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Schedule C Type or print in ink. SCHEDU�E C <br /> Amounts may be rounded Statement covers period <br /> NonmonetaryContributionsReceived towholedollars. • ' � � � <br /> from 9/ZjIQ� • � <br /> SEE INSTRUCTIONS ON REVERSE th�0ugh page �O Of_LZ <br /> NAME OF FILER I.D.NUMBER <br /> CUMULATIVE TO <br /> IFAN INDIVIDUAL,ENTER AMOUNT/ PER ELECTION <br /> FULL NAME,STREET ADDRESS AND CONTRIBUTOR DESCRIPTION OF DATE <br /> DATE OCCUPATION AND EMPLOYER FAIR MARKET TO DATE <br /> RECEIVED ZIP CODE OF CONTRIBUTOR CODE � (IFSELF-EMPLOYED,ENTER GOODSORSERVICES VALUE CALENDAR YEAR IF REQUIRED) <br /> QF COMMITTEE,ALSO ENTER I.D.NUMBER) NAME OF BUSMESS) (JAN 1-DEC 31) ( <br /> 9l�81Q3 �T� �}�z,� o��,, T�T'. ��R�' 650.ab 6SD.a� 65�rts <br /> �c�wc�.�D �tty �i4 94A�6" o Pn <br /> ❑scc <br /> ❑IND <br /> ❑COM <br /> ❑OTH <br /> ❑PTY <br /> ❑SCC <br /> ❑IND <br /> ❑COM <br /> ❑OTH <br /> ❑PTY <br /> ❑SCC <br /> ❑IND <br /> ❑COM <br /> ❑OTH <br /> ❑PTY <br /> ❑SCC <br /> Attach additlonal information on appropnately labeled continuation sheets. SUBTOTAL $ � -�� � � =e���e� <br /> Schedule C Summary 'Contributor Codes <br /> 1. Amount received this period-nonmonetary contributions of$100 or more. iNO-individuai <br /> (Include all Schedule C subtotals.) $ (�,� COM—�other than PTY oe SCC) <br /> ........................................................................ <br /> OTH—Olher <br /> 2. Amount received this period-unitemized nonmonetary contributions of less than$100 ....................................$ pTY_political Party <br /> 3. Totalnonmonetarycontributionsreceivedthisperiod. scc-Smauconmbuiorcommittee <br /> (Add Lines 1 and 2. Enter here and on the Summary Page, Column A, Lines 4 and 10.) ...................... TOTAL $ ��� - <br /> FPPC Porm 460 (June/01) <br /> FPPC Toll-Free Helpline: 866/ASK-FPPC <br />