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PC <br /> Summary Statement of Contributions and Expenditures <br />Please type or print legibly in black ink. Page 2 of 2 <br />Candidate or Political Committee Name: Committee ID Number: <br />Tom Slocum for City Council <br />[] Original [] Pr/mary 200~4 [] General 20__ [] Other __ <br />[~] Amendment [~] 1 st Pre-election [] 2nd Pre-election [~ Post-election [~1 20__ September Supplemental <br /> LOAN SUMMARY <br />2 t. Begim~ing Outstanding Loans FOR OFFICE USE ONLY <br />(line 29 ofpre~,ious report) 0.00 <br />22. Loans Received (Non-Exempt) <br />(line 2) + 0.00 <br />23. Loans Received (Exempt) <br />(line 14) + 0.00 <br />24. LOANS RECEIVED SUBTOTAL <br /> (lines 2t + 22 + 23l = 0.00 <br />25. Loan Payments (Non-Exempt) 0.00 <br /> (line 7) <br />26. Loan Payments (Exempt) + 0.00 <br /> (line 18} <br />27. Forgiven Loans <br /> + 0.00 <br /> (Total loans forgiven dunng this accounting period) <br />28. LOAN PAYMENT SUBTOTAL <br /> = 0 00 <br /> (lines 25 + 26 +27) <br />29. TOTAL OUTSTANDING LOANS <br /> (line 24 min~s hne 2.q) = 0.00 <br /> PERSONAL EXPENDITURE <br />30 Beginrfing Outstanding Personal Expenditures 0.00 <br /> (line 30 of previous report) <br />31. Personal Expenditures + 0.00 <br /> (Accounting Period Total from PC 3Al <br />32. PERSONAL EXPENDITUPd~ SUBTOTAL <br /> = 0.00 <br /> (lines 304- 31 ) <br />33~ Personal Expenditure Reimbursements <br />(Total expenditures on PC 3 with purpose code R) 0.00 <br />34. Forgiven Personal Expenditures + 0.00 <br />(Total personal expenditures forgiven this acctg, period) <br />35. REIMBURSEMENq' SUBTOTAE <br /> = 0.00 <br />(lines 33 + 34) <br />36~ OUTSTANDING PERSONAL EXPENDITURES <br /> = 0.00 <br />(line 32 minus line 35) <br /> FINANCIAL STATUS AT CLOSE OF ACCOUNTING PER[OD <br />37. Ending Cash Balance J 52~00 <br />{line 20) <br />38. Acconnts Receivable + 0.00 <br />(Accounting Period Tutal from PC 5) <br />39. SUBTOTAL = J §2~00 <br />(lines 37 + 38~ <br />40. Total Outstanding Loans 0.00 <br />(line 2% <br />4 l~ Outstanding Personal Expenditures + 0.00 <br />(line 30} <br />42. Accounts Payable + 5,937 OB <br />(Accounting Period Total from PC 6} <br />43. SUBTOTAL = 5,937.9~ <br />(lines 40 + 41 + 42) <br />44~ BALANCE/DEFICIT <br /> = <br /> (line 39 ~ninus linc 43: indicate + or - balance) <br /> <br /> 1[. Thomas Slocum (name of candidate or treasurer), hereby certify that the above statement and the attached supporting reports are <br /> <br /> S~gnamre of candidate or treasurer Date signed <br /> <br /> <br />