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PC 1 Summary ,tatement of Contributions .nd Expenditures Please type or print legibly in black ink. Page 2 of 2 Candidate or PohUcal Committee Name: Committee ID Number: [] Original ]~.Pnmary 20 OF [] General 20 [] Other [] Amendment ~st Pre-election [] 2nd Pre-election [] Post-election [] 20... September Supplemental LOAN SUMMARY 21. Beginmng Outstanding Loans FOR OFFICE USE ONLY (line 29 of previous report) 22. Loans Received (Non-Exempt) + (line 2) 23. Loans Received (Exempt) + (line 14) 24. LOANS RECEIVED SUBTOTAL (lines 21 + 22 + 23) = 25. Loan Payments (Non-Exempt) (line 7) 26. Loan Payments (Exempt) + (line 18) 27. Forgiven Loans + (Total loans forgiven dunng this accounting period) 28. LOAN PAYMENT SUBTOTAL (lines 25 + 26 +27) 29. TOTAL OUTSTANDING LOANS (hne 24 m~nus hne 28) = PERSONAL EXPENDITURE SUMMARY 30. Beginning Outstanding Personal Expenditures (hne 36 of prewous report) 31. Personal Expenditures + (Accounting Period Total from PC 3A) 32. PERSONAL EXPENDITURE SUBTOTAL (lines 30 + 31) 33. Personal Expenditure Reimbursements (Total expenditures on PC 3 with purpose code R) 34. Forgiven Personal Expenditures + (Total personal expenditures forgiven this acctg, period) 35. REIMBURSEMENT SUBTOTAL (lines 33 + 34) 36. OUTSTANDING PERSONAL EXPENDITURES = FINANCIAL STATUS AT CLOSE OF ACCOUNTING PERIOD 37. Ending Cash Balance (line 20) 38. Accounts Receivable (Accounting Period Total from PC 5) + 39. SUBTOTAL (lines 37 + 38) = 40. Total Outstanding Loans (hne 29, O . RECEIVED 41. Outstanding Personal Expenditures + (hne 36) 42. Accounts Payable APR 1 2004 (Accounting Period Total from PC 6) + 43. SUBTOTAL (lines 40 + 41 + 42) = 44. BALANCE/DEFICIT (line 39 minus hne 43 indicate + or- balance) = I, ~'~ /4~/ ~/~//ffOCMd t ~ ~ (name of candidate r trr ~~~rr'r_j) hereby certify that the above statement and the attached supporting/reports are true and correct. S~gn ture of candidateQ'~treasurer~/ / Date signed