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<br />PC 2 Amendment Cash Contributions, Loans Received and In-Kind <br />please type or print legibly in black ink; list only one entry per line <br /> <br />rev 1/06 <br /> <br />.J, name of committee use full name <br /> <br />committee ID number <br /> <br />o Primary 20 <br /> <br />Jana Jackson for City Council <br /> <br />o other: <br /> <br />o 1st pre-election <br /> <br />page <br /> <br />of 2 <br /> <br />o General 20 <br /> <br />o 2nd pre-election <br /> <br />o Post-election <br /> <br />020 <br /> <br />Sept. Suppl. <br /> <br />o Report of Initial Assets <br /> <br />Code 1 Contributor Type <br />B Business Entity <br />C Political Committee <br />F Candidaters Immediate Family <br />I Individual <br /> <br />L Labor Organization <br />o Other <br />P Political Party Committee <br /> <br />Code 2 Contribution Type <br />CA Cash <br />CO Cosigner Obligation <br />IK In-Kind <br />LR Loan Received <br /> <br />amending <br />page# and line# <br /> <br />in-kind purpose <br /> <br />name and address of contributor <br /> <br />amount of <br />contribution <br /> <br />date received <br /> <br />code 2 <br /> <br />occupational information* or contributing committee's 10# contributor aggregate code 1 <br /> <br />*occupational information includes occupation, employer's name, city and state or self-employed <br /> <br />page 1 line 2 <br />o new entry <br />o correcting <br />o deleting <br /> <br />Jana Jackson <br />1012 E 22nd Ave <br />Eugene, OR 97405 <br /> <br />$ <br /> <br />10.90 <br /> <br />Homecare Worker and Counter Clerk <br /> <br />$ <br /> <br />CA <br /> <br />416.18 <br /> <br />F <br /> <br />page 1 line 3 <br /> <br />o new entry <br />o correcting <br />o deleting <br /> <br />Don Flinn <br />599 Spyglass Dr <br />Eugene, OR 97401 <br /> <br />$ <br /> <br />20.00 <br /> <br />Video Rental Business Owner <br /> <br />$ <br /> <br />CA <br /> <br />20.00 <br /> <br />page line <br />o new entry <br />o correcting <br />o deleting <br /> <br />$ <br /> <br />$ <br /> <br />page line <br />o new entry <br />o correcting <br />o deleting <br /> <br />$ <br /> <br />$ <br /> <br />~\/E[~ <br />~ y, J1 <br /> <br />page line <br />o new entry <br />o correcting <br />o deleting <br /> <br />$ <br /> <br />OCT 2 6 2006 <br /> <br />$ <br /> <br />CITY RECORDEH <br /> <br />signature <br /> <br />for office use only <br /> <br /> <br />date signed <br /> <br />10 - 2(; - Ora <br /> <br />see instructions on back and in Campaign Finance Manual <br /> <br />PC 2 Amendment <br />