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06/14/2004 10:00 541--4~4~4942 EUGENE CHAMSER P~GE <br /> Cash Contributions, Loans Received and In-Kind <br /> <br /> Candidate or Political Co~ce Name: Co~ee ID Numbs: <br /> <br /> R~on: ~ 1 st P~lection ~ 2nd ~e-election ~st-el~on ~ 20~ Sep~mber Su~lcmenal <br /> SEE BACK FOR INSTRUCTIONS ~D CODE DEFINITIONS <br /> <br /> CODE t: Contributor Typ~ CODE 2; Contribution Type, <br /> B Business EnOW CA C~ <br /> C Political Co~iffee (~cludes b~iness ~d ~on PACe) CO Cosigner Obligation <br /> F C~di~te's I~ediate Family (includes candidate) IK I~-~nd <br /> I In,ritual LR Lo~ Re~ived <br /> L Labor O~izafion <br /> O Oth~ <br /> P Political P~ <br /> ~unt of' In. Kind Pu~ <br /> Line ~ Name and Addmss of Cont~butor ~,t8b~n (see manu~l Er s~g~sted pu~ose codes) <br /> ~upa~al In~a~ or ~n~butor Code 1 ~ C~e 2 <br /> Date Re~lved Co~buUn~ Commi~e's I~ . <br /> <br /> 4. $ <br /> $" <br /> <br /> 5. $ <br /> <br /> See page Totals (Add all a~uounts with the same Accounting Period Totals (Complete only for ]as~ page and <br /> <br /> Instructions contribution type. Do not include aggregates ) transfer lhese amounts to the Summary Statement, PC 1 .) <br /> <br /> on Back and <br /> in Campaign Cash (CA) $ <br /> Enter on Sununa~y Slst~en~, Column A, Ltne 1 <br /> <br /> Finance <br /> Manual I~-K. ind (IK.) $ lu-K. ind (II<.) <br /> Enter on Summary Statement, Column ^, <br /> <br /> PC 2 Loans Rec¢ivud (LR) $ Loans Received (LR) $ _. - <br /> Enter o~ Summary Staiement, Co½uirm A, LIn~ 2 <br /> <br /> <br />