HomeMy WebLinkAboutTom Slocum for City Council PC 1
Summary ,. atement of Contributions Expenditures
Please type or pnnt legibly in black ink. Page 1 of 2
Can&date or Political Committee Name (use full name):
Mailing Address as ~t Appears ~n Statement of Organization (sWeet, route or box number, ciW, state, z~p code):
Treasurer' s Name: ~ ~ ': Telephone Number (day):
Committee ID Number: Cor~ntiee T~ Me~su~ Number or Office:
~Original ~Prima~ 20~ E General 20 E Other
~ Amendment ~ 1 st Pre-election ~ 2nd Pre-election ~ Post-electron ~ 20~ September Supplemental
A-TOTALS FOR THIS ~CUMULATIVE TOTALS
ACCOUNTING PE~OD FOR THIS ELECTION
CONTRIBUTIONS
1. Cash Contribut, ons ¢k '~ 2.~~/4' 'e* ~ i' ~Z
(Accosting Pe~od Total from PC 2) '~ ---' , ~ (-
2. Loans Received (Non-Exempt) + ..~ +
(Accosting Period Total from PC 2)
3. Total Cash Conmbunons = ~ ~57 : ~ :~'
(lines 1+ 2) -: ~ ~-' '~:' ~-
4. In-K~nd + /'X~ +
(Accounnng Period Total from PC 2}
5. TOTAL CONT~BUT1ONS '{~> ~ ~ -. ~ ~ ', ~ ':"' q .-' ' .. ?
(lines3+4) = .~ ~ ,~ . = ~ .. ~ ,'
EXPENDITURES
(Accosting Period Total from PC 3) -~ ~ ~ --" [ ' ~' '- ' ::~ -~"~
7. Loan Pa~ents (Non-Exempt) + ¢~q +
(Accounnng Period Total ~om PC 3)
8. TotalCashExpend~mres = "~_ .-,,--~ ('/" ~ * ': ':'
(hnes6+7) ~- t ~ ' ~ ~ = ~ ~ ~
9. In-Kind + ~7~ + :7+<.. _
(Accounting Period Total tkom PC 2)
t0. TOTAL EXPENDITU~S ~ ;2(. ~: ./~ ~, ~
CASH BALANCE
11. Beg~lng Cash Balance
FOR
OFFtGE
ONLY
(hne 20 of prewous report)
12. Total Contributions + q' *-~ , ~
(line5) ~ -~' ~ ~
13. Other Recmpts +
(Accounting Period Total from PC 4A)
14 Loans Recmved (Exempt) +
(Accounting Period Total from PC 4A)
15. CONTRIBUTION SUBTOTAL = ~;
(hnestl+12-~ 13~14) ~'
16. Total Expenditures :, '~ 0_ *..: ~ . Q~z.
(hne 10) ' '~
'(;::IVE
17. Other Dlsb~sements + .~::
(Accounting Period Total from PC 4B ) ~
18. Loan Payments (Exempt) + ,'~ ~- ~7~ * ~;
(Accounting Period Total from PC 4B) ,,~ .... L ~.
I9 EXPENDt~SUBTOTAL = ¢ ~, ,, : , :'~
(hnes16+ 17+ 18) ' - ~,>~
20 ENDING CASH BALANCE = -~ : ~ ~__~: ~ ~ : ;
time 15 minus hne 19)
PC 1
Summary L_atement of Contributions , .md Expenditures
Please type or print legibly in black ink. Page 2 of 2
Candidate or Polmcal Committee Name: I Committee ID Number:
[] Original buT1 Primary 20:! .... i [] General 20 [] Other
[] Amendment [] 1st Pre-election [] 2nd Pre-election [~ Post-election [~] 20__ September Supplemental
LOAN SUMMARY FOP, OFFICE USE ONLY
21. Beginning Outstan&ng Loans f~"
(hne 29 of prewous report}
22 Loans Received (Non-Exempt) + ~2,.~
(hne 2)
23. Loans Recmved (Exempt) +
(hne 14)
24. LOANS RECEIVED SUBTOTAL
(hnes 21 + 22 + 23)
25. Loan Payments (Non-Exempt)
(hne 7)
26. Loan Payments (Exempt) + ....
(hne 18) "- ~
27. Forgwen Loans + -,c
(Total loans forgiven dunng th~s accounting per/od)
28. LOAN PAYMENT SUBTOTAL
(lines 25 + 26 +27)
29. TOTAL OUTSTANDING LOANS = *~
(hne 24 minus hne 28)
PERSONAL EXPENDITURE SUMMARY
30. Begmmng Outstanding Personal Expenditures ~ ~,
(hne 36 of previous report)
31 Personal Expenditures +
(Accounting Period Total from PC 3Al
32. PERSONAL EXPENDITURE SUBTOTAL =
(hnes 30 ,- 31)
33. Personal Expenditure Rmmbursements
(Total expen&tures on PC 3 w~th purpose code R)
34. Forgiven Personal Expenditures +
(Total personal expen&tures forgiven th~s acctg, period)
35. REIMBURSEMENT SUBTOTAL =
(lines 33 + 34) /
36. OUTSTANDING PERSONAL =
EXPENDITURES
FINANCIAL STATUS AT CLOSE OF ACCOUNTING PERIOD
37. Ending Cash Balance ~t : ()L_; ~ '~"/ ~
(hne 20) ' '
38. Accounts Receivable +
(Accounnng Period Total frem PC 5)
39. SUBTOTAL = ~'-' /~, ~' c~'4~
{hnes 37 -* 38) ~ ~ % .
40 Total Outstanding Loans //? , '. L_ ~
(hne 29) ,'~ ~-
41. Outstan&ng Personal Expenditures + ~-~;'" zA 2':/ ,_~ ~''
(hne 36)
42. Accounts Payable + ~ 9 ?~' ,~ .......
(Accounting Period Total from PC 6) ~ i ~ '? J~ i~7 ~
43. SUBTOTAL = ~ ~
(hnes 40 -~ 41 - 42}
44. BALANCE/DEFICIT = -? '~ ~"~-' ',, .
(hne 39 minus hne 43 ~n&cate + or - balance)
I. ..... /~"~,"~,'~' ' ~ ~ --.,' - ~ : ~-, (name of candidate or treasureD, hereby, certify that the abo¥c
statement and the attached suppg~tmg reports are true and correct.
Signature of candidate or treasurer Date s~gned
PC 2
Cash Contributions, Loans Received and n-Kind
Candidate or Polmcal Comamttee Name: Committee iD Number:
Election: ~ Prima~ 20_C* ~ ~ G~neral 20 ~ Other
Repo~' ~)st Pre-~lection ~ 2nd Pre-election ~ Post-election ~ 20~ September Supplemen~l
SEE BACK FOR INSTRUCTIONS AND CODE DEFINITIONS
CODE ~: Contributor Type CODE 2: Contribution Type
B Business Ennty CA Cash
C Political Co--tree (includes business and union PACs) CO Cosigner Obliganon
F Can&date's Immediate Family (includes candidate) IK In-Kind
I Individual LR Loan Received
L Labor Orgamzat~on
O Other
P Pohncal Party Co~i~ee
Amount of ln-&nd Purpose
Line ~ Name and Address of Contributor Contribution (see manual for suggested purpose codes)
Occupational
Information
Contributor
Code ~ ~ Code 2
Date Received Contributing Commi~ee's I~ Aggregate
See Page Totals (Add all amounts with the same Accoanting Period Totals (Complete only for last page and
Instructions con~bution ~e. Do not include aggregates.) transfer these amounts to the Summ~y Statement, PC 13
on Back and
~n Campaign Cash (CA) $ ~ ~ (~(?' ' ~' ~''~- ' Cash (CA) $
Enter on Su~a~ Statement. Colu~ A. Line 1
F~nance
Man~l In-Kind (IK) $ In-~nd (IK) $
Enter on S~ Statement, Col~ A, Lines 4 and 9
PC 2 Loans Recmved (LR} $ Loans Recmved (LR) $
Enmr on Sm~ Statement, Colum A. Line 2
PC 2
Cash Contributions, Loans Received and in-Kind
Candidate or Poht~cal Committee Name: Committee [D Nmnber:
ElecUon: ~ Pfima~ 20 C~ [{ ~ General 20 ~ Other
Repo~ ~lst Pre-election ~ 2nd Pre-elecuon ~ Post-election ~ 20 September Supplemental
SEE BACK FOR INSTRUCTIONS AND CODE DEFINITIONS
CODE ~: Contributor Type CODE 2: Contribution Type
B Busmess Ent~ CA Cash
C Political Co~i~ee (includes business and union PACs) CO Cosigner Obhgatmn
F Candidate's l~ediate Family (includes candidate) [K In-Kind
~ Individual LR Loan Received
L Labor Orgamzation
O Other
P Pohtical Pa~y Co~niuee
Line ~ Name and Address of Contributor Amount of In-~nd Purpose
Contribution (see manual for suggested pu~ose codeg
Date Received Occupational Information or Contributor
Code I Code 2
Contributing Commi~ee's I~ Aggregate
S~e ~ge Totals (Add all amounts ~ith th~ sam~ ~eo[]ti~g ~¢ri~a T~t~ls (Complete only for last page and
Instructions conmbution ~e. Do not include agF~gates.) ~=sfer these amounts to the S~a
on Back and
in Campai~ Cash (CA) $ }~ ~5("} ,b4 ) Cash (CA) $
Finance Enter on S~ Statement, Colum A, Line 1
Manual In-Kind (IK) $ In-Kind (IK) $
En~r un St~ Statement, Col~ A, Lies 4 ~d 9
PC 2 Loans Received (LR) $ Loans Recetved (LR) $
Enter on Sm~ Statement, Column A, Lie 2
PC 2
Cash Contributions, Loans Received and n-Kind
Candidate or Pohtical Committee Name: Committee ID Number:
.... ~ Page
Elect~on: [] Primary 20~ [] General 20 [] Other
Report: ~t Pre-election [] 2nd Pre-election [] Post-election [] 20 September Supplemental
SEE BACK FOR INSTRUCTIONS AND CODE DEFINITIONS
CODE 1: Contributor Type CODE 2: Contribution Type
B Business Entity CA Cash
C Political Committee 0ncludes business and union PACs) CO Cosigner Obhgatmn
F Candidate's Immediate Family (includes candidate IK In-Kind
I Individual LR Loan Received
L Labor Orgamzat~on
O Other
P Political Part5, Committee
Amount of In-Kind Purpose
Line # Name and Address of Contributor Contribution (see manual for suggested purpose codes)
Occupational
Information
or
Contributor
Code ~ I Code 2
Date Received Contnbuttng Committee's ID# Aggregate
4. $
5, $
$
See Page Totals (Add all amounts with the same Accounting Period Totals (Complete only for last page and
Instructions contribution type. Do not include aggregates.) transfer these amounts to the Summary StatemenL PC 1
on Back and ....... Cash (CA) $ -~z2 ~ ~ {r~. _ (i~
in Campaign Cash (CA} $
Enter on ~unnnary Statement. Colunm A, L~ne
Finance
Manual In-Kind (IK) $ In-Kind (IK) $
Enter on Summary Statement, Column A, Lines 4 and 9
PC 2 Loans Received (LR) $ Loans Received (LR) $
Enter on Smnmary Statement. Column A, Line 2
P( 3
Cash Expenditures and Loan Payments
Candidate or Pohtical Committee Name: Corrmnttee [D Number.
. ~ ~-, 4. Page
Election: ~ Primary 20ff'j [~] General 20 ~ Other
Repom ~ 1 st Pre-elect~on ~ 2nd Pre-election ~ Post-elecnon ~ 20~ September Supplemental
PU~OSE CODES (see back of form for instructions and code definitions) EXPENDITURE TYPES
A Agent O O~er Adve~ising (y~d si~s, buUons, ctcJ CA Cash
B Broadcast Advemsmg (Radio, TV) P Postage LP Loan Payment
C Cash Contributions R Retmb~sement for Pemonal Expenditures
F Fundrais~ng Event Expenses S Surveys and Polls
G General ~erational Expenses (describe ~fover $50) T Travel Expenses (describe ~fover $50~
I Interest Payment U Utdities
L Literature, Brochures, Printing W Wages, Salaries, Benefits
M Management Services Y Petition C~rculators
N Newspaper and Other Penodtcal Adve~ising Z Prep~a~on and Producuon of Advems~ng
Payee's Name and Payee's Comm~ee I~, Exp. Amount of
Uno ~ Date Check ~ ~f applicable Purpose Type Expenditure Pad
(as ¢t appears on invoice, receipt or check) to NP
3. $
4 $
$ [21
$
See Page Totals (Add all expenditures with the same Accounting Per~od Totals (Complete only for last page and
Instructions expenditure type.) transfer these amounts to the Summary StatemenL PC 1.)
on Back and
in Campaign Cash (CA) $ ~ ,.2qO~ .C~*~ Cash (CA) $
Enter on Smmma~ Statement, Colunm A, Line 6
Finance
Manual Loan Payment (LP) $ Loan Payment (LP) $
Enter on Sunm~ary Statement, Colunm A, Line 7
PC 3
PC
Persona Expenditures for Reimbursement
Candidate or Polincal Committee Name: Commtttee ID Number:
~ *, ~' , .... ," Page I of
Elecnon: ~ Prima~ 20 C~'i ~ General 20 ~ Other
Report: ~ 1st Pre-elecnon ~ 2nd Pre-election ~ Post-election ~ 20, , September Supplemental
PURPOSE CODES (see back of form for instructions and code definitions)
A Agent O Other Advemstng {`yard signs, hurons, etc.)
B Broadcast Adve~ismg {.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 Utihties
[ Interest Payment W Wages~ Salahes. Benefits
L Ltteramre, Brochures, Pnnt~ng Y Petition Circulators
M Management So.ices Z Preparatmn and Production of Adve~ising
N Newspaper and Other Periodical Adve~is~ng
Amount of
Line # Date Payee's Name Purpose Expenditure
1. $
$
3 $
4. $
5. $
6. $
$
8. $
9. $
10. $
See Page Total Accounting Period Total (Complete only for last page and
Instructions ~ {~ ~ transfer this amount to the SunTnmary Statement. PC 1.)
on Back and Personal Expenditures $
in Campaign Personal Expenditures $
Finance Enter on Summary Statement, Line 31
Manual
PC 3A
PC 4A
Other Receipts :,o3
Candidate or Polmcal Committee Name' Conmmtee ID Number:
Elect~on: [] Primary 20 .) .a. E~ General 20 [] Other
Report: ~st Pre-elect~on [] 2nd Pre-elecnon [] Post-election [] 20~ September Supplemental
SEE BACK FOR INSTRUCTIONS AND CODE DEFINITIONS
Other Receipt Transaction Type Codes
EL Exempt Loan Proceeds
FM Items Sold at Fair Market Value
[N Interest/Investment Income
OM Miscellaneous (provide a description)
Pd~ Refunds, Rebates and Returns
Date Name Other Receipt
Line # Received (requlred for codes EL, OM and RF; Transaction Type Other Receipt Amount
optional for codes FM and IN) Code
$
2. $
3. $
4 $
5. $
$
7. $
8 $
9 $
10. $
See Page Totals (Add all Othm Recmpt Transaction Accounting Period Totals (Complete only for last page and
Instructions Type Codes specified.) transfer these amounts to the Sununary Statement. PC 1.)
on Back and ~-
in Campaign Codes FM, IN, OM, RF ~ ¢ Codes FM, IN, OM, RF $
Finance Enter on Summm~y Statement, Cotunm A, L m~ 13
Manual Code EL $ Code EL $
Enter on Summary Statement, Column A, Line N
PC 4A
PC 4[3
Other Disbursements
Candidate or Political Committee Name: Committee iD Number:
Election: ~,_~rtmary 20 C ~ [] General 20__ [] Other
Report ~ 1st Pre-election [] 2nd Pre-election [] Post-elect~on [] 30 September Supplemental
SEE BACK FOR INSTRUCTIONS AND CODE DEFINITIONS
Other Disbarsemeat Transaction Type Codes
EL Exempt Loan Paymem
NP Nonpamsan Activin'
OM Miscellaneous ~rovide a description)
RT Remm or Re.nd of Contributions
Payee's Name Other Disbursement
Other Disbursement
bne # Date Check # (required for codes EL, OM and RT; Transaction Type Amount
optional for code NP) Code
1. $
2 $
3 $
4, $
5 $
6,
7. $
8. $
9. $
10 $
See Page Totals (Add all amounts for the Other Accounting Period Totals (Complete only for last page and
Instructions Disbursement Transaction Type Codes transfer these amounts to the Summary Statement, PC 1.
on Back and specified )
in Campaign
Finance Codes NP, OM, RT $ Codes NP, OM, RT $
Manual Enter on Summary Statement, Column A, Ltne 17
Code EL $ Code EL $
Enter on Summary Statement. Colunm A, Line 18
PC 4B
Pt_ 5
Accounts Receivable
Can&date or Pohncal Cmrunitree Name Conm~ittee iD Number:
- ~ Page __j__ of I _
Elecnon' ~mary 20:.Z.:~ [] General 20~ [] Other
Report: ~J 1st Pre-election [] 2nd Pre-election [] Post-election [] 20~ September Supplemental
SEE BACK FOR INSTRUCTIONS AND CODE DEFINITIONS
CODE 1: Contributor Type CODE 2: Account Receivable Type
B Business Entity OR Other Account Receivable
C Political Committee { includes business and union P. ACs) PC Pledge of Cash
F Candidate's Immediate Family (includes candidate} PI Pledge of In-Kind
I Individual PL Pledge of Loan
L Labor Organization
O Other
P Political Party Con~nittee
Amount of In-Kind Purpose
Line # Name and Address of Contributor
Account Recetvable (see manual for suggested purpose codes)
Occupattonal
Informatton
Contributor
or
Code '/ J Code 2
Date Contributing Committee's ID# Aggregate
I $
2 $
3 $
4. $
5 $
$
See Page Total (Add all amounts for the Accounts Accounting Period Total (.Complete only Ibr last page and
Instructions Receivable Type Codes specified. Do not transfer these amounts to the Summary Statement, PC l.)
on Back and include PI or aggregate.)
in Campaign ~ (~ ~
Finance Codes OR, PC, PL $ Codes OR, PC, PL $
Enter on Sunm~ary Statement Col~ A, Line 38
Manual
PC 5
Accounts Payable
Candidate or Political Committee.Name: Committee ID Number:
. ~~_~. Page
Election: ~Prima. 20~ ~ General 20~_ ~ O~er
Report: ~' ~lst Pre-election ~ 2nd Pre-elect~on ~ Post-etect~on ~ 20 September SupplemenmI
PU~OSE CODES (see back for ~nstrucfions and code
A Agent O Other
B BroadcastAdven~smg{Radio. TV) P Postage
C Cash Contributions S Surveys and Polls
F Fur~dra~sing Event Expenses T Travel Expenses (describe ifoxer Sf0)
G GeneralOperat~onal Expenses (describe ~fover $50) U Ufiht~es
I hxterest Payment W Wages. Salaries. Benefits
L L~reramre. Brochures, Printing Y Petition C~rculators
M Management Se~Sces Z Preparauon and Production ot'Advemsing
N Newspaper and Other Per~od~cal AdYenismg
Amount
Line ~ Date Payee ~ Name Pu¢ose Account
3, $
$
$
8. $ '~
10. $
See Page Total (Add all accounts payable on this Ac¢otmting Period Total (Complete only i~>r last page and
Instructions form.) trmnsfer these amounts to the Summary Statement, PC 1.}
on Back and ' ';/
in Campaign Accounts Payable $ ~ O ~' Accounts PavaNe $ ~¢
~ Enter on Surnmao~ Sta[emen~. Col~rm A, Linc 42
Finance
Manual
PC 6
iCl
Summary S ,ement of Contributions Expenditures tm
Plebe ~e or print legibly in black ~ Page 1 of 2
C~didate or Political Co~i~ee Nme (use hll nme):
Mailing Ad.ess as ff Appears ~ Statemem ofOrg~zafion (s~eet, route or box n~ber, cffy, sm,e, z~p code):
Treasurer's Name: Telephone Number (day}:
Co~ittee ID Number: Cog~ee T~e, Measure Number or Office:
[~ Original ~.~,j>rimapj 20_F~ Et General 20 ~ ~her
~mendment -~ 1st Pre-election ~ 2nd Pre-election ~ Post-election ~ 20 ' September Supplemental
A-TOTALS FOR ~IS ~UMUEATI~ TOTALS
ACCOUNTING PE~OD FOR ~HIS ELECTION
CONTR}BUTIONS
1. Cash Contributions
(Acco~tNg Period Total from PC 2)
2. Loans Received (Non-Exempt) +
+
(Accosting Pehod Total from PC 2
4. In-Kind
(Accounting PeNod Torat from PC 2} +
5. TOTAL CONTaBUTIONS -~$'~2~, 2.~ C . O(~
EXPENDITU~ES
(Accomnting Period TomI from PC 3
7. Loan Payments (-Non-Exempt) +
(Accounting Period Total from PC 3)
g. Total Cash Expenditures =
9 In-Kind
(Accounting P=riod To=l horn PC 2} +
CASH BA~NCE
11. Beginning Cash Balance
(line 20 of previous report)
t2. Total Con~ibutions
t3. OO~er Receipts
{Accounting Pefic~i To~l ~om PC 4A)
14. Loans Received (ExempQ +
(Accomn~qg Period Total ~om PC 4A)
15. CONTmBUTION SUBTOTAL =
(lines ti + i2 + 13 + I4)
16. To~I Ex~nditures
(tine lO)
t7. Other Disbu~ements
{Accounting Ped~ Total ~m PC 4B
18. Loan Pa3menm (Exempt)
(A~ouniLqg P~ T~I ~m PC 4B)
(lines I6 + 17 + 18)
PC1
Please ~e or print legibly in black i~. Page 2 of 2
C~didate or Political Com~i~ee Name: I Com~mi~ee ID Number:
gh;al ~2fima~ 20~ ~ General 20 ~ Other
mendment ~1 st Pre-election ~ 2nd Pre-election ~ Post-election ~ 20~ September Supplemental
LOA~ SUmmArY
21. Begi~ng Ou[stand~g Loans ~ F~ ~F~CE USE ONLY
{1/ne 29 of previous repo~)
22. Lomqs Received (Non-Exempt)
(line 2) +
23. Lo~s ReceB'ed (Exempt)
(hne 14'~ +
24. LOANS P~CEIVED SL~TOTAL
(lines 21 * 22 + 23) =
25. Loan P%ments ~on-Exempt)
(line 7)
26. Loan Payments (Exempt)
thne 18) +
27. Forgiven Loans
(Tomt lomns forgiven d~ng th~s accounting period) +
28. LOAN PAYMENT SUBTOTAL
(lines 25 + 26 *2% =
29. TOTAL OUTSTANDING LOANS
{line 24 m~nus hne 28) =
PE~$0NAL EXPENDITU~E
30. Beginnine Outstanding Personal Expenditures
(hne 36 of~rc~, ious repo~)
31. Personal Expenditures
(Accoun6ng Period Total from PC 3A} +
32 PERSONAL EXPENDITU~ SL~TOTAL
(lines 30 * 31 ~ =
33. Personal Expenditure Reimbursements
(Total expen&~es on PC 3 w~h p~pose code R
34. Forgiven Pemonal Ex~ndit~es
(Total per~nal expenditures fbrgP,'en this acctg, period)
+
35. R~E~4BURSEMENT SUBTOT.~
I1Nes 33 + 3%
36. OUTSTANDING PE~ON~
E~ENDITU~S =
FINANCIAL STAT~$ AT CLOSE OF ACCOUnTInG PER~OD
38. Accounts Receivable
(Accocmfing Period Total from PC 5) +
39. SUBTOTAL =
(lhnes 37 4 38)
40. Total Oumtanding Loans
{hne 2%
41~ Outstanding Personal Expendit~es
(line 36) +
4Z Accounts Payable
(Accounting Period lomI from PC 6} +
(lines 40 + 41 * 42) =
44. BALANCE[DEFICIT
(line 39 minus ~ine 43: indicate * or - bal~ce) =
I, ~ (~ q ~ ~[OC *~ t~5 (name of c~ndidate or ~eas~xe0, here-by c~ni¢ ~al the above
statemept and the atta~d s~N~g repons are ~e ~d co~ect.
Signature of candidate or treas~er Date signed
PC 2 Ame=dm¢~
Amendments-Cash Contributions, Loans Re( ~od and lmKind
C~ or Pol~fic~ Committee Name: Con=hte¢ iD Number:
Election: ~Pfimmw 20~ ~ General 20 ~ Other
Repom ~Ist Pre-election ~ 2nd Pre-election ~ Post-election ~ 20~ September Supplemental
SEE BACK FOR INSTRUCTIONS AND CODE DEFINITIONS
CODE ~: Contributor Type CODE 2: ContriBution Type
B Bushness Enmy CA Cash
C Political Commme~ rincludes business and union PACs) CO Cosigner Obligation
F Candi~te's In~raediate Famd~ (includes candidate~ IK Ia-Kind
I In&v~duaI LR Lo~n Recehed
L Labor Organizat:on
O Other
P Polincat Pa~' Committee
Amending Pags g Name aad Add~ess of Contributor Amount of tn-K~no Pu¢ose
and Dde ~ Contribution Cee m~nuai ~or suggested puDc3e codes)
Date Received Occupatioaa; l~formaton or Contributor Code ~ Code 2
Contnbut~T Commi~ee s ~D~ Aggregate
~ Cs-reclr, g
~ Delenng
$
Page ~ L,ne
~ New Ent~
~ Correct,ng
~ Deleting
$
Dne
~ Correcting
~ Detebng
$
Page.~ L,ne
~ New Enfry
~ Coweotmg
~ Detetmg
$
on Back and
in Campaign ~; ~
Fhmnce S~gnature of candidate or treasurer
Manual
PC: o ClTY REO0 OER
Amendment Date sigmed
P( I
Summary Statement of Contributions and Expenditures
Please type or print legibly m black ink. Page 1 of 2
Can&date or Political Committee Narne {use full name):
Tom Slocurn for City Council
Maihng Address as it Appears on Statement of Orgamzatton (street, route or box number, city. state, zip code):
1210 Willagillespie Road Eugene, OR 97401
Treasurer's Name: } Telephone Number (day):
Robin Lobdell I 541-345-9966
Conm~ittee ID Number: I Committee Type, Measure Number or Office:
Eugene City Council, Ward 1
~ Original [] Primary 200_~4 [~ General 20__ [] Other ~
[~ Amendment [] 1st Pre-election [] 2nd Pre-election [~ Post-election [~ 20__ September Supplemental
A-TOTALS FOR Tills lB-CUMULATIVE TOTALS
ACCOUNTING PERIOD FOR THIS ELECTION
CONTRIBUTIONS
1. Cash Contributions 3,770~00 7,010.00
(Accounting Period Total from PC 2)
2. Loans Received (Non-Exempt) + 0 00 + 0.00
(Accounnng Period Total from PC 2)
3~ Total Cash Contributions
= 3,770.00 = 7,010.00
(lines 1~- 2)
4. In-Kind + 0 00 + 0.00
(Accounting Period Total from PC 21
5. TOTAL CONTRIBUTIONS
= 3,770.00 = 7,010.00
(hnes 3 + 4)
EXPENDITURES
6. Cash Expenditures 5,559 00 6,858.00
tAccounting Period Total from PC 3)
7. Loan PayTnents (Non-Exempt) + 0.00 + 0.00
(Accounting Period Total from PC 3)
8. Total Cash Expenditures = 5,559.00 = 6,858.00
(lines 6 + 7)
9. In-Kind + 0.00 + 0.00
(Accounting Period Total from PC 2)
10. TOTAL EXPENDITURES
= 5,559.00 = 6,858~00
dines 8 + 9)
CASH BALANCE
1 l. Beginning Cash Balance 1,941.00 FOR OFFICE USE ONLY
{line 20 ofprevmus report)
12. Total Contributions + 3,770.00
(hne 5 )
13. Other Receipts + 0.00
(Accounting Period Total from PC
14. Loans Received (Exempt) + 0.00
(Accounting Period Total from PC 4A}
t 5.CONTRIBUTION SUBTOTAL
= 5,711.00
(lines Ii+ 12+ 13+ 14}
16. Total Expenditures 5,559.00 ~'
(line 10)
17. Other D~sbursements + 0.00 ' - -
{Accountirm Period Total from PC
18. Loan Payments (Exempt} + 0 00 (; i ~ '¢ ~ ~ ~*
~ ,
(accounting Period Total from PC 4B) ....
19. EXTENDITURE SUBTOTAL
= 5,559.00
{lines 16~- 17+ 18~
20. ENDING CASH BALANCE
= 152.00
(hne 15 m~nus line It))
PC
Summary Statement of Contributions and Expenditures
Please type or print legibly in black ink. Page 2 of 2
Candidate or Political Committee Name: Committee ID Number:
Tom Slocum for City Council
[] Original [] Pr/mary 200~4 [] General 20__ [] Other __
[~] Amendment [~] 1 st Pre-election [] 2nd Pre-election [~ Post-election [~1 20__ September Supplemental
LOAN SUMMARY
2 t. Begim~ing Outstanding Loans FOR OFFICE USE ONLY
(line 29 ofpre~,ious report) 0.00
22. Loans Received (Non-Exempt)
(line 2) + 0.00
23. Loans Received (Exempt)
(line 14) + 0.00
24. LOANS RECEIVED SUBTOTAL
(lines 2t + 22 + 23l = 0.00
25. Loan Payments (Non-Exempt) 0.00
(line 7)
26. Loan Payments (Exempt) + 0.00
(line 18}
27. Forgiven Loans
+ 0.00
(Total loans forgiven dunng this accounting period)
28. LOAN PAYMENT SUBTOTAL
= 0 00
(lines 25 + 26 +27)
29. TOTAL OUTSTANDING LOANS
(line 24 min~s hne 2.q) = 0.00
PERSONAL EXPENDITURE
30 Beginrfing Outstanding Personal Expenditures 0.00
(line 30 of previous report)
31. Personal Expenditures + 0.00
(Accounting Period Total from PC 3Al
32. PERSONAL EXPENDITUPd~ SUBTOTAL
= 0.00
(lines 304- 31 )
33~ Personal Expenditure Reimbursements
(Total expenditures on PC 3 with purpose code R) 0.00
34. Forgiven Personal Expenditures + 0.00
(Total personal expenditures forgiven this acctg, period)
35. REIMBURSEMENq' SUBTOTAE
= 0.00
(lines 33 + 34)
36~ OUTSTANDING PERSONAL EXPENDITURES
= 0.00
(line 32 minus line 35)
FINANCIAL STATUS AT CLOSE OF ACCOUNTING PER[OD
37. Ending Cash Balance J 52~00
{line 20)
38. Acconnts Receivable + 0.00
(Accounting Period Tutal from PC 5)
39. SUBTOTAL = J §2~00
(lines 37 + 38~
40. Total Outstanding Loans 0.00
(line 2%
4 l~ Outstanding Personal Expenditures + 0.00
(line 30}
42. Accounts Payable + 5,937 OB
(Accounting Period Total from PC 6}
43. SUBTOTAL = 5,937.9~
(lines 40 + 41 + 42)
44~ BALANCE/DEFICIT
=
(line 39 ~ninus linc 43: indicate + or - balance)
1[. Thomas Slocum (name of candidate or treasurer), hereby certify that the above statement and the attached supporting reports are
S~gnamre of candidate or treasurer Date signed
?C 2
Cash Contributions, Loans Received and In-Kind
Candidate or Pohtmal Committee Name: Committee ID Number:
Tom Slocum for City Counci~ Page 1 of 5
Elect~on: [] Primary 2004 E~] General 20__ E] Other __
Report: [] I st Pre-election [] 2nd Pre-election [] Post-electron E] 20__ September Supplemental
SEE BACK FOR INSTRLTCTIONS AND CODE DEFINITIONS
CODE l: Contributor Type CODE 2: Contribution Type
B Business Entity CA Cash
C Political Cmrmfittee (includes bus/ness and union PACs) CO Cosigner Obligation
F Candidate's Immediate Family (includes candidate) IK In-Kind
I Individual LR Loan Received
L Labor Organization
O Other
P Political Party Committee
Amount of In-Kind Purpose
Line # Name and Address of Contributor
Contribution (see manual for suggested purpose codes)
Occupational Information or Contributor Code 1 I Code 2
Date Received Contributing Comm~ee's tD~ Aggregate
Chambers Construction
1. 2295 Coburg Road Suite I00 $ 500.00
Eugene, OR
04t01/04 Construction $ 500.00 B
CA
Cascade Title Company
2. 811 Willamette Street $ 500 00
Eugene, OR 97401
04/15/04 Title Company $ 500.00 B
CA
J.B. Buller Reatty Company
3. 3309 Antigua Drive $ 250.00
Eugene, OR 97408
04~20~04 Real Estate Broker $ 250.00 B CA
Rexlus Forest By-Products
4. PO Box 2276 $ 200 00
Eugene, OR 97402
04/02/04 Forest By Products Business $ 200 00 B CA
J.P. Hammer Property AccL
5. Po Box 2266 $ 200.00
Eugene, OR 97402
04/10/04 Investment Company $ 200.00 B CA
See Page Totals (Add all amounts with the same Accounting Period Totals (Complete only for last page and
Instructions contribution type. Do not include aggregates.) transfer these amounts to the Surmmary Statement, PC i,)
on Back and Cash (CA) $1,650,00 Cash (CA) $ _
Ln Campaign Enter on Summa~' Stateroom. (_ olunm A. Line 1
Fmance
Manual In-Kind (IK) $ 0 00 In-Kind (IK) $ __
Lnter on Summary Statement. Colunm A. Lines 4 and 9
PC 2 Loans ReceiYed (LR) $ 0.00 Loans Received (LR) $ __
Fnt~.r on Sunmur2, StatsmenL ( olurral A Line 2
PC 2
Cash Contributions, Loans Received and n-Kind
Candidate or Political Committee Name' ~Committee ID Number:
Torn $1ocurn for City Coun¢i~ Page 2 of 5
Election' [] Primary 2004 E] General 20__ [] Other __
Report: [] 1st Pre-election [] 2nd Pre-election [] Post-election E~ 20__ September Supplemental
SEE BACK FOR INSTRUCTIONS .AND CODE DEFINITIONS
CODE I: Contributor Type CODE 2: Contribution Type
B Business Entity CA Cash
C Political Cormnittee (includes business and union PACs) CO Cosigner Obligation
F Candidate's Invnediate Family (includes candidate) IK In-K/nd
I Individual LR Loan Received
L Labor Organization
O Other
P Political Party Committee
Amount of In-Kind Purpose
Line # Name and Address of Contributor
Contributton (see manual for suggested purpose codes)
Occupational lnformatton or Contributor Code 1 I Code 2
Date Received Contributing Committee's ID¢¢ Aggregate
Bob Bennett Reaty, Inc.
1. 280 East 11th $ 100 00
Eugene, OR 97401
04/01/04 Real Estate Broker $ 100.00 B t CA
CW Walker & Associates, Inc.
2. PO Box 1338 $ 100.00
Eugene, OR 97440
04/01/04 Real Estate Broker $ 100.00 B CA
James Brown
3~ 1385 Oak Street $ 100.00
Eugene, OR 97401
04/10/04 Real Estate Broker $ 100.00 ~ CA
Michael R. O'Connell Sr.
4. 84936 Peaceful Valley $ 100.00
Eugene, OR 97405
04/15/04 Real Estate Broker $ 100.00
CA
Jerry L. Kershner
5. 34316 Deerwood Drive $ 100.00
Eugene, OR 97405
04/10/04 retired $ 100.00
CA
See Page Totals (Add all amounts with the same Accounting Period Tota~ (Complete only for last page and
instructions contribution type. Do not include aggregates.) transfer these mnounts to the Summary Statement, PC I .)
on Back and Cash (CA) $ 500.00 Cash (CA) $ 2,150.00
in Campaigm Fnt~.r on SummaD Statement. Column A Line t
Finance
Manual In-Kind {IK) $ 0.00 In-Kind (IK) $ 0.00
Enter t~n Smnmauy %~a~emem~ ( ohmin *\, Lines 4 4nd 9
PC 2 Loans Received (LR} $ 0.00 Loans Received (LR) $ 0.00
Enter on Suntn~r~, Statement, L olunm A. Line 2
PC 2
Cash Contributions, Loans Received and In-Kind
Candidate or Political Committee Name, Conamttee ID Number:
Tom $1ocum for City Counci~ Page 3 of 5
Election: [] Primary 2004 [7~1 General 20__ [~ Other __
Report' [] I st Pre-election [] 2nd Pre-election [~] Post-election ~ 20__ September SupplementaI
SEE BACK FOR INSTRUCTIONS AND CODE DEFINITIONS
CODE 1: Contributor Type CODE 2: Contribution Type
B Business Enti~ CA Cash
C Political Committee (includes business ai~d union PACs) CO Cosigner Obligation
F Candidate's Immediate Family (includes candidate) IK In-Kind
I Individual LR Loan Received
L Labor Organization
O Other
P Politmal Party Connmittee
Amount of in-Kind Purpose
Line Cf Name and Address of Contributor
Contribution (see manual for suggested purpose codes)
Occupational Information or Contributor Code 1 I Code
Date Received Contrtbutin~ Committee's ID~ Agqregate
2
Gordon C. Gallic
I PO Box 11077 $ '~00.00
Eugene, OR 97440
04/I0/04 investor $ 100.00 I t CA
Henry N. Eastey
2. 1985 Friendly Street $ 100.00
Eugene, OR 97405
04/15/04 retired $ 100.00 ~ I
CA
David E. Carmichael
3. 150 Forum Bidg. 777 High Street $ 100.00
Eugene, OR 97440
100.00 B [ CA
04/081O4
attorney
$
George Myrmo
4. 2323 Shields $ 100.00
Eugene, OR 97405
04ll 3/04 independent business $ 100.00 B CA
Western Properties
5. 66 Club Road Suite 160 $ 100.00
Eugene, OR 97401
04/13/04 Real Estate Brokerage $ 100.00 B [
CA
See Page Totals (Add all amounts with the same Accounting Period Totals (Complete only for last page and
Instructions contribution type. Do not include aggregates.) transfer these amounts to the Summary Statement~ PC 1 ~)
on Back and Cash (CA} $ 500.00 Cash {CA) $ 2,~50 00
in Campaign Enter on Sunm'~ry Statemem. £ olmnn a,. I me 1
Finance
Manual In-Kind (IK) $ 0.00 In-Kind (IK) $ 0.00
Enler on St~nl-r~lr5 Statement. ( olumn a Lllle~ 4 and 9
PC 2 Loans Recewed (LR) $ 0.00 Loans Received (LR} $ 0.00
Epter on Sunmktry Statement, Coltam~ A 1 mc 2
PC 2
Cash Contributions, Loans Received and In-Kind
Candidate or Political Committee Name: Conm~ittee ID Number:
Tom Slocum for City Council Page ~ of'_5
Election: [] Pr/mary 2004 [] General 20__ [] Other __
Report: [] 1 st Pre-elect~on [] 2nd Pre-election [] Post-election [~ 20__ September Supplemental
SEE BACK FOR INSTRUCTIONS AND CODE DEFINITIONS
CODE 1: Contributor Type CODE 2: Contribution Type
B Busmess Entity CA Cash
C Political Committee (includes business and tmion PACs) CO Cosigner Obligation
F Candidate's hnmediate Family (includes candidate) IK In-Kind
I Individual LR Loan Received
L Labor Organization
O Other
P Political Party Committee
Amount of tn-Kind Purpose
Line # Name and Address of Contributor Contribution (see manual for suggested purpose codes)
Occupational Information or Contributor Code ~/ I Code 2
Date Received Contributing Committee's ID# Aggregate
David W. Sohm
1. 720 Mountain View Drive $ 1100.00
Eugene, OR 97401
04/15~04 Real Estate Appnaser $ 100.00 I CA
John L. Scott Real Estate
2. 201 East 13th Ave $ 100.00
Eugene, OR 97401
04/15/04 Real Estate Brokerage $ 100.00 B
CA
W. L Schultz
3. 2490 Lawrence $ '100.00
Eugene, OR 97405
04~26~04 retired $ 100.00 I CA
Gus Keller
4. 2942 Flintrock $ 100.00
Eugene, OR 97408
04123104 Stock Broker $ 100.00 I
CA
Bill Elliott
5. 580 Taney Street $ 100.00
Eugene, OR 97402
04~26~04 Real Estate Broker $ 100.00 I CA
See Page Totals (Add all amounts with the same Accounting Period Totals (Complete only for last page and
[nstmcnons contribution type. Do not include aggregates.) transfer these amounts to the Summary Statement, PC
on Back and Cash (CA) $ 500.00 Cash (CA) $ 3,150.00
~n Calnpalgn Enter on SmranaE¢ Statement Colunm A.
Finance
Manual In-K~nd {IK) $ 0.00 In-Kind (IK) $
Fnter on S~nm~q~ Statement, £ olu~rm A. Lmeb 4 and 9
PC 2 Loans Received (LR} $ 0.00 Loans Received (LR~ $ 0.00
Enter on Sunttllary Statement. (otunm A, Line 2
PC 2
Cash Contributions, Loans Received and In-Kind Rev ,203
Candidate or Political Con~nittee Name: Connnittee ID Number:
Tom $~ocum for City Counci~ Page_5 of_5
Election: [] Primary 2004 [] General 20__ [] Other __
Report: [] 1st Pre-election [] 2nd Pre-election [] Post-election [~ 20__ September Supplemental
SEE BACK FOR INSTRUCTIONS AND CODE DEFINITIONS
CODE I: Contributor Type CODE 2: Contribution Type
B Business Entity CA Cash
C Political Correnittee (includes business and union PACs) CO Cosigner Obligation
F Candidate's Immediate Family (includes candidate) IK In-Kind
I Individual LR Loan Received
L Labor Organization
O Other
P Political Party Committee
Amount of In-Kind Purpose
Line # Name and Address of Contributor
Contribution (see manual for suggested purpose codes)
Date Recetved Occupational Informatton or Contributor Code l Code 2
Contributing Committee's ID¢¢ Aggregate
Sang Joo Knudtson
1 1689 Willamette Street $ 100.00
Eugene, OR 97401
04/23/04 independent business owner $ 100.00 I CA
David Earl
2, 148 Rockridge Loop $ 100.00
Eugene, OR 97405
04/26/04 retired $ 1100,00 I CA
miscellaneous cash contributions
3. $50 and under $ 420,00
miscellaneous $ 420.00 CA
4. $
5. $
$
See Page Totals (Add all amounts vath the same Accounting Period Totals (Complete only for last page and
Instructions contribution [ype. Do not include aggregates.) transfer these amounts to the Summary Statement, PC
on Back and Cash iCA) $ 620.00 Cash iCA) $ 3,770.00
in Campaign E~ter on Smmmry Statement. i_ olumn A. Line
Finance
Manual In-Kind {IK) $ 0.00 In-Kind (IK} $ 0.00
Enter nn Smratktry Statement. Columi1 A. Lilies 4 and 9
PC 2 Loans Received {LR) $ 0.00 Loans Received (LR} $
Enter on Sunan,u3 Statenient. Cultura A, Lmm: 2
F£ 3
Cash Expenditures and Loan Payments
Cand/date or Political Cormnittee Name: Committee ID Nmnber:
Tom S~ocum for City Counci~ Page 1_ of 1_
Election: [] Primary 200_A4 [] General 20__ [] Other __
Report' E~ 1st Pre-election [] 2nd Pre-election [] Post-election E~ 20__ September Supplemental
PURPOSE CODES (see baek of form for instructions and code definitions) EXPENDITURE TYPES
A Agent O OLherAdver~ing(ym'dsigns, buttons, etc.) CA Cash
B Broadcast Advertising (Radio, TV) P Postage LP Loan Payment
C Cash Contributions R Reimbursement for Personal Expend/tums
F Fundraising Event Expenses S Surveys and Polls
G General Operational Expenses (descn~be if over $50) T Travel Expenses (describe if over $50)
I Interest Payment U Utilities
L L~teramre, Brochures, Printing W Wages, Salaries, Benefits
M Management Services Y Petition Circulators
N Newspaper and Od:~er Periodical Advertising Z Preparation and ProducUon of Advertising
Payee's Name and Payee's Committee ID#, Exp Amount of
bne # Date Check # if apphcable Purpose Type Expenditure Paid
(as it appears on invoice, receipt or check) to AlP
Z CA $ 150 00 [~
l. 04/19/04 101 John Bauguess (photography)
2. 04/22/04 102 McKenzle River Broadcasting B CA $ 833,00 [~
3. 04/22/04 103 Clear Channel Broadcasting B CA $ 799.00
4. 04/22~04 104 Cumulus Media B CA $ 765.00
5. 04/29~04 105 McKenzie R~ver Broadcasting B CA $ 833,00
6. 04/29~04 106 Clear Channel Broadcasting B CA $ 799.00 E~
7. 04/29/04 107 Cumulus Media B CA $ 765.00 [~
61
5~00
8. 04/30~04 108 EDMS LLC bJ
9.
$
See Page Totals (Add all expenditures with the same Accounting Period Totals (Complete only for last page and
Inst2'uctions expenditure type.} transfe~ these amounts to the Smnmary Statement, PC 1.)
on Back and
in Campaign Cash (CA) $ 5,559.00 ~ Cash (CA) $ ___
Finance
Manual Loan Payment (LP} $ 0 00 Loan Payment (LP } $ _ .
Enter on Summ,~r~, StatemcnL Coltmm A_ Line 7
PC 3
p£
Accounts Payable ,2.,,,
Candidate or Political Committee Name: Committee ID Number:
Tom $1ocum for City Counci} Page 1 of 1
Election: ~] Primary 2004 [] General 20 [] Other__
Report: [] I st Pre-election [] 2nd Pre-election [] Post-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 i£over $50)
G General Operational Expenses (describe if over $50) U U'tihties
I Interest Payment W Wages, Salaries, Benefits
L Literature, Brochures~ PrinUng Y Petition Circulators
M Management Services Z Preparation and Production of Advertis~ng
N Newspaper and Other Periodical Advertising
Amount of
Line # Date Payee's Name Purpose Account Payable
1. 05/06/04 Insta-Print Z, L $ 5,568.38
05/06/04 EDMS, LLC P $ 369.58
3. $
$
5. $
$
7. $
8. $
9. $
10. $
See Page Total (Add all accounts payable on this Accounting Period Total (Complete only for last page and
Instructions form.) transfer these amounts to the Summary Statement. PC 1.)
on Back and
~n Campaign Accounts Payable $ 5,937.96 Accounts Payable $ 5.937 96
Finance Enter on Stmurulry Staten~nt, Column A, L~ne 42
Manual
PC 6
Summ Stateraent of Contributior s Expenditures
P~e~se type or pnnt teg~bly m bilk mk Page 1 of 2
C~d~date or Pobt~c~ Cormnmlee Name {use fi2tI n~ne)
Tom $1ocum br C~ty Council
Marling Address ~ ~t Appe~ on Staement of Org~za~on (street. route or box number, ch>. state, z~p code)
1210 W~lag~lesp~e Rd., Eugene, OR 97401
Robin Lobde~ ~ (541~345-9966
CondUce ID N~ber: Corp~nee Type. Meas~e N urEber or O~ce
Eogene City Counc~l, Ward
~ Ongma2 ~ Pn~ ~o 0 ~ Oener¢ 20 ~ Other
~ ~en~ent ~ 1st Pre-election ~ 2nd Pre-elect, on ~ Post-elect,on ~ 20~ September Supptement,~
A-TOTALS }'OR THIS ~CUMULA~IYE TOTALS
CONTRiBUTiONS
I C~h Comnbut~ons 17.702.41 24.712.41
(Accournmg Period Total flora PC 2)
2 Loas Received tNon-Exempt) + 2.200 00 + 2.200-00
(Accounting Period Total from PC 2)
3~ To~ CashConmbudons = 19,902.41 = 26,912.41
dines t~ 2}
4~ in-Kind + 0.00 + 0.00
(&cco~tmg Period To~l from PC 2~
5 TOTAL CONTRIBUTIONS = 19,902 41 = 26,912 41
/lmes 3 + 4~
EXPENDITURES
6 Cash Expenditures
~Accountmg Period To~al from PC ~ ~
7 Loma Payments (Non-Exempl } + 2 200 00 + 2,200,00
(Accounm~g Penod To~l l%m PC I}
8. Tot~ C~hExpendimres = ~,902.4~ = 2~7~0.4~
dines ~ + 7}
{Accosting Period To~l from PC 2)
t~ TOTAL EXPENDITURES =
0roes 8 -v 9)
CASH BALANCE
I 1 Beglmnh~g C~h B~lce 152.00 FOR OFFICE USE ONLY
dine 20 of prevmas
12 Total Contnbunons +
(hn¢ 5)
t30~er Receipts +
(Acco[rating Period To~l flom PC
t4 Loa~s Recelx, ed (ExempO + 0.00
{Accoummg P~nod 7o~i from PC 4A>
15 CON%~BU~iON SUB~IOTAL = 20,054
(imes Il -~ t2 + 13 * 14)
t6 Total Expert&rares
~ line 10t
17 Other Disbm%ements + 0.00
(AccounUng Period Total from PC 4B}
18 Loa~ Payments (Exempt} * 0.00
(Aczoum~ng Period Totat from PC 4B
19 EXPENDITU~ SUBTOTAL =
dines i6 + 17 +
2iL ENDING CASH BALANCE =
rime 15 minus line I9)
PL I
Summary S tement of Contributions and Expenditures
Please type or pnnt teg[bly m black mk Page 2 of 2
C~dtdate or Pohuc~ Co~nttee Nmme ~ Con2~ee ID Number
Tom Stocum for C~ty Council
~ ~endmenlt ~ 1st Pre-elecaon ~ 2nd Pre-et~aon ~ Post*elect, on ~ 20 September S~tpptemen~
LOAN SUmmARY
2 [ B%~m~g Outs~dmg Lo~s FOR OFF~CE USE ONLY
(tree 29 of pmx lOlB mpoa) 0,00
(line 21 ' + 2 200,00 ~ . t~
23 Lo~s Rece~ed(Exempti + 0.00
24 LOANS P~CEIVED SUBTOT~ '
~tmes 21 .__9~ + 23t = 2 200~00
26. Loan Payments (Exempt~
dine 18) +
27 Forgiven Lo~s
+ 0 00
/Tolai loans forgn~en dmmg thru accounUng ~nod~
2g LOAN PAYMENT SUBTOTAL
dines 25 + 26 +2% = 2,200 00
29. TOTAL OUTSTANDING LOANS
tlme 24 mi~s h~m 28) =
PERSONAL EXPENDITURE SUmmARY
30 Begqmmng Outst~ng Person~ Expendip~es
lime 36 orpmvmus m~n~ 0,00
3 t Personal Expen&~res
(Acco*~tmg Period To~I lkom PC 3 A) + 0.00
32 PERSONAL EL~ENDtTURE SUBTOT~
limes 30 + 3 i~ =
33 Personal Expen&ture Re~mb~sements
{To~l expendi~ms on PC 3 w~th p~se code R~
34 For~ven Pe~on~ Expen&twes
(t'ot~ ~mo~ ex~nd~mres forgiven tks acctg period) + 0 00
35 P~I~fBURSE~ SLIBTOTAL
= 0
(lg~s 33 +
3~. OUTSTANDING PERSONAL E~ENDITU~S
= 0 00
Ihne 12 minus hne
FiNANOIAL STATUS AT OLOSE 0F AOOOUNTiNG PE~10D
37. Ending Cash B~ce
0me 2o~ ~ 52,00
38 Accotmts Recei~able
+ 0,00
(Accoummg Period To~ from PC 5'~
39 SUBTOT~
= ~ 52
(lines 37 + 38)
4(Y To[a! Outstgtdmg Lo~s
thne 2%
4 t Oats~ndlng Personal Expendtmres
(line 361 + 0,00
4Z Accomnts Payable
iAcco~tmg ~enod To~ from PC (,; + 0,00
43 SUBTOTAL
= 0 00
~lh~es 40 + 41 +
44. gALANCE~DIFICIT
= ~ 52 00
thne 39 fmnus hnc 43 re&cate ~ or - b~ance}
L THOMAS R SLOCUM /name o£ candidate or treasurei ). ilereb? cettlf~ that the ahoy, e
S~gnatm e of candidate or treasurer Date signed
Pc 2
Cash Contributions, Loans Received and In-Kind
Car~d~date oz Pohucat Commii~ee Name Corn~ttee ~D Namer
Tom Stocam for C~ty Couadl Page ~ of
Election~ ~Prlm~} 20 04 ~ Gener~ 20 ~ Other
Report ~ t st Pre-elecI~on ~ 2nd Pre~elec'uon ~Post-elec~on ~ 2t* Septembe~ Supplemem~
SEE BACK FOR INSTRUCTIONS AND CODE DEFINITIONS
CODE i: Contr~butor Type CODE 2: retribution Type
B Business ~tm ~ A Cash
C PolmceJ Com~mJ~ee ~mcl~des business ~d ~no~] PACs) CO Cost.er
F C~dae% I~e~ae Fa~ly (mctudes c~dldate~ IK
I Individual LR Loan R~e~ved
L Labor Org~zalor~
O Other
P Polmc~ Pa~0
Amouni of /n-~ind Pu~oso
Dne S Name and Address of Contnbu~or
ConL¢¢but~on (see manual ~or suggested p~[pc~e
Date ~ece~ved Occupahona/ ¢nfomaf¢on or Contr, butor Or. Ye ¢ Cede 2
Contributing Committee's ~ Aggregate
C~amber PAC
~. ~401 ',~fillameEe St. $ 750 00
Eugepe. OR 97401
5/6/04
PAC $ 7~3 00 C CA
Broadway and Pearl Assocs.
2. PO Box 529 $ 200 00
Eugene, OR 97440-0529
5/7~04
Rea; Estate ~nvestmept Co $ 200.00 B CA
Gcegow Lee Giustma
3 PO Box 529 $ 100 00
Eugene. OR 97~0
5/7/04
]n.¢estor $ 100,00 ] CA
E. Danelt G]ustma
4. PO Box 529 $ 100 00
Eugene, OR 97440
5ff¢04
~pvestor $ 100 00 ~ CA
Enramn Gm.ma
5 PO Box 529 $ 100 00
Eugene, OR 97440
5/7/04
]nvesto~ $ 100 00 ] CA
See Page Tet~s {Add ~1 ~mo~ts with the same Accounting Be~i~d Totals ~Complete only for last page and
~srmctmns coaIribu~on type Do ~ot include aggregaes ~ ~trar~sfer ~h~e mnom~s Io the Su~m~y State~r~m PC
on Back ~d ~ ,250 00
m Campmgn C~h (CA) $ Cab {CAi
Mamal Ir~-Kmd ilK) 5 0 00 In-Cad {ilK) $
PC 2 L,~ans Received ii,R> S 0.00 Lo~s R~eiYed (LR~ $
PC 2
Cash Contributions, Loans Received and n-Kind
Candidme or Pohtma~ Comml~ee Narne~ Commitlee ID Number
Tom Stocum for City Council Page 2 of
Electiori ~Prinm~ 20 04 ~ General 2(L~ ~ O~er
Repro1 ~ lsr Pre-electron ~ 2nd Pre-election ~Posi-elecilon ~ 20~ September Supplememml
SEE BACK FOR INSTRUCTIONS AND CODE DEFINITIONS
CODE ~: Contri~utor Type CODE 2: Co~r~b~t~on Type
B Business Erm~ CA Cash
C Pohfic~J Commas:tee m~dudes b~smess ~d mzorz PACs) CO Cos~er Obl~gauon
F Cm~d~date's lm~ned~me F~dy (includes c~d~date) [K ~rtd
I ~nd~ ~duat LR Lo~ Received
L Labor Org&mzai~en
O Olher
P Pohacal Parb Con~n~ee
Amount of /o-K~cd Pu¢~se
L~ne ~ Name a~d Address of Cont'nbuto~
Contribution (see manual ~or suggested purple codesi
Occuoational ~nform~tion or ~ntributor
Date Recezved Ccde ~ Ccde 2
Contributing Commi~ ~ 1~ Aggregate
Oregon Real,om PAC
~ PO Box 351 $ 400 00
Salem, OR 97308
5Pz04
PAC ID ~ 000191 $ 400 00 C CA
Jed Keever
2. $ 100.00
Eugene, OR
517/04
$ 100.00 ~ CA
Opus Development Corp
3 ~210 W~llagitlespCe Rd $ 2,2~3 00
Eugene, OR 97401
5/7104
Real Estate Development $ 2,200 00 B LR
Lamy Von Klein
4 111 W 7th Ave, State 320 $ 100,00
Eugene, OR 9740~
5/12/04
Real Estate Broker $ 1~ 00 t CA
Ead Dorman
5 66 Club Rd. State 200 $ 100 00
Eugene, OR 97401
CPA $ 100.00 ~ ~ CA
5/12104
See Page To/als (Add ~1 amotmis w~th the same Accounting Period Toials tComplete only for lat page and
l~ucnons comnbution type Do not include aggregates ~ e~mrbr these ~o~ts ~o
on B~k ~d 700 00
m Campmgm Cash/CA~ $ C~h iCA) $
Mmual In~nd ([K) $ 0.00 In-~hnd ilK)
PC 2 Lo~s Received (LR} $ 2,200.00 Lo~s Received (LR~ g
PC2
Cash Contributions, Loans Received and In-Kind
Candidate or Poht~cal Corr~ntme Name Corrmnttee ID Number
Tom S~oeum ~or G~ty Council Page 3 of
Electmrr ~ Pnma~' 2~; 04 ~ Gener~ 20 ~ Cd, er
Report- ~ 1st Pre*elecnon ~ 2nd Pre*election ~ Post-elect~on ~ 2(~ September Supplemental
SEE BACK FOR ~STRUCTIONS AND CODE DEFINITIONS
CODE ~: Contributor Type CODE 2: Co~dbut~on Type
B Business Entity CA C~sh
C Poht~c~ Co~ee (includes business ~d m~on PACs) CO Cos~gmer Obtigm~on
F Cm~&date's lrmmedmte Fmmly {includes c~d~date) tK In*Fdhd
i lndn ~du~ LR Lomn R~e~ved
L Labor Org~zat,on
O O~her
P Pohtmat Pa~ Con~mee
Amount of in-~pd Pu¢ose
Line ~ Name an~ Addres~ of Cont~butor
ContnSut~on (~ee manua~ br suggested pu~oo~e codes)
Occupat~onai Information or Contributor Code f
Da[e
Recd,ed
Code
2
Contributing Commi~ee's I~ Aggregate
Bou HitCh
I 2105 Washington St $ 200
Eugene OR 97405
5112/04
Retired $ 200.00 t CA
GaW Henry
2. PO Box 2592 $ 100 00
Eugene. OR 97402
5112/04
Real Estate Developer $ 100,00 I CA
Jeff Lansdon
3 1736 R~ver Pomte Leap $ 200.00
Eugene, OR 97408
5/12/04
T~tte insurance $ 200,00 ~ CA
L L Stewa~
4 PO Box 10293 $ 100.00
Eugene, OR 97440
5/12/04
Retired $ 100 00 f CA
RobeA S. BenneE
5 980 W~llameAe St, State 200 $ 250 00
Eugene, OR 97~0t
5/12/04
lnveaor $ 250.00 I CA
See ~age Tot~s (Add aH amotmts ~th the same Acc~uat~ng Pe~5od Tet~s (Complete anN' ~or
~strtmuons contr~buBon b~pe Do not include aggregates / transfer these &mottoes ~o the Sum~m~ Sta~emenL PC I )
on Back ~d 850.00
in Campmgn Cash (CA~ $ C~h (CA) $
Fln~ce
M~u~ In-F~nd (IK) $ 0,00 ln-FJnd {IK)
PC 2 Lomns Received (LR~ $ 0.00 Lo~s Recer, ed {LR) $
?,~te~ ~ Surmm.~ State.ut. Cohmm A Im. 2
PC 2 '
Cash Contributions, Loans Received and In-Kind "°'
Candidate or Political ContrmV~ee Name Comrmttee ID Number
Tom Stocum for City Council Page 4 of .~
Elecuon ~ Primam' 20 04 ~ Oener~ 20 ~ Offier
Report ~ 1st Pre-elecnon ~ 2nd P~e~elec~on ~ Posbelecaon ~ 2o September SupplemenmI
SEE gACK FOR INSTRUCTIONS AND CODE DEFINITIONS
CODE 1: CoatNbutor Type CODE 2: Coatdbut~on Type
g Business Ent~' CA C~
C Polmc~ ComrNtlee {includes business m~d mmon PACs~ CO Cosigner Obhganon
F C~didate's Iw~edmte F~A> (includes cm~&date~ IK In-Cad
I ln&x,~du~ LR Lomq R~e~ ed
L Labor Org~zaaon
0 Other
P Poliac~ Parb Co~ttee
Amount of /n-~and Purpose
Line ~ Name and Address & Cont~butor
ContnbuSon ~see manug for suggested pu(pose ~des)
Dge Received Occupationa~ /nforrnati~ or Contfib~or C~e ~ C~e 2
Contnbuting Comm¢~ ~ 1~ Agg~gate
Seneca Jones T~mbe¢ Co
1 PO Box 10265 $ 1.000.00
Eu9ene, OR 97440
5/14/04
Timber Company $ 1,000 00 B CA
Alan Evans
2 101 E Broadway, SuRe 101 $ 100.00
Eugene, OR 97401
5/14/04
RE Broker $ 100D0 I CA
G¢egow Demers
3 PO Box 1042 $ 5,000 00
Veneta, OR 97487
5/17/04
lnvestodDeveioper $ 5,000.00 ~ CA
Ed Anderson
4_ 62! Spyglass Dr $ 100.00
Eugene, OR 97401
5~21/04
Retired $ 100.00 ~ CA
Ottomans for affordable Housing
5 375 Taylor NE $ 1.500.00
Sa;em, OR 97303
5/28/0~ PAC ~D ~ 002069 $ -.,.f38 30 C CA
See P~ge Totals (Add a}I amours w~th the samg A~o~nting Pe~5od Tot~s (Complete onl~ l~r k~st page ~d
Instructions contnbutmn ~)pe Do ~ot include aggregaesJ tr~sfer these amounts [o the Su~p~O- Stammerer PC 1 }
ca Back ~d { 7.700 O0
m C~mp~ugn ~ Cash (CA) $ C~h ~CA~ ~,
Fl.&rice
M~nu~ In-~nd {iK~ $ 0 00 N-~nd (IK) $
PC 2 Lo~s Received ILR) $ 0.00 Lo~s Recmved (LRI $
P(. 2
Cash Contributions, Loans Received and tn Kind
Can&date or Polmcal Conmortee Name Comrmttee ID Number
Tom Sbcum for C~ty Coundt Page_..~ of 5
EtecUon ~ Pnm~' 20 04 ~ General 20 ~ O~er
Report ~ 1 st Pre-elecuon ~ 2nd Pre-elecuon ~ Posbelecuon ~ 20 ....... September Supplemem~
SEE BACK FOR }NSTRUrCTIONS AN D CODE DE F[NIT[ONS
CODE 1: Contdb~tor Type CODE 1: Co~dbut~on Type
B Business Ermb CA
C Pohtmat Com~ee 0nctudes business ~d mmon PACs~ CO Cost.er Obhga~on
F Can&date's I~me&a[e F~mly (mctudes c~&date/ 1K B-Knnd
~ ln&wduM LR Lo?m Rece~ ~, ed
L Labor Org~fizat~on
O Other
P Pohtzcal Pady
Amount o~ ;r-Kind Pug, ese
Dne ¢ Name and Address of Contributor Contribution (see manual ~cr suggesfed pu¢ose codes)
Occupational Information o~ Contributor C~e f ~ Code 2
Date Received Conmbut, ng Comm¢~ I~ Aggm.¢ate
Adze and Company
t. 722 Country Club Rd $
Eugene. OR 97401
6/1/04 RE Developer $ 6,900 00 B CA
M~scetiapeous Cash Contnbut~or,s
2 $50.00 and under $ 160 00
M~scellaneous $ 160.00 CA
3 $
5
See Page Tot,ds (Add all amounts ~th the same Accmmfmg Period To/als (Complete onl;, for last page add
Instructions contnba2-non type Do not k~clude aggregates ~ trim,hr thee amomnts to the
on Back ~d 7,080.00 17,560.00
m C~pmgn C~h ~CA) $ Cash (CA)
M~ue3 ln-~nd (IK~ $ 0 00 in-~nd (IK) $ 0 00
PC 2 Lo~s Rece~ed (LR~ $ 0 00 Lo~s Received (LR~ $ 2,200 00
Cash Expenditures and Loan Payments
Ca~d~date or Potmcal Comm~ee Name: Comm~uee ID Number:
Tom S~ocum for C~ty Coundl Page~ of 2
glecnon: ~ Primal, 20 04 ~ General 20 ~ Other
R¢pon' ~ 1st Pre-elect,on ~ 2nd Pre-election ~ Post-elect,on ~ 20~ Septem;oer Supplemental
PURPOSE CODES (see back of form br ~nstructions and cnde definitions) EXPENDI~'RE TYPES
A Agent O L~er Adverting {yard s~gn~ bu~¢¢~ em.~ CA C ash
B Broadcast Advems}ng ¢Rad~o. TV) P Postage LP Loan Paymem
C Cash Con~ibarions R Re~bmsPment for Personal E:~pendi~es
F Fun&asing Event Expenses S Sttm'eys and Polls
G General Opemonat Ex~e~es (d~4g~ ifovei $50) T Travel Expenses (describe tf over
[ interest Payment U Utilities
L L~teiamre. Brochures, Printing W Wages, Salaries, Benefits
M Management Services Y Petitmn C~mtdators
N Newspaper and Other Periodical Advernsmg Z Preparation and Producaon of Adxemsmg
~ P~vee:s ~me and Payee ~ 6~,mmi~ee tDg E;~, AmoutTt o/
t.~n~ Y Date Check ~ ~/ app~b/e Purpose Type Exper;d~tu~ e Pa~d
(as it appears on ~nvoice receipt o~ cflecA~) to AZP
5/5/04 109 US POSTMASTER P
1 CA $ 607 fi~
517104 1 ~ 0 US POST~ASTER P
2 CA $ 1,2~5,00
3. 5t7104 ~ 1 ~ MC KENZ~E R~VER BROADCASTING CA $ 833 00
517104 ~ 12 CLEAR CHANNEL BROADCASTING CA $ 799 00
4.
5, 517104 113 CUMULUS MED~A B CA $ 765.00
5/~4/04 1 ~4 MC KENZ~E R~VER BROADCASTING CA $ 27.50
6~
7 5;14t~ 115 CUMULUS MEDIA B CA $ 255 00
5117/04 117 JAVA BYTES M
CA $ 475 00
8~
5/21/04 117 D~GITALLY TOUCHED L
9 CA $ 5OO.OO
~0~ 5121/04 118 OPUS DEVELOPMENT CORP. LP $ 2,200 C~
S~e ~ P~ge To~a~s (Add all exp:n~tm'es wkh the same Accounting Per~od ~r~tals {{O~LPlete only fbr last pa~e and
lnstrucfions expen&~re Dpe, ) transfer ~hese ~mounts to the Su~tmy StaremenL PC t~)
on B~ck and 5,477 t 9
m Camp~zgn Cash iCA) $ Cash {CA) S
Ent~z on Sm:~rmy StaI~r~ut Colu~mA [mc
Finance
Manual Loan Payment (LP~ S 2,200.00 Loan Payment (LP; $
PC 3
PC 3
Cash E×pe ditures Loa Payments
Candidate or Po!mcM C'omrm~ee Name: Comm~ee ID Number:
Tom S~oaum for C~ty Ooundl Page 2 o~ 2
Etect~on: ~ Primal, 20 04 ~ General 20 ~ Other
Report' ~ 1st Pre-elec~on ~ 2nd Pre-elec~on ~ Post-elecnon ~ 20 September Supplemental
PURPOSE CODES (see back of tbrm tbr instructions and code definitions} EXPEND~RE TYPES
A Agent O O~er Adve~mmg (y~d s~gnr~ bu~o~, etc.) CA Cash
B Broadcast Advemsing (Ra&o. 'IV) P Postage LP Loan Payment
C Cash Conmbunons R Re~bement ~vr PemonalE~en&mres
F F~a~s~.ng Event Expermes S Su~eys and Polls
G Genemt O~mtional Ex~nses (de~m~ ffover $50) T Travel Expenses (descnbe ~f over $50 ~
I Interest Payment U Ufilines
L L2eramre. Brochures. Pnnting kg' '&ages, SManes, Benefits
M Management Services Y Petition C~rcutators
N Newspaper and Other Peno&cat Advernsmg Z PreFamuon and Pro4ucnon of Adve~mmg
P~yee ~ Name and Payee 3 Committee JDg~ ~
Dne # Date Check ~ F ap~;~ab/e Pu¥;ose E~9. Amoun~ o/ Paid
(as ~t a~pea[s on invoice, receipt or c;~g ~}~ Expen~'~ure to ~'P
61~104 ~ ~9 PREVEDELLO & ASSOCIATES, ~NC. A
~ $ 12225 22 ~
See Page Totals (Add all expenditures w~th the same Aeconntiag Period Totals [Complete only for last page and
fnstructmns expenditure vfpeJ transfer these amours to fbe Sumsmary Sta~emenL PC 1.
Back and ,7 702.4~
Campaign Cash (CA) $ 12,225 22 Cash rCA)
Manna Loan Payment (LP~ S 0 00 Loan Payment {LP) S Z200 00
PC 3
C,a~d~da~e or Pol_~ca~ Corr~r~ee N~e Corm~ee ~D N~nber
Tom S{ocum for C~ty Council ?~e ...._~_.._ of 1
Elect~on ~ Pr~m~' 2~ 04 ~ Gener~ 20 ~ ad,er
Report ~ 1st Pre-election ~ 2nd Pre-elect-mn ~ Post*electron ~ 20~ September Supplemental
SEE BACK FOR ~STR~JCTIONS AND CODE DEFINITIONS
Complete the info.anon m ~s box fbr each payment m~e to ~ ~ent &ad then prox zde the detmt of expenddures made by the
agent m the spaces belo~
The fotlowmg expen~tt~es were made by PREVEDELLO AND ASSOCIATES, tHC (name o¢ agent).
The pK~ ments to the agent axe hsted on:
Fom~ one) Page g Line ~ Check ¢ Amomqt
PC ~C.~r PC 6 2 1 119 $12,225.22
Pc 2. PC 3 or PC ¢4
PC 2. PC 3 or PC 6
PC 5 (ofp~or mpo~
Payee's Name Pu¢ose Amount o~
[see purpose ~2es
Line ¢ Date ( s~: it appears on in~,o¢ce, receipt or chezk) on bac~ of form) Expendt¢c, re
6/2/04 ADAM + HULL, INC L
1 $ 2,350 00
6/2/~ INSTA PRINT L
2 $ 4~313 25
6/2/04 EDMS L
3 $ 370 17
6/2/04 LABELS AND LISTS. INC. L ~
4. $ 373 00
6/2/04 PREVEDELLO AND ASSOCIATES, tNC Z
5 $ 1.500 00
6/2/~ CLEAR CHANNEL BROADCASTING B
6 $ 127 50
6/2/04 EDGEWATER ST~TEGIES M
7 $ 55O 00
6/2/~ PREVEDELLO AND ASSOCIATES. INC M
8 $ 2,641 ~30
9
10, t
See
Lnstracr~or, s Page Total of Agent Expenditures: $ 12 225 22
on Back and
in Campmgn , Complete ~h~ box ordy fbr l~t page of the detml of expenditures made bY tb~s agent.
Fm~ce
Te~ Ameurtt of Agent Expe~adimms: $ 12,225~22
~'nexpende~ g~l~ce (~¢ ~y): S 0 00
PC ~
(repo~ th~s ~no~( ~ mn accost mce~vable on fo~ PC 5)
Supplement to Second Pre-E ect on - Expenditures
Cand~d3te or Pohficd Co~m~ee Name: Commmee tD Nm~fbex
Tom S~ocum for C~ty Councd ~age ~ of
Elec[~om ~ Pnma6~ 20_04 ~ Genera~ 20 ~ O[her
Report: ~ 1st Supp! ~o ~e 2n~ Pre-decuon ~ ~d Suppt. to the 2nd Pre-decnon
PURPOSE CODES (see back of form for instructions anO code definitions} EXPENDETU~ TS~PES
4 Age¢, O Off, er Advemsmg Lvard stg~s~ bu~o~m, em. ~ C A Cash
B Broadcast Advcmsmg (Rad:o, TV~ P Postaee LP Loan Payment
C Cash Conmbut~on~ R Re~mbumerncnt 5or Personal Expen&mrcs AP Account Payabk
F Funamsmg Event Expenses S Stt~wey~, and Polls PE Personal E~e~d~mres
G General O[~ranoml E~ms (d~mnbe ~ ovei $50~ T Tra~ el Expenses { describe i~ over $50~
[ tnteresi Payment U Utdmes
L L,teramre. Bro:hures, Printing W Waggm, Sslan~}, Benefits
M Management Services Y Petmon Ctrctflamrs
N Newspaper and Othe~ Penoacal Aflvemsmg Z Preparation and Pmdacnon of Adve~mmg
Line # Date Check z~ (as/c ap#ears on im, oice, receipt or cflecJ~) ?ype Ezpendit'~e
5;7t04 ~lO U S~ Postmaster P
2 $
4 $
5. $
6 $
7 $
10. $
See FOR OFFICE USE ONLY
RECEIVED
msnucaons L Thomas R. Slocum , ~namc of candidate or
on Back and rreas~er) hereby cemfy that the above statement Is tm¢ and co~ect.
in Campaign
bAanual .....
Supplement to Second Pre/Post-Election - Contributions
£'arM~date or Pokt~c~t Co~n~ee N~e. Cow~ee ID N ~9er~
Tom S{ocum for City Council Pt~ge 1 or 1
Elec~loi~ ~Prm~? 20Q~ ~G~erat 20~
Report ~tst SuppL to ~e ~xd Pre-elecaon ~ ~d Suppt to the 2nd Pre-e!ec~on ~ Suppl lo PosbeiecBoa
SEE ~ACK }'OR iNSTRUCTIONS AND CODE DE~'IN1TIONS
CODE i: Contdbaor T~e CO~ 2: Contribution Ty~e
B Business Enm} CA Cash
C Potmc~ Corr~ttee .~xctudes br~mess ~d [m~on PACs~ (O Cos~er ObLgauon
F C~&d~e's twice, ale Famdy (includes candidate) IK
I [nd~ ~ ~d~ LR Lom~ Ro:ei ~ ed
L Labor Orgm~za~o~ PC P~edge ol ( ~h
O Oth~[ PI Pledge of ln~d
P Potmca Pa~, Con~varree PL Pledge of Loan
gmc,~s~ of
Line ~ Name and Address of Cor;Inbutor Coc4ribuilo. /n-Rnd Pu¢ose
~ (see man~at ~b~ suggested putpcse ~des)
Oc~pat¢ona/Information or Ccde ~ ~ Cee 2
Date Received Conl:dbuting Commi~'s I~
Opus OeveDpmet Corp
1. 1210 Willag,ilesp~e Rd $ 2.200.00
Eugene. OR 97401
De~¢opmeot c~mpany F ~ LR
5,'7/04
2. $
4 $
5
See~.F~~ t~'~ FOR OFFICE USE ONLY
k,s~rucuons L ~~ V~ .. ~~ .,name of co-ed,date or
on Back ~d tre~urer)~~hereby cem~¢ ~mt ~ae above satement ~s true ~d cogec~
m Campmgn
PC gA S~gnamre of candidate or ~easurer
PC £ &mendmcnt
Amendments-Cash Contributions, Loans Received and In-Kind 1203
Can&date or Political Committee Name: Committee ID Number:
Tom Slocum for City Council Page I of_5
Election: ~ Primary 200_j4 [] General 20__ [] Other __
Report: [] 1 st Pre-election ~ 2nd Pre-election [] Post-election [] 20__ September Supplemental
SEE BACK FOR INSTRUCTIONS AND CODE DEFINITIONS
CODE 1: Contributor Type CODE 2: Contribution Type
B Business Entity CA Cash
C Political Committee (.includes business and umon PACs) CO Cosigner Obliganon
F Candidate's Immediate Family (includes candidate) IK In-Kind
I Individual LR Loan Received
L Labor Organization
O Other
P Political Party Committee
Amending Page # 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 1 Code 2
Contributing Committee's ID# Aggregate
Page ~ Une ~ Chambers Construction
[] New Entry 2295 Coburg Road Suite 100 $ 500,00
[] Correcting
[] Delebng Eugene, OR 97401
04/02/04 Construction $ 500.00 B CA
Page. Line
[] New Entry $
[] Correcbng
[] Deleting
$
Page[ Due
[] New EntW $
[] Correcting
[] Deleting
$
Page~__ Line
El New Entry
[] Correcting
E] Deleting
Page Line
El New Entry
El Correcting
El Deleting
Instructions
on Back and L~
in Campaign
Finance Signature of candidate or treasurer
Manual
Amendment Date s~gned
PC 2 Arnendmcnt
Amendments-Cash Contributions, Loans Received and In-Kind
Candidate or Political Comrmttee Name: Committee ID Number:
Torn Slocurn for City Council Page 2
Election: [~ Primary 2004 [] General 20__ [] Other __
Report: E} 1st Pre-election [~ 2nd Pre-election [] Post-election [] 20__ September Supplemental
SEE BACK FOR INSTRUCTIONS AND CODE DEFINITIONS
CODE 1: Contributor Type CODE 2: Contribution Type
B Business Entity CA Cash
C Political Committee (.includes business and tmion PACs) CO Cosigner Obligation
F Candidate's Immediate Family 0ncludes candidate) IK In-Kind
I Individual LR Loan Recmved
L Labor Organizanon
O Other
P Political Party Committee
Amending Page # Name and Address of Contributor Amount of In-Kind Purpose
and Ltne# Contnbution (see manual for suggested purpose codes)
Date Received Occupational Information or Contributor Code I Code 2
Contributing Commtttee's ID# Aggregate
Page ~-, Line ~ Bob Bennett Realty, Inc
E] New Entry 280 East 11th Street $ 100.00
[] Correcting
[] Deleting Eugene, OR 97401
04~02~04 Real Estate Broker $ 100 00 B CA
Page Dne OW Walker & Associates
[~ New Entry PO BOX 1338 $ 100.00
[] Correcting
E] Deleting Eugene, OR 97440
/
04/02/04 Real Estate Broker $ I00.00 B
CA
Page Line
[~ New Entry $
E] Correcting
E} Delebng
$
Page_ Une
E] New Entry $
E] Correcting
E] Deleting
$
Page Line
[] New Entry $
[] Correcting
[7] Ddetmg
Instructions ~! ~/ L U
on Back and
in Campaign ~!~ .~:' : "~ .... ?i ,,
Finance Signature of candidate or treasurer ~ o ,-
Manual
Amendment Date signed
PC 2 An~endmcnt
Amendments-Cash Contributions, Loans Received and In-Kind
Candidate or Political Committee Name: Committee iD Number:
Tom Slocum for City Council Page 3 of 5
Elecnon. ~1 Primary 200__4_ [] General 20__ [] Other __
Report: [] I st Pre-election [] 2nd Pre-election [] Post-election [] 20__ September Supplemental
SEE BACK FOR INSTRUCTIONS AND CODE DEFINITIONS
CODE 1: Contributor Type CODE 2: Contribution Type
B Business Enfi~' CA, Cash
C Political Committee (includes business and union PACs) CO Cosigner Obligation
F Candidate's Immediate Family (includes candidate) IK In-Kind
I Individual LR Loan Received
L Labor Organization
O Other
P Political Party Cormnittee
Amending Page # Name and Address of Contributor Amount of In-Kind Purpose
and Ltne# Contribution (see manual for suggested purpose codes)
Occupational Information or Co,r~tnbutor Code ~ I Code 2
Date Received Contnbuttng Committee's ID~ Aggregate
Page f~ Line~; George Myrmo
[] New Entry 2323 Shields $ 100.00
[] Correcting
[] Deleting Eugene, OR 97405
04/13/04 Machine Shop Owner $ 100.00 B
CA
Page___ L~ne.___
[21 New Entry $
Cl Correcting
C] Deleung
Pag~ L,ne____
[] New Entry
[] Correct, ng
[] Deleting
$
Page___ L~ne
[] New Entry $
[] Correcting
[] Deieung
Page__. Line
D New Entry
g Correcbng
E~ Deleting
$
on Back and
in Campmgn Signature of candidate or treasurer ~,4 ~,? : ~' ~" ~;
Manual
Amendment Date signed
PC 2 Amendment
Amendments-Cash Contributions, Loans Received and In-Kind
Candidate or Political Committee Name: Corrgnittee ID Number:
Tom $1ocum for City Council Page 5 orS_
Election: [] Pdmaw 200_~4 [] General 20__ [~ Off,er __
Report: [-1 1st Pre-election [] 2nd Pre-election [~] Post-election [~3 20__ September Supplemental
SEE BACK FOR INSTRUCTIONS AND CODE DEFINITIONS
CODE 1: Contributor Type CODE 2: Contribution Type
B Business Entity CA Cash
C Polincal Committee 0ncludes business and union PACs) CO Cosigner Obligation
F Candidate's Immediate Family/includes candidate) IK In-Kind
i Individual LR Loan Received
L Labor Organization
O Other
P Political Party Commatee
Amending Page # Name and Address of Contnbutor Amount of In-Kind Purpose
and Line # Contnbut¢on (see manual for suggested purpose codes)
Occupational Information or Contributor Code l I Code 2
Date Recewed Contributing Commtttee's ID# Aggregate
Pagff %* Line ~ Sang Joe Knudtson
[] New Entry 1689 Willamette Street $ 100,00
J~ Correcting
E] Deleting Eugene, OR 97401
04~23~04 Restaurant Owner $ 100.00 B CA
Page~Lme-3- miscellaneous cash contributions $50 and
El New Entry under $ 420.00
[] Correcting
[] Deleting
04/0Z/04-
$ 420.00
CA
O5/O2/O4
Page~ L~ne
El New Entry $
E] Correcting
E] Deleting
$
Page Dne
E1 New Entry
[] Correcting
E} Deleting
$
Page.~ Line
[] New Entry
[] Correcting
[] Deleting
on Back and .~ ¢2 ~ ~ ~_~,, -,~
Finance Signature of candidate or treasurer
Manual ~,~ ~ .~ ~d ,~, t~ ~% ,~
Amendment Date signed
PC 3 Amendn~nt
Amendments-Cash Expenditures and Loan Payments
Candidate or Political Committee Name: Connnittee ID Number:
Tom SIocum for City Council Page I of 1
Election: [] Primary 200i~4 [] General 20__ [] Other __
Report: [] 1st Pre-election [] 2nd Pre-election E] Post-election [] 20__ September Supplemental
PURPOSE CODES (see back of form for instructions and code definitions) EXPENDITURE TYPES
A Agent O Other Advertising (3ard signs, buttons, etc~} CA Cash
B Broadcast Advert/sing (Radio, TV~ P Postage LP Loan Payment
C Cash Contributions R Re/mbursement for Personal Expenditures
F Fundraising Event Expenses S Stwveys and Polls
G General Operational Expenses (describe ifover $50) T Travel Expenses (describe if over $50}
I Interest Payment U Utilities
L Literature, Brochures. Printing W Wages, Salaries, Benefits
M Management Se~ices Y Petition Circulators
N Newspaper and Other Periodical Advertising Z Preparation and Production of Advertising
Amending Page # []
Payee :s Name and Payee's Commgttee ID#, Exp. Amount of
and L¢ne # Check # if applicable Purpose Type Expendtture Pa¢d
Date (as ¢t appears on tnvo¢ce, recetpt or check) to A/P
Page ~ Line '~*
[] New Entry
[] Correcting
BI Deleting 108 EDMS LLC P CA $ 615~00 E~
04/30/04
Pag~ ~ Line
[] New Entry
[] Correcting
[] Deleting Account Period Totals- CA $ 5,559.00 E~
Page__; IJne
[] New Entry
[] Correotlrl~
Period Totals- LP $ 0.00 E~
Accountin9
[]
Deleting
Page_~ Ltne
[] New Entry
E] Correctm9
El Deletln9
Page.__ Lme~__
[] New Er,try
[] Correcting
[] Deleting
Instructions ~.¢/ FOR
on Back and ~ , ~ ~>v ~%C ~,~ ~ ¥
Finance Signature of candidate or ~easurer ~:.-~ ~ : ..... : ~-
Manual
PC3 5 -/7 0iTY
~nendment Date signed
PC 6 Amendmem
Amendments-Accounts Payable R.v ,.,o,
Candidate or Political Committee Name: Conmfittee ID Number'
Tom SIocum for City Council Page ~_ of 1_
Election: ~ Primary 200_.44 [] General 20__ [] Other __
Report: [] I st Pre-election [5~ 2nd Pre-election [] Post-electron [] 20__ September Supplemental
PURPOSE CODES (see back for instructions and code definitions)
A Agent O Other Advertising (yard signs, buttons, etc,)
B Broadcast Advert/sing (Radio, TV) P Postage
C Cash Contributions S Surveys and Polls
F Fundraising Event Expenses T Travel Expenses (describe if over $50)
G General Operational Expenses (describe if over $50) U Utilities
I Interest Pa3anent W Wages~ Salaries. Benefits
L L~terature. Brochures, Printing Y Petition Circulators
M Management Services Z Preparation and Production of Advertising
N Newspaper and Other Periodical Advertising
Amending Page #
and Line # Payee's Name Purpose Amount of
Date Account Payable
Page f Line ¢
[] New Entry
~ Correcting
E] Deleting Insta-Pdnt Z,L $ 5,568.38
05/01/04
Page_ ~ I~ne~¢
F'I New Entry
~ Correchng
E] Deleting EDSM, LLC P $ 369.58
05/01104
Page Line _
[] New Entry
[] Correcting
E~ Deleting $
Page Ltne
[] New Entry
[] Correcting
[] Deleting $
Page Dne
[] New Entry
[] Correcting
E] Deleting
Instructions ~'~'
on Back and
in Campaign
F~nance Signature
Manual
Amendment Date
Summat Statement of Contributions and Expenditures
Please type or print leg~bty in black ink Page t of 2
Candidae or Political Commi~ee Name (use f~l name}.
TOM SLOGUM FOR CiTY COUNCIL
Mailing Address as it Appears on Statement of Organization (streel, ~ol2te or box number, city, slate, z~p code L
1210 W~LLAGILLESPiE RD., EUGENE, OREGON 97401
Treasurer $ Name { Telephone Number (day).
ROBIN LOBDELL ~ (54~)~345-9966
Commigee ~ Number Comminee Type, Measure Number or Office
~ EUGENE CITY GOUNC{L, WARD ~
~ ONginaI ~ PNmap~, 300~ ~ General 20~ ~ Other
~ ~nendment ~ l a Pre-ele~lon ~ 2nd Pre-election ~ Post-election ~ 20__ September Supplementa
A-TOT aLS FOR THIS ~CU'Mi~ATfV~ TOTterS
ACCOUNTING PE~OB FO~ THIS ELECTION
CONTR)BUTIONS
l~ Cash Contdbutm~s ~7~702 41 24,7~2
(A~oantmg Period Total ~om PC 2)
2 Loans Received/Non-Exempt}
tAccoummg Period TofaI from PC 2~ + 2,200.00 + 2200.00
3 ~cfat Cash Conrhbufions
dines i+ 2~ = 19,902 4~ = 26,9~2.4~
4 la-Kind
(Accounting Period Tot~ lkom PC 2) + ~ 95 82 + ~ 95.82
q TOTAL CONT~UTIONS
'- dines; ~4) = 20,098.23 = 27,108.23
EXPENOffURES
6 Cash Expendnures 17,702.41 24.560 41
(Accoummg Penod Total l~om PC 3,
?, Loan Payments (NomExempU + 2,200.00 + 2 200.00
(Accounting Period Tol~ fi'om PC 3>
8 Total Cash Expendkures
times d ~ 7~ = 19,902.41 = 26,760.41
9 Ia-Kind
+ 195.82 + t 95 82
/Accmmbmg Period TorM ~om PC 2)
10 TOTAL EXPENDITU~S
¢t~es 8 * 9) = 20,09823 = 27,108 23
CASa BALANCE
~ 1 Beginning Cas~ Balance 152.00 FOR OFFICE USE ONLY
dine 20 of previous repoa)
12 Total Contributions R~ O¢~X~ ~
(line 5 } + 20,098.23
13 Other Receipts + 000
(Accotmting Period Total ~om PC ~A~ ,
14 Loans Rec&ved (Exempt) + 0 00
(Accounting Period Total from PC 4A; ~ ¢
15 CONT~UTION SI~TOT~ = 20,098 23 C17~~4 ~
dines 11 + 12 + t3 + 14)
16 Total Expenditures 20,098.23
(hue 10~
i70the~ Disbursements
+ 0 00
(Accopn/mg Period Total kom PC
t 8 Lo~ Payments (Exempt) + 0 00
iAccountmg Period Total from PC 4B}
17. E~EN~ITU~ SUBTOTAL
Omes ~ + [7 + 18'~ = 20,09823
20~ ENDENG CASH BALANCE
0me 15 minus l~ne i9~ = 152 00
Summary Statement of Contributions and Expenditures
Please Type or print legibly in black mk Page 2 of 2
Candidate or Political Committee Name i Committee iD Number~
TOM SLOCUM FOR C~TY COUNCIL
~ Original ~ Primary 200__4 [771 General 20 ~ Other
~ Amendment ~ tst Pre-election ~ 2nd Pre-election [~ Post-election ~ 20 September Supplemental
LOAN SUmmARY
FOR OFFICE USE ONLY
21. Beginning Outstanding Loans
(line 29 of previous report* 0 00
22 Loans Received (Non-Exempt}
dine 2) + 2 200 00
23. Loans Received (Exempt)
(line 14~ + 0 00
24 LOA~NS RECEPv%D SUBTOTA~L
(lines 21 +22 +23/ = 2~200 00
25. Loan Payments (Non-Exempt}
dine 7~ 2,200 O0
26 Loan Payments (Exempt}
Pine 18) + 0 00
27 Forgiven Loans
{ Total loans £org~ven dtmng tbas accmmnng penod~ + 0, 00
28 LOAN PAYMENT SUBTOT)d_
dines 25 * 26 -27) = 2,200,00
29. TOTAL OUTSTAN~D][NG LOANS
(line 24 rmnus hne 2gl = 0 00
PERSONAL EXPENDITURE SUmmARY
50. Beginning Outstanding Personal Expenditures
(hne 56 of previous report) 0,00
3t Person~ Expenditures
(Accotm~mg Period Total from PC 3A) + 0.00
3Z PERSONAL E.XPENDITUt~2E SUBTOTAL
(lines 30 + 3I) = 0 00
33 Personal Expenditure Reimbursements 0 00
(Total expenchtures on PC 3 with purpose code R)
34 Forgiven PeIsonal Expendit, ares
(Total personal expendgures fbrg~vcn ins acctg, period) + 0.00
35. REtMBURSEMEi*-¥F SUBTOTAL
{jmes 33 4 34) = 0 00
36 OIJTSTANDING PERSONAL
EXPENDITURES = 0.00
FINANCIAL STATUS AT CLOSE OF ACCOUNTING PERIOD
37 Ending Cash Balance
dine 205 152.00
38 Accounts Receivable
(Accotmtmg Period Total from PC 5 > + 0 00
39 SUBTOTAL
llmes 3~ * 38) = 152 00
40, 7oral Outstanding Loans 0.00
(line 29 ~
41, Outstanding Personal Expenditures + 0 O0
0me 36)
42 Accounts Payable + 0 00
¢&ccotmtmg Period Tota~ from PC 6)
43 S UrBTOTAL
(hnes 40 + 41-42~ = 0 00
44 BALANCE/DEFICIT
(line 39 minus hne 43 re&cate + or ~ balm-ice) = 152 00
1, Thomas R Slocum (na~me of candidate or treasurer}, hereby certify that the above statement and the attached supporting repons
C sh Contributions,
Candidate o~ Pol~fica~ Commk~ee Name Committee ~D Number
Tom $tocum for City Counci~ Page 2 ors
Election ~ Primary 2004 ~ Gener~ 20 ..... ~ O, her
RepoA' ~ ts( Pre-election ~ 2nd ~e-elecfion ~ Post-electio~ [~ 20~ September Supplemental
SEE BACK FOR [NSTRUCTIONS AND CODE DEF~I~IONS
CODE 1: Ooatributor Type CODE 2: Contribution Type
B Bus, ness EafiW CA Cash
C Polk~cal Committee fiac;udes bus~aess and anon PACs) CO Cosigner Obligation
F Csmd~date's Imme&ate F~n~Iy 0ncludes c~d~date) tK In~K~ad
I Individual LR Loan kecdYed
L Labor Organization
0 0iher
P Political Pa~y Commi~ee
Amoun~ of in-~nd Pucoose
Line ~ Name and Address of Cont~b~or Cont~bu~ion (see manual ~r suggested puc~ose co~s )
OccupatJanaJ ~nformation or Contributor Co~e I Code 2
Date ReceJved Contributing CommJ~ee
$
$
ded Keever
2 2590 Lawrence St $ 100.00
Eugene, Oregon 97405
5~7/04 R~red $ 100.00 l CA
3 $
4. $
5.
$
See Page Totals I Add alt amounts with the same Aeroaali~ag Period Totals (Complete only for last page and
InstructiorJs contribution type Do not include aggrega~ces.) transfer Cese amounts to ~he Summm~~ S~temeat, PC 1 ~}
on Back ~d Cash (CA) $. Cash (CA) $
Camp~gn Enter on Smmnm> Skttem~nt. O~leum A_ Line
Finance
N'hpiual la-Kind (~) $ Ia-Kind ilK} $
PC 2 Loans Received (LR} $ Lo~s Received/LR) $
gulcr en Sum:naE~ Stat~men[ Column .% L,ne 2
2(_2
Cash Contributions, Loans Received and in-Kind
Candidate or Political Committee Name Committee ID Number
Tom $1ocum for City Cound~ Page 3 of 5
Election ~ Primal' 200~ ~ Gener~ 20~ ~ Other ~.
Repo~ ~ l sr Pre-elec~on ~ 2nd ~e-election ~ Post-electio~ [~ 20 Septemba~ Supplem~ml
SEE BACK FOR 1NSTA[~CTIONS AND CODE DEFINITIONS
CODE 1: Contributor Type CODE 2: Contribution Type
B Business Entity CA Cash
C Political Committee dncludes business and un,on PACs) CO Cosigner Obligation
F Cemd~date's Immediate Fan¢fiN d~ctades candidate) [K ~-K~nd
f individual LR Loan Received
L Labor Oxganizafion
O O~her
P Pohfica Pa~* Committee
~ouni of l~-Kind Pu¢ose
Line ¢ Name and Address of Con~dbufor Conidbuiion eeo monaal ¢or suggested pa~¢ose codes)
Occupalionai ln~¢¢aiion or Conadbuior Co~e I Code 2
Daie Received Contn~bu¢¢ng Commi~ee's I~ Aggre¢aie
I $
2 $
$
Jeff Lansdon
3. 1736 Rwer Po~nte Loop $ 200.00
Eugene, Oregon 97408
5112/04 Title insurance Office Mgr. $ 200 00 I CA
.I;
5 $
See Page TerMs (Add all amounts with the same Aceounti~g Period Te~als (Complete only for last page amd
Instructions cont~bution type Do not ~ndude aggregates,) tr~s~er these amounts to the S~nmary Stateroom, PC
ua Back and Cash (CA) $ Cash (CA;~ $
iB Camp~Dn ~,,t~, on St,mmaO S~tcment Cola~m~ .~ Line 1
Finance
ManuM in-Kind (K<) $ In-Kind t~)
PC 2 Loans Received (LR} $ Loans Received
C~ter ,>;~ St~mmar, S~ltem~L C%}umB ~. Llz;e 2
Cash Contributions, Loans Received and in-Kind
Candidate o~ PoJitical Committee Name Committee iD Number~
Tom
S~ocum
for City Council Page
SEE ~AC~ FCA ~S%A~;C%~ONS A~ CO~ ~gF~N~%~ONS
CODE 1: Contributor Type CODE 2: Co~tdbut~o~ Type
B Bus, ness gmff~ CA C~sh
C Poi~fica~ Comm~Ae~ ¢~dudes business and u~o~ PA(s) CO Cos~¢er
O Othe~
P ~o~ifical P~y Com~Aee
Line ~ Name and Address of Contributor Amount of ¢'n-~nd Pu¢ose
Contribution ~see manuai for suggested pu¢ose cedes)
Date Receded Occupationa~ ~n~o~ation or ~ntdbutor
Oontribuffng Commi¢ee's ~ Aggre¢~e Code f Cede 2
Eugene Chamber PAC
1 1401 Willamette St $ 8 74 Z
EugeRe, Oregon 97401
5/14/04 PAC $ 758 74 C ~ ~K
Eugene Chamber PAC
2. 1401 Wdlamette St $ 72.40 L
Eugene, Oregon 97401
i
5/14/04 PAC $ 831 14 C ~
Eugene Chamber PAC
3 1401 Willamette St. $ 65~54 P
Eugene, Oregon 97401
5/14/04 PAC $ 896~ 68 C I K
Eugeqe Chamber PAC
4 1401 Wdlame~te St_ $ 49.14 S
Eugene, Oregon 97401
5/17/04 PAC $ 945~82 C ~K
5. $
$
See Page Totals (Add ali amounts with the same Aeeounti~g Period ~[etals (.Complete only for last page and
instructions contribution type Do eot include aggregates ) trans~r these amounts to the Summ~¢ Statement, PC 1
on Back and Cash (CA~ $ 0 00 Cash (CA} $ 0 O0
in Campaign Ent~ on Summa,
Finance
M~u~ In-Kind ([K) $195.82 In*Kind (1K) $195 82
Enter o2 Smnrp¢~C, SOt~menL O3hmm g~ J meq 4 ~n3 9
PC 2 Loans Received (LRt $ 0.0~ Loans Received (LR) $ 0 0~ 0
Enter on Sumner? Sotemen[ O'iurrm
Summary Statement of Contributions and E×penditure$
Piease type or print legibly m black _ink Pa~e ! of 2
~ a~,~ cr Poikica! Commi~ee Nam~ ~asc ~ namey
TOM SLOCOM FOR CiTY COUNCIL
Mailing Address as it Appea~s mt Statement of ~ga~izaicm (sxea~ route or ~ox humbert ckv.
1210 WiLLAGiLLESPtE RD., EUGENE, OREGON 9740!
ROBIN LOBDELL i (541,<M5-9966
, EUGENE CiTY COLiNCiL, WARD !
, , 2nd Pre~e!ecficm ~ PosPelecdoa
A-TOTALS FOR THIS ~CUMULATtVE TOTALS
ACCOUNiING PERIOD
CONTRIBUTIONS
'~ C)¢~ Cqntdhution~ 0 00 0_00
2 Loans Reef',ed ~Non-Exem~t~
(Acconntma Penal Total from b( ?, ~ 0 00 , + 0 OO
3. Total. C~bt2 Centr}b,~tk:m~
= 0 00
times t ~ 2~
{Accom!hng Pen~ Tot~ i?orn PC 2~ + O O0 +
5 TOTAL CON~_IBUT!ONS
. = 0 O0 = 0.00
EXPENDITURES
~-~ ........... 102 59 102 59
7 Loan Payments {Non-Exempt~ . 0.00
lAccotmZmg Period Total ~om PC 3;
L ~n :v_zpenmtures = ! 02 59 = 102 59
dines o -- 7)
9 tn-Kind
tAcco~tmg Period leta ~om PC 2~
! 0 TO~/gL E~PENDITU~S
= !02.59 ~= ~02.59
(imps 8 ,- 9~ i
CASH BALANCE
~=- ~ ! 02 59 ~ FO~ OFFICE US~ ONLY
(fmc 20 o~ piev;o~s ~eFor;;
~2 Total (ontNbuttons
(tree 55 + 0 00
! 3, O:her Receip:s + 0 O0
~c~,~m% Period [~al ~om PC 4A,
t4 Loans Recmved (Exempt~
,Acco~qtm~ Period To~i kom PC 4A~ + 0 00
! 5 CONTPABUTB3N SL~TOT:~
dines I1 :- i' -- 13 + 14) = 0 00
!6, Total Expenditures 102 59
dine
~,~ Other D~sburseme~$ + 0 00
i~ccoummg Period ~otai from PC 4~
tS. Lomb. Payments (Exempt1 + 0 00
~ ~ccou~tma~ Pene4 TolE! .~ng'3 ~ PC. 4B~
} 20 ENDING CASH BALANCE
Summarg Statement of Contributions and Expenditures
P!ease type or print legibly in black ~nk Pa~e 2 of 2
TOM SLOCUM FOR CiTY C ~UN(~iL
~ Onmnai~ ~ ~_, Primary _ ~ G~n~ml 2G04__ L~ C~h~r .
Amendment
21 Begmnin~ f~atstandkm Loans ~ FO~ ,~==~r-~ USE ~.u v
( hnc 29 of ~enous repori } 0~00
22 Loans ReceN ed (No2-Exempt)
flme 2) + 0.00
~2 Loa~s Rece;x ed (-Exempt)
d,se 14¢ ! + 0 00
{hues 2i ¢22 :-23; ~: 0 00
25 L~an raym~nt~ ~Non-Exempr~ I 0 nO
26 Loan Payments/Exemp0 ~ ,
d~e la~ ~ ~ 000
27 Forgivc~ Loa~s ~ -
di~es 25 ~- 26 +27~ I = 0 O0
~" TOTAL O'[YrSTANDING LOANS
PERSONAL EXPENDITURE
30 Begiurd~ Out~tandM~ Personat E'<pend~mres
i 0 0o
3 ! PersonaJ Expenditures
(Acco~mt;ng Pence Total from PC 3A; ~ ~ O 00
~ PERSONAL E~mEP~DI~¢~ SUBTOT~
(hncs 3c ~ 3i } m 0 00
33_ Personal Expenditure R~mbu~ements
il'om! expes~mres on PC 3 wiel pm~ese code R, 0 00
~4_ For~b:en P~..o.mt ExUe.m~m ~s
(To/a! personal expend{tums foCglvat tbJs acc% ~md~ , * 0.00
35 RE~.IBURSEMFNT SL~TOTaI
rimes ~3 + 34) ~ = 0 O0
~60U I~.M 9~ G PEiLSON~
E~ENBD'~S ; = 0 O0
F~NANCJAL STATUS AT CLOSE OF A~COUNTiNG PER~OD
37 En~n2 C~h BManze
3g Acco,nfs ReceNgv!e
(Acco~mfing Period lot~ ~om PC 5~ + 0 00
39 SUBTOTP&
times 37 ~ 3g) = 0 00
4u Tot~ Outstanding Loans
{line 29~
41. Outstanding Pemonal Expenditm~es
db~e 26~ ~ 0 00
42 Accoums PavaNe
~Acco~mimg ~ertod lb!at 5-em PC 6} + 0 00
43. SUBTOT_~
44 BALANCE/DEFICIT
{ime 59 menus line 45 in,cate, or - baim~ce~ { = 0 ¢3
!. Tnorqas R Siocum isame of candidate or treasurer}, hereby cerh~- that the above statement aha the attached R~p[:mrting reports
~ Signatafe o1 candidate o~ tre~er Date si}¢ned ~ t
PC3
Cash Expenditures and Loan Payments
Candidate or Political Committee Name. Committee ~D N~,~rnbe~
TOM SLOCUM FOR CITY COUNCIL Paae t of 1
Election ~ Pfima~y 20 _ ~ Genial 200_~ ~ ~her
Repoll' ~ 1 st P~e-el~fion ~ 2nd Pre-elemion ~ Post-election ~ 20 September Supplemental
PU~OSE CODES {see back of ~rm ~or i~tr~etio~ a~d code definitions} ~K_PENDFrU~ TYPES
A Agent O ~h~ Adve~isSng (y~d 5~s. hurons, etc.~ CA Cash
B Broadcast Advertising (Radio. TV) P Postage LP Loan Payment
C Cash Contributions R Reimbamment Gr Permn~ Expen&t-~
F Ftmdraising EYent Expenses S Supeevs and Polls
G Cmneral Operafiona Expenses (~mqbe if over $50) r Travel Expel~ses (describe if over $50~
I interest Payment U Utilities
L Literature, Brochures., Printing W Wag~, Salazies. Benefits
M M~agement SemSces Y Petition Ci~aflators
N Newspaper a~d Othe~ Pefiodic~ Adve~ising Z PmFe~afion and Predu~on of A&'e~dsing
Exp, ~nt d
Line ~ DaCe Ohe~ ~ ~ appt/ca~e Pu~ose Type Ex~ndi~e Pa~d
(as ~ appeam on invci~, rece{¢ or ch~k) to A/P
9/10/2004 120 Faye Stewart for Commissioner C CA $ 102.59
$
9 $ ' ;
10
See Page Totals (Add ail expenditures with the same Ae¢olmting Period Toials (Complete ooJy for' last page and
Instructions expenditure type.) transfer d~ese amounts to tixe Summapy StatemeaL PC
on Back and
in C~npaign Cash (CA) $102 59 Cash iCA) $ I02.59
M~uai Loan Payment (LP} $ Loan Payment (LP)
Euter on SummaE~ S~a~m~t, C~,lm~ .~ Line 7
PC 3
Summary Statement of Contributions and E×pend]tures
Please type or pnnt ~egib!y in black mk Page
Candi~t~ or Po!hic~ ~ .....
TOM SLOUUM FOR C}TY COi
~ ~ .epe~rs on Staement cf Organization (s~a. fout~ oT box number, c~ tv. ata~c~' m~.' .....o~e,
1210 WiL~G{LLESP~E RD., EUGENE, OREGON 97401
ROBIN LOBDELL i {SA~. )~345~9966
(ommix~e ID Numbe= Comm~ee Type. Measure N~mber or Office'
EUGENE C~T~' COUNCIL, WARD ~
~ Original ~ Primary 200~ ~ GeaeraI 20 ~ O~her
~ )~meedment ~ t st Pre=e!ecdo2 ~ 2nd Pm~elecfion ~ Post-election ~ >n S~tember
A-TOTALS FOR rEIS ~=CUSIULATI~T TOTALS
ACCOUN~ tNG PE~OD FOR
CONTRIBUT}ONS
I Cash
, a .......... o:,¢,~4 Tom! ~om PC 2~ 17.560 OgO 24.670 00
2 Lo~s Received {Non-Exempt}
iA~ountmg Pen~ Fotz4 eom PC 2 ~ * 2,200 00 ,v
dines 1- 2; = ~9_760 O0 =
/Accotmapg Pe¢od Total Eom PC 2~
5 TOTAL CONT~BUT!ONS
dine5: -' 4; = 19,955 82 = 27_065.82
EXPENB~JURES
5 C:4sh Exp~nditurv>
(Accounting Pcnod To~! from PC 3; 17.702 41 24,567
7. Loan Payments tNon~Exempt~ ~, 2,200 00 ~ 2,200.00
(Accotmtmg Period Total kom PC 3~ '
~ Total ~ ~ .....
~ ',~ ~s ~ Exp=nmtgtes 19 909 41 = 26,767 4
9
10 TOTAL EXPENDiTUF~S
(Jmes a -'- P) = 20.098 23 = 26,963.~
CASH BALANCE
~ i. Beglmxng C~sn B~.ce 245.00 FOR
dine 2U ofp~ex~mm repoa~ ~. ~ -~E USE ONLY
J2 Tokai Comributions
dine 5~ + I
!3. C~Z~ sr 9.scc~pts
~.Accogmmg Period I oral ~,>m i'C 4A~ + O. 00
14_ Loans Received {Exempt}
(Accomn~ng Period Total ~om PC 4Al + 0.0C
~..~ 4 CONTB~UTION 5L~TOTAL
{hnes 11 + 12 + 13 -- t4~ = 20,200.82
17. Other Disbursements
+ 0 00
tAccommng Period 'J or& ~om ~t, 4B ~
!8 Lo~Payments(Exemm} ' ' ~'~ '
0.00
fACCOlintlDg Penod Total karo PC 4B}
20 ENDING CAS_~ ~ALkNCE
~ ....~ !me ~o = 102.59
Summary Statement of Contributions and Expenditures
P!ease type or print ~eg~b!y i~ black mk Page 2 of
aa~m~ .... Patitic~ Commk~ee N~mg : ( ammiu-cc ~ Nu~nber
TOM SLOCUM FOR C~TY COUNCIL
[~ Origi~i ~ Prknarv 2004 [2~ General >,5_. ~ O~her
~:~, Pr~-e .........n 2nd Pre<lemon ~ Post-elecoon r~ 20 S~p~.m...r
LOAN SU~ARY
2i BeDnmng Outstanding Loans FOR OFF~CE USE ONLY
¢ me 29 of pre vmus repo~0
22. Lomns Received (N<,n~Exempt~
~ line 2 ~ + 2, 2vv 00
~' ed (E
,_, LeaBs Receiv xem
dina t4) + 0.00
2 t LOANS P~CEIYED S[~TOT~
dines 2!~ +_}.~ = 2.20000
25 Loan Paymenb
Hme 7~ 2 200 O0
26 Loan Payments (Exempt~
dk~e i8~ + 0 O0
27 ~orgivca Loans
28 LOz~q PA~%4ENT SUBTOT/d.
hines _ ~ 26 e>~' = 9 900 O0
2~ TOTAL OUTSTANDING LOANS
{linc 24 !mau~ line 2g) = 0 00
PERSONAL EXPENDITURE $0~ARY
~0 Beginning Cmt~tanding Per~ona~ Expenditures
~hne 36 of pre~ ,ous repo~) 0 00
3 i. Personal ExpenSimres
b&ccc~xmg ?~nod Tot~ Eora PC SA: + 0 00
'0_." PERSONP~ EXPENDiTUP~ x~U~B'~i OTA_=
(hnes 30 * 31, = 0-00
35 Personal Expenditm'e Reimb[gsa~mnts
~ F~ml expenditures on. PC 3 web purpose coOe R~
34 Forgiven Person~ Expenditures
{Total pm~onaI expenditures tbrg~cn ibis acclg acncxt) ~ 0 O0
-~ REP~IBr/RSEb~XT St~ ¢ O ~
Ok~s 35 + 34~ = 0.00
30. OUTST2~Z¢D~G PEt~ONAL
......... = 0 O0
EXP~5 D~'U ~S
FiNANCiAL STATUS AT CLOSE OF ACCOUNTING PERIOD
37 Endin~ Cash Bxtsxme
dine 2~ I 102.59
3g %cccua~s Recei,,able
{Accouming Period %t~ from PC 5 ~ + 0 00
3q SU BTOlb~_
lhne 2~ ~ 0.00 -
4 t. Outstanding Personal Expend(tufTs - ,-', t
~ Acco~nts Pa~abie
~ - 0.00
dines 4U -: 4i ~*-' ~', , -
44 BAMkNCE/DEFICIT l
, = ~02 59 ,
{tine 39 ~nrms imc 43 md(cate -v or ~ b~ancc~ i
Thomas R S~ocum ~ rmme of candtdee:e or treasurer)~ hereby cemfv that the above s~tatemen~ and the atached suppomng repo~s
/
Sisnature o2 cm~date ox transfer D~J.e ~gt;e~, /
Summary Statement of Contributions and Expenditures
P~ease ~.ype o~ pdnt ~eg~bb¢ m Nack ~g:-~ Pa~e
C~didat~ c: Poikk~ C cmmktee Nmm~ ;ase !~A! name L
TOM SLOCUM FOR CFP¢ COUNCIL
N,~,n8 :~ddre~, as Sm~ament of O~anization (streeL rou~e or box numbcq ci~ s;ate, z(p code7
!210 WIL~LLESP~E RD~ EOGENE ORE~ON 97401
ROBIN LOBDELL I (54!N345-9966
EUGENE CiTY COUNCIL WARD 1
L2 Original ~ PnmaW ~uu~ ~ General 20__ ~
~ Amendment ~ ~ - P = ~ 4~a ~ 2nd Pre-election I ' Posbelecfion '~ 29
.s~ ~ r~-e, ec~. ~ September Supp!emem~
, k-TOTAlS FOR T~tS B-CUa4UL kJfk'E TOTALS
ACCOUNTING PE~OD I'ORTHIS ELECI3ON
GONJRiBUT}ONS
~ Cash Contfibations
2_ Loans Rec&ved ~ Non-Exempu ~- 0.00 + 0 O0
~Accountm¢ Pen~ %ix~ from PC 2,
{Hncs 1 ~ 2', = 3 870 O0 = 7 110 O0
4_
+ 0 O0 ~
~Accotmnn~ Period/ot~J eom PC 2~
~ TOTAL CO~ TR~BbT~ONS
' = 3.870 O0 = 7j t0 O0
flints 3 + 4;
EXPENDITURES
6 Ca~& Fxpendm~re~ 5~559 00 ' 6,865 00
~Accounimg Ps~od Taal ~om PC ?,
7 Loan Payments (Non-Exempu + 0.00 + 0 00
(Accotmtm~ Period Tota~ from PC 3~
S Te,:a2 Cash Expenditures = 5~559_00 = 6 865 OKI
~ In-Kknd
+ 0 O0 + 0.90
lO TOTAL EXPENDITURES
= 5,559 O0 = 6.865.00
CASH BALANCE
~ ~..,, ¢ !_93,! O0 FOR OFFICE
......... o~ pre~ ~ous report) .. ¢o~ ONLY
12 l otaf Contnbotmns ~- 3.870.00
tS C~her Racdp~s + 0 O0
~A~com~tmg Period i'otai fi~3n~ PC
!4 Loa2s Reccwed ~ExempO
+ v. 0~
~Acco~antmg Period Tomi ~om, PC
i5 CONTR~UTION SUBTOT)& '
, = 5 804 oo
!& Tota! Expen&po~es
', ~ O~her Dksbursements + n~.0n
iAccountmg Penoo. total from PC 4B.~ ...... ?
} lg Lo~ Payments iExempt~ i "~
: :&ccountmg P'- 4 ~ n~ , 0.00
~. EXPENDtEURZ SL~BIOTA& ....
, = 5 559 O0 k_ ,~ '
Summary Statement of Contributions and Expenditures
Ptease Wpe or pnnt legibly m black mk Page 2 of'2
rOM SLOCUM FOR CiTY COUNCIL
LJ Ofigma~ ~ Prhna%' 200~ ~ Genera~ zt; ~ Other
~ Amendmem ~-_~ 1st Pre-elemior; ~ 2nd Pre~dection _~ Post*ele~xkm ~.,~ ~-'__~r' ~-'?*'--'-'% .... ~
LOAN
c, O0
lime 29 ot pmv~otm repo~}
22 Loans Recdve~ (Non-Exempt~
dine 2, + 0 00
23 Loan~Rece~ved~Exemix)
pine ~ 4) + 0 00
2 ~ LOANS P~CE[VED SC~TOTAL
,hnes 21 -~ 23 ~-Z3) = 0,00
Z5 Loan Pa~ ment~ i Non~ExempU
dine 7~ 0 O0
2{> Loan PaymentsiExempt}
{line t8~ + 9 00
~ Foraiven Loans
{l~t,~ to~,:, ~o,~t, c~ dum~ ins aco>~imm~ pcncd~ ~ 0 O0
28 LOAN PA~%iENT SL~TOTXL
29 TO-I'AL OUTSTANDE~G LOANS
PERSONAL EXPENDITURE SUmmARY
oO Begdnning OntstandmS Persona! Expen,,{.,.,es 245 00
3 ! Personal Expen~mre~ ~ 0 L~
{Accosmmg Period Iotal from P(
:~ PERSONAL E~ENDITUT~
dmcs 50 ~ 31; = 0 O0
33 Pe~son~ Exoen~mre Rmmbm~sements
([ot~ expenditures oq PC 3 ~5ith pl¢ose code R* 0 O0
34~ ForeSven Person~ Expenditures
~Tot3! t~c~soa:fl expenditures tbrg-~a~ tMs ~c~ pcr,~5 + 0~00
' = ..... -~N S~3TOTAL
a_' RE~,viBURSE~m, IT
;~. O~ITSI'ANB~NC t'E~ONAL
EXPEND~U ~S = 9 O0
FiNANCiAL STATUS AT CLOSE OF ACCOUNTING PERIOD
37 En~na Cash B~aace
,tree =0, ~ 245 O0
38_ Accotmt5 Receiz, aNe
(Accopntmg Period lot~ from PC ~ ~ + 0 O0
dines 37 k 38!
40 Total Oummnding Loans 0 O0
41 O~tst~ding Personal Expenditures : + 0.00
dine 36;
45 SUBTOT;~A.
-,< , -,., 42, = 5.937 96
,= -5,692.96
thn¢ 39 minus line 43 in&care ~ or -
i, T~omas R Secure {name of candidate or treamrer). ~ereb) certify mat the above statement and e~e attache~ suppomng
51gaato~e of c~didate c~ treasure~
PC 2 Amendmeat
Amendments-Cash Contributions, Loans Received and In-Kind
Candidate or Pohtical Cormmittee Name: Committee ID Number:Page ~__ ~of
ElecUon: ~Pnmaw 20 0~ ~ General 20.~ n Other
Report ~lst Pre-election ~2nd Pre-electron ~ Post-elect~on ~ 20~ September Supplemental
SEE BACK FOR INSTRUCTIONS AND CODE DEFINITIONS
CODE ~: Contributor Type CODE 2: Contribution Type
B Business Entity CA Cash
C Political Coati,ce 0ncludes business and umon PACs) CO Cosigner Obligauon
F Candidate's l~edmte Family (includes candidate) IK In-Kind
I lnd~wdual ER Loan Received
L Labor Organization
O Other
P Political Pa~ Committee
Amend&g Page ~ Name and Address of Contributor Amount of In-Kind Purpose
and Line ~ Contribution (see manual for suggested purpose codes)
i
Occupational
Information
Contributor
Code 1 ~ Code 2
Date Received ~ ~.~C°ntn~uting C~m~ttee's I~ Aggregate
Correcting
Pa~o~ Line
~ New Entw $
~ Oorrectm~
Page_ Line
~ New Ent~
~ Correcting
~ Detebng
$
Page~ Line
~ New ~nt~
~ Correcting
~ Deleting
$
Page~ Line
~ New Entw
~ Correcting
~ Deleting
$
Instructmns /
on Back and
~n Campaign ¢ ....
Finance Sigm~ofcand~date t e ,o~.P ~ ~
Manual
Amendment Date sighed [
Please type or print legibly in black mX Pa~e ~ of 2
Ca:d~date or Pahtica1 Commit~ee Ns, me fuse fsi
TOM SLOCUM FOR C~TY COUNCIL
Ma/Hag Address as k Appears on ~ .....
o,a.~m..m of Organizaficn ~ s~eet, route ar box ndmber, city. state, zip code r
1210 W~L~GtLLESPiE RD.. EUGENE, OREGON 97401
TreasurcFs Name ~ Telephone Number (dsy~
aOBIN LOBDELL i (541>345-9966
Commi~ee ~ Nsmbar' Commixee Type. Measm~e Number or O~ce:
, EUGENE C~TY COUNCIL WARD 1
~ ~ O~ L~ General zu ~ Other
~ Amendment ~ 1 ~2 Pre-e!ecmm ~ 2nd ~e-e!ecem~ ~ Post-election f~ 20 September
A~TOT&LS FOR THiS B-Cb55[ZAT~VE TOTALS
ACCOLNI lNG PE~OD EOR THIS
CONTRiBUTiONS
I_ Cash Contfib~ttlon~
{Accoemmg Period Tsr~ ~om PC 2) 3,240.00 3240 O~
" Lo~s Received ~ Non-Exemou. ~. 0.O0 . ~ .....
{Acco~mnrkg Period Total from PC 22
al,men i.- 2) = 3 24000 = 3 240 00
~ Accou ~tmg Pc%od Tot~ ~om PC 2 }
¢ TOTAL CONTRIBUTIONS
= 3,240 00 =
EXPENDITURES
5 C%h Expenditttrc~.
:Acceuming Period lomi from PC 5) 1.30a00 1.306 O0
v Loan Payments {Non-Exempt! + (ZOO +
~Accountmg Period Total sore PC ~ >
~ oax Ca¢~ Expend~tmes
= t 30&00 = ~ 30~ 00
dross 6 ~ 7)
9
~Accountmg Period Total ~em PC 2}
i% TOTAL EXPENDi~S
CASH BALANCE
~ ~ Be~nrdng Cash Bv~m:ce 000 FOR OFF~CE USE ONLY
12 Total Contributions
dine 5~ e 3,240 00
13 Ohher Receipts + 0 00
(Accotmtmg Period Total a-om PC
J 4 Loans Received (Ex~mpt} O 0O
' < CONTRJBUTION SUBTOT~
" 3,240,00
{Jmes El ~ 12-, i3 ~ i4~
1.6 Total Expendkmes ~ .o~* a~
+ 8 O0
tAccoupan~g Period tomi from PC ob} ~
lg Loan Payments {Exempt} '
· ....... , o~,J tkom PC 4B~ ~
{imes 16+ [7 ~ ig~
20 END~G CASH BALANCE
Summary Statement of Contributions E×penditures
P~ease. wpe. or pr, hr legibly m Nack mk PaLe.. ¢~' of 2
TOM SLOCUM FOR CiTY COUNCIL
~ Odcnal ~ Primary 200~ ~
~ Amendment ~ 1st Pre-eiecuo~ ~ ~d Pre-e~ec,.k_~ ~ Po~t-e!ection 7~ ~ q ....... ~' S~o~lemer~a~
LOAN SUg~ARY
FOR ~=~'~,, ,~ USS ONLY
2i Beginning Outstanding Loans
(hne 29 of or¢~ ~ous r~pon)
22 Lomas Received (Non-Exempt¢
Cme 2} + C~00
.:~ Loans Rec&ved(Exempt) * 0.00
2 ~ LO_'C*:S P~CE~%TD SL~ ~OTAL
~¢ LeanPa>ments {Non-Exempt~
lhne 7~
26 Loan Paymeats (Exempt) + 0',09
dine
2' Foraiven Lcans
28 LOAN P:L~hk,~NT SL~TOTAL
:lines 25 -~ '*': 427)
29 TOI'~ OUTS'I~NDLNG LOA_ $
tlm~ 24 minas i_me ~'"a, = 0 00
PERSONAL EXPENDITURE SU~BARY
~ ~ O't~t~tanamg Persona, Expemgtures O' O0
dine 36 of pre¥,o~s
3 ! Personzd Expenditures + 000
,A~c,~u ...... e Pzriod To~ kom PC 3A;
,2 PERSON2& EXPE~DI~P~ S~,B t ~**;~.
.- ., +._ = 000
3~ Personai Expenditure Reimbm'sements
34. Fo~¢x en P~;onalExpen~mres
gq REPdBL~SEMENT SUBTOT&L
i = O00
~!~s 33 ~- 34)
35. OCI~IANT,~NG .E~O, AL * - O. O0
EXPEND~IT'~S i -
F~NANCEAL STATUS AT CLOSE OF ACCOUNTING P~alOD
37 En~ng Cash Ba~m~ce
dine 2e; I i 934.00
{Accut~N~g Psnod Tot~ fiom PC 5} + 0 00
40. Toi~ Outstanding Loans O.0O
t line 2~ }
~ Outstanding Persona! Expenditures
42..Accounts Payabtc 0 00
43. SUBTOTAL , ~ nO
~.[mes 4.0 + 41 + 42)
~ BALANCE/DEFICIT
t line 39 minus imc 43. in~oa~e -i- oI ~ b~mme;
L Thomas R Stocum marne of candidate or treamrerL hereby cernO t~at the above statement and the attacaed supp<}mng repoag
PC 3 Amendmear
Amendments-Cash Expenditures and Loan Payments
Candidate or Pohtical Committee Name: Committee ID Number:
Electron ~Primary 20~ [~ General 20~ ~ Other
Repo~ ~ 1st Pre-election ~ 2nd Pre-election ~ Post-election ~ 20~ September Supplemental
PU~OSE CODES (see back of form for instructions and code definitions) EXPENDITU~
A Agent O O~er Adve~smg (yard si~s, bu~ons~ etc ) CA Cash
B Broadcast Adverttsmg (Radio, TV) P Postage [P Loan Payment
C Cash Contributions R Re~bm~sement for Personal Expenditures
F F~drais~ng Event Expenses S Surveys and Polls
G General Operational Expenses {describe ~fover $50) T Travel Expenses (describe if over $50)
I Interest Payment U Utilities
[ E~terature~ Brochures~ Printing W Wages, Salaries, Benefits
M Management Serwces Y Pet~non Orculators
N Newspaper and Other Periodical Advertising Z Preparauon and Production of Adve~smg
Amending Page g Payee's Name and Payee's Comm~ee I~, Exp. Amount of ~
and L¢ne ~ Check ~ if apphcable Purpose Pa¢d
Date (as it appears on ¢nvoice, receipt or check) Type Expenditure to NP
Page ~ _L,ne~ ~ ~
$ Deleting ~
~ New Entw
~ Correcting
~ Deleting $ ~
Page_ Line
F1 New Entry
[] Correcting
[] DeJetmg
Page.__ Dne
FI New Entry
[] Correcting
[] Delet, ng $ E~
Page_ Line
[] New Entry
[] Correct~ng
[] Delebng
in Campaign
Finance ~a~e o~ canS~date or treasurer
Amendment Date si~ed /