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PC ~ <br /> Cash Contributions, Loans Received and In-Kind ,:,,, <br /> <br />Candidate or Political Committee Name: Cormnittee ID Number: <br />Nancy Nathanson for Mayor Page 2 of 18 <br /> <br />Election: [] Primary 200_3_4 [] General 200_A4 [] Other <br />Report: [] 1st Pre-election [] 2nd Pre-election [] Post-election [] September Supplemental <br /> <br />SEE BACK FOR ~[NSTRUCTIONS AND CODE DEFINliTIONS <br /> <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 IndNidual LR Loan Received <br /> L Labor Organization <br /> O Other <br /> P Political Party Committee <br /> Amount of in-Kind Purpose <br /> Dne# Name and Address of Contributor <br /> Contribution (see manual for suggested purpose codes) <br /> Occupational Information, Contributing Cont~butor i <br /> Date Received Committee's lDO, or Descnptlon rf Code lls "0" Aggregate Code ~ , Code 2 <br /> <br /> Divine & Hammer <br /> <br /> 1. $ 200 00 <br /> <br /> 5/7/04 $ 200 00 B CA <br /> <br /> Chuck's Servme Center <br /> <br /> 2. $ 100.00 <br /> <br /> 5/7/04 $ 100.00 B <br /> CA <br /> <br /> Chambers Construction <br /> 3 $ 1000.00 <br /> <br /> 5/7/04 $ 1000 00 B CA <br /> <br /> Triad Good Government Fund <br /> <br /> 4 $ 1000.00 <br /> <br /> 5/10/04 $ 1000 00 B CA <br /> <br /> The Utum Group <br /> <br /> 5 $ 25O 00 <br /> <br /> 5/10/04 $ 350 00 B <br /> CA <br /> <br /> See Page Totals (Add all amounts with the same Accounting Period Totals (Complete only for last page and <br /> <br /> Instructions contribution type, Do not include aggregates.) transfer these amounts to the Summary Statement, PC 13 <br /> <br /> on Back and Cash (CA) $ 2550 00 Cash (CA) $ <br /> Ca~pa~ll Lnt~r on Stanmary Statemem. Cokmm A. Line <br /> Finance ln-Kind ([K) $ _ In-Kind (IK) $ __ <br /> l¥~allna~ Ent~.r on Snmma~ Sta*ement Colamn A~ Lines 4 ,md 9 <br /> <br /> Loans Received (LR} $ __ Loans Received (LR~ $ _ <br /> PC 2 Lurer on Strmraary Smtemeut, Coltann A Line 2 <br /> <br /> <br />