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HomeMy WebLinkAboutKitty Piercy for Mayor Summary Statement of Contributions and Expenditures Please type or print legibly in black ink. Page 1 of 2 Candidate or Political Committee Name (use full namel: Kitty Piercy for Mayor Mailing Address as it Appears on Statement of Organization (street. route or box number, city. state, zip code): P.O. Box 23301, Eu§ene, OR, 97402 TreasureFs Name: Telephone Number (day). C. Michael Arnold 541-338-9111 Committee lD Number: I Committee Type. Measure Number or Office. n/a I Candidate for Mayor [~ Original [~ Primary 200_A4 [] General 20__ [] Other __ [~ Amendment [~ 1st Pre-elect~on [~ 2nd Pre-election [] Post-election [] 20__ September Supplemental A-TOTALS FOR THIS B-CUMULATIVE TOTALS ACCOUNTING PERIOD FOR THIS ELECTION CONTRIBUTIONS 1. Cash Contributions ~Accountmg Period Total from PC 2) 38,445.50 38,445 50 2 Loans Received (Non-Exempt; + 0.00 + 38,445 50 tAccountmg Period Total from PC 2} 3. Tutu! Cash Contributions = 38,445 50 = 381445 50 (hncs 1¢ 2) 4. in-Kind + 977 84 + 977.84 (Accounhng Period Total trom PC 2) 5. TOTAL CONTRIBUTIONS = 39,423 34 = 39,423.34 (hncs 3 ~- 4) EXPENDITURES 6 Cash Expenditures 22,988 13 22,988 13 {Accounting Period Total from PC 3} 7 Loan Payments (Non-Exempt) + 0 00 + 0.00 tAcct, untmg Period Total from PC 3} 8. Total Cash Expenditures = 22,988 13 = 22,988 ~3 (lines 6 -~ 7) 9. In-Kind + 977 84 + 977 84 tAccoantmg Period Total from PC 2I l0 TOTAL EXPENDITURES = 23,965 97 = 23,965 97 (hncs 8 ~- 9) CASH BALANCE t l. Beginning Cash Balance 0 FOR OFFICE USE ONLY (line 20 or' pre~ lous report) 12 TotatContributions + 39,423 34 13. Driver Receipts + 0 O0 (Accounting Period Total fiom PC 4A~ 14. Loans Received tExempt) + 0 (Accommng Period Total fimm PC IA) 15. CONTRIBUTION SUBTOTAL = 39,423 34 ihnesll+12~13~ 14) 16. Total Expenditures 23,965 97 17. Other Disbursements + 0 O0 i Accountmg Period Total from PC 4B } 18 Loan Payments (Exempt) + 0 00 (Accounting Period Fotal from PC 4B) 19. EXPENDITURE SUBTOTA£ = 23,965 97 ''~ ~ ~' ~{~,_.'~ (lAnes 16- 17 + 18) 20. ENDING CASH BALANCE = 15,457.37 (line t5 minus iine 19) Summary Statement of Contributions and Expenditures Please type or print legibly in black ink. Page 2 of 2 Candidate or Political Committee Name: Committee ID Number' Kitty Piercy for Mayor n/a [~ Original [~1 Primary 300_~4 [~2 General 20__ [] Other __ [~ Amendment [] 1st Pre-election [] 2nd Pre-election [] Post-election [] 20__ September Supplemental LOAN SUMMARY 21. Beginning Outstanding Loans FOR OFFICE USE ONLY (hne 29 ot pre¥1ous ~¢port) 0 00 22. Loans Received (Non-Exempt) (hne 2) + 0 00 23. Loans Received (Exempt) (line 14) + 0 00 24 LOANS RECEIVED SUBTOTAL Ihncb 21 + 22 -~ 23) = 0.00 25, Loan Payments tNon-Exempt) 0.00 (line 7) 26. Loan Payments (Exempt) + 0 00 {line 18) 27. Forgiven Loans + 0 O0 (f'otal loans torglven during this accounting period) 28. LOAN PAYMENT SUBTOTAL (lines 25 + 26 +27/ = 0 00 29. TOTAL OUTSTANDING LOANS (hne 24 minus line 28) = 0 00 PERSONAL EXPENDITURE SUMMARY 30, Beginning Outstanding Personal Expenditures ( hne 36 of pre¥~ous report) 0.00 31. Personal Expenditures + 0 00 (Accodnnng Period Total from PC 3 A~ 32 PERSONAL EXPENDITURE SUBTOTAL = 0.00 (lines 30 -v 31 ) 33. Personal Expenditure Reimbursements 0 00 (Total expenditures on PC 3 with purpose code R) 34. Forgiven Personal Expenditures + 0 00 ([ oral personal expenditures ~brgivcn this acctg, period) 35. REIMBURSEMENT SUBTOTAL = 0 00 (lines 33 + 36. OUTSTANDING PERSONAL EXPENDITURES = 0 00 {hn~~ 32 mmu> line 35) FiNANCiAL STATUS AT CLOSE OF ACCOUNTING PERIOD 37. Ending Cash Balance (~me 20) 15,457 37 38 Accounts Receivable + 0 00 { Accodnm~g Period Total from PC' 5} 39 SUBTOTAL = 15,457 37 Ihnes 37 + 38) 40, Total Outstanding Loans 0 00 41. Outstanding Personal Expenditures + 0,00 ;',t (linc 36) 42. Accounts Payable {Act. ounting Period Total I¥om PC 6) + 0 00 / ~ 43. SUBTOTAL = 0 00 (line 39 minus line 43' indicate + or- balance) = 15,457 37 ' '~ ' ' ~,- - l. C Michael Amoici (name ofcandtdate or treasurert, hereb~y certify that the above statement and the attached supporting reports ate true and correct. Signature of candidate or treasurer Date signed Cash Contributions, Loans Received and Candidate or Political Committee Name: Committee ID Number: Kitty Piercy for Mayor n/a Pa~e 1 of' Election. ~;~ Pnmau 200~4 [] General 20__ E~ Other __ Report: [] 1 st Pre-elecuon [] 2nd Pre-election [~ Post-election [] 20__ September Supplemental SEE BACK FOR INSTRUCTIONS AND CODE DEFINITIONS CODE 1: Contributor Type CODE 2: Contribution Type B Business Entity CA Cash C Political Committee (includes business and union PACs) CO Costgner Obligation F Can&date's Immediate Family (includes candidate} IK In-Kind 1 Individual LR Loan Recewed L Labor Organization O Other P Political Party Committee Amount of In-K~nd Purpose Line # Name and Address of Contributor Contribution (see manual for suggested purpose codes) Date Received Occupational Informah'on or Contributor Code 1 Code 2 Contributing Committee's IDf¢ Aggregate Joan Acker ~ 2031 Hilyard $ 100 00 Eugene OR 97405 2/19/2004 rebred $ 100 00 I CA John AIIcott 2 2650 Cresta De Ruta $ 250 00 Eugene OR 97403 212612004 Physician/Therapist $ 250 00 I CA Joe Alsup 3 36 W 38th Ave $ 100 00 Eugene OR 97405 3/10/2004 School Pnnc~pal $ 100 00 I CA GdAvery 4 1175 F~ Lane $ 200 00 Eugene OR 97405 3/16/2004 RetFed Episcopal Priest $ 200 00 t CA Summit Run Corp. 5 2780 Ol~ve St $ 100 00 Eugene OR 97405 2/7/2004 $ 100 00 B CA S~e Page Totals (Add all amounts with the same Accounting Period Totals (Complete on}>, for last page and Instructions contribunon type. Do not include aggregates.) transfer these amounts to the Summar? Statement. PC on Back and Cash (CA) $ 750 00 Cash (CA) $ ~ in Campaign Emer,m Summarx Statement Colt, mn ~ ~mc I Finance Manual In-Kind (IK~ $ ~ In-Kind (IK) $ ~ PC 2 Loans Received (LR) $ __ Loans Received CLR} $ _- PC 2 Cash Contributions, Loans Received and In-Kind Candidate or Political Committee Name: Committee [D Number' Kitty P~ercy for Mayor n/a Page 2_ of Election: [] Primary 200_~4 [] General 20__ [] Other .__ Report: [] 1 st Pre-election [] 2nd Pre-election [] Post-election [~ 20__ September Supplemental SEE BACK FOR iNSTRUCTIIONS AND CODE DEFINITIONS CODE 1: Contributor Type CODE 2: Contribution Type B Business Entity CA Cash C Political Committee (includes business and anion PACs) CO Cosigner Obligation F Candidate's Immediate Family (includes candidate) [K In-Kind I Individual LR Loan Received L Labor Organization O Other P Political Party Conn-nittee Amount of In-Kind Purpose bne # Name and Address of Contributor Contdbutlon (see manual for suggested purpose codes) Date Recewed Occupational Information or Contributor Code ? Code 2 Contributing Committee's ID~ Aggregate James Baker 1 51013 McKenz~e Hwy $ 60 00 Finn Rock OR 97488 21512004 Retired $ 60 00 I CA Mel Bankoff 2 2905 Adams St_ $ 1,000 00 Eugene OR 97405 3/2612004 D~rector of Orgamc Foods, Monterey Pasta $ 1,000 00 I CA Joan Bayhss 3 2550 Dncoln $ 100 00 Eugene OR 97405 3~5~2004 Retired $ 100.00 I CA Rebecca Bent 4 2051 Dogwood $ 250.00 Eugene OR 97405 3/712004 Physician $ 250 00 I CA Bonny Bettman 5 2191 Friendly $ 200 00 Eugene OR 97405 112812004 Retired RN $ 200 00 I CA See Page Totals (Add all amounts with the same Accounting Period Totals (Complete only for last page and Instructions contribution type. Do not include aggregates.) transfer these amounts to the Summary Statement, PC on Back and Cash (CA) $1,610 00 Cash (CA) $ __ in Campatgn Eme~ 02 Stullmar5 Statement (.,4mm~ A Lm~ 1 Finance Manual In-Kind (IK} $. ~ In-Kind (IK) $ Enter on Sblxlm&~ Statem¢nt Cohm:n PC 2 Loans Received (LR) $ ,__ Loans Received (LR) $ __ Enter on Summm) Statemem, Column A, Line 2 PC 2 Cash Contributions, Loans Received and In-Kind R,, Candidate or Political Committee Name: Committee ID Number: Kitty Piercy for Mayor n/a Paae 3 of ~& Election: [~ Primary 2004 [~ General 20__ [~ Other ~ Report: [5~ 1st Pre-election [] 2nd Pre-election [] Post-election [~ 20__ September Supplemental SEE BACK FOR INSTRUCTIONS AND CODE DEFINITIONS CODE 1: Contributor Type CODE 2: Contribution Type B Business EntitT CA Cash C Political Committee (includes business and union PACs) CO Cosigner Obligation F Candidate's Immediate Family (includes candidate) 1K In-Kind i individual LR Loan Received L Labor Organization O Other P Political Party Committee Amount of In-Kind Purpose Line # Name and Address of Contributor Contribution (see manual for suggested purpose codes) Date Received Occupatmnai Information or Contributor Code l Code 2 Contributing Commlttee's ID¢¢ Aggregate Mary Ehzabeth Betts Sdver 1 2409 Lincoln St $ 100 00 Eugene OR 97405 3/16/2004 Rebred $ 100 00 I CA Anthony B~glan 22324 W. 28th Ave $ 100.00 Eugene OR 97405 3/10t2004 Psychologist $ 100 00 I CA B~ng Blngham 3 697 Crest Dr $ 100 00 Eugene OR 97405 3/6/2004 Rebred $ 100.00 I CA Jonathan Brandt 4 401 E Tenth Ave, Suite 530 $ 250 00 Eugene OR 97401 1/2612004 F~nanc~al Planner $ 250 00 I CA Ann Brown 5 997 %ara St. $ 250 00 Eugene OR 97405 3/21/2004 Rebred $ 250~00 i CA See Page Totals (Add all amounts vdth the same Accounting Period Totals (Complete only For hast page and Instructions contribution type. Do not include aggregates.) transfer these amounts to the Surrm}ary Statement, PC I. ~ on Back and Cash (CA) $ 800 O0 Cash (CA) $ _ in Campaign Enter on Summar~ Statement. C ott~mn A Line I Finance Manual In-Kind (IK) $ ~_ in-Kind (IK) $ __ Entel on Summar.~ St~temem Colmnn A Lilies 4 d. qd 9 PC 2 Loans Received (LR) $ __ Loans Received (LR} $ ~ Enter on Summary_ btatemem Column A. LIlle 2 PC 2 Cash Contributions, Loans Received and in-Kind Candidate or Political Committee Name: Committee ID Number: Kitty Piercy for Mayor n/a PaEe 4 of' ~:;: Llecvon: ~ Primao, 200_4_4 [] General 20_ [] Other__ Report [~ 1st Pre-elect~on [] 2nd Pre-election [] Post-election [] 20__ September Supplemental SEE BACK FOR INSTRUCTIONS AND CODE DEFINITIONS CODE 1: Contributor Type CODE 2: Contribution Type B Business Entity CA Cash C Political Committee (includes business and union PACs) CO Cosigner Obhgation 1: Candidate's Immediate Family (includes candidate~ IK In-Kind I Individual LR Loan Received L Labor Organization O Other P Political Party Committee Amount of /n-K~nd Purpose L¢ne # Name and Address of Contnbutor Contribution (see manual for suggested purpose codes) Date Received Occupat~ona! Information or Contributor Code ~ Code 2 Contributing Committee's ID# Aggregate Laurie Buchanan I 944 Tyler $ 100.00 Eugene OR 97402 217/2004 VP of On %me Systems, Inc (Eugene, OR) $ 100 00 I CA Suzanne Bunker 2 1870 E 27tn Ave $ 100 00 Eugene OR 97403 211212004 Speech instructor $ 100 00 I CA Lorn Byxbe 3, 677 W 23rd Ave $ 100 00 Eugene OR 97405 112612004 Rebred Architect $ 100 00 ~ CA Lmda Carmne 4 5455 Saratoga St $ 100 00 Eugene OR 97405 313112004 education consultant $ 100 00 I CA Darnel Carol 5 2440 Charnelton $ 250 00 Eugene OR 97401 1/27/2004 Polibcal Consultant $ 250 00 I CA See Page Totals lAdd all amounts with the same Accounting Period Totals (Complete only tbr last page and Instructions contribution type. Do not include aggregates ) transfer these amounts to the Sumn}a~ Statement. PC t~) on Back and Cash (CA) $ 650 00 Cash (CA/ $ __ in Campaign ~m~, o~ SmumaL~ %talcmrnt, C,)kanr~ ,~ Lm,z ' Finance Manual fn-Kind (IK) $ ~_ In-Kind (IK) $ _ g*ltel on SUIIlIIldI3~ Stalemer, t £ Oltmql ~ Lnte- 4 ~.ltd PC' 2 Loans Recewed {LR) $ ~_ Loans Received (LRt $ ~ £nte~ on Stilllm,lt-_', qtatelnch~ (. oltdnil -\ Line ~ pL Cash Contributions, Loans Received and Candidate or Political Committee Name: Committee ID Number: Kitty Piercy for Mayor n/a Page Election: [~ Primary 200_~4 [~ General 20__ [] Other ~ Report. [] 1st Pre-election [] 2nd Pre-election [] Post-elect~on [] 20__ September Supplemental SEE BACK FOR INSTRUCTIONS AND CODE DEFINITIONS CODE 1: Contributor Type CODE 2: Contribution Type B Business Entity CA Cash C Political Committee (includes business and union PACs) CO Cosigner Obligation F Candidate's Immediate Family (includes candidate) IK In-Kind 1 Individual LR Loan Received L Labor Organization O Other P Political Party Committee Amount of In-K¢nd Purpose bne # Name and Address of Contributor Contnbut¢on (see manual for suggested purpose codes) Date Received Occupatzonal Information or Contributor Code 1 Code 2 Contrtbut¢ng Committee's lDO Aggregate Chuck Catlett 1 2551 Foothills Drive $ 200 00 Burmmgham AL 35226 3t17/2004 F~nanc~al lnsbtubon Manager $ 200 00 I CA Hans Chnstofferson 2 450 Horizon Rd $ 100 00 Eugene OR 97405 2/12~2004 Theatre D~rector $ 100 00 I CA Louise Christofferson 3 450 Horizon Rd $ 100 00 Eugene OR 97405 2112/2004 Homemaker $ 100 00 ~ CA Doug Clark 4~ 346 N Grand St $ 500 00 Eugene OR 97402 1/27/2004 Retired $ 500 00 I CA Richard Coolman 5 3345 Storey B~vd $ 200.00 Eugene OR 97405 2/24/2004 Pediatrician $ 200 00 i CA See Page Totals (Add all amounts -with the same Accounting Period Totals (Complete only for last page and instructions contribunon type. Do not include aggregates.) transfer these amounts to the Summary Statement. PC 1 on Back and Cash {CA) $1,100 00 Cash (CA) $ _ in Campaign Enter on Smnmao S~temcnt. Finance Manual In-Kind (IK) $ ~. in-Kind (IK) $ __ ~Bte] un PC 2 Loans Received (LR) $ Loans Received (LR} $ __ Ellter cn Suannap_, Statemem Loltmm A, I lnc 2 PL 2 Cash Contributions, Loans Received and Candidate or Political Committee Name. Committee ID Number: Kitty Piercy for Mayor n/a Pane 6 of Elecnon: [~ Primary 200_A [] General 20__ [] Other __ Report: ~ 1 st Pre-election [--'[ 2nd Pre-election ~ Post-election [] 20__ September Supplemental SEE BACK FOR INSTRUCTIONS AND CODE DEFINITIONS CODE 1: Contributor Type CODE 2: Contribution Type B Business Entity CA Cash C Political Committee (includes business and umon PACs) CO Cosigner Obligation F Candidate's hnmediate Family (includes candidate) iK in-Kind I individual LR Loan ReceiYed L Labor Organization O Other P Political Party Committee Amount of In-Kind Purpose Dne # Name and Address of Contributor Contribution (see manual for suggested purpose codes] Occupatlonat Information or Contributor Code 1 I Code 2 Date Received Contributing Committee's ID# Aggregate Nancy Cummings I 1833 Falrmount BIvd $ 100 00 Eugene OR 97403 3131t2004 forester $ 100 00 CA Susan Cundlff 2 1515 Sylvan $ 100 00 Eugene OR 97403 1/2612004 Adjunct Professor--NCC $ 100 00 I CA R~chard Cunningham Jr 3, 1699 N Terry Spc 293 $ 100.00 Eugene OR 97402 2~20~2004 insurance Consultant $ 100 00 CA Teresa Dameron 4~ 605 Howard Ave $ 250.00 Eugene OR 97404 2/5/2004 Small Business Owners Arbonst $ 250 00 I CA Teresa Damron 5 605 Howard Ave $ 300 00 Eugene OR 97404 3/31t2004 Bus~ness Manager - Sperry Tree Care $ 300 00 I CA See Page Totals (Add all amounts with the same Accounting Period Totals (Complete only for last page and Instructions contribution type. Do not include aggregates,) transfer these amounts to the Summary Statement, PC I .) on Back and Cash/CA) $ 850 00 Cash (CA) $ __ in Campaign Emcr on bttmmau Statcraem Coltullrt A. Fmance Manual In-Kind (IK) $ ~_ In-Kind (IK) $ __ Ente~ on Summao S,,a~emcnt. CMum~ PC 2 Loans ReceNed (LR) $ Loans Received (LR) $ ~ lS. Iltc! PC 2 Cash Contributions, Loans Received and In-Kind Candidate or Political Committee Name. Committee 1D-Number: Kitty P~ercy for Mayor n/a Page Z of Election: [] Primary 200_A4 [] General 20__ [] Other Report: [] I st Pre-election [] 2nd Pre-election [~ Post-election [~J 20__ September Supplemental SEE BACK FOR INSTRUCTIONS AND CODE DEFINITIONS CODE l: Contributor Type CODE 2: Contribution Type B Business Entity CA Cash C Political Committee (includes business and union PACs) CO Cosigner Obligation F Candidate's Immediate Family (includes candidate} iK In-Kind I Individual LR Loan Received L Labor Organization O Other P Political Party Committee Line # Name and Address of Contributor Amount of ImKmd Purpose Contribution (see manual for suggested purpose codes) Date Received Occupational Information or Contributor Code 1 Code 2 Contributing Committee's ID¢¢ Aggregate Elinore Darland 1 3094 Hendncks H~iI Dr $ 100 00 Eugene OR 97403 3/10~2004 Retired $ 100 00 I CA Jean Dav~dson 2, 2295 Riverview St $ 150 00 Eugene OR 97403 1/26t2004 Counsellor $ 150 00 I CA Jean Davldson 3 2295 R~verwew St $ 100.00 Eugene OR 97403 3/10t2004 Counsellor $ 250 00 I CA John Detwefler 4 1757 Lawrence $ 100 00 Eugene OR 97401 3/10/2004 Consulting Engineer $ 100,00 I CA Elizabeth Deutch 5 1784 Skyhne Blvd. $ 100 00 Eugene OR 97403 2/5/2004 Retired $ 100 00 I CA See Page Totals (Add all amounts with the same Accounting Period Totals (Complete only for last page and Instructions contribution type. Do not include aggregates,) transfer these amounts to the Summary StatemenL PC on Back and Cash (CA) $ 550 00 Cash (CA) $ __ in Campaign Et,t~ on Snmma~ Statement Cuhmm A Line Finance Manual In-Kind (iK) $ ~. In-Kind (IK) $ __ Enter on SUIBItldF5 btatelnent Colullln PC 2 Loans Received (LR) $ __~ Loans Received tLR) $ __ Elttcr O,q StllB,llaI-.X btatemel,t. Colmnd A.. Lnlc Cash Contributions, Loans Received and Candidate or Political Committee Name. Committee ID Number: Kitty P~ercy for Mayor n/a Page_8 of~ Election, [~ Primary 200_4_4 [-1 General 20__ ~ Other__ Report [~ 1 st Pre-election [] 2nd Pre-election [] Post-election [~ 20__ September Supplemental SEE BACK FOR INSTRUCTIONS AND CODE DEFINITIONS CODE 1: Contributor Type CODE 2: Contribution Type B Business Entity CA Cash C Political Committee {includes business and umon PACs) CO Cosigner ObligatIon F Candidate's Immediate Family (includes candidate) IK In-Kind 1 Individual LR Loan Received L Labor Organization 0 Other P Pohncal Party Committee Amount of' ln-K¢nd Purpose Dne # Name and Address of Contributor Contribution (see manual for suggested purpose codes) Date Received Occupational Information or Contributor Code ? Code 2 Contributing Committee's ILY¢¢ Aggregate ,Jerome D~ethelm 1 2652 Agate St $ 100 00 Eugene OR 97403 1/28/2004 Architect/Landscape Arch~tec~ $ 100.00 I CA Diane Duke 2 1737 Walnut Dr $ 100 00 Eugene OR 97403 3~7~2004 Associate Executive D~rector of Nonprofit $ 100 00 t CA Vick~e Elmer 3 2852 Willamette St $ 100 00 Eugene OR 97405 3/1/2004 Professor $ 100 00 I CA Alison Erde 4 870 West 36th Avenue $ 100 00 Eugene OR 97405 3~7~2004 Phystctan $ 100 00 I CA Audrey Enckson 5 2555 Agate St $ 100 00 Eugene OR 97403 31412004 Rettred $ 100 00 I CA See Page Totals {Add alt amounts with the same Accounting Period Totals t Complete only tor ~ast page and Instructions contribution type. Do not include aggregates.) transfer these amounts to the Summary Statement, PC on Back and Cash (CA) $ 500 00 Cash (CA) $ ~ in Campaign En~cr on Summars. St,~t~:ment Finance Manual In-Kind (IK) $ ~_ In-Kind (IK) $ - EDIei O1l Stlll/lllaP:' Stat¢lrlCllf ( t)]tltltll PC 2 Loans Received tLR) $ _ Loans Received (LR) $ _ F~F!tUI Cash Contributions, Loans Received and In-Kind Candidate or Political Committee Name: Committee ID Number. Kitty Piemy for Mayor n/a Page 9 of ',~5 Election: [~ Primary 200_~4 [~ General 20__ [] Other__ Report: [~ 1st Pre-election [] 2nd Pre-election [] Post-election [] 20__ September Supplemental SEE BACK FOR INSTRUCTIONS AND CODE DEFINITIONS CODE 1: Contributor Type CODE 2: Contribution Type B Business Entity CA Cash C Political Committee (includes business and union PACs) CO Cosigner Obligation F Candidate's Immediate Family/includes candidate~ IK In-Kind I Indiv~dual LR Loan Received L Labor Organization O Other P Political Party Committee Amount of In-K~nd Purpose L/ne ~¢ Name and Address of Contributor Contribution (see manual for suggested purpose co¢es) Date Received Occupational Informahon or Contributor Code ~ Code 2 Contributing Committee's lot? Aggregate Arthur Farley ~ 1667 Farmount $ 75 00 Eugene OR 97403 2/19/2004 U of O professor $ 75 00 I CA Lynn Feekm 2 1060 Tyler $ 100 00 Eugene OR 97402 2/19~2004 teacher $ 100 00 I CA Ann F~danque 3 P O Box 5917 $ 200 00 Eugene OR 97405 3/21/2004 Teacher $ 200 00 I CA Juhe F~scher 4 778 Elm Dr $ 100 00 Eugene OR 97404 3fl 0~2004 Grant Writer $ 100 00 I CA Don F,sher 5 2555 H~ghland Oaks Dr $ 100.00 Eugene OR 97405 3/10/2004 Rebred $ 100 00 I CA See Page Totals (Add all amounts with the same Accounting Period Totals (Complete onl> for last page a~ld Instructions contribution type. Do not include aggregates.) transfer these amounts to the Summary, Statement. PC l,) on Back and Cash (CA) $ 575 00 Cash ICA) $ in Campaign Lurer on Sumlna~ Stateroom O4umn ~\ L,p~ t Fmanc¢ Manual In-Kind (IK) $ ~ In-Kind ilK) $ __ PC 2 Loans Received (LR) $ ~ Loans Received (LR) $ ~ Cash Contributions, Loans Received and In-Kind Candidate or Pohtical Committee Name' Committee ID Number Kitty Piercy for Mayor ale Page 10 of Electkm: [~ Primer> 200._4_4 [] General 20__ [] Other __ Report' [~ 1st Pre-election [] 2nd Pre-elect~on [] Post-election [] 20__ September Supplemental SEE BACK FOR INSTRUCTIONS AND CODE DEFINITIONS CODE 1: Contributor Type CODE 2: Contribution Type B Business Entity CA Cash C Political Committee {includes business and union PACs) CO Cosigner Obhgation F Candidate's Immediate Family (includes candidate) IK In-Kind I Individual LR Loan Received L Labor Organization t) Other P Political Part), Committee Dne # Name and Address of Contributor Amount of /n-&nd Purpose Contnbutton (see manual for suggested purpose codes) Date Recetved Occupational Information or Contributor Contributing Commtttee's ID# Aggregate Code 7 Code 2 Caroline Forell I 40 W 20th $ 200 00 Eugene OR 97405 1/28/2004 Law Professor $ 200 00 I CA Rachel Foster 2 3431 V~ew Lane $ 100 00 Eugene OR 97405 1/28/2004 Self Employed Gardemn9 Consultant/Writer $ 100 00 I CA Lawrence Fox 3 9 North Monroe St $ ~00 00 Eugene OR 97402 3/10/2004 Civd Engineer $ 100 00 I CA Gmny Freeman 4 2650 Portland St. $ 75 00 Eugene OR 97405 2/29/2004 retired $ 75 00 I CA Ronna Friend 5 2385 Madrona Dr $ 100 00 Eugene OR 97403 2/29/2004 Psychotherap~stJTeacher $ 100.00 I CA See Page Totals (Add all amounts with the same Accounting Period Totals (Complete only for last page and lnstrdct~on~ contribution type, Do not include aggregates.) transfer these amounts to the Summar? Statement. PC 13 on Back and Cash (CA) $ 575 00 Cash (CA) $ in Campaign - -- Elite, Oll StllIH~laD_~ Stdfen~ent. Colmlm A Finance Manual in-Kind (IK) $ __ In-Kind ilK) $ PC 2 Loans Received {LR) $ ~ Loans Received (LR) $ __ PC 2 Cash Contributions, Loans Received and Candidate or Political Committee Name: Committee ID Number: K~tty Piercy for Mayor n/a Page 1_21 of Election: [~ Primap~ 200_44 [] General 20__ [~ Other __ Report. [~ 1st Pre-election [] 2nd Pre-election [~ Post-election [~ 20__ September Supplemental SEE BACK FOR INSTRUCTIONS AND CODE DEFINITIONS CODE l: Contributor Type CODE 2: Contribution Type B Business Enti~ CA Cash C Political Committee (includes bus~ness and union PACs) CO Cosigner Obligation F Candidate's immediate Family (includes candidate} IK ln-Kind I Individual LR Loan Received L Labor Organization O Other P Political Party Committee Amount of In-Kind Purpose Dne # Name and Address of Contributor Contribution (see manual for suggested purpose codes) Date Received Occupational information or Contributor Code ? Code 2 Contnbut~n¢ Committee's IDB Aggregate Lmda Fuller 1 2401 W 22nd Ave $ 150 00 Eugene OR 97405 112812004 Umvers~ty Professor $ 150 00 I CA Dawd Funk 2. 30806 Blanton Rd. $ 500 00 Eugene OR 97405 2/1212004 Graphic Designer $ 500 00 I CA Duane Funk 3 30806 Blanton Rd $ 500 00 Eugene OR 97405 211212004 ESL Teacher $ 500 00 I CA Kathy G~ng 4 PO Box11245 $ 10000 Eugene OR 97440 1126/2004 Realtor $ 100 00 I CA Rebecca Gladstone 5_ 2713 Fa~rmount BIvd $ 125.00 Eugene OR 97403 2t24/2004 Not Employed $ 125 00 I CA See Page Totals (Add all amounts with the same Aeeounting Period Totals (Complete only tut last page and Instructions contribution type. Do not include aggregates.) transfer these amounts to the Summary Statement, PC on Back and Cash/CA) $1,37500 Cash (CA) $ _ in Campaign kmet OD S[tlnlllaP ~tat~men' Finance Manual In-Kind (IK) $ ~ In-Kind (IK) $ _ Enter PC 2 Loans Received (LR) $ ~ Loans Received tLR) $ __ eL 2 Cash Contributions, Loans Received and in-Kind Candidate or Political Committee Name: Committee ID Number. Kitty Piercy for Mayor nta Paae 12 of Election: [] Primary 200_A [] General 20__ [] Other __ Report: [] 1st Pre-election [] 2nd Pre-election [~1 Post-election [~1 20__ September Supplemental SEE BACK FOR INSTRUCTIONS AND CODE DEFINITIONS CODE 1: Contributor Type CODE 2: Contribution Type B Business Entity' CA Cash C Political Committee (includes business and union PACs) CO Cosigner Obligation [: Candidate's immediate Family tincludes candidate) IK Fa-Kind 1 Individual LR Loan Received L Labor Organization O Other P Political Party Committee Amount of In4~lnd Purpose Line # Name and Address of Contributor Contribution (see manual for suggested purpose codes) Occupational information or Contributor Code 1 I Code 2 Date Received Contributing Committee's ID¢¢ Aggrecate Bill Goldsmith 1 390 E 30th Ave $ 100 00 Eugene OR 97405 1/28/2004 Rebred $ 100 00 I CA Denms Gordmeer 2 821 Kelly $ 100 00 Eugene OR 97404 2/19/2004 teaching assistant $ 100,00 I CA Dawd Gusset 3 16'11 Lincoln St $ 100 00 Eugene OR 97401 2/5/2004 Viohn Maker $ 100 00 { CA Allen Hancock 4 2244 Aider St $ 100 00 Eugene OR 97405 3/31/2004 Non profit consultant $ 100 00 I CA Cece Headley 5 1204 Sunnys~de Dr $ 100 00 Eugene OR 97404 3/17~2004 Forester $ 100 00 I CA See Page Totals (Add all amounts with the same Accounting Period Totals (Complete only ~br last page and Instructions contribution ty'pe. Do not include aggregates.) transfer' these amounts to the SummaD Statement, PC on Back and Cash (CA) $ 500 00 Cash (CA) $ ill Campaign Enmr on Summarx SLllem¢Irt. Coitum, A Linc Fmance Mantra} In-Kind (IK) $ __ In-Kind (IK) $ PC 2 Loans Received (LR) $ ~ Loans Received (LR) $ ~ gnrer on SdllllI'tar? Statement Cl)JttlBh ;Sx, LIBO 2 PC 2 Cash Contributions, Loans Received and Candidate or Pohncal Committee Name: Commtrree I-D Number: Kitty Piercy for Mayor n/a Page 13 ol Elecnon: [] Primau 2004 [] General 20__ [] Other__ Report: [] 1 st Pre-election [] 2nd Pre-election [] Post-election [] 20__ September Supplemental SEE BACK FOR INSTRUCTIONS AND CODE DEFINITIONS CODE 'i: Contributor Type CODE 2: Contribution Type B Business Entity CA Cash C Political Committee (includes business and union PACs) CO Cosigner ONiganon F Candidate's lrmnediate Family (includes candidate) IK in-Kind I Individual LR Loan Recewed L Labor Organization 0 Other P Political Party Committee Amount of ln-K~nd Purpose Dne # Name and Address of Contributor Contnbutton (see manual for suggested purpose codes) Date Received Occupational Information or Contributor Code ~ Code 2 Contributing Committee's ID~ Aggregate Sloan Heermance I 2406 Lawrence Alley $ 100 00 Eugene OR 97405 3/17/2004 Wnter $ 100 00 I CA Emily Hellbrun 2 86437 Greenbrlar Dr $ 100 00 Eugene OR 97402 3/17~2004 Unemployed $ 100 00 I CA Sarah Hendrlckson 3 1036 Adams St $ 100 00 Eugene OR 97402 2/12/2004 Physician $ 100 00 I CA Stephen Hidalgo 4 1010 EIkay Dnve $ 60 00 Eu9ene OR 97404 2/5/2004 Educator $ 60 00 I CA Douglas Hmtz 5 2536 Wood Ave $ 100~00 Eugene OR 97402 2/5/2004 Umverslty instructor $ 100 00 t CA See Page Totals (Add alt amounts with the same Accounting Period Totals (Complete ont3 for last page and [nstrucnons contribution type, Do not include aggregates.) transfer these amounts to the Summao Statement. PC 1,) on Back and Cash (CA) $ 460 00 Cash (CA) $ __ Finance Manual In-Kind (IK) $ ~ In-Kind (IK) PC 2 Loans Received (LR) $ __ Loans ReceiYed (LR} $ __ p~£ 2 Cash Contributions, Loans Received and In-Kind Candidate or Political Committee Name: Committee ID Number: Kitty Piercy for Mayor n/a Page 14 of Election [] Primary 2004 [] General 20__ [~ Other__ Report. [] 1st Pre-election [] 2nd Pre-election [] Post-election [] 20__ September Supplemental SEE BACK FOR ~NSTRUCTIONS AND CODE DEFINITIONS CODE 1: Contributor Type CODE 2: Contribution Type B Business Entity CA Cash C Political Committee (includes business and union PACs} CO Cosigner Obligation F Candidate's Immediate Family (includes candidate) IK In-Kind I Individual LR Loan Received L Labor Organization 0 Other P Political Party Committee Amount of In-K;nd Purpose Line # Name and Address of Contnbutor Contribution (see manual for suggested purpose codes) Occupational Information or Contributor Date Received Contnbuting Commtttee's IDt¢ Aggregate Code 1 , Code 2 Patnc~a H~ne 1 29755 Lusk Rd $ 100.00 Eugene OR 97405 1/26t2004 College instructor/Corporate Trainer $ 100 00 I CA Patncia H~ne 2 29755 Lusk Rd $ 100 00 Eugene OR 97405 3t10/2004 College instructor/Corporate Trainer $ 200 00 I CA Rosemary H~te 3 77500 S. 6th St,, Umt B22 $ 100 00 Cottage Grove OR 97424 2/5/2004 Rebred $ 100 00 I I CA Pau~ Holvey 4 468 E 34th Ave $ 100 00 Eugene OR 97405 3/1/2004 State Leg~slatodCarpenter $ 100 00 I CA Carol Home 5 540 East 30th Ave, #1 $ 100 00 Eugene OR 97405 2/5/2004 Research Assistant/Writer $ 100 00 I i CA See Page Totals (Add all amounts with the same Accounting Period Totals (Complete only for last page and Instructions contribution b, pe. Do not include aggregates ) transfer these amounts to the Summa[5, Statement. PC 13 on Back and Cash (CA) $ 500 00 Cash (CA) $ __ in Campaign Enter o~ bm~maf}, Stmemen'; C Finance Manual In-Kind (IK/ $ _ In-Kind (IK) $ ~ PC 2 Loans Received (LRt $ __ Loans Received (LRt $ __ Enle! on Suttqllar5 Stalcblcr4. (-olulti,l A k tile PE 2 Cash Contributions, Loans Received and n-Kind Candidate or Politica~ Committee Name: Committee ID Number. Kitty Piercy for Mayor n/a Pane 15 off~ Election: [~ Primary 200__~4 E~ General 20__ [~ Other Report: [] 1 st Pre-election [] 2nd Pre-election [] Post-election [] 20__ September Supplemental SEE BACK FOR iNSTRUCTIONS AND CODE DEFINITllONS CODE 1: Contributor Type CODE 2: Contribution Type B Business Entity CA Cash C Political Committee (includes business and union PACsl CO Cosigner Obliganon F Candidate's Immediate Family (includes candidate) iK in-Kind I IndividuaI LR Loan Received L, Labor Orgamzation O Other P Political Party Committee Amount of ln-Ktnd Purpose Lee # Name and Address of Contributor Contribution (see manual for suggested purpose codes) Date Received Occupational Information or Contributor Code ~ Code 2 Contributing Committee's ID# Aggregate Arnold Ismach 1 5326 Tahsd~ St Eugene OR $ 100 00 97405 2/5~2004 Retired $ 100 00 I CA Peter James 2 202 Hawthorne $ 100 00 Eugene OR 97404 2/19/2004 attorney $ 100 00 ~ CA Amta Johnson 3 2288 B~rch Lane $ 500 00 Eugene OR 97403 1127/2004 Joumahst $ 500 00 t CA Martin Jones 4 2300 Parkslde LN $ 100 00 Eugene OR 97403 112812004 Phys,oan $ 100 00 I CA Barbara Kellogg 5 3465 Chevy Chase $ 100 00 Eugene OR 97401 3110/2004 Umon Organizer $ 100 00 I CA See Page Totals (Add all amounts witl~ the same Accounting Period Totals (Complete only for last page and instructions contribution type. Do not include aggregates.) transfer these amounts to the Summary Statement, PC ~. ) on Back and Cash (CA) $ 900 00 Cash (CAt $ tn Campaign Enter on %ummau St~.temcni L'~,humt ,~, :mc I Finance Manual ln-Kmd(IK) $_ in-Kind (1K) $ __ PC 2 Loans Received (LR) $ _ Loans Received (LR) $ ~ Cash Contributions, Loans Received and In-Kind Candidate or Political Committee Name: Committee ID Number: Kitty Piercy for Mayor n/a Page 16 of ~ Election: [~ Primary 200_¢_4 [] General 20__ [] Other__ Report: ~] 1st Pre-election [] 2nd Pre-election [] Post-election [] 20__ September Supplemental SEE BACK FOR INSTRUCTIONS AND CODE DEFINITIONS CODE 1: Contributor Type CODE 2: Contribution Type g Business Entib' CA Cash C Political Committee (includes business and union PACs l CO Cosigner Obligation F Candidate's Immediate Family (includes candidate) 1K in-Kind I Individual LR Loan Received L Labor Organization 0 Other P Pohtmal Party Committee Amount of ln-t<~nd Purpose bne # Name and Address of Contributor Contribution (see manual for suggested purpose codes) Date Received Occupational Information or Contributor Code '1 Code 2 Contributing Committee's ID# Aggregate Dawd Kelly 1 1040 Ferry St #B405 $ 100 00 Eugene OR 97401 1/28f2004 computer systems consultant $ 100 00 I CA HeatherKent 2 24214 Suttle Rd. $ 250 00 Veneta OR 97487 2t1212004 consultant for small businesses $ 250 00 I CA Judith Krug 3 2551 Foothdls Dr $ 100 00 B~rmingham AL 35226 3/2112004 Professor $ 100.00 ~ CA Georgia Layton 4 2324 W 28th Ave $ 100 00 Eugene OR 97405 3/10/2004 Preschool D~rector $ 100 00 I CA Mona Lmstromberg 5 87140 Terntonal Rd $ 100 00 Veneta OR 97487 1/26/2004 Licensed Tax Consultant $ 100 00 I CA Sec Page Totals (Add all amounts w~th the same Accounting Period Totals (Complete only for last page and Instructions contribution type. Do not include aggregates.) transtar these amounts to the Summary Statement, PC 1.) on Back and Cash (CA) $ 650 00 Cash iCA) $ m Campaign ~:,~r ot~ Smm~mp, Stattm~¢t~t ~ olt~mu K Linc [ Finance Manual Ia-Kind (iK) $ ~ In-Kind (IKt $ __ PC' 2 Loans Received (LR) $ __ Loans ]Received (LR) $ __ PL 2 Cash Contributions, Loans Received and in-Kind Candidate or Political Committee ]',lame: Committee ID Number Kitty Piercy for Mayor n/a Page 1_Z7 ot: }5 Election: [] Primar~ 2004 [] General 20__ [] Other __ Report' [] 1st Pre-elecnon [] 2nd Pre-election [] Post-election [--] 20__ September Supplemental SEE BACK FOR INSTRUCTIONS AND CODE DEFINITIONS CODE 1: Contributor Type CODE 2: Contribution Type B Business Entity CA Cash C Political Contmittee (includes business and union PACs) CO Cosigner Obhgation F Candidate's Immediate Family (includes candidate) 1K [n-Kind I Individual LR Loan Received L Labor Organization ,5) Other P Political Party Committee bne # Name and Address of Contributor Amount of In-Kind Purpose Contribution (see manual for suggested purpose codes/ Date Received Occupational Information or Contributor Contributing Committee's ID# Aggregate Code ~ Code 2 V~rgm,a Lo 1 1855 E 28th Avenue $ 500 00 Eugene OR 97403 2~612004 Professor of Computer Science $ 500 00 I CA Lydia Lord 2 334 Lone Oak Ave $ 100 00 Eugene OR 97404 3/2112004 Songwriter $ 100.00 I CA Joy Marshall 3 5166 Alpine Loop $ 100 00 Eugene OR 97405 2/12/2004 Dir Of Non-Profit $ 100 00 I CA James Mattiace 4 P O Box 10063 $ 100 00 Eugene OR 97440 3t3/2004 Teacher $ 100 00 I CA Robert McCarthy 5 24214 Suttle Rd $ 250.00 Veneta OR 97487 2/1212004 retired $ 250 00 I CA See Page Totals (Add all amounts with the same Accounting Period Totals (Complete onb fur last page and Instructions contribution t:~pe. Do not include aggregates.) transfer these amounts to the Summar? Statement. PC 1 ~) on Back and Cash (CA) $1,050 00 Cash (CA) $ in Campaign Enlcr on Sumlna~, Statement Column K, i_mc ~ Finance Manual In-Kind (IK) $ ~ In-Kind (IK~ $ PC 2 Loans Received (LR/ $ __ Loans Received (LR) $ __ Cash Contributions, Loans Received and In-Kind R,, Candidate or Potitica~ Committee Name: Committee ID Number: Kitty Piercy for Mayor n/a Page 1__8.8 of ~ ~ Election. [~ Primary 200~4 [] General 20__ [] Other__ Report' [] 1st Pre-elect~on [] 2nd Pre-election [] Post-elecnon [] 20__ September Supplemental SEE BACK FOR ]iNSTRUCTiONS AND CODE DEFINITIONS CODE 1' Contributor Type CODE 2: Contribution Type B Business Ent~t~ CA Cash C Pohtical Committee (includes bus~ness and union PACs) CO Cosigner Obligation F Candidate's Immediate Family Oncludes candidate) 1K in-Kind ~ Individual LR Loan Received L Labor Orgamzation O Other P Political Party Committee Dne # Name and Address of Contributor Amount of ln-K~nd Purpose Contribution (.see manual for suggested purpose codes) Date Received Occupational Information or Contributor Contributing Commlttee's ID¢¢ Aggregate Code ~ Code 2 Laurie McClam 245 North I Polk Eugene OR 97402 $ 100 00 3/26/2004 Financial Advisor $ 100 00 I CA GregoryMcLauchlan 2401 W 2 22nd Ave Eugene OR $ 150 00 97405 1/28/2004 Umvers~ty Professor $ 150 00 I CA Robert Melmck 1870 E 27th Ave Eugene OR 97403 $ 100 00 2/t2/2004 ua Architecture Prof $ 100 00 I CA Kathleen Mercer 1367 Keller 4 St. Eugene OR 97404 $ 200 00 3/10/2004 Attorney $ 200 00 I CA Betsy Meredith 2075 5 Kmcaid St Eugene OR $ 125~00 97405 3/17/2004 Nursing Supervisor $ 125 00 I CA See Page Totals (Add ail amounts with the same Accounting Period Totals (Complete onb ~br last page and Instructions contribution type. Do not include aggregates.) transfer these amounts to the Summary Slatement, PC 1. ) on Back and Cash (CA~ $ ~75 00 Cash (CA) $ _ in Campaign Enter on bumma~~, Statement C,~/tmm & ~.me _' Finance Manual In-Kind (iK) $ __ In-Kind (IK) $ __ Erlf~r Oil St~l111113t~ b[atcmepf. CollllilD ~,~ ktt/c~ 4 and '~ PC 2 Loans Received (LR) $ __ Loans Received ILRt S ~ PC Cash Contributions, Loans Received and in-Kind Can&date or Polmcat Commi~ee Name: Comml~ee ID Number: Kitty Piercy for Mayor n/a Page 19 Election· ~ Primary 200~ ~ Oenera120~ ~ Other ~ Repo~. ~ 1st Pre-election ~ 2nd Pre-election ~ Post-election ~ 20~ September Supplemental SE~ BACK FOR INSTRUCTIONS AND CODE B~FINITIONS CODE 1: Contributor Type CODE 2: Contribution Type B Business Entity CA Cash C Political Committee (includes business and union PACs) CO Cosigner Obligation F Can&date's Immediate Family (includes candidate) iK In-Kind I IndMdual LR Loan Recetved L Labor Orgamzatlon O Other P Political Pa~y Commi~ee Amount of /n-K¢nd Purpose Dne¢ Name and Address of Contributor Contribution (see manual for suggested pu¢ose codes) Date Recetved Occupational Informat/on or Contributor Code 1 Code 2 Contnbottng Comm~¢ee's I~ Aggregate Dawd Meredith I 2075 Kmcald St $ 125.00 Eugene OR 97405 3/17/2004 Foundation D~rector $ 125 00 I CA Hamet Memck 2~ 1332 Oak Patch Rd Apt 84 $ 300 00 Eugene OR 97402 2/29/2004 Manager-Purchasing UO $ 300 00 I CA Harriet Memck 3 1332 Oak Patch Rd, ~84 $ 100 00 Eugene OR 97402 3/21/2004 Manager-Purchasing UO $ 400 00 ~ CA Steven Me~m 4 2220 Sandy Dr $ 100 00 Eugene OR 97401 3/7/2004 Soc~al Worker $ 100 00 I CA Christopher M~chaels 5 1193 Van Buren $ 100 00 Eugene OR 97402 1/28/2004 Teacher, Daycare Co-Director $ 100 00 ~ CA Sec Page Totals (Add all amounts with the same Accounting Period Totals (Complete only ~or last page and ~nswucdons contdbutmn Dpe. Do nor include aggregates3 transfer these amounts to the Summary Statement. PC l on Back and Cash {CA) $ 725 00 Cash (CA) in Campaign E~r on Smnmar5 Statement Column L Finance Manual ln-K~nd (IK) $ In-Kind (IK) $ - PC 2 Loans Received (LR) $ Loans ReceNed (LR} $ ~ Enter on Sttllllllar} Statenleq~ Colt[nm A. LIlle PC 2 Cash Contributions, Loans Received and n-Kind Can&date or Political Committee Name: Committee ID Number. Kitty Piercy for Mayor n/a Page 2_~0 of ~} Election: ~1 Primary 200_A4 [77] General 20__ [~ Other__ Report: ~ 1st Pre-election [] 2nd Pre-elecnon [] Post-election [~ 20__ September Supplemental SEE BACK FOR IINSTRUCTIONS AND CODE DEFINIITIONS CODE 1: Contributor Type CODE 21 Contribution Type B Business gnnt5 CA Cash C Political Committee (includes bus~ness and union PACs) CO Cosigner ObligatIon F Candidate's Immediate Family (includes candidate) iK in-Kind I Individual LR Loan Received L Labor Organization O Other P Pohtical Party Committee Amount of In~K~nd Purpose L;ne # Name and Address of Contributor Contribution (see manual for suggested purpose codes} Date Received Occupational Information or Contributor Code ? Code 2 Contributing Committee's lDO Aggregate Gretchen Miller ~ 1036 Adams St $ 100 00 Eugene OR 97402 2112/2004 Attorney $ 100 00 I CA Nancy Miller 2 3625 Donald $ 100 00 Eugene OR 97405 3/1612004 Property Manager $ 100 00 I CA Tracy M~ller 3 1895 Lawrence St $ 100 00 Eugene OR 97401 3/5/2004 WnterlTeacher $ 100.00 I CA Dawd Monk 4 3720 Emerald $ 500 00 Eugene OR 97405 2/19/2004 Exec Director of nonprofit $ 500 00 I CA Sandra Morgen 5 ~910 Chamelton $ 100 00 Eugene OR 97405 1/28/2004 Umverslty Professor $ 100 00 I CA See Page Totals ~Add ali amounts with the same Accounting Period Totals (Complete only ~br las~ page and Instructions contribution type. Do not include aggregates.) transfer these amounts to the St~mmar> Statement. PC on Back and Cash (CA) $ 900 00 Cash (C'A) $ __ in Campaign ~,,~e~ on Summar5 Statement Column ~'~ Finance Manual In-Kind (IK) $ ~ In-Kind (1K) $ __ Emei on SUllllllat.x btatcmen: (_'oblliili _:k PC 2 Loans Received (LR) $ __ Loans Received (LR) $ __ Elltcl O~ SUlPlTlfll75 Statclllellt, COIUIllll A L~le Pt' Cash Contributions, Loans Received and n-Kind Candidate or Political Committee Name' Committee ID Number K~tty Piercy for Mayor n/a Pa~.e 21 of }} Elect~on: ~_~ Primary 200_~4 [] General 20__ E~ Other __ Report' ~ 1st Pre-election [] 2nd Pre-election E~ Post-election [] 20__ September Supplemental SEE BA£ K FOR INSTRUCTIONS AND CODE DEFINITIONS CODE 1: Contributor Type CODE 2: Contribution Type B Business EntIty CA Cash C Political Committee (includes business and union PACs) CO Cosigner Obhgation F Candidate's Immediate Family (includes candidate) IK In-Kind 1 lndiwdual LR Loan Received L Labor Organization O Other P Political Party Committee Amount of In-K~nd Purpose Dne # Name and Address of Contributor Comnbut~on (see manual for suggested purpose codes) Occupational Information or Co~tnbutor Code ~I I Code 2 Date Received Contributing Committee's ID¢¢ Aggregate Ann Muller 1330 E 25th Ave Eugene OR 97403 $ 100 00 2/7t2004 Retired $ 100 00 I CA Lucmda Mumz-Hale 2811 Tandy 2 Turn Eugene OR 97401 $ 100 00 2~5/2004 Soc~a~ Worker $ 100 00 CA Judith A Nakhmklan-We~ntraub 3 2135 Essex Lane EugeneOR $ 100 00 97403 1126/2004 mvesbgator $ 100 00 I CA Deborah Noble 4990 West 4 Hdls~de Dr Eugene OR $ 500 00 97405 2/5/2004 Business owner (t~mber sales) $ 500 00 t CA Patnc~a Noyes 2014 Elk Ave 5 Eugene OR 97403 $ 300 00 3131/2004 ReSted $ 300 00 I CA See Page Totals (Add alt amounts with the same Accounting Period Totals tOomplete only for ~ast page and Instructions contribution type. Do not include aggregates.) transfer these amounts to the Summa on Back and Cash (CA) $1,100 00 Cash (CA) $ _ in Campaign Eme, Finance Manual In-Kind (IK) $ ~ In-Kind (1K) $ __ PC 2 Loans Received (LR} PE 2 Cash Contributions, Loans Received and In-Kind Candidate or Political Committee Name: Committee ID Ndmber: Kitty Piercy for Mayor n/a Page 22 of Election: [~ Primary 2004 [] General 20__ E~] Other ___ Report' [~ tst Pre-election [] 2nd Pre-election [] Post-election E~] 20__ September Supplemental SEE BACK FOR I~NSTRUCTIONS AND CODE DEFItNITIONS CODE 1: Contributor Type CODE 2: Contribution Type B Business Entity CA Cash C Polincal Committee (includes business and union PACs) CO Cosigner Obligation F Candidate's immediate Family (includes candidate) IK ln-Kind I Individual LR Loan Received L Labor Organization O Other P Political Par~y Commtrtee Amount of In-Ktnd Purpose L/ne # Name and Address of Contributor Contribution (see manual for suggested purpose codes) Occupatlonal Informatton or Contributor Date Received Code 1 Code 2 Contributing Committee's IDt¢ Aggregate Mary O'Bnen 1 3525 Gflham Rd $ 300 00 Eugene OR 97408 2/6/2004 Environmental Sctenbst $ 300 00 I CA Charle Ogle 2 2540 Woodland Dr $ 200 00 Eugene OR 97403 3/1/2004 Musical Instruments Maker $ 200 00 I CA Deborah Olson 3 1755 W. 25th Ave $ 100.00 Eugene OR 97405 3/26/2004 Professor $ 100 00 I CA Carole Patterson 4 2561 Fnendly St $ 100 00 Eugene OR 97405 2/12/2004 Artist/Orgamzer $ 100 00 I CA Lynn Pederson 5 759 Sunnys~de Dr $ 200 00 Eugene OR 97404 2/12/2004 rebred $ 200 00 t CA Sec Page Totals (Add ali amotmts with the same Accounting Per~od Totals (Complete onk' for last page and Instructions contribution type. Do not include aggregates.) translbr these amounts to the Summar5 Statement, PC on Back and Cash (CA) $ 900 00 Cash (CA) $ _ in Campaign Lntc~ o1~ 5dlnnlat~, St,~temcnt (olulni, Finance Manual In-Kind (IK) $ ~ In-Kind (IKI $ PC 2 Loans Received tLR~ $ ~ Loans Received (LR} $ ~ P£ 2 Cash Contributions, Loans Received and In-Kind Candidate or Political Committee Name: Committee ID Number: Kitty Piercy for Mayor n/a Page 23 ot Election: [] Primary 2004 I~ General 20__ [~ Other ~ Report: [] 1st Pre-election [] 2nd Pre-election [] Post-election [] 20__ September Supplemental SEE BACK FOR INSTRUCTIONS AND CODE DEFINITIONS CODE 1: Contributor Type CODE 2: Contribution Type B Business Enttty CA Cash C Political Committee (includes business and union PACs) CO Cosigner Obligation F Candidate's Immediate Family (includes candidate) ~K In-Kind I lndwMual LR Loan Received L Labor Organization O Other P Pohtical Party Committee Amount of ln-Ktnd Purpose Dne# Name and Address of Contributor Contribution (see manual for suggested purpose codes) Date Received Occupational Information or Contributor Code ? Code 2 Contributing Committee's ID'CC Aggregate Galen L Ph~pps ~ 56759 North Bank Rd $ 200 00 McKenme Bridge OR 97413 2/5/2004 Social Worker $ 200 00 I CA Amy Pmcus 2 2220 Sandy Drive $ 100 00 Eugene OR 97401 112812004 Radio Producer, owner InForm Producbons $ 100 00 I CA Ann Porterfleld 3 117 Elkay Dr $ 100 00 Eugene OR 97404 2/12/2004 Energy Spec~ahst $ 100 00 I CA Sharon Posner 4 2473 Columbia St $ 250 00 Eugene OR 97403 21512004 TV Producer $ 250 00 I CA Jack Pueschner 5 1512 Barber Dr $ 100 00 Eugene OR 97405 3/10/2004 Retired $ 100 00 I I CA See Page Totals (Add alt amounts with the same Accounting Period Totals (Complete only for last page and tnstrucnons contribution .type. Do not include aggregates.) transfer these amounts to the Summary StatemenL PC 1. on Back and Cash (CA) $ 750 00 Cash (CA) $ __ in Campaign Enter un Sammao StaB. merit Finance Manual In-Kind (IK) $ _ In-Kind (iK) $ _ Lurer on %llPO. llla. F~ Statemen~ PC 2 Loans Received tLR) $ __ Loans Received tLR} $ __ £nte~ on Smmnao Statement Colmn,1 4. [ mc 2 {'£' 2 Cash Contributions, Loans Received and In-Kind Can&date or Polmcal Committee Name: Committee ID Number: Kitty Piercy for Mayor nlm Pa~e 24 of ~ Election' [~ Primary 200~4 [] General 20__ [] Other _ Report: [~ 1st Pre-election [] 2nd Pre-election [] Post-election [] 20__ September Supplemental SEE BACK FOR INSTRUCTIONS AND CODE DEFINITIONS CODE 1: Contributor Type CODE 2: Contribution Type g Business Ennty CA Cash C Pohtical Committee (includes business and umon PACs} CO Cosigner Obligation F Candidate's Immediate Family {includes candidate) ~K In-Kind I Individual LR Loan Received L Labor Organization O Other P Political Party Committee Dne# Name and Address of Contributor Amount of In-Ktnd Purpose Contribution (see manual for suggested purpose codes) Date Recewed Occupational Information or Contributor Contributing Committee's ID# Aggregate Code ~ Code 2 Gary Rayor I 2373 Washington $ 100.00 Eugene OR 97405 3/10/2004 C~v~l Engineer $ 100 00 I CA Joe R~chards 2 3581 Agate St $ 75 00 Eugene OR 97405 3117/2004 Attorney $ 75 00 I CA Marian R~chards 3 3581 Agate St $ 75 00 Eugene OR 97405 3/17/2004 Rebred $ 75 00 I CA Richard Romm 4 5120 Nectar Way $ 100 00 Eugene OR 97403 3/21/2004 retired $ 100 00 I CA M~chael Rose 5 2690 Lawrence $ 100.00 Eugene OR 97405 3/31/2004 Rebred $ 100 00 I CA See- Page Totals (Add all amounts xvith the same Accounting Period Totals {Complete onl5 fbr last page and Instructions contribution type~ Do not include aggregates.) transfer these amounts to the Summary Statement, PC 1 on Back and Cash iCA} $ 450 00 Cash (CA} $ in Campaign ~,~[e,- on Smnmao >~at~.mcnt C~,lmni, ,x, Linc Finance Manual In-Kind (IK) $ __ In-Kind (iK) $ PC 2 Loans Received (LR) $ __ Loans Received (LR) $ __ Et_ 2 Cash Contributions, Loans Received and tn-Kind Can&date or Pohtlcal Committee Name: Committee ID Number. Kitty P~ercy for Mayor n/a Page 2~5 of > ~ Election. [~ Primary 200_~4 [~ General 20__ [] Other __. Report' []I st Pre-election [] 2nd Pre-election [-'1 Post-election [] 20__ September Supplemental SEE BACK FOR INSTRUCTIONS AND CODE DEFINITIONS CODE l: Contributor Type CODE 2: Contribution Type B Business Entity CA Cash C Political Committee (includes business and union PACs) CO Cosigner Obligation F Candidate's Immediate Family (includes can&date) iK in-Kind I IndMdual LR Loan Received L Labor Organization O Other P Political Party Committee Amount of In-Kind Purpose Line # Name and Address of Contributor Contribution (see manual for suggested purpose codes) Date Received Occupational Information or Contributor Code 1 Code 2 Contributing Committee's IDOl: Aggregate Nancy Rose 1 2690 Lawrence $ 100 00 Eugene OR 97405 3/3112004 Retired $ 100 00 I CA Magaret (Margo) Schaefer 2 1625 Wdson St ', $ 100 00 Eugene OR 97402 2112/2004 Cornmumty Education $ 100 00 I CA Laun Segel 3 120 W Broadway $ 100 00 Eugene OR 97401 3110/2004 Planmng Advocate $ 100 00 I CA Ekse Self 4 87201 Reynolds Dr. $ 100 00 Eugene OR 97402 3/21t2004 Minutes Recorder $ 100 00 I CA Roslyn Slowc 5 4801 Donald St $ 100 00 Eugene OR 97405 3/31/2004 Semor Research Assistant $ 100.00 I CA See Page Totals (Add all amounts with the same Accounting Period Totals tComplete Chi5 for last page and fnsn'uctions contribution type Do not include aggregates.) transfeI these amounts to the Summary Statement, PC 1. } on Back and Cash (CA) $ 500 00 Cash (CA) $. m Campaign Eme~ on 5tnm~ary Sta[emel t. Cob,mn ,\ Lint. l Finance Manual In-Kind (fK) $ __ In-Kind (1K) $ __ Enter on %tlltilllar}_ btAemcl t. C OlttDtll ,~. Linc- 4 PC 2 Loans Received (LR) $ _ Loans Received (LR) S __ Cash Contributions, Loans Received and In-Kind Candidate or Pohncat Committee Name: Committee iD Number: Kitty Piercy for Mayor nla E~e 26 of '~; Eiection [] Primary 2U0_~4 [] General 20__ [7] Other ~ Reporp [] 1st Pre-election [~] 2nd Pre-election [~] Post-election [] 20__ September Supplemental SEE BACK FOR INSTRUCTIONS AND CODE DEFINITIONS CODE 1: Contributor Type CODE 2: Contribution Type B Business Entity CA Cash C Political Committee (includes business and union PACs) CO Cosigner Obligation F Can&date~s Immediate Family (includes candidate) IK Ia-Kind I Individual LR Loan Received 1_ Labor Organization O Other P Pohncal Party Committee Amount of In-a~nd Purpose Dne # Name and Address of Contributor Contribution (see manual for suggested purpose code~l Date Received Occupational Information or Contributor Code 1 Code 2 Contributing Committee's ID'cC Aggregate Thelma Soderqmst ~ 2577 N~xon St $ 100 00 Eugene OR 97403 1/28/2004 Unemployed $ 100 00 I CA Amta Stellmg 2_ 997 Tiara St $ 250 00 Eugene OR 97405 3/21/2004 Retired $ 250 00 1 CA Trna Stupasky 3 30900 Blanton Rd $ 100 00 Eugene OR 97405 3/2112004 Attorney $ 100 00 I CA Sue Subbot 4 85213 Chezem Rd $ 100 00 Eugene OR 97405 3/4/2004 Teacher $ 100 00 I CA Cary Thompson 5 966 Jackson $ 500 00 Eugene OR 97402 2112/2004 retired $ 500 00 I CA See Page Totals (Add ail amounts with the same Accoutering Period Totals (Complete only for last page and Instrucno~s contribution type. Do not include aggregates.) transfer these amounts to the Summar~ Statement. PC t ~ on Back and Cash (CA) $ q ,050 00 Cash (CA) $ __ in Calnpaign £nt~[ o~ Slmun~ir,, S~temenL C~,im;ln a., Linc t Finance Manual In-Kind (IK) $ ~ In-Kind (IK) $ PC' 2 Loans Received (LR) $ ~ Loans ReceNed (LR/ $ __ Cash Contributions, Loans Received and Candidate or Political Committee Name: Committee ID Number' Kitty Piercy for Mayor n/a Page 27 Election: [~ Primary 200~4 [~ General 20__ [~ Other__ Report: [~ 1st Pre-elecnon [---] 2nd Pre-election [] Post-election [] 20__ September Supplemental SEE BACK FOR INSTRUCTIONS AND CODE DEFINITIONS CODE 1: Contributor Type CODE 2: Contribution Type B Bus~ness Entity CA Cash C Political Committee (includes business and union PACs) CO Cosigner Obitganon F Candidate's Immediate Family (includes candidate) IK In-Kind I lndMdual LR Loan Received L Labor Organization O Other P Political Party Committee Dne # Name and Address of Contributor Amount of In-K~nd Purpose Contribution (see manual for suggested purpose coues) Date Received Occupational Information or Contributor Contributing Committee's IDg Aggregate Code ~ ~ Code 2 Jonathan Tressler 1 1090 W 16th Ave $ 100 00 Eugene OR 97402 2/7/2004 Attorney $ 100 00 I CA Tamara Irm~nger Underwood 2 2780 Ohve St $ 100 00 Eugene OR 97405 2~7/2004 Bus~ness Owner (restaurants) $ 100 00 I CA R ,Joe Valasek 3 2580 Chula V~sta Blvd $ 100 00 Eugene OR 97403 2~5~2004 Carver & Sculptor $ 100 00 I CA David Wade 4 1673 Wllard St $ 100 00 Eugene OR 97403 3/3112004 Lawyer $ 100 00 I CA Mary Wagner 5 1128 W Broadway $ 100 00 Eugene OR 97402 21512004 Attorney $ 100 00 I CA See Page Totals (Add all amounts with the same Accounting Period Totals (Complete only tbr last page and instructions contribution type, Do not include aggregates.) transtbr these amounts to the Summary Statement. PC t on Back and Cash (CA) $ 500 00 Cash (CA) $ in Campaign Enter on Finance Manual In-Kind (iK) $ __ In-Kind (IK) $ __ PC 2 Loans Received (LR) $ Loans Received (LR) $ ~ Cash Contributions, Loans Received and in-Kind Candidate or Political Committee Name: Committee ID Number' Kitty Piercy for Mayor n/a Page 2_~8 of ~ Election ~ Primao 200~4 [] General 20__ [] Other__ Repot1 [~ I st Pre-election [] 2nd Pre-election [~ Post-election [~ 20__ September Supplemental SEE BACK FOR INSTRUCTIONS AND CODE DEFINITIONS CODE 1: Contributor Type CODE 2: Contribution Type B Business Entity CA Cash C Political Committee (includes business and union PACs) CO Cosigner Obhgation F Can&daWs Immediate Family (includes candidate) IK In-Kind I individual LR Loan Received L Labor Orgamzation O Other P Pohtical Party Cotmmttee Amount of In-Ktnd Purpose Dne # Name and Address of Contributor Contribution (see manual for suggested purpose codes) Date Recewed Occupational Information or Contnbutor Code ~ Code 2 Contributing Committee's ID# Aggregate Robin Weft 190 E 49th 1 Eugene OR 97405 $ 100 00 3/412004 Energy Spec~ahst $ 100 00 I CA Robert Weiss 5338 Tahslh St, 2 Eugene OR 97405 $ 200 00 3/1/2004 Professor EmentusfPsycholog~st $ 200 00 t CA Jerry Welsh 2051 Dogwood 3 Eugene OR 97405 $ 250 00 3/7/2004 Retired $ 250 00 I CA Sarah Weston 2595 Highland Dr 4 Eugene OR 97403 $ 100 00 3/10/2004 Homemaker $ 100 00 I CA Pamela Whyte 10 Monroe St 5 Eugene OR 97402 $ 100 00 1/2812004 CPA $ 100 00 I CA See Page Totals (Add al~ amounts with the same Accounting Period Totals (Complete ertl5 ~or last page and lnstru~tion~ contribunon type. Do not include aggregates,) transfer these amounts to the Summau~ Statement, PC on Back and Cash {CA) $ 750 00 Cash (CA) $ in Campaign Ent¢t oit bammao ¢,~atcmem. Cobmm ~. Linc 1 Finance Manual In-Kind (IK) $ la-Kind ilK} $ _ _ PC 2 Loans Received (LR> $ __ Loans Received (LRt $ PC 2 Cash Contributions, Loans Received and in-Kind Can&date or Political Committee Name: Committee ID Number Kitty P~ercy for Mayor n/a Pane 29 of '~ Election, [~ Primary 200_4_4 [~ General 20__ [] Other__ Report' ~ 1st Pre-election [~ 2nd Pre-election [] Post-election [~ 20__ September Supplememal SEE BACK FOR INSTRUCTIONS AND CODE DEFINITIONS CODE 1' Contributor Type CODE 2: Contribution Type B Business Entity CA Cash C Political Committee (includes business and union PACs) CO Cosigner Obhganon F Candidate's Imme&ate Family (includes candidate) IK In-Kind I Individual LR Loan ReceNed L Labor Organization O Other P Polmcal Party Committee Amount of in-K~nd Purpose Dna ',=¢ Name and Address of Contributor Contnbutton (see manual for suggested purpose codes) Date Received Occupattonal Informatton or Contributor Code 1 Code 2 Contributing Committee's/DC Aggregate Kurt Wdcox 2887 Lydlck Way 1 Eugene OR 97401 $ 100 00 3/412004 Union Orgamzer $ 100 00 I CA Mara Wile 1347 Dalton Dr 2 Eugene OR 97404 $ 100 00 2/29/2004 accountant $ 100 00 I CA Mark Wdtlams P O Box 3 695 Eugene OR 97440 $ 500 00 1/26/2004 LCC Faculty $ 500 00 i CA Mark Wdllams P O, Box 4 695 Eugene OR 97440 $ 500 00 3/31/2004 LCC Faculty $ 1,000 00 ~ CA Susan Welling 85219 Willamette 5 St Eugene OR 97405 $ 100 00 1/28/2004 R N $ 100 00 I CA See Page Totals (Add all amounts with the same Accounting Period Totals (Complete ord) for last page and ~nstructions contribution type. Do not include aggregates.) transfer these amounts to the Summary Statement. PC l ~ on Back. and Cash (CA) $1,300 00 Cash (CA) $ ~ 1~ inance Manual in-Kind (1K) $ In-Kind (IK) $ PC 2 Loans Received (LR) $ ~ Loans Received tLR) $ ___ PC 2 Cash Contributions, Loans Received and In-Kind Can&date or Polinca~ Committee Name: Committee ID Number: Kitty Piercy for Mayor n/a Page 3_9_0 of 3_~3 Election: ~ Primary 2004 [~ General 20__ ~ Other __. Report: [~ 1st Pre-election [] 2nd Pre-election [~ Post-election [] 20__ September Supplemental SEE BACK FOR INSTRUCTION5 AND CODE DEFINITIONS CODE ~: Contributor Type CODE 2: Contribution Type B Business Entity. CA Cash C Political Committee (includes business and umon PACs) CO Cosigner Obliganon F Candidate's lmme&ate Family (includes candidate) IK In-Kind I IndJvidua~ LR Loan Received L Labor Organization O Other P Polincal Party Committee Amount of In-Kind Purpose Line ~ Name and Address of Contributor Contribution (see manual for suggested purpose codes) Date Recelved Occupat~ona! Information or Contributor Code I Code 2 Contributing Committee's IDf¢ Aggregate Jan Wostmann 1 2645 R~ven~ew Eugene OR $ 100 00 97403 2/19/2004 systems analyst $ 100 00 I CA EUGENE FIREFIGHTERS FiRE PAC 2 2300 Oakmont Way, Suite 201 $ 1,000 00 Eugene OR 97401 2/29~2004 Fire P.A C #60 $ 1,000.00 C CA EUGENE FIREFIGHTERS FIRE PAC 3 2300 Oakmont Way, State 201 $ 2,000 00 Eu9ene OR 97401 3/1/2004 F~re P A C ¢60 $ 3,000 00 C CA Friends of Arammta Hawkins 4 P O Box 580z~ $ 100.00 Eugene OR 97405 3/2/2004 PAC #004348 $ 100 00 C CA James Gang Pubhshmg, Ltd 5 620 Horn Lane $ 1,000 00 Eugene OR 97404 1/27/2004 $ 1,000 00 B CA See Page Totals (Add all amounts with the same Accounting Period Totals (Complete only for last page and lnstrdcnons contribution type. Do not include aggregates.) transfer these amounts to the Summary StatemenL PC on Back and Cash (CA) $ 4,200.00 Cash (CA) $ _ Finance Manual in-Kind (IK) $ in-Kind (I K) $ PC 2 Loans Recewed tLR) $ __ Loans Received (LR) $ P~ 2 Cash Contributions, Loans Received and In-Kind Candidate or Political Committee Name: Comtnittee ID Number: Kitty Piercy for Mayor n/a Pa_oe 31 of 33 Election: [] Primary 2004 [] General 20__ ~ Other ~ Report' [~ 1st Pre-election [] 2nd Pre-election [] Post-election [] 20__ September Supplemental SEE BACK FOR INSTRUCTIONS AND CODE DEFINITIONS CODE 1: Contributor Type CODE 2: Contribution Type B Business Entity, CA Cash C Political Committee (includes business and union PACs) CO Cosigner Obligation F Candidate's immediate Family (includes candidate) IK In-Kind I Individual LR Loan Received L Labor Organizanon O Other P Political Party Committee Line # Name and Address of Contributor Amount of ln-K~nd Purpose Contnbut/on (see manual for suggested purpose codes) Date Recewed Occupational Information or Contributor Contributing Committee's tD¢¢ Aggregate Code ~ Code 2 293 Miscellaneous Cash Contnbubons $50 1 & Under $ 11,250 50 2/16/2004- ; 3/31/2004 $ 11,250 50 B I CA 2 $ 3 $ 4 $ 5 $ See Page Totals (Add all amounts with the same Accounting Period Totals (Complete only fbr last page and Instructions contribution b'Pe, Do not include aggregates. on Back and Cash (CA) $11,250 50 Cash (CA) $ lB Campaign Finance Manual In-Kind ilK) $ In-Kind (IK} $ _ Enter PC 2 Loans Received (LR) $ __ Loans Received (LR) $ __ Enter op 5umma~5 Statement Column Pt, 2 Cash Contributions, Loans Received and Candidate or Polit~ca~ Committee Name: Committee ID Number. Kitty Piercy for Mayor n/a Page 32 of Election. [~ Primary 2004 [~1 General 20__ [] Other__ Report: [~ 1st Pre-election [] 2nd Pre-election [] Post-election [] 20__ September Supplemental SEE BACK FOR INSTRUCTIONS AND CODE DEFINITIONS CODE 1: Contributor Type CODE 2: Contribution Type B Business Ennty CA Cash C Political Committee (includes bus~ness and union PACs) CO Cosigner Obliganon F Candidate's Immediate Family (includes candidate) IK In-Kind I lndiwdual LR Loan Recewed L Labor Orgamzation O Other P Political Party Committee Amount of In-K~nd Purpose Dne# Name and Address of Contributor Contribution (see manual for suggested purpose codes) Date Received Occupational Information or Contributor Code ~ I Code 2 Contributing Committee's tD# Aggregate FLORBEST, INC ~ 254 Lincoln $ 200 00 Roses - Fundraismg event Eugene OR 97401 31912004 $ 200 00 B RUCKER ENTERPRISES, INC,, DBA Acbon 2 Rental $ 58.65 Room d~wders, tablecloths, hehum 4340 Franklin - Fundraismg event 3~9~2004 $ 58 65 B IK CAFE' MAM, INC 3 PO Box 21123 $ 64.20 Coffee and supphes - Fundra~slng Eugene OR 97402 event 3/9/2004 $ 64 20 B I K SWEET SISTERS, INC, DBA THE SWEET 4 LIFE PATISSERIE 755 Monroe St $ 55 00 Cake Fundra~smg event Eugene OR 97402 3/9~2004 $ 55 00 B iK Summit Run Corp dba Bagel Sphere 5 810 Wdlamette $ 55 25 80 Bagels Fundra~smg event Eugene OR 97401 3~9~2004 $ 155 25 B IK See Page Totals (Add all amounts with the same Accounting Period Tota{s (Complete only, for last page and Instructions contribution type, Do not include aggregates.) transfer these amounts to the Summary Statement, PC on Back and Cash (CA) $ Cash (CA) $ ~ in Campaign Eate~ on Su:mna Finance Manual In-Kind (IK) $ 433 10 [n-Kind (IK) $ ~ Enter on Stllnlllal~. Statement. PC 2 l,oans Received (LR) $ ~ Loans Received (LR) $ _ Pt Cash Contributions, Loans Received and In-Kind (andidate or Pohticai Committee Name: Committee iD N umber: Kitty Piercy for Mayor n/a Page 33 of 33 Election: ~5~ Primary 2004 [~ General 20__ l---] Other Report: ~] 1 st Pre-election [] 2nd Pre-election [] Post-election [] 20__ September Supplemental SEE BACK FOR INSTRUCTIONS AND CODE DEFINITIONS CODE 1: Contributor Type CODE 2: Contribution Type B Business Entity CA Cash C Polmcal Committee (includes business and union PACs) CO Cosigner Obligation F Candidate's immediate Family (includes candidate) [K in-Kind I lndi¥idual LR Loan Received L Labor Organization O Other P Pohtical Party Committee Amount of In-Kind Purpose Line # Name and Address of Contributor Contribution (see manual for suggested purpose codes) Occupational Information or Contnbutor Code ? / Code 2 Date Received Contributing Committee's ID~ Aggregate EMERALD VALLEY KITCHEN, INC 1 90472 Woodruff St $ 50 00 5 cases d~p/salsa - Fundra~smg Eugene OR 97402 event 3/912004 $ 50 00 B C B S~mons 2 215 W 5th $ 426.76 off~ce space Eugene OR 97401 3/5/04- Realtor $ 426 76 I 3/31/04 D~anne Lobes 3 160 E 37th Ave $ 7,98 Apple juice - Fundra~smg event Eugene OR 97405 3~9~2004 Psychologist $ 27 98 l Lucmda Mumz-Hale 4 2811 Tandy Turn $ 60 00 photo development - Fundra~smg Eugene OR 97401 event 1/27/2004 Homemaker $ 60.00 I I 5 $ $ See Page Totals (Add all amounts with the same Accounting Period Totals (Complete onty for tast pag~ and instructions contribution type, Do not include aggregmes.) transfer these amounts to the Summary StatemenL PC 1. ~ on Back and Cash (CA) $ ~ Cash (CA/ $ 38,445 50 m Campaign E,~[e, 011 St£i~ltlLll3 Stalemcr,L Column A Line ! Finance Manual In-Kind ilK) $ 544 74 In-Kind (iK) $ 977 84 Enter on Summar~ Sta[cmc~:t Colturm A Lmc~ 4 and 9 PC 2 Loans Recewed (LR} $ ~ Loans Received ~LR} S 0 00 Enter on bulllI~d0 Statcme~ t Column A Line 2 PC 3 Cash Expenditures and Loan Payments ,:03 Candidate or Political Committee Name: Committee iD Number: Kitty Piercy for Mayor n/a Page 1_ of ~ Election: [] Primary 200_~4 [] General 20__ [] Other __ Report: [~ 1st Pre-election [] 2nd Pre-election [] Post-election [] 20__ September Supplemental PURPOSE CODES (see back of form for instructions and code definitions} EXPENDITURE TYPES A Agent O Other Advertising (yard signs, buttons, etc. I CA Cash B Broadcast Advertising (Radio, TV) P Postage LP Loan Payment C Cash Contributions R Reimbm'sement for Personal Expenditures F Fundraising Event Expenses S Sur~,eys and Polls G General Operanonal Expenses (describe if over $50) T Travel Expenses (describe if over $50) 1 Interest Payment U Utilities L Literature, Brochures, Printing W Wages. Salaries, Benefits M Management Services Y Petition Circulators N Newspaper and Other Periodical Advertising Z Preparation and Production of Advertising Payee's Name and Payee's Committee ID#, Exp Amount of [] L¢ne ~ Date Check # ~f apphcable Purpose Type Expendlture Pa~d (as it appears on ~nvoice, receipt or check) to A/P 1 2~3~04 I Susan Detroy L CA $ 200 00 ~ 2 2/3~04 2 Northwest Survey & Data S CA $ 2,500 00 E~ 3 2/11104 EFT Umpqua Bank G CA $ 11 00 [~ 4 2/11/04 1001 Signs Of The Times O CA $ 92.75 5 2/13/04 1003 USPS P CA $ 111 00 [~ 6 2/16/04 EFT Phil Noble G CA $ 5 00 E~ 7_ 2/26104 1004 usps p CA $ 148.00 E~ G (office CA $ 186 00 E~ 8 2/26/04 1005 clancey Printing company supphes) 9 2/27/04 EFT Qwest U CA $ 400 00 [~ U CA $ 31 00 [~ 2/27/04 EFT Qwest 10 See Page TotaLs (Add all expenditures with the same Accounting Period Totals (Complete only tbr last page and Instructions expenditure type,) transfer these amounts to the Summar), Statement, PC 1,) on Back and in Campaign Cash {,CA) $ 3,684 75 Cash (CA) $ _ £ntrr on SuttlmaC~ S[a~em~.nt Colmnn A [.llle (~ Finance Manual Loan Payment (LP) $ ~__ Loan Payment (LPI $ __ Enter on Smnmcu2~ StatcmcnL C,)lumn A. Lm~ 7 PC 3 PC ~ Cash Expenditures and Loan Payments Re, ,:0, Can&date or Political Committee Name: Cormnittee [D Number: Kitty Piercy for Mayor n/a Page 2 of ~. Election: [] Primary 2004 [] General 20__ [] Other _ Report' [] 1st Pre-election [] 2nd Pre-election [] Post-election [] 20__ September Supplemental PURPOSE CODES (see back of form for instrnetions and code definitio~ts) EXPENDITURE TYPES A Agent O C~her Advernsing (yard sips, buttons, etc.) CA Cash B Broadcast Advernsing (Radio, TV) P Postage LP Loan Paymem C Cash Contributions R Reimbursement for Personal Expenditures F Fundraising Event Expenses S Surveys and Polls G General Operational E,penses (describe if overS50) T Travel Expenses (describe ifo~er $50~ I Interest Payment U Utilities L Literature, Brochures, Printing W Wages, Salaries, Benefits M Management Services Y Petition Circulators N Newspaper and Other Periodical Advertising Z Preparation and Production of Advertising Payee's Name and Payee's Committee ID#, ~ bne # Date Check # if applicable Purpose Exp. Amount of (as ¢t appears on invoice, receipt or check) Type Expenditure Paid to A/P 1 2/27/04 EFT Phil NoNe G (credit card CA $ 68 60 [~ bank fee) 2 3/1/04 EFT Polibcs Onhne G CA $ 25 00 ~ 3 3/1104 1006 LeDoux Insurance Agency G (L~abd~ty insurance) CA $ 1,382 00 E~ 4~ 3~4~04 1007 Northwest Survey & Data S CA $ 4,500 00 E~ 5 3/4/04 1008 Oregon T's O CA $ 1,125.00 ~ 6 3~4~04 1009 Oregon Secretary Of State O CA $ 300 00 E~ 7 3~8~04 1010 Planned Parenthood Of SW Oregon G CA $ 20 00 E~ 8 3/8/04 1012 John Jordan Cascade L CA $ 225 00 [~ 9 3/9~04 1011 Pride Printing L CA $ 204 00 ~ 10 3/10~04 EFT Politics Onhne G CA $ 20 00 See Page Totals (Add all expenditures with the same Accounting Period Totals (Complete only tbr last page and Instructions expenditure type, ) transfer these amounts to the Summary StatemenL PC on Back and in Campaign Cash (CA) $ 7,869 60 Cash (CA) $ __ Finance Enter on SummaD' btatemelJ Co[uclm A, Lnic o Manual Loan Payment (LP) $ __ Loan Payment (LP) $ __ Enter on PC 3 ¢C 4 Cash Expenditures and Loan Payments '- Candidate or Political Committee Name: Committee ID Nurnber: Kitty Piercy for Mayor n/a Pa~e 3 of ~ Election: [~ Primary 200_!4 [] General 20__ [] Other __ Report: [~ 1st Pre-election [] 2nd Pre-election [] Post-election [] 20__ September Supplemental PURPOSE CODES (see back of form for instructions and code definitions) EXPENDITURE I YPES A Agent O Other Advertising (ym:d signs, buttons, etc.t CA Cash B Broadcast Advertising (Radio, TV) P Postage LP Loan Payment C Cash Contributions R Reimbursement for Personal Expenditures F Fundraising Event Expenses S Surveys and Polls G General Operational Expenses (describe if over $50) T Travel Expenses (describe if over $50) 1 Interest Payment U Utilities L Literature, Brochures, Printing W Wages, Salaries, Benefits M Management Services Y Petition Circulators N Newspaper and Other Periodical Advertising Z Preparation and Production of Advertising Payee's Name and Payee's Committee tD#, Exp Amount of Line # Date Check # ~f apphcable Purpose Type Expenditure Pa¢d (as ~t appears on invoice, receipt or check) to ,~ZP t 3/15/04 1013 USPS P CA $ 111 00 ~ 2 3/15/04 1014 John Jordan Cascade L CA $ 40 00 t-i-1 3 3/15/04 1015 Pemn/Pack StrategIc Development M CA $ 750 00 [~ LLC 3/16104 1016 Northwest Semor News N CA $ 310 00 E~ 5 3/I 7/04 EFT Pohbcs Onhne G CA $ 38.50 E~ 6 3/22/04 EFT Cardinal Employment Services W CA $ 2,046 00 [~ 7 3/22/04 1017 Button Place O CA $ 105 00 E~ 8 3/23/04 1018 Qwest U CA $ 82 39 ~ 9 3/24/04 1019 Register-Guard N CA $ 391 04 ~-~ 10 3/26/04 EFT Politics Onhne G CA $ 5 00 See Page Totals (Add all expenditures with the same Accounting Period Totals (Complete only for last page and Instructions expenditure t2pe.) transfer these amounts to the Summary Statement. PC l on Back and in Campaign Cash (CA) $ 3,878 93 Cash (CAt $ __ Emer on StilPdlla~ Statemert Colm~a~ A. Line Finance Manual Loan Payment (LP) $ ~ Loan Payment (LP) $ __ PC 3 pt. 3 Cash Expenditures and Loan Payments Candidate or Political Committee Name: Committee ID Number: Kitty Piercy for Mayor n/a Page 4 of Election' [] Primary 200~4 [] General 20__ [] Other Report [] 1st Pre-election [] 2nd Pre-election [] Post-election [] 20__ September Supplemental PURPOSE CODES (see back of form for instructions and code definitions} EXPENDITURE TYPES A Agent O Other Advertising Lvard signs, buttons, etc.) CA Cash B Broadcast Advertising (Radio, TV) P Postage LP Loan Payment C Cash Contributions R Reimbursement for Personal Expenditures F Fundrmsing Event Expenses S Surveys and Polls G General Operational Expenses (describe if over $50) T Travel Expenses (describe if over $50t I Interest Payment U Utilities L Literature, Brochures, Printing W Wages, Salaries. Benefits M Management Services Y Petition Circulators N Newspaper and Other Periodical Advertising Z Preparation and Production of AdYemsing Payee's Name and Payee's Committee ID~, L#ne # Date Check # if appl¢cable Purpose Exp. Amount of (as ~f appears on #nye#ce, receipt or check) Type Expenditure Pa#d to AZ, P 3/26/04 EFT Poht~cs Online G CA $ 10 00 E~ 2 3/26/04 EFT Polibcs Onhne G CA $ 10 00 E~ 3 3/26/04 EFT Politics Onhne G CA $ 5 00 E~ 4 3/29/04 EFT Cardinal Employment Services W CA $ 4 092 00 F-~ 5 3/31/04 EFT Pohtlcs Online G CA $ 2 00 ~ 6 3/31/04 1020 Susan Cundlff G CA $ 13 99 E~ 7 3/31/04 1021 Deanna Kllger F CA $ 24 50 E~] 8 3/31/04 1022 Lmda Wheatley F CA $ 252.60 9 3/31/04 1023 Mary Leu VIgnola F CA $ 260.49 10 3/31/04 1024 Lynne Fessenden F CA $ 104 26 [~ See Page Totals lAdd all expenditures with the same Accounting Period Totals (Complete only tut last page and instructions expenditure type.) translbr these amounts to the Summary. Statement, PC 1.) on Back and m Campaign Cash (CA) $ 4,774 84 Cash (CA) $ __ Finance Enter on Surnmat3 Sta~e,nent Colunm A_ Line 6 Manual Loan Payment (LP) $ __ Loan Payment (LP) $ __ Enter on Stunmary Statement. Co[mnr, ?,, L~ne; PC 3 PC 3 Cash Expenditures and Loan Payments Candidate or PoLitical Committee Name: Committee ID Number: Kitty Piercy for Mayor n/a Page 5 of ¢ Election. [] Primary 200_A4 [~1 General 20__ [--1 Other __ Report' [] 1st Pre-election [] 2nd Pre-election [] Post-election [] 20__ September Supplemental PURPOSE CODES (see back of form for instructions and code definitions) EXPENDITURE TYPES A Agent O Other Advertising (ya2'd signs, buttons, etc.) CA Cash B Broadcast Advertising (Radio, TV) P Postage LP Loan Payment C Cash Contributions R Reimbursement for Personal Expenditures F Fundraising Event Expenses S Surveys and Polls G General Operational Expenses (describe if over $50) T Travel Expenses (describe if over $50/ I Interest Payment U Utilities L Literature, Brochures, Printing W Wages, Salaries, Benefits M Management Services Y Petition Circulators N Newspaper and Other Periodical Advertising Z Preparation and Production of Advertising Payee's Name and Payee's Committee tD#, [] bne # Date Check # if appltcable Purpose Exp Amount of (as it appears on invoice, receipt or check) Type Expenditure Pa¢d to A/P I 3/31104 1025 Jennifer Knowlton F CA $ 4 96 E~ 3/31104 1027 Em,ly Hedbrun G (office CA $ 115 53 ~] supplies), L G (office 3t31/04 1028 Jana Rygas supphes) M, CA $ 427 51 [~ L,F 3/31104 1029 Kayleen Hanna G (off~ce supphes) CA $ 59 00 E~ 5 3131104 1030 Joanne Vmton G CA $ 29 85 E~ 6 3/31t04 1031 Robert Zako G CA $ 24,95 E~] 7 3/31/04 1032 Wren Dawdson G (off~ce supphs) CA $ 112 61 E~ 8 3/31/04 1033 Becky Gladstone G CA $ 31 97 [~ 9 3/31/04 1034 Ray Eveland O CA $ 112 50 E~ G (office 10 3/31/04 1035 Jana Rygas refreshments CA $ 79 04 & supphes) See Page Totals (Add all expenditures with the same Accounting Period Totals (Complete only fbr last page and instructions expenditure type.) transfer these amounts to the Summary StatemenL PC t. on Back and in Campaign Cash (CA) $ 997 92 Cash (CA) $ __ Finance Lurer on Smmnao Sl'.~tement C,~hmln A, Line o Manual Loan Payment (LP) $ __ Loan Payment (LP) $ __ Enter on Smnmar/, S[atemcn* Column A PC 3 PC' 5 Cash Expenditures and Loan Payments Candidate or Political Committee Name: Committee ID Number: Kitty Piercy for Mayor n/a Page 6 of Election: [] Primary 200_4. [~7] General 20__ [7] Other __ Report' [] 1st Pre-election [] 2nd Pre-election [] Post-election [] 20__ September Supplemental PURPOSE COD ES (see back of form for instr-actions and code definitions) EXPEND~T U RE TY P ES A Agent O Other Advertising (yard signs, buttons, etc.) CA Cash B Broadcast Advemsing (Radio, TV) P Postage LP Loan Payment C Cash Contributions R Reimbursement for Personal Expenditures F FundmismgEvent Expenses S Surveys and Polls G General Operational Expenses (describe if over $50) T Travel Expenses (describe if over $50) I Interest Payment U Utilities L Literature, Brochm'es, Printing W Wages, Salaries. Benefits M Management Services Y Petition Circulators N Newspaper and Other Periodical Advertising Z Preparation and Production of Advertising Payee's Name and Payee's Committee ID#, Exp Amount of [] Dne # Date Check ¢ ff applicable Purpose Type E×pend~ture Pa~d (as it appears on ~nvotce, receipt or check) to A/P t 3/31/04 1036 Lynn Pedersen G CA $ I4 54 [~ 2 3/31/04 1037 Gte9 Weiss L CA $ 43 50 E~ G (office CA $ 51 05 [~ 3 3/31/04 1038 Wren Dawdson supplies) 4 4/1/04 1039 Pride Printing O CA $ 500.00 [~ 5 4/1/04 1040 Pride Pnntmg L CA $ 804 00 ~ 6 4/1/04 1041 Pride Pnntin9 O CA $ 369 00 ~ 7 CA $ ~ 8. CA $ [~ 9 CA $ [~ 10 CA $ See Page Totals (Add all expenditures with the same Accounting Period Totals (Complete only fbr last page and Instructions expenditure type,) transtbr these amounts to the Summa~T Statement. PC t. t on Back and in Campaign Cash (CA) $1,782 09 Cash (CA) $ 22,988 13 Finance Enter on Smamar> btatCmunt Coimnn A Lin: ~, Manual Loan Payment (LP) $ - Loan Payment (LP) $ Enter c,n %umrnaU Statement Coiuam A t.mc ~ PC 3 Summary Statement of Contributions and Expenditures Please type or print legibly in black ink. Page l of 2 Candidate or Political Committee Name (use full name): Kitty Piercy for Mayor Mailing Address as it Appears on Statement of Organization (street, route or box number, city, state, zip code): P.O. Box 23301, Eugene, OR, 97402 Treasurer's Name: I Telephone Number (day): C. Michae{ Arnold { 541-338-9111 Committee ID Number: I Committee Type, Measure Number or Office: n/a i Candidate for Mayor . Original ~ Primapj 200~4 [~ General 20__ [~ Other__ [2~mendment [] 1st Pre-election [] 2nd Pre-election [] Post-election [] 20__ September Supplemental A-TOTALS FOR THIS B-CUMULATIVE TOTALS ACCOUNTING PERIOD FOR THIS ELECTION CONTRIBUTIONS t. Cash ContributIons (Accounting Permd Total ii'om PC 2} 38,445 50 38,445 50 Z Loans Received (Non-Exempt) + 0 00 + 0 00 (Accounting Period qotal fkom PC 2) 3 Fotat Cash Contributions = 38,445.50 = 38,44550 thnes l+ 2) 4. In-Kind + 977 84 + 977 84 /Accounting Period Total from PC 2) 5. TOTAL CONTRIBUTIONS = 39,423.34 = 39,423 34 (lines 3 + 4~ EXPENDITURES 6. Cash Expenditures 22,988 13 22,988 13 (Accounting Period Total fi*om PC 3l 7. Loan Payments (Non-Exempt) + 0 00 + 0.00 (Accounnng Period Total t'rom PC 3) 8. Total Cash Expenditures = 22,988 13 = 22,988 13 (hnes 6 + 7) 9. In-Kind + 977.84 + 977 84 IAccountmg Period Total from PC 2) 10. TOTAL EXPENDITURES = 23,965 97 = 23,965 97 (hnes 8 -~ 9) CASH BALANCE 11. Beginning Cash Balance 0 FOR OFFICE USE ONLY (line 20 ofprev~ous report) 12. Total Contributions + 39,423 34 (hne 5) 13. Other Receipts + 0 00 tAccounting Period l'otal from PC t4. Loans Received (Exempt) + 0 (Accounting [ enod Total from PC 4Al 15 CONTRIBUTION SUBTOTAL = 39,423 34 (hnes 11 + 12 ~- 13 + 14) 16 Total Expenditures 23,965.97 (hne 10t 17. Other Disbursements + 000 (Accounting Period Total ii'om PC 4B) 18. Loan Payments (Exempt) + 0 00 (Accounting Period Total from PC 4B) 19. EXPENDITURE SUBTOTAL = 23,965 97 20 ENDING CASH BALANCE = 15,457 37 (hne 15 minus linc 1% Summary Statement of Contributions and Expenditures Please type or print legibly in black ink. Page 2 oi'2 Candidate or Political Committee Name: Committee ID Number: Kitty Piercy for Mayor n/a [] Original [] Primary 200_~4 [] General 20__ [~ Other__ [] Amendment [] 1st Pre-election [] 2nd Pre-election [~ Post-election [~ 20__ September Supplemental LOAN SUMMARY 21 Beginning Outstanding Loans FOR OFFICE USE ONLY {line 29 of prevmus report) 0 00 22. Loans Received (Non-Exempt} + 0 00 (line 2) 23, Loans Received (Exempt) + 0 00 (line 14) 24. LOANS RECEIVED SUBTOTAL {hncs 21 * 22 * 23) = 0.00 25, Loan Payments (Non-Exempt) 0 00 (hne 7) 26 Loan Payments [Exempt) + 0.00 (line 27. Forgiven Loans + 0 00 {Total loans ~b~given during thus accounting period) 28. LOAN PAYMENT SUBTOTAL = 0 00 (lines 25 -- 26 +27t 29. TOTAL OUTSTANDING LOANS = 0 00 (line 24 m~nus line 28) PERSONAL EXPENDITURE SUMMARY 30. Beginning Outstanding Personal Expenditures 0 00 (hne 36 ofprewous report) 31. Personal Expenditures + 0 00 (.Accounting Period Total from PC o_. PERSONAL EXPENDITURE SUBTOTAL = 0 00 (hnes 30 -v 31~ 33. Personal Expenditure Reimbursements {Total expenditures on PC 3 with purpose code R) 0 00 34. Forgiven Personal Expenditures + 0 00 (Total personat expenditures forgiven this acctg period} 35~ REIMBURSEMENT SUBTOTAL = 0 00 dines 33 + 34 } 36 OUTSTANDING PERSONAL EXPENDITURES = 0 00 (linc 32 minus line 35) F~NANCIAL STATUS AT CLOSE OF ACCOUNTING PERIOD 37. Ending Cash Balance (hne 20) 15,457 37 38. Accounts Receivable + 0 00 (Accounting Period Total from PC 5) 39. SUBTOTAL = (lines 37 .- 38l 15,457.37 40. Total Outstanding Loans 0.00 (hne 20) 41dineOUtstanding36) Personal Expenditures + 0 00 ;"~'5, ~ f; ; 42. Accounts Payable + 0 00 (Accounting Period Total trom PC 6) /; , 43. SUBTOTAL = 0 00 (lines 40 + 41 + 42) 44. BALANCE/DEFICIT = ' '~ TM (hnc39m~nushne43:mdicate+or-balance) 15,45737 ~.~. : ~': ~':,~ i'. L C M~chae{ Arnold (name of candidate or treasurer), hereby certify that the above statement and the attached supporting reports are true and correct. Signature of candidate or treasurer Date signed PC 2 Amendmcqr Amendments-Cash Contributions, Loans Received and Candidate or Political Committee Name: Committee iD Number: Kitty Piercy for Mayor n/a Pag¢ I of 1 Election: [~ Primary 2004 [~ General 20__ [] Other __ Report: [] 1st Pre-election [] 2nd Pre-election [~ Post-election E~ 20__ September Supplemental SEE BACK FOR INSTRUCTIONS AND CODE DEFINITIONS CODE 1: Contributor Type CODE 2: Contribution Type B Business Entity CA Cash C Political Committee (includes business and union PACs) CO Cosigner Obiigaion F Candidate's immediate Family (includes candidate) iK M-Kind i individual LR Loan Received L Labor Organization 0 Other P Political Part), Committee Amending Page # Name and Address of Contributor Amount of In-Kind Purpose and Dne # Contribution (see manual for suggested purpose codes) Date Received Occupational Informatmn or Contributor Code 1 Code 2 Contributing Committee's IDg A¢gregate Page . Line Magaret (Margo) Schaefer [] New Entry 1625 Wilson St, $ 100 00 [] correcting Eugene OR 97402 [] De!etm9 2/1212004 Community Educator - Community outreach d~r for domesbc violence nonprofit $ 100 O0 I CA Page.__ Dne [] New Entry $ E] Correcting [] Deleting $ Page. Line__ [] New Entry $ [] Correcting [] Deleting $ Page. Line [] New Entry $ Ci Correcting E~ Deleting $ Pag~ Line [] New Entry $ [] Correcting [] Deleting $ See FOR OFFICE USE ONLY on Back and ~/~¢ ' in Campaign '~' ' ~ '~ ~' '<) Finance Signature of candidate or treasurer Manual ~" ~ ' " O IG!T!AL S[~ement O~ Contributions ,.,umma, ~ an~ Expenditures Please type or print legibly in black ink. Page t of 2 Candidate or Political Commi~ee Name (use full name): Kitty Piercy for Mayor Mailing Address as it Appears on Statement of Org~ization (streeL route or box number, ci~, state, zip code): P.O~ Box 2330~, Eu2ene, OR, 97402 Treasurer's Name: Telephone Number {day}: C, Michael Arnold 54q-338-9~ ~ q Comm~ee ID Number: [ Commi~ee Type, Measure Number or Office: n/a ~ Candidate for Mayor ~ Original ~ PrimaO' 200~ ~ General 20~ ~ Other ~ ~ Amendment ~ 1st Pre-election ~ 2nd Pre-election ~ Post-election ~ 20~ September Supplemental A-TOTALS FOR THIS B-CU MULATIVE TOTALS ACCOUNTING PERIOD FOR THIS ELECTION GONTRIBUTIONS ~. Cash Contributions tAcumntmg Period Total from PC 2} 3] ,358 50 ~9,804 00 2. Loans Received (Non-Exempt) (Accounting Period ~[otal l~om PC 2} + ~ 5,000 00 + q 5,000~00 3~ ~otal Cash Contributions (hncs t+ 2) = 46,358 50 = 84,804 00 4. b~-Kind + 4,157 05 + 5,134_89 (Accounting Period Total from PC 2) 5. TOTAL COnTRIBUTIOnS = 50,515 55 = 89,938 89 fllnc:, 3 + 4) EXPENDITURES 6. Cash Expenditm'es (Accounting Period Total from PC 3~ 49,570 45 72,558 58 7 Loan Payments (Non-Exempt) + 0 00 + 0 00 IAccounting Period Total fi'om PC 3~ 8 Total Cash Expenditures ~hncs 6 -- 7) = 49,939 45 = 72,558 58 9. l,-Kind + 3788 05 + 4765 89 (Accounting Per~od Total lycra PC 2) t0. TOTAL EXPENDITURES (lines 8 * % = 53,727 50 = 77,693 47 CASH BALANCE 1 ~. Beginmng Cash Balance (hne 20 ofprevmus report) 15,457 37 FOR OFFICE USE ONLY 12. Total Contributions ~hnc 5) + 50,515 55 13. Other Receipts + 0 00 (Accounm~g Period Total t~om PC 14. Loans Received (Exempt) + 0 00 (Accoummg Period Total ~om PC 15. CO-NTRIBUT1ON SUBTOTAL = 65,972 92 (lines 11 ~ 12 + 13 + 14) 16 Total Expenditures (line 10~ 53,727.50 t 7. Other Disbursements + 0 00 (Accoumm~ Period 'Iotal t}om PC 4B) 18. Loan Payments~Exempt) + 000 ~? ' ¢} ~' {Accounting Period Total from PC 4B) I9. EXPENDITURE SUBTOTAL = 53,72750 " ~<r- (lines 16~ 17+ 18} -~J- ~ ~ 20, ENDING CASH BALANCE = 12,245 42 (line 15 minus hne 19) Stamment of Contributions ..urnma, y anu Expenditures Please type or print legibly in black ink. Page 2 o1'2 Candidate or Political Committee Name: I Committee iD Nmnber: Kitty Piercy for Mayor t alu [] Original [~] Primary 200_4 [] General 20__ E~ Other [] Amendment ~ 1st Pre-election [] 2nd Pre-election [] Post-election [] 20__ September Supplemental LOAN SUMMARY 2t Beginning Outstanding Loans FOR OFFICE USE ONLY (line 29 of previous report) 0.00 22. Loans Received (Non-Exempt) (line 2) + 15,000 00 23 Loans Received (Exempt) (hne 14) + 0 00 24. LOANS RECEIVED SUBTOTAL fhnes 21 + 22 + 23) = 15 000 00 25 Loan Payments (Non-Exempt) (linc 7) 0 00 26 Loan Payments (Exempt) dine t8) + 0 00 27. Forgiven Loans (Total loans fbrglven during this accounting period) + 0 00 28. LOAN PAYMENT SUBTOTAL (lines 25 + 2t) *-2% = 15,000 00 29. TOTAL OUTSTANDING LOANS (line 24 minus linc 28) = 15,000 00 PERSONAL EXPENDITURE SUMMARY 30~ Beginning Outstanding Personal Expen&tures (line 36 ofprewous report) 0 00 31. Personal Expenditures (Accounting Period Total from PC 3A) + 0 00 32. PERSONAL EXPENDITURE SUBTOTAL (hncs 30 4 3I} = 0 00 33. Personal Expenditure Reimbursements ('l oral cxpenchtures on PC 3 ~ ith purpose code R) 0 00 34 Forgiven Personal Expenditures (Total personal expenditures.forgiven this acc(g, period) + 0 00 35 REIMBURSEMENT SUBTOTAL (lines 33 + 34; = 0 00 36. OU STANDING PERSONAL EXPENDITURES thnc 32 minus hn~ 35) = 0 00 FINANCIAL STATUS AT CLOSE OF ACCOUNTING PERIOD 37 Ending Cash Balance (line 20) 12,245.42 38. Accounts Receivable + 0.00 (Accounting Period Total f?om PC 5) 39. SUBTOTAL ( hne_-, 37 + 38) = 12,245 42 40, Total Outstanding Loans (hn¢ 29) 15,000 00 4l Outstanding Personal Expenditures R. E C ~ '%''~ ~ i V r~!~i (line 36) ~ + 0 00 42. Accounts Payable ~ ,'~- ''~ ~ I_Accountmg Period Total/rom PC 6I + 0 00 ~ '" '~ ~' 43. SUBTOTAL (imc~ 40 + 4l ¢ 42) 44. BALANCE/DEFICIT = -2~754 58 (line 39 minus line 43' indicate ¢ or -balancet I. C Michael Arnold (name of candidate or treasurer}, hereby certify that the above statement and the attached supporting reports are true and correct S~gnature of candidate or treasurer Date signed PC 2 Cash Contributions, Loans Received and in-Kind Candidate or Pohtical Committee Name: Committee ID Number' Kitty Piercy for Mayor n/a Page 1_ of_~_ Elec[~on: [~ Primary 2004 [] General 20__ [] Other___ Report' [] 1st Pre-election [] 2nd Pre-election [] Post-election [] 20__ September Supplemental SEE BACK FOR INSTRUCTIONS AND CODE DEFINITIONS CODE 1: Contributor Type CODE 2: Contribution Type B Business Entity CA Cash C Political Committee (includes bustness and union PACs) CO Cosigner Obligation F Candidate's Immediate Family (includes candidate) IK ImKmd I Individual LR Loan Received L Labor Organization O Other P Poht~cal Party Committee Amount of In-Ktnd Purpose Line # Name and Address of Contributor Contribution (see manual for suggested purpose codes) Date Received Occupational Information or Contributor Code 1 Code 2 Contributing Committee's ID# Aggregate Amta Johnson 2288 B~rch ~ Lane Eugene OR 97403 $ 500 00 4/2~2004 Journahst $ 1,000 00 I CA Caw Thompson 966 2 Jackson Eugene OR $ 500.00 97402 4/16/2004 Retired $ t ,000 00 I CA Deborah Noble 4990 W. 3 Hillside Dr Eugene OR $ 500 00 97405 4/13/2004 Brokerage Business Owner $ 1,000 00 I CA Steve Adey 2385 Madrona Dr. 4 Eugene OR 97403 $ 1,000 00 4/27/2004 Teacher $ 1,000 00 I [ CA Tom Bowerman 33707 5 McKenzle View Eugene OR 97408 $ 1,000.00 4/27/2004 property manager $ 1,000 00 I CA See Page Totals (Add all amounts with the same Acconnting Period Totals (Complete only for last page and Instructions contribution type. Do not include aggregates.) transfer these amounts to the SummaE? Statement, PC /,) on Back and Cash (CA) $ 3,500 O0 Cash (CA) $ ~ in Campaign Enter on Sunnnao Stateme.,a. Column A, [ nte 1 Finance Manual In-Kind (IK) $ __ In-Kind (IK) $ ~ Ente~ on Summau Stare'riehL Cohum~ A [ roes 4 at~d 9 PC 2 Loans Received (LR) $ ~ Loans Received (LRI $ ~ F~ltel O[/Summao btatemem Coltdllll A Lltte 2 PC 2 Cash Contributions, Loans Received and Candidate or Political Committee Name: Committee }D Number: Kitty Piercy for Mayor n/a Page 2 of Election: [~ Primary 200_!4 [] General 20__ [] Other __ Report: [] I st Pre-election 15~ 2nd Pre-election [] Post-election [] 20__ September Supplemental SEE BACK FOR INSTRUCTIONS AND CODE DEFINITIONS CODE 1: Contributor Type CODE 2: Contribution Type B Business Entit5 CA Cash C Political Committee (includes business and union PACs) CO Cosigner Obligation F Candidate's Immediate Family (includes candidate) IK in-Kind 1 Individual LR Loan Received L Labor Organization O Other P Political Par~y Committee Dne# Name and Address of Contributor Amount of tmK~nd Purpose Contribution (see manual for suggested purpose codes) Date Received Occupational Information or Contributor Code f Code 2 Contributing Committee's ID¢¢ Aggregate Wdham Gilbert 2382 Malabar Dr 1 Eugene OR 97403 $ 1,000 00 4/1212004 Investor $ 1,000 00 I CA Lane, Coos, Curry, Douglas Braiding Trade 2 Councd 1174 Gateway Loop, State 114 $ 1,000 00 Spnngfield OR 97477 4/6/2004 N/A (not a PAC) $ 1,000 00 L CA Eugene Firefighters 2300 3 Oakmont Way, State 201 Eugene OR $ 1,000 00 97401 4/29/2004 Fire P A C ¢/430 $ 4,000 00 I CA Mahou Sweeney 25 W. 34th 4 Ave Eugene OR 97405 $ 500 00 4/28/2004 Homemaker $ 500 00 ~ CA Peter James 202 Hawthorne Ave, 5 Eugene OR 97404 $ 400 00 412412004 Attorney $ 500 00 I CA See Page Totals (Add all amounts with the same Accounting Period Totals (Complete only for last page arid Instructions contribution type. Do not include aggregates.) transfer these amounts to the Summary Statement, PC 1 t on Back and Cash (CA) $ 3,900 00 Cash (CA) $ in Campaign Enter on Stanmar, Statement Colttlpa~ A Lmut Finance Manual In-Kind {IK) $ In-Kind (IK) $ __ Enter on Summal5 Statement, Column A Lme~- 4 ,md 9 PC 2 Loans Received (LR) $ ~ Loans Received (LR) $ __ Entel un Sumn*ap.~ Statement C*llantn A_, [_la. 2 PC 2 Cash Contributions, Loans Received and Candidate or Political Committee Name: Committee ID Number: Kitty Piercy for Mayor n/a Pa~e 3 of Election: ~ Primary 200~4 E~] General 20__ [] Other __ Report' ET] 1st Pre-election ~ 2nd Pre-election [] Post-election E~ 20__ September Supplemental SEE BACK FOR INSTRUCTIONS AND CODE DEFINITIONS CODE 1: Contributor Type CODE 2: Contribution Type B Business Entity CA Cash C Politmal Committee (includes business and union PACs) CO Cosigner Obligation F Candidate's Immediate Family (includes candidate) IK In-Kind I Individual LR Loan Received L Labor Organization 0 Other P Political Party Committee Amount of In-K~nd Purpose Dne # Name and Address of Contributor Contnbutton (see manual for suggested purpose codes) Date Recelved Occupat¢onal Information or Contributor Code 1 Code 2 Contributing Committee's ID¢¢ Aggregate Ron Budey 28234 Bn99s 1 Rd Eugene OR 97405 $ 500 00 4/19/2004 Writer $ 500 00 t CA Donald Van Houten 768 W. 2 10th Ave Eugene OR $ 300 00 97402 4/27/2004 Rebred $ 350.00 I CA Oregon AFL-CiO 2110 State 3 St Eugene OR 97301 $ 350.00 4/15/2004 ID#000032 $ 350.00 C CA Jean Davldson 2295 4 R~vervlew St Eugene OR $ 200 00 97403 4/25/2004 Counsellor $ 300 00 I CA Jean Dawdson 2295 5 Riverwew St Eugene OR $ $20 00 97403 4/25/2004 Counsellor $ 320 00 I CA See Page Totals (Add ali amounts with the same Aecountittg Period Totals (Complete only fbr last page and Instructions contribution type. Do not include aggregates.) transfer these amounts to the Summary Statement. PC on Back and Cash (CA) $1,370 O0 Cash (CA) $ ~ in Campaign Enter on Summao Statement Column A Finance Manual In-Kind (iK) $ ~ In-Kind (iK) $ ~nter on St~¢lmar5 St2ttcnlen[ Column A PC 2 Loans Received (LR) $ __ Loans Received (LR} $ __ Enter on Summdr5 Statement, Cohtmn A L,n¢ 2 PC 2 Cash Contributions, Loans Received and in-Kind Re, Can&date or Political Committee Name: Committee ID Number: Kitty Piercy for Mayor n/a Pao~e 4 of ~ i Elecnon' [] Primary 200.A4 [--1 General 20__ [] Other Report: [~ 1st Pre-election [] 2nd Pre-election [] Post-elecnon [] 20__ September Supplemental SEE BACK FOR INSTRUCTIONS AND CODE DEFINITIONS CODE 1: Contributor Type CODE 2: Contribution Type B Business Entity CA Cash C Political Committee (includes business and union PACs) CO Cosigner Obligation F Candidate's Immediate Family (includes candMate) IK ln-K~nd 1 Indiwdual LR Loan Received L Labor Organizanon 0 Other P Political Party Committee Dne # Name and Address of Contributor Amount of ln-g~nd Purpose Contribution (see manual for suggested purpose codes) Date Received Occupational Information or Contributor Code ~ Code 2 Contributing Committee's IDI¢ Aggregate Caroline Forell 40 W 20th 1 Ave Eugene OR 97405 $ 100 00 4~26~2004 Law Professor $ 300 00 I CA Robert O'Bnen 3525 Gilham Rd 2 Eugene OR 97408 $ 300 00 4/19/2004 Professor $ 300 00 I CA Roberta Riley 1116 Grand Ave. 3 Seattle WA 98122 $ 300 00 4/16/2004 Attorney $ 300 00 I CA Juh Miller 2141 Hams St 4 Eugene OR 97405 $ 250 00 4~7/2004 Homemaker $ 250 00 I CA Martin Miller 2141 Harris St 5 Eugene OR 97405 $ 250.00 4~7/2004 Geologist $ 250 00 ~ CA See Page Totals (Add all amounts with the same Accounting Period Totals (Complete only for last page and Instrucnons contribution type. Do not include aggregates.) transfer these amounts to the Summary Statement. PC 1~ ~ on Back and Cash (CA) $1,200 00 Cash/CA) $ __ in Campaign Enter on Sammarv Statement Coltmm A_ L~ne ~ Finance Manual In-Kind (IK) $ __ In-Kind (IK) $ __ Enter on Summao Statement Co[tllfln A Lines 4 add 9 PI_ 2 Loans Received (LR) $ __ Loans Received (LR) $ __ Entel OI1 _'3ttllilndF~ Statement Colnlrlll A. [ lOC 2 Cash Contributions, Loans Received and In-Kind Candidate or Pohtical Committee Name: Committee ID Nmr~ber: ¢*.~ '~, Kitty Piercy for Mayor n/a Pa~e 5 of ~'' ~ Election: [] Primary 200i4 E~ General 20__ [] Other ~ Report E] 1st Pre-election [] 2nd Pre-election [] Post-election E~ 20__ September Supplemental SEE BACK FOR INSTRUCTIONS AND CODE DEFINITIONS CODE ~: Contributor Type CODE 2: Contribution Type B Business Entity CA Cash C Political Committee (includes business and union PACs) CO Cosigner Obhgation F Candidate's Immediate Family (includes candidate) tK la-Kind [ Individual LR Loan Received L Labor Organization O Other' P Pohtical Party Committee Line # Name and Address of Contributor Amount of in-&nd Purpose Contribution (see manual for suggested purpose codes) Date Recewed Occupational information or Contributor Contributing Committee's/DC Aggregate Code ~ Code 2 Robert Melmck 1870 E 27th Ave I Eugene OR 97403 $ 150 00 4/28/2004 ua Architecture Prof $ 250 00 I CA Suzanne Bunker 1870 E. 2 27th Ave Eugene OR $ 150 00 974O3 4/28/2004 Commumty Colleg Instructor $ 250 00 I CA Amy Carpenter 1280 Mill 3 St Eugene OR 97401 $ 200 00 4/27/2004 Owner/Manager, Book Umverse, lnc $ 200 00 I CA Arnold Ismach 5326 Tahsih St 4 Eugene OR 97405 $ 100.00 4/15/2004 Retired $ 200 00 I CA BarbaraSkiar 2435 Jackson St 5 Eugene OR 97405 $ 150 00 4/8/2004 Homemaker $ 200 00 I CA See Page Totals (Add all amounts with the same Accounting Period Totals (Complete only for last page and Instructions contribution ~pe~ Do not include aggregates. ~ transfer these amounts to the Summm2¢ Statement, PC l~'~ on Back m~d Cash (CA) $ 750 00 Cash (CA) $ in Campaign -- Finance Manual In-Kind (IK) $ - In-Kind (IK) $ PC' 2 Loans Received (LR) $ __ Loans Received (LR) $ __ Enter on Snnnna~? Statement. Colump A_ Line 2 PC Cash Contributions, Loans Received and Candidate or Political Committee Name: Committee 1D Number: Kitty Piercy for Mayor n/a Page Election: [] Primary 2004 [] General 20__ [] Other__ Report. [~ 1st Pre-election [~ 2nd Pre-election [] Post-election [--} 20__ September Supplemental SEE BACK FOR INSTRUCTIONS AND CODE DEFINITIONS CODE 1: Contributor Type CODE 2: Contribution Type B Business Entity CA Cash C Political Committee (includes business and union PACs) CO Cosigner Obligation F Candidate's Immediate Family (includes candidate) IK In-Kind ~ Individual LR Loan Received L Labor Organization O Other P Political Party Committee Amount of ln44~nd Purpose bne # Name and Address of Contributor Contribution (see manual for suggested purpose codes) Date Received Occupational Information or Contributor Code ~ Code 2 Contributing Committee's IDg Aggregate Carol Home 2221 Hawkins Lane 1 Eugene OR 97405 $ 100 00 4~27/2004 WrltedResearch Assistant $ 200,00 I CA Deborah Olson 1755W. 2 25th Ave EugeneOR $ 100 00 97405 4~28/2004 Professor $ 200 00 I CA Joan Acker 2031 H~lyard St 3 Eugene OR 97405 $ 100 00 4/10/2004 Retired $ 200 00 I CA Linda Lew~s 1712 Estate Dr 4 Eugene OR 97405 $ 200 00 4/28~2004 Umvers~ty Faculty $ 200 00 I CA Lora Byxbe 677W 23rd Ave 5 EugeneOR 97405 $ 100 00 4/15~2004 Rebred $ 200.00 I CA See Page Totals (Add all amounts with the same Accounting Period Totals (Complete only for hast page and Instructmns contribution type. Do not include aggregates.) transfer these amounts to the Summary Statement, PC ~,) on Back and Cash (CA) $ 600,00 Cash (CA) $ ~ in Campaign Enter oB SktlBl[lat~ Statement Column A. L,ne l Finance Mmmal In-Kind (IK) $ ~ In-Kind (IK) $ ~ Enter on SultlraatT Statement Coimnn A. Lines 4 and ~ PC 2 Loans Received (LR) $ __ Loans Received (LR) $ ~ Enter on Summar5 Statemeht. Column A, I..~e 2 PC 2 Cash Contributions, Loans Received and n-Kind Candidate or Political Committee Name: Committee ID Number: Kitty Piercy for Mayor n/a Pa~e 7 of E~ection, [] Primary 2004 [] General 20_ [~ Other ~ Report' [] 1st Pre-election ~ 2nd Pre-election ~] Post-election [] 20__ September Supplememat SEE BACK FOR INSTRUCTIONS AND CODE DEFINITIONS CODE 1: Contributor Type CODE 2: Contribution Type g Business Entity CA Cash C Political Committee (includes business and union PACs) CO Cosigner Obligation F Candidate's immediate Fa-mdy (includes candidate) IK In-Kind I Individual LR Loan Received L Labor Organization O Other P Political Party Committee Amount of In-Kind Purpose Due # Name and Address of Contributor Contfibutton (see manual for suggested purpose codes) Date Recetved Occupat¢onal Information or Contributor Code ¢ Code 2 Contributing Committee's IDg Aggregate Mabel Armstrong P O Box I 585 Eugene OR 97454 $ 200 00 4/6~2004 Rebred $ 200 00 I CA Michael Rose 2690 Lawrence 2 Eugene OR 97405 $ 100 00 4~22~2004 Retired $ 200 00 ~ CA CIca Turner 2144 Madison St. 3 Eugene OR 97405 $ 200 00 4~3/2004 Retired $ 200 00 I CA Philip Barnhart 182 Sunset 4 Dr Eugene OR 97403 $ 200 00 4/22/2004 State Representative & Psychologist $ 200 00 I CA Roberta Boyden 1568 5 Falrmount Blvd. Eugene OR 97403 $ 200 00 4/23/2004 Vetennanan $ 200 00 ~ CA See Page Totals (Add all amounts with the same Accounting Period Totals (Complete only fYr last page and Instructions contribution type. Do not include aggregates.) transfer these amounts to the Summary Statement, PC t .t on Back and Cash (CA) $ 900 00 Cash (CA) $ in Campaign Enter on Smnmao Statemem Column -X Line I Finance Manual In-Kind (1K) $ In-Kind (IK) $ ~ Eotcr ,on SmmnaD. Statemem. Colmnn A [ me.s $ and v PC 2 Loans Received (LR} $ _ Loans Received (LR) $ ~ Enter on SummaO Statemem Cohlmn A. Line 2 Pt 2 Cash Contributions, Loans Received and Candidat~ or Political Committee Name: Committee [D Nmnber: K tty Piercy for Mayor n/a Page 8 of Election: [~ Primary 2004 [] General 20__ E~ Other__ Report E~] 1st Pre-election [~ 2nd Pre-elect/on [] Post-election [] 20__ September Supplemental SEE BACK FOR INSTRUCTIONS AND CODE DEFINITIONS CODE 1: Contributor Type CODE 2: Contribution Type B Business Entity CA Cash C Political Committee (includes business and union PACs) CO Cosigner Obliganon F Candidate's Immediate Family (includes candidate) IK In-Kind i Individual LR Loan Received L Labor Organization 0 Other P Political Party Committee Amount or In-Kind Purpose Dne ¢¢ Name and Address of Contributor Contribution (see manual for suggested purpose codes~ Occupational Information or Contributor Date Received Contnbuhng Committee's ID¢¢ Aggregate Code 1 ~ Code 2 Thelma Soderqmst 2577 N~xon 1 St. Eugene OR 97403 $ 100.00 200 00 I I CA 4/3/2004 Unemployed $ Joint Councd of Teamsters No 37 2 1872 NE 162nd Ave Portland OR $ 200 00 97230 4/16/2004 No 000080 $ 200.00 C CA Alice Strong 2447 RIverview St 3, Eugene OR 97403 $ 150,00 4~25/2004 Home Salesperson $ 150 00 I CA Cathenne Harris 845 4 24th Ave Eugene OR $ 150 00 97405 4/29/2004 Retired $ 150 00 CA Cheryl Crumbley 880 Glory 5 Dr Eugene OR 97404 $ 150 00 I CA 4/1612004 Pubhc Relabons Consultant $ 150 00 See Page Totals (Add all amounts with the same Accounting Period Totals (Complete only for last page and Instructions contribution type. Do not include aggregates.) transfer these amounts to the Summary Statement, PC I ) on Back and Cash (CA) $ 750 00 Cash (CA} $ in Campaign Enter on Sunm~ao btatement Finance Manual An-Kind 0K) $ _ In-Kind (IK) $ __ Entre op- SmTnnal PC 2 Loans Received (LR) $ Loans R~ceived (LR) $ Enter on SummaD Stalemcm Coittmn A LinD 2 PC 2 Cash Contributions, Loans Received and in-Kind Candidate or Political Committee Name: Committee ID Number: bewca n/a Page_9 of ~ Election: [] Primary 20_OA [~ General 20__ [~ Other __ Report: [] 1 st Pre-election [] 2nd Pre-election {~ Post-election [] 20_ September Supplemental SEE BACK FOR INSTRUCTIONS AND CODE DEFINITIONS CODE 1: Contributor Type CODE 2: Contribution Type B Business Entity CA Cash C Political Committee (includes business and union PACs) CO Cosigner Obliganon F Candidate's hnmediate Family (includes candidate) IK in-Kind I individual LR Loan Received L Labor Organization O Other P Political Party Committee Amount of In-Kind Purpose L/ne # Name and Address of Contributor Contributton (see manual for suggested purpose codes) Date Received Occupational Information or Contributor Code 1 Cede 2 ContrJbutlng Committee's ID¢¢ Aggregate Elizabeth Hall 3275 I Bryceler Dr. Eugene OR $ $150 00 97405 4~26/2004 rebred $ 150 00 ~ CA Evelyn Matthews 3952 South 2 Ridge Dr Eugene OR 97405 $ 150.00 4/14/2004 Rebred $ 150 00 I CA Gordon Lafer 1675 Agate St 3 Eugene OR 97403 $ 100 00 4~27~2004 Professor $ 150.00 I CA Karen Hamilton 511 4~ Brooks(de Drive Eugene OR $ 100 00 97405 4/28/2004 Head Start Administrator/Consultant $ 150 00 I CA Lindsay P~erce 355 Fawway Loop 5 Eugene OR 97401 $ 150 00 4/13~2004 Rebred $ 150 00 ~ CA See Page Totals (Add all amounts with the same Accounting Period Totals (Complete only for last page and lnswuct~ons contribution type, Do not include aggregates. ) transfer these amounts to the Summary StatemenL PC 1 ~) on Back and Cash (CA) $ 650.00 Cash (CA) $ ~ in Campaign Ente~ on Sut'mnaO St~ttemcnt CobJ. mn A_ Linc I Finance Manual [n-Kind (IK) $ -- ln-Kind(1K) $__ Enter on Smnmar~ Statement. Co[m~n A. Lme~ 4 and 9 PC 2 Loans Received (LR) $ ~ Loans Received (LR) $ _ Enter on SmllmaO btal'ement Cohunl~ A. Line 2 PC 2 Cash Contributions, Loans Received and Candidate or Political Committee Name: Committee ID Nmnber: Kitty Piercy for Mayor n/a Page 1_0 of Election: ~ Primary 200__4.4 E~ Oenera~ 20__ E~ Other ~ Report: [~ 1st Pre-election [~ 2nd Pre-election [~ Post-election [] 20__ September Supplemental SEE BACK FOR INSTRUCTIONS AND CODE DEFINITIONS CODE 1: Contributor Type CODE 2: Contribution Type B Business Entity CA Cash C Political Committee (includes business and union PACs) CO Cosigner Obligation F Candidate's Immediate Family (includes candidate) 1K in-Kind 1 Individual LR Loan Received L Labor Organization O Other P Political Par~y Committee Amount of In-Ktnd Purpose Ltne# Name and Address of Contrtbutor Contributton (see manual for suggested purpose codes) Date Received Occupattonal Inforrnatton or Contributor Code I Code 2 Contributing Committee's ID¢¢- Aggregate Lo~s Dlller 994 E 20th Ave. Eugene OR 97405 $ 50.00 4/20/2004 Retired $ 150 00 I CA Rachel Foster 3431 V~ew Ln Eugene OR 97405 $ 50 00 4/13t2004 Self Employed Gardemng Consultant/Writer $ 150 00 I CA Ross Bondurant 845 W. 3 24th Ave Eugene OR $ 150 00 974O5 4~29~2004 Retired $ 150 00 I CA Teressa O'Caer 5210 4 Canyon Dr Eugene OR $ 100 00 97405 4116~2004 Retired $ 150.00 I CA JoathanBrandt 4660 W. Hillside Dr 5 Eugene OR 97405 $ 125 00 4115/2004 Financial Planner $ 125 00 I CA See Page Totals (Add all amounts with the same Accounting Period Totals (Complete only fur last page and Instructions contribution type. Do not include aggregates.) transfer these amounts to the Summary Statement. PC t~) on Back and Cash (CA) $ 475 00 Cash (CA) $ __ }n Campaign Enter on Summm) b~atelnem Column &_ Line t Finance Manual in-Kind (iK) $ In-Kind ilK) $ __ Lntc~ on Summa~ Stalcment Cohmm A. l_mca 4 a~d '1 PC 2 Loans Received (LR) $ Loans Received (LR) $ _ Entel on Sumn~ao Staten'ient. Co[[llllll _'~. l.lne ? PE 2 Cash Contributions, Loans Received and Candidate or Political Committee -Name: Committee ID Number: Kitty Piercy for Mayor n/a Page 11 ot'~~ Election: [] Primary 2004 [~1 General 20__ [] Other__ Report: [~ 1 st Pre-election [] 2nd Pre-election [] Post-election [~ 20__ September Supplemental SEE BACK FOR, INSTRUCTIONS AND CODE DEFINITIONS CODE 1: Contributor Type CODE 2: Contribution Type B Business Entity CA Cash C Political Committee (includes business and union PACs) CO Cosigner Obligation F Candidate's Immediate Family (includes candidate) IK in-Kind i Individual LR Loan Received L Labor Organization O Other P Political Party Committee Amount of fn-K~nd Purpose bne Ct Name and Address of Contributor Contribution Isee manual for suggested purpose codes) Date Received Occupational Information or Contributor Code 1 Code 2 Contributing Committee's IDg Aggregate Sara Brandt 4660 W. H~lls~de Dr 1 Eugene OR 97405 $ 125.00 4 ' 15/2004 Assistant D~rector of a Community $ 125 00 I CA Foundation Sylvia Hart 260 N Grand St. 2 Eugene OR 97402 $ 120 00 4~23~2004 Retired $ 120 00 I CA Alan Anderson 1241 3 AIfaretta Dr Eugene OR $ 50 00 97401 4/24/2004 Rebred $ 100 00 I CA Amy Adams-Scjaler 3812 4 Monroe St. Eugene OR $ 100 00 97405 4/8/2004 High School Counselor $ 100.00 I CA Ann Tryk 1855 Olive St 5, Eugene OR 97401 $ 100.00 4/10/2004 Retired $ 100 00 I CA See Page Totals (Add all amounts with the same Accotmting Period Totals (Complete only for last page and Instructions contribution type. Do not include aggregates.) transfer these amounts to the Smmma~ Statement, PC t .) on Back and Cash ICA) $ 495 00 Cash (CA) $ ~ in Campaign Enter on SummaD Statement Column A, Line 1 Finance Manual In-Kind (IK) $ ~ In-Kind IlK) $ Enter on St[~Ilrlldr~ Statement. Co~[hltlll A L[B¢~ 4 and L) PC 2 Loans Received (LR) $ ~ Loans ReceiYed (LR) $ __ Cash Contributions, Loans Received and In-Kind Candidate or Political Committee Name: Committee ID Number: Kitty Piercy for Mayor n/a Page 12 of ~[ Election: [~ Primary 200_A4 [~] General 20__ [] Other__ Report' ~ 1st Pre-election [~ 2nd Pre-election [] Post-election [] 20__ September Supplemental SEE BACK FOR INSTRUCTIONS AND CODE DEFINI[TIONS; CODE t: Contributor Type CODE 2: Contribution Type B Business Entity CA Cash C Political Committee (includes business and union PACs) CO Cosigner Obhgation F Candidate's Immediate Family (includes candidate) IK in-Kind I Individual LR Loan Received L Labor Organization O Other P Political Party Committee Amount of In-Kind Purpose Line # Name and Address of Contributor Contnbutton (see manual for suggested purpose codes) Date ReceIved Occupational Information or Contributor Code 1 Code 2 Contributing Committee's IDI¢ Aggregate Anne Forrestel 2745 1 Lincoln St. Eugene OR $ 100 00 97405 4/4/2004 University Instuctor $ 100 00 I CA Ava Milosevlch 3198 2 Metolius Dr~ Eugene OR $ 100 00 97408 4/20/2004 CEO--Financial tnstttutlon $ 100,00 I CA BarbaraShirk 3115 Harris St. 3. Eugene OR 97405 $ 100 00 4~28/2004 Retired $ 100 00 I CA BarbaraPerry 5338 Tahslh St, 4 Eugene OR 97405 $ 100 00 4/15~2004 Psychologist $ 100.00 I CA BarbaraBerkley 100 W. 37th Ave 5 Eugene OR 97405 $ 100 00 4/3~2004 Teacher $ 100 00 I CA See Page Totals (Add all amounts with the same Accounting Period Totals (Complete only for last page and Instructions contribution type~ Do not include aggregates.) transfer these amounts to the Summary Statement. PC 1. ~ on Back and Cash (CA) $ 500 00 Cash (CA) $ _ in Campaign Enter on Summar5 btatemcnt, Colmnn A. Line t Finance Manual ln-Kind (1K) $ ~ in-Kind { IK) $ Enter on SummaO Stateroom, Column A. Lines 4 c,~d v PC 2 Loans Received (LR) $ ~ Loans Received (LR) $ ~ Ente~ on SummaU Stateroom Loltmm A. Line 2 PC 2 Cash Contributions, Loans Received and [n-Kind Candidate or Political Committee Name: Committee ID Number: Kitty Piercy for Mayor n/a Page 13 of'~¢( Election: [~ Primary 200._4_4 [] General 20__ [] Other __ Report: [~1 1st Pre-election [~1 2nd Pre-election [] Post-election [] 20__ September Supplemental SEE BACK FOR INSTRUCTIONS AND CODE DEFINITIONS CODE 1: Contributor Type CODE 2: Contribution Type B Business Entity CA Cash C Political Committee (includes business and union PACs) CO Cosigner Obliganon F Candidate's Immediate Family (includes candidate IK In-Kind I Individual LR Loan Received L Labor Organization O Other P Pohtical Party Committee Amount of In-Ktnd Purpose Dne Cf Name and Address of Contributor Contribution (see manual for suggested purpose codes) Date Received Occupational Information or Contributor Code 1 Code 2 Contributing Committee's Il)CC Aggregate Bean Comrada 990 Van 1 Buren St. Eugene OR $ 100 00 97402 4/3/2004 L~terary Translater $ 100 00 I CA Bob Weiss 5338 Tahslli St 2. Eugene OR 97405 $ 100 00 4/15/2004 Professor $ 100 00 I CA Bob Coiner 1543 Happy Lane 3 Eugene OR 97401 $ 100.00 4/20/2004 Educabonal consultant $ 100 00 ~ CA Carlos Barrera 2852 Willamette St 4 #103 Eugene OR 97405 $ 100 00 4/16/2004 Builder-developer $ 100 00 I CA CarmenYokum 2643 Woodstone 5 Eugene OR 97405 $ 50 00 4/15/2004 Retired $ 100 00 I CA See Page Totals (Add all amounts with the same Accounting Period Totals (Complete only for last page and instructions contribution type, Do not include aggregates.) transfer these amounts to the Summary Statement, PC 1. t on Back and Cash (CA) $ 450 00 Cash (CA) $ ~ in Campaign Enter on SttmmaL', Statement Colt~mn A_ Lint, I Finance Manual In-Kind (IK) $ ~ In-Kind (IK} $ .__ Enter on Sumnlao Statement CO!tlIBR &, Lme~ .1 and 9 PC 2 Loans Received (LR} $ __ Loans Received (LR) $ ~ £nte~ oi/SmnmaB S[atemcm. Column A. Linc 2 PC L Cash Contributions, Loans Received and In-Kind Candidate or Polmcal Committee Name: Committee ID Number: Kitty Piercy for Mayor n/a Page 14 of ~ ~ E~ection: [] Primary 2004 [] General 20__ [] Other __ Report: [] 1st Pre-election [] 2nd Pre-election [] Post-election [~ 20__ September Supplemental SEE BACK FOR INSTRUCTIONS AND CODE DEFINITIONS CODE 1: Contributor Type CODE 2: Contribution Type B Business Entity CA Cash C Political Committee (includes business and union PACs'~ CO Cosigner Obligauon F Candidate's Immediate Family (includes candidate) IK in-Kind I Individual LR Loan Received L Labor Organization O Other P Political Party Committee Amount of ln-K~nd Purpose Line # Name and Address of Contributor Contributton (see manual for suggested purpose codes) Occupational Information or Contributor Code l I Code 2 Date Received Contnbuhng Committee's ID¢¢ Aggregate Carohne Woollard 282 1 Sterhng Ave. Eugene OR $ 100 00 97404 4~27/2004 retired $ 100 00 I CA Chnsbne Miles 1543 Happy 2 Lane Eugene OR 97401 $ 100 00 4120/2004 Healthcare Administrator $ 100 00 ~ CA Constance Brown 35401 Row 3 River Rd. #3 Eugene OR 97424 $ 100 00 4/28~2004 Rebred $ 100,00 I CA Daniel Pope 3322 Ohve St 4 Eugene OR 97405 $ 50 00 4/13/2004 Retired $ 100 00 I CA Daniel Goldnch 2262 Birch 5 Ln Eugene OR 97403 $ 100.00 4/12~2004 Retired $ 100.00 ~ CA See Page Totals (Add all amounts with the same Accounting Period Totals (Complete only for last page and Instructions contribution type. Do not include aggregates3 transfer these amounts to the Summar~ Statement, PC on Back and Cash {.CA) $ 450 00 Cash (CA) $ ~ in Campaign Enter on Summar,~ %tatmnem, Cc, lunm Finance Manual in-Kmd (IK) $ _ In-Kind (IK) $ _ £mel un Summacv Statement_ Coh~mn PC 2 Loans Received (LR) $ Loans Received (LR) $ ~ Entc~ on Sttlllllla~ Stalelllellt Cohlllld Pt. 2 Cash Contributions, Loans Received and Candidate or Polincal Committee Name: Committee ID Number: Kitty Piercy for Mayor n/a Page 15 of Elecnon: [~ Primary 2004 [~ General 20__ [~ Other__ Report: E~ I st pre~elecnon ~ 2nd Pre-election [] Post-election [] 20__ September Supplemental SEE BACK FOR INSTRUCTIONS AND CODE DEFINITIONS CODE 1: Cor~tributor Type CODE 2: Contribution Type B Business Entity CA Cash C Political Committee (includes business and union PACs) CO Cosigner Obligation F Candidate's Immediate Family (includes candidate) IK In-Kind I Individual LR Loan Recewed L Labor Organization O Other P Political Party Committee Amount of in-K~nd Purpose L~ne # Name and Address of Contributor Contnbutton (see manual for suggested purpose codes) Date Recewed Occupattonal information or Contributor Code ~ Code 2 Contributing Committee's ID¢¢ Aggregate Dawd Brewer 39100 Camp Creek I Rd. Eugene OR 97478 $ 100 00 4/14/2004 Human Resource Risk Manager $ 100 00 I CA Deb Wilson 105 E. 38th Ave. 2 Eugene OR 97405 $ 100 00 4/27/2004 Energy Management Spec,ahst $ 100 00 t CA D~ana Avery 32481 Howard Lp. 3 Cottage Grove OR 97427 $ 100 00 4/29/2004 Program Services Coordinator $ 100 00 ~ CA D~ane Longcore 1969 4 Orchard St Eugene OR $ 100 00 97403 4/14/2004 Retired $ 100.00 I I CA Edward Meservey 2070 E 5 27th Ave Eugene OR $ 50 00 97402 4/13/2004 Rebred $ 100 00 I CA See Page Totals (Add all amounts with the same Accounting Period Totals (Complete only for last page and Instructions contribution type. Do not include aggregates,) transfer these amounts to the Summary Statement, PC l.) on Back and Cash (CA) $ _450 00 Cash (CA} $ __ in Campaign Enter on Summars. Stat~ment Colunm A, Linc 1 Finance Manual In-Kind (IK) $ - in-Kind (IK) $ __ Enier oi1 Sumlna~ btdtc,rlent COiUI2qll PI Lme~ 4 and 0 PC 2 Loans Received (LR) $ .~ Loans Received (LR) $ Enter on Su-nln'lar5 Statement Cohnnn A Lille 2 PC 2 Cash Contributions, Loans Received and [n-Kind Candidate or Political Committee Name: Committee ID Number: Kitty Piercy for Mayor n/a Page 16 of ~( Election: [~ Primary 2004 E~ General 20__ E~ Other __ Report: E~ 1st Pre-election [] 2nd Pre-election ['-1 Post-election [] 20__ September Supplemental SEE BACK FOR INSTRUCTIONS AND CODE DEFINITIONS CODE 1: Contributor Type CODE 2: Contribution Type B Business Entity CA Cash C Political Committee (includes business and union PACs) CO Cosigner Obligation F Candidate's Immediate Family (includes candidate) IK In-Kind l Individual LR Loan Received L Labor Organization O Other P Political Party Committee # Name and Address of Contributor Amount of I In-Kind Purpose Dne Contnbutton I' (see manual for suggested purpose cedes) Date Received Occupational Informatlon or Contributor Code I Code 2 Contributing Commtttee's IDg Aggregate Ehzabeth Pownall 83 Marlboro I Ln Eugene OR 97405 $ 100 00 4/12/2004 Writer $ 100 00 I CA Ellen Scott 5217 Cold Springs Way Eugene OR 97405 $ 100 00 4/12/2004 Professor $ 100 00 I CA Enk Fisher 2660 Falrmount 3 Blvd Eugene OR 97403 $ 100 00 4/14/2004 Psychtatr~st $ 100 00 I CA Esther Jacobson-Tepher 4 3177 Owl Road EugeneOR $ 100 00 97405 4/8/2004 Professor $ 100 00 ~ CA Fred Tepfer 1380 Ba~ley Ave 5 Eugene OR 97402 $ 100 00 4~24~2004 Architect $ 100 00 I CA See Page Totals (Add ail amounts with the same Accounting Period Totals (Complete only ~'or last page and instructions contribution type, Do not include aggregates.) transfer these amounts to the Summary Statement, PC 1, ) on Back and Cash (CA) $ 500 00 Cash (CA) $ __ in Campaign gmer on Summm5 Stat~me~U Cotmnn A, t. mc t Finance Manual In-Kind (IK) $ In-Kind IlK) $ ~ Enter on Summa~5 %tatemenL L olmnt~ A i mos -I a~d 9 PC 2 Loans Received (LR) $ ~ Loans Received (LR) $ __ E~tgr on Sttltllllat-_~ Statemenl, ~.'Olqlllll A, Liiiu 2 PC 2 Cash Contributions, Loans Received and In-Kind Candidate or Political Committee Name: Committee ID Number: Kitty Piercy for Mayor n/a Page 1_7 of glecnon: [] Primary 200_4 [~ General 20__ [] Other __ Report. [] 1 st Pre-election [] 2nd Pre-election [] Post-election [] 20__ September Supplemental SEE BACK FOR INSTRUCTIONS AND CODE DEFINITIONS CODE 1: Contributor Type CODE 2: Contribution Type B Business Entity CA Cash C Political Committee (includes business and union PACs) CO Cosigner Obligation F Candidate's Immediate Family (includes candidate~ IK In-Kind I Individual LR Loan Received L Labor Organization O Other P Political Parry Committee Amount of In-Kind Purpose One # Name and Address of Contributor Contnbut~on (see manual for suggested purpose codes) Date Received Occupational Informatton or Contributor Code I Code 2 Contributing Committee's IDff Aggregate Jan Becket 2153 Madtson St 1 Eugene OR 97405 $ 100 00 4/312004 Self Employed Tax Consultant $ 100 00 I CA Jeff Davis 283 Spyglass Dr. 2 Eugene OR 97401 $ 100.00 4~3~2004 Retired $ 100 00 I CA Joan Kelly 3265 Elmira Rd. 3 Eugene OR 97402 $ 100 00 4/17/2004 Retired $ 100 00 I CA Johanna M~tchell 2175 4 R~ve~iew St Eugene OR $ 50.00 97403 4/25~2004 Astrological Consultant $ 100 00 I CA John VanLandmgham 335 5 North Grand Eugene OR $ 100,00 97402 4~3~2004 Non-profit pubhc ~nterest attorney $ 100 00 I CA See Page Totals (Add all amounts with the same Accounting Period Totals (Complete only for last page and Instructions contribution type, Do not include aggregates.) transfer these amounts to the SummaLv Statement. PC on Back and Cash {CA) $ 450.00, Cash (CA) $ in Campaign Ente~ on Suminar> Statemem Colunm A Finance Manual In-Kind (IK} $ ~ in-Kind (IK) $ Enter on Stu'Lmtar5 Statement, Column -\, [ roes 4 and o PC 2 Loans Received (LR/ $ ~ Loans Received (LR) $ __ Enter on Summar) Statement, Column A Lnle 2 P( 2 Cash Contributions, Loans Received and In-Kind Candidate or Political Committee Name: Committee ID Number: Kitty Piercy for Mayor n/a Page 1_~8 of_~__ Election: l~ Primary 200_A4 [] General 20__ [~ Other Report' [~ I st Pre-election ~ 2nd Pre-election [] Post-election [7~1 20__ September Supplemental SEE BACK FOR INSTRUCTIONS AND CODE DEFINITIONS CODE 1: Contributor Type CODE 2: Contribution Type B Business Entity CA Cash C Polincal Committee (includes business and union PACs) CO Cosigner Obligation F Candidate's Immediate Family (includes candidate) IK in-Kind I lndwidual LR Loan Rece~ed L Labor Organization O Other P Political Party Committee Amount of In-Ktnd Purpose Dne # Name and Address of Contributor Contributton (see manual for suggested purpose codes) Date Recewed Occupational Information or Contributor Code 1 Code 2 Contnbuttng Committee's ID¢¢ Aggregate John Reynolds 2495 1 M~ss,on Eugene OR 97403 $ 100 00 4/26/2004 Architect $ 100 00 I CA John Kmman P O. Box 782 2 Marcola OR 97454 $ 100 00 4/1312004 President, American Association for Nude $ 100.00 I CA Recreation, Western Region John Jordan-Cascade 3. 1575 Larkspur Lp Eugene OR $ 50 00 97401 4/20/2004 Web Content Coordinator $ 100 00 ~ CA Joseph McKmney 2968 4 Summit Sky Blvd Eugene OR $ 100 00 97405 4~20~2004 Financier/President Oregon Roads, Inc $ 100.00 I CA Judith E~sen 2788 Riverwew St 5 Eugene OR 97403 $ 50.00 4129/2004 Professor $ 100 00 I CA See Page Totals {.Add all amounts with the same Accounting Per~od TotaN (Complete only for last page and Instructions contribution type. Do not include aggregates.) transfer these amounts to the Summary Statement, PC l,) on Back and Cash (CA) $ _400.00 Cash (CA) $ ~ in Campaign Enter o~ Summa~5 StatemenL Column A, L ~¢ 1 Finance Manual in-Kind (IK) $ ~ In-Kind (IK} $ ~ Enter on StnnmaO Statemept_ Column A. Lilies 4 and c, PC 2 Loans Received (LR} $ Loans Received (LR} $ Enter oil Stu~llnar) Statcment Cokunn A Line 2 P£ Cash Contributions, Loans Received and n-Kind Can&date or Political Committee Name: Committee ID Number. Kitty Piercy for Mayor n/a Page 1~9 o~ '~ ~ Election: [] Primary 200~4 [~] General 20__ [~ Other __ Repoct: [] 1st Pre-election [~ 2nd Pre-election [] Post-election [] 20__ September Supplemental SEE BACK FOR INSTRUCTIIONS AND CODE DEFINITIONS CODE 1: Contributor Type CODE 2: Contribution Type B Business Entity CA Cash C Political Committee (includes business and union PACs) CO Cosigner Obligation F Candidate's Immediate Family (includes candidate) IK In-Kind 1 individual LR Loan Received L Labor Organization O Other P Political Party. Committee Amount of I ln-K~nd Purpose Dne # Name and Address of Contributor Contribution i (see manual for suggested purpose codes) Date Received Occupational/nformatlon or Contributor Code 1 Code 2 Contributing Commlttee's ID¢¢ Aggregate Jud,th Anderson 1241 1~ AIfaretta Dr Eugene OR $ 50 00 97401 4~24/2004 Rebred $ 100 00 I CA Kate McGee 1466 Washington 2 Eugene OR 97401 $ 100 00 4/20/2004 Landscape Architect $ 100 00 I CA Kate Kelly 1185 Sunnyside Dr. 3 Eugene OR 97404 $ 100.00 4/27/2004 Counselor/Bodyworker $ 100 00 ! CA Kate Bollons 1380 Bailey Ave. 4 Eugene OR 97402 $ 100 00 4~24/2004 Painter $ 100.00 I CA Kathle T~ppens Wiper 3772 Pine 5. Canyon Dr Eugene OR 97405 $ 100 00 4/22~2004 Retired $ 100 00 I CA See Page Totals (Add all amounts with the same Accot~nting Period Totals (Complete only for last page and Instructions contribution type. Do not include aggregates.) transfer these amounts to the Summao Statement, PC 13 on Back and Cash (CA) $ 450 00 Cash (CA~ $ __ in Campaign Ente~ on Summ,~r'~ Statement Culumn &. Line I Finance Manual In-Kind (IK) $ ~ In-Kind (IK) $ Enter o~ Sumnlap, Statement Column A klllt3> 4 and ~} PC 2 Loans Received (LR~ $ ~ Loans Received (LR) $ _ PC' Cash Contributions, Loans Received and In-Kind Candidate or PoLitical Committee Name: Co~nmittee ID Number. Kitty Piercy for Mayor n/a Page 20 of ~ Election' [] Primary 2004 [~ General 20__ [~1 Other __ Report: [] 1st Pre-election [] 2nd Pre-election [] Post-election [~ 20__ September Supplemental SEE BACK FOR INSTRUCTIONS AND CODE DEFINITIONS CODE 1: Contributor Type CODE 2: Contribution Type B Business Entity CA Cash C Political Committee (includes business and union PACs) CO Cosigner Obliganon F Candidate's Immediate Family (includes candidate) IK In-Kind I Individual LR Loan Received L Labor Organization O Other P Political Party Committee Amount of tn-K~nd Purpose LJne # Name and Address of Contributor Contribution (see manual for suggested purpose codes) Date Received Occupat¢onal Information or Contributor Code 1 Code 2 Contributing Committee's ID¢ Aggregate Larry Brink 2242 Riverv~ew St 1 Eugene OR 97403 $ 100 00 4/28~2004 General Contractor $ 100 00 I CA Dnda Frederick 180 W. 2, 15th Ave. Eugene OR $ 100.00 97401 4/6/2004 Retired $ 100 00 I CA Lou~s Smmger 25416 Irene 3 St Eugene OR 97437 $ 50,00 4/1412004 Union Representabve $ 100 00 ~ CA Lynn Stephen 2346 Aider ' 4 St. Eugene OR 97405 $ 100.00 4/21/2004 Professor $ 100.00 I CA Marcia Meyer 600 Cherry Dr 1 5 Eugene OR 97401 $ 100.00 4/26~2004 rettred $ 100.00 I CA See Page Totals (Add all amounts with the same Accounting Period Totals (Complete only for last page and Instructions contribution type. Do not include aggregates.) transfer these amounts to the Summa~ Statement, PC 1 .) on Back and Cash (CA) $ 450 00 Cash (CA) $ __ lB Campaign Enter on 5ummao Statement, Coklmn )~ Line I Finance Manual In-Kind (IK) $ ~ in-Kind (IK) $ ~ El;tel on btllYn'fl.tD Statement Co[mnn A. Lmm', 4 2vM ~) PC 2 Loans Received (LR) $ __ Loans Received (LR) $ _ Enter on SummaD Statement. C ulumn A, Linc 2 PL 2 Cash Contributions, Loans Received and In-Kind Candidate or Political Committee Name: Committee ID Number: Kitty Piercy for Mayor n/a Page 21 of'l~l Election: [~ Primary 200__4_4 E] Genera~ 20__ [] Other __ Report. [] 1 st Pre-election [] 2nd Pre-election E~ Post-election E~ 20__ September Supplemental SEE BACK FOR INSTRUCTIONS AND CODE DEFINITIONS CODE 1: Contributor Type CODE 2: Contribution Type B Business Entity CA Cash C Political Committee (includes business and union PACs) CO Cosigner Obligation F Candidate's Immediate Family (includes candidate) IK In-Kind 1 Individual LR Loan Received L Labor Organization O Other P Political Party Committee Amount of ! ln-Ktnd Purpose bne # Name and Address of Contributor Contribution (see manual for suggested purpose codes) Date Recewed Occupational Information or Contributor Code 1 Code 2 Contributing Committee's IDI¢ Aggregate Margaret Via 89846 I Poodle Creek Rd Nob OR $ 100 00 97461 4~27/2004 artist $ 100 00 ~ CA Margaret Kelly 1980 2, Columbia Eugene OR $ 100 00 97403 4/4/2004 Pubhc Relations Consulting $ 100 00 I CA Mane "Lou" Enge 259 W 3 19th Ave. Eugene OR $ 100 00 97401 4~23~2004 Non-Profit Serrate D~rector $ 100 00 I CA Mary Z~er 1202 Lemery Ln 4 Eugene OR 97405 $ 100 00 4~8/2004 Retired $ 100 00 I CA Mary Keens 85400 S, Wdlamette 5 Eugene OR 97405 $ 100 00 4/20/2004 nurse $ $100 00 I CA See Page Totals (Add all amounts with the same Accounting Period Totals (Complete only for last page and lnstrucnons contribution type. Do not include aggregates.) transfer these amounts to the Summar~ Statement, PC 1,) on Back and Cash (CA) $ 500 00 Cash (CA) $ __ in Campaign Enter on 5ummar5 'Statement. Column A Line Finance Manual In-Kind (IK) $ ~ [n-Kind (IK) $ _ [nt~ on Stlmn/ao Stateroom Co[tnBt~ A LW~cS 4 a,ld 9 PC 2 Loans Received (LR) $ ~ Loans Received (LR) $ ~ £mer on Sllnllllal) Stalemenl Goltlnlll &., Linc 2 Cash Contributions, Loans Received and In-Kind Candidate or Political Committee Name: Committee ID Number: Kitty Piercy for Mayor n/a Pa~e 22 of ~ ~ Electiom [~ Primary 2004 [] General 20__ [] Other __ Report: [] 1st Pre-election [~ 2nd Pre-election [] Post-election [] 20__ September Supplemental SEE BACK FOR INSTRUCTIONS AND CODE DEFINITIONS CODE 1: Contributor Type CODE 2: Contribution Type B Business Entity CA Cash C Political Committee (includes business and union PACs} CO Cosigner Obligation F Candidate's Immediate Family (includes candidate) IK in-Kind I Individual LR Loan Received L Labor Organization O Other P Political Party Committee Amount of In-K~nd Purpose Line ¢¢ Name and Address of Contributor Contnbut¢on (see manual for suggested purpose codes,) Occupational Information or Contributor Code 1 Code 2 Date Received Contributing Committee's IDI¢ Aggregate Mary Gossart 30488 Fox Hollow 1 Rd, Eugene OR 97405 $ 100.00 4/4/2004 Education Director $ 100 00 ~ CA Matthew Denms 4827 Old 2 Dillard Rd. EugeneOR $ 100 00 97405 4/7/2004 Professor $ 100.00 I CA Megan Moseley 61 W. 31st 3. Ave Eugene OR 97405 $ 100 00 4~20~2004 ph, ys~cal therapists $ 100 00 I CA Mery Wendy Roberts 11537 SE 4 Flavel St Portland OR $ 100.00 97266 4/20/2004 Retired $ 100.00 I CA Michael Staszak 61 W 31st. Ave 5 Eugene OR 97405 $ 100 00 4120/2004 physical therapists $ 100 00 I CA See Page Totals (Add all amounts with the same Accounting Period Totals (Complete only for last page and lnstrucuons contribution type~ Do not include aggregates.) transfer these amounts to the Summary StatemenL PC 1 .) on Back and Cash (CA} $ 500 00 Cash (CA) $ ~ in Campaign ~mcr ca Sumnlar~ Stmrment, Cohimn A. Lute 1 Finance Manual In-Kind (IK) $ ~ In-Kind (IK) $ ~ Entel OI1 Summao Statement Cokwrm A L,mes 4 ~llld ') PC 2 Loans Received (LR) $ Loans Received (LR) $ ~ Enter on Sulnma~ Statement, Coltnnr~ A. Lille 2 PL 2 Cash Contributions, Loans Received and Candidate or Political Committee Name: Committee ID Number: Kitty Piercy for Mayor n/a Page 23 of%~ Election: ~ PrimaO, 2004 E~ General 20__ [] Other __ Report. [~ 1st Pre-election [] 2nd Pre-election [~ Post-electiov E~ 20__ September Supplemental SEE BACK FOR INSTRUCTIONS AND CODE DEFINITIONS CODE 1: Contributor Type CODE 2: Contribution Type B Business Entity CA Cash C Political Committee (includes business and union PACs) CO Cosigner Obligation F Candidate's Immediate Family (includes candidate) IK In-Kind 1 Individual LR Loan Received L Labor Organization O Other P Political Party Committee Amount of In-K~nd Purpose LJne # Name and Address of Contributor Contribution (see manual for suggested purpose codes) Date Received Occupattonal Informatton or Contributor Code ? Code 2 Contributing Committee's ID# Aggregate Phd Catlett 2249 Okemos SE 1 Grand Rapids MI 49506 $ 100.00 4/17/2004 General Manager of Regent Broadcasting $ 100 00 I CA Rich Phaigh 35917 Camp Creek 2 Rd Springfield OR 97478 $ 100 00 4/28/2004 message therapist $ 100 00 I CA Richard Kraus 1313 Lincoln St 3 #1301 EugeneOR 97401 $ 100 00 4~6~2004 Professor $ 100.00 I CA Robert Smith 3432 W. 15th Ave. 4 Eugene OR 97402 $ 100 00 4113/2004 Rebred $ 100.00 I CA Robin Irish 2559 Emerald ST 5 St. Eugene OR 97403 $ 100,00 4/13/2004 CEO of PFS MED, INC. $ 100 00 ~ CA See Page Totals (Add ali amounts with the same Accounting Period Totals (Complete only for last page and Instructions contribution type° Do not include aggregates.) transfer these amounts to the Summary Statement, PC l ) on Back and Cash (CA) $ 500 00 Cash (CA) $ in Campmgn Enter on Smmnm) Statement Cotmnn A. Lira: [ Finance Manual In-Kind (IK) $ ~ ln-K~nd (IK) $ Ente~ O11 Sl[tllmdF). btatcllqel/t. OoltllI~n A., L111¢5 4 and ~ PC 2 Loans Received (LR) $ Loans Received (LR) $ _ Enter on Summau Statement Column A L~,,e 2 Cash Contributions, Loans Received and In-Kind Candidate or Political Committee Name: Committee ID ?'.lumber: Kitty Piercy for Mayor n/a Page 24 of'~t Election: ~ Primary 2004 [] General 20__ ~ Other __ Report: El 1st Pre-elect~on [] 2nd Pre-election [~ Post-election E~ 20__ September Supplemental SEE BACK FOR INSTRUCTIONS AND CODE DEFINITIONS CODE 1: Contributor Type CODE 2: Contribution Type B Business Entity CA Cash C Political Committee (includes business and union PACs) CO Cosigner Obligation ic Candidate's Immediate Family (includes candidate) IK In-Kind I ln&vldual LR Loan Received L Labor Organization O Other P Political Party Committee Amount of In-Kmd Purpose Dne # Name and Address of Contributor Contribution (see manual for suggested purpose codes) Date Received Occupational Information or Contributor Code ~ Code 2 Contributing Committee's ID¢ Aggregate Ron Tenmty 999 Brooks~de Dr 1 Eugene OR 97405 $ 100 00 4~3/2004 Union Orgamzer $ 100 00 I CA Serafina Clarke 3973 Onyx 2 St. Eugene OR 97405 $ 100 00 4~8~2004 County Program Services Coordinator $ 100 00 I CA Stephen Smith 128 3 Lynbrook Dr~ Eugene OR $ 100 00 97404 4/28/2004 rebred $ 100 00 I CA Stryder Thompkins 2640 4, McMdlan St Eugene OR $ 100.00 97405 413/2004 Consultant w~th Carol/Trevelyan Strategy $ 100 00 I CA Group Susan Connolly 189 W, 5 37th Ave. Eugene OR $ 100 00 97405 4/17t2004 Property Manager $ 100 00 ~ CA See Page Totals (Add all amounts with the same Accounting Period Totals (Complete only, for last page and instructions contribution type. Do not include aggregates.) transfer these amounts to the Summary Statement. PC 1~ ) on Back and Cash (CA') $ 500.00 Cash (CA) $ in Campaign Enter o~ Stmnnao Slatement. Co;mnn A~ Linc ] Finance Manual In-Kind (IK~ $ ~ In-Kind (IK) $ ~ Enter on Sulnma~ Statemen~ Colulnn A k111¢$ 4 311d c) PC 2 Loans Received (LR) $ ~ Loans Received (LR) $ ~ Enter nn bumraau Statement Column A. Line 2 PC 2 Cash Contributions, Loans Received and In-Kind Candidate or Political Committee Name: Committee ID Number: Kitty Piercy for Mayor n/a Pa~e 25 of'~ [ Election: [~ Primary 200_¢_4 E~ General 20__ [-1 Other__ ReporL ~_~ 1st Pre-election ~ 2nd Pre-election [-'1 Post-election [] 20__ September Supplemental SEE BACK FOR INSTRUCTIONS AND CODE DEFINITIONS CODE 1: Contributor Type CODE 2: Contribution Type B Business Entity CA Cash C Political Committee (includes business and union PACs) CO Cosigner Obligatmn F Candidate's Immediate Family (includes candidate) IK In-Kind 1 Individual LR Loan Received L Labor Organizanon O Other P Political Part¢ Committee Amount of ln-Kmd Purpose Dne # Name and Address of Contributor Contribution (see manual for suggested purpose codes) Date Recelved Occupational Information or Contributor Code 1 Code 2 Contributing Commtttee's ID# Aggregate Thomas Pnngle 3295 I Kinca]d St. Eugene OR $ 100 00 97405 4/13/2004 b~omed~cal consultant $ 100 00 I CA Wdham Balsom 83 Marlboro Ln. Eugene OR 97405 $ 100 00 4/12/2004 Physician $ 100 00 I CA Leslie Brockelbank 1527 W 25th Eugene OR 97405 $ 20.00 4/23/2004 Retired $ 80 00 I CA Ahc~a Hays 274 Regal Court 4 Eugene OR 97401 $ 75 00 4/16/2004 Director, County Department Children and Families $ 75 00 I CA Ahson Peara 410 E, 34th Ave, 5 Eugene OR 97405 $ 75.00 4t10/2004 Non-Profit D,rector $ 75 00 I CA See Page Totals (Add all amounts with the same Accounting Period Totals (Complete onl~ for last page and instructions contribution type. Do not include aggregates.) transfer these amounts to the Summary Statement. PC 1.~ on Back and Cash {CA) $ 370 00 Cash (,CA) $ ~ in Campaign Emcr on Smmnar5 Statement, Column A Line ~ Finance Manual In-Kind (IK) $~ In-Kind t, IK) $ Entel (Jrt Surm'aat),' Stalement. Column A. Lines 4 ami 9 PC 2 Loans Received (LR} $ ~ Loans Received (LR} $ __ Enter on Smnma~:~ Statement. Column _5 Line 2 PL 2 Cash Contributions, Loans Received and in-Kind Candidate or Political Committee Name: Committee ID -Number: Kitty Piercy for Mayor n/a Page 2--6 o~ [ Election: [] Primary 200_4_4 [] General 20__ [] Other __ Report: [] 1st Pre-election [] 2nd Pre-election [] Post-election [-1 20__ September Supplemental SEE BACK FOR INSTRUCTIONS AND CODE DEFINIITIONS CODE 1: Contributor Type CODE 2: Contribution Type B Business Entity CA Cash C Political Commktee (includes business and union PACs) CO Cosigner Obligation F Candidate's immediate Family (includes candidate) [K la-Kind I individual LR Loan ReceIved L Labor Organization O Other P Politica~ Party Committee Amount of tn-Kind Purpose bne # Name and Address of Contributor Contribution (see manual for suggested purpose codes) Date Received Occupational Information or Contributor Code I Code 2 Contributtng Committee's ID~ Aggregate Andrew Peara 410 E 34th Ave I Eugene OR 97405 $ 75 00 4/10/2004 School Administrator $ 75~00 I CA Chris Helm 1147 E 26th Ave 2 Eugene OR 97403 $ 25 00 4/12/2004 Teacher $ 75 00 I CA Ehzabeth Churchill 3 2476 N~xon St. Eugene OR $ 25 00 97403 4/1512004 Nurse Pract~boner $ 75 00 I CA Jonathon Stafford 437 E 11th 4 Ave Eugene OR 97401 $ 50 00 04~22/04 Architect $ 75 00 I CA M~chael Camgan 1439 W 5 4th Ave. Eugene OR $ 25.00 97402 4/2412004 Commumty Organizer $ 75.00 ~ CA See Page Totals (Add all amounts with the same Accounting Period Totals (Complete cab for last page and instructions contribution type. Do not include aggregates,) transfer these amounts to the Summary Statement, PC ~,) on Back and Cash (CA) $ 200 00 Cash (CA) $ ___ m Campaign Emer crt Summm5 Statement Cokmm A. Lm~ 1 Finance Manual Ia-Kind {IK) $ In-Kind (IK) $ -- Enter on SumlnaO Statement Colmnn A L~ne~ 4 and 9 PC 2 Loans Received (LR) $ ~ Loans Received (LR} $ __ Enter on Summm_~ Statement, Column A, Line 2 Cash Contributions, Loans Received and Candidate or Political Committee Name: Committee I-D Number: Kitty Piercy for Mayor n/a Pa~e 27 Election: ~ Primary 200__&4 E~ General 20__ ~ Other __ Report: E~ 1st Pre-election ~ 2nd Pre-election [] Post-election [] 20__ September Supplemental SEE BACK FOR INSTRUCTIONS AND CODE DEFINITIONS CODE 1: Contributor Type CODE 2: Contribution Type B Business Entity CA Cash C Political Committee (includes business and union PACs) CO Cosigner Obligation F Candidate's Immediate Family (includes candidate) IK tn-Kind I Individual LR Loan Received L Labor Organization O Other P Political Party Committee Amount of In-Kind Purpose Dne # Name and Address of Contributor Contribution (see manual for suggested purpose codes) Date Received Occupattonal Information or Contributor Code ~ Code 2 Contributing Committee's IDg Aggregate M~ke Helm 1147 E 26th Ave 1. Eugene OR 97403 $ 25.00 4/12/2004 Ph~losophedauthor $ 75 00 I CA Mmam Jordan P O Box 50683 Eugene OR 97405 $ 25 00 4/21/2004 Exec Asst to Dir UO Museum of Art $ 75 00 I CA Molly Stafford 437 E. 11th Ave 3 Eugene OR 97401 $ 50,00 04~22~04 RebredNolunteer $ 75.00 I CA Ron Chase 924 Sunnyside Dr 4 Eugene OR 97404 $ 25.00 4/2012004 Execubve Director--Sponsors Inc $ 75 00 ~ CA Ruth Simon 747 Brookside Dr 5 Eugene OR 97405 $ 50 00 4/16/2004 Teacher $ 75,00 1 CA See Page Totals (Add all amounts with the same Accounting Period Totals (Complete only tar last page and Instructions contribution type. Do not include aggregates.) transfbr these amounts to tt~e SummaLv Statement, PC 1~ ~ on Back and Cash (CA) $ J 75 00 Cash rCA) $ ~ in Campaign Enter on Smmnar~, Statemem, Colmm~ & Linc t Finance Manual tn-Kind (IK) $ In-Kind (IK} $ __ Enter on StLII111lal~ gtatemeflt Coldmn A_. L llles 4 olld ~ PC 2 Loans Received (LR) $ ~ Loans Received (LRi $ ~ Ellier oil Stl~illllal'5 Statement COlUlll~l -k. LIlle 2 ~C 2 Cash Contributions, Loans Received and In-Kind Candidate or Political Committee Name: Committee ED Number: Kitty Piercy for Mayor n/a Page Elect~on: [~ Primary 2004 E~ General 20__ E~ Other __ Report: [] 1st Pre-election [5~ 2nd Pre-election [] Post-election [] 20__ September Supplemental SEE BACK FOR INSTRUCTIONS AND CODE DEFINITIONS CODE l: Contributor Type CODE 2: Contribution Type B Business Entity CA Cash C Political Committee (includes business and union PACs) CO Cosigner Obligation F Candidate's Immediate Family (includes candidate) IK In-Kind I Individual LR Loan Received L Labor Organization O Other P Political Party Committee Amount of In-Kind Purpose bne # Name and Address of Contributor Contribut¢on (see manual for suggested purpose codes) Occupational Information or Contributor Code I I Code 2 Date Received Contributing Commtttee's IDI¢ Aggregate Susan Barnhart 1439 W 1 4th Ave Eugene OR $ 20 00 97402 4124/2004 Social Worker $ 70 00 I CA Marion Malcolm 110 Mayfair 2 Eugene OR 97404 $ 25.00 4/20~2004 Self-employed Nonprofit Consultant $ 60 00 CA Sarah Lichtenstem 1650 Kona 3 St Eugene OR 97403 $ 4/6/2004 Researcher $ 60 00 I CA Junko Toll 4800 Brookwood St. 4 Eugene OR 97405 $ 25.00 4~24~2004 Teacher $ 55 00 I CA Sue Subbot 85213 Chezem Rd 5 Eugene OR 97405 $ 100 00 4/15/2004 Teacher $ 200.00 See Page Totals LAdd all amounts with the same Accounting Period Totals (Complete only for }ast page and Instructions contribution type. Do not include aggregates.) transfer these amounts to the Summary Statement. PC' 1.) on Back and Cash (CA) $ 230 00 Cash/,CA) $ In Campaign Ente~ on Summm-, Statement Cohma* & LI;'tc t Finance Manual In-Kind (IK) $ -.~ In-Kind ilK) $ __ Ente~ cm St[Ig!iYldr) %tatemem (~(.)ltllllll & [ lite> 4 dltd 'J PC 2 Loans Received (LR) $ Loans Received (LR~ $ ~ Enter on Smmnar_', Statement Column -% [ ]nc 2 PC ] Cash Contributions, Loans Received and in-Kind Candida[e or Political Committee Name: Committee ID Ntlmber: of 5~ Kitty Piercy for Mayor n/a Page 2__9_9 Election: [~ Primary 20,0~4 [--1 General 20__ ~ Other __ Report: [~1 I st Pre-election [~1 2nd Pre-election [] Post-election [] 20__ September Supplemental SEE BACK FOR INSTRUCTIONS AND CODE DEFINITIIONS CODE t: Contributor Type CODE 2: Contribution Type B Business Entity CA Cash C Political Committee (includes business and union PACs) CO Cosigner Obligation F Candidate's Immediate Family tincludes candidate~ IK In-Kind I lndNidual LR Loan Received L Labor Organization O Other P Political Party Committee Amount of lo*and Purpose Line # Name and Address of Contributor Contnbut~on (see manual for suggested purpose codes} Occupattonal Information or Contributor Code '1 t Code 2 Date Received Contributing Committee's ID# Aggregate 260 Miscellaneous Cash Contributions of 1 $50 and Under $ 9,693 50 412104-512t04 $ I CA Clancy Pnntmg Company 2 350 W 5th Eugene OR $ 98 00 L - reducbon m cost of prmtm9 97401 notecards, letterhead, envelopes 4/2/2004 $ 98 00 B IK Carl Below PO Box 40693 3 Eugene OR 97404 $ 625 00 O - Lawn Signs production 4/30/2004 Retired $ 625 00 CB Simons 4 215 W 5th Eugene OR $ 500 00 G - office space 97401 4/2/2004- Realtor $ 926 76 ~ I IK 5/212004 5 $ See Page Totals (Add all amounts with the same Accounting Period Totals (Complete ertl> for last page and Instructions contribution type. Do not include aggregates.) transfer these amounts to the Summary Statement, PC on Back and Cash (CA) $ 9,693 50 , Cash (CA) $ ~ ii1 Campaign Emer on *,tmm~ar~ %tatement Colunm/k. Line Finance Manua~ m-Kind flK) $ t ,223 00 In-Kind (tK} $ .__ kntel on St.lltna[) Statcwent. Coitull.q A. Lilies 4 and 9 PC 2 Loans Received (LR) $ _ Loans Received (LR) $ - Enter on Stlmlllar? Statement. (oll.tlllll ,~, Lille Cash Contributions, Loans Received and In-Kind .e, Candidate or Pohtical Committee Name: Committee iD Number, Kitty Piercy for Mayor n/a Page 30 of ~{ Election, ~ Primary 200_&4 E~ General 20__ E] Other __ Report: E~ 1st Pre-election [~ 2nd Pre-election [] Post-election [] 20__ September Supplemental SEE BACK FOR INSTRUCTIONS AND CODE DEFINITIONS CODE 1: Contributor Type CODE 2: Contribution Type B Business Entity CA Cash C Political Committee (includes business and union PACs) CO Cosigner Obhgat~on F Candidate's Immediate Family (includes candidate) iK In-Kind 1 individual LR Loan Received L Labor Organization O Other P Political Party Committee Amount of In-Kind Purpose Dne# Name and Address of Contributor Contribution (see manual for suggested purpose codes) Occupational Information or Contnbutor Code 1 I Code 2 Date RecePved Contributing Committee's ID# Aggregate Oregon League of Conservation Voters 320 1 S W. Stark, Ste 415 Portland OR $ 359.83 G (staff time) 97204 4/2/04-5/2/04 No 002352 $ 359 83 C Oregon League of Conservation Voters 320 2 S W Stark, Ste 415 Portland OR $ 35 99 T (rental car) 97204 4/17/04 No 002352 $ 395 82 C Oregon League of Conservation Voters 320 3 S.W Stark, Ste. 415 Portland OR $ 530 53 L 97204 4/27/04 No 002352 $ 926.35 C IK Oregon League of Conservation Voters 320 4 S W Stark, Ste. 415 Portland OR $ 10.00 T 97204 4/28/04 No 002352 $ 936 35 C iK Oregon League of Conservabon Voters 320 5 S W Stark, Ste. 415 Portland OR $ 2 50 L 97204 4/28/04 No. 002352 $ 938 85 C See Page Totals (Add ali amounts with the same Accounting Period Totals {Complete only for last page and instructions contribution type~ Do not include aggregates.) transfer these amounts to the Summary Statement, PC 1, on Back and Cash (CA) $ 0 00 Cash (CA) $ __ in Campaign Enter Finance Manual In-Kind (IK) $ 938 85 in-Kind (IK) $ __ Emer on St'4runaD Sla[cmepr Coltmm & Ltn~:~ 4 dtld 9 PC '~ } Loans ReceiYedlLR/ $ ~ Loans Received (LR} $ _ - En/e~ 0ii SullllBctl~ Statement, CL, II. iliii/ A.. Lille 2 PC Cash Contributions, Loans Received and In-Kind Candidate or Political Committee Name: Committee ID Number Kitty Piercy for Mayor n/a Page 31 of 31 Election: [] Primary 200_A [~1 General 20__ [-] Other __ Report: [] 1st Pre-election [] 2nd Pre-election [] Post-election [] 20__ September Supplemental SEE BACK FOR INSTRUCTIONS AND CODE DEFINITIONS CODE t: Contributor Type CODE 2: Contribution Type B Business Entity CA Cash C Political Committee (includes business and union PACs) CO Cosigner Obligation F Candidate's immediate Family (includes candidate) IK in-Kind I individual LR Loan Rece~ed L Labor Organization O Other P Political Party Committee Amount of In-Kind Purpose Line # Name and Address of Contributor Contribution (see manual for suggested purpose codes) Occupational Information or Contributor Date Received Contributing Commtttee's ID¢4 Aggregate Code 1 ~ Code 2 Oregon League of Conservabon Voters 320 1 S W. Stark, Ste 415 Portland OR $ 1994 P, L 97204 4/29/04 No, 002352 $ 2,932 85 C IK Oregon League of Conservation Voters 320 2 S W. Stark, Ste 415 Portland OR $ 1 20 T 97204 4/30/04 No 002352 $ 2,934 05 C IK David Plercy 3 1371 W 4th Ave $ 15~000 00 Eugene OR 97404 4/28/04 Rebred $ 15~000 00 ~ LR 4 $ 5 $ See Page Totals (Add all amounts with the same Acconnting Period Totals (Complete only fbr last page and Instructions contribution type. Do not include aggregates.) transfer these amounts to the SummaLy Statement, PC 1. I on Back and Cash {CA) $ 0 00 Cash (CA} $ 31,358 50 in Campaign £n,.e~ on Summalw' ~tate~nen~ Coltum~ A, [ me 1 Finance Manual In-Kind (IK) $1,995 20 In-Kind (IK) $ 4,157 05 Entel ou StumilaO State. motet Coluum A ~ tries 4 a.d ' PC 2 Loans Received (LR) $15,000.00 Loans Received (LR) $15.000 00 Cash Expenditures and Loan Payments Candidate or Political Committee -Name: Committee ID Number. Kitty Piercy for Mayor n/a Paae 1 of ~ Election: [~ Primary 2004 [~ General 20__ ['-[ Other __ Repom ~ let Pre-election [~ 2nd Pre-election [-1 Post-election [--I 20__ September Supplemental PURPOSE CODES (see back of form for instructions and code definitions} EXPENDITURE TYPES A Agent O Other Advertising (>,md signs, buttons, etc. I CA Cash B Broadcast Advertising (Radio~ TV) P Postage LP Loan Payment C Cash Contributions R Reimbursement for Personal Expenditures F Fundraising Event Expenses S Surveys and Polls G General Operational Expenses (describe if over $50) T Travel Expenses (describe if over $503 I Interest Payment U Utilities L k~terature~ Brochures, Printing W Wages, Salaries, Benefits M Management Services Y Petition Circulators N Newspaper and Other Periodical Advertising Z Preparation and Production of Advertising Payee's Name and Payee s Committee IDg, ~ Exp. Amount of bne # Date Check # if applicable Purpose Type Expenditure Pa~d (as tt appears on ¢nvotce, receipt or check) to A/P 2 4~3/04 EFT Pohbcs Online G CA $ 10 00 E~ 3 4/3~04 EFT Pohbcs Onhne G CA $ 5.00 E~ 4 4~5~04 1042 usps p CA $ 370 00 E~] 5 4~6/04 1043 Kmkos L CA $ 89 88 E~ 6 4~8~04 EFT Politics Online G (Bank CA $ 93 00 charge) 7 4/9~04 1044 Oregon T's O CA $ 1,125 00 ~ 8 4111/04 EFT Politics Online G CA $ 4 00 E~ 9 4/13/04 EFT Politics Onhne G CA $ 5 00 E~ 10 4f14/04 EFT Pohbcs Onhne G CA $ 10 00 E~ See Page TotaLs (Add all expenditures with the same Accounting Period Totals (Complete onb, tut last page and Instructions expenditure type.) transfer these amounts to the Smnmary StatemenL PC I ) on Back and m Campaign Cash (CA) $1,711 88 Cash (CA) $ _ Finance Enter on Summar5 btatemcn~ Co,oran A Line (~ Manual Loan Payment (LP) $ ~ Loan Payment (LP) $__ PC 3 PC I Cash Expenditures and Loan Payments Candidate or Political Committee Name: Committee ID ?,lumber. Kitty Pierey for Mayor n/a Page 2_ of (,¢ Elecnon: [~ Primary 200_~4 [] General 20__ [] Other __ Report: [] 1 st Pre-election [] 2nd Pre-election E~ Post-election [] 20__ September Supplemental PURPOSE CODES (see back of form for instructions and code definitions) EXPENDITURE TYPES A Agent O Other Advertising (yard signs, buttons, otc3 CA Cash B Broadcast Advertising/Radio, TV) P Postage LP Loan Payment C Cash Contributions R Reimbursement for Personal Expenditures F FundraisingEvent Expenses S Surveys and Polls G General Operational Expenses (describe if over $50) T Travel Expenses (describe if over $50t I Interest Payment U Utilines L Literature. Brochures, Printing W Wages, Salaries. Benefits M Management Services Y Petition Circulators N Newspaper and Other Periodical Advertising Z Preparation and Production of Advertising Payee's Name and Payee's Commtttee ID'¢, Exp Amount of ~ Ltne# Date Check # if applicable Purpose Type Expenditure Pa#d (as it appears on ~nvo~ce, receipt or check) to AlP 1. 4/14/04 EFT Poht~cs Online G CA $ 10 00 2 4/16/04 1045 S~gn Language O CA $ 417.30 E~ 3 4/16/04 1046 Charlton Engel Marketing (invoice A (see attached CA $ 9,727 20 E~] attached m lieu of PC9) invoice) 4 4/16/04 1047 Accessible Data Services L P CA $ 6,441 60 E~ 5 4/16/04 1048 c,ty of Eugene G CA $ 25 00 6 4/17/04 EFT Cardinal Employment Services W CA $ 2 046 00 ~ 7 4/17/04 EFT Politics Online G CA $ 10 00 I~ 8 4/17/04 EFT Pohbcs Onhne G CA $ 10 00 [~ 9 4/19/04 EFT Politics Online Gcharge)(bank CA $ 62 00 [~ 10 4/20/04 EFT Pohbcs Onhne G (bank CA $ 11 50 ~ charge) See Page Totals (Add all expenditures with the same Accounting Period Totals (Complete only' tot' last page and Instructions expenditure type3 transfer these amounts to the Summary Statement. PC t. ~ on Back and in Cmnpaign Cash (CA) $18.760 ~0 Cash (CA) $ kt~tc~ on SummaO Stateroom. Columt~ A, Line 0 Fmance Manual Loan Payment (LP) $__ Loan Payment (LP) $__ PC 3 p(_ 2 Cash Expenditures and Loan Payments Candidate or Political Committee Name: Committee ID Number: Kitty Piercy for Mayor n/a Page 3 of ~ Elect~on. ~ Primary 200~ ~ General 20i ~ Other ~ Repo~: ~ lsr Pre-election ~ 2nd Pre-electron ~ Post-election ~ 20~ September Supplemental PURPOSE CODES (see back of form for instructions and code definitions) EXPENDITURE TYPES A Agent O ~her Adve~ising ~d si~s, bu~ons, etc.) CA Cash B Broadcast Adve~ising (Radio, TV) P Postage LP Loan Payment C Cash Contributions R Reimbursement for Personal Expenditures F Fundraismg E~ent Expenses S Surveys and Polls G General ~erational Expenses (describe if over $50) T Travel Expenses (describe if over $50~ I Interest Payment U Utilities L Literature, Brochures, Printing W Wages, Salaries, Benefits M Management Services Y Petition Circulators N Newspaper and Other Periodical Adve~ising Z Preparation and Production of Adve~ising Payee's Name and Payee's Commt~ee I~, Exp Amount of ~ Line ~ Date Check g tf apphcable Purpose Type Expenditure Pa/d (as it appears on invoice, receipt or check) to ~P 1 4/21/04 1050 Accessible Data Services L, P CA $ 1,852 26 E~ 2 4/22/04 EFT Pohtics Onhne B CA $ 10 00 E~ 3 4/23/04 1051 Chadton Engel Marketing (invoice A (see attached CA $ 7,115 40 ~ attached in lieu of PC9) invoice) 4 4/26/04 EFT Pohbcs Online G CA $ 10 00 [~ 5 4/27/04 EFT Pohtics Online G (Bank charge) CA $ 115 00 E~ 6 4/27/04 1052 Accessible Data Services L, P CA $ 6,900 21 [~ 7 4/27/04 1053 Padnfo U CA $ 31 90 [~ 8 4/27/04 1054 Funk/Levis L CA $ 26.07 9 4/27/04 1055 Northwest Senior News N CA $ 145 00 E~ 10 4/27/04 1056 EWEB U CA $ 65 17 ~ See Page Totals (Add all expenditures with the same Accounting Period Totals (Complete only for last page and lastructiorts expenditure type.} transfer these amounts to the Summau Statement, PC l.} or~ Back and in Campaign Cash (CA) $16,271 01 Cash iCA) $ __ Finance Manual Loan Payment (LP) $ __ Loan Payment (LP) $ _ Enter on Smnmao Stdfelll¢llf Cohlmn A, Linc 7 PC 3 PC ~ Cash Expenditures and Loan Payments Candidate or Political Committee Name: Committee ID Number. Kitty Piercy for Mayor n/a Page 4_ of_ (~ Election: [] Primary 2004 Eli General 20~ ~ Other ~ Rcpo~ ~ 1st Pre-election ~ 2nd Pre-election ~ Post-election ~ 20~ September Supplemental PURPOSE CODES (see back of form for instructions a~d code definitions) EXPENDITURE TYPES A Agent O ~her Adve~ising (y~d si~s. burtons, etc.) CA Cash B Broadcast Advemsmg[Radio, TV} P Pos~age LP Loan Payment C Cash Contributions R Reimbursement for Personal Expenditures F Fundrms~ng Event Expenses S Surveys and Polls G General Operational Expenses (describe if over 5;50) T Travel Expenses (describe if over 5;50) ~ Interest Payment U Utilities k Literature, Brochures, Printing W Wages~ Salaries, Benefits M Management Serwces Y Petition Circulators N Newspaper and Other Periodical Adve~Mng Z ~eparation ~d ~oduction of Adve~Mng Payee~ Name and Payee~ Commt~ee I~, Exp. Amount of Dne ~ Date Check ~ if applicable Purpose Type Expenditure Pard (as it appears on tnvotce, recetpt or check) to ~P I 4~27~04 1057 NW Natural U CA $ 63 77 [~ 2. 4/27/04 1058 Jana Rygas L CA $ 40 88 G (paper, CA $ 394 00 3 4/27/04 1059 Ctancey Printing Company enelopes) G (office 4 4/27/04 1060 Wren Dawdson supphes, CA $ 102 17 [~] paper towels 5 4/27/04 1061 Ann Brown F CA $ 8.00 E~] G (ink CA $ 50 75 6 4/27/04 1062 Ray Eveland cartndges) 7 4/27/04 1063 Wren Dawdson L CA $ 35 96 8 4/27/04 1064 Ray Eveland O CA $ 151 53 ~ 9 4/30/04 EFT Politics Online G CA $ 1500 E~] A (see 10 4/30/04 1066 Chadton Engel Marketing attached CA $ 9,918 90 E~] invoice) See Page Totals (Add all expenditures with the same Accounting Period Totals (Complete only for last page and instructions expenditure type.) transfer these amounts to the Summat? StatemenL PC 1 ) on Back and tn Campaign Cash (CA) $10,780 96 Cash (CA) $ ~ Finance Marmal Loan Payment (LP~ $ Loan Payment (LP) 5; ___ PC 3 PC; Cash Expenditures and Loan Payments Can&date or Political Committee Name' Committee ID Number' K~tty Piercy for Mayor n/a Pa~e 5 of (~ Election' [~1 Pdmar3' 200___4 [--I General 20__ [] Other__ Report. [] 1st Pre-election [] 2nd Pre-election [] Post-election [] 20__ September Supplemental PURPOSE CODES (see back of form for instructions aad code definitions) EXPENDITURE TYPES A Agent O Other Advertising (yard signs, buttons~ etc.) CA Cash B Broadcast Advertising(Radio. TV) P Postage LP Loan Payment C Cash Contributions R Reimbursement for Personal Expenditures F Fundraising Event Expenses S Surveys and Polls G General Operational Expenses (describe if over $50) T Travel Expenses (describe if over $50) I interest Pa:~ment U Utilities L Literature, Brochures, Printing W Wages, Salaries, Benefits M Management Services Y Petition C~rculators N Newspaper and Other Periodical Advertising Z Preparation and Production of Advertising Payee's Name and Payee's Commtttee ID#, Exp Amount of bne # Date Check # ~f applicable Purpose Type Expenditure Pa#d (as ~t appears on invoice, receipt or check) to A/P I 5/1104 EFT Cardinal Employment Services W CA $ 2,046 00 [~ 2. CA $ [~ 3 CA $ [~ 4 CA $ E~ 5 CA $ [~ 6 CA $ E~ 7 CA $ E~ 8 CA $ ~ 9 CA $ [~ CA $ E~ 10 See Page Totals (Add all expenditures with the same Accounting Period Totals (Complete only for last page and Instructions expenditure type3 transfer these amounts [o the Summary Statement, PC on Back and in Campaign Cash (CA/ $ 2,046.00 Cash iCA) $ 49,570 45 Enter ~n SUllllllc[l_% Stat~lltCllt. Coltttrill 'k Lille Finance Manual Loan Payment I. LP) $ ~ Loan Payment/LP/ $ _ PC 3 05/06/04 TflU 10:20 FAX 503 234 0851 CHARLTON ENGEL ~ARRETING ~:~'~ l~ ~002 invoice DATE iNVOICE # C[tARLTON~NGEL MARKETING INC. 419 SE PINE STREET PORTLAND, OR 97214 503-23441811 FAX 503-234-0851 BILL TO KITTY PIEt~CY FOR MAYOR ATYN: IANA RYGAS P.O. BOX 23301 EUGENE, OR 97402 TERMS DUE UPON RECEIPT DESCRIPTION COST AMOUNT KITTY PIERC-Y FOR EUGENE M_A, YOR TELEVISION MEDIA 9,727.20 WEEK OF 4/26104 - EUGENE MA1LKET STATIONS ARE BILLED AT NET PLUS 5% KEZI - GROSS $2,350~00 2,115.00 K2vITR - GROSS $3,890.00 3,501.00 KVAL - GROSS $2,750.00 2,475.00 COMCAST - GROSS $1,g I 8.00 l ~636 20 YOU FOP, YOUR BUSINESS Total 05/06/04 THU 10:20 FAX 503 234 0851 CHARLTON ENGEL MARKETING ~,2~/{,¢ 1~003 Invoice DATE IlqVOICE # CtlARLTON/ENGEL MARKETING INC. 4/~9/2004 419 SE PINE STREET PORTLAND, OR 97214 503-2344811 FAX 503434-0851 [ BLLTO YdTTY PERCY FOR lvIAYOR ATTN': JANA RYOAS P~O. BOX 2J301 EUGENE, OR 97402 TERMS DUE UPON' RECEIPT DESCR{PTION COST AMOUNT KITTY PIERCY FOR EUGENE MAYOR TELEVISION MEDIA 7,115.40 WE. EK OF 5/03/04 EUGENE MARKET STATIONS ARE BILLED AT NET PLUS 5% KEZI - GROSS $1,280.00 l,152.00 I(dMTR- GROSS $2,565.00 2,308.50 KVAL - GROSS $2.255.00 2,029.50 COMCAST - GROSS $1,806.00 1,625.40 THAI'4K YOU FO[~ YOUR BUSINESS Iota 05/06/04 T~U 10:21 FAX 503 234 085l CHARLTON ENGEL ~ARI~TING Invoice DATE INVOICE # CHAI~J_,TON/ENGEL MAR_2K3ETING INC. 5/~r2oo4 419 SE PINE STREET PORTLAND, OR 97214 503-234-0811 FAX 503-234-0851 B1LL TO ATTN: ]ANA RYGAS P,O. BOX 23301 EUGENE, OR 97402 TERMS DUE UPON RECEIPT DESCRIPTION COST AMOUNT KITI'Y PIERCY FOR EUdENE MAYOR - TELEVISION MEDLA 9,918,90 WEEK OF 5/10/04 EUGENE I~LARFdET STATIONS ARE B1LLED AT N~ET PLUS 5% KEZI - GROSS $2,550.00 2,295.00 KMTR - GROSS $3,940~00 3,546.00 KVAL - GROSS $2,725,00 2,452.50 COMCAST - GROSS $1,806.00 1,625,40 TItANK YOU FOR YOUR BUSINESS Total $9,918,90 Pc Summary S a emen of Contributions and E×pendRures Please type or print legibly in black ink. Page 1 of 2 Candidate or Political Committee Name (use full name): Kitty Piercy for Mayor Mailing Address as it Appears on Statement of Organization (street, route or box number, city. state, zip code): P.O. Box 23301, Eugene, OR, 97402 Treasurer's Name~ Telephone Number (day): C. Michael Arnold 541-338-9111 Committee ID Number: Committee Type, Measure Number or Office: n/a Candidate for Mayor [~] Original ~ Primap~: 2004_ ~ General 20__ [~ Other __ [~ Amendment [--t 1 st Pre-election ~1 2nd Pre-election [~1 Post-election [7] 20__ September Supplemental A-TOTALS FOR THIS B---CUMULATIVE TOTALS ACCOUNTING PERIOD FOR THIS ELECTION CONTRIBUTIONS 1. Cash Contributions (Accounting Period Total h'om PC 2) 31,358 50 69,804.00 2. Loans Received (Non-Exempt) + 15,000.00 + 15,000 00 tAccountmg Period Total from PC 2) 3. Total Cash Contributions = 46,358 50 = 84,804 00 (hnes 1+ 2) 4. In-Kind + 4,157.05 + 5,134 89 tAccoantmg Period Totat from PC 2) 5 TOTAL CONTRIBUTIONS = 50,515 55 = 89,938.89 (hn¢> 3 * 4} EXPEND)TtJRES 6~ Cash Expenditures 49,570 45 72,558.58 (Accounting Period Total ~*rom PC 3) 7. Loan Payments (Non-Exempt) + 0 00 + 0 00 (Accounting Period Total l?om PC 3I 8. Total Cash Expenditures = 49,570 45 = 72,558 58 (hne~ 6 + 7) 9. In-Kind + 4,157.05 + 5134 89 (Accounting Period l'otal frora PC 2) 10. TOTAL EXPENDITURES = 53,727 50 = 77,693.47 (hnea 8 ~- 9) CASH BALANSE 11. Beginning Cash Balance 15,457 37 FOR OFFICE USE ONLY Ihne 20 of previous report) 12. Total Contributions + 50,515 55 (linc 5) t3. Other Receipts + 0 00 (Accounling Period Total from PC 4A~ 14. Loans Received ~Exemp0 + 0 00 (Accounnng Period Total from PC 4A,~ 15. CONTRIBUTION SUBTOTAL = ~5,972 ~2 (hne= 11 q- I2+ 13+ 16. Total Expenditures 53,727 50 tl~ne 10) 17 Other Disbursem¢nts+ 000 (Accountin~ Period Potal from PC 4F~) 18 Loan Payments(Exempt} + 0.00 (Accounting Period Total Ico,a~ PC 4BI t9. EXPENDITURE SUBTOTAL = 53,727 50 20. ENDING CASH BALANCE = 12,245 42 (hne 15 m~nus line PC l Summary Statement of Contributions and Expenditures Please type or print ~egibl3 in black ink. Page 2 of 2 Candidate or Political Committee Nmne: Committee iD Number: Kitty Piercy for Mayor n/a [] Original ~ Primaqv 200_4_ [] General 20__ [] Other __ [Sk:q Amendment [] 1st Pre-election [] 2nd Pre-election [] Post-election [] 20__ September Supplemental LOAN SUM~ViARY 21. Beginning Outstanding Loans FOR OFFICE USE ONLY (line 29 ofpre~ious report) 0 00 22 Loans Received (Non-Exempt) + 15,000.00 (hne 2) 23. Loans Receixed (ExempO (hne 1% + 0 00 24 LOANS RECE1VED SUBTOTAL ~ ~ ~_ = 15,000.00 (nne _1 ~ ~'> +23~ 25. Loan Payments (Non-Exempt) (hnc 7~ 0 O0 26 Loan Payments (Exempu (hne tgi + 0.00 27 Forgiven Loan~ + 0 00 {. fotal lomas forg~ cn tim mg :ms accounung ?thud ) 28~ LOAN PAYMENT SUBTGTAL = 0.00 {lines ;5 + 20 *2% 2% TOTAL OUTSTANDING bOANS = 15,000 O0 ~hne 2~t minus linc 281 PERSONAL EXPENDITURE SUMMARY 30. Beginning Outstanding Personal Expend(iL:es 0 00 (hne 3o ut pre~ taus repor'~l 31~ Personal Expenditures + 0.00 (Accounnng Period Total f'om PC' 3).) 32. PERSONAL EXPENDITURE SLBTOTAL = 0 O0 (lines 30 ~ 31 ~ 33. Personal Expen&ture Reimbursements 0.00 (Total e-,penditurcs on PC ~_ ~ :tn purpo:ie c,,cle R) 34. Forgiven Personal Expenc&kres + 0.00 ([otal per=onal e,~pendit]rcs g>lg_ven ins aczrg penodl 35. REIMBURSEMENT SOb'5OTAL = 0 O0 (hncs 33 * 34) 36 OUTSTANDING PER,~uNAL EXPENDITURES = 0.00 (hnc 32 minus linc 35) FINANCIAL STATUS AT CLOSE OF ACCOUNTING PERIOD 37. Ending Cash Balancc 12,245.42 (hnc 20) 38 Accounts Receivable + 0 00 U~.ccountm~ Period Total "_ o_~' PC 5} 39 SUBTOTAL = 12,245 42 (hats 37-v 38~ 40 Total Outstaad!ng Loans (hne_'~9) 15,000 00 41. Oatstandmg Personal £xpcr. ditt;r~s + 0 O0 (hnc 3o) 42. Accounts PayaNe + (Accounting Permd ~fota: 1-'~v,-n ,:~C 6) 43. SUBTOTAL = 15,000 00 (lines 40 ~- 41 - 42, 44 BALANCE/DEFICiT = -2,754 58 (hnc 39 minus line 43 mcl~cat: ~ o~ - balance} 1, C M~chael Arnold (name of can&date or treasurer), hereby certify that the above statement and the attached supporting reports are true and correct Signature of candidate o: tref ~¢ler Date signed PC 2 Amv. ndlnem Amendments-Cash Contributions, Loans Received and In-Kind Candidate or Political Committee -Name: Committee ID Number: Kitty Piercy for Mayor n/a Page I of 1 Election: ~ Primary 2004 ~ General 20~ ~ Other ~ ~ Report. ~ I st Pre-election ~ 2nd Pre-election ~ Post-election ~ 20~ September Supplemental SEE BACK FOR ~NSTRUCT{ONS AND CODE DEFINITIONS CODE 1: Contributor Type CODE 2: Contribution Type B Business E,~tiO' CA Cash C Political Comminee 3ncludes business and union PACs) C0 Cosigner Obligation F Cand:date'~ I nmediae ::&ml~, (includes candidate) iK In-Kind l Individual LR Loan Received k Labor Organization O Other P Political ParE, Committee Amending Page ¢ ~iame and A,~'dress of Contributor Amount of } ln-K/nd Purpose and Line ~ Contribution dee manual for suggested pu¢ose codeO Date Recewed Occupational Information or Contributor Code ¢ Code 2 Co, ¢~¢/but~ng Commdttee ~ 1~ Aggregate Pa9~ Line Sue 3ubbot 85213 Chezem Rd. ~ New EntW eugene GR 97405 $ 100 00 ~ Correcting ~ Deleting 4/15/2004 Teacher $ 200.00 ~ CA Page~ Line ~ New Enid, $ ~ Correcting ~ Deleting $ Page~ Line ~ New Emry ~ Correcting ~ Deleting $ Pag~ Line ~ New Ent~ $ ~ Correcting ~ Delet,n9 $ Page.~ Lme~ ~ New Entw ~ Correcting ~ Deleting $ See FOR OFFI~I~¢~LY Instructions t~ l ~}~ on Back and ~" ~'¥~ ~L ............ ~ m Campaign Finance Signature of candidate o~ tr,~asurer , ' ~ -, Manual Amendment Date signed Supplement to Second Pre/Post-Election - Contributions Can&date or Political Committee Name: Committee ID Number: Kitty Piercy for Mayor n/a Page -__, of L_ Election' [] Primary 200__4 [] General 20__ ~ Other__ Report: [] I st Suppl. to the 2nd Pre-election [] 2nd Suppl. to the 2nd Pre-election [] Suppl. to Post-dcction SEE BACK FOR iINSTRUCTIONS AND CODE DEFINITIONS CODE 1: Contributor Type CODE 2: Contribution Type B Business Ennty CA Cash C Political Committee (includes business and union PACs) CO Cosigner Obligation F Candidate's Immediate Family {includes candidate) tK In-Kind ~ Individual LR Loan Recewed L Labor Organization PC Pledge of Cash O Other Pi Pledge of In-Kind P Political Party Committee PL Pledge of Loan Line # Name and Address of Contributor Amount of Contribution /n-Kind Purpose Occupational Informatton or (see manual for suggested purpose codes) Date Recewed ~ · , Code ~ Code 2 Cont~ buting Commtttees ID~ AFSCME Local 1724 688 1 Chamelton Eugene OR $ 1,000 00 97401 I 5/4/2004 n/a (not a PAC) L CA Oregon League of Conservabon Voters 320 L,P 2 S W Stark, Ste 415 Portland OR $ 3,260 00 97204 5/7/04 No 002352 C I IK 3 $ 4 $ 5 $ See instructions I, C M,chael Arnold, Attorney at Law, (name of candidate or on Back and treasurer) hereby certify that the above statement is true and correct. m Campaign Finance Manual ' PC gA Signature of candidate or treasurer Date signed P(~ 8B Supplement to Second Pre-Becfion - Expenditures Candidate or Political Committee Name: Committee ID Number: Kitty Piercy for Mayor nd/ Page ~ of~ Election. ~ PrimaW 2004 ~ General 20i ~ Other ~ Repow ~ 1st Suppl, to the 2nd Pre-election ~ 2nd Suppl. to the 2nd Pre-election PURPOSE CODES (see back oftbrm lbr instr~etions and code definitions) EXPENDITURE TYPES A Agent O ~her Adve~ising oard si~s. bu~ons, etc3 CA Cash B Broadcast Adve~ising(Radio, TV) P Postage LP Loan Payment C Cash Contributions R Reimbursement fbr Personal Expenditures AP Account Pa?able F Fundraising Event Expenses S Surveys and Polls PE Personal Expenditures G GenemJ Operational Ex~n~s (describe ifover$50) T Travel Expenses (describe if over $50 t lnterest Payment U Utilities L Literamre~ Brochures, Printing W Wages, Salaries, Benefits M Management Services Y Petition Circulators N Newspaper and Other Periodical Adve~ising Z Preparation and Production of Adve~ising Payee ~ Name E~p Amount of bne ¢ Date Check ~ (as ~t appears on ~nvo~ce, receipt or check) Pu(oose Type Expenditure I 5/5/04 1067 KEZI Z CA $ 2,500 00 2 5/5/04 1071 McKenz~e River Broadcasting B CA $ 1,147 50 G - Phone bank 3 5/7/04 1082 Precision Commumcatlons calls to potenbal CA $ 4,811 05 voters 4 5/7/04 1083 Accessible Data Services L, P CA $ 4,059 39 5 $ 6 $ 7 $ 8 $ 9 $ 10 $ See FOR OFFICE USE ONLY Instructions i. C Michael Arnold, Attorney at Law. (name of candidate or on Back and treasurer) hereby certify that the above statement is true a~d correct, in Campaign Finance PC 8B Signature of candidate or treasurer Date signed PC 8A Supplement to Second Pre/Post-Election - Contributions Candidate or Political Committee Name: Conwnittee ID Number: Kitty Piercy for Mayor n/a Page 1 of Election: ~ Primary 200_3_4 E~ General 20__ [] Other ___ Report [] 1 st Suppl. to the 2nd Pre-election ~ 2nd Suppl. to the 2nd Pre-election [] Suppl. to Post-election SEE BACK FOR INSTRUCTIONS AND CODE DEFINITIONS CODE 1: Contributor Type CODE 2: Contribution Type B Business Entity CA Cash C Political Committee (.includes business and union PACs) CO Cosigner Obligation F Candidate's Immediate Family (includes candidate) IK In-Kind I Individual LR Loan Received L Labor Organization PC Pledge of Cash O Other PI Pledge of In-Kind P Political Party Committee PL Pledge of Loan Amount of Dne # Name and Address of Contributor Contnbutton In-Kind Purpose Occupational Informatton or I (see manual for suggested purpose codes) Date Received Contributing Committee's ItYi¢ Code I, Code 2 Patnc~a Noyes 2014 EIkAve. 1 Eugene OR 97403 $ 700 5/10/2004 Retired I CA Susan Sherman 3200 2 Emerald St Eugene OR $ 1,000 00 97405 5/11/2004 Owner/Director of Wellness Center I CA 3 $ 4 $ 5 $ See FOR OFFICE USE ONLY Instructions I, C Michael Arnold, Attomev at Law, (narne of candidate or on Back and treasurer) hereby certify that the above statement is true and correcL in Campaign Finance PC SA Signature of candidate or treasurer Date signed PC .qB Supplement to Second Pre-Election - Expenditures Re, Candidate or Political Committee Name: Committee ID Number: Kitty Piercy for Mayor na/ Page 1_ of 1_ Election: [] Primary 2004 [] General 20__ [] Other__ Report: [] 1st Suppl. to the 2nd Pre-election [] 2nd Suppl. to the 2nd Pre-election PURPOSE CODES (see back of form for instructions and code definitions) EXPENDITURE TYPES A Agent O Other Advertising (yard signs, buttons, etc.) CA Cash B Broadcast Advertising (Radio. TV) P Postage LP Loan Payment C Cash Contributions R Reimbursement for Personal Expenditures AP Account Payable F Fundraising Event Expenses S Surveys and Polls PE Personal Expenditures G General Operational Expenses (describe if over $50) T Travel Expenses (describe if over $50) I interest Payment U Utilities L Literature, Brochures, Printing W Wages, Salaries, Benefits M Management Services Y Petition Circulators N Newspaper and Other Periodical Advertising Z Preparation and Production of Advertising Payee's Name Exp Amount of Ltne# Date Check # (as it appears on invoice receipt or check) Purpose Type Expend#ture 1 5/11/04 1085 Register-Guard N CA $ 563 38 2 5/11/04 1087 Register-Guard N CA $ 10 72 3 5/12/04 1090 Register-Guard N CA $ 573.34 4 CA $ 5 CA $ 6 CA $ 7 CA $ 8 CA $ 9 CA $ 10. CA $ See FOR OFFICE USE ONLY instructions 1, C Michael Arndd, Attorney at Law, (name of candidate or ~ ~ ".~ ~, ? ~ ~/ on Back and Weasurer) hereby ce~i~ that the above statement is ~ue and correct. in CampaJan Finance : Manual PC 8 B Signature of candidate or treasurer Date signed ~ ~ ~ ~ ' ~ L.. OR 6 I .iAL Summary S atemen of Contributions Expenditures Please type or print legibly in black ink. Page 1 of 2 Candidate or Political Committee Name (use full name): Kitty Piercy for Mayor Mailing Address as it Appears on Statement of Organization (street, route or box number, city. state, zip code): P.O Box 23301, Eugene, OR, 97402 Treasurer's Name: [ Telephone Number (day): C. Michael Arnold I 541-338-9111 Committee iD Number' I Committee Type, Measure Number or Office: n/a I Candidate for Mayor [~ Original [] Primary 2004 []]]] General 20__ [] Other __ [] Amendment [] 1st Pre-election [~ 2nd Pre-election [] Post-election [-] 20__ September Supplemental A-TOTALS FOR THIS B-CUM ULATIVE TOTALS ACCOUNTING PERIOD FOR THIS ELECTION CONTRIBUTIONS t. Cash Contributions 26,004 00 95,808.00 (Accounting Period Total trom PC 21 2. Loans Received (Non-Exempt) + 0 00 + 15,000 00 (Accounting Period Total trom PC 2~ 3 Total Cash Contributions = 26,004.00 = 110,808 00 dines 1+ 2t 4 In-Kind + 5,604.52 + 10,739 41 (.Accounting Period Total trom PC' 2t 5. TOTAL CONTRIBUTIONS = 31,608 52 = 121,547 41 (hncs 3 + 4) EXPENDITURES 6. Cash Expenditures 37,824 91 110,383 49 {Accounting Period Total from PC 3) 7. Loan Payments (Non-Exempt) + 0 00 + 0 00 (Accounting Period Total fiom PC 31 8. Total Cash Expenditmes = 37,824.91 = 110,383 49 Ihnes 6 ~- 7j 9. In-Kind + 5,604.52 + 10,739 41 ~Accounting Period Total from PC 2) 10. TOTAL EXPENDITURES = 43,429.43 = 121,122 90 (hncs8 ~9) ~' CASH BALANCE 11. Beginning Cash Balance 12,245 42 FOR OFFICE USE ONLY (hne 20 of previous report) t_. ~ Total Contributions + 31,608.52 t3. Other Receipts + 0 00 i Accounting Period Total i?om PC 4A) 14. Loans Received (Exempt) + 0 00 (Accounting Period Total from PC 4A) t5. CONTRIBUTION SUBTOTAL = 43,853.94 Ihnes II -- 12 + 13 + 14l I o. Total Expenditures 43,429 43 dine 10) 17. Other Dmbursements + 0.00 (Accounting Period Total t?om PC 4B) 18. Loan Payments (Exempt) + 0.00 (Accounnng Period ~otal from PC 4B) lO. EXPENDITURE SUBTOTAL = 43,429 43 {hne~ 16 + 17+ 18) 20 ENDING CASH BALANCE = 424.51 (line 15 minus hne 19) PC I Summary Statement of Contributions an( Expenditures Please type or print legibly in black ink. Page 2 of 2 Candidate or Political Committee Name: [ Committee iD Ntm-tber: Kitty Piercy for Mayor I n/a [~ Original [5~ Primary 2004 [~ General 20__ ~ Other __ [~ Amendment [-] I st Pre-election E] 2nd Pre-election [] Post-election ~ 20__ September Supplemental LOAN SUMMARY FOR OFFICE USE ONLY 21. Beginning Outstanding Loans 15,000.00 (line 29 ot previous report) 22. Loans Received (Non-Exempt) + 0.00 (line 2~ 23. Loans Received (Exempt) + 0 00 (bne 14~ 24. LOANS RECEIVED SUBTOTAL = 15,000.00 limes 21 + 22 + 23) 25. Loan Payments (Non-Exempt) 0 00 (line 7) 26. Loan Payments (Exempt) + 0.00 (line 18) 2T Forgiven Loans + 0.00 (Total lo:ms forgiven during this accounting period) 28. LOAN PAYMENT SUBTOTAL = 0.00 (hnes 25 T 26 +27) 29. TOTAL OUTSTANDI[NG LOANS = 15,000 00 (hne 24 mmu~ hne 28t PERSONAL EXPENDITURE SUMMARY 30. Beginning Outstanding Personal Expenditures 0.00 time 3(> of pre¥~ous report) 31. Personal Expenditures + 0.00 (Accounnng Period Total from PC 3A) 32 PERSONAL EXPENDITURE SUBTOTAL = 0 O0 {lines 30 + 31) 33. Personal Expenditure Reimbursements 0.00 (Total expenditares on PC 3 with purpose code R) 34 Forgiven Personal Expenditures + 0 00 (Total personal expenditures forgiven this acctg, period) 35. REIMBURSEMENT SUBTOTAL = 0 00 (lines 33 + 34) 36. OUTSTANDING PERSiONAL EXPENDITURES = 0 00 {hnc 32 minus line 351 RNANCIAL STATUS AT CLOSE OF ACCOUNTING PERIOD 37 Ending Cash Balance 424 51 {line 20~ 38. Accounts Receivable + 0.00 (Accounting Permd Total fi'om PC 5} 39. SUBTOTAL = 424.5~ (hne.-, 37 * 38) 40. Total Outstanding Loans q 5,000.00 {line 29) 41. Outstanding Personal Expenditures + 0 00 (line 36) 42. Accounts Payable + 1,736.00 (Accounting Peliod Total t¥om PC 61 43. SUBTOTAL = ~16,736 00 (lines 40 + 4t + 42) 44. BALANCE/DEFICIT = -~6,31~ 49 I me 39 minus line 43: indicate + or - balance) 1, C Michael Arnold, Attorney at Law (name of candidate or treasurer), hereby certi~' that the above statement and the attached supporting reports are true and correct. S~gnature of candidate or treasurer Date signed Cash Contributions, Loans Received and In-Kind Candidate or Political Committee Name: Committee tD Number: Kitty Piercy for Mayor n/a Page ~ of Z~ % Election: ~ Primaw 200~ ~ General 20~ ~ Other ~ Repo~' ~ 1st Pre-election ~ 2nd Pre-election ~ Post-election ~ 20~ September Supplemental SEE BACK FOR INSTRUCTIONS AND CODE DEFINITIONS COD~ ~: Contributor Type CODE 2: Contribution Type B Business EntiD CA Cash C Political Commi~ec (includes business and union PACs) CO Cosigner Obligation F Candidme's lmmediate Family (includes candidate) iK in-Kind I Individual L~ Loan Received L Labor Organization 0 Other P Political Party Commi~¢e Amount of Imgmd Purpose Dne ~ Name and Address of Contributor Contribution (see manuel for suggested purpose codes) Occupational Information or Contributor ~ Date Received Contributing Comm~ee~ I~ Aggregate Code 1 ~ Code 2 AFSCME Local 1724 688 I Charnelton Eugene OR $ 1,000.00 97401 5/4/2004 n/a (not a PAC) $ 1,000 00 " L CA GdAvew 1175 Fir Lane 2 Eugene OR 97405 $ 500.00 5/3/2004 Rebred $ 700 00 I CA Mark W~lliams P O. Box 3 695 Eugene OR 97440 $ 100 00 5/4/2004 LCC Faculty $ 650 00 I I CA John Allcott 2650 Cresta De 4 Ruta Eugene OR 97403 $ 375.00 5/4/2004 Physician $ 625 00 I CA Rebecca Gladstone 5 2713 Falrmount BIvd. EugeneOR $ 375 00 97403 5/4/2004 Not Employed $ 500.00 I CA See Page Totals (Add all amounts with the same Accounting Period Totals (Complete only fbr last page and Instructions contribution type. Do not include aggregates.) transfer these amounts to the Summary Statement. PC 1 ~) on Back and Cash (CA) $ 2,350.00 Cash (CA) $ __ in Campaign Enter on Summao Statement, Column A, Lmm: 1 Finance Manual in-Kind {,lK) $ . In-Kind (IK) $ __ Enter on Smmnar3 Statement Cohimn A. LilieS 4 and c; PC 2 Loans Received (LR) $ ~ Loans Received (LR) $ __ Enter on Stm~mm3 Statement. Column A. L mc 2 PC 2 Cash Contributions, Loans Received and Can&date or Pohtica[ Committee Name: Committee ED Number: Kitty Piercy for Mayor n/a Page 2 of Electron: [~ Primary 200--4 [] General 20__ [] Other __ Report: [] let Pre-election [] 2nd Pre-election [~ Post-election [] 20__ September Supplemental SEE BACK FOR iNSTRUCTiONS AND CODE DEFINITIONS CODE 1: Contributor Type CODE 2: Contribution Type B Business Entire' CA Cash C Political Committee (includes business and union PACs) CO Cosigner Obligation F Candidate*s Immediate Family (includes candidate) [K In-Kind I Individual LR Loan Received L Labor Organization O Other P Political Party' Committee Amount of In-g~nd Purpose Line # Name and Address of Contributor Contribution (see manual for suggested purpose codes) Date Received Occupational Information or Contributor Code 1 Code 2 Contributing Committee's IDf¢ Aggregate M~chael James-Long 620 Horn 1 Lane Eugene OR 97404 $ 500 00 5/7/2008 Pubhsher $ 500 00 I CA Gary Rayor 2373 Washington 2 St Eugene OR 97405 $ 250 00 5~5~2004 C~vtl Engineer $ 350 00 1 CA Gary Rayor 2373 Washington 3 St Eugene OR 97405 $ 150.00 5/5~2004 Civil Engineer $ 500 00 I CA Elizabeth Hunt 2650 4 Cresta De Ruta Eugene OR $ 375,00 97403 514/2004 Therapist $ 375 00 I CA Eric Hanneman 1038 E. 5. 21st Ave. Eugene OR $ 250 00 97405 5/412004 Bookkeeper $ 275,00 I CA See Page Totals (Add all amounts with the same Accounling Period Totals (Complete only for last page and Instructions contribution type. Do not include aggregates.) transfer these amounts to the Summary. StatemenL PC l. ) on Back and Cash (CA) $1,525 00 Cash (CA) $ tn Campaign Enter on SummaEy Statement Column A. [ me I Finance Manual In-Kind (iK) $ ~ In-Kind t lK) $ -- Enter on SmnrnaD StatemenL Colm~r, *%. Lines 4 ,md 9 PC 2 Loans Received (LR) $ ~ Loans Received (LR) $. Enter on Stunmary StatemenL Co,mnn A, Line 2 PC2 Cash Contributions, Loans Received and In-Kind Candidate or Political Committee Name: Committee ID Number: K~tty Piercy for Mayor n/a Page 3 of Election: [~ Primary 200_~4 [] General 20_ U_~ Other ~ Report' [] 1st Pre-election [] 2nd Pre-election ~ Post-election [] 20__ September Supplemental SEE BACK FOR iNSTRUCTIONS AND CODE DEFINITIONS CODE 1: Contributor Type CODE 2: Contribution Type B Business Entity CA Cash C Political Committee (includes business and union PACs) CO Cosigner Obligation F Candidate's Immediate Family (includes candidate) IK In-Kind I Individual LR Loan ReceiYed L Labor Organization 0 Other P Political Party Committee Amount of In-Kind Purpose bne # Name and Address of Contributor Contrtbution (see manual for suggested purpose codes) Date Received Occupational Information or Contributor Code i' Code 2 Contributing Committee's/DC Aggregate Tamara Stenshoel 1038 E. 1 21st Ave. Eugene OR $ 250 00 97405 5/4/2004 Physician $ 275 00 I CA C~t~zen Action by Political Employes 2 PO [Box 12159 Salem OR $ 250.00 97309 51412004 Pohtical ID #000033 $ 250 00 C CA T~na Stupasky 30900 3 Blanton Rd. Eugene OR $ 150 00 97405 5/4/2004 Attorney $ 250.00 ~ CA Marian R~chards 3581 Agate 4 St Eugene OR 97405 $ 150 00 5~4~2004 Retired $ 225 00 I CA ,Joe Alsup 36 W, 38th Ave. 5 Eugene OR 97405 $ 100 00 5/7/2004 School Pnnclpal $ 200.00 CA See Page Totals (Add all amounts with the same Accounting Period Totals (Complete only for last page and Instructions contribution type~ Do not include aggregates.) transfer these amounts to the Summary Statement, PC 1. on Back and Cash (CA) $ 900 00 Cash (CA) $ iB Campaign Ente~ on Summao Smrernent~ Colm'm~ Finance Manual In-Kind (IK) $ Entre- on Sttmmar~ Star.mem. Colthmn PC 2 Loans ReceiYed (LR) $ Enter on Sttnlm:t~' Stateroom Cotumn A. Linc 2 Cash Contributions, Loans Received and In-Kind Candidate or Political Committee Name: Committee ID Number: Kitty Piercy for Mayor n/a Page 4_ of Election: ~] Primary 200_!4 E~ General 20__ [] Other__ Report: [] 1st Pre-election [] 2nd Pre-election [] Post-election [~ 20__ September Supplemental SEE BACK FOR INSTRLICTIONS AND CODE DEFINITIONS CODE t: Contributor Type CODE 2: Contribution Type B Business Entity CA Cash C Political Committee (includes business and union PACs) CO Cosigner Obligation F Candidate's Immediate Family {includes candidate) IK In-Kind I ln&vidual LR Loan Received L Labor Organization O Other P Political Party Committee Amount of ImKind Purpose Dne # Name and Address of Contributor Contnbutton (see manual for suggested purpose codes) Occupational Information or Contributor Date Received Contributing Committee's ID# Aggregate Code 1 , Code 2 Patnc~a Hine 29755 Lusk Rd 1 Eugene OR 97405 $ 100.00 5/4/2004 College Instructor $ 200.00 I CA DIx~e Maurer 339 W. 22nd Ave 2 Eugene OR 97405 $ 200.00 5/5/2004 Educational Consultant $ 200.00 t CA Bob Emmons 40093 Dttle 3 Fall Creek Rd. Fall Creek OR $ 150.00 97438 5/4/2004 Retired $ 150 00 I CA Nena Lovinger 40093 Little 4 Fall Creek Rd, Fall Creek OR $ 150 00 97438 5/412004 Property Manager $ 150,00 ~ CA Larry Robidoux 2577 N~xon 5~ St Eugene OR 97403 $ 150,00 5/8/2004 Owner Larry RoNdoux Design Corp $ 150.00 I CA See Page Totals (Add all amounts with the same Accounting Period Totals (Complete only for last page and Instructions contribution type, Do not include aggregates.) transfer these amounts to the Summary Statement, PC on Back and Cash (CA) $ 750.00 Cash (CA) $ ~ in Campaign Enter on Summa% Statement Colmm~ Finance Maimal In-Kind (IK) $ ~ In-Kind (IK) $ __ Enter on SmmnaD Statemenh Colunmt PC 2 Loans Received (LR) $ Loans Received (LR) $ ~ Enter on SummaD' Statement Colurm~ A Line 2 PC 2 Cash Contributions, Loans Received and Candidate or Political Committee Name: Committee ID Number: Kitty Piercy for Mayor n/a Page Election: [~ Primary 200_!4 [] General 20__ [] Other __. Repow [] 1 st Pre-election [~] 2nd Pre-election [~ Post-election E~ 20__ September Supplemental SEE BACK FOR INSTRUCTIONS AND CODE DEFINITIONS CODE 1: Contributor Type CODE 2: Contribution Type B Business Entity CA Cash C Political Committee (includes business and union PACs) CO Cosigner Obligation F Candidate's Immediate Family (includes candidate) IK In-K~nd I Individual LR Loan Received L Labor Organization 0 Other P Political Party Committee Amount of In-Kind Purpose Dne # Name and Address of Contributor Contribution (see manual for suggested purpose codes) Occupational information or Contributor Code '~ [ Code 2 Date Received Contnbutinq Committee's ID¢~ Aggregate Jams Weeks 1960 University St. 1 Eugene OR 97403 $ 100.00 5/7/2004 Professor $ 150 00 CA Andrea Held 2421 Madrona Dr. 2 Eugene OR 97403 $ 125 00 5/4/2004 Accounting TechnicIan $ 125.00 CA Ted He~d 2421 Madrona Dr~ 3 Eugene OR 97403 $ 125 00 5/4/2004 School District Administrator $ t25.00 ~ CA Richard Ahrens 558 Baxter 4 Eugene OR 97402 $ 100 00 5/6/2004 Educator $ 100 00 I I CA Mark Baker 360 E, 15thAve 5 Eugene OR 97401 $ t 00.00 5/4/2004 Engineer $ 100 00 ~ CA See Page Totals (Add all amounts with the same Accounting Period Totals tComplete only for last page and Instructions contribution ts, pe~ Do not include aggregates.) transfer these amounts to the Summary Statement, PC 1. ~ on Back and Cash (CA) $ 550 00 Cash (CA) $ ~ in Campaign Enter on Summa~ Statement, Colmnn A Linc I Finance Manual la-Kind (IK) $ ~ In-Kind (IK) $ .__ Enter on Sulmnarv Statement. Column A Lmeb 4 and o PC 2 Loans Received (LR) $ ~ Loans Received tLR) $ __ Enter on Smnma~ Statement. Colnmr~ A, Line 2 PC 2 Cash Contributions, Loans Received and In-Kind Re~ 12{)3 Candidate or Political Committee Name: Committee ID Number: Kitty Piercy for Mayor n/a Page e of ~2~; Election: [~ Primary 200~4 [~ General 20__ [] Other ~ Report: [] 1st Pre-election [] 2nd Pre-election [] Post-election [] 20__ September Supplemental SEE BACK FOR INSTRUCTIONS AND CODE DEFINITIONS CODE 1: Contributor Type CODE 2: Contribution Type B Business Entity CA Cash C Political Committee (includes business and union PACs) CO Cosigner Obligation F Candidate's Immediate Family (includes candidate) IK In-Kind I Individual LR Loan Received L Labor Organization O Other P Political Part?, Committee Amount of In-Kind Purpose Dne # Name and Address of Contributor Contribution (see manual for suggested purpose codes) Date Received Occupattonal Information or Contributor Code 1 Code 2 Contributing Committee's ID# Aggregate Michael Cardgan 1439 W t 4th Ave, Eugene OR $ 25.00 97402 5/4/2004 Community Organizer $ 100,00 I CA Hope Hughes Pressman 2 1644 27th Ave EugeneOR $ 100.00 97403 5/6/2004 Rebred $ 100.00 I CA Claire Kennedy 25 Palmer 3 Dr South Windsor CT $ 100.00 5/6/2004 Retired $ 100 00 ~ CA Albert Leinbach 1950 4 Orchard St, Eugene OR $ 100 00 97403 5/4/2004 Rettred $ 100.00 I CA Paul Machu 5365 Nectar Way 5 Eugene OR 97405 $ 100.00 5/4/2004 Television ProducedDirector $ 100 00 ~ CA See Page Totals (Add all arr~ounts with the same Accounting Period Totals (Complete only for last page and Instructions contribution type, Do not include aggregates,) transfer these amounts m the Summary Statement, PC 13 on Back and Cash (CA) $ 425.00 Cash [CA) $ ~ in Campaign Enter o~ Summary StatemenL Coluran A, Lm~ l Finance Manua~ In-Kind (IK) $ .~ In-Kind (IK) $ ~ Enter on Sm~mar5 Stateroom Cokmm A. Lmm. 4 and 9 PC 2 Loans Received (LR} $ ....... Loans Received (LR) $ ~ Emer on Sm-ninny' Statement. Colmnn A. L ~nc 2 PC 2 Cash Contributions, Loans Received and in-Kind Candidate or Political Committee Name: Committee ID Number: Kitty Piercy for Mayor n/a Page 7 of ~ Election: ~ Primary 200_&4 El General 20__ [] Other ~ Report: [] I st Pre-election [] 2nd Pre-election [] Post-election E~ 20__ September Supplemental SEE BACK FOR INSTRUCTIONS AND CODE DEFINITIONS CODE 1: Contributor Type CODE 2: Contribution Type g Business Entity CA Cash C Political Committee (includes business and union PACs) CO Cosigner Obligation F Candidate's Immediate Family (includes candidate) IK In-Kind I Individual LR Loan Received L Labor Organization O Other P Political Party Committee Amount of In-Kind Purpose L;ne # Name and Address of Contributor Contnbution (see manual for suggested purpose codes) Occupational Information or Contributor Code 1 I Code 2 Date Recewed Contributing Committee's/D¢¢ Aggregate Andrea Ortlz 189 Foch St. I Eugene OR 97402 $ 100 00 5/4/2004 Patient Access Specialist $ 100 00 I CA Suz~ Prozanski P O. Box 2 11511 Eugene OR 97440 $ 100.00 5/4/2004 Adjunct Instructor/Writer/Editor $ 100 00 CA Stephen Ramey P O. Box 3 3153 Eugene OR 97403 $ 50 00 5/6/2004 property investor $ 100,00 I CA Cynthia Smtth P.O.Box 190 4 Walterv~lle OR 97489 $ 100.00 5/4/2004 Medical Prat~tioner $ 100 00 CA Josephine von Hippel 5 1900 Crest Dr EugeneOR $ 100 00 97405 5/4/2004 Professor $ 100 00 I CA See Page Totals (Add all arnounts with the same Accounting Period Totals (Complete only fur last page and Instructions contribution type, Do not include aggregates.) transfer these amounts to the Summary Statement, PC on Back and Cash (CA) $ 450,00 Cash (CA) $ in Calnpalgn Emer on Smnmary Statement, Finance Manual in-Kind (IK) $ Enter on Snmmar5 Statement CO[[tIBB PC 2 Loans Received (LR) $ Enter on Smmniu¢ Statement, Colunm A. Line 2 Cash Con(ribu(ions, Loans Received and In-Kind Candidate or Political Committee Name: Committee ID Number: Kitty Piercy for Mayor n/a Page _8 of'~ Election: [] Primary 200~4 [~] General 20__ El Other _ Report: [] 1 st Pre-election [~] 2nd Pre-election [] Post-election [~] 20__ September Supplemental SEE BACK FOR INSTRUCTIONS AND CODE DEFINITIONS CODE 1: Contributor Type CODE 2: Contribution Type B Business Entity CA Cash C Political Committee (includes business and union PACs) CO Cosigner Obligation F Candidate's immediate Family (includes candidate) IlK In-Kind I Individual LR Loan Received L Labor Organization O Other P Political Part3, Committee Amount of In-Kind Purpose Line # Name and Address of Contributor Contribution (see manual for suggested purpose codes) Occupational Information or Contributor Date Recetved Contributing Committeels lDO Aggregate Code I Code 2 Peter van H~ppel 1900 Crest I Dr Eugene OR 97405 $ 100.00 5~4/2004 Professor $ 100.00 I CA West Moon Trading Co. 840 E. 13th 2 Ave Eugene OR 97401 $ 100.00 5/6/2004 $ 100 00 B CA Susan Barnhart 1439 W. 3 4th Ave Eugene OR $ 25 00 97402 5/4/2004 Social Worker $ 95.00 I CA Carol McBrian 1875 W, 4, 15th Ave. Eugene OR $ 35 00 97402 5/4/2004 Substitute Teacher $ 85.00 ~ ~ CA Dlanne Lobes 180 E. 37th Ave. 5 Eugene OR 97405 $ 50,00 5/512004 Psychologist $ 77.98 I CA See Page Totals (Add all amounts with the same Accounting Period Totals (.Complete only for last page and instructions contribution type. Do not include aggregates.) trans~r these amounts to the Summary. Statement. PC 1 .) on Back as~d Cash (CA) $ 310 00 Cash (CA) $ in Campaign Enter on Smmnapv Statemenh Colmnn A. Line 1 Finance Manual In-Kind (IK) $ - In-Kind (iK) $ IEnte~ on Smmnary Statement, Column A. Lines 4 and t~ PC 2 Loans Received (LR) $ Loans Received (LR) $ ~ Enter on Suture:wy Statement. Cohnnn A, Linc 2 PC 2 Cash Contributions, Loans Received and lmKind Candidate or Political Committee Name: Committee ID Number: Kitty Piercy for Mayor n/a Page 9 o£ .225 Election: [] Primary 200~4 [] General 20__ [] Other Report: [] t st Pre-election [] 2nd Pre-election ~ Post-election [~ 20__ September Supplemental SEE BACK FOR INSTRUCTIONS AND CODE DEFINITIONS CODE 1: Contributor Type CODE 2: Contribution Type B Business Entity CA Cash C Political Committee (includes business and union PACs) CO Cosigner Obligation F Candidate's Immediate Family (includes candidate) IK In-Kind l Individual LR Loan Received L Labor Organization O Other P Political Party Committee Amount of in-Kind Purpose L~ne # Name and Address of Contributor Contribution (see manual for suggested purpose codes) Occupational information or Contributor Code ? I Code 2 Date Received Contributing Committee's IDfl Aggregate Marci Gordon 2609 Fairmount 1 BIvd Eugene OR 97403 $ 75.00 5/6/2004 Teacher $ 75.00 I CA Jack Radey 2230 Garfield St. 2 EugeneOR 97405 $ 25.00 5/4/2004 Rebred $ 75,00 CA Robert Ro~:h 2510 Kmcald St. 3. Eugene OR 97405 $ 50.00 5/4/2004 Attorney $ 75 00 CA Karyn Kaplan P.O.Box 3518 4 Eugene OR 97403 $ 25.00 514/2004 UO recychn9 manager $ 60.00 CA Clarence Townsend 5 1820 Grant St. EugeneOR $ 60.00 97405 5/4/2004 Soc,al Worker $ 60.00 CA See Page Totals (Add all amounts with the sane Accoanting Period Totals (Complete only for last page and Instructions contribution type. Do not include aggregates.) transfer these amounts to the Summary StatemenL PC 13 on Back and Cash (CA) $ 235.00 Cash (CA) lB Campaign Enter on Sttmmar) StatemenL Coltunn A Lme Finance Manual In-Kind (IK) $ - In-Kind (IK) $ Enter on Summary Statement, Cokum~ PC 2 Loans Received (LR) $ ~- Loans Received (LR) $ Enter on Stullmar2_, Statement. Column A, gltl~ PC 2 Cash Contributions, Loans Received and n-Kind Candidate or Political Committee ?,lame: Committee ID Number: Kitty Piercy for Mayor n/a Page 10 of Election: [] Primary 200_4 [~ General 20__ E~ Other ~ Repo~l: E] 1st Pre-election [~] 2nd Pre-election [] Post-election [] 20__ September Supplemental SEE BACK FOR INSTRUCTIONS AND CODE DEFINITIONS CODE 1: Contributor Type CODE 2: Contribution Type B Business EntiVy CA Cash C Political Committee (includes business and union PACs) CO Cosigner Obligation F Candidate's Immediate Family (includes candidate) IK In-Kind I Individual LR Loan Received L Labor Organization O Other P Political Party Committee Amount of In-Kind Purpose bne Ct Name and Address of Contributor Contribution (see manual for suggested purpose codes) Occupational Information or Contributor Date Received Contributing Committee's ID¢¢ Aggregate Code I ~ Code 2 Jean Weick 2301 Fairmount I Blvd. Eugene OR 97403 $ 100 00 5/4/2004 retired $ 100 00 ~ CA 2. $ Oregon League of Conservation Voters 320 3. S.W. Stark, Ste. 415 Portland OR $ 3,260~00 L, P 97204 5/7/04 No 002352 $ 6,194.05 C IK Deb Noble 4990 W. Hillside Dr. 4 Eugene OR 97405 $ 2,000 00 5116~2004 Business owner (timber sales) $ 2,000.00 t CA Eugene Fire Fighters 2300 Oakmont 5 Way, Suite 201 Eugene OR 97401 $ 1,000,00 5/20/2O04 PAC # 60 $ 5,000.00 C CA See Page Totals (Add all amounts with the same Accounting Period Totals (Complete only ibc last page and Instructions contribution type. Do not include aggregates.) transfer these amounts to the Summary Statement, PC 1.) on Back and Cash (CA) $ 3,100.00 Cash (CA) $ ~ in Campaign Enter on S~mu'nary Statement, Coltm~.n A Lint: 1 Finance Manual In-Kind (IK) $ 3,260 O0 In-Kind (IK) $ - Enter on Sttmmarv Statement, Coknnn A_ Lines 4 and 9 PC 2 Loans Received (LR) $ ~ Loans Received (LR) $ 0.00 Ente~ on Smmnao' Statement Coltann A. Line 2 Pc 2 Cash Contributions, Loans Received and n-Kind Candidate or Pohtical Committee Name: Committee ID Number: Kitty Piercy for Mayor n/a Page 11 of 5%~ Election. [] Primary 200_¢,4 [~ General 20_ E~ Other ~ Report: [] I st Pre-election [~ 2nd Pre-election [] Post-election [] 20__ September Supplemental SEE BACK FOR INSTRUCTIONS AND CODE DEFINITIONS CODE 1: Contributor Type CODE 2: Contribution Type B Business Entity CA Cash C Political Coramittee (includes business and union PACs) CO Cosigner Obligation F Candidate's Immediate Family (includes candidate) IK In-Kind i Individual LR Loan Received L Labor Orgamzation O Other P Political Party Committee Amount of In.Kind Purpose bna # Name and Address of Contributor Contribution (see manual for suggested purpose codes) Occupational Information or Contributor Date Received Contributing Committee's ID¢¢ Aggregate Code 1 ~ Code 2 Art Johnson 975 Oak St, SuIte1050 1 Eugene OR 97401 $ 1,000 00 6t3/2004 Lawyer $ t ,000.00 I I CA Patricia Noyes 2014 Elk Ave. 2 Eugene OR 97403 $ 700.00 5/10/2004 Rebred $ 1,000.00 I I CA Susan Sherman 3200 Emerald St. 3. Eugene OR 97405 $ 1,000~00 5/11/2004 Owner/Director of Wellness Center $ 1.000 00 I CA Robert O'Bden 3525 Gilham Rd. 4 Eugene OR 97408 $ 400.00 5/1 7/2004 Professor $ 700 00 I CA Thomas Pdnple 3295 Kinca~d St. 5~ Eugene OR 97405 $ 400 00 B~o Medical Consultant $ 500 00 ~ 5/1 8/2004 CA See Page Totals (Add ail amounts with the same Accounting Period Totals (Complete only for last page and Instructions contribution type. Do not include aggregates.) transfer these amounts to the Summary Statement, PC on Back and Cash (CA) $ 3,500.00 Cash (CA) $ ~ in Campaign Enter on Sm~maty Stmgment, Cohn~r~ A. Line I Finance Manual In-Kind (IK'~ $ In-Kind (IK) $ ~ Enter on Smnmar,/Statement, Colmnn A, Lines 4 and 9 PC 2 Loans Received (LR) $ Loans Received (LR) $ ~ Enter on Smnmao Statement, Column A, Line 2 Cash Contributions, Loans Received and In-Kind Candidate or Political Committee Name: Committee 1D Number: Kitty Piercy for Mayor n/a Page 12 of Election: ~ Primary 200_A4 [] General 20__ [] Other __ Report: E~ 1st Pre-election [] 2nd Pre-election ~ Post-election [] 20__ September Supplemental SEE BACK FOR INSTRUCTIONS AND CODE DEFINITIONS CODE 1: Contributor Type CODE 2: Contribution Type B Business Entity CA Cash C Political Committee (includes business and union PACs) CO Cosigner Obligation F Candidate's Immediate Family (includes candidate) IK In-Kind t Individual LR Loan Received L Labor Organization O Other P Political Party Committee Amount of In-Kind Purpose Line # Name and Address of Contributor Contribution (see manual for suggested purpose codes) Date Received Occupational Information or Contributor Code 1 Code 2 Contributing Commzttee~ ID# Aggregate Harriet Merrick 1332 Oak Patch Rd. Apt 84 1 Eugene OR 97402 $ 50.00 5/16/2004 Manager-Purchasing UO $ 450.00 I CA Amy Carpenter 1280 Mill St 2 Eugene OR 97401 $ 200 00 5/13t2004 OwnedManager, Book Universe, Inc. $ 400.00 I CA Amy Carpenter 1280 Mill St. 3 Eugene OR 97401 $ 25.00 5~20/2004 OwnedManager, Book Universe, Inc. $ 425.00 I CA R,chard Coolman 3345 Storey Blvd. 4 Eugene OR 97405 $ 100.00 Developmental Pediatrician $ 300 00 5/1 7/2O04 CA Greg McLauchlan 2401 W. 22nd. Ave. 5 Eugene OR 97405 $ 300.00 5/16/2004 Professor $ 300.00 ~ I CA See Page Totals (Add all amounts with The same Accounting Period Totals (Complete only ~¥r last page and Instructions contribution type, Do not include aggregates.) transfer these amounts to the Summary Statement, PC on Back a~d Cash (CA) $ 675.00 Cash (CA) $ in Campaign E~ter on Smmria~ Statement. Colmnn Finance Manual in-Kind (1K) $ In-Kind (IK) $ __ Enter on Smmnary Statement, Column PC 2 Loans Received (LR) $ Loans Received Enter m~ Summar} Statement Colmnn A~ Line 2 Cash Contributions, Loans Received and Candidate or Political Committee Name: Committee [D Number: Kitty Piercy for Mayor n/a Page Election: [] Primary 2004 E~ General 20__ g~ Other __ Report: [~ l s~ Pre-election [~] 2nd Pre-election [~ Post-election [] 20__ September Supplemental SEE BACK FOR iNSTRUCTiONS AND CODE DEFINITIONS CODE 1: Contributor Type CODE 2: Contribution Type B Business Entity CA Cash C Political Committee (includes business and union PACs} CO Cosigner Obligation F Candidate's Immediate Family (includes candidate) IK In-Kind I Individual LR Loan Received L Labor Organization O Other P Political Party Committee Amount of fn-Kmd Purpose Line # Name and Address of Contributor Contribution (see manual for suggested purpose codes) Occupational information or Contributor Date Received Contributing Commtttee's lDO Aggregate Code 1 , Code 2 Dwight Collins 1600 Orchard St. 1. Eugene OR 97403 $ 250.00 5/11/2004 Owner of Fish Market $ 250.00 I CA Peggy Collins 1600 Orchard St. 2 Eugene OR 97403 $ 250.00 Teacher $ 250.00 5/1 1/2004 CA Lmda Oppenheimer 1234 E. 21st Ave 3 Eugene OR 97403 $ 250.00 5/10/2004 Physician $ 250.00 ~ CA Thelma Soderqu~st 2577 N~xon St. 4, Eugene OR 97403 $ 50.00 Unemployed $ 250.00 5/21/2004 CA Stephen Allanketner 212 Crest 5 Dr Eugene OR 97405 $ 200~00 5/17/2004 Psychologist $ 250.00 i CA See Page Totals (Add all arnour~ts with the same Accounting Period Totals (Complete only for last page and Instructions contribution ~,pe. Do not include ag~egates.) transfer these amounts to the Summary Statement, PC 1.) on Back and Cash (CA) $1,000.00 Cash (CA) $ ~ in Campaign Ente~ on SummaD Statemem, Cok~mr~ &~ Line t Finance Manual In-Kind (IK) $ In-Kind ([K) $ Emer ca Stmm~ar~ Statement Cotumm & Lines 4 ,,nd 9 PC 2 Loans Received (LR} $ Loans Received (LR} $ ~ Enter on Summar5 Statement Collator A, Line 2 PC 2 Cash Contributions, Loans Received and In-Kind Re, Candidate or Political Committee Name: Committee iD -Number: Kitty Piercy for Mayor nla Page 14 of'~-~ Election: [] Primary 20044 ~ General 20__ [] Other ~ Report: [~ 1 st Pre-election E~ 2nd Pre-election [] Post-election E~] 20__ September Supplemental SEE BACK FOR INSTRUCTIONS AND CODE DEFINITIONS CODE 1: Contributor Type CODE 2: Contribution Type B Business Entity CA Cash C Political Committee (includes business and union PACs) CO Cosigner Obhgation F Candidate's Immediate Family (includes candidate) iK in-Kind I Individual LR Loan Received L Labor Organization O Other P Political Party Committee Amount of In-Kind Purpose Lnne ¢¢ Name and Address of Contributor Contribution (see manual for suggested purpose codes) Occupational Information or Contnbutor I Date Received Contributing Committee's ID¢¢ Aggregate Code I , Code 2 Leah Edelman 345 BraeBum Dr. 1 Eugene OR 97405 $ 200 00 5/12/2004 Homemaker $ 200.00 ~ I CA Mary Gossart30488 FoxHollow Rd. 2 Eugene OR 97405 $ 100 00 Education Director $ 200.00 I 1 5/1 7/2004 CA Patnc,a Straub 1552 C St. 3 Springfield OR 97477 $ 200.00 6/3~2004 Retired $ 200 00 t CA David Adee 109OakteighLn. 4 Eugene OR 97404 $ 150 00 Landscaper $ 150.00 I 1 5/1 1 /2004 CA Kate Barry 2773 Harris 5. Eugene OR 97405 $ 100 00 5/18/2004 College Admimstrator $ 150.00 ~ CA See Page Totals (Add all amounts with the same Accounting Period Totals (Complete only fo~ last page and instructions contribution type~ Do not include aggregates.) transfer these amounts to the Summary Statement, PC I. ~ on Back and Cash iCA) $ y50.00 Cash (CA) $ ~ in Campaign Entre on Smmnar~ Statement. Colmnl~ A~ Lm~ 1 Finance Manual In-Kind (IK} $ ~ In-Kind (IK) $ ~ Enter on Smmnary Statement. Colmm~ A. Lm~ 4 and ~; PC 2 Loans Received (LR) $ -- Loans Received (,LR) $ , Ente~ on Stamnary Stateroom. Column h~ Line 2 PC 2 Cash Contributions, Loans Received and In-Kind Candidate or Political Committee Name: Committee ID Number: Kitty Piercy for Mayor n/a Page 15 of ~ Election. [] Primary 2004 [~ General 20__ E~] Other __ Report: E~ ]st Pre-election E~ 2nd Pre-elect/on [] Post-election E~ 20__ September Supplemental SEE BACK FOR INSTR, UCTION$ AND CODE DEFINITIONS CODE 1: Contributor Type CODE 2: Contribution Type B Business Entity CA Cash C Political Committee (includes business and union PACs) CO Cosigner Obligation F Candidate's Immediate Family (includes candidate) IK In-Kind I Individual LR Loan Received L Labor Organization O Other P Political Party Committee Amount of tn-K~nd Purpose Dne# Name and Address of Contributor Contribution (see manual for suggested purpose codes) Date Received Occupational Information or Contributor Code '/ Code 2 Contnbuttng Committee's ID# Aggregate Joan Connolty 109 Oakleigh Ln. 1 Eugene OR 97404 $ 150.00 5/11/2004 M ustc Teacher $ 150,00 I CA Darnel Goldnch 2262 Birch Ln, Eugene OR 97403 $ 50 00 5/11/2004 Retired $ 150.00 I CA SIoan Heermance 2406 Lawrence 3 Alley Eugene OR 97405 $ 50 00 5111/2004 Wnter $ 150.00 I CA Martin Jones 2300 Parkside Ln, 4 Eugene OR 97403 $ 50.00 5/11/2004 Physician $ 150.00 ~ I CA Charlene Phipps 56759 North Bank 5 Rd. McKenzie Bridge OR $ 150,00 97413 5/11/2004 LCC Assistant D~rector of counseling $ 150 00 CA See Page Totals (Add all amounts with the same Accounting Period Totals (.Complete only fbr last page and Instructions contribution type. Do not include aggregates.) transfer these amounts to the Summary Statement, PC 1.) on Back and Cash (CA) $ 450.00 Cash (CA) $ in Campaign Ente~ on Sumanary Statement_ Colunm Finance Manual In-Kind ([K) $ -~- In-Kind (IK) Enter on Smm~iar5 Statement. Column A, Ltnes 4 and 9 PC 2 Loans Received (LR) $ Loans Received (LR) $ Enter on Sm-nmar5 Statement, Colttm~l A Lillc 2 ?c 2 Cash Contributions, Loans Received and In-Kind Candidate or Political Committee Name: Committee ID -Number: Kitty Piercy for Mayor n/a Page 18 of Election: [~ Primary. 2004 E~ General 20_ E~ Other ,__ Report: El 1st Pre-election E~ 2nd Pre-election L~ Post-election El 20__ September Supp[ementa~ SEE BACK FOR INSTRUCTIONS AND CODE DEFiNITiONS CODE 1: Contributor Type CODE 2: Contribution Type B Business Entity CA Cash C Political Committee (includes business and union PACs) CO Cosigner Obligation F Candidate's immediate Family (includes candidate) iK in-Kind [ Individual LR Loan Received L Labor Organization O Other P Political Part5, Committee Amount of In-Kind Purpose Lrne # Name and Address of Contributor Contribution (see manual for suggested purpose codes) Occupat~bnal Information or Contributor Code 1 I Code 2 Date Received Contributtng Committee's IDOl Aggregate Galen Phipps 56759 North Bank Rd 1. McKenz~e Bridge OR 97413 $ 150 00 Social Worker $ 150.00 I 5/1 1/2004 CA BarbaraRose 381 Oak Leaf Dr. 2 Eugene OR 97404 $ 50 00 5/11/2004 Retired $ 50.00 I CA BarbaraRose 381 Oak Leaf Dr. 3. Eugene OR 97404 $ 100,00 Retired $ 150 00 5/20/2004 CA Rachel Strauber 1160 Park Ave 4 New York NY 10128 $ 150.00 5/17~2004 Retired $ 150.00 1 CA Susan Wolling 85219 S. Willamette St 5 Eugene OR 97405 $ 50 00 5/12t2004 ,registered nurse $ 150.00 ~ CA See Page Totals (Add all amounts with the same Accounting Period Totals (Complete chi? for last page and instructions contribution type. Do not include aggregates./ transfer these amounts to the Summary Statement, PC } ) on Back and Cash ICA) $ 500.00 Cash (CA) $ ~ in Campaign Enter on Summaw S~atemenL Column A, Line t E inance Manual In-Kind (IK) $ ~ In-Kind (IKt $ ~ Enter on Summar'~ Statement, Colmrm A. L,ne', 4 and ~; PC 2 Loans Received (LR) $ Loans Received (LR) $ ~ Enter on Smmllary_ Stalmltent. Cotu~m A, Lnle 2 PC 2 Cash Contributions, Loans Received and n-Kind Candidate or Political Committee Name: Committee 1D Number: Kitty Piercy for Mayor n/a Page 17 of £[ection: ~2 Primary 200_8_4 E~ General 20__ L-] Other __ Report' E~ 1st Pre-election E~ 2nd Pre-election ~ Post-election [~ 20__ September Supplemental SEE BACK FOR INSTRUCTIONS AND CODE D£FINITIONS CODE 1: Contributor Type CODE 2: Contribution Type B Business Entity CA Cash C Political Committee (includes business and union PACs) CO Cosigner Obligation F Candidate's Immediate Family (includes candidate) IK In-Kind I Individual LR Loan Received L Labor Organization O Other P Political Parb~ Committee Amount of In-Kind Purpose Line # Name and Address of Contributor Contribution (see manual for suggested purpose codes) Occupational Information or Contributor Date Received Contributing Committee's ID'cC Aggregate Code '~ i Code 2 Chris Helm 1147 E, 26th Ave, 1 Eugene OR 97403 $ 50.00 5/13/2004 Teacher $ 125 00 ~ CA Mike Helm 1147 E 26th Ave. 2 Eugene OR 97403 $ 50 00 5/13/2004 Philosopher $ 125 00 I CA Carole Patteron 2561 Fdendly 3 Eugene OR 97405 $ 25.00 Writer $ 125.00 I 5/10/2004 CA David Atkin P.O. Box 10008 4 Eugene OR 97440 $ 100.00 5/1412004 Attorney $ 100.00 I CA Jill Baxter 2295 University St. 5 Eugene OR 97403 $ 100.00 5/10/2004 Professor $ 100.00 I t CA i See Page Totals (Add all amounts with the same Accounting Period 'Totals (Complete only for last page and Instructions contribution type. Do not include aggregates.) transfer these amounts to the Summary Statement, PC l. ~ on Back and Cash (CA~ $ 325.00 Cash (CA) $ in Campaign Enter on Summmy Statemem. Column A Line 1 Finance Manual tn-Kind (IK) $ ~ ln-K ind (IK'~ $ ~ Enter on Summary Statement. Colmnn A. Lines 4 and 9 PC 2 Loans Received (LR) $ Loans ReceiYed (LR) $ _ Enter on Smmna~D' Stateroom. Colmnn A. Line 2 Cash Contributions, Loans Received and n-Kind Candidate or Political Committee Name: Committee 1D Number: Kitty Piercy for Mayor n/a Page 18 Election: [] Primary 200__44 [~ General 20__ [~ Other _ _ Report: [~ 1st Pre-election [~ 2nd Pre-election [] Post-election [~ 20__ September Supplemental SEE BACK FOR INSTRUCTIONS AND CODE DEFINITIONS CODE 1: Contri~3utor Type CODE 2: Contribution Type B Business Entity CA Cash C Political Committee (includes business and union PACs) CO Cosigner Obligation F Candidate's Immediate Family (includes candidate) IK In-Kind I Individual LR Loan Received L Labor Organization O Other P Political Party Committee Amount of In-Kind Purpose Line # Name and Address of Contributor Contribution (see manual for suggested purpose codes) Date Recelved Occupational Information or Contributor Code 1 Code 2 Contributing Committee's ID'CC Aggregate William Buskirk P O Box 50984 1. Eugene OR 97405 $ 100 00 5/18/2004 retired $ 100 00 ~ CA Robert Daugherty 2295 University St 2. Eugene OR 97403 $ 100.00 5/10~2004 Physician $ 100 00 1 CA Donald Eckenrode 750 Foothill Dr. 3. Eugene OR 97405 $ 100 00 5/2O/2O04 Retired $ 100.00 I CA Lynne Fessenden 95348 Grimes Rd. 4 Junction City OR 97448 $ 50.00 6/3/2004 Sc~ent,st $ 100.00 ~ CA Gary Gillespie P.O. Box 1 5 Eugene OR 97440 $ 100 00 5/10/2004 Adrmmstrative Assistant $ 100.00 I CA See Page Totals (Add all amounts with the same Aeeounting Period Totals (Complete only t~r last page and Instructions contribution type, Do not include aggregates,) transfer these amounts to the Summary Statement, PC 1 .) on Back and Cash {CA) $ 450.00 Cash (CA) $ lB Campaign Enter on Surmna~ Statemer~t. Column A~ Linc 1 Finance Mmmal In-Kind (IK) $ ~ In-Kind (IK) $ Enter ~m Smmr~ary Stateme~tt Colmnn A, Lme~ 4 a~d '} PC 2 Loans Received (LR) $ Loans Received (LR) $ Enter on Smmnar~ Stat-emer~t, Column A, Line 2 Cash Contributions, Loans Received and In-Kind Candidate or Political Committee Name: Committee 1D Number: Kitty Piercy for Mayor n/a Page 19 of 53 Election: [] Primary 200~4 E~ General 20__ E~ Other ~ Report: E] 1st Pre-election [] 2nd Pre-election [] Post-election E] 20__ September Supplemental SEE BACK FOR INSTRUCTIONS AND CODE DEFINITIONS CODE t: Contributor Type CODE 2: Contribution Type B Business Entity CA Cash C Political Committee (incLudes business and union PACs) CO Cosigner Obligation F Candidate's Immediate Family (includes candidate) tK In-Kind l lndMdual LR Loan Received L Labor Organization O Other P Political Party Committee Amount of fmKtnd Purpose Dne # Name and Address of Contributor Contribution (see manual for suggested purpose codes) Occupational Information or Contributor Date Received Contributing Committee's lDO Aggregate Code 1 , Code 2 Dawn Helwig 1470 E. 20th Ave. 1 Eugene OR 97403 $ 100.00 Dbrary OrgamzedFundraiser $ 100.00 t 5/1 0/2004 CA Fred Hmtz 2125 Fairmount Blvd. 2 Eugene OR 97403 $ 100.00 Student $ 100.00 I 5/1 6/2004 CA Demse Hotiz 2125 Fa~rmount Blvd, 3. Eugene OR 97403 $ 100.00 5/16/2004 Student $ 100.00 I CA Kathryn Madden 70 W, 30th Ave, Eugene OR 97405 $ 50.00 Research Administrator $ 100,00 I [ 5/4/2004 CA Beth Naytor 2411 Monroe St. 5 Eugene OR 97405 $ 100~00 5/21/2004 teacher $ 100 00 ~ CA See Page Totals (Add all amounts with the same Accounting Period Totals (Complete only fbr last page m~d Instructions contribution type. Do not include aggregates.) transfer these amounts to the Summary Statement. PC 1. } on Back and Cash (CA) $ 450 00 Cash (CA) $ in Campaign Enter on Smmnary Stateroom Colttran a, Line 1 Finance Manual In-Kind (IK) $ ~ In-Kind (IK) $ Enter on SmnmaB Statement_ Culmmt &, I mos 4 aud O PC 2 Loans Received (LR) $ Loans Received (LR) $ ~ Enter on Summao Statement Cohmm A. Line 2 PC 2 Cash Contributions, Loans Received and ia-Kind Candidate or Political Committee Name: Committee ID Number: Kitty Piercy for Mayor n/a Page 2~0 of Electiort: [] PrimaO' 200_&4 El General 20__ El Other Report: [] 1 st Pre-election El 2nd Pre-election [] Post-election [--} 20__ September Supplemental SEE BACK FOR 1NSTRUCTIiON$ AND CODE DEFINITIONS CODE 1: Contributor Type CODE 2: Contribution Type B Business Entky CA Cash C Political Committee (.includes business and union PACs) CO Cosigner Obligation F Candidate's Immediate Family (includes candidate) [K In-Kind I Individual LR Loan Received L Labor Organization O Other P Political Par~5 Committee Amount of ln-Ktnd Purpose Dne # Name and Address of Contributor Contribution (see manual for suggested purpose codes) Occupational Information or Contributor Code I Code 2 Date Received Contributing Commtttee's ID#- Aggregate Irwin Noparstak 2550 Lincoln ~ Eugene OR 97405 $ 100,00 5/20/2004 Physician $ 100.00 t CA Dan Rosenthal 1470 E, 20th Ave 2 Eugene OR 97403 $ 100.00 5110/2004 Architect $ 100.00 I CA Thomas Rubick 1963 Sylvan Ave 3. Eugene OR 97403 $ 100 00 5/17~2004 Educator $ 100.00 I CA J~m Watson 2411 Monroe St. 4 Eugene OR 97405 $ 100 00 5/21/2004 Teacher $ 100.00 t CA Charlotte Zeller 5283 W~ Amazon 5, Eugene OR 97405 $ 100.00 6/3/2004 Teacher $ 100 00 I CA Sec Page Totals (Add all amounts with the same Accounting Period Totals (Complete only for last page and instructions contribution type. Do not include aggregates.) transfer these amounts to the Summar5 StatemenL PC !.) on Back and Cash (CA) $ .500.00 Cash (CA) $ ~ in Campaign Ente~ on Summar~ Statement. Coktmn A~ Line 1 Finance Man,at in-Kind (IK) $ ~.- In-Kind (IK) $ ~ Enter on SummmT StatemenL Coluwm A Dne:. 4 and v PC 2 Loans Received (LR) $ - Loans Received (LR) $ Enter on Summao S~atement, Col,mm A. L~ne 2 Cash Contributions, Loans Received and In-Kind <' Candidate or Political Committee Name: Committee ID Number' Kitty Piercy for Mayor n/a Page 21 of 23 Election. [~ Primary 200_A4 [] General 20__ [~ Other Report: [~ 1 st Pre-election [] 2nd Pre-election ~ Post-election [] 20__ September Supplemental SEE BACK FOR INSTRUCTIONS AND CODE DEFINITIONS CODE 1: Contributor Type CODE 2: Contribution Type B Business Entity CA Cash C Political Committee (includes business and union PACs) CO Cosigner Obligation F Candidate's Immediate Family (includes candidate) 1K In-Kind l individual LR Loan Recetved L Labor Organization 0 Other P Political Part3' Committee Amount of In~Kind Purpose Line # Name and Address of Contributor Contribution (see manual for suggested purpose codes) Occupational Information or Contributor Code l f Code 2 Date Recetved Contributing Committee's ID# Aggregate R~chardZeller 5283 W, Amazon I Eugene OR 97405 $ 100 00 6/3/2O04 Rebred $ 100 00 I CA Rex Fox 615 Pnncess Ave. 2 Eugene OR 97405 $ 25.00 5/22/2004 Credit Umon Manager $ 75 00 ~ CA Leonard Hockley220 N. Adams 3 Eugene OR 97402 $ 25.00 5/11/2004 Information Specialist $ 75.00 I CA Judy Volem 2362 Chamelton St 4 Eugene OR 97405 $ 25 00 5/24/2004 Teacher $ 75.00 I CA 196 Misc, contributions of $50 & Under 5 $ 6634 5/3-6/7/04 $ CA See Page Totals (Add ail amounts with the same Accounting Period Totals (Complete only for last page and Instructions contribution type. Do not include aggregates.) transfer these amounts to the Summary Statement, PC on Back and Cash (CA) $ 6,809 00 Cash (CA) in Campaign Enter on Finance Manual In-Kind (IK) $. - in-Kind (IK) $ - Enter on Surmnarv Statement, Cokmm A LIBeq 4 and c~ PC 2 Loans Received (LR) $ ~ Loans Received (LR) $ Fnter on Snmmary Statement, Column A_. Line 2 PC 2 Cash Con(dbutions, Loans Received and In-Kind Candidate or Political Committee Name: Committee ID Number: K~tty Piercy for Mayor n/a Page 22 of Election: ~ Primary 200~4 E~ General 20__ [] Other ~ Report' [~ I st Pre-election [] 2nd Pre-election [~ Post-election [] 20__ September Supplemental SEE BACK FOR INSTRUCTIONS AND CODE DEFINITIONS CODE 1: Contributor Type CODE 2: Contribution Type B Business Entity CA Cash C Political Committee (includes business and union PACs) CO Cosigner Obligation F Candidate's Immediate Family (includes candidate} iK In-Kind I Individual LR Loan Received L Labor Organization O Other P Political Party Committee Amount of In-Kind Purpose Dne # Name and Address of Contributor Contnbution (see manual for suggested purpose codes) Occupational Information or Contributor Code 1 ! Code 2 Date Received Contributing Commtttee's IlY¢ Aggregate Oregon League of Conservation Voters 320 1 S.W Stark, Ste, 415 Portland OR $ 257 01 G (staff t~me) 97204 5/3-5/18/04 No 002352 $ 6,532.54 C Oregon League of Conservation Voters 320 2~ S,W Stark, Ste. 415 Portland OR $ 11.61 S (survey data) 97204 514104 No. 002352 $ 8,544.15 C IK Oregon League of Conservation Voters 320 3 S W Stark, Ste. 415 Portland OR $ 250 76 S (survey data) 97204 5/16/04 NO 002352 $ 6,794.91 C t Oregon League of Conservation Voters 320 4. S.W. Stark, Ste. 415 Portland OR $ 81.48 T (m~leage, food wh~le travding) 97204 5/16/04 No. 002352 $ 6,876 39 C IK Northwest Comic News 5 296 East 5th ¢141 Eugene OR $ 650.00 Donabon of space for thank you ad 97401 5/24/2004 $ 650~00 B tK See Page Totals (Add all amounts with the same Accounting Period Totals (Complete onl~ for last page and instructions contribution type. Do not include aggregates.) transfer these amounts to the Summary Statement. PC l.) on Back and Cash (CA) $ Cash (CA) in Campaign Entel o~ Summaw Sratemem. Coltann A. Line Finance Manual In-Kind (IK) $1,250.86 In-Kind (IK) $ ~ Enter on Summao Statement. C ohmm A. i,me~ 4 m~d 9 PC 2 Loans Received (LR) $ Loans Received (LR) $ ~ Enter on SulrallaO Statement, Column PC Cash Contributions, Loans Received and Candidate or Political Committee Name: Committee ID Number: Kitty Piercy for Mayor n/a Page 2_~3 of~ Election: [~ Primary 200~4 [] General 20__ [] Other __ Report: [] 1st Pre-election [] 2nd Pre-election [] Post-election [~] 20__ September Supplemental SEE BACK FOR INSTRUCTIONS AND CODE DEFINITIONS CODE 1: Contributor Type CODE 2: Contribution Type B Business Entity CA Cash C Political Committee (includes business and union PACs) CO Cosigner Obligation F Candidate's Immediate Family (includes candidate) IK [n-Kind [ Individual LR Loan Received L Labor Organization O Other P Political Party Committee Amount of In-Kind Purpose Dne # Name and Address of Contributor Contfibutlon (see manual for suggested purpose codes) Occupational Information or Contributor Date Received Contributing Committee's ID# Aggregate Code I , Code 2 Ray Eveland 280 Rosemary 1 Eugene OR 97404 $ 20.00 Blank CDs Retired $ 70.00 5/14t2004 IK CB S~mons 215 W 5th Eugene OR 2 97401 $ 400.00 G - off~ce space 511-5125/04 Realtor $ 1,326.76 I IK McLauchlan Grey 2401 W. 22nd 3. Eugene OR 97405 $ 72.80 L - Printing costs 4/19~2O04 Umversity professor $ 522.80 I IK $ 5 $ $ See Page Totals (Add all amounts with the same Accounting Period Totals (Complete only fbr last page and Instructions contribution type, Do not include aggregates.) transfer these amounts to the Summary Statement. PC IJ on Back and Cash (CA) $ Cash (CA) $ 26,004 00 in Campaign Enter on Stm~mary Statement, Colnm~ ,A, Linc / Finance Manual ImKind (IK) $ 492.80 In*Kind (IK) $ 5,604 52 Emer on Sumll~aO Statemem, Column A. Lines 4 and 9 PC 2 Loans Received (LR) $ ~ Loans Received (LR) $ Enter on St~rnmar) StatemenL Column A Line 2 PC Cash Expenditures and Loan Payments Candidate or Political Committee Name: Committee -iD Number: Kitty Piercy for Mayor n/a Page 1_!. of £1ect~on: [~] Primary 2004 []~] General 20__ [] Other ~ Report: E] 1st Pre-election [] 2nd Pre-election [] Post-election [] 20__ September Supplemental PURPOSE CODES (see back of form for instructions and code definitions) EXPENDITURE TYPES A Agent O Other Advertising (yard signs, buttons, etc.) CA Cash B Broadcast Advertising (Radio, TV) P Postage LP Loan Payment C Cash Contributions R Reimbursement for Personal Expenditures F Fundraising Event Expenses S Surveys and Polls G General Operational Expenses {describe if over $50) T Travel Expenses (describe if over $50) I Interest Payment U Utilities L Literature, Brochures, Printing W Wages, Salaries, Benefits M Management Services Y Petition Circulators N Newspaper and Other Periodical Advertising Z Preparation and Production of Ad,eertising Payee's Name and Payee's Committee ID#, Exp. Amount of Line # Date Check # if applicable Purpose Type Expenditure Pard (as Jt appears on invotce, recetpt or check) to 1 5/3/04 EFT Polibcs Online G CA $ 37 50 [~ 2 5/4/04 EFT Pohbcs Online G CA $ 11 50 E~ 3. 5/5/04 EFT Politics Online G CA $ 39 98 E~ 4 5/5/04 1067 KEZI Z CA $ 2,50000 5 5/5/04 1068 Eugene WeeMy N CA $ 554 00 E~ 6 5/5/04 1070 usPs P CA $ 111 00 ~ 7 5/5/04 1071 McKenzie River Broadcasting B CA $ 1,147 50 ~ G (table/food 8 5/5/04 1072 Lane County Fairgrounds for election CA $ 144 00 E~ mght) 9 5/5/04 1073 Dave Lurid Z CA $ 50.00 E~ 10 5/6/04 EFT Qwest U CA $ 89 81 [~ See Page Totals (Add all expenditures with the same Acconnting Period Totals (Complete only for last page and instructions expenditure type./ transfkr these amounts to the Summary Statement, PC 1.) on Back and m Campaign Cash rCA) $ 4,685.29 Cash (CA) $ _ Finance Enter on SmmnaO Statement Culumn A, i mu ~ Manua~ Loan Payment (LP) $ ~ Loan Payment (LP} $ __ Enter on Surmnao Statement. Colttlllll ~ Lllt~ 7 PC 3 PC_ ~ Cash Expenditures and Loan Payments Candidate or Political Committee Name: Committee iD Number: K~tty Piercy for Mayor n/a Page 2_ of~ E~ection: [] Primary 2094 [~1 General 20__ [~ Other __ Report: [~1 1st Pre-election [] 2nd Pre-election [] Post-election [~1 20__ September Supplemental PURPOSE CODES (see back of form for instructions and code definitions} EXPENDITURE TYPES A Agent O Othe~ Advertising {yard signs~ buttons~ etc.) CA Cash B Broadcast Advertising (Radio. TV) P Postage LP Loan Payment C Cash Contributions R Reimbursement for Personal Expendkures F Fundrmsing Event Expenses S Surveys and Polls G Genera! Operational Expenses (describe if over $50) T Travel Expenses (describe if over $50) I lnterest Payment U Utilities L Literature, Brochures, Printing W Wages, Salaries, Benefits M Management Services Y Petition Circulators N Newspaper and Other Periodical Advertising Z Preparation and Production of Advertising Payee's Name and Payee's Commtttee ID#, Exp. Amount of Lcne# Date Check # if applicable Purpose Type Expenditure Pacd (as it appears on ~nvoice, receipt or check) to A/P I 5/6/04 1074 Ann Brown L CA $ 60 00 E~ 2 5/6/04 1075 Paula DeBeli O CA $ 93.40 3 5/6/04 1076 Ray Eveland O CA $ 59.70 ~ 4 5/6/04 1077 Kate Kelly L CA $ 10.50 E~ 5 5/6t04 1078 Jana Rygas L, G (Snacks), CA $ 145 75 E77] 0 G (Office CA $ 23 88 E~ 6 5/6/04 1079 Aiexandra Roberts Supplies) 7 5/6/04 1080 Jerry Welsh F CA $ 54 84 A (see 8 5/7/04 1081 Charlton Engel Marketing attached CA $ 236.70 invoice) G (Phone 9 5/7/04 1082 Precision Commumcatlons bank calls to CA $ 4,81 t 05 voters) 10 5/7/04 1083 Accessible Data Services L, P CA $ 4 059 39 See Page Totals (Add all expenditures with the same Accounting Period Tot~s (Complete only l~br last page and Instructions expenditure ~/pe.) trans~kr these amounts to the Summary StatemenL PC 1 on Back and m Campaign Cash (CA'~ $ 9,555.21 Cash (CA) $ _ , Enter on Summap¢ Statement. Colunln A Ln}e O Finance Manual Loan Payment (LP) $ Loan Payment (LP) Enter on Summar:~ Stamment Co}m~n A I me PC 3 PC 3 Cash Expenditures and Loan Payments Candidate or Political Committee Name: Committee ID Number: Kitty Piercy for Mayor n/a Page 3 of Election: [] Primary 200_3_4 [] General 20__ [Z~] Other _t Report. [~] 1st Pre-election [~] 2nd Pre-election [] Post-election [] 20__ September Supplemental PURPOSE CODES (see back of ~'orm for instrnctions and code definitions) EXPENDITURE TYPES A Agent O Other Advertising (yard signs, buttons, otc,) CA Cash B Broadcast Advertising {Radio, TV) P Postage LP Loan Payment C Cash Contributions R Reimbursement for Personal Expenditures F Fundraising Event Expenses S Surveys and Polls G General Operational Expenses (describe if over $50) T Travel Expenses (describe if o~er $50) I Interest Payment U Utilities L L~terature, Brochures, Printing W Wages, Salar~es~ Benefits M Management Services Y Petition Circulators N Newspaper and Other Periodical Advertising Z Preparation and Production of Advertising Payee's Name and Payee's Commtttee ID#, Exp Amount of Ltne# Date Check # tf applicable Purpose Type Expenditure Pa~d (as it appears on invoice, receipt or check) to 1 5/5/04 1069 USPS P CA $ 74 00 ~ 2 5/9/04 1084 Reg~ster-Guard N CA $ 699~00 ~ 3 5/11/04 1085 Register-Guard N CA $ 563 38 E~ 4 5/11/04 1086 Direct Communicat,ons G (Phone calls) CA $ 227 50 ~ 5 5/11/04 1087 Register-Guard N CA $ 10~72 ~ G (Phone CA $ 204 75 E~ 6 5/12/04 1089 Direct Communications calls) 7 5/12/04 1090 Register-Guard N CA $ 573 34 [~ G (data 8 5/14/04 1091 , Astra Data Services management CA $ 325 00 E~ for phone lists) G (Voter 9 5/14/04 1093 Lane County Elections updates) CA $ 20 00 E~ 10 5/14/04 1094 Oregon Daily Emerald N CA $ 70 00 See Page Totals (Add all expenditures -with the same Accounting Period Totals (Cornplete only fo~ last page and instructions expenditure type.) transfer these amounts to the Summary Statement, PC ot~ Back and in Campaign Cash iCA) $ 2,767.69 Cash (CA) $ ~ Finance Enter oil Summary Sta~enlent, Cohlmn ~ Line Manual Loan Payment (LP} $ ~ Loan Payment (LP) $ . Enter on Summar~ StatemenL Coltlmll A Lille 7 PC 3 PC 3 Cash Expenditures and Loan Payments Candidate or Political Committee Name: Committee iD Number: Kitty Piercy for Mayor n/a Page 4 of Election: [~ Primary 2004 [~ General 20__ [~] Other t_ Report. ~ 1st Pre-election ~ 2nd Pre-election [] Post-election [~ 20__ September Supplemental PURPOSE CODES (see back of form for instructions and code definitions) EXPENDITURE TYPES A Agent O Other Advertising (yard signs, buttons, etc.} CA Cash B Broadcast Advertising (Radio, TV) P Postage LP Loan Payment C Cash Contributions R Reimbursement for Personal Expenditures F Fundraising Event Expenses S Surveys and Polls G General Operational Expenses (describe if over $50) T Travel Expenses (describe if over $50) I interest Payment U Utilities L Literature. Brochures, Printing W Wages, Salaries, Benefits M Management Services Y Petition Circulators N Newspaper and Other Periodical Advertising Z Preparation and Production of Advertising Payee's Name and Payee's Committee ID#, [] Exp. Amount of Line # Date Check # if apphcable Purpose Type Expendtture Pard (as ~t appears on invoice, receipt or check) to NP G (names and I 5/14/04 1095 NARAL Pro-Choice Oregon numbers for CA $ 83.64 phone banks) 2 5114104 1096 Paclnfo U CA $ 21 00 E~] 3 5/14/04 1097 Jana Rygas P, G CA $ 29 48 E~ 4~ 5/14t04 1098 Pride Printing O CA $ 1 621 00 [~ 5 5/14t04 1099 Paula DeBell G CA $ 10 79 E~ 6 5/14/04 1100 Ray Eveland O CA $ 101.49 7 5/14/04 1101 Bob Walters L CA $ 27.80 8 5f16/04 EFT Cardinal Employment Sermces W CA $ 2,046 00 E~ 9 5/17/04 1103 McKenzie R,ver Broadcasbng B CA $ 170 00 E~ 10 5117/04 1104 McKenzie R~ver Broadcasting B CA $ 45 00 See Page Totals (Add all expenditures with the same Accounting Period Totals (Complete only for last page and Instructions expenditure type.) transfer these amounts to the Smnmary Statement, PC 1 on Back and in Campaign Cash (CA) $ 4,156,20 Cash (CA) $ _ Finance Enter on Smmn,~o, StatemenL COItiHIII A Line 0 Manual Loan Payment (LP) $ - Loan Payment (LP) $ _ Enter PC 3 PC 3 Cash Expenditures and Loan Payments Candidate or Political Committee Name: Committee iD Number: Kitty Piercy for Mayor n/a Page_5 of~,~' Election' ~ Primary 200_&4 E~ General 20__ L-~ Other ~ Report: [~ 1st Pre-election ~ 2nd Pre-election ~ Post-election E~ 20__ September Supplemental PURPOSE CODES (see back of form for instructions and code definitions) EXPENDITURE TYPES A Agent O Other Advertising (yard signs, buttons, etc.) CA Cash B Broadcast Advertising (Radio, TV) P Postage LP Loan Payment C Cash Contributions R Reimbursement for Personal Expenditures F Fundraising Event Expenses S Surveys and Polls G General Operational Expenses (describe if over $50) T Travel Expenses (describe if over $50) I Interest Payment U Utilities L Literature~ Brochures, Printing W Wages, Salaries. Benefits M Management Services Y Petition Circulators N Newspaper and Other Periodical Advertising Z Preparation and Production of Advertising Payee's Name and Payee's Commetfeo ID#, Exp. Amount of bne # Date Ct~eck # if appl¢cable Purpose Type Expendcture Pacd (as it appears on invoice, receipt or check) to A/P 1 5t17/04 1105 Powell Phones G - Phone CA $ 602 90 E~ Banks 2 5tl 7t04 1106 Powell Phones G - Phone CA $ 278 26 Banks G - Data for CA $ 75 00 3 5/17/04 1107 Astro Data Services phone banks 4 5/20104 1108 Chambers Media B CA $ 323 00 G - Sounds 5 5/20/04 1109 Diana Robson system for CA $ 150 00 party G - Par~y 6 5/20104 1110 Carol Home expenses CA $ 847 21 (food) 7 5/22104 1112 Dianne Lobes P CA $ 37 00 G - Computer CA $ 33 00 E~ 8 5~22/04 1113 Robert Zako Cables $3 less 9 5/22~04 1114 NW Natural U CA $ 43.44 [~ 5~22~04 1115 Pride Pnntmg L CA $ 5,905 00 ~ See Page Totals (Add a~l expenditures with the same Accotmting Period Totals (Complete only for last page a~d Instructions expenditu, e type~) transfer these amounts to the Summary Statement. PC 1. ~ on Back and Campaign Cash (CA) $ 8,294.81 Cash (CA) $ Et~ter o~t Smmna~ %~atement Colurrm A, Ltrle 5 Finance Manual Loan Payment (LPI $ -- Loan Payment (LP) $ E~ter on StllnlTlai~ Statell~ell[ Coltllll~l A, Et[lc ~ PC 3 PC ~ Cash Expenditures and Loan Payments Candidate or Poht~cal Committee Name: Committee ID Number: Kitty Piercy for Mayor n/a Page _6 of_6 Election: [] Primary 2004 [] General 20__ E~ Other ~ Report' El 1st Pre-election [] 2nd Pre-election E~ Post-election E~ 20__ September Supplemental PURPOSE CODES (see back of form for instructions and code definitions) EXPENDITURE TYPES A Agent O Other Advertising (yard signs, buttons, etc.) CA Cash B Broadcast Advertising (Radio, TV) P Postage LP Loan Payment C Cash Contributions R Reimbursement fbr Personal Expenditures F Fundraising Event Expenses S Surveys and Polls G General Operational Expenses (describe if over $50) T Travel Expenses (describe if over $50) l Interest Payment U Utilities L Literature, Brochures, Printing W Wages, Salaries, Benefits M Management Services Y Petition Circulators N Newspaper and Other Periodical Advertising Z Preparation and Production of Advertising Payee's Name and Payee's Committee ID#, Exp Amount of Dne # Date Check # if appltcable Purpose Type Expendtture Pa~d (as it appears on invoice, receipt or check) to A/P I 5/26/04 EFT Umpqua Bank G (checks) CA $ 27 88 [~ 2 6/1/04 EFT Cardinal Employment Services W CA $ 2,046 00 E~ 3 6/1/04 1116 CB Simons U CA $ 104 22 E~ 4 6/1/04 1117 Clancey Pnnting Company L, G (office supplies) CA $ 370 00 [~ 5 616104 EFT Cardinal Employment Sermces W CA $ 2,046 00 E~ 6 6/7/04 1121 Becky R~ley L CA $ 125 11 E~ 7 6/1/04 1118 Pnde Printing L CA $ 3,564 00 [~ G (bank CA $ 82.50 [~ 8 5117/04 EFT Polibcs Online charge) 9 CA $ E~ 10 CA $ ~ See Page Totals (Add all expenditures with the same Accounting Period Totals (Complete only for last page and Instructions expenditure type.) transfer these amounts to the Summary Stateroom, PC 13 on Back and in Campaign Cash (CA) $ 8,365.71 Cash (CA) $ 37,824 91 Finance Manual Loan Payment (LP) $ -. Loan Payment (LP) $ £mer tm Stemna~5 Statement Corm-m; A. [ me 7 PC 3 Accounts Payable Can&date or Political Committee Name: Committee ID Number: Kitty Piercy for Mayor n/a Page 1_ of 1_ Elecnon: [~ Primary 200_h4 [~ General 20__ [~ Other ~ Report. [~ 1st Pre-election [] 2nd Pre-election [~ Post-election [] 20_ September Supplemental PURPOSE CODES (see hack for instructions and code definitions) A Agent O Other Advertising (yard signs, buttons, etc.) B Broadcast Advertising (Radio~ TV) P Postage C Cash Contributions S Surveys and Polls F Fundraising Event Expenses T Travel Expenses (describe if over $50) G General Operational Expenses (describe if over $50) U Utilities I Interest Payment W Wages, Salaries, Benefits L Literature~ Brochures, Printing Y Petition Circulators M Management Services Z Preparation and Production of Advertising N Newspaper and Other Periodical Advertising Amount of L¢ne ¢¢ Date Payee's Name Purpose Account Payable I 5/3/04 Pride Pdntmg Company L $ 1,736 00 2, $ $ 4 $ 5 $ $ 7 $ 8 $ 9 $ 10 $ See Page Total {,Add all accounts payable on this Accounting Period Total (Complete only for last page and Instructions form.) transfer these amounts to the Summary Statement, PC 1.; on Back and in Campaign Accounts Payable $1,736.00 Accounts Payable $1,736 00 Enter on Stlmlllapj StatemenL ComlYm A, Lille 42 Finance Manual PC 6 Statement of Contributions oummary an,, Expenditures Please ~pe or print legibly in black ink. Page I of 2 Candidate or Political Committee Name (use full name): K~tty Piercy for Mayor Marling Address as it Appears on Statement of Organization (street, route or box number, city, state, zip code)' P.O, Box 23301, Eugene, OR, 97402 Treasurer's Name: Telephone Number (day): C. Michael Arnold 541-338-9111 Committee ID Number: I Committee Type, Measure Number or Office: n/a I Candidate for Mayor [] Original [] Primary 200~_4 [] General 20__ [] Other__ ]7~ Amendment [] 1st Pre-election [] 2nd Pre-election [] Post-election [] 20__ September Supplemental A-TOTALS FOR THIS B-CUMULATIVE TOTALS ACCOUNTING PERIOD FOR THIS ELECTION CONTRIBUTIONS 1 Cash Contributions 26,004 00 95,808 00 (Accoummg Period Total ti'om PC 2) 2. Loans Received (Non-Exempt) + 0 00 + 15,000 00 (Accounting Period Total from PC 2) 3. Total Cash Contributions = 26.004.00 = 110,808 00 (hnc~ 1+ 2) 4. In-Kind + 5,003 86 + 10,138 75 (Accounnng Period Total from PC 2) 5 TOTAL CONTRIBUTIONS = 31,007 86 = 120,946.75 (hne_s 3 ' 4) EXPENDITURES 6. Cash Expenditures 37,824 91 110,383 49 (_'~ccountmg Period t-oral from PC 3) 7. Loan Payments (Non-Exempt~ + 0 O0 + 0 O0 ( Accounnng Period Total i?om PC 3) 8. Total Cash Expenditures = 37,824 91 = 110,383 49 (line> 65 7) 9 ln-Kmd + 6,003 86 + 10,138 75 /Acco~mting Period '1 oral from PC 2/ 10 TOTAL EXPENDITURES = 42,828 77 = 120,522 24 Ihne~ 8 + 91 CASH BALANCE 11. Beginning Cash Balance 12,245 42 FOR OFFICE USE ONLY Ihne 20 of pre* lous report) 12. Total Contributions + 31,007 86 (hnc 5} t3. Other Receipts + 0 00 (Accounting Period Total from PC 4A) 14. Loans Received (Exempt) + 0 00 /Accountmg Pei~od total lrom PC 4Al t5. CONTRIBUTION SUBTOTAL = 43,253 28 ~ ~2T ~-'¢;'~'~r"' 16. Total Expen&tures 42,828 77 17. Other Disbursements + 0 00 IAccountmg Period Total Dom PC 4B) '/"~ ~_ ~" ~~"t ~ {.. !,.. f} (,i l 18 Loan Payments tExemptt + 0 00 -%~ 1 Y ;'~ r": (Accounting Period Total lrom PC 19. EXPENDITURE SUBTOTAL = 42,828 77 {lines 1¢~+ 17+ 181 20. ENDING CASH BALANCE = 424 51 time 15 mums line 19~ PL l Summary Statement of Contributions an, Expenditures Please type or print legibly in black ink. Page 2 of 2 Candidate or Political Committee Name: Committee ID Nmnber: K~tty Piercy for Mayor n/a [] Ongmat [] Pr,mary 200_!4 [] General 20__ [] Other __ [] Amendment [] 1st Pre-election [] 2nd Pre-election [~ Post-elecnol~ [] 20__ September Supplemental LOAN SUMMARY 21 Beginning Outstanding Loans FOR OFFICE USE ONLY (line 29 of prex ious report) 15,000 00 22. Loans Received (Non-Exempt) (hnc 2~ + 0 00 23. Loans Received (Exempt) + 0 00 (hnc t4~ 24 LOANS RECEIVED SUBTOTAL (l,ne,, 21 ~ 22 -~ 23) = 15,000 00 25 Loan Payments (Non-Exempt) {hnc 7) 0 00 26, Loan PaTyments (Exempt) (hne 18) + 0 00 27 Forgiven Loans (~lotai loan~ tbrgi~en during this accounting penodl + 0 00 28. LOAN PAYMENT SUBTOTAL = 0 O0 (hncs 25 + 26 +27~ 29. TOTAL OUTSTANDING LOANS = 15,000 O0 (lin~ 24 m~nus line 28~ PERSONAL EXPENDITURE SUMMARY 30. Beginning Outstanding Personal Expenditures 0 00 time 36 ofp~e~ lou~ report) 31 Personal Expenditures + 0 00 {Accounnng Period Total from PC 3A) 32 PERSONAL EXPENDITURE SUBTOTAL = 0 O0 (hnes 30 + 31) 33. Personal Expenditure Reimbursements 0 00 ( {oral expenditures on PC 3 ~ lth purpuse code R) 34. Forgiven Personal Expenditures + 0 00 (Total personal expenditures torglvcn this acctg period) 35. REIMBURSEMENT SUBTOTAL = 0 00 (lines 33 * 34~ 36 OUTSTANDING PERSONAL EXPENDITt~ES = 0.00 (line 32 minus line 35t FINANCIAL STATUS AT CLOSE OF ACCOUNTING PERIOD 37 Ending Cash Balance 424 51 (line 20) 38. Accounts Recewable + 0 00 {Accounting Period ~ oral from PC 5; ~_, SUBTOTAL = 424 51 (hnc= 37 ~- 38/ 40, Total Outstanding Loan< (line 29) 15,000 O0 4[. Outstanding Personal Expenditures + 0 00 (hne 30) 42. Accounts Payable + 1.736 00 t %cotmtmg Period 'lYtal irom PC o) 43. SUB]OffAL = 16,73600 times 40 ~ 41 + 42) 44. BALANCE/DEFiCIT = -16,311 49 (line 39 minus line 43 re&cate ~ or - balance; l, C M~chaet Amolci, Attorney at Law (name of candidate or treasurer}, hereby certi(y tha the above statement and the attached supporting reports are true and correct, S~gnature of candidate or treasurer Date signed PC Summary Statement of Contributions and Expenditures Please type or print legibly in black ink. Page 1 of 2 Candidate or Political Committee Name (use full name): Kitty Piercy for Mayor Mailing Address as it Appears on Statement of Organization (street, route or box number, city. state, zip code): P.O. Box 23301, Eugene, OR, 97402 Treasurer's -Nan:lc: Telephone Number (day): C. Michael Arnold 541-338-9111 Committee ID Number: I Committee Type, Measure Number or Office: n/a I Candidate for Mayor [~ Original [] Primary 20__ [] General 200~4 [] Other __ E]] Amendment [] 1 st Pre-election [] 2nd Pre-election [] Post-election [] 20__ September Supplemental A-TOTALS FOR THIS B-CUMULATIVE TOTALS ACCOUNTING PERIOD FOR THIS ELECTION CONTRIBUT)ONS l. ~ash Contributions (Accounting Period Total from PC 2) 16,370.00 16,370 00 2. Loans Received (Non-Exempt) (Accounting Period Total from PC' 2) + 2,000 00 + 2,000 00 3. Total Cash Contributions (lines l* 2) = 18,370 00 = 18,370 00 4. In-Kind + 355.68 + 355 68 (Accounting Period Total from PC 2) 5. TOTAL CONTRIBUTIONS = 18,725 68 = 18,725 68 (lines 3 + 4) EXPENDITURES 6. Cash Expenditures 6,594 16 6 594 16 (Accounting Period Total from PC 3 ' 7. Loan Payments tNon-Exempt) + 0 00 + 0 00 (Accounting Permd Total from PC 3 8. Total Cash Expenditures (lines 6 -~ 7) = 6,594 16 = 6,594 16 9. in-Kind + 355~68 + 355 68 (Accounting Period Total from PC 2) 10. TOTAL EXPENDITURES = 6,949 84 = 6,949 84 (hnes 8 + 9) CASH BALANCE 11. Beginning Cash Balance 424 51 FOR OFFICE USE ONLY (line 20 of previous report) 12, Total Contributions + 18,725 68 (hue 5) 13. Other Receipts + 289 77 (Accounting Period Total from PC 4A) 14. Loans Recei,ced iExempt) + 0 00 (Accounting Period Total fi-om PC' 4A} 15. CONTRIBUTION SUBTOTAL = 19,439 96 (hues 11 + 12+ 13 + 14) 16.dmeT°tal~t))Expenditures 6,949 84 !~' ~' C ~.F'~I~¢/E D 17. Other Disbursements + 0 00 (Accounting Period Total/rom PC 4B) ' i , " ' l $. Loan Payments (Exempt) + 0 00 (Accounting Period Total from PC 4B) ~iT ~/}~ ~ k.-r' r-~ F' ,I~} ~ rqi~k~C ~ t9. EXPENDITURE SUBTOTAL -~ = 6949 84 (lines 16 + 17 + 18) 20. ENDING CASH BALANCE = 12,490 12 (hue 15 minus hne t9) Summary Statement of Contributions and Expenditures Please type or print legibly in black ink. Page 2 of 2 Candidate or Political Committee Name: Committee ID Number: Kitty Piercy for Mayor n/a [] Original []] Primary 20_ [] General 200_E []] Other _ [] Amendment [] 1st Pre-election [] 2nd Pre-election [] Post-election [] 20__ September Supplemental LOAN SUMMARY FOR OFFICE USE ONLY 21. Beginning Outstanding Loans thne 29 of previous report) 15,000 00 22. Loans Received (Non-Exempt) (hne 2) + 2.000 O0 23. Loans Received {Exempt) + 0.00 (line [4) 24. LOANS RECE1VED SUBTOTAL = 17,000 O0 (hne~ 21 4 '~n + _~ 23) 25. Loan Payments (Non-Exempt) 0 00 (line 7} 26. Loan Payments (Exempt) + 0 00 (line 18) 27, Forgiven Loans + 0.00 (Total loans forgiven during this accounting period) 28. LOAN PAYMENT SUBTOTAL = 0 00 (lines 25 + 26 +27) 29. TOTAL OUTSTANDING LOANS = 17,000 O0 (line 24 minus line 28) PERSONAL EXPENDITURE SUMMARY 30. Beginning Outstanding Personal -Expenditures 0 00 (line 3o of previous [epon) 31. Personal Expenditures + 0.00 {Accounting Period Total from PC 3A) 32. PERSONAL EXPENDITURE SUBTOTAL = 0 00 (lines 30 + 31 ) 33. Personal Expenditure Reimb,~sements 0.00 {Total expenditures on PC 3 t~th pu~ose code R) 34. Forgiven Personal Expenditures + 0 00 (Total personal expenditures £orgN en this acctg period) 35. REIMBURSEMENT SUBTOTAL = 0 O0 (lines 33 + 34) 36. OUTSTANDING PERSONAL EXPENDITU~S = 0 O0 (line 32 minus line 35) FINANCIAL STATUS AT CLOSE OF ACCOUNTING PERIOD 37. Ending Cash Balance 12,490.12 (line 20~ 38. Accounts Receivable + 0 00 (Accounting Period Total fi'om PC' 5) 39. SUBTOTAL : 12,490A2 (lines 37 * 38~ 40. Total Outstanding Loans 17,000.00 (line 2% 41. Outstanding Personal Expenditures + 0.00 Ihn¢ 36) 42. Accounts Payable + 0.00 tAccountmg Period Total from PC 6 / 43. SUBTOTAL : 17,000 00 dines 40 + 4l + 42) 44, BALANCE/DEFICIT = -4,509 88 {llnc 39 minus line 43' indicate ¢ or - balance) l, C Michael Arnold (name of candidate or treasurer), hereby certify that the above statement and the attached supporting reports are true and correct. Signature of candidate or treasurer Date signed PC 2 Cash Contributions, Loans Received and In-Kind Candidate or Political Committee Name: Committee ID Number: Kitty Piercy for Mayor n/a Page 1_ of_l~ Election: E~] Primary 20¢4 [] General 200~4 [] Other ~ Report' [] I st Pre-election [] 2nd Pm-election [] Post-election [] 20__ September Supplemental SEE BACK FOR iNSTRUCTIONS AND CODE DEFINITIONS CODE 1: Contributor Type CODE 2: Contribution Type B Business Entity CA Cash C Political Committee (includes business and union PACs) CO Cosigner Obligation F Candidate's immediate Family (includes candidate) IK In-Kind I Individual LR Loan Received L Labor Organization O Other P Political Party Committee Amount of In-K~nd Purpose Dne # Name and Address of Contributor Contribution (see manual for suggested purpose codes) Occupational Information or Contributor Date Received Contribut~nq Committee's ID¢¢ Aggregate Code '/ , Code 2 McKenzie-W~llamette Hospital 1460 G 1 Street Springfield OR 97477 $ 1,000 00 6/21/2004 $ 1,000 00 B CA David Van W~e P O Box 5610 2. Eugene OR 97405 $ 1,000 00 6/14/2004 venture capltahstJmvestor $ 1,000 00 I CA Anita Johnson 2288 B,rch Lane 3 Eugene OR 97403 $ 500 00 7/11/2004 Journalist $ 500 00 ~ CA Jonathon Brandt 401 E. 10th Ave. 4 Suite 530 Eugene OR 97401 $ 300 00 Financial Planner $ 300 00 ~ 1 8/19/2004 CA Nancy Rose 2690 Lawrence Eugene OR 5. 97405 $ 300.00 6/18/2004 Retired $ 300 00 I CA See Page Totals (Add all amounts with the same Accounting Period Totals (Complete only for last page and Instructions contribution type. Do not include aggregates.) transfbr these amounts to the Summary Statement, PC 1 .) on Back and Cash (CA/ $ 3,100 00 Cash (CA) $ ~ in Campaign Enter on Summary Statement, Colttmn A. Line 1 Finance Manual ln-K~nd (IK) $ In-Kind (IK) $ - Enter on Starumm2~ Statement. Column ALmcs 4 :md 9 PC 2 Loans Received (LR? $ ~ Loans Rece~¥ed (LR} $ _ PC 2 Cash Contributions, Loans Received and n-Kind Re, ,:,,, Candidate or Political Committee Name: Committee ID Number: Kitty Piercy for Mayor n/a Page 2_ of~ Election: [] Primary 2004 [] General 200__44 [~ Other __ Report: [] 1st Pre-election [~] 2nd Pre-election [] Post-election [] 20__ September Supplemental SEE BACK FOR INSTRUCTIONS AND CODE DEFINITIONS CODE 1: Contributor Type CODE 2: Contribution Type B Business Entity CA Cash C Political Committee (includes business and union PACs) CO Cosigner Obligation F Candidate's Immediate Fmnily (includes candidate) IK In-Kind I Individual LR Loan Received L Labor Organization O Other P Political Part>, Committee Amount of In-&nd Purpose Line # Name and Address of Contributor Contribution (see manual for suggested purpose codes) Occupational Information or Contributor t Date Received Contributing Committee's ID¢¢ Aggregate Code 1 , Code 2 Doug Bales PO Box 10141Eugene OR 1 97440 $ 200 00 7tl 112004 Stockbroker $ 200.00 I CA Bdl Busk~rk P.O Box 50984 Eugene OR 2 97405 $ 200 00 8/27/2004 Retired $ 200 00 I t CA Caroline Forell 40 W 20th Ave. 3 Eugene OR 97405 $ 200 00 8/25/2004 Professor $ 200 00 I CA Joint Council of Teamsters No. 37 4 1872 NE 162nd Ave. Portland OR $ 200 00 97230 Polibcal Fund No 000080 $ 200.00 C 8/19/2004 CA Kathleen MacLeod 6452 5 Scimitar Dr San Diego CA $ 200 00 92114 Retired $ 200 00 7/30/2004 CA See Page Totals (Add all amounts with the same Accounting Period Totals (Complete only for last page and instructions contribution type. Do not include aggregates.) transfer these amounts to the Summary Statement, PC 1 .) on Back and Cash (CA) $1,000 00 Cash (CA) $ __ in Campaign Eater on Summar5 Statement. Column A. Line Finance Manual In-Kind (iK) $ ~ In-Kind (IK) $ Enter on Snmmar> Statement C~,lumn A. i mos 4 aad 9 PC 2 Loans Received (LR) $ __ Loans Received (LR) $ __ Enter on Snmmary Statement Column A, Line 2 PC Cash Contributions, Loans Received and n-Kind ,:,0, Candidate or Political Committee Name: Committee ID Number: Kitty Piercy for Mayor n/a Page 3_ of_L~ Election: [~] Primary 2004 [] General 2004 [] Other - Report: [] 1st Pre-election [~1 2nd Pre-election [] Post-erection [~ 20__ September Supplemental SEE BACK FOR INSTRUCTIONS AND CODE DEFINITIONS CODE 1: Contributor Type CODE 2: Contribution Type B Business Entity CA Cash C Political Committee (includes business and union PACs) CO Cosigner Obligation F Candidate's Immediate Family (includes candidate) IK In-Kind i Individual LR Loan Received L Labor Organization O Other P Political Party Committee Amount of In. Kind Purpose Line # Name and Address of Contnbutor Contnbutton ('see manual for suggested purpose codes) Occupational Information or Contributor t Date Received Contnbut/ng Committee's IDg Aggregate , Code 1 ~ Code 2 Lynn Pedersen 759 Sunnys~de I Eugene OR 97404 $ 200.00 9~3~2004 Retired $ 200.00 I [ CA STEPHEN SCHMIECHEN 2 P.O Box 844 EugeneOR $ 200.00 97440 6~30/2004 Owner of Th~nk Electric $ 200 00 I CA Dan Carol 2440 Charnelton 3 Eugene OR 97405 $ 150.00 7/1112004 Poht~cal Consultant $ 150 00 I CA James Harrang 86451 Needham 4 Rd Eugene OR 97405 $ 125 00 Attorney $ 125 00 I I 7/1 1/2004 CA Nadme Harrang 86451 Needham 5 Rd. Eugene OR 97405 $ 125 00 7/1112004 Rebred $ 125 00 I CA See Page Totals (Add all amounts with the same Accounting Period Totals (Complete onl~ lbr last page and Instructions contribution type. Do not include aggregates3 transfer these amounts to the Summary Statement. PC 1 .) on Back and Cash (CA) $ 800 00 Cash (CA) $ ~ in Campaign Entel on Smnmao Statement Colmnn A. Lm~ 1 Finance Manual In-Kind (1K) $ ~ In-Kind (IK) $ ___ Enmr on SummaD Stammeln. Coltlmp A, Lilies 4 aud 9 PC 2 Loans Received {LR) $ .__ Loans Received (LR) $ ~ Emer on SummarTy Statement Colmrm A, Line 2 PC 2 Cash Contributions, Loans Received and [n-Kind Re, ,?0, Candidate or Political Committee Name: Committee ID Number: Killy Piercy for Mayor n/a Pa~e 4 of ~¢ Election: [] Primar~ 200_&4 [] General 200_~4 [] Other __ Report: [] I st Pre-election E~ 2nd Pre-election [] Post-election [] 20__ September Supplemental SEE BACK FOR iNSTRUCTIONS AND CODE DEFINITIONS CODE 1: Contributor Type CODE 2: Contribution Type B Business Entity CA Cash C Political Committee [includes business and union PACs) CO Cosigner Obligation F Candidate's immediate FamiLy (includes candidate) IK In-Kind I Individual LR Loan Received L Labor Organizanon O Other P Political Party Committee Amount of In-&nd Purpose Line # Name and Address of Contributor Contnbut~on (see manual for suggested purpose codes) Date Received Occupatlonat Information or Contributor Code ¢ Cede 2 Contributing Commtttee's ID# Aggregate Katherine Wiper 3772 Pine Canyon I Dr Eugene OR 97405 $ 125 00 7/11/2004 Rebred $ 125 00 ~ CA Chuck Bader 915 Lorane Hwy 2. Eugene OR 97405 $ 100 00 6/14/2004 Property Manager $ 100 00 I CA Thomas WIper 3772 Pine Canyon 3 Dr Eugene OR 97405 $ 125 00 7/11/2004 Retired $ 125 00 I CA Dennis Ba~ley 85 Crest Dr EugeneOR 4 97405 $ 100 00 7/11/2004 Architect $ 100 00 i CA irene Ball 280 Ridgewood Dr 5 Eugene OR 97405 $ 100 00 7/11/'2004 Sales Representative, Cabinet Design and $ 100 00 i CA Installation Co See Page Totals (Add all amounts with the same Accounting Period Totals (Complete only for last page and lnstrucnons contribution type. Do not include aggregates.) transfer these amounts to the Summary Statement, PC 1./ on Back and Cash (CA) $ 550.00 Cash (CA) $ __ in Campaign Enter on Smmnat}, Statement, Column A, Line 1 Finance Manual in-Kind (IK) $ In-Kind ([K) $ Enter on Sttmmao' Statement Column A Line= 4 and 9 PC 2 Loans Received (LR) $ _ Loans Received (LR) $ ~ Enter on bmmllao Stateroom, Column A., L'ne 2 Pc 2 Cash Contributions, Loans Received and n-Kind Candidate or Pohtical Committee 'Name: Committee ID N umber: Kitty Piercy for Mayor n/a Page _5 ot'3~__ Election: [] Primary 200_A4 [] General 200__44 [] Other __ Report: [] 1st Pre-election E~ 2nd Pre-election [] Post-elecnon ~ 20__ September SupplementM SEE BACK FOR INSTRUCTIONS AND CODE DEFINITIONS CODE 1: Contributor Type CODE 2: Contribution Type B Business Entity CA Cash C Political Committee (includes business and union PACs) CO Cosigner Obligation F Candidate's Immediate Family (includes candidate) tK In-Kind I individual LR Loan Received L Labor Organization O Other P Political Parry Committee Amount of In-&nd Purpose Line # Name and Address of Contributor Contribution (see manual for suggested purpose codes) Date Recewed Occupational information or Contributor Code '/ Code 2 Contributing Committee's ID¢¢ Aggregate Larry Brink 2242 Riverwew St I Eugene OR 97403 $ 100 00 8/3O/20O4 Construction Contractor $ 100 00 I CA Deborah Cordell 2913 Ehsa Ct 2. Medford OR 97504 $ 100 00 7/12/2004 Not Employed $ 100 00 ~ CA Sue Dockstader 1163 W 3 4th Ave Eugene OR $ 250.00 97402 9/8/2004 F~reflghter $ 250 00 I CA Chnstme M~tchell 1163 W 4 4th Ave. Eugene OR $ 250 00 97402 9/8/2004 Set Designer $ 250.00 I CA Thomas Pnngle 3295 5 Kmcad St Eugene OR $ 250 00 97405 9/8/2004 B~o Medical Consultant $ 250 00 I CA See Page Totals (Add all amounts with the same Accounting Period Totals (Complete only for last page and Instructions contribution type. Do not include aggregates,) transfer these amounts to the Summary Statement. PC 13 on Back and Cash (CA) $ 950 00 Cash (CA) $ ~ in Campaign Emer on Smnma~ StatemenL Column A, Line I Finance Manual In-Kind (IK} $ ---- In-Kind (1K) $ ~ Enter on Summary' Statement CoMnn A. Lines 4 and 9 PC 2 Loans Received (LR) $ ,__ Loans Received qLR) $ Enter on Summa~ Statement Cohmm A. Line 2 PC 2 Cash Contributions, Loans Received and In-Kind Candidate or Political Committee Name: Committee ID Number: Kitty Piercy for Mayor n/a Page 6_ Election: [~ Primary 200~4 [] General 2004 [--} Other __ Report. [~ 1st Pre-elecUon [] 2nd Pre-election [] Post-election [] 20__ September Supplemental SEE BACK FOR INSTRUCTIONS AND CODE DEFINllTIONS CODE 1: Contributor Type CODE 2: Contribution Type B Business Entity CA Cash C Political Committee (includes business and union PACs) CO Cosigner Obligation F Candidate's Immediate Family (includes candidate) )[K In-Kind t Individual LR Loan Received L Labor Organization O Other P Political Parpj Committee Amount of In-Kind Purpose Dne # Name and Address of Contributor Contribution (see manual for suggested purpose codes) Occupational Information or Contnbutor Date Received Contnbutlng Committee's ID¢¢ Aggregate Code 1 , Code 2 Laurel F~sher 2555 Highlande 1. Oaks Dr Eugene OR 97405 $ 100 00 8~2~2004 Retired $ 100.00 I CA Don F~sher 2555 H~ghlande 2. Oaks Dr Eugene OR 97405 $ 100 00 Rebred $ 100 00 1 8/212004 CA Duane Funk 30806 Blanton Rd 3 Eugene OR 97405 $ 100 00 7tl 1/2004 ESL Teacher $ 100 00 I CA David Funk 30806 Blanton Rd 4 Eugene OR 97405 $ 100 00 7/11t2004 Graphic Designer $ 100 00 I CA Sloan Heermance 2406 5 Lawrence St Eugene OR $ 100 00 97405 Water $ 100 00 I 8~24~20O4 CA See Page Totals (Add al~ amounts with the same Accounting Period Totals (Complete only fbr last page and instructions contribution type. Do not include aggregates.} transfer these amounts to the Summary Statement, PC 1 .) on Back and Cash {,CA) $ 500 00 Cash (CA) $ I11 Campaign Enter on Summars, Statement Culnm~l A_ Line 1 Finance Manual la-Kind (IK) $ ~ In-Kind (IK) $ ~ Enter on Summar> StatrmenL Colunlll A. Lines 4 and 9 PC 2 Loans Received (LR) $ .__ Loans Received (LR) $ __ Entel on Summar'~ Statement Cohmm A. Line 2 Pc 2 Cash Contributions, Loans Received and In-Kind Candidate or Political Committee Name: Committee ID Number: Kitty Piercy for Mayor n/a Page Z of~ Election: [~ Primary 2004 [] General 200_~4 [~71 Other __ Report: [] 1st Pre-election [] 2nd Pre-election [~1 Post-election [~ 20__ September Supplemental SEE -BACK FOR INSTRUCTIONS AND CODE DEFINITIONS CODE 1: Contributor Type CODE 2: Contribution Type B Business Entity CA Cash C Pohtical Committee (includes business and union PACs/ CO Costgner Obligation F Candidate's immediate Family (includes candidate) 1K In-Kind I Individual LR Loan Received L Labor Organization O Other P Polincal Party Committee Amount of In-&nd Purpose Dne # Name and Address of Contributor Contnbutton (see manual for suggested purpose codes) Date Received Occupational Information or Contributor Code 1 Code 2 Contributing Committee's ID'CC Aggregate Sarah Hendnckson 1036 Adams Eugene OR 97402 $ 100 00 8/26/2004 Physician $ 100 00 I CA Rosemary Hire 77500 S 2 6th St., Space B#22 Cottage Grove OR $ 100 00 97424 8~23~2004 Retired $ 100.00 CA Beverly Holman 1066 E 20th Ave 3 Eugene OR 97405 $ 100.00 7111/2004 Psychologist $ 100.00 CA Arnold lsmach 5326 Tahslh St. 4 Eugene OR 97405 $ 100 00 8~20/2004 Retired $ 100 00 CA Don Kahle 400 E 32nd Ave 5 Eugene OR 97405 $ 100.00 7/11/2004 Publisher $ 100.00 CA See Page Totals (Add all amounts with the same Accounting Period Totals (Complete only for last page and Instructions contribution type. Do not include aggregates.) transfer these amounts to the Summaw Statement, PC 1.) on Back and Cash (CA) $ 500 00 Cash (CA) $ ~ in Campaign Enter ,on Summaw Statement. Column A, Line I Finance Manual ~n-Kind (1K) $ ~ In-Kind (IK) $ ~ Enter on St,mmao Statement Column A, Ltnes 4 and 9 PC 2 Loans Received (LR) $ .... Loans ReceNed (LR) $ __ Enter on Surnmao Statement, Cohlmn A Line 2 PC 2 Cash Contributions, Loans Received and in-Kind Candidate or Political Committee Name: Committee [D Number: Kitty Piercy for Mayor n/a Page _8 of~_ Elect~on: E~ Primary 2004 [] General 2004 E~ Other _ Report: ~ I st Pre-election [] 2nd Pre-election [~ Post-election [] 20__ September Supplemental SEE BACK FOR INSTRUCTIONS AND CODE DEFINITIONS CODE 1: Contributor Type CODE 2: Contribution Type B Business Entity CA Cash C Political Committee (includes business and union PACs) CO Cosigner Obligation F Candidate's Immediate Family (includes candidate) IK In-Kind I individual LR Loan Received L Labor Organization O Other P Political Party Committee Amount of In-Kind Purpose Dne # Name and Address of Contributor Contribution (see manual for suggested pu(pose codes) Occupational Information or Contributor Code 1 [ Code 2 Date Recetved Contributing Committee's IIY¢ Aggregate Larry Lewln 2145 Lincoln St ~. Eugene OR 97405 $ 100 00 Educator $ 100.00 I I 8/31/2004 CA Jeffrey Lewis P OBox 1462 2 Eugene OR 97440 $ 100 00 7/27/2004 Computer Software Developer $ 100.00 I CA Andrew McWdhams 91232 3 Tnpple Oaks Dr EugeneOR $ 100 00 97408 7/11/2004 Stockbroker $ 100.00 I I CA David Meredith 2075 4. Kmcaid St Eugene OR $ 100,00 97405 9/3/2004 Foundation Director (Eugene Education $ 100 00 I CA Fund) Megan Moseley 61 W 31st 5 Eugene OR 97405 $ 100 00 8/24~2004 Physical Therapist $ I00.00 I I CA See Page Totals (Add all amounts w~th the same Accounting Period Totals (Complete only for last page and Instructions contribution type. Do not include aggregates,) transfer these amounts to the SummaO' Statement, PC 13 on Back and Cash (CAI $ 500 00 Cash (CA} $ _ lB Campaign Enter op Summao Statement Column A, Line 1 Finance Manual in-Kind (IK) $ .- In-Kind (IK) $ Enter on StumnaB. S~dtement, Colmnn A Lines 4 and 9 PC 2 Loans Received (LR) $ ~ Loans Received (LR) $ _~ Enter on Summary Statement, Column A. Line 2 ~C 2 Cash Contributions, Loans Received and In-Kind Candidate or Political Committee Name: Committee ID Number: Kitty Piercy for Mayor n/a Page_9 of ~__~L_ Election: El Primary 2004 [] General 2004 ~,, Other __ Report' [] 1 st Pre-election [-] 2nd Pre-election [~ Post-election [~ 20__ September Supplemental SEE BACK FOR INSTRUCTIONS AND CODE DEFINITIONS CODE 1: Contributor Type CODE 2: Contribution Type B Business Entity CA Cash C Political Committee (includes business and union PACs) CO Cosigner Obligation F Candidate's immediate Family (includes candidate) IK In-Kind I Individual LR Loan Received L Labor Organization 0 Other P Political Party Committee Amount of In-Kind Purpose L~ne # Name and Address of Contributor Contribution (see manual for suggested purpose codes) Occupational Information or Contributor [ Date Received Contributing Committee's ILYc¢ Aggregate Code 'i , Code 2 Jernl Nflson 2128 Lawrence 1 Eugene OR 97405 $ 100.00 Graphic Designer $ 100 00 I 1 7/1 1/2004 CA Mary Nolan 910 S.W. Canning 2 St Portland OR 97201 $ 100 00 7/30/2004 State Legislator $ 100.00 ~ CA Lmdsay Pierce 355 Lairway Loop 3 Eugene OR 97401 $ 100 00 9/8/2004 Rebred $ 100.00 I CA Rosemary Pc/or 2671 E 4 Wilshire Dr Eugene OR $ 100 00 97405 7/11/2004 Pubhc Relations Administrator $ 100 00 I CA Jack Pueschner 1512 5 Barber Dr. Eugene OR $ 100 00 97405 Retired $ 100 00 l 9/2/2004 CA See Page Totals (Add all amounts with the same Accounting Period Totals (Complete only for last page and Instructions contribution type~ Do not include aggregates.) transfer these amounts to the Surnmary Statement. PC on Back and Cash (CA) $ 500.00 Cash (CA) $ ~ in Campaign Enter on Summao Statement. Column A. Line 1 Finance Manual In-Kind (IK) $ ~ in-Kind IlK) $ ~ Enter on Summao StatemenL Colmnn A, Lines 4 and 9 PC 2 Loans Received (LR} $ ~ Loans Received (LRt $ Enter on Summao Statement, Column A., Line 2 PL 2 Cash Contributions, Loans Received and In-Kind Candidate or Political Committee Name: Committee ID Number: Kitty Piercy for Mayor n/a Page ~0 of J~3 Election: [~ PrimmT 2004 [] General 200~4 [] Other__ Report: [] 1st Pre-election [] 2nd Pre-election [] Post-election [] 20__ September Supplemental SEE BACK FOR INSTRUCTIONS AND CODE DEFINITIONS CODE 1: Contributor Type CODE 2: Contribution Type B Business Entity CA Cash C Polincal Committee tincludes business and union -PACs) CO Cosigner Obligation F Candidate's immediate Family (,includes candidate) ilk In-Kind i individual LR Loan Received L Labor Organization O Other P Political Party Committee Amount of In-Kind Purpose Dne ¢¢ Name and Address of Contributor Contribution (see manual for suggested purpose codes) Occupational Information or Contributor Date Received Contnbuttng Committee's ID# Aggregate Code '1 , Code 2 Jack Roberts 2330 Park Grove 1 Dr Eugene OR 97408 $ 100 00 7/11/2004 Director, Lane Metro Partnership $ 100 00 t CA Roz Siowc 4801 Donald St 2. Eugene OR 97405 $ 100 00 812512004 Research Assistant $ 100 00 I I CA Stephen Smith 128 3~ Lynbrook Dr Eugene OR $ 100 00 97404 8/25/2004 Retired $ 100 00 i CA Mike Staszak 61 W. 31st 4 Eugene OR 97405 $ 100.00 8/24/2004 Physical Therapist $ 100 00 I CA Kathenne %ppens W~per 5. 3772 P~ne Canyon Dr $ 100 00 Eugene OR 97405 Retired $ 225 00 1 8/24/2004 CA See Page Totals (Add all amounts with the same Accounting Period Totals (Complete onl~ for last page and Instructions contribution type. Do not include aggregates.) transfer these amounts to the Summary Statement. PC 1.) on Back and Cash (CA) $ 500 00 Cash (CA) in Cmnpaign Enter on Stwmnary Statement, Column A_ L,ne l Finance Manual In-Kind (IK) $ ~ In-Kind (1K) $ Enter on Smnmary Statement, Column A. Lines 4 and 9 PC 2 Loans Received (LR; $ __ Loans Received (LR) $ Enter on Sumrnap_, Statement Column A. Line 2 PC 2 Cash Contributions, Loans Received and n-Kind ':'°' Candidate or Political Committee Name: Committee ID Number: Kitty Piercy for Mayor n/a Page 1__J_1 of~_~ Election: E~ Primary 200~4 [] General 200_~4 [] Other Report: [] 1 st Pre-election [] 2nd Pre-election [] Post-election [~] 20__ September Supplemental SEE BACK FOR INSTRUCTIONS AND CODE DEFINITIONS CODE l: Contributor Type CODE 2: Contribution Type B Business Entity CA Cash C Political Committee (includes business and union PACs) CO Cosigner Obligation F Candidate's Immediate Family (includes candidate) iK In-Kind I Individual LR Loan Received L Labor Organization O Other P Pohtical Party Committee Amount of In-Kind Pu(pose Llne# Name and Address of Contributor Contribution (see manual for suggested purpose codes) Occupational Information or Contributor [ Date Received Contributing Committee's IDg Aggregate Code 1 ~ Code 2 Jenmfer Ulum 2493 1 Panorama Dr. Eugene OR $ 100 00 97405 7/1112004 Pubhc Relabons D~rector $ 100 00 I I CA Dawd Whitlow 1760 Sweetbriar Ln 2, Eugene OR 97405 $ 10000 8/2612004 financial adwsor $ 100 00 I I CA Para Whyte 10 Monroe St 3 Eugene OR 97402 $ 100.00 7~26~2004 CPA $ 100 00 I CA Kurt Wilcox 2887 Lyd~ck Way 4. Eugene OR 97401 $ 100 00 8/31/2004 Umon Representative $ 100 00 I CA Jan Becket 2153 Madison St 5. Eugene OR 97405 $ 75 00 8/23~2004 Tax Consultant $ 75 00 I CA See Page Totals (Add all amounts with the same Accounting Period Totals (Complete only for last page and [nstrucuons contribution type. Do not include aggregates.) transfer these amounts to the Summary Statement, PC l .) on Back and Cash {CA) $ .475 00 Cash (CA) $ in Campaign Enler on Summus, Stateroom Culnrnn A, Line I Finance Manual In-Kind (.IK) $ ~ In-Kind (IK) $ Eater on SummaO Statement. Column A, Lines 4 arld 9 PC 2 Loans Received (LR) $ .__ Loans ReceiYed (LR'~ $ __ Enter on SmnmaD' Statement, Colmnn A, Line 2 PC 2 Cash Con(ributions, Loans Received and Candidate or Political Committee Name: Committee ID Number: Kitty Piercy for Mayor n/a Page 12 of 13 Elect~on: [] Primary 200__44 [] General 200__~4 [] Other _ Report. [5~ I st Pre-election [] 2nd Pre-election [] Post-election [] 20__ September Supplemental SEE BACK FOR INSTRUCTIONS AND CODE DEFINITIONS CODE 1: Contributor Type CODE 2: Contribution Type B Business Entity' CA Cash C Political Committee (includes business and union PACs) CO Cosigner Obligation F Candidate's Inm~ediate Family (includes candidate) IK In-Kind I Individual LR Loan Received L Labor Organization 0 Other P Political Party Committee Amount of In-K~nd Purpose Line # Name and Address of Contributor Contribution (see manual for suggested purpose codes) Occupat~ona! Information or Contributor Date Received Contributing Committee's ID# Aggregate Cede I ~ Code 2 Margaret Halleck 850 Doms I St Eugene OR 97404 $ 75 00 6/23/2004 D~rector, Wayne Morse Center $ 75.00 I CA John Kline 693 W. 10th Ave 2 Apt. I Eugene OR 97402 $ 75.00 8/19/2004 School Counselor $ 75 00 I I CA Dawd Piercy 1371 W 4th Ave 3 Eugene OR 97402 $ 2,000 00 retired $ 2,000 00 I t LR 6/30/2004 173 Miscellaneous Cash Contributions of 4 $50 and Under $ 6845 6/14/2004- $ I CA 9/13~2004 Mary Zler 1202 Lemery Ln Eugene OR 97405 $ 40 68 G (Beads for Eugene Celebration) Retired $ 90.68 8/1 8/2004 I K See Page Totals (Add ail amounts with the same Accounting Period Totals (Complete only for last page and Instructions contribution type. Do not include aggregates.) transfer these amounts to the Sunc~mary Statement, PC on Back and Cash (CA) $ 6.995 00 Cash (CA) $ in Campaign Enter on Sumnmry Statemetlt, Column Finance Manual In-Kind (IK) $ 40 68 [n-Kind (IK} $ __ Enter on Summao Statement, Column A, Lines 4 and 9 PC 2 Loans Received (LR) $ 2,000 00 Loans Received (LR) $ Enter on Sunmlary Statement, Column A~ Line 2 PC ~ Cash Contributions, Loans Received and in-Kind Candidate or Political Committee Name: Committee ID Number: Kitty Piercy for Mayor n/a Page 13 of 13 Election: E~ Primary 200_~4 [] General 2004 [] Other __ Report: [] 1st Pre-election [] 2nd Pre-election [] Post-election [~ 20__ September Supplemental SEE BACK FOR INSTRUCTIONS AND CODE DEFINITIONS CODE 1: Contributor Type CODE 2: Contribution Type B Business Entity CA Cash C Political Committee (includes business and union PACs) CO Cosigner Obligation F Candidate's Immediate Family (includes candidate) [K In-Kind I individual LR Loan Received k Labor Organization O Other P Political Party Committee Amount of In-Kind Purpose bne # Name and Address of Contributor Contributton (see manual for suggested purpose codes) Occupattonal informatton or Contributor Code l t Code 2 Date Received Contributing Committee's IDt¢ Aggregate QSL PRINTING COMPANY, ABN of 1. QUICK SERVICE LITHO-PRINT CO, INC $ 315.00 L P.O Box 1184 EugeneOR 97440 8/2012004 $ 315.00 B IK 2 $ $ I CA 3 $ $ I CA 4 $ $ I CA 5 $ $ ~ CA See [}age Totals (Add all amounts Mth the same Accounting ?eriod Totals (Complete only for last page and Instructions contribution t:ype. Do not include aggregates.) transfer these amounts to the Summary Statement. PC 13 on Back and Cash (CA) $ ~ Cash (CA) $ ~ ~,370 00 in Campaign Ente~ m~ Summao Statemem Column A~ [ .,ne 1 Finance Manual In-Kind (IK) $ ~ In-Kind (IK) $ 355 68 Enter un Summao Statement. Co[I. llIlll A. Lines 4 and 9 PC 2 Loans Received (LR) $ ~ Loans Received (LR) $ 2,000 00 Enter on Sulpa-n3r3 Statement, Coltunn A. Line 2 PC 3 Cash Expenditures and Loan Payments Se, Candidate or Political Committee Name: Committee iD Number: Kitty Piercy for Mayor n/a Page 2 of' 2 Election: [] Primary 20__ [~ General 200_4 [] Other __ Report: [~ 1st Pre-election [] 2nd Pre-election [] Post-election [] 20__ September Supplemental PURPOSE CODES (see back of form for instructions and code definitions) EXPENDITURE TYPES A Agent O Other Advertising(yard signs, buttons, etc.) CA Cash B Broadcast Advertising (Radio, TV) P Postage LP Loan Payment C Cash Contributions R Reimbursement for Personal Expenditures F Fundraising Event Expenses S Surveys and Polls G General Operational Expenses (describe if over $50) T Travel Expenses (describe if over $50.) I Interest Payment U Utilities L Literature, Brochures, Printing W Wages, Salaries, Benefits M Management Services Y Petition Circulators N Newspaper and Other Periodical Advertising Z Preparation arrd Production of Advertising Payee's Name and Payee's Committee Il)g, Exp Amount of [~ L¢ne # Date Check # if apphcable Purpose Type Expendtture Paid (as it appears on ~nvo~ce, receipt or check) to A/P 1 9/3/04 1131 Dav}d P~ercy O CA $ 150~00 ~ 2 9/9/04 1132 C~ty Of Eugene O CA $ 100 00 E~ 3 9/14/04 1133 Michael Gannon O CA $ 122 00 E~] 4 CA $ ~ 5 CA $ E~ 6 CA $ ~ 7 CA $ E~ 8 CA $ E~ 9 CA $ E~ 10 CA $ E~ See Page Totals (Add ali expenditures with the same Acconnting Period Totals (Complete only for last page and instrucnons expenditure type.) transfer these amotmts to the Summary Statement, PC l.) on Back and in Campaign Cash (CA) $ 372 00 Cash (CA) $ 6,594 16 Enter on Sumroar~ Statement. Co[t[lrln A, Lille 6 Finance Manual Loan Payment (LP) $ ~ Loan Payment (LP) $ Enter oI~ S[[rftln2t~5 Statement Column ,\, Linc '~ PC 3 PC Cash Expenditures and Loan Payments Candidate or Political Committee Name: Committee 1D Number: Kitty Piercy for Mayor n/a Page I of Election: E] Primary 200_~4 [] Genera~ 200~4 [] Other ~ Report: [2~1 1 st Pre-election []]] 2nd Pre-election []~] Post-election []]] 20__ September Supplemental PURPOSE CODES (see back of form for instructions and code definitions) EXPENDITURE TYPES A Agent O Other Advertising (yard signs, buttons, etc.) CA Cash B Broadcast Advertising (Radio, TV) P Postage LP Loan Payment C Cash Contributions R Reimbursement for Personal Expenditures F Fundraismg Event Expenses S Surveys and Polls G General Operational Expenses (describe if over $50) T Travel Expenses (describe if over $50) I Interest Payment U Utilities L Literature, Brochures, Printing W Wages, Salaries, Benefits M Management Services Y Petition Circulators N Newspaper and Other Periodical Advertising Z Preparation and Production of Advertising Payee's Name and Payee's Committee ID#, Exp Amount of [] bne # Date Check # if applicable Purpose Type Expenditure Pard (as tt appears on ~nvoice, receipt or check) to A/P Oregon League Of Conservation ~ 6/29/04 1122 Voters (PAC ¢2352) C CA $ 3,000 00 2 6/29/04 11i 23 USPS P CA $ 37 00 [~ 3 7/9/04 1125 Pr~de Printing L CA $ 1,762 00 E~ 4. 7~9~04 1126 usPs G CA $ 19 00 E~ 5 8/11/04 1127 DEMI G (Parade Entry) CA $ 350 00 E~ 6 8/19/04 1128 oregon Secretary of state 0 CA $ 300 00 [~ 7 9/3/04 EFT Phil Noble G CA $ 32 50 [~ 8 9~3~04 EFT Phil Noble G CA $ 22,50 9 9~3~04 1129 QSL L, P CA $ 454 16 ~ 10 9~3/04 1130 Michael Gannon O CA $ 245 00 E~ See Page Totals (Add all expenditures with the same Accounting Period Totals (Complete only ~br last page and Instructions expenditure type~) transfer these amounts to the Summary StatemenL PC I.) on Back and in Campaign Cash (CA) $ 6,222.16 Cash (CA) $ ~ Finance Enter -n Summao Statement, Colmm~ A. Line 6 Manual Loan Payment (LP) $ Loan Payment (LP) $ Enter tm StumnaO StatemenL Column A. Line 7 PC 3 PL 4A. Other Receipts Candidate or Political Committee Name: Commtttee ID Number: Kitty Pierey for Mayor n/a Page 1 of 1 Election: [] Primary 20__ [~ General 200_~4 [] Other __ Report: [~ 1st Pre-election [] 2nd Pre-election [] Post-election ~ 20__ September Supplemental SEE BACK FOR INSTRUCTIONS AND CODE DEFINITIONS Other Receipt Transaction Type Codes EL Exempt Loan Proceeds FM ltems Sold at Fair Market Value IN Interest/investment Income OM Miscellaneous(provide adescription) RF Refunds, Rebates and Returns Dote Name Other Recetpt Ltne# Recewed (required for codes EL, OM and RF, Transaction Type Other Receipt Amount optional for codes FM and IN) Code I 9~3~04 Qwest RF $ 289.77 $ 3 $ 4 $ 5 $ 6 $ $ 8 $ 9 $ 10 $ See Page Totals (Add all Other Receipt Transaction Accounting PerKed Totals (Complete only fbr last page and Instructions Type Codes specified.) transfer these amounts to the Summary Statement, PC 1. ) on Back and in Campaign Codes FM, IN, OM, P,F $ 289 77 Codes FM, IN, OM, RF $ _289 77 F lriarlce Enter on Summao Statement, Colunm A. Line 13 Manual Code EL $ Code EL $ ~ Enter on Smnmary Statement. Column A, L~ne 14 PC 4A Summary Statement of Contributions and Expenditures Please type or print legibly in black ink. Page I of 2 Candidate or Political Committee Name (use full name): Kitty Piercy for Mayor Mailing Address as it Appears on Statement of Organization (street. route or box number, city. state, zip code): P.O. Box 23301, Eugene, OR, 97402 Treasurer's Name: Telephone -Number (day): C. Michael Arnold 541-338-9111 Committee ID Number: t Committee Type, Measure Number or Office: n/a I Candidate for Mayor {~1 Original [] Primary 20__ [] General 200_~4 ~ Other __ [] Amendment [] 1st Pre-election [] 2nd Pre-election E~ Post-election [] 20__ September Supplemental A-TOTALS FOR THIS B--CUMULATIVE TOTALS ACCOUNTING PERIOD FOR THIS ELECTION CONTRiBUTiONS l, Cash Contributions 2,480 00 18,850 00 (Accounting Period Total from PC 2t 2. Loans Received (Non-Exempt) + 0 00 + 2,000 00 (Accounting Period Total from PC 21 3 Total Cash Contributions = 2,480.00 = 20.850 00 (hnes l-~ 2} 4. In-Kind + 447 89 + 803 57 (Accounting Period Total tfom PC 2) 5. TOTAL CONTRIBUTIONS = 2,927.89 = 23,653 57 (hnes 3 + 4) EXPENDITURES 6. Cash Expenditures 325 25 6,919.41 (Accounnng Period Total from PC 3l 7. Loan Payments (Non-Exempt) * 0 00 + 0 00 (Accounting P~nod Total from PC 3) 8. Total Cash Expenditures = 325 25 = a,919 4q (lin~s o 4- 7) 9. In-Kind + 447 89 + 803 57 ( Accounting Period Total from PC 2/ 10. TOTAL EXPENDITURES = 773 14 = 7,722 98 lilacs 8 + 9t CASH BALANCE 11. Beginning Cash Balance 12,490 12 FOR OFFICE USE ONLY (line 20 of previous reportl 12. Total Contributions + 2,927 89 (hne 5) t3. Other Receipts + 0 00 (Accounting Period Total from PC 4A) 14. Loans Received (Exempt) + 0.00 " (Accounnng Per~od Total f?om PC 4A "~ , 15. CONTRIBUTION SUBTOTAL = 15,418.01 -' ,, - (hne,~ll~ 12+13+14) ._ ~_ 16. Total Expenditures 773 14 (line t7. Other Disbursements + 0 00 (Accounting Period Total from PC 4BI 18. Loan Payments {Exempt) + 0 00 ~Accounung Permd Total l¥om PC 4B) 19. EXPENDITURE SUBTOTAL = 773 14 lhnes 16+ 17+ 20. ENDING CASH BALANCE = 14,644 87 (linc 15 minus hne 19) PC Summary Statement of Contributions and Expenditures Please type or print legibly in black mk. Page 2 of 2 Candidate or Political Committee Name: Committee ID Number: Kitty Piercy for Mayor n/a [~ Original ~ Primao' 20_ [~ General 200_~4 [] Other ~ [] Amendment [] 1 st Pre-election ~ 2nd Pre-election [] Post-election [] 20__ September Supplemental LOAN SUMMARY 2 l. Beginning Outstanding Loans FOR OFFICE USE ONLY (hne 29 ofpre~ious report) 17,000 00 22. Loans Received (Non-Exempt) (linc 2) + 0 00 23. Loans Received (Exempt) (hne 14) + 0.00 24~ LOANS RECEIVED SUBTOTAL (hnes 21 + 22 + 23) = 17,000.00 25. Loan Payments (Non-Exempt) {hne 7) 0 00 26. Loan Payments (Exempt) + 0 00 {line 18) 27. Forgiven Loans + 0 00 (Total loan~ forgh, en during thi~ accounting period) 28. LOAN PAYMENT SUBTOTAL = 0 00 (lines 25 + 2{> +27} 29. TOTAL OUTSTANDING LOANS = 17,000 O0 ~hne 24 minas hne 28) PERSONAL EXPENDITURE SUMMARY 30. Beginning Outstanding Personal Expenditures 0 O0 (hne 36 of previous report} 31. Personal Expenditures + 0 00 (Accounting Period 7oral from PC 3A) 32. PERSONAL EXPENDITURE SUBTOTAL = 0 O0 (hncs 30 + 31 ) 33 Personal Expenditure Reimbursements (Total expenditures on PC 3 w~th purpose code R) 0,00 34. Forgiven Personal Expenditures + 0 00 (Total personal expenditures forgiven th~s acctg, period) 35. REIMBURSEMENT SUBTOTAL = 0 00 (lines 33 -~ 34) 36 OUTSTAN-DING PERSONAL EXPENDITURES = 0,00 (hne 32 minus tine 35) FINANCIAL STATUS AT CLOSE OF ACCOUNTING PERIOD 37. Ending Cash Balance (hne 20) 14,644 87 38. Accounts Receivable + 0.00 (Accounting Period Total from PC 5} 39. SUBTOTAL = 14,644 87 (hnes 37 ,- 38) 40~ Total Outstanding Loans 17,000 00 dine 29) 41. Outstanding Personal Expenditures + (hne 36) 42. Accounts Payable + 0.00 (Accounting Period Total from PC 6} 43. SUBTOTAL = (lines 40 + 41 + 42) 44. BALANCE/DEFICIT = -2,355 13 (hne 39 minus hne 43. mdmate + or ~ balance) l, C Michael Arnold (name of candidate or treasurer), hereby certify that the above statement and the attached supporting reports are true and correct. Signature of candidate or treasurer Date signed PC 2 Cash Contributions, Loans Received and In-Kind Candidate or Political Committee Name: Committee iD Number: Kitty Piercy for Mayor n/a Page I of Election: [-] Primaw 200___4 [] General 200_44 [~] Other __ Report: [~] 1st Pre-election [~ 2nd Pre-election [~ Post-election [] 20__ September Supplemental SEE BACK FOR INSTRUCTIONS AND CODE DEFINITIONS CODE 1: Contributor Type CODE 2: Contribution Type B Business Entity CA Cash C Political Committee (includes business and union PACs) CO Cosigner Obligation F Candidate's immediate Family (includes candidate) IK in-Kind I individua~ LR Loan Received L Labor Organization O Other P Political Party Committee Amount of In-Kind Purpose Dne # Name and Address of Contributor Contnbutton (see manual for suggested purpose codes) Date Recewed Occupational Information or Contributor Code 1 Code 2 Contnbutlng Committee's ID# Aggregate Christine Helm 1147 E. I 26th Ave. Eugene OR $ 10.00 97403 9/20/20O4 Teacher $ 60 00 I CA Lucinda Muniz-Ha~e 2811 Tandy 2 Turn Eugene OR 97401 $ 20.00 9/2O/2OO4 Homemaker $ 70 00 I CA Tom Bowerman 33707 3 McKenzle View Eugene OR $ 500 00 97408 9/23/2004 Property Manager $ 500 00 t CA Citizen Action by Pubhc Employees 4 P.O. Box 12159 Salem OR $ 500 00 97309 9/23/2004 Polltlca~ ID #00033 $ 500 00 C CA Robert O'Bnen 3525 G~lham Rd 5 Eugene OR 97408 $ 150 00 9/20/2004 Professor $ 150 00 I CA See Page Totals (Add all amounts with the same Accounting Period Totals (Complete only for last page and Instructions contribution type, Do not include aggregates.) transfer these amounts to the Summary Statement, PC 1./ on Back and Cash (CA) $1,180 00 Cash (CA) $ ~ m Campaign E,,te~ ou Summary Statement Column A. Line 1 Finance Manual ln-Kind (IK) $ ~ In-Kind (iK) $ Enter on Summao Statement. Coktmn A. Lules 4 al/d 9 PC 2 Loans Received (LR) $ Loans Received (LR~ $ _ Enter o~ Snrnmar'~ bl;atemem, Co{eton A. Line 2 PC 2 Cash Contributions, Loans Received and In-Kind Candidate or Political Committee Name: Committee iD Number: Kitty Piercy for Mayor n/a Page 2 of ?* Election: [~ Primary 200_44 [] General 200_~4 [] Other __ Report: [~ 1st Pre-election [] 2nd Pre-election [] Post-election [~ 20__ September Supplemental SEE BACK FOR INSTRUCTIONS AND CODE DEFINITIONS CODE 1: Contributor Type CODE 2: Contribution Type B Business Entity CA Cash C Political Committee (includes business and union PACs) CO Cosigner Obligation F Candidate's lmme&ate Family (includes candidate) IK In-Kind I Individual LR Loan Received L Labor Organization O Other P Political Party Committee Amount of In-K¢nd Purpose Line # Name and Address of Contributor Contribution (see manual for suggested purpose codes) Date Received Occupational Information or Contributor Code I Code 2 Contributlng Committee's lDO Aggregate Susan Archbald 2361 I Jefferson St Eugene OR $ 100 00 97405 912712004 Retired $ 100.00 I CA Silver Betts 2409 bncoln St. 2 Eugene OR 97405 $ 100 00 10~4/2004 Retired $ 100 00 I CA Constance Brown 35401 Row 3 R~ver Rd Cottage Grove OR $ 100.00 97424 9/23/2004 Retired $ 100 00 I CA Peter Von H~pple 1900 Crest 4 Dr. Eugene OR 97405 $ 100 00 9/20/2004 Professor $ 100 00 I CA Teresa Dameron 605 Howard 5 Ave Eugene OR 97404 $ 100.00 9/23/2004 Business Manager for tree care company $ 100.00 ~ CA See Page Totals (Add all amounts with the same Accounting Period Totals (Complete only for last page and Instructions contribution type. Do not include aggregates.) transfer these amounts to the Summary Statement, PC 1 .) on Back and Cash (CA) $ ~50_00__~0 Cash (CA) $ in Campaign Enter on Stm~mao Statement. Column A. L me I Finance Manual ln-Kind (IK) $ In-Kind (IK) $ Enter on Smmnary Statement, Column A, Lines 4 and 9 PC 2 Loans Received (LR) $ _ Loans Received (LR,~ $ _ Enter on Summa~ Statement. Column A. Line 2 ~C 2 Cash Contributions, Loans Received and In-Kind ,:°3 Candidate or Political Committee Name: Committee ID Number: Kitty Piercy for Mayor n/a Page 3 of 3 Election: E~ Primary 200~4 [] General 200_&4 E~ Other __ Report: [] 1 st Pre-election [] 2nd Pre-election [] Post-election [] 20__ September Supplemental SEE BACK FOR INSTRUCTIONS AND CODE DEFINITION'S CODE 1: Contributor Type CODE 2: Contribution Type B Business Entity CA Cash C Political Committee (includes business and union PACs) CO Cosigner Obligation F Candidate's Immediate Family (includes candidate) iK In-Kind i Individual LR Loan Received L Labor Organization O Other P Political Parry Committee Amount of In-Kcnd Purpose Line # Name and Address of Contributor Contnbut¢on (see manual for suggested purpose codes) I Occupattonal Information or Contributor Code '/ ] Code 2 Date Recetved Contributing Committee's ID'g Aggregate S~gns of the T~mes, Inc 3666 W 11th Ave I Eugene OR 97402 $ 244 00 Parade Banners $ 244.00 B [ I K 9/1 7/2004 Lmda Wheatiey 65 W 36th 2, Ave Eugene OR 97405 $ 150.89 Eugene Celebrabon parade supphes Rebred $ 150 89 i I 1 0/1 1 /20O4 IK Clancey Pnntmg Company 350 W 5th 3. Ave_ Eugene OR 97401 $ 53 00 Part of printing costs 9/21/2004 $ 53~00 B I K 38 M~scellaneous Cash Contributions of $50 4 and Under $ 800 00 9/17/04- $ CA 10/17/04 5 $ $ ~ CA See Page Totals (Add all amounts with the same Accounting Period Totals (Complete only for last page and instructions contribution type. Do not include aggregates.) transfer these amounts to the Summary Statement, PC on Back and Cash (CA) $ 800 00 Cash (CA) $ 2,480 00 in Campaign Emcr on Summat~ Stateroom. Column A. Line t Finance Manual In-Kind (IK) $ 447 89 In-Kind (IK) $ 447 89 Enter on Snrnmao Statement. Coltwnn A Lines 4 and PC 2 Loans Received (LR) $ ~ Loans Received (LR) $ __ Entel on Stllllnlar5 Stdtement. Column A. I me PC ~ Cash Expenditures and Loan Payments "-*" Candidate or Political Committee Name: Committee ID Nmnber: Kitty Piercy for Mayor n/a Page ~_ of__ Elecnon: [] Primary 200~4 [] General 200~4 [~ Other ~ Report: [] 1 st Pre-election [] 2nd Pre-election [] Post-election [] 20__ September Supplemental PURPOSE CODES (see back of form for instructions and code definitions) EXPENDITURE TYPES A Agent O Other Advertising (yard signs, buttons, etc.) CA Cash B Broadcast Advertising (Radio, TV) P Postage LP Loan Payment C Cash Contributions R Reimbursement for Personal Expenditures F FundraismgEvent Expenses S Surveys and Polls G General Operational Expenses (describe if over $50) T Travel Expenses (describe if over $50) I Interest Payment U Utilities L Ltterature, Brochures, Printing W Wages, Salaries, Benefits M Management Services Y Petition Circulators N Newspaper and Other Periodical Advemsing Z Preparation and Production of Advertising Payee's Name and Payee's Commtttee /I:Y~, Exp. Amount of [] bne # Date Check # if apphcable Purpose Type Expenditure Pa¢d (as ~t appears on invoice, receipt or check) to A/P G (office CA $ 213.00 [~ 1 9/29/04 1134 Clancey Pnnbng Company letterhead) 2 9/29/04 1135 Funk/Levis O CA $ 112 25 D 3 CA $ E~ 4. CA $ E~ 5 CA $ E~ 6 CA $ E~ 7 CA $ ~ 8 CA $ 9 CA $ E~ 10 CA $ [~ See Page Totals (Add all expenditures with the same Accounting Period Totals (Complete only for last page and instructions expenditure type,) transfer these amounts to the Summary Statement, PC l.t on Back and tn Campaign Cash (CA) $ 325 25 Cash (CA) $ 325 25 Finance Enter on SmmnaD State,neut. Cok~mn A Line 6 Manual Loan Payment (LP) $ ~ Loan Payment (LP) $ _ Enter oi! Stmtmar3 Statement. Colunm A. Line 7 PC 3 Statement of Contributions oummary aha Expenditures Please type or print legibly in black ink. Page 1 of 2 Candidate or Political Committee Name (use full name): Kitty Piercy for Mayor Mailing Address as it Appears on Statement of Organization (street, route or box number, city', state, zip code): P.O. Box 23301, Eugene, OR, 97402 Treasurer's Name: { Telephone Number (day): C. Michael Arnold I 541-338-9111 Committee ID Number: Committee Type. Measure Number or Office: n/a Candidate for Mayor [] Original [] Primary 20__ [] General 200.~4 [] Other __ [] Amendment [] 1st Pre-election [] 2nd Pre-election [] Post-election [] 20__ September Supplemental A-TOTALS FOR THIS B-CUMULATIVE TOTALS ACCOUNTING PERIOD FOR THIS ELECTION CONTRIBUT)ONS l. Cash Contributions ~Accountmg Period Total from PC 2) 2,480 00 18,850.00 2. Loans Received (Non-Exempt) + 0.00 + 2,000.00 (Accounting Period Total from PC 2) 3. TotalCash Contributions = 2,480 00 = 20,850.00 (lines 1+ 2) 4. In-Kind + 447 89 + 803.57 (Accounting Period Total from PC 2) 5. TOTAL CONTRIBUTIONS = 2,927 89 = 21,653.57 (lines 3 + 4) EXPENDITURES 6. Cash Expenditures 325.25 6,919.41 (Accounting Period Total from PC 3) 7. Loan Payments (Non-Exempt) + 0 00 + 0.00 (Accounting Period Total from PC 3) 8. Total Cash Expenditures = 325.25 = 6,919.41 (lines 6 + 7/ 9. In-Kind + 447.89 + 803.57 (Accounting Period Total from PC 2) 10. IOTAL EXPENDITURES = 773A4 = 7,722 98 (lines 8 + 9) CASH BALANCE 11. Beginning Cash Balance 12,490 12 FOR OFFICE USE ONLY thne 20 of previous report) 12. Total Contributions + 2,927,89 (hne 5) 13, Other Receipts + 0.00 (Accounting Period Total from PC 4A) 14. Loans Received (Exempt) + 0.00 {Accounting Period Total from PC 4A) 15. CONTRIBUTION SUBTOTAL = 15,418 01 (lines 11 + 12 + 13 + 14) 16. Total Expenditures 773 14 (line 10) 17. Other Disbursements + 0.00 (Accounting Period Total from PC 4B) 18, Loan Payments (Exempt) + 0 00 (Accounting Period Total t¥om PC 4B) 19. EXPENDITURE SUBTOTAL = 773.14 tlines 16+ 17+ 18) 20. ENDING CASH BALANCE = 14,644.87 (line 15 minus line 19) '" PC Summary Statement of Contributions Expenditures Please ~vpe or print legibly in black ink. Page 2 of 2 Candidate or Political Committee Name: Committee ID Number: Kitty Piercy for Mayor n/a [~ Original [] Primary 20_ [] General 2004 C] Other __ [] Amendment [] 1st Pre-election [] 2nd Pre-election [] Post-election [~ 20__ September Supplemental LOAN SUMMARY 21. Beginning Outstanding Loans FOR OFF~CE USE ONLY (line 29 of previous reportl 17,000.00 22. Loans Received (Non-Exempt) (Fine 2) + 0 00 23. Loans Received (Exempt) (line 14) + 0.00 24. LOANS RECEIVED SUBTOTAL (lines 21 * 22 + 23) = 17,000 00 25. Loan Payments (Non-Exempt) (tine 7) 0.00 26. Loan Payments (Exempt) + 0 00 {line 18) 27. Forgiven Loans + 0.00 (Total loans forgiven dunng th~s accounting period) 28. LOAN PAYMENT SUBTOTAL (hncs 25 + 26 +27) = 0.00 29. TOTAL OUTSTANDING LOANS {line 24 minus line 28) = 17,000 00 PERSONAL EXPENDITURE SUMMARY 30. Beginning Outstanding Personal Expenditures 0.00 t line 36 of previous report) 3 l. Personal Expenditures + 0.00 (Accounnng Period Total from PC 3Al 32. PERSONAL EXPENDITURE SUBTOTAL = 0 00 (lines 30 + 31 t 33. Personal Expenditure Reimbursements 0.00 (Total expenditures on PC 3 with purpose code R) 34. Forgiven Personal Expenditures + 0.00 (Total personal expenditures forgiven this acctg period) 35. REIMBURSEMENT SUBTOTAL = 0.00 (hues 33 ~- 34) 3& OUTSTANDING PERSONAL EXPENDITURES = 0.00 (hue 32 minus line 35) FINANCIAL STATUS AT CLOSE OF ACCOUNTING PERIOD 37 Ending Cash Balance i4,644.87 { hue 20) 38. Accounts Receivable + 0 00 (Accounting Period Total from PC 5) 39. SUBTOTAL = ~4,~44 87 (hnes 37 + 38~ 40. Total Outstanding Loans ~7,000 00 tline 29) 41. Outstanding Personal Expenditures + 0 00 thne 36) 42. Accounts Payable + 0.00 {Accounting Period Total from PC 6} 43. SUBTOTAL = '~7,000 00 (lines 40 + 41 + 42t 44. BALANCE/DEFICIT = (line 39 minus tine 43. red,cate + or - balance) -2,35& ~ 3 I, C. M~ch@o} Arnold (name of candidate or treasurer), hereby certify that the above statement and the attached supporting reports are true and correct~ Signature of candidate or treasurer Date signed ORIGINAL PC I Summary Statement of Contributions and Expenditures .~, ,~0~ Please type or print legibly in black ink. Page I of 2 Candidate or Political Committee Name (use full name): Kitty Piercy for Mayor Mailing Address as it Appears on Statement of Organization (street, route or box number, city, state, zip code): P.O. Box 23301, Eugene, OR, 97402 Treasurer's Name: Telephone Number (day): C. Michael Arnold 541-338-9111 Committee 1D Number: ICommittee Type, Measure Number or Office: n/a [ Candidate for Mayor [] Original [] Primary 20__ [] General 2004 [] Other __ [] Amendment [] 1st Pre-election [] 2nd Pre-election [] Post-election [] 20__ September Supplemental A-TOTALS FOR THIS B-CUMULATIVE TOTALS ACCOUNTING PERIOD FOR THIS ELECTION CONTRIBUTIONS l. Cash Contributions 1225 20,075 O0 (Accounting Period Total from PC 2) 2. Loans Received (Non-Exempt) + 0 00 + 2,000 00 (Accounting Period Total from PC 2) 3. Total Cash Contributions = 1,225.00 = 22,075 00 (hnes l+ 2) 4. In-Kind + 0 O0 + 803 57 (Accounting Period Total from PC 2) 5. TOTAL CONTRIBUTIONS = 1,225 00 = 22,878 57 (hnes 3 + 4) EXPENDITURES 6. Cash Expenditures 100 O0 7,019.41 (Accounting Period Total from PC 3) 7. Loan Payments (Non-Exempt) + 13,769 87 + 13,769.87 (Accounting Period Total from PC 3) 8. Total Cash Expenditures = 13,869 87 = 20,789 28 (hnes 6 + 7) 9. In-Kind + 0 + 803.57 (Accounting Period Total from PC 2) 10. TOTAL EXPENDITURES = 13,869 87 = 21592.85 (hnes 8 + 9) CASH BALANCE 11. Beginning Cash Balance 14,644.87 FOR OFFICE USE ONLY (hne 20 of previous report) 12. Total Contributions + ~,225 00 (line 5) 13. Other Receipts 4- 0 00 (Accounting Period Total from PC 4A) 14. Loans Received (Exempt) + 0.00 (Accounting Period Total from PC 4A) 15. CONTRIBUTION SUBTOTAL = 15869.87 (lines 11 + 12 + 13 + 14) 16. Total Expenditures 13,869 87 R E C E IV E D (hn¢ 10) 17. Other Disbursements + 0.00 NOV ~ 0 ~004 {Accountin~z Period Total from PC 4B) 18. Loan Payments (Exempt) + 0 00 (Accounting Period Total from PC qB) CITY RECORDER 19. EXPENDITURE SUBTOTAL = 13,869.87 (lines 16+ 17+ 18) 20. ENDING CASH BALANCE = 2,000 O0 (line 15 minus hne 19) PC 1 Summary Statement of Contributions and Expenditures Re, Please type or print legibly in black ink. Page 2 of 2 Candidate or Political Committee Name: Committee ID Number: Kitty Piercy for Mayor n/a [] Original [] Primary 20_ [] General 2004 [] Other ~ [] Amendment [] I st Pre-election [] 2nd Pre-election [] Post-election [] 20__ September Supplemental LOAN SUMMARY 21. Beginning Outstanding Loans FOR OFFICE USE ONLY (line 29 of previous report) 17,000.00 22. Loans Received (Non-Exempt) (line 2) + 0 00 23. Loans Received (Exempt) (line 14) + 0 00 24. LOANS RECEIVED SUBTOTAL = 17,000.00 (hnes 21 + 22 + 23) 25. Loan Payments (Non-Exempt) (hne 7) 13,7t59 87 26. Loan Payments (Exempt) (line 18) + 0.00 27. Forgiven Loans + 0 00 (Total loans forgiven dunng this accounting period) 28. LOAN PAYMENT SUBTOTAL (hnes 25 + 26 +27) = 13,7159 87 29. TOTAL OUTSTANDING LOANS (line 24 minus line 28) = 3,230 13 PERSONAL EXPENDITURE SUMMARY 30. Beginning Outstanding Personal Expenditures 0 00 (line 36 of previous report) 31. Personal Expenditures + 0.00 (Accounting Period Total from PC 3A) 32. PERSONAL EXPENDITURE SUBTOTAL = 0.00 (lines 30 + 31) 33. Personal Expenditure Reimbursements 0 00 (Total expenditures on PC 3 with purpose code R) 34. Forgiven Personal Expenditures + 0 00 (Total personal expenditures forgiven this acctg period) 35. REIMBURSEMENT SUBTOTAL = 0.00 (lines 33 + 34) 36. OUTSTANDING PERSONAL EXPENDITURES = 0.00 (line 32 minus line 35) FINANCIAL STATUS AT CLOSE OF ACCOUNTING PERIOD 37. Ending Cash Balance (line 20) 2,000 00 38. Accounts Receivable + 0.00 (Accounting Period Total from PC 5) 39. SUBTOTAL = 2,000 00 (lines 37 + 38) 40. Total Outstanding Loans (line 29) 3,230.13 RECEIVED 41. Outstanding Personal Expenditures + 0.00 (hne36) NOV 3 0 2004 42. Accounts Payable + 0 00 (Accounting Period Total from PC 6) 43. SUBTOTAL CITY RECORDER (lines 40 + 41 + 42) = 3,230 13 44. BALANCE/DEFICIT = (line 39 minus line 43: indicate + or - balance) -1,230.13 I, C M~¢hael Arnold (name of candidate or treasurer), hereby certify that the above statement and the attached supporting reports are true and correct. Signature of candidate or treasurer Date signed PC 2 Cash Contributions, Loans Received and In-Kind Candidate or Political Committee Name: Committee ID Number: Kitty Piercy for Mayor n/a Page 1 of 1 Election: [] Primary 2004 [] General 2004 [] Other __ Report: [] I st Pre-election [] 2nd Pre-election [] Post-election [] 20__ September Supplemental SEE BACK FOR INSTRUCTIONS AND CODE DEFINITIONS CODE 1: Contributor Type CODE 2: Contribution Type B Business Entity CA Cash C Political Committee (includes business and union PACs) CO Cosigner Obligation F Candidate's Immediate Family (includes candidate) IK In-Kind I Individual LR Loan Received L Labor Organization 0 Other P Political Party Committee Amount of In-Kind Purpose Line # Name and Address of Contnbutor Contributton (see manual for suggested purpose codes) Date Received Occupational Informat/on or Contributor Code 1 Code 2 Contributing Committee's ID~ Aggregate Comcast 1 2897 Chad Drive EugeneOR $ 1,000 00 97408 11/1/2004 n/a $ 1,000 00 C CA Manlyn Mflne P.O. Box 5602 2 Eugene OR 97405 $ 200 00 10/29/2004 Pubhc Relabons Consultant $ 205 00 I CA 1 M~scellaneous Cash Contnbubon of $50 3 and Under $ 25.00 10/25/2004 $ I CA 4 $ RECEIVED $ I CA NOV 3 0 CiTY RECORDER $ $ I CA See Page Totals (Add all amounts with the same Accounting Period Totals (Complete only for last page and Instructions contribution type. Do not include aggregates.) transfer these amounts to the Summary Statement, PC 1.) on Back and Cash (CA) $1 ~225.00 Cash (CA) $1,225.00 in Campaign Enter on Smnmary Statement, Colmnn Finance Manual In-Kind (IK) $ ~ In-Kind (IK) $ __ Enter on Sununary Statement, Column A, L~nes 4 and 9 PC 2 Loans Received (LR) $ ~ Loans Received (LR) $ __ Enter on Summary Statement, Column A~ Line 2 PC Cash Expenditures and Loan Payments Candidate or Political Committee Name: Committee ID Number: Kitty Piercy for Mayor n/a Page 1_ of 1 Election: [] Primary 200_~4 [] General 200_A [] Other __ Report: [] I st Pre-election [] 2nd Pre-election [] Post-election [] 20__ September Supplemental PURPOSE CODES (see back of form for instructions and code definitions) EXPENDITURE TYPES A Agent O Other Advertising (yard signs, buttons, etc.) CA Cash B Broadcast Advertising (Radio, TV) P Postage LP Loan Payment C Cash Contributions R Reimbursement for Personal Expenditures F Fundraising Event Expenses S Surveys and Polls G General Operational Expenses (describe if over $50) T Travel Expenses (describe if over $50) I Interest Payment U Utilities L Literature, Brochures, Printing W Wages, Salaries, Benefits M Management Services Y Petition Circulators N Newspaper and Other Periodical Advertising Z Preparation and Production of Advertising Payee's Name and Payee's Committee ID#, Exp. Amount of [] Line # Date Check # if applicable Purpose Type Expenditure Pa~d (as it appears on invoice, receipt or check) to A/P G (table and 1 10/25/04 1136 Lane Events Center food for CA $ t00 00 [] elecbon mght) 2 11/22/04 1137 David Piercy n/a LP $ 13,769 87 [--] 3 CA $ 4 CA $ E~ 5 CA $ E~] 6. CA $ 7 CA $ ~ 8. ' ' "' .... ~ ]~ CA $ [-"[ NO¥ 3 0 , UU4 9 CA $ I'--'l CITY RECORDER 10 CA $ r'-] See Page Totals (Add all expenditures with the same Accounting Period Totals (Complete only for last page and Instructions expenditure type.) transfer these amounts to the Summary Statement, PC 1 .) on Back and in Campaign Cash (CA) $100.00 Cash (CA) $100.00 Enter on Summary Statement, Column A, Line 6 Finance Manual Loan Payment (LP) $13,769 87 Loan Payment (LP) $13,769 87 Enter on Sutmnary Statement, Column A, Line 7 PC 3