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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 separately. <br />All other contributions may be totaled together and listed as one entry in Exhibit B. Attach additional sheets if necessary. <br /> <br />Date Name and address Money or thing <br />received of value received <br /> . <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 be listed by <br />type rather than contributor. <br /> <br />MONEY <br />THINGS OF VALUE <br /> <br />17'56':60 <br /> <br />+ <br /> <br />$ <br />$ <br />$ <br /> <br />J95roo <br /> <br />TOTAL AMOUNT RECEIVED <br />