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<br /> PC3A <br /> Personal Expenditures for Reimbursement Rev. 12103 <br />Candidate or Political Committee Name: Committee ill Number: <br />Elect Maurie Denner Page 1 of 1 <br />Election: IZI Primary 2004 o General 20 o Other <br />Report: o 1st Pre-election o 2nd Pre-election o Po51-election IZI 2005 September Supplemental <br />PURPOSE CODES (see back of form for instructions and code definitions) <br />A Agent 0 Other Advertising (yard signs, buttons, etc.) <br />B Broadcast Advertising (Radio, TV) P Postage <br />C Cash Contributions S Surveys and Polls <br />F Fundraising Event Expenses T Travel Expenses (describe if over $50) <br />G General Operational Expenses (describe if over $50) U Utilities <br />I Interest Payment W Wages, Salaries, Benefits <br />L Literature, Brochures, Printing y Petition Circulators <br />M Management Services Z Preparation and Production of Advertising <br />N Newspaper and Other Periodical Advertising <br />Une Date Payee's Name Purpose Amount of <br /> # Expenditure <br /> 1. $ <br /> 2. $ <br /> 3. $ <br /> 4. $ <br /> 5. $ <br /> 6. $ <br /> 7. $ <br /> 8. $ <br /> 9. $ <br /> 10. $ <br /> See Page Total Accounting Period Total (Complete only for last page and <br /> Instructions Personal Expenditures $ 0.00 transfer this amount to the Summary Statement, PC 1.) <br /> on Back and <br /> in Campaign Personal Expenditures $ 0.00 <br /> Finance Enter on Summa!)' Statement, Line 31 <br /> Manual <br /> PC3A <br />