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Schedule C <br />Nonmonetary Contributions Received <br />Type or print in ink. <br />Amounts may be rounded <br />to whole dollars. <br /> <br />DATE I FULL NAME, STREET ADDRESS AND <br />RECEIVED ZIP CODE OF CONTRIBUTOR <br />(IF COMMITTEE. RlSO ENTER I.D. NUMBER) <br /> <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 />Statement covers period _ <br />~ I <br />from ~~/J43 •' • <br />through ~ ~d~d3 page ~~' of~ <br />I.D. NUMBER <br />9~a 9/,3 <br />CONTRIBUTORI IF ANINDIVIDUAL, ENTER <br />CODE * OCCUPATION AND EMPLOYER DESCRIPTION OF <br />IIF SELF-EMPLOYED, ENTER GOODS OR SERVICES <br />NMAE OF BUSINESS) <br />AMOUNT/ CUMULATIVE TO <br />FAIR MARKET DATE PER ELECTION <br />VALUE CALENDAR YEAR TO DATE <br />(JAN 1 -DEC 31) (IF REQUIRED) <br />^IND <br />^COM <br />^OTH <br />^ PTY <br />^SCC <br />Attach additional information on appropriately labe/ed continuation sheets. SUBTOTAL $ <br />Schedule C Summary <br />t. Amount received this period -nonmonetary contributions of $100 or more. <br />(Include all Schedule C subtotals.) ..................................................................................................................... $ <br />2. Amount received this period - unitemized nonmonetary contributions of less than $100 .:.................................. $ <br />3. Total nonmonetary contributions received this period. <br />(Add Lines 1 and 2. Enter here and on the Summary Page, Column A, Lines 4 and 10.) ...................... TOTAL $ <br />'Contributor Codes <br />IND -Individual <br />COM -Recipient Committee <br />(other than PTY or SCC) <br />OTH -Other <br />PTY -Political Party <br />SCC -Small Contributor Committee <br />FPPC Form 460 (June/01) <br />FPPC Toll-Free Helpline: 866/ASK-FPPC <br />