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<br /> Summary Statement of Contributions and Expenditures PC J <br /> Rev. 12/03 <br />Please type or print legibly in black ink. Page 2 of2 <br />Candidate or Political Committee Name: I Committee ID Number: <br />Vote Yes For External Police Review <br />[g] Original o Primary 20 [g] General 2005 o Other <br />o Amendment o I st Pre-election [g] 2nd Pre-election o Post-election 020 September Supplemental <br /> LOAN SUMMARY FOR OFFICE USE ONLY <br />21. Beginning Outstanding Loans 1,600.00 <br /> (line 29 of orevious report) <br />22. Loans Received (Non-Exempt) + 0.00 <br /> (line 2) <br />?" Loans Received (Exempt) <br />-.). + 0.00 <br /> (line 14) <br />24. LOANS RECEIVED SUBTOTAL = 1,600.00 <br /> (lines 21 + 22 + 23) <br />25. Loan Payments (Non-Exempt) 1,300.00 <br /> (line 7) <br />26. Loan Payments (Exempt) + 0.00 <br /> (line 18) <br />27. Forgiven Loans + 300.00 <br />(Total loans forgiven during this accounting period) <br />28. LOAN PAYMENT SUBTOTAL = 1,600.00 <br /> (lines 25 + 26 +27) <br />29. TOTAL OUTSTANDING LOANS = 0 <br /> (line 24 minus line 28) <br /> PERSONAL EXPENDITURE SUMMARY <br />30. Beginning Outstanding Personal Expenditures 0.00 <br /> (line 36 of previous report) <br />31. Personal Expenditures + 0.00 <br /> (Accounting Period Total from PC 3A) <br />32. PERSONAL EXPENDITURE SUBTOTAL = 0.00 <br /> (lines 30 + 31) <br />33. Personal Expenditure Reimbursements 0.00 <br /> (Total expenditures on PC 3 with ouroose code R) <br />34. Forgiven Personal Expenditures + 0.00 <br /> (Total oersonal expenditures forQ:iven this acctg. period) <br />35. REIMBURSEMENT SUBTOTAL = 0 <br /> (lines 33 + 34) <br />36. OUTST ANDINC PERSONAL EXPENDITURES = 0.00 <br /> (line 32 minus line 35) <br /> FINANCIAL STATUS AT CLOSE OF ACCOUNTING PERIOD <br />37. Ending Cash Balance 684.23 <br /> (line 20) <br />38. Accounts Receivable + 0.00 <br /> (Accounting Period Total from PC 5) RECEIVED <br />39. SUBTOTAL = 684.23 <br /> (lines 37 + 38) <br />40. Total Outstanding LOHns 0.00 OCT 2 6 2005 <br /> (line 29) <br />41. Outstanding Personal Expenditures + 0.00 <br /> (line 36) CITY RECORDER <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. BALANCEIDEFICIT = 684.23 <br /> (line 39 minus line 43: indicate + or - balance) <br />I, Judith Schaap (name of candidate or treasurer), hereby certifY that the above statement and the attached supporting reports are <br />true and correct. <br /> ~ --- <br /> ~ IO~~(" ,. oS <br />Signature of candidate ~ ylasurer Date signed <br /> / <br />