Fec Form 3 - Report Of Receipts And Disbursements Page 9
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10SCHEDULE D (FEC Form 3)
PAGE
OF
(Use separate
FOR LINE NUMBER:
schedule(s)
DEBTS AND OBLIGATIONS
for each
(check only one)
9
Excluding Loans
numbered line)
10
NAME OF COMMITTEE (In Full)
A. Full Name (Last, First, Middle Initial) of Debtor or Creditor
Nature of Debt (Purpose):
Mailing Address
City
State
Zip Code
Outstanding Balance Beginning This Period
,
,
.
Outstanding Balance at Close of This Period
Amount Incurred This Period
Payment This Period
,
,
.
,
,
.
,
,
.
B. Full Name (Last, First, Middle Initial) of Debtor or Creditor
Nature of Debt (Purpose):
Mailing Address
City
State
Zip Code
Outstanding Balance Beginning This Period
,
,
.
Amount Incurred This Period
Outstanding Balance at Close of This Period
Payment This Period
,
,
.
,
,
.
,
,
.
C. Full Name (Last, First, Middle Initial) of Debtor or Creditor
Nature of Debt (Purpose):
Mailing Address
City
State
Zip Code
Outstanding Balance Beginning This Period
,
,
.
Amount Incurred This Period
Payment This Period
Outstanding Balance at Close of This Period
,
,
.
,
,
.
,
,
.
1) SUBTOTALS This Period This Page (optional) ...................................................................
,
,
.
2) TOTALS This Period (last page this line number only) ......................................................
,
,
.
3) TOTAL OUTSTANDING LOANS from Schedule C (last page only) ..................................
,
,
.
,
,
.
4) ADD 2) and 3) and carry forward to appropriate line of Summary Page (last page only)
FEC Schedule D (Form 3) (Revised 05/2016)
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