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Taylor for City Council
PC 1 Summar~ 'tatement of Contribution~ nd Expenditures Please q/pc or print leg£oiy in black i~k. P2ge l of 2 Candidate or Potmcal Co--lace Name [use BAll name): Marling A[~ess as :t Appears on Statement of Orgamzanon (street, route or box number, c~, stare, zip code)' Treasurer's Name: Telephone Nmber (day): Con2iVree ID Number: Co.niece Type, Measure Number or Office: j~ Ortgmat ~'Pnmary 20 0 m' [] General 20_ [] Other [] Amendment ~ 1st Pre-election [] 2nd Pre-election [] Post-dection [] 20 September Supplernental A-TOTALS FOR THIS B-CUMULATIVE TOTALS ACCOUNTING PE~OD FOR TInS ELECTION CONTRIBUTIONS 1. Cash Con~bufions (Acco=nng Period Total ~om PC Z) 2. Loans Received ~on-Exempt) (Accotmt~ng Period Total from PC 2) ~ ~ ~ + 3. Total Cash Conmbutmns = / dines 1~ 2) 4, In-Kind + (Accormtmg Period Total from PC 2) ~, Tox~ co~xmmmo~s = } ~ 3 ~ g / = (hnes 3 + 4) EXPENDITURES 6. Cash Expendmares ,Accotmnng Pemod Total ~om PC 7. Loan Payments ~Non-Exempt) + ~ d ~ + (Accounting Pe~od Total from PC 3) 8 Total Cash Expen&mres = 2 . ~ q~ ¢0 = (hnes 6 * 7) 9. In-Kind (AccountmgPenodTota!fromPC2) + ~ ~ ~' ~ ] + 10. TOTAL EXPENDITU~S = 2 7 ~ J U ] = dines 8 + 9) CASH BALANCE 11. Begz~mg Cash Balance FOR OFFICE USE ONLY Oine 20 ofprewous repoa) l~. ;o~a~ Co~=i~=on~ dine 5) / ' 13, Other Recmpts + (Accounnng Permd Total ~om PC 4A) 14. Loans Recmved (Exempt) + (Accosting Period Total from PC 4A) ~. COSTmSUT~ON SU~TOT~ = (lines 11 * 12 + 13 + 14) 16. Total ExpendlmreS(hne 10, 17. Other D~sb~sements + (Accounting Period Total from PC 4B) t 8. Loan Pa~en~s (Exempt) + (Acccunt~ng Period Total from PC 4B) 20. ENDING CASH BALANCE = (llne 15 minus hne 19) Summ atement ofContNbutions Expenditures Please type or print ieg~biy m black ~. Page 2 of 2 Can&date or Potmcal Cow~ee Name: { Co~mttee ID Number: ~ Original ~ Pr~ma~' 20 ~ ¢ ~ General 20~ D Other ~ Amendment ~ 1st Pre-ekcdon ~ 2nd Pre-etect~on ~ Post-elect~on ~ 20 September Supplemental LOAN SU~MASY 2i. Beg~mg Outstanding Loans FOR OFFICE USE ONLY (hue 29 of pre, taus report) 22. Loans Received {Non-Exempt) + ~ ~ ~ (hue 2) 23. Loans Received (Exempt5 (hue 14) + 24. LOANS ~CEIVED SUBTOTAL (lines 21 ~ 22 + 23) = 25. Loan Payments ~on-Exempt) D (line 7} 26. Loan Payments (Exempt) (hue 18) + 27. Forgiven Loans + (Total loans forgiven dunng this accounting period) 28. LOAN PAYMENT SUBTOTAL 0 dines 25 + 26 *27) = 29. TOTAL OUTSTANDING LOANS = dine 24 minus line 28) PERSONAL EXPENDITURE SUMMARY 30. Bcg~mg Ou[stand~g Personal (tree 36 of previous repo~) "~ 31. Personal Expenditures + (Acco~tlng Period Total from PC 3A) 32. PERSONAL EXPENDITU~ SUBTOT..L (hnes 30 * 31) = co. Personal Expert&rare Re~m&ursemenzs ~ Total expen&mres on PC 3 wxth pu¢ose code R) 34. Forgiven Personal Expen&~es + ~ Total persona~ expendm~es 2brg~ven th~s accrg period) 35 P~¥~L~SEMENT SUBTOT.~ (hues 33 ~ 31) = 36. OUTST.~NDkNG PERSON.~ EXPENDITU~S = FINANCIAL STATUS AT CLOSE OF ACCOUNTING PERIOD 37. Ending Cash Balance 38. Accounts Recmvable + (Accounting Period Total from PC 5) 39. SUBTOT~ (I~nes 37 4 (hue 29) 41. Outstanding Personal Expendin~es ........ ~: 42. Accosts Payable + ] t 3 ~ ] ~ 0 (Accosting Period Total ~om PC 6) ~ ~ ~ T~~ , ~ c +~, -~ (hues 40 + 41 + 42) 44. B~ANCE/DEFICIT = ~ ~j ~3~ 7 ~ (hue 39 minus line 43 md~cate + or - balance) I, /4~[Ce~ ~. ~¢ ~ ¢9~~ (name of candidate or.~easm~er;, kereby cex~,' that statement and the aaached suppomng repons are tree and co~ect. Signature of candidate or neasurer Zt,te Cash k ntdbufions, Loans Recei .J and In-Kind ,..v Candidate or Pohncal Commerce Name: Co--tree ~D Number: Elecnon: ~Pnmm-z 20 0 ~ ~ General 20 ~ Other Report. ~lst Pre-election ~ 2nd Pre-elecuon ~ Post-elecnon ~ 20 ...... September Supplemental SEE BACK FOR INSTRUCTIONS MiD CODE DEFINITIONS COD~ ~: Contributor Type CODE 2: Contribution Typo B Business Enti~ CA Cash C Political Co~ittee (includes bus~ness and umon PACe) CO Cost.er Obhgation F Can&date's Ira=mediate Family 0ncludes candidate) [K In-~nd I In&vidual LR Loan Received L Labor Orgamzanon O Other P Pohtical P~ Com~ee Amount of In-K~nd Purpose Dne ~ Name and Address of Contributor ConNbution (see manual for suggested purpose codes) Occupational Information O¢ Contributor Code ~ ~ Code 2 Date Received Contnbutzng Commi~ee's I~ Aggregate See Page Totals (Add all amounts wi~ the same Aeeounfing Per~od Totals [Complete only for last page and Instructions con~buhon ~,pe. Do not include aggregates.) ~ansfer ~ese amo~ts to the S[~m~ Statement, PC on Back and m Campaign Cash (CA) $ ~ O0 Cash (CA) Enter Finance PC 2 Loans Rece~wd (LR) S ~ 0' ~ Loans Cash ntribut]ons, Loans Receiv j and Candidate or Pohncal Co~ee Name: Co~i~ee ID Number: Election: ~ PrimaW 20 d ~ ~ General 20 ~ Other Report: ~ 1st Pre-election ~ 2nd Pre-electron ~ Post-elecnon ~ 20~ September Supplemental SEE BACK FOR ~STRUCTIONS AND CODE DEFINITIONS COD~ 1: Contributor Type CODE 2: Contribution Type B ~usi~css g~t~ CA C~sh C Po~t[c~[ Co--Met O~cludes bus[~ess ~nd umo~ PACs) CO Cos~c~ Obhg~no~ F Candidate's I~ediate Family (includes candidate~ [K In-~nd I In&vidual LR Lo~ Recmved L Labor OrganizaUon O Other P Poliucal P~ Co~ee Amount of In-Kind Purpose bne ~ Name and Address of Contributor Contribution (see manual for suggested purpose codes) Date Received Occupational Information or Contributor Code ~ Code 2 Contributing Commi~ee's 1~ Aggregate /~/~ m P/a~ See Page Totals (Add all amotmts with the same Accounting Period Totals (Complete only for last page and Instructions con~ibunon ~e. Do not ~nclude aggega~es.) transfbr these amounts to fhe Su~z Statement, PC 1.) on Back and Enter on Finance M~ual In-Kind (]K) ~ ~n-~nd (]K; S PC 2 Lo~s Recmved (LR) $ Lo~ns Zecs:, ~s Lv_, ~ Candidate or Potincal Co~ee Name: Co~i~ee ~D Number: E!ecnon: ~ Pnmaw 20 O q ~ General 20 ~ Other Repo~: ~ 1st Pre-election ~ 2nd Pre-election ~ Post-elecnon ~ 20 _ September Supplemental SEE BACK FOR INSTRUCTIONS ~D CODE DEFINITIONS COD~ ~: Contributor Type CODE 2: Contribution Type B Business EntiW CA Cash C Pohtical Co~i~ee (includes business and union PACs) CO Cos~gmer Obhgatzon F CandMate's Immediate Family (includes c~didate) [K In-Kind ~ Individual LR Loan Recmved L Labor 0rganJzatJon 0 Other P PolJncaI Pa~ Commi~ee Amount of In-Kind Purpose Dne ~ Name and Address of Contributor Contribution (see manual for suggested purpose codes) Date Received Occupational informat~on or Contributor Code ~ Code 2 Contributing Commi~ee~ tD~ Aggregate $ See Page Totals (Add all amounts with the same Aeeo~nd~g Period Totals (Complete only for last page and Instructions conmbution ~e. Do not ~nclude aggregates.) ~ansfer ~ese amounts to on Back and ~ %¢ Cash (CA} m C~palgn Cash (CA) Emer on Manual In-K~nd (iK) $ _n-l<~nd PC 2 Loans Received (LR) S Lo2ns Cash _.ntributions, Loans Receiv,.J and n-Kind Candidate or Pohfical Co~z~ee Name: Co~e~ ID N'~ber: Elect~om ~ Prnna~ 20 0N ~ General 20~ ~ Other Report' ~ ls~ Pre-elecuon ~ 2nd Pre-etect~on ~ Post-elecuon ~ 20 ._~ September Supplemental SEE BACK FOR INSTRUCTIONS .~ND CODE DEFINITIONS CODE ~: Contributor Type CODE 2: Contribution Type B Buszness EnU~~ CA Cash C Political Co~i~ee (includes business and umon PACs) CO Cosz~er Obligation F Candzdate's [~edzate Family (includes c~didate) IK I Indzvzdual LR Loan Recezved L Labor Org~zaUon O Other P Pohucal Pa~- Co~ee Amount of ~n-K~nd Pu¢ose bne ~ Name and Address of Contributor Contribution (see manual for suggested purpose codes) Occupational Information or Contributor Date Received Code I Code 2 Contributing Commi~ee's ID~ Aggregate I See Page Totals {Add all amours w~th the same Accounting Per~od Totals (Complete only for last page and lnstmcfions con~bnt~on ¢~e. Do not include ag~egates,) ~ansfer these amounts to the Su~ Statement, PC ~.) on Back ~d ~ C~mpm~ Cash (CA) $ ~ ~ 0 Cash (CA) Eh[er on F~nance Manual In-Kind (~K~ $ ln-32md t~l() PC 2 Loans Received (ER) S Loans :~ece:' ~d Lzq Cash C .atributions, Loans Can&dare or Political Cor~ee Name: Comm~nee ID Number: Elecnon: ~PnmaW 20 ~ ~ ~ General 20 ~ Other Repom ~i st Pre-electron ~ 2nd Pre-etecnon ~ Posbelecdon ~ 20_ September Supplementai SEE BACK FOR iNSTRUCTIONS AND CODE DEFINITIONS CODE ~: Contributor Type CODE 2: Contribution Type B BusNess Enti~~ CA Cash C Political Co~i~ee (includes business and umon PACs) CO Coagner Obhgatmn F Can&date's Immediate Famdy (includes candidate) IK I Individual LR Loan Received L Labor Organizanon O Other P Polincat P~j Committee Amount of In-g~nd Purpose bne ~ Name and Address of Contributor Contribution (see manual for suggested purpose codes) Occupational Information or ContnbuDr Code ~ Code 2 Date Received Contributing Commigee's 1~ Aggregate ~, ~oe ~7~' ~ $ /0~ C See Page Totals LAdd alt amounts with the same Accounting Period Totals (Complete only tbr last page and lns~ucnons con.button ~pe. Do not include aggregates.) ~ansfer these amo~ts to the Summa/Statement, PC 1 ) on Back and inCampagn Cash(CA) S .73 ~00 Cash(CA) $ I Enter on Manual In-Kind t!K~ ~ In-Kind (~, PC 2 Loans Received (ER; 5 Loans FLev ~2;03 C .,h Expenditures and Loan Candidate or Poht~cai Comn2~ttee Name: Co~ee ID Number: EIecuon: ~PnmaW 20 O ~ ~ General 20 ....... ~ Other Report: ~ lot Pre-etecuon ~ 2nd Pre-elecUon ~ Post-elecuon ~ 20~ September Supptemental PU~OSE CODES {see back of form for instructions and code definidons) EXPENDITU~ TYPES A Agent O OnSet Advemsmg (y~d si~xs, bu[o~, cm.} CA Cash B Broadcast Advertising (Radio, TV) P Postage LP Loan Payment C Cash C onmbnnons R Re:mb~sement for Personal Expendi~es F Fundraismg Event Expenses S S~eys and Polls G G~al Opera, omi Exp~zes (&scribe if over $50) T Travel Expenses (describe [f over $503 [ ~nterest Payment U UtfliUes L L~teramre. Broch~es, Pnnting W Wages: Salaries, Benefits M Management Se~ces Y Peufion C~cuNtors N Newspaper and Other Peno&cal Advertising Z Prepamt:on and Product:on of Advems~g Payee's Name and Payee's Committee l~, Exp. Amount of L¢ne ~ Date Check ~ ff applicable Pu(~ose Type Expenditure Paid (as it appears on envoice, receipt or check) to AYP See Pase Totals (Add alt expendzmres wzth the same Accounting ~edod Totals (~~ only t~r last p&ge and lns~uctions expend~t~e ts~e.) transfer these amom~ts to the Su~j Statement, PC ~ ) on Back and m Campaign Cash (CA) $ ~ ¢ ¢ ?, ~d Cash (CA) Eater on 5ummaw Finance ~ &~ Loan Pavmem Manual Loan Payment (LP) $ . PC 3 PC5 Expenditures and Loan ,-ayments Candidate or Polmcal Cow~m~tree Name: Committee ID N-tuber: glect~on: ~ Pfima~ 20 0 ~ ~ General 20~ ~ Other Repo~: ~ 1st Pre-dectmn ~ 2nd Pre-etecnon ~ Post-electron ~ 20 September Supplemental PURPOSE CODES (see back of form for instructions and code definitions) E~END[TU~ TYPES A Agent O O~er Advemsmg (y~d si~s, buUons, etc.) CA Cash B Broadcast Advemsmg (Radio. TV) P Postage LP Loan Payment C Cash Contfibutmns R Reimb~sement for Personal Expen~mres F Fun&rasing Event Expenses S Su~eys and Polls G Oene~ ~emuoml Exposes (describe ~f over $50) T Travel Expenses (describe if over $50) f Interest Payment U Utilmes L L~tera~e, Broch~es, Pnntmg W Wages, Salanes~ Benefits M Mmnagement Se~Aces Y Pemmn Circulators N Newspaper and Other Pefiod~caI Advemsmg Z Prepararmn ~md Producnon of Adv~s~g Payee's Name and Payee's Comm~ee I~, ffxp. Amount of Line $ Date Check ~ ff applicable Pu6oose Typo Expenditure Paid (as it appears on invoice, receipt or check) to 3, $ [~ 4 $ ~ 10. $ [~] See Page Totals (Add all expenditures w~th the same Accounting Period Totals (Complete only for last page and Instmctmns expenditure type.) transfer these amounts to the Summary Statement, PC 1.) onB~ckana ~ Off ~ ~'~ in Campmgn Cash (CA) $ ~,o~ Cash fCA) $ , Enter on Summaw Srarem~or, Column % tm~ ~ Finance M~rdal Loan Papmerr~ ~LP) ~ Loan PaTment liP, .. PC 3 PC 6 Accounts Payable Candidate or Polmcal Cormmirree Name: Com~i~ee ~D N~ber: ElecUon: ~ PrimaW 20 ¢ ~ ~ General 20 ~ Other Report: ~ 1st Pre~e~ecuon ~ 2nd Pre-electron ~ Post-election ~ 20 . September Supplemental PURPOSE CODES (see back for instructions and code definltlons) A Agent O Other Advemsing (y~d si~s, bu2ons, etc.) B Broadcast Advemsmg (Radio, TV) P Postage C Cash Contributions S S~eys ~d Polls F Fundrmsing Event Expenses T Travel Expenses (deschbe ~f over S50) G General Operational Expenses (describe ~f over $50) U Utilities I Interest Pa~ent W Wages, Salmes, Benefits L L~teramre, Broch~es, P~ting Y Petition C~rculators M Management Seduces Z Preparatmn and Producuon of Advemsmg N Newspaper and Other Periodical Advemsmg bne # Date Payee's Name Purpose Amount of Account Payable p See Page Total (Add all accounts payable on th~s Accounting Pe~od Total (Complete only for last page and Ins~crmns fo~.) ~ansfer these amounts to the Smmaw Statement, PC 1.) on Back and in Campmgn Accounts Payable $ /~0 7~ '~ Accounts Payable $ FiBa~ce Et~ter on %~ap7 Statement, Col~ A, L,ne 42 Manual PC 6 Accounts PayabJe Candidate or Polmcal Committee Name: Commn~ee ID Number' Election: ~PnmaW 20~ ~ General 20 ~ Other Repo~: ~ 1 st Pre-election ~ 2nd Pre-elecnon ~ Posbelecuon ~ 20 ..... September Supplememal P~OSE CODES (see back for ~nstrucdons and code definitions) A Agent O Other Advemsing (yard si~.s, bu~ons, etc.) B Broadcast Adve~sing ~adm, TV) P Postage C Cash ConMbutions S S~eys and Polls F Fundrms~g Event Expenses T Travel Expenses (describe if over $50) G General Operatmnal Expenses (describe zf over $50) U Utilmes I Interest Paymem W Wages, Salmes, Benefits L Lkeramre, Brochures, Printing Y Petmon Ctrcularors M Management Seduces Z Preparation and Production of Advemsmg N Newspaper and Other Periodical Advemsmg Line # Date Payee's Name Purpose Amount of Account Payable / See Page Total (Add all accounrs payable on this Accounting Period Total (Complete only for last page and lnstmcfions fo~,) ~ansfer these amounts to the Su~aw Statement, PC ~.) on Back and m Campai~ Accounts Payable S ~q q, 2 ~ Accounts Payable $ ~, g ~ } , ~J ~ Finance Enter on ¢~n~y Statement. Calm2: A Line z2 Manual PC 6 ~ PC, Summaw b,atsment of Contributions d Expenditures Please t~e or print leg~bty in black ~r~ Page I of 2 Can&date or Polmcal Co~mee Name (use ~11 aame): Marling Address as ~t Appears on Statement of Organizanon (smeet, route or box m~ben ciW. state, z~p code) Treasure~ Name: Telephone N~ber {day): Com~i~ee ~D Number: Co~i~ee Type, Measure N~ber or Office: [] Original [~"Pnmary 20 C)~ [] General 20 [] Other ~ Amendment [~ 1st Pre-etecnon [] 2nd Pre-election [] Post-elecnon [] 20 September Supplemental A-TOTALS FOR THiS B-CUMULATIVE TOTALS ACCOUNTING PERiOD FOR THIS ELECTION CONTRIBUTIONS 1, Cash Contributions (Accosting Period Total ~om PC 2) ~ ~ '~ ~ Loans Received (Non-Exempt) + (Acco~mng Period Tota~ from PC 2) ~ o 0 3 Total Cash ConMbufions (hnes 1+ 2) = ~ ~ Z ~ = 4. in-K~nd + + (Accomnnng Period Total from PC 2) 5. TOTAL CONT~BUTIONS (l~nes 3 ¢ 4) = ~,~ ~ ~, ~ ~ : EXPENDITURES 6. Cash Expen&~es ~Accoummg Period Total Eom PC 3) ~ O '~ ~. ~O 7. Loan Payments (Non-Exempt~ + ~o ~ + (Acco~ng Period Total ~om PC 3) 8. Total Cash Expenditures 9. In-Kind + + (Acco~tmg Period Total from PC 2) 10. TOTAL EXPENDITUP~S CASH BALANCE 11. Beg~mg Cash Balance /hne 20 of previous repo~) FOR OFFICE USE ONLY 12. Total Conmbutmns + 13. Other Recmpts + (Accosting Period Total from PC 4A) 14. Loans Recmved (Exempt) + IAccounnng Period Total from PC 4A) 15. CONTmBUTION SUBTOTAL = (hnes 11 + 12 + 13 + 14) 16. Total Expen&mres 17. Other Disbursements + /Accounnng Period Tot~ from PC 4B) 18, Loan Pa~ents (Exempt) + ~Accounnng Period Total 2>om PC 20. ENDING CASH B~ANCE (line 15 minus hne I9) = PC Summary atement of Contributions a d Expenditures Please type or print legibly in black ink. Page 2 of 2 Candidate or Pohtlcal ColpnTllttee Name: Committee ID Number: []Onginat ~ Prima~ 20 ¢ ~ [] General 20 [] Other ~Amendment ~ 1st Pre-elecnon [] 2nd Pre-elecnon [] Post-elecnon [] 20 September Supplemental LOAN SUMMARY FOR OFFICE USE ONLY 21. Beginning Our. standing Loans (hne 29 ofprevtous report) 22. Loans Recmved {Non-Exempt) + (hne 2) cf O O 23 Loans Received (Exempt) (line !4) + O 24. LOANS RECEIVED SUBTOTAL (lines 21 + 22 + 23) = '4 © 0 25 Loan Payments (Non-Exempt) t line 75 ~ 0 0 26. Loan Payments (Exempt) (hne 18) + 27. Forgiven Loans + (Total loans forgiven dunng this accounting penod) 28, LOAN PAYMENT SUBTOTAL (Imes 25 ~- 26 +27) = t~ ~ O 29. TOTAL OUTSTANDING LOANS (line 24 minus line 28) = PERSONAL EXPENDITURE SUMMARY 30,Beginmng Outstanding Personal Expenditures (hne 36 of previous report) 31. Personal Expenditures + (Accounting Period Total from PC 3A) 32. PERSONAL EXPENDITURE SUBTOTAL (!k~es 30 + 31) = 33. Personal Expen&ture Reunbm'sements (Total expenchtures on PC 3 ,vlth purpose code R) 34. Forgiven Personal Expen&mres + (Total personal expenditures forgiven this acctg period) 35 REIMBLrRSENPENT SUBTOTAL {lines 33 -e 34) = 36. OUTSTANDD{G PERSONAL EXPENDITUtLES = FINANCIAL STATUS AT CLOSE OF ACCOUNTING PERIOB 3% Ending Cash Balance (hne20) ~; ?~, 5-0 38. Accounts Recmvable + (Accounting Period Total from PC 5) 39. SUBTOTAL ~lines 37 + 38i = 40. Total Outstanding Loans (hne 2% 41. Outstanding Personal Expen&tures + ~ 'r~ ~}" (line 36) l:.,~,~ · 42. Accounts Payable + ] / 5 3 7~ 7 '~ (Accountmg Penod Total from PC 6} 6i'~[ Y I2~ !L~(5 43. SUBTOTAL (lines 40 + 41 + 42) 44. BALANCE/DEFICIT '*5 7 {hne 39 minus line 43. mchcate ~ or - balance) ~'/ ~ statement and tke attached suppomng r:ports ~e m_re and correct. Signature of can&date or treasurer D_4:e 3:~r. ea PC 2 Amendmem Amendments-Cash Contributions, Loans Received and In-Kind Re~.12/03 Candidate or Political Committee Name: Committee ID Number: ~7 ~c- ?&~£- ~"q-;1 ~e~¢7 I Page ( of Election: ~[ Primary 20 e cf [] General 20 [] Other Report: []-1 st Pre-election Eli 2nd Pre-election E] 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 Conmnittee (includes business and union PACs) CO Cosigner Obligation F Can&date% Immediate Family (mcludes candidate) IK In-Kind I Individual LR Loan Received L Labor Organization O Other P Political Pazty Committee Amending Page # Amount of In-Kind Purpose and Line # Name and Address d Contributor Contribution (see manual ~or suggested purpose codes) Date Received Occupational Information or Contributor Contributing Committee's ID# Aggregate Code 1 Code 2 [] New Entry ~ Correcting , ¢ ~. ¢ ¢ D Delebng ~ New Entw ~ Correcting ~ Deleting Instructions on Back and inCampmgn /¢v~¢ ~F~. F~nance Signature of candidate or treasurer Manual Amendment Date s~gned PC 2 gmaendrner~t Amendments-Cash Contributions, Loans Received and In-Kind Rev 12/03 Candidate or Political Committee Narne: Committee ID Number: Election: ~Primary 20~4 ~ General 20 ~ Other Repo~: ~ 1 st Pre-election ~ 2nd Pre-elect~on ~ Post-electron ~ 20 September Supplemental SEE BACK FOR INSTRUCTIONS AND CODE DEFINITIONS CODE ~: Contributor Type CODE 2: Contribution Type B Business Enn~' CA Cash C Political Co~i~ee (includes business and union PACs) CO Cosigner Obliganon F Candidate's I~ediate Family (includes can&date) IK In-~Gnd I lndMdual LR Loan Received L Labor Organization O Other P Poht~cal Pa~ Co~i~ee Amending Page ~ Amount d tn-Kind Purpose and Line ~ Name and Address of Contributor Contribution (see manual for suggested pu~ose codes) Date Received Occupational Information or Contributor ConNbufing Committee's I~ Aggregate Code ~ I Code 2 D NewEntw ~~ ~r ~ff ~ ' $ ~ Correcbng ~ ~ Deleting ~ New Entw D Correcting ~ Deleting $ Page ~ Line [~ New Ent~ ~ Correcting ~ Deleting Page.~ Line ~ New EnW $ D Correcting ~ Deleting Instructions in Campaign Finance Sl~na~re ofc~didate or treas~er Ma.ual RECORDER Amen~ent Date s~d PC 3 Arnendmear Amendments-Cash Expenditures and Loan Payments Candidate or Pohtical Committee Name' Committee tD Number: ~ (~ lot- ~c- ~'i':¢~ Ge> ct~e~c [ Page [ of ] _ Election: ~ Pfima~ 20 ~ G ~ General 20 ~ Other Repo~: ~lst Pre-electron ~ 2nd Pre-election ~ Post-election ~ 20 September Supplemental PURPOSE CODES (see back of form for instructions and code definitions} EXPENDITURE A Agent O Other Adve~isbg Card si~, bu~ons, etc.) CA Cash B Broadcast Adve~ising (Ra&o, TV) P Postage LP Loan Payment C Cash Con~ibutions R Reimbursement for Personal Expendi~es F Fundraismg Event Expenses S S~veys and Polls G General Operational Expe~es (describe if over $50) T Travel Expenses (describe if over $50) I Interest Payment U Utihties L L~terature, Broch~es, Printing W Wages, Salaries, Benefits M M~agement Services Y Petition Ckrculators N Newspaper and Other Periodical Adve~ising Z Prepara~on and Production of Adve~ismg Amending Page g and Line ~ Payee's Name and Payee's Comm~ee I~, ~ Check ¢ if appficable Purpose Exp, Amount of Date (as ~ appears on invoice, receipt or check) Type Expenditure Paid to NP Page ~ Line /~ ~ New EmW $ ~ Deleting ~ ~ d * Page~ Line ~ New Entw ~ Correcting ~ Deleting $ ~ Page~ L~ne [] New Entry [] Correcting [] Deleting $ Ed Page.__ Line__ [] New Entry [] Correcting [] Deleting Page__ Line [] New Entry [] Correcting [] Deleting See ~ONLY Instructions [~~' ~ onBackand ~~t~¢-~ /f<z~ ~¢'~ in Campaign ~ ~g~' 0 ~ ~00~ Finance Signature of c~didate or treas~er .... ~ ~ ~ Manual PC3 O TY SEGORDER Amendment Date s~ed PC 6 Amendment Amendments-Accounts Payable Candidate or Political Committee Name: Committee ID Number: '~/~r pc/- ~?¢~7 ~.e7 { Page { of ( Election: ~Pnma~ 20 ~ q ~ General 20 ~ Other Report: ~ 1 st Pre-election ~ 2nd Pre-election ~ Post-election ~ 20 ....... September Supplemental PURPOSE CODES (see back for instructions and code definitions) A Agent O Other Adve~is~ng (yard signs, bu~ons, etc.) B Broadcast Adve~ising (Radio, W} P Postage C Cash Contributions S Su~eys and Polls F Fundraising Event Expenses T Travel Expenses (describe if over $50} G General Operational Expenses (describe if over $50) U Utilities [ Interest Pa~ent W Wages, Salaries, Benefits L LiteraOxe, Brochures, Printing Y Petition Ckculators M Management Seduces Z Preparation and Production of Advertising N Newspaper and Other Periodical Adve~ising Amending Pa~e ~ Amount of and Line ¢ Payee's Name Purpose Account Payable Date B New Entw ~ CorreCm9 ~ Delet, ng $ Page~Llne ~ " ~ , ~' ~ ' ~ CorrectmgNeW Entry ¢~ ..... ¢' D Deletm9 U Deleting Page L,ne ~ New Entw ~ Correcting ~ Deleting Page. Line D New Entry [] Correcting [] Deleting $ onBackand /~/¢b~7 ~ ~;_~/~o<~Z__- - Finance Signature of ca~d~date or treasurer . CITY"RECORDER- Amendment Date signed ~7~7)~ ~ Accounts Payable ~M ;, ~?~~ :: o~ Candidate or Pohncal Co~i~ee Name. Co~ee ID Number: 7~ ~ ¢;~ c~'~ ~~ ( P~ ~ of ~ Elecnon: ~ Primary 20 ~ ¢ ~ General 20 ~ Other Repo~: ~ I st Pre-electron ~ 2nd Pre-etecuon ~ Post-elecnon ~ 20 September Supplememal PU~OSE CODES (see back for ~nstrucdons and code definitions) A Agent O Other Advemsmg (yard s~s, bu~ons, etc.) B Broadcast Advemsing (Radio, TV) P Postage C Cash Contributions S Su~eys and Polls F Fun&ms~g Event Expenses T Travel Expenses (describe if over $50) G General Operanonal Expenses (describe if over $50) U Utd~ties [ interest Payment W Wages, Salaries, Benefits L Literate, Brochures, P~fing Y Petition Circulators M Management SeD4ces Z Preparatmn and Produc~on of Advemsmg N Newspaper and Other Peho&cal Advemsmg Amount of Line # Date Payee's Name Purpose Account Payable 3 $ 4 $ 5. $ $ 7. $ 8. $ 9 $ 10~ $ See Page Total (Add ali accounts payable on this Accounting Period Total (Complete only for last page and Instrucnons form.) transfer these amounts to the Summary Statement, PC 1.) on Back and in Campaign Accounts Payable $ ~¢~ ~ ~ Accounts Payable Finance Enter on ¢*ummary Statement Colt~ PC6 }~ ~ CiTY Summary statement of Contributions a, d Expenditures Please fy[pc c4 print legibly m black mk Page 1 of 2 Can&date or Pohtmat Corn:mt[ce Name {use full nameL Marling &ddt as ~1 Appears on Sratem.nt of Orgamzat~on {street, route or bor number, c~ty, stxte, z~p Treasm er's N amc. 7 elcphone N umber { day;: Commu:tce ID Number Committee Type, Measure Number or Office. ~-~-Or-lgmal ~Pnmary 20~' ~4 ~ General 20 [~ Other ~ Amendment [~ 1st Pre-elect~on ~ 2nd Pre-eIecnon ~ Post-elecnon ~ 20~ September Supplemental A-TOTA LS FOR ~ HIS B-C UM ULATiVL TOTALS ACCOUNTING PERIOD FOR THIS ELECT[ON CONTRiBUTiONS Cash Contributions 2. Loans Rece~ved(Non-Exemp:; + Period To[a! ~rom PC 2 tA~cou2[lng 3. Total C2sh Contributions 4 In-Kind 5 TOTAL CONTRIBUTIONS EXPENDITURES 6. Cash Expenditures 7. Loan Payments (Non-Exempt~ LKccountm~ Period Tom] ~om PC 3~ + 8. Total Cash Expen&tu~es ln-Ktnd (Accounting Period Total lkom PC 2> 10. TOTAL EXPENDITURES CASH BALANCE ~ 1. Bcgmrdng Cash Batance (hne 20 ofpre,~ous repo~O ~/ ~ ~ ~ ~ FOR OFF~CE USE ONLY 1Z Total Conb:but~ons (hue 5) !3. Other Receipts + (Ac~ounm~g Period Total from PC 4A~ 14. Loans Received (Exempt) + {Accounung Period Total ~kum PC 15 CONTRiBUTION SUBTOTAL 16. Totat Expert&[utes 17. Other D~sbursemer~ts + 18, Loan Payments {Exempt) + (Agkountmg Period ~otal I~orn PC i9. EXPENDITURE SUBTOTAL = dines 16 ~- 17 + ~8; 20. ENDING CASH BALANCE 7 P( 1 Summary atement of Contributions Please type or print legibly in bktck ink. Page 2 of 2 Candidate.7~t°r Politlcal~ [~J e Committee~c c~Name:~J~( ('~; k~ e; { ~l Committee tD Number: ~C'Orig~nal [~Primary 20 0 ~( [] General 20 [] Other [] Amendment [] 1 st Pre-election ~2nd Pre-election [] Post-election [~ 20__ September Supplemental LOAN SUMUARY 21 Beginmng Outstanding Loans FOR OFFICE USE ONLY (line 29 ofprcvmus report) 22. Loans Received (Non-Exempt) + (hne 2) 23. Loans Received (Exempt) + (hne 14) 24. LOANS RECEIVED SUBTOTAL hnes 2l + 22 + 23) 25. Loan Payments (Non-Exempt) (hne 7 ) 26. Loan Payments (Exempt) + (hne I8) 27. Forgiven Loans + (Total loans lYrglven dunng this accounting period) 28. LOAN PAYMENT SUBTOTAL (hnes 25 + 26 +27) 29. TOTAL OUTSTANDING LOANS (line 24 minus hne 28) PERSONAL EXPENDITURE SUMMARY 30. Beginning Outstanding Personal Expenditures (line 36 ofprc~,lous report} 31 Personal Expenditures + (Accounting Period Total from PC 3A) 32. PERSONAL EXPENDITURE SUBTOTAL (hnes 30 + 31 ) 33. Personal Expenditure Reimbursements (Total expen&tures on PC 3 w~th purpose code R) 34, Forgiven Personal Expenditures + {Total personal expenditures ~brg~ven th~s acctg penod~ 35. REIMBURSEMENT SUBTOTAL (lines 33 + 34) 36. OUTSTANDING PERSONAL EXPENDITURES = F~NANCIAL STATUS AT CLOSE OF ACCOUNTING PERIOD 37. Ending Cash Balance ( lne 0) 38. Accounts Receivable + (Accounting Period Total from PC 5) 39. SUBTOTAL (lines 37 + 38} 40. Total Outstanding Loans (line 29) : 41. Outstanding Personal Expenditures 42. Accounts Payable 43 SUBTOTAL Ihnes 40 + 41 + 42) 44. BALANCE/DEFICIT (hne ~ rmnus hne 43 re&cate + or- balance) , I '/~gr-~' (ffl ~F'?c./c~>.,_ (name of candidate or treasurer), hereb-v certlfv that the above statement and the attached supporting reports are true and correct. Signature of car(didate or treasurer Date s~gned PC2 Cash C..,~tributions, Loans Receiv~ and ~mKind Candidate or Political Committee Name: Committee ID Number: ~t,o~: ~m~-2o~ ~ ~=~a 20__ ~ Repo~: ~ 1st Pre-election ~2nd Pre-election ~ Post-election ~ 20 __ September Supplememal SEE BACK FOR INSTRUCTIONS ~ND CODE DEF~ITIONS CODE 1: Contributor Type CODE 2: Contribution Type B Business Ent[~ CA Cash C Pohfical Co~mi~ee (includes buszness and union PACs) CO Cost.er Obhganon F Candidate's I~ediate Fa~ly 0ncludes candidate) IK In-Kind I Individual LR Lomn Received L Labor Orgamzation O Other P Polmcal Pa~' Co~inee Amount of In-Ki~d Purpose Dne ~ Name and Address of Contributor Contribution (see manual for suggested purpose codes) Occupational Information or Contributor Code f Date Received Contributing Commi~ee's I~ Aggregate Code 2 See Page Totals (Add all amounts with ~e s~e Aceounfing Period Totals (Complete only for last page and Instmcnons contribution on Back ~d in Campaign Cash (CA) $ ~ ~) Cash {CA) $ Enter on 5u~aw Statement. Cmm~ A, Line 1 Finance ~ Manual fn-Kmd (!K) $ tn-Kind PC 2 Loans Recmved (LR) $ Loans i~scs~",'ed L2~ 5 PC 2 Cash C,.ntributions, Loans Receiv. and In-Kind Candidate or Pohtical Committee Name: Commmee ID Number' Elect,on [] Pr, maw 200 ~ General 20 ~ Other Report: ~ 1st Pre-elect~on ~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 Enti~ CA Cash C Pohtical Con~ittee (includes business and union PACs) CO Cosigner Obhgation F Can&date's Immediate Family (includes candidate) IK In-Kind I Individual LR Loan Rece~ed L Labor Orgamzation O Other P Polincal Pa~y Co~ittee Amount of ln-K;nd Purpose Dne ~ Name and Address of Contributor Contribution (see manual for suggested purpose codes) Occupational Information or Contributor Date Recetved Contributing Comm~ee's I~ Aggregate Code ~ , Code 2 $ See Pa~e T~tals (Add ail amounts with the same Aee~t[n8 Per[od Totals (Complete only for last page and Instructions contribution type, Do ~ot Jnetude aggregates,) tr~sfer these amounts to the Summa~ Statement~ PC on Back and , in Campaign Cash (CA) $ ~ } ~ W ~ Cash (CA} Enter on Su~a~ Statement, Colunm A~ [ me 1 Finance Manual In-Kind (IK) $ ImKind ([K) $ Enter on Su~ao Statement. Colamn PC 2 Loans Recewed (LR) $ Loans Received fLR) $ Enter on Summ~y Statement. Colmm~ ~ Line 2 PC 2 Cash Contributions, Loans Receiv . and n-Kind Candidate or Polmcal Committee Name: Corr~mittee ID Nm-abet: Elect~on. ~rJmary 20 8& ~ General 20 ~ Other Repo~, ~ 1 st Pre-elecnon ~ 2nd Pre-elect~on ~ Post-dection ~ 20 September Supplemental SEE BACK FOR INSTRUCTIONS AND CODE DEFINITIONS CODE ]: Contributor Type CODE 2: Contribution Type B Business Entity CA Cas~ C PolidcM Commi~ee (includes business and union PACs) CO Cosigner Obligation F CandMate's I~ed]a~e Famdy (includes candidate) [K ~n-Kmd ] ]nd]vMual LR Loan Received L Labor Orgamzat~on O Other P Political Pa~y 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 I Code 2 Contributing Commi~ee ' s I~ Aggregate See Page Totals (Add alt amounts with the same Accounting Per~od Totals (Complem only t%}r las~ page a~d Instructions conmbution ~e. Do not include aggregates.) transfer these amounts to the Summa~ StatemenL PC t.~ on Back and in Campaign Cash (CA) $ Cash (CA) $ Enter on Su~a~ Stateroom. Column F~n~ce Manual lmKind (iK) $ ~]~ ~ In-K~nd (iK) $ Freer on Sumary S~atemenL PC 2 Loans Received [LR) $ Lo~s Received (LR) $ Enter on Su~n~ Statement Cdumn A~ Line 2 Cash Contributions, Loans Received and In-Kind Can&date or Pohtical Committee Name: Committee ID Number. Election: ~ PrimaD' 20 d g ~ General 20 ~ Other Report: ~ 1st Pre-elecdon ~2nd Pre-election ~ Post-electron ~ 20 September Supplemental SEE BACK FOR INSTRUCTIONS AND CODE DEFINITIONS CODE ~: Contributor Type CODE 2: Contribution Type B Business Entity CA Cash C PolJhcal Court,nee 0ncludes business and union PACs~ CO Cob~gne~ Ob!igadon F Candidate's lmmedmte Family (includes candMate) [K In:Kind I Individual LR Loan Received L Labor Organkadon O Other P Polmcat Pa~- Comm~ee Line ~ Name and Addmss of Contributer Amount of ln-K~nd Purpose Contnbutmn (see manua~ for suggested purpose Date Received Occupstional Informat]on or Contributor Con[nbutmg Comm~ee's I~ Aggregate Code ~ Code 2 / $ 4. $ $ $ See Page Totals ladd all amounts with the same Accounting Period Totals (Complete only for last page and Instrucnons contribunon ~¢pe. Do not include ag~egates.) ~ans1~r these 2mounts to the Summaw Statement, PC i. ~ on Back and ~ ~ O ' ~ Finance Enter,m SummaZ. Statement Eommn *, Lm~ ~ Manual In-Klnd{iK~ S ~, ?0 In-Klnd{iK~ 5 /~ 0 7~, ~7 PC 2 Loans Rec¢t~ cd LR ~ S Loans Rece:xed { LR) ~ Cash Expenditures and Loan Payments C'and~dp, tc or Pt, iit~a! Comm:tt~ N.tm,~ C umm}ttce R_euon ~ !:4 Pze-dect~on ~Phd P~c-olecaon ~ Post-decuon ~} 2h September Supplcmcnmi PURPOSE CODES/see back of ibrm br instnieiions nad code definitions} EXPEND[TL RE Ti PES ~ ~,,,.:dcast Ad-,,¢msm~ ~R~,dio, iV) P Pe~ta~z LP Loan Povmcm ; i:us~e~t Paymcn~ U Utfiine~ L L:cmtu:¢, Brochures. Pn:ltmg ~a Wage~, SAanc~,, ~cncfi:s PWee ',s ~?ame and Payee's Cc,,nm~ttee ID~ L,ne fl Date Check ~ / ap~,hcable Pu;pose Type E4~enerure Pa~d :as ~t appears on invo,'ce rece,,pt or check) Page Totals (Add all cxpen&tu:e: -w-':l} thc ,,~m~e Accounting Period l-orals (Complerc only fo: la: pate and ?.,l:nua/ ko:n Pa} mcnt eL Pt $ Loan Pa> mcnt/kP~ PC x PC 6 Candidate or Political Cormmktee Name: Corr~ittee ID Number: Repom '~ 1 st Pre-elect~on ~ 2nd Pre-elecr~on ~ Post-election ~ 20~ September Supplemental PU~OSE CODES {see back for instructions and code definkions) A Agent O Other Adx, emsing (yard s~s. buaons, etc.) B Broadcast Adve~ismg (Radio, TV) P Postage C Cash Con.buttons S S~Teys and Polls F F~dralsing Event Expenses T Travel Expenses (describe if over $50) G General Operaional Expenses (describe ~f over $50) U Utilities I Interest Payment W Wages, Satanes. Benefits L L~terap~xe, Brochures, Pnntmg Y Petition Clrculaors M M~agement Se~ices Z Prep~atmn and Production of Adve~ismg N Newspaper and Other Periodical Advemsing Line # Date Payee's Name Purpose Amount of Account Payable See Page Total {Add ali accosts payable on this Accounting ~e~io8 Total (Complete only fo; last page and Ins~mtzons fo~.) ~ansfer t~ese amo~mts to the S~maW Statement, PC 1 .) o~ Back and m Campaign Accounts Payable $ '} Accounts Payable S Finance Enter )n Sum~.aq¢ Sta~amenL Colamm A. Line al Manual PC 6 ~ Accounts Payable Candidate or Political Committee Name: Co~itree tD Number: Election ~nmary 20 0 ~ [] General 20 ~ Other Report: ~ 1 st Pre-election [~J~nd Pre-elecnon [] Posr-e!ecnon [] 20 September Suppiememal PURPOSE CODES (see back for instructions and code definkions) A Agent O Other Advemslng (yard signs, buttons, etc.) B Broadcast Advertising (Radio, TV) P Postage C Cash Contribunons S Smweys and Polls F Fundrmsing 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 hrerature, Brochures, Pnntmg Y Petition Circulators M Management Services Z Preparation and Production of Advertising N Newspaper and Other Periodical Advertising Line # Date Payee's Name Purpose Amount of Account Payable See Page Total (Add all accounts payable on this Accounting Per~od Total (Complete only for last page and Instmctmns fo~.) ~ansfer these amounts ro the Summ~z Staremem, PC t.) on Back and [ ~ m Campaign Accosts Payable $ ~ ~ ~ Accounts Pavabte $ Finance Enter an Sun~/Statement Cokmm A. Line z2 Manual PC 6 ' PC o Accounts Payable Re', 12/03 Can&date or Pohtical Committee Name' Committee ID Number: ~_~{o~ *~,jc 0.7~ ~2~c~ ( Page ~ of 3 Elecnon' ~ Prima~ 200 % ~ General 20 ~ Other Report: ~ 1 st Pre-electron ~ 2nd Pre-election ~ Post-election ~ 20 September Supplemental PU~OSE CODES (see back for instructions and code definitions) A Agent O O~erAdvenis~ng{yard s~gns, buttons, etc.) B Broadcast Adve~ismg {.Radio, TV) P Postage C Cash Contributions S Su~eys and Polls F Fundraising Event Expenses T Travel Expenses {describe ~fover $50) G General Operanonal Expenses (describe ff over $50) U Utilities I Interest Pa~nent W Wages, Salar~es~ Benefits L Literature, Brochures, Phntmg Y Petition C~rculators M Management Se~dces Z Preparatmn and Production of Advems~ng N Newspaper and Other Peno&cal Advems~ng Line # Date Payee's Name Purpose Amount of Account Payable See Pa~e Tetal (Add all accounts payable on this Aeee~tin~ Perie8 Teta~ (Complete only for last page and 1nstmcttons fo~.) transfer these amounts to the Summa on Back and ,n Campaign Accounts Payable $ Finance Emcr on Summa, Statement, Colu~m A, [ me 42 Manual PC 6 PC Summary, atement of Contributions, d Expenditures Please type or pnnt legibly in black ink. Page 1 of 2 Can&date or Political Cormmttee Name (use full name) Mmhng Address as it Appears on Statement of Organization (street, route or box number, city. state, zip code). Treasurer's Name' Committee ID -Number' Co~ttee Type~ Measure Number or Office: [-'1 Original [] Pnma~ 20~ ~( [] General 20__ [] Other ~mendment [~lst Pre-election [] 2nd Pre-election [] Post-elect~on [] 20 September Supplemental A-TOTALS FOR THIS B-CUMULATIYE TOTALS ACCOUNTING PE~OD FOR THIS ELECTION CONTRIBUTI0NS 1~ Cash Conmbunons ( ~ccountmg Period Total from PC 2 2. Loans Received (Non-Exempt) + (Accounting Period Total from PC 2) q ~ ~ + 3. Total Cash Contributions (hnes 1+ 2) = ~, ~. ~0 = 4. In-Kind + + (Accounting Period 7otal from PC 2) 5. TOTAL CONTRIBUTIONS EXPEnDITUrES 6. Cash Expen&tures (Accounnng Period Total from PC 3) ~o 7. Loan Payments (Non-Exempt) + + (Accounnng Period Total from PC 3) g3) o 8 Total Cash Expenditures = = (hnes6* 7) ~f ~ (q ~ ~O 9. in-Kind + + (Accounting Per, od Total ~om PC 2) 10 TOTAL EXPENDITU~S (hnes8+9) = ~ 7 ~ . q3 = CASH BALANCE 11. Beginning Cash Balance (line 20 of previous repo~) FOR OFFICE USE ONLY 12. Total Contributions 13. Other Receipts + (Accounnng Period Total ~om PC 4A) 14. Loans Received (Exempt) + (Accounting Period Total ~om PC 4A) 15. CONT~BUTION SUBTOTAL (hnes 11 * 12+ 13 + 14) = 16. Total Expen&mres (hne 10) 17. Other D~sbursements (Accounting Period Total from PC 4B) 18. Loan Payments (Exempt} + (Accounting Period Total from PC 4B) 19. EXPENDITU~ SUBTOTAL 20. ENDING CASH BALANCE UIT¥ RECORDER Summary .atement of Contributions ,d Expenditures Please type or print legibly m black ~nk Page 1 of 2 Can&date or Pohncal Conm21ttee Name (use full name)' Mmhng Address as ~t Appears on Statement of Organization (street, route or box number, c~, state, z~p code): Treasurer's Name. Telephone Number (day): Cmmmttee ID Number. Con~ttee Type, Measure Number or Office: [] Original [] PnmaFy 20 0 ~{ [] General 20__ [] Other ~[ Amendment [] 1st Pre-elect~on J~2nd pre-elect~on [] Post-election [] 20 September Supplemental A-TOTALS FOR THiS B-CUMULATIVE TOTALS ACCOUNTING PE~OD FOR THIS ELECTION CONTRIBUTIONS 1. Cash Contributions (Accounting Period Total I~om PC 2) 2. Loans Recm~ed(Non-Exempt) + + (Accuunnng Period Total from PC 3. 7oral Cash Contnbunons (hnes 1+2) = 4. ln-Kmd (Accounnng Period Total from PC 2) + [ 5 TOTAL CONT~BUTIONS EXPENDITURES 6. Cash Expen&tures (Accounting Pe~od Total t~om PC 3) 7 Loan Payments (Non-Exempt~ + + (Accounnng Period Total ~om PC 3) 8. Total Cash Expenditures = = 9. In-K~nd (Accounting Period Total from PC 2) + 10. TOTAL EXPENDITU~S CASH BALANCE 11. Beg~nng Cash Balance ~ FOR OFFICE USE ONLY /hne 20 of previous repo~) 12. Total Contributions (hne 5) + 13. Other Receipts + (Acco~nng Period Total fi-om PC 4A) 14. Loans Received (Exempt) + (Accounnng Period Total from PC 4A) 15. CONT~BUTION SUBTOTAL (lines 11 + 12 + 13 + 14) = 16. Total Expenditures 17. Other Disbursements + (Accounting Period Total from PC 4B) 18. Loan Payments (Exempt) + (Accounnng Period Total from PC 4B) 19. EXPENDITUR~ SUBTOTAL (lines 16 + 17 ~ 18) 20. ENDING CASH BALANCE (hne 15 lmnus hne 19) = PC Summary atement of Contributions d Expenditures Please type or pnnt legibly in black ink. Page 2 of 2 Candidate or Polmcal Committee Name. Comnnttee ID Number. [~1 Original [~Primary 20° 4 [] General 20__ [] Other [~Amendment [] 1st Pre-election [~/2nd Pre-elecnon [] Post-clecnon [] 20__ September Supplemental LOAN SUMMARY 21. Begmmng Outstanding Loans FOR OFFICE USE ONLY (hne 29 ofprewous report) 22 Loans Received (Non-Exempt) (line 2~ + 23. Loans Rece~,/ed (Exempt} 4hnc 14) + 24. LOANS RECEIVED SUBTOTAL lhnes 2t + 22 + 23) = 25 Loan Payments (Non-Exempt) (line 7) 26. Loan Payments (Exempt) (line I8) + 2Z Forgiven Loans (7 oral loans forg~ en during tins accounting period) + 28, LOAN PAYMENT SUBTOTAL (lines 25 + 26 +27) = 29. TOTAL OUTSTANDING LOANS (hne 24 minus hnc 28) = PERSONAL EXPENDITURE SUMMARY 30. Bcginmng Outstan&ng Personal Expenditures Ihne 36 ofpre¥~ous report) 31 PersonatExpendlmres {Accounting Period Total from PC 3A) 32, PERSONAL EXPENDITURE SUBTOq[AL (lines 30 + 31) = 33, Personal Expenditure Reimbursements (Total expen&tures on PC 3 with purpose code R) 34. Forgiven Personal Expenditures + (Total personal expenditures forgiven th~s acctg, period) 35. REIMBURSEMENT SUBTOTAL ehnes 33 + 34) = 36. OUTSTANDING PERSONAL EXPENDITURES = FINANCIAL STATUS AT CLOSE OF ACCOUNTING PERIOD 37. Ending Cash Balance thne 20) ~Z c( ~7 ~ 2*7 38. Accounts Recmvable + t. Account~ng Period Total from PC 5) 39. SUBTOTAL (hnes 37 + 38) = 40. Total Outstanding Loans (hue 29) 41, Outstanding Personal Expen&tures + (hne 36) 42. Accounts Payable + (Accounting Period Total fiom PC 6) 2~ . 43. SUBTOTAL (hnes 40 + 41 +42) 44. BALANCE/DEFICIT , (hne 39 mmu~ hne 43: ~n&cate* or- balance) = ~ ~' ~'~ ~ ~ ~/9 ,) I, ~ ¢~ C-~,_ c4 ~ ~C ~ c~ 5 e c~ (name of candidate or treasurer), hereby cemfy that the above statement and the attached supporting reports are true and correct. £ Signature of candidate or treasurer Date s~gned Summary '*atement of Contributions Expenditures Please type or print leg$1y tn black ~mk. Page 1 oil Can&date or Pohfical Co~aee Name {use fi~ll name~: Marling Address as k Appears on Statement of Organ=atmn {'s~eet, route or box number, c~¢', stare, zip code): Treasurer's Name: Telephone Number rday): Comm~ee [D Number: Co~2~ee Type, Meas~e Number or Of~ce: ~ Original ~Pnma~ _~ ~ General 20~ ~ Other ~Amendment ~ I st Pre-election ~nd Pre-electron ~ Post-eiecnon ~ 20 September Supplemental A-TOT.~S FOR THIS ~CUMULATF~ TOT ~S ACCOU.~ TING PE~OD FOR T~S ELECTION' O0NT~IBUTIONS 1. Cash Conmbunons (Accounnng Period Total ~om PC 2~ ~ ~ ~¢ ~ ~ ~ V ~ 2. Loans Received(Non-Exempt) 'Accounting Penod Total from PC 21 + ~-- + q o ¢ 3. Total Cash Conmbutmns 4. In-Kind (Accounting P~nod Total from PC 2) ~ t ~ O ~, ~ ~ + ~ ~ ~ ~ ~. 5. TOTAL CONT~BUTIONS EXPENDITURES 6. Cash Expert&rares (Accounnng Period Total lkom PC 3~ ~'~ b~ f 6. ~ -~ ~, 6~ 0 . 7 7. Loan P}.vments (Non-Exempt} + { Accounting P~nod Total from PC 31 * ~ ¢ O S. Total Cash Expen&mres 9. [n-Kind (AccountmgP.znodTotal~omPC2) (, f off. ~ ? * l~ % ~. TOTAL EXPENDITU~S (lines 3 - 9) ~, q Y7, CASH BALANCE t t. Beg~mning Cash Balance (!me 20 ofprevtous report) ~ ~ V ~¢~ ¢'~ FOR OFFICE USE ONLY 12. Total Contnbunons + 4 q ¢ ~ · k ~ 13. Other Recmprs + (Acco~nng Period Total from PC 4A~ 14. Loans Received (Exempt) · {Accomnrmg Period Total from PC · * T i5. CONTPGBUTION ScaB_ OTAL ld. Tomi Expen&mres 17. Other D~sbursements . ~ r ~ [7 (Accounnnz Ported Total from PC 4B} ; ;- ~' ~ *~ L~ 18 Loan Payments (Exempt) + ~ , ,, hkccounnng Period Total from PC 4B ~ 19. EXPEND[TU~ SUBTOTAL 20 ENDING CASH BALANCE dine 15 minus hne tO, Jtement Contdb t]ons oummary Please .type or pnnr legibly m black ip&. Page 2 of' 2 Candidate or Political Committee Name: I Corcmaittee ID Number: ~r-~,~ to..-- 52~<-- <~,4-% [~1 Original [~Primary 20 r2 ,.~ [] General 20 [] Other ~Amendment [] Ist Pre-election ~2nd Pre-election [] Post-electzon [] 20 September Supplemental LOAN SUMMARY 21. Beginning Outstanding Loans FOR OFFICE USE ONLY (line 29 of previous report) 22. Loans Recmved (Non-Exempt) (tine 23 + 23. Loans Received (Exempt) (hne 14) + 24. LOANS RECEIVED SUBTOTAL (hnes 21 + 22 + 23) = 25. Loan Payments (Non-Exempt) (line 7) 26 Loan Payments (Exempt) (line 18) + 27. Forgiven Loans (Total loans forgiven during th~s accounting period) + 28. LOAN PAYMENT SUBTOTAL (hnes 25 + 26 +27) = 29. TOTAL OUTSTANDING LOANS tline 24 minus line 28) = PERSONAL EXPENDITURE SUMMARY 30. Begmming Outstanding Personal Expenditures (line 36 of previous report) 31. Personal Expenditures (Accounnng Period Total from PC 3A) 32. PERSONAL EXPENDITURE SUBTOTAL (hnes 30 + 31) = 33. Personal Expenditure Reimbursements (Total expenditures on PC 3 with purpose code R} -- 34. Forgiven Personal Expenditures ITotal personal expenditures forgiven th~s acctg, period) 35. RELMBURSEMENT SUBTOTAL (lines 33 * 34~ 36. OUTSTANDING PERSONAL EXPENDITURES = FINANCIAL STATUS AT CLOSE OF ACCOUNTING PERIOD 37. Ending Cash Balance (line 20) 38. Accounts Receivable tAccountmg Period Total from PC 5) + 39. SUBTOTAL (lines 37 ~- 38) = 40. Total Outstanding Loans (line 29) 41. Outstanding Personal Expenditures (line 36) + 42. Accounts Payable (Accounting Period Total from PC 6) + 43. SUBTOTAL (hnes 40 + 41 +42) = 44. (line 39 minus hne 43. md~cate + or- balance) = I, /~14#'~-e~ fl. ~r'/'~/~$ov-- (na~neofcandidateortreasurer).herebycert~fythatrheabove statement and the attached supporting reports are tree and correct. Signature of ca/nd~date or treasurer Date signed Amendments-Cash Expenditures and Loan Payments Cand~dat~ ur Pohucai Committee Name Committee iD N umber Report ~ 1st Pre-elecuon ~2nd Pm-electxm ~ Post-olecuon ~ 20 September Supplemental PURPOSE CODES (see back of ~brm ibr instr=ctions and code definitiol~s} EXPENDI1- U RE A Agem O Other Adx erasing (},mrd stuns, bapion>, etc, } C ~x Cash B Broadca>t AdYemsmg (Radio, TV~ P Postage LP Loan Payment C Cash Contributions R Rc~mburscmcr,t lorPcrsonalExpcnd~turc5 F Fandlalsmg EYent Expenses S Surveys and Poll~ G General Operational E~ocnse~ (describe if over $50~ T Tra5 el Expensc~ (describe if over t lntcre=r Payment U U /_ L~temture, Biochu:e>, Printing W Wages, Salaries, Benefits M Management Scr,,qces Y Petmon N Nex5 spapcr and Other Peliod:cal Adx ertlsmg Z Preparation and Production of Ad', erasing Amending P?ge ~ . ~ I , and L,ne ~ Payee's Name and Payee s vomm~ttee ~ Check ~ ff aopticable Purpose Exp. Amour, t of , Pa~d Date (as ;t appears on ~vo~ce, recetpt or check) TXae Expendmre ~ Correcting °aae Line ~ New ~ Correchng ~ Dele[mo $ Page. L,ne t~] New Entr5 ~ Ccrrectlqg ~ Deleting $ ~ Page.__ L,ne__ [~] New Enrr,~ [~ Correct,ng ~ Deleting $ ~ Page .... Dne [] New EmU [~. C0r'eo:pg ~ [~] Deleting $ ~ Sec FOR OFFICE USE ONLY ~llstroct!,~l~s Flnallcc Signature of candidate of trcasurc~ Manual Amendment Date s~gncd PC Summary .atement of Contributions Expenditures Please type or print leg,Ny in black mk. Page 1 of 2 Candidate or PohUcal Corem,tree Name (use full name): Mailing Address as ]t Appears on Statement of Orgamzation (street, route or box number, c]ty, state, z]p code). Treasurer's Name:w Co~mlttee ID NumbeF. Co~]ttee T~pe, ~e~suFe N~bez 0[ [] Original ~Pnmary 20~ [] General 20 [] Other [] Amendmem [] 1st Pre-elect~on [~J 2nd Pre-elect~on [] Post-elect, on [] 20__ September Supplemental A-TOTALS FOR THIS B-CUMULATIVE TOTALS ACCOUNTING PERIOD FOR THIS ELECTION CONTRIBUTIONS 1 Cash Contributions (Accounting Period Total from PC 2) ~ "5 .Z O ~ [ '70 2 Loans Received (Non-Exempt) + + (Account,ng Period Total t¥om PC 2) 3. TotalCash Contributions (lines t+ 2) = 4 In-Kind + ~: /o'f./. ;Y + (Accounting Per,od Total from PC 2) 5 TOTAL CONTI~ABUTIONS EXPENDITURES 6. Cash Expen&tures (Account,ng Period Total from PC 3) 7. Loan Payments(Non-Exempt) + + (Account,ng Per,od Total from PC 3) ~o 0 8 Total Cash Expenditures (hnes 6+ 7) 9 lm-K~nd tAccount,ng Period Total from PC 2) + 10. TOTAL EXPENDITURES dines 8 + 9) = CASH BALANCE 11. Beginning Cash Balance (line 20 ofprev,ous report) 5'_/ ~7 5'(~ ~8 FOR OFFICE USE ONLY 12. Total Contributions {line 5) + 13. Other Receipts + (Accounting Period Total from PC 4A) 14. Loans Received (Exempt) + (Account,ng Period Total from PC 4At 15. CONTRIBUTION SUBTOTAL (hnes 1i + 12 + 13 + I4) = 16. Total Expen&tures (line 10) 17. Other Disbursements + (AccounUng Period Total from PC 4B) 18 Loan Payments (Exempt) + (Accounting Period Total from PC 4B) 19. EXPENDITURE SUBTOTAL 20. ENDING CASH BALANCE (hne 15 minus line t9) Summary mtement of Contributions a, d Expenditures PJc~s~ ~ypc or pant legibly m bJack ~c Candidate o~ Pohhcal Committee Name. ~ Comnmtec ID Nm-ribes' ~ Amci, dment~ ~ ist Pre-elcctlon ~ 2nd Pre-election [! Post-decuon ~ 20___ September Supplemental LOAN SUM~ARY 2~ ~c~mn~ Ouv~t~ndm~ Loan~ FOR O~F~C~ USE ONLY ',1mc 29 of l:uc~-ous report) 22. Lonns Received/~on-E'~emptl ~., Luaus Reechoed (ExempO 2& LOANS RECEIVED SEBZOTAL 25 Loan Payments {Non-Ekempt} 26 Loan Payments (Exemo0 27, For?,,en Leans /l otaI 1 )~ns fbi g~x cn dunng th.N a~counnng pcnod~ fi& LOAN PAYMENT SUBTOTAL 29 TOTAL OUTSTANDING LOANS PERSONAL EXPENDITURE SUI~ARY 30 Beginmng Outstanding Personal E:<l~endimzes 31 Personai gxpen&ture~ + {Azcot:ntm2 Period Iota! ri*om PC 32 PERSONAL EXPENDITURE SUBTOTAL Personal Expen&ture Reirffbu~ements (lot d .:xpzn&tu 'c-, on PC 3 x~ nh 9amo,c code R} 34. Forgiven Persona! Expenditures + {To~al personal expend;tares %,r~t, zn th~s accrg pe~,cd} 35 REIMBURSLMENT SL'BTOTA~ thm~ 33 ~ 34) 36. OU1STAND~NG PERSONAE EXPENDITU ~S FINANCIAL STATUS AT CLOSE OF ACCOUNTING PER]OD 37 [~ndhg Cad~ Balancc 38. AccouNts Recenable + (Accounting Pcncd Io~al ham PC 5~ 59. SL bTOTAL {linch 37 ~ 40. lomi Out>tandmg Loans 41 Oustanding Per=anal Expcndmxez + 42. ~etzco.tnts Payable + (,~cct,untmg Pcr.ud To{al homPC/,i ~ ~ ~ O ~ ~ g~ 43. SUBTOTAL dme¢' 40 ~ 41 "- 42 } 44. BALANCE/DEF[C[I ~ hnc 39 md~tts linc 43 re&cate + er ~ ~a:ancc I statement and thc at}ached s~tpportmg :'epa:% are true and correct. S~na~ure of candktaEc or treasurvr Oak -~gned PC 2 Amendment Amendments-Cash Contributions, Loans eceived and n-Kind Can&date or Polmcal Co~ee Name: Co~ee tD Number: Elecnon: ~Pnmarj 20D ff ~ General 20 ~ Other Report: ~ 1st Pre-election ~ 2nd Pre-elecnon ~ Post-etecnon ~ 20 September Supplemental SEE BACK FOR INSTRUCTIONS AND CODE DEFINITIONS CODE 1: Contributor Type CODE 2: Contribution Type B Business Entz~ CA Cash C Political Com~J~ee (includes business and umon PACs) CO Coaxer Obhgation F Can&date's I~e&ate Family (includes can&date) IK In-Kind ~ In&vidual LR Loan Recezved L Labor Orgamzat[on O Other P Pohtical Pa~ Co~z~ee Amendin~ Pa~e ~ Name and Address of Contributor Amount of In-Kind Purpose and Line ~ Contribution (see manual for suggested purpose codes) Date Received Occupational Information or Contributor Code f Code 2 Contributing Commt~ee's t~ Aggregate New Entw ~ Correcung ~l ~ ~' ~ Deleting Page~ Line ~ ~ Correcting E Deleting ~ Correcting ~¢ 0 ~ Co~ect~ng ~ Deleting Page L~ne~ ~ New Em~ $ ~ Correcting ~ Ddebng $ See FOR OFFICE USE ONLY [nsm~ctions in Campmgn F~nance S~gna~e of can&date or treasurer Man~l A~e~e~t Date signed PC Summaw _.atement,of Contributions ,d Expenditures Please qcpe or pnnt legibly in black ink. Page i of 2 Can&dare or Pohncal Conzmittee Name (use full name): Matting Address as it Appears on Statement of Orgamzanon (street. route or box number, city, state, zip code)- Treasurer's Name:.L Telephone Nmnber (day): Cormmttee iD Number: Committee Type, Measure Number or Office: []~Ongmat '~ Primary 20 Gq [] General 20 [] Other F-] Amendment ~ 1st Pre-election [] 2nd Pre-election ~.Post-etecnon [] 20__ September Supplemental A-TOTALS FOR THIS B-CUMULATiVE TOTALS ACCOUNTING PERIOD FOR THIS ELECTION CONTRIBUTIONS 1. Cash Contributions (Accounting Period Total from PC 2) 2. Loans Recmved ~'on-Exempt) + (Accosting Period Total ~om PC 2~ 3. Total Cash Conmbunons = 4. In-Kind (Accosting Period To~l from PC 2) + 5. TOTAL CONT~BUTIONS EXPENDITURES 6. Cash Expen&mres (Accounting Period Total from PC 3 7 Loan Payments (Non-Exempt) + o (Accounting Period 7oral from PC 3 8. Total Cash Expend,rares = 9. In-KmO (Accounnng Period Total from PC 2 + (lines 8 + 9) CASH BALANCE 11. Begi~mg Cash Balance (line 20 of prey, Gus repo~) ~ .¢. ( FOR OFFICE USE ONLY 12. Total Con~bufions 13. Other Recmpts + (Acco~nng Period Total ~om PC 4A) 14. Loans Received (Exempt) + (Accounting Period Total from PC 4A) 15. CONTmBUTIONSU~TOTAL = 5" Zq7 '75 (hnes 11 + 12 ~ 13; 14) 16,Total Expen&mres (line 10) . + 17 Other Disbursements (Accounting Period Total ~om PC 4B) 18. Loan P%~ents (Exempt) + (Accounting Period Total from PC aB) 15. EXPENDIT~ SUBTOTAL = Crees 16- 17- 18) 20. ENDING CASH B~ANCE (hne i5 minus hne 19/ PC 1 Summary..atement of Contributions ,d Expenditures R,. Please type or print legibly in black mk Page 2 of 2 Candidate or Political Commmee Name: Commmee ID Number: [] Ongmat [] Pnmarv 20 [] General 20__ [] Other [] Amendment [] ts( Pre-election [] 2nd Pre-election [] Post-elect~on [] 20 September Supplemental LOAN SUM~'IARY 21. Beg~nmng Outstanding Loans FOR OFFICE USE ONLY {line 29 ofprex ious report) 22 Loans Received (Non-Excmptt + (hne 2) 23. Loans Received (Exempl) + (hue 14) 24, LOANS RECEIVED SUBTOTAL (lines 21 * 22 + 23) 25, Loan Payments (Non-Exempt) (hue 7) 26. Loan Payments (Exempt) + (hnc 18) 27. Fmglven Loans + (Total loans forgp, en dunng th~b accounting period) 28. LOAN PA5 MENT SUB1' )TAL (hncs 25- 26 ~27) 29 TOTAL OUTSTANDING LOANS (hne 24 minus hnc 28) PERSONAL EXPENDITURE SUMMARY 30. Beginning Outstanding Personal Expen&tures thne 36 of prexqous report) 31. Personal Expendmtres + (Accounting Period Total ii-om PC 3A) 32. PERSONAL EXPENDITURE SUBTOTAL (hnes 30 + 31) 33. Personal Expenditure Reimbursements (Total expen&tures on PC 3 v,~th purpose code Ri 34. For~ven Personal Expenditures + (Total personal expenditures forglYen this acctg period) _~3. REIMBURSEMENT SUBTOTAL (lines 33 + 34) 36. OUTSTANDING PERSONAL EXPENDITURES = FINANCIAL STATUS AT CLOSE OF ACCOUNTING PERIOD 37. Ending(line 20)Cash Balance 38 Accounts Recmvable + /Accounting Period Total from PC 5) 39. SUBTOTAL (hues 37 + 38) 40. Total Outstanding Loans (line 29) 41. Outstanding Personal Expenditures + (line 36) 42. Accounts Payable + (Accounting Period Total from PC 6~ 43. SUBTOTAL dines 40 + 41 + 42) 44, BALANCE/DEFICIT = (line 3') m~nus hne 43' in&cate ~ or - balance) I, /~'5~C~ * ~~ (~. ~ ('~' C- ~Seo ~ (name of candidate or treasurer)~ hereby certify that the abo~ e statement and the attached supporting reports are true and correct S~gnamre of can~hdate or treasurer Date signed Cash Contributions, Loans Received and Candidate or Pol.t~cal Committee Name Commhtec ID Number Report' ~ tst Pre-election ~ 2nd Pre-election ~,Post-elecdon ~ 20 September Supplemental SEE BACK FOR INSTRUCTIONS AND CODE DEFINITIONS GODE ~: Gontributor Type CODE 2: Contribution Type B Business Entitx CA Cash C Polmcal Conmutree (includes business and union PACs) CO Cosigner Obhgation F CandMate% Immediate Farmly tmcludes can&date~ IK In-Kind I individual LR Luan Recdx ed L Labor Organization O Other P Polmcal Pa~,: Co~n~rtee Amount of In-K~nd Pu¢ose Line ~ Name and Address of Contnbutor Contribution (see manual for sugges[ed puq~ose codes) Occupat, onal information or Contributor Date Rece¢ved Code ~ Ccde 2 Contr¢bu¢¢ng Commi~ee b t~ Aggrega[e See Page Totals ladd a~i amounts with the same Accounting Period Totals fComplete only for last page and Instractmns contnbutmn E, pe. Do not include agcegates.) transfier these amounts to the Summap,' Statement, PC on Back and ~ ~ O0 m Campaign Cash iCA; S ' ~ Ca>h ~CA/ S Manual in-Kind ~IK; 5 ' tn-Kind IIKj PC 2 Loan~ P. eccv.,:c L3, $ ~ Loans Rece?,cd ~LRj S Pc 2 Cash C,,ntributions, Loans Receiw.. and In-Kind Candidate or Political Committee Name. Con~ee ID Number: 7~'-~ ~ ~ e~4'~. ~o~ ~ Page Elecnon: ~Pnmaw 20 4 ~{ . ~ General 20 ~ Other Report ~ Ist Pre-election ~ 2nd Pre-election ~Post-eIection ~ 20 September Supplemental SEE BACK FOR INSTRUCTIONS AND CODE DEFINITIONS CODE ~: Contributor Type CODE 2: Contribution Type B Business End~ CA Cash C Poht~cal Co~ttee tincludes business and umon PACs) CO Cosigner Obligauon F Can&date's Immediate Family (includes can&date) [K In-Kind 1 In&~idual LR Loan Recewed L Labor Orgamzanon O Other P Polincal Pa~ Comminee Amount of ln-K~nd Purpose One ~ Name and Address of Contributor Contribution (see manual for suggested purpose codes) Occupational Information or Contributor Code ~ ~ Code 2 Date Received Contributing Comm¢¢ee's I~ Aggregate 2. ,'~ ~. %g $ Z~~ X See P~e T~tals (Add ali amounts with ~e same Aeeo~t~ Pe~d T~ta~s (Complete only for bst page and Instructions conmbut~on Wpe. Do not include aggregates ) tmnstkr these amounts to the Su~a~ Statement, PC 1 ) on Back and ~ S in Campmgn Cash (CA) $ Cash (CA) $ ~a~Ce Enter on Summ~ State~nent. Column A, Line Manual In-Kind (IK) $ ~. ~ In-Kind (IK) $ Enter an Su~na~ Statement~ Col~ ~. Lines 4 and 9 PC 2 Loans Recmved (LR) $ Loans Received (LR) $ Enter on Su~aw Statement Colmmn PC 2 Cash (, ,ntributions, Loans Receiv and in-Kind Candidate or Polmcal Co~nittee Name. Co~ittee ID Nmnber: Election. ~ PumaW 2Od) 4 ~ General 20~ ~ Other Report: ~ 1st Pre-elecnon ~ 2nd Pre-elecnon ~Post-elecnon ~ 20 September Supplemental SEE BACK FOR INSTRUCTIONS AND CODE DEFINITIONS CODE ~: Contributor Type CODE 2: Contribution Typo B Business Ent~U CA Cash C Pohncal Committee (includes buaness and union PACs) CO Coagner Obligation F Candidate's hnmediate Family (includes candidate) iK In-Kind I Indwidual LR Loan Received L Labor Orgamzanon O Other P Political Pa~ Comm~aee L~se ~ Name a,d Address of ContnDator Co~tribdion (see ma,~al for swggostod p~¢oso codes) Date Recewe4 Occupational I,[ormottoo or Contributor Co~o ~ Cage 2 Contributing Gomm~ee's I~ Aggrogato See Page Totals (Add all amounts w~th the same Accounting Period Totals (Complete only fbr last page and Instructions conmbut~on Dpe. Do not include aggregates. } transfer these amounts to the Su~a~ Statement, PC 1 on Back and X 0 0 in Campaign Cash (CA) $ Cash (CA) $ Finance Enter on Sum2~aU Statement, Colum A. Linc 1 Manual In-Kind (IK) $ 3 ~' ~' ~ / In-~nd (IK) Enter un Sunm~a~ Statement, Colmnn A, [ mos 4 and 9 PC 2 Loans Received (LRI $ Loans Received (LR) $ Enter Cash Contributions, Loans Received and In-Kind Can&date or Political Comrmttec Nan}e: Committee ID Number: Elect,on. ~Pr~ma(v 20 SC ~ General 20 ~ Other Repo~: ~ ist Pre-election ~ 2nd Pre-elect,on ~ Post-election ~ 20 September Supplemental SEE BACK FOR INSTRUCTIONS AND CODE DEFINITIONS CO~E ~: Contributor Type CODE 2: Contribution Type B Business Entity CA Cash C Politics[ Con~J~ee (includes basiness and union PACs) CO Cosigner Obhgat,on F Can&date's [mmedmte Family {.includes can&date) IK In-Kind I Indiwdual LR Loan Reccix ed L Labor Organization O Other P Polmcal Prow Commiaee Amount of In-&nd Purpose L~ne ~ Name and Address of Contributor Contribution (see manual for suggested purpose codes) Occupattonal Information Contributor Code ~ ~ Cede 2 Date Received ContnSut~ng Committee's I~ Aggregate 2 $ 5 $ S See Page Totals (Add all amounts w~th the same Accounting Period Totals (Complete only for last page and lnstrucnons contribution type~ Do not include aggregates.) transfer these amounts to the Summaq/Statement. PC on Back and ~ P bCam"avm Cash (CA) S Cash ~CA* m Finance Manual In-K~nd (iK) $ ~ g' 5~ ln-K~nd t IK) S Fnrcr _.c~.., .cc PC 2 Loans P PC 3 Cash Expenditures and Loan ! yments Can&date or Polmcat Cormnlt[ee Name. Committee ID Number: /' Page [ of Election' ~ Pnmmw 20 o¢ D General 20 ~ Other Report' ~ I st Pre-election ~ 2nd Pre-elecnon ~Post-elecnon ~ 20 September Supplemental PURPOSE CODES (see back of form for ~nstrucdons and code definitions) EXPENDITURE TYPES A Agent O O~er Advems~ng ~ym~d s~s, bu~onb, etc.) CA Cash B Broadcast Advems~ng (Radio. TV) P Postage LP Loan Payment C Cash Contributions R Rmmbursement lbr Personal Expen&mres F Fundrmang Event Expenses S Su~eys and Polls G General ~eranonal Expenses (describe ~fover $50) T Travel Expenses (describe ~f over I Interest Payment U Utflmes L Literature, Brochures, Printing W Wages, Salanes, Benefits M Management Se~'~ces Y Petmon Circulators N Nexxspaper and Other Periodical Advertising Z Preparation and Producnon of Advemsing Payee ~ Name and Payee's Comm~ee I~, Line ~ Date Check ~ ff apphcable Pu~oose Exp Amount of (as ~t appears on ~nvo~ce, receipt or check) Type Expendtture Patd to ~P 6. $ F-"[ 7. $ 8. $ E3 lO. $ [~ See Page Totals (Add all expenditures with the same Ac,counting Period Totals (Complete only for last page and Instrucnons expen&mre type.) transfer these amounts to the Summary Statement, PC 1 ) onBackand O~I7'~ Cash(CA) $ :2/ 0c{7' 5f~ in Campaign Cash (CA) $ ~l Finance Enter on Summa~ S~atemen~ Colamn A Linc 6 Manual Loan Payment {LP) $ Loan Payment {LP~ $ Enter on Smrandry Statement Column A_ hne 7 PC 3 PC 4~ Other Receipts Candidate or Polmcai Committee Name: Commmee 1D Number: Repc, rt ~ 1st P~e-elceuon ~ 2ud Pre-eiect~on ~ Posbckcaon ~ 2c) Scpb;mber SupplcmentA SEE BACK FOR INSTRUCTIONS AND CODE DEFINITIONS OtherRece~p~ Transaction Type Codes EL Exempt Loan Proceeds FM Items Sold ar Faw Market Vakte IN Interest/Investment Income OM Mn,,_ellancous ~prov;dc a descnptzon} RF Rutkmds~ Rebates and Reg~rns Date Name Other Receipt Doe # Received (requlred for codes EL, OM and RF: TratTsact/on Type Othe,* Reoetpt Amount oot¢onal for codes FM and h¥) Code 2 3 $ 4 $ 5 $ 7 $ 8 $ 10 $ See Page Totals (Add all Otl~cr .Receipt Transaction Accounting Period ~[otals i C'ompiezc only f~l last page and Instructions Type Codes specified. ~ trans~kr these ~lnoun[s to the Summary S~atcmenL PC m Carnpmgn Codc~ FM, iN, OM, RF $ ~ Codes FM, Finance Manual Code EL $ Code EL PC 4A Accounts Payable Can&date or Polmcal Commzttee Name: Comnnlttee iD Number: Page Elect, on: ~Pfim~ 20 b 4 ~ General 20 .... ~ Otb. er Report: ~ 1 st Pre-elecnon ~ 2nd Pre-elecnon ~. Post-decnon ~ 20 September Supptementai PU~OSE CODES (see back for instructions ~nd code definitions) A Agent O Other Advemsing (yard si~s, bu~ons, etc.) B Broadcast Advegising (Rd&o, TV) P Postage C Cash Conmbutzons S Sup¢eys and Polls F Fun&rasing Event Expenses T Travd Expenses (describe ~f over $50' G General Operational Expenses (describe tf over $50) U Unhties [ lnterest Payrnent W Wages, Sala~es, Benefits L L~teramre, Broch~es, Printing T Per,non C~rculators M Management Services Z Prep~atzon and Producuon of Adve~ising N Newspaper and Other Pedo&cal Adve~iszng Amount of One ~ Date Payee's Name Purpose Account See Page Total (Add ail accounts payabte on th~s Accounting Period Total (Complete onty for last page and Nstractions fo~3 ~ansfer these amounts to the Su~mao Statement, PC 1 ) on Back and m Campaign Accounts Payable $ '~ ~ ~' ~ ~ Accounts Pay~ole $ Enter ~n S~ma¢ Sr2tement, Finance Manual PC d : PC Accounts Payable Candidate or Pohtical Committee Name: Committee ID Number: %-t b.- ' ...... (_~4~-~, ( Page ~ of___~_ Election' [~Prtmary 20 0 q [] General 20 [] Other Report: [] 1 st Pre-election [] 2nd Pre-election ~Post-elecnon [] 20__ September Supplemental PURPOSE CODES (see back for instructions and code definitions) A Agent O OtherAdvertlsing (yard B Broadcast Advertising (Radio, TV) P Postage C Cash Contributions S Surveys and Polls F Fundraismg Event Expenses T Travel Expenses (describe if over $50) G General Operational Expenses (describe if over $50) U Utilities t Interest Payment W Wages, Salaries, Benefits L Literature, Brochures, Printing Y Petition Circulators M Management Services Z Preparation and Producuon of Advertising N Newspaper and Other Periodical Advertising Amount of Dne # Date Payee's Name Purpose Account Payable See Page Total (Add all accounts payable on th~s Accounting Period Total (Complete only for last page and Instructions IU~-) transfer ~ese ~nounts to the Summaw Statement, PC 1.) on Back and in Campagn Accounts Payable $ J~ q ~ 5~ [ ~ Accounts Payable $ / Enter on Su~a~ StaremenL Colm~m A, Line 42 Finance Manual PC 6 PC Accounts Payable Can&date or Political Committee Name: Committee ID Number: Elecnon [~ Primary 20 ¢ ~ [] General 20 [] Other Report: [] 1 st Pre-election [] 2nd Pre-election ~ffPost-election [] 20 September Supplemental PURPOSE CODES (see back 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 Utlhtles 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 L/ne # Date Payee's Name Purpose Amount of Account Payable See Page Total (Add all accosts payable on this Accounting Period Total (Complete only for last page ~d Instructions fo~.) transfer these amounts to the Summa~ Statement, PC 1.) on Back and } ~ ~ 7, ~ Accounts Payable $ m Campmgn Accounts Payable $ ~ } FinaDce Enter on Summ~ StaemenL Colu~ A, L me 42 Manual PC 6 PC O Accounts Payable ,: o: Can&date or Pohtical CormmJttee Name: Conzmntee ID Number: Elect~on. ~Phma~, 20~ff _ ~ General 20 ~ Other Report: ~ t st Pre-electron ~ 2nd Pre-election ~Posbelecnon ~ 20 September Supplemental PU~OSE CODES (see back [or ~nstrucfions and code definitions) A Agent O Other Adve~ismg (yard si~s~ bu~ons~ otc ) B Broadcast Advemsmg (Radm. TV~ P Postage C Cash Contnbutmns S Su~eys and Polls F Fundraising Event Expenses T Travel Expenses {describe ~f over $50~ G GeneralOperanonal Expensesldescnbe ~fo-ver $50) U Utilines I Interest Payment W Wages, Salaries. Benefits L Literature, Brochures~ Pnnfing Y Petition C~rculators M Management Se~ces Z Preparanon and Production of Adve~ismg N Newspaper and Other Pefio&cal Advertising Dne # Date Payee's Name P,,r cse Amount of ~ P Account Payable 8 $ 9. $ 10. $ See Page Total { Add all accounts payable on this Accounting Period Total (Complete only for last page and Instractmns form.) transfer these arnoums to the Summary Statement, PC 1 .) m Campaign Accounts Payable $ ' Accounts Payable $ , Finance Enter on $umrnar:, Statement, Cmunm A, Line 42 Manual PC 6 Certificate of Limited Contributiens and Expenditures Trea~u e~ 's N~lnw (Sf &flbrcnt than ~and~da~e L 7 cieph,me N umber Mmhng Address as n Appear~ on Stakment of O~g~m!zatlon (>t¢cet, TOUk OF box 1}tallbcF. (17, bMOC, Z!p COd~ }, the aggregate co~m~ibut~ons recel,, ed nor lite aggregate expen&tures made b> o~ on behalf of m) candidaq, o~ committee fo~ tlu5 elcchon ~o ¢x~,xd S2,o00. t m~derst.md thai ii tl~e comnnn,-e cxcced~ $2.U00 m total centnbutK, n~, or exp~n&t~ire; dunng tl~c elcctu-z,m ~Ltbbcqucnt detaded rcp,2its mu~t bc tiled d' 5i~nature of candidate or trcastacc Date If a candidate ol political comm:tkc EXPECTS ~o i~elther iccdve a total ol more ~ba2 SAOOO no~ >pend a total of :non: 52.000 lbr th.c enm'e eieo~on, a E crt~ficate of Lmnted C ontnNalons and Expcr~dm_tr¢5 m%, be flied Corotar!ecs may hlc th~ ccmikate v, hen riley oHgmal!y Ilk their Staemcnt of Orgamzation or during the first pfc-election r=pomng period A committee Wi~en e~ther thc to:a~ contributions o~ total cxt2~nd~tm c5 for mc elecuon e~,:eed $2.00O. detailed contnbano:~ and lcpo~s nmst be tiled, lh~ fi: ut deta~kd repo~ mttst bc filed fo~ Gc accou:mng pcrxod s~ v,'h~ch the committee exceeds SI,000 e~thcr otntnbuuon~ ot expeu&tu~c~ and mTst reflect all contnbuttons ani expend~t4re, to ,i2te Rcl~r to the Campat~n Finance Manual ~b~ ii~rthe~ rain matron Dead] m~ dates tot fihng a Cc~ nficate of L;mmM Contributions and Expen&tm'es or deta~1¢d cona ~bunola and expen&tm e repo~ ts MUST BE strictly obsen ed Under ORS 260 23A the Secretary of Start: may mmooe ~ cn'fi pcn~ky ag~,~nst a can&date or tree, surer fbr ghng a late or m~dffic:cn[ dem~led contribution and cxpen&turc report or Cemfica~e of LnmtCd Omtrtbtmons and FOR OFFICE USE ONLY