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Contributions from Individuals <br />ft <br />Amendment � <br />�/ r ❑ Yes ❑ No <br />of <br />Use this form to report individual contnbutions over $50 or contributions udder $50 if form CRU 1205 is not used <br />I. Committee Full Name and Fund if applicable) <br />2. ID Number <br />3. Coatrbutor information <br />❑ Add ❑. ,- ..'noVe <br />a. Fall Name, wing Address & Pboee <br />b. Job Thou <br />d. Comments <br />(include city, state, & z3p) <br />-� crti r�- <br />1 <br />_ ++ r <br />e_ Employees NameSpeLiSe Field <br />.0 f\Q o (ci.I K C ),ga,7 <br />e. Election Sm to Date <br />f. Prior g. Account Code lw Form of Payment <br />i. ItFKind DracripEios j. Date (mmddddyM) L Apt <br />❑ I C` �� <br />�! I `7 <br />rZG�ar $y� ac, <br />❑ <br />$ <br />❑ <br />$ <br />3. Conf ibutor Information <br />El Add El Remove <br />a_ Fait Name, Mailing Address & Phone <br />b. Job 15t1eIPro%scion <br />d. Comments <br />(iodude city, state, & zip) <br />toil evt <br />Ye-�tid ol� <br />' � 1 a u. 'K�;�CC��.� r[L,A] <br />c. Employer's Name6pedfie RM <br />Cov�CAS)' .,al C Agoz"I <br />394; - U�hoby <br />e. motion Sum to Darr <br />'lvy»"cS6- L9(o9 <br />ov <br />$ AOO <br />f_ Prior g- Account Code h. Form of Payment <br />i. In -Wind Aeaeriptinn j. Date (mm1 dddyYYy) ZL Amosa! <br />❑ rylcs►� v�de�r <br />to b� <br />$ ❑o °° <br />❑ <br />$ <br />3. Contributor Information <br />❑ Add:. - : ❑ Remove <br />a. Full Name, Maitieg Address & Phone <br />b. doh TttledPrefewaou <br />d. Comments <br />(include city, state, & zip) <br />-Rer 'Die- Ex-fef <br />�ei rer� <br />c. Employer's Name/Specific Field <br />r <br />�ek rr� GVmp l Owne-f <br />ConcaYd, 4�- <br />Election saaq to Date <br />WAI-2309 <br />oC <br />f. Prior g. AmLa t Code h. Form of Payment <br />i. ln-Wad Description j. Date (mmdddlyyyy) k. Amount <br />❑ In OYCI&Y <br />$ b000 <br />❑ <br />$ <br />❑ <br />$ <br />Page <br />$, •of <br />E4.ToW:900y.this <br />ALL Cl Q-1;10 Pages <br />psrse3eete F— 6 of Aeitffe dS�e--7 Page CRO-I1@D) <br />: $ <br />CRa1210 <br />NC ShftBowd of Elections <br />r prd zone <br />