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Cash Expenditures and Loan Payments vt3 <br /> <br />Candidate or Polit]cal Committee Name- Committee ID Number <br />It's Only Fair Page 1 of 1 <br /> <br /> Elect]on [] Primary 20 [] General 2004 [] Other __ <br /> Report. [] 1 st Pre-elect]on [] 2nd Pre-elect]on [] Post-election [] September Supplemental <br /> <br /> PURPOSE CODES (see back of form for instructions and code definitions) EXPENDITURE TYPES <br /> A Agent N Newspaper and Other Penodmal Advertising CA Cash <br /> B Broadcast Adverhsmg (Radio, TV) O Other Advertising (.yard signs, buttons, etc.) LP Loan Payment <br /> C Cash Contributions P Postage <br /> F Fundralsmg Event Expenses R Reimbursement <br /> G General Operational Expenses (describe S Surveys and Polls <br /> if over $50 T Travel Expenses (describe if over $50) <br /> I Interest Payment U Utflibes <br /> L Literature, Brochures, Printing W Wages, Salaries, Benefits <br /> M Management Services Z Preparation and Produetmn of Adverhsmg <br /> <br /> Payee's Name and Payee's Commtttee ID~, Exp. Amount of [] <br /> Ltne# Date Check~ /f apphcable Purpose Type Expenditure Pd to <br /> (as tt appears on invoice, recetpt or check) AlP <br /> <br /> Key Bank G (Bank fees) <br /> I 11/2/2004 Cash CA $ 70 12 [~ <br /> <br /> C&E Systems, LLC M <br /> 2 11/2/2004 1004 CA $ 700.00 [2] <br /> <br /> 3 $ J'--J <br /> <br /> 4 $ [] <br /> <br /> 5, $ 0 <br /> <br /> 6 $ [] <br /> <br /> 7 $ [] <br /> <br /> 8 $ [] <br /> <br /> 9 $ [] <br /> <br /> 10 $ [] <br /> <br /> See Page Totals (Add all expenditures uath the same Accounting Period Totals (Complete only for last page and <br /> Instructions expenditure type.) transfer these amoums to the Summary Statement, PC 1 ) <br /> on Back and <br /> in Campaign Cash (CA) $ 770 12 Cash (CA) $ 770 12 <br /> Finance E~ on s,m.~ stat~.,a~ co~u~, ~ t~,e 6 <br /> <br /> Manual Loan Payment (LP) $ 00 Loan Payment $ 00 <br /> Enter on Summary Statement, Colunm A, Lines 7 <br /> PC3 <br /> <br /> <br />