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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. (See note on contribution limits on page 4.) All other contributions may be totaled together and listed as one entry in <br />Exhibit B. Attach additional sheets if 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. (See note on contribution limits on page 4.) <br /> <br />MONEY $ <br />+ <br />THINGS OF VALUE $ <br /> <br />TOTAL AMOUNT RECEIVED $ <br />