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NUM-LOULL L: "11N-1lK IM)" UC)INTHIBU MAN <br /> A.G.L.c.55 requires the name and residential address be reported for all in-kind contributions from a contributor over$50 in the aggregate in a calendar year.In <br /> addition,the occupation and employer must be reported for each contributor who contributes$200 or more in a calendar year.Receipts from a contributor of$50 <br /> nd less in the aggregate in a calendar year can be reported in total without itemization,however,the candidate or committee must keep detailed accounts and <br /> ecords of all contributions received of any amount.In determining aggregate amounts received from a contributor,add monetary as well as in-kind contributions <br /> eceived.Do not include out-of-pocket expenditures of candidate reported on Schedule D.Attach additional pages as needed to report all receipts.Please <br /> nclude the candidate or committee name and a- a e number on each additional page. <br /> Date Received From Whom Received* Residential Address Description of Contribution Value <br /> *Ifyou have itemized in-kind contributions of Line 16: In-Kind Contributions over$50(or listed above) <br /> $50 and under,include them in line 16. Line 17 <br /> should include only those expenditures not Line 17: In-Kind Contributions$50 and under(not listed above) <br /> itemized above. <br /> Enter on page 1, line 6 Line 18:TOTAL IN-KIND CONTRIBUTIONS IN THE PERIOD <br /> Page 6 <br />