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<br />Page 2 <br /> <br />MAJOR CONTRIBUTORS <br />(Exhibit A) <br /> <br />Any individual or committee that during the year has made one or more contributions that total $500 or more must be listed <br />separately. All other contributions may be totaled together and listed as one entry in Exhibit B. Attach additional sheets if <br />necessary. <br /> <br />Date Name and address Money or thing <br />received of value received <br /> <br />Total amount received $ <br /> <br />OTHER CONTRIBUTIONS RECEIVED <br />(Exhibit B) <br /> <br />All contributions not listed under Exhibit A received during the period of time covered by this report. Contributions should <br />be listed by type rather than contributor. <br />$ lSS" \ CJj;J <br /> <br />.--- <br /> <br />MONEY <br /> <br />+ <br /> <br />THINGS OF VALUE <br /> <br />$ <br />=-r oe <br />$ l~0i <br /> <br />TOTAL AMOUNT RECEIVED <br />