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<br /> PC5 <br /> Accounts Receivable Rev. 12/03 <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 Post-election IZI 2005 September Supplemental <br />SEE BACK FOR INSTRUCTIONS AND CODE DEFINITIONS <br />CODE 1: Contributor Type CODE 2: Account Receivable Type <br />B Business Entity OR Other Account Receivable <br /> C Political Committee (includes business and union PACs) PC Pledge of Cash <br /> F Candidate's Immediate Family (includes candidate) PI Pledge of In-Kind <br /> I Individual PL Pledge of Loan <br /> L Labor Organization <br /> 0 Other <br /> P Political Party Committee <br />Une# Name and Address of Contributor Amount of In-Kind Purpose <br /> Account Receivab/e (see manual for suggested purpose codes) <br />Date Occupationa/lnformation or Contributor Code 1 I Code 2 <br /> Contributing Committee's IDIt- Aggregate <br />1. $ <br /> $ I <br />2. $ <br /> $ I <br />3. $ <br /> $ I <br />4. $ <br /> $ I <br />5. $ <br /> $ I <br />See Page Total (Add all amounts for the Accounts Accounting Period Total (Complete only for last page and <br />Instructions Receivable Type Codes specified. Do not include transfer these amounts to the Summary Statement, PC 1.) <br />on Back and PI or aggregate.) <br />in Campaign Codes OR, PC, PL $ 0.00 Codes OR, PC, PL $0.00 <br />Finance <br />Manual Enler on Summary Statement, Colwnn A, Line 38 <br />PC 5 <br />