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C sh Contributions, <br />Candidate o~ Pol~fica~ Commk~ee Name Committee ~D Number <br />Tom $tocum for City Counci~ Page 2 ors <br /> <br />Election ~ Primary 2004 ~ Gener~ 20 ..... ~ O, her <br />RepoA' ~ ts( Pre-election ~ 2nd ~e-elecfion ~ Post-electio~ [~ 20~ September Supplemental <br /> <br />SEE BACK FOR [NSTRUCTIONS AND CODE DEF~I~IONS <br /> CODE 1: Ooatributor Type CODE 2: Contribution Type <br /> B Bus, ness EafiW CA Cash <br /> C Polk~cal Committee fiac;udes bus~aess and anon PACs) CO Cosigner Obligation <br /> F Csmd~date's Imme&ate F~n~Iy 0ncludes c~d~date) tK In~K~ad <br /> I Individual LR Loan kecdYed <br /> L Labor Organization <br /> 0 0iher <br /> P Political Pa~y Commi~ee <br /> <br /> Amoun~ of in-~nd Pucoose <br /> Line ~ Name and Address of Cont~b~or Cont~bu~ion (see manual ~r suggested puc~ose co~s ) <br /> OccupatJanaJ ~nformation or Contributor Co~e I Code 2 <br /> Date ReceJved Contributing CommJ~ee <br /> <br /> $ <br /> <br /> $ <br /> <br /> ded Keever <br /> 2 2590 Lawrence St $ 100.00 <br /> Eugene, Oregon 97405 <br /> <br /> 5~7/04 R~red $ 100.00 l CA <br /> <br /> 3 $ <br /> <br /> 4. $ <br /> <br /> 5. <br /> <br /> $ <br /> <br /> See Page Totals I Add alt amounts with the same Aeroaali~ag Period Totals (Complete only for last page and <br /> <br /> InstructiorJs contribution type Do not include aggrega~ces.) transfer Cese amounts to ~he Summm~~ S~temeat, PC 1 ~} <br /> on Back ~d Cash (CA) $. Cash (CA) $ <br /> Camp~gn Enter on Smmnm> Skttem~nt. O~leum A_ Line <br /> Finance <br /> N'hpiual la-Kind (~) $ Ia-Kind ilK} $ <br /> <br /> PC 2 Loans Received (LR} $ Lo~s Received/LR) $ <br /> gulcr en Sum:naE~ Stat~men[ Column .% L,ne 2 <br /> <br /> <br />