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PC Summary St. ement of Contributions ar, Expenditures Rev,2,03 Please type or print leg]Ny in black ink. Page 2 of 2 Candidate or Pohtlcal Committee Name: Committee ID Number: ]~Origmal [] Pr,mary 20 [] General 20 [] Other [] Amendment [] 1 st Pre-elect~on [] 2nd Pre-elect~on [] Post-election [] 20 O~ September Supplemental LOAN SUMMARY 21. Beginning Outstanding Loans FOR OFFICE USE ONLY (line 29 of previous report) -- O -- 22. Loans Recmved (Non-Exempt) (line 2) + ~ O -- 23. Loans Recmved (Exempt) (hne 14) + - 24. LOANS RECEIVED SUBTOTAL (lines 21 + 22 + 23) 25. Loan Payments (Non-Exempt) (line 7) -- 26. Loan Payments (Exempt) (hne 18) + 27 Forgiven Loans (Total loans forgiven during this accounting period) 28. LOAN PAYMENT SUBTOTAL (lines 25 + 26 +27) 29. TOTAL OUTSTANDING LOANS (line 24 minus line 28) PERSONAL EXPENDITURE SUMMARY 30. Beginmng Outstanding Personal Expenditures (line 36 of previous report) '" O -- 31. Personal Expenditures (Accounting Period Total from PC 3A) + 32 PERSONAL EXPENDITURE SUBTOTAL (lines 30 + 31) 33. Personal Expenditure Reimbursements (Total expenditures on PC 3 w~th purpose code R) 34 Forgiven Personal Expenditures (Total personal expenditures forgiven this acctg period) + -" 35 REIMBURSEMENT SUBTOTAL (lines 33 + 34) 36. OUTSTANDING PERSONAL EXPENDITURES = -- FINANCIAL STATUS AT CLOSE OF ACCOUNTING PERIOD 37. Ending Cash Balance (line 20) 38. Accounts Recmvable (Accounting Period Total from PC 5) + 39. SUBTOTAL (lines 37 + 38) 40. Total Outstan&ng Loans (hne 29) 41. Outstanding Personal Expenditures + .~/5} _ (line 36) SEP 1 0 2004 42. Accounts Payable + '-- O (Accounting Period Total from PC 6) 43. SUBTOTAL CITY RECORDER (hnes 40 + 41 + 42) = 44. BALANCE/DEFICIT (line 39 minus line 43 indicate + or - balance) I, '~ oma $ Z e$"Per~ (name of candidate or treasurer), hereby cert,fy that the above statement and the attached supporting reports are true and correct. Signature of candidate or treasurer Date