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<br /> Summary Statement of Contributions and Expenditures PC I <br /> Rev. 12/03 <br />Please type or print legibly in black ink. Page 2 of2 <br />Candidate or Political Committee Name: Committee ID Number: <br />Vote Yes For External Police Review <br />[g] Original o Primary 20 [g] General 2005 o Other <br />o Amendment [g] 1 st Pre-election o 2nd Pre-election o Post-election 020 September Supplemental <br /> LOAN SUMMARY FOR OFFICE USE ONL Y <br />21. Beginning Outstanding Loans 0.00 <br /> (line 29 of previous report) <br />22. Loans Received (Non-Exempt) + 1,600.00 <br /> (line 2) <br />23. Loans Received (Exempt) + 0.00 <br /> (line ]4) <br />24. LOANS RECEIVED SUBTOTAL 1,600.00 <br /> (lines 21 + 22 + 23) = <br />25. Loan Payments (Non-Exempt) 0.00 <br /> (I ine 7) <br />26. Loan Payments (Exempt) + 0.00 <br /> (line] 8) <br />27. Forgiven Loans + 0.00 <br />(Total loans forgiven during this accounting period) <br />28. LOAN PAYMENT SUBTOTAL 0.00 <br /> (lines 25 + 26 +27) = <br />29. TOTAL OUTSTANDING LOANS 1,600.00 <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 + 34.00 <br /> (Accounting Period Total from PC 3A) <br />32. PERSONAL EXPENDITURE SUBTOTAL 34.00 <br /> (lines 30 + 31) = <br />33. Personal Expenditure Reimbursements 34.00 <br /> (Total expenditures on PC 3 with purpose code R) <br />34. Forgiven Personal Expenditures + 0.00 <br /> (Total personal expenditures forgiven this acctg. period) <br />35. REIMBURSEMENT SUBTOTAL = 34.00 <br /> (lines 33 + 34) <br />36. OUTSTANDING PERSONAL EXPENDITURES 0.00 <br /> (line 32 minus line 35) = <br /> FINANCIAL STATUS AT CLOSE OF ACCOUNTING PERIOD <br />37. Ending Cash Balance 1 069.1 8 <br /> (line 20) <br />38. Accounts Receivable + 0.00 <br /> (Accounting Period Total from PC 5) <br />39. SUBTOTAL 1069.18 <br /> (lines 37 + 38) = <br />40. Total Outstanding Loans 1,600.00 <br /> (line 29) <br />41. Outstanding Personal Expenditures + 0.00 <br /> (tine 36) <br />42. Accounts Payable + 576.00 <br /> (Accounting Period Total from PC 6) <br />43. SUBTOTAL 2,176.00 <br /> (lines 40 + 41 + 42) = <br />44. BALANCE/DEFICIT -1,106.82 <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 /> C)^ 7- :>7,. -- <br /> O~ <br />Signature of candid~ or treasurer Date signed <br /> .. <br />