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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 12 of ~[ <br /> <br />Election: [~ Primary 200_A4 [~] General 20__ [] Other__ <br />Report' ~ 1st Pre-election [~ 2nd Pre-election [] Post-election [] 20__ September Supplemental <br /> <br />SEE BACK FOR INSTRUCTIONS AND CODE DEFINI[TIONS; <br /> CODE t: Contributor Type CODE 2: Contribution Type <br /> B Business Entity CA Cash <br /> C Political Committee (includes business and union PACs) CO Cosigner Obhgation <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-Kind Purpose <br /> Line # Name and Address of Contributor <br /> Contnbutton (see manual for suggested purpose codes) <br /> <br /> Date ReceIved Occupational Information or Contributor Code 1 Code 2 <br /> Contributing Committee's IDI¢ Aggregate <br /> <br /> Anne Forrestel 2745 <br /> 1 Lincoln St. Eugene OR $ 100 00 <br /> 97405 <br /> <br /> 4/4/2004 University Instuctor $ 100 00 I CA <br /> <br /> Ava Milosevlch 3198 <br /> 2 Metolius Dr~ Eugene OR $ 100 00 <br /> 97408 <br /> <br /> 4/20/2004 CEO--Financial tnstttutlon $ 100,00 I CA <br /> <br /> BarbaraShirk 3115 Harris St. <br /> 3. Eugene OR 97405 $ 100 00 <br /> <br /> 4~28/2004 Retired $ 100 00 I CA <br /> <br /> BarbaraPerry 5338 Tahslh St, <br /> 4 Eugene OR 97405 $ 100 00 <br /> <br /> 4/15~2004 Psychologist $ 100.00 I CA <br /> <br /> BarbaraBerkley 100 W. 37th Ave <br /> 5 Eugene OR 97405 $ 100 00 <br /> <br /> 4/3~2004 Teacher $ 100 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.) transfer these amounts to the Summary Statement. PC 1. ~ <br /> on Back and Cash (CA) $ 500 00 Cash (CA) $ _ <br /> in Campaign Enter on Summar5 btatemcnt, Colmnn A. Line t <br /> Finance <br /> Manual ln-Kind (1K) $ ~ in-Kind { IK) $ <br /> Enter on SummaO Stateroom, Column A. Lines 4 c,~d v <br /> <br /> PC 2 Loans Received (LR) $ ~ Loans Received (LR) $ ~ <br /> Ente~ on SummaU Stateroom Loltmm A. Line 2 <br /> <br /> <br />