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PC 2 <br /> Cash Contributions, Loans Received and In-Kind <br />Candidate or Political Committee Name: Committee ID Number: <br />Kitty Piercy for Mayor n/a Page 1_ of_l~ <br /> <br />Election: E~] Primary 20¢4 [] General 200~4 [] Other ~ <br />Report' [] I st Pre-election [] 2nd Pm-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 In-K~nd Purpose <br /> Dne # Name and Address of Contributor <br /> Contribution (see manual for suggested purpose codes) <br /> Occupational Information or Contributor <br /> Date Received Contribut~nq Committee's ID¢¢ Aggregate Code '/ , Code 2 <br /> <br /> McKenzie-W~llamette Hospital 1460 G <br /> 1 Street Springfield OR 97477 $ 1,000 00 <br /> <br /> 6/21/2004 $ 1,000 00 B <br /> CA <br /> <br /> David Van W~e P O Box 5610 <br /> 2. Eugene OR 97405 $ 1,000 00 <br /> <br /> 6/14/2004 venture capltahstJmvestor $ 1,000 00 I CA <br /> <br /> Anita Johnson 2288 B,rch Lane <br /> 3 Eugene OR 97403 $ 500 00 <br /> <br /> 7/11/2004 <br /> Journalist $ 500 00 ~ CA <br /> <br /> Jonathon Brandt 401 E. 10th Ave. <br /> 4 Suite 530 Eugene OR 97401 $ 300 00 <br /> <br /> Financial Planner $ 300 00 ~ 1 <br /> 8/19/2004 <br /> CA <br /> <br /> Nancy Rose 2690 Lawrence Eugene OR <br /> 5. 97405 $ 300.00 <br /> <br /> 6/18/2004 Retired $ 300 00 I CA <br /> <br /> See Page Totals (Add all amounts with the same Accounting Period Totals (Complete only for last page and <br /> Instructions contribution type. Do not include aggregates.) transfbr these amounts to the Summary Statement, PC 1 .) <br /> <br /> on Back and Cash (CA/ $ 3,100 00 Cash (CA) $ ~ <br /> in Campaign Enter on Summary Statement, Colttmn A. Line 1 <br /> Finance <br /> Manual ln-K~nd (IK) $ In-Kind (IK) $ - <br /> Enter on Starumm2~ Statement. Column ALmcs 4 :md 9 <br /> <br /> PC 2 Loans Received (LR? $ ~ Loans Rece~¥ed (LR} $ _ <br /> <br /> <br />