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Cash Contributions, Loans Received and <br />Candidate or Political Committee Name: Committee [D Number: <br />Kitty Piercy for Mayor n/a Page <br /> <br />Election: [] Primary 2004 E~ General 20__ g~ Other __ <br />Report: [~ l s~ 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 /> I Individual LR Loan Received <br /> L Labor Organization <br /> O Other <br /> P Political Party Committee <br /> <br /> Amount of fn-Kmd Purpose <br /> Line # Name and Address of Contributor <br /> Contribution (see manual for suggested purpose codes) <br /> Occupational information or Contributor <br /> Date Received Contributing Commtttee's lDO Aggregate Code 1 , Code 2 <br /> Dwight Collins 1600 Orchard St. <br /> 1. Eugene OR 97403 $ 250.00 <br /> <br /> 5/11/2004 <br /> Owner of Fish Market $ 250.00 I CA <br /> <br /> Peggy Collins 1600 Orchard St. <br /> 2 Eugene OR 97403 $ 250.00 <br /> <br /> Teacher $ 250.00 <br /> 5/1 <br /> 1/2004 <br /> CA <br /> <br /> Lmda Oppenheimer 1234 E. 21st Ave <br /> 3 Eugene OR 97403 $ 250.00 <br /> <br /> 5/10/2004 <br /> Physician $ 250.00 ~ CA <br /> <br /> Thelma Soderqu~st 2577 N~xon St. <br /> 4, Eugene OR 97403 $ 50.00 <br /> <br /> Unemployed $ 250.00 <br /> 5/21/2004 <br /> CA <br /> <br /> Stephen Allanketner 212 Crest <br /> 5 Dr Eugene OR 97405 $ 200~00 <br /> <br /> 5/17/2004 Psychologist $ 250.00 i CA <br /> <br /> See Page Totals (Add all arnour~ts with the same Accounting Period Totals (Complete only for last page and <br /> Instructions contribution ~,pe. Do not include ag~egates.) transfer these amounts to the Summary Statement, PC 1.) <br /> <br /> on Back and Cash (CA) $1,000.00 Cash (CA) $ ~ <br /> in Campaign Ente~ on SummaD Statemem, Cok~mr~ &~ Line t <br /> Finance <br /> Manual In-Kind (IK) $ In-Kind ([K) $ <br /> Emer ca Stmm~ar~ Statement Cotumm & Lines 4 ,,nd 9 <br /> <br /> PC 2 Loans Received (LR} $ Loans Received (LR} $ ~ <br /> Enter on Summar5 Statement Collator A, Line 2 <br /> <br /> <br />