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<br /> Summary Statement of Contributions and Expenditures PCI <br /> Rev. 12/03 <br />Please type or print legibly in black ink. Page 2 of2 <br />Candidate or Political Committee Name: I Committee ill Number: <br />Elect Maurie Denner <br />IZI Original o Primary 20 o General 20 o Other <br />o Amendment o 1st Pre-election o 2nd Pre-election o Post -election IZI 2005 September Supplemental <br /> LOAN SUMMARY FOR OFFICE USE ONLY <br />21. Beginning Outstanding Loans <br />(line 29 oforevious reoort) 800.00 <br />22. Loans Received (Non-Exempt) + 0.00 <br />(line 2) <br />23. Loans Received (Exempt) + 0.00 <br />(line 14) <br />24. LOANS RECEIVED SUBTOTAL = 800.00 <br />(lines 21 + 22 + 23) <br />25. Loan Payments (Non-Exempt) 0.00 <br />(line 7) <br />26. Loan Payments (Exempt) + 0.00 <br />(line 18) <br />27. Forgiven Loans + 800.00 <br />(Total loans forgiven durin!! this accounting oeriod) <br />28. LOAN PAYMENT SUBTOTAL = 800.00 <br />(lines 25 + 26 +27) <br />29. TOTAL OUTSTANDING LOANS = 0.00 <br />(line 24 minus line 28) <br /> PERSONAL EXPENDITURE SUMMARY <br />30. Beginning Outstanding Personal Expenditures 100.48 <br />(line 36 of previous report) <br />31. Personal Expenditures + 0.00 <br />(Accounting Period Total from PC 3A) <br />32. PERSONAL EXPENDITURE SUBTOTAL = 100.48 <br />(lines 30 + 31 ) <br />33. Personal Expenditure Reimbursements 0.00 <br />(Total expenditures on PC 3 with Duroose code R) <br />34. Forgiven Personal Expenditures + 100.48 <br />(Total personal exoenditures forgiven this acctg. <br />35. REIMBURSEMENT SUBTOTAL = 100.48 <br />(lines 33 + 34) <br />36. OUTSTANDING PERSONAL = 0.00 <br />EXPENDITURES <br /> FINANCIAL STATUS AT CLOSE OF ACCOUNTING PERIOD <br />37. Ending Cash Balance 0.00 <br />(line 20) <br />38. Accounts Receivable + 0.00 <br />(ACCOWlting Period Total from PC 5) <br />39. SUBTOTAL = 0.00 <br />(lines 37 + 38) <br />40. Total Outstanding Loans 0.00 <br />(line 29) <br />41. Outstanding Personal Expenditures + 0.00 <br />(line 36) <br />42. Accounts Payable + 0.00 <br />(Accounting Period Total from PC 6) <br />43. SUBTOTAL = 0.00 <br />(lines 40 + 41 + 42) <br />44. BALANCEIDEFlCIT = 0.00 <br />(line 39 minus line 43: indicate + or - balance) <br />I, Mark A. Denner (name of candidate or treasurer), hereby certify that the above statement and the attached supporting reports <br />are true and correct. <br />~ - 7'....//-~#o<>- <br />Slgnatu of candIdate or treasurer Date signed <br />