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PC 1 Summary Statement of Contributions and -xpenditures Rev Please type or print legibly in black ink. Page 2 of 2 Candidate or Political Committee Name: [ Committee ID Number [] Original [] Primary 20 Gq [] General 20 [] Other [] Amendment [] 1st Pre-election [] 2nd Pre-election [] Post-election [] 20 . September Supplemental LOAN SUMMARY FOR OFFICE USE ONLY 21. Beginning Outstanding Loans (hne 29 of previous report) O 22. Loans Received (Non-Exempt) + (line 2) O 23. Loans Received (Exempt) + (line 14) 0 24. LOANS RECEIVED SUBTOTAL (lines 21 + 22 + 23) = 25. Loan Payments (Non-Exempt) (line 7) 0 26. Loan Payments (Exempt) + (line 18) 0 27. Forgiven Loans + O (Total loans forgiven during this accounting period) 28. LOAN PAYMENT SUBTOTAL = O (lines 25 + 26 +27) 29. TOTAL OUTSTANDING LOANS = (line 24 m~nus line 28) PERSONAL EXPENDITURE SUMMARY 30. Beginning Outstanding Personal Expenditures O (line 36 of previous report) 31. Personal Expenditures (Accounting Period Total from PC 3A) + ID 32. PERSONAL EXPENDITURE SUBTOTAL (hnes 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 (tine 20) 38. Accounts Receivable + (Accounting Period Total from PC 5) 39. SUBTOTAL = (lines 37 + 38) 40. Total Outstanding Loans (line 29) 41. Outstanding Personal Expenditures + (line 36) CS 42. Accounts Payable + (Accounting Period Iotal from PC 6) 43. SUBTOTAL = (lines 40 + 41 + 42) 0 44. BALANCE/DEFICIT = C) (line 39 minus line 43 ~nd~cate + or - balance) I, S coT[ ~e;.sw~ o- (name of candidate or treasurer), hereby certify that the above statement and the attached supporting reports are true and correct. Signature of cand~ate or treasurer Date s~gne