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�chedule C Type or print in ink. SCHEDULE C <br /> Amounts may be rounded Statement covers period <br /> d�aunonetary Contributions Received towholedollars. • � / � � <br /> Ifrom 7' / — O$ • • <br /> I through `�- 30 -og page_�� of� <br /> 3��eTRUCTtONS ON REVERSE I.D.NUMBER <br /> �OF FILER n <br /> C ��r�zElJs ?b �eoTEc-r %Z£'Dw000 C�T o��T,cac. Tiu� �-O.a^,�rr£ / 30 '7 63 <br /> CUMUL4TNE 70 <br /> IF AN INOIVIDUAL ENTER pESCRIPTION OF AMOUNT! �ATE PER ELECTION <br /> �E Fl1LL NAME.STREE7 AD�RESS AND CONTRIBUTOR aLCUPA710NAND EMPLO�ER fAIR MARKET TO DATE <br /> ZiP COOE OF CONTRIBU70R CO�E • GOODS OR SERVICES GALENDAR YE4R <br /> i'�NED OFSE�F-eua�orEO.enreA UnWE ��qNt -DEC3t) (IfREQUIRED) <br /> �IF COMMITTEE,+L50 ENTEP i D,Nt11dBEP1 N�ME OF BUSME551 <br /> ❑IND <br /> QCOM <br /> ❑OTH <br /> ❑FTY <br /> ❑SCC <br /> ❑IND <br /> ❑COM <br /> porr+ <br /> ❑PTv <br /> ❑scc <br /> ❑IND <br /> OCAM <br /> ❑OTH <br /> ❑PTY <br /> ❑SCC <br /> ❑IND <br /> ❑COM <br /> ❑OTH <br /> ❑PTY <br /> ❑SCC <br /> 9Elfach adddional informaGon on appropriately labeled continuation sheets <br /> SUBTOTALS <br /> 'Contriburor Codes <br /> .el�edule C Summary <br /> IND-Individual <br /> _Rmount received this period—itemized nonmonetary contributions. ��� COM-RecipientCommittee <br /> �Endude all Schedute C subtotals.) ......_._......................._........................._................................................,..... $ (other than PTY or SCCI <br /> � �� OTH-Olher(e.g., business en[iry) <br /> _ Amount received this period—unitemized nonmonetary contributions of less than$100 .................. pTy_poinicai Party <br /> � SCC-SmallContri6u�orCommittee <br /> _ �otal nonmonetary contributions received this period. TOTAL $ <br /> �.Add Lines 1 and 2. Enter here and on the Summary Page, Column A, Lines 4 and 10.) .................. FPPC Fo.m aso�aanuary�os� <br /> FPPC Toll-Free Helpline:8661ASK-FPPC(866/275-3772) <br />