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PC 2 <br /> Cash Contributions, Loans Received and In-Kind e,r <br />Candidate o~ Pohtmal Committee Name: Comn~ttee ID Number <br />Andrea Ortiz for City Council NIA Page 6 of 6 <br /> <br />Election [] Prrmary 20 04 [] General 20., [] E~her <br />Report' [] 1st Pre-electron [] 2nd Pre-electron [] Post-elect~on [] 20 __ September Supplemental <br /> <br />SEE BACK FOR INSTRUCTIONS AND CODE DEFINITIONS <br /> <br /> CODE 1: Contributor Type CODE 2: Contribution Type <br /> B Business Entity CA_ Cash <br /> C Pohtmal Committee 0ncludes business and umon PACs) CO Coszgner Obhgatmn <br /> F Candidate's Immediate Famdy 0ncludes candidate) IK in-Kind <br /> I indzwdual LR Loan Received <br /> L Labor Orgamzation <br /> O Other <br /> P Pohucal Party Committee <br /> <br /> Amount of In-Kind Purpose <br /> Line # Name and Address of Contnbutor Confnbuf¢on (see manual for suggested purpose codes) <br /> <br /> Occupational Information or Contnbutor Code ~ [ Code 2 <br /> Date Received Contributing Committee's ID# Aggregate <br /> <br /> Mary O'Bnen <br /> 1 3525 Gilham Road $ 100.00 <br /> Eugene, OR 97408 <br /> <br /> 4/24/2004 Professor $ 100.00 I CA <br /> <br /> Dawd Witkin, M.D. <br /> 2. 1755 Coburg Road, Ste 6 $ 100.00 <br /> Eugene, OR 97401 <br /> <br /> Physician $ 100.00 I I CA <br /> 4/26/2004 <br /> <br /> Pat Hadley P <br /> 3 2611 Edison $ 214,00 <br /> Eugene, OR 97402 <br /> <br /> Political Consultant $ 214.00 I I IK <br /> 4/3O/20O4 <br /> <br /> M~scellaneous Cash Contnbutlons $50 and Under <br /> 4. $ 1,915.99 <br /> <br /> 4/2/04-5/2/04 $ I CA <br /> <br /> 5. $ <br /> <br /> See Page Totals (Add all amotmts weh the same Accounting Period Totals (.Complete only for last page and <br /> Instructmns contribution type Do not include aggregates,) transfer these amounts to the Surrmmry Statement, PC 1 ) <br /> on Back and 2,115.99 4,5I 0 99 <br /> in Campmgn Cash (CA) $ ~ Cash (CA) $ <br /> Enter on Summary Statement. Column .~ Line 1 <br /> Fmance <br /> Manual In-K~nd (IL/ $ 214,00 . In-Kind (III) $ 271,13 <br /> Enter on Summar) Statement. Column A. Lines 4 and 9 <br /> <br /> PC 2 Loans Received (LR) $ 0,00 Loans Received (LR) $ 745,00 <br /> Enter on Summary Statement. Coltumn A, Line 2 <br /> <br /> <br />