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PC 2 <br /> Cash Contributions, Loans Received and in-Kind ,,v <br />Candidate or Pohtical Committee Name Comm}ttee ID NtLrnbe~ <br />Andrea Ortiz for City Counci~ N/A Page .~_~ of 4 <br /> <br />Elechon [] Primary 20 04 E~ General 20 [] Other <br />Report' [] 1st Pre-electzon [] 2nd Pre-elechon [] Post-electron [] 20__ September Supplemental <br /> <br />SEE BACK FOR INSTRUCTIONS AND CODE DEFINITIONS <br /> <br /> CODE 1: Contributor Type CODE 2: Contribution Type <br /> B Buszness Entity CA Cash <br /> C Pohtzcal Cormmttee 0ncludes business and umon PACs) CO Coszgner Obhgatmn <br /> F Candzdate's Immedzate Family (includes candzdate) IK In-Kind <br /> I Indn,zdual LR Loan Recmved <br /> L Labor Orgamzahon <br /> O Other <br /> P Politzcal Par~, Cornmzttee <br /> <br /> Amount of In-Kind Purpose <br /> Line # Name and Address of Contributor Contnbut¢on (see manual for suggested purpose codes) <br /> <br /> Occupational Information or Conb'ibutor Code 1 I Code 2 <br /> Date Received Contributing Committee's IDI¢ Aggregate <br /> <br /> Andrea Ortiz <br /> 1. 189 Foch Street $ 500,00 <br /> Eugene, OR 97402 <br /> <br /> Hospital Ward Clerk $ 896.90 F I CA <br /> 3/15/2004 <br /> <br /> David R. P~ercy <br /> 2 1371 West 4th $ 200 00 <br /> Eugene, OR 97402 <br /> <br /> Retired $ 200.00 I I CA <br /> 311 <br /> 6t2004 <br /> <br /> Andrea Ortlz L <br /> 3 189 Foch Street $ 41,84 <br /> Eugene, OR 97402 <br /> <br /> Hospital Ward Clerk $ 938 74 F I IK <br /> 3/1 <br /> 8/2004 <br /> <br /> Carmen Urbina <br /> 4, 788 Blackfoot Avenue $ 100,00 <br /> Eugene, OR 97404 <br /> <br /> Director El Centre Latmo $ t00.00 I I CA <br /> 3/1 <br /> 9/2004 <br /> <br /> Ray G, Wolfe <br /> 5. 1473 Luella Street $ 100.00 <br /> Eugene, OR 97401 <br /> <br /> 3/24/2004 Retired $ 100.00 I CA <br /> <br /> See Page Totals (Add all amounts xvzth the same Accounting Period Totals (Complete only for last page and <br /> Instructions contribution type Do not ~nclude aggregates.) transfer these amotmts to the Summary Statement, PC 1 ) <br /> <br /> on Back and 900 00 <br /> in Campmgn Cash (CA) $ Cash rCA) $ <br /> ' Enter on Summary Statement. Colunm A_ Linc 1 <br /> Finance <br /> Manual In-K~nd (IK) $ 41,84 In-Kind (IK) $ <br /> Enter on Summa~' Statement. Column A~ Lines 4 and 9 <br /> <br /> PC 2 Loans Received (LR) $ 0.00 Loans Recmved (LR) $ <br /> Enter on Stm~mary Statement. Column A. Line 2 <br /> <br /> <br />