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Schedule B — Part 1 <br /> Loans Received <br /> SEEINSTRUCTIONSON REVERSE <br /> NAME OF FlLER <br /> �° O i">1 [ � � G/L°G/ <br /> DATE FULLNAME,MAILINGADORESSANDZIPCODE <br /> RECEIVED OF LENDER OR GUARANTOR <br /> pFCOMMIiTEEhLSOENTERtA NUMBEH) <br /> ❑ Lender ❑Guarantor <br /> Q Lentler ❑ Guaranlor <br /> ❑ Lender ❑ Guaranlor <br /> Type or print in ink. <br /> Amounts may be rounded <br /> to whole doilars. <br /> CONTRIBUTOR �FANINDIVIDUAL,ENTER <br /> CODE • �CCUPATIONANDEMPLOVER <br /> (IFSELFEMPLOVED.ENTER <br /> ❑IND <br /> p Conn <br /> ❑OTH <br /> ❑IND <br /> ❑COM <br /> ❑OTH <br /> ❑IND <br /> ❑COM <br /> ❑OTH <br /> OUE OATEI AMOIINT <br /> INTERESTRlUE OFLOAN <br /> DUE DATE <br /> INTEREST RATE <br /> x <br /> DUE DATE <br /> INTERESTRATE <br /> x <br /> DUE DATE <br /> INTERESTRATE <br /> x <br /> SUBTOTAL $ <br /> period <br /> CUMULATNE <br /> TOOATE <br /> GALENOPR YEPR <br /> s <br /> OTMER <br /> S <br /> CALENDPR YEAR <br /> s <br /> OTHER <br /> t <br /> CALENOPR YEAR <br /> s <br /> OTHER <br /> s <br /> E <br /> B-PART 1 <br /> Page� of � <br /> I.D.NUMBER <br /> ���� 75 � <br /> GUARANTORINFORMATION <br /> (b) CUMULATIVE <br /> AMOUNT <br /> GUARANTEEO TOOATE <br /> CALENDAR YEAR <br /> a <br /> OTHER <br /> 5 <br /> CALENDAR YEAR <br /> s <br /> OTHER <br /> a <br /> CALENDAR VEFR <br /> s <br /> OTHER <br /> s <br /> Enler(b)on <br /> Summary Page. <br /> ❑ne 1]onlv <br /> .. —_—__..__ <br /> Schedule B — Part 7 Summary <br /> 1. Loans of$100 or more received this period. (Include all Loans Received -PaR 1 (a) subtotals.)................... $ � <br /> 2. Amount received this period -unitemized loans of less than $100................................................................... $ p.UO <br /> 3. Total loans received this period. (Add Lines 1 and 2.) ...................................................................... .TOTAL $ � �f! <br /> Schedule B — Part 2 Summary <br /> 4. Loans of$100 or more repaid, forgiven, or paid by a third party this period. (Include all PaR 2 (c) <br /> subtotals. If forgiven or paid by a third party, also itemize the transaction on Schedule A.).............................$ ���� 'Con[ributorCodes <br /> 5. Loans under$100 repaid, forgiven, or paid by a third party. (Do not itemize.) If forgiven or � �d IND-Individual <br /> paid by a third party, include this amount on Schedule A Summary, Line 2. .....................................................$ COM—RecipientCommittee <br /> 6. Total loans re aid, for iven, or aid b a third art this eriod. Add Lines 4 + 5. o7ti-other <br /> P 9 P Y P Y P � )........................... TOTAL $ � Io�� .� <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 /> �b a�e�e�e nor�ber. FPPC Fottn 460(BI99) <br /> ForTechnical Assistance: 9161322-5660 <br />