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<br />PC 2 Amendment <br />Amendments-Cash Contributions, Loans Received and In-Kind Rev. 12/03 <br /> <br /> <br />Election: <br />Report: <br /> <br />D Primary 20_ <br />D 1 st Pre-election <br /> <br />D General 20_ <br />D 2nd Pre-election <br /> <br />SEE BACK FOR INSTRUCTIONS AND CODE DEFINITIONS <br />CODE 1: Contributor Type <br />B Business Entity <br />C Political Committee (includes business and union PACs) <br />F Candidate's Immediate Family (includes candidate) <br />I Individual <br />L Labor Organization <br />o Other <br />P Political Party Committee <br /> <br />Amending Page # <br />and Line # <br /> <br />Date Received <br /> <br />page---1- LineL <br />D New Entry <br />g Correcting <br />D Deleting <br /> <br />I'Z/wl ()f <br /> <br />Page_ Line_ <br /> <br />D New Entry <br />D Correcting <br />D Deleting <br /> <br />Page_ Line_ <br /> <br />D New Entry <br />D Correcting <br />D Deleting <br /> <br />Page_ Line_ <br /> <br />D New Entry <br />D Correcting <br />D Deleting <br /> <br />Page_ Line_ <br /> <br />D New Entry <br />D Correcting <br />D Deleting <br /> <br />See <br />Instructions <br />on Back and <br />in Campaign <br />Finance <br />Manual <br /> <br />PC2 <br />Amendment <br /> <br />Name and Address of Contributor <br /> <br />Occupational Information or <br />Contributing Committee's 10# <br />C-oMcmf h1V1lvCl4! AfW~ e~. <br />1<(3 rl./~S J:h IGblr <br />E;v. /w(}:)d ofr;t-Ad1 <80//2- <br /> <br />(! O/Yl !11V-l-/tc.;l-4dM <br /> <br />---:D~ &/,<91 ~c/,i.& <br /> <br />Signature of candidate or treasurer <br /> <br />s~ ~t.l '71 ~r <br /> <br />Date signed <br /> <br />D Other _ <br />D Post-election <br /> <br /> Amount of <br /> Contribution <br /> Contributor <br /> Aggregate <br />$ .500 <br />$ 50j <br />$ <br />$ <br />$ <br />$ <br />$ <br />$ <br />$ <br /> <br />$ <br /> <br />Committee ID Number: <br /> <br />Page 1- of -'-- <br /> <br />~ 20.t2.1feptember Supplemental <br /> <br />CODE 2: Contribution Type <br />CA Cash <br />CO Cosigner Obligation <br />IK In-Kind <br />LR Loan Received <br /> <br />In-Kind Purpose <br />(see manual for suggested purpose codes) <br /> <br />Code 1 <br /> <br />Code 2 <br /> <br />8 <br /> <br />ell- <br /> <br />