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Cash Contributions, Loans Received and In-Kind <br />Candidate or Political Committee Name: Committee 1D Number: <br />Kitty Piercy for Mayor n/a Page 12 of <br /> <br />Election: ~ Primary 200_A4 [] General 20__ [] Other __ <br />Report: E~ 1st Pre-election [] 2nd Pre-election ~ Post-election [] 20__ September Supplemental <br /> <br />SEE BACK FOR INSTRUCTIONS AND CODE DEFINITIONS <br /> CODE 1: Contributor Type CODE 2: Contribution Type <br /> B Business Entity CA Cash <br /> C Political Committee (includes business and union PACs) CO Cosigner Obligation <br /> F Candidate's Immediate Family (includes candidate) IK In-Kind <br /> t Individual LR Loan Received <br /> L Labor Organization <br /> O Other <br /> P Political Party Committee <br /> <br /> Amount of In-Kind Purpose <br /> Line # Name and Address of Contributor <br /> Contribution (see manual for suggested purpose codes) <br /> <br /> Date Received Occupational Information or Contributor Code 1 Code 2 <br /> Contributing Commzttee~ ID# Aggregate <br /> <br /> Harriet Merrick 1332 Oak Patch Rd. Apt 84 <br /> 1 Eugene OR 97402 $ 50.00 <br /> <br /> 5/16/2004 <br /> Manager-Purchasing UO $ 450.00 I CA <br /> <br /> Amy Carpenter 1280 Mill St <br /> 2 Eugene OR 97401 $ 200 00 <br /> <br /> 5/13t2004 OwnedManager, Book Universe, Inc. $ 400.00 I CA <br /> <br /> Amy Carpenter 1280 Mill St. <br /> 3 Eugene OR 97401 $ 25.00 <br /> <br /> 5~20/2004 <br /> OwnedManager, Book Universe, Inc. $ 425.00 I CA <br /> <br /> R,chard Coolman 3345 Storey Blvd. <br /> 4 Eugene OR 97405 $ 100.00 <br /> <br /> Developmental Pediatrician $ 300 00 <br /> 5/1 <br /> 7/2O04 <br /> CA <br /> <br /> Greg McLauchlan 2401 W. 22nd. Ave. <br /> 5 Eugene OR 97405 $ 300.00 <br /> <br /> 5/16/2004 Professor $ 300.00 ~ I CA <br /> <br /> See Page Totals (Add all amounts with The same Accounting Period Totals (Complete only ~¥r last page and <br /> Instructions contribution type, Do not include aggregates.) transfer these amounts to the Summary Statement, PC <br /> <br /> on Back a~d Cash (CA) $ 675.00 Cash (CA) $ <br /> in Campaign E~ter on Smmria~ Statement. Colmnn <br /> Finance <br /> Manual in-Kind (1K) $ In-Kind (IK) $ __ <br /> Enter on Smmnary Statement, Column <br /> <br /> PC 2 Loans Received (LR) $ Loans Received <br /> Enter m~ Summar} Statement Colmnn A~ Line 2 <br /> <br /> <br />