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PC Summary Statement of Contribuiions and ×pendilures Please type or print legibly m black u~. Page 2 of 2 Candidate or PolitmaI Commmee Name: ~ Cmr~ttee ID Number ~ Original ~ Primary 20 ~_ ~ General 20 ~ Other LOAN SUmmARY FOR OFFICE USE ONLY 2 [ Bcghmmg OutstaYing (Total Outstanding Loans fi'om prevmus repo~) 22. Loans Received ~omExempt) + lhne 2) 23. Loans Received (Exempt) + (hue 14) 24. LOANS ~CE1VED SUBTOTAL {lines 2t + 22 -~ 23) 25. Loan Payments (NomExempt) {line 7) 26. Loan Payments (Exempt) + (hue 18) 27. Forgiven Loans + (Total loans forgiven during th~s accounti~ pmmd) 28. LOAN PAYMENT SUBTOTAL dines 25 - 26 +27) 29. TOTAL OUTSTANDING LOANS (hue 24 minus hue 28) PERSONAL EXPENDITURE SUMMARY 30Beginning Outstanding Personal Expendi~es dine 36 ofprewous report) 3l. Personal Expenditures + / ~ tAccotmtmg Period Total fi*om PC 3Al ~ ~ 32 PERSONAL EXPENDITU~ SUBTOTAL (hnes30 +31) = / ~9 ..~ 33 Personal Expenditure Reimbursements (Total expenditures on PC 3 w~th purpose code R~ 34 Forgiven Perso~ml Expendinwes + (Total persona[ expenditures tbrg~ven th~s acctg period) 35. REtk~URSEMENT Sb~TOT~ (lh~es 33 + 34) 36. OUTST~N D~G PERSONAL E~KND,TU~S / time 32 minus line 35) = [fi ' F~NANCIAL STATUS AT CLOSE OF ACCOUNTING 37. Ending Cash Balance ~) 38. Accounts Receivable (Accosting Period Fotal from PC 5) 39. SUBTOTAL = ~ ~ 40. Total Outstanding Loans ~ (line 29) 41. Outstanding Personal Expenditures 42. Accounts Payable + {Accosting Per~od Total fi-om PC 6) 43. SUBTOTAL dines40~-41+42) = /rl~ . ~ , . dine 39 minus line 43 mdmate + or- balanc~e) ~ ., /GL. Z L / ~,/~' ~ ,,.,,," ~5~ ~/(0 ~, (name of can&date or treasurer), hereby ccm fy tha the abc-ye state~ent and the attached suppomng reports a~d tree and correct.