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<br /> PC 2 <br /> Cash Contributions, Loans Received and In-Kind Rev. 12/03 <br />Candidate or Political Committee Name: Committee ID Number: <br />Vote Yes For External Police Review Page Z of~ <br />Election: o Primary 20 [g] General 2005 D Other <br />Report: o 1 st Pre-election [g] 2nd Pre-election o Post-ejection 020 September Supplemental <br />SEE BACK FOR INSTRUCTIONS AND CODE DEFINITIONS <br />CODE 1: Contributor Type CODE 2: Contribution Type <br /> B Business Entity CA Cash <br />C Political Committee (includes business and union PACs) CO Cosigner Obligation <br /> F Candidate's Immediate Family (includes candidate) IK In-Kind <br /> I Individual LR Loan Received <br /> L Labor Organization <br /> 0 Other <br /> P Political Party Committee <br />Line # Name and Address of Contributor Amount of In-Kind Purpose <br /> Contribution (see manual for suggested purpose codes) <br />Date Received Occupational Information or Contributor Code 1 I Code 2 <br /> Contributing Committee's 10# Aggregate <br /> David Monk <br />1. 3720 Emerald St $ 100.00 <br /> Eugene, OR 97405 <br />10/17/2005 Unemployed $ 100.00 I I CA <br /> Ron Chase <br />2. 924 Sunnyside Dr. $ 100.00 <br /> Eugene, OR 97404 <br />10/17/2005 Executive Director Non-Profit $ 500.00 I I CA <br /> Sara Rich <br />3. 390 E 43rd Ave $ 50.00 <br /> Eugene, OR 97405 <br />10/17/2005 Family Therapist $ 50.00 I I CA <br /> Miscellaneous Donations Under $50.00 <br />4. $ 1067.00 <br />9/27/2005 to $ I I CA <br />10/23/2005 <br /> ACLU of Oregon <br />5. PO Box 50426 $ 14.40 L <br /> Eugene, OR 97405 <br />9/30/2005 Non-Profit Organization $ 14.40 0 I IK <br />See Page Totals (Add all amounts with the same Accounting Period Totals (Complete only for last page and <br />Instructions contribution type. Do not include aggregates.) transfer these amounts to the Summary Statement, PC I.) <br />on Back and Cash (CA) $ 1317.00 Cash (CA) $ <br />in Campaign Enter on Summary Statement, Column A, Line 1 <br />Finance <br />Manual In-Kind (IK) $14.40 In-Kind (IK) $ <br /> Enter on Summary Statement, Column A. Lines 4 and 9 <br />PC 2 Loans Received (LR) $ 0.00 Loans Received (LR) $ <br /> Enter on Summary Statement. Column A, Line 2 <br />