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HEMLE A: RECEIPTS(continued) <br /> Name and Residential Address Occupation&Employer <br /> Date Received (alphabetical listing required) Amount (for.confr�buttons of;$2(ltl or mode <br /> . ........... <br /> EL <br /> ............ <br /> 4 <br /> {ggp{p <br /> B@$ <br /> ;d <br /> Line9:Total.Receipts over$50(or listed above) o.�o <br /> Line 10-Total Receipts$50 and under* (not listed above) a.00 <br /> Line 11:TOTAL RECEIPTS IN THE PERIOD Enter on page 1,line 2 <br /> II`yau bave itemized receipts of$50 and under,include them in line 9. Line 10 should include only those receipts not itemized above. <br /> Page 3 <br /> d <br />