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PCI <br /> Summary St~.dment of Contributions and _xpenditures Rev <br /> <br />Please type or print legibly in black ink. Page 2 of 2 <br />Candidate or Political Committee Name: &~& OF q Ic°mmitt~IDs~mber: <br />~.Original [-'] Primary 20 ~General 20 O' ~' Other <br /> Amendment [] I st Pre-election 2nd Pre-election 'Post-election [] 20 September Supplemental <br /> LOAN SUMMARY FOR OFFICE USE ONLY <br /> :2l. Beginning Outstanding Loans <br /> (line :29 of previnus report) <br /> :2:2. Loans Received (Non-Exempt) <br /> (line 2) + ---'"'"' 0.00 <br /> :23. Loans Received (Exempt) ,.,,,..--- <br /> (line 14) + 0.00 <br /> :24. LOANS RECE[VED SUBTOTAL <br /> (lines :21 + 22 + 23) = ~ 0.00 <br /> 25. Loan Payments (Non-Exempt) <br /> (line 7) e'""" 0,00 <br /> :26. Loan Payments (Exempt) <br /> (line 18) + ,,--'" 0.00 <br /> :27. Forgiven Loans <br /> + <br /> (Total loans forgiven during this accounting period) <br /> :28. LOAN PA¥1VlENT SUBTOTAL <br /> (lines :25 + :26 +:27) = ~ 0.00 <br /> 29. TOTAL OUTSTANDING LOANS <br /> (line :24 minus linc 28) = ~ 0.00 <br /> <br /> PERSONAL EXPENDITURE SUMMARY <br /> 30. Beginning Outstanding Personal Expenditures <br /> (linc 36 ofprevinus report) <br /> 31. Personal Expenditures + ,~. <br /> (^ccounting Period Total from PC 33,) <br /> 3:2. PERSONAL EXPENDITURE SUBTOTAL <br /> (lines 30 + 31) = ~ 0.00 <br /> 33. Personal Expenditure Reimbursements <br /> (Total expenditures on PC 3 with purpose code R) <br /> 34. Forgiven Personal Expenditures <br /> (Total personal expenditures forgiven this acctg, period) + <br /> 35. REIMBURSEIVlENT SUBTOTAL = -'"'" 0.00 <br /> (lines 33 + 34) <br /> 36. OUTSTANDING PERSONAL EXPENDITURES <br /> (line 32 minus line 35) = ~ 0.00 <br /> <br /> FINANCIAL STATUS AT CLOSE OF ACCOUNTING PERIOD <br /> 37. Ending Cash Balance <br /> ,ine 20, o.oo <br /> 38. Accounts Receivable <br /> + <br /> {Accounting Period Total from PC 5) <br /> 39. SUBTOTAL <br /> (lines3?+38) ~ 5~ ~ ~;7 0.00 <br /> 40.(lineT°tal Outstanding Loans29) ~ 0.00 RECEIVED <br /> 41. Outstanding Personal Expenditures + ~ 0.00 <br /> (line 36) <br /> 42. Accounts Payable * .... SEP 1 0 2004 <br /> (Accounting Period Total from PC 6) <br /> 43. SUBTOTAL = --'- 0.00 CiTY RECORDER <br /> (lines 40 + 41 + 42) <br /> 44. ~ALA~¢~,~moT ~ ~ ~'7 o.oo <br /> (line 39 minus line 43: indicate + or - balance) = <br /> I, ~ ~~J~ (name ofcandidate or treasurer), hereby certify that the above <br /> statement and the attached supporting reports are true and correct. <br /> <br /> Signature of candidate or treasurer Date signed <br /> <br /> <br />