Californi : 1. Office, Agency, or Court
Californi : 1. Office, Agency, or Court
Californi : 1. Office, Agency, or Court
A PUBLIC DOCUMENT
FEB 28 2011
(d)(5)
Please type or print in ink.
NAME OF FILER (LAST) •• (fIRST)
Agency: Position:
o Assuming Office: Date ----1----..l_ _ o The period covered is ----1----..l_ _, through the date
01 leaving office.
o Candidate: Election Year _ _ _ _ __ Office sought, if different than Part 1: _ _ _ _ _ _ _ _ _ _ _ _ _ _ __
4. Schedule Summary
Check applicable schedules or "None." ~ Total number of pages including this cover page: _=_ 12
~ Schedule A-1 - Investments - schedule attached ~ Schedule C - Income, Loans, & Business Posffions - schedule attached
~ Schedule A-2 - Investments - schedule attached ~ Schedule D - Income - Gifts - schedule attached
o Schedule B - Real Property - schedule attached o Schedule E - Income - Gifts - Travel Payments - schedule attached
-or-
O None - No reportable interests on any schedule
5.
I have used all reasonable diligence in preparing this statement. I have reviewed thi
herein and in any attached schedules is true and complete. I acknowledge this is
I certify under penalty of perjury under the laws of the State of California that
Name
Stocks, Bonds, and Other Interests
(Ownership Interest is Less Than 10%) WILLIAM R. BERRYHILL
Do not attach brokerage or financial statements.
BANKING INVESTMENT
FAIR MARKET VALUE FAIR MARKET VALUE
o $2,000 - $10,000 0$10,001 - $100,000 ~ $2,000 - $10,000 0$10,001 - $100,000
~ $100,001 - $1,000,000 DOver $1,000,000 o $100,001 - $1,000,000 Dover $1,000,000
NATURE OF INVESTMENT
~ Stock 0 Other _ _ _ _ ---;;:==_____
(Describe)
NATURE OF INVESTMENT
~ Stock 0 other _ _ _ _ ---;;:==_____
(Describe)
o Partnership o Income Received of $0 - $499
o Income Received of $500 or More (Report on Schedule C)
D Partnership o Income Received of $0 - $499
o Income Received of $500 or More (Report on Schedule C)
IF APPLICABLE, LIST DATE: IF APPLICABLE, LIST DATE:
INVESTMENT
FAIR MARKET VALUE FAIR MARKET VALUE
o $2,000 - $10,000 ~ $10,001 - $100,000 o $2,000 - $10,000 0$10,001 - $100,000
0$100,001 - $1,000,000 DOver $1,000,000 o $100,001 - $1,000,000 DOver $1,000,000
Commenm: ___________________________________________________________________________________
.... 2 IDENTIFY THE GROSS INCOME RECEIVED (INCLUDE YOUR PRO RATA ... 2 IDENTIFY THE GROSS INCOME RECEIVED (INCLUDE YOUR PRO RATA
SHARE OF THE GROSS INCOME TO THE ENTITY/TRUST) SHARE OF THE GROSS INCOME TO THE ENTITY/TRUST)
.... 3 LIST THE NAME OF EACH REPORTABLE SINGLE SOURCE OF .... 3 LIST THE NAME OF EACH REPORTABLE SINGLE SOURCE OF
INCOME OF $10,000 OR MORE (Att~tll ~ ~eparate sheet ,I nctessary J INCOME Or: $10,000 OR MORE (Attach a separate sheet 'f necessary)
.... 4 INVESTMENTS AND INTERESTS IN REAL PROPERTY HELD BY THE .... 4 INVESTMENTS AND INTERESTS IN REAL PROPERTY HELD BY THE
BUSINESS ENTITY OR TRUST BUSINESS ENTITY OR TRUST
Check one box: Check one box:
I8J INVESTMENT o REAL PROPERTY o INVESTMENT o REAL PROPERTY
STANISLAUS FARM SUPPLY
Name of Business Entity .Q[ Name of Business Entity .Q[
Street Address or Assessor's Parcel Number of Real Property Street Address or Assessor's Parcel Number of Real Property
FAIR MARKET VALUE IF APPLICABLE, LIST DATE: FAIR MARKET VALUE IF APPLICABLE, LIST DATE:
I8J $2,000 - $10,000 0$2,000 - $10,000
0$10,001 - $100,000 -----'-----'~ -----'-----'~ 0$10,001 - $100,000 -----'-----'~ -----'-----'~
0$100,001 - $1,000,000 ACQUIRED DISPOSED 0$100,001 - $1,000,000 ACQUIRED DISPOSED
Dover $1,000,000 DOver $1,000,000
.... 2 IDENTIFY THE GROSS INCOME RECEIVED (INCLUDE YOUR PRO RATA ... 2 IDENTIFY THE GROSS INCOME RECEIVED (INCLUDE YOUR PRO RATA
SHARE OF THE GROSS INCOME TO THE ENTITYITRUST) SHARE OF THE GROSS INCOME TO THE ENTITYfTRUST)
~ 3 LIST THE NAME OF EACH REPORTABLE SINGLE SOURCE OF ~ 3 LIST THE NAME OF EACH REPORTABLE SINGLE SOURCE OF
INCOME OF $10,000 OR MORE (Atlacl> a separate Sheet if necessary) INCOME OF $10,000 OR MORE (Attach a separate sheet of necessary)
~ 4 INVESTMENTS AND INTERESTS IN R.EAL PROPERTY HELD gy THE ~ 4 INVESTMENTS AND INTERESTS IN REAL PROPERTY HELD BY THE
BUSINESS ENTITY OR TRUST BUSINESS ENTITY OR TRUST
Check one box: Check one box:
o INVESTMENT ~ REAL PROPERTY o INVESTMENT o REAL PROPERTY
11751,12625,13499 W 8 MILE RD, STOCKTON, CA
Name of Business Entity .Q.[ Name of Business Entity Q[
Street Address or Assessor's Parcel Number of Real Property Street Address or Assessor's Parcel Number of Real Property
FAIR MARKET VALUE IF APPLICABLE, LIST DATE: FAIR MARKET VALUE IF APPLICABLE, LIST DATE:
0$2,000 - $10,000 0$2,000 - $10,000
~ $10,001 - $100,000 ---'---'~
ACQUIRED
---'---'...1Q...
DISPOSED
o $10,001 - $100,000 ---,---,...1Q... ---'---'...1Q...
ACQUIRED DISPOSED
0$100,001 - $1,000,000 0$100,001 - $1,000,000
Dover $1,000,000 DOver $1,000,000
Comments: FMV IS VALUE OF EACH PARCEL FPPC Fonn 700 (2010/2011) Sch, A-2
FPPC Toll-Free Helpline: 866/275-3772 www.fppc.ca.gov
SCHEDULE A-2 CALIFORNIA FORM 700
FAIR POLITICAL PRACTICES COMMISSION
Investments, Income, and Assets Name
of Business EntitieslTrusts
(Ownership Interest is 10% or Greater) WILLIAM R BERRYHILL
WILLIAM & TRIANA BERRYHILL REVOCABLE TRUST WILLIAM & TRIANA BERRYHILL REVOCABLE TRUST
Name Name
1912 E TAYLOR RD, CERES CA 95307 1912 E TAYLOR RD, CERES CA 95307
Address (Business Address Acceptable) Address (Business Address Acceptable)
Check one Check one
~ Trust, go to 2 o
Business Entity, complete the box, then go to 2 1&1 Trust, go to 2 o Business Entity, complete the box. then go to 2
FAIR MARKET VALUE IF APPLICABLE, LIST DATE: FAIR MARKET VALUE IF APPLICABLE, LIST DATE:
0$2,000 - $10,000 0$2,000 - $10,000
0$10,001 - $100,000 ----'----'.JJL ----'----'.JJL 0$10,001 - $100,000 ----'----'JSL ----'----'JSL
0$100,001 - $1,000,000 ACQUIRED DISPOSED o $100,001 - $1,000,000 ACQUIRED DISPOSED
DOver $1,000,000 Dover $1,000,000
NATURE OF INVESTMENT NATURE OF INVESTMENT
D Sole Proprietorship D Partnership 0
Other
o Sole Proprietorship D Partnership 0
Other
YOUR BUSINESS POSITION YOUR BUSINESS POSITION
... 2 IDENTIFY THE GROSS INCOME RECEIVED (INCLUDE YOUR PRO RATA ... 2 IDENTIFY THE GROSS INCOME RECEIVED (INCLUDE YOUR PRO RATA
SHARE OF THE GROSS INCOME !Q THE ENTlTYfTRUST) SHARE OF THE GROSS INCOME TO THE ENTlTYfTRUST)
0$0 - $499 181 $10,001 - $100,000 0$0 - $499 181 $10,001 - $100,000
0$500 - $1,000 DOVER $100,000 0$500 - $1,000 DOVER $100,000
o $1,001 - $10,000 0$1,001 - $10,000
... 3 LIST THE NAME OF EACH REPORTABLE SINGLE SOURCE OF ... 3 LIST THE NAME OF EACH REPORTABLE SINGLE SOURCE OF
INCOME OF $10,000 OR MORE jAttach a separale sheet ,I necessary) INCOME OF $10,000 OR MORE jAttacll a sep...ate sheet ,r necessary)
... 4 INVESTMENTS AND INTERESTS IN REAL PROPERTY HELD BY THE ... 4. INVESTMENTS AND INTERESTS IN REAL PROPERTY HELD BY THE
BUSINESS ENTITY OR TRUST BUSINESS ENTITY OR TRUST
Check one box: Check one box:
o INVESTMENT 181 REAL PROPERTY o INVESTMENT 181 REAL PROPERTY
1912 E TAYLOR RD, CERES CA 95307 4512 WASHINGTON RD, TURLOCK, CA 95382
Name of Business Entity 2C Name of Business Entity 2C
Street Address or Assessor's Parcel Number of Real Property Street Address or Assessor's Parcel Number of Real Property
FAIR MARKET VALUE IF APPLICABLE, LIST DATE: FAIR MARKET VALUE IF APPLICABLE, LIST DATE:
0$2,000 - $10,000 0$2,000 - $10,000
0$10,001 - $100,000 ----,----,...1Q. ----'----'.JJL o $10,001 - $100,000 ----'----,JSL ----'----'JQ..
181$100,001 - $1,000,000 ACQUIRED DISPOSED 181$100,001 - $1,000,000 ACQUIRED DISPOSED
DOver $1,000,000 DOver $1,000,000
o Leasehold 7.""-~-'--
Yrs. remaining
o Olher - - - - - - -_ __ o Leasehold -:-;--="CC""
o Olher _ _ _ _ _ _ _ __
Yrs. remaining
D Check box if additional schedules reporting investments or real property D Check box if additional schedules reporting investments or real property
are attached are attached
Commen~: _______________________
FPPC Fonn 700 (2010/2011) Sch_ A-2
FPPC Toll-Free Helpline: 866/275-3772 www.fppc_ca_90v
SCHEDULE A-2 CALIFORNIA FORM
FAIR POLITICAL PRACTICES COMMISSION
700
Investments, Income, and Assets
Name
of Business EntitieslTrusts
(Ownership Interest is 10% or Greater) WILLIAM R BERRYHILL
WILLIAM & TRIANA BERRYHILL REVOCABLE TRUST WILLIAM & TRIANA BERRYHILL REVOCABLE TRUST
Name Name
1912 E TAYLOR RD, CERES CA 95307 1912 E TAYLOR RD, CERES CA 95307
Address (Business Address Acceptable) Address (Business Address Acceptable)
Check one Check one
~ Trust, go to 2 D Business Entity, complete the box, then go to 2 18] Trust, go to 2 D Business Entity, complete the box, then go to 2
FAIR MARKET VALUE IF APPLICABLE, LIST DATE: FAIR MARKET VALUE IF APPLICABLE, LIST DATE:
o $2,000 - $10,000 __L--'...1Q..
0$2,000 - $10,000
o $10,001 - $100,000 -'-'...1Q.. 0$10,001 - $100,000 -'-'...1Q.. -'-'...1Q..
o $100,001 - $1,000,000 ACQUIRED DISPOSED 0$100,001 - $1,000,000 ACQUIRED DISPOSED
DOver $1,000,000 DOver $1,000,000
II- 2 IDENTIFY THE GROSS INCOME RECEIVED (INCLUDE YOUR PRO RATA ... 2 IDENTIFY THE GROSS INCOME RECEIVED (INCLUDE YOUR PRO RATA
SHARE OF THE GROSS INCOME !Q THE ENTITYfTRUST) SHARE OF THE GROSS INCOME TO THE ENTITYfTRUST)
.. 3 LIST THE NAME OF EACH REPORTABLE SINGLE SOURCE OF .. 3 LIST THE NAME OF EACH REPORTABLE SINGLE SOURCE OF
INCOME OF $10,000 OR MORE (Attach a separate sheet If necessary) INCOME OF $10,000 OR MORE (Attach ~ separate sheet If necessary)
.. 4 INVESTMENTS AND INTERESTS IN REAL PROPERTY HELD BY THE .. 4 INVESTMENTS AND INTERESTS IN REAL PROPERTY HELD BY THE
BUSINESS ENTITY OR TRUST BUSINESS ENTITY OR TRUST
Check one box: Check one box:
o INVESTMENT 181 REAL PROPERTY o INVESTMENT 181 REAL PROPERTY
31353 MACKVILLE RD, HERALD, CA 13500 MACKVILLE RD, HERALD, CA
Name of Business Entity Q( Name of Business Entity Q(
Street Address or Assessor's Parcel Number of Real Property Street Address or Assessor's Parcel Number of Real Property
FAIR MARKET VALUE IF APPLICABLE, LIST DATE: FAIR MARKET VALUE IF APPLICABLE, LIST DATE:
0$2,000 - $10,000 o $2,000 - $10,000
0$10,001 - $100,000 -'-'~
ACQUIRED
-'-'...1Q..
DISPOSED
o $10,001 - $100,000
ACQUIRED DISPOSED
0$100,001 - $1,000,000 0$100,001 - $1,000,000
181Over $1,000,000 181Over $1,000,000
... 2 IDENTIFY THE GROSS INCOME RECEIVED (INCLUDE YOUR PRO RATA ... 2 IDENTIFY THE GROSS INCOME RECEIVED (INCLUDE YOUR PRO RATA
SHARE OF THE GROSS INCOME TO THE ENTITYITRUST) SHARE OF THE GROSS INCOME TO THE ENTITY/TRUST)
... 3 LIST THE NAME OF EACH REPORTABLE SINGLE SOURCE OF ... 3 LIST THE NAME OF EACH REPORTABLE SINGLE SOURCE OF
INCOME OF $10,000 OR MORE (Attach a separa!e sl"leet ,f necessary) INCOME OF $10,000 OR MORE (Attacl"l a separa!Q sheet 'f necessJrv)
... 4 INVESTMENTS AND INTERESTS IN REAL PROPERTY HELD BY THE ... 4 INVESTMENTS AND INTERESTS IN REAL PROPERTY HELD BY THE
BUSINESS ENTITY OR TRUST BUSINESS ENTITY OR TRUST
Check one box: Check one box:
o INVESTMENT o REAL PROPERTY o INVESTMENT I8J REAL PROPERTY
13193 CARMEN LN, CHICO, CA 95973
Name of Business Entity Q[ Name of Business Entity Q[
Street Address or Assessor's Parcel Number of Real Property Street Address or Assessor's Parcel Number of Real Property
FAIR MARKET VALUE IF APPLICABLE, LIST DATE: FAIR MARKET VALUE IF APPLICABLE, LIST DATE:
0$2,000 - $10,000 0$2,000 - $10,000
0$10,001 - $100,000 0$10,001 - $100,000 -1--.l~ --.l--.l~
0$100,001 - $1,000,000 ACQUIRED DISPOSED 0$100,001 - $1,000,000 ACQUIRED DISPOSED
DOver $1,000,000 jgI Over $1,000,000
NATURE OF INTEREST NATURE OF INTEREST
o Property Ownership/Deed of Trust o Stock o Partnership 1&1Property Ownership/Deed of Trust o Stock o Partnership
o Leasehold o Other _ _ _ _ _ _ _ _ __
o Leasehold =-,,-== o Other _ _ _ _ _ _ _ _ __
Yts. remaining Yts. remaining
o Check box if additional schedules reporting investments or real property
are attached
D Check box if additional schedules reporting investments or real property
are attached
Comments: BFLP IS A PARTNER IN PAIVIA BERRYHILL ORCH. FPPC Fonn 700 (2010/2011) Sch. A-2
FPPC Toll-Free Helpline: 866/275-3772 www.fppc.ca.gov
SCHEDULE A-2 CALIFORNIA FORM 700
FAIR POLITICAL PRACTICES COMMISSION
Investments, Income, and Assets
Name
of Business EntitieslTrusts
(Ownership Interest is 10% or Greater) WILLIAM R BERRYHILL
WILLIAM & TRIANA BERRYHILL REVOCABLE TRUST WILLIAM & TRIANA BERRYHILL REVOCABLE TRUST
Name Name
1912 E TAYLOR RD, CERES CA 95307 1912 E TAYLOR RD, CERES CA 95307
Address (Business Address Acceptable) Address (Business Address Acceptable)
Check one Check one
~ Trust, go to 2 D Business Entity, complete the box, then go to 2 ~ Trust, go to 2 o Business Entity, complete the box, then go to 2
FAIR MARKET VALUE IF APPLICABLE, LIST DATE: FAIR MARKET VALUE IF APPLICABLE, LIST DATE:
0$2,000 - $10,000 0$2,000 - $10,000
0$10,001 - $100,000 ___L..J.JJL
ACQUIRED
----1----1.JJL
DISPOSED
o $10,001 - $100,000 ----1----1.JJL
ACQUIRED
----1----1.JJL
DISPOSED
0$100,001 - $1,000,000 0$100,001 - $1,000,000
DOver $1,000,000 DOver $1,000,000
NATURE OF INVESTMENT NATURE OF INVESTMENT
o Sale Proprietorship o Partnership 0
Other
o Sale Proprietorship o Partnership 0
Other
YOUR BUSINESS POSITION YOUR BUSINESS POSITION
... 2 IDENTIFY THE GROSS INCOME RECEIVED (INCLUDE YOUR PRO RATA II- 2. IDENTIFY tHE GROSS INCOME RECEIVED (INCLUDE YOUR PRO RATA
SHARE OF THE GROSS INCOME !Q THE ENTITYITRUST) SHARE OF THE GROSS INCOME TO THE ENTITYITRUST)
... 3 LIST THE NAME OF EACH REPORTABLE SINGLE SOURCE OF ... 3 LIST THE NAME OF EACH REPORTABLE SINGLE SOURCE OF
INCOME OF $10,000 OR MORE rA"ach a separate sheet ,f necessary • INCOME OF $10,000 OR MORE (Attach a separate sheet If necessary I
... 4 INVESTMENTS AND INTERESTS IN REAL PROPERTY HELD BY THE ... 4 INVESTMENTS AND INTERESTS IN REAL PROPERTY HELD BY THE
BUSINESS ENTITY OR TRUST BUSINESS ENTITY OR TRUST
Check one box: Check one box:
o INVESTMENT 181 REAL PROPERTY o INVESTMENT 181 REAL PROPERTY
1472 E TAYLOR RD, CERES, CA 95307 1555 E TAYLOR RD, CERES CA 95307
Name of Business Entity Q[ Name of Business Entity Q[
Street Address or Assessor's Parcel Number of Real Property Street Address or Assessor's Parcel Number of Real Property
FAIR MARKET VALUE IF APPLICABLE, LIST DATE: FAIR MARKET VALUE IF APPLICABLE, LIST DATE:
0$2,000 - $10,000 0$2,000 - $10,000
0$10,001 - $100,000 ----1----1.JJL ----1----1.JJL 0$10,001 - $100,000 ----1----1.JJL ----1----1.JJL
0$100,001 - $1,000,000 ACQUIRED DISPOSED 0$100,001 - $1,000,000 ACQUIRED DISPOSED
~ Over $1,000,000 181Ove' $1,000,000
Name
Positions
(Other than Gifts and Travel Payments) WILLIAM R BERRYHILL
WESTAMERICA BANCORPORATION
ADDRESS (Business Address Acceptable) ADDRESS (Business Address Acceptable)
FAIRFIELD, CA
BUSINESS ACTIVITY, IF ANY, OF SOURCE BUSINESS ACTIVITY, IF ANY, OF SOURCE
BANKING
YOUR BUSINESS POSITION YOUR BUSINESS POSITION
SHAREHOLDER
GROSS INCOME RECEIVED GROSS INCOME RECEIVED
D $500 - $1,000 D $1,001 - $10,000 D $500 - $1,000 D $1,001 - $10,000
1&1 $10,001 - $100,000 DOVER $100,000 D $10,001 - $100,000 DOVER $100,000
CONSIDERATION FOR WHICH INCOME WAS RECEIVED CONSIDERATION FOR WHICH INCOME WAS RECEIVED
D Salary o Spouse's or registered domestic partner's income o Salary 0 Spouse's or registered domestic partner's income
D Loan repayment o Partnership o Loan repayment o Partnership
D Sale of _ _ _ _ _ _-;;::--,-.,--_,--,:-:--;-_ _ _ _ __ D Sale of ------==~___;_,_,:""C77"-----
(Property, car, boat. etc.) (Property, car. boat, etc.)
o Commission or o Rental Income, list each source of $10,000 or more o Commission or o Rental Income, fist each source of $10,000 or more
* You are not required to report loans from commercial lending institutions, or any indebtedness created as part
of a retail installment or credit card transaction, made in the lender's regular course of business on terms
available to members of the public without regard to your official status. Personal loans and loans received
not in a lender's regular course of business must be disclosed as follows:
_ _ _~% o None
ADDRESS (Business Address Acceptable)
SECURITY FOR LOAN
Comments:
2300 RIVER PLAZA DR, SACRAMENTO, CA 95833 1221 H ST, SACRAMENTO, CA 95814
BUSINESS ACTIVITY, IF ANY, OF SOURCE BUSINESS ACTIVITY, IF ANY, OF SOURCE
DATE (mm/dd/yy) VALUE DESCRIPTION OF GIFT(S) DATE (mmfdd/yy) VALUE DESCRIPTION OF GIFT(S)
----1---.J_ $_ __
425 MARKET ST, STE 1000, SAN FRANCISCO, CA 1020 PROSPECT ST, STE 310, LA JOLLA, CA 9203
BUSINESS ACTIVITY, IF ANY, OF SOURCE BUSINESS ACTIVITY, IF ANY, OF SOURCE
DATE (mm/dd/yy) VALUE DESCRIPTION OF GIFT(S) DATE (mm/dd/yy) VALUE DESCRIPTION OF GIFT(S)
~~~ $, _ _5_0_.1_3 FOOD & BEVERAGE ~2.J~ $ 205.30 FOOD & BEVERAGE
$ $
4640 SPYRES WAY, STE 4, MODESTO,CA 95356 520 CAPITAL MALL,STE 260, SACRAMENTO, CA
BUSINESS ACTIVITY, IF ANY, OF SOURCE BUSINESS ACTIVITY, IF ANY, OF SOURCE
DATE (mm/dd/yy) VALUE DESCRIPTION OF GIFT(S) DATE (mm/dd/yy) VALUE DESCRIPTION OF GIFT(S)
----1----1_ $_ _ _ ----1---.J_ $ _ _ __
----1----1_ $_ _ _ ----1---.J_ $ _ _ __
Commenm: __________________________________________________________________________
11160 SUN CENTER DR, RANCHO CARDOVA, CA 777 S FIGUEROA ST, STE 4050, L.A., CA 90017
BUSINESS ACTIVITY, IF ANY, OF SOURCE BUSINESS ACTIVITY, IF ANY, OF SOURCE
DATE (mm/dd/yy) VALUE DESCRIPTION OF GIFT(S) DATE (mm/dd/yy) VALUE DESCRIPTION OF GIFT(S)
1530 J ST, STE 400, SACRAMENTO, CA 95814 1000 G ST, STE 230, SACRAMENTO, CA 95814
BUSINESS ACTIVITY, IF ANY, OF SOURCE BUSINESS ACTIVITY. IF ANY. OF SOURCE
DATE (mm/dd/yy) VALUE DESCRIPTION OF GIFT(S) DATE (mm/dd/yy) VALUE DESCRIPTION OF GIFT(S)
~~~ ...
$ __9_2._68_ FOOD & BEVERAGE ~ 26 /~ $_--=2::....1--=.3-'-6 FOOD & BEVERAGE
$ $
500 BUENA VISTA, BURBANK, CA 91521 1215 K ST, STE 2030, SACRAMENTO, CA 98814
BUSINESS ACTIVITY, IF ANY, OF SOURCE BUSINESS ACTIVITY. IF ANY. OF SOURCE
DATE (mmldd/yy) VALUE DESCRIPTION OF GIFT(S) DATE (mmldd/yy) VALUE DESCRIPTION OF GIFT(S)
~~~ $~_ _4=2~0 TICKET DISCOUNTS ~~~ $,_ _ _2_00_ 2 TICKETS MOD COC
Commenw: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __
DATE (mmfddfyy) VALUE DESCRIPTION OF GIFT(S) DATE (mmlddfyy) VALUE DESCRIPTION OF GIFT(S)
~--1_ $, _ _ __ ~--1_ $ _ _ __
DATE (mmfddfyy) VALUE DESCRIPTION OF GIFT(S) DATE (mmlddfyy) VALUE DESCRIPTION OF GIFT(S)
$---- $
DATE (mmlddfyy) VALUE DESCRIPTION OF GIFT(S) DATE (mmlddfyy) VALUE DESCRIPTION OF GIFT(S)
~--1_ $,_ _ __
~~- $----
Commenm: __________________________________________________________________________________