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<br />Page 2 . <br /> <br />RECEIPTS <br />(Exhibit A) <br /> <br />Include all money. property and things of value received during the period of time covered by this report. Attach additional sheets if necessary. <br /> <br />Date Name and address Monev or thing <br />received of velue received <br /> .. <br /> <br />Total amount received $ <br /> <br />PROMISES OR PLEDGES RECEIVABLE <br />(Exhibit B) <br /> <br />Include all things of value promised or pledged. Include things listed in previous report which still fall within this category. Attach <br />additional sheets if necessary. <br /> <br />Total amount promised or pledged <br /> <br />$ <br /> <br />- <br /> <br /> <br />Date <br /> <br />Name and address <br /> <br />Thing promised and value <br />