Beruflich Dokumente
Kultur Dokumente
Late flied reports are subject to possible civil and criminal penalties .
SEE INSTRUCTIONS ON BACK AND COMPLETE THE FOLLOWING SENTENCE :
I AM FILING A % REPORT FOR AN/A (1 ELECTION /(2)NON-ELECTION YEAR.
(report date) Indicate one
CCHECKIF AMENDMENT TO REPORT DATED Local Comrre'l6eas, enter Date of Election
11 ~q t0 4
l~ Check if this is final (termination) report and attach Notice of Dissolution Form DR-3. County & Loral Committees, enter Courdy in
(You must continue to file reports until a Notice of Dissolution is filed.) which Election rs hel
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"UNPAID BILLS (From Schedule D -Attach Schedule D) ........ . ........ ..... ..... .............. . ..... ........ ......$
"IN KIND CONTRIBUTIONS (From Schedule E - Attach Schedule E) _......... ........ . ... .. ... ... .. ........... .... $
"'OUTSTANDING LOANS (From Schedule F - Attach Schedule F) ... ...... ........ .............. ..... ...... ........ . $
CANDIDATE COMMITTEES ONLY:
CONSULTANT BREAKDOWN (Schedule G Attached?) A YES F_] NO
VALUE OF CAMPAIGN PROPERTY (From Schedule H -Attach Schedule H)
_- u,abr i 1 son
5632886574
P .2
Page . ~of
ial figure Is unknown, show 'eattmated" beside
the figure . (for Schedule D)