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<br /> PC8A <br /> Supplement to Second Pre/Post-Election - Contributions Rev. 12/03 <br />Candidate or Political Committee Name: Committee ID Number: <br />Vote Yes For External Police Review Page 1 of 1 <br />Election: o Primary 20 [g] General 2005 o Other <br />Report: o 1st Suppl. to the 2nd Pre-election [g] 2nd Suppl. to the 2nd Pre-election o Suppl. to Post-election <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 PC Pledge of Cash <br /> 0 Other PI Pledge of In-Kind <br /> P Political Party Committee PL Pledge of Loan <br />Line # Name and Address of Contributor Amount of <br /> Contribution In-Kind Purpose <br />Date Received Occupational Information or Code 1 I Code 2 (see manual for suggested purpose codes) <br />Contributing Committee's 10# <br /> Bonny Bettman <br />1. 2191 Friendly St $ 1,000.00 <br /> Eugene, OR 97405 <br />11/2/05 City Councilor I I LR <br />2. $ <br /> I <br />3. $ <br /> I <br />4. $ <br /> I <br />5. $ <br /> I <br />See FOftt~ tlJETIL Y <br />Instructions I, Judith Schaap, (name of candidate or treasurer) hereby certifY that <br />on Back and the above statement is true and correct. <br />in Campaign (\>o NOV 1 5 2005 <br />Finance -- <br />Manual 1/"') s: J7~ ~lfrv RECORDER <br />PC8A Signature of cylftidate or treasurer Date signed <br /> U <br />