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PC 4A <br /> Other Receipts <br /> <br /> Candidate or Pohtical Committee Name' Committee ID Number: <br /> <br /> Election: [] Primary 20 [] General 20 [] Other <br /> Report: [] 1 st Pre-election [] 2nd Pre-election [] Post-election ,~ 20 0 g September Supplemental <br /> SEE BACK FOR INSTRUCTIONS AND CODE DEFINITIONS <br /> <br /> Other Receipt Transaction Type Codes <br /> EL Exempt Loan Proceeds <br /> <br /> FM Items Sold at Fair Market Value <br /> <br /> IN Interest/Investment Income <br /> <br /> OM Miscellaneous (provide a description) <br /> <br /> RF Refunds, Rebates and Returns <br /> <br />' Date Name Other Recetpt <br /> Ltne# Received (requtred for codes EL, OM and RF; Transaction Type Other Receipt Amount <br /> optional for codes FM and IN) Code <br /> <br /> 1 07//30/05f Il"/ $ .0.2.. <br /> 2 0~/31/0~ .7.~,3,] $ ,0~.._ <br /> g-- <br /> <br /> 3 $ <br /> <br /> 4 $ <br /> <br /> 5 $ <br /> <br /> 6 $ <br /> <br /> 7 $ <br /> <br /> 8 $ <br /> <br /> 9 $ <br /> <br /> 10 $ <br /> <br /> See Page Totals (Add all Other Receipt Transaction Accounting Period Totals (Complete only for last page and <br /> InstrucUons Type Codes specified.) transfer these amounts to the Summary Statement, PC 1 .) <br /> on Back and <br /> in Campaign Codes FM, IN, OM, RF $ , O ~ Codes FM, IN, OM, RF $ <br /> Finance Enter on Summary Statement, Column A, Line l 3 <br /> <br /> Manual Code EL $ -- t~ ~ Code EL $ <br /> Enter on Summary Statement, Column A, Line 14 <br /> <br /> PC 4A <br /> <br /> <br />