received this period. (Add Lines 1 and 2.) ....................................................................... TOTAL $ <br />Schedule B - Part 2 Summary <br />4. Loans of $100 or more repaid, forgiven, or paid by a third party this period. (Include all Part 2 (c) <br />subtotals. If forgiven or paid by a third party, also itemize the transaction on Schedule A.) ............................. $ ~7~""~;:) *Conlributor Codes <br />5. Loans under $100 repaid, forgiven, or paid by a third pady. (Do not itemize.) If forgiven or <br /> ~ IND- Individual <br />paid by a third pady, include this amount on Schedule A Summary, Line 2 ...................................................... $ COM-RecipientCommitlee <br />6. Total loans repaid, forgiven, or paid by a third party this period. (Add Lines 4 + 5.) ........................... TOTAL $ <~"7~''O OTH-Other <br /> <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 2 .......................................................... NET $ ~ <br /> May be a negahve nu~lber FPPC Form 460 (8199) <br /> For Technical Assistance: 9161322-5660 <br /> <br /> <br />