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PC9 <br /> Report of Expenditures Made by an Agent <br /> <br />Candidate or Political Committee Name: Committee ID Number: <br />Committee for a Better Eugene Page 1 of 1 <br /> <br />Election: [] Primary 20__ [] General 2004 [] Other __ <br />Report: [] 1 st 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/INDHOLM COMPANY, LLC (name of agent). The payments to the agent are listed <br />off: <br /> <br />Form (circle one) Page # Line # Check # Amount <br />PC 2, PC 3 or PC 6 I ~_ 600.00 <br />PC 2, PC 3 or PC 6 <br />PC 2, PC 3 or PC 6 <br /> <br /> Purpose Amount of <br /> Payee's Name (see purpose codes Expenditure <br />Line # Date (as it appears on invoice, receipt or check) on back of form) <br /> <br /> I 9/9~04 Eugene City Recorder O $ 300.00 <br /> 2. 9/9/04 Eugene City Recorder O $ 300.00 <br /> 3. $ <br /> 4. $ <br /> 5. $ <br /> 6. $ <br /> 7. $ <br /> 8 $ <br /> 9. $ <br /> <br /> 10. <br /> <br /> See <br /> Instructions Page Total of Agent Expenditures: $ 600 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: $ 600.00 <br /> <br /> Unexpended Balance (if any): $ ~ <br /> PC 9 (report this amount as an account receivable on form PC 5) <br /> <br /> <br />