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Contributions from Individuals <br />Amendment <br />Pg of ❑ Yes ❑ No <br />Use this form to report individual contributions over $50 or contributions under $50 if Form CR0 1705 k not iiNed <br />1. Cortundttee Full Name (and Fund if applicable} <br />�Av 4-t r,1 f:!I, Fk- c:/}6 jfl-+�"S <br />2. Ill Number <br />3. Contributor Information 0 Add ❑ Remove <br />a. Full Name, Mailing Address & Phone <br />(include city, state, & zip) <br />ZO [ jo^x-"RTF L <br />b. Job Title/Pratession <br />d. Comments <br />C. Employer's Name/Speeille Field <br />ie. Election Sum to Date <br />. Prior <br />❑� <br />g. Account Code <br />�t' f <br />h. Form of Payment <br />€. In -Kind Description <br />W BFlT� <br />'. Date (mvnlddlyyyy) <br />k. Amount <br />CG <br />11[2-`i <br />$ 23f o a <br />❑ <br />G-f <br />GC <br />€nAf�tC- Ky5 vG <br />lt�l <br />$ 1 Z. I t7 <br />❑ <br />F;° I <br />GC_ <br />wt-R5c7� �t'jfl -o �] <br />101 <br />$ 12f.00 <br />3. Contributor Information ❑ Add ❑ Remove <br />a. Full Name, Mailing Address & Phone <br />(include city, state, & zip) <br />trW-oa.s B t-dir 1V G 2g A'[ S <br />b. Job Title/Profession <br />d. Comments <br />c. Employer's Nan►etSpecific Field <br />f <br />FEIon Sum to Date <br />fZU. 3¢ <br />F. Prior <br />❑ <br />g. Account Code <br />h. Form of Payment <br />i. In -Kind Description <br />'. Date (mmWdd/yyyy) <br />�z j <br />k. Amount <br />$ 131.4-1- <br />cv! <br />cKr01r- <br />TrLiv, foe <br />❑ <br />pe + <br />r,z,t.t� <br />il�y7 <br />$ frtfl <br />❑ <br />$ { <br />3. Contributor Information ❑ Add ❑ Remove <br />a. Full Name, Mailing Address & Phone <br />(include city, state, & rap) <br />b. Job T ille/Profession <br />d. Comments <br />c. Employer's Name/Specific Field <br />Sum to Date <br />rlection <br />F. Prior <br />g. Account Code <br />h. Form of Payment <br />i. In -Kind Description <br />J. Date (mmlddlyyyy) <br />k. Amount <br />❑ <br />$ <br />❑ <br />$ <br />4. Total only this Page <br />$ ! + 7 p • 3-� <br />5. Total of ALL CRO-1210 Pages <br />(This line nsusi be nn line 6 of DetaRed Summary Page CRO-1-700) <br />$ <br />I 71D- <br />L.nV-iZ►u At- Sgs[e board of Elections April 2007 <br />