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Cash Contributions, Loans Received and In-Kind <br />Candidate or Political Committee Name: Committee ID Number: <br />Kitty Piercy for Mayor n/a Page 16 of ~ <br /> <br />Election: [~ Primary 200_¢_4 [] General 20__ [] 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 /> g Business Entib' CA Cash <br /> C Political Committee (includes business and union PACs l CO Cosigner Obligation <br /> F Candidate's Immediate Family (includes candidate) 1K in-Kind <br /> I Individual LR Loan Received <br /> L Labor Organization <br /> 0 Other <br /> P Pohtmal Party Committee <br /> <br /> Amount of ln-t<~nd Purpose <br /> bne # 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 Committee's ID# Aggregate <br /> <br /> Dawd Kelly <br /> 1 1040 Ferry St #B405 $ 100 00 <br /> Eugene OR 97401 <br /> <br /> 1/28f2004 computer systems consultant $ 100 00 I CA <br /> <br /> HeatherKent <br /> 2 24214 Suttle Rd. $ 250 00 <br /> Veneta OR 97487 <br /> <br /> 2t1212004 consultant for small businesses $ 250 00 I CA <br /> <br /> Judith Krug <br /> 3 2551 Foothdls Dr $ 100 00 <br /> B~rmingham AL 35226 <br /> <br /> 3/2112004 Professor $ 100.00 ~ CA <br /> <br /> Georgia Layton <br /> 4 2324 W 28th Ave $ 100 00 <br /> Eugene OR 97405 <br /> <br /> 3/10/2004 Preschool D~rector $ 100 00 I CA <br /> <br /> Mona Lmstromberg <br /> 5 87140 Terntonal Rd $ 100 00 <br /> Veneta OR 97487 <br /> <br /> 1/26/2004 Licensed Tax Consultant $ 100 00 I CA <br /> <br /> Sec Page Totals (Add all amounts w~th the same Accounting Period Totals (Complete only for last page and <br /> Instructions contribution type. Do not include aggregates.) transtar these amounts to the Summary Statement, PC 1.) <br /> <br /> on Back and Cash (CA) $ 650 00 Cash iCA) $ <br /> m Campaign ~:,~r ot~ Smm~mp, Stattm~¢t~t ~ olt~mu K Linc [ <br /> Finance <br /> Manual Ia-Kind (iK) $ ~ In-Kind (IKt $ __ <br /> <br /> PC' 2 Loans Received (LR) $ __ Loans ]Received (LR) $ __ <br /> <br /> <br />