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Other Disbursements <br /> <br />Candidate or Political Committee Name: Committee ID Number: <br /> ,~C0~ M~'l$1,te~' i=Ol~ CC'Ti/ C. DLttO0..IL. ~/tOf Page I of/ <br /> <br />Election: [] Primary 20 0 q [] General 20 [] 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 />Other Disbursement Transaction Type Codes <br /> <br /> EL Exempt Loan Payment <br /> <br /> NP Nonpartisan Actiwty <br /> <br /> OM Miscellaneous (provide a description) <br /> <br /> RT Return or Refund of Contributions <br /> <br /> Payee's Name Other Disbursement Other Disbursement <br />Line # Date Check # (required for codes EL, OM and RT; Transactton Type Amount <br /> optional for code NP) Code <br /> <br /> 2. $ <br /> <br /> 3. $ <br /> <br /> 4. $ <br /> <br /> 5. $ <br /> <br /> 6. $ <br /> <br /> 7. $ <br /> <br /> 8. $ <br /> <br /> 9. $ <br /> <br /> 10. $ <br /> <br /> See Page Totals (Add all amounts for the Other Accounting Period Totals (Complete only for last page and <br /> <br /> Instructions Disbursement Transaction Type Codes transfer these amounts to the Summary Statement, PC 1.) <br /> on Back and specified.) <br /> in Campaign ~-"x L/ <br /> Finance CodesNP, OM,~ $ ~O60.00 ../ CodesNP, OM, RT $ ~ OOO.OD <br /> Enter on Summary Statement, Column A, Line 17 <br /> Manual <br /> Code EL $ ~ Code EL $ -- <br /> Enter on Summary Statement, Column A, L~ne 18 <br /> PC 4B <br /> <br /> <br />