HomeMy WebLinkAboutScott Meisner for City Council PC
Summary _latement of Contributions. nd Expenditures Rev 1~0~
Please type or print legibly in black ink. Page 1 of 2
Candidate or Political Committee Name (usc full name):K~o,./.~ Pi~ ~_i 5 ,q ~/.jg_.. ~ C iT't/ ~x9o/4
Mailing Address as it Appears on Statement of Organization (street, route or box number, city, state, zip code):
Telephone Number (day):
Treasurer's Name: ~/~'/a~O /~, ~Jd-~l.d-~t~___./4/0,~ g~-'iYt°3'-~(t'~''~$'*~t-')
- tot'7
Committee ID Number: Commmee Type, Measure Number or Office:
,v[,4 c/b,, ? ,~ ,,~
Original [~erimary 20 Ow [] General 20 [] Other
Amendment ~ 1 st Pre-election [] 2nd Pre-election [] Post-election [] 20 September Supplemental
A-TOTALS FOR TItlS B-CUMULATIVE TOTALS
ACCOUNTING PERIOD FOR THIS ELECTION
CONTRIBUTIONS
1. Cash Con~butions lq,'z3o - ,,' cf, ~;o - '
(Accounting Period Total from PC 2)
2. Loans Received (Non-Exempt) 4- +
(Accounting Period Total from PC 2)
3. T otal(hnes l+Cash2) Contributions = ~g ql~2,__~ -- ~ = k~! ~2--')~ --
4. In-Kind + ~'7.-9, ~'""/ + ~-~'7.
(Accounting Period Total from PC 2)
s. TOT~ CONTInUaTiONS -- ~ ~ 'Zff. ~-? -- q?~ Z3"XT,
(lines 3 + 4)
EXPENDITURES
6. Cash Expenditures ~- ,,_~ ~ ~'
(Accounting Period Total from PC 3) '
7. Loan Payments (Non-Exempt) + +
(Accounting Period Total from PC 3)
a. Total Cash Expenditures = ~ ~50~
(lines 6 + 7)
(Accounting Penod Total from PC 2) c
10. TOTAL EXPENDITURES : S 3 ~,~". g~'~ = '~'L~
(lines 8 + 9)
CASH BALANCE
11. Beginning Cash Balance
FOR
OFFICE
USE
ONLY
(hne 20 of prev,ous report) k.~ ~\C~
12. Total Contributions +
(line 5) ?, ~"~'~° '~'~
13. Other Receipts
(AccounUng Period Total from PC 4A)
14. Loans Received (Exempt) +
(Accounting Period Total from PC 4A)
15. CONTRIBUTION SUBTOTAL = q -~'fJ'7, ~"'9
(lines II * 12 + 13 + 14)
16. Total Expenditures
17. Other Disbursements +
(Accounting Period Total from PC 4B)
18. Loan Payments (Exempt) +
(Accounung Period Total from PC 4B) APR 1 2 2004
19. EXPENDITURE SUBTOTAL = "~"b t'"' ,~-"~ "
(lines 16 + ¥',+ la) -', --" CIIY REG0flDER
20. ENDING CASH BALANCE = t~ ~ .-, t
(hne 15 minus line 19) 3 (
PC 1
Summary ,tatement of Contributions .nd Expenditures
Please type or print legibly in black ink. Page 2 of 2
Candidate or PohUcal Committee Name: Committee ID Number:
[] Original ]~.Pnmary 20 OF [] General 20 [] Other
[] Amendment ~st Pre-election [] 2nd Pre-election [] Post-election [] 20... September Supplemental
LOAN SUMMARY
21. Beginmng Outstanding Loans FOR OFFICE USE ONLY
(line 29 of previous report)
22. Loans Received (Non-Exempt) +
(line 2)
23. Loans Received (Exempt) +
(line 14)
24. LOANS RECEIVED SUBTOTAL
(lines 21 + 22 + 23) =
25. Loan Payments (Non-Exempt)
(line 7)
26. Loan Payments (Exempt) +
(line 18)
27. Forgiven Loans
+
(Total loans forgiven dunng this accounting period)
28. LOAN PAYMENT SUBTOTAL
(lines 25 + 26 +27)
29. TOTAL OUTSTANDING LOANS
(hne 24 m~nus hne 28) =
PERSONAL EXPENDITURE SUMMARY
30. Beginning Outstanding Personal Expenditures
(hne 36 of prewous report)
31. Personal Expenditures +
(Accounting Period Total from PC 3A)
32. PERSONAL EXPENDITURE SUBTOTAL
(lines 30 + 31)
33. Personal Expenditure Reimbursements
(Total expenditures on PC 3 with purpose code R)
34. Forgiven Personal Expenditures +
(Total personal expenditures forgiven this acctg, period)
35. REIMBURSEMENT SUBTOTAL
(lines 33 + 34)
36. OUTSTANDING PERSONAL
EXPENDITURES =
FINANCIAL STATUS AT CLOSE OF ACCOUNTING PERIOD
37. Ending Cash Balance
(line 20)
38. Accounts Receivable
(Accounting Period Total from PC 5) +
39. SUBTOTAL
(lines 37 + 38) =
40. Total Outstanding Loans
(hne 29, O . RECEIVED
41. Outstanding Personal Expenditures +
(hne 36)
42. Accounts Payable APR 1 2004
(Accounting Period Total from PC 6) +
43. SUBTOTAL
(lines 40 + 41 + 42) =
44. BALANCE/DEFICIT
(line 39 minus hne 43 indicate + or- balance) =
I, ~'~ /4~/ ~/~//ffOCMd t ~ ~ (name of candidate r trr ~~~rr'r_j) hereby certify that the above
statement and the attached supporting/reports are true and correct.
S~gn ture of candidateQ'~treasurer~/ / Date signed
PC 2
Cash C ,ntributions, Loans Receiw. u and In-Kind Rev. 12/03
Candidate or Political Committee Name: Committee ID Number:
ElecUon: ~Pnmary 20 Oc( [] 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 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 /n-Kind Purpose
Line # Name and Address of Contributor
Contribution (see manual for suggested purpose codes)
Date Received Occupational Information or Contributor Code 1 Code 2
Contributing Committee's ID~ Aggregate
See Page Totals (Add all amounts wi~ the same Accounting Period Totals (Complete only for last page and
Ins~ctions conmbution ~e. Do not include ag~egates.) ~ansfer ~ese amounts to ~e Su~aw Statement, PC 1.)
on Back and
in Campm~ Cash (CA) $ ~0 Cash (CA) $
Fin~ce Enter on
M~ual In-~nd (IK) $ In-Kind (IK) $
~ntar on Su~ Stat~mant, Col~ A, Lines 4 ~d 9
PC 2 Lo~s Received (LR) $ ~ Loans Received (LR) $
~nmr on S~ S~tement, Col~ ~ Line 2
PC2[
Cash Cuntributions, Loans Receiw and In-Kind Rev
Candidate or Pohtical Comnuttee Name: Committee ID Number:
~C.~'[~ ~J/L'q.4~L ~ C~ C~~ ~ Page ~of~
Election: ~Pnm~ 20 O g ~ General 20 U Other
Repo~: ~ 1 st Pre-election ~ 2nd Pre-election ~ Post-electron ~ 20~ September Supplemental
SEE BACK FOR INSTRUCTIONS AND CODE DEFINITIONS
CODE 1: Contributor Type CODE 2: Contribution Type
B Business Enti~ CA Cash
C Political Co~i~ee (includes business ~d union PACs) CO Cost.er Obligatmn
F C~di~te's ~ediate Family (includes candidate) IK In-~nd
I Indiwdual LR Loan Received
L Labor Org~ization
O O~er
P Political Pa~ Co~i~ee
Amount of In-Kind Pu~ose
Line ~ Name and Address of Contributor
Contribution (see manual for suggested purpose codes)
Occupational Information or Contributor Code 1 Code 2
Date Received Contributing Commi~ee's I~ Aggregate
See Page Totals (Add all a~o~ts wi~ ~e sine Accounting Period Totals (Complete only for last page and
hs~ctions con~ibution ~e. Do not hclude ag~egates.) ~ansfer ~ese amounts to the S~a~ Statement, PC 1.)
on Back and ~D ~
in Cmpm~ Cash (CA) $ Cash (CA) $
Enter on S~ Statement, Col~ A, Line [
F~ce
M~ual In-~d (IK) $ In-~nd (IK) $
Ent~ on Su~ S~temen~ Col~ A, Lines 4 and 9
PC 2 Loans Received (LR) $ ~ Lo~s Received (LR) $
Enter on S~ S~tm~t, Col~ & Line 2
PC 2
Cash C,,ntributions, Loans Receiv u and In-Kind kev ,2,03
Candidate or Political Committee Name: Committee ID Number:
~C.D~ Pl/l~a~J,,Jzq~_ ~ Ct~ ~JZ~/j~__. ,aJ//~- Page.3 of'~[
Election: ~ Primary 20 Dc// [] General 20 [] Other
Report: ~ 1 st Pre-electron [] 2nd Pre-elect~on [] 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 union PACs) CO Cosigner Obligation
F Candidate's Immediate Famdy 0ncludes candidate) IK In-Kind
I Individual LR Loan Recmved
L Labor Organization
O Other
P Political Party Committee
Amount of In-Kind Purpose
Line # Name and Address of Contnbutor
Contribution (see manual for suggested purpose codes)
Date Received Occupational Information or Contributor Code 1 Code 2
Contributing Committee's ID~ Aggregate
See Page Totals (Add all amounts w~ ~e same Accounting Period Totals (Complete only for last page and
Ins~ctions con~bution ~e. Do not include ag~egates.) ~sfer ~ese amounts to the Su~ Statement, PC 1.)
on Back and
in Cmpaign Cash (CA) $ ~ ~ Cash (CA) $
Finance / Enter on Sm~ Statement, Col~ A, Line 1
M~ual
In-K~d (IK) $ b, ~ In-~nd (IK) $
Ent~ on S~ Statem~t, Col~ A, Lines 4 ~d 9
PC 2 Lo~s Received (LR) $ Lo~s Received (LR) $
Enter on Su~ S~tement, Col~ A, Line 2
PC 2
Cash C,,ntributions. Loans Receive. and In-Kind =,03
Candidate or Political Committee Name: Committee ID Number:
Election: ~Primary 20 O~7/ [] General 20 ~ Other
Repo~: ~lst Pre-election ~ 2nd Pre-elecUon ~ Post-elect~on ~ 20 September Supplemental
SEE BACK FOR INSTRUCTIONS ~D CODE DEFINITIONS
CODE 1: Contributor Type CODE 2: Contribution Type
B Business Enfi~ CA Cash
C Political Co~i~ee (includes business and umon PACs) CO Cosi~er Obligation
F C~didate's Imediate Fmfly (includes candidate) IK In-Kind
I Individual LR Loan Received
L Labor Org~ization
O Other
P Political Pa~ Co~i~ee
Amount of In-Rind Purpose
Line ~ Name and Address of Contributor
Contribution (see manual for suggested pu~ose codes)
Date Received Occupational Information or Contributor Code 1 Code 2
Contributing Comm/~ee's I~ Aggregate
ccc
q~o8
See Page Totals (Add all amounts wi~ ~e same Accounting Periad Totals (Complete o~y for last page ~d
Ins~ctions con~butlon ~e. Do not include agFegates.) ~ansfer those ~ounts to ~ Su~ Statement, PC 1.)
onBacN~d [ $~ ~ ~' CasN(CA) $
in Campai~ Cash (CA) $ I
Enter on Su~ StatemenL Colum A, Line 1
Finance
Manual In-~nd (IK) $ ~ In-~nd (IK) $
Enter on Su~ Statement, Col~ A, Lines 4 ~d 9
PC 2 Lo~s Received (LR) $ Lo~s Received (LR) $
Ent~ on Sma~ Statement, Col~ A, Line 2
PC 2
Cash C.,ntributions, Loans Receiw. u and In-Kind Rev
Candidate or Political Committee Name~ Committee ID Number:
Election: ~Phma~ 20 O ~ ~ General 20 E Other
Repo~: ~ 1st Pre-election ~ 2nd Pre-election ~ Post-election ~ 20 September Supplemental
SEE BACK FOR INSTRUCTIONS ~D CODE DEFINITIONS
CODE 1: Contributor Type CODE 2: Contribution Type
B Business Enti~ CA Cash
C Political Co~i~ee (includes bus~ness ~d union PACs) CO Cost.er Obligation
F C~didate's I~ediate Family (includes c~didate) IK In-Kind
I Indiwdual LR Loan Received
L Labor Org~zat~on
O O~er
P Political Pa~ Co~i~ee
Amount of /n-Kind Pu~oso
Line ~ Name and Address of Contributor
Contribution (see manual for suggested pu~ose codes)
Occupational
Information
Contributor
Code 1 ~ Code 2
or
Date Recetved Contributing Commt~ee's I~ Aggregate
See Page Totals (Add all ~o~ts with the same Accounting Period Totals (Complete oMy for last page and
Instructions con~butzon ~pe. Do not Nc]udc ag~egatcs.) ~ansfer these amounts to the Su~ Statement, PC 1.)
o. 8aok and
M Campa]~ Cash (CA) $ wDw ~' Cash
(CA)
$
Finance Enter on Sm~ Statement, Colum A, Line t
Manual In-~nd (IK) $ ~ In-Kind (IK) $
Enter on Su~ StatemenL Col~ A, Lines 4 ~d 9
PC 2 Loans Received (LR) $ Lo~s Received (LR) $
Enter on Sm~ Statement, Col~ & Line 2
PC 2
Cash C ,ntributions, Loans Receiv u and In-Kind Rev. 2,03
Candidate or Polincal Committee Name: Committee ID Number:
Page (O of '~
' '~_~m
Election: ( aw 20 ~ General 20. ~ O~er
Repom ~ ~ ~Pre-election ~ 2nd Pre-elec(~on ~ Post-election ~ 20 September Supplemental
SEE BACK FOR~STRUCTIONS ~D CODE DEFINITIONS
CODE 1: Contributor Type CODE 2: Contribution Type
B Business Enti~ CA Cash
C Political Co~i~ee (includes bus~ness and union PACs) CO Cos~er Obligation
F C~didate's I~ediate Family (includes c~didate) IK In-Kind
I Individual LR Loan Received
L Labor Organization
O O~er
P Political P~ Co~iRee
Amount of In-Kind Pu~ose
Line ~ Name and Address of Contributor Contribution (see manual for suggested purpose codes)
Occupational
Info~ation
or
Contributor
Code 1 ~ Code 2
Date Received Contributing Commi~ee's I~ Aggregate
See Pa~e Totals (Add ~11 amounts with the same Accounting Period Totals (Complete o~y for l~st p~e and
~s~ctmns con~bution ~e. Do not include a~greg~tes.)/ ~sfer these amours to ~e Su~a~ Statement, PC 1.)
on Back and ~ 4
in Cmpm~ Cash (CA) $ Cash (CA) $
Enter on S~a~ Statement, Colum A, Line 1
Finance
Manual In-~d (IK) $ In-Kind (IK) $
Enter on Sum Statement, Col~ A, Lines 4 ~d 9
PC 2 Lo~s Received (LR) $ Loans Received (LR) $
Enter on S~ Statement, Col~ A, Line 2
PC 2
Cash C.,ntributions, Loans Receiv u and In-Kind Rev 12/03
Candidate or Polincal Comrmttee Name: Committee ID Number:
Election: [~Primary 200~/ [] General 20 [] Other
Report: ~'~lst 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 PoliUcal Committee (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 OrgamzaUon
O Other
P Political Party Committee
Amount of In-Kind Purpose
Ltne# Name and Address of Contributor
Contribution (see manual for suggested purpose codes)
Occupational
Information
or
Contributor
Code 1 I Code 2
Date Received Contributing Committee's ID4¢ Aggregate
3. ~ $
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 Statement, PC 1.)
in Campaign Cash (CA) $ Cash (CA) $
Finance Enter on Summary Statement, Column A, Line 1
Manual In-Kind (Ir) $ .... In-K/nd (IK) $
Enter on Smmmry Statement, Column A, Lines 4 and 9
PC 2 Loans Received (LR) $ Loans Received (LR) $
Enter on Summary Statement, Column A, Line 2
PC 3
Expenditures and Loan 'ayments Rev
Candidate or Political Committee Name: Committee ID Number:
;(--0"~ P'I/I(--.4~,,J~7.~ ~c:~l'v'L C--~.7 (~-3~A,I<-i/_ ,AJi/,~ Page */ of /
Election: ~4Primary 20 d)~ [] General 20 [] Other
Report: [~1 st Pre-election [] 2nd Pre-election [] Post-election [] 20 September Supplemental
PURPOSE CODES (see back of form for instructions and code definitions) EXPENDITURE TYPES ,
A Agent O Other Advertising (yard signs, buttons, etc.) CA Cash
B Broadcast Advertising (Radio, TV) P Postage LP Loan Payment
C Cash Contributions R Reimbursement for Personal Expenditures
F Fundraising Event Expenses S Surveys and Polls
G General Operational Expenses (describe if over $50) T Travel Expenses (describe if over $50)
I Interest Payment U Utilities
L Literature, Brochures, Pnnting W Wages, Salaries, Benefits
M Management Services Y Petition Circulators
N Newspaper and Other Periodical Advertising Z Preparation and Production of Advemsing
Payee's Name and Payee's Committee ID~, Exp. Amount of []
Line # Date Check # /f applicable Purpose Type Expenditure Paid
(as it appears on involce, receipt or check) to A/P
3. $ [--]
4. $
s. $
6. $ ["'-]
8.
9. $
lo $ [-']
See Page Totals (Add all expenditures with the same Accounting Period Totals (Complete only for last page and
Instructions expenditure type.) transfer these amounts to the Summary Statement, PC 1.)
on Back and
in Campaign Cash (CA) $ '~ Cash (CA) $ 700
Finance Enter on Summary Statement, Colunm A, Line 6
Manual Loan Payment (LP) $ '-'-" Loan Payment (LP) $ '---"*
Enter on Summary Statement, Column A, Line 7
PC 3
PC 2
Rev 12/03
Cash Contributions, Loans Received and In-Kind
Candidate or Political Committee Name: Committee ID Number:
~C071- M~'lSIo~'~ ~ol~. ~_IT~ COt4/~P_IL.- /3/~ Page I of
Election: [] Primary 20 0 ~ [] General 20 [] Other
Report: [] 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 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
Date Received Contributing Committee's IDI~ Aggregate Code I , Code 2
I~.:>bev+ co.
s. "Po i~,~ Zt, Ix~', eug~,~.- ~ O~t~'~z. $ lO~. ~
~-oo~ J.
u[le]o3, q~ select I~ &-}~e~. $ ~
$
O '
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
in C,ampmgn Cash (CA) $ LJ O0, ~ Cash (CA) $
Finance Enter on Summary Statement, Column A Line 1
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 Summar~ Statement, Column A Line 2
PC 2
Cash Contributions, Loans Received and In-Kind .ev 12/03
Candidate or Political Committee Name: Committee ID Number:
SCoWl~' MCfk,.qv~e4,.. .~-o.-v O__~4.,t[ O__.o~ ~ tO ;~ Page ~ of ~
Election: [] Primary 20 0~ [] 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 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 I
Date Received Contributing Committee's IDg Aggregate Code 1 ~ Code 2
.~. ~o~e ~v.a,~ C~.~ '~. $ _~0.-
.~. 9~1 oeP.. c~. $ t oo . ~
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
in Campaign Cash (CA) $ t~ C~. ~ Cash (CA) $
Finance Enter on Summary Statement, Column A Line 1
Manual ln-K~nd (IK) $ '--- In-Kind (IK) $
Enter on Summary Statement, Column A Lines 4 and 9
PC 2 Loans Recmved (LR) $ Loans Received (LR) $
Enter on SummaD' Statement, Column A L~ne 2
PC 2
Cash Contributions, Loans Received and In-Kind Rev ,2,03
Candidate or Political Committee Name: Committee ID Number:
Election: ~ Pfima~ 20 0~ ~ General 20 ~ Other
~epo~: ~ 1st Pre-election ~ 2nd Pre-election ~ Post-election ~ 20_ ~ September Supplememal
SEE BACK FOR INSTRUCTIONS AND CODE DEFINITIONS
CODE 1: Contributor Type CODE 2: Contribution Type
B Business Enti~ CA Cash
C Political Co~i~ee (includes business and union PACs) CO Cosigner Obligation
F Candidate's I~ediate Family (includes candidate) IK In-Kind
I Individual LR Loan Received
L Labor Organization
O Other
P Political Pa~ Co~i~ee
Amount of In-Kind Purpose
Line ~ Name and Address of Contributor Contribution (see manual for suggested pu~ose codes)
Occupational Info.etlon or Contributor Code 1 ~ Code 2
Date Received Contdb~ing Commi~ee's I~ Aggregate
See Page Totals (Add all amounts with the same Accounting Period Totals (Complete only for last page and
Instructions contribution ~e. Do not include aggregates.) transfer these amounts to the Summa~ Statement, PC 1 .)
on Back and
in Campaign Cash (CA) $ ~¢~, ~ Cash (CA) $
Eater on Su~a~ Statement, Column A Line I
Finance
Manual In-K~nd (IK) $ Z~.~ In-Kind (IK) $
Enter on Summa~ Statement, Column A Lines 4 and 9
PC 2 Loans Recetved (LR) $ Loans Received (LR) $
Enter on Summed Statement, Column A Line 2
PC 2
Cash Contributions, Loans Received and In-Kind ~cv ~2,o3
Candidate or Political Committee Name: Committee ID Number:
.ggO'Tr' ~6'ff;k~6'0,. ~ 0.,(TX{ ~,-oqboCll..-
Election: [] Primary 20 O~ [] General 20 [] Other
Report: [~] 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 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
Line # Name and Address of Contributor Amount of In-Kind Purpose
Contribution (see manual for suggested purpose codes)
Occupational Information or Contributor
Date Received Contributing Committee's IDi~ Aggregate Code 1 ~ Code 2
..j.r. 3~'oo v', ~ Mflg~. $ 5'0.--
..4'. i'2.~o c~.~,d.~,,.~ $ 2%"0.----
,..4c. $ 25'0 ~
:~ lo. I o,.t t.~.. ~,o.+,.o 'vo,.,+~ ~ ~.,:e $ ~ 0.4
311~[o¥ C<eP,,.,,t.I ~%t~ $ 6oo. ~
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
m Campaign Cash (CA) $ J~ 3 00. ~ Cash (CA) $
Finance Enter on Summary Statement, Column A Line 1
Manual In-Kind (IK) $ ~ In-Kind (IK) $
Enter on Summary Statement. Column A kmes 4 and 9
PC 2 Loans Recewed (LR) $ ~ Loans Received (LR) $
Enter on SummaD Statement, Column A kine 2
PC 2
Cash Contributions, Loans Received and In-Kind .ev
Candidate or Political Committee Name: Committee ID Number:
5Co'fi' Iv~lf:~Oe-~ ~-~P_ (~rl~ Co~zt,~l[--
Election: ~ Pfim~ 20 b ff ~ 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 Enti~ CA Cash
C Political Co~i~ee (includes business and union PACs) CO Cosigner Obligation
F Candidate's I~ediate Family (includes candidate) IK In-Kind
I Individual LR Loan Received
L Labor Organization
O Other
P Political Pa~ Co~i~ee
Amount of In-Kind Pu~ose
Line ~ Name and Address of Contributor
Contribution (see manual for suggested pu~ose codes)
Occupational Info~ation or Contributor
Date Received Contfib~ing Commi~ee's I~ Aggregate Code 1
~ 0 ~ ~0
I~/0
See Page Totals (Add all amounts w~th the same Accounting Period Totals (Complete only for last page and
Instructions contribution ~e. Do not include aggregates.) transfer these amounts to the Summa~ Statement, PC 1 .)
on Back and
~n Campaign Cash (CA) $ ~ ~0. ~ Cash (CA) $
Finance Enter on Summa~ Statement, Colum A Line I
Manual In-Kind (IK) $ ~ In-Kind (IK)
Enter on Summa~ Statement, Column A Lines 4 and 9
PC 2 Loans Received (LR) $ ~ Loans Recewed (LR) $
Enter on Summa~ Statement, Column A Line 2
PC 2
Cash Contributions, Loans Received and In-Kind ,2,o3
Candidate or Political Committee Name: Committee ID Number:
Election: [] Primary 20 O ({ [] General 20 [] Other
Report: [] 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 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 if Name and Address of Contributor
Contribution (see manual for suggested purpose codes)
Date Received Occupational Information or Contributor Code 1 Code 2
Contributing Committee's IDI~ Aggregate
~. 7'0 oooff. ~ z9 $ 2 ~'0 .--'
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
tn Campaign Cash (CA) $ ~' ~9 t~. ----- Cash (CA) $
Finance Enter on Summary Statement, Column A Line I
Manual ln-K~nd (IK) $ '--'-- In-K~nd (IK) $
Enter on Summary Statement, Column A Lines 4 and 9
PC 2 Loans Received (LR) $ Loans Received (LR) $
Enter on Summary, Statement, Column A Line 2
PC 2
Cash Contributions, Loans Received and In-Kind ~ev ,2/03
Candidate or Political Committee Name: Committee ID Number:
~C-OTI" /v~t~WC-4L W~P._ 0_~ Ct~6t. eo~lt~ k3/pr Page
Election: [] Primary 20Ocr [] 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 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 Received Occupational Information or Contributor
Contributing Committee's ID~ Aggregate Code I , Code 2
7 { c~c~3
.~. '~ ~, ~ l S w,,~ ed t3n~. $ '5-0 . ~
3. $
4.
$
See Page Totals (Add all amounts w~th 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
~n Campatgn Cash (CA) $ g'b. ~ Cash (CA) $ /~ t ~ O.--
Finance Enter on Summary Statement, Column A L~ne I
Manual ln-K~nd (IK) $ ~ In-K~nd (IK) $ 7_ b--.
Enter on Summary Statement, Column A Lines 4 and 9
PC 2 Loans Received (LR) $ Loans Received (LR) $
Enter on Summar~ Statement Column A Line 2
PC 1
Summary Statement of Contributions and Expenditures
Please type or print legibly in black ink. Page 1 of 2
Candidate or Political Committee Name (use full name): ~ --
Mailing Address as it Appears on Statement of Organization (street, route or box number, city, state, zip code):
Treasurer's Name: Telephone Numb_er (day):
Co~i~ee ID Number: Co~ee T~e, Measure Number or Office:
~ Original ~ Prima~ 20 O~ ~ General 20 ~ Other
~ Amen~ent ~ 1st Pre-election ~ 2nd Pre-election ~ Post-election ~ 20 September Supplemental
A-TOTALS FOR THIS ~UMULATWE TOTALS
ACCOUNTING PE~OD FOR THIS ELECTION
~0flT~IBHTIO~S
1. CashConffibutions ~ q ~JO, ~ b ~/2~0.
(Accosting Period To~l ~om PC 2) _)
2. Loans Received ~on-Exempt) + +
(Accosting Period To~l from PC 2)
3. Total Cash Contributions
4. In-Kind + ~ ~
(Accosting Period To~l ~om PC 2) 2 ~, ~ ~ + ·
(lines 3 + 4)
EXPENDITURES
6. Cash Expenditures ~
(Accosting Period Total ~om PC 3) ~ ~O, ~ ~ O O. ~
7. Loan Pa~ents ~on-Exempt) + +
(Accosting Period Total ~om PC 3)
8. Total Cash Expendi~es
(lines6+7) = 3 OO. ~ = ~ OO. ~
(Acco~nng Period To~l ~om PC 2) 2 ~, ~ +
(lines 8 + 9)
CASH BALANCE
I I. Bcgmmng Cash Bahmce O FOR OFFICE USE ONLY
(hne 20 ol prc~ taus ~eport)
12. Total Contr,butmns + ~ q. ~ ~ ~
(hne 5~
13. Other Recc,pts + RECEIVED
(Accounting Pertod I oral from I)(' 4A I ~ '
14. Loans Recc,xcd (I xemp,) + o APR ~ 0 2004
{Accotlllllll~ Period Iola] h'om PC4 k)
16. Total I.xpcnchtures 3 ~ ~. g~
(hne 10)
17. ()ther D~sbursemenl~ +
(Accounting Pcnod Total from P(4B)
i 8. Loall I)a5 ments (Exempt) +
(&ccounl]ng Pcnod Tolal flora P(411)
19. FXPI:NI)ITURE SUB'I()TAI.
(hne, 16, I',
20. ENDING CASll BALXN('E
(hne Iq nlmus hnc 19) t
PC 1
Summary Statement of Contributions and Expenditures ~e~ 12/{}3
Please type or print legibly in black ink. Page 2 of 2
Candidate or Political Committee Name: [ Committee ID Number:
[] Original [] Primary 20Or{ [] General 20 [] Other
[] Amendment [] 1st Pre-election [] 2nd Pre-election [] Post-election [] 20 September Supplemental
LOAN SUMMARY
21 Beginning Outstanding Loans FOIl OFFICE USE ONLY
(hne 29 of prewous report)
22. Loans Received (Non-Exempt) +
(line 2)
23. Loans Received (Exempt) +
(line 14)
24. LOANS RECEIVED SUBTOTAL
(lines 21 + 22 + 23) =
25. Loan Payments (Non-Exempt)
(line 7)
26. Loan Payments (Exempt) +
(line 18)
27. Forgiven Loans
+
(Total loans tbrglven dunng th~s accounting period)
28. LOAN PAYMENT SUBTOTAL
(hnes 25 + 26 +27)
29. TOTAL OUTSTANDING LOANS
(line 24 minus hnc 28) =
PERSONAL EXPENDITURE SUMMARY
30. Beginning Outstanding Personal Expenditures
(hne 36 ofprevwus report)
31. Personal Expenditures +
(Accounting Period Total from PC 3A)
32. PERSONAL EXPENDITURE SUBTOTAL
(lines 30 + 31)
33. Personal Expenditure Reimbursements
(Total expenditures on PC 3 w~th purpose code R)
34. Forgiven Personal Expenditures +
(Total personal expen&tures forgiven th~s acctg permd)
35. REIMBURSEMENT SUBTOTAL
(hnes 33 ~ 34)
36. OUTSTANDING PERSONAL
EXPENDITURES =
FINANCIAL STATUS AT CLOSE OF ACCOUNTING PERIOD
37. Ending Cash Balance(hne 20)
38. Accounts Receivable
(Accounting Period Total from PC 5) +
39. SUBTOTAL
(hnes 37 + 38) : 3,~30. --'"' RECEIVED
40. Total Outstanding Loans
(hne 29)
41. Outstanding Personal Expenditures + o APR ~, 0 2004
(line 36)
42. Accounts Payable
(Accounting Period Total from PC 6) + c> CITY RECORDER
43. SUBTOTAL
(lines 40 -~ 41 + 42) =
44. BALANCE/DEFICIT = 3t 3 ~0. '---'
(line 39 minus line 43' indicate + or - balance) ,
I, ~ C6~ 'lM.~.~la~.~" (name ~or treasurer), hereby certlfy
that
the
above
statement and the attached supporting reports are true and correct.
Signature of c~easurer Date signed
Pc 1
Summary S...iement of Contributions ab..~ Expenditures
Please type or print legibly in black ink. Page I of 2
Candidate or Political Committee Name (use full name):
,ScoTF ~t$~'tL ~ofd. ~"ry
Mailing Address as it Appears on Statement of Organization (street, route or box number, city, state, zip code):
Treasurer's Name: Te_lephone Number,(day):
Committee ID Number: Committee Type, Measure Number or Office:
[] Original [] Primary 20 0 ~{ . [] General 20 [] Other
[] Amendment [] I st Pre-election [] 2nd Pre-election [] Post-election [] 20 September Supplemental
A-TOTALS FOR THIS B-CUMULATIVE TOTALS
ACCOUNTING PERIOD FOR THIS ELECTION
C0NTRIBOTION$
1. Cash ContribuUons
(Accounting Period Total from PC 2) 3 9 ~ ~"'. 0 0 ~ [ ~ ~". 0
2. Loans Received (Non-Exempt) + ~ +
(Accounting Period Total from PC 2)
3. Total Cash Contributions
0ines 1+2) = 396 5.~o = 9$tgT. O0
4. In-Kind + +
(Accounting Period Total from PC 2) '"-' ~ ~'. ~"~"
5. TOTAL CONTRIBUTIONS
(hnes 3 + 4) = ~ ~'. DO = ~20. '~"~'
EXPENDITURES
6. Cash Expenditures
(Accounting Period Total from PC 3) 3 .~' 0. ~' (o 9 0. ~
7. Loan Payments (Non-Exempt) + ~ +
(Accounting Period Total from PC 3)
8. Total Cash Expenditures
(hnes 6 + 7) = 3 90. 9 ~ = to 90.9
(Accounting Period Total from PC 2)
10.TOTAL EXPENDITURES
(hnes 8 + 9)
CASH BALANCE
11. Beginning Cash Balance
(line 20 ofprewous report) ,~ ~ ~ O. OO FOR OFFICE USE ONLY
12. Total Contributions +
(line 5) 3 9 b ~', 0 0
13. Other Receipts +
(Accounting Period Total from PC 4A)
14. Loans Received (Exempt) +
(Accounting Period Total from PC 4A)
15. CONTRIBUTION SUBTOTAL
(lines 11 + 12 + 13 + 14) = ~t'z~ ~ ~'' · 6 0
16. Total Expenditures
(hne 10) ~0. ~)~' RECEIVED
17. Other Disbursements +
(nccount, ng Per, od Total from PC 4~) 2O0 ~. 0 0 MAY- 0 6 2004
] 8. Loan Payments (Exempt) +
(Accounting Period Total from PC 4B)
19. EXPENDITURE SUBTOTAL CITY RECORDER
20. ENDING CASH BALANCE
Pc 1
"summary S,, ement of Contributions m..., Expenditures
Please type or print legibly in black ink. Page 2 of 2
Candidate or Political Committee Name: Committee ID Number:
[] Original [] Primary 20 0c4 [] General 20 [] Other
[] Amendment [] I st Pre-election [] 2nd Pre-election [] Post-election [] 20 September Supplemental
LOAN SUMMARY
21. Beginning Outstanding Loans FOR OFFICE USE ONLY
(line 29 of previous report)
22. Loans Received (Non-Exempt) +
(hne 2) ----
23. Loans Received (Exempt) +
(hne 14)
24. LOANS RECEIVED SUBTOTAL
(hnes 21 + 22 + 23) =
25. Loan Payments (Non-Exempt)
(hne 7)
26. Loan Payments (Exempt) +
(line 18)
27. Forgiven Loans
(Total loans forgiven dunng th~s accounting period) +
28. LOAN PAYMENT SUBTOTAL
(hnes 25 + 26 +27) =
29. TOTAL OUTSTANDING LOANS
(hne 24 minus line 28) = O
PERSONAL EXPENDITURE SUMMARY
30. Beginning Outstanding Personal Expenditures
(line 36 of previous report)
31 Personal Expenditures +
(Accounting Period Total from PC 3A)
32. PERSONAL EXPENDITURE SUBTOTAL
(lines 30 + 31) =
33. Personal Expenditure Reimbursements
(Total expenditures on PC 3 with purpose code R)
34. Forgiven Personal Expenditures +
(Total personal expenditures forgiven this acctg period)
35. REIMBURSEMENT SUBTOTAL
(hnes 33 + 34) =
36. OUTSTANDING PERSONAL
EXPENDITURES =
FINANCIAL STATUS AT CLOSE OF ACCOUNTING PERIOD
37. Ending Cash Balance
(line 20) ~-0 ~. 0~"
38. Accounts Receivable
+
(Accounting Period Total from PC 5)
39. SUBTOTAL
(lines 37 + 38) = ~ ~'0 C{. (5
40, Total Outstanding Loans
(line 29)
41. Outstanding Personal Expenditures +
(hne 36)
42. Accounts Payable +
(Accounting Period Total from PC 6)
43. SUBTOTAL
(bnes 40 + 41 + 42) = 0
44. BALANCE/DEFICIT
(line 39 m~nus line 43: ~nd~cate + or - balance) = 5' got-(, 0
I, ~c~'~ /k/~ ~v (name of candidate or treasurer), hereby certify that the above
statement and the attached supporting reports are true and correct.
PC 2
Cash Contributions, Loans Receivea and In-Kind Rev
Candidate or Political Committee Name. Committee ID Number:
,~C, OTU tV~l$~E:/?.. FoO,. ~{~ ~l ~ ~]~ Page I of ~
Election: ~ Pnma~ 20 0 ~ ~ General 20 ~ Other
Repom ~ 1st Pre-election ~ 2nd Pre-elect~on ~ Post-election ~ 20 September Supplemental
SEE BACK FOR INSTRUCTIONS AND CODE DEFINITIONS
CODE 1: Contributor Type CODE 2: Contribution Type
B Business Enti~ CA Cash
C Political Co~ttee 0ncludes business and union PACs) CO Cosigner Obhgat~on
F Candidate's Immediate Family (includes candidate) IK In-Kind
I Individual LR Loan Received
L Labor Organization
O Other
P Political Pa~ Co~i~ee
Amount of /n-Kind Purpose
Line ~ Name and Address of Contrtbutor
Contribution (see manual for suggested purpose codes)
Date Received Occupational Informatton or Contributor Code 1 Code 2
Contributtng Commi~ee's I~ Aggregate
3. ~,05 gox llo~ $ I~00. oo
See Page Totals (Add all amounts with the same Accounting Period Totals (Complete only for last page and
Instructions contribution type. Do not ~nclude aggregates ) transfer these amounts to the Summa~ Statement, PC 1 )
on Back and
tn Campmgn Cash (CA) $ I~ I ~. O 0 v Cash (CA) $
Finance Fnter on 5umma~ Statement Column & [ ]nc I
Manual In-Kind (IK) $ ~ In-Kind (IK) $
[ nter on ~UHlllla~ %tdtcmcnt ( oJumn [ [:nes I and
PC 2 Loans Recm~cd (LR) $ ~ Loans Rccc~xed (LR) S
ntcr
PC2
Cash Contributions, Loans Receivea and In-Kind
Candidate or Political Committee Name: Committee ID Number:
~qC.,O"k~ t~l..~t,o~0~ g'ok. CIT~ CO~al~ ~]~ Page
Election: ~ Pfima~ 20 O~ ~ General 20 ~ Other
Repom ~ 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 Enti~ CA Cash
C Political Commi~ee (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 Pa~ Committee
Amount of In-~nd Pu~ose
Line ~ Name and Address of Contdbutor
Contribution (see manual for suggested pu~ose codes)
Occupational Info~ation or Contributor
Date Received Contributing Commi~ee's I~ Aggregate C~e 1 ~ Code 2
~ ' $ 2000.00
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 Statement, PC 1.)
on Back and
in Campaign Cash (CA) $ 2. 7. ~0. 00 // Cash (CA) $ 3 ~i' l, _ff. 00 v/
Finance Enter on Sununary Statement. Column A, Line 1
Manual In-Kind (IK) $ J In-Kind (IK) $ --
Enter on Sununary Statement. Column A. Lines 4 and 9
PC 2 Loans Received (LR) $ ~ Loans Received (LR) $ '---
PC3
Cast] Expenditures and Loan Payments Rev 12,03
Candidate or Political Committee Name: Committee ID Number:
~ do'lT' AA~I$%3E/~ ~OgL ~ t~ Co~ ~ ~/~ Page I of J
Election: ~ Pfima~ 200~ ~ General 20 ~ Other
Repo~: ~ 1st Pre-election ~ 2nd Pre-election ~ Post-election ~ 20 September Supplemental
PURPOSE CODES (see back of form for instructions and code definitions) EXPENDITU~ TYPES
A Agent O Other Adve~ising ~d si~s, burns, etc.) CA Cash
B Broadcast Advemsmg (Radio, TV) P Postage LP Loan Payment
C Cash Con~ibutions R Reimbu~ement for Pe~onal Expendi~es
F Fundraising Event Expenses S Su~eys and Polls
G General ~emtional Expenses (describe if over $50) T Travel Expenses (describe if over $50)
I Interest Payment U Utilities
L Litera~re, Brochures, Printing W Wages, Salaries, Benefits
M Management Se~ices Y Petition Circulators
N Newspaper and Other Periodical Adve~ising Z Prepa~fion and Production of Adve~s~g
Payee's Name and Payee's Commi~ee I~, ~
Exp. Amount of
Line ~ Date Check ~ if applicable Purpose Type Expenditure Paid
(as it appeam on invoi~, receipt or check) to ~P
4. $ [~]
5. $ [--1
7. $ [~
8. $ I--1
9. $ ~
10. $ [--]
See Page Totals (Add all expenditures with the same Accounting Period Totals (Complete only for last page and
Instructions expenditure type.) transfer these amounts to the Summary Statement, PC 1.)
on Back and
in Campaign Cash (CA) $ ~ ~0. ~} ~' ~ Cash (CA) $ ~ oj 0 · ~} g' -/
Finance Enter on Summary Statement, Column A, L~ne 6
Manual Loan Payment (LP) $ Loan Payment (LP) $
Enter on Summary Statement. Column A, Line 7
PC 3
Other Disbursements
Candidate or Political Committee Name: Committee ID Number:
,~C0~ M~'l$1,te~' i=Ol~ CC'Ti/ C. DLttO0..IL. ~/tOf Page I of/
Election: [] Primary 20 0 q [] General 20 [] Other
Report: [] 1 st Pre-election [] 2nd Pre-election [] Post-election [] 20 September Supplemental
SEE BACK FOR INSTRUCTIONS AND CODE DEFINITIONS
Other Disbursement Transaction Type Codes
EL Exempt Loan Payment
NP Nonpartisan Actiwty
OM Miscellaneous (provide a description)
RT Return or Refund of Contributions
Payee's Name Other Disbursement Other Disbursement
Line # Date Check # (required for codes EL, OM and RT; Transactton Type Amount
optional for code NP) Code
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 ~-"x L/
Finance CodesNP, OM,~ $ ~O60.00 ../ CodesNP, OM, RT $ ~ OOO.OD
Enter on Summary Statement, Column A, Line 17
Manual
Code EL $ ~ Code EL $ --
Enter on Summary Statement, Column A, L~ne 18
PC 4B
Supplement to Second Pre/Post-Election - Contributions
Candidate or Political Committee Name: Committee ID Number:
gC0TI' ME'IStoE'c~. ~o~ O.,ITx( ~OU. tO6tL.. ~dt} Page J of
Election: [] Primary 200~' [] General 20 [] Other
Report: [] 1st Suppl. to the 2nd Pre-election [] 2nd Suppl. to the 2nd Pre-election [] Suppl. to Post-election
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 union PACs) CO Cosigner Obligation
F Candidate's Immediate Family (includes candidate) IK lu-Kind
I Individual LR Loan Received
L Labor Organization PC Pledge of Cash
O Other PI Pledge of In-Kind
P Politmal Party Committee PL Pledge of Loan
Ltne ii Name and Address of Contributor Amount of
Contribution In-Ktnd Purpose
Date Received Occupational Information or Code I Code 2 (see manual for suggested purpose codes)
Contnbuting Committee's IDii
5. ~o ~og 3~t $ 300.00
See FOR OFFICE USE ONLY
Inst~ctions 1, g o~ ~a~ , (name of~or
on Back and ~easurcr)hereby ceni~ that the above statement is tme and co~ect, e e C ElY E D
in Campaign
Finance
Manual 1 0 2004
Supplement to Second Pre-Election - Expenditures .e~. 12,o3
Candidate or Political Committee Name: Committee ID Number:
..g~,o"lr' tv~-'~e~ tpo~ ~lT~ ~ot~C~c. ~) Page J of/
Election: [] Primary 20 O~ [] General 20 [] Other
Report: [] 1st Suppl. to the 2nd Pre-election [] 2nd Suppl. to the 2nd Pre-election
PURPOSE CODES (see back of form for instructions and code definitions) EXPENDITURE TYPES
A Agent O Other Advertising (yard signs, buttons, etc.) CA Cash
B Broadcast Advertising (Radio, TV) P Postage LP Loan Payment
C Cash Contributions R Reimbursement for Personal Expenditures AP Account Payable
F Fundraising Event Expenses S Surveys and Polls PE Personal Expenditures
G General Operational Expenses (describe if over $50) T Travel Expenses (describe if over $50)
I Interest Payment U Utilities
L Literature, Brochures, Printing W Wages, Salaries, Benefits
M Management Services Y Petition Circulators
N Newspaper and Other Periodical Advertising Z Preparation and Production of Advertising
Payee's Name Exp. Amount of
Line # Date Check # (as it appears on invoice, receipt or check) Purpose Type Expenditure
4. $
5. $
6. $
7. $
o. $
9. $
10. $
Instructions I, .~ co'ff' t~¢i.$~ v , (name o r
on Back and treasurer) hereby certify that the above statement is true and correct.
in Campaign
Finance MAY 1 0 2004
Manual
CITY RECORDER
PC 813 Signature of candidate or treasurer Date signed
PC 8A
Supplement to Second Pre/Post-Election - Contributions R~v 13/03
Candidate or Political Committee Name: Committee ID Number:
$¢0'q[' A4~-'LS~,IE;/-~. For (~IT~ (~OLxI~iL.. NR Page ~ of i
Election: [] Primary 20 [] General 20 [] Other
Report: [] 1st Suppl. to the 2nd Pre-election [] 2nd Suppl. to the 2nd Pre-election [] Suppl. to Post-election
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 union PACs) CO Cosigner Obligation
F Candidate's Immediate Family (includes candidate) IK In-Kind
I Individual LR Loan Received
L Labor Organization PC Pledge of Cash
O Other PI Pledge of In-Kind
P Political Party Committee PL Pledge of Loan
Amount of
Line # Name and Address of Contributor
Contribution In-Kind Purpose
Date Received Occupational Information or Code 1 Code 2 (see manual for suggested purpose codes)
Contributing Committee's ID~
~ 3~ ~o. I(TM- ~ ~o $ 2~O.OP
2. $
3. $
4. $
5. $
Instructions I, ~¢t~+- t~X.d~e~ , (name o~ or
on Back and treasurer) hereby certify that the above statement is true and correct.
in Campaign
Finance ~A¥ ! 4 2004
Manual
$~u;,~. ~l, q loq CiTY RECORDEt:I
PC 8A Signature of candidate or treasurer Date signed
PC 8B
Supplement to Second Pre-Election - Expenditures Rev
Candidate or Political Committee Name: Commtttcc ID Number:
~qCo"tT ~vt~.lSklF_.jT.. Y:or/._ OatT~ ~OU. tO~4/.~. /am Page I of I
Election: [] Primary 20 0 ~4 [] General 20 [] Other
Report: [] I st Suppl. to the 2nd Pre-election [] 2nd Suppl. to the 2nd Pre-election
PURPOSE CODES (see back of form for instructions and code definitions) EXPENDITURE TYPES
A Agent O Other Advertising (yard signs, buttons, etc.) CA Cash
B Broadcast Advertising (Radio, TV) P Postage LP Loan Payment
C Cash Contributions R Reimbursement for Personal Expenditures AP Account Payable
F Fundrmsing Event Expenses S Surveys and Polls PE Personal Expenditures
O General Operational Expenses (describe if over $50) T Travel Expenses (describe if over $50)
I Interest Payment U Utihties
L Literature, Brochures, Printing W Wages, Salaries, Benefits
M Management Servmes Y Petition Circulators
N Newspaper and Other Periodmal Advert]sing Z Preparation and Production of Advems~ng
Payee's Name Exp. Amount of
Line ii Date Check ii (as it appears on invoice, receipt or check) Purpose Type Expendtture
3. $
4. $
5. $
6. $
7. $
8. $
9. $
10. $
See ~ FOR OFFICE USE ONLY
Instructions I, ,~ ¢o'ht'' ~;~5~' , (name of~ or
on Back and treasurer) hereby certify that the above statement is true and correct. RECEIVED
in Campaign
Finance ~Y 1 4 2004
Manual
PC 8B Signature of~e or treasu er Date signed
PC 1
Summary Statement of Contributions and Expenditures
Please type or print legibly in black ink. Page 1 of 2
Candidate or Political Committee Name (use full name):
Mailing Address as it Appears on Statement of Organization (street, route or box number, city, state, zip code):
Treasurer's Name: Telephone Number (day):
Committee ID Number:
Committee Type, Measure Number or Office:
[] Original [] Primary 20 ~ q [] General 20~ [] Other
[] Amendment [] 1 st Pre-election [] 2nd Pre-election [] Post-election [] 20 ......September Supplemental
A-TOTALS FOR THIS B-CUMULATIVE TOTALS
ACCOUNTING PERIOD FOR THIS ELECTION
CONTRIBUTIONS
1. Cash Contributions
(Accounhng Per]od Total from PC 2) 3 000. oD I I J 9 ~
2. Loans Received (Non-Exempt) + +
(Accounting Per]od Total from PC 2) ~
3. Total Cash Contributions
(hnes 1+ 2) = 3000.00 = I I I tS~'.Oo
4. In-Kind
+ + ~..~ ~
(Accounting Per]od Total from PC 2)
5. TOTAL CONTRIBUTIONS
(hnes 3 +4) = 2o OoO.~o =
EXPENDITURES
6. Cash Expenditures
(Accounting Per]od Total from PC 3) ff ~' 0 q, O~ .5 I°J 5'. O O
7. Loan Payments (Non-Exempt) + +
(Accounting Per]od Total from PC 3) ~
8. Total Cash Expenditures
(hnes 6 + 7) = ,9 5'0 q. O~'- = 91
9. In-Kind + +
(Accounting Per]od Total from PC 2) ~ ~ ~,
10. TOTAL EXPENDITURES
= 8~;Oq.og' = 5zZ o.
(hnes 8 + 9)
CASH BALANCE
I I. Beginning Cash Balance
(line 20 of previous report) ~ 5"0 q.~ FOR OFFICE USE ONLY
12. Total Contributions
(line 5) + ~ o o o. o o
13. Other Receipts +
(Accounting Period Total from PC 4A)
14. Loans Received (Exempt) +
(Accounting Per]od Total from PC 4A)
15. CONTRIBUTION SUBTOTAL
(hnes 11 + 12 + 13 + 14) =
16. Total Expenditures
(h'a~ 10) RECEIVED
17. Other Disbursements +
(Accounting Per]od Total from PC 4B)
JUN 0 9
18. Loan Payments (Exempt) +
(Accounting Period Total from PC 4B)
19. EXPENDITURE SUBTOTAL CITY RECORDER
(lines 16 + 17 + 18) = 8'~0~. Ot~'
20. ENDING CASH BALANCE
=
(hne 15 minus hne 19)
PC 1
Summary Statement of Contributions and Expenditures Rev
Please type or print legibly in black ink. Page 2 of 2
Candidate or Political Committee Name: Committee ID Number:
So. otC ~I~'P.- ~P~ ¢~Ty COC~toelt~
[] Original [] Primary 20 0q [] General 20~ [] Other
[] Amendment [] 1st Pre-election [] 2nd Pre-elect~on [] Post-election [] 20 September Supplemental
LOAN SUMMARY
21. Beginning Outstanding Loans FOR OFFICE USE ONLY
(hne 29 of previous report) O
22. Loans Received (Non-Exempt)
(line 2) + o
23. Loans Received (Exempt)
(line 14) +
24. LOANS RECEIVED SUBTOTAL
(lines 21 + 22 + 23) = O
25. Loan Payments (Non-Exempt)
(hne 7) O
26. Loan Payments (Exempt)
(lane 18) +
27. Forgiven Loans
+
(Total loans forgiven during this accounting period)
28. LOAN PAYMENT SUBTOTAL
(lines 25 + 26 +27) = O
29. TOTAL OUTSTANDING LOANS
(hne 24 minus hne 28) = O
PERSONAL EXPENDITURE SUMMARY
30. Beginmng Outstanding Personal Expenditures
(line 36 of previous report)
31. Personal Expenditures +
(Accounting Period Total from PC 3A)
32. PERSONAL EXPENDITURE SUBTOTAL
(lines 30 + 31) = O
33. Personal Expenditure Reimbursements
(Total expen&mres on PC 3 with purpose code R) C5
34. Forgiven Personal Expenditures +
(Total personal expenditures forgiven this acctg, period)
35. REIMBURSEMENT SUBTOTAL
= O
(lines 33 + 34)
36. OUTSTANDING PERSONAL
EXPENDITURES = O
FINANCIAL STATUS AT CLOSE OF ACCOUNTING PERIOD
37. Ending Cash Balance
(line 20) O
38. Accounts Receivable
+
(Accounting Period Total from PC 5)
39. SUBTOTAL
=
(lines 37 + 38)
40. Total Outstanding Loans
(line 29)
41. Outstanding Personal Expenditures
(line 36) + O
42. Accounts Payable + O
(Accounting Period Total from PC 6)
43. SUBTOTAL
=
(lines 40 + 41 + 42)
44. BALANCE/DEFICIT
=
(line 39 minus line 43' indicate + or - balance)
I, S ~,X'r ~e~. ~e~, (name of~r treasurer), hereby certify that the above
statement and the attached supporting reports are tree and correct.
Signature of ~ndidate or treasurer Date signed
pc
Cash Contributions, Loans Received and In-Kind Rev 12,0,
Candidate or Political Committee Name. Committee ID Number:
~e. oTr' ivxoqg~tt~.~ ~oa. 6~'T,.~ c. ott~oett.., tO]iq Page ~ of ~
Election: [] Primary 20 O~f [] General 20 [] Other
Report: [] 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 union PACs) CO Cosigner Obligation
F Candidate's Imme&ate Family (includes candidate) IK In-Kind
I Individual LR Loan Received
L Labor Organization
0 Other
P Political Party Committee
Amount of In-Kind Purpose
bne # Name and Address of Contributor Contribution (see manual for suggested purpose codes)
Occupational Information or Contributor Code 1 Code 2
Date Received Contributing Committee's ID# Aggregate
1 ZHg3 'Pa~m,a~, ~. $ (00.oo
3. 6'~oo T~mi~,,~ l>o,~y $ 5-00.00
J ~es %. Lo ~Ls ~
I
oeo I $
See Page Totals (Add all amounts with the same Accounting Period Totals (Complete only for last page and
Ins=ctions con~butio~ ~e. Do nm include aggregates.) ~sfer these amoun~ to the Su~ Statement, PC l .)
on Back ~d
in Campaign Cash (CA) $ J 050.00 Cash (CA)
Enter on Sum~ Statement, Co[m A, Line l
FNance
Manual In-Kind (IK) $ In-Kind (IK) $
Enter on Sum~ Statement, Colum A, Lines 4 md
PC 2 Loans Received (LR) $ Loans Received (LR) $
Enter on Su~ S~tement, Colum A, Line 2
pc
Cash Contributions, Loans Received and In-Kind Rev
Candidate or Political Committee Name: Committee ID Number:
~ P-,orr t~r t..~d~F4 ~o~. P.,cty ~o~c~ ~ ~]~ Page Z of ~
Election: ~ Pnma~ 20 O q ~ General 20 ~ Other
Report: ~ 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 Ent~W CA Cash
C Political Co~ee (includes business and union PACs) CO Cosigner Obligation
F Candidate's I~ed~ate Family (includes candidate) IK In-Kind
I Individual LR Loan Received
L Labor Organization
O Other
P Poht~cal Pa~ Co~ee
Amount of In-Kind Purpose
Line ~ Name and Address of Contributor
Contribution (see manual for suggested purpose codes)
Date Received Occupational Information or Contributor Code 1 Code 2
Contributing Commi~ee's I~ Aggregate
~ ~o~ ~o.
1. 335 ~. f~ ~11o $ Z~O.OO
2 ~,o. ~o~ IO~ $ ZOo.~
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 Statement, PC 1.)
on Back and
in Campaign Cash (CA) $ ! 0 5'0. oD Cash (CA) $ 3 DO O. oD
Finance Enter on Summary Statement, Column A, Line 1
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 Summary Statement, Column A, Line 2
Cash Expenditures and Loan Payments
Candidate or Political Committee Name: Committee ID Number:
~¢OTt- tvl~.~;~.. V~ ¢l'r'f ~Ou.~JCl~ ~]/q Page
Election: [] Primary 20 0t( [] General 20 [] Other
Report' [] 1st Pre-election [] 2nd Pre-election [] Post-election [] 20 September Supplemental
PURPOSE CODES (see back of form for instructions and code definitions) EXPENDITURE TYPES
A Agent O Other Advemsing (yard signs, buttons, etc.) CA Cash
B Broadcast Advertising (Radio, TV) P Postage LP Loan Payment
C Cash Contributions R Reimbursement for Personal Expenditures
F Fundraising Event Expenses S Surveys and Polls
G General Operational Expenses (describe if over $50) T Travel Expenses (describe if over $50)
I Interest Payment U Utilities
L Literature, Brochures, Printing W Wages, Salaries, Benefits
M Management Services Y Petition Circulators
N Newspaper and Other Periodical Advertising Z Preparation and Production of Advemsing
Payee's Name and Payee's Committee ID~, Exp. Amount of []
Line # Date Check # if apphcable Purpose Type Expenditure Paid
(as tt appears on invoice, receipt or check) to A/P
3. Fl/,/oq too-q. Preeecs ;gt~. 'b~.'k~ 'p ¢.~ $ ggO.lg. I--]
6. 5]lttloq I010 ka.l~,c~ '.' kC..'~-r. I~c. L. eR $ 9q.19 I--I
See Page Totals (Add all expenditures with the same Accounting Period Totals (Complete only for last page and
Instructions expenditure type.) transfer these amounts to the Summary Statement, PC 1.)
on Back and
in Campaign Cash (CA) $ g q (oar. 2 q Cash (CA) $
Finance Enter on Summary Statement, Column A, Lzne 6
Manual Loan Payment (LP) $ Loan Payment (LP) $
Enter on Summary Statement, Column A, L~ne 7
PC 3
PC
Cash Expenditures and Loan Payments Rev
Candidate or Political Committee Name: Committee ID Number:
SCofF t~rtsN~'/L ~0~ CtW~/ ~Ot~J~t~ "JlO, Page 2- of Z
Election: [] Primary 20 O t4 [] General 20~ [] Other
Report' [] I st Pre-election [] 2nd Pre-election [] Post-election [] 20 September Supplemental
PURPOSE CODES (see back of form for instructions and code definitions) EXPENDITURE TYPES
A Agent O Other Advertising (yard signs, buttons, etc.) CA Cash
B Broadcast Advertising (Radio, TV) P Postage LP Loan Payment
C Cash Contributions R Reimbursement for Personal Expenditures
F Fundraising Event Expenses S Surveys and Polls
G General Operational Expenses (describe if over $50) T Travel Expenses (describe if over $50)
I Interest Payment U Utilities
L Literature, Brochures, Printing W Wages, Salaries, Benefits
M Management Services Y Petition Circulators
N Newspaper and Other Periodical Advertising Z Preparation and Production of Advertising
Payee's Name and Payee's Committee ID#, []
Exp. Amount of
Line # Date Check # if apphcable Purpose
(as it appears on invoice, receipt or check) Type Expenditure Paid
to AlP
2. $ F-]
3. $ [--1
4 $ ~
5. $ F-]
6. $
7. $ F--]
I-1
$ F1
See Page Totals (Add all expenditures with the same Accounting Period TotaLs (Complete only for last page and
Instructions expenditure type.) transfer these amounts to the Summary Statement, PC 1.)
on Back and
in Campaign Cash (CA) $ ~ {o. ~ ! Cash (CA) $ ~ b'-0~4, o ~
Finance Enter on Summa~ Statement, Column A, L~ne 6
Manual Loan Payment (LP) $ Loan Payment (LP) $
Enter on Summary Statement, Column A, L~ne 7
PC 3
PC
Summary Statement of Contributions and .xpenditures Rev
Please type or print legibly in black ink. Page 1 of 2
Candidate or Political Committee Name (use full name):
Mailing Address as it Appears on Statement of Organization (street, route or box number, city, state, zip code):
Treasurer's Name: Telephone Numb gr (day):
Co~iUee ID Number: Co~iaee Type, Meas~e Number or Office: v~~~
~ Original ~ Prima, 20 O q ~ General 20 ~ Other
~ Amendment ~ 1st Pre-election ~ 2nd Pre-election ~ Post-election ~ 20 September Supplemental
A-TOTALS FOR THIS ~UMULATIVE TOTALS
ACCOUNTING PE~OD FOR T~IS ELECTION
CONTRIBUTIONS
1. Cash Contnbubons
(Acco~tlng Period To~l from PC 2) 3 o o o. o o I I [ 0~. 60
2. Loans Received ~on-Exempt) + +
(Accounting Period To~l ~om PC 2)
3. Total Cash Con~ibutions
= 3000.00 = ItlOF. oo
(lines 1+ 2)
4. In-Kind + Z o ~.3 ~ + Z3 I. 9 ff
(Accounting Period Total ~om PC 2)
5. TOTAL CONTmBUT1ONS
= 3 Zog. g~ = Ilq~b. 9~
(lines 3 + 4)
EXPENDITURES
6. Cash Expendi~res
(Accounting Period Total from PC 3) ~ ff O ~. O ~ ~ I ~ b-. O O
7. Loan Pa~ents ~on-Exempt) + +
(Accounting Period Total ~om PC 3) ~
8. Total Cash Expenditures = 8 ~0~. O ~ = ~ I 9 ~. oo
(hnes 6 + 7)
9. In-Kind + ~ ~ I. 5 ~
(Accosting Period To~l ~om PC 2) Z O b. ~ ~ +
10. TOTAL EXPENDITU~S
(hnes 8 + 9)
CASH B~LANCE
11. Beginmng Cash Balance 5 ~ 0 ~. 0 ~ FOR OFFICE USE ONLY
(hne 20 of prewous repo~)
12. Total Contributions + ~ ~ O~. 3 ~
(hne 5)
13. Other Receipts +
(Accounting Period Total from PC 4A)
14. Loans Received (Exempt) +
(Accounting Period Total ~om PC 4A)
15. CONTRIBUTION SUBTOTAL
= 9~.~
(hnesll+12q 13+14)
16. Total Expenditures ~ ~ I 0. ~ ~
17. O~er Disbursements +
(Accounting Period Total from PC 4B)
18. Loan ea~ents (Exempt) + , UL 0~8 2004
(Accounting Period Total ~om PC 4B) ~ ' '
(lines 16 + 17 + 18) = ~ IO .~ ~ .
20. ENDING CASH BALANCE = O
(hne 15 minus line 19)
PC 1
Summary Statement of Contributions and -xpenditures Rev
Please type or print legibly in black ink. Page 2 of 2
Candidate or Political Committee Name: [ Committee ID Number
[] Original [] Primary 20 Gq [] General 20 [] Other
[] Amendment [] 1st Pre-election [] 2nd Pre-election [] Post-election [] 20 . September Supplemental
LOAN SUMMARY FOR OFFICE USE ONLY
21. Beginning Outstanding Loans
(hne 29 of previous report) O
22. Loans Received (Non-Exempt) +
(line 2) O
23. Loans Received (Exempt) +
(line 14) 0
24. LOANS RECEIVED SUBTOTAL
(lines 21 + 22 + 23) =
25. Loan Payments (Non-Exempt)
(line 7) 0
26. Loan Payments (Exempt) +
(line 18) 0
27. Forgiven Loans + O
(Total loans forgiven during this accounting period)
28. LOAN PAYMENT SUBTOTAL
= O
(lines 25 + 26 +27)
29. TOTAL OUTSTANDING LOANS
=
(line 24 m~nus line 28)
PERSONAL EXPENDITURE SUMMARY
30. Beginning Outstanding Personal Expenditures O
(line 36 of previous report)
31. Personal Expenditures
(Accounting Period Total from PC 3A) + ID
32. PERSONAL EXPENDITURE SUBTOTAL
(hnes 30 + 31) =
33. Personal Expenditure Reimbursements
(Total expenditures on PC 3 with purpose code R)
34. Forgiven Personal Expenditures +
(Total personal expenditures forgiven this acctg period)
35. REIMBURSEMENT SUBTOTAL
(lines 33 + 34) =
36. OUTSTANDING PERSONAL
EXPENDITURES =
FINANCIAL STATUS AT CLOSE OF ACCOUNTING PERIOD
37.Ending Cash Balance
(tine 20)
38. Accounts Receivable +
(Accounting Period Total from PC 5)
39. SUBTOTAL =
(lines 37 + 38)
40. Total Outstanding Loans
(line 29)
41. Outstanding Personal Expenditures +
(line 36) CS
42. Accounts Payable +
(Accounting Period Iotal from PC 6)
43. SUBTOTAL =
(lines 40 + 41 + 42) 0
44. BALANCE/DEFICIT = C)
(line 39 minus line 43 ~nd~cate + or - balance)
I, S coT[ ~e;.sw~ o- (name of candidate or treasurer), hereby certify that the above
statement and the attached supporting reports are true and correct.
Signature of cand~ate or treasurer Date s~gne
PC 2 Amendmeat
Amendments-Cash Contributions, Loans Received and In-Kind
Candidate or Political Committee Name: Committee ID Number:
~ toT/ t~'l~ F'o~ e~rry ¢~cc~e.t/.~ ~ or Page ! of
Elect]on: [] Primary 20 0 t/ [] General 20~ [] Other
Report: [] 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 union PACs) CO Cosigner Obligation
F Candidate's Immediate Family (includes candidate) IK In-Kind
I Individual LR Loan Received
L Labor Organization
0 Other
P Political Party Committee
Amending Page # Name and Address of Contributor Amount of la-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 L,ne '~ ~.~e14,*.~ C ~'~ ~' (~1,*-~,,~,~.~
[] Correcting
Page L,ne 1~ ~.~ {? I~ ~ ~,~.e.~ '~/q' C
~ Corre~mg
~ 9elettng ~""-
O~
~ NewEnt~ ~.O,~ ~0~ $ ~.~
D Correcting ~ ~ ~
D Deleting
~ Correcting
D Oelet, ng [~ 0 ~
Pago.~ Lme~
~ New Ent~ $
~ Correcting
~ Delet,ng
$
Instructions " /": ~", '
on Back and , .;, ,. ,, ~. ~.:.,~
in Campmgn ~ - ~ "
Finance Signature of candidate or treasurer ~ ~ :
Manual "' ., ', , ,,
Amendment Date signe~ , , , ~' ~,',