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PL 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 ~0 of J~3 <br /> <br />Election: [~ PrimmT 2004 [] General 200~4 [] Other__ <br />Report: [] 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 Polincal Committee tincludes business and union -PACs) CO Cosigner Obligation <br /> F Candidate's immediate Family (,includes candidate) ilk 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-Kind Purpose <br /> Dne ¢¢ Name and Address of Contributor <br /> Contribution (see manual for suggested purpose codes) <br /> Occupational Information or Contributor <br /> Date Received Contnbuttng Committee's ID# Aggregate Code '1 , Code 2 <br /> <br /> Jack Roberts 2330 Park Grove <br /> 1 Dr Eugene OR 97408 $ 100 00 <br /> <br /> 7/11/2004 Director, Lane Metro Partnership $ 100 00 t CA <br /> <br /> Roz Siowc 4801 Donald St <br /> 2. Eugene OR 97405 $ 100 00 <br /> <br /> 812512004 Research Assistant $ 100 00 I I CA <br /> <br /> Stephen Smith 128 <br /> 3~ Lynbrook Dr Eugene OR $ 100 00 <br /> 97404 <br /> <br /> 8/25/2004 Retired $ 100 00 i CA <br /> <br /> Mike Staszak 61 W. 31st <br /> 4 Eugene OR 97405 $ 100.00 <br /> <br /> 8/24/2004 Physical Therapist $ 100 00 I CA <br /> <br /> Kathenne %ppens W~per <br /> 5. 3772 P~ne Canyon Dr $ 100 00 <br /> Eugene OR 97405 <br /> <br /> Retired $ 225 00 1 <br /> 8/24/2004 <br /> CA <br /> <br /> See Page Totals (Add all amounts with the same Accounting Period Totals (Complete onl~ for last page and <br /> Instructions contribution type. Do not include aggregates.) transfer these amounts to the Summary Statement. PC 1.) <br /> <br /> on Back and Cash (CA) $ 500 00 Cash (CA) <br /> in Cmnpaign Enter on Stwmnary Statement, Column A_ L,ne l <br /> Finance <br /> Manual In-Kind (IK) $ ~ In-Kind (1K) $ <br /> Enter on Smnmary Statement, Column A. Lines 4 and 9 <br /> <br /> PC 2 Loans Received (LR; $ __ Loans Received (LR) $ <br /> Enter on Sumrnap_, Statement Column A. Line 2 <br /> <br /> <br />