HomeMy WebLinkAboutDavid Kelly for City Council a
Summary Stat ..,ent of Contributions and ..penditures
Please IS. pc or print legibly in black mk Page 1 of 2
Candidate or Polmcal Commmee Name (use ~11 name)'
Marling Address as ~t ~ppea~s on Statemen~ of OrganJzafio~ (street, route or box number, c~ry. state, z~p code).
Trea.urer s Name: Telephone Number (day):
Conferee ID ~u~:ber: -': Committee T~e, Measure Number or Office:
[~ 6ngmal [] Primary 20 [~-eneraI 20 O~. [] Other
[] Amendment [] 1 st Pre-election [] 2nd Pre-elecnon [] Post-elecnon ~eptember Supplemental
A-TOTALS FOR THIS B-CUMULATIVE TOTALS
ACCOUNTING PERIOD FOR THIS ELECTION
CONTRIBUTIONS
(Accounting Period Total from PC 2~
2. Loans Recessed (Non-Exempt) + +
(Accounting Period Total from PC 2}
3. Total Cash Contnbutmns
4. In-Kind +
(Accounting Period Total from PC 2)
5~ TOTAL CONTRIBUTIONS
(l~nes 3 + 4)
EXPENDITURES
6. Cash Expend:uTes
[Accounnng Period Total from PC 3}
7. Loan Paymems (Non-Exempt) + +
(Accounnng Period Total from PC 3)
8. Tolal Cash Expen&tures =
9. In-Kind
IAccountmg Period Total flora PC 21 /
10. TOTAL EXPENDITURES =
(lines 8 - 9) ,
CASH BALANCE
11. Beginning Cash Balance
FOR
OFFICE
USE
ONLY
t2. Total Contributions +
13. Other Receipts +
(Accounting Period Total from PC 4A)
14. Loans Rece~x ed (Exempt) +
iAccounnng Period Total from PC 4A)
(hnes 11 + I2 + 13 + 14}
16. Total Expen&tures
17. Other D~sbursements +
(Accountm2 Period Total fi'om PC
1S Loan l'a3nlcms (Excmp0 +
(Account:nc f>c~od Total from PC 4B~
19. EXPENDITURE SUBTOTAL
20 ENDING CASH BALANCE = /
ti{nc 15 mmushnc lO)
PL 1
Summary State ent of Contributions and
Pteas~ type or print legibly m bi~ck ~nk.
Candidate or Poht~cal Commntee Name' I Commmee 1D Number'
~ ~enem! 20 O~ ~ Other
~ Amendment ~ 1st Pre-elecUon ~ 2nd Pre-election ~ Post-election ~ September Supplemcntal
LOAN SUMMARY
21. Beginning Outstanding Loans FOR OF/ICE USE ONLY
(Total Outstanding Loans from prex ~ous report)
22 Loans Recen'ed (Non-Exempt)
(hne 2)
23. Loans ReceB ed (Exempt) +
(hne 14)
24. LOANS RECEIVED SUBTOTAL
(hnes 21 ~22 +23) =
25 Loan Payments (Non-Exempt)
dzne 7)
26~ Loan Payments (Exempt) +
(hne 18)
27. Forgiven Loans
+
(Total loans lbrgB cn dunng tlus accounung pe~od;
28. LOAN PAYMENT SUBTOTAL
(hnes 25 + 26 ~27)
29. TOTAL OUTSTANDING LOANS
{line 21 minus hne 28) :
PERSONAL EXPENDITURE SUMMARY
30. Beginning Outstanding Personal Expenditures
[line 36 ofp~ev~ous report)
31. Personal Expen&tures
(tccoummg Period Total from PC ~X) * ~ ~ ~
32. PERSONAL EXPENDITU~ SUBTOTAL
33. Personal Expen&mre Reimbursements
34. ForgB,en Personal Expen&mres +
(Total personal expen&rurcs GrgB en th~s acctg period)
35. REIMBURSEMENT SUBTOT~
(hnes 33 + 34) :
36. OUTSTANDING PERSONAL EXPENDITU~S
(line 32 mmu~ hne 35}
FINANCIAL STATUS AT CLOSE OF ACCOUNTffqG PERIOD
37 Ending Cash Balance
38 Accounts ReceBable
(Accounnng Period Total fi-om PC :)
39. SUBTOTAL =
q
40. Total Outstanding Loans
(line 29)
41. Outstanding Personal Expcndm~rcs +
(line
42. Accounts Payable +
(Accounting Period Total from PC 6~
4~. SUBTOTAL
(hncs 40 + 41 + 42 )
44. BALANCE/DEFICIT
I. -_ ~ ~.~' , //~ ~ ~ v~ / (namc of candidate or treasurer L l~crcby ccrtd ~' th,: thc abu~ c
state~ent an~ thc attached su[]}m:u(~ reports are truc and co:cc[
PC
Cash Expenditures and Loan Payments
Can&date or Pohncal Comnmtee Name: Committee IL-) Number.
Election: --~ aln~a~ 2~-~; ~Genera1200~ ~ Other
Report: ~ 1st Pre-elecnon ~ 2nd Pre-elecnon ~ Post-elecnon ~eptember Supplemental
PURPOSE CODES (see back of form for instructions and code definitions) EXPENDITL RE TYPES
A Agent N Newsyaper and Other Periodical Advertising CA Cash
B Broadcast Advertising (Radio, TV) O OtberAdvemsing (yard signs, buttons, otc3 LP Loan Payment
C Cash Contribunons P Postage
F Fundrmslng Event Expenses R Reimb~sement
G General Operanonal Expenses (describe S Sunevs and Polls
if over $50} T Travel Expenses (describe if over $50'~
I Interest Payment U Utflhies
L Literature. Brochures, Printing W Wages, Salaries, Benefits
M Management Sen'ices Z Preparation and Production of Advertising
Payee's P4ame and Payee's Commtttee 1~,
bne ~ Date Check ~ ~f applica&:e Purpose Exp Amount of
(as ~t appears on invoice, receipt or check) Type Expenditure Pa~d
to ~'P
7. $
s
10 $
Page Totals (Add all expen&tu~es with the same Accounting Period Totals (Complete only for last page and
See expcn&mre type.) transfer these amounts to the Summa~ Statement, PC
Instructions
Finance
Loan Payment (LP; $ Loan Payment (LP)
~auua~ D ~ ~,n %n,m~-3 gu:cm~ut. (ulumn X Line 7
P£ 3
Persona, Expenditures for Reimbursement ':"'
Can&date or Political Committee Name' Conmmtee iD Number.
Elecnon: '~ ~ ~rima~ 20" ~ene~120 0~ ~ Other
Report: ~ 1st Pre-election ~ 2nd Pre-election ~ Post-election ~eptember Supplemental
PURPOSE CODES (see back of form for instructions and code definitions)
A Agent N Newspaper and Other Peno&cal Advertising
B Broadcast Advertising (Ra&o. TV) O Other Advemsing (yard agns, burtons, etc.)
C Cash Contributions P Postage
F Fundraismg Event Expenses S Su~ceys and Polls
G General Operational Expenses (describe ~fo~er $50) T Traxel Expenses (describe ~fover $50)
[ Interest Pa~nent U Unhnes
L Literature, Brochures, Printing W Wages, Salaries, Benefits
M Management Sen'~ces Z Preparation and Production of Adveniang
Amount of
Line # Date Payee's Name Purpose
Expendmre
2.
3, $
4. $
5 S
6. $
7 S
8. $
9 $
10. $
Page Total Accounting Period Total (Complete only for last page and
See
Instructions Personal Expenditures $ -
on Back and Per,onal Expen&tures S
Finance
Man~al
PL 3 \