HomeMy WebLinkAboutVote Yes for External Police Review
Summary Statement of Contributions and Expenditures PC 1
Rev. 12/03
Please type or print legibly in black ink. Page I of2
Candidate or Political Committee Name (use full name):
Vote Yes For External Police Review
Mailing Address as it Appears on Statement of Organization (street, route or box number, city, state, zip code):
P.O. Box 50155, Euqene, OR 97405
Treasurer's Name: I Telephone Number (day):
Judith Schaap 541-342-8303
Committee ID Number: I Committee Type, Measure Number or Office:
Ballot Measure 20-106
[g] Original o Primary 20 [g] General 2005 o Other
o Amendment [g] I st Pre-election o 2nd Pre-election o Post-election o 20_ September Supplemental
A-TOTALS FOR THIS B-CUMULA TlVE TOTALS
ACCOUNTING PERIOD FOR THIS ELECTION
CONTRIBUTIONS
I. Cash Contributions 899.00 899.00
(Accounting Period Total from PC 2)
2. Loans Received (Non-Exempt) + 1,600.00 + 1,600.00
(Accounting Period Total from PC 2)
3. Total Cash Contributions 2,499.00 = 2,499.00
=
(lines 1+ 2)
4. In-Kind + 0.00 + 0.00
(Accounting Period Total from PC 2)
5. TOTAL CONTRIBUTIONS 2,499.00 = 2,499.00
=
(lines 3 + 4)
EXPENDITURES
6. Cash Expenditures 1,429.82 1,429.82
(Accounting Period Total from PC 3)
7. Loan Payments (Non-Exempt) + 0.00 + 0.00
(Accounting Period Total from PC 3)
8. Total Cash Expenditures = 1,429.82 = 1 ,429.82
(lines 6 + 7)
9. In-Kind + 0.00 + 0.00
(Accounting Period Total from PC 2)
10. TOTAL EXPENDITURES = 1,429.82 = 1,429.82
(lines 8 + 9)
CASH BALANCE
II. Beginning Cash Balance 0.00 FOR OFFICE USE ONLY
(line 20 of previous report)
12. Total Contributions + 2,499.00
(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 = 2,499.00
(lines II + 12+ 13+ ]4)
16. Total Expenditures 1,429.82 RECEIVED
(line 10)
17. Other Disbursements + 0.00
(Accountin!r Period Total from PC 48) SEP 2 7 2005
18. Loan Payments (Exempt)
+ 0.00
(Accounting Period Total from PC 48) CITY RECORDER
19. EXPENDITURE SUBTOTAL = 1,429.82
(lines 16+ 17+ 18)
20. ENDING CASH BALANCE = 1 069.1 8
(line 15 minus line] 9)
Summary Statement of Contributions and Expenditures PC I
Rev. 12/03
Please type or print legibly in black ink. Page 2 of2
Candidate or Political Committee Name: Committee ID Number:
Vote Yes For External Police Review
[g] Original o Primary 20 [g] General 2005 o Other
o Amendment [g] 1 st Pre-election o 2nd Pre-election o Post-election 020 September Supplemental
LOAN SUMMARY FOR OFFICE USE ONL Y
21. Beginning Outstanding Loans 0.00
(line 29 of previous report)
22. Loans Received (Non-Exempt) + 1,600.00
(line 2)
23. Loans Received (Exempt) + 0.00
(line ]4)
24. LOANS RECEIVED SUBTOTAL 1,600.00
(lines 21 + 22 + 23) =
25. Loan Payments (Non-Exempt) 0.00
(I ine 7)
26. Loan Payments (Exempt) + 0.00
(line] 8)
27. Forgiven Loans + 0.00
(Total loans forgiven during this accounting period)
28. LOAN PAYMENT SUBTOTAL 0.00
(lines 25 + 26 +27) =
29. TOTAL OUTSTANDING LOANS 1,600.00
(line 24 minus line 28) =
PERSONAL EXPENDITURE SUMMARY
30. Beginning Outstanding Personal Expenditures 0.00
(line 36 of previous report)
31. Personal Expenditures + 34.00
(Accounting Period Total from PC 3A)
32. PERSONAL EXPENDITURE SUBTOTAL 34.00
(lines 30 + 31) =
33. Personal Expenditure Reimbursements 34.00
(Total expenditures on PC 3 with purpose code R)
34. Forgiven Personal Expenditures + 0.00
(Total personal expenditures forgiven this acctg. period)
35. REIMBURSEMENT SUBTOTAL = 34.00
(lines 33 + 34)
36. OUTSTANDING PERSONAL EXPENDITURES 0.00
(line 32 minus line 35) =
FINANCIAL STATUS AT CLOSE OF ACCOUNTING PERIOD
37. Ending Cash Balance 1 069.1 8
(line 20)
38. Accounts Receivable + 0.00
(Accounting Period Total from PC 5)
39. SUBTOTAL 1069.18
(lines 37 + 38) =
40. Total Outstanding Loans 1,600.00
(line 29)
41. Outstanding Personal Expenditures + 0.00
(tine 36)
42. Accounts Payable + 576.00
(Accounting Period Total from PC 6)
43. SUBTOTAL 2,176.00
(lines 40 + 41 + 42) =
44. BALANCE/DEFICIT -1,106.82
(line 39 minus line 43: indicate + or - balance) =
I, Judith Schaap (name of candidate or treasurer), hereby certifY that the above statement and the attached supporting reports are
true and correct.
C)^ 7- :>7,. --
O~
Signature of candid~ or treasurer Date signed
..
PC 2
Cash Contributions, Loans Received and In-Kind Rev. 12/03
Candidate or Political Committee Name: Committee ID Number:
Vote Yes For External Police Review Page 1 of~
Election: o Primary 20 [g] General 2005 o Other
Report: [g] I st Pre-election o 2nd Pre-election o Post-election 020_ 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
Line # 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
Judith Schaap
1. 100 West 38th Ave $ 100.00
Eugene, OR 97405
8/24/2005 Graphic Artist $ 100.00 I I LR
Michael Carrigan
2. 139 W. 4th Ave. $ 50.00
Eugene, OR 97402
9/10/2005 Non-Profit Organization Development $ 50.00 I I CA
Director
Andrea Ortiz
3. 189 Foch St. $ 300.00
Eugene, OR 97402
9/10/2005 Patient Access Specialist $ 300.00 I I LR
Bonny BeUman
4. 2191 Friendly St. $ 100.00
Eugene, OR 97405
9/10/2005 City Councilor $ 100.00 I I CA
Ron Chase
5. 924 Sunnyside Dr. $ 100.00
Eugene, OR 97404
9/13/2005 Non-Profit Executive Director $ 100.00 I I CA
See Page Totals (Add all amounts with the same Accounting Period Totals (Complete only for last page and
Instructions contribution type. Do not include aggregates.) transfer these amounts to the Summary Statement, PC 1.)
on Back and Cash (CA) $ 250.00 Cash (CA) $
in Campaign Enter on Summary Statement, Column A, Line I
Finance In-Kind (IK) $
Manual In-Kind (IK) $
Enter on Summary Statement, Column A, Lines 4 and 9
PC 2 Loans Received (LR) $ 400.00 Loans Received (LR) $
Enter on Summary Statement, Column A. Line 2
PC 2
Cash Contributions, Loans Received and In-Kind Rev. 12/03
Candidate or Political Committee Name: Committee ID Number:
Vote Yes For External Police Review Page ,g of ~
Election: o Primary 20 [g] General 2005 o Other
Report: [g] I st Pre-election o 2nd Pre-election o Post-election 020 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
Line # 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
Aaron Boyce
1. 422 Brookside Dr. $ 300.00
Eugene, OR 97405
9/12/2005 Nurse $ 300.00 I I LR
Andrea Ortiz
2. 189 Foch St. $ 300.00
Eugene, OR 97402
9/14/2005 Patient Access Specialist $ 600.00 I I LR
Bonny BeUman
3. 2191 Friendly St. $ 300.00
Eugene, OR 97405
9/16/2005 City Councilor $ 400.00 I I LR
Charles S. Dalton
4. 3012 Timberline Dr. $ 50.00
Eugene, OR 97405
915/2005 Customer Relations Manager $ 50.00 I I CA
Ron Chase
5. 924 Sunnyside Dr. $ 300.00
Eugene, OR 97404
9/15/2005 Non-Profit Executive Director $ 400.00 I I LR
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 I.)
on Back and Cash (CA) $ 50.00 Cash (CA) $
in Campaign Enter on Summary Statement, Column A, Line]
Finance
Manual In-Kind (IK) $ In-Kind (IK) $
Enter on Summary Statement, Column A, Lines 4 and 9
PC 2 Loans Received (LR) $ 1 ,200.00 Loans Received (LR) $
Enter on Summary Statement. Column A, Line 2
pe2
Cash Contributions, Loans Received and In-Kind Rev. 12/03
Candidate or Political Committee Name: Committee ID Number:
Vote Yes For External Police Review Page ~ of~
Election: o Primary 20 [g] General 2005 o Other
Report: [g] I st Pre-election o 2nd Pre-election o Post-election 020 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
Line # 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
Deborah Noble
1. 4990 W. Hillside Dr. $ 250.00
Eugene, OR 97405
9/20/2005 Lumber Products Business Owner $ 250.00 I I CA
Jerome Diethelm
2. 2652 Agate St. $ 100.00
Eugene, OR 97403
9/20/2005 Architect $ 100.00 I I CA
David Kelly for City Council Committee
3. 1040 Ferry St. B405 $ 50.00
Eugene, OR 97401
9/20/2005 PAC $ 50.00 C I CA
Cary D. Thompson
4. 966 Jackson $ 100.00
Eugene, OR 97402
9/22/2005 Retired $ 100.00 I I CA
Miscellaneous Donations Under $50.00
5. $ 99.00
9/12/2005- $ I I CA
9/20/2005
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) $ 599.00 Cash (CA) $ 899.00
in Campaign Enter on Summary Statement, Column A, Line 1
Finance $ 0.00
Manual In-Kind (IK) $ 0.00 In-Kind (IK)
Enter on Summary Statement, Column A, Lines 4 and 9
PC 2 Loans Received (LR) $ 0.00 Loans Received (LR) $ 1.600.00
Enter on Summary Statement. Column A, Line 2
PC3
Cash Expenditures and Loan Payments Rev. 12/03
Candidate or Political Committee Name: Committee ID Number:
Vote Yes For External Police Review Page 1 of 1
Election: o Primary 20 [g] General 2005 o Other
Report: [g] I st Pre-election o 2nd Pre-election o Post-election 020 September Supplemental
PURPOSE CODES (see back of form for instructions and code definitions) EXPENDITURE TYPES
A Agent 0 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 10#, Exp. Amount of ~
Line # Date Check # if applicable Purpose Type Expenditure Paid
(as it appears on invoice, receipt or check) to AlP
1. 8/31 /2005 Pacific Continental Bank G CA $ 16.20 D
2. 9/15/2005 101 City of Eugene 0 CA $ 1,200.00 D
3. 9/15/2005 102 Instaprint L CA $ 2.80 D
4. 9/20/2005 103 John Jordan-Cascade 0 CA $ 21.36 D
5. 9/20/2005 104 Office Max L CA $ 32.71 D
6. 9/20/2005 105 Instaprint P CA $ 122.75 D
7. 9/20/2005 106 Judith Schaap R CA $ 34.00 D
8. $ D
9. $ D
10. $ D
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 I.)
on Back and Cash (CA) $ 1.429.82 Cash (CA) $ 1.429.82
in Campaign
Finance Enter on Summary Statement, Column A, Line 6
Manual Loan Payment (LP) $ Loan Payment (LP) $
Enter on Summary Statement, Column A, Line 7
PC 3
PC3A
Personal Expenditures for Reimbursement Rev. 12/03
Candidate or Political Committee Name: Committee ID Number:
Vote Yes For External Police Review Page 1 of 1
Election: D Primary 20 [g] General 2005 o Other
Report: [g] I st Pre-election o 2nd Pre-election o Post-election 020 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
Line # Date Payee's Name Purpose Amount of
Expenditure
1. 8/24/2005 U.S. Postal Service G $ 34.00
2. $
3. $
4. $
5. $
6. $
7. $
8. $
9. $
10. $
See Page Total Accounting Period Total (Complete only for last page and
Instructions Personal Expenditures $ 34.00 transfer this amount to the Summary Statement, PC 1.)
on Back and
in Campaign Personal Expenditures $ 34.00
Finance Enter on Summary Statement, Line 31
Manual
PC3A
PC 6
Accounts Payable Rev. 12/03
Candidate or Political Committee Name: Committee ID Number:
Vote Yes For External Police Review Page 1 of 1
Election: o Primary 20 [g] General 2005 o Other
Report: [g] I st Pre-election o 2nd Pre-election o Post-election 020 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
Line # Date Payee's Name Purpose Amount of
Account Payable
1. 9/15/2005 Postal Connection P $ 420.00
2. 9/15/2005 Northwe~Sen~rNews N $ 156.00
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 Summary Statement, PC I.)
on Back and Accounts Payable $ 576.00 Accounts Payable $ 576.00
in Campaign
Finance Enter on Summary Statement, Column A, Line 42
Manual
PC 6
Summary Statement of Contributions and Expenditures PC I
Rev. 12/03
Please type or print legibly in black ink. Page I of2
Candidate or Political Committee Name (use full name):
Vote Yes For External Police Review
Mailing Address as it Appears on Statement of Organization (street, route or box number, city, state, zip code):
P.O. Box 50155, Euqene, OR 97405
Treasurer's Name: I Telephone Number (day):
Judith Schoap 541-342-8303
Committee ID Number: I Committee Type, Measure Number or Office:
Ballot Measure 20-106
[g] Original o Primary 20 [g] General 2005 o Other
o Amendment o I st Pre-election [g] 2nd Pre-election o Post-election o 20_ September Supplemental
A-TOTALS FOR THIS B-CUMULATIVE TOTALS
ACCOUNTING PERIOD FOR THIS ELECTION
CONTRIBUTIONS
I. Cash Contributions 3,767.00 4,666.00
(Accounting Period Total from PC 2)
2. Loans Received (Non-Exempt) + 0.00 + 1,600.00
(Accounting Period Total from PC 2)
3. Total Cash Contributions = 3,767.00 = 6266.00
(lines 1+2)
4. In-Kind + 1,093.42 + 1,093.42
(Accounting Period Total from PC 2)
5. TOT AL CONTRIBUTIONS = 4,860.42 = 7,359.42
(lines 3 + 4)
EXPENDITURES
6. Cash Expenditures 2,851.95 4281.77
(Accounting Period Total from PC 3)
7. Loan Payments (Non-Exempt) + 1300.00 + 1,300.00
(Accounting Period Total from PC 3)
8. Total Cash Expenditures = 4151.95 = 5581.77
(lines 6 + 7)
9. In-Kind + 1,093.42 + 1,093.42
(Accounting Period Total from PC 2)
10. TOTAL EXPENDITURES = 5,245.37 = 6,675.19
(lines 8 + 9)
CASH BALANCE
11. Beginning Cash Balance 1,069.18 FOR OFFICE USE ONL Y
(line 20 of previous report)
12. Total Contributions + 4,860.42
(line 5)
13. Other Receipts + 0.00 RECEIVED
(Accounting Period Total from PC 4A)
14. Loans Received (Exempt) + 0.00
(Accounting Period Total from PC 4A) OCT 2 6 2005
15. CONTRIBUTION SUBTOTAL = 5929.60
(lines II + 12 + 13 + 14) CITY RECORDEH
16. Total Expenditures 5,245.37
(line 10)
17. Other Disbursements + 0.00
(AccountinQ: Period Total from PC 4B)
18. Loan Payments (Exempt) + 0.00
(Accounting Period Total from PC 4B)
19. EXPENDITURE SUBTOTAL = 5,245.37
(Iincs 16 + 17 + 18)
20. ENDING CASH BALANCE = 684.23
(line 15 minus line 19)
Summary Statement of Contributions and Expenditures PC J
Rev. 12/03
Please type or print legibly in black ink. Page 2 of2
Candidate or Political Committee Name: I Committee ID Number:
Vote Yes For External Police Review
[g] Original o Primary 20 [g] General 2005 o Other
o Amendment o I st Pre-election [g] 2nd Pre-election o Post-election 020 September Supplemental
LOAN SUMMARY FOR OFFICE USE ONLY
21. Beginning Outstanding Loans 1,600.00
(line 29 of orevious report)
22. Loans Received (Non-Exempt) + 0.00
(line 2)
?" Loans Received (Exempt)
-.). + 0.00
(line 14)
24. LOANS RECEIVED SUBTOTAL = 1,600.00
(lines 21 + 22 + 23)
25. Loan Payments (Non-Exempt) 1,300.00
(line 7)
26. Loan Payments (Exempt) + 0.00
(line 18)
27. Forgiven Loans + 300.00
(Total loans forgiven during this accounting period)
28. LOAN PAYMENT SUBTOTAL = 1,600.00
(lines 25 + 26 +27)
29. TOTAL OUTSTANDING LOANS = 0
(line 24 minus line 28)
PERSONAL EXPENDITURE SUMMARY
30. Beginning Outstanding Personal Expenditures 0.00
(line 36 of previous report)
31. Personal Expenditures + 0.00
(Accounting Period Total from PC 3A)
32. PERSONAL EXPENDITURE SUBTOTAL = 0.00
(lines 30 + 31)
33. Personal Expenditure Reimbursements 0.00
(Total expenditures on PC 3 with ouroose code R)
34. Forgiven Personal Expenditures + 0.00
(Total oersonal expenditures forQ:iven this acctg. period)
35. REIMBURSEMENT SUBTOTAL = 0
(lines 33 + 34)
36. OUTST ANDINC PERSONAL EXPENDITURES = 0.00
(line 32 minus line 35)
FINANCIAL STATUS AT CLOSE OF ACCOUNTING PERIOD
37. Ending Cash Balance 684.23
(line 20)
38. Accounts Receivable + 0.00
(Accounting Period Total from PC 5) RECEIVED
39. SUBTOTAL = 684.23
(lines 37 + 38)
40. Total Outstanding LOHns 0.00 OCT 2 6 2005
(line 29)
41. Outstanding Personal Expenditures + 0.00
(line 36) CITY RECORDER
42. Accounts Payable + 0.00
(Accounting Period Total from PC 6)
43. SUBTOTAL = 0.00
(lines 40 + 41 + 42)
44. BALANCEIDEFICIT = 684.23
(line 39 minus line 43: indicate + or - balance)
I, Judith Schaap (name of candidate or treasurer), hereby certifY that the above statement and the attached supporting reports are
true and correct.
~ ---
~ IO~~(" ,. oS
Signature of candidate ~ ylasurer Date signed
/
PC2
Cash Contributions, Loans Received and In-Kind Rev. 12/03
Candidate or Political Committee Name: Committee ID Number:
Vote Yes For External Police Review Page 1 of~
Election: o Primary 20 [g] General 2005 o Other
Report: o I st Pre-election [g] 2nd Pre-election o Post-election o 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
Line # 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
Nancy Ellen Locke
1. 1130 W 25th Ave $ 100.00
Eugene, OR 97405
9/24/2005 Small Woodlot Tree Farmer $ 100.00 I I CA
Daniel Goldrich
2. 2262 Birch Ln $ 50.00
Eugene, OR 97403
9/24/2005 Retired $ 50.00 I I CA
Richard Kraus
3. 1313 Lincoln #1301 $ 100.00
Eugene, OR 97401
9/27/2005 University Professor $ 100.00 I I CA
R. Joe Valasek
4. 2580 Chula Vista Rd $ 50.00
Eugene, OR 97403
9/27/2005 Sculptor $ 50.00 I I CA
John B. Holtzapple, III, M.D.
5. 1404 E 23rd Ave $ 50.00
Eugene, OR 97403
9/27/2005 Family Physician $ 50.00 I I CA
See Page Totals (Add all amounts with the same Accounting Period Totals (Complete only for last page and
Instructions contribution type. Do not include aggregates.) transfer these amounts to the Summary Statement, PC I.)
on Back and Cash (CA) $ 350.00 Cash (CA) $
in Campaign Enter on Summary Statement, Column A, Line I
Finance $
Manual In-Kind (IK) $ 0.00 In-Kind (IK)
Enter on Summary Statement, Column A. Lines 4 and 9
PC 2 Loans Received (LR) $ 0.00 Loans Received (LR) $
Enter on Summary Statement, Column A, Line 2
PC 2
Cash Contributions, Loans Received and In-Kind Rev. 12/03
Candidate or Political Committee Name: Committee ID Number:
Vote Yes For External Police Review Page.f. of~
Election: o Primary 20 [g] General 2005 o Other
Report: o I st Pre-election [g] 2nd Pre-election o Post-election o 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
Line # 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
Edward B. Meservey
1. 2070 E. 27th Ave $ 50.00
Eugene, OR 97403
9/27/2005 Retired $ 50.00 I I CA
Ruth E. Miller
2. 2460 Malbar Dr $ 50.00
Eugene, OR 97403
9/27/2005 Retired $ 50.00 I I CA
Nancy Gabriel
3. 2275 Washington $ 100.00
Eugene, OR 97405
9/27/2005 Pre-School Teacher $ 100.00 I I CA
Dan Dreier
4. 285 W 14th Ave #6 $ 50.00
Eugene, OR 97401
9/27/2005 Bus Driver $ 50.00 I 1 CA
Sylvia Hart
5. 260 N Grand St $ 60.00
Eugene, OR 97402
9/27/2005 Retired $ 60.00 I I CA
See Page Totals (Add all amounts with the same Accounting Period Totals (Complete only for last page and
Instructions contribution type. Do not include aggregates.) transfer these amounts to the Summary Statement, PC 1.)
on Back and Cash (CA) $ 310.00 Cash (CA) $
in Campaign Enter on Summary Statement, Column A. Line 1
Finance In-Kind (IK) $
Manual In-Kind (IK) $ 0.00
Enter on Summary Statement, Column A, Lines 4 and 9
PC 2 Loans Received (LR) $ 0.00 Loans Received (LR) $
Enter ou Summary Statement, Column A, Line 2
PC 2
Cash Contributions, Loans Received and In-Kind Rev. 12/03
Candidate or Political Committee Name: Committee ID Number:
Vote Yes For External Police Review Page ~ ofH
Election: o Primary 20 [g] General 2005 o Other
Report: o I st Pre-election [g] 2nd Pre-election o Post-election 020 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
Line # 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
David Piercy
1. 1371 W 4th St $ 100.00
Eugene, OR 97402
9/27/2005 Retired $ 100.00 I I CA
Art Johnson
2. 975 Oak St, Ste 1050 $ 500.00
Eugene, OR 97401
9/27/2005 Lawyer $ 500.00 I I CA
Angelina Sifuentez
3. 1811 Russet Dr $ 100.00
Eugene, OR 97401
9/28/2005 Marketing Representative $ 100.00 I I CA
Etta S. Tressler
4. 389 W 29th Ave $ 50.00
Eugene, OR 97405
9/28/2005 Retired $ 50.00 I I CA
Neil Van Steenbergen
5. 1366 Lawrence St #8 $ 50.00
Eugene, OR 97401
9/28/2005 Retired $ 50.00 I I CA
See Page Totals (Add all amounts with the same Accounting Period Totals (Complete only for last page and
Instructions contribution type. Do not include aggregates.) transfer these amounts to the Summary Statement, PC I.)
on Back and Cash (CA) $ 800.00 Cash (CA) $
in Campaign Enter on Summary Statement. Cohunn A. Line 1
Finance
Manual In-Kind (IK) $ 0.00 In-Kind (IK) $
Enter on Summary Statement. Column A, Lines 4 and 9
PC 2 Loans Received (LR) $ 0.00 Loans Received (LR) $
Enter on Summary Statement, Column A, Line 2
PC 2
Cash Contributions, Loans Received and In-Kind Rev. 12/03
Candidate or Political Committee Name: Committee ID Number:
Vote Yes For External Police Review Page 1 of~
Election: o Primary 20 [g] General 2005 o Other
Report: o 1 st Pre-election "'0 2nd Pre-election o Post-election o 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
Line # 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
Constance P. Brown
1. 35401 Row River Rd. #3 $ 50.00
Cottage Grove, OR 97424
9/29/2005 Retired $ 50.00 I I CA
Donald Brodsky
2. 3085 Whitbeck Blvd $ 50.00
Eugene, OR 97405
9/29/2005 Musical Instrument Builder $ 50.00 I I CA
Deborah Telew
3. 30065 LeBleu Rd $ 50.00
Eugene, OR 97405
9/29/2005 Retired $ 50.00 I I CA
Rob Handy
4. 455 1/2 River Rd $ 165.00
Eugene, OR 97403
9/29/2005 Landscaper $ 165.00 I I CA
Carolyn Partridge
5. 3575 Knob Hill Ln $ 50.00
Eugene, OR 97405
9/29/2005 Teacher $ 50.00 I I CA
See Page Totals (Add all amounts with the same Accounting Period Totals (Complete only for last page and
Instructions contribution type. Do not include aggregates.) transfer these amounts to the Summary Statement, PC I.)
on Back and Cash (CA) $ 365.00 Cash (CA) $
in Campaign Enter on Summary Statement. Column A, Line I
Finance
Manual In-Kind (IK) $ 0.00 In-Kind (IK) $
Enter on Summary Statement, Column A. Lines 4 and 9
PC 2 Loans Received (LR) $ 0.00 Loans Received (LR) $
Enter on Summary Statement, Column A. Line 2
PC 2
Cash Contributions, Loans Received and In-Kind Rev. 12/03
Candidate or Political Committee Name: Committee ID Number:
Vote Yes For External Police Review Page .Q of JZ
Election: o Primary 20 [g] General 2005 o Other
Report: o I st Pre-election [g] 2nd Pre-election o Post-election 020_ 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
Line # 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
Sarah S. Weston
1. 2595 Highland Dr $ 50.00
Eugene, OR 97403
9/30/2005 Retired $ 50.00 I I CA
Patricia Straub
2. 1552 C St $ 50.00
Springfield, OR 97477
10/5/2005 Retired $ 50.00 I I CA
Howard Bonnett
3. 1835 E 28th Ave $ 50.00
Eugene, OR 97403
10/10/2005 Retired $ 50.00 I I CA
Virginia M. La
4. 1855 E 28th Ave $ 50.00
Eugene, OR 97403
10/10/2005 Professor $ 50.00 I I CA
Howard J. Anderson
5. 1027 West Broadway $ 50.00
Eugene, OR 97402
10/10/2005 Attorney $ 50.00 I I CA
See Page Totals (Add all amounts with the same Accounting Period Totals (Complete only for last page and
Instructions contribution type. Do not include aggregates.) transfer these amounts tv the Summary Statement, PC I.)
on Back and Cash (CA) $ 250.00 Cash (CA) $
in Campaign Enter on Summary Statement. Column A, Line I
Finance $
Manual In-Kind (IK) $ 0.00 In-Kind (IK)
Enter on Summary Statement, Column A, Lines 4 and 9
PC 2 Loans Received (LR) $ 0.00 Loans Received (LR) $
Enter on Summary Statement, Column A. Line 2
PC 2
Cash Contributions, Loans Received and In-Kind Rev. 12/03
Candidate or Political Committee Name: Committee ID Number:
Vote Yes For External Police Review Page Q of~
Election: o Primary 20 [g] General 2005 o Other
Report: o 1 st Pre-election [g] 2nd Pre-election o Post-election 020 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
Line # 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
Stephen Isaac
1. PO Box 294 $ 100.00
Eugene, OR 97440
10/10/2005 Office Specialist $ 100.00 I I CA
Hope Marston
2. PO Box 51434 $ 50.00
Eugene, OR 97405
10/10/2005 Political Committee Organizer $ 50.00 I I CA
Polly Nelson
3. 2470 Lawrence St $ 100.00
Eugene, OR 97405
10/12/2005 Non-Profit Education Director $ 100.00 I I CA
Greg McLauchlan
4. 2401 W 22nd Ave $ 75.00
Eugene,OR 97405
10/17/2005 Professor $ 75.00 I I CA
Joe Connelly
5. 1361 Pearl St $ 50.00
Eugene, OR 97401
10/17/2005 Lawyer $ 50.00 I I CA
See Page Totals (Add all amounts with the same Accounting Period Totals (Complete only for last page and
Instructions contribution type. Do not include aggregates.) transfer these amounts to the Summary Statement, PC I.)
on Back and Cash (CA) $ 375.00 Cash (CA) $
in Campaign Enter on Summary Statement, Column A, Line 1
Finance ~
Manual In-Kind (IK) $ 0.00 In-Kind (IK)
Enter on Summary Statement, Column A, Lines 4 and 9
PC 2 Loans Received (LR) $ 0.00 Loans Received (LR) $
Enter on Summary Statement. Column A, Line 2
PC 2
Cash Contributions, Loans Received and In-Kind Rev. 12/03
Candidate or Political Committee Name: Committee ID Number:
Vote Yes For External Police Review Page Z of~
Election: o Primary 20 [g] General 2005 D Other
Report: o 1 st Pre-election [g] 2nd Pre-election o Post-ejection 020 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
Line # 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
David Monk
1. 3720 Emerald St $ 100.00
Eugene, OR 97405
10/17/2005 Unemployed $ 100.00 I I CA
Ron Chase
2. 924 Sunnyside Dr. $ 100.00
Eugene, OR 97404
10/17/2005 Executive Director Non-Profit $ 500.00 I I CA
Sara Rich
3. 390 E 43rd Ave $ 50.00
Eugene, OR 97405
10/17/2005 Family Therapist $ 50.00 I I CA
Miscellaneous Donations Under $50.00
4. $ 1067.00
9/27/2005 to $ I I CA
10/23/2005
ACLU of Oregon
5. PO Box 50426 $ 14.40 L
Eugene, OR 97405
9/30/2005 Non-Profit Organization $ 14.40 0 I IK
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 I.)
on Back and Cash (CA) $ 1317.00 Cash (CA) $
in Campaign Enter on Summary Statement, Column A, Line 1
Finance
Manual In-Kind (IK) $14.40 In-Kind (IK) $
Enter on Summary Statement, Column A. Lines 4 and 9
PC 2 Loans Received (LR) $ 0.00 Loans Received (LR) $
Enter on Summary Statement. Column A, Line 2
PC2
Cash Contributions, Loans Received and In-Kind Rev. 12/03
Candidate or Political Committee Name: Committee ID Number:
Vote Yes For External Police Review Page ~ of~
Election: o Primary 20 [g] General 2005 o Other
Report: o 1 st Pre-election [g] 2nd Pre-election o Post-election 020 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
Line # 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
ACLU of Oregon
1. PO Box 50426 $ 443.92 L
Eugene, OR 97405
10/7/2005 Non-Profit Organzation $ 458.32 0 I IK
ACLU of Oregon
2. PO Box 50426 $ 410.43 P
Eugene, OR 97405
10/11/2005 Non-Profit Organzation $ 868.65 0 I IK
ACLU of Oregon
3. PO Box 50426 $ 109.56 L
Eugene, OR 97405
10/21/2005 Non-Profit Organzation $ 978.21 0 I IK
Andrea Ortiz
4. 189 Foch St. $ 32.66 G
Eugene, OR 97402
10/19 Patient Access Specialist $ 632.66 I I IK
Andrea Ortiz
5. 189 Foch St. $ 7.91 G
Eugene, OR 97402
10/22/2005 Patient Access Specialist $ 640.57 I I IK
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 I.)
on Back and Cash (CA) $ 0.00 Cash (CA) $
in Campaign Enter on Summary Statement. Column A, Line I
Finance In-Kind (IK) $
Manual In-Kind (IK) $ 1,004.48
Enter on Summary Statement, Column A. Lines 4 and 9
PC 2 Loans Received (LR) $ 0.00 Loans Received (LR) $
Enter on Summary Statement. Column A. Line 2
PC2
Cash Contributions, Loans Received and In-Kind Rev. 12/03
Candidate or Political Committee Name: Committee ID Number:
Vote Yes For External Police Review Page ~ of~
Election: o Primary 20 [g] General 2005 o Other
Report: o I st Pre-election [g] 2nd Pre-election o Post-election o 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
Line # 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
Andrea Ortiz
1. 189 Foch St. $ 74.54 G
Eugene, OR 97402
10/21/2005 Patient Access Specialist $ 715.11 I I IK
2. $
$ I
3. $
$ I
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) $ 3,767.00
in Campaign Enter on Summary Statement, Column A, Line 1
Finance In-Kind (IK) $ 1 ,093.42
Manual In-Kind (IK) $ 74.54
Enter on Summary Statement, Cohunn A, Lines 4 and 9
PC 2 Loans Received (LR) $ 0.00 Loans Received (LR) $ 0.00
Enter on SlUnmary Statement, Column A. Line 2
PC 3
Cash Expenditures and Loan Payments Rev. 12/03
Candidate or Political Committee Name: Committee ID Number:
Vote Yes For External Police Review Page 1 of~
Election: o Primary 20 [g] General 2005 o Other
Report: o 1 st Pre-election [g] 2nd Pre-election o Post-election 020 September Supplemental
PURPOSE CODES (see back of form for instructions and code definitions) EXPENDITURE TYPES
A Agent 0 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 10#, Exp. Amount of ~
Line # Date Check # if applicable Purpose Type Expenditure Paid
(as it appears on invoice, receipt or check) to AlP
1. 9/28/05 107 Bonny Bettman LP $ 300.00 D
2. 9/28/05 108 Postal Connection p CA $ 469.99 D
3. 9/28/05 109 Northwest Senior News N CA $ 159.00 D
4. 1 0/3/05 110 Eugene Weekly N CA $ 200.00 D
5. 10/7/05 111 Postmaster P CA $ 37.00 D
6. 10/11/05 112 Eugene Weekly N CA $ 264.00 D
7. 10/2/05 Pacific Continental Bank G CA $ 6.75 D
8. 10/18/05 113 Judith Schaap LP $ 100.00 D
9. 10/18/05 114 Andrea Ortiz LP $ 300.00 D
10. 10/18/05 115 Aaron Boyce LP $ 300.00 D
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 Cash (CA) $ 1 ,136.74 Cash (CA) $
in Campaign
Finance Enter on Summary Statement, Column A, Line 6
Manual Loan Payment (LP) $ 1 ,000.00 Loan Payment (LP) $
Enter on Summary Statement, Column A, Line 7
PC 3
PC 3
Cash Expenditures and Loan Payments Rev. 12/03
Candidate or Political Committee Name: Committee ID Number:
Vote Yes For External Police Review Page ~ of~
Election: o Primary 20 [g] General 2005 o Other
Report: o I st Pre-election [g] 2nd Pre-election o Post-election 020 September Supplemental
PURPOSE CODES (see back of form for instructions and code definitions) EXPENDITURE TYPES
A Agent 0 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 10#, Exp. Amount of ~
Line # Date Check # if applicable Purpose Type Expenditure Paid
(as it appears on invoice, receipt or check) to AlP
1. 10/18/05 116 Ron Chase LP $ 300.00 D
2. 10/18/05 117 Eugene Weekly N $ 264.00 D
3. 10/18/05 118 Register Guard N $ 1,286.46 D
4. 10/19/05 119 Paper Plus L $ 12.75 D
5. 10/19/05 120 Instaprint L $ 15.00 D
6. 10/21/05 121 Instaprint L $ 137.00 D
7. $ D
8. $ D
9. $ D
10. $ D
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 I.)
on Back and Cash (CA) $ 1,715.21 Cash (CA) $ 2,851.95
in Campaign
Finance Enter on Summary Statement, Column A, Line 6
Manual Loan Payment (LP) $ 300.00 Loan Payment (LP) $ 1 ,300.00
Enter on Summary Statement. Coltunn A, Line 7
PC 3
PC 2 Amendment
Amendments - Cash Contributions, Loans Received and In-Kind Rev. 12103
Candidate or Political Committee Name:
Vote Yes For External Police Review
Election:
Report:
o Primary 20
o I st Pre-election
[g] General 2005
[g] 2nd Pre-election
Committee ID Number:
Page 1 of 1
o Other
o Post-election
o 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) ~ Cosigner Obligation
F Ca~d!date's Immediate Family (includes candidate) R E eEl V t!U In-Kind
I IndIvIdual LR Loan Received
L Labor Organization
o Other
P Political Party Committee
Amending Page #
and Line #
Date Received
Page~ Line2
D New Entry
i:8l Correcting
D Deleting
1 0/11/2005
Page~ Line2
D New Entry
i:8l Correcting
D Deleting
1 0/21/2005
Page_ line_
D New Entry
D Correcting
D Deleting
Page_ Line_
D New Entry
D Correcting
D Deleting
Page_ line_
D New Entry
D Correcting
D Deleting
See
Instrwctions
on Back and
in Campaign
Finance
Manual
PC 2
Amendment
Name and Address of Contributor
Occupational Information or
Contributing Committee's 10#
ACLU of Oregon
PO Box 50426
Eugene, OR 97405
Non-Profit Organzation
ACLU of Oregon
PO Box 50426
Eugene, OR 97405
Non-Profit Organzation
~
Signaturety'andidate or treasurer
/1~/--t:J~
Date signed
NOV 0 1 2005
~ II y A~"" ~t 1m JER In-Kind Purpose
Contribution (see manual for suggested purpose codes)
Contributor Code 1 I Code 2
Aggregate
$ 41 0.43
$ 868.75
$ 109.56
$ 978.31
$
$
$
$
$
$
P
I
o
IK
L
I
o
IK
I
I
I
FOR OFFICE USE ONLY
PC8A
Supplement to Second Pre/Post-Election - Contributions Rev. 12/03
Candidate or Political Committee Name: Committee ID Number:
Vote Yes For External Police Review Page 1 of 1
Election: o Primary 20 [g] General 2005 o Other
Report: o 1st Suppl. to the 2nd Pre-election [g] 2nd Suppl. to the 2nd Pre-election o 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
0 Other PI Pledge of In-Kind
P Political Party Committee PL Pledge of Loan
Line # Name and Address of Contributor Amount of
Contribution In-Kind Purpose
Date Received Occupational Information or Code 1 I Code 2 (see manual for suggested purpose codes)
Contributing Committee's 10#
Bonny Bettman
1. 2191 Friendly St $ 1,000.00
Eugene, OR 97405
11/2/05 City Councilor I I LR
2. $
I
3. $
I
4. $
I
5. $
I
See FOftt~ tlJETIL Y
Instructions I, Judith Schaap, (name of candidate or treasurer) hereby certifY that
on Back and the above statement is true and correct.
in Campaign (\>o NOV 1 5 2005
Finance --
Manual 1/"') s: J7~ ~lfrv RECORDER
PC8A Signature of cylftidate or treasurer Date signed
U
Supplement to Second Pre-Election - Expenditures
PC8B
Rev. 12/03
Candidate or Political Committee Name:
Vote Yes For External Police Review
Committee ID Number:
Page 1 of 1
Election: 0 Primary 20 [g] General 2005 0 Other
Report: 0 1st Suppl. to the 2nd Pre-election [g] 2nd Suppl. to the 2nd Pre-election
PURPOSE CODES (see back of form for instructions and code definitions) EXPENDITURE TYPES
A Agent 0 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 ifover$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
Line #
Date
Check #
Payee's Name
(as it appears on invoice, receipt or check)
Purpose
1.
10/31/05
125
Register Guard
N
Exp. Amount of
Type Expenditure
CA $ 306.30
CA $ 980.16
$
$
$
$
$
$
$
$
FO~E6t~~[} Y
NOV 1 5 2005
CITY RECORDER
2.
11/2/05
127
Register Guard
N
3.
4.
5.
6.
7.
8.
9.
10.
See
Instructions
on Back and
in Campaign
Finance
Manual
I, Judith Schaap, (name of candidate or treasurer) hereby certifY that
the above statement is true and correct.
~
/' /'
//.- /~ - OS
PC 8B
Signature of candidf~ or treasurer
V
Date signed
Summary Statement of Contributions and Expenditures PC 1
Rev. 12/03
Please type or print legibly in black ink. Page I of2
Candidate or Political Committee Name (use full name):
Vote Yes For External Police Review
Mailing Address as it Appears on Statement of Organization (street, route or box number, city, state, zip code):
P.O. Box 50155, Eugene, OR 97405
Treasurer's Name: I Telephone Number (day):
Judith Schoap 541-342-8303
Committee ID Number: I Committee Type, Measure Number or Office:
Ballot Measure 20-106
[g] Original o Primary 20 [g] General 2005 o Other
o Amendment o I st Pre-election o 2nd Pre-election [g] Post-election 020 September Supplemental
A-TOTALS FOR THIS B-CUMULA TIVE TOTALS
ACCOUNTING PERIOD FOR THIS ELECTION
CONTRIBUTIONS
1. Cash Contributions 1,570.00 6,236.00
(Accounting Period Total from PC 2)
2. Loans Received (Non-Exempt) + 1,000.00 + 2,600.00
(Accounting Period Total from PC 2)
3. Total Cash Contributions = 2,570.00 = 8,836.00
(lines 1+ 2)
4. In-Kind + 0.00 + 1,093.42
(Accounting Period Total from PC 2)
5. TOT AL CONTRIBUTIONS = 2,570.00 = 9,929.42
(lines 3 + 4)
EXPENDITURES
6. Cash Expenditures 2,503.46 6,785.23
(Accounting Period Total from PC 3)
7. Loan Payments (Non-Exempt) + 0.00 + 1,300.00
(Accounting Period Total from PC 3)
8. Total Cash Expenditures = 2,503.46 = 8,085.23
(lines 6 + 7)
9. In-Kind + 0.00 + 1,093.42
(Accounting Period Total from PC 2)
10. TOTAL EXPENDITURES = 2,503.46 = 9,178.65
(lines 8 + 9)
CASH BALANCE
11. Beginning Cash Balance 684.23 FOR OFFICE USE ONLY
(line 20 of previous report)
12. Total Contributions + 2,570.00
(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) RECEIVED
15. CONTRIBUTION SUBTOTAL = 3,254.23
(lines 11 + 12+ 13 + 14)
16. Total Expenditures 2,503.46 DEe 0 6 2005
(line 10)
17. Other Disbursements + 0.00 CITY RECORDfB
(Accounting Period Total from PC 48) I
18. Loan Payments (Exempt) + 0.00
(Accounting Period Total from PC 48)
19. EXPENDITURE SUBTOTAL 1= 2,503.46
(lines 16+ 17+ 18)
20. ENDING CASH BALANCE = 750.77
(line 15 minus line 19)
Summary Statement of Contributions and Expenditures PC 1
Rev. 12/03
Please type or print legibly in black ink. Page 2 of2
Candidate or Political Committee Name: Committee ID Number:
Vote Yes For External Police Review
[g] Original o Primary 20 [g] General 2005 o Other
o Amendment o 1 st Pre-election o 2nd Pre-election [g] Post-election 020 September Supplemental
LOAN SUMMARY FOR OFFICE USE ONL Y
21. Beginning Outstanding Loans 0
(line 29 of previous report)
22. Loans Received (Non-Exempt) + 1,000.00
(line 2)
23. Loans Received (Exempt) + 0.00
(line 14)
24. LOANS RECEIVED SUBTOTAL = 1,000.00
(lines 21 + 22 + 23)
25. Loan Payments (Non-Exempt) 0.00
(line 7)
26. Loan Payments (Exempt) + 0.00
(line 18)
27. Forgiven Loans + 0.00
(Total loans forgiven during this accounting period)
28. LOAN PAYMENT SUBTOTAL = 0
(lines 25 + 26 +27)
29. TOTAL OUTSTANDING LOANS = 1,000.00
(line 24 minus line 28)
PERSONAL EXPENDITURE SUMMARY
30. Beginning Outstanding Personal Expenditures 0.00
(line 36 of previous report)
31. Personal Expenditures + 0.00
(Accounting Period Total from PC 3A)
32. PERSONAL EXPENDITURE SUBTOTAL = 0.00
(lines 30 + 31)
33. Personal Expenditure Reimbursements 0.00
(Total expenditures on PC 3 with purpose code R)
34. Forgiven Personal Expenditures + 0.00
(Total personal expenditures forgiven this acctg. period)
35. REIMBURSEMENT SUBTOTAL = 0
(lines 33 + 34)
36. OUTSTANDING PERSONAL EXPENDITURES = 0.00
(line 32 minus line 35)
FINANCIAL STATUS AT CLOSE OF ACCOUNTING PERIOD
37. Ending Cash Balance 750.77
(line 20)
38. Accounts Receivable + 0.00
(Accounting Period Total from PC 5)
39. SUBTOTAL = 750.77
(lines 37 + 38)
40. Total Outstanding Loans 1000.00
(line 29)
41. Outstanding Personal Expenditures + 0.00
(line 36)
42. Accounts Payable + 0.00
(Accounting Period Total from PC 6)
43. SUBTOTAL = 1,000.00
(lines 40 + 41 + 42)
44. BALANCE/DEFICIT = -249.23
(line 39 minus line 43: indicate + or - balance)
I, Judith SeMan (name of candidate or treasurer), hereby certifY that the above statement and the attached supporting reports are
true and ITC~~
1:2 -~ ~ oS-
\~?
Signature of ca#tate Jr treasurer Date signed
7'
PC 2
Cash Contributions, Loans Received and In-Kind Rev. 12/03
Candidate or Political Committee Name: Committee ID Number:
Vote Yes For External Police Review Page 1 of+
Election: o Primary 20 [g] General 2005 o Other
Report: o 1 st Pre-election [g] 2nd Pre-election [g] Post-election o 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
Line # 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
Jan Wostmann
1. 2645 Riverview St $ 100.00
Eugene, OR 97403
10/25/2005 Systems Analyst $ 100.00 I I CA
Anita Johnson
2. 2288 Birch Ln $ 300.00
Eugene, OR 97403
10/26/2005 Retired $ 300.00 I I CA
Unitarian Universalist Church In Eugene
3. 477 E 40th Ave $ 100.00
Eugene, OR 97405
10/26/2005 Church $ 100.00 0 I CA
Mary O'Brien
4. 3525 Gilham Rd $ 100.00
Eugene, OR 97408
10/29/2005 Professor $ 100.00 I I CA
Bonny Bettman
5. 2171 Friendly St $ 1,000.00
Eugene, OR 9740
11/2/2005 City Councilor $ 1,400.00 I I LR
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 I.)
on Back and Cash (CA) $ 600.00 Cash (CA) $
in Campaign Enter on Summary Statement, Column A. Line I
Finance $
Manual In-Kind (IK) $ In-Kind (IK)
Enter on Summary Statement, Column A, Lines 4 and 9
PC 2 Loans Received (LR) $ 1 ,000.00 Loans Received (LR) $
Enter on Summary Statement, Column A, Line 2
PC 2
Cash Contributions, Loans Received and In-Kind Rev. 12/03
Candidate or Political Committee Name: Committee ID Number:
Vote Yes For External Police Review Page ~ of 4-
Election: o Primary 20 [g] General 2005 o Other
Report: o 1st Pre-election o 2nd Pre-election [g] Post-election o 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
Line # 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
Andrea Ortiz
1. 189 Foch St $ 100.00
Eugene, OR 97402
11/2/2005 Patient Access Specialist $ 700.00 I I CA
Jan Wostmann
2. 2645 Riverview St $ 50.00
Eugene, OR 9740
11/2/2005 Systems Analyst $ 150.00 I I CA
Mary O'Brien
3. 3525 Gilham Rd $ 100.00
Eugene, OR 9740
11/2/2005 Professor $ 200.00 I I CA
Mary O'Brien
4. 3525 Gilham Rd $ 50.00
Eugene, OR 97408
11/3/2005 Professor $ 250.00 I I CA
Tom Lininger
5. 1221 U of 0 $ 100.00
Eugene, OR 9740
11/3/2005 Professor $ 100.00 I I CA
See Page Totals (Add all amounts with the same Accounting Period Totals (Complete only for last page and
Instructions contribution type. Do not include aggregates.) transfer these amounts to the Summary Statement, PC I.)
on Back and Cash (CA) $ 400.00 Cash (CA) $
in Campaign Enter on Summary Statement, Column A, Line I
Finance $
Manual In-Kind (IK) $ In-Kind (IK)
Enter on Summary Statement, Colunm A, Lines 4 and 9
PC 2 Loans Received (LR) $ Loans Received (LR) $
Enter on Summary Statement, Column A, Liue 2
PC 2
Cash Contributions, Loans Received and In-Kind Rev. 12/03
Candidate or Political Committee Name: Committee ID Number;
Vote Yes For External Police Review Page ~ of 1-
Election: o Primary 20 [g] General 2005 o Other
Report; o 1 st Pre-election o 2nd Pre-election [g] Post-election 020_ 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
Line # 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
Tom Schneider
1. 3245 W 16th Ave $ 50.00
Eugene, OR 97402
11/4/2005 RV Salesman $ 50.00 I I CA
Judith Schoap
2. 100 West 38th Ave $ 100.00
Eugene, OR 97405
11/4/2005 Graphic Artist $ 200.00 I I CA
Rob Handy
3. 455 1/2 River Rd $ 150.00
Eugene, OR 97403
11/5/2005 Landscaper $ 315.00 I I CA
David Kelly For City Council
4. 1040 Ferry St B405 $ 50.00
Eugene, OR 9740
11/7/2005 PAC $ 100.00 P I CA
Gwen Jaspers
5. 510 Van Buren $ 35.00
Eugene, OR 9740
11/8/2005 Senior Meals Provider $ 55.00 I I CA
See Page Totals (Add all amounts with the same Accounting Period Totals (Complete only for last page and
Instructions contribution type. Do not include aggregates.) transfer these amounts to the Summary Statement, PC 1.)
on Back and Cash (CA) $ 385.00 Cash (CA) $
in Campaign Enter on Summary Statement, Column A, Line 1
Finance $
Manual In-Kind (IK) $ In-Kind (IK)
Enter on Summary Statement, Colwnn A, Lines 4 and 9
pe2 Loans Received (LR) $ Loans Received (LR) $
Enter on Summary Statement, Column A, Line 2
PC 2
Cash Contributions, Loans Received and In-Kind Rev. 12/03
Candidate or Political Committee Name: Committee ID Number:
Vote Yes For External Police Review Page 1 of 1
Election: o Primary 20 [g] General 2005 o Other
Report: o 1 st Pre-election o 2nd Pre-election [g] Post-election 020_ 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
Line # 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
Miscellaneous Donation Under $50
1. $ 185.00
10/26/2005 - $ I I CA
11/8/2005
2. $
$ I
3. $
$ I
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) $ 185.00 Cash (CA) $ 1 ,570.00
in Campaign Enter on Summary Statement, Column A, Line 1
Finance $
Manual In-Kind (IK) $ In-Kind (IK)
Enter on Summary Statement. Column A. Lines 4 and 9
PC 2 Loans Received (LR) $ Loans Received (LR) $ 1 ,000.00
Enter on Summary Statement, Column A, Line 2
PC 3
Cash Expenditures and Loan Payments Rev. 12/03
Candidate or Political Committee Name: Committee ID Number:
Vote Yes For External Police Review Page 1 of 1
Election: o Primary 20 [g] General 2005 o Other
Report: o 1 st Pre-election o 2nd Pre-election [g] Post-election 020 September Supplemental
PURPOSE CODES (see back of form for instructions and code definitions) EXPENDITURE TYPES
A Agent 0 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 10#, Exp. Amount of ~
Line # Date Check # if applicable Purpose Type Expenditure Paid
(as it appears on invoice, receipt or check) to AlP
1. 10/25/05 122 Eugene Weekly N CA $ 556.00 D
G
2. 10/25/05 123 Jan Wostmann Voter CA $ 90.44 D
Database
3. 1 0/27/05 124 Staples G CA $ 13.38 D
4. 10/31/05 125 Register Guard N CA $ 306.30 D
5. 10/31/05 Pacific Continental Bank G CA $ 6.25 D
6. 11/1/05 126 Eugene Weekly N CA $ 218.00 D
7. 11/2/05 127 Register Guard N CA $ 980.16 D
8. 11/4/05 128 Register Guard N CA $ 332.93 D
9. $ D
10. $ D
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 Cash (CA) $ 2,503.46 Cash (CA) $ 2,503.46
in Campaign
Finance Enter on Summary Statement, Column A, Line 6
Manual Loan Payment (LP) $ Loan Payment (LP) $
Enter on Summary Statement, Column A, Line 7
PC 3
Summary Statement of Contributions and Expenditures PC 1
Rev. 12/03
Please type or print legibly in black ink. Page I of2
Candidate or Political Committee Name (use full name):
Vote Yes For External Police Review
Mailing Address as it Appears on Statement of Organization (street, route or box number, city, state, zip code):
P.O. Box 50155, EUQene, OR 97405
Treasurer's Name: I Telephone Number (day):
Judith Schaap 541-342-8303
Committee ID Number: I Committee Type, Measure Number or Office:
Ballot Measure 20-106
IZI Original D Primary 20 IZI General 2005 IZI Other Discontinuation
D Amendment D 1 st Pre-election D 2nd Pre-election D Post-election D 20_ September Supplemental
A-TOTALS FOR THIS B-CUMULA TIVE TOTALS
ACCOUNTING PERIOD FOR THIS ELECTION
CONTRIBUTIONS
I. Cash Contributions 0.00 6,236.00
(Accounting Period Total from PC 2)
2. Loans Received (Non-Exempt) + 0.00 + 2,600.00
(Accounting Period Total from PC 2)
3. Total Cash Contributions = 0.00 = 8,836.00
(lines 1 + 2)
4. In-Kind + 0.00 + 1,093.42
(Accounting Period Total from PC 2)
5. TOTAL CONTRIBUTIONS = 0.00 = 9,929.42
(lines 3 + 4)
EXPENDITURES
6. Cash Expenditures 7.00 6,792.23
(Accounting Period Total from PC 3)
7. Loan Payments (Non-Exempt) + 743.77 + 2,043.77
(Accounting Period Total from PC 3)
8. Total Cash Expenditures = 750.77 = 8,836.00
(lines 6 + 7)
9. In-Kind + 0.00 + 1,093.42
(Accounting Period Total from PC 2)
10. TOTAL EXPENDITURES = 750.77 = 9,929.42
(lines 8 + 9)
CASH BALANCE
II. Beginning Cash Balance 750.77 FOR OFFICE USE ONL Y
(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 REr'I.,,-r,
(Accounting Period Total from PC 4A) 1- '.j ,.
_ ,,' _ j,' L
15. CONTRIBUTION SUBTOTAL = 750.77
(lines II + 12 + 13 + 14) DEe 0 6 2005
16. Total Expenditures 750.77
(line 10) CITY RECORDER
17. Other Disbursements + 0.00
(Accountine Period Total from PC 48)
18. Loan Payments (Exempt) + 0.00
(Accounting Period Total from PC 48)
19. EXPENDITURE SUBTOTAL = 750.77
(lines 16 + 17 + 18)
20. ENDING CASH BALANCE = 0.00
(line 15 minus line 19)
Summary Statement of Contributions and Expenditures PC 1
Rev. 12/03
Please type or print legibly in black ink. Page 2 of2
Candidate or Political Committee Name: I Committee ID Number:
Vote Yes For External Police Review
IZI Original D Primary 20 IZI General 2005 IZI Other Discontinuation
D Amendment D 1 st Pre-election D 2nd Pre-election D Post-election D 20_ September Supplemental
LOAN SUMMARY FOR OFFICE USE ONLY
2I. Beginning Outstanding Loans 1,000.00
(line 29 of previous report)
22. Loans Received (Non-Exempt) + 0.00
(line 2)
23. Loans Received (Exempt) + 0.00
(line 14)
24. LOANS RECEIVED SUBTOTAL = 1,000.00
(lines 21 + 22 + 23)
25. Loan Payments (Non-Exempt) 743.77
(line 7)
26. Loan Payments (Exempt) + 0.00
(line 18)
27. Forgiven Loans + 256.23
(Total loans forgiven during this accounting period)
28. LOAN PAYMENT SUBTOTAL = 1,000.00
(lines 25 + 26 +27)
29. TOTAL OUTSTANDING LOANS = 0.00
(line 24 minus line 28)
PERSONAL EXPENDITURE SUMMARY
30. Beginning Outstanding Personal Expenditures 0.00
(line 36 of previous report)
3I. Personal Expenditures + 0.00
(Accounting Period Total from PC 3A)
32. PERSONAL EXPENDITURE SUBTOTAL = 0.00
(lines 30 + 31)
33. Personal Expenditure Reimbursements 0.00
(Total expenditures on PC 3 with purpose code R)
34. Forgiven Personal Expenditures + 0.00
(Total personal expenditures forgiven this acctg. period)
35. REIMBURSEMENT SUBTOTAL = 0.00
(lines 33 + 34)
36. OUTSTANDING PERSONAL EXPENDITURES = 0.00
(line 32 minus line 35)
FINANCIAL STATUS AT CLOSE OF ACCOUNTING PERIOD
37. Ending Cash Balance 0.00
(line 20)
38. Accounts Receivable + 0.00
(Accounting Period Total from PC 5)
39. SUBTOTAL = 0.00
(lines 37 + 38)
40. Total Outstanding Loans 0.00
(line 29)
4I. 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. BALANCE/DEFICIT = 0.00
(line 39 minus line 43: indicate + or - balance)
I, Judith Schaap (name of candidate or treasurer), hereby certify that the above statement and the attached supporting reports are
true and corre~ ---
~ Id---V'- O~
Signature of candid;~ or treasurer Date signed
,
PC 3
Cash Expenditures and Loan Payments Rev. 12/03
Candidate or Political Committee Name: Committee ID Number:
Vote Yes For External Police Review Page 1 of 1
Election: D Primary 20 IZI General 2005 IZI Other Discontinuation
Report: D 1st Pre-election D 2nd Pre-election D Post-election D 20_ September Supplemental
PURPOSE CODES (see back of form for instructions and code definitions) EXPENDITURE TYPES
A Agent 0 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 10#, Exp. Amount of ~
Line # Date Check # if applicable Purpose Type Expenditure Paid
(as it appears on invoice, receipt or check) to AlP
1. 11/30/05 Pacific Continental Bank G CA $ 7.00 0
2. 12/2/05 Bonny Bettman LP $ 743.77 0
3. $ 0
4. $ 0
5. $ D
6. $ 0
7. $ 0
8. $ 0
9. $ 0
10. $ D
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 Cash (CA) $ 7.00 Cash (CA) $ 7.00
in Campaign
Finance Enter on Summary Statement, Column A, Line 6
Manual Loan Payment (LP) $ 743.77 Loan Payment (LP) $ 743.77
Enter on Summary Statement, Column A, Line 7
PC 3