HomeMy WebLinkAboutAdam Walsh for City Council Summary Statement of Contributions and Expenditures
Please type or p:mt leg~bt} iii black mk. Page I of 2
Candidate or Polincal Commkttee Name luse full namcL /, ~
Marling Add:ess ~s ~t Appear: on Sta~ement'of Or:m~z:do:~s~r~et. mute or box number, c~ty~ st:t~, z~p code}
Treasmer:s Name. ~. Telephone Number iday:
Comm~ttez ID Number: Committee Type, Measure Nmnbe~ o:
, _0_~ ~ General 20 ~ Other
~Ongmal ~Pnmarv ~ ".~
~ Amendment ~i~t Pre-electron ~ 2nd Pre-elecnon ~ Po~belecnon ~ 20_~ September Supplemental
A-TOTALS FOg TH1S B--CUMULATtX~E TOTALS
ACCO[ NTING PER~OD FOR TH1S ELECT[ON
CONTRIBUTIONS
CAsh Contributions
2. Loans Recmved(Non-Exempt~ + +
(Acq~untmg Period Total tkom PC 2~
3. 7o~1 Cash ContF~butions
4. In-K~nd' ~ +
(Accommng Period Total from PC 2) ~ ~
5 FOTAL CONT~BUTIONS
EXPENDffURES
6. Cash Expert&rares %~ -~ _~, :~
{Accountmg Period Total from PC 3 ~ ~" ~ ? ~- ~
7 Loan Pa~ents (Non-Exempt) + ,~ +
(Accounting Period Total fi'om PC 3)
8 Total Cash Expen&mres ~> =
9 lmKmd + ~ G c : +
(Accoummg Period Total ~rom PC 2}
10 TOTAL EXPENDITLRES
CASH BALANCE
J ! Be~mg Cash Balance
-. FOR OFF~CE USE ONLY
(hne 20 o1 prewous report)
12. Total Contributmns + ~ / ([,
(line 5)
13. Other Receipts +
(Accommng Period Total trom PC 4A)
14. Loans Recewed (Exempt) +
(Accounting Period Total flora PC 4A~
15. CONTmBUT1ON SUBTOTAL =~ / 5/ ¢ / C C
-16. Total Expenditures ~{.~ ~'~ ~L~J
17. Oth~: Disbursements , _~ ~. 0
~Accountmg Period 1oral flora PC 4B)
1~ LoanPaymenrs~Exempt) + .... D~t ~ ~
(Accounting Period Total ~kom PC 4B)
{lines 16+ 17~ 18~
Z0. ENDING CASH BALANCE =.& ~ 3 &~ ? 3. ~ "7
dine 15 minus hne 191
Summary dtatement of Contributions and Expenditures
Pfcase type or print legibly m black mk Page 2 of
Can&dare or Pohtm3l Cgmmmee Name: , , ,~;. ,- } Committee ID Number'
~Ongmal ~qh',mary 20e d ~ deneral 20~ ~ Other
~ Amendment ~ Ist Pre-elccnon ~ 2nd Pre-elect,on ~ Post~etecnon ~ 20~ September Supplemental
~ LOAN SUMr~ARY FOR OFFICE USE ONLY
2i BcghmmgOutstand~ng Loans
dine 29 of p~evmus repot~
22 Loans Received ~Non-Exempr} +
23. Loans Rzcmved iExempt) +
dine i4t
24 LOANS RECEIVED SUBTOFAL
(hnes 21 - 22 ~ 23~
25 Loan Payments (N3n-Exempt)
( hne ? )
26. Loan Payments (Exempl)
t !me 1 g~
27. J orgp~en Loans
+
47 oral roans (o~ gn, en dm mg th ~s accounting period ~
28 LOAN PAYMENT SUBTOTAL
dines 25 + 26
29 TOTAL OUTSTANDING LOANS
dine 24 minus hne 28) =
PESSONAL EXPENBffUSE
~0. Beginning Outstanding Personal Expe~ditt~e~
(line 36 of prevmus reporO
31 Personal Expenditures
(AccountmgPmtodTotatflomPC3Al + '~ ~-~ ~ % -~ ~'~ ~
32. PERSONAL EXPENDITURE SUBTOTAL
dines 30 -,- 3 / )
33. Personal Expert&rare Reimbursements
( Fotal cxpcn&mres on PC 3 with propose code R) ~
34 Forgiven Personal Expenditures +
(Total personal cxpen&tures for~wen rhts acctg, peno& - '
35 REIMBU-RSEMENT SUBTO%~
dines 33 - 34) =
3& OUTSTANDING PERSONAL
EXPENDITURES = ~7 Z ~, c~
FINANCIAL STATUS AT CLOSE OF ACCOUNTING PERIOD
37 Ending Cash Balance ; ,(,
38. Accounts Receivable
+
{Accounnng Per{od Total from PC 5)
SUBTOTAL
40, Total Outstanding Loans
41. OutstandmgPersonal Expen&mres ~7 ~ ~": ~' 7 C
Ihne 36) + ~~. ~ C
42. Accounts Payable
~Accountmg Permd Total flora PC 6~ + ' ' ~' 0 ~ : *"
43 SUBqOTAL
44 B,kLANCE ~EFI'CI'T -
[,-~{ ~..q ~ ~* [ [ 5; .~ L d "c:,~ ~ ;, tname of can&date or treasurer L hereby tert~fv, that the
statement and the anached supporting reports are tree and con'ed.
S~gnaturc of candidate or treaburei Date ,qgned
PC 2
Cash Contributions, Loans Received and In-Kind
Can&date or Pohncal Commmee Name: Commiuee ID Number
Election: ~Prnnmy 20 ~ 4 ~ General 20~ ~ Other
Repoil: ~lsr Pre-elect~on ~ 2nd Pre-election ~ Post-elect~on ~ 20~ September SuppJemenial
SEE BACK FOR INSTRUCTIONS AND CODE DEFINITIONS
CODE ~: Contributor Typo CODE 2: Contribution Typo
B Business Enutv CA Cash
C Polkkal Committee [includes business and amen PACs) CO Cosigner Obhgar~on
F Can&date's [mmedmte Famdy (includes c~mdidate~ IK In-K~nd
[ Indivtdual LR Loan Recewed
L Labor Orgamzauon
0 Other
P Pohncal PaW Commmec
- 'Amount of In-Kind Purpose
Line ~ Name and Address of Contributor
Contnbufion (see manual for suggested purpose codes)
Date Received Occupational Information or Contfibuto¢ Code ~ Code 2
Contnbutm¢ Corem/tree s t~ Aggregate
s 7 $ [ oo
See Page Totals (Add ali amounts with the same Accounting Period Totals (Complete only ~or last page and
lnsxuctmns contnbuuon type Do not include aggregates,; tra~stkr theae amounts to the Summat¢' Statement, PC
on Back and
m Campaign Cash (CA) $_ Q ~" [" "~ Cash (CA}
Flllance Enter on SmwnaE Statement. Lulmnn A 1 me
Manual In-Kind ilK) $ in-Kind (1K)
Enter un Su~naEv S*atemenr Column A tines 4 aml 9
PC 2 Loans Received (LR) $ Loans ReceB, ed tLR) S
Enter on Sumlnary Stateroom Colm~ A, Line 2
Cash Contributions, Loans Received and In-Kind
Candidate or Political Committee Name: Committee II) Number:
Election: ~Pnmary 20~ ~ General 20 ~ Other
Report: ~ I st Pre-elecnon ~ 2nd Pre-eiect~on ~ Post-elecnon ~ 20~ Sepmmber Snpplemenml
SEE BACK FOR iNSTRUCTIONS AND CODE DEFINITIONS
CODE l: Contributor Type CODE 2: Contribution Type
B Business Enmy CA Cash
C Poliucal Committee iincludes business and umon PACs) CO Cos;grief Obliganon
F Candidate's Immediate Faro:l; (includes can&date) IK In-Kind
I Individual LR Loan Recc~x ed
L Labor Orgamzanon
O Other
P Political Party Committee
........ ~mount of - ~q.Kind Purpose
Lzne ~ Name and Address of Oontnputor
Contribution (see manual for suggested pu~oose codes)
Date Received Occupational lnlormation or Contributo~ Code t Code 2
Contributing Committee ~ f~ Aggregate
See-- Page To/al~ (Add all amounts with thc same Acceunti~g Period Totals (Complete only for last page and
Instructions contnbunon wpe Do nor include agg-regates,~ transfer these amounts to the Sum~na~ Statement, PC
on Back and ~
m Campaign Cash (CA) $ x,,__ __~ / .~ Cash fCA} S ~ q ~ ~
[ltlaBce Enter c,~: SuntaraU, Star,mere ( olumn A, Line
Manual In-Kind ilK) S '} d ~ In-Kind (1K) $ '~ ~
knte~ ,,r~ Sultana? S*atemem Column ~
PC 2 Loans Recei,ved (LRt S Loans Recew~d (LR~ $
Enter un ~tlll~ry Statement c mtliBll A Line
Cash Expenditures and Loan Payments
Can&dal~ or Political Committee Name: Comnnttec ID Number.
Report ~lst Pre-c!ecfion ~ 2nd Pre-clecnon ~ Pos>election ~ 29~ September Supplemental
PURPOSE CODES tsee back of form fl~r instructions m~d code de~nitions) EXPENDI~ URE TYPES
A Agent O Other Adx cmsmg (~md s~g~s, bunons~ ere,) CA C ash
B Broadcast Advemsing(Rad~o. TV) P Postage LP LoanPayment
(' Cash Contnbutmns R Re~mburseme~t forPersonnl Expcad~ttaeb
f Fundrmsmg Event Expenses S SurseSs and Polls
G General Operational Expenses (describe ~fover bS0) T 'lravel Expenses (de~cribe if,over
I D~tercst Pa?men[ L7 Utflmcs
L Lheram~c, Brochures, Pnntmg W Wages. Sa[aries, Bcnctit~
M Management Senates Y Pctmon C~rculator=
N Newspape~ and Other Perto&ca] Advernsing Z PreparaUoD m~d Producnvn of {d~
Payee's Name and Payee's Comoxttee fda, Exp Amount of
Lzne ~ Date Check ~ if appticab!e Purpose Type ~xpend~ture Pa~d
(as ~t appeam on tnvoice receipt or check) to ~zP
s, S
See Page Totals (Add ~,11 expcn&mros W1Tt2 thc same Accomtt~ng Period Totals ~ Complete only ~or last page and
lnstr'uct~ons expenditure type,) transfer these amoums to the Summm¢' Stammem, PC 1 ~
Campmgn Cash (CA} $ ~;~ Cash (CA) S ~2 ~ ~- ;~
Manual Loan Payment{LP) S Loan Payment (LP~ $_
pc 3
PL 3A
Personal E×penditures for Reimbursement
Candidate o~ Potmcal Commltree Name: Co.mm~ttec ID Nb. tuber.
Electron: ~P~,mary 20 ? q_ ~ General 20 ~ Other
Report' ~Ist Pre-elecuon ~ 2nd Prc-elecnon ~ Post-elecn~n ~ 20 September Supplemental
PURPOSE CODES (see back ~f form f~r instrnetions and code definitions)
A Agent O Od~er Advemsmg iyardstgns, battons, etc
a Broadcast Ad,~emsmg{Rad~o. TV} P Postage
C Cash Contnbuuons S Smwe'~ s and Polls
F Ftmdra:smg Event Expenses T Travel Expenses (describe ~fo,ver
G GeneralOperanonal Expenses tdescnbe ~fvver S50~ U Utdihes
~ Interest Payment W Wages. Salaries. Ben¢dts
L L:emture, B~ochm'es, Prmnng Y Petmon C~rculaors
M Management Serwces Z Preparanon and Producnon of Adxemsmg
N Newspaper and Other Peno&calAdvemsmg
Amount of
bne # Date Payee's Name Purpese Expenmure
4 $
5. $
6 $
7 $
8 $
9 $
10, $
See Page Total A. ccuundng Period ~[ota[ tComplete only fbt last page and
Instructions ,', ct' ,.~'7. transfer th~s arnonnt to the Surmnary Statement. PC t
on Back and PersonalExpen&tures $ ~ &~> ....
m Campaign Personal Expert&rares
Finance
Manna1
PC 3A
PC 3 Axnendrae~rr
Amendments-Cash Expenditures and Loan Payments R~v ~:,03
Candidate or,Political ~;~ni[tee Name: Committee ID Number,
Elect,on: ~rima~ 20~ ~ General 20 ~ Other
Report: ~lst Pre-elect~on ~ 2nd Pre-elect~on ~ Post-elect~on ~ 20 September Supplemental
PL1~OSE CODES (see back of form for instructions and code definitions) EXPENDITU~
A Agent O Other Advertising (y~d s~s, bu~ons, etc ) CA Cash
B Broadcast Advemsmg (Radio, TV) P Postage LP Loan Payment
C Cash Contributions R Rem~bursement for Personal Expend~tm-es
F Fundra/s~ng Event Expenscs S S~eys and Polls
G General ~eranonal Expenses (describe if over $50) T Travel Expenses (describe if over $50)
I Interest Payment U Utd~ties
L L~terature, Brochures, Printing W Wages, Salaries, Benefits
M Management Se~mes Y Petition C~rculators
N Newspaper and Other Periodical Advemsing Z Prep~atton and Production of Advem~sing
Amending Page ~ Payee's Name and Payee ~ Committee I~, ~
and Line ~ Check ~ ¢f applicable Purpose Exp Amount of Pa~d
Date (as ~t appears on ¢nvo/ce, recect or check) Type Expendtture to ~P
~ New Entw
~Deletmg *
~New Entw ~ ,
~ Deleting $ ~
~4ew Entw
~ Deleting t $ ~
Page Line
~ New Entw
~ Correcting
~ Deleting $ ~
Page. Line !'~ ~' ¢
[] New Entry
[] Deleting ~
See FOR OFFICE USE ONLY
,ns~ct,ons ~~ ~~ RECEIVED
on Back and
in Campaign
Finance S~amre of candidate or treas~er
Manual APR 3 0 2004
¢, 30 CiTY RECORDER
Amen~ent Date si~ed
Summary Statement of Contributions and Expenditures
Please type or p~Snt legibly in black ink - Parc l
Candidate or Political Cotton(tree Name (use ~11 name): (*',
Ma/ling Address as it Appe~s on gtatemen~ of Orgmdzafion (su e% mute or box ~mnbcr, c~(v~ state~ z~p
Treasurer's Nm~e: . ~/'elephonc NumBer lda} ),
Contm/~ee ID Number: Committee ] ype. Measure Nmnber or Off'ce:
~Drigma}. ' ~Primmy 20 ~ Genera120~ ~ Other
~ Cmendmeiit *(~ ~st Pre-elect~on ~ 2nd P~e-elecdon L~ Post-elecnon L~ 20 September SuppLm~cntai
' .... A-I'OTAL$ FOR THIS B-~UMUL &TIVE I'OTAL~
ACCOU~'TING PERIOD FOR THIS FLKCT]O~
CONTgIBUT~ONS
Loans Recewed (Non*Exempt)
(Accounting Period Total flora PC 2)
3 Total Cash Conn'ibudons = /
4. ]n-Kind
~ (Accounting Period Total from ¢C 2) + ~ ~) .
(trees 3 + 4) ~ ~
(Accounting Period Total ~}'om PC 3)
7. Loan Payments (Non-Exempt) + ~ +
(Accmmtmg Period Total fi'om PC 3)
8 Total Cash Expenditures
In-Kind
+
(Accou~tlllg Period %<)mt fi'om PC 2) ~ +
to, TOTAL EXPENDITURES -
"CASH BALANCE
(hne 20 of previous repo~x) --~ FOR OFFICE USE ONLY
12 Total Contributmns
Other
Receipts ·
(Accommng Period Total fi'om PC 4A)
14. I.oans Recewed (Exempt) +
(Accounting Permd Totat ~kom PC 4A)
[5. CONTmBUTION SUBTOTAL14) =[ Z/-O{~
(bnes I 1 - 12 + 13 +
17, Other D~sbursements ~ ~ t. ,-~ ~,~ ~ ~'
(Accoummg Period Tota] I~om PC 4B)
18. Loan Paymems (Exempt) +
{Accounting Per~od Total tkom PC 4B)
(hnes 16-17+ 18) = ~- ~} } ~
(line 15 minus tine 19) = [ ,
PC
Summary Statement of Contribuiions and ×pendilures
Please type or print legibly m black u~. Page 2 of 2
Candidate or PolitmaI Commmee Name: ~ Cmr~ttee ID Number
~ Original ~ Primary 20 ~_ ~ General 20 ~ Other
LOAN SUmmARY FOR OFFICE USE ONLY
2 [ Bcghmmg OutstaYing
(Total Outstanding Loans fi'om prevmus repo~)
22. Loans Received ~omExempt) +
lhne 2)
23. Loans Received (Exempt) +
(hue 14)
24. LOANS ~CE1VED SUBTOTAL
{lines 2t + 22 -~ 23)
25. Loan Payments (NomExempt)
{line 7)
26. Loan Payments (Exempt) +
(hue 18)
27. Forgiven Loans +
(Total loans forgiven during th~s accounti~ pmmd)
28. LOAN PAYMENT SUBTOTAL
dines 25 - 26 +27)
29. TOTAL OUTSTANDING LOANS
(hue 24 minus hue 28)
PERSONAL EXPENDITURE SUMMARY
30Beginning Outstanding Personal Expendi~es
dine 36 ofprewous report)
3l. Personal Expenditures + / ~
tAccotmtmg Period Total fi*om PC 3Al ~ ~
32 PERSONAL EXPENDITU~ SUBTOTAL
(hnes30 +31) = / ~9 ..~
33 Personal Expenditure Reimbursements
(Total expenditures on PC 3 w~th purpose code R~
34 Forgiven Perso~ml Expendinwes +
(Total persona[ expenditures tbrg~ven th~s acctg period)
35. REtk~URSEMENT Sb~TOT~
(lh~es 33 + 34)
36. OUTST~N D~G PERSONAL E~KND,TU~S /
time 32 minus line 35) = [fi '
F~NANCIAL STATUS AT CLOSE OF ACCOUNTING
37. Ending Cash Balance ~)
38. Accounts Receivable
(Accosting Period Fotal from PC 5)
39. SUBTOTAL = ~ ~
40. Total Outstanding Loans ~
(line 29)
41. Outstanding Personal Expenditures
42. Accounts Payable +
{Accosting Per~od Total fi-om PC 6)
43. SUBTOTAL
dines40~-41+42) = /rl~ . ~ , .
dine 39 minus line 43 mdmate + or- balanc~e) ~ ., /GL. Z
L / ~,/~' ~ ,,.,,," ~5~ ~/(0 ~, (name of can&date or treasurer), hereby ccm fy tha the abc-ye
state~ent and the attached suppomng reports a~d tree and correct.
PC 2 ~\m,_-dment
Amendments-Cash Contributions, Loans Neceived and n-Kind
Can&date or Pohtical Comm::ee Name: ~ Committee iD Number'
~0,~ ' 20
Report L~st P~e-ciect',on [~ 2nd Pre-elecnon [~ Post-elect~on ~ 2{; %eptember Suppiemental
SEE BACK FOR ~NSTRUCT~[ONS AND CODE DEF~N[TIlONS
CODE ~: Contributor Type CODE 2: Contribution Type
B Business Entl~< CA Cash
C PohdcM Commzttec (includes business and umon PACs) CO Cosigner Obhgat]on
F CandMate's lrnmedmte Famdy (includes candMa'~) [K ~n-Kmd
~ [n&wdu~i LP. Loan Received
L Labo~ Orgmnzat~on
O Other
P Poht~ca[ Pa~,y Committee
Amen&ng Pa~e # ~ame and Address of Contributor Amount of In-K~nd Purpose
and Dne # Contribution (see manual for,suggested purpose codes)
Date Received Occupational Information or Contnbutor Code ? Code 2
ContnDuting Committee's ID~ A99regate
Pag~
$,New' Eatry
Correcung $
De,etmg
$
[72 New Entry
El] Deleting
Correctmg
Page_ Dne
[] New Em. fy $
[] Correcting
[[] Deleting
$
/? FOR OFF~CE USE ONLY
on 9:ok ::d
Pm&nee $~gnature of candidate or truasure~
.(
Amendment Date s~gned
Amendments-Cash Expenditures ann Loan Payments
Candidate or~Poht~caI Co~}~¥ec Name...
, , ~ ¢7~ :(~(/ [C[/ C°mnn~te~iDNumbcr:
R:pon ~i st Pre--el¢cnon ~ 2nd Prc-clcct~o: ~ Post-elect~on ~ 20 Sept:robe: Suppicmemal
PURPOSE CODES {see back of form I~r instructioas and code definitions} EXPENDIT[~RE
A .&gent O Other Ad; erasing- ¢ymd s~gms, buttons, crc } CA Cash
B Broadcast~ Axcrusme (Ra&o. TV) P Postage LP Lean Pa*ment
C Cash Contnbut~ol~s R Rem~burscmcnt io~ Persona Expendm~e~,
F Fundra~smg Event Expenses S Surx cys and Polk,
G G:netal Opemnonal Expcases~descnbc ~lo, cr $50~ T Traxel Expenses (descrme tfoxct S50t
[ lmeres~ Payment U
L L~terature. B~ochurcs, Prmrmg W Wages, Salaries.
M Management Ser~ Kes 5' Petmon C:culalor'_,
N Newspaper ~md Other Periodical Adxemsm~ Z P~eparauon and Producuop eFAdx
Amending Page ~ Payee's Name and Payee b Committee I~, Sxp Amour: of
and L~ne ~ Check ~ ' if appflcable Purpose Type Expend~[ure Pa~d
Pale (as ~[ appeam on m~ome, receipt or check) to
Page / Llpe~_
~ New Ent~
~ Deleting
C~ag~__ LID~
New Entry
Cerrecang
De:er,ng
See FOR OFFICE USE ONLY
Instruction:, ,~i /
:': " ' EC !VE9
Finance S~gnatme o~ candidate or treasurer
Amendment Date s~gned
Amendments- Persona Expenditures for Reimbursement
Can&date or Polmcal Comrmrtee Name' Committee ID Number:
Page
Report: ~t Pre-elecuon ~ 2nd Pre-elect~on ~ Post-electKm ~ 20_ September Supplemental
PURPOSE CODES (see back of form hr instructions and code definitions)
A Agent O Other Advemsmg ~yard s~gns, buttons, etc )
B Broadcast Advemsmg/Ra&o, 7V~ P Postage
C Cash Contnbunons S Surveys and Polls
F Ftmdra~smg Event Expenses T Travel Expenses idescnbc if over 550)
G GeneralOperauonalExpenses (describe i~over 550) U Utdmes
I Interest Paymem W Wages, Satanes, Benefits
L L~terature, Brochures, Pnntmg Y Petmon Cnculators
M Management Serwce> Z Preparauon and Producnon of Advemsmg
N Newspaper and Other Peno&catAdve~ismg
Ame,dtng Page ~
and brio ~ Amount of
Payee's Name Purpose Expenditure
Date
Page~.L_
L,pe~
Pag~ L~ne
~ New
~ Deleting
Page. Line
~ hJew Entry
[] Correcting
~ De!et P9 $
Page__ L~ne
[] New Entpy
[71 Correcting
~ Detenng
Page_ L,ne
[] New Entry
[] Correcting
[] Delenng
m Campa, gn ~- ~5 ~'L~ /
Finance S~gnatme ot can&date or treasurer
Manual
PC3A
Amendment Date s~gned
Summary ,¢atement of Contributions Expenditures
Please type or print legibly m black J~k Page 1 of
Candidate or Potincal Co~ttee Name (use ~11 ~e ~:
Ma~ling Address as it Appears on Statement of' OrgamZation i street, route or box number, c~tv, state, z~p code ~:
Con~ttee ID Nm2ber: Committee Type. Measure Namber or Of'rice'
~ Original ~, ~nm~ 20 ~ ~/ E General 20 ~ ~ Other
~x. mendm~i{~" ,~ st Pre-elect,on E 2nd Pre-election E Post-e!ectton E 20__ Septcmoer Supplemental
A-TOTALS FOR Tills B-CUiI~U LATIVE TOTALS
ACCOUNTING PER~OB FOR T~IS ELECTION
CONTR[BUTIONS
1, Cash Comnbut~ons
,Accommng Period Total flora PC 2) ~ ~ {~
2 Loans Received{Non-Exempt) + ~ +
(Accounting Period Total flora PC 2~
3. Total Cash Contributions
4. Jrt-Kind +
(Accounting Period Total Oom PC 2) ~ ~:
5 TOTAL CONT~BUTIONS
EXPENDITURES
6, Cash Expenditures
,.~.ccountmg Period Total l¢om PC 3) ~ '7 q' /, } ~
7. Loan Payments (Non-Exempt) + +
(Accotmtmg Period Total from PC 3)
~ Totat Cash Expert&rares
9. ~n*Kind + +
(Accounting Pm'md Total/rom PC 21 ~6' ~ C (,
10. 'rOTtL EXPENDITURES
CASH BALANCE
11. Beginning Cash Balance
~hne 20 of prev~ou~ repoa) ~ FOR OFFICE USE ONLY
12 Total Contrtbunons
13, Other Receipts +
(Accounting Period Total flora PC 4A)
14. Loans Received (Exempt) +
~Accountmg Pmnod Total ~rom PC
15, CONTRIBUTION SUBTOTAL
~lmesll*12-13+14) = l q C~ ~, ,
16, Total Expenditures
17, Other D~sbursements +
(Accounting Pmqod Total from PC 4B) ~.
I8. Loan Payments ~Exempt) + . -
tAccounnng Period Total fi'om PC 4B)
19 EXPENDITURE SUBTOTAL
20. ENDING CASH BALANCE
Summary Statement of Contributions and Expenditures
Pkase type or print tegfbb~ in black mk. Pngc 2 of 2
Candida~,?t~ Political Cq~g!~tt¢ Nabae:
mendment t Pre-electron ~ 2nd Pre-elcct~on ~] Post-electK, n ~] September Suppl~mentat
LOAN SUmmARY
2 t. Beginmng Outstanding Loans - FOR OFFICE USE ONLY
tTotal Outstanding Loans ~om prewous report)
22. Loans Recewed (Non-Exempt)
(hue 2) +
23 Loans Recezved (Exempt)
(lzne 14) +
24 LOANS ~CEIVED SUBTOTAL
0mcs 21 *- 22 + 23)
25, l,oan Payments (Non-Exempt)
( [me 7)
26. Loan Payments (Exempt)
(hue 18) +
2% Forgzs, en Loans
+
(Total lomns forgiven during tins accotmtmg penod}
28, LO.&N PAYMENT SUBTOTAl,,
(hues 25 + 26 ~27) =
29. TOTAL OUTSTANDING LOANS
{1 me 24 minus hne 281 =
PERSONAL EXPENDITURE SUmmArY
30. Beginning Outstanding Personal Expenditm'es
(hue 30 ofprev~ous report)
31. Personal Expert&rares
tAccountmg Period Total from PC 3A) + /~ ~ 5~ ~
2,, PERSONAL EXPENDITU~ SUBTOTAL
33, Personal Expert&rare Re~mbm'sements
(Total expert&rares on PC 3 with pu~ose code Ri
34 Forgwen Personal Expen&tm'es +
~ Fotal persoua] expendz~res forgiven this acctg, period}
35. ~I~URSE~NT SUBTOTAL
(hues 33 - 34~ =
36, OUTST~D~C PERSONAL E~END~TURES ~9I / [' 5 d
(~ne 32 minus hue 35) =
FINANCIAL STATUS AT CLOSE OF ACCOUNTING PERIOD
37, Ending Cash Balance
38 Accounts Receivable
(Accounting Period Total horn PC 5~ ~
39. SUBTOTAL
40. Total Outstanding Loans
thne 29)
4 I. Outstanding Personal Expendk~es
(hue36) + / 0 , 5~ 0
42, Accounts Payable
(Accounting Period Total ~om PC 61 +
43, SUBTOTAL
ihnes40 +41 +42) = /~; ~ 5-
(hue 39 minus hue 43' indicate + or- balance) = 5 ? ~: f~ 3
statement and the attached supporting reports are true and con'em,
Amendments-Cash Expenditures and Loan Payments
Candidate or polmcal Commfttc~ Nan,:
¢~ ~ , , '~ ~ ,~,~ Commmec [D Number:
Electm~' ~-Pdma~, ~0~' ~
Report: ~lst Pre-elecnon ~ 2nd Pre-electron ~ Po,t-election ~ 20~_ S~ptember Suppt~mcntaI
PURPOSE CODES (see back of form for instructions and code definitions~ EXPENDITURE
A Agent 0 Other Advem~,mg (ya~-d s~s. buttons, etc.) C,k Cash
B Broadcast Advertising (Radio, TV~ P Postage LP Loan Pavmem
C Cash Contributions R Reimbursement fbrPersonA Expenditures
F Fundrmsing Event Expenses S Surveys and Polls
G GeneralOpemtionalExpenses(descnbeifoverSS0} T Traxd Expenses tdescrJbc ~fover
1 Interest Paymom U Ut~lmes
L Literature, Brochures, Printing W Wages, Salm~cs, Benelits
M Management Services Y Petition Cn'culators
N New?aper and Other PeriodicaiAdvenismg Z Preparation and Producnon oFAdxem~mg
Amending Page ~
and Line ~ Payee's Name and Payee ~ Oomm/t~ee f~, ,
-~ Exp Amount of
Check ~ tf applicable Purpose Type Expend~tuze Paid
Date (as ]t appears on ~nvo~ce receipt or check~ to A/P
Page .... k lne__ _
New Entry
CorrecTing
Page ___ Line
[] New Entry
~ Correcting
[] Deleting
Page ....... bne___ ,
[] New Ent~
[] Correct,rg
[] Deietlqg $
Page L~oe
BI New Entry
[] Correceng
[] Deleting
Sec FOR OFFICE USE ONLY
]ItstrLlcttorts
on Back and '~ ~ ' *' /
Finance Signature of can&date or treasurer
Manual
PC3
Amendment Date s~gned
Summary tatement of Contributions and Expenditures
Piea~e [ype or pnnt lembly m black mk Pa~e I ~-~
Can&date or Po/meal Cpmrmttce Name (use Attl name)'
Mmhng A&h es: a: ~t Appea~s on St:tement of ~)rgamzat~on (s/reeL rouXe o~ bo~ number, cky. ~ta~e. z~p cod~ ~.
Treasure; s Name, ~ Tekphone Number ~da} y
Comm~aCe 1D N:mbe:: Cmm~ittee ~[y~e. Measure Number ot
~ Amendment ~ 1 st Pre-decuon ~nd Pre-etecnon ~ Post-elect,on ~ 20 September Supplemental
A-TOTALS FOR THfS B-CUMt,LATIVE TO'I ALS
ACCOUNTING PE~OD FOR Tf-flS ELECTION
GONT~}BDT}0NS
1. Ca=i~ Contnbuuons
(Accounting Period Tota~ fioni PC 2~ ~'7(x % ~-- ~ I ~,~' f
2, LoansRecer, ed(Non-Exenp9 + +
(Accotmtmg Period Total Nora PC 21
i ~ otA Cash Contnbtmons = ~-' , ,..
4 In-Kind + + 72,'
{Acco=ntmg Pcnoo 7otal tram PC 2~
5 TOTAL CONTRIBUTIONS = "~ -/ 7' <7- . .... =?' ?-0 ' ~
EXPEND{TURES
6. Cash E>.pend:m-~s ~ , ~ , .~ .:
(AccountmgPenodTotalfromPCS~ /" C k~ ~L V / 7 ~'-< ,. ~-~
7 LoanPaymcn~s (Non-Exempt;, + +
t Accountmg Peno~ Total ikom PC 5)
8, Total Cash Expen&turcs = = ~ -? v
9. In-Kind . ..... + :, ,7
(Acco:ntmg Period Total from P( 2~
10, IOTAL EXPENDITURES = : ~ ¢ Q
CASH BALANCE
11 Beginning Cash Balance
..... :, :-~> FOR OFF~CE USE ONLY
[2. Total Contributions . ~
/ hne 5 )
[3. Othct Receipts +
tAccountmg Pcr~od Total fi'om PC 4A}
14. Loans Recerved ~ Exempt} . ~ ~
¢Avcountmg Period Total from PC
15. CONTRIBUTION SUBTOTAL = .. (~ 4~
16 Total Expenditures
17. Other D~s'bursements +
(Accounting Period Total from PC 4B) ~]i}~[. O.
18. Loan Paymcnt~ (Exempt)
( Accounting Period Total fi'om PC 4B ~
19 EXPENDITURE SUBTOTAL 0JT~'
itme 15 :mnu~ hnc lO)
Summary tatement of Contributions and Expenditures
Can&dat~or~o~mcal Cg~n~tte¢ Nm~: ~
~ Amendment ~ i< Pre-elcO. ion ~ Pte-elecuon
LOAN SUMMARY
21~ B~lnmng Oat~tandmg Lo~m~ FOR OFF~CE USE ONLY
22. Loans Rccmx ed (Non-Exempt) +
~lm¢ 2 )
23 Lv,ms Reccp.,cd tExcmpt)
(line ~4)
_.. L 3AN~ RECEIVED SUBTOTAL
25 Loan Payments
26 Loan Payments (Exempt~ +
27 F~,~given Lo,m~
22 L JAN PAYMENT ~U~ JI~L
29 TOTAL OUTSTANDING LOANS
PEtSONaL EXPENBffU~E
30 Bc~mmag Oarstan&ng Pets,mol Expenditures
(hnc 3o ofpremoas ~cport}
{Accotmtmg Period Total from PC 3A)
32. PERSONAL EXPENDITURE SUBTOTAL
33 Pe:scn2l E~pcn&tu~¢ Rmmbuvsemcnts
{ Tota~ ,.xpcnd~turcs on PC 3 ,~ nh polpose t,3dc R)
34. [orgxxen Personal Expert&rares +
('f~,ta! personal expcn&ture, lorgn cn th~ acctg period}
35 P~JMBURSEMENJ SUBTOTAL
~tme: 33 - 34)
36OUTSTANDING PERSONAL
EXPENDITURES
F~NANCIAL STATUS AT CLOSE OF ACCOUNTING PER~OD
3z End:n:~ Cash BaLmce
38. Accounts Receivable +
39. SUBTOTAL
,10TotaiOtttstanding Loans
(line 29~
4 t Outstaadmg Personal E,..pcndimres
42. Accounts Payable
{Ac~ou2rmg Pertod Total Irom PC 6)
43 SUBTOTAL
44 BALANCE/DEFICiT
{linc 39 mmu~ l;m: 43 red, cate + ~r - oamncc}
, ' _ i ~'l t ~ ~~" , ~._ ~ (name of can&date or a'casm'crL hereby cz. mi,, dmi thc above
statement and d:e attached supporting repons are tree and .mTect
51~aamre vi' can&d~_tc or trcas.tl'cF Date s~ned
PC
Cash C ntdbutions, Loans Received and in-Kind
Can&date or Pohdcai Canto:tree Name. / Camm:tree ~D
Report: ~ 1st PFe-eiccnon ~2nd Pr¢-decnon ~ Post-elect~on ~ 20~ Sep[embe~ Supplemental
SEE BACK FOR INSTRUCT]ONS AND CODE DEFINITIONS
CODE ~: Contdbuto~ Type CODE 2: Contribution Type
B B~me~s Enuty CA
C Pulmcal C'ommmee ~mcludes b~smess and umon PACs) CO Cosigner Obhgat~on
5 Can&date's immediate Famdy (includes can&date) IK [r,-Kmd
[ ind~wdua~ LR Loan Received
L Labor Orgamzat~on
O Other
P Polmcat Party Con~mee
Amount cf I~-K;nd Purpose
Lee ff Name and Address of Oontnbutor
Contribution (see manual For suggested purpose codes]
Date Received Occupational ~nforrnat~on or Oont ~bu~or C~de ? Code 2
Contributing Committee's ID~ Aggregate
See Page Totals tAdd a11 amounb ;wth the same Accounting Period T~tals (Complete on15 ~br last page and
Insrrucnons contnbutton type. Do not include aggregaresJ transfkr these amonnts to the Summary Statement. PC
m Campaign C'~J: (CA} $ ~ :, ~'. Cash ~CA~ ~ .
Finance
Manual In-Kind (IK~ $ In-Kind dK) $
PC 2 Loans Retorted (LR} $ Loans Received fLR) $
Cash Expenditures and Loan
Rzport ~Cj ist Pic-clcuuon ~sd Pre-elcct~on ~ Posr-elc,.t~on ~ 20 September Supplcmcmal
PURPOSE CODES (ste back of lbrm far instructions and code definitions) EXPENDITURE TYPES
A A<ent O Other Ad; em, in-~ =/y'x'd.
g B;c, adcas, t Adscmsmg f R~(ho. TV; P Postage LP Loan P:gment
F ~un,JieXSmB E~cut Lxpen~es S Storeys and Polls
() Gz-nrr. l OT,e,'.'.:~ona~ L.~pm~es ~dcscnbe if o~er 550~ T Tm~ el Expensc~ 'describe
] %}'ee s Name and Payee s Comm,,ttee ID#,
L ~ne ~ Date Check ~ ,4 appf,,cable Purpose Type ExoeqCt~re Pa~d
fas ,t appears on ~nvo~ce, receipt or check)
%.~ Page I-o~ag ~,Add all c.,:pend:tu~,e~
! r,~tru,: tmr,~, e.,.pend;t~rc
on Back and
Ni~nt~m Loan Paymunt
PC 3
Summary tatement of Contributions a, d Expenditures
Please ~pe or print legibly in black ~nk~ Page 1 o~
C~ndi~am or Political Cm~ittee ?me (use flail nmne):
Matlhxg Ad~ss as ~t Appe~s on Statement,of O[~amzat~on fstreet, rontc or box number, chy, s!ate, zip eodp):
Na~e:
~: Telephone Number tday)'
Comminee ID Number: { Committee T>~,e. Measure Number m'
_~%rnendment ~ !st Pre-election ~nd Pre-elecnon ~ Post-elect:co ~ 20 .... Septembc~ Suppicmcnlat
A-TOTAl ,$ FOR THIS B~-CUI~U L ~1 I~-E
ACCOUNTING PERIOD POR THIS ELECTIO~
CONTRIBUTIONS
1, Cash Conmbudons :~ ~<~ ~. ,~ .~ ~/' /
2. Loans Received (Non-Exempt) +
(Accounting Pe~%d Tomt from PC 2)
3. Total Cash Conn'ibutions
4. tn-Kind . + 2~ ~
(Accounting Permd Total fi'om PC 2~ ? "-'
TOTAL CONTRIBUTIONS .....
6, Cash Expenditures /
5 Loan Payments (Non-Exempt) + +
(Accmmtmg Period To~al fi'om PC 3)
8(hnesT°tat 6Cash+ 7) Expenditures =~ / [ c '~< ,/- -7 = [ T/ <,., ?,
9.
(Accosting Period Total fi'om PC 2) .........
~0. TOTAL EXPENDrrURES
(hnes 8 - 9) / ~
CASH BALANCE
1 L Beginning Cash Balance
(line 20 ofprev~ous r~ot~) 9 Q L{~ %, ? FOR OFFICE US~ ONLY
t2 Total Contributions .
(hne5~ _ ~55 > '
13. O~er Receipts +
(Accoummg Permd Total fi'om PC 4A)
14, Loaas Received (Exempt) +
(Accounting Pertod Tota~ from PC 4A)
15. CONTRIBUTION SUBTOTAL ~_~ ,'
(hnesll+12+13+14) =~'~ ~ ~ ~ j~ '~
16 Tomi gxpend~l~rek
(Accotmlmg Period Total l~om PC 4B)
l 8, Lo~ Payments (Exempt) · ~ ',' 5 ~ , '~..
(Aecoummg Period Total ~om PC
19. EXPENDITURE SUBTOTAL .
t t ment of Contributions
Please type or pnrt leglolF m b ,~:ck ip2. Page
Candidate or Poiit, cal C ~ m ...... e ~,~mc.
~ Or}g~nat ~ ~:r~ma&: 20 ~ ~ ~ General 20
~mendment ~ ~st ?ze-er%t~c~ :~d Pre-eiection
~, . F¢~F~,C~ USE ONLY
2!. Beg~¢ming Outst~n&rg Losn~
(kne 29 of pzev;cus '*open)
22. Loans Rece:ved (Non-Ex~mot~
(lbo 2)
23.emeLcansl4iReceived (Ex:rapt) + ' " ,, ;~ ( :5 * .: ;, '-' '
24. LOANS RECiEITED SU970TAL
25. Loan Payments (Non-Exem~;
(hPe 7}
26. Loan P~.vmcnts 1:'
( ine 18 } } "
27. ~org;ven Low~s
+
(Total trams Pn gwct; d a: ,wA 7 ~s ~ccounting period)
~8. LOAN PAYMENT SUBTOTAL
.fhnes 25 = 25 027) { =
29. TOTAL OUTST~4Bi);G LOANS }
(~re 24 minus hre 28) ~ =
:=:E~O~%L EXPENDITURE SUMMARY ,.
30. E;egirning Omstm%dmg F:rsca~ Expenditures { ,. ;: , ,,
(!me 36 oi prcw ~us -e~u~; i / '-
3 l. Fersonal E~ pendi~es '
32. PERSONAL EXPE?CZ}T%TLE SUBTOTAL
33. Personal Expenditure Re~mbrrsements
(Tota~ expeadttures on 5C 5 v, tt~ ?u¢ose code R)
34. Forgtven ?ersonaI Zxp%,ditz:ss +
(Total personal ,zxp~nditar~s )c; given th:s acctg, period)
35. gZIMB~S~t IEN ~
(Iktes 33 + 3t) =
F~N ~,t;C~gL '~T,QTL3 LT CLOS~ OF ACCOUNTING PERDD ,
37. Ending Cas5 B~b::c~,
38, Accounts P, ec~,v¢, l .... -'
(Account~t g Pe~,od To:al Pram PC 5) + ~ ~ '~ ' ' '
39. SUBTOTAL
40. Total Out'xtandi~g ,..o~os
(h,~c 29)
4 I. Cutstand53g Personal :=~ "-,.,~,-.-,~. di 'u~es ;
(2rio 36>
42. Accounts Pas'able }+
43. SUBTOTAL f :-': '" ': ' '
(hne 39 m:,~us line 43. indicate -~ ct-bo:once) , =
L.-,~ ~. ~ ~ % L~t (nam~ of candidate or ~'easurer), ;:ereby;ce~J(v that ere above
statement mhd ;he aila&ed suFpmtJng repo~s are mae and co.oct.
Stgnal~re of cend]date or Veasv~el Date
p~ t
"~'['p.' 5 ~ 's - - , ' c-- ~'xe~rem of Orgamzatmr: (street. route or*:ox m.m ,er .fit}. ~tat. e. z:p code)'
1
, ' u,nm.iu:,~ I'x ', , j Comm~Ree Tvp~, Measm'e Number o~
' ~ 'l":~i{~,i~'" , :'- ": = '~/ ,*~_: 020 =
m~ 5,
,, ,',x.,.c 'nt~q 4 , , - -' .'C
fi..C~x"~ ?Id r:-'---4,. = ~.d~ or~-
.......................... RECEIVE
qr,' 1(: ',,
Please ~,,'p~. o:' p:a: :,~ ~= .... ~,: n b ack ~nk.Pa~e~- _~ o~_
Candidate or Po 'tic zl _ o~ ~ .... ee Name. Committee ID Number:
_~ Amer. dm,mt~ ~-:' ',_ 'q~-e,ec:~o=' ~ znd' .Pre-elect~on' ~est'eiccdc~ ~ 20 . September Supplemental
LOAN SUmmARY
21. Beginning ..u,stx':m: % L')~ns FO~ OFF~CE USE ONLY
22 Looms Rcce ,, ed C',
(hn~ 2~ +
23. Loans Rote: eu ,.k.,c
24. LOANS KECEF,: E:; SU3TOr'AL
25 Loa~ Payments ¢ Ex ~ :17
28. LOAN ,~.v.z ............. L
= 0%0
(hr<:, 25 ' 2( +7
29. TOTAL OUT,Fi .T>, _; g LOANS
= C.C0
::'5 ~:$O}~AL EXPEND}TU~E SUmmARY
?0. Beginrip¢ Ox:s ~;c;,.',: Z:sc.r.a¢ Expenditures
3 t. Per,,o 'ad Ex[ e:.,f,;.t:<_-
+
(Aco>unt ng r'372- J '"~ ....... f' ,m ?C 3A~
~3. Pzr:n~a~ Ex:er,:':t~e ':'-mb:,rsements
(Toh I exFzrd h:':s ~,' ~ 7: v':th purpose code R)
34. Forgn'en Pe,'son~ ~ 5':;'~-~5 ?:~s +
( Fol:! ~:,tm,' c- 3¢n:I'. r. ,.' ~1'%h en this acctg, period)
36. OUTST,%~z~F :q; T~T',~"N~'& EXPEN~TU~S
= C 0.c0
thee 32 m,ws ~ 7.
F'~ ~ :Pi'-.,,./... q FATUS A,T CLOSE OF ACCOUNTING PER~OD
(bp< 2~ ) O.C0
f 'kc,zo'mt ng 1':,>:, ' -',1 , :~')m "C 5)
39 S [ 13TO T' 4 _
= ;' C 30
ftm~s 37 ~- 38,
42. Account., Pa)az e
(Acc,,un, ng Psr.~ :. ~-x f-.,.m ?C 5, +
43. SLr.]O. q = :' C ¢0~,
(hms,49-- 4' e ~-'
= 0 C0
fl:nc.~9 ~.m ~, 1--,~ ~,.': -,: cs. tz - er - bai~ce)
stateme~: am; th= gGf ....... ,,,.~ ~t Fscrt:~g repons are true and correct.
' 4 ' . ' / /
R Reimbursement for PeTsv'~a!
5~s S Suweys and Polls
,:cai :,.d',e~ising Z Pr~aralion avd Prod;sct~: i~ o¢
$ L_
, ,% aiz expcndltpres wkh the sa:me ~ Aceour:~f~_ 7adod Tgla~s/~-'~:~tp ere ~,~ty rbr ~ast page' ~r~
; Cash pr" ~ , c'
"' :'. ,-~:,~:-~e :includes business and unio~ P~Cs~ 20
~ F : - :.' , :, n*,~i~te =emily (includes cmdk~te} '< t~-'~ ~nd
' : -'-, : LR Loav RccziwJ
;;~ ~ _,St t5 ~5 f J ail amounts wfth the same
h}strt, ct'o :, ,.., ~ ::~ ,.: .~. m. not include aggregstes.}
['. '- ,-t. ~ 2rd Pre-election
gACK 7,.:F ',' ': ~:~A~:D CODE
:2 ] ~ (~'_~ k:des hush,ess and unioa PACs)
: ", ~ ' ~t~ :~mi:y (includes candidate)
,~txccr'~
l ,ns ¢ ~u ...... ~ :/~ ,' ':~,~ ma~ua~ fo,' suggested putDose codes)
~'~ "¢:':' : Scc'e f [ Ssde2
Re~:,~:~ 6: "' : ~ i':,r ~ .?formation o: '
,: .... : ~,m~ C,::wmi~ee s IS~ ,~g']rcFav :
S
act u,~
chr'g
s
FOR