Laserfiche WebLink
Schedule C rype or print in ink SCHEDULE C <br /> Amounfs may be rounded <br /> NonmonetaryContributionsReceived towholedollars. Statementcoversperlod � _ � <br /> from � • ' • � <br /> ( SEEINSTRUCTIONSONREVERSE th�OUgh �'� � Page �� OfL� <br /> NAME OF FILER n n I.D.NUMBER <br /> Co�+,.►n � �}� � � �� /Ja,r�a-�..- /"ler'�e 9� lI <br /> CUMULATIVE TO <br /> IFAN INDIVIDUAL,ENTER AMOUNT/ pER EIECTION <br /> FULL NAME,STREET A�ORESS AND CONTRIBUTOR DESCRIPTION OF DATE <br /> DATE Z�pCODEOFCONTRIBUTOR CODE * OCCUPATIONANDEMPLOYER GOOOSORSERVICES FAIRMARKET CALENDARYEAR TODATE <br /> RECEIVED (IFCOMMITTEEALSOENTERLD.NIlMBER� (IFSELF£MPLOYED,EIJ�ER VALUE (IFREQUIRED) <br /> w.Me oF BuSIr+ESS) (JAN 1-DEC 31) <br /> Roh,a✓t O 'Qreen pconn Cf>rt f"�c.- SerFfu�ar.� <br /> 7� -/ -� p PrTMi, �/ P'1�'��i � �/��l <br /> ��WOAaIC �-L' C.W I� ❑SCC /�f)b�G/� �nn�� lalk <br /> ❑IND <br /> ❑COM <br /> ❑oni <br /> ❑arr <br /> ❑scc <br /> ❑IND <br /> pCOM <br /> ❑oni <br /> ❑Prv <br /> ❑scc <br /> ❑IND <br /> ❑COM <br /> ❑oni <br /> ❑arv <br /> ❑scc <br /> Attach additional information on appropriately labeled continuation sheets. SUBT07aL S t�(�� (o� <br /> Schedule C Summary -conrributorcoaes <br /> 1. Amount received this period-nonmonetary contributions of$100 or more. � IND-Individual <br /> Include all Schedule C subtotals. $ ��S,(�l coM-Redpierncommittee <br /> � �..................................................................................................................... (other than PN or SCC) <br /> D•0� OTH-Other <br /> 2. Amount received this period-unitemized nonmonetary contributions of less than$100 ....................................$ pTY-political Party <br /> 3. Total nonmonetary contributions received this period. � scc-smaii convibutorcommittee <br /> (Add Lines 1 and 2. Enter here and on the Summary Page,Column A, Lines 4 and 10.) ......................TOTAL $ Yis•�1 <br /> FPPC Form 460 (June101) <br /> FPPC Toll-Free Helpline: 8661ASK-FPPC <br />