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HomeMy WebLinkAboutElection Info: Cate HartzellPC 1 Rev. 11/99 Summary Statement of Contributions and Expenditures Please type or print legibly in black ink. Page I of 2 Address (street or route, ~ity, state, zip code): Treasurer's Name: Committee ID Number: Committee Type, Measure Number or Office: tTelephone Number (day): Original Amendment [-'] Primary 20 ~ 1 st Pre-election F-] General _0 CC. F-~ 2nd Pre-election Other Post-election ~[ September Supplemental A-TOTALS FOR THIS B-CUMULATIVE TOTALS ACCOUNTING PERIOD FOR THIS ELECTION CONTRIBUTIONS 1. Cash Contributions (Accounting Period Total from PC 2) 2. Loans Received (Non-Exempt) ('Accounting Period Total from PC 2) 3. Total Cash Contributions (lines 1 + 2) 4. In-Kind (Accounting Period Total from PC 2) 5. TOTAL CONTRIBUTIONS (lines 3 + 4) EXPENDITURES + ' ( Cash Expenditures (Accounting Period Total from PC 3) 7. Loan Payments (Non-Exempt) (Accounting Period Total from PC 3) 8. Total Cash Expenditures (lines 6 + 7) 9. In-Kind ('Accounting Period Total from PC 2) 10. TOTAL EXPENDITURES (lines 8 + 9) CASH BALANCE +':: '5 11. Beginning Cash Balance (Ending Cash Balance from previous report) 12. Tota[ Contributions (line 5) 13. 14. 15. Other Receipts (Accounting Period Total from PC 4A) Loans Received (Exempt) (Accounting Period Total from PC 4A) CONTRIBUTION SUBTOTAL (lines 11 + 12 + 13 + 14) 16. Total Expenditures (line 10) 17. Other Disbursements (Accounting Period Total from PC 4B) 18. Loan Payments (Exempt) (Accounting Period Total from PC 4B) 19. EXPENDITURE SUBTOTAL (lines 16 + 17 + 18) 20. ENDING CASH BALANCE (line 15 minus line 19) FOR OFFICE USE ONLY IPC ! iRev.,, 99 Su ommary Statement of Contributions and Expenditures Please type or print !.e=ibly in black ink. Page 2 of 2 Candidate or Political Committee Name: ^ , , . Committee ID Number: ~,Original { [~] Primary 20~ [--] General 20.~,~i F-] Other L_J Amendment [ [-] let Pre-election ['-] 2nd Pre-election ['-] Post-election ~ September Supplemental 21. 22. 23. 24. 25. 26. 27. 28. 29. 30. 31. 32. 33. LOAN SUMMARY Beginning Outstanding Loans (Total Outstanding Loans from previous report) Loans Received (Non-Exempt) (line 2) + Loans Received (Exempt) (line 14) + LOANS RECEIVED SUBTOTAL (lines 21 + 22 + 23) = Loan Payments (Non-Exempt) (line 7) + Loan Payments (Exempt) (line'18) + Forgiven Loans (Total loans forgiven during this accounting period) + LOAN PAYMENT SUBTOTAL (lines 25 + 26 +27) = TOTAL OUTSTANDING LOANS (line 24 minus line 28) = PERSONAL EXPENDITURE SUMMARY Beginning Outstanding Personal Expenditures (line 34 of previous report) Personal Expenditures (Accounting Period Total from PC 3A) + PERSONAL EXPENDITURE SUBTOTAL (lines 30 + 31) = Personal Expenditure Reimbursements (Total expenditures on PC 3 with purpose code R) - 34. OUTSTANDING PERSONAL EXPENDITURES (line 32 minus line 33) = FINANCIAL STATUS AT CLOSE OF ACCOUNTING PERIOD 35. 36. Ending Cash Balance (line 20) Accounts Receivable (Accounting Period Total from PC 5) 37. SUBTOTAL (lines 35 + 36) 38. Total Outstanding Loans (line 29) 39. Outstanding Personal Expenditures (line 34) 40. Accounts Payable (Accounting Period Total from PC 6) 41. SUBTOTAL (lines 38 + 39 + 40) 42. BALANCE/DEFICIT (line 37 minus line 41' indicate + or - balance) FOR OFFICE USE ONLY (name of candidate or treasurer), hereby certify that the above /oz, PC 4A Amendment Other Receipts Rev. / / Andidateor Political Committee Name: Committee ID Number: 'lhl~[~[~'~ ~ ~ (~+ ~ ~-~0.~'"~'~-~1 Page _~ of ~ Election: [--] Primary 20 F-] General 20 tO~) [--] Other Report: [~] 1st Pre-election [--] 2nd Pre-election [--] Post-election )X~ September Supplemental SEE BACK FOR INSTRUCTIONS AND CODE DEFINITIONS Other Receipt Transaction Type Codes EL Exempt Loan Proceeds FM Items Sold at Fair Market Value IN Interest/Investment Income OM Miscellaneous (provide a description) RF Refunds, Rebates and Returns Amending Page # Name and Line # Other Receipt (required for codes EL, OM and RF; Transaction Type Code Other Receipt Amount Date Received optional for codes FM and IN) Page~____Line ['~ ~[~l(~t~ '~)O~[.~~T~&~iC~ 5 4New Entry Correcting 7~i~ / ~¢.[.~ ~ ~__ [] Deleting Page Line__ [] New Entry [] Correcting [] Deleting $ Page Line [] New Entry [] Correcting [] Deleting $ Page Line__ [] New Entry [] Correcting [] Deleting $ Page Line [] New Entry [-]Correcting [] Deleting See ~oo~or ~su ~llt~, ~R OFFICE t.~Et~y !~ Instructions on Back and ~'~ ~ in Campaign Signature rer Finance~~ ' Manual PC 4A Amendment Dat~ sit~ned Other Receipts Please type or print legibly in black ink. List only one entry per line. AMENDING PAGE # AND LINE # - Identify the specific page and line number of the original report entry you are amending or deleting. For a new entry, do not complete this information. DATE RECEIVED - The date the moneys were received into the committee's physical custody. Date must include the month, day and year. Do not use the date of the check unless the check is dated and received the same day. NAME - The name of the source of other receipt. Name is required for other receipt transaction type codes EL, OM and RF, and is optional for codes FM and IN. OTHER RECEIPT AMOUNT - Amount of other receipt received on this date. OTHER RECEIPT TRANSACTION TYPE CODE - Select the appropriate transaction type from the list provided below. Designate only one transaction type for each entry. EL Exempt Loan Proceeds: Any loan of money made by a financial institution, other than any overdraft made with respect to a checking or savings account, if the loan bears the usual and customary interest rate for the category of loan involved, is made on a basis that assures repayment, is evidenced by a written instrument and is subject to a due date or amortization schedule. However, each endorser or guarantor of the loan is considered to have contributed that portion of the total amount of the loan for which that person agreed to be liable in a written agreement, unless the endorser or guarantor is the candidate's spouse. Name must be listed for these transactions. FM Items Sold at Fair Market Value: Proceeds from the sale of items that are purchased by the buyer at fair market value. Any amounts paid to the committee that exceed fair market value are contributions. IN Interest/Investment Income: Interest earned from bank accounts and proceeds earned from investments. OMMiscella~neous: If code OM is used, a description must be provided. Use code OM for lOst or returned checks. Name must be listed for these transactions. RF Refunds, Rebates and Returns: Refunds of deposits, rebates from vendors, and refunds or returns of contributions. Name must be listed for these transactions. City of Ashland City Recorder's Office Barbara Christensen, City Recorder (541) 488-5307 (phone) City Hall 20 E. Main St. Ashland, Oregon 97520 (541) 488-5311 (fax) September 3, 2002 Cate Hartzell 881 E Main St Ashland, OR 97520 This is a reminder that your committee is not considered "Discontinued" until a final Contribution and Expenditure Report showing a zero balance has been received in ray office. Because your September supplemental report shows a balance of $74.28, your comxnittee is required to file a September supplemental report until a report is filed showing a zero balance. I have enclosed a copy of your September 2000 Supplemental Report for your convenience. The accounting period for the current subsequent supplemental report began on September 2, 2001 and ended on September 2, 2002. Supplemental reports must be filed with my office no later than 5:00 p.m. on September 10, 2002. If you have any questions, please feel free to contact my office. Sincerely, Barbara Christensen City Recorder/Treasurer Cit of Ashland CityRecorder's Office Barbara Christensen, City Recorder (541) 488-5307 (phone) City Hall 20 E. Main St. Ashland, Oregon 97520 (541) 488-5311 (fax) September 26, 2001 Cate Hartzell 881 E Main St Ashland, OR 97520 I have examined your September Supplemental to the contribution and expenditure: report for the General Election of November 7, 2000 and found the following: [Yourcommittee's report is sufficient. Please note: Because your September supplemental report shows a balance, your committee is required to file a September supplemental report until a report is filed showing a zero balance. The accounting period for each subsequent supplemental report begins on September 2 and ends on September 1 of the following year. Supplemental reports must be filed not later than 5:00 p.m. September 10 of each year. If you have any questions regarding this examination letter, please feel free to contact my office. Sincerely, Barbara Christensen City Recorder/Treasurer Summary Statement of Contributions and Please type or print legibly in black ink. Candidate o[ Political Committee NamE: Address (street or route, city, state, zip code): Treasurer' s Name: Committee ID Number: Committee Type, Measure Number or Office: Telephone Number (day): (~ Original Amendment ~ Primary 20 [~] i st Pre-election [--1 General 20 GO [--~ 2nd Pre-election Other Post-election J.September Supplemental A-TOTALS FOR THIS ACCOUNTING PERIOD B-CUMULATIVE TOTALS FOR THIS ELECTION CONTRIBUTIONS I. Cash ConTributions (Accounting Period Total from PC 2) Loans Received (Non-Exempt) (Accounting Period Total from PC 2) .3. Total Cash Contributions (lines l+ 2) tn-Kind (Accounting Period Total from PC 2') 5. TOTAL CONTRIBUTIONS (lines 3 + 4) EXPENDITURES Cash Expenditures (Accounting Period Total from PC 3) Loan Payments (Non-Exempt) (Accounting Period Total from PC 3') 8. Total Cash Expenditures (lines 6 -' 7) 9. In-Kind (Accounting Period Total from PC 2) TOTAL EXPENDITURES I = (lines 8 + 9) CASH BALANCE. + Zg05.7& + f =30-7'7.7=2 11. Beginning Cash Balance (Ending Cash Balance from previous repon) t2. Total Contributions (line 5) 13. 14. 15. Other Receipts (Accounting Period Total from PC 4A) Loans Received (Exempt) (Accounting Period Total from PC 4A) CONTRIBUTION SUBTOTAL (lines 11 + 1:2+ 13+ 14) 19. EXPENDITURE SUBTOTAL (lines 16+ 17+ 18) 20. ENDING CASH BALANCE (line 15 minus line 19) ?q, a4 16.(lineT°tall 0)]Expenditures + 17. Other Disbursements t +' (Accounting Period Total from PC 4B) 18. Loan Payments (Exempt) (Accounting Period Total from PC 4B) FOP-, OFFICE USE ONLY I,~C ? SuTmary Statement of Contributions and Expenditures Please type or print le=ibly in black ink. Candidate or Political Committee Name: ,, . } Committee ID Number: Primary 20~ 1 st Pre-election / ~'Original Amendment LOAN SUMMARY 21. Beginning Outstanding Loans (Total Outstanding Loans from previous report) Accounts Receivable (Accounting Period Total from PC 5) SUBTOTAL (lines 35 + 36) General 20 t~ 2nd Pre-election 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 during this accounting period) + 28. LOAN PAYMENT SUBTOTAL (lines 25 + 26 +27) = 29. TOTAL OUTSTANDING LOANS (line 24 minus line 28) = PERSONAL EXPENDITURE SUMMARY 30.Beginning Outstanding Personal Expenditures (line 34 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. OUTSTANDING PERSONAL EXPENDITURES (line 32 minus line 33) = FINANCIAL STATUS AT CLOSE OF ACCOUNTING PERIOD 35. Ending Cash Balance I (line20) I 7(.~' ~_~;;v I= '7(4, 2.8 38. Total Outstanding Loans (line 29) 39. Outstanding Personal Expenditures (line 34) 40. Accounts Payable (Accounting Period Total from PC 6) 41. 42. Other Post-election (lines 38 + 39 + 40) BALANCE/DEFICIT (line 37 minus line 41' indicate + or - balance) Is'ta~d ~e a~~ac d suff~port~~g~p~'orts~are0~t~ta~nd !!rrect. Page 2 of 2 [~September Supplemental FOR OFFICE USE ONLY Signature of candidate ~[treasurer (name of candidate or treasurer), hereby certify that the above Date sign& City of Ashland City. Recorder's Office~ Barbara Christensen, City Recorder (541) 488-5307 (phone) City Hall 20 E. Main St. Ashland, Oregon 97520 (541) 488-5311 (fax) September 14, 2001 Cate Hartzell 881 E Main St Ashland, OR 97520 I have examined your September Supplemental to the contribution and expenditure report for the General Election of November 7, 2000 and found the following: The totals brought forward from the report filed in my office on December 19, 2000 are different than the ones reflected on the September Supplemental. Please see attached for correct totals to bring forward. Please make necessary corrections and submit to my office no later than September 21 2001. If you have any questions regarding this examination letter, please feel free to contact my office. Sincerely, Barbara Christensen City Recorder/Treasurer Summary Statement of Contributions and Expenditures Please ~pe or print legibly in black ink. Page t of 2 · Candidate or Political CommiUee Name: Address (street or route, city, state, zip code): Treasurer's Name: Telepho'n'e Number (day): Committee ID Number: Committee Type, Measure Number or Office: 1~ Original [~ Primary 20 [--] General 20 ~53 CD ['-3 Other [--] Amendment [--] I st Pre-election [-] ?nd Pre-election 1---] Post-election ,f~ September Supplemental A-TOTALS FOR THIS B--CUMULATIVE TOTALS ACCOUNTING PERIOD FOR THIS ELECTION CONTRIBUTIONS ..... I. Cash Contributions /,~ (Accounting Period Total from PC 2) + 2.' Loans Received CNon-Exempt) (Accounting Period Total from PC 2) + + , , , , 3. Total Cash Contributions f75, (lines 1+ 2) = , . , 4. I'n-Kind + (accounting Period Total from PC 2) ]Z_ Iff-,, 5. TOTAL CONTRIBUTIONS = = (Dines 3 + 4) · , EXPENDITURES '6. C~N Expenditures + (Accounting Period Total from PC 3) , - 7. Loan Payments (Non-Exempt) (Accounting Period Total from PC 3) , , 8. Total Cash Expenditures = (lines 6 + 7) .... . .. 9. In-Kind + ~.(Accoun. t!n.g Period Total from PC 2) + 10. TOTAL EXPENDITURES = = (lines 8 + 9) CASH BALANCE Il. Beginning Cash Balance V (Ending Cash Balance from previous report) , ~ FOR OFlZlCE USE ONLY 12. Total Contributions (line 5) + 13. Other Receipts (Accounting Period Total from PC 4A) + 14. Loans Received(Exempt) (Accounting Period Total from PC 4A) + 15. CONTRIBUTION SUBTOTAL = (lines I1 + 12 + 13 + 14) , '2? '16. (lineT°tall 0)Expenditures + ....... 17. Other Disbursements + (Accounting Period Total from PC 4B) 18. Loan Payments (Exempt) (Accounting Period Total from PC 4B) + 19. EXPENDITURE SUBTOTAL (lines 16- 17- 18) 20. ENDING CASH BALANCE : (line 15 minus linc 19) = / " ;','72 7.7 [PC 1 -- ~.e,'. ,1/99 Summary Statement of Contributions and Expenditures Please type or print legibly in black ink. Page 2 of 2 Can~tidate or Political Committee Name: Committee II7)' Number: [~ Original ~'3 Primary 20~ [~ General 20, C~) ~ Other [--1 Amendment [~ 1st Pre-election [-'] 2nd Pre-election [--] Post-election ~ September Supplemental LOAN SUMMARY 21. Beginning Outstanding Loans (Total Outstanding Loans from previous report) FOR OFFICE USE ONLY 22. Loans Re"c~ived (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 during this accounting period) + 28. LOAN PAYMENT SUBTOTAL (lines 25 + 26 +27) = , , 29. TOTAL OUTSTANDING LOANS (line 24 minus line 28) = PERSONAL EXPENDITURE SUMMARY 30. Beginning Outstanding Personal Expenditures (line 34 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. OUTSTANDING PERSONAL EXPENDITURES (line 32 minus line 33) = FINANCIAL STATUS AT CLOSE OF ACCOUNTING PERIOD . , , 35. Ending CaSh Balance 36. Accounts Receivable .-.Z' (Accounting Period Total from PC 5) + 37. SUBTOTAL (lines 35 + 36) = . , 38. Total Outstanding Loans (line 29) 39. Outstanding Personal Expenditures .Cz/ (line 34) + 40. Accounts Payable (Accounting Period Total from PC 6) + 41. SUBTOTAL (lines 38 + 39 + 40) = 7 42. BALANCE/DEFICIT (line 37 minus line 41' indicate + or - balance) = .... state-merit and th~ atta .¢~ed supporting repons are true and correct. Sitnature of candid~e or treasurer Date signed Summary Statement of Contributions and Expenditures Please type or print legibly in black ink. Page I of 2 Ca0didate or Political Comm'irtee ~qame: .... Address (street or route, city, state, zip code): · Treasurer's Name: Telephone Number (day): "Committee ID Number: Committee ~'ype, Measure Number or Office: [5~ Original [~ Prima, 20~ [--} General 20 O O [--] Other ['-1 Amendment [-] 1st Pre..-.e. lection ~ 2nd Pre-election [-"] Post-election ,J~ September Supplemental ACCOUNTING PERIOD FOR THIS ELECTION CONTRIBUTIO'fiS ....... 1. Cash Contributions (Accounting Period Total from PC 2) +"/-' + ~_~ ~(~ ~, OO .. 2. ' 'L~ans' Received (Non-Exempt) .... (Accounting Period Total from PC 2) +. ...... + . . 3. Total Cash (~ontribUtions ' ' 4. In-Kited " (Accounting Period Total from PC 2) + + 2 5. TOTAL CONTRIBUTIONS (lines 3 -~ 4) EX"PENDITURES 6. "Cash Exper~ditures ' ' /~ "' (Accounting Period Total from PC 3) + 7. Loan Payments }li,lon-E~empt) ...... + ~ + -----' (Accounting Period Total from PC 3) 8. Total Cash Expenditures ,~' ' ......... (lines 6 + 7) = = 9. In-Kind (Accounting Period Total from PC 2) + + ., 10. TOTAL EXPENDITURES = ~ --7 t~ 5 7.5' (lines 8 + 9) = ¢i$H BALANCE ............. ~11. Beginning Cash Balance .... I ' ' (Ending Cash Balance from previous report) V 4, '~ ~7 FOR OFFICE USE ONLY . 12." Total Contributions ' (line 5) + 13.' Other Receipts ' ' (Accounting Period Total from PC 4A) + 14. Loan~ l~eceived (Exer~pt) (^=oun in *o a, erom 4^) i5. CONTRIBUTION SUBTO]ZAL (lines 11 + 12 + 13+ 14) ,. = 16. Total Expendim~'es - (line 10) + 5/, · . - 17. Other Disbursements ~' (Accounting Period Total from PC 4B) + 18. Loan Payments(Exempt) (Accounting Period Total from PC 4B) + 19. EXP'~NDITURE SUBTOTAL (lines 16 + 17 + 18) = 20. ENDING CASH BALANCE .... = 7~ 5957 (line 15 minus line 19) ..... [PC 1, ' Summary Statement of Contributions and Expenditures Please type or print legibly in black ink. ICandidate or Political Committee Name: Committee: ID Number: I~ Original J J--J Primary 20 [-3 general 20 gO ['~ Other [-'] Amendment '] [-] 1st Pre-election J-'q 2nd Pre-election ~ Post-election 21. 22. 23. 24. 25. 26. LOAN SUMMARY Beginning Outstanding Loans (Total Outstanding Loans from previous report) Loans Received (Non-Exempt) (line 2) + Loans Received (Exempt) (line 14) + LOANS RECEIVED SUBTOTAL (lines 21 + 22 + 23) = Loan Payments (Non-Exempt) (line 7) + Loan Payments (Exempt) (line' 18) + 27. Forgiven Loans (Total loans forgiven during this accounting period) + 28. LOAN PAYMENT SUBTOTAL (lines 25 + 26 +27) = 29. TOTAL OUTSTANDING LOANS (line 24 minus line 28) = PERSONAL EXPENDITURE SUMMARY 30. Beginning Outstanding Personal Expenditures (line 34 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. OUTSTANDING PERSONAL EXPENDITURES (line 32 minus line 33) = FINANCIAL STATUS AT CLOSE OF ACCOUNTING PERIOD 35. Ending Cash Balance 36. Accounts Receivable (Accounting Period Total from PC 5) + 37. SUBTOTAL (lines 35 + 36) = 38. Total Outstanding Loans (line 29) 39. Outstanding Personal Expenditures (line 34) 40. Accounts Payable (Accounting Period Total from PC 6) 41. SUBTOTAL (lines 38 + 39 + 40) 42. BALANCE/DEFICIT (line 3 7 minus line 41: indicate + or - balance) statement and the attag'j]ed supporting reports are true and correct. Si~,-nature" of 'dgte r Page 2 of 2 fi~] September Supplemental FOR OFFICE USE ONLY (name of candidate or treasurer), hereby certify, that the above Date si=ned City of Ashland City Recorder's Office Barbara Christensen, City Recorder (541) 488-5307 (phone) City Hall 20 E. Main St. Ashland, Oregon 97520 (541) 488-5311 flax) December 27, 2000 Cate Hartzell 881 E Main St Ashland, OR 97520 I have examined your post-election contribution and expenditure report for the General Election of November 7, 2000 and found the following: [Your committee's report is sufficient. If you have any questions regarding this examination letter, please feel free to contact my office. Sincerely, Barbara Christensen City Recorder/Treasurer REMINDER: If you have a ending cash balance on your Contribution and Expenditure Post-Election Report, the Supplemental Report for Accounting Period November 28, 2000 to September 2001 filing period is no sooner than September 2, 2001 and no later than September 10, 2001. pc 1 Summary Statement of Contributions and Expenditures Please type or print legibly in black ink. Page 1 of 2 Cal:kdidate or.Political Committee Name: Address (street or route, city, state., zip code): Treasurer's Name: Committee ID Number: Original ~Amendment Committee Type, Measure Number or Office: [--] Primary 20 [~ 1 st Pre-election Telephone Number (day): [-'3 General 20 r-'] 2nd Pre-election Other jJPost-election [~ September Supplemental A-TOTALS FOR THIS B-CUMULATIVE TOTALS ACCOUNTING PERIOD FOR THIS ELECTION CONTRIBUTIONS 1. Cash Contributions (Accounting Period Total from PC 2. Loans Received (Non-Exempt) (Accounting Period Total from PC 2) 3. Total Cash Contributions (lines 1+ 2) In-Kind (Accounting Period Total from PC 2) 5. TOTAL CONTRIBUTIONS (lines 3 -' 4) EXPENDITURES -'7.5, o o Cash Expenditures (Accounting Period Total from PC 3) Loan Payments (Non-Exempt) (Accounting Period Total from PC 3) 8. Total Cash Expenditures (lines 6 + 7) 9. In-Kind (Accounting Period Total from PC 2) 10. TOTAL EXPENDITURES (lines 8 + 9) CASH BALANCE ii. Beginning Cash Balance (Ending Cash Balance from previous report) 12. Total Contributions (line 5) 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) 16, Total Expenditures (line 10) Other Disbursements (Accounting Period Total from PC 4B) 17. 18. Loan Payments (Exempt) (Accounting Period Total from PC 4B) 19. EXPENDITUKE SUBTOTAL (lines 16+ 1'7+18) 20. ENDING CASH BALANCE (line 15 minus line 19) 7 FOR OFFICE USE ONLY PC 1 Rex,. 11/99 please D'pe or print legibly in black ink. Candidate or Political Committee Name: Summary Statement of Contributions and Expenditures Committee ID Number: Page 2 of 2 Original Amendment 21. Primary 20~ 1 st Pre-election General 20 ~,L") 2nd Pre-election LOAN SUMMARY Beginning Outstanding Loans (Total Outstanding Loans from 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 during this accounting period) + 28. LOAN PAYMENT SUBTOTAL (lines 25 + 26 +27) = 29. TOTAL OUTSTANDING LOANS (line 24 minus line 28) = PERSONAL FXPENDITURE SUMMARY 30. Beginning Outstanding Personal Expenditures (line 34 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. OUTSTANDING PERSONAL EXPENDITURES (line 32 minus line 33) = --"- FINANCIAL STATUS AT CLOSE OF ACCOUNTING PERIOD 35. Ending Cash Balance 36. Accounts Receivable (Accounting Period Total from PC 5) , ~. SUBTOTAL (lines 35 + 36) 38. Total Outstanding Loans (line 29) 39. Outstanding Personal Expenditures (line 34) 40. Accounts Payable (Accounting Period Total from PC 6) 41. SUBTOTAL (lines 38 + 39 + 40) 42. BALANCE/DEFICIT (line 37 minus line 41' indicate + or - balance) 4- j Is~nt - ' ' ~l,~p '~, reports are true and correct. Signature of can~iciate orf~easurer Other IPost-election September Supplemental FOR OFFICE USE ONLY (name of candidate or treasurer), hereby certify that the above Date signed City of Ashland City Recorder's Office Barbara Christensen, City Recorder (541) 488-5307 (phone) City Hall 20 E. Main St. Ashland, Oregon 97520 (541) 488-5311 (fax) December 11, 2000 Cate Hartzell 881 E Main St Ashland, OR 97520 I have examined your post-election contribution and expenditure report for the General Election of November 7, 2000 and found the following: [--1 Your committee's report is sufficient. ],~ Your committee's report is not sufficient in the following way(s). 1. Cumulative total for total Cash Expenditures do not add up correctly. Form# Page# Line# PC1 1 of 2 6 Prior cumulative total on 2nd pre-election report which indicated a total of $2,241.75, when adding post-election expenditures, does not match ending post- election total. You must file the necessary amended information on amendment forms. All requested information on this exam letter must be submitted by December 19, 2000 to avoid penalties. For your convenience, I have enclosed a copy of your original report that indicates areas where correction is needed. If you have any questions regarding this examination letter, please feel free to contact my office. Sincerely, Barbara Christensen City Recorder/Treasurer Enclosures REMINDER: If you have a ending cash balance on your Contribution and iExpenditure Post-Election Report, the Supplemental Report for Accounting Period November 28, 2000 to September 2001 filing period is no sooner than September 2, 2001 and no later than September 10, 2001. ~,, ~o9 Summary Statement of Contributions and Expenditures abe type or print legibly in black ink. Page I of 2 didate or Political Committee Nam.e: Address (s~yt or route, ci~, s~te, zip code):. 2000 T~r~ffsName'_ ~_ Telephone Num~Jer (day): Commi~ee ID Number: Commi~ee Type, Measure Number or Office: ~riginal ~ Prima, 20~ ~ General 20 ~ ~ Other r~ ~ Amendment ~ l st Pre-election ~ 2nd Pre-election ~ost-election ~ September Supplemental A-TOTALS FOR THIS ~UMUL~TIVE TOTALS ACCOUNTING PERIOD FOR THIS ELECTION CONTRIBUTIONS l. Cash Contributions (Accounting Period Total from PC 2) ,, , 2. Loans Received (Non-Exempt) (Accounting Period Total from PC 2) + + , 3. Total Cash Contributions 4. In-Kind (Accounting Period Total from PC 2) 5. TOTAL CONTRIBUTIONS (lines 3 + 4) , , EXPENDITURES 6. Cash Expenditures (Accounting Period Total from PC 3) + 7. Loan Payments (Non-Exempt) + (Accounting Period Total from PC 3) 8. Total Cash Expenditures (,ines6+ 7) :5¢ ~.ff~ : A5 1'5.75 9. In-Kind ~} CO (Accounting Period Total from PC 2) 10. TOTAL EXPENDITURES CASH BALANCE 11. Beginning Cash Balance FOR OFFICE USE ONLY (Ending Cash Bal~ce from previous report) 12. Total Contributions ~,,.~,~ + 75. ~ ~C3 DEC 0 7 ~000 i3. Other Receipts + (Accounting Period Total from PC 4A) ]4, Loans Received (Exempt) + (Accounting Period Total from ~C 4A) 15. CONT, BUTION SUBTOTAL = 6' 8 Z5 (lines 11 + 12 + 13 + 14) 16. Total Expenditures 17. Other DiSbursements + (Accounting Period Total from PC 4B) 18. Loan Payments (Exempt) + (Accounting Period Total from PC 4B) 1~. EXPENDITU~ SUBTOTAL : (lines 16 + 17 + 18) 20. ENDING' CASH BALANCE (line 15 minus line 19) = PC l ~.~v. ]]!99 Summary Statement of Contributions and Expenditures Please type or print legibly in black ink. Page 2 of 2 Candidatecl0 ![~0,~[~,°r Political~ ~C°mmittee'~ [~.,,¥.Name: ~~* -- -- ~,~ ([~...~,~.,({ Committee ID Number: gJ, Original ~'~ Primary 20 ['-] General 20(~:) [~] Other --] Amendment [--] l st Pre-election [--] 2nd Pre-election r~Post-election ~] September Supplemental ..... LOAN SUMMARY "' 21. Beginning Outstanding Loans ' ' (Total Outstanding Loans from previous report) .-'" FOR OFFICE USE ONLY , , 22. Loans Received (Non-Exempt) (line 2) + 23. Loans(line 14)Received (Exempt) + 24. LOANS RECEIVED SUBTOTAL ' ' 0 7 2000 (lines 21 + 22 + 23) : 25. Loan Payments ('Non-Exempt) (line 7) + 26. Loan Payments (Exempt) (line' 18) + 27'. Forgiven Loans '" (Total loans forgiven during this accounting period) + 28. LOAN PAYMENT SUBTOTAL (lines 25 + 26 +27) = '- 29. TOTAL OUTSTANDING LOAlq~ (line 24 minus line 28) ' ' PERSONAL EXPENDITURE sUMMARY .... 30. Beginning Outstanding Personal Expenditures (line 34 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.' ' OUTSTANDING PERSONAL EXPENDITURES (line 32 minus line 33) = "" FINANCIAL STATUS AT CLOSE OF ACCOUNTING PERIOD 35. Ending Cash Balance (line 20) .... 36. Accounts Receivable (Accounting Period Total from PC 5) + 37. SUBTOTAL (lines 35 + 36) : 7 38. Total Outstanding Loans (line 29) 39. Outstanding Personal Expenditures (line 34) + ,, 40. Accounts Payable (Accounting Period Total from PC 6) + 41. SUBTOTAL ' (lines 38 + 39 + 40) = 42. BALANCE/DEFICIT (line 37 minus line 41: indicate + or-bald, nc.e) = '/~'1 I, ~~~1~ (name of candidate or treasurer), hereby certify that the above stat~nt rand th.~t~/~ing reports are true and correct. tZ- 7-od) __ Signature of c[tndidate (~reasurer Date signed IIIII II ~. PC 2 Amendment " ' Cash Contributions, Loans Received and In-Kind Please type or print legibly in black ink. Candidate or Political Cc~mmitte~ Name: (..~~~1~-., ~ ~,l~--~ ~ ~'~0,,~""~'~O,.,~ Committee ID Number: Page [ of Election: ~ Primary 20__ ['~ General 20~ [-'] Other Report: [-'] 1st Pre-election ~ 2nd Pre-election [~Post-election [-] September Supplemental SEE BACK FOR INSTRUCTIONS AND CODE DEFINITIONS CODE 1: Contributor Type CODE 2: Contribution Typ B Bt~siness 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 Pagre # Name and Address of Contributor AmoUnt of In-Kind Purpose and Line # Contribution (see manual for suggested purpose codes) Date Received Occupational Information, Contributing Contributor Code 1 Code 2 Committee's ID#, or Description if Code 1 is "0" Aggregate " Page Line ~~e~ ~~) A [] New Entry $ 75. O0 [] Correcting [] Deleting Page Line [] New Entry [] Correcting [] Deleting Page Line [] New Entry $ [] Correcting [] Deleting $ Page Line [] New Entry $ r-] Correcting [] Deleting ,, Page Line [] New Entry $ [] Correcting [] Deleting $ , FOR OFFICE: USE ONLY See ' ,' "· Instructions '' · ' on Back and Signature of can~didate ori~easure~' . in Campaign . Finance '. Manual ~0~-- 7-- O0 Date signed ' '. , . , Pc 3 Cash Expenditures and Loan Payments Please type or print legibly in black ink. Candidate.or~~(~~ g[IP°litical Committee Nan~:~~~~~~ ...... Commiu~e' ID Number: Page ( of ,, , Election: ~ Prima~ 20~ ~ General 20~ ~ Other Repom ~ 1st Pre-election ~ 2nd Pre-election ~Post-election ~ September Supplemental ,, , PU~OSE CODES (see back of form for instructions and code definitions) EXPENDITURE TYPES A Agent N Newspaper and Other Periodical Advertising CA Cash B Broadcast Adve~ising (Radio, TV) O Other Advertising (yard signs, buuons, etc.) LP Loan Payment C Cash Conwibutions P Postage F Fundraising Event Expenses R Reimbursement~IC~-~DF~'~ G General Operational Expenses (describe S Su~eys ~d Polls if over $50) T Travel Expenses (describe if over $50) 0 7 I Interest Payment W Wages, Salaries, Benefits L Literature, Brochures, Printing Z Prep~ation and Production of Advertising M Management Se~ices Payee's Name Exp. Amount of Line ff Date Check ~ (as it appears on invoice, receipt or check) Purpose Type Expenditure Paid to ~P , , , ,, , , 8. $ 9. $ ,. 10. $ , , . , Page Totals (Add all expenditures wi~ the same Accounting Period Totals (Complete only for last page and See expenditure ~pe.) =ansfer these mounts to the Summ~y Statement, PC 1 .) Instructions Cash (CA) $ ~'~3, ~ 7 Cash (CA) $ 5¢ ~ ,'~ 7 on Back and Enter on Summ~ Statement, Column A, Line 6 in Campaign ~ Finance Loan Payment (LP) $ Loan Payment (LP) Enter on Summ~ St~ttement, Column A, Line 7 Manual City of Ashland City Recorder's Office Barbara Christensen, City Recorder (541) 488-5307 (phone) 20 E. Main St. Ashland, Oregon 97520 (541) 488-5311 (fax) November 7, 2000 John Fields, Treasurer Committee to Elect Cate Hartzell 845 Oak Street Ashland, OR 97520 I have examined your 2nd Pre-Election contribution and expenditure report for the General Election of November 7, 2000 and found the following' Your committee's report is sufficient. If you have any questions regarding this examination letter, please feel free to contact my office. Sincerely, Barbara Christensen City Recorder/Treasurer ~P¢ l 'Rev.,,, 99 Summary Statement of Contributions and Expenditures Please type or print legibly in black ink. Page I of 2 & a~didate or Political Committee Name: . Address (street or route, city, state, zip code): ~reasurer's Name: Te~'ephone ~umber (day): Comminee ID Number: Comminee Type, Measur'e Number or Office: AOriginal ~ Prima~ 20CO ~General 20Ot~ ~ Other mendment ~ 1st Pre-election ~2nd~ Pre-election ~ Post-election ~ September Supplemental A-TOTALS FOR THIS ~UMULATIVE TOTALS ACCOUNTING PERIOD FOR THIS ELECTION 1. Cash ContributiOns + ~ / _ ,~ .~ + ,o/;f),~ (Accounting Period Total from PC 2) O UO ~-' ,~-~C' ...... 2. Loans Received ~on-Exempt) (Accounting Period Total from PC 2) + + 3. Total Cash Contributions (lines 1+ 2) = ~ 0 '~ = 4. In-Kind + + (Accounting Period Total from PC 2) .... 5~ TOTAL CONTRIBUTIONS EXPENDITURES 6. Cash Expenditures ¢i~:5 ~ ~ L/ (Accounting Period Total from PC 3) + ~ ~-' + '~ ~- 7~ Loan Payments (Non-Exempt) (Accounting Period Total from PC 3) , ...... 8. Total Cash Expenditures = ~--, ~'~ 7 (lines6+7) (;'~ ~ ~- : ~ Z L// 9. In-Kind (Accounting Period Total from PC 2) + + ~ ~ 10. TOTAL EXPENDITURES e. ~-- 2~2. ~ CASH BALANCE 11. Beginning Cash Balance (Ending Cash Balance from previous report) ~,~ 3 ~- FOR OFFICE USE ONLY 12. Total Contributions + (line 5) ~C',~~ 13. Other Receipts + (Accounting Period Total from PC 4A) 14. Loans Received (Exempt) (Accounting Period Total from PC 4A) 15. CONT~BU'TION SUBTOTAL (lines 11 + 12+ 13 + 14) = /'~/~l ~ ~ 16[ Total Expenditures' + 17. Other Disbursements (Accounting Period Total from PC 4B) + 18. Loan Payments (Exempt) (Accounting Period Total from PC 4B) 19. EXPENDITU~ SUBTOTAL _ (lines 16 + 17 + 18) = '~ ~ , 20. ENDING CASH BALANCE ~~, ~ (line 15 minus line 19) = .... PC 1 Summary Statement of Contributions and Expenditures Please type or print legibly in black ink. Page 2 of 2 Candidate or Political Committee Name: Committee ID'NUmber: --  Original [-~ Primary 20~ J~ General 20 6)0 [-] Other Amendment [--] 1st Pre-election ~ 2nd Pre-election [--] Post-election [-~ September Supplemental , , LOAN SUMMARY 21. Beginning Outstanding Loans (Total Outstanding Loans from previous report) -'-"- FOR OFFICE USE ONLY ., 22. Loans Received (Non-Exempt) (line 2) + 23. Loans Received iExempt) (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 during this accounting period) + ----- 28. LOAN PAYMENT SUBTOTAL (lines 25 + 26 +27) = ,, , 29. TOTAL OUTSTANDING LOANS (line 24 minus line 28) '- PERSONAL EXPENDITURE SUMMARY 30.'Beginning Outstanding Personal EXpenditures // (line 34 of previous report)c.-[ ~-j .__._. 31. Personal Expenditures / (Accounting Period Total from PC 3A) + 32. PERSONAL EXPENDITURE SUBTOTAL = /~ ~,/.(, (lines 30 + 31) /.x:v[ ------ 33. Personal EXpenditure Reimbursements (Total expenditures on PC 3 with purpose code R) ' 34. OUTSTANDING PERSONAL EXPENDITURES = (line 32 minus line 33) FINANCIAL STATUS AT CLOSE OF ACCOUNTING PERIOD 35. Ending Cash Balance (line 20) 36. Accounts Receivable (Accounting Period Total from PC 5) + 37. SUBTOTAL - ,.~ ~'~-~ (lines 35 + 36) = 38. Total Outstanding Loans (line 29) -.-~--'--'-- 39. Outstanding Personal Expenditures (line 34) + 40. Accounts Payable (Accounting Period Total from PC 6) + 41. SUBTOTAL .... Cuu" (lines 38 + 39 + 40) = 42' BALANCE/DEFICIT qq¢ (line 37 minus line 41' indicate + or - balance) = I, ) ~ '('" i (" uS_ ~' _."' (name of candidate or treasurer), hereby certify that the above statement and the attached supporting repons gr.e-4m~and correct. '--sT~aty, ?,~- Date signed c2 Cash Contributions, Loans Received and In-Kind Please type or print legibly in black ink. Ca~ndidate or Political Committee Name: Committee ID NUmber: ~~(_~ ..1~ i~i~CJ~ ~ ga~ ~ Page Election: ~ Primau 20 ~ General 20~ ~ Other Repo~: E 1st Pre-election ~2nd Pre-election E Post-election E 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~ Commi~ee , , Amount of In-Kind Purpose Line ~ Name and Address of Contributor Contribution (see manual for suq¢ested purpose codes) Occupational Information, Contributing Contributor ~ Date Received Commi~ee's I~, or Description ff Code ~ is "0" Aggregate ~ Code 7~ Code 2 I 5. $ Page Totals (Add all amounts with the same Accounting Period Totals (Complete only for last page and See contribution ~pe. Do not include aggregates.) transfer these amounts to the Summa~/Statement, PC 1.) Instructions Cash (CA) $ 6~ ~: Cash (CA, $ on Back and ~ , Enter on Summa~ Stat%ment, Column A, Line l in Campaign Finance In-Kind (IK) $ In-Kind (IK) , Enter on Summa~ Statement, Column A, Lines 4 and 9 Manual Loans Received (LR) $~ Loans Received (LR) $ [ Enter on Summa~ St C ash Contributions, Loans Received and In-Kind List only one entry per line. ACCOUNTING PERIOD TOTALS - Complete this box only on the last page of the section. Add Cash totals from all pages of form PC 2 and enter the amount on the Cash line in the Accounting Period Totals box. Add In-Kind totals from all pages of form PC 2 and enter the amount on the In-Kind line in the Accounting Period Totals box. Add Loans Received totals from all pages of form PC 2 and enter the amount on the Loans Received line in the Accounting Period Totals box. Transfer these totals to the lines indicated on the Summary Statement of Contributions and Expenditures (PC 1). AMOUNT OF CONTRIBUTION - Amount of contribution received on this date. CODE 1: CONTRIBUTOR TYPE - Select the appropriate contributor type from the list provided on the form. Designate only one contributor type for each entry. If code O (Other) is used, a description of the contributor must be provided in the Occupational Information box. Code 1 should not be completed when reporting "miscellaneous contributions $50 and under." CODE 2: CONTRIBUTION TYPE - Select the appropriate contribution type from the list provided on the form. Designate only one contribution type for each entry. CONTRIBUTING COMMITTEE'S ID# o If the contribution is from a state political committee, list the six digit ID# assigned to the contributing committee by the Secretary of State. CONTRIBUTOR AGGREGATE - Total amount of all contributions received from one contributor during all of the accounting periods for one election (i.e., first pre-election, second pre-election, post-election and supplemental accounting periods). Aggregate includes cash contributions, loans received (except exempt loans), cosigner obligations (except candidate's spouse), in-kind contributions and accounts receivable pledges. DATE RECEIVED - The date the contribution or loan was received in the candidate or political committee's physical custody or the date the candidate or committee first had knowledge of the in-kind contribution. Date must include the month, day and year. Do not use the date of the check unless the check is dated and received the same day. A range of dates may be used for "miscellaneous contributions $50 and under" and other limited circumstances. See pages 48 and 49 of the Campaign Finance Manual. IN-KIND PURPOSE - If thE, contribution type is IK, provide a description of the in-kind contribution or use the suggested purpose codes listed in the Campaign Finance Manual on pages 61 and 62. NAME AND ADDRESS OF: CONTRIBUTOR - Name and complete address for contributor, including residence or mailing address, city, state and zip code. OCCUPATIONAL INFORMATION - If the contributor is an individual, provide the occupation of the contributor or the name and address of the contributor'.,; employer, or provide a copy of a dated letter showing that you requested the information within seven days of receipt of the contribution. "Self-employed," "business owner," "public employee" or "education employee" are not acceptable unless the nature of the business or employment is indicated. PAGE TOTALS - Add all code CA contributions and enter the amount on the Cash line in the Page Totals box. Add all code IK contributions and enter the amount on the In-Kind line in the Page Totals box. Add all code LR contributions and enter the amount on the Loans Received line in the Page Totals box. Code Definitions Code 1: Contributor Type B Business Entity: Includes for-profit and professional corporations, cooperatives, partnerships, limited liability companies, etc. C Political Committee: Committees filed in the State of Oregon or any other jurisdiction, including political committees established by business entities and labor organizations. F Candidate's Immediate Family: Includes the candidate, the candidate's spouse and any child, parent, grandparent, brother, half-brother, sister or half-sister of the candidate and the spouses of such persons. Individual: Includes a sole proprietorship. L Labor Organization O Other: Includes clubs, associations, nonprofit corporations, etc. If this code is used, a description of the contributor must be provided in the Occupational Information box. P Political Party Committee: A committee established by a major or minor political party in Oregon. Code 2: Contribution Type CA Cash: Any legal instrument redeemable as currency, transmitted via physical or electronic means. CO Cosigner Obligation: The amount of the loan for which that person agreed to be liable in a written agreement, except if the endorser or guarantor is the candidate's spouse. This amount must be considered as part of the cosigner's individual contribution aggregate until the loan has been repaid or forgiven. IK In-Kind: A thing or service, other than money, having monetary value. The value of this contribution is based on the fair market value of the product or service. This amount is considered both a contribution and expenditure for the committee and must be reported on line 4 and line 9 of the Summary Statement of Contributions and Expenditures (PC 1). All in-kind contributions must be itemized, regardless of the amount. LR Loan Received: Each endorser or guarantor of a non-exempt loan is considered to have contributed that portion of the total amount of the loan for which that person agreed to be liable in a written agreement, except if the endorser or guarantor is the candidate's spouse. Note: A loan from a financial institution may be exempt and, if so, is reported on form PC 4A. However, any cosigner of that loan must be reported on form PC 2, except if the cosigner is the candidate's spouse. PC 2 :Rev. l,/99 Cash Expenditures and Loan Payments Please type or print legibly in black ink. Candidate or Political Committee Name: ~ ~ . , , , ~ Committee ID Number: , Election: ~ Prima~ 20 ~ General 20 aa ~ Other Repoa: ~ 1st Pre-election ~ 2nd Pre-election ~ Post-election ~ September Supplemental PU~OSE CODES (see back of form for instructions and code definitions) EXPENDITURE TYPES A Agent N Newspaper and Other Periodical Adve~ising CA Cash B Broadcast Adve~ising (Radio, TV) O Other Adve~ising (yard signs, buaons, etc.) LP Loan Payment C Cash Con~ibutions P Postage F Fundraising Event Expenses R Reimbursement G General Operational Expenses (describe S Surveys and Polls if over $50) T Travel Expenses (describe if over $50) I Interest Payment W Wages, Salaries, Benefits L Literature, Brochures, Printing Z Preparation and Production of Adve~ising M Management Services .... Payee's Name Exp. Amount of Line fl Date Check ~ (as it appears on invoice, receipt or check) Purpose Type Expenditure Paid ~ to ~P ,, 3. $ 4. $ S. $ e. $ 7. $ 8. $ 9. $ Page Totals (Add all expenditures with the same Accounting Period Totals (Complete only for last page and See expenditure ~pe.);~-A~ ~ansfer these amounts to the Summm~ Statement, PC 1.) Instructions Cash(CA) $ ,gb. H'/ Cash(CA) $ ~;'~ .... ~ ~['--¢ on Back and Enter on Summ~ Statement, Column A, Line 6 / in Campaign ~ Finance Loan Payment (LP) $ Loan Payment (LP) $ ' Enter umm~ S'tatement, Column A, Line 7 Manual Cash Expenditures and Loan Payments List only one entry per Iline. ACCOUNTING PERIOD TOTALS - Complete this box only on the last page of the section. Add Cash totals from all pages of form PC 3 and enter the amount on the Cash line in the Accounting Period Totals box. Add Loan Payment totals from all pages of form PC 3 and enter the amount on the Loan Payment line in the Accounting Period Totals box. Transfer these totals to the lines indicated on the Summary Statement of Contributions and Expenditures (PC 1). AMOUNT OF EXPENDITUP, E - Amount of check, cash transaction or credit card charge. CHECK # - The number of the check. For cash transactions, write "cash" in the check number box. If the expenditure was charged on a credit card, enter "credit card." DATE - The date the expenditure or loan payment was made. Date must include the month, day and year. A range of dates may be used for reporting bank charges. EXPENDITURE TYPE - Select the appropriate expenditure type from the list provided on the form. Designate only one expenditure type for each entry. PAGE TOTALS - Add all code CA expenditures and enter the amount on the Cash line in the Page Totals box. Add all code LP expenditures and enter the amount on the Loan Payment line in the Page Totals box. PAID TO ACCOUNTS PAYABLE - Check this box if the expenditure is a payment of a previously reported account payable. PAYEE'S NAME - The narne of the vendor or individual to whom payment was made. PURPOSE - Use the purpose codes from the list provided below (note exceptions) or write in the purpose of the expenditure. If one or more of the following purpose codes are used to describe an expenditure, no other description is generally needed. A Agent: A payee who is, an individual or firm, such as an advertising agency or a public relations firm, authorized by a committee to make expenditures on behalf of the committee. If an expenditure is made for the committee by an agent, you must file a Report of Expenditures Made by an Agent (PC 9) or submit a copy of an invoice from the agent detailing the agent's expenditures. The invoice must contain the same information required on form PC 9. B Broadcast Advertising: Expenditures for the purchase of radio and television advertising. This is a sufficient purpose only if payment is made directly to a specific radio or TV station. If payment is made to an agent for preparation or production of advertising, use code Z. If payment is made to an agent for purchase of advertising, use code A. C Cash Contributions: Contributions made to other committees or organizations. F .Fundraising Event Expenses: Expenditures associated with holding a fundraiser, including payments to restaurants, hotels, caterers, other food and refreshment vendors, entertainers and speakers. Use code L for expenditures associated with printed matter produced in connection with fundraising events. G General Operational IExpenses: General campaign operating expenses, including filing fees, bank service charges, purchase or rental of office equipment and furniture for the campaign and office supplies. If a general operational expenditure is over $50, describe the type of expenses (e.g., office supplies, furniture, etc.) Interest Payment: Payment to a financial institution or other lender for the interest on a loan to the campaign. L Literature, Brochures., Printing: Expenditures made for the preparation and production of campaign literature and printed solicitations, including expenditures for mailing lists, design, photography, copy, layout, printing and reproduction. Use code P for expenditures associated with literature mailing costs. M Management Service,s: Includes salaries, fees and commissions paid to campaign management companies and contract consultants. Contract consultants must include an explanation such as photography, legal services, etc. N Newspaper and Other Periodical Advertising: Expenditures for the purchase of advertising in newspapers, periodicals and other publications. This is a sufficient purpose only if payment is made to a specific publication. If payment is made to an agent for preparation or production of advertising, use code Z. If payment is made to an agent for purchase of advertising, use code A. O Other Advertising: Expenditures associated with the production and purchase of advertising on billboards, yard signs and campaign paraphernalia such as buttons, bumper stickers, T-shirts, etc. P Postage: Expenditures for stamps, postage, United Parcel Service, Federal Express and direct mail services. Use code L for design and other production costs associated with producing campaign literature. R Reimbursement: An expenditure reimbursing the candidate or treasurer for personal expenditures (including credit card charges) made on behalf of the committee. The personal expenditures made by the candidate or treasurer must be reported on PC 3A during the accounting period in which they are made. S Surveys and Polls: Expenditures associated with polls, reports on election trends, voter surveys, telemarketing, telephone banks, etc. T Travel Expenses: Expenditures associated with travel. If a travel expenditure is over $50, describe the type of expenses (e.g., lodging, airfare, meals, gas, etc.) W Wages, Salaries, Benefits: Expenditures associated with hiring campaign employees and other freelance workers (including wages, employment taxes, insurance etc.) who provide miscellaneous services other than campaign management or consulting. Z Preparation and Production of Advertising: Payments associated with the preparation or production of broadcast, newspaper or other periodical advertising. The exceptions when using one of the above purpose codes are: 1. When reporting general operational (code G) or travel expenses (code T) over $50, the type of expenses must be described (e.g., lodging, airfare, meals, !;las, office supplies, furniture for campaign office, etc.) 2. If an expenditure is made on behalf of the committee by an agent (code A), such as an advertising agency, you must file a Report of Expenditures Made by an Agent (PC 9) or submit a copy of an invoice from the agent detailing the agent's expenditures. The invoice must contain the same information required on form PC 9. 3. If an in-kind expenditure is made on behalf of another committee, the purpose description must include the purpose of the expenditure, state that it: is an in-kind contribution and name the recipient candidate or committee. 4. If an expenditure is an independent expenditure on behalf of a candidate, measure or political committee, the purpose description must include the purpose of the expenditure, state that it is an independent expenditure and name the candidate, measure or political committee. ,-- Personal Expenditures For Reimbursement Please type or print legibly in black ink. Candidate or Polit'ical Committee ~arne: Committee ID Number: .,, Election: ["'] Primary 20 ~ General 2~_. C) [--] Other Report: ~ 1st Pre-election ~ 2nd Pre-election I'-] Post-election ~ September Supplemental . ,, PURPOSE CODES (see back of form for instructions and code definitions) A Agent N Newspaper and Other Periodical Advertising B Broadcast Advertising (Radio, TV) O Other Advertising (yard signs, bun:ohs, etc.) C Cash Contributions P Postage 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 W Wages, Salaries, Benefits L Literature, Brochures, Printing Z Preparation and Production of Advertising M Management Services . Amount of Line # Date Payee's Name Purpose Expenditure , 2. $ 4. $ 5. $ 6. $ i 7. $ 8. $ 9. $ Page Total Accounting Period Total (Complete only for last page and See Personal £xpenditures $ Iq~ ;'~'¢ transfer this amount to the Summary Statement, PC I.) Instructions Personal Expenditures $ /~, on Back and Enter on Summary Statcmcm. Line in Campaign Finance Manual CitY of Ashland City Recorder's Office Barbara Christensen, City Recorder (541) 488-5307 (phone) ~.X,. 20 E. Main St. As~and, Oregon 97520 (541) 488-5311 ~) October 17, 2000 John Fields, Treasurer Cate Hartzell, candidate for City Council Position #3 881 E Main St Ashland, OR 97520 I have examined your amended pre-election contribution and expenditure report for the General Election of November 7, 2000 and found the following: [/ Your committee's report is sufficient. Sincerely, Barbara Christensen City Recorder/Treasurer Page 1 PC '~ Amendmen~ ~-'"*~ ~ Cash Contributions, Loans Received and In-Kind Pleas~ type or print legibly in black ink. Candidate or Political Committee Name: Committee ID ~umber: Election: [-1 Primary 2060 [~ General 20~ ['-] Other Report: ~m,v~r~0//461T[~11st Pre-election [-] 2nd Pre-election !-'] Post-election I-] September Supplemental SEE BACK FOR INSTRUCTIONS AND CODE DEFINITIONS c:oo~= ~- Contributor Typ~ ¢OOE 2: Contribution T¥~ B B~siness 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 Amending Page # Name and Address of Contributor Amount of In-Kind Purpose and Line # Contribution (see manual for suggested purpose codes) Occupational InfOrmation, 'contri~utin D~to ~ocoivod .. Committoe~s IlY~, or Doscript~on ff ¢odo 1 is '0~. . A~grog~to Codo 1 .... Codo 2 [] New Entry [] Co~e~ng do~ 6-~,vz~M .Sp ~ ~'4'4 s /0o [] New Entn/ [] Correcting ~ ~ ~,~ $ ' / r'] Deleting ..... ....... b. II I I PC .." Amcndmcm ~v.,,,~ Cash Contributions, Loans Received and In-Kind Please type or print legibly in black ink. Candidate or Political Committee Name: Committee ID Number: ,. _ ..... .... . Election: ['"] Primary 20 ~ General 20~[__. [-] Other Report:/~[al~,l~t~.~/~ 1st Pre-election [-"] 2nd Pre-election r-] Post-election ~ September Supplemental , , SEE BACK FOR INSTRUCTIONS AND CODE DEFINITIONS CODE 1' Contributor Type CODE 2: Contribution Type B B~siness 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 In-Kind Purpose and Line # Contribution (see manual for suggested purpose codes) Occupational Information, ContrJbuting Contributor Date Received Committee's IDg, or Description if Code 1 is "0" Aggregate Code 1[ Code 2 [] New Entry Page Line [] New Entry $ I--] Correcting [] Deleting , ,, $ ,, Page ,, Line [] New Entry $ [] Correcting [] Deleting Instructions 'i,:'. :!' :'?;i ~!:~,A~'?:.::.-~ :Zi.:!~~['?: ',':!;ii on Back and ' ,,,, urer in Campaign ~..~ ' FJllance ; ~. ~ .... ,-'~' ', .... "':','""~" : · ·, Malltlai .: . ....:..:'..:~?,' .~.. f: -,, .. ,, :...:, , .~. , , City of Ashland City Recorder's Office Barbara Christensen, City Recorder (541) 488-5307 (phone) City Hall 20 E. Main St. Ashland, Oregon 97520 (541) 488-5311 (fax) October 10, 2000 John Fields, Treasurer Cate Hartzell, candidate for City Council Position #3 Ashland, OR 97520 I have examined your first pre-election contribution and expenditure report for the General Election of November 7, 2000 and found the following: [~] Your committee's report is sufficient. _,,, Your committee's report is not sufficient in the following way(s). ~/1. Accounting Period Total for Loans Received, information missing insufficient. or Form# Page# Line# PC2 2 of 2 Account Period Total at bottom of form 3. In-Kind Purpose information missing or insufficient. Form# Page# Line# PC2 2 of 2 6, 7, 8 Code purpose missing or insufficient. (Would only bring this to your attention so that the codes would be in the correct spot for the next filing period, but as you haw,. the In-Kind to correct, you will need to move these anyway.) Form # Page# Line# PC2 all pages all lines Dates of contributions received is missing. Form # Page# Line# PC2 2 of 2 7, 8 Aggregates are not complete. (Would only bring this to your attention so that it would be correct for the next filing period, but as you have others to correct, you might as well make these changes also.) Form # Page# Line# PC2 all pages 1, 2, 4, 5, 6, 7, 8 Page 1 City of Ashland City Recorder's Office Barbara Christensen, City Recorder (541) 488-5307 (phone) City Hall 20 E. Main St. Ashland, Oregon 97520 (541) 488-5311 (fax) You must file the necessary amended information on amendment forms. All requested information on this exam letter must be submitted by October 18, 2000 to avoid penalties. For your convenience, I have enclosed a copy of your original report that indicates areas where correction is needed. If you have any questions regarding this examination letter, please feel free to contact my office. Sincerely, Barbara Christensen City Recorder/Treasurer Enclosures Page 2 ~.~ Summary Statement of Contributions and Expenditures Please type or print legibly :in black ink. Page 1 of 2 Candidate or Political Committee Name: Address (street or route, ciD', state, Zip code): "Treasurer's Name: ~ Telephone Number (daY): Committee ID Number: Committee Type, Measure Number or Office: '< , , '[--] Original [~] Primary 20 E~ General 20~ [---] Other [--] Amendment ~ 1st Pre-election ["-] 2nd Pre-election [--] Post-election [-'] September Supplemental A-TOTALS FOR THIS B-CUMULATIVE TOTALS ACCOUNTING PERIOD FOR THIS ELECTION CONmBUT~ONs .... ,, , a, on,r,bu,,ons + q5 gCC- (Accounting Period Total from PC 2) + 2. Loans Received (Non-Exempt) (Accounting Period Total from PC 2) + + .... 3. Total Cash Contributions 4. In-Kind (Accounting Period Total from PC2) + ~ Z7 2-- -7, ,, + ~> 2 7~.- ,, 5. TOTAL CONTRIBUTIONS (lines 3 + 4) = EXPENDITURES 6. Cash Expenditures + (accounting Period Total from PC 3) 7. Loan Payments (Non-Exempt) _- ~ ' .... (Accounting Period Total from PC 3) + .... 8. Total Cash Expenditures (lines6+ 7) = / ~ ~ ~, L/-g = [ 5-gg 4"~ 9.' In-Kind (Accounting Period Total from PC 2) + Z7 2. -- + J'7~ -- ....... 10. TOTAL EXPENDITURES (lines 8 + 9) = ' ' cash E~k~UCe " 11. Beginning Cas'h Balance "' FOR C}FFICE USE ONLY (Ending Cash Balance from previous report) .... 12. Total Contributions s) + 2-, 2- IT --- 13. Other Receipts (Accounting Period Total from PC 4A) + .. , 14. Loans ReceiVed (Exempt) ,. + (Accounting Period Total from PC 4A) 15. 'CONTRIBUTION SUBTOTAL j~ 2- ='~Z ?"~ Z (lines 11 + 12 + 13 + 14) ~, 16. Total Expenditures 17. Other Disbursements (Accounting Period Total from PC 4B) + 18. Loan Payments (Exempt) 4- . . (Accounting Period Total from PC 4B) , , _. "19~ EXPENDITURE SUBTOTAL (lines 16+ 17+ 18) = . '2'0. ENDING CASH BALANCE 3~.,~g3 ~2---- (line 15 minus line 19) -- .......... ~PC 1 Summary Statement of Contributions and Expendit~ures Please type or print legibly in black ink. Page 2 of 2 Candidate or Political Commilxee Name: Committee ID Number: 6L4' ' ['-] Original [-'] Primary 20~ [--] General 20 [-] Other ~ Amendment [~ 1st Pre-election 1--] 2nd Pre-election [~ Post-election [-] September Supplemental LOAN SUMMARY 21. Beginning Outstanding Loans (Total Outstanding Loans from previous report) ~ FOR OFFICE USE ONLY 22. Loans Received (Non-Exempt) (line 2) + 23. Loans Received (Exempt) (line 14) + 2~4. LOANS RECEIVED SUBTOTAL (lines 21 + 22 + 23) = 25. Loan Payments (Non-Exempt) + C.3 ~-"- (line 7) 26. Loan Payments (Exempt) (line' 18) + 27. Forgiven Loans (Total loans forgiven during this accounting period) + 28. LOAN PAYMENT SUBTOTAL (lines 25 + 26 +27) = 29. TOTAL OUTSTANDING LOANS (line 24 minus line 28) = PERSONAL EXPENDITURE SUMMARY 30. Beginning Outstanding Pe, rsonal EXpenditures (line 34 of previous report) 31. Personal Expenditures (Accounting Period Total from PC 3A) + 32. PERSONAL EXPENDITURE SUBTOTAL (lines 30 + 31) = 7 33. Personal Expenditure Reimbursements (Total expenditures on PC 3 with purpose code R) - ~_o V~'-'-'-' 34. OUTSTANDING PERSONAL EXPENDITUREs (line 32 minus line 33) = .---- FINANCIAL STATUS AT CLOSE OF ACCOUNTING PERIOD 35. Ending Cash Balance (line 20) '~ ~'~'~ '''~2'' 36. Accounts Receivable (Accounting Period Total from PC 5) + 37. SUBTOTAL "~-'. ,'~. ~--2.- (lines 35 + 36) = 38. Total Outstanding Loans (line 29) 39. Outstanding Personal Expenditures (line 34) + 4q 40. Accounts Payable (Accounting Period Total from PC 6) L0 + ~) 41. SUBTOTAL38+ 39 + ~ ~/~ (lines 40) . I= 42. BALANCE/DEFICIT (line 37 minus line 41' indicate + or-balance) = '~'~ ,,, I, ,~ ~C. j ~2/.~ ~ (name of candidate or treasurer), hereby certify that the above statement and the attacJnzd-~mr!~ing reports are true an~;lw, qrrect. Sim~'mr.o/6f candidate or treasurer - Date si=ned PC 3 Cash Expenditures and Loan Payments Please type or print legibly in black ink. Candidate or Political Committee Name: Committee ID Number: ~--/'~~ P'~7-2TT~/( Page [ of / Election: [-'] Primary 20~ [~ General 20~ ~ Other Report: [~lst Pre-election [-'] 2nd Pre-election [~] Post-election E~ September Supplemental PURPOSE CODES (see back of form for instructions and code definitions) EXPENDITURE TYPES A Agent N Newspaper and Other Periodical Advertising CA Cash B Broadcast Advertising (Radio, TV) O Other Advertising (yard signs, buttons, etc.) LP Loan Payment C Cash Contributions P Postage F Fundraising Event Expenses R Reimbursement G GeneralOperational Expenses (describe S Surveys and Polls if over $50) T Travel Expenses (describe if over $50) I Interest Payment W Wages, Salaries, Benefits L Literature, Brochures, Printing Z Preparation and Production of Advertising M Management Services Payee's Name Exp. Amount of ['~ Line # Date Check # (as it appears on invoice, receipt or check) Purpose Type Expenditure Paid to A/P F) /./. '"~-'' ~ · ~,a, 6. 7. $ 8. $ 9. $ ~0. $ Page Totals (Add all expendi~y~s with the same Accounting Period Totals (Complete only for last page and See expenditure,me.) !;f*~~~ transfer these amounts to the Summary Statement, mc1.) Instructions Cash(CA)$ ~-- Cash(CA) $ ~{~ on Back and Enter on Summ~ Statement, Column A, Line 6 in Campaign ~-- Finance Loan Payment (LP) $ Loan Payment (LP) Manaal Enter on Summa~ Statement, Column A, REC'D OCT 9 2000 Cash Expenditures and Loan Payments List only one entry per line. ACCOUNTING PERIOD TOTALS - Complete this box only on the last page of the section. Add Cash totals from all pages of form PC 3 and enter the amount on the Cash line in the Accounting Period Totals box. Add Loan Payment totals from all pages of form PC 3 and enter the amount on the Loan Payment line in the Accounting Period Totals box. Transfer these totals to the lines indicated on the Summary Statement of Contributions and Expenditures (PC 1). AMOUNT OF EXPENDITURE - Amount of check, cash transaction or credit card charge. CHECK # - The number of the check. For cash transactions, write "cash" in the check number box. If the expenditure was charged on a credit card, enter "credit card." DATE - The date the expenditure or loan payment was made. Date must include the month, day and yea~r. A range of dates may be used for reporting bank charges. EXPENDITURE TYPE - Select the appropriate expenditure type from the list provided on the form. Desi~lnate only one expenditure type for each entry. PAGE TOTALS - Add all code CA expenditures and enter the amount on the Cash line in the Page Totalis box. Add all code LP expenditures and enter the amount on the Loan Payment line in the Page Totals box. PAID TO ACCOUNTS PAYABLE - Check this box if the expenditure is a payment of a previously reported account payable. PAYEE'S NAME - The name of the vendor or individual to whom payment was made. PURPOSE - Use the purpose codes from the list provided below (note exceptions) or write in the purpose of the expenditure. If one or more of the following purpose codes are used to describe an expenditure, no other description is generally needed. A Agent: A payee who is an individual or firm, such as an advertising agency or a public relations firm, authorized by a committee to make expenditures on behalf of the committee. If an expenditure is made for the committee by an agent, you must file a Report of Expenditures Made by an Agent (PC 9) or submit a copy of an invoice from the agent detailing the agent's expenditures. The invoice must contain the same information required on form PC 9. B Broadcast Advertising: Expenditures for the purchase of radio and television advertising. This is a sufficient purpose only if payment is made directly to a specific radio or TV station. If payment is made to an agent for preparation or production of advertising, use code 7. If payment is made to an agent for purchase of advertising, use code A. C Cash Contributions: Contributions made to other committees or organizations. F Fundraising Event Expenses: Expenditures associated with holding a fundraiser, including payments to restaurants, hotels, caterers, other food and refreshment vendors, entertainers and speakers. Use code L for expenditures associated with printed matter produced in connection with fundraising events. G General Operational Expenses: General campaign operating expenses, including filing fees, bank service charges, purchase or rental of office equipment and furniture for the campaign and office supplies. If a general operational expenditure is over $50, describe the type of expenses (e.g., office supplies, furniture, etc.) Interest Payment: Payment to a financial institution or other lender for the interest on a loan to the campaigr~. L Literature, Brochures, Printing: Expenditures made for the preparation and production of campaign literature and printed solicitations, including expenditures for mailing lists, design, photography, copy, layout, printing and reproduction. Use code P for expenditures associated with literature mailing costs. M Management Services: Includes salaries, fees and commissions paid to campaign management companies and contract consultants. Contract consultants must include an explanation such as photography, legal services, etc. N Newspaper and Other Periodical Advertising: Expenditures for the purchase of advertising in newspapers, periodicals and other publications. This is a sufficient purpose only if payment is made to a specific publication. If 13ayment is made to an agent for preparation or production of advertising, use code Z. If payment is made to an agent for purchase of advertising, use code A. O Other Advertising: Expenditures associated with the production and purchase of advertising on billboards, yard signs and campaign paraphernalia such as buttons, bumper stickers, T-shirts, etc. P Postage: Expenditures for stamps, postage, United Parcel Service, Federal Express and direct mail services. Use code L for design and other production costs associated with producing campaign literature. R Reimbursement: An expenditure reimbursing the candidate or treasurer for personal expenditures (including credit card charges) made on behalf of the committee. The personal expenditures made by the candidate or treasurer must be reported on PC 3A during the accounting period in which they are made. S Surveys and Polls: Expenditures associated with polls, reports on election trends, voter surveys, telemarketing, telephone banks, etc. T Travel Expenses: Expenditures associated with travel. If a travel expenditure is over $50, describe the type of expenses (e.g., lodging, airfare, meals, gas, etc.) W Wages, Salaries, Benefits: Expenditures associated with hiring campaign employees and other freelance workers (including wages, employment taxes, insurance etc.) who provide miscellaneous services other than campaign management or consulting. Z Preparation and Production of Advertising: Payments associated with the preparation or production of broadcast, newspaper or other periodical advertising. The exceptions when using one of the above purpose codes are: 1. When reporting general operational (code G) or travel expenses (code T) over $50, the type of expenses must be described (e.g., lodging, airfare, meals, gas, office supplies, furniture for campaign office, etc.) 2. If an expenditure is made on behalf of the committee by an agent (code A), such as an advertising agency, you must file a Report of Expenditures Made by an Agent (PC 9) or submit a copy of an invoice from the agent detailing the agent's expenditures. The invoice must contain the same information required on form PC 9. 3. If an in-kind expenditure is made on behalf of another committee, the purpose description must include the purpose of the expenditure, state that it is an in-kind contribution and name the recipient candidate or committee. 4. If an expenditure is an independent expenditure on behalf of a candidate, measure or political committee, the purpose description must include the purpose of the expenditure, state that it is an independent expenditure and name the candidate, measure or political committee. ,, Personal Expenditures For Reimbursement Please type or print legibly in black ink. cand'idatec-- g''~~r P°litical[4.~~~.~.~~Committee Name: 'Committee ID Number:II Page ___~_ of ~ Election: ['"] P~nary 20 [-~ General 20~ ~ Other Report: .... "~ 1st Pre-election [-'] 2nd Pre-election ~'] Post-election [-'] September Supplemental PURPOSE CODES (see back of form for instructions and code definitions) A Agent N Newspaper and Other Periodical Advertising B Broadcast Advertising (Radio, TV) O Other Advertising (yard signs, buttons, etc.) C Cash Contributions P Postage F Fundraising Event Expenses S Surveys and Polls G General Operational Expenses (describe if over $50) T Travel Expenses (describe if over S50) I Interest Payment W Wages, Salaries, Benefits L Literature, Brochures, Pt-hating Z Preparation and Production of Advertising M Management Services Amount of D'ne # Date Payee's Name Purpose Expenditure ) 10. ~ $ Page Total ~'~ Accounting Period Tota! (Complete only for l~t page and See Personal Expenditures $ /O~~ ~ansfer this ~ount to the Summa~ S~tement, PC 1.) Instructions Personal Expendi~res $ .... OR Back aRd Enter on Summary Statement. Lin~ 31 in Campaign Finance m..a, REC'D OCT 9 2000 PC 3A ~v.~,99 Personal Expenditures For Reimbursement Please type or print legibly in black ink. Candidate or Political Committee Name: Committee ID Number: Page g Election: ~] Primary 20~ [-~ General 20~ [-~ Other Report: ~ 1st Pre-election ~ 2nd Pre-election ~ Post-election ~ September Supplemental PU~OSE CODES (see back of form for instructions and code definitions) A Agent N Newspaper and Other Periodical Advertising B Broadcast Advertising (Radio, TV) O Other Advertising (yard signs, bu~ons, etc.) C Cash Conwibutions P Postage 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 W Wages, Salaries, Benefits L Literature, Brochures, Printing Z Preparation and Production of Adwe~ising M Management Services Amount of Line ~ Date Payee's Name Purpose Expenditure ~. $ 5. $ 6. 7. 8. 9. ~0. transfer this amount to the Summa~ Statement, PC 1.) See Personal ~xpendimres $ Instructions Personal Expenditures $ '7 ~~, ~ on Back and Enter on ~ummau State~n[ Line 31 in Campaign Finance Manual REC'D 00T 0 2000 Personal Expenditures For Reimbursement This form is used when a candidate or treasurer expects to be reimbursed by the committee for expenditures made from their personal , funds (including charges on a personal credit card). List only one entry per line. ACCOUNTING PERIOD TOTAL - Complete this box only on the last page of the section. Add all pages totals for personal expenditures from all pages of form PC 3A and enter the amount in the Accounting Period Total box. Transfer this total to line 31 on the Summary Statement of Contributions and Expenditures (PC 1). AMOUNT OF EXPENDITURE - Amount of check, cash transaction or credit card charge. DATE - The date the expenditure was made. The date when using a credit card is the date of the actual charge on the credit card, not the date of payment to the credit card company. Date must include the month, day and year. PAGE TOTAL - Add all personal expenditures on the page and enter the amount in the Page Total box. PAYEE'S NAME - The name of the vendor or individual to whom payment was made by the candidate or treasurer. PURPOSE - Use the purpose codes from the list provided below (note exceptions) or write in the purpose of the expenditure. If one or more of the following purpose codes are used to describe an expenditure, no other description is generally needed. A Agent: A payee who is an individual or firm, such as an advertising agency or a public relations firm, authorized by a committee to make expenditures on behalf of the committee. If an expenditure is rnade for the committee by an agent, you must file a Report of Expenditures Made by an Agent (PC 9) or submit a copy of an invoice from the agent detailing the agent's expenditures. The invoice must contain the same information required on form PC 9. B Broadcast Advertising: Expenditures for the purchase of radio and television advertising. This is a sufficient purpose only if payment is made directly to a specific radio or TV station. If payment is made to an agent for preparation or production of advertising, use code Z. If payment is made to an agent for purchase of advertising, use code A. C Cash Contributions: Contributions made to other committees or organizations. F Fundraising Event Expenses: Expenditures associated with holding a fundraiser, including payments to restaurants, hotels, caterers, other food and refreshment vendors, entertainers and speakers. Use code L for expenditures associated with printed matter produced in connection with fundraising events. G General Operational Expenses: General campaign operating expenses, including filing fees, bank service charges, purchase or' rental of office equipment and furniture for the campaign and office supplies. If a general operational expenditure is over $50, describe the type of expenses (e.g., office supplies, furniture, etc.) I Interest Payment: Payment to a financial institution or other lender for the interest: on a loan to the campaign. L Literature, Brochures, Printing: Expenditures made for the preparation and production of campaign literature and printed solicitations, including expenditures for mailing lists, design, photography, copy, layout, printing and reproduction. Use code P for expenditures associated with literature mailing costs. The exceptions when using one of the above purpose codes are: M Management Services: Includes salaries, fees and commissions paid to campaign management companies and contract consultants. Contract consultants must include an explanation such as photography, legal services, etc. N Newspaper and Other Periodical Artvertising: Expenditures for the purchase of adw~rtising in newspapers, periodicals and other publications. This is a sufficient purpose only if payment is made to a specific publication. If payment is made to an agent for preparation or production of advertising, use code Z. If payment is made to an agent for purchase of advertising, use code A. O Other Advertising: Expenditures associated with the production and purchase of advertising on billboards, yard signs and campaign paraphernalia such as buttons, bumper stickers, T-shirts, etc. P Postage: Expenditures for stamps, postage, United Parcel Service, Federal Express and direct mail services. Use code L for design and other production costs associated with producing campaign literature. S Surveys and Polls: Expenditures associated with polls, reports on election trends, voter surveys, telemarketing, telephone banks, etc. T Travel Expenses: Expenditures associated with travel. If a travel expenditure is over $50, describe the type of expenses (e.g., lodging, airfare, meals, gas, etc.) W Wages, Salaries, Benefits: Expenditures associated with hiring campaign employees and other freelance workers (including wages, employment taxes, insurance, etc.) who provide miscellaneous services other than campaign management or consulting. Z Preparation and Production of Advertising: Payments associated with the preparation or production of broadcast, newspaper or other periodical advertising. 1. When reporting general operational (code G) or travel expenses (code T) over $50, the type of expenses must be described (e.g., lodging, airfare, meals, gas, office supplies, furniture for campaign office, etc.) 2. If an expenditure is made on behalf of the committee by an agent (code A), such as an advertising agency, you must file a Report of Expenditures Made by an Agent (PC 9) or submit a copy of an invoice from the agent detailing the agent's expenditures. The invoice must contain the same information required on form PC 9. 3. If an in-kind expenditure is made on behalf of another committee, the purpose description must include the purpose of the expenditure, state that iii is an in-kind contribution and name the recipient candidate or committee. 4. If an expenditure is an independent expenditure on behalf of a candidate, measure or political committee, the purpose description must include the purpose of the expenditure, state that it is an independent expenditure and name the candidate, measure or political committee. PC 2 Cash Contributions, Loans Received and In-Kind Please ~'pe or print legibly in black ink. Candidate or Political Committee Name: Committee ID Number: C~C~'~ /¢/~ ~-'~' 'Z~['~'~ Page / of ~ Election: ~ Pr~au 20 ~ General 20~ ~ Other Repo~: ~ 1st Pre-election ~ 2nd Pre-election ~ Post-election ~ 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 Party CommiUee ~mount of In-Kind Purpose Line ~ Name and Address of Contributor Contribution (see manual for suggested purpose codes) Occupational Information, Contributing Contributor Date Received Commi~ee's I~, or Description if Code ~ is "0" Aggregate Code ~I Code 2 2, $ 4. $ Page Totals (Add all amounts with the same Accounting Period Totals (Complete only for last page and See contribution l~pe. Do not include aggregates.) transfer these amounts to the Summau, Statement, PC 1 .) Instructions Cash (CA) $ j~~ Cash (CA) $. iq' ~¢ ~ on Back and ' Enter on Summau Statement, Column A, Line 1 in Campaign Finance In-Kind (IK) $ In-Kind (IK) $ Enter on Summa~ Statement. Column A, Lines 4 and 9 Manual Loans Received (LR) $ Loans Received (LR) $ Enter on Summa~ Statement. Column A. Line 2 , , Cash Contributions, Loans Received and In-Kind List only one entry per line. ACCOUNTING PERIOD TOTALS - Complete this box only on the last page of the section. Add Cash totals from all pages of form PC 2 and enter the amount on the Cash line in the Accounting Period Totals box. Add In-Kind totals from all pages of form PC 2 and enter the amount on the In-Kind line in the Accounting Period Totals box. Add Loans Received totals frorn all pages of form PC 2 and enter the amount on the Loans Received line in the Accounting Period Totals box. Transfer these totals to the lines indicated on the Summary Statement of Contributions and Expenditures (PC 1). AMOUNT OF CONTRIBUTION - Amount of contribution received on this date. CODE 1: CONTRIBUTOR TYPE - Select the appropriate contributor type from the list provided on the form. Designate only one contributor type for each entry. If code O (Other) is used, a description of the contributor must be provided in the Occupational Information box. Code 1 should not be completed when reporting "miscellaneous contributions $50 and under." CODE 2: CONTRIBUTION TYPE - Select the appropriate contribution type from the list provided on the form. Designate only one contribution type for each entry. CONTRIBUTING COMMITTEE'S ID# - If the contribution is from a state political committee, list the six digit ID# assigned to the contributing committee by the Secretary of State. CONTRIBUTOR AGGREGATE - Total amount of all contributions received from one contributor during all of the accounting periods for one election (i.e., first pre-election, second pre-election, post-election and supplemental accounting periods). Aggregate includes cash contributions, loans received (except exempt loans), cosigner obligations (except candidate's spouse), in-kind contributions and accounts receivable pledges. DATE RECEIVED - The date the contribution or loan was received in the candidate or political committee's physical custody or the date the candidate or committee first had knowledge of the in-kind contribution. Date must include the month, day and year. Do not use the date of the check unless the check is dated and received the same day. A range of dates may be used for "miscellaneous contributions $50 and under" and other limited circumstances. See pages 48 and 49 of the Campaign Finance Manual. IN-KIND PURPOSE - If the contribution type is IK, provide a description of the in-kind contribution or use. the suggested purpose codes listed in the Campaign Finance Manual on pages 61 and 62. NAME AND ADDRESS OF CONTRIBUTOR - Name and complete address for contributor, including residence or mailing address, city, state and zip code. OCCUPATIONAL INFORMATION - If the contributor is an individual, provide the occupation of the contributor or the name and address of the contributor's employer, or provide a copy of a dated letter showing that you requested the information within seven days of receipt of the contribution. "Self-employed," "business owner," "public employee" or "education employee" are not acceptable unless the nature of the business or employment is indicated. PAGE TOTALS - Add all code CA contributions and enter the amount on the Cash line in the Page Totals box. Add all code IK contributions and enter the amount on the In-Kind line in the Page Totals box. ,Add all code LR contributions and enter the amount on the Loans Received line in the Page Totals box. Code Definitions Code 1: Contributor Type B Business Entity: Includes for-profit and professional corporations, cooperatives, partnerships, limited liability companies, etc. C Political Committee: Committees filed in the State of Oregon or any other jurisdiction, including political committees established by business entities and labor organizations. F Candidate's Immediate Family: Includes the candidate, the candidate's spouse and any child, parent, grandparent, brother, half-brother, sister or half-sister of the candidate and the spouses of such persons. Individual: Includes a sole proprietorship. L Labor Organization 0 Other: Includes clubs, associations, nonprofit corporations, etc. If this code is used, a description of the contributor must be provided in the Occupational Information box. P Political Party Committee: A committee established by a major or minor political party in Oregon. Code 2: Contribution Type CA Cash: Any legal instrument redeemable as currency, transmitted via physical or electronic means. CO Cosigner Obligation: The amount of the loan for which that person agreed to be liable in a written agreement, except if the endorser or guarantor is the candidate's spouse. This amount must be considered as part of the cosigner's individual contribution aggregate until the loan has been repaid or forgiven. IK In-Kind: A thing or service, other than money, having monetary value. The value of this contribution is based on the fair market value of the product or service. This amount is considered both a contribution and expenditure for the committee and must be reported on line 4 and line 9 of the Summary Statement of Contributions and Expenditures (PC 1). All in-kind contributions must be itemized, regardless of the amount. LR Loan Received: Each endorser or guarantor of a non-exempt loan is considered to have contributed that portion of the total amount of the loan for which that person agreed to be liable in a written agreement, except if the endorser or guarantor is the candidate's spouse. Note: A loan from a financial institution may be exempt and, if so, is reported on form PC 4A. However, any cosigner of that loan must be reported on form PC 2, except if the cosigner is the candidate's spouse. PC 2 ?.er. Il/99 Cash Contributions, Loans Received and In-Kind Please type or print legibly in black ink. candidate or Political Committee Name: Committee ID Number: /'~] ~ /¢t~-~a/~ ,[/ P age o f Election: ~ Pr~aw 20~ ~ General 20 ~ Other Repom ~1 st Pre-election ~ 2nd Pre-election ~ Post-election ~ September Supplemental SEE BACK FOR INSTRUCTIONS AND CODE DEFINITIONS CODE ~: Contributor Type CODE 2: Contribution Type B Business EntiW CA Cash C Political Commi~ee (includes business and union PACs) CO Cosigner Obligation F Candidme's l[mmediate Family (includes candidme) IK In-Kind I Individual LR Loan Received L Labor Organization O Other P Political Pa~y Commiaee Amount of In-Kind Pu¢ose Line ~ Name and Address of Contributor Contribution (see manual for suggested purpose codes) Occupational Information, Contributing Contributor Date Received Commi~ee's I~, or Description if Code 1 is "0" Aggregate Code I~ Code 2 4. $ 5. $ Page Totals (Add all amounts with the same Accounting Period Totals (Complete only for last page and See contribution ~pe. Do not include aggregates.) transfer these amounts to the Summac~ Statement, PC 1.) Instructions Cash (CA) $ Cash (CA) $ on Back and Enter on Summaw Statement, Column A, Line 1' Finance In-Kind (IK) $ , In-Kind (IK) $ ~)- 7~ ~a~ual Enter on Summa~ Loans Received (LR) $ Loans Received (LR) * Enter on Summa~ Statement. Column A, Line 2 Cash Contributions, Loans Received and In-Kind List only one entry per line. ACCOUNTING PERIOD TOTALS - Complete this box only on the last page of the section. Add Cash totals from all pages of form PC 2 and enter the amount', on the Cash line in the Accounting Period Totals box. Add In-Kind totals from all pages of form PC 2 and enter the amount on the In-Kind line in the Accounting Period Totals box. Add Loans Received totals from all pages of form PC £ and enter the amount on the Loans Received line in the Accounting Period Totals box. Transfer these totals to the lines indicated on the Summary Statement of Contributions and Expenditures (PC 1). AMOUNT OF CONTRIBUTION - Amount of contribution received on this date. CODE 1: CONTRIBUTOR TYPE - Select the appropriate contributor type from the list provided on the form. Designate only one contributor type for each entry. If code O (Other) is used, a description of the contributor must be provided in the Occupational Information box. Code 1 should not be completed when reporting "miscellaneous contributions $50 and under." CODE 2: CONTRIBUTION TYPE - Select the appropriate contribution type from the list provided on the form. Designate only one contribution type for each entry. CONTRIBUTING COMMITTEE'S ID# - If the contribution is from a state political committee, list the six digit ID# assigned to the contributing committee by the Secretary of State. CONTRIBUTOR AGGREGATE - Total amount of all contributions received from one contributor during all of the accounting periods for one election (i.e., first pre-election, second pre-election, post-election and supplemental accounting periods). Aggregate includes cash contributions, loans received (except exempt loans), cosigner obligations (except candidate's spouse), in-kind contributions and accounts receivable pledges. DATE RECEIVED - The date the contribution or loan was received in the candidate or political committee's physical custody or the date the candidate or committee first had knowledge of the in-kind contribution. Date must include the month, day and year. Do not use the date of the check unless the check is dated and received the same day. A range of dates may bt._. used for "miscellaneous contributions $50 and under" and other limited circumstances. See pages 48 and 49 of the Campaign Finance Manual. IN-KIND PURPOSE - If the contribution type is IK, provide a description of the in-kind contribution or use, the suggested purpose codes listed in the Campaign Finance Manual on pages 61 and 62. NAME AND ADDRESS OF: CONTRIBUTOR - Name and complete address for contributor, including residence or mailing address, city, state and zip code. OCCUPATIONAL INFORMATION - If the contributor is an individual, provide the occupation of the contributor or the name and address of the contributor's employer, or provide a copy of a dated letter showing that you requested the information within seven days of receipt of the contribution. "Self-employed," "business owner," "public employee" or "education employee" are not acceptable unless the nature of the business or employment is indicated. PAGE TOTALS - Add all code CA contributions and enter the amount on the Cash line in the Page Totals box. Add all code IK contributions and enter the amount on the In-Kind line in the Page Totals box. Add all code LR contributions and enter the amount on the Loans Received line in the Page Totals box. Code Definitions Code 1' Contributor Type B Business Entity: Includes for-profit and professional corporations, cooperatives, partnerships, limited liability companies, etc. C Political Committee: Committees filed in the State of Oregon or any other jurisdiction, including political committees established by business entities and labor organizations. F Candidate's Immediate Family: Includes the candidate, the candidate's spouse and any child, parent, grandparent, brother, half-brother, sister or half-sister of the candidate and the spouses of such persons. Individual: Includes a sole proprietorship. L Labor Organization O Other: Includes clubs, associations, nonprofit corporations, etc. If this code is used, a de.~cription of the contributor must be provided in the Occupational Information box. P Political Party Committee: A committee established by a major or minor political party in Oregon. Code 2: Contribution Type CA Cash: Any legal instrument redee~mable as currency, transmitted via physical or electronic means. CO Cosigner Obligation: The amount of the loan for which that person agreed to be liable in a written agreement, except if the endorser or guarantor is the candidate's spouse. This amount must be considered as part of the cosigner's individual contribution aggregate until the loan has been repaid or forgiven. IK In-Kind: A thing or service, other than money, having monetary value. The value of this contribution is based on the fair market value of the product or service. This amount is considered both a contribution and expenditure for the committee and must be reported on line 4 and line 9 of the Summary Statement of Contributions and Expenditures (PC 1). All in-kind contributions must be itemized, regardless of the amount. LR Loan Received: Each endorser or guarantor of a non-exempt loan is considered to have contributed that portion of the total amount of the loan for which that person agreed to be liable in a written agreement, except if the .endorser or guarantor is the candidate's spouse. Note: A loan from a financial institution may be exempt and, if so, is reported on form PC 4A. However, any cosigner of that loan must be reported on form PC 2, except if the cosigner is the candidate's spouse. SEL 120 R~.v. 10/99 FILING OF CANDIDACY FOR NONPARTISAN NOMINATION ORS249.031 PLEASE TYPE OR LEGIBLY PRINT IN BLACK INK. NOTE: This information is a matter of )ublic record and may be published or reproduced. ~'] INCUMBENT FOR OFFICE OF JUDGE NAME OF CANDIDATE NAME SHOULD APPEAR ON BALLOT AS FOLLOWS TELEPHONE (HOME) FAX Sql. q~Z-7282 TELEI?HONE (WORK) 5q q 2.- qqz[ EMAIL TO THE SECRETARY OF STATE OF OREGON COUNTY ELECTIONS OFFI'CIAL OF CITY RECORDER (AUDITOR), CITY OF FILING FOR OFFICE OF DISTRICT AND DEPARTMENT OR POSITION NUMBER ?osib'o RESIDENCE A.D .D1RESS (STREET/RQUTE, CITY, STATE ZIP (.'ODE) Ash[a~ct, Of~. c175 2o MAILING ADDRESS TO WHICH ALL. CORRESPONDENCE WILL BE SENT 88~ ~.121,S+/V~r~ S±ceet Ashland, oK, q'l zo COUNTY FILING OF CANDIDACY BY DECLARATION, WITH THE REQUIRED FILING FEE (ORS 249.056). FILING FEES FILING OF CANDIDACY BY DECLARATION (ORS 249.056) STATE VOTERS' PAMPHLET OFFICE STATEWIDE OFFICES $100 $1000 CIRCUIT COURT JUDGE $ 50 $300 DISTRICT ATTORNEY $ 50 $300 MSD EXECUTIVE OFFICER, 1M[SD AUDITOR $100 $300 MSD COUNCILOR $ 25 $300 COUNTY OFFICE $ 50 $300 CITY OFFICE * **$300 JUSTICE OF THE PEACE NONE N/A *SET BY CHARTER OR ORDINANCE '*FOR CITIES WITH A POPULATION OF 50,000 OR MORE (ORS 251.(~r,n.,.,, MAY 2000 Filing of candidacy by PROSPECTIVE petition, with the required proposed signature sheet signed by the candidate (SEL 121) and statement one or more circulators will or will not be compensated (SEL 300) (ORS 249.020). Filing of candidacy by PERFECTED petition, with the required signature sheets properly certified by the appropriat~unty elections REC1) J u [ _ officials (ORS 249.020, 249.064). FILING FOR CANDIDACY: FIRST DAY FILING FOR CANDIDACY: LAST DAY FILING FOR STATE VOTERS' PAMPHLET: 2000 FILING DATES PRIMARY ELECTION SEPTEMBER 9, 1999, 8:00 A.M. MARCH 7, 2000, 5:00 P.M. MARCH 9, 2000, 5:00 P.M. GENERAL ELECTION MAY 31, 2000, 8:00 A.M. AUGUST 29, 2000, 5:00 P.M. AUGUST 29, 2000, 5:00 P.M. INITIALS RECEIPT NUMBER OFFICE NUMBER FOR OFFICE USE ONLY CASH OR CHECK NUMBER PRINCIPAL CAMPAIGN COMMITTEE IDENTIFICATION NUMBER CANDIDATE IDENTIFICATION NUMBER REQUIRED INFORMATION (ORS 249.031) OCCUPATION (PRESENT EMPLOYMENT - PAID OR UNPAID) OCCUPATIONAL BACKGROUND (PREVIOUS EMPLOYMENT - PAID OR UNPAID) EDUCATIONAL BACKGROUND (SCHOOLS ATTENDED; LAST GRADE COMPLETED; DEGREE(S), IF ANY) tq-/q - iq 7 7 ~'tvec~4-q of Nebcask,,a o,¥ &oho, PRIOR GOVERNMENTAL EXPERIENCE (ELECTED OR APPOINTED) iclqq- p,rc,s¢~¢ Ash[aaA NOTE: This information is a matter of public record and may be published or reproduced. By signing this document, I hereby state: THAT I shall accept the nomination for the office indicated above; THAT I shall qualify for said office if elected; THAT all information provided by me on this form, including my occupation, educational and occupational background, and prior governmental experience, is true to the best ofmykn~ ~.,~. Candidate's sigature v Date~;igned ! [ WARNING: IAny person who supplies any information on this form, knowing it to be false, is subject upon conviction to imprisonment in the penitentiary for up to five years or to a fine of $100,000, or both (ORS 260.715). No person shall file a nominating petition or declaration of candidacy for more than one lucrative office before the date of the primary' election, unless the person first files a written withdrawal with the officer who accepted the initial filing (ORS 249.013(1)). SEL 300 REV. 10/99 STATEMENT ONE OR MORE PETITION CIRCULATORS WILL BE COMPENSATED ORS 248.OO8 ORS 249.061 ORS 249.078 ORS 249.74O ORS 249.865 ORS 250.045 ORS 250.165 ORS 250.265 ORS 255.135 I/We hereby declare one or more petition circulators will be paid money or other valuable consideration for obtaining signatures of registered voters on the attached petition or certificate. I/We understand the filing officer must be notified not later than the tenth day after I/we first have knowledge or should have had knowledge no petition circulator is being paid for obtaining signatures. Identify Petition (Name of Candidate or Minor Political Party on Prospective Petition; or Subject of Initiative, Referendum Petition or Name of Officeholder on Recall Petition) Signed* Date signed Date signed Date signed *Statement must be signed by one of the following persons or groups: - candidate for nomination; - all chief petitioners for initiative or referendum petition; - chief petitioner for recall F~etition; - chief sponsor for certificate of nomination; - chief sponsor for minor political party formation petition. STATEMENT NO PETITION CIRCULATORS WILL BE COMPENSATED I/We hereby declare no petition circulator will be paid money or other valuable consideration for obtaining signatures of registered voters on the attached petition or certificate. I/We 'understand the filing officer must be notified not later than the tenth day after I/we first have knowledge or should have had knowledge one or more petition circulators is being paid for obtaining signatures. Identify Petition (Name of Candidate or Minor Political Party on Prospective Petition; or Subject of Initiative, Referendum Petition or Name of Officeholder on Recall Petition) Signed* dO2/,~ ~, ~~ Date signed '2'~/~~'0 ~' Date signed Date signed *Statement must be signed by one of the following persons or groups: - candidate for nomination; - all chief petitioners for initiative or referendum petition; - chief petitioner for recall petition; - chief sponsor for certificate of nomination; - chief sponsor for minor political party formation petition. REG'D N1AY $1 2(]100 ' hereby certify ~1 ~nalures ~ ,~ pe~Rion a~ ,~ose o, regislered ~olers in ~~ SlGNATUR~ O~ COUNTY ~L~CTIONS g~ICIAL~ ~O~ TO CA~IgA'I'E: ~TNON S~GNATU~S MUST B~ V~F~D B~FO~ A P~TmON CAN B~ ~L~D. B~ SUR~ YOU SUB~T YOUR P~T~T~ON ~N AMPL~ T~ FOR TH~S PR~SS TO B~ CO~PL~T~D B~FO~ 5:~ P.~. ON TH~ ~L~N6 D~ADL~N~ DAY. ~o .z> ~> ©> ~Z Z 0 Z ~ REC'D J U L - 5 2000 ~ Z~ ~ , Z ~ ~ , , NOTE TO CANDIDATE: ~'ETITION SIGNATU~S MUST BE VEBFIED 8E~ A PETITION CAN BE FILED. BE SURE YOU SUBMIT YOUR PETITION IN AMPLE TIME FOR THIS PR~ESS TO BE COMPLETED BEFO~ 5:~ P.M. ON THE FILING DEADLINE DA t~ m .z> ~> ©> > ~Z Z 0 Z ~REO'D J U L - 5 2000 SEL 220 ORS 260.037 ~v. 0,~ Candidate's Statement of Organization 0~s260.039 ORS 260.04 I Please type or print legibly in black ink. 1 Primary 20 General 2000 Other election date FI Will exist for more than one year 2 This filing is an: ~Original F1 Amendment [-1 Discontinuation 3 N~e of principal campaign commi~ee Commi~ee address (s~ee~route, ciW, state, zip code) - no post office box numbers Name of ~easurer Telephone numbers (worn} ' (home) Mailin~ address to which all commi~ee co~espo~dence will be sent 4 Name of c~didate Residence address (s~eeVroute, ci~, state, zip code) - no post office box numbers sV[o.e&, 0¢. q75zo Mailing address to which all c~didate co~espondence will be sent Occupation of candidate Telephone numbers (wo~) (home) N~e of office sought (include count, positiom depa~ment or zone number, if applicable) 5 Additional address that may be used on political publications (post office box or streegroute, ci~, state, zip code) 6 P~ aaliation (complete only if filing for pa~isan office)  Democratic ~ ~ibe~ian ~ Pacific Omen ~ Republican ~ Not a member of a pa~y ~ Other 7 Political commi~ee intends to solicit ~nds by (mark all that apply): ire , mi: m on : on,m U meiemion ~ Banquet N Ne wspa~r D Other Please complete and sign the back side of th~ for~ 8 Committee Directors (if any) , Name Address (including zip code) Occupation _ , II ~o o~ more dk¢cto~s o~ tkis Eolitic~l comm i~ ~ also directors o~ ~otk~ Eolitical commie,s, list tb~ ~s o~thos~ d~:cto~s ~md ~¢ ~ ~d address o~ other political commie,s(s). BX si~k~ this d~um~t I ~cko~l~d~ tk~t I ~ p~rso~all~ liabl~ ~o~ ~ p~alti~s imposed u~d~r O~S chapt:~ 260. C~didate s signature q' Tre~urer's signature (if different a~ candidate) Date si~e~ Date signed Impo~ant: Both the candidate and treasurer of a principal campaign committee must sign the Statement of Organ~tion. Instructions Filin~ an original 8~t~m~nt o~ Orflani~ation lhree (3) ~pies of this ~mploted form must be filed within three business days of first receivin~ a contribution or makin~ an oxponditum. ~ date ~tamped ~py, which includes your idontifi~tion number, will ~e rotumed to you as an acknowledgment of your filin~. ~OIfi: A mndidate may have only one principal mmpai~n ~mmi~eo. ~ ~andidat~ ~o ~ a~ ~e ~ea,urer ~ mndidat~ may either se~e as the mndidate's own treasurer or may appoint a separate treasurer. A mndidate who se~es as thoir own treasurer and ~ho does not expo~ to m~}vo or spend more than $300 for the entke ele~ion is not required to filo a Statement of Organization or contribution and expenditure mpo~s. However, if at any time they exceed $300 in either contributions or expenditures, they must then filo a Statement of Organization and contribution and expenditure repo~s. ~m~ndin~ info~a~on on thi~ ~o~ Any chan~e in the information on this fo~ must be filed within ten 00) days of the chan~e. 1o noti~ the filin~ officor of a chan~e in infomation, submit three (3) ~pies of this form, ~mpleted in its entire~, and mark the 'Amendment" box. Di~on~nuin~l You must file a final ~ntfibution and expenditure repod that shows a zero balan~, alon~ with a ~mploted Silk 220 with the 'Dis~ntinuation' box ma~ed. For Office Hso Initials Commi~ee ID Numar ~ ~ce Nm~, C~didate ID N~r ~ SEI. 220 ORS 260.037 9,99 Candidate's Statement of Organization ORS 260.041 Please type or print legibly in black ink. 1 Primary 20~ General 20 CO Other election date r-] Will exist for more than one year 2 This filing is an: r-] Original ~ Amendment Discontinuation 3 Name of principal campaign commiUee Commiuee address (st:reeffroute, ci~, state, zip code) - no post office box numbers Name of treasurer Telephone numbers (work) (home) Mailing address to which all commi~ee co~espondence will be sent 4 Name of candidate Residence address (s~eegroute, ci~, state, zip code) - no post office box numbers Mailing address to which all c~didate co~espondence will be sent cE 52o Occupation of candidate Telephone numbers (work) (home) Name of office sought (include count, position, depa~ent or zone ~mber~ ~f applicable) ~ Additional ~ss that ~ b~ ~s~ o~ ~olitic~l ~ublic~tions (~OSI Of~ bOX or sl~f[oute, oil, st~t~, zi~ ~o~) ~ P~6 ~ffili~tion (oom~l~t~ onl~ if filin~ for ~nis~n office) ~Democratic ~ Libe~ian ~ Pacific Green ~ Republican ~ Not a'member of a party ~ Other 7 Political commiaee intends to solicit hnds by (mark all that apply): ~ Direct mail ~ Personal contact ~ Radio ~ Television ~Banquet ~Newspaper ~Other ~l*~'~ ~~ Please complete and sign the back side of th~ for~ 8 Committee Directors (if any) - Name Address (including zip code) Occupation If ~o or more directors of this political commiuee are also directors of ~other political commiRee, list t~ names of ~ose directors and the name and address of the other political commiaee(s). By signing this document I ac~owledge that I am personally liable for ~y penalties imposed' under ORS chapter 260. C~date's signature ' ~" '~ qignamre (if different th~ candidate) Date'sign~ Date signed Important: Both the candidate and treasurer of a principal campaign committee must sign the Statement of Organization. Instructions Vilin6 an ori6inal S~[tem~nt of Organization Three (3) copies of this completed form must be filed within three business days of first receivin9 a contribution or makin~ an expenditure. A date stamped copy, which includes your identification number, will bo returned to you as an acknowledgment of your filing. NOTE: A candiclate may have only one princioal campaign commiRee. A candidate who a~rvea aa the treasurer A candidate may either se~e as the candidate's own treasurer or may aopoint a separate treasurer. A ~ndidate who se~es as their own treasurer and who does not expect to receive or spend more than $300 for the entire election is not required to file a Statement of Organization or contribution and expenditure repoas. However, if at any time they exceed $300 in either contributions or expenditures, they must then file a Statement of Organization and contribution and expenditure repoas. Amendin6 info~ation on this fo~ Any chan~o in the information on this form must be filed within ten (~ 0) days of the change. To noti~ the illin9 officer of a chan~e in information, submit three (3) copies of this form, completed in its entire~, and mark the 'Amendment' box. Oiacontinuin6 You must file a final contribution and expenditure repoa that shows a zero balance, alon~ with a completed SEL 220 with the "Discontinuation" box marked. . Vor Office Only Initials Commi~ee ID S~ber ~G"D ~ g 1 2~ Office Number C~didate ID Number