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<br /> PC4A <br /> Other Receipts Rev. 12/03 <br />Candidate or Political Committee Name: Committee ID Number: <br />The /v1;1I Sfreet Brjd~e C.OM I\o'\i+fe.e.. Page ----2- of 2 <br />Election: D Primary 20_ D General 20_ D Other <br />Report: D 1 st Pre-election D 2nd Pre-election D Post-election .18l20 os September Supplemental <br />SEE BACK FOR INSTRUCTIONS AND CODE DEFINITIONS <br />Other Receipt Transaction Type Codes <br /> EL Exempt Loan Proceeds <br /> FM Items Sold at Fair Market Value <br /> IN Interest/Investment Income <br /> OM Miscellaneous (provide a description) <br /> RF Refunds, Rebates and Returns <br /> Date Name Other Receipt <br />Line # Received (required for codes EL, OM and RF; Transaction Type Other Receipt Amount <br /> optional for codes FM and IN) Code <br />1. 07/~qloS" IN $ .0 J <br />2. Oa/31/ O~ IN $ ,01 <br />3. $ <br />4. $ <br />5. $ <br />6. $ <br />7. $ <br />8. $ <br />9. $ <br />10. $ <br /> See Page Totals (Add all Other Receipt Transaction Accounting Period Totals (Complete only for last page and <br />Instructions Type Codes specified.) transfer these amounts to the Summary Statement, PC I.) <br />on Back and ,OJ... $ .'{o <br />in Campaign Codes FM, IN, OM, RF $ Codes FM, IN, OM, RF <br /> Finance Enter on Summary Statement. Column A, Line 13 <br /> Manual Code EL $ -0 - Code EL $ -D- <br /> Enter on Summary Statement, Column A, Line 14 <br /> PC4A <br />