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<br /> PC3A <br /> Personal Expenditures for Reimbursement 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: D Primary 20 [g] General 2005 o Other <br />Report: [g] I st Pre-election o 2nd Pre-election o Post-election 020 September Supplemental <br />PURPOSE CODES (see back of form for instructions and code definitions) <br />A Agent 0 Other Advertising (yard signs, buttons, etc.) <br />B Broadcast Advertising (Radio, TV) P Postage <br />C Cash Contributions S Surveys and Polls <br />F Fundraising Event Expenses T Travel Expenses (describe if over $50) <br />G General Operational Expenses (describe if over $50) U Utilities <br />I Interest Payment W Wages, Salaries, Benefits <br />L Literature, Brochures, Printing y Petition Circulators <br />M Management Services Z Preparation and Production of Advertising <br />N Newspaper and Other Periodical Advertising <br />Line # Date Payee's Name Purpose Amount of <br /> Expenditure <br /> 1. 8/24/2005 U.S. Postal Service G $ 34.00 <br /> 2. $ <br /> 3. $ <br /> 4. $ <br /> 5. $ <br /> 6. $ <br /> 7. $ <br /> 8. $ <br /> 9. $ <br /> 10. $ <br /> See Page Total Accounting Period Total (Complete only for last page and <br /> Instructions Personal Expenditures $ 34.00 transfer this amount to the Summary Statement, PC 1.) <br /> on Back and <br /> in Campaign Personal Expenditures $ 34.00 <br /> Finance Enter on Summary Statement, Line 31 <br /> Manual <br /> PC3A <br />