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Report of Expenditures Made by an Agent ~ [~ [!~,~ [~) '2~°~ <br />Candidate or Political Committee Name: Committee ID Number: ~{0 V' 3 0 /.004 <br />Committee for a Better Eugene Page ~_ of 1 <br /> <br />Election: [] Primary 20__ [] General 2004 [] Other__ !TY S [ C 0 ~ DEbl <br />Report: [] 1st Pre-election [] 2nd Pre-election [] Post-election [] 20__ September Supplemental <br /> <br />SEE BACK FOR INSTRUCTIONS AND CODE DEFINITIONS <br /> <br />Complete the information in this box for each payment made to an agent and then provide the detail of expenditures made by the <br />agent in the spaces below: <br /> <br />The following expenditures were made by ~ (name of agent). The payments to the agent are listed on: <br /> <br />Form (circle one) Page # Line # Check # Amount <br />PC 2, PC 3 or PC 6 ~_ I 1.550 00 <br />PC 2, PC 3 or PC 6 <br />PC 2, PC 3 or PC 6 <br />PC 5 (of prior report) __ <br /> <br /> Purpose Amount of <br /> Payee's Name (soo purpose codes Expenditure <br />Uno it Date (as it appears on invoice, receipt or chock) on back of fo~) <br /> <br /> 1 11/1/04 Verb Creative M $ 1,550 00 <br /> <br /> 2. $ <br /> <br /> 3. $ <br /> <br /> 4. $ <br /> <br /> 5. $ <br /> <br /> 6. $ <br /> <br /> 7. $ <br /> <br /> $ <br /> <br /> 9. $ <br /> <br /> 10. $ <br /> <br /> See <br /> Instructions Page Total of Agent Expenditures: $1550.00 <br /> on Back and <br /> in Campaign Complete this box only for last page of the detail of expenditures made by this agent. <br /> Finance <br /> Manual Total Amount of Agent Expenditures: $1550 00 <br /> <br /> Unexpended Balance (if any): $ 0 0,0 <br /> PC 9 (report this mount as an account receivable on form PC 5) <br /> <br /> <br />