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OCT 2 1 2 0 1 1 1 1 : 4 9 FR 3 1 7 2 7 7 4 7 5 5 3172774755 TO 9 7 7 6 8 2 1 8 REPORT OF RECEIPTS AND EXPENDITURES OF A POLITICAL COMMITTEE State Form 4606 (Raw 1-05) LN Dana ELectlanCornmiss on 3-9-5-14)

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1. Start by entering the current date in the designated space at the top of the form, using the month, day, and year format.
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Oct 2 1 2 refers to a specific form or document that individuals or entities may need to file for tax or regulatory purposes.

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