Occupation & Employer
(for contributions of $200 or more)
Amount
Name and Residential Address
(alphabetical listing required)
Date Received
SCHEDULE A: RECEIPTS
M.G.L. c. 55 requires that the name and residential address be reported, in alphabetical order, for all receipts over $50 in a calendar
year. Committees must keep detailed accounts and records of all receipts, but need only itemize those receipts over $50. In addition, the
occupation and employer must be reported for all persons who contribute $200 or more in a calendar year.
Line 9: Total Receipts over $50 (or listed above)
Line 10: Total Receipts $50 and under* (not listed above)
Line 11: TOTAL RECEIPTS IN THE PERIOD
* If you have itemized receipts of $50 and under, include them in line 9. Line 10 should include only those receipts not itemized above.
f Enter on page 1, line 2
Committee Name: Page:
Date Received Amount
Occupation & Employer
(for contributions of $200 or more)
Name and Residential Address
(alphabetical listing required)
Line 9: Total Receipts over $50 (or listed above)
Line 10: Total Receipts $50 and under* (not listed above)
Line 11: TOTAL RECEIPTS IN THE PERIOD
* If you have itemized receipts of $50 and under, include them in line 9. Line 10 should include only those receipts not itemized above.
f Enter on page 1, line 2
SCHEDULE A: RECEIPTS (continued)
Committee Name: Page: