Fec Form 3 - Report Of Receipts And Disbursements Page 7

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PAGE
OF
SCHEDULE C (FEC Form 3)
Use separate schedule(s)
FOR LINE NUMBER:
for each category of the
LOANS
(check only one)
13a
Detailed Summary Page
13b
NAME OF COMMITTEE (In Full)
LOAN SOURCE Full Name (Last, First, Middle Initial)
Election:
Memo Item
Primary
General
Mailing Address
Other (specify) 
City
State
ZIP Code
Personal Funds of the Candidate
Original Amount of Loan
Cumulative Payment To Date
Balance Outstanding at Close of This Period
,
,
.
,
,
.
,
,
.
TERMS
Date Incurred
Date Due
Interest Rate
Secured:
(If none, enter 0)
M
M
/
D
D
/
Y
Y
Y
Y
.
M
M
/
D
D
/
Y
Y
Y
Y
%
Yes
No
(apr)
List All Endorsers or Guarantors (if any) to Loan Source
Name of Employer
1. Full Name (Last, First, Middle Initial)
Occupation
Mailing Address
Amount
,
,
.
Guaranteed
City
State
ZIP Code
Outstanding:
Name of Employer
2. Full Name (Last, First, Middle Initial)
Occupation
Mailing Address
Amount
,
,
.
Guaranteed
City
State
ZIP Code
Outstanding:
3. Full Name (Last, First, Middle Initial)
Name of Employer
Mailing Address
Occupation
Amount
,
,
.
Guaranteed
City
State
ZIP Code
Outstanding:
4. Full Name (Last, First, Middle Initial)
Name of Employer
Occupation
Mailing Address
Amount
,
,
.
Guaranteed
City
State
ZIP Code
Outstanding:
SUBTOTALS This Period This Page (optional) ....................................................................
,
,
.
TOTALS This Period (last page in this line only) ................................................................
,
,
.
Carry outstanding balance only to LINE 3, Schedule D, for this line. If no Schedule D, carry forward to appropriate line of Summary.
FEC Schedule C (Form 3) (Revised 05/2016)

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