HomeMy WebLinkAboutElect Maurie Denner
Summary Statement of Contributions and Expenditures PC I
Rev. 12103
Please type or print legibly in black ink. Page Iof2
Candidate or Political Committee Name (use full name):
Elect Maurie Denner
Mailing Address as it Appears on Statement of Organization (street, route or box number, city, state, zip code):
PMB#125. 2852 Willamette St. Euaene OR 97405
Treasurer's Name: I Telephone Number (day):
Mark A. Denner 541-736-2198
Committee ill Number: I Committee Type, Measure Number or Office:
City Council. Ward 2. Euaene. OR
o Original o Primary 20 o General 20 o Other
o Amendment o 1st Pre-election o 2nd Pre-election o Post-election IZI 2005 September Supplemental
A-TOTALS FOR THIS B-CUMULA TIVE TOTALS
ACCOUNTING PERIOD FOR THIS ELECTION
CONTRIBUTIONS
1. Cash Contributions 0.00 20,029.17
(Accounting Period Total from PC 2)
2. Loans Received (Non-Exempt) + 0.00 + 1,550.00
(Accounting Period Total from PC 2)
3. Total Cash Contributions = 0.00 = 21,579.17
(lines 1+ 2)
4. In-Kind + 0.00 + 305.37
(Accountin~ Period Total from PC 2)
5. TOTAL CONTRIBUTIONS = 0.00 = 21,884.54
(lines 3 + 4)
EXPENDITURES
6. Cash Expenditures 216.57 20,860.99
(Accounting Period Total from PC 3)
7. Loan Payments (Non-Exempt) + 0.00 + 750.00
(Accounting Period Total from PC 3)
8. Total Cash Ex-penditures = 216.57 = 21,610.99
(lines 6 + 7)
9. In-Kind + 0.00 + 305.37
(Accounting Period Total from PC 2)
10. TOTAL EXPENDITURES = 216.57 = 21,916.36
(lines 8 + 9)
CASH BALANCE
11. Beginning Cash Balance 216.57 FOR OFFICE USE ONLY
(line 20 of previous report)
12. Total Contributions + 0.00
(line 5)
13. Other Receipts + 0.00
(Accounting Period Total from PC 4A)
14. Loans Received (Exempt) + 0.00
(Accounting Period Total from PC 4A)
15. CONTRIBUTION SUBTOTAL = 216.57
(lines 11 + 12 + 13 + 14)
16. Total Expenditures 216.57
(line 10)
17. Other Disbursements + 0.00
(Accountin!! Period Total from PC 4B)
18. Loan Payments (Exempt) + 0.00
(Accounting Period Total from PC 4B)
19. EXPENDITURE SUBTOTAL = 216.57
(lines 16 + 17 + 18)
20. ENDING CASH BALANCE = 0.00
(line 15 minus line 19)
Summary Statement of Contributions and Expenditures PCI
Rev. 12/03
Please type or print legibly in black ink. Page 2 of2
Candidate or Political Committee Name: I Committee ill Number:
Elect Maurie Denner
IZI Original o Primary 20 o General 20 o Other
o Amendment o 1st Pre-election o 2nd Pre-election o Post -election IZI 2005 September Supplemental
LOAN SUMMARY FOR OFFICE USE ONLY
21. Beginning Outstanding Loans
(line 29 oforevious reoort) 800.00
22. Loans Received (Non-Exempt) + 0.00
(line 2)
23. Loans Received (Exempt) + 0.00
(line 14)
24. LOANS RECEIVED SUBTOTAL = 800.00
(lines 21 + 22 + 23)
25. Loan Payments (Non-Exempt) 0.00
(line 7)
26. Loan Payments (Exempt) + 0.00
(line 18)
27. Forgiven Loans + 800.00
(Total loans forgiven durin!! this accounting oeriod)
28. LOAN PAYMENT SUBTOTAL = 800.00
(lines 25 + 26 +27)
29. TOTAL OUTSTANDING LOANS = 0.00
(line 24 minus line 28)
PERSONAL EXPENDITURE SUMMARY
30. Beginning Outstanding Personal Expenditures 100.48
(line 36 of previous report)
31. Personal Expenditures + 0.00
(Accounting Period Total from PC 3A)
32. PERSONAL EXPENDITURE SUBTOTAL = 100.48
(lines 30 + 31 )
33. Personal Expenditure Reimbursements 0.00
(Total expenditures on PC 3 with Duroose code R)
34. Forgiven Personal Expenditures + 100.48
(Total personal exoenditures forgiven this acctg.
35. REIMBURSEMENT SUBTOTAL = 100.48
(lines 33 + 34)
36. OUTSTANDING PERSONAL = 0.00
EXPENDITURES
FINANCIAL STATUS AT CLOSE OF ACCOUNTING PERIOD
37. Ending Cash Balance 0.00
(line 20)
38. Accounts Receivable + 0.00
(ACCOWlting Period Total from PC 5)
39. SUBTOTAL = 0.00
(lines 37 + 38)
40. Total Outstanding Loans 0.00
(line 29)
41. Outstanding Personal Expenditures + 0.00
(line 36)
42. Accounts Payable + 0.00
(Accounting Period Total from PC 6)
43. SUBTOTAL = 0.00
(lines 40 + 41 + 42)
44. BALANCEIDEFlCIT = 0.00
(line 39 minus line 43: indicate + or - balance)
I, Mark A. Denner (name of candidate or treasurer), hereby certify that the above statement and the attached supporting reports
are true and correct.
~ - 7'....//-~#o<>-
Slgnatu of candIdate or treasurer Date signed
PC2
Cash Contributions, Loans Received and In-Kind Rev. 12103
Candidate or Political Committee Name: Committee ill Number:
Elect Maurie Denner Page 1 of 1
Election: IZI Primary 2005 o General 20 o Other
Report: o 1 st Pre-election o 2nd Pre-election o Post-election IZI 2005 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
Une# Name and Address of Contributor Amount of In-Kind Purpose
Contribution (see manual for suggested purpose codes)
Date Received Occupational Information or Contributor Code 1 I Code 2
Contributing Committee's 10# Aggregate
Maurie Denner
1. 3853 Blanton Rd., Eugene, OR 97405 $ 1 00.48 IK
Forgiven personal expenditures
09-01-2005 Candidate $ 2,450.48 F I IK
2. $
$ I
3. $
$ T
4. $
$ I
5. $
$ I
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) $ 0.00 Cash (CA) $ 0.00
in Campaign Enter on Summary Statement, Column A Line I
Finance
Manual In-Kind (IK) $ 100.48 In-Kind (IK) $ 100.48
Enter on Summary Statement, Column A Lines 4 and 9
PC 2 Loans Received (LR) $ 0.00 Loans Received (LR) $ 0.00
Enter on Summarv Statement Column A Line 2
PC3
Cash Expenditures and Loan Payments Rev. 12103
Candidate or Political Committee Name: Committee ill Number:
Elect Maurie Denner Page 1 of 1
Election: ~ Primary 2004 o General 20 o Other
Report: o 1st Pre-election o 2nd Pre-election o Post-election [8] 2005 September Supplemental
PURPOSE CODES (see back of form for instructions and code definitions) EXPENDITURE
A Agent 0 Other Advertising (yard signs, buttons, CA Cash
B Broadcast Advertising (Radio, TV) etc.) LP Loan Payment
C Cash Contributions P Postage
F Fundraising Event Expenses R Reimbursement for Personal Expenditures
G General Operational Expenses (describe if over S Surveys and Polls
$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
Une Payee's Name and Payee's Committee 10#, Exp. Amount of ~
# Date Check # if applicable Purpose Type Expenditure Paid
(as it appears on invoice, receipt or check) to AlP
1. 8/3/2005 Pacific Continental Bank G CA $ 32.70 0
2. 8/3/2005 Pacific Continental Bank G CA $ 5.00 0
3. 8/3/2005 Kidsports (donation of remaining C CA $ 178.87 0
funds)
4. $ 0
5. $ 0
6. $ 0
7. $ 0
8. $ 0
9. $ 0
10. $ 0
See Page Totals (Add all expenditures with the Accounting Period Totals (Complete only for last page and
Instructions same expenditure type.) transfer these amounts to the Summary Statement, PC 1.)
on Back and $ 216.57 Cash (CA) $ 216.57
in Campaign Cash (CA)
Finance Enter on Summary Statement. Column A. Line 6
Manual Loan Payment (LP) $ 0.00 Loan Payment (LP) $ 0.00
Enter on Surrunary Statement. Column A. Line 7
PC3
PC3A
Personal Expenditures for Reimbursement Rev. 12103
Candidate or Political Committee Name: Committee ill Number:
Elect Maurie Denner Page 1 of 1
Election: IZI Primary 2004 o General 20 o Other
Report: o 1st Pre-election o 2nd Pre-election o Po51-election IZI 2005 September Supplemental
PURPOSE CODES (see back of form for instructions and code definitions)
A Agent 0 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 if over $50)
G General Operational Expenses (describe if over $50) U Utilities
I Interest Payment W Wages, Salaries, Benefits
L Literature, Brochures, Printing y Petition Circulators
M Management Services Z Preparation and Production of Advertising
N Newspaper and Other Periodical Advertising
Une Date Payee's Name Purpose Amount of
# Expenditure
1. $
2. $
3. $
4. $
5. $
6. $
7. $
8. $
9. $
10. $
See Page Total Accounting Period Total (Complete only for last page and
Instructions Personal Expenditures $ 0.00 transfer this amount to the Summary Statement, PC 1.)
on Back and
in Campaign Personal Expenditures $ 0.00
Finance Enter on Summa!)' Statement, Line 31
Manual
PC3A
PC5
Accounts Receivable Rev. 12/03
Candidate or Political Committee Name: Committee ill Number:
Elect Maurie Denner Page 1 of 1
Election: IZI Primary 2004 o General 20 o Other
Report: o 1st Pre-election o 2nd Pre-election o Post-election IZI 2005 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 PACs) 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
0 Other
P Political Party Committee
Une# Name and Address of Contributor Amount of In-Kind Purpose
Account Receivab/e (see manual for suggested purpose codes)
Date Occupationa/lnformation or Contributor Code 1 I Code 2
Contributing Committee's IDIt- Aggregate
1. $
$ I
2. $
$ I
3. $
$ I
4. $
$ I
5. $
$ I
See Page Total (Add all amounts for the Accounts Accounting Period Total (Complete only for last page and
Instructions Receivable Type Codes specified. Do not include transfer these amounts to the Summary Statement, PC 1.)
on Back and PI or aggregate.)
in Campaign Codes OR, PC, PL $ 0.00 Codes OR, PC, PL $0.00
Finance
Manual Enler on Summary Statement, Colwnn A, Line 38
PC 5
PC6
Accounts Payable Rev. 12103
Candidate or Political Committee Name: Committee ID Number:
Elect Maurie Denner Page 1 of 1
Election: ~ Primary 2004 o General 20 o Other
Report: o 1st Pre-election o 2nd Pre-election o Post-election ~ 2005 September Supplemental
PURPOSE CODES (see back for instructions and code definitions)
A Agent 0 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 if over $50)
G General Operational Expenses (describe if over $50) U Utilities
I Interest Payment W Wages, Salaries, Benefits
L Literature, Brochures, Printing Y Petition Circulators
M Management Services Z Preparation and Production of Advertising
N Newspaper and Other Periodical Advertising
Une Date Payee's Name Purpose Amount of
# Account Payable
1. $
2. $
3. $
4. $
5. $
6. $
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 Sumlnary Statement, PC I.)
on Back and $ 0.00 Accounts Payable $0.00
in Campaign Accounts Payable
Finance Enter on Summary Statement. Column A. Line 42
Manual
PC6