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ScHedule A Type or print in ink. SCHEDUIE A <br /> Amounts ma be rounded <br /> . Y <br /> Statement eovers perfod � , <br /> Monetary Contributions Received to Wno�e ao��e�g. • - � � <br /> trom � �� �03 • " <br /> through 6��0"�„3 Page�of_� <br />' SEEINSTRUCTIONS ON REVERSE <br /> I.D. NUMBEF <br /> I NAMEOFFlLER ' ������ <br /> I RoSaK F�vs <br /> 1 FULL NAME,STFEET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR �F AN INDIVIDUAL ENTER AMOUNT CUMUTATIVETO DATE PER ELECTION <br /> �A� QFCOMMIiTEE.AL50ENTER1.p.NUMBER� OCCUPATIONANDEMPLOYER RECEIVEDTNIS CALENOAR VEAR TODFTE <br /> I RECENED CODE � �ipse�F�eMa�oreqeHieaHnMe PERIOD (JAN. 1 �DEC.31) (IF REQUIRED) <br /> OFBUSMESS) <br /> ❑IND <br /> ❑COM <br /> ❑OTH <br />, �� aTr�� os�� <br /> ❑IND <br /> ❑COM <br /> ❑OTH <br /> ❑PTV <br /> i ❑SCC <br /> I ❑IND <br />� ❑COM <br /> ❑OTH <br /> ❑PTY <br /> ❑SCC <br /> I ❑IND <br /> ❑COM <br /> ❑OTH <br /> ❑PTY <br /> ❑SCC <br /> ❑IND <br /> ❑COM <br /> ❑OTH <br /> ❑PTY <br /> ❑SCC <br /> ��k ,A�WS �� �. <br /> SUBTOTAL$ � . <br /> $C�1Bf�U�2 l4 $Utllll'18�/ 'CoMributor Codes <br /> 1. Amount received this period-contributions of$100 or more. uvo-indi�iduai <br /> (IncludeallScheduleAsubtotals.) g I �.$5 COM-RecipientCommittee <br /> ........................................................................................................ (other tlian PTY or SCC) <br /> 2. Amouni received this eriod-unitemized contributions of less than$100............................................. $ 49 oTH-otner <br /> p PTY-Po�itical Party <br /> 3. Total monetary contributions received this period. /� OQQ SCC-Small CorMributorCommittee <br /> (Add Lines 1 and 2. Enter here and on the Summary Page,Column A, Line 1.)....................... TOTAL $ <br /> FPPC Form 460 (June/01) <br /> � � FPPC Toll-Free Helpline: 866/ASK-FPPC <br />