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Outstanding Loans <br />Amendment <br />Pg of ❑ 'Yes Q No <br />Use this form to report any outstanding loans received during a previous reporting period and until the loan is paid in full. <br />1..f Committee Fall and Fund if applicable) <br />2. M Number <br />NName <br />i 0MIII � S l Pic - '%J 1=�.cr�.'� bu-i- BA&!�-S LJ G^ ?t r7F' uii r- <br />3. Lender Information ❑ Add <br />❑ Remove <br />a. Full Name, Mailing Address & Phone <br />(include city, state, & zip) <br />rNZRLFN RFa[S <br />1 3 f 0 -D �' �¢ ftRL dT-i �o <br />Cs nGco�fA/ o <br />b. Job Title/Profession <br />_ <br />C�L-Fii-r Of &ai.�l <br />(!,aB'-Pi,(.,S Cui,{-id TV <br />c Employer's Name/Specific Field <br />!� / Ji �-- <br />d. Comments <br />C. Start Date (mmlddtyyyy) <br />�$ ! <br />L End Date (mm/dd,9rM) <br />g. Rate h. Secur* Pledged <br />i_ Original Loan Amount <br />j. Remaining Loan Balance <br />tr. Full Name of Lending hdatitution <br />1. Loan Number <br />3. Lender Information ❑ Add <br />❑ Remove <br />a. Full Name, Madding Address & Phone <br />(include city, state, & up) <br />[i,L)D Cj4Jj12LvTtr- )3cAD <br />b. Job TitielProfenion <br />61_+3/��' �' is } � ua�r'+� <br />zEmployer'sNamelSpeeiTeField <br />/� <br />d. Comments <br />e. Start Date (mmldd)yyy) <br />/ <br />f. End Date (mmfddfypyp) <br />g. Rate h. Security Pledged <br />L Original Loan Amount <br />j. Remaining Loan Balance <br />o <br />k. Full Name of [ending�Iynstitution <br />L Loan Number <br />Ivfff� <br />3. Leader Information ❑ Add <br />❑ Remove <br />a. Full Name, Mailing Address & Phone <br />(include city, state, & zip) <br />j1J lfl►Yt� t0liRl�ea <br />16 ,]j`I 61-.D iC ttilll�i_ 671j i= -RoRD <br />Gonc:ac�, i } <br />b. Job Title/Profession <br />e. Employees NamelSpeeiGc Field <br />d. Comments <br />e. Start Date (mm/ddlyyyy) <br />O$/wC1/-20j4 <br />L End Date (mm/dd/yyyy) <br />g. Rate <br />b. Security Pledged <br />L Original Loan Amount <br />j. Remaining Loan Balance <br />l f� <br />k. Fall Name of Lending lustitafion <br />L Loan Number <br />!Y 1 <br />-4. Total only tbis Page. <br />S. Total of ALL CRO-1430 Pages <br />(7Yris line mast be on tine,21 ofDdaded SYmmtmy Page CRO-11oo) <br />$ 160 C VC <br />� <br />t,ilr1-l4]v NU State Board of Elections December 2007 <br />