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Home My WebLink AboutMAGGARD SEMIANN98(1) fficeholder, Candidate, and Controlled Committee Campaign Statement -- Long Form Type or print in ink. (Government Code Sections 84200~842 t 6.5) SEE ~NSTRUCTIONS ON REVERSE Check one of the following boxes to Indicate the type of statement being flied: B B P re-election St ateme nt Supplemental Prellaction Statement (Attach i completed Form 495 to this statement.) [~ Special Odd-Year Campaign Report ~ Semi-annual Statement ~ Termination Statement (Attach · completed Form 415 to this Statement.) I Officeholder. Candidate. and Control ed Committee Included in this Statement N^ME OF OmCE,OLOER O, C~NmO^T; COMMITTEE N^ME CnY III Verification Statement Covers period Date Stamp Data of aleetlon If appltcal~a: ~- ~'- ~ (Month, Day, Year} II COVER PAGE- LONG FORM For Of f,csal Use Only Other Committee~ Not Included in this ! tatement: committees not Included In this consolidated Sea Cement that are controlled by you a~ any comm~ees of ~lch you have knowledge that are prlm4~ formed to receive c~trl~l~ ~ to make ex~iture~ on ~half of your ca~ida~. I hlvl usld all reasonable diligence in preparing this statement. 1 have reviewed the statement and to the best of my knowledge the information conta~ed herein and in the attached schedules is true and complete. I,~ertify~dar penalty of ~r~undlr the laws of the Stlte of California that the foregoing tS tru~rre~ ~ .~ // . complete. I codify under ~nal~ of ~rju~ under the laws of the State of California that the foregoing is true end corre~. ~ ~ ~ Executedo. ., ,, Executed on At By Allocation Page -- Part I Contributions and Independent Expenditures Made From Campaign Funds Type or print In Ink. Amounts may be rounded tO whole dolleri. SEE ~NSTeUC~ONS ON.EVeeSE NAME OF OFFICEHOLDER OR CANDIDATE AND CONTROLLED COMMITTEE L/St each contribution and independent expenditure of $ ! O0 or more made from campaign funds to other committees or to support or oppose other candida tes or ballot measures. CHECK ONE IND DATE NAME OF OFFICEHOLDER. CANDIDATE, COMMITTEE, OR MEASURE EXP~' AMOUNT Support Oppose ALLOCATION - PART I D. NUMBER CUMULATIVE TO DATE LENOAR YEAR J~jAIN. 1 - DEC. 31 ) CUMULATIVE TO DATE OTHI R (IF APPLICABLE) *See rever~e regarding independent expenditures. ALLOCATION '-- PARTI SUMMARY SUBTOTAL t $ ~L/ Attach additional information on appr~'p~iately labeled continuation sheets. I. Contributions and independent expenditures of $100 or more made this period from campaign funds. (Include all Allocation Page -- Part I subtotals.) .................................................................................... $ 2. Contributions and independent expenditures under $100 made this period from campaign funds. (Do not itemize.) ....................................................................................................... $ 3. Total contributions and independent expenditures made this period from campaign funds. (Do not carry this total to the Summary Page.) ................................................................................ TOTAL $ Allocation Page -- Part II Contributions and Independent Expenditures Made From Personal Funds SEE INSTRUCTIONS ON REVERSE NAME OF OFFICEHOLDER OR CANDIDATE Type Ot print In ink. Amounts may be rounded to whole dollars, through ALLOCATION - PART II List each contribution and independent expenditure of $1 O0 or more made ¥rom the officeholder or candida te ' s personal funds to support or oppose other officeholders, candidates and committees. NAME OF OFFICEHOLDER, CANDIDATE. COMMIl-rE E, OR MEASURE DATE *See reverse regarding independent expenditures. ALLOCATION -- PARTII SUMMARY CHECK ONE IND. CUMULATIVE TO DATE EXP· AMOUNT CALENDAR YEAR Support Oppose (JAN. I - DEC. 31} SUBTOTALIS CUMULATIVe' TO DATE OTHER (IF APPLICASLE~ Attach additional information on appropriately labeled continuation sheets. 1. Contributions and independent expenditures of $100 or more made this period from personal funds. (Include all Allocation Page -- Part II subtotals.) ........................................................................................... $ 2. Contributions and independent expenditures under $100 made this period from personal funds. (Do not itemize.) .............................................................................................. $ 3. Total contributions and Independent expenditures made this period Irom personal funds. (Do not carry this total to the Summary Page.) ....................................................................... TOTAL $ Campaign Disclosure Statement Summary Page SEE INSTRUCTIONS ON REVERSE N&ME OF OFFICEHOLDER OR CANDIDATE AND CONTROLLED CO MMI~I'E E Contributions Received 1. Monetary Contributions ............................... Schedule A, Line 2. Loans Re¢eived ......................................... Schedule a, Line 3. SUBTOTAL CASH CONTRIBUTIONS ...................... addUnes ~ + 4. Non-monetary Contributions ......................... schedule C, Line 5. 5UBTOTAL CONTRlBUTlONS"(Exdude Enfo~able Promlses) Add Unes $ . 4 6. Enforceable Promises fixsliMe Loan Guarantees, Line I m below) ................... Schedule D, Line 7. TOTAL CONTRIBUTIONS RECEIVED ..................... AddUnesS * 6 Expenditures Made 8. Cash PaymentJ (Other than Loans Made) ............ ScheduleE, UneS 9. Loans Made ............................................. Schedu/e H, Une Z 10. SUBTOTALCASH PAYMENTS ............................ AddLinesa, ~ 1 1. Accrued Expenses(Unpaid Bills) ........................ScheduleF, Une5 12. TOTAL EXPENDITURES MADE ......................... ~ddtJnes~O ,, l~ Current Cash Statement 13. Beginning Cash Ilalance .................. PrevlouJSumrnmryPege, Line17 i 4, Cash Receipts ...................................... Column A, Line .t abow 15. Mis(ellaneous Increases to Cash ........................Schedule I, Une 4 16. Cash Payments .................................... co~u~l~n~, ~ lO&bove 17. ENDING CASH BALANCE ..... AddLIneslJ ~ 14 * 15, th~nsubt~'ectUne 16 If thb b a termination Selement, Line F 7 mult be xero. 18. LOAN GUARANTEES RECEIVED .............. ~<hedole a, Patti, Column ~bJ Cash Equivalents and Outstanding Debts lg. Cash Equivalents ................................See Insttu(tlons on reverse Type or print In Ink. Amounts may be rounded to whole through Column B* $ S $ SUMMARY PAGE Column C $ S $ $ · From previous Statement Summery Page, Column C. However. this is the first report filed for the calendar year. Column B should be Summary for Candidates in Both June and November Elections 111 th.rough 6/30 7/1 to Date 21. [ontribqtions ~ecelveo .... s nditures -. ....... , Schedule A Monetary Contributions Received Type or print in Ink. Amounts nil), be rounded to whole dollars. SEE INSTRUCTIONS ON REVERSE NAME OF OFFICEHOLDER OR C~NDIDATE AND CONTROLLED COMMITTEE FULL NAME AND ADDRESS OF CONTRIBUTOR OCCUPATION AND EMPLOYER through AMOUNT RECEIVED THIS PERIOD SCHEDULE A Monetary Co~ribu tad ~'s-Su mma ry 1. Amount received this period -- contributions of $100 or more. (Include all Schedule A subtotals.) ................................................................................................... 2. Amount received this period -- contributions of less than $100. (Do not itemize.) ................................................................................................................ 3. Total monetary contributions received this period. (Add Lines 1 and 2. Enter here and on the Summary Page, ColumnA, Line 1.) %' :,_~: ' C.~x.~,~.=,4 SUBTOTAL ....................................... TOTAL Page of -- I.D. NUMBER o/&oLooo CUMULATIVE TO DATE LENDAR YEAR CUMULATIVE TO DATE OTHER (IF APPLIC~,B LE Schedule A (Continuation Sheet) Monetary Contributions Received Type or print in Ink. Amounts may be rounded to whole dollars. SUBTOTAL $ Statement Covers period through ~c~ ~ ~-? ' ! ~ AMOUNT RECEIVED THIS PERIOD SCHEDULE A (cont.) CUMULATIVE TO DATE ' CUMULATIVE TO DATE CALENDAR YEAR OTHER (JAN, 1 - DEC. 31) (IF APPLI~SLE Schedule A (Continuation Sheet) Monetary Contributions Received Type or print in ink. Amounts may pe rounded to whole dollars. NAME OF OFFICEHOLDER OR CANDIDATE AND CONTROLLED COMMITTEE Statement covert period \ -~ _ CUMULATIVE TO DATE CALENDAR YEAR (}AN. 1 - DEC. 31) SCHEDULE A (cont. I,D. NUMBER CUMULATIVE TO DATE OTHER (IF APPLICAi~LE) Schedule A (Continuation Sheet) Monetary Contributions Received Typ~ or print in Ink. Amount; may b~ rounded to who~ NAME OF OFFICEHOLDER OR CANDIDATE AND CONTROLLED COMMITTEE SUBTOTAL Statement covers period from ~ through SCHEDULE A (cont I.D. NUMBER CUMULATIVE TO DATE CALENDAR YEAR (JAN. l-DEC. 31) CUMULATIVE TO DATE OTHER (IF APPLICABLE) Schedule A (Continuation Sheet) Monetary Contributions Received TyI~ or print In ink. Amounts may be rounded to whole dollarl. NAME OF OFFICEHOLDER OR CANDIDATE AND CONTROLLED COMMITTEE SUBTOTAL Statement covert AMOUNT RECEIVED THIS PERIOD SCHEDULE A (cont.) CUMULATIVE TO DATE CUMULATIVE TO DATE CALENDAR YEAR OTHER {JAN 1-DEC, 31) (IF APPLICABLE Schedule A (Continuation Sheet) Monetary Contributions Received Type or print in Ink. Amounts may b~ rounded to whole dollars. NAME OF OFFICEHOLDER OR CANDIDATE AND CONTROLLED COMMITTEE SUBTOTAL Statement covers period through SCHEDULE A (cont.) I.D. NUMBER 'rot ~'0 6~ oo AMOUNT RECEIVED THIS PERIOD CUMULATIVE TO DATE CALENDAR YEAR (JAN. 1 -DEC. 3~) CUMULATIVE TO DATE OTHER (IF APPLICABLE Schedule A (Continuation Sheet) Monetary Contributions Received Typ~ or print In ink. Amounts may b~ ~ounded to whole dollars. NAME OF OFFICEHOLDER OR C~NDIDATE AND CONTROLLED COMMITTEE ,' OCCUPATION A~ID EMPLOYER SUBTOTAL $ SCHEDULE A (cont.) I,O. NUMBER AMOUNT RECEIVED THIS PERIOD t Do \c~ t0o t 00 CUMULATIVE TO DATE CALENDAR yEAR {JAN. l-DEC.31) CUMULATIVE TO DATE OTHER (IF APPLI~BLE) Schedule A (Continuation Sheet) Monetary Contributions Received Tyl~ or print in Ink. Amounts may b~ rounded to whole dollarl. NAME OF OFFICEHOLDER OR CANDIDATE AND CONTROLLED COMMITTEE SUBTOTAL $ Statement CoverF period SCHEDULE A (cont.) I.D. NUMBER AMOUNT CUMU~TIVE TO DATE RECEIVED THIS CALENDAR YEAR PERIOD (JAN 1-DEC. 31) O0 )c~o CUMULATIVE TO DATE OTHER (IF APPLICABLE) Schedule A (Continuation Sheet) Monetary Contributions Received Type or pdnt in Ink, Amounts may pe rounded to whole dollars. NAME OF OFFICEHOLDER OR CANDIDATE AND CONTROLLED COMMITTEE O~C~PATION AND EMPLOYER SUBTOTAL $ Statement covets period from through IL~ ~ ~ '"'f~ ~ SCHEDULE A (cont.) I,D. NUMBER AMOUNT CUMULATIVE TO DATE RECEIVED THIS CALENDAR YEAR PERIOD (JAN 1-DEC, 31) CUMULATIVE TO DATE OTHER (IF APPLICABLE) Schedule A (Continuation Sheet) Monetary Contributions Received Type or pdnt In tnk. Amounts may b~ rounded to whole dollars. NAME OF OFFICEHOLDER OR CANDIDATE AND CONTROLLED COMMITTEE Statement covers pert-,.-d from through SCH[DUL[ A I.D,NUMBER CUMULATIVE TO DATE CALENDAR YEAR (JAN. I-DEC. 31) CUMULATIVE TO DATE OTHER (IF APPLICABLE SUBTOTAL $ \, ~3 ~ ~ Schedule B -- Part Loans Received Type or print in ink. Amounts may be rounded to whole dollars. SEE INSTRUCTIONS ON REVERSE NAME OF OFFICEHOLDER OR CANDIDATE AND CONTROLLED COMMITTEE LENOER OR GUARANTOR'S FULL NAME AND ADDRESS LEND[ R / GUARANTOR'S i'-I Lender I-] Guarantore [-I Lender [] Guarantore Statement covers period from *See important instructions on reverse. through LENDER INFORMATION $ $ SUBTOTAL $ SCHEDULE B- Part I I.D. NUMBER GUARANTOR INFORMATION Loans Received - Part I Summary I. Loans of $100 or more received this period. (include a!! Loans Received -- Part I (a) subtotals.) .......... 2. Loans under $100 received this period. (Donoritemize.) ........................................... 3. Total loans received this period. (Add Lines 1 and 2.) ....................................... TOTAL Loans Received - Part II Summary 4. Loans of $100 or more repaid, forgiven, or paid by a third party this period. (Include all Part U (c) subtotals. If forgiven or paid by a third party, also itemize the transaction on Schedule A.) .............. S. Loans under $100 repaid, forgiven, or paid by a third party. (Do no itemize.) If forgiven or pald by a third party, include this amount on Schedule A Summary, Line 2 ............................ 6. Total Joans repaid, forgiven, or paid by a third party this period. (Add Lines 4 + 5.) ...................................................................... TOTAL 7. Net change this period. (Subtract Line 6 from Line 3.) Enter the r~,,t here and on the 5urnmary Page, Column A, Line 2 ................................ NET OTHER Schedule B - Part II Repa. yment$ Made on Loans Received, Loans Forgiven, and Loans Repaid by a Third Party NAME OF OFFICEHOLDER OR CANDIDATE AND CONTROLLED COMMITTEE Typ~ or print in Ink. Amounts may be rounded to whole dollars. Attach additional information on appropriately labeled continuation sheets. from Ih~ough I.D. N U~_M 8 E R INTEREST AMOUNT REPAID OR RATE FORGIVEN ON PRINCIPALe OUTSTANDING PRINCIPAL / / \ (') TOTAL INTEREST SURTOTAL S PAID THIS PERIOD *IMPORTANT: If any part of a loan is forgiven or repaid by a third party, also itemize the transaction on Schedule A, including the name and address of the person forgiving the loan or the third party making the payment, and the amount forgiven or paid. INTEREST PAJD $ summarysectlonof$¢heduleE. Line ~ Do Schedule B. Schedule B -- Part III Annual Report of Outstanding Loans Received SEE ~NSTRUCTIONS ON REVERSE NAME OF OFFICEHOLDER OR CANDIDATE AND CONTROLLED COMMITTEE [',~!!iC~ ~v~,'~C~r~,:?; '~:- _ ~.~:. ~,:~_=.: ,.:' FULL NAME OF LENDER ORIGINAL DATE OF LOAN Type or print In ink. Amounts may be rounded to whole doller$. A~VIOUNT OF ORIGINAL LOAN Statement Covers period through UNPAID PRINCIPAL SCHEDULE B- Part III I.D NUMBER UNPAID INTEREST Attach additional information on appropriately labeled continuation sheets. TOTAL NOTE: Thl~ toCal should b~ Schedule C Non-Monetary Contributions Received Type or print in ink. Amounts rely be rounded to whole dollart, SEE INSTRUCTIONS ON REVERSE NAME OF OFFICEHOLDER OR CANDIDATE AND CONTROLLED COMMITTEE FULL NAME AND ADDRESS OF CONTRIBUTOR OCCUPATION AND EMPLOYER DESCRIPTION OF Statement covers period through FAIR MARKET VALUE SCHEDULE C CUMULATIVE TO DATE CALENDAR YEAR (JAN 1 -DEC. 31) CUMULATIVE TO DATE OTHER (IF APPLICABLE) Attach additional information on appropriately labeled continua tion sheets. SUBTOTAL Non-Monetary Contributions Summary 1. Amount received this period-- non-monetary contributions of $100 or more. (Include all Schedule C subtotals.) .................................................................................... 2, Amount received this period-- non-monetary contributions of less than $100. (Do not itemize.) ........................................................................................................ 3. Total non-monetary contributions received this period. (Add Lines I and 2. Enter here and on the Summary Page. Column A, Line 4.) .................. TOTAL Sched u le D T¥~or printin Ink. Amounts may be rounded Enforceable Promises Received (Other than Loan towholedollars, Guarantees, Loan Endorsements, and Loan Security) NOTE: Loan guarantees, loan endorsements and loan security are "enforceable promises' that must be reported on Schedule B - NOT Schedule D. SEE INSTRUCTIONS ON REVERSE NAME OF OF F~CE HOLDER OR CANDIDATE AND CONTROLLED COMMITTEE FULL NAME ANO ADDRESS OF CONTRIBUTOR DATE (iF tOM M FiT[ E. it~ AODfTiO¢470 COMMirrT{ E.$ NAME ANO ADORE $S. OCCUPATION AND EMPLOYER AMOUNT PROMISED THIS PERIOD AMOUNT PAiD THIS PERIOD SCHEDULE D I.D. NUMBER CUMULATIVE TO DATE CALENDAR YEAR (JAN. I -DEC. 3U CUMULATIVE TO DATE OTHER (IF APPLICABLE Attach additional information on appropriately labeled continuation SUBTOTALS S ] (') sheets. Enforceable Promises Received Summary 1. Promises received of $100 or more this period (Column (a)) ....................... $ 2. Promises received under $100 this period. (Do not itemize.) ............................................................ $ 3. Total promises received this period. (Add Lines 1 add 2.) .................................................. TOTAL $ 4. Payments received on promises of $100 or more this period. (Column (b)) .................................................................................... 5. Payments received on promiseE under $100 this period. (Do not itemize. Also include on Schedule A Summary, Line 2.) ...................................... 6. Total payments received. (Add Lines 4 and 5.) ..................................................................... TOTAL 7. Nat change this period. (Subtract Line 6 from L~ne 3. Enter the difference here and on the Summary Page, Column A. Line 6.) ...................................................... NET Schedule E Payments and Contributions (Other Than Loans) Made Type or print in ink. Amounts mey be rounded to whole SEE INSTRUCTIONS ON REVERSE NAME OF OFFICEHOLDER OR CANDIDATE AND CONTROLLED COMMITTEE CODES FOR CLASSIFYING EXPENDITURES Statement covers p~rlod through SCHEDULE I.D. NUMBER Ifone of the following codes accurately describes the expenditure,you may enter the code and leave the 'Description of Payment' column blank. Refer to the back of Schedule E-Continuation Sheet for detailed explanations of each category. MONETARY AND IN-KIND (NON-MONETARY) CONTRIBUTIONS TO OTHER CANDIDATES AND COMMITTEES INDEPENDENT EXPENDITURES LITERATURE 'g' - BROADCASTADVERTISING °N' - NE~V~PAPERANDPERIODICALADVERTISING 'O' - OUTSIDE ADVERTISING 'S' - SUAVE YS, SIGNATURE GATH E RING. DOOR-TO-DOOR SOLICITATIONS 'F' - FUNDRAISINGEVENTS 'G°- GENERAL OPERATIONS AND OVERHEAD 'T'- TRAVEL. ACCOMMODATIONS AND MEALS (MUST BE DESCRIBED) °P' -- PROFESSIONALMANAGEMENTANDCONSULTING SERVICES CODE OR IMPORTANT: DO NOT ITEMIZE THE PAYMENT OF ACCRUED EXPENSES ON SCHEDULE E. REPORT ONLY THE LUMP 5UM OF SUCH PAYMENTS ON LINE 4 OF THE SUMMARY SECTION BELOW. DESCRIPTION OF PAYMENT AMOUNT PAID Important: Contributions and expenditures rnade out of campaign funds to or on behalf of other officeholders, candidates, committees, or ballot measures must also be entered on the Allocation Page, Part I. Payments and Contributions Made Summary 1. Payments made this period of $100 or more. (Include all Schedule E subtotals.) ...................................................... 2. Payments made this period of under $100. (Do not itemize.) ....................................................................... $ 3. Total interest paid this period on outstanding IDans. (Enter amount from Schedule B, Part II, Column (d).) .............................. $ 4. Total accrued expenses paid this period. (Do not itemize Enter amount from Schedute F, Line4.) ................................. SUBTOTAL Schedule F Accrued Expenses (Unpaid Bills) Type or print In Ink. Amounts may be rounded to whole dollars, SEE INSTRUCTION5 ON REVERSE NAME OF OFFICE HOLDER OR CANDIDATE AND CONTROLLED COMMITTEE CODES FOR CLASSIFYING EXPENDITURES SCHEDULE I.D. NUMBER IroneDf the followlngcodesaccuratelydescribestheexpenditure,you may enter the code and leave the "Description of Payment' column blank. Refer tothe back of Schedule E-Continuation Sheet for detailed explanations of each category, 'C'- MONETARY AND IN-KIND (NON-MONETARY) CONTRIBUTIONS TO OTHER CANDIDATES AND COMMITTEES '1' - INDEPENDENTEXPENDITURES 'L'- LITERATURE 'B' - BROADCASTADVERTISING 'N'- NEWSPAPER AND PERIODICAL ADVERTISING '0°- OUTSIDE ADVERTISING 'S'- SURVEYS, SIGNATURE GATHERING, DOOR-TO-DOOR SOLIOTATION5 °F' - FUNDR~ISING EVENTS 'G°- GENERALOPERATIONSANDOVERHEAD 'T" - TRAVEL. ACCOMMODATIONSANDMEALS (MUST BE DESCRIBED) °P' - PROFESSIONAL MANAGEMENT AND CONSULTING SERVICES NAME AND ADDRESS OF PAYEE. CREDITOi~, OR RECIPIENT OF CONTRIBUTION ~- CODE OR DESCRIPTION OF OUTSTANDING PAYMENT ! AMOUNT ACCRUED Attach additional information on appropriately labeled continua tion sheets. Accrued Expenses Summary 1. Accrued expenses this period of $100 or more. (tndudeallScheduleFsubtotals.) ..................................................... 2. Accrued expenses this period of under $100. (Do not itemize.) ..................................................................... 3. Total accrued expenses incurred this period. (Add Lines 1 and 2.) ................................................. INCURRED TOTAL 4. Total accrued expenses paid this period. (Do not itemize. Enter here and on Schedule E Summary, Line 4.) ................. PAID TOTAL 5. Net change this period. (Subtract Line4 from Line3. Enter thedifferencehereandontheSummaryPage, ColumnA, Line 11.) ..... NET SUBTOTAL Schedule H -- Part I Loans Made to Others Typ~ or print in ink. Amounts may be rounded to whole dollars. SEE INSTRUCTIONS ON REVERSE NAME OF OFFICEHOLDER OR CANDIDATE AND CONTROLLED COMMITTEE FULL NAME AND ADDRESS OF RECIPIENT Statement covers period INTEREST RATE DUE DATE Loans Made to Others -Part I Summary 1. Loans of $100 or more made this period. · (Include all Loans Made - Part I subtotals.) ............................................................ 2, Loans under $100 made this period. (Do not itemize.) .................................................................................... 3. Total loans made this period. (Add Lines 1 and 2.) .......................................................................... TOTAL Loans Repayments Received - Part II Summary 4. Payments received on loans of $100 or more. (Include all loan payments received and all loans of $100 or more which have been forgiven by this officeholder, candidate or committee - Part II (a) subtotals. If forgiven, also itemize on Schedule E.) ................................................................ 5. Payments received on loans under $100. (Inc uding a forgiveness Do not itemize ) ...................................................... ~ Total loan payments received this period. (Add Lines 4 and 5.) .......................................................................... TOTAL ~. Net change this period. (Subtract Line 6 from Line 3. Enter the net here and on the Summary Page, Column A, Line g.) ................... : ................ NET SUBTOTAL SCHEDULE H- Part I NUMBER AMOUNT Schedule H -- Pert II Loan Repayments Received on Loans Made to Others (Including Payments Received from Third Parties) and Loans Forgiven SEE INSTRUCTIONS ON REVERSE NAME OF OFFICEHOLDER OR CANDIDATE AND CONTROLLED COMMITTEE DATE OF DATE OF J REPAYMENT OR ORIGINAL FULL NAME OF RECIPIENT OF LOAN FORGIVE NES5 LOAN Type ar print In Ink. Amounts may be rounded to whole dollits. AMOUNT REPAID OR FORGIVEN ON PRINCIPAL IEXCLUDER~CEIFT Attach additional information on appropriately labeled continuation sheets. SUBTOTAL $ *IMPORTANT: If any part of a loan is forgiven, also itemize the forgiveness on Schedule g. If a repayment is received from a third party, enter the name and address of third party in the 'FULL NAME OF RECIPIENT OF LOAN ' column above, along with the name of the recipient of the loan. SCHEDULE H - Part OUTSTANDING INTEREST PRINCIPAL RECEIVED TOTAL INTEREST ~o) RECEIVED THIS PERIOD $ Enter the amount In column (b) in fh~ ~ummary Section o~ Schedule I, Line 3. Do of Schedule H. Schedule H -- Part III Annual Report of Outstanding Loans Made Typ~ or print In ink. Amounts mey b~ rounded to whole dollars. SEE INSTRUCTtONS ON REVERSE NAME OF OFFICEHOLDER OR CANDIDATE AND CONTROLLED COMMI~'~ E E Attach additional information on appropria rely labeled continuation sheets. TOTAL Statement covers from ~ ~ - f~'~ through UNPAID PRINCIPAL SCHEDULE H- Part III ID NUMBER UNPAID INTEREST Schedule I Miscellaneous Increases to Cash SEE INSTRUCt'IONS ON REVERSE NAME OF OFFICEHOLDER OR CANDIDATE AND CONTROLLED COMMITTEE DATE FULL NAME AND ADDRES5 OF SOURCE Type or print in Ink. Amountl rne¥ be rounded to whole doller$, from through SCHEDULE AMOUNT OF INCREASE TO CASFI Attach additional information on appropriately labeled continuation sheets. Miscellaneous Increases to Cash Summary 1. ~ncreases to cash of $100 or more this period ............................................................. 2. increases to cash under $100 this period. (Do not itemize.) ................................................. 3. Total of all interest received this period on loans made to others. (Schedule H, Part II (b).) .................... 4. Total miscellaneous increases to cash this period. (Add Lines 1, 2, and 3. Enter here and on the Summary Page, Line 15.) ....................................................................... TOTAL SUBTOTAL $