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Chris Pryor for City Council
P( Summary Statement of Contributions and Expenditures Please type or print legibly m black m& Page 1 of 2 Can&date or Polmcal Comm!ttee Name (~e full name). Treasurer's Name T~'-~~ /~(~ ~ ~ Telephone Number (day) Co~lttee iD Number Co~lnee Type, Measure Nmnber or Office ~ Original ~ Primary 20~¢ ~ General 20__ ~ Other ~ ~ Amendme.t ~ 1 st Pre-elect,on ~ 2nd Pre-elect,on ~ Post-elect,on ~ 20__ September Supplemental X-TOTALS FOR THIS ~CUMULATB'R TOTALS ACCOUNTING PERIOD FOR Tn~S ELECTION CONTRIBUTIONS 1 Cas~ Contnbunons ~ ~ (Accounting Period Total fiom PC 2) ¢-7 -~J ~" 2. ~o~ns ~¢cCBcd(~on-Exe~pU (Accou~m~ Period qomi t~om PC 2/ ~ ¢¢~ 4 5. TOT~ CONT~BUTIONS EXPENDITURES O Cash Expendtmies (Accounting Period Total from PC 3 ) 7 Loan Payments (Non-Exempt) + ~ + (Accounting Period TotM fi-om PC 3 / 8 Total Cash Expert&rares = (hoes 0 ~ ~) _ = 9 In-Kind (Accodnnng Period Total from PC 2) 10 TOTAL EXPENDITU~S = ~ = (hnes 8 ~ 9) CASH BALANCE 11, Begmmng Cash Balance (line 20 ofprex~ous repro1) .~¢/~ FOR OFFICE USE ONLY 12 Total Conmbuttons + ~ 7 ~:¢'"' (hnsS) ~ ~ ~ 13 Other Receipts + (Accodntmg Period Total from PC 4A) 14 Loans ReceBed (Exempt) + (Accounting Period Total from PC 4A) ~ 15 CONT~BUTtONSUBTOTAL = 9 .~y'~' yY ~EC~]~ 16. Total Expendnures 17 Other D~sbursements GiTY RECORDER 18, Loan Payments (Exempt) + ~ Accodnnng Period Total from PC 4B) EXPENDITURE SUBTOTAL thnes 10 ~ 17 ~- 18) 20 ENDING CASH BALANCE ' 5'~ PC Summary Statement of Contributions and Expenditures Please ~pe or print leg~bl; m black ir& Page 2 of 2 Can&date or Poht~cat Conm~ttee Name ~ 6 ' [ Conmnttee 1D Number : Gng~nat : Primary 20:¢ : General 20__ : ~ Amenamem ~'ist Pre-elecnon ~ 2nd Pre-elecnon ~ Post-elecnon ~ 20__ September Supplemental LOAN SUMMARY 21. Beg~mmng Outstanding Loans FOR OFF~CE USE ONLY (hne 29 of prex ~ous report) 22. Loans Received ~Non-Exempt/ (hne 2~ + . 23. Loans Recmved [Exempt) + (hne 14) 24. LOANS RECEIVED SUBTOTAL {hnes 2I +22+23) 25 LoanPayrnents (NomExempt) (hne 7~ 26. Loan Payments (Exempt) . 27. Forgiven Loans + ~Total loans forg~x en during th~s accounting period} 28 LOAN PATMENT SUBTOTAL (hnes Z5 -~ 26 +27) 29 TOTAL OUTST~DING LO~S {hne 24 tnmus hne 28) PERSONAL EXPE~DffURE SUMMARY 30. Begnm~ng Outstandm~ Personal Expen&tures (hne 30 of previous report) 31 Personal Expcn&mres + {Accounting Per~od Total from PC 3 ~ 3Z PERSONAL EXPENDITURE SUBTOTAL (hnes 30~ 31) 33 PersonalExpend~mre Reimbursements (Total expcn&tures on PC 3 w~th purpose code R) 34. Forgiven Personal Expen&m~es + (Total personal expen&tures tbrg~ven th~s acctg period) ~[N~URSEN~NT SUBTOTAL (hnes 3.z + 34) 36. OUTSTANDING PE~ON~ E~ENDITU~S dine_,_ ~0 minus hne 35) FINANCIAL STATUS AT CLOSE OF ACCOUNTING PERIOD 37 Ending Cash Balance I line 20) va. Accoums Receivable + (Accounting Period Total from PC 5) 39 SUBTOTAL {hnes 37; 38) 40 Total Outstanding Loans (bne 29) 41 Ou:standmg Personal Expenditures + (hne 36) 42 Accounts Payable + ( &ccounnng Period Total from PC 6 ) 43 SUBTOTAL (hnes 4i} + 41 + 42) : 44 B~NCE/DEFICiT 4 /hne 39 minus hn~ 43 indicate ~ or - Da!ante> ~ ~ .? :~ ~ I, __ t name of can&date o~ treasurerS, hereby cernfy *~ ~ . ,n~,t the above statement and the a~ached supporting reports a~e truc and CO~OC~ S~gnature of candidate or treasurer Date signed PL' Cash Contributions, Loans Received and Cand~dar~ or Poh~cai Conwmttee Name Cozmmrte¢ iD Number- Election' /Pnma~ 20e'~ ~ General 20__ ~ Other ~ Report, ~ l st Pre-elect~on ~ 2nd Pre-electron ~ Post-elect,on ~ 20~ September Supplemental SEE BACK FOR INSTRUCTIONS _LND CODE DEFINITIONS CODE ~: Contributor Type CODE 2: Contribution Typo B Bus~ness Entity CA Cash C Polmcal Co~ttee {includes bus~ness and umon PACs) CO Cosigner Obhgatmn F Candidate's In~edmte Family { includes candidate} IK In-Kind I Index ldual LR Loan Received L Labor Orgamzat~on O Other P Pohncal ParU~ Co~x~ee Dne g Name and Address of Contsbutor Amount of tn-K~nd Pu¢ose Contribution (see manual for suggested purpose codes) Date Received Occupational Information or ?ontnbutor Contributing Comm~ee's I~ Aggregate Code ~ Code 2 PC 2 Cash Contributions, Loans Received and n-Kind Candidate or Polmcal Committee Name: Cormm~nee 1D .'-;umber Elect,on. ~'Prnnary _ JL~ ~ General 20__ ~ Other Repom ~tst Pre-etect~on ~ 2nd Pre-elecnon ~ Post-elect~on ~ 20~ September SuppternentM SEE BACK FOR INSTRUCTIONS AND CODE DEFINITIONS CODE 1' Contributor Type CODE 2: Contribution Type B Business Ennty CA Cash C Pohncai Cormm~ee 0ncludes business and union PACs) CO Cosigner Obhganon F Can&date's In2ncdmte Family (includes candidate) IK In-Kind I In&v~dual LR Loan Received L Labor Orgamzat~on O Other P Polmcal Pa~y Committee Amount of /n-Ktnd Purpose Line ~ Name and Address of Contributor Contribution (see manual for suggested purpose codes) Date Received Occupational Information or Contributor Code ~ Code 2 Contributing Commt~ee's I~ Aggregate $ Cash Contributions, Loans Received and In-Kind ~' ':°J Can&date or Polxt~cal Comm~ee Name' Committee iD Number ~ , ~,, ,{: / ~:~ ~ Page ~ of ~ Repo~ ~ 1st Pre-elect~on ~ 2nd Pre-elect~on ~ P,~st-eled~on ~ 20___ September Supplemental SEE BACK FOR INSTRUCTIONS ~D CODE DEFINITIONS CODE ~: Oontdbutor Type CODE 2: Contribution Type B Business EnUty CA Cash C Poht~cal Co~t:ee (includes business and umon PACs} CO Cos~g~er Obhgauon F Candidate's ln~ed~ate Family 0ncludes candidate) IK In-Kind I Indp:~dual LR Loan Received L Labor Orgamzatxon O Other P Poht~cal Pa~ Committee Amount of ln-EtnO Puqoose Dne ~ Name and Address of Contnbutor Contnbutton (see manual for suggested purpose cedes) Date Received Occupational Information or Contributor Code ? Code 2 Contno~t,ng Comm~ftee's ID~ Aggregate ?, 2 Cash Contributions, Loans Received and In-Kind Can&date or Pohncal Comrmttee Name Committee ID Number Election. ~ Primav 20~'4 ~ General 20__ ~ Other ~ Report' ~ 1st Pre-elecnon ~ 2nd Pre-elea~on ~ Post-election ~ 20~ September gupplemental SEE BACK FOR INSTRUCTIONS ~ND CODE DEFINITIONS OODE ~: Contributor Type GODE 2: Contribution Type B Business Ent~ CA Cash C Polmcai Committee 0ncludes business and umon PACs) CO Cosigner Obhgatmn F Can&date's h~me&ate Family (includes can&date) IK [n-K~nd I In&~ ~duaI LR Loan Recmved L Labor Orgamzat~on O Other P Polmcal Party Con~ttee Dne ff Name and Address of Contributor Amodnt of In-Kind Purpose Contribution (see manuai for suggested purpose codes) Date Received Occupahonal Information or Contributor Code I Code 2 Contnbuhng Commt~ee b I~ Aggregate PE 2 Cash Contributions, Loans Received and In-Kind Can&da~e or Polmcal C ommn~tee Name, Commmee iDN,. L. mber Elect~on. ~ Primary 20 d~ ~ General 20__ ~ Other _~ Repo~. ~ 1st Pre-elecnon ~ 2nd Pre-elect~on ~ Post-elect~on ~ 20~ September Supplemental SEE BACK FOR INSTRUCTIONS AND CODE DEFINITIONS CODE l' ContNb~tor Type CODE 2: Contribution Type B Business Enmv CA Cash C Poht~cal Comml~ee (includes business and unlo~l PACs) CO Cosigner Obhgatmn F Candidate's In~mediate Family (includes candidate} IK In-Kind I Indlv~dual LR Loan Received L Labor Orgamzat~on O Other P Polmcal ParD' Co~nee Amount of In-g~nd Purpose Dne ~ Name and Address of Contributor Contribution (see manual for suggested purpose codes) Date Received Occupanonal fnformat~on or Contributor Ccntnbuhng Comm~ee's I~ Aggregate Code 1 ~ Code 2 Cash ,.,ontributions, Loans Received and In-Kind Can&da~e or Polmcal Committee Name Commmee ID Number Electlon ~ Prl;~a~' ~0D¢ ~ General 20 ~ Other Report .~ 1st Pre-elect~on ~ 2nd Pre-elecnon ~ Post-doormen ~ 20 September SupplementA SEE BACK FOR I~STRUCTIONS AND CODE DEFINITIONS; CODE ~' Contdbuto~ Type CODE 2: Contribution Type B Business Enn~y CA Cash C Pohnca[ Committee (includes business and umon PACs) CO Cosigner Obhgauon F Candidate% Immedmte Fam~b (includes can&date) tK In-Kind t in&vidual LR Loan Recc~, ed L Labor Orgamzanon O Other P Polmcal Pony Commmee Amount of In-K;nd Purpose Dne ~ Name and Address of Comnbutor Contribution (see manual for suggested purpose codes) Date Received Occupat~onaf InformaOon or Contnbutor Code f Code 2 Contributing Committee's i~ Aggregate See Page Totals (Add all amounts with the same Accounting Period Totals (Complete onh' tbr last page and Iustmcnons conmbunon bpe Do not include aggregates ) nansficr these amounts to the Summaw StatemenL PC 1 on Back and tn Campaign Cash (CA) $ . Cash (E'A~ Manual in-Kind ([K~ $ In-K~nd (tK) PC 2 Loans Rece~x ed {LR) $ Loans Rece~ ed { LR) $ PL Cash ,ontributions, Loans Rece,, d and in-Kind Can&date or PohtKal Comm:?e Name'~ ~ ommmee ID Number Rope: ~lst Pre-elecnon ~ :nd Pre-elecuon ~ Post-elecnon ~ 20~ September 5applemental SEE BACK FOR ~NSTRUCT~ONS A~D CODE CODE 1' Contributor Typ~ CODE 2: Contribution Type B Business Entzty CA Cash C Polmcal Commzttee (includes bus~ness and umon PACs) CO Cos:gner Obhgat~on F Can&date's hnme&ate Family (includes can&date ) LK In-Kind I ln&v~dual LR Eoan Rcce~¥ed L Labor Orgamzanop~ O Other P Polmcal Pa:y Committee Amount of In-Kind Purpose Line ~ Name and Address of Contributor Contribution (see manual for suggested purpose codes) Date Recewed Occupattonal InformaOon or Contributor Code ~ Code 2 Contributing Committee's I~ Aggregate 3 $ 5 L2.~' Z/,,-z'C/~ :;h $ See Page Totals ladd xlFd~o~nts w~th the hame Accounting Per~od Totals {Complete only for last page and instructions contnbtmon D'pe. Do not include aggregates ) transfer these amounts to the $umma~' sfa~e~ent, PC 1.) un Back and :: ~n C~mpazgn Cash (CA) $ Cash (CA) $ Enter on Fmance Manual In-Kind ([K) $ In-Kind IlK} $ PC 2 Loans RecmYed (LR) $ Loans Rece~xed (LR> $ PL 2 Amendment Amendments-Cash Contributions, Loans Received and tn-Kind R~v ,:,°3 Can&date or Poht~cal Committee Name Corr. m~ee ID Number, Elect,on: ~'PnmaEg .0° :~ ~ General 20 ~ Other Report. ~ l st Pre-elect~on ~ 2nd Pre-elecnon ~ Post-elecnon ~ 20~ September Supplemental SEE BACK FOR INSTRUCTIONS AND CODE DEFINITIONS CODE ~: Contributor Typo CODE 2: Contribution Typo B Bus,ness Entity CA Cash C Pohncal Conferee (includes bus~ness and union PACs) CO Cosigner Obhgation F Can&date's i~e&ate Famdy 0ncludes can&date) IK In-Kind I In&vMuat LR Loan Received L Labor Orgamzanon O Other P Polmcal Pa~v Co~mttee Amending Page g Name and Address of Contributor Amount of In-Kind Pu(pose and Line ~ Contribution (see manual for suggested purpose codes) Date Received Occupational Information or Contributor Contributing Comm~ee's I~ Aggregate Code ~ Code 2 ~ New Ent~ . ~ Correcting ~ New Ent~ - See FOR OFFICE USE ONLY Instructions - _ - , ....... ' ':"/ -RECEIVED ~n Campaign . Finance S~gna~:~f can&date or treas-~er Amendment Dates~gned ..... , --_..- . :- . . PC 2 Kmendment Amendments-Cash Contributions, Loans Received and In-Kind ,:,°3 Candidate or Political Camm:tree Name Committee 1D Number' Elecm,n' ~Pnma. 20C% ~ General 20~ ~ Other Report: ~lst Pre-elecnon ~ 2nd Pre-elecnon ~ Post-election ~ 20 September Supplemental SEE BACK FOR INSTRUCTIONS AND CODE DEFINITIONS CODE ~: Contributor T~pe COD~ 2: Contribution Type B Business Entity CA Cash C Pohncal Co~maee ~ ~ncludes bus~ness and umon PACs) CO Cosigner Obhgat~on F Can&date's I~edmte Family (includes candidate) iK In-Kind I In&vi&al LR Loan ReceB~ed L Labor Organization O Other P Polmcal Pa~ Cabin,nee Amend;ny Page ~ Name and Address of Contnbutor Amount of ln-K¢nd Purpose and Line fl Contribution (see manual for suggested purpose codes) Occupatonal Information or Contributor Date Received Contributing Comm¢~ee's I~ Aggregate Code ~ ~ Code 2 ~ Covmctm9 m Delet,ng 6:~?C:¢~, (vl .;iTfd / / d& ~ Correcting ' ' '~ . ~ ~ ~- ~ Deleting ~-~? ~- ~ ~ ~ Co~ct,~g g '74: . 4t~.~,,~: -~ ~ ~-' $ T-' See FOR OFFICE [nstrdctlons . - t -- i .. m Campmgn __ - ~ ' .. fmance S~gnarure of camhdate or treasurer -- - :--'"? T - Manual .... ' ': ' ~ -- ---.'.' Amendment Date signed ' ._ PC 2 ~.snendmc-nt Amendments-Cash Contributions, Loans Received and In-Kind Candidate or Political Conzmlttce Name, Cormmttee ID Number' Elccnon* ~ Pnmau~ 20 J'~ ~ Genera1 20 ~ Other Report- ~ 1 s~ Pre-elecnon ~ 2nd Pre-elecnon ~ 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 Potmcal Cor~mee (includes business and umon PACs) CO Coagner Obhgatlon F Candidate's Imanedmte Family (includes candidate) iK In-Kind I ln&vldual LR Loan ReceB ed L Labor Orgamzatmn O Other P Polmcai Pa~ Co~tttee Amending Page ~ Name and Address of Contributor Amount of In-Kind Pu(pose and Line ~ Contnbuhon (see manual for suggested purpose codes) Occupational lnforma[~on or Contnbutor Code ~ ~ Code 2 Date Received Contnbut~ng Comm~ee's I~ Aggregate ~ Correcting ~ /, ~ New Ent~ ? ~7 ~ 'Correcting ~ /~ ~ ~ Page~ ~~ Une Correcting ~ P3ge Line New Ent~ Correcting Deleting See FOR OFFICE USE ONEY in Campmgn ' ' Finance Slgnamf~ of candidate or treasurer . , ,- Manual - -- -~-'- Amendment Date s~gned _ _. _., _',,~ ":':f', PC I Summary Statement of Contributions and Expenditures Please type or print legibly in black ink. Page 1 of 2 Candidate or Political Con-mitt e Name (a_se full naCe)' Mailing Address as it Appears on Statement of Organization (street, route or box number, c~ty, state, z~p code): Treasurer's Name: ~'~'-~'~ ~ff [ Telephone Number (day): Co~l~ee ID Number: [ Co~ee Type, Measure Number or Office: t ~ Original ~ Pr,mary 20 O~ ~ General 20__ ~ Oaer ~ ~ Arnen~ent ~ 1 st Pre-election ~ 2nd Pre-elect~on ~ Post-election ~ 20__ September Supplemental A-TOTALS FOR THIS ~CUMU/ATIVE TOTALS ACCOUNTING PERIOD FOR THIS ELECTION CONTRIBUTIONS I Cash Conmbutions ( Account,ng Period Total from PC 2) '*' ~¢' ~ ,~ {j~ ~' 9 Loans Received (Non-Exempt) + ~ (Accounting Period Total from PC 2) ~ 3. Total Cash Contributions (hnesl+2) = ~ ,~ = ~ 2q~ [ ~* 4. In-Kind + .... ~ + (Accounnng Period Total from PC 2) / 5. TOT~ CONT~BUTIONS (hnes3+4) = ~J ~ = ~ ~ [}~ EXPENDITURES 6. Cash Expenditures ~~ ~5~ ~ (Accounting Period Total from PC 3) 7. Loan Payments (Non-Exempt) + ~~ + / (Accounting Period Total from PC 3 } .~. 8. Total Cash Expen&mres ~ ~ 9. In-Kind + ~ (Accounting Period Total from PC 2) ~ + 10. TOT~ EXPENDITU~S CASH BA~NCE (hne 30 ofprewous report) FOR OFFICE USE ONLY 12. Total Conmbunons + Z'.la (line 5) 13. Other Recmpts + {Accounting Period Total from PC 4A) "~ 14. Loans Received {Exempt) + (Accounting Period Total from PC 4A) -- ff/' 15. CONT~BUTION S~TOTAL = * 3 / j d:' (hnes II + 12+ 13+ 14) 16. TotalExpendm~es Z v RECEIVED (line lO) ~ ~ 17. Other Disb~sements + /~,// ~)qY 0 3 (Accounting Period Total kom PC 4B) 18. Loan Payments (Exempt) + CiTY RECORDER (Accourmng Period Total from PC 4B) 19. EXPENDIT~E SUBTOTAL s- ~ we¢ (hnes ld + l? + 18) = 20, ENmNG CASa BaLaNCE ~; ~ Lq (line 15 minus line 19) PC 1 Summary Statement of Contributions and Expenditures Please type or print legibly m black ~rd<. Page 2 of 2 Candidate or Political Cg~n_ lttee Name: Committee ID Number: [~ Original [] Primary 20~~} [] General 20__ [] Other __ [] Amendment [] 1st Pre-election ~[ 2nd Pre-election [] Post-electron [] 20__ September Supplemental LOAN SUMMARY FOR OFFICE USE ONLY 21. Beginning Outstandmg Loans (line 29 of previous report) 22. Loans Received (Non-Exempt) (hne 2) + 23. Loans Received (Exempt) + (hne 14) 24. LOANS RECEIVED SUBTOTAL (lines 21 + 22 + 23) 25. Loan Payments (Non-Exempt) (line 7) 26. Loan Payments (Exempt) (line 18) + 27. Forgiven Loans + (Total loans forgiven dunng this accounting period} 28. LOAN PAYMENT SUBTOTAL (hues 25 + 26 +27) 29, TOTAL OUTSTANDING LOANS illne 24 minus line 28) = PERSONAL EXPENDITURE SUMMARY 30. Beginning Outstanding Personal Expenditures (hne 36 of previous report) 31. Personal Expert&rares + (Accounting Period Total from PC 3Al 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 Expenchtures (Total personal expenditures forgiven this acctg period) + 35. REIMBURSEMENT SUBTOTAL = (lines 33 + 34) 36. OUTSTANDING PERSONAL EXPENDITURES = ~' (llne 32 minus line 35) FINANCIAL STATUS AT CLOSE OF ACCOUNTING PERIOD 37. Ending Cash Balance ~ .~,/2,~~- ~ (line 20) 38. Accounts Receivable + (Accounting Period Total from PC 5) 39. SUBTOTAL = 'S > / g~5' Lq (lines 37 + 38) D / " *' ~ ~' 40. Total Outstanding Loans ~'~'~ l:,, (line 29) 41. Outstanding Personal Expen&tures + J ~[~'~' 0 (line 36) 42. Accounts Payable + (Accounting Period Total from PC 6l SUBTOTAL = CiTY RECORDER (lines 40 + 41 + 42) 44. BALANCE/DEFICIT = ~; -~ /~5~ 'l (line 39 minus line 43 indicate + or - balance) - ~ I, a~ (hame of candidate or treasurer), hereby certify that the above statement and the attached supportmg reports are rote and correct. S~gnafti~e of candidate or treasurer Date' s~gned Cash ,ontdbutions, Loans Receb d and Can&date or Poht~cal Commlttee Name Committee ID N umber' Electron ~ Pnma~ 20 ~ ~ ~ General 20 ~ Other Report: ~ 1 st Pre-eiecnon ~ 2nd Pre-elect~on ~ Post-cie, tzon ~ 20~ September Supplemental SEE BACK FOR ~NS'[Rt;C'HONS AND CODE DEFINITIONS CODE l: Contributor Type CODE 2: Contribution Type B Business Enti~' CA Cash C Political Committee (includes business and union PACs) CO Cosigner Obhgat~on F Cand~date~,; lmmed:ate Famdy (includes candidate) iK ~n-Ktnd I In&~idual LR Loan Recel~ ed L Labor Orgamzat~on O O~her P Pohtical Party Committee Amoupt of In-K,~d Purpose L/ne ~ Name and Address of Co~tnbutor Contribution (see manual for suggested purpose codes) Date Received Occupational Information or Centnbutor Code 1 Code 2 Contributing Committee's ID~ Aggregate 3 $ 4 $ 5 $ Sec Page Totals ( Add all amount~ w~th the same Accounting Period Totals (Complete onl} tbr last page and [nstpact~onb contnbunon bpe Do not include aggregates ~ transfer m°ncampmgnBaCk and (CA; ~ Cash S .f'/b ~ Cash ~CA) $ Manual In-Kind (IK) $ ~' ln-Kmd/IK) $ Enter ~n bumm&f} S:at~mcnt, CoKmm ~ Lmc~ 4 ~lld 9 PC 2 Loans Received {LR~ $ ~"/ Loans Rece~x ed ~LRt PC 3 Cash Expenditures and Loan Payments ,:°3 Candidate or Political Con. tattoo Name: Con~ttee ID Number. Electron: ~ Pr=sty 20 :'~' ~ General 20__ ~ Other ~ Report: ~lst Pre-electron ~ 2nd Pre-electron ~ Post-elecuon ~ 20~ September Supplemental PURPOSE CODES (see back of i~rm for instructions and code definitions) E~NDITU~ A Agent O O~er Advemsmg (y~d agra. buaons, etc.) CA Cash B Broadcast Advemsing {Radio, TV) P Postage LP Loan Payment C Cash Conx~bunons R Re~b~sement tut Personal Expend~es F Fundrmsmg Event Expenses S Su~eys and Polls G General Operaaonal Expemes (~scnbe ~'over $50) T Travel Expenses (describe if over $50) I Interest Payment U Utdmes L Literature, Brochures, Printing W Wages, Salaries, Benefits M Management Se~ices Y Petltmn Circulators N Newspaper and Other Periodical Advemsing Z Prepara~on ~d Producaon of Advems~g Payee's Name and Payee's Committee I~, Exp. Amount of ~ bne ~ Date Check ~ ~f applicable Purpose Type Expenditure Paid (as it appears on ~nvoice, receipt or check) to AYP 2. $ ~ 4. $ [~ 9 $ ~ 10 $ [~ ~ V See Page Totals (Add alt expert&rares w~th the same Accounting Period Totals (Complete only for last page and Instrucnons expenditure type.) transfer these amounts to the Sun'Lmary Statement, PC 1.) on Back and _Tt,~ . 75' in Campaign Cash (CA) $ 3'J" Cash iCA) $ ~ f- Finance Enter on Stm'anao Statement, Colunm :~ Ln~c t, $ ~ Manual Loan Payment (LP) $ _ ?; Loan Payment (LP) gn~m~ar>'~ Statement Cottmm A LilI= 7 PC 3 Cash Expenditures and Loan Payments Please type or print ~egibly in black ink. List only one ent~, per line. ACCOUNTING PERIOD TOTALS - Complete this box only on the last page of the section. Add Cash totals from all pages of form PC 3 and enter the amount on the Cash line m the Accounting Penod Totals box. Add Loan Payment totals from alt pages of form PC 3 and enter the amount on the Loan Payment hne ~n the Accounting Period Totals box. Transfer these totals to the lines indicated on the Summary Statement of Contnbutions and Expenditures (PC 1). AMOUNT OF EXPENDITURE - Amount of check, cash transaction, credit or dent card charge. CHECK # - The number of the check. For cash transactions, write "cash" in the check number box. if the expenditure was charged on a committee credit or debit card, enter "credit card" or "debit card." DATE - The date the expenditure or loan payment was made, Date must mclu,de the month, day and year. A range of dates may be used for reporting bank charges. EXPENDITURE TYPE - Select the appropriate expenditure type from the hst provided on the form. Designate only one expenditure type for each entry. PAGE TOTALS - Add all code CA expenditures and enter the amount on the (gash hne in the Page Totals box. Add all code LP expenditures and enter the amount on the Loan Payment line m the Page Totals box. PA~D TO ACCOUNTS PAYABLE - Check this box if the expenditure is a payment of a prewousiy reported account payable. PAYEE'S NAME - The name of the vendor or mdiwdual to whom payment was made. If the payee is a state pohtmat committee, also ~st the s~x-dig~t I.D. number assigned to the committee by the Secretary of State. PURPOSE - Use the purpose codes from the list provided below (note exceptions) or provide a written description of the purpose of the expenditure. If one or more of the following purpose codes are used to descnbe an expenditure, no other description is generally needed, Statement of Contributions oummary and Expenditures Please type or print leg]bty in black ~nk, Page I of 2 Candidate or Polmcal Commmee ~lame ~us¢ ~II name), Marling Ad&ess as it Appears on Statement oi Orgamzatmn (street, ri.ute or box humbert cn~, state, z~p code)* z.' e z Telephone Nmnber (day~ Contmntce iD Number Co~nttee Type, Measure Number or O~fice ~ Ongmai ~ Pnma~ 20 ~ ~ General 20~ ~ Other ~Amendment ~ 1st Pre-decnon ~2nd Pre-elecnon ~ Posbelecuon ~ 20 September Supplemental A-TOTALS FOR TJH8 ~-CUMULAT~VE TOTALS ACCOUNTING PEPdOD FOR THiS ELECT~ON CONTRIBUTIONS 1 Cash Contnbunons ~ Loans Received N -, (: on-ExempU (Accouptlng Period Total from Pf 2) + -- ........... + ._-.~ 3 Total Cash Contr~bunons = ~ = ~ ~ 4 tn-K ~nd ~-- _ ~Accountmg Period Total ~om PC 2) + + 5 TOTAL CONTmBUTIONS EXPENDITURES 6. Cash Expendnures ¢ ~ / (A~counnng Period Total from PC 3~ ,~ ~ 7 Loan Payments (Non-Exempt} ... - -- (Accoum~ng Perlod Total irom PC 3 ~ + ...... /~-- + 8almosT°iai 6Cash+ 7) Expen&mres = g 5', 7~ = ( _5 ff ~' ln-K~nd (Accounting Period Total ~?om PC 2) . ~ ~ !0. ~OFALEXPEND1TU~S ~ ~ ?5-/_ '3 .- CASH BALANCE t I(ImeBegmning20 of prev,uusCaSh Batancercpon) '~ =Z'~ -9 ? ¢:'. :~ ? .. V:OR OFFicE US 12 Total Contnbunons L -- - _ -5.=7 . .7- ' 13 Other Receipts , -. . -. .... _. - ~Accounnng Period Total from PC 4~) .... "' ~- --_..-7_ .: 14 Loans Received (Exempt) + _~-/~' --7-'--~': ,-"-A '- (Accourmng Period Total from PC 4A) / .... ' 16. Total Expen&tures ~ _ :: .- · - - t7 Other D~sbursements .... -"' ' ~Accountmg Period Total from PC aB) ..... 2:.. 7~ -~:'. ~:~ ' '8. LoanPavmeDtsqExempt) + -'::_C! (Accounting Period Total from PC 4B; f ' L -- C -, F_,,-_;f EXPENDiTURE SUBTOTAL g ~. 75.~ ll~nes I6+ 17 + 18) -=" ' ENDING CASH BALANCE ~ ~ '-' "- '- ' -- ~ Summary Statement of Contributions and Expenditures Please t?pe ur pnnt legibly in black mk Page 2 of 2 C andldate °r P°htical C°mrm?'ee Nag'nc ,~;c. ~ Colmnmee 1D Number O Onglnal ~ Primary 2t)~ ~ General 20 O Other ~'Amendment ~ 1st Pre-elect~on ~ 2nd Pre-elecuon ~ Po>t-elect~on ~ 2~, September Supp!emcntal LOAN SUMMARY 2! Beginning Outbtandmg Loans _~-~ FOR OFF}CE USE ONLY ( line 2o of previous rcpo~O - 22. Loans Recmved ~Non-Exempt; + I hne 2 ) 23 Loans Recened (Exempt) + 24 LOANS ~CEIVED SUBTOTAL {lines 21 * o9 ~ w~ = 25 Loan Payments (Non-Exempt~ (hne 7~ 26 Loan Pasment~ (Exempt) . /~ ..... (hnc 18~ 27 Furgl~e~: Loan~ · 7otaI loan~ long,sen during this accounting penod) 2~. ~ OAN PAYMENT SUBTOTAL ,hnes 25 e 2b +27) 29 7-OTAL OUTSTANDING LOANS = (linc 24 minus hue 28) PERSONAL EXPENDITURE SUMMARY 30 Beginnmj Outstandlrig Personal Expen&mres Omc 30 ofprex ~ou~ report) 3 t. Personal Expendn-ures + (Accounung Period Total from PC 3A) X' PERSONAL EXPENDITU~ SUBTOTAL (hneb 30 + 31} 33. Personal Expen&ture Rennbursemcnts {,Total expendlmre~ on PC 3 x~ lth ptl~ose ~ode R~ 34 Forglxen Personal Expenditures + (Total personal cxpen&mres forgik el1 th~s acctg 35 ~[MBURSEMENT SL~TOTA~ (]lnes 33 T 34~ 36. OUTSTANDING PERSONAL EXPENDITU~S = Na.C a SlalUS al CLOS 37. Ending Cash Balance 38. Accounts Receivable + (Accounnng Period Total flora PC 5~ 30 SUBTOTAL = 40. Total Outstanding Loans 41 Outstanding Personal Expen&mres + ,~- dine 36) 42 Accounts Payable + (Accounting Period Total from PC o) 43 SUBTOIAL (hnes 40 + 41 ~ 42) 44 BALANCE/DEFICIT dine 3c) minus hne 43 ,ndlcate~ o~-balance) = [, ~- ~/4.~ ] -~. ~/~ (name of candidate oF~ asure~ ),'hereby certeS' that the above tatemcnt and the attached suppomn~ reports are tree and con'ect .... ~amre of candidate or n easurer Date qgncd PC 2 Amendmeat Amendments-Cash Contributions, Loans Received and In-Kind ~v Candidate or Poht~cal Committee Name: Committee ID Number: Electron: ~ Primary 20 J, ~? ~ General 20 ~ O~her Repo~: ~ 1st Pre-elect~on ~ 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 Entity CA Cash C Political Co~ittee (includes bus~ness and union PACs) CO Cosigner Obhgatmn F Candidate's I~ed~ate Famdy (includes candidate) IK In-Kind I Individual LR Loan Received L Labor Orgamzat~on O Other P Political Pa~y Co~mttee Amending Page ~ Name and Address of Contributor Amount of In-K~nd Pu¢ose and Line ~ Contribution (see manual for suggested purpose codes) Date Recetved Occupational information or Contributor Code ~ Code 2 Contributing Committee's I~ Aggregate Correcting .- '~ z , / ~-, 0 co~ectlng Pa~e~ Line ~ New Entw $ ~ Correcting ~ Delebng $ Page Line ~ New Entw $ ~ Correcting ~ Deleting $ Page L~ne D New EntW $ D Correcting ~ Deleting See FOROFFIGE OSE ONkY l~stBactions .¢-~ i//¢ , RECEIVED in Campmgn Fznance Signature of candzdate or treas~er ~: ..... Manual PC: <. z y OJTY RECORDER ~endment Date signed Summary Statement of Contributions and Expenditures Please type or print legibly m black mk Page 1 of Can&date or Polmcal Cowmmtee Name tuse fall n~me). Marling Address as ~t Appears on Statement of Or~anlzat~on (.s~eet, roate or box number, :tU,, state, z~p code): I l(:lephone Number (~ayV Comnnttee ~D Number. ~ Co~m~e~ Type, Measure Number or Office ~ Original ~ Pr,mary 20__ ~ General 20__ ~ 'Other ~ ~ Amendment ~ 1st Pre-elecaon ~ 2nd P~e-elecnon ~ Post-decnon ~ 20~ September Supplemental A-TOTALb FOR THIS ~CUMULATIVE TOTALS ACCOUNTING PER~OD FOR TH~$ ELECTION CONTRiBUTiON8 I Cash Conmbanons C~Xccounnng Period Total from PC2) k 2 Loans Received (Non-Exempt) + + {Accounting Period Total from PC 2~ 3 Total Cash Contnbunons 4 In-K~nd {Accommng Period Total from PC 2) 5 TOT~ CONT~BUTIONS EXPENDITURES O Cash Expen&mres (Accounting Period total from PC 3) ~ ~U 7. Loan Payments (Non-Exempt) {Accounting Period Total from PC 3) + ~'/ + S Total Cash Expen&mres 9 + + (Accountm~ Period Total fl om PC 2~ 10. TOT~ EXPENDITUI~S CASH BALANCE 1 I. Begnmmg Cash Balance (hne 20 of previous report) ~ .}; / Z D J'~; FOR OFFICE USE ONLY 12 Total C onn'lbunons ( hne 5 ) + 13 Other Receipts + (Accounting Period Total from PC 4A; + RECEIVED 14. Loans Received (Exempt) {Accountmg Period Total from PC 4A) t5. CONTRIBUTION SUBTOTAL (hnesll~ 12 13+ 14) ~ TJt 1~ 1~ To~a] Expert&rares 17. Other D~sbursements (Accou:mng Period Total from PC 4B' 18. Loan Payments (Exempt) + (Accounting Period Total item PC 19. EXPENDI2)RE SUBTOTAL = ;~ (hnes i6+ 17; 18) 20 ENDING CASH B,&LANCE [ = ~ /~/ (llne I5 minus hne 19~ , ~:'/ 7 ~-~ ?l 1 Summary Statement of Contributions and Expenditures Please b'pe or print leg~bl~ m black ~: Pa~e 2 of 2 Candidate ur PolmcaI Co~mtee 5;ame: Con~mtee ID Number ~ Ong,nal ~ Pr,mary 20__ ~ General 20__ ~ Other ~ ~ Amendment ~ 1st Pre-elect~on ~ 2nd Pre-elezuon ~ Post-electron ~ 20~ September Supplemental LOAN SUMMARY 21 Begmmng Outstanding Loans ~/ FOR OFFICE USE ONLY (line 29 of prey ous report) 2Z. Loa:s ~ec~ved (KomExCmp~) (hne 2} + j~ ..... 23 Loans Received (Exempt) (hne 14} + 24 LOANS ~CEiVED SUBTOTAL dines 21 +22¢23) = ~~'~ 25. Loan Payments (Non-Exempt~ (hne 7 ~ 26 Loan Payments (Exempt) 27 Forgiven Loans + (Total loans lbrg~x en during th~s accounting penod~ 28 LOAN PAYMENT SUBTOTAL dines 25- 26 427) = 29. TOT.~ OUTSTM DING LO_&NS = (hne 24 minus hne 28) PERSONAL EXPENDITURE SUMMARY 30 Beg~mnng Omstandmg Personal Expert&rares (hne 36 ofprev~ous repon~ 31 Personal Expenditures (Accounting Permd Total from PC 3A) + 32 PERSONAL E~ENDITU~ SUBTOTAL (hnes 30 + 31) = 33 Personal Expen&ture Rem~bursements (Total expenditures on PC 3 w~th purpose code R) 34. Forgiven Personal Expen&~es + {Total personal expenditures lbrg~x en th~s acctg period) 35. P~LMBUT~EX'~NT SUBTOTAL (hnes 33 .- 34) = 36. O UTST_~qDENG PE[~ON~ E?OE~IT~S (hne 32 minus hne 35) = FINANCIAL STATUS AT CLOSE OF ACCOUNTING PERIOD 37 Endlng(hne 20)Cash Balance ~ ~/ X~ ~ 38 Accounts Receivable (Accountm~ Period Total from PC 5 ) + 39 SUBTOTAL 40 Total Outstanding Loans (linc 29) ,~ ~'~ 41 Outsrandm~ Personal Expendm~res 42, Accounts Payable + ..... ( Accounting Period Total from PC 0) 43. SUBTOTAL 44. B~_~NCE/DEFICiT (hne39 minus hne43 re&cate--o:- balance) = ~ '~ g/ T~5 ' {name of candidate or t~'easme~)~ herebi~' ccm~'y that the above statement and the attached supposing reports are axle and cc~rr~ct. S~namre ot candidate or treasurer Date s~ned PC 3 Cash Expenditures and Loan Payments k~, ,:°3 Candidate or Political Committee Name: Comnnttee ID Number /' / Pa e_ / or_/__ Election: ~ Primary 20~ ~ General 20~ ~ Other ~ Report: ~ I st Pre-elect~on ~ 2nd Pre-elect~on ~'Post-etecI~on ~ 20~ September Supplememat PL~POSE CODES tsee back of form for instrnetions and earle definitions) EXPENDITUI~ A Agent O O~er Advemsmg (ym'd s~ ba~o~, etc.) CA Cash B BroadcastAdvemsmg {Ra&o~ TV) P Postage LP Loan Payment C Cash Conelbutmns R Rem2b~sement for Personal Expen&~es F F~&msma Event Expenses S Surveys and Polls G General ~erafional Expe~es (describe ~over $50) T Travel Expenses (describe if over $50) I Interest Payment U Utflmes L L~teramre, Brochures, Priming W Wages, Salaries, Benefits M Management Serwces Y Petmon Circulators N Newspaper and Off, er Peno&cal Advemsmg Z Prepara~on ~d Production of AdvemsNg Payee ~ Name and Payee's Commi~ee 1~, Exp Amount of ~ Line ~ Date Check ~ if applicable Purpose Type Ezpenditure Pad (as it appears on invoice, receipt or check) to AYP ~l~/c~ ~. . ,~ ~ -w . r /pu~¢,t, _~ 9 $ E~ ~o $ [~ See Page Totals (Add all expen&tures w~th the same Accounting Period Totals (Compiete only for last page and Instructions expen&ture type ) transfer these amounts to the Sumxnary Statement. PC 1.~ on Back and m Campmgn Cash (CA) $ ~' Cash (CA; $ ~b~ Finance Enter on Summ~ Statemen~ Colunm A Lh~c, Manual Loan Payment (LP) $ ~-/ Loan Payment (LP) S~// Enter en Summar_', Statement, Columm A, Lm~ 7 PC 3 Cash Expenditures and Loan Payments Please type or print legibly in black ink. List only one entry per line. ACCOUNTING PERtOD TOTALS - Complete this box only on the last page of the section. Add Cash totals from all pages of form PC 3 and enter the amount on the Cash line in the Accounting Period Totals box. Add Loan Payment totals from all pages of form PC 3 and enter the amount on the Loan Payment hne in the Accounting Penod Totals box. Transfer these totals to the hnes indicated on the Summary Statement of Contributions and Expenditures (PC 1). AMOUNT OF EXPENDITURE - Amount of check, cash transaction, credit or debit card charge. CHECK # - The number of the check. For cash transactions, write "cash" m the check number box. if the expenditure was charged on a committee credit or debit card, enter "credit card" or "debit card." DATE - The date the expenditure or loan payment was made. Date must include the month, day and year. A range of dates may be used for reporting bank charges. EXPENDITURE TYPE - Select the appropriate expenditure type from the list provided on the form. Designate only one expenditure type for each entry'. PAGE TOTALS - Add ali code CA expenditures and enter the amount on the (gash line in the Page Totals box. Add all code LP expenditures and enter the amount on the Loan Payment line ~n the Page Totals box. PAID TO ACCOUNTS PAYABLE - Check thts box if the expenditure is a payment of a previously reported account payable. PAYEE'S NAME - The name of the vendor or mdlwdual to whom payment was made. if the payee is a state political committee, also list the mx-digit I.D. number assigned to the committee by the Secretary of State. PURPOSE ~ Use the purpose codes from the list provided below (note exceptions) or provide a written description of the purpose of the expend~ture, if one or more of the following purpose codes are used to describe an expenditure, no other descnpt~on ~s generally needed. Summary Statement of Contributions and Expenditures- Please bpe or p~mt lug~bly iix black u-ftc " P~agc 1 of 2 Can&date or Polmcal Commmee Name {use full name} Ma!hng Address as ~t Appears on Statement of Orgamzatmn (sxeet, route or box number, c~U', state, zzp code) TdepJxone Number {day}, Comnn~ee iD Number: Co~rn~ee Type, Measure Number or Office .[] Original E] P . ,ary 20__ ~ Amendment -~ 1st Pre-elecnon ~ 2nd Pre-elecnon ~ Post-electmn ~ 20~ September Supplemental A-TOTALS FOR THIS ~CUMULAT]VE TOTALS ACCOUNTING PERIOD FOR THIS ELECTION CONTRIBUTIONS 1 Cash Conmbutmns { Accounting Period Tutal from PC 2) 2 Loans Received (Nun-Exempt) + / + / Accounting Period Total flora PC 2 3 Total Cash Contnbunons = 4 In-Kind + + (Accounting Period Total ~rom PC 2) 5 TOTAL CONI~BUTIONS {lines 3 + 4) ~ - ' EXPENBITURES O Cash Expen&mres (Account,nc Period Total from PC 3) 7 Loan Payments (Non-Exempt) + ~ + (Accountm~ Period Total from PC 3) 8 Total Cash Expert&tufts = (Accounnn~ Period Total from PC2) 10 TOTAL EXPENDITURES = CASH BALANCE 11. Bcglrmlng Cash Balance [hnc 20 ofprevmus report> ~i 7 ~ '~ ' ¢ FOR OFFICE UgE ONLY 12 Total Contnbunons + ~ hne 5 ~ 13 Othex Receipts + (Accounting Pcr~od Total flora PC 4-~) 14 Loans Received (Excmp[~ + ( Accounting Period Total from PC 4 ~ ) 15 CONTRIBUTION SL'BTOTAL = 17 Od:er Disbursements + (Accounup~ Pc~od I'otal ~¥om PC 48) 1S. Loan Payments (Exempt) ~Accounung Period Total from PC 4B} 19 EXPENDITURE SUBTOTAL /hncsio- 17 ~ lS~ 20. ENDLNG CASH BALA~NCE t = 7/7 ~ 5~ hne I3 minus hne 19) PC 1 Summary Statement of Contributions and Expenditures Please b'pe or print legibly m black mk Page 2 of 2 Can&dare or PolmcM Con~ttee Name: ~ Con~ttce ID Numbe~ ~ Or,gmal ~ Primary 20__ ~ General 20 6'~ ~ ~ Amendment ~lst Pre-elecnon ~ 2nd Pre-elccnon ~ Post-elecnon ~ 20~ September Supplemental LOAN SUMMARY ;1 Begwmmg Omstandmg Loans ~,,~ FOR OFFICE USE ONLY (hne 29 o~ pre~ ~ous report) 22 Loans Received(Non-Exempt) + (hne 2) -o, Loans Recezx ed (Exempt) (hne 14) + 24. LOANS R~CEIVED SUBTOTAL (hnes 21 - 22 + 235 = 25 Loan Payments (Non-Exempt} (hne 7~ 26 Loan Payments (,Exempt) + 27 Forgiven Loans + (Total loans forg~ cn during th~s accounting period) 28 LOAN PATMENT SUBTOTAL (hnes 25 + 26 +27t 29. ~OT~ OUTST~'DING LOANS : (hne 24 minus hne PERSONAL EXPENDITURE SUMMARY 30 Beg~mg Outstanding Personal Expen&tures (hne 36 of prex ions report ~ 31 Personal Expert&rares + ~~/~ (Accounting Period Total from PC 3A~ 32 PERSONAL E~ENDITURE SUBTOTAL = (hnes 30 - 31 ) ~ Personal Expcn&ture Rennbursements (Total expenditures on PC 3 ~ ~th F, urpos~ code R) 34 Forg~venPersonalExpen~es + /Total personal expenditures ibrg~x en th~s acctg period) 35 P~U~EMENT SUBTOTAL = (hnes 33 * 34) 36, OUTST.~NDING PE~ON~ E~E~ITU~S lime 32 minus hne 35) = FINANCIAL STATUS AT CLOSE OF ACCOUNTING PERIOD 37 ~hneEndmgCashBalance20) 6~/ 7Z.~- ~ ~ Accounts Recmvable ~ (Accounting Period To~al from PC 5) 39 SUBTOTAL (hnes 37 + 38) = ~, ~ ~- ~5~,~; 40 Total Outstandma Loans (hne 29; 41 Omstandmg Personal Expen&mres + (hne 3o) 42 Accounts PayabIe + (Accounting Period Total from PC o) 43 SUBTOTAL : ~ ' 5 / ~ 44, B~.~NCE/DEFICIT L anti,date or t~e:~surer)~ hereb> cc~£y ~ha~ ~he above statement and thc an~ched supporting reports are truc and coi'rect S~g,natme of candidate or treasure~ Date s~gned Summary Statement of Contributions and Expenditures Please ~,'pe or print legibly In black u~ Page 1 of Can&date or Pohncal Comml~ee Name (u? thll nnme) Marl;ns Address as it Appea~s' on Statement of Orgamzation (street, route or box number, c~, state, zip code)' %easurer's Name -~-. / / Telephone Number (day~: Conmntte~ ID Number. Co:~:ee Type. Measure Number or Office ~ Original ~ Primary 20__ ~ General 20~'~ ~ Other ~ ~ ~mendment ~ i st Pre-eIecnon ~ 2nd Pre-elecnon ~ Post-elecuon ~ 20__ Sept=tuber Supplemental A-TOTALS FOR ~ HIS ~CUMULATIVE TOTALS ACCOUNTING PERIOD FOR TH~S ELECT~O~ CONTRI~UTi0N8 i, Cash Conmounons (Accounun~ Period Total from PC 2) '~/ / 2 Loans Received (Non-Exempt~ + ~ + / iAccounting Period Total from PC 2) 3 Total Cash Contnbutmns = 0..- 4 I n- Kind : (Acco~ntmg Period Tokai i~om PC 2~ ( ' + ~ TOTAL COS'H~BUTIONS EXPEnDiTURES o CashEspen&~res ~ X5* ~5- tAccommng Period Total fi-om PC 3} * '~ ~ ~ 7 Loan Payments tNon-ExempU ¢ ~_~ + (Accounung Period Tmal from PC 3) 8. To~al Cash Expen&m~es 9 ln-K;nd + ]- + (Accoantmg Period Total fiom PC 2) C I0 TOTAL EXPENDITUI~S = ~ ~ = CASH BALANCE 11 Begriming Cash Balance (hne 20 oFp~ev~ous report) ~; 7/~ % ~ FOR OFFIG[ USE ONLY 12 TotalConmbutmns + (hne 5 ) lo OtherRece~pts + : rt ~ ...... (Accounting Period Total hon! PC -tA ) ~' I4 Loans Retraced (Exempt) + (Accounting Period Total fi om PC ,4A) ~ ~ 15 CONTRIBUTION SUBTOTAL = _<~ 16. Total Expert&rufus : ~4~ 17 Other D~sbursement3 + (Accounting Pc~md Tora~ lrom PC 4E) 1S Loan Payments (ExempO + ~Accountmg Per,oa Total from PC 4B) [¢ ~ 19 EXPE%DITUP~ SUBTOTAL = (hncs l~, * 17 ~ IS) (hne 15 minus line 19) Summary Statement of Contributions and Expenditures Please type or pnnt legibly in black' ink Page 2 of Candidate or Polmcal Comnmtee Name I Con~ace ID Number- ~ Amendment ~ 1st Pre-elect,on ~ 2nd Pre-elect~on ~ Post-electron ~ 20__ September Supplemental LOAN SUMMARY 21 Beginning Outstan&ng Loans < FOR OFFICE USE ONLY lhnc 29 of previous report) 22. Loans Received (Non-Exempt) + (1,ne 2) 25 Loans Recezved (Exempt) + 24. LOANS ~CEIVED SUBTOTAL (hnes 21 +22+23) = 25 Loan Payments (Non-Exemp0 (hne 7) 2d Loan Payments (.ExcmpU 27 Forgiven Loans + (Total loans forgiven during th~s accounnng period) '~- 2~ LOAN PATMENT S~TOTAL (hnes 25 + 26 +27~ = 29. ~OTAL OUTST.&NDING LO.~%S (hne 24 minus hne 28) = PERSONAL EXPENDITURE SUMMARY 30 Bcgmmng Outstanding Personal Expen&mres dine 30 ofprev:ous repo~) 31 PersonalExpen&mres fAccount~ng Period Total from PC aA) + ~.~ 32 PERSONAL E~ENDITURE SUBTOTAL {hnes 30 ~ 31) = 33 Personal Expendnure Reimbursements (Total expcnd,tures on PC 3 with purpose code R) 34. For~ven Personal Expen&~xes + ; - (Total personal expenditures Ibrg~ven this acctg penod} 35 REb~-L~SEMENT SUBTOTAL = (hnes 33 * 34) 36. OUt ST~NDENG PE~3ONAL E~EN~ITUI~S (hne 32 minus hne 35) = FINANCIAL STATUS AT CLOSE OF ACCOUNTING PERIOD 37 Ending Cash Balance ~ ~ 38. Accounts Rece~xabte (Accounting Period Total from PC 5) 39 SUBTOTAL . 40 Total Outbtandm~ Loans / / {hne 29) ~ - 41 Outstanding Personal Expen&rurcs + 42 Accounts Payable + (Accountme Period Total from PC 6> 43 SUBTOTAL = ' -7 ~.L d? 44 B~ANCE/DEFICIT (hneaOmmushne43 mdlcate~o~ balance) = ~ -o ~)~.t~ - I~ _-~2'4"~/name of candidate or neasu~er)~ hereb,,, ccmR' that the above statcmeut and the attached su?port~nlg reports are tnic and S~,gnanire oi' candidate or treasu{rer Date s~gned Summary Statement of Contributions and Expenditures Please b'pe or pnnt legibly m black mk Page 1 of 2 Can&date or Pohucal Commtttee Name luse l]alt nameL Marling Address as zt Appea~s on Statement of Orgamzauon ts~ee~, route or box nurnbcr, czw. state, z~p codel ~ Yd~phone Number (dayL Treasurer's Name~ ........ / Conmuu~ee iD Number ] Co~ec Type~ Measure Number or Office ~ Amendment ~ 1st Pie-e!ecUon ~ 2nd Pre-elecUon ~ Posbe!ecuon ~ 20__ September Supplemental A-TOTALS FOR THIS ~CUMULATIVE TOTALS ACCOUNTING PERIOD FOR THIS ELECTION CONTRiBUTiONS 1 Cash Conmbuuons : . (Accounting Period Total from PC 2) 2 Loans Rece~x ed (Non-Exempt) + ; + ~ . (Accounting Period Total from PC 2~ ~' 3 Total Cash Contnbunons dines 1+ 2) 4 In-Kind + / + (Accounting Period Total Irom PC 2~ ~ 5 TOTAL CONTriBUTIONS : ( ~ = (hnes 3 ~ 4~ '~ EXPENDITURES 0 Cash Expen&mres (Accounting Period Total from PC 3~ / '_~.. 7 Loan Payments (Non-Exempt) + :' + ,.- (Accounung Period Total from PC 3 ~ '._ -' 8 Total Cash Expcn&tures = .'- = (hnes 6 ~ 7) ', ..... o in-Kind + , + (Accounting Pet~od Total from PC-' ~ --- 10 TOTAL EXPENDITUI~S (hnes S - ')) ,_~ CASH BALANCE I 1 Begmming Cash Balance ,-. - ' ~ Omc 20 of precious report) ~ ~ ~ ~ FOR OFFICE USE ONLY 12 Total Conmbuuons + (hne 5) 13 Other Receipts + L~cco~ntmg Period Total h om PC 4A ~ 14 Loans Received (Exernpr~ ~ /Accoun~m~ . Period Total ffum PC 4A) __.~._~ 15 CONTRIBUTION SUBTOTAl = 3 .~-~ -, / '[ thnesll ~1> ~13-~ 145 ~- ~- 1~ Total Expendmnes (line I0) 17 (Other Disbursements + . ~ (Accounung Period Total from PC :E) iS Loan Payments/Excmvt) + lA,counting Period Yot4~ from PC 4B) IF. EXPENDiYUP. E SUBIOTAL dmesi~,~ 17+lS) 20 ENDING CASH BALANCE (hne 15 minus line 1©) = '5 ~ ~ p*' 1 Summary Statement of Contributions and Expenditures Please ~,'pe or pnnt legibly ~n biack mk Pa~e 2 of Candidate or Pohncal Co~m~ee Na~e. J Cogmm~cc ID Number ~ Original ~ Primary 20__ ~ General 20&-- ~ Other ~ ~ Amendment ~ I st Pre-elecnon ~ 2nd Pre-elecnon E Post-eiccnon ~ 20__ September Supplemental LOAN SUMMARY 21 Begt~ng Outstan&ng Loans FOR OFFICE USE ONLY (hne 29 of pre~ ~ous report) 22. Loans Recmved (Non-Exempt) + (hne 2) 23. Loans Recez~ ed (Exempt) + (hne 14) 24. LOANS ~CEIVED SUBTOTAL (hnes 21 + 22 + 23) = 25 Loan Payments (Non-Exempt) (hne 71 26 Loan Payments (Exempt) + _- ~ (hne 15; 27 Forg~xen Loans t Total loans forgiven dunng th~s accounting period} + ~"- ~ 28 LOAN PATMENT SUBTOTAL .......... dines 25 + 26 ~271 29 IOTAL OUTSTANDING LOANS (hne 24 minus hne 28~ = PERSONAL EXPENDITURE SUMMARY 30 Begmmng Outstan&n~ Personal Expen&tures (hne 36 ofp~evmus report) 31. Personal Expen&mres + (Account:n~ Permd Total fi-om PC 3A) ..~ 32 PERSONAL E~ENDITU~ SUBTOTAL ,hnes ~0 ~ 3I) 33 Personal Expen&ture Reimbursements , (Total cxpend~tures on PC 3 with purpose code R) 34 Forgiven Personal Expen&~es + .~'~ ¢Total p¢rsonal expert&tm es Ibrg~x en th~s acctg period) 35. ~U~SEMENT SUBTOTAL (lines 33 ~ 34) = 36. OUTS%~ND~G PE~ON~ EM'EN~ITU~S (line 32 m~nus hne 35) = FINANCIAL STATUS AT CLOSE OF ACCOUNTING P~IOD 37 Ending Cash Balance ~ ~ (hne 20) ~G ~, .. 38. Accounts Recmvabte + (Accounting Period Total from PC 5) - - 39 SO~TOTAL 49 Total Outstanding Loans ~? ~ ~¢; ?-?" (hne 29; .... '*: ~ 41. Outstanding Personal Expen&mres + (hne 36) 42 Accounts Payable + ~- (AccountmgPenodTotaliromPCo} ¢~ ~,~ ~ ,~ :.~ 43 SUBTOTAL = '~Z"O*?; % (hnes ~0 * 41 + 42) ~ 44 B~.~NCE/DEFICIT (line 3,9 minus hne ~3 indicate + or - balance) = ~ 7' 7' L ;' '_2' (name o~ cana~date or h'eastuer), hereby cc~-af~' that the abo~ e sra[cment and the auached supporting reports are true and CO!TCCt S~gnamre of c~nd~date or treasurer Date s~gned Amendments-Cash Expenditures ar,_ Loan Payments Can&date or Poht~cal Comtmttce Name. Committee ID Nmnber. '~ ' :~ ~ ~ . Page Elect~on' ~ Pnmap/20 ~ Genera] 20 ~' ~ ~ Other Repo~ ~ 1st P~e-etcct~on ~ 2nd Pre-elect~on ~ Posbelecnon ~ 20 September Supplemenml PURPOSE CODES (see back of form for ~nstructions and code definitions) EXPENDI~U~ A Agen~ O O~ez Advems~g (y~d szgms, bu~ons, etc ) CA Cash B Broadcast Advemsm~ {Ra&o, TV) P Postage LP Loan Payment C Cash Contnbnnons R Rc~mb~sement for Personal Expen&mres E Fundra~smg Event Expenses S Sun evs and Polls G General~eranonaI Expenses {dcscnbe ~foxer $50) T Travel Expenses (de~cnbe ~fover I interest Payment U Unhties L L~terature, Brochures. Printing W Wages, Salaries, Benefits M Management Settees Y Petmon Orculators N Newspaper and Other Peno&cal Advemsmg Z Prep~anon and Production of Adxemsmg Amending Page ~ Payee's Name and Payee's Committee I~, and Line ~ Check ~ /f applicable Purpose Exp Amounz of Pa~d Date (as ¢t appears on invoice, receipt or check) Type Expenditure to R'P Page__ L~ne [] New Ent~ [] Qorrectlng [] Delebng $ ~ Page___ L~ne E] New Entry [] Correcbng [] Delebng Page Line [] New Entw [~ Correcbng E] Delebng $ [~ Page__ Ltne [] New Entry [] Correchng [~ Delebng $ []7] Se~ FQ~ 9F~IQE ~E~Y Instructions .; on Back and --' e-/ / F~nanc¢ S~gnamre of candidate or ~easurer "- ;' ~ pc: : ./. [ 4 ,- - / Amendment D2te s~gned PC 1 Summary Statement of Contributions and Expenditures Re,, 12/03 Please ty. pe or print legibly in black mk Page 1 of 2 Candidate or Pohtlcal Commlttee Name (use full n;g) ~ Malhng Address as it Appears on Statement of Organization (street, route or box number, mty, state, zip code)' Treasurer's Name..~_~~ ~0{g~r- I Telephone Number (day): Committee ID Number: I Cornrmttee Type, Measure Number or Office: I .~ Original [] Primary 20__ [] General 20p~[ [] Other__ [] Amendment [] I st Pre-election [] 2nd Pre-electron [] Post-election [] 20__ September Supplemental A-TOTALS FOR THIS B-CUMULATIVE TOTALS ACCOUNTING PERIOD FOR THIS ELECTION CONTRIBUTIONS I. Cash Contributions (Accounting Period Total from PC 2) 2. Loans Received (Non-Exempt) (Accounting Period Total from PC 23 + + 3 Total Cash Contnbuhons (hnes l+ 2) = 4. In-Kind (Accounting Period Total from PC 2) + 5 TOTAL CONTRIBUTIONS (hnes 3 + 4) = EXPENDITURES 6 Cash Expenditures (Accounnng Period Total from PC 3) / -"-' ff 7. Loan Payments (Non-Exempt) + (Accounnng Period Total from PC 3 8 Total Cash Expenditures = O O (hnes 6 + 7) = 9. In-K~nd (Accounnng Period Total from PC 2) + 10 TOTAL EXPENDITURES O O CO (hnesS+9) = / -"-'- = / -- CASH BALANCE 11, Begmmng Cash Balance (hne 20 ofprevtous report) ~'1 7 ~t) ~ ~ FOR OFFICE USE ONLY 12. Total Contributions (line 5) + 13. Other Receipts (Accounting Period Total from PC 4A) + 14 Loans Received (Exempt) (Accounting Period Total from PC 4A) + 15 CONTRIBUTION SUBTOTAL (hnesll+12+13+14) = ZT~O RECEIVED 16 Total Expen&tures O O (hne lO) / --- NOV 3 0 20134 17 Other Disbursements + (Accounting Period Total from PC 4B) 18. Loan Payments (Exempt) CiTY RECORDER (Accounting Period Total from PC 4B) + 19 EXPENDITURE SUBTOTAL (hncs 16 + 17+ 18) = / '~' 20. ENDING CASH BALANCE I 7/? (hne 15 m,nus hne 19) = 0'2 ~"'~ PC 1 Summary Statement of Contributions and Expenditures Rev Please type or print legibly ]n black ink. Page 2 of 2 Candidate or Pohtlcal Commlttee~_.fi[(L~Name:p/L}t0~ ¢^ ~4 ~5,.da~ { 1[ Committee ID Number [~ Original [] Primary 20__ [~ General 20 O__~ [] Other__ [] Amendment [] 1st Pre-election [] 2nd Pre-election ~'Post-elecnon [] 20__ September Supplemental LOAN SUMMARY 21 Beglnmng Outstanding Loans ~ FOR OFFICE USE ONLY (hne 29 of previous report) 22.(llneL°ans2)Recelved (Non-Exempt) + ~ 23 Loans(line 14)Received (Exempt) + k ~' 24. LOANS RECEIVED SUBTOTAL (lines 21 + 22 + 23) = 25. Loan Payments (Non-Exempt) (llne 7) CJ 26.(hneLOan18)Payments (Exempt) + t.J 27. Forgiven Loans (Total loans forgiven during this accounting period) + 28. LOAN PAYMENT SUBTOTAL (lines 25 + 26 +27) = 29 TOTAL OUTSTANDING LOANS (hne 24 minus line 28) = PERSONAL EXPENDITURE SUMMARY 30 Beginning Outstanding Personal Expen&tures (line 36 ofpremous report) 31 Personal Expenditures (Accounting Period Total from PC 3A) + 32 PERSONAL EXPENDITURE SUBTOTAL (lines 30 + 31) = 33 Personal Expenditure Reimbursements (Total expenditures on PC 3 with purpose code R) 34. Forgiven Personal Expenchtures (Total personal expen&tures forgiven th~s acctg period) + 35 REIMBURSEMENT SUBTOTAL (lines 33 + 34) = 36. OUTSTANDING PERSONAL EXPENDITURES (hne 32 m~nus hne 35) = FINANCIAL STATUS AT CLOSE OF AcCOUNTIN lCD 37 En&ng Cash Balance 7/7 -- 38 Accounts Receivable (Accounting Period Total from PC 5) + (~ 39. SUBTOTAL (hnes37+38) : z, 7/? RFC -"'qD 40 Total Outstanding Loans (line 29) 41 Outstanding PersonalExpendltures - ,,~.) NOV 3 0 ;'004 + (hne 36) 42 Accounts Payable (Accounting Period Total from PC 6) +,__. CITY ....... 43. SUBTOTAL (hnes 40 + 41 + 42) : 7! '7[7 ~''''? 44 BALANCE/DEFICIT (hne39m,nusllne43 ,n&cate+or-balance) = 4 Zl 7t7-- I, _.a'q'~' (name of-candidate or treasurer), hereby certify that the above statement and the attached supporting reports are true and correct. Signature of candida e or easu er Date signed NOV ~ 0 ~004 CITY 14D_.U U HDER PC 3 Cash Expenditures and Loan Payments Rev Candidate or Pohtical Committee Name: Committee ID Number: ~-~t~t~ p~t/~...~ ~_~.~ ~;t~',v.! Page / of [ Election: [] Primary 20__ [] 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 A Agent O Other Advertzsmg (yard signs, buttons, etc.) (2~ Cash B Broadcast Advertising (Radio, TV) P Postage LP Loan Payment C Cash Contributmns 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 Servmes Y Petition Circulators N Newspaper and Other Periodical Advemsmg Z Preparatton and Production of Advemsing Payee's Name and Payee's Committee II2~, [] Line # Date Check # if applicable Purpose Exp. Amount of (as it appears on invoice, receipt or check) Type Expenditure Paid to AlP 2. $ I'--] 3. $ 1--'-I 4. $ [-] 5. $ ~] 6. $ I'~ 7. $ 8. $ [] 9. $ ~] 10. $ F--I CITY 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 ~n Campmgn Cash (CA) $ / ~ Cash (CA) $ Finance Enter on Summary Statement, Column A, Line 6 Manual Loan Payment (LP) $ ~ Loan Payment (LP) $ Enter on Summary Statement, Column A, Line 7 PC 3 Cash Expenditures and Loan Payments Please type or print legibly in black ink. List only one entry per line. ACCOUNTING PERIOD TOTALS - Complete this box only on the last page of the section. Add Cash totals from all pages of form PC 3 and enter the amount on the Cash line in the Accounting Period Totals box. Add Loan Payment totals from all pages of form PC 3 and enter the amount on the Loan Payment line in the Accounting Period Totals box. Transfer these totals to the lines indicated on the Summary Statement of Contributions and Expenditures (PC 1). AMOUNT OF EXPENDITURE - Amount of check, cash transaction, credit or debit card charge. CHECK # - The number of the check. For cash transactions, write "cash" in the check number box. If the expenditure was charged on a committee credit or debit card, enter "credit card" or "debit card." DATE - The date the expenditure or loan payment was made. Date must include the month, day and year. A range of dates may be used for reporting bank charges. EXPENDITURE TYPE - Select the appropriate expenditure type from the list provided on the form. Designate only one expenditure type for each entry. PAGE TOTALS - Add all code CA expenditures and enter the amount on the Cash line m the Page Totals box. Add all code LP expenditures and enter the amount on the Loan Payment line in the Page Totals box. PAID TO ACCOUNTS PAYABLE - Check this box if the expenditure is a payment of a previously reported account payable. PAYEE'S NAME - The name of the vendor or individual to whom payment was made. If the payee is a state political committee, also list the six-digit I.D. number assigned to the committee by the Secretary of State. PURPOSE - Use the purpose codes from the hst provided below (note exceptions) or provide a written description of the purpose of the expenditure. If one or more of the following purpose codes are used to describe an expenditure, no other descripbon is generally needed.