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PC <br /> Summary Statement of Contributions and Expenditures Rev <br /> <br />Please type or print leg,bly m black ink Page 2 of 2 <br />Candidate or Pohtical Committee Name' Committee ID Numben <br />Andrea Ort~z for City Council N/A <br /> <br /> Ong,nal ~ Pr,mary 20 04 [] General 20 [] Other <br />Amendment [] 1st Pre-election ]~ 2nd Pre-election [] Post-elect,on [] 20 September Supplemental <br /> LOAN SUMMARY <br />21. Beginmng Outstanding Loans FOR OFFICE USE ONLY <br />(line 29 of pre¥1ous report) 0.00 <br />22 Loans Received ('Non-Exempt) + 745.00 <br />(hne 2) <br />23. Loans Received (Exempt) + 0 00 <br />(hne 14) <br />24 LOANS RECEIVED SUBTOTAL <br />(lines 21 + 22 + 23) = 745.00 <br />25. Loan Payments (Non-Exempt) <br />(line 7) 0.00 <br />26 Loan Payments (Exempt) + 0.00 <br />(line 18) <br />27 Forg,ven Loans + 0.00 <br />(Total loans lbrgiven dunng this accounting period) <br />28 LOAN PAYMENT SUBTOTAL <br /> = 0.00 <br />(lines 25 + 26 +27) <br />29. TOTAL OUTSTANDING LOANS <br /> = 745.00 <br /> (line 24 minus line 28) <br /> PERSONAL EXPENDITURE SUMMARY <br /> 30. Beg~nmng Outstanding Personal Expenditures 879.00 <br /> (line 36 of previous report) <br />31 Personal Expenchtures + 0.00 <br /> (Accounting Period Total from PC 3A) <br />32 PERSONAL EXPENDITURE SUq3TOTAL <br /> = 879.00 <br /> (lines 30 + 31) <br /> 33 Personal Expenditure Rmmbursements 87~.00 <br /> (Total expenditures on PC 3 w~th purpose code R) <br /> 34 Forgiven Personal Expenchtures + 0.00 <br /> (Total personal expenditures tbrgiven th~s acctg period) <br /> 35. REJMB~SE~ SUBTOTAL <br /> = 879.00 <br /> (lines 33 + 34) <br />36 OUTSTANDING PERSON.kL EXPENDITURES <br /> = 0.00 <br /> (hne 32 minus line 35) <br /> FINANCIAL STATUS AT CLOSE OF ACCOUNTING PERIOD <br /> 37 Endmg Cash Balance 2,276.28 <br /> (hne 20) <br /> 38 Accounts Receivable + 500.00 <br /> (Accounting Period Total from PC 5) <br />39 SUBTOTAL <br /> = 2,77~.28 <br /> (lines 37 + 38) <br /> 40 Total Outstanding Loans 745.00 RECEIVED <br /> (hne 29) <br /> 41 Outstanding Personal Expenditures + 0.00 ~{IJ¥'{' 0 ~ 200~} <br /> (line 36) <br /> 42 Accounts Payable + 0.00 <br /> (Accommng Period Total from PC 6) 01TY <br /> 43 SUBTOTAL = 745.00 <br /> (lines 40 + 41 + 42) <br /> 44 BALANCE/DEFICIT <br /> = 2,031.28 <br /> (line 39 minus hne 43 in&cate + or - balance) <br /> <br /> I, Tamara Miller (name of candidate or treasurer), hereby certify that the above <br /> statement and the attached supporting reports are true and correct <br /> <br /> ~' ' Date signed <br /> S,gnature of can&date or ~easurer ~' ~ ~ ~ <br /> <br /> <br />