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PC 8A <br /> Supplement to Second Pre/Post-Election - Contributions R~v 13/03 <br /> <br />Candidate or Political Committee Name: Committee ID Number: <br /> $¢0'q[' A4~-'LS~,IE;/-~. For (~IT~ (~OLxI~iL.. NR Page ~ of i <br /> <br />Election: [] Primary 20 [] General 20 [] Other <br />Report: [] 1st Suppl. to the 2nd Pre-election [] 2nd Suppl. to the 2nd Pre-election [] Suppl. to Post-election <br /> <br />SEE BACK FOR INSTRUCTIONS AND CODE DEFINITIONS <br /> <br /> CODE 1: Contributor Type CODE 2: Contribution Type <br /> B Business Entity CA Cash <br /> C Political Committee (includes business and union PACs) CO Cosigner Obligation <br /> F Candidate's Immediate Family (includes candidate) IK In-Kind <br /> I Individual LR Loan Received <br /> L Labor Organization PC Pledge of Cash <br /> O Other PI Pledge of In-Kind <br /> P Political Party Committee PL Pledge of Loan <br /> <br /> Amount of <br /> Line # Name and Address of Contributor <br /> Contribution In-Kind Purpose <br /> Date Received Occupational Information or Code 1 Code 2 (see manual for suggested purpose codes) <br /> Contributing Committee's ID~ <br /> <br /> ~ 3~ ~o. I(TM- ~ ~o $ 2~O.OP <br /> <br /> 2. $ <br /> <br /> 3. $ <br /> <br /> 4. $ <br /> <br /> 5. $ <br /> <br /> Instructions I, ~¢t~+- t~X.d~e~ , (name o~ or <br /> on Back and treasurer) hereby certify that the above statement is true and correct. <br /> in Campaign <br /> Finance ~A¥ ! 4 2004 <br /> Manual <br /> $~u;,~. ~l, q loq CiTY RECORDEt:I <br /> PC 8A Signature of candidate or treasurer Date signed <br /> <br /> <br />