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In -Kind Contributions EAmriendment <br />� of No <br />Use this form to report non -monetary contributio=%�, donations, goods or services provided to the committee or fund. <br />Use CRO-1215 if In -Kind Contributions were or will be rehtnded within 7 day.s. <br />iF JA U;;u„ , NUU;og Addrm & Phone <br />(include city, state, <br />� T3o� a1 <br />ller�rriptat�n <br />- ---- <br />3076 ;�{ <br />h. Type of Costribator <br />Individual <br />Candidate <br />Party <br />❑ PAC <br />❑ Referendum tl.l7dptiattt 5ireu to 17�te :..: <br />❑ Other Receipt Source <br />_.. f Date (unnlddJyyyy) 9- Fair Market Aanean <br />_.. — <br />C�a Mrs C oc-- C�,►'li <br />a ; .:I ! rk�nre, Mailing Address & Phone <br />(ioe;udc city, adore, & 2dp) <br />_' a "dAMK-, MWing Address & Ptwae <br />(iz'Judzt cittyls� a rgp) <br />1alr01/Aca 1 7a, 7q <br />�alra12oa5 $ <br />1 o�jal,acrz s t 3 q. jq <br />h. Type of Cunthbawr <br />Individual <br />Candidate <br />Party <br />❑ PAC <br />❑ Referendum <br />❑ Other Receipt Source <br />arse (marddl" <br />. FAetitiion Sum to Date <br />$ F!53 f 1 <br />g. Fair'.MaxUt Amount <br />b. Type of Contributor t~ Contmcnts <br />indi v ictual <br />❑ Candidate <br />❑ t-drty <br />❑ PAL: <br />❑ t &TUndum <br />El Other Receipt Source - <br />$ 53 f g <br />� S53t 18 <br />CRo-rsI U NC State Board of EIections Doccmber 2DU7 <br />