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PC 3 Cash Expenditures and Loan Payments Rev ,21o3 Candidate or Poht~cal Committee Name: Committee ID Number: Andrea Ortiz for City Council N/A Page 1 of 1 Election. [] Primary 20 [] General 20 04 [] Other Report: [] 1st Pre-elect~on [] 2nd Pre-election [] Post-election [] 20 September Supplemental PURPOSE CODES (see back of form for instructions and code definitions) EXPENDITURE TYPES A Agent O Other Adveras]ng (yard signs, buttons, etc.) CA Cash B Broadcast Advertising (Radio, TV) P Postage LP Loan Payment C Cash Contributions R Reimbursement for Personal Expenditures F Fundrals~ng Event Expenses S Surveys and Polls G General Operational Expenses (describe If over $50) T Travel Expenses (describe ~f over $50) I Interest Payment U Utilities L L~terature, Brochures, Pnntmg W Wages, Salaries, Benefits M Management Serwces Y Petition C~rculators N Newspaper and Other Periodical Advems]ng Z Preparation and Production of Advertls~ng Payee's Name and Payee's Committee IDg, [] Ltne# Date Check # tf applicable Purpose Exp Amount of (as it appears on tnvoice, receipt or check) Type Expenditure Paid to A/P 10/20/04 1024 Keep Hampton Our Commissioner C 1. CA $ 100 00 I--I 10/27/04 1025 Eugene Weekly N 2. CA $ 277.00 ~l 10/27/04 1026 Peace Rose Graphics L 3 CA $ 30 00 FI 4 I-I 5. $ 6. $ [-I 7. $ ~ 8 $ I-I I-I 10. $ O See Page Totals (Add all expenditures with the same Accounting Period Totals (Complete only for last page and Instructions expenditure type.) transfer these amounts to the Summary Statement, PC 1.) on Back and in Campmgn Cash (CA) $ 407.00 Cash (CA) $ 407 00 Finance Enter on Summary Statement, Colunm A, L~ne 6 Manual Loan Payment (LP) $ 0 00 Loan Payment (LP) $ 0 00 Enter on Summary Statement, Column A, L~ne 7 PC 3