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Contributions from Individuals <br />Awtendmem <br />�-�- to <br />_3 <br />or 0 <br />Use this fiorm to repot individual coninjutiow over S% or aotmn under $50 if form CRU 1ZDS is not used <br />1. Committee Full Name and Fund if a ikable) <br />2. ID Number <br />`y r.nrn: A J6 a e p—k -bi s Clrru <br />3. Contributor Information <br />❑ Add ❑ Remove <br />a. Fnii iVrattne, Maffing Address & Pkaae <br />h Job rakffitafnaft <br />d. Comments <br />{{Calorie City, stste. & zip) <br />�^�alS l<ir{e.�Cu i�+►G' - <br />e-`s�liidd <br />��iltitlGl�y <br />ry <br />t. <br />�i�Y k' <br />r- Mcbm Swn to Date <br />{cq -<I 3E)-"79'7 <br />fC <br />L Prior g. Accolmt Code 1L life[= ofPaymmt <br />i. lw4c>td ]• Dhtf+t (mmlddlyyyy) k Amnnat <br />El■ <br />a� �� a�a� Db �n <br />� <br />❑ <br />$ <br />❑ <br />$ <br />3. Contributor Information <br />❑ Add ❑ Remove <br />a_ Futl N2olc, Malting Address & Mom <br />b. Job T-wddProfawd= <br />d. Comwepb <br />(tIIe city, staty6t �} <br />3 �c>`� Ave, No �� <br />CoK� hi c AMIT <br />� <br />�7 <br />I�DL ~� v. �i.7►-�['i(� �►"► <br />e. >;d:cfiou Sam m Date <br />L Prier F. Acconot Curie iw Form of Paymeet <br />i_ in-wmd g. Date {mimlddlyyM k Azaenat <br />3. Contributor Information <br />❑ Add ❑ Remove <br />a. Fish Name, AtrtMag Address & Pbow <br />b. dob'Fi idprofessiaa <br />d. Camment� <br />Ondude City, sf%te,& <br />5fai5rY a f 1 l�`R.. Y1 �TY <br />LEM*yWxNawzNpecM-wFzdd <br />S�s�i..c.ar PJ + <br />W <br />P• E• 0009II Sum to date <br />L Prior g. AccmW Code L. Fo m e[raymeat <br />i. Ii�-Wmd Dmwodw j, p hryyy) h. Anrnast <br />❑ 1 (�Jh , <br />1,44 <br />Avas <br />4. Total only this Pagea <br />o �� <br />5. Total of ALL CRO-1210 Pages <br />(37+ir fare rrwist been Gae S of0daW dywmnury Pine CRQ-1100) <br />CR0421 D <br />NC Stne Baud of Elections <br />ApcH 2W7 <br />