Image# 201507109000082095 FOR LINE NUMBER: PAGE OF SCHEDULE A-P PAGE 14 / 46 Use separate schedule(s) (check only one) ITEMIZED RECEIPTS for each category of the 16 17a 17b 17c 17d 18 Detailed Summary Page 19a 19b 20a 20b 20c 21 Any information copied from such Reports and Statements may not be sold or used by any person for the purpose of soliciting contributions or for commercial purposes, other than using the name and address of any political committee to solicit contributions from such committee. NAME OF COMMITTEE (In Full) Chafee 2016 Full Name (Last, First, Middle Initial) A. John Koza Transaction ID : VR05BAS19G5 Date of Receipt Mailing Address PO Box 1441 M M / D D / Y Y Y Y 04 10 2015 City State Zip Code Los Altos CA 94023-1441 FEC ID number of contributing C federal political committee. Amount of Each Receipt this Period Name of Employer Occupation 2700.00 National Popular Vote, Inc. Information Requested , , .  V V V Receipt For: Election Cycle-to-Date W Primary General Other (specify) 2700.00 W , , .  V V V B. Full Name (Last, First, Middle Initial) Transaction ID : VR05BAS11H5 Jaime Longhi Date of Receipt Mailing Address 75 Todd Hill Rd M M / D D / Y Y Y Y 04 10 2015 City State Zip Code West Cornwall CT 06796-1709 FEC ID number of contributing C federal political committee. Amount of Each Receipt this Period Name of Employer Occupation 250.00 22/7 Pictures, Inc. video documentary prod/director , , .  V V V Receipt For: Election Cycle-to-Date W Primary General Other (specify) 250.00 W , , .  V V V Full Name (Last, First, Middle Initial) Transaction ID : VR05BAS1184 C. GA Nassikas Date of Receipt Mailing Address 6115 Ramshorn Pl M M / D D / Y Y Y Y 04 10 2015 City State Zip Code McLean VA 22101-2421 FEC ID number of contributing C federal political committee. Amount of Each Receipt this Period Name of Employer Occupation 1000.00 self artist , , .  V V V Receipt For: Election Cycle-to-Date Primary General W Other (specify) 1000.00 W , , .  V V V Subtotal Of Receipts This Page (optional)............................................................................... 3950.00 W  V V V , , . Total This Period (last page this line number only) ........................................................ W , , .  V V V FEC Schedule A±P (Form 3P) (Rev. 03/2011)