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Home My WebLink AboutCate Hartzell FILING OF CANDIDACY FOR NONPARTISAN NOMINATION PLEASE TYPE OR LEGIBLY PRINT IN BLACK INK. NOTE: This information is a matter of public record and may be published or reproduced. NAME OF CANDIDATE (AC\ ~~\f\e. a.rt z.~ \ \ '.{.'-ot) ~ 3 o INCUMBENT FOR OFFICE OF JUDGE 4* NAME SHOULD APPEAR ON BALLOT AS FOLLOWS Ca1-~ t\art2eJ\ RESIDENCE ADDRESS (STREET IROUTE, CITY STATE, ZIP CODE) 88 \ D:ts-t Mo.(o ~ee.t- ASh\Mc\) oR, '175,2.0 TELEPHONE (HOME) ~ TELEPHONE (WORK) '18 2 - iLl 2l EMAIL e.aT~ @) MlOd.Y\Et COUNTY OF RESIDENCE q~2-L\\\\ FAX MAILING ADDRESS WHERE ALL CORRESPONDENCE WILL BE SENT WEBSITE o SECRETARY OF STATE OF OREGON o COUNTY ELECTIONS OFFICIAL OF COUNTY MCITY RECORDER (AUDITOR), CITY OF tLt\o. o FILING OF CANDIDACY BY DECLARATION, WITH THE REQUIRED FILING FEE (ORS 249.056). FILING FEES FILING OF CANDIDACY BY DECLARA nON (ORS 249.056) STATE VOTERS' PAMPHLET OFFICE STA TEWIDE OFFICES CIRCUIT COURT JUDGE DISTRICT ATTORNEY COUNTY JUDGE MSD EXECUTIVE OFFICER, MSD AUDITOR MSD COUNCILOR COUNTY OFFICE CITY OFFICE JUSTICE OF THE PEACE * Set By Charter or Ordinance $100 $ 50 $ 50 $ 50 $100 $ 25 $ 50 NONE ** For Cities With a Population of 50,000 or More (ORS 2 ci Filing of candidacy by PROSPECTIVE petition, with the required proposed signature one or more circulators will or will not be paid (SEL 300) (ORS 249.020). ~ Filing of candidacy by COMPLETED petition, with the required signature sheets pr perIy cer 1 officials (ORS 249.020, 249.064). Primary Election 2004 FILING DATES Filing For Candidacy: First DilY March 31, 2003 Filing For Candidacy: Last Day March 9, 2004 Deadline to Withdraw Candidacy: March 12, 2004 Filing For State Voters' Pamphlet: March 11, 2004 Filing for Candidacy: first Day September 15, 2003 Filing For Candidacy: Last Day August 24, 2004 Deadline to Withdraw Candid2,cy: August 27, 2004 Filing For State Voters' Pamphlet: August 24, 2004 FOR OFFICE USE ONLY INITIALS CASH OR CHECK NUMBER RECEIPT NUMBER CANDIDA TE ID NUMBER OFFICE NUMBER PRINCIPAL CAMPAIGN COMMITTEE ID II sa 120 REV. 121m ORS 249.031 REQUIRED INFORMA nON OCCUPATION (PRESENT EMPLOYMENT - PAID OR UNPAID) .-L. No\')- p'd~ ,'t f'fc8f"amcoor-di(\C1\ or OCCUP A TIONAL BACKGROUND (PREVIOUS EMPLOYMENT _ PA.ID OR UNPAID) EDUCA TIONAL BACKGROUND (SCHOOLS ATTENDED, use attachment if needed) Complete name of school - no acronyms Course of study (optional) Other: PRIOR GOVERNMENTAL EXPERIENC9-iELECTED OR APPOINTED) l()O() - 2004 CI'-t~ l..O~r\c.\\ * 3 ~uqge- + G)Mm (l\-€e - Cl i-y of,~ \t1laYld G~'u~ eo',^"Mul1lca-ho(\ Comrv\r\tet- 'Ad fu>c ~\i\\s\'~e Sh:l(\d.a.rds ; ~',.:;." ~.' " a matter of public record and may be published or reproduced. ,/" By signingl,~s 'd~ument, I bereb1'st~t;: .. \ ." "-" , ~ THA T ac~!'$~thei1omination for t e mdicated above; THA T I hall qualify..!\> ice if elected; and THAT al i IOn c:>rovided by me on this form, including my occupation, educational and occupational background, and prior governmental experience, is true to the best of my knowledge. )~ ~ I/)/ r1IJOt( WARNING: Supplying false information on this form may result in conviction of a felony with a fine of up to $100,000 and/ or prison for up to five years. (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 filing (ORS 249.013(2)). SEL 120 REV. 12/03 ORS 249.031 CERTIFICATE OF LIMITED EXPENDITURES (ASHLAND CANDIDATES ONLY) PLEASE TYPE OR PRINT LEGIBL Y IN BLACK INK 5t D Political Committee D Primary 20_ B' General 20~ 0 Other Election Date t Imittee Name Committee Identification Number e 2{ ,ddress (street ( Jte i\y, state, zip code) 00 l -Ea.: It ..{(\ S\"fle.-r )ffice of Filing ( ~ :DW\ci \ -:PDS\-\i~'(\ -:\t ~ I certify that if I am signing as a candidate, I will not make attributable expenditures fot this election in excess of $2,980,00 (including expenditures of my principal campaign committee), or, if I am signing as a treasurer of a political committee organized exclusively to support or to oppose a candidate, I certify that the committee will not make attributable expenditures in this election in excess of $2'980'O~ ~-/ (4 ~d/ D Signed [NOTE: If the candidate or committee treasurer elects NOT to be bound by the expenditure limitations, the following line should be signed instead of the line above.] I elect not to be limited to the attributable expenditures specified in this certificate and city ordinance. Candidate or treasurer's signature Date Signed If a candidate, including the candidate's principal campaign committee, elects to spend not more than $2,980 for .---=-;;; the entire election, the candidate or the treasurer of the committee may file this Certificate of Limited Expenditures. This ;~~~ Certificate must be filed at the time the candidate files for office or accepts a nomination. Political committees must file ~ this Certificate when they file an original Statement of Organization (Secretary of State Form SEL 221). The City Recorder is authorized to publish a statement in the City, indicating whether or'not the candidate has agreed to 1 n ?00tt \ '0- limit expenditures. If the City Recorder or the City Attorney finds that a candidate filing a declaration of limitation on expenditures has exceeded the applicable expenditure limit, at the next election at which the candidate isa candidate for election to pubiic office, the City Recorder shall publish a statement, in the City, indicating that the candidate violated a previous declaration of limitation. fJ'J ~ > ~ t"I"J ~ t"I"J Z ~ o Z t"I"J o ~ ~ -;:::;0 ~. ~ j;j' t"I"J ~. "'0 ro t"I"J -......~ :;::;- ~~ ..... - ~ 0 g-z !3 () 0- 2-~ :S{) c::: t"'" > ~ o ~ fJ'J ~ - t"'" t"'" - ;;; "'0 > - o n ::r::r...... "0 D ...... ro ~ -....... ~ ri@~=Eo.: J:: 0" ro tj "'0 PJ',< ::r J:: ;:J >-t M-"'~::IOo o M-0...0...::I \11 :-' ::;. ~ ro ro "0 ro ::I ... '< ~ M-O~S;n g-i~o::r. M-roo...M-< ::Io...M-~~ 0~::r..."'O Q. M- ~ < ~ ~ ::r':::: ~...... n ~ ...... J:: ... SM-::I~::r. ~::IOtIO"o 8"0 0 ro::S ~~~----. 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ClJ .::: .... u OJ ........ o ClJ U) o -= .;. ~~ '0 "; co ~ t Q.I -:5 : -:5 .~ -0 ~ ;.+:: 2 1:' c: '" u c J ~ ~ c: :~ : t. ~" IlJ -:5 IlJ >-; o 0:;" ,!:). -0 ~ .>:; Q) > Q.I ,!:). <fJ ;j E C ClJ ... OJ c .9 .... ',p ClJ P-. U) :s c o U) ClJ ... ;:J -:;; 5b .u) <fJ Q.I >-;. ;j -ro. c: OJ:) 'uo c: :~ t. ~. "-i ... < o o z. < U o ... u.J f-< o z( ..J < o .- u.. u.. o z o ~ U \JJ .....J W ,Q C;~ ',p \JJ 0 ... P:::....... ClJ ::J ~, f-< ~ ..Q <r: Z ~ Z ~ ClJ C) 0 ,J:::; U) u PETITION I.D. PETITION FOR NONPARTISAN NOMINATION SIGNATURE SHEET Hzv+JLdJ THIS IS A CANDIDATE NOMINATING PETITION. SIGNERS OF THIS PAGE MUST BE ACTIVE REGISTERED VOTERS IN ~SOAJ _ COUNTY ONL Y. (IF APPLICABLE) DISTRICT, POSITION, DEPARTMENT OR ZONE NUMBER p()~, :It.3 CANDIDATE'S NAME OFFICE ONE OR MORE (CIRCLE ONE) PETITION CIRCULATORS WILL BE PAID to the office indicated, be placed upon the TO THE SECRETARY OF STATE! We, the undersigned voters, request the candidate's name printed above, for nomination COUNTY ELECTIONS OFFICIAU CITY RECORDER: appropriate ballot following the filing of this petition. I hereby certify every person who signed this sheet did so in my presence and I believe each person is a qualified voter in the State of Oregon (ORS 249.061). Warning: Falsely signing this statement may result in conviction of a felonywHh a fine of up d/orp tofiv (ORS260.715). -rhhl- --- I ' CITY AND ZIP CODE ^ RESIDENCE ADDRESS STREET AND NUMBER PRINT NAME d! DATE SIGNED MO/DAY/YR SIGNATURE LA TOR'S CERTIFICATION 5J.O DATE SIGNED CIRCULATOR SIGNATURE PRINTED NAME OF CIRCUL{y6R CIRCULATOR'S ADDRESS (street, city and zip code) THIS CERTIFICArtON MUST BE SIGNED BY THE CIRCULATOR. 3-~ ~'" SHEET NUMBER County, Oregon '7 -/3 - !) <-f DATE CERTIFIED ----.J those of active registered voters in can be filed with the filing officer. 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Main St. Ashland, Oregon 97520 (541) 488-5311 (fax) February 2 2005 Cate Hartzell 881 East Main Street Ashland, OR 97520 I have examined your post-election contribution and expenditure report for the General Election of November 2, 2004 and found the following: Gf Your committee report is sufficient. If you have any questions regarding this examination letter, please feel free to contact my office. Sincerely, /cL- Barbara Christensen City Recorder/Treasurer Enclosures Summary Statement of Contributions and Expenditures Please type or print legibly in black ink. Candidate or Political Committee Name (use full name): Committee to Elect Cate Hartzell Mailing Address as it Appears on Statement of Organization (street, route or box number, city, state, zip code): 881 East Main St Treasurer's Name: John Fields Committee ill Number: Committee Type, Measure Number or Office: o Original [gI Amendment o Primary 20_ o 1 st Pre-election o General 2004 0 Other _ o 2nd Pre-election [gI Post-election A-TOTALS FOR THIS ACCOUNTING PERIOD 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) 1,585.00 V + = 1,585,00 + = 1,585.00 EXPENDITURES 6. Cash Expenditures (Accountim~ 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 11. Beginning Cash Balance (line 20 of 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) . 17. Other Disbursements (Accountin~ Period Total from PC 4B) 18. Loan Payments (Exempt) (Accounting Period Total from PC 4B) 19. EXPENDITURE SUBTOTAL (lines 16 + 17 + 18) 3,449.70 ./ + = 3,449.70 + = 3449.70 1,864.70 1/ 1,585.00 + \/ + + = 3449,70 3,449.70 + + = 3,449.70 PC 1 Rev. 12103 Page 1 of2 Telephone Number (day): 541-482-8442 o 20 September Supplemental B-CUMULATIVE TOTALS FOR THIS ELECTION 3,988.00 V + = 3,988.00 + 60.00 = 4,048,00 4,120.88 \/ + = 4120,88 + 60.00 = 4,180,88 ,~,. FOR OFFICE USE ONLY .,-.-- ..--'"..-~--- ._...--~. v ~~~, '6 ~ W~" f/-" a-a"r~Q3'd 20. ENDING CASH BALANCE = 0.00 I (line 15 minus line 19) Summary Statement of Contributions and Expenditures PC I Rev. 12/03 Please type or print legibly in black ink:. Page 2 of2 Candidate or Political Committee Name: Committee ill Number: Committee to Elect Cate Hartzell D Original D Primary 20_ D General 2004 D Other _ [g) Amendment D 1 st Pre-election D 2nd Pre-election [g) Post-election D 20_ September Supplemental LOAN SUMMARY FOR OFFICE U&E ONL Y 21. Beginning Outstanding Loans (line 29 of previous report) . 22. Loans Received (Non-Exempt) + (line 2) 23. Loans Received (Exempt) + (line 14) 24. LOANS RECEIVED SUBTOTAL = (lines 21 + 22 + 23) 25. Loan Payments (Non-Exempt) (line 7) 26. Loan Payments (Exempt) + (line 18) 27. Forgiven Loans + (T otalloans 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 1.453.22 (line 36 of previous report) 31. Personal Expenditures + 0.00 (Accounting Period Total from PC 3A) 32. PERSONAL EXPENDITURE SUBTOTAL = 1,453.22 (lines 30 + 31) 33. Personal Expenditure Reimbursements 1408.57 (Total expenditures on PC 3 with purpose code R) 34. Forgiven Personal Expenditures + 44.65 (Total personal expenditures forgiven this acctg. period) 35. REIMBURSEMENT SUBTOTAL = 1 .453.22 (lines 33 + 34) 36. OUTSTANDING PERSONAL = 0 EXPENDITURES FINANCIAL STATUS AT CLOSE OF ACCOUNTING PERIOD 37. Ending Cash Balance 0.00 ~<<,<> (line 20) 38. Accounts Receivable + (Accounting Period Total from PC 5) 39. SUBTOTAL 0.00 (lines 37 + 38) = .;(;'0 ~~ .~\";\- "'\ (; ,~\ l~ 40. Total Outstanding Loans 0.00 \\;~ ~"1 . ~ ~~; ~ ~ (line 29) \~ V .~~ \.: ..;~~ 41. Outstanding Personal Expenditures 0.00 ~. \ ,,~~. (line 36) + .,;' 42. Accounts Payable ."'" 0.00 / (Accounting Period Total from PC 6) + ,?~/' 43. SUBTOTAL = 0 , (lines 40 + 41 + 42) /' 44. BALANCEIDEFICIT 0.00 " (line 39 minus line 43: indicate + or - balance) = I, Cate Hartzell (name of candidate or treasurer), hereby certifY that the above statement and the attached supporting reports are true and correct. li.hrlk1{g 6 ;:JoCQ ate SIgned PC2 Cash Contributions, Loans Received and In-Kind Rev. 12/03 Candidate or Political Committee Name: Committee ill Number: Committee to Elect Cate Hartzell Page 1 of~ Election: D Primary 20_ I2?J General 2004 D Other _ Report: D 1 st Pre-election D 2nd Pre-election I2?J Post-election D 20_ September Supplemental SEE BACK FOR INSTRUCTIONS AND CODE DEFINITIONS CODE 1: Contributor Type CODe 2: Contribution Type B Business Entity CA Cash C Political Committee (includes business and union PACs) CO Cosigner Obligation F Candidate's Immediate Family (includes candidate) IK In-Kind I Individual LR Loan Received L Labor Organization 0 Other P Political Party Committee Une# Name and Address of Contributor Amount of In-Kind Purpose Contribution {see manual for suggested purpose codes) Date Received Occupational Information or Contributor Code 1 I Code 2 Contributing Committee's ID# Aggregate Misc. Contributions under $50.01 1. $ 575.00 12-02-04 $ 1,548.00 I I CA Bonnie Moody 2. 901 Beach Street $ 100.00 Ashland, Oregon 97520 10-26-04 Retired School Administrator $ 150.00 I I CA Brian and Cathy Freeman 3. 109 High Street $ 100.00 Ashland, Oregon 97520 1 0-25-04 Graphic designers $ 100.00 I I CA Jeff Heglie 4. 919 Oak Street $ 60.00 Ashland, Oregon 97520 10-27 -04 Hydro-geologist $ 60.00 I I CA Oregon Sierra Club PAC 5. PO Box 19730-17 $ 250.00 Portland, Oregon 97280 1 0-29-04 Non-profit $ 250.00 C I CA See Page Totals (Add all amounts with the same Accounting Period Totals (Complete only for last page and Instructions contribution type. Do not include aggregates.) transfer these amounts to the Summary Statement, PC 1.) on Back and Cash (CA) $ 1 ,085.00 Cash (CA) $ in Campaign - Finance Enter <m Summary Statement, Column A, Line 1 Manual In-Kind (IK) $0.00 In-Kind (IK) $ - Enter on Summary Statement, Column A, Lines 4 and 9 pe2 Loans Received (LR) $0.00 Loans Received (LR) $ - Enter on Summarv Statement. Column A. l.ine 2 Cash Contributions, Loans Received and In-Kind Please type or print legibly in black ink. 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. Code 1 should not be completed when reporting "miscellaneous cash 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 10# - If the contribution is from a state political committee, list the six-digit 1.0. number assigned to the contributing committee by the Secretary of State. CONTRIBUTOR AGGREGATE - Total amount of contributions received from one contributor during all the accounting periods for one election (Le., 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 cash contributions $50 and under" and other limited circumstances. See pages 57 and 58 of the Campaign Finance Manual. IN-KIND PURPOSE - If the contribution type is IK, provide a written description of the in-kind contribution or use the suggested purpose codes listed in the Campaign Finance Manual on pages 74 to 76. 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 documentation showing that you requested the information within seven days of receipt of the contribution. See pages 59 and 60 of the Campaign Finance Manual for guidelines on acceptable and unacceptable occupational descriptions. 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 Pe2 Cash Contributions, Loans Received and In-Kind Rev. 12/03 Candidate or Political Committee Name: Committee II> Number: Committee to Elect Cate Hartzell Page_ of - Election: D Primary 20_ ~ General 2004 D Other _ Report: D 1 st Pre-election D 2nd Pre-election ~ Post-election D 20_ September Supplemental SEE BACK FOR INSTRUCTIONS AND CODE DEFINITIONS CODE 1: Contributor Type CODE 2: Contribution Type B Business Entity CA Cash C Political Committee (includes business and union P ACs) CO Cosigner Obligation F Candidate's Immediate Family (includes candidate) IK In-Kind I Individual LR Loan Received L Labor Organization 0 Other P Political Party Committee Line # Name and Address of Contributor Amount of In-Kind Purpose Contribution (see manual for suggested purpose codes) Date Received Occupationallnfonnation or Contributor Code 1 I Code 2 Contributing Committee's 10# Aggregate John Fields 1. 845 Oak Street $ 300.00 Ashland, Oregon 97520 10-31-04 Builder $ 300.00 I I CA Evan and Nancy Archerd 2. 120 N. Second Street $ 100.00 Ashland, OR 97520 10-31-04 Real Estate Appraiser $ 100.00 I I CA Larry Medinger 3. $ 100.00 10-31-04 Builder $ 100.00 I I CA 4, $ $ I 5. $ $ I See Page Totals (Add all amounts with the same Accounting Period Totals (Complete only for last page and Instructions contribution type. Do not include aggregates.) transfer these amounts to the Summary Statement, PC 1.) on Back and Cash (CA) $ 500.00 Cash (CA) $1585.00 in Campaign Finance Enter on Summary Statement, Column A, Line 1 Manual In-Kind (IK) $ - In-Kind (IK) $ - Enter on Summary Statement, Column A, Lines 4 and 9 pe2 Loans Received (LR) $ - I Loans Received (LR) $ - Enter on Summllrv Statement. C.olumn A. T .ine 2 Cash Contributions, Loans Received and In-Kind Please type or print legibly in black ink. 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. Code 1 should not be completed when reporting "miscellaneous cash 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 10# - If the contribution is from a state political committee, list the six-digit 1.0. number assigned to the contributing committee by the Secretary of State. CONTRIBUTOR AGGREGATE - Total amount of contributions received from one contributor during all the accounting periods for one election (Le., 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 cash contributions $50 and under" and other limited circumstances. See pages 57 and 58 of the Campaign Finance Manual. IN-KIND PURPOSE - If the contribution type is IK, provide a written description of the in-kind contribution or use the suggested purpose codes listed in the Campaign Finance Manual on pages 74 to 76. 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 documentation showing that you requested the information within seven days of receipt of the contribution. See pages 59 and 60 of the Campaign Finance Manual for guidelines on acceptable and unacceptable occupational descriptions, 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 PC3 Cash Expenditures and Loan Payments Rev. 12/03 Candidate or Political Committee Name: Committee ill Number: Committee to Elect Cate Hartzell Pagelofl Election: D Primary 20_ I:8J General 2004 D Other _ Report: D 1 st Pre-election D 2nd Pre-election I:8J Post-election D 20_ September Supplemental PURPOSE CODES (see back of form for instructions and code definitions) EXPENDITURE TYPES A Agent 0 Other Advertising (yard signs, buttons, etc.) CA Cash B Broadcast Advertising (Radio, TV) P Postage LP Loan Payment C Cash Contributions R Reimbursement for Personal Expenditures F Fundraising Event Expenses S Surveys and Polls G General Operational Expenses (describe if over $50) T Travel Expenses (describe if over $50) I Interest Payment U Utilities L Literature, Brochures, Printing W Wages, Salaries, Benefits M Management Services y Petition Circulators N Newspaper and Other Periodical Advertising Z Preparation and Production of Advertising Payee's Name and Payee's Committee 10#, Exp. Amount of ~ Line # Date Check # if applicable Purpose Type Expenditure Paid (as it appears on invoice, receipt or check) toNP 1, 11-1-04 006 Tidings N Cc $ 159.28 D 2. 11/11/04 008 Printfast 0 CC $ 966,55 D 3. 10/21/04 005 Tidings N CA $ 728.75 D 4. 11/01/04 004 Printfast L CA $ 36,55 D 5. 11/12/04 007 Crystal Castle L CA $ 150.00 D 6. 11/12/04 0000 Cate Hartzell R CA $ 1408.57 D 7. $ D 8. $ D 9. $ D 10. $ D See Page Totals (Add all expenditures with the same Accounting Period Totals (Complete only for last page and Instructions expenditure type.) transfer these amounts to the Summary Statement, PC 1.) on Back and Cash (CA) $ 3.449,70 Cash (CA) $ 3.449.70 in Campaign Finance. Enter on Summary Statement, Column A, Line 6 Manual Loan Payment (LP) $0,00 Loan Payment (LP) $Q Enter on Summary Statement, Column A, Line 7 PC3 City of Ashland City Hall 20 E. Main St. Ashland, Oregon 97520 (541) 488-5311 (fax) City Recorder's Office Barbara Christensen, City Recorder (541) 488-5307 (phone) January 24, 2005 Cate Hartzell 881 East Main Street Ashland, OR 97520 I have examined your post-election contribution and expenditure report for the General Election of November 2, 2004 and found the following: ci Your committee report is not sufficient. I have attached a corrected Summary Statement of Contributions and Expenditures along with corrected Cash Contributions and Cash Expenditures forms. The needed corrections are noted in "red, " Please submit an amended Post-Election repOlt with the indicated corrections. A completed report must be submitted by Februarv L 2005 to avoid penalties. If you have any questions regarding this examination letter, please feel free to contact my office. Sinc~ Barbara Christensen City Recorder/Treasurer Enclosures PC 1 Summary Statement of Contributions and Expenditures Rev. 12103 Please type or print legibly in black ink. Page 1 of2 Candidate or Political Committee Name (use full name): Committee to Elect Cate Hartzell Mailing Address as it Appears on Statement of Organization (street, route or box number, city, state, zip code): 881 East Main Street, Ashland, Oregon 97520 Treasurer's Name: I Telephone Number (day): John Fields 541-482-4111 Committee [0 Number: I Committee Type, Measure Number or Office: D Original D Prirruuy 20_ o General 20_ o Other ~ Amendment o 1st Pre-election D 2nd Pre-election ~ Post-election D 20_ September Supplemental . A-TOTALS FOR THIS B-CUMULATIVE TOTALS ACCOUNTING PERIOD FOR THIS ELECTION CONTRIBUTIONS 1. Cash Contributions 1585. ()[) .1;825.80 3q~.1Jl) 3,928.0Q (Accounting Period Total from PC 2) 2. Loans Received (Non-Exempt) + + (Accounting Period Total from PC 2) 3. Total Cash Contributions = lSB6. on 1,S28.0e = ~BB.tJl) -3,S~8.0n (lines 1+ 2) 4. In-Kind + + 60.00 (Accounting Period Total from PC 2) 5. TOTAL CONTRIBUTIONS = l58.5.02) 1,628.00 = 4oif8./JD ~,988.QQ (lines 3 + 4) EXPENDITURES 6. Cash Expenditures 2,041.13 2,712.31 (Accounting Period Total from PC 3) 7. Loan Payments (Non-Exempt) + + (Accounting Period Total from PC 3) 8. Total Cash Expenditures = 2,041.13 = 2,712.31 (lines 6 + 7) 9. In-Kind + 0.00 + 60.00 (Accounting Period Total from PC 2) 10. TOTAL EXPENDITURES = 2,041.13 = 2,772.31 (lines 8 + 9) CASH BALANCE 11. Beginning Cash Balance ~Q€J i1P rl- FOR OFFICE USE ONLY (line 20 of previous report) 12. Total Contributions + I~.OD A ,S2S.e€Y RECE\VED (line 5) 13. Other Receipts + (Accounting Period Total from PC 4A) 14. Loans Received (Exempt) + JAM 18 2005 (Accounting Period Total from PC 4A) 15. CONTRIBUTION SUBTOTAL = ~~4~.lO 3;38S'. TO (lines 11 + 12 + 13 + 14) 16. Total Expenditures 2,041.13 (line 10) - . 17. Other Disbursements + \.a...-, . ., .. .... (Accou~ Period Total from PC 4B) 18. Loan Payments (Exempt) + (Accounting Period Total from PC 4B) 19. EXPENDITURE SUBTOTAL = 2,041.13 (lines 16 + 17 + 18) 20. ENDING CASH BALANCE = IIYoe.57 1,348.S7 (line 15 minus line 19) 20. ENDING CASH BALANCE 1= 1 (line 15 minus line 19) Summary Statement of Contributions and Expenditures PC I Rev. 12/03 Please type or print legibly in black ink. Page 2 of2 Candidate or Political Committee Name: Committee In Number: Committee to Elect Cate Hartzell D Original D Primary 20_ D General 20__ D Other _ D Amendment D I st Pre-election o 2nd Pre-election r:8J Post-election 020 September Supplemental LOAN SUMMARY FOR OFFICE USE ONL Y 21. Beginning Outstanding Loans 0.00 (line 29 of previous report) RECEIVECI 22. Loans Received (Non-Exempt) + (line 2) 23. Loans Received (Exempt) + (line 14) 24. LOANS RECEIVED SUBTOTAL JAH 18 2005 (lines 21 + 22 + 23) = 25. Loan Payments (Non-Exempt) k (line 7) 26. Loan Payments (Exempt) 0.00 I. + (line 18) .. 27. Forgiven Loans i., ,~ .4.~.._ .4 ... "'~'.A.. ..:...: ._.. . ..- (Total loans forgiven during this accounting period) + 28. LOAN PAYMENT SUBTOTAL (lines 25 + 26 +27) = 29. TOTAL OUTSTANDING LOANS = 0.00 (line 24 minus line 28) PERSONAL EXPENDITURE SUMMARY 30. Beginning Outstanding Personal Expenditures noo. H3 ( '+53. ~ ~L (line 36 of previous report) 31. Personal Expenditures + 1 ,45~l~2 ~. *nO fC.3 ~~ (Accountin~ Period Total from PC 3A) 32. PERSONAL EXPENDITURE SUBTOTAL = 1 A~Q .dn 146~. 2 2- (lines 30 + 31) , 33. Personal Expenditure Reimbursements ~1A -9- ~ no pur-post ~~R (Total expenditures on PC 3 with purpose code R) 34. Forgiven Personal Expenditures + <M fc-' 3 (Total personal expenditures forgiven this acct~. period) 35. REIMBURSEMENT SUBTOTAL = ~.1e ..e- (lines 33 + 34) 36. OUTSTANDING PERSONAL = 1453.22 EXPENDITURES FINANCIAL STATUS AT CLOSE OF ACCOUNTING PERIOD 37. Ending Cash Balance ~ , 3.t18. 57 ItfDe;"S' 7 (line 20) 38. Accounts Receivable + (Accountin~ Period Total from PC 5) 39. SUBTOTAL = ~ ,J48.&7 I tfoe, 5- 7 (lines 37 + 38) 40. Total Outstanding Loans (line 29) 41. Outstanding Personal Expenditures + 1,453.22 (line 36) 42. Accounts Payable + 0,00 (Accountin~ Period Total from PC 6) 43. SUBTOTAL = 1.453.22 (lines 40 + 41 + 42) 44. BALANCE/DEFICIT 104.65- zLf4-. lP6) (line 39 minus line 43: indicate + or - balance) = I I, Cate Hartzell (name of candidate or treasurer), hereby certify that the above statement and the attached supporting reports are true and correct. D~~ I ~ 1-1105 RECE\VED JAM 1 8 2005 ~~i' ~~ ~.::,:,,: .:.:*.. ........;--~-- . _....,. PC 3 Cash Expenditures and Loan Payments Rc\' 12/03 Candidatc or Political Committcc Namc: I Commillec lD Number Committee to Elect Cate Hatzell Pagc 1 of 1 Election: o Primary 20_ ~ Gcncral2004 o Other __ Report : o 1st Prc-clection o 2nd Prc-e1cction ~ Post-election o 2004 Scptcmber Supplcmcntal PURPOSE CODES (see hack of form for instructions and code ddinitions) EXPENDITURE A Agcnt 0 Othcr Advcrtising (yard signs. buttons. CA Cash B Broadcast Advertising (Radio. TV) ctc. ) LP Loan Pavmcnt C Cash Contributions P Postage F Fundraising Event Expenscs R Reimbursemcnt for Pcrsonal E\:pcnditures G Gcncrcll Operational Expenses (describe if over S SUlyeys and Polls $50) T Travel Expenscs (describe if over $50) I Interest Paymcnt U Utilities L Literature. Brochures. Printing \V Wages, Salarics. Benefits M Management Services y Petition Circulators Une Payee's Name and Payee's Committee 10#, Exp. Amount of ~ # Date Check # if applicable Purpose Type Expenditure Paid (as it appears on invoice, receipt or check) to AlP 1. 11-1-04 006 Tidings N c $ 1 59,28 D 2. 11-11-04 008 Printfast 0 c $ 966.55 D 3. 10-21-04 005 Tidings N 'R $ 728.75 D . 4. 11-1-04 004 Printfast L c... $ 36.55 D 5. 11-12-07 007 Crystal Castle L ~ $ 150.00 D 6. $ D -- h ...---_. 6, ~ ~ ~~ r:co '.\' ~ .- --"7 ~~:- .~ D 7. -,=- \ _..:,_'---::~ \ .... IJI\ D 8. .... \ \ \'i \'. ,,~(' ~ \ 0_\...0 \ - \11 \ Ii L-------- ~ D 9. .------ ---- - 10. $ D See Page Totals (Add all expenditures with the Accounting Period Totals (Complete only for last page and Instructions same expenditure type.) transfer these amounts to the Summary Statement. PC 1.) on Back and in Campaign Cash (C A) $ 2.041 .13 Cash (C A) $ 2,041 .13 Finance Enter on Summary Statemcnt, Column A. Line 6 Manual Loan Payment (LP) $ 0,00 Loan Payment (LP) $ 0.00 Enter on Summary Statement. Column A, Line 7 PC 3 Cash Contributions, Loans Received and In-Kind PC :-: Rc'\' 1 ~ '(1.1 D Primary 20_ D I st Pre-election I.. Commillee ID Number: .. Pagc 2 of 2 D Othcr _ [2J Post-election D 20_ Scptcmber Supplemcntal Candidate or Political Committee Name: Committee to Elect Cate Hartzell Election: Report: [2J General 2004 D 2nd Pre-election SEE BACK FOR INSTRUCTIONS AND CODE DEFINITIONS CODE 1: Contributor Type B Business Entity C Political Committee (ineludes business and union P ACs) F Candidate's Immediate Family (includes candidate) I Individual L Labor Organization o Other P Political Party Committee Une# Date Received 1. 1 0-31-04 2. 10-31-04 3. 10-31-04 4. 5. See Instructions on Back and in Campaign Finance Manual PC 2 CODE 2: Contribution Type C A Cash CO Cosigncr Obligation IK In-Kind LR LO<lIl Received Name and Address of Contributor Amount of Contribution Contributor Aggregate I II (see manual ;~;~~~Q:~t:~~:rpose codes) Occupational Information or Contributing Committee's 10# John Fields 845 Oa k Street Ashland, Oregon 97520 Code 1 Code 2 $ 300.00 Builder 0.00 $ CA Evan and Nancy Archerd 120 N. Second St Ashalnd, OR 97520 $ 100.00 Real Estate Appraiser Larry Medinger PO Box 702 Ashland, OR 97520 0.00 $ CA $ 100.00 --.' ----. Builder .. "~=5~'\R\,\ CA - , ~\ \. \\ \ 1\' ',\ \.\ . :~;~~ . '---" .- .. . ' $ I ~ 1.0'; I l\U ~ '= ~ - - ._- ~\~ ~; '~re 2 $ $ \ ' . L--- _._.___-c~.--I .-l CA T - $ 0.00 $ ca Pa~e Totals (Add all amounts with the same contribution type. Do not include aggregates.) Accountin~ Period Totals (Complete only for last page and transfer these amounts to the Summary Statement. PC I.) Cash (CA) $ 1.525.00 '5~G.lf7) Entcr on Summary Statement, Column A. Linc I Cash (CA) $ 500.00 In-Kind (lK) $ In-Kind (IK) $ Enter on Summary Statement, Column A. Lines 4 and 9 Loans Received (LR) $ Loans Received (LR) $ Entcr on Summary Statement Column A Line 2 PC :; Cash Contributions, Loans Received and In-Kind Rc'\ 1 ~'(1' Candidate or Political Committee Name: \ Committee ID Number: Committee to Elect Cate Hartzell Page 1 of ~ Election: D Primary 20 [2J General 2004 D Othcr _ Report : D 1st Prc-clection D 2nd Prc-election [2J Post-e1cction D 20_ September Supplemental SEE BACK FOR INSTRUCTIONS AND CODE DEfiNITIONS CODE 1: Contributor Type CODE 2: Contribution Type B Business Entity CA Cash C Political Committce (includes business and union PACs) CO Cosigner Obligation F Candidatc's Immediatc Family (includes candidate) IK In-Kind r I ndiyidual LR Loan Recei\"cd L Labor Organi/.ation 0 Other P Political Party Committee Une# Name and Address of Contributor Amount of In-Kind Purpose Contribution (see manual for suggested purpose codes) Date Received Occupational Information or Contributor Code 1 1 Code 2 Contributing Committee's ID# Aggregate Misc. Contributions under $50.01 1. $ 575,00 - 12-02-04 $ 1,548.00 I I CA Bonnie Moody 2. 901 Beach Sf. $ 100.00 Ashland, Oregon 97520 10-26-04 Retired School Adminsiter $ 150.00 I I CA Brian and Kathy Freeman ;~ 3. 109 High Street $ 100.00 Ashland, OR 97520 _u -- - ': ::\ 10-25-04 " Graphic designers $ ~.~ ~,~\ I I f' t\\ ~\ f\ [. ,-, Jeff Heglie " , \" t. ==:J 4. 919 Oak Street $ 60 Ashland, OR 97520 : \ --- , -.---" -- I 1 0-27 -04 Hydro-geologist $ I CA Oregon Sierra ClubPAC 5. PO BOX 19730-17 $ 250.00 Portland, Oregon 97280 10-29-04 Non-profitr $ C I ca See Page Totals (Add all amounts with the same Accounting Period Totals (Complete only for last page and Instructions contribution type. Do not include aggregates.) transfer these amounts to the Summary Statement PC 1.) on Back and Cash (CA) $ 1.025.00 Cash (CA) $ in Campaign IOe~'ao - Finance Enter on Summary Statement, Column A, l.ine 1 Manual In-Kind (IK) $ - In-Kind (lK) $ - Enter on Summary Statement. Column A. Lmes 4 and 9 PC 2 Loans Received (LR) $ - Loans Received (LR) $ Enter on Summary Statement Column A Lme 2 PC 1 Summary Statement of Contributions and Expenditures Rev. 12/03 Please type or print legibly in black ink. Page 1 of2 Candidate or Political Committee Name (use full name): Committee to Elect Cate Hartzell Mailing Address as it Appears on Statement of Organization (street, route or box number, city, state, zip code): 881 East Main Street, Ashland, Oregon 97520 Treasurer's Name: I Telephone Number (day): John Fields 541-482-4111 Committee ID Number: I Committee Type, Measure Number or Office: D Original D Primary 20_ D General 20_ o Other o Amendment o 1st Pre-election o 2nd Pre-election o Post-election 020_ September Supplemental A-TOTALS FOR THIS B-CUMULATIVE TOTALS ACCOUNTING PERIOD FOR THIS ELECTION CONTRIBUTIONS 1. Cash Contributions 1,525.00 3,928.00 (Accounting Period Total from PC 2) 2. Loans Received (Non-Exempt) + + (Accounting Period Total from PC 2) 3. Total Cash Contributions = 1,525.00 = 3,928.00 (lines 1+ 2) 4. In-Kind + + 60.00 (Accounting Period Total from PC 2) 5. TOTAL CONTRIBUTIONS = 1,525.00 = 3,988.00 (lines 3 + 4) EXPENDITURES 6. Cash Expenditures 2,041.13 2,712.31 (Accounting Period Total from PC 3) 7. Loan Payments (Non-Exempt) + + (Accounting Period Total from PC 3) 8. Total Cash Expenditures = 2,041.13 = 2,712.31 (lines 6 + 7) 9. In-Kind + 0.00 + 60.00 (Accounting Period Total from PC 2) 10. TOTAL EXPENDITURES = 2,041.13 = 2,772.31 (lines 8 + 9) CASH BALANCE 11. Beginning Cash Balance 1,864,70 FOR OFFICE USE ONLY (line 20 of previous report) 12. Total Contributions + 1,525.00 RECE\VED (line 5) 13. Other Receipts + (Accounting Period Total from PC 4A) 14. Loans Received (Exempt) + JAM 18 2U05 (Accounting Period Total from PC 4A) 15. CONTRIBUTION SUBTOTAL = 3,389.70 (lines II + 12 + 13 + 14) 16. Total Expenditures 2,041.13 (line 10) 17. Other Disbursements - . + ~,_. .' .. .... (AccoulltiIu! Period Total from PC 4B) 18. Loan Payments (Exempt) + (Accounting Period Total from PC 4B) 19. EXPENDITURE SUBTOTAL = 2,041.13 (lines 16 + 17 + 18) 20. ENDING CASH BALANCE = 1,348.57 (line 15 minus line 19) .IlL. 20. ENDING CASH BALANCE 1= 1 (line 15 minus line 19) Summary Statement of Contributions and Expenditures PC ] Rev. ] 2/03 Please type or print legibly in black ink. Page 2 of2 Candidate or Political Committee Name: Committee In Number: Committee to Elect Cate Hartzell o Original o Primary 20_ o General 20_ o Other _ o Amendment o 1 st Pre-election D 2nd Pre-election [8J Post-election D 20_ September Supplemental LOAN SUMMARY FOR OFFICE USE ONL Y 21. Beginning Outstanding Loans 0.00 (line 29 of previous report) RECEIVECI 22. Loans Received (Non-Exempt) + (line 2) 23. Loans Received (Exempt) + (line 14) 24. LOANS RECEIVED SUBTOTAL = JAN 18 2005 (lines 21 + 22 + 23) 25. Loan Payments (Non-Exempt) ~ (line 7) 26. Loan Payments (Exempt) 0.00 J. + (line 18) .. 27. Forgiven Loans ,..... fit. ~ .. .-... .. ..... ...:.-'.A.. . .:.~ .41_ . ...... (T otalloans forgiven during this accounting period) + 28. LOAN PAYMENT SUBTOTAL = (lines 25 + 26 +27) 29. TOTAL OUTSTANDING LOANS = 0.00 (line 24 minus line 28) PERSONAL EXPENDITURE SUMMARY 30. Beginning Outstanding Personal Expenditures 386.18 (line 36 of previous report) 31. Personal Expenditures + 1,453.22 (Accounting Period Total from PC 3A) 32. PERSONAL EXPENDITURE SUBTOTAL = 1,839.40 (lines 30 + 31) 33. Personal Expenditure Reimbursements 386.18 (Total expenditures on PC 3 with purpose code R) 34. Forgiven Personal Expenditures + (Total personal expenditures forgiven this acctg. period) 35. REIMBURSEMENT SUBTOTAL = 386.18 (lines 33 + 34) 36. OUTSTANDING PERSONAL = 1453.22 EXPENDITURES FINANCIAL STATUS AT CLOSE OF ACCOUNTING PERIOD 37. Ending Cash Balance 1,348.57 (line 20) 38. Accounts Receivable + (Accounting Period Total from PC 5) 39. SUBTOTAL = 1,348.57 (lines 37 + 38) 40. Total Outstanding Loans (line 29) 41. Outstanding Personal Expenditures + 1,453.22 (line 36) 42. Accounts Payable + 0.00 (Accounting Period Total from PC 6) 43. SUBTOTAL = 1,453.22 (lines 40 + 41 + 42) I 44. BALANCEIDEFICIT = -104.65 (line 39 minus line 43: indicate + or - balance) I, Cate Hartzell (name of candidate or treasurer), hereby certify that the above statement and the attached supporting reports are true and correct. ~ ! 5 J.1J05 D te signed ) RECE\VED JAM 18 2005 ~:~'.~ ~.::~:,.: ~.;.:.,. .........;--~-... ... --". PC -' Cash Expenditures and Loan Payments Rc\" 12'( I., Candidatc or Political Committcc Namc: I Committee lD Number Committee to Elect Cate Hatzell Pagc 1 of 1 Election: D Primary 20 ~ Gcncral 20Q.4 D Othcr _ Rcport: D 1st Prc-elcction D 2nd Prc-clection ~ Post -clect ion D 2004 Scptcmbcr Supplemcntal PURPOSE CODES (scc hack of form for instructions and codc dcfinitions) EXPENDITlJRE A Agcnt 0 Othcr Advcrtising (yard signs. buttons. CA Cash B Broadcast Advertising (Radio. TV) ctc. ) LP Loan Paymcnt C Cash Contributions P Postagc F Fundraising Evcnt Expcnscs R RCIJnbursc111cnt for Pcrsonal Expenditures G Gencral Operational Expenscs (dcscribe if ovcr S SlI1\'cys and Polls $50) T Travel Expcnscs (dcscribc if O\'cr $50) I Interest Paymcnt U Utilitics L Literature. Brochurcs. Printing \V \Vages. Salarics. Benefits M Management Services y Pcl ition Circulators Une Payee's Name and Payee's Committee 10#, Exp. Amount of ~ # Date Check # if applicable Purpose Type Expenditure Paid (as it appears on invoice, receipt or check) toNP 1. 11-1-04 006 Tidings N c $ 159.28 D 2. 11-11-04 008 Printfast 0 c $ 966.55 D 3. 10-21-04 005 Tidings N R $ 728.75 D 4. 11-1-04 004 Printfast L $ 36.55 D 5. 11-12-07 007 Crystal Castle L $ 150.00 D 6. $ D ._~ r1 - ~ r'\\~ ~ -'- 1 .---- D 7. ~~. '\ _.:,-_.?~ \ ,~ \ \ ~I\ 8. \ . , r'\ ~=-_ (" - J\ D ' \ . ,) - '-' '"" ' f' i)\ ---- - hJu \---- D 9. .--------- l------ - 10. $ D See Page Totals (Add all expcnditures with the Accounting Period Totals (Complcte only for last page and Instructions same expenditure type.) transfer these amounts to the Summary Statement. PC I.) on Back and $ 2.041 .1 3 in Campaign Cash (CA) $ 2.041 .1 3 Cash (CA) Finance Enter on Summar\' Statement, Column :\, Litle 6 Manual Loan Payment (LP) $ 0.00 Loan Payment (LP) $ 0.00 Enter on Summarv Statement Column A, Line 7 PC 3 PC:: Cash Contributions, Loans Received and In-Kind RL'\' 1~'().' Candidate or Political Committee Name: I Committee ID Number: Committee to Elect Cate Hartzell Page ~ of~ Election: D Primary 20_ ~ General 2()~4 D Other _ Report: D I st Pre-election D 2nd Pre-election ~ Post-election D 20_ September Supplemental SEE BACK FOR INSTRUCTIONS AND CODE DEFINITIONS CODE 1: Contributor Type CODE 2: Contribution Type B Business Entity CA Cash C Political Committee (includes business and union P ACs) CO Cosigner Obligation F Candidate's Immediate Family (includes candidate) IK In-Kind I Individual LR Loan Received L Labor Organization 0 Other P Political Party Committee Une# Name and Address of Contributor ! Amount of In-Kind Purpose Contribution (see manual for suggested purpose codes) Date Received Occupational Information or Contributor Code 1 Code 2 Contributing Committee's ID# Aggregate John Fields 1. 845 Oak Street $ 300,00 Ashland, Oregon 97520 10-31-04 Builder $ 0.00 I CA Evan and Nancy Archerd 2. 120 N. Second St $ 100.00 Ashalnd, OR 97520 10-31-04 Real Estate Appraiser $ 0.00 I I CA Larry Medinger 3. PO Box 702 $ 100.00 Ashland, OR 97520 -. ...- -...--, -. 'i:~i t . ~J1> 10-31-04 Builder $ I~~= I "-"1 CA ~/ - -".- i \'\', \.\ \ I \. 4. $ Hm ~.. , ),~ ,.~ j\~) ':.. . ': I \ .. R .~--- -~-- -..... r --1 $ ...---~. I CA ...- l..- S. $ 0.00 $ I I ca See Pa~e Totals (Add all amounts with the same Accountin~ Period Totals (Complete only for last page and Instructions contribution type. Do not include aggregates.) transfer these amounts to the Summary Statement. PC I.) on Back and Cash (CA) $ 500.00 Cash (CA) $ 1.525.00 in Campaign Enter on Summary Statement, Column A. Line 1 Finance Manual In-Kind (IK) $ - In-Kind (IK) $ - Enter on Summary Statement. Column ^- Lines 4 and 9 PC 2 Loans Received (LR) $ - Loans Received (LR) $ - Enter on Summary Statement. Column A Line 2 !'C :; Cash Contributions, Loans Received and In-Kind Rc'\ 1 ~ '()~ Candidate or Political Committee Name: \ Committee ID Number: \~"ge 1 of ;1 Committee to Elect Cate Hartzell Election: o Primary 20_ ~ General 2004 o Other _ Rcport: o I st Pre-election D 2nd Pre-election ~ Post -elect ion o 20_ September Supplemental SEE BACK FOR INSTRlJCTIONS AND CODE DEI<-'INITIONS CODE 1: Contributor Type CODE .2: Contribution Type B Business Entity CA Cash C Political Committee (includes business and union P ACs) CO Cosigner Obligation F Candidate's Immediate Family (includes candidate) IK In-Kind I I ndiyidual LR Loan Recci\"cd L Labor Organi/,at ion 0 Other P Political Party Committee Une# Name and Address of Contributor Amount of In-Kind Purpose Contnoution (see manual for suggested purpose codes) Date Received Occupational Information or Contributor Code 1 \ Code 2 Contributing Committee's ID# Aggregate Misc. Contributions under $50.01 1. $ 575.00 - 12-02-04 $ 1,548.00 I I CA Bonnie Moody 2 901 Beach St. $ 1 00.00 Ashland, Oregon 97520 10-26-04 Retired School Adminsiter $ 150.00 I I CA Brian and Kathy Freeman --lR 3. 109 High Street $ 100.00 C I?;, f\ Ashland, OR 97520 - 10-25-04 Graphic designers $ \~ U~\ I I \CJ' 1\ ~\ f'\[ \ I Jeff Heglie ,\ , l ---j ~ , 919 Oak Street - ' 4. $ 60 Ashland, OR 97520 \ --- , 1-.'-'--- " \ 10-27-04 Hydro-geologist $ I CA Oregon Sierra ClubPAC 5. PO BOX 19730-17 $ 250.00 Portland, Oregon 97280 10-29-04 Non-profitr $ C I ca See Page Totals (Add all amounts with the same Accounting Period Totals (Complete only for last page and Instmctions contribution type. Do not include aggregates.) transfer these amounts to the Summary Statement. PC 1.) on Back and Cash (CA) $ 1.025.00 Cash (CA) $ in Campaign - Enter on Summary Statement, Column A, Lme I Finance Manual In-Kind (IK) $ - In-Kind OK) $ - Enter (m Summary Statement. Column A Lmes ~ ilnd 9 PC 2 Loans Received (LR) $ - Loans Received (LR) $ Enter on Summar'\" Statement Column A Lme 2 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 10, 2004 Cate Hartzell 881 East Main Street Ashland, OR 97520 I have examined your post-election contribution and expenditure report for the General Election of November 2, 2004 and found the following: ~ Your committee report is not sufficient. Report is unsigned and incomplete in many areas, including beginning cash balance. A completed report must be submitted by January 15" 2005 to avoid penalties. F or 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. Barbara Christensen City Recorder/Treasurer Enclosures \---.-------------.------.--------.-----.----.---..--------------------------------.--.--1 I Summary Statement of Contributions and Expenditures ' I II Please type or print Icgibl: in bl:tck ink Page I of? I ----- ---------...--------------.-------.-..-....-..----------------.-1 I Candidate or Political ('cmunitlee Name (use flllllil;lIllC) i I Committee to Elect Cate Hartzell . ______._____________~-----__---.-----._-.----~ i ~1:Jilillg :\ddress as It ,'\ppcars on StatCll1CI1l ofOrg:lIli/allon (street. route or bo\ number Cil~. slate. /ip code) j I 881 1=_8st Ma i n 5~_______.__________________________________----,___________._________________________~ I -rreasurer's Name: I Telephone Number ((b~ ) I I John Fields I 541-482-8442 i I--~------- .---------,----.------__-.------.------.--~-_--L-:::..._-------------------_'_._____.___________.__, I Committee 10 Number i COlllmittee '1'\ pe_ l\1casnre Number or Office. I I " I 1-________-,-______..______1.___________.___...___._._____---------------------------------------------------..1 I 0 Original 1 [J Primary C2J General :WOL1~ 0 Other __ i I 0 Amendment I [J ist Pre-election 0 2nd Pre-election ~ Post-cIcctiOl~____q 20__ September Sllpplemcnt_~~L_J i ------~---------:\-TOTALS FOR THIS B-CUl\lliLATIVE TOTALS I I ACCOUNTING PERIOD FOR THIS ELECTION i ,---------- ----------------------------.-----.---.-.-1 ~---- _CONTRIBUTIONS ----------r------------------~---.---------------------~ I I. Cash Contributions 11,525.00 I 3.92800 ! ~ ~ AlCOllJ~ 111~ !\:n~)~l~ olet ~!n~l1J J )~- :2 )------.-------+------------------+----------------.---j I L ._oaIlS ceel\ cc ~.OI1-_ XUllp 1 ! + i + i Il~. (/\lCOllI111l1i! I\:nod lotdlli-om 1)(' 21 ------J------ . +_______________________.________j. Tota i Clsh ConI ribut ions I , L times I 2 I --t:___~250~~_t_= 3,928,00, ~ I -1 In-Kind + 0.00 I + 60.00 I L \ !\cloul1til1~ Period lotalli-oll1 I'C :2 ) --t---------- --+____ --J l' (~i~~I;,~~,~ONTRIBUTlON~_____~=____ 1 ,525,00 ~__ 3,988,00 L-- ~~~~I(:,:,~,;,~,~?:ll~~~~)~l~::~~~:___L--=~~~~-- 1-=~~7~31=J I 7 Loan Payments (Non-Excmpt) I + I + ! l__l:l(TOlll1tll1~ j \.'11 (leI 1 otn 1 liom PC -----+----.----.---..---------------------t------------------------1 I X Total Cash Expenditures I = 2.04'1,13 I = 2,712.31 ! t (lille:' ().' _1-__________________+__.________________ .____~-----------------.--------~ I () In-Kind ! + ! + 60.00 : I (/\CCOl.lJ~ j'erltKl 'J 'olal If()l)) I !('l..!......_.,_____+____________._______________+-______________________~ . 1(1_ ~~'i~:~.~ 1: ~)XPE N D I T (1 R ES ~ = 2.04 '1 ~~~_______l~__________ 2. 77~~~_~__.___________i CASH BALANCE------- ---------------- - ! III Bcgllll1ll1i-\ ClSh Balance ~----~;-;;;/-~-r FO~FF~~E u~; O~L y----1 ~"') ~lll1e2(}~OIP1C\IO~i"Jep()lt) --- I I 1_ rotal (ontnbutlons i + 1,525 00 I 1-" ~~~~i~~'1;~~H=~I=~~ t====~ 0>_ ~ \l~~ I I 1-1- Loans Rl..?cCI\cd (E\Cmptl I + ~ I I I 1 ~___ I ~ ! /\CCOllllt1l1!.!. I\':llod i oullrom PC L \ I +-------------- t~. .- I ):'. CONTRIBUTION SLBTOTAL ; = 1 29:3 31 \\--: \ r i . I' . I"" , n~ 1 ~l_1 ~~~;~,~ ~:';);'~d~1 :,;c: 11 I 1_. 2,04'1 .1 3 \ 'J '- \) . ___ tlme Ji)1 ___~___ )l---- 17 Ot hcr Disburscmcnts I I . i + I--- (/\lcountll1S!. Period TutalIIOllll'(_-Il'>J ------t----------------- I I X. Loan Pa~mcnts (Exempt) ; + I . (i\cc"""llll~ Period 'I ""Ii ITom 1'C1Ii) -t---.~~-- --1 I () EXPENDITURE SUBTOTAL :,1 = 2041_13 I il Jl1e:~ I I 7 IS) ----t-----------------------.---------i Ll. {~1~~11~1~1~:~1~~~ l~ij~LANCE _._~_:__________ 7~~~_~__ . I r-----.--------------.--------------.-- -------------------.-..l I Summary Statement of Contributions and E:xpenditures : I I P1C~ISC t~pc or prIllt Icgibl~ ill bl:lCk il1k ____~~_~_________________~~~--_-----~-~c l~f~_J I Candidate or Political Committee N:I11JC I Committee ID ~\illlllbcr: I I Committee to Elect Cate Hartzell ! ! , ____~__________________________ _--1_.___~____ --------~----'1 I [~Original I D PrIlnaf\ 2ll__ 9 (n..'lIeral '::()Q~4 0 ()tlh:l ~- r- i ~ [.J -\mcndll1ent ~q Plc-dectlon LJ 2nd PI\:'-clcct lOll [SJ Post-clcctlOIl l~ 2()_ Scpll..'ll1brr Sllppkl1l1..lll:J1 i 1------------- -------LOAN-SUMMARY ---------------------- I --- j f---.,-------------.------------------..---.--------.---.-----.-----------1 F OR OFFICE USE ONLY ! 21. Beginnin~ Outstanding Loans I 1 L___~:.c 2') (It prc\ 1011~ ]....P()!:.t..L______._________+____________________________~ I 22. Loans Recei\ cd (Non-E~clllpl) i + I I (Ime ~'\ ' I ~--' -,',. " -------+--~------------------------j I 2. ~ LO;lllS Recci\cd (t~:~cmpll I + I h ilme !)l .. .. -.. .. +------------------~ I 2-l LOANS RECEI\'[D SCBTOTAL i = I I (lin....;--;21-r22+23) _ I II 25 Loan Payments (No-n-E\cmpt) I,. ------~-- --1 dine -, l ~ 127>. Loan Payments (E~cll1pt) ( +--------------- I ~27 ~I~;~il\~n Loans . ~ '. ~----t:-~--~------1 12 X il(~;\.,.t ~ <. }I~;~\.l.,'",)lit-, ~'.~l; '~.lL: ~i\,. ~;';:t nll..11..] ng J2.'::.~~lL--t-_=_-------------------------.-~ h, i1i",',2,; 2',+27, .' ." . , .~~--~------~ ~~;~I~:2~~;'~,~;'~I~~~;DING LOANS ___~ = _~_____~___~ [-,ii Beginning O"tslandi,~E~e~~~~\~;~~d~I~~~~RE iUMMARY -~-~---1 r-r- ~~~~~,\;~;'~'~~;dl~~;t;~:~~rt 1~~-~-t:----~----11 : 1!\CCOl!l1lms:. ]\:nod iotal1rom l)c'.\i I 1,2. PERSONAL .EXPENDITURE SUBTOTAL T:----------------------------l Ik- )--;-----~~;-~~;~:~l E~I;encliturc Reimbursements - ----t------------------------------, ___.__L-.IOl..!..:1-C"PC11lhtures 01111('; \\lthpurposc '::\Kk: 1<' i ---J..----------------------------1 Iq Forgi\cn Personal E~pcnditlln:s ! + I ~-. ~.' I.t),t;!.l ~, ,"",mal "'p"lHhl": c, 'Ore"""II", ,~ I ---------~~- JI I ), REIMBURSEMENT Sl if3TOT AL _. I iJmcs33+J~1 ! t. ~6 OlJTSTANDING PERSONAL ---------~~------------ -- i I EXPENDITljRES I - I f.- -- ------L-------------...--~-----___J I FINANCIAL 5T A TU5 AT CLOSE OF ACCOUNTING PERIOD r-~-7 Ending Cash B;Jlancc -231.69 L ! ]]]1C 2l)) ____.____--1-__._______________ I ~X Accounts Rccei\ablc i + 11~-'si"-~~~~~l~~cn",I I owl I, <1111 PC "----t-------..;~~9 (] ilk'-. ~- t 'x) I ::: -LoJ - ~(\ Tot~ll Oulst~lndlng I,O;lllS ----------i---~----------- (11llC 2<l) i -\- I -+1 0, lltst.,,:lI',.l,dll1l! Persollal hPclldllili:;:;:------r:--~ L=r---- I ~ (l111c 'II) I I -+2. ~i\ZCOWlts P;l\;lble I + .-~--._------~---- i . I I ~\ '\u_nllllt]J1~ j>cl1~)(lloldl-'l,)l11l\ I" ~-_-_----___---------------~ : I -+~. Sl;BTOTi\L ! ::: 0 I ! j-w ~l,~~:i~\~C~l/DF~.~')ICIT -- -t~----------------- ---i i 1 ! lm~' ;') 1l11llll" 1111.... i, 111d]l..dk r PI h,ddlld.: I i-I i I_______~__________________L___________._______ _______-1.___ ______________---l i 1'- ______ (name of candldalc or treasurer!. hcrcb~ ccrttl\ thaI tile ;lbm c stalclllcnt and the attached supporting reports are true and I COtTeel. I ! i I I[ Signature of candidatc or lrcasurer ----------- i l):IIC sll.!Iled ! , ------------------.-----_..__._1 Cash Expendituresi and Loan Paynlents I Committee ID Number: ----_________1 Election D Primary 20_ [2SJ General 20Q..~ D Other ___ Report: 0 I st Pre-election D 2nd Pre-cIccI ion [2SJ Post-election PlJRPOSE CODES (se{~ had" of form for instructions and code definitions) A Agent 0 Other AdYCrllsing (yard signs. buttons. B Broadcast Adycrtising (Radio. T\/) etc.) C Cash Contributions P Postage r; Fundraising Eyent E-"penses R Reimbursement for Personal E."\penditurcs G General Operational E-"penses (describe if mcr S Sune~ s and Polls $SO) '1 1'ra\el E-'penses (describe if mer SSO) 1 Interest Paymenl U Utilities L Literature. Brochures. Printing \V Wages. Salaries. Benefits 1\\/1 Management SeIYices Y Petition Circu\;]tors !;I .~ Committee to Elect Cate Hatzell I 11 {.lanc 1 of 1 b _ _ --- . ,,' Candidale or Political Committee Name: I I I : I --1--- I ---t- I I 10 I I I L I I ~'See I Page Totals (Add all e-'penditures \vith the Instructions same e-'penditure type.) on Back and in Campaign Cash (e A) Finance Manual Line # --t- 1 I 11-1-04 --+ " I 11-11-04 -~-I i 3 I 10-21-04 I 4. I 11-1-04 5. 111-12-07 6 r I 7. PC 3 Date I Check # J I I 006 I I I I 008 005 004 007 D 2004 September Supplemental EXIPENDITliRE CA Cash LP Loan Payment I I Payee's Name and Payee's Committee fD# if applicable I (as it appears on invoice. receipt or check) I I Tidings ~fast Purpose N I Tidings I Printfast $ ~Q.11~~ $ ~-L04 1 . 1 3 Loan Paymcnt (LP) $ ~OO Loan P<J\11lcnt (LP) $ 0.00 Cmdidalc or Political Committee Name: Cash Contributions, LOc:tns Received and In-Kind T~\..' 1....,rq Committee to Elect Cate Hartzell Election: Report: D Prima~ 20_ o I sl Pre-election ~ General 2004 o 2nd Pre-election r('OI~itte~D NUllilier: ---1 o Other __ ~ Post-election SEE BACK FOR INSTRlJCTIONS AND CODE DEFINITIONS CODE 1: Contributor Type B Business Entit: C Political Commitlee (includes business and union PACs) F Candidate' s Immediate Family (includes candidate) I I ndi\idual L Labor Org~H1i/atlon o Olher P Political Party Comnllttee Lme # :i- Date Received 10-31-04 2 10-31-04 3 1 0-31-04 4 I ------1 I I 5+ See Instructions on Back and in Campaign Finance Mannal PC 2 Name and Address of Contributor Occupational Information Of Contributing Committee's 10# John Fields 845 Oak Street Ashland, Oregon 97520 Builder Evan and Nancy Archerd 120 N. Second St Ashalnd. OR 97520 Real Estate Appraiser Larry Medinger PO Box 702 Ashland, OR 97520 Builder Page Totals (Add all (lIllOl1nts \\itl1 the same contribution t} pc. Do not include aggregates Cash (C A) $ iQQ-,-OO In-Kind (I K) $ Loans Recein:d (LR) ~ Page ~ of~ o 2()__ September Supplemental CODE 2: Contribution Type C A ('ash CO Cosigner Obligation lK In-Kind LR Loan Rcccl\ed 1 Amount of _~ Contribution I Contributor I Aggregate I I I $ 300.00 I ~~ l n____1 15) 0.00 I ! I 1$ 100.00 I =f 0.00 ~ i I .~::J- -I: ~,'~I:: I "'~,~ ~ I . ! --to 1$ L '+ 1$ 000 I ! I -+ I - I $ I Accounting Period Totals (Complete onl~ for last page ~Ind ! transfer thcsc amollnt':; to the SU!1l111;ln Statemcnt. PC I ) i I Clsh (C;\) 111l-KlIlcl ilK) i I Loalls Reed\ eel (LR) ~:':l;:1 ";'i!n:" 11\ : : tl',"lh'lI: , In-Kind Purpose (see manual for s~ggested purpose codes) Code 1 Code 2 - r ----------- CA CA CA CA --r-----.- I ca ! $ 1;,IlI(;'/" I in Cash Contributions, Loans Received and In-Kind =~~rm~ltcc ~~ NU~=t~~~~~~~ o General 2004 0 Ollicr_______ o 2nd Pre-election ~ Post-election 0 20__ September Supplemental Candidate or Political Committee Name: Committee to Elect Cate Hartzell Elect ion Report o Priman 20 o I st Pre-election 1 '" 'r\~ SEE BACK FOR INSTRUCTIONS AND CODE DEfINITIONS CODE 1: Contributor Type B Business EntIl: C Political Committee (includes business and union P ACs) F Candidate' s Immediate Family (includes candiclate) I r ndiyidual L Labor Organi/.ation o Other P PolitIcal Party Comnllttee -I Amount of \ In-Kind Purpose ___t-___fontribution ___-+J~~ee mi!..17ua! for SUil2p1~ purpose cod~s) I c.ontnb.. u. tor! 1_ c' j 1 1 " 1 2 I' A t AX e I 'I' GOG e ggrega e I 1 I $ 575.00 I -l; 1.548.001 I I I I I $ 100.00 \ ___________________1____.________.___.___+__________1'_---.---..---.---------- \$ 150.00 1 I 1 CA -\ --t .e::~~ 1$ '100.00 \ " \' I I ---~-~['. Jeff Heglie I ," 919 Oak Street 1 S 60 Ashland, OR 97520 I ----- - ----------------.-t------------'p. ---~=--.._-~.--.._---------- Hydro-geologist I $ i I CA I I Oregon Sierra ClubPAC I I I I POBOX 19730-17 'I' $ 250.00 I Portland, Oregon 97280 I ' ____________________+...__..____..______--t-___ , ! , Non-profitr ~ $ I c ca Page Totals (Add all :llnounts \\Ith the same I Accountmg Penod Totals l( omplctc onl:- for last page and contribution t~ pe Do Ilol include ;}!..',grcgates') 1 (ClIJslcr thesl' amollnts to the SlInmlar:\ Stltclllcnl. PC 1.) I I Cash ICAI I I Tn-Kind (lK) I 1 i I Loans Rccci\ccl (LR) S'ki.n 'Uilin,i'. :.'.li'.:'1i,'nt l.T,[,..! ,," Line # Name and Address of Contributor Date Received Occupational Information or Contributing Committees 10# Misc. Contributions under $5001 I - 12-02-04 'J L. Bonnie Moody 901 Beach St. I Ashland, Oregon 97520 10-26-04 Retired School Adminsiter Brian and Kathy Freeman ~09 High Street Ashland, OR 97520 10-25-04 Graphic designers 3 4 10-27 -04 5_ 10-29-04 See Inst ructions on Back and in Campaign Finmlce i'v1anual Casll(CAl $1~~5.0Q r n-Kind (TK) $ PC 2 Loans Rccci\cd (LR) 1\ CODE 2:: Contribution Type CA Cash CO COSIgner Obligation II( In-Kind LR Loall Received CA -.-r-------------- $ $ i.j-lt...-:1" IJi'i ,"lurnnl,t!"\. .l.>i\-,-':'-',,'["'< Summary Statement of Contributions and Expenditures p(' 1 Rc\' I ~I ).' Please type or print legibly in black ink. Page I of 2 Candidate or Political Committee Name (use full name): Committee to Elect Cate Hartzell - Mailing Address as it Appears on Statement of Organization (street. route or bo.\: number. cit}. state. zip code): 881 East Main 8t. Ashland, Or 97520 Treasurer's Name: I Telephone Number (dm) John Fields 541-482-8442 Committee ID Number: I Committee T~pe. Measure Number or Office: o Original o Primary 20_ [B General 20~* o Other _ [2J Amendment o I st Pre-election [2J 2nd Pre-election o Post-election o 20_ September Supplemental A-TOTALS FOR THIS B-CUMULA TIVE TOTALS ACCOUNTING PERIOD FOR THIS ELECTION CONTRIBUTIONS 1. Cash Contributions 1,723.00 / 2,403.00 V" (Accounting Period Total from PC 2) 2. Loans Received (Non-Exempt) + + (Accounting Period Total from PC 2) 3. Total Cash Contributions = 1,723.00 = 2,403.00 (lines 1+ 2) .f. In-Kind + aO.ao ~J + 60.00 (Accounting Period Total from PC 2) 5. TOTAL CONTRIBUTIONS \J V = j ,726.08 17S.3.tJZ 2,463.00 (lines.3 + 4) ...:it EXPENDITURES ( .,,'" 6. Cash Expenditures 671.18 671.18 (Accounting Period Total from PC .3) 7. Loan Payments (Non-Exempt) + 0.00 + 0.00 (Accounting Period Total from PC .3) 8. Total Cash Expenditures = 671.18 = 671.18 (lines 6 + 7) 9. In-Kind + 30.00 + 60.00 (Accounting Period Total trom PC 2) 10. TOTAL EXPENDITURES = 701.18 = 731.18 ~ (lines 8 + 9) CASH BALANCE II. Beginning Cash Balance 812.88 ./ FOR OFFICE USE ONL Y (line 20 of previous report) 12. Total Contributions + 1,753.00 ~ (line 5) IT ~~~U~~ ~ 13. Other Receipts + (Accounting Period Total from PC 4A) 14. Loans Received (Exempt) + ~[OCT 2 8 2004 L.....I (Accounting Period Total trom PC 4A 0) 15. CONTRIBUTION SUBTOTAL = 2,565.88 .; (lines 11 + 12 + 1 3 + 14) 16. Total Expenditures 701.18 .j (line 10) 17. Other Disbursements + (Accountin2. Period Total from PC 413) 18. Loan Payments (Exempt) + (Accounting Period Total trom PC 413) 19. EXPENDITURE SUBTOTAL = 701.18 J (lines 16 + 17 + 18) 20. ENDING CASH BALANCE = 1,864.70 J (line 15 minus line 19) Summary Statement of Contributions and Expenditures Plcasc typc or print legibly in black ink. Candidatc or Political Committce Namc: Committcc ID Numbcr: committee to ELect Cate Hartzell 1'(' 1 Rc'\' 12113 Pagc 2 of 2 o Original [g] Amcndmcnt o Primary 20 [g] Gcncral 2004 o 1st Prc-elcction [g] 2nd Prc-elcction LOAN SUMMARY o Othcr _ o Post-elcction o 2004 Septcmber Supplemcntal 21. Bcginning Outstanding Loans (line 29 of )reViOlls re )ort 22. Loans Rcccivcd (Non-E\:cmpt) (line 2 2:1. Loans Rcccivcd (E\:cmpt) (line 14 2-l. LOANS RECEIVED SUBTOTAL (lines 21 + 22 + 23' 25. Loan Paymcnts (Non-E\:cmpt) (line T 26. Loan Payments (Exempt) line 18 27. Forgiven Loans Total loans for iven durin this accountin 28. LOAN PAYMENT SUBTOTAL (lines 25 + 26 +27 29. TOTAL OUTSTANDING LOANS (line 24 minus line 28 FOR OFFICE USE ONLY 0.00 + + = 0.00 + + = = 0.00 PERSONAL EXPENDITURE SUMMARY :10. Beginning Outstanding Pcrsonal Expenditurcs (line 36 of xevious re )ort :11. Personal E\:penditures (Accollntino Period Total from PC 3A' :12. PERSONAL EXPENDITURE SUBTOTAL (lines 30 + 31 :1:1. Personal E\:penditure Reimbursements Total e\: )enditures on PC 3 with 1lI )ose code R' 3-l. Forgiven Personal Expenditures (Total )ersonal e\: enditures for iven this aceto. 35. REIMBURSEMENT SUBTOTAL (lines 33 + 34 36. OUTSTANDING PERSONAL = 1 453 22 EXPENDITURES ' . FINANCIAL STATUS AT CLOSE OF ACCOUNTING PERIOD 37. E~ding Cash Balance 1 864.70 (hne 20 ' 38. Accounts Rcceivable (Accountino Period Total from PC 5 39. SUBTOTAL (lines 37 + 38 40. Total Outstanding Loans (line 29 -ll. Outstanding Pcrsonal Expcnditurcs (line 36 -l2. Accounts Payablc Aceountin Period Total from PC 6 43. SUBTOTAL (lines 40 + 41 + 42 44. BALANCE/DEFICIT (line 39 minus line 43: indicate + or - balance 386.18 ,j + 1,453.22 386.18 .; ./ .; = 1,839.40 + = 386.18 ..; v + = 1,864.70 + 1,453.22 ~ + 643.17 = 2,096.39 .; = asur r). hercby certi(y that the above statemcnt and the attached supporting reports are Signature cjf , I ' ! I f I I f 1'<' 2 Cash Contributions, Loans Received and In-Kind Rc\' 1211-' Candidatc or Political Committcc Namc: Committcc ID Numbcr: Committee to Elect Cate Hartzell Pagc 1 of 1 Elcction: D Primary 20_ ~ Gcncral 2004 D Othcr _ Rcport:t'\M.~tEJ 1st Prc-e1cction ~ 2nd Prc-e1cction D Post-e1cction D 20_ Scptcmbcr Supplemcntal SEE BACK FOR INSTRUCTIONS AND CODE DEFINITIONS CODE 1: Contributor Type CODE 2: Contribution Type B Busincss Entity CA Cash C Political Committec (includcs business and union P ACs) CO Cosigner Obligation F Candidatc's Immcdiatc Family (includcs candidatc) IK In-Kind 1 Individual LR Loan Rcccn'cd L Labor Organization 0 Other P Political Party Committcc Une# Name and Address of Contributor Amount of In-K;nd Purpose Contribution (see manual for suggested purpose codes) Date Received Occupational Information or Contributor Code 1 I Code 2 Contributing Committee's 10# Aggregate Misc. Contributions under $50.01 1. $ 973.00 9-17 -04 - 1 0-17 -04 $ I I CA Sarah Collard! Tom Dimitre 2. 901 Beach S1. $ 250.00 Ashland, Oregon 97520 9-20-04 Psychologist! Union representative $ I I CA Darwin Thusius 3. PO Box 963 $ 250.00 Ashland, Oregon 9-20-04 Owner, SULA technologies $ I I CA Angelika Thusius 4. PO Box 963 $ 250.00 Ashland, Oregon 97520 9-17-04 Founder KENTRO Body Balance $ I J CA Helga Motley 5. P.O. Box 205 $ 30.00 IK Ashland, Oregon 97520 Photographer $ I I IK See Page Totals (Add all amounts with the same Accounting Period Totals (Complete only for last page and Instructions contribution type. Do not include aggregates.) transfer thcse amounts to the Summary Statcment. PC I.) on Back and Cash (CA) $ 1.723.00 Cash (CA) $ 1.723.00 in Campaign Enter on Summarv Statemcnt. Column:\. J .mc 1 Finance Manual In-Kind (lK) $ - In-Kind (lK) $ - Entcr on Summary Statcment. Column .\. Lmes -+ and 9 PC 2 Loans Receivcd (LR) $ - Loans Received (LR) $ - Entcr on Summarv Statcment. Column A. Line 2 I'C 3 Cash Expenditures and Loan Payments RL'\' 12113 Candidatc or Political Committcc Namc: Committec ID Numbcr: Committee to Elect Cate Hatzell Pagc 1 of 1 Elcction: o Primary 20_ ~ Gcncral 2004 o Othcr _ Rcport: o 1st Prc-clection ~ 2nd Pre-clection o Post-elcction o 2004 Septcmber Supplemcntal PURPOSE CODES (see back of form for instructions and code definitions) EXPENDITURE A Agcnt 0 Othcr Advcrtising (yard signs. buttons. CA Cash B Broadcast Advcrtising (Radio. TV) ctc.) LP Loan Paymcnt C Cash Contributions P Postage F Fundraising Evcnt Expcnscs R Reimburscmcnt for Pcrsonal Expenditurcs G Gencral Operational Expenscs (dcscribe if ovcr S SUIYCYS and Polls $50) T Travel Expenscs (dcscribc if ovcr $50) I Intcrest Paymcnt U Utilitics L Literaturc. Brochures. Printing W \Vages. Salarics. Bencfits M Managcment Serviccs y Petition Circulators Une Payee's Name and Payee's Committee 10#, Exp. Amount of ~ # Date Check # if applicable Purpose Type Expenditure Paid (as it appears on invoice, receipt or check) toNP 1. 09-21-04 001 Eastburn Photography L c $ 100.00 D 2. 09-06-04 002 Crystal Castle Graphics 0 c $ 185.00 D 3. 1 0-1 5-04 003 Cate Hartzell R R $ 386.18 ~ 4. $ D 5. $. D 6. $ D 7. $ D 8. $ D 9. $ D 10. $ D See Page Totals (Add all expenditures with the Accounting Period Totals (Complct(~ only for last page and Instructions same expenditure type.) transfer these amounts to the Summary Statement. PC 1.) on Back and in Campaign Cash (CA) $671.18 Cash (CA) $671.18 Finance Enter on Summary Statement. Column A Line 6 Manual Loan Payment (LP) $ 0.00 Loan Payment (LP) $ 0.00 Enter on Summar'\' Statement. Column A LIne 7 PC 3 PC' 3A ~O Personal Expenditures for Reimbursement Re'\'. \ ~'(I~ Candidate or Political Committee Name: Committee 10 Number: Committee to Elect Cate Hatzell i . Page 1 of\.1 Election: o Primary 20_ [) General 2~ f o Olhcr _ Report: o 1 st Pre-elcction ~ 2nd Pre-elcction o Post -election o 2004 S(~ptembcr Supplemental PURPOSE CODES (see back of fonn for in~1ructions and code definitions) A Agent 0 Other Advertising (yard signs, buttons. etc.) B Broadcast Advertising (Radio. TV) P Postage C Cash Contributions S Surveys and Polls F Fundrdising Event Expenses T Travel Expenses (describe if over $50) G Generdl Operational EX']Jenses (describe if over $50) U Utilities I Interest Payment W Wages, Salaries. Benefits L Literature, Brochures, Printing y Petition Circulators M Management Services Z Preparation and Production of Advertising N Newspaper and Other Periodical Advertising Line Date Payee's Name Purpose Amount of # Expenditure 1. 1 0-05-04 As~land Lumber 0 $ 6.00 2. 1 0-11-04 RAM L $ 748.40 3. 1 0-8-04 Jackson County G $ 1.50 4. 9-17-04 spearco 0 $ 356.25 5. 1 0-02-04 medford mail tribune n $ 300.00 6. 9-18-04 ash land hardware 0 $ 5.40 -- - - -. - ... 7. 9-25-04 ash land hardware 0 $ 12.59 8. 9-18-04 ashland hardware 0 $ 5.13 9. 9-25-04 ashland lumber 0 $ 17.95 10. $ See Page Total Accounting Period Total (Complete only for last pagc and Instructions Personal Expenditures $ 1.453.22 transfer this amount to the Summary simenl PC 1.) on Back and in Campaign Personal Expenditures $ 1.453.22 Finance Enter on Swnnwy Statement, Line 3\ Manual PC3A f+rM (}Al--<M)U) PC' (, Accounts Payable J{('v I ::!'()3 Candidate or Political Committee Name: Commit1ee ID Number: Pagc ~ Of~ Committee to Elect Cate Hatzell Election: o Primary 20_ ~ General 20f)f:( o Other _ Report: o 1st Pre-elcction ~ 2nd Pre-elcction o Post -election o 2004 September Supp1cmcntal PURPOSE CODES (see back for instructions and code definitions) A Agent 0 Other Advertising (yard signs, buttons, etc.) B Broadcast Advertising (Radio, TV) P Postage C Cash Contributions S Surveys and Polls F Fundraising Evcnt Expenses T Travel E"':penscs (describe if ovcr $50) G General Operational Ex-pcnses (describc if over $50) U Utilities I I nterest Payment W Wages. Salaries, Benefits L Literature, Brochures, Printing y Petition Circulators M Management Services Z Preparation and Production of Advertising N Newspaper and Other Periodical Advertising Une Date Payee's Name Purpose Amount of # Account Payable 1. 10-01-04 Printfast L $ 36.55 2. 10-05-04 Printfast L $ 470.79 3. 10-13-04 Crystal Castle L $ 85.00 4. 10-15-04 Printfast L $ 49.15 5. 10-16-04 Printfast L $ 1.68 6. $ -. - - " - 7. $ 8. $ 9. $ 10. $ See Page Total (Add all accounts payable on this Accounting Period Total (Complete only for last page and Instructions fonn.) transfer these amounts to the Summary Statement, PC 1.) on Back and Accounts Payable $ 643.17 $ 643.17 / in Campaign Accounts Payable Finance Enter on Summary Stal.emenl, Column A, Line 42 Manual PC6 I I Summary Statement of Contributions and Expenditures I Ple'lse type or print legibly III bhck ink I I I Page I of 2 I 1 ! I ---j i i -~ I I -1 i ( '.- L ( Candidate or Political Committee Name (use full name): Committee to Elect Cate Hartzell Mailing Address as it Appears on Statement of Organi/ation (S 881 East Main 8t. Ashland, Or 97520 Treasurer's Name: John Fields Committee ID Number: I Committee Type. i\'1ca s - o Original D Primary 20_. ~ General 20~ L2;J Amendment D I st Pre-election [2J 2nd Pre-elecl I CONTRIBUTIONS l. Cash Contributions I I (/\ccollnting I\~riod Total from PC 21 I ') Loans Receiyed (Non-E:\empt) I L.. (/\cc(\llntim~ l\~riod Total from PC 2 I , Total Cash Contributions -+ (llllCS 1 + 2) 4 In-Kind (/\ccounting Period Total from PC ::: I r 5. TOTAL CONTRIBlJTIONS I = (lincs 3 -t 41 I -,. . ---!. IreeL route or bo:\ number. cit~, state, /ip code) ~~lepho~le Number (d;l~ ): I 541-482-8442 ure Number or Office: ~'t 0 Other_ lOll D Post-election A-TOTALS FOR TH IS \CCOUNTING PERIOD D 20_ September SlIpplemeIlt~ B--CUMULATIVE TOTALS I FOR THI~_ ELECTION J I ._-~ I J I I I I I i ! I I r I 7 EXPENDITURES I 1,72300 +- -------F-- 1.723 00 ----L- 2.463.00 1.723.00 2.403.00 2.403.00 60.00 -r- I Cash E:\penditures I I 671.18 I 671.18 ( /\ccounting Period Total Jrom PC .-; i I I -r: Loan Payments (Non-E:\empt) 1+ 0.00 0.00 u\ccollnting Pcriod Total from PC 3) t- Total Cash E:\penditures +- 671.18 E 671.18 (hucs 6 + 7) In-Kind 30.00 60.00 (/\ccollnting Period Total from PC 2 ) 1+ --!-- TOT AL EXPENDITURES I I 731.18 I = 701.18 ~ Oilll:S R + 91 x. 9. 1 (). CASH BALANCE ~l. B.. e. ginning Cash Balance...' _ (]jne 20 of previous rcport I 12. Total Contributions ~ (!ll1C :;) ~.i. Other Receipts (Accounting Period Totallmm PC 4;\ I 14. Loans Rccci\ed (E:\empt) , (Accounting Pcriod Iota! from H..' -1/\ ! 15. CONTRIBUTION SUBTOTAL (lines 1 ] + 12 +- 13 +- I ~) 16. Total E:\pcnditurcs Oine Hi) 17. Other Disbursements (Accounting Period Total 11'0]11 PC LW) I S. Loan Payments (E:\empt) u\ccounting Period Total tJ-om PC --+ H) 19. EXPENDITURE SUBTOTAL (lines I h -+- 17 + 1 Xl I 20. ENDING CASH BALANCE . (lll1e 15 mUlllS linc Il)) r--------.- I I 81.2.88 -----r------- I + 1,753.00 I . 1+ 1+ t= I -r-...---- ~ I 1+ I -. I~ I- i- -L. FOR OFFICE USE ONLY j o ~~~U\f~ n ~CT 2 8 2004 U 2.565.88 701.18 701.18 I v-j 1,864.70 -1 i (/' I i ---1 I ~ I ~ i I ~ I ~ ! i -1 I ! --J i I .:1 , I I p')OC ') of ~ I (t:' L, ~ ~ tommlltee ID Number ~ ! i o 20Q1 September SllPPlcmel~ FOR OFFICE USE ONLY I Summary Statement of Contributions and Expenditures Please type or print legibly in black ink. Candidate or Political Committee Namc: I committee to ELect Cate Hartzell D Original ~ Am~lIdJl1ent I 21. Beginning Outstanding Loans D Primary 20_ D 1st Pre-clection ~ Gcncral 2()0L1~ ~ 2nd Prc-elcction LOAN SUMMARY =E-~ I~ _.) . 2-L 2(). 29. 37. Ending Cash Balancc (line2()) 38. Accounts Rccchable (Accounting Period Total from PC :; I 39. SUBTOTAL 4(). (IJl1L~S 37 3X) Total Outstanding Loans (line 20) Olltst:.lI1ding Pcrsonal E\:penditurcs (line 36) Accounts Payable (/\ccollntuHl Period Total [1-0111 FC (, ) SUBTOTAL ( lines ..W + 41 + -+2) BALANCE/DEFICIT 41. 42. 43. D Other _ D Post-clection 0.00 ----- 0.00 0.00 38(3.18 1.453.22 1 ,83!~.40 386.18 1,864.70 1.864.70 1,453.22 ~ ~ I,,;asur r). hcreby ccrtif~ that thc abO\e statcmcnt and the attached supporting reports arc -&~ ~-f--- Datc signc fn.: I I I I I I I I I I I I I I I I , ~ I Cash Contributions, Loans Received and In-Kind Candidate or Political Committee Name: I Committee 10 Number: I . Committee to Elect Cate Hartzell -______J I Page 1 of 1 Election: D Primary 20__ LSl General 200Ll 0 Other __ Report :fr\M.t\~tCJ I st Pre-election ~ 2nd Pre-election 0 Post-election SEE BACK FOR INSTRIJCTIONS AND CODE DEFINITIONS CODE 1: Contributor Type B Business Entit~ C Political Committee (includes busincss and union PACs) F ('andiclatc's Immediate Family (includes candidate) I Indi\idual L Labor Organil.ation o Other P Political Part~ Committee Line # Date Received 9-17-04 ,.., L 9-20-04 Name and Address of Contributor Occupational Information or Contributing Committee.s 10# Misc. Contributions under $50.01 I I - 1 0-1 7 -04 Sarah Collard! Tom Dimitre 901 Beach St Ashland, Oregon 97520 I Psychologist! Union representative Darwin Thusius PO Box 963 Ashland, Oregon 9-20-0~1 Owner, SULA technologies 3 4 9-17-04 5. See Instructions on Back and in Campaign Finance Man na I PC 2 Angelika Thusius I PO Box 963 Ashland, Oregon 97520 Founder KENTRO Body Balance Helga Motley P.O. Box 205 Ashland, Oregon 97520 Photographer Cash (CA) $ 1 ,723.00 In-Kind OK) ~ Loans Recei\ecl (LR) $ [J 20_ September Supplemental CODE: 2: Contribution Type CA Cash CO Cosigner Obligation IK In-Kind LR Loan Recei\ecl I 973.00 I 2:000 r- --1--- ---1- ;~-- -+----~----_._-- 1_ I CA 250.00 J ::-f 250.00 I I I I 30.00 I I -+ I Amount of Contribution Contributor Aggregate Loans Recci\ed (LR) $ In-Kind Purpose (see manual for s~/ggested purpose co~es)_ Code 1 Code 2 I I ------j -I I i$ ! --.-..-..----""----'-"-- -.----. .-- --- ------ ___________m___ __ .______ _ +-_ m.______m____ 1$ I ~ I 0/ I IS I 1$ I Is ! 1$ I i I Is I I i I 1$ I Is I I Pa~e Totals (Add all amounts \\ith the same I Accounting Period Totals (Complete only for last page and contribution t~ pe. Do not include aggregates. I I transfer these amOllnts to the Summar" Statcmcnt. PC I.) I Cash (CAd $ 1 ,723.00 . 111l-KlIld OK) I I I CA -I CA IK IK ~~ urnn);!r\ $ \, i J ': nk'f nn ~~~Llnlnlan >~tak'nlL'nL ( 'I~! Unlrt ,~~, I'! . :. Cash Expenditures and Loan Payments Candidate or Political Committee Name: .J Committee ID Numl~~I' . Committee to Elect Cate Hatzell ---.lPage 1 ofl Election: 0 Primary 2()_ ~ General 2004 0 Other Report: 0 I st Pre-election ~ 2nd Prc-election 0 Post-election PURPOSE CODES (se<.~ had,. of form fOl' instructions and codl' definition~) A Agent 0 Ot her /\cherl ising (yard signs. buttons. B Broadcast Ad\ertising (Radio. TV) etc.} C Cash Contributions P Postage F Fundraising E\ent E\:penses R Reimbursement for Personal E\:penditures G General Operational E\:penses (describe if mer S Suneys and Polls $50) T Trmel E'\penses (describe if mer $50) I Interest Payment U Utilities L Literature. Brochures. PrintlIlg \V Wages. Salaries. Benefits M Management Senices Y Petition Circulators o 2004 September Supplemental EX i(> END IT lJ R E C A Cash LP Loan Pa~ ment I 09-21-04 I Check # I I 001 ~ Eastburn PhotOgraPhY. 09-06-04 I 002 I Crystal Castle Graphics I 10-15-04 I 003 ~ate Hartzell ~ I I Date r--Dl " --r''-x.n I -,Amoun-t of -r- r\;l Payee's Name and Payee's Ccmmittee 10#. I PlJrnr ::: '", ~ if applicable I' urpose I Type Expenditure PaId (as it appears on invoice. receipt or check) t------ -+' to AlP I Lie $ 100.00 0 10 I t-- I I I I I i- I I J I $ I D I I I I ~B I 0 I -+ ~ I $-----1 0 L-jj- $ I 0 I I $ 10 J L__ Page Totals (Add all e\:penditures \\ith the I Accounting P<.'riod Totals (Complete only for last page and same e\:penditure t~ pe.) I transfer these amounts to the Summar:\ Statement. PC I.} I I Cash (eA) I I Loan Pa~ment (LP) $ 0.00 I I c I (' ,) Line # 3. R R (' ,) 185.00 0 386.181 f2]- --r---- 10 I ----rc; 2. 5. Is I I I $ . 4. 9. I +-~ I I I -1- T-] I I 6 7. 8 10 See Instructions OIl Back and in Campaign Finance t'vlanual Cash (CA) $671.18 $671.18 Loan Payment (LP) $ 0.00 \, 1 PC 3 PC3A AWJJLitvl)~ 0 Personal Expenditures for Reimbursement Rev. I :!/("'~ Candidate or Political Committee Name: Committee TO Number: Committee to Elect Cate Hatzell Page 1 of 1 i ... - \- Election: o Primary 20_ [J Gcncral 2~ f o Othcr _ Report: o 1 st Pre-election I2$) 2nd Prc-election o Post -election o 2004 Scptembcr Supplcmcntal PURPOSE CODES (see back of form for in~1ructions and code definitions) A Agent 0 Other Advertising (yard signs, buttons. etc.) B Broadcast Advertising (Radio. TV) P Postage C Cash Contributions S Surveys and Polls F Fundmising Event Expenses T Travel Expenses (describe if over $50) G Generdl Operational EXlJenses (describe if over $50) U Utilities I Interest Payment W \Vages, Salaries. Benefits L Literature, Brochures, Printing y Petition Circulators M Management Services Z Preparation and Production of Adve:t1.ising N Newspaper and Other Periodical Advertising Une Date Payee's Name Purpose Amount of # Expenditure 1. 1 0-05-04 As~land Lumber 0 $ 6.00 2. 1 0-11-04 RAM L $ 748.40 3. 10-8-04 Jackson County G $ 1.50 4. 9-17-04 speareD 0 $ 356.25 5. 10-02-04 medford mail tribune n $ 300.00 6. 9-18-04 ashland hardware 0 $ 5.40 -. - - -. - - 7. 9-25-04 ashland hardware 0 $ 12.59 8. 9-18-04 ashland hardware 0 $ 5.13 9. 9-25-04 ashland lumber 0 $ 17.95 10. $ See Page Total Accounting Period Total (Complctc only for last pagc and Instructions Personal Expenditures $ 1 .453.22 transfer this amount to the Summary Sjment. PC 1.) on Back and in Campaign Pcrsonal Expenditurcs $ 1.453.22 Finance Enter on Swnmary Statement, Line 31 Manual PC3A f4:vv\ t~tiUl/JR- J) PC (. Accounts Payable J({'\" 12'03 Candidate or Political Committee Name: Committec 10 Number: Pagc ~ Of~ Committee to Elect Cate Hatzell Election: o Primary 20_ ~ General 200t{ D Othcr _ Report: D 1st Pre-election ~ 2nd Pre-elcction D Post -election D 2004 Septcmbcr Supplemental PURPOSE CODES (see back for instructions and code definitions) A Agent 0 Other Advertising (yard signs, buttons, etc.) B Broadcast Advcrtising (Radio, TV) p Postagc C Cash Contributions S Surveys and Polls F Fundraising Evcnt Expenses T Travel EA-pcnscs (dcscribe if ovcr $50) G General Operational Expenses (describc if over $50) U Utilities I I nterest Payment W Wages. Salaries, Benefits L Literature, Brochures, Printing y Petition Circulators M Managcment Services Z Preparation and Production of Advc11ising N Newspaper and Other Periodical Advertising Une Date Payee's Name Purpose Amount of # Account Payable 1. 10-01-04 Printfast L $ 36.55 2. 1 0-05-04 Printfast L $ 470.79 3. 1 0-1 3-04 Crystal Castle L $ 85.00 4. 10-15-04 Printfast L $ 49.15 5. 1 0-16-04 Printfast L $ 1.68 6. $ ~ - - - -. - 7. $ 8. $ 9. $ 10. $ See Page Total (Add all accounts payable on this Accounting Period Total (Complete only for last page and Instructions fonn.) transfer these amounts to the Summary Statement, PC I.) on Back and vi in Campaign Accounts Payable $ 643.17 Accounts Payable $ 643.17 Finance Enter on Swnmary Statement, Column A, Line 42 Manual I I PC6 I 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 21,2004 Cate Hartzell 881 East Main Street Ashland, OR 97520 I have examined your 2nd pre-election contribution and expenditure report for the General Election of November 2, 2004 and found the following: D Your committee report is sufficient. ~Your committee report is not sufficient in the following way(s). 1. Summary Statement of Contribution and Expenditures · Beginning Cash Balance incorrect (page 1) · Totals need to be corrected based on corrections of other forms (page 1 and 2) · Beginning Outstanding Loans incorrect (page 2) · Beginning Outstanding Personal Expenditures incorrect (page 2) · Cumulative Totals incorrect (page 1) 2. Cash Expenditures and Loan Payments · Incorrect coding on line 3, Expenditure Type. REMINDER: You must file the necessary amended information on amendment forms. All requested information on this exam letter must be submitted by October 27.. 2004 to avoid penalties. F or 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, ph~ase feel free to contact my office. ZPM~~ Barbara Christensen City Recorder/Treasurer Enclosures Summary Statement of Contributions and Expenditures PC I Re\'. 12'03 Please type or print legibly in black ink. Pagc I of 2 Candidate or Political Committee Name (use full name): Committee to Elect Cate Hartzell Mailing Addrcss as it Appcars on Statcmcnt of Organization (street routc or box numbcr. city, statc, zip code): 881 East Main 8t. Ashland. Or 97520 Trcasurcr's Namc: I Telephone Number (day): John Fields 541-482-8442 Committee ID Number: I Committee Type, Measure Number or Office: o Original D Primary 20_ D Gencral 20_ D Other _ ~ Amendment D I st Pre-election ~ 2nd Pre-election D Post-election D 20 September Supplemental A-TOT ALS FOR THIS B-CUMlJLA TIVE TOTALS ACCOUNTING PERIOD FOR THIS ELECTION CONTRIBUTIONS 1. Cash Contributions 1,723.00 2,423.00 (Accountin!.! Period Total from PC 2) 2. Loans Received (Non-Exempt) + + (Accounting Period Total from PC 2) .., Total Cash Contributions .) . = 1,723.00 = 2,403.00 (lines 1 + 2) 4. In-Kind + + 30.00 (Accounting Period T ota11rom PC 2) 5. TOTAL CONTRIBUTIONS = 1,723.00 = 2,433.00 (lines 3 + -4) EXPENDITURES I 6. Cash Expenditures 285.00 285.00 (Accounting Period Total from PC 3) 7. Loan Payments (Non-Exempt) + 386.18 + 386.18 (Accountlllg Period Total from PC 3) 8. Total Cash Expenditures = 671.18 = 671.18 (lines 6 + 7) 9. In-Kind + 0.00 + 30.00 (ACcoulltin!.! Period Total from PC 2) I 10. TOTAL E:XJ>ENDITURES = 671.18 = 701.18 (lines 8 + 9) CASH BALANCE II. Beginning Cash Balance 0.00 FOR OFFICE USE ONL Y (line 20 of orevious rel)ort) 12. Total Contributions + 1,723.00 rDJ~~~n~~ ~ (line 5) 13. Other Reccipts + (Accountin12 Period Totnl from PC 4A) ~lGCT 2 1 2004 ~ 14. Loans Received (Exempt) + (Accounting Period Total from PC 4A) 15. CONTRIBUTION SUBTOTAL = 1,723.00 (lines 11 + 12 + 13 + 14') 16. Total Expcnditurcs 671.18 (line 10) 17. Ot hcr Di sburscmcnts + (Accountin!! Period Totnl from PC 4B) 18. Loan Payments (Exempt) + (Accounting Period Totallroll1 PC 4B) 19. EXPENDITURE SUBTOTAL = 371.18 (lines 16 + 17 + 1 R) 20. ENDING CASH BALANCE = 1,051.82 (line 15 minus line 19) Summary Statement of Contributions and Expenditulres Please type or print legibly in black ink. Candidate or Political Committee Name: committee to ELect Cate Hartzell D Original 0 Primary 20_ D General 20_ ~ Amcndmcnt ~ 1st Pre-clcction [Zl 2nd Prc-clection LOAN SUMMARY 1'(' 1 1\.<:\ 12'1)] Page 2 of 2 Committec ID Number: D Other _ D Post-clcction D 2004 Septcmber SupplcmcntaI 21. Beginning Outstanding Loans (line 29 of revious re )Ort 22. Loans Received (Non-Exempt) (line 2') 23. Loans Receivcd (Excmpt) (line 14) 24. LOANS RECEIVED SUBTOTAL (lines 21 + 22 + 23) 25. Loan Paymcnts (Non-Excmpt) (line T 26. Loan Payments (Exempt) (line 18) 27. Forgiven Loans (Tota110ans fon!.lven during this accounting )eriod) 28. LOANPAY~~NTSUBTOTAL (lines 25 + 26 +27) 29. TOTAL OUTSTANDING LOANS (line 24 minus line 2~n FOR OFFICE USE ONLY 3,86.18 + + = 386.18 + + = 386.18 = PERSONAL EXPENDITURE SUMMARY 30. Beginning Outstanding Personal Expenditures (line 36 of revious report) 31. Pcrsonal Expcnditurcs (Accountino Period T otal from PC 3A) 32. PERSONAL EXPENDITURE SUBTOTAL (lines 30 + 31) 33. Personal Expenditurc Rcimburscments (Total ex endnures on PC 3 with u ose code Rl 34. Forgiven Personal E~qJe.nditures (Total ersonal ex enditurcs forgiven this acctg. 35. RETh1BURSEME~l SUBTOTAL nines 33 + 34) = 386.18 1,453.22 1,839.40 386.18 1+ + = 386.18 36. OUTSTANDLNG PERSONAL = 1 453 22 EXPENDITURES ' . FINANCIAL STATUS AT CLOSE OF ACCOUNTING PERIOD 37. Ending Cash Balance (line 20) 38. Accounts Receivable (Accounting Period Total from PC 5) 39. SUBTOTAL (lines 37 + 38) 40. Total Outstanding Loans (line 29) 41. Outstanding Personal Expenditures (line 36) 42. Accounts Payable (Accountino Period Total from PC 6) 43. SUBTOTAL (lines 40 + 41 + 42 44. BALANCE/DEFICIT hne 39 minus line 43: indicate + or - halan' . 293.02 + = 293.02 = 1,453.22 643.17 2,096.39 + + , , ertify that the above statement and the attached supporting reports are PC 2 Cash Contributions, Loans Received and In-Kind Re\' 1 :2IO:i Candidate or Political Committee Name: Committee ID Number: Committee to Elect Cate Hartzell Page 1 of 1 Election: o Primary 20_ D Gcncral 20_ o Other _ Rcport: o 1st Prc-clcction ~ 2nd Prc-election D Post-c1cction D 20_ Septcmbcr Supplemcntal SEE BACK FOR INSTRUCTIONS AND CODE DEFINITIONS CODE 1: Contributor Type CODE 2: Contribution Type B Business Entity CA Cash C Political Committcc (includes business and union P ACs) CO Cosigncr Obligation F Candidate's Immediate Family (includes candidate) IK In-Kind I Individual LR Loan Received L Labor Organization 0 Other P Political Party Committee Une# Name and Address of Contributor Amount of In-Kind Purpose Contribution (see manual for suggested purpose codes) Date Received Occupational Information or Contributor Code 1 I Code 2 Contributing Committee's 10# Aggregate Misc. Contributions under $50.01 1. $ 973.00 9-17-04 $ I I CA Sarah Collard! Tom Dimitre 2. 901 Beach St. $ 250.00 Ashland, Oregon 97520 9-20-04 Psychologist! Union representative $ I I CA Darwin Thusius 3. PO Box 963 $ 250.00 Ashland, Oregon 9-20-04 Owner, SULA technologies $ I I CA Angelika Thusius 4. PO Box 963 $ 250.00 Ashland, Oregon 97520 9-17-04 Founder KENTRO Body Balance $ I I CA 5. $ $ I Sec Pa~c Totals (Add all amounts 'with the same Accountin~ Period Totals (Complete only for last page and Instructions contribution typc. Do not includc aggregatcs.) transfcr thcsc amounts to the Summary Statcmcnt PC I.) on Back and Cash (CA) $ 1.723.00 Cash (CA) $ 1.723.00 in Campaign Enter on Summary Statement, Column A Line J Finance Manual In-Kind (lK) $ - In-Kind (IK) $ - Enter on Summary Stat.ement, Column A. Line~ 4 and 9 pe2 Loans Reccivcd (LR) $ - Loans Received (LR) $_ I Enter on Summarv SlaLement Column A Line 2 1'(' .) Cash Expenditures and Loan Payments Rev 121(1.' Candidate or Political Committee Name: Committee ID Number: Committee to Elect Cate Hatzell Pagc 1 of 1 Election: D Primary 20_ D General 20_ o Other _ Report: D 1 st Pre-election ~ 2nd Pre-election o Post -election D 2004 September Supplemental PURPOSE CODES (see back of form for instructions and code definitions) EXF'ENDITURE A Agent 0 Otller Advertising (vard signs, but1ons, CA Cash B Broadcast Advcrtising (Radio. TV) ctc.) LP Loan Payment C Cash Contributions P Postagc F Fundraising Event Expenses R Reimbursement for Personal E\:penditures G General Opemtional E,:pcnses (describe if ovcr S Survcys and Polls $50) T Travel Expenses (describe if over $50) I Intcrcst Paymcnt U Utilities L Literaturc. Brochures. Printing W \Vages. Salarics. Bcncfits M Management Services y Petition Circulators Une Payee's Name and Payee's Committee 10#, Exp. Amount of ~ # Date Check # if applicable Purpose Type Expenditure Paid (as it appears on invoice, receipt or check) toNP 1. 09-21-04 001 Eastburn Photography L c $ 100.00 D 2. 09-06-04 002 Crystal Castle Graphics 0 c $ 185.00 D 3. 10-15-04 003 Cate Hartzell R LP $ 386.18 ~ 4. $ D 5. $ D I 6. $ D 7. $ D 8. $ D 9. $ D 10. $ D See Page Totals (Add all cA-pcnditurcs with the Accounting Period Totals (Complcte only for last pagc and lnstructions same cxpcnditure typc.) transfcr thcsc amounts to thc Summary StatcmcnL PC 1.) on Back and in Campaign Cash (CA) $ 285.00 Cash (CA) $ 285 Financc Enter on SummaT'\' Statement. Column A. Lme f> Manual Loan Payment (LP) $ 386.18 Loan Paymcnt (LP) $ 386.18 Enter on Summary Statement. Column A. Lme 7 PC 3 PC 3A Personal Expenditures for Reimbursement Rev. 12j().~ Candidate or Political Committee Name: Committee ID Number: Committee to Elect Cate Hatzell Page 1 of 1 Election: o Primary 20_ o Gencral 20_ D Othcr _ Report: D 1st Pre-clection [g} 2nd Pre-election D Post-election o 2004 Scptcmbcr Supplcmcntal PURPOSE CODES (see back of form for in~1ructions and code definitions) A Agent 0 Other Advertising (yard signs. buttons. etc.) B Broadcast Advertising (Radio, TV) P Postage C Cash Contributions S Surveys and Polls F Fundraising Event Expenses T Travel Expenses (describe if over $50) G Generdl Operational Expenses (describe if over $50) U Utilities I Interest Payment W Wages, Salaries, Benefits L Literature, Brochures, Printing y Petition Circulators M Management SCf\'ices Z Preparation and Production of Adverti.sing N Newspaper and Other Periodical Advertising Line Date Payee's Name Purpose Amount of # Expenditure 1. 10-05-04 As~land Lumber 0 $ 6.00 2. 1 0-11-04 RAM L $ 748.40 3. 1 0-8-04 Jackson County G $ 1.50 4. 9-17-04 spearco 0 $ 356.25 5. 10-02-04 medford mail tribune n $ 300.00 6. 9-18-04 ashland hardware 0 $ 5.40 7. 9-25-04 ashland hardware 0 $ 12.59 8. 9-18-04 ashland hardware 0 $ 5.13 9. 9-25-04 ash land lumber 0 $ 17.95 10. $ Scc Page Total Accounting Period Total (Completc only for last pagc and InstnJctions Personal Expcnditures $ 1 .453.22 transfer this amount to the Summary Statement PC 1.) on Back and in Campaign Personal Expcnditurcs $ 1.453.22 Finance Enter on Summary Statement Line 31 Manual PC 3A PC t~ Accounts Payable Re\' I ~;n3 Candidate or Political Committee Name: Committee ID Number: Committee to Elect Cate Hatzell Pagc_of_ Elcction: o Primary 20_ D Gcneral 20_ D Othcr Report: o 1 st Pre-elcction ~ 2nd Pre-election D Post -elcction D 2004 Septembcr Supplemental PURPOSE CODES (see back for instructions and code definitions) A Agent 0 Other Advertising (yard signs, buttons, etc.) B Broadcast Advcrtising (Radio. TV) P Postage C Cash Contributions S Surveys and Polls F Fundraising Evcnt Expenses T Travel EX'PCnscs (describe if ovcr $50) G General Operational Expcnses (describc if over $50) U Utilities I I nterest Payment W Wages. Salaries, Benefits L Literature, Brochures, Printing Y Petition Circulators M 1\1anagcment Services Z Prcparation and Production of Advcrtising N Newspapcr and Other Periodical Advertising Une Date Payee's Name Purpose Amount of # Account Payable 1. 10-01-04 Printfast L $ 36.55 2. 10-05-04 Printfast L $ 470.79 3. 10-13-04 Crystal Castle L $ 85.00 4. 10-15-04 Printfast L $ 49.15 5. 10-16-04 Printfast L $ 1.68 6. $ 7. $ 8. $ 9. $ 10. $ See Page Total (Add all accounts payable on this Accounting Period Total (Complete only for last page and Instructions form. ) transfer these amounts to the Summary Statement, PC 1.) on Back and in Campaign Accounts Payable $ 643.17 Accounts Payable $ 643.17 Finance Enter on Summary Statement, Column A, Line 42 Manual PC6 Summary Statement of Contributions and Expenditures I'C 1 Re\' I:: (I., Pleasc typc or print legibly in black ink. Page I of 2 Candidatc or Political Committee Name (use full namc): Committee to Elect Cate Hartzell Mailing Address as it Appears on Statemcnt of Organization (street. roule or box Ilumber. CIty. state. Ijp codc): 881 East Main St Treasurer" s Namc: I Telephone Number (day) John Fields 541-482-8442 Commiltcc ID Numbcr: I Commiuec Type. Measure Number or omce o Original o Primary 20_ Lg] Gencral 2004 o Other _ Lg] Amendmcnt Lg] I st Pre-election o 2nd Pre-election o Post -elect ion o 20_ Septcmbcr Supplemental A- TOT ALS FOR THIS B-CUMULA TIVE TOTALS ACCOUNTING PERIOD FOR THIS ELECTION CONTRIBUTIONS 1. Cash Contributions 698.00 ~a, Q.~~ .-998.00 ~J (Accounting Period Total from PC 2) - -.P- 2. Loans Received (Non-Exempt) U \I + + (AccOlUlting Period Total from PC 2) .., Total Cash Contributions ..6Qg.$ 6eO:/' .L = = 680~el~ (lines l+ 2) 4. In-Kind .. " + 30.00 V + 30.00 J (Accounting Period Total from PC 2 ') \ 5. TOTAL CONTRIBUTIONS = 720 QQ.- 7/ 0 ~ = ~ 71 O?JC;~ (lines:; + 4) EXPENDITURES \J (). Cash Expenditures 0.00 0.00 (Accounting Period Total tram PC 3) 7. Loan Payments (Non-Exempt) + 0.00 + 0 (Accounting Period Total tram PC 3) 8. Total Cash Expenditures = 0.00 = 0.00 (lines 6 + 7) 9. In-Kind + 0.00 + 0.00 (Accounting Period Total from PC 2) 10. TOTAL EXPENDITURES = 00 = 0.00 (lines 8 + 9) CASH BALANCE 11. Beginning Cash Balance 102.88 FOR OFFICE USE ONL Y (line 20 of previous report) 12. Total Contributions + 710.00 lO)~-cg ~ 0 Y; [g -f\ (line 5) n. Other Receipts + 0.00 (Accounting Period Total tram PC 4A ') 01[OCT 2 8 2'~J!, 14. Loans Rcceived (Exempt) + 0.00 (Accounting Period Total tram PC 4A) ~ 15. CONTRIBUTION SUBTOTAL = 812.88 (lines 11 + 12 + 13 + 14) , I 16. Total Expenditures 0.00 I'\. (line 10) 0f1~ 17. Other Disbursements + (Accounting Period Total from PC 4B) , if J;- 18. Loan Payments (Exempt) + (Accounting Period Total from PC 4B) 19. EXPENDITURE SUBTOTAL = 0.00 (lines 16 + 17 + 18) 20. ENDING CASH BALANCE = 812.88 ~ (line 15 minus line 19) Summary Statement of Contributions and Expenditures Please typc or print legibly in black ink. Candidatc or Political Committee Name: Committec ID Numbcr: PC I Re'\". 12'03 Page 2 of 2 D Original Amcndmcnt D Primary 20_ SJ> I st Pre-election LOAN S Of Gencral 20t) 'l 2nd Pre-election MARY D Othcr _ D Post-election D 20 Scptcmbcr Supplcmcntal 21. Beginning Outstanding Loans (line 29 of )revious re )ort) 22. Loans Received (Non-Exempt) (line 2 2l. Loans Received (Excmptl (line 14 24. LOANS RECEIVED SUBTOTAL (lines 21 + 22 + 23 25. Loan Payments (Non-Exempt) (line T 26. Loan Payments (Exempt) (line 18 27. Forgiven Loans Total loans for iven durin this accountin 28. LOAN PAYMENT SUBTOTAL (lines 25 + 26 +27 29. TOTAL OUTSTANDING LOANS (linc 24 minus line 28 FOR OFFICE USE ONLY + + = + + = = PERSONAL EXPENDITURE SUMMARY lO. Beginning Outstanding Personal Expenditures (line 36 of )rc"ious rc ort' 3 ]. Personal Expenditures (Accountino Period Total from PC 3A) l2. PERSONAL EXPENDITURE SUBTOTAL (lincs 30 + 31 :n. Pcrsonal Expenditure Rcimbursements Total ex enditurcs on PC 3 with m )ose code R' 34. Forgiven Personal Expenditures (Total )ersonal ex )enditures foraiven this aceto. 35. REIMBURSEMENT SUBTOTAL (lines 33 + 34 36. OUTSTANDING PERSONAL EXPENDITURES FINANCIAL STATUS AT CLOSE OF ACCOUNTING PERIOD 37. Ending Cash Balance (line 20 38. Accounts Receivable (Accountin Period Total from PC 5 39. SUBTOTAL (Jines 37 + 38 40. Total Outstanding Loans (line 29 41. Outstanding Personal Expenditures (line 36) '+2. Accounts Payable (Aeeountina Period Total from PC 6 '+3. SUBTOTAL (lines 40 + 41 + 42 44. BALANCE/DEFICIT (line 39 minus line 43: indicate + or - ha ' 0.00 + 386.18 = 386.18 + = = 386.18 v" 812.88 + + 3e~. /8 + = 1,199.9i = 1~W.I'9 asure ). hereby certify that the above statement and the attached supporting reports are Date Sig!~'} g![} tf PC 2 Cash Contributions, Loans Received and In-Kind R-:\' 12/(13 Candidatc or Political Committee Name: Committcc ID Number: Committee to Elect Cate Hatzell Pagc 1 of ~ Elcction: D Primary 20_ ~cncral 20 try D Other _ Rcport: -/1W'M2M.a'f'~ 1st Prc-election D 2nd Prc-clection D Post-election D 20_ Septcmbcr Supplemcntal SEE BACK FOR INSTRUCTIONS AND CODE DEFINITIONS CODE 1: Contributor Type CODE 2: Contribution Type B Busincss Entity CA Cash C Political Committee (includcs business and union P ACs) CO Cosigner Obligation F Candidatc's Immediate Family (includes candidate) IK In-Kind I Individual LR Loan Received L Labor Organization 0 Other P Political Party Committee Une# Name and Address of Contributor Amount of In-Kind Purpose Contribution (see manual for suggested purpose codes) Date Received Occupational Information or Contributor Code 1 I Code 2 Contributing Committee's 10# Aggregate Ken Crocker 1. 134 Nutley St. $ 75.00 Ashland, OR 97520 9/6/04 photographer $ I I CA John Fricker 2. 1101 Paradise $ 25.00 Ashland, OR 97520 9/10/04 Website Manager $ I I CA Bill Greenstein 3. 191 N. Wightman $ 50.00 Ashland, OR 97520 91 0/04 Realator $ I 1 CA Marge and Hal Jamison 4. 60 Golden Spike Way $ 200.00 Ashland, OR 97520 9/10/04 retired $ 0.00 I I CA Tom Marvin 5. 499 Iowa St. $ 35.00 AShland,Or 97520 9/10/04 Retired Professor SOU $ I I CA See Page Totals (Add all amounts with the same Accounting Period Totals (Complete: only for last page and Instructions contribution typc. Do not include aggregates.) transfer these amounts to the Summary Statcmcnt. PC 1.) on Back and Cash (CA) $ 385.00 Cash (CA) $ in Campaign - Finance Enter on Summary Statement. Column A. Line 1 Manual In-Kind (IK) $ - In-Kind (IK) $ - Enter on Summary Statem-:nt. Column A. Lmes 4 and 9 PC 2 Loans Rcceivcd (LR) $ - Loans Received (LR) $ - Enter on Summary Statement. Column A Line 2 )'(' : Cash Contributions, Loans Received and In-Kind I~l'\ 1: II.' Candidatc or Political Committcc Namc: Committcc ID Numbcr: Committee to Elect Cate Hartzell Pagc ~ of ~ Elect ion: o Primary 20_ ~ Gcncral 2004 o Othcr --'- Rcp011: ~ 1st Pre-clcction o 2nd Prc-clcction o Post-clection o 20_ Septcmbcr Supplcmcntal SEE BACK FOR INSTRUCTIONS AND CODE DEFINITIONS CODE 1: Contributor Type CODE 2: Contribution Type B Busincss Entity CA Cash C Political Committec (inc1udcs business and union P ACs) CO Cosigncr Obligation F Candidatc's Immcdiatc Family (inc1udcs candidate) IK In-Kind I Indi\'idual LR Loan Rccciyed L Labor Organization 0 Other P Political Party Committee Une# Name and Address of Contributor Amount of In-Kind Purpose Contribution (see manual for suggested purpose codes) Date Received Occupational Information or Contributor Code 1 I Code 2 Contributing Committee's 10# Aggregate Richard Seidman 1. 924 Garden Way $ 50.00 Ashland, OR 97520 9/13/04 Fundraiser $ I I CA Bill Street 2. 180 Meade St. $ 40.00 Ashland, OR 97520 9/11/04 Librarian $ I I CA Alice Suter 3. 575 Dogwood Way $ 30.00 Ashland, OR 97520 9/08/04 Retired $ I I CA Rich and Diane Werich 4. 568 Walnut St. $ 100.00 Ashland, OR 97520 9/5/04 Pharmacist $ I I CA Sunni Vianni 5. 1010 Paradise Lane $ 15.00 Ashland, OR 97520 9/15/04 Teacher $ 1 I ca Sec Page Totals (Add all amounts with the same Accounting Period Totals (Complcte only for last pagc and Instructions contribution type. Do not includc aggregates.) transfer these amounts to the Summary Statcmcnt PC 1.) on Back and Cash (CA) $ 235.00 Cash (CA) $ in Campaign - Finance Enter on Summary Statement. Column A LInC I Manual In-Kind (IK) $ - In-Kind (IK) $ - Entcr on Summary Statcmcnt. Column A LInCS -+ and l) PC 2 Loans Recciycd (LR) $' - Loans Receivcd (LR) $ - Entcr on Summary Statement Column A LInc 2 \'C ::' Cash Contributions, Loans Received and In-Kind Rl'\' I ::'IJ, Candidatc or Political Committec Name: Committec ID Numbcr: Committee to Elect Cate Hatzell Pagc ~ of~ Elect ion: o Primary 20_ o Gencral 20_ o Ot her Rcport: [8J 1st Pre-clection o 2nd Pre-election o Post -election o 20_ September Supplcmental SEE BACK FOR INSTRUCTIONS AND CODE DEFINITIONS CODE 1: Contributor Type CODE 2: Contribution Type B Busincss Entity CA Cash C Political Committee (includcs business and union PACs) CO Cosigncr Obligation F Candidate's Immcdiate Family (includes candidate) IK In-Kind I Indiyidual LR Loan Recei\'ed L Labor Organization 0 Other P Political Party Committee Une# Name and Address of Contributor Amount of In-Kind Purpose Contribution (see manual for suggested purpose codes) Date Received Occupational Information or Contributor Code 1 I Code 2 Contributing Committee's 10#- Aggregate Alan and Myra Erwin 1. 134 Nutley St. $ 50.00 Ashland, OR 97520 9/16 /04 Retired $ I I CA Nancy Richardson 2. 93 California Street $ 10.00 filh5t6~Fal3R&- Ashland, OR 97520 9/16/04 Non profit ceo $ I I CA Jason Couch 3 207 Enders Alley $ 30.00 ~ ~\:-b~ 0"" S Ashland, OR 97520 \ Photographer $ I I IK 4. $ $ 0.00 I I CA 5. $ 0.00 $ I I CA Sec Page Totals (Add all amounts with the same Accounting Period Totals (Complet(~ only for last page and Instructions contribution type. Do not include aggregates.) transfer these amounts to the Summary Statement. PC I.) on Back and Cash (CA) $ 50.00 Cash (CA) $ 680.00 in Campaign Enter on Summary Statement. Column A. Lme 1 Financc Manual In-Kind (IK) $ 30.00 In-Kind (IK) $ 30 Enter on Summary Stall'ment. Column .\. Lines -I and 9 PC 2 Loans Received (LR) $ - Loans Received (LR) $ - Enter on Summary Statement Column A Line::' 'v! I Please Iype or pr~t~c~b~i~~c~~tement of Contributions and Expenditures Candidate or Political Committee Name (use full name) Committee to Elect Cate Hartzell Telephone Number (da~) 541 -482 -8442 ;,~ i Page J or] J i I l I -1 ! Mailing Address as it Appears on Statement ofOrganil.ation (Sltreet. route or bo'\ number. cit~. stlte. I.ip codc) 881 East Main St ~l1lllittee T~pc. 1'v1casnre Number or Office: I I -j I I l I I o 20_ Septcmber Supplemel~ B-CUMULATIVE TOTALS I FOR THIS ELECTION I I -~ I ! ~ GClleral 20~~ D Other "_ o 2nd Pre-election 0 Post-election A-TOTALS FOR THIS ACCOUNTING PERIOD Treasurer's Name: John Fields I Committee !D Number: r--" o Original 0 Primary 20_ ~ Amendment ~ 1st Pre-election I ~ CONTRIBUTIONS Cash Contributions (i\ccountinS!. Period Total Ii'om PC 2) Loans Recei\ed (Non-Exempt) (l\ccollntinS!. Period TotaIli'om PC 2 ) Total Cash Contributions (lines 1+ 2 In-Kind (!\ccollntinS!. Period Total trom PC' r--- ~ ~ --r 1+ --I: ~- ..J.. 5. TOTAL CONTRIBlJTIONS (lines.1 4) L EXPENDITURES (l. Cash Expenditures U\ccountinS!. Period Total from PC 3) -. ' 7 Loan Paymcnts (Non-Exempt) (/\ccountin$! Period Total from PC 3 i 8. Total Cash E'\penditmes (lines () + 7) In-Kind (,-\'ccounting Period Total from PC 2 i 9. !O. TOTAL EXPENDITlJRES (Jincs S + 9) CASH BALANCE ! I Beginning Cash Balance (Iinc 20 of previous report) 12. Total Contributions , (lmc )) n. Other Receipts (!\ccollnting I\~riod Totalll"om PC.f/\ i I..J.. Loans Recei\ed (Exempt) (/\ccountinp. Period Totallrom PC ,t'\) 15. CONTRIBUTION SUBTOTAL (Jines I] +]7 + 1::1 + I-ll I (l. Total Expenditures (line/i)) 17. Other Disbursemems (i\ccollntllw Period Total hom PC -l] n IX. Loan Payments (Exempt) li\ccollntil1S!. Period Total1r0111 PC .-Ill I ~<). g~~'iEl~Dl~l~R~:UBTOTAL 20. ENDING CASH BA, LANCE (line] 5 minus line It)) 690.00 690.00 690.00 30.00 720.00 ~ ~ I- i- t-- E I 1+ 1= I -++ 1= I ~ I I I ---1 I ~ 30.00 i I -i ! 720.00 I ---l i 0.00 I i -j 0 I I I ~ 0.00 I -i 0.00 i 0.00 I ~ I I 0.00 0.00 0.00 0.00 00 + + 0.00 = 812.88 L ~ t: r- 1= 1-.. ~ ~ 0.00 812.88 t 1= + 1+ 1= i J I Committee TD Nnmber: PC'i I l,c,', 12.. ()"~ I Pagc 2 of 2 j J I I Summary Statement of Contributions and Expenditlllres Pleasc typc or print legibly in black ink. Candidatc or Political Committcc Namc: o Original I 0 Primary 20__ [$ Gcncral 20CJ.'f 0 Othcr _ Amendment . [if lSI pre-eleeli~~AN S~M~~:re-elceIIOn . 0 Posl-eleclion J 0 ;~~ :c;)~el::e~::p:~~~tal 21. B," cgil1Jling Outst;lI1ding Loans 'J ==J (line 2() or )revlous...!:92or[j '_ _____ 22. Loans Rccci\cd (Non-E.\:cmpt) + ( line 2 ) 2'. ~i~~~)f:,ecei'cd (Exempt) I + - J 2-1-. LOANS RECEIVED SUBTOTAL l _ I (lines21 +22t-23) - I 25. Loan Paymcnts (Non-E.\:cmpo 1-' 1 dinc]) I ! 2(). L, ,oan Paymcnts (E.\:cmpt) I + 3 (line Ig) --J 27. Forgi\cn Loans ----- I + - (101<11 loans ror~iven durim!. this accountl1152 ]kTlOd) I 2X. ~~~~t: ~)~f;~T SUBTOTAL I = ' 1- J - PERSONAL EXPENDITURE SUMMARY 10. Bcginning Outstanding Pcrsonal E.\:penditures I (line )() of previous report I 11 I 31. Pcrsonal E.\:pcndilurcs I + 386.18 I !l\ccolllltin~ Period Total from PC '-:\/\ I I I :12. PERSONAL EXPENDITURE SUBTOTAL 1---- 386.18 II (lines j() + 31 ) -L . ~]. Personal E:xpcn.ditllrc R.ci 1l1bllrSClllcIlts L ('I olal c'\pemhtures on PC ,-:\ \\ ltl1 purpose code R) , I 3-1-. Forgivcn Personal E.\:pcnditllf'es notal x.~rson(l] e'\: )e!H.litures l()rui\l~n this (lcctu ]5. REI1'vlBURSEI'vlENT SUBTOTAL l6. ~J~~.~~~;j)lNG PERSONAL t-~~ EXPENDITURES ~ FINANCIAL STATUS AT CLOSE OF ACCOUNl 29. TOTAL OUTSTANDING LOANS (line 2et minus line 2g) I "'~ .1 ! . Ending Cash Balance (line 20) jX. Accounts Recci\ablc (Accountin~ Period Total from PC 5) 39. SUBTOTAL -1-{) . (lines ,-:\] + :;g) Total Outstanding Loans (line 2l)) Outstanding Personal E.\:penditures (line 36) Accounts Payable (/\ccounting Period Total 11'0111 PC I,) SUBTOTAL nines 40 -I' 41 42 ) BALANCE/DEFICIT -1-1. -1-2. -1-j. -t.-1-. I. JOhn." Fie~(namc of candidate true ancJ,corre1. ! J . . 0.00 ,--- I ~ 1+ ~ 1- L h- t= t I _L riNG PERIOD I 812.88 I ~F~rf( ;. ~;.,..;,. / "- ---- 1,199.06 1199.06 V ). hereby ccrti(\ that the abmc statcment and the attached supporting reports are / I () O~I~ ~JrjlgJ!J-'i-_------- Candidate or Political Committee Namc: Cash Contributions, Loans Received and In-Kind Committee to Elect Cate Hatzell Election: D Primary 2()_ Report: -f11N\NW~t~ I st Pre-election C!rGcneraJ 2() b:y' o 2nd Pre-election 'I ('ommittee ID Number: ]------- Pagc 1 of~ ------- o Other o Post-election 0 2()_ September Supplemental SEE BACK FOR INSTRUCTIONS AND CODE DEFINITIONS CODE 1: Contributor Type B Business Entit\ C Political Committee (includes busincss and Ulilioll PACs) F Candidate' s Immediate Fami Iy (lIlcludes candidate) I Indi\idual L Labor Organi/ation o Ot hcr P Political Par1~ Committee Line # Date Received 9/6/04 2. 9/10/04 3 91 0104 4. 9/10/04 5 9/10/04 See Instructions on Back and inCa mpaign Finance Ma nual PC 2 I I --- I I I j 1$ I -- -.. -+----------. -.--------- $ I $ I . I 1$ -+ 1$ ! 1$ I -f . I 1$ 35+00 I -4--- $ I Name and Address of Contributor Occupational Information or Contributing Committee's iD# Ken Crocker 134 Nutley St. Ashland, OR 97520 photographer I John Fricker 1101 Paradise Ashland. OR 97520 Website Manager Bill Greenstein 191 N. Wightman Ashland, OR 97520 Realator Marge and Hal Jamison 60 Golden Spike Way Ashland, OR 97520 retired Tom Marvin 499 Iowa St. I Ashland,Or 97520 Retired Professor SOU Page Totals (Add all amounts \\ ith the same I contribution t~ pc. Do not include aggregates.) ! Cash (CA) $ 385.00 In-Kind (lK) $ Loans Recehed (LR) $ CODE 2: Contribution Type CA Cash CO Cosigncr Obligation IK In-Kind LR Loan Recci \cd Amount of Contribution Contributor Aggregate I In-Kind Purpose 1_ (see manual for suggested purpose codes) I I ! Code 1 Code 2 I I 75.00 CA $ 25.00 CA 50.00 CA 200.00 0.00 CA CA Afcounting Period Totals (Complete only for last page and transfer these amounts to the SUlllman Statemcnt. PC I.) Cash (CA) il' .f) In-Kind OK) If; 4 Loans Rccci\cd (LR) 'f; J ':nt\.~r ~~t:ltlTn,-'nL ( nll.inln .\. !.lri'..':: Cash Contributions, Loans Received and In-Kind D Primary 20_ ISJ I st Pre-election ---r I Committee I D N limber: J D Ot her --'-_ D Post-election L Page ~ of ~ Candidate or Political Committee Name: Committee to Elect Cate Hartzell SEE BACK FOR INSTRUCTIONS AND CODE [)EFINITIONS CODE 1: Contributor Type B Business Entit~ C Political COlllmittee (includes busincss and union PACs) F Candidate's Immediatc Family (includes candidate) I Indi\ idual L Labor Organi/.ation o Other P Political Part~ Committee -+ Amount of Name and Address of Con tributo_r_ . Contribution Occupational Information or Contributor Date Received Contributing Committee's 10# I Aggregate j_RiChard Seidman !I I 1 924 Garden Way $ 50.00 ' --;~04-- ;:~~~~~~~_975~0______ m_-~t;-_--- -1----- -r Bill Street I 1180 Meade St. I $ 40.00 I Ashland, OR 97520 I 1 ----r---.---r I $ I -I $ 30.00 I -+ I I $ I I I I $ 1 00.00 I 11$ +- . . I I $ 15.00 I --+--.--J- I $ I Election: Rep0l1 : Line # 2 9/11/04 3 9/08/04 4 9/5/04 5 9/15/04 See Instructions on Back and in Campaign Finance fv1anual PC 2 ~ General 2( lOLl D 2nd Pre-election D 20_ September Supplemental CODE 2: Contribution Type CA Cash CO Cosigner Obligation IK In-Kind LR Loan Recei\ed In-Kind Purpose (see manual for suggested purpose codes) I Code 1 Code 2 CA Librarian r------ CA I I Alice Suter , 575 Dogwood Way Ashland, OR 97520 Retired CA Rich and Diane Werich 568 Walnut St. Ashland, OR 97520 Pharmacist CA I Sunni Vianni 11010 Paradise Lane I Ashland. OR 97520 Teacher ca Pa~e Totals (Add all amounts \\ith the same contribution t~pe. Do not include aggregates I Accountin~ Period Totals (Complete onl~ for last page and transfer these amounts to the Summar~, Statement. PC I.) Cash (CA) $ 235.00 Cash (CA) \1' ,)) In-Kind OK) ~ In-Kind OK) 'l; Loans Recei\ed (LR) $ Loans Recei\ed (LR) $ j.:nt<..:r >~unlnl;:r\' >~t;tll~.lrll...'nt, . \ I. in,.' = Candidate or Political Committee Name: Cash Contributions, Loans Received and In-Kind Committee to Elect Cate Hatzell Election: Report: D Primary 2()_ ~ I st Pre-election D General 20_ D 2nd Pre-eIcct ion I Committee ID NUlllbe~- 1 I Page 3 of 3 ----1 ,- - D Other D Post-election D 20_ Septcmbcr Supplemcntal SEE BACK FOR INSTRUCTIONS AND CODE DEFINITIONS CODE 1: Contributor Type B Business Entity C Political Committec (includcs busincss and union PACs) F Candidate's Immcdiate Family (includes candidate) I Indi\idual L Labor Organi/ation o Ot her P Political Party Committee Line # Name and Address of Contributor Occupational Information or Contributing Committee's 10# I Alan and Myra Erwin 1 1134 Nutley St. Ashland, OR 97520 _ --__~_________J__----m-m...-------------.----.---m------------____________________m ___. _______ _n_ 9/16 /04 I Retired Date Received " L 9/16/04 3 4 5 See Instructions on Back and in Campaign Finance Manual PC 2 '1,.../ Nancy Richardson 93 California Street Ashland, OR 97520 Non profit ceo I Jason Couch 207 Enders Alley Ashland, OR 97520 Photographer Page Totals (/-\dd all amounts \\ ith the same contribution type_ Do not include aggregates. ) Cash (CA) $ 50.00 In-Kind OK) $ 30.00 Loans Recei'ed (LR) $ CODE 2: Contribution Type CA. Cash CO Cosigner Obligation IK In-Kind LR Loan Recei\ecl Amount of Contribution Contributor Aggregate I I I $ 50.00 I H --- - - ~ _u - --- --- - -- -- -- --f I: II J) 10.00 I I I ----L- I I I $ I I I I $ 30.00 ~ I ~ I I ~ I i I , I L I 1$ 0.00 I 1 $ 0.00 I I $ I In-Kind Purpose (see manual for suggested purpose cOdes) I Code 1 Code 2 CA ~)t5gr~~R&- CA 7 ~~b~ @ "" S IK CA CA A<.'counting Pedod Totals (Complete only for last page and I transfer these amounts to the Summan Statement. PC I ) Cash (CA) In-Kind OK) Loans Recei\ed (LR) $ $ 680.00 $ 30 >~U1l1nldrY ~<t:lh:ll1\..TIL i '-'lurrm, \. I.lnl' .~ Personal Expenditures for Reimbursement PC 3A Rev. 12/03 Candidate or P?l:committe:;~u + ~ ~ Jk Election: 0 Primary 20_ -EtGeneral20 c 'f Report: I st Pre-election 0 2nd Pre-election Committee ID Number: PageLo~_ o Other o Post-election o 20_ September Supplemental PURPOSE CODES (see back of form for instructions and code definitions) A Agent 0 Other Advertising (yard signs, buttons, etc.) B Broadcast Advertising (Radio, TV) P Postage C Cash Contributions S Surveys and Polls F Fundraising Event Expenses T Travel Expenses (describe if over $50) G General Operational Expenses (describe if over $50) U Utilities I Interest Payment W Wages, Salaries, Benefits L Literature, Brochures, Printing Y Petition Circulators M Management Services Z Preparation and Production of Advertis:ing N Newspaper and Other Periodical Advertising Line # Date Payee's Name Purpose Amount of Expenditure 1. t.6 ~ 01 or [Lt~ -:Pl'S ~ C4J2Q;> S '--' $ yq~ 2. ut ~.~l~({ Cu.-l: I~J( ku-u-c\ cSt 6<\$ It 4. rJrl4 ~- $~(~ $ /(JO--- 3. 5. $ 6. $ 7. $ 8. $ 9. $ 10. $ See Instructions on Back and in Campaign Finance Manual Page Total $ ~ rt& ~ Accounting Period Total (Complete only for last page and transfer this amount to the Summary Statement, PC I.) Personal Expenditures $ ::3S?&, /'3 Enter on Summary Statement, Line 31 Personal Expenditures PC3A \ Summary Statement of Contributions and Ex~n~~~ PC 1 Rev. 12/03 Please type or print legibly in black ink. / ' Page lof2 Candidate or Political Committee Name (use full name): ' \. , "- committee to Elect Cate Hartzell Mailing Address as it Appears on Statement of Organization (street, route or box number, city, state, zip code): 881 East Main St. Ashland, Or 97520 Treasurer's Name: I Telephone Number (day): John Fields 541-482-8442 Committee ill Number: I Committee Type, Measure Number or Office: o Original o Primary 20_ o General 20_ o Other _ C8J Amendment ~ 1 st Pre-election o 2nd Pre-election o Post-election o 20_ September Supplemental A-TOTALS FOR THIS B-CUMULATIVE TOTALS ACCOUNTING PERIOD FOR TillS ELECTION CONTRIBUTIONS 1. Cash Contributions 680.00 680.00 (AccOWlting Period Total from PC 2) 2. Loans Received (Non-Exempt) + + (ACCOWlting Period Total from PC 2) 3. Total Cash Contributions = 680.00 = (lines 1+2) 4. In-Kind + 30.00 + 30.00 (Accounting Period Total from PC 2) 5. TOTAL CONTRIBUTIONS = 71 0.00 = 710.00 (lines 3 + 4) EXPENDITURES 6. Cash Expenditures -e- ~~~rn ~~ (AccoWlting Period Total from PC 3) 7. Loan Payments (Non-Exempt) + a8.88 + (AccoWlting Period Total from PC 3) ..e- 8. Total Cash Expenditures = -G- 386.18 = (lines 6 + 7) 9. In-Kind + 0.00 + ~O..Q-. (AccoWlting Period Total from PC 2) 10. TOTAL EXPENDITURES = -e- 41G.1& = M6.16 .(J- (lines 8 + 9) CASH BALANCE 11. Beginning Cash Balance {o2. SI 0.00 FOR OFFICE USE ONL Y (line 20 of previous report) 12. Total Contributions + 71 0.00 (line 5) 13. Other Receipts + (AccoWlting Period Total from PC 4A) \; l~ ~~ 14. Loans Received (Exempt) + ~/~. PJfJ.. (Accounting Period Total from PC 4A) 15. CONTRIBUTION SUBTOTAL = :tI O~. JOO.O~ ~O\ ItV (lines 11 + 12 + 13 + 14) 16. Total Expenditures ~ -4 te 1:1 (line 10) 17.. Other Disbursements + (ACCOWlting 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) \ "'" \ ~1~.8'g ~ Summary Statement of Contributions and Expenditures Please type or print legibly in black ink. Candidate or Political Committee Name: committee to ELect Cate Hartzell D Original D Primary 20_ D General 20_ ~ Amendment ~ 1st Pre-election D 2nd Pre-election LOAN SUMMARY PC 1 Rev. 12103 Page 2 of2 Committee ill Number: D Other _ D Post -election D 2004 September Supplemental FOR OFFICE USE ONLY + + = + + = = --aDO. 18 ~ + 386.18 = , L r 34. + = = 38. + ~~*~ = -293.e~ 8(2.9 ~U~ \h\\ ~ + "3 ~"., - It + 43. = ~ 1/ 9.0' = -i1f1f -I: re ), hereby certify that the above statement and the attached supporting reports are PC2 Cash Contributions, Loans Received and In-Kind Rt:V. 12/03 Candidate or Political Committee Name: Committee ill Number: Committee to Elect Cate Hatzell Page 1 of~ Election: o Primary 20 o General 20_ o Other _ Report: ~ I st Pre-election o 2nd Pre-election o Post-election o 20_ September Supplemental SEE BACK FOR INSTRUCTIONS AND CODE DEFINITIONS CODE 1: Contributor Type CODE 2: Contribution Type 8 Busincss Entity CA Cash C Political Committee (includcs business and union PACs) CO Cosigner Obligation F Candidatc's Immediate Family (includcs candidatc) IK In-Kind I Individual LR Loan Recellved L Labor Organization 0 Othcr p Political Party Committee Une# Name and Address of Contributor Amount of In-Kind Purpose Contribution (see manual for suggested purpose codes) Date Received Occupational Information or Contributor Code 1 I Code 2 Contributing Committee's 10# Aggregate I Ken Crocker 1, 134 Nutley St. $ 75.00 I Ashland, OR 97520 9/6/04 photographer $ I I CA John Fricker 2. 1101 Paradise $ 25.00 Ashland, OR 97520 9/10/04 \rJ t[:Y? j' \-c lVl~G-e.-1- $ I I CA I Bill Greenstein 3. 191 N. Wightman $ 50.00 Ashland. OR 97520 I I 910/04 I Realator $ I CA I Marge and Hal Jamison 4, 60 Golden Spike Way $ 200.00 Ashland, OR 97520 9/10/04 retired $ 0.00 I I CA Tom Marvin 5, 499 Iowa St. $ 35.00 Ashland,Or 97520 9/10/04 ~,~ M~J SSU ~rbf, $ I I CA See Pa~c Totals (Add all amounts with the same Accounting Period Totals (Complct(~ only for last page and Instmctions contribution type. Do not include aggregates,) transfer thcse amounts to the Summary Statemcnt, PC 1.) on Back and Cash (CA) $ 385.00 Cash (CA) $ in Campaign - Enter on Summaf\' StJtc:mcnt. Column A.. Line I Finance Manual In-Kind (IK) $ - In-Kind (lK) $ - I Enkr on Su:nmarv Stc,lcment, Column A.. Lmes -I- ;md ') PC 2 I Loans Rcccivcd (LR) $ - Loans Receiycd (LR) $ - Enll:r on Summary Sl',tl'IDl'Ilt. Column A Lmc 2 I PC 2 , C'ashContributions,' Loans Recei'ved'~and 'In~Kind ; Rev. 12103 Candidate or Political Committee Name: Committee ill Number: Committee to Elect Cate Hartzell Page ~ of~ Election: D Primary 20_ D General 20 D Other _ Rcport: ~ 1st Prc-elcction D 2nd Pre-election D Post-election o 20_ September Supplemental SEE BACK FOR INSTRUCTIONS AND CODE DEFINITIONS CODE 1: Contributor Type CODE 2: Contribution Type B Busincss 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 RccEived L Labor Organization 0 Ot hcr p Political Party Committee Une # Name and Address of Contributor Amount of In-f(ind Purpose Contribution (see manual for suggested purpose codes) Date Received Occupational Information or Contributor Code 1 I Code 2 Contributing Committee's 10# Aggregate Richard Seidman 1 , 924 Garden Way $ 50.00 Ashland, OR 97520 9/13/04 I Fundraiser $ I I CA Bill Street I 2. 180 Meade St. $ 40.00 Ashland, OR 97520 9/11/04 I Librarian $ I I CA I Alice Suter 3, I 575 Dogwood Way $ 30.00 I Ashland, OR 97520 ! I 9/08/04 I Retired $ I CA I Rich and Diane Werich 4. I 568 Walnut St. $ 100.00 I Ashland, OR 97520 9/5/04 I Pharmacist $ I I CA Sunni Vianni .. 5, 119ft! pd.rc~~ t..AvLe- $ 15.00 Ashland, OR 97520 9/15/04 Teacher $ 1 I ca Scc Pa~c Totals (Add all amounts with the same Accounting Period Totals (Complctc only for last page and Instructions I contribution type. Do not include aggregates.) transfer these amounts to the Summary Statcmcnt PC 1.) on Back and ; Cash (CA) $ 235.00 Cash (CA) $ in Campaign - Entcr on Swnmary Statement. Cnlumn .\. Llnc I Financc Manual In-I<,illd OK) $ - In-Kind (lK) $ - Fnh:r nn Summar. ~;tah:ment. ~,)Iumn ,\, Lines .+ ;md ') PC 2 I Loans Rccci\'cd (LR) $ - Loans Rcceiycd (LR) $ - IZnter nn Summa,,; :;tatement. ('"Iumn j\, l,me2 . ~ I :.~ ,f . ":: .- PC 2 Cash Contributions, Loans Received and In-Kind R~v. 12/03 Candidate or Political Committee Name: Committee ill Number: Committee to Elect Cate Hatzell Page ~ of~ Election: D Primary 20_ D General 20_ D Other _ Report: ~ 1st Pre-elcction o 2nd Pre-election o Post -election D 20_ September Supplemental SEE BACK FOR INSTRUCTIONS AND CODE DEFINITIONS CODE 1: Contributor Type CODE 2: Contributiion Type B Business Entity CA Cash C Political Committee (includes business and union PACs) CO Cosigner Obligation F Candidatc's Immediate Family (includes candidate) IK In-Kind I Individual LR Loan Received L Labor Organization 0 Other P Political Party Committee Une# Name and Address of Contributor Amount of In-Kind Purpose Contribution (see manual for suggested purpose codes) Date Received Occupational Information or Contributor Code 1 I Code 2 Contributing Committee's 10# Aggregate i Alan and Myra Erwin 1. 134 Nutley St. $ 50.00 Ashland. OR 97520 9/16 /04 Retired $ I I CA Nancy Richardson sf:. 2. C(:; Cu-/,1791h1 tit- $ 10.00 Ashland, Oregon I I 9/16/04 I Non-profit ceo $ I CA /' ~ ("' dA.- '7~t&~Cla-p ~s, __~ A~()(/l l,,~' 3, 7-V7 "2 -'t./)(.v, (.\--((& $ '38 A<i.i\ \ ~f\ . 0 Q., tl7 20 ~ . , ~ I \ '7~~(d.~~ $ I 1~ I , t 4, $ S 0.00 I I CA 5. $ 0.00 $ I I CA See I Pal(c Totals (Add all amounts with Ihe same Accountin~ Period Totals (Complete only [or last page and Instructions contribution type. Do not include aggregates.) transfer thcse amounts to the Summary Statement. PC 1.) on Back and Cash (CA) $ 50,00 Cash (CA) $ 680.00 in Campaign Enter on SummarY ::;latemenl. Cnlumn ,\. Line! 1 Finance Manual In-Kind OK) $ 30.00 In-Kind (lK) $ 30.00 Enta on SummarY :;lalemenl Column A. Lines 4 and c, PC 2 Loans Rcceivcd (LR) $ - Loans Reccived (LR) $ - F.nk'T on SummarY St;\leml."Tll Column :\. Lme 2 City of Ashland City Hall City Recorder's Office Barbara Christensen, City Recorder (541) 488-5307 (phone) 20 E. Main 5t. AsWand, Oregon 97520 (541) 488-5311 (fax) October 1, 2004 Cate Hartzell 881 East Main Street Ashland, OR 97520 I have examined your first pre-election contribution and expenditure report for the General Election of November 2,2004 and found the following: D Your committee report is sufficient. ~Your committee report is not sufficient in the following way(s). 1. Cash Contributions, Loans Received and In-Kind a) Missing dates received, addresses, occupational information and complete name of contributor Form # PC2 PC2 PC2 Line # Page 1 of 3; lines 2, 3 and 5 Page 2 or 3; lines 2, 3 and 5 Page 3 of 3; lines 2 and 3 b) Incorrect page total on PC 2 page 3 of 3 2. Summary Statement will need to indicate the proper period totals for the PC2 forms. You must file the necessary amended information on amendment forms. All requested information on this exam letter must be submitted by October 12~ 2004 to avoid penalties. F or 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 Summary Statement of Contributions and Expenditures PC 1 Rev, 12/03 Please type or print legibly in black ink. Page 1 of 2 Candidate or Political Co mittee Name (use full name): / t'" ~ 'L~ (. . C; . c_+- Mailing Ad~:ess as it Appears on, Statement of Organization .(stre.et, route or ~ox nurber, city, s~ ~?5 1- r /V1-fT-c N c-- . C~ \.G-L,~ d52- It eel Tr~~'s Name: , \ Te~hone Number (day): -JD VV'\ ~ e..\o S 5 LII - 4'(,7- - ~ t..j tJ ~ Committee ID Number: Committee Type, Measure Num~er or Office: SDriginal tJ Amendment D Primary 20_ ~ 1 st Pre-election D Other D Post-election A-TOT ALS FOR THIS ACCOUNTING PERIOD D 20_ September Supplemental B-CUMULA TIVE TOTALS 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) ~7CJ ( .~ 1..9 l- a 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 (lines 6 + 7) 9. In-Kind (Accounting Period Total from PC 2) 10. TOTAL EXPENDITURES (lines 8 + 9) + + = + '30 + 0 = .{ ,0 -7 CJo ? $?' (;, 1'6 -~ ~ t 'is + + )<6~ + 3 [) + LJ~ ~ i~ 0 FOR OFFICE USE ONL Y + 700 + + CASH BALANCE 11. Beginning Cash Balance (line 20 of 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) 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) len 4- J'~ ~ + + = = 2-<5'3 - Summary Statement of Contributions and Expenditures PC 1 Rev, 12/03 Please type or print legibly in black ink. can(9~~~~a~ee r:~ejkd- Cc~t D Original D Primary 20_ D General 2<b.L o Amendment 1 st Pre-election 0 2nd Pre-election LOAN SUMMARY Page 2 of2 Committee ID Number: D Other o Post-election 020_ September Supplemental 21. Beginning Outstanding Loans (line 29 of previous report) 22. Loans Received (Non-Exempt) (line 2) 23. Loans Received (Exempt) (line 14) 24. LOANS RECEIVED SUBTOTAL (lines 21 + 22 + 23) 25. Loan Payments (Non-Exempt) (line 7) 26. Loan Payments (Exempt) (line 18) 27. Forgiven Loans (Total loans forgiven during this accounting period) 28. LOAN PAYMENT SUBTOTAL (lines 25 + 26 +27) 29. TOTAL OUTSTANDING LOANS (line 24 minus line 28) FOR OFFICE USE ONLY + + = + + = PERSONAL EXPENDITURE SUMMARY 30. Beginning Outstanding Personal Expenditures (line 36 of previous report) 31. Personal Expenditures (Accounting Period Total from PC 3A) 32. PERSONAL EXPENDITURE SUBTOTAL (lines 30 + 31) 33. Personal Expenditure Reimbursements (Total expenditures on PC 3 with purpose code R) 34. Forgiven Personal Expenditures + (Total personal expenditures forgiven this acctg. period) 35. REIMBURSEMENT SUBTOTAL (lines 33 + 34) 36. OUTSTANDING PERSONAL EXPENDITURES FINANCIAL STATUS AT CLOSE OF ACCOUNTING PERIOD 37. Ending Cash Balance 0 z.. (line 20) 38. Accounts Receivable (Accounting Period Total from PC 5) 39. SUBTOTAL (lines 37 + 38) 40. Total Outstanding Loans (line 29) 41. Outstanding Personal Expenditures (line 36) 42. Accounts Payable (Accounting Period Total from PC 6) 43. SUBTOTAL (lines 40 + 41 + 42) 44. BALANCE/DEFICIT (lin s line 43: indicate + or - balance) + ~<6~ ?~ = c " , Ii + ~ 2~~6 ----- + ./ + /" 2-~ 3- ~g' 3 0 '2.- (name of candidate or treasurer), hereby certify that the above Date Sign1 /21 /(J ~f Personal Expenditures for Reimbursement Candidate or :~l: committe5a~u + & t;: ;h Election: 0 Primary 20_ -EtGeneral20 D 'f Report: 1 st Pre-election 0 2nd Pre-election Committee ID Number: PC 3A Rev, 12/03 PageLo~_ 020_ September Supplemental PURPOSE CODES (see back of form for instructions and code definitions) A Agent 0 Other Advertising (yard signs, button~;, etc.) B Broadcast Advertising (Radio, TV) P Postage C Cash Contributions S Surveys and Polls F Fundraising Event Expenses T Travel Expenses (describe if over $50) G General Operational Expenses (describe if over $50) U Utilities I Interest Payment W Wages, Salaries, Benefits L Literature, Brochures, Printing Y Petition Circulators M Management Services Z Preparation and Production of Advert:ising N Newspaper and Other Periodical Advertising Accounting Period Total (Complete only for last page and transfer this amount to the Summary Statement, PC 1.) --:::2.<:9/ /g Personal Expenditures $ -.....-/25 (C' Enter on Summary Stat~ment, Line 31 Line # Date Payee's Name Purpose 1. '6 Vj,~ of c~ tLt uilil ~~ ~ L4f2-(j.) S ~ 2. it 3. ~t ~{2~({ C6t I~?d( i-tuUl\ 'Si L"'\5 0 (::) h&f $ 4. rI etU 5. 6. 7. 8. 9. 10. See Instructions on Back and in Campaign Finance Manual Page Total A (#~/... (15 $ ::) (S (9. - Personal Expenditures PC3A Amount of Expenditure $ . 'Q.3 '1- $~(~ /80-- $ $ $ $ $ $ Cash Contributions, Loans Received and In-Kind PC2 Rev, 12/03 Candidate or Political Committee Name: Committee to Elect Cate Hatzell Election: D Primary 20_ D General 20_ Report: ~ 1 st Pre-election D 2nd Pre-election SEE BACK FOR INSTRUCTIONS AND CODE DEFINITIONS CODE 1: Contributor Type B Business Entity C Political Committee (includes business and union P ACs) F Candidate's Immediate Family (includes candidate) I Individual L Labor Organization o Other P Political Party Committee Committee ill Number: Page ~ of~ D Other _ D Post -election D 20_ September Supplemental CODE 2: Contribution Type CA Cash CO Cosigner Obligation IK In-Kind LR Loan Received Une# Name and Address of Contributor Amount of Contribution Date Received Occupational Information or Contributor Code 1 Contributing Committee's 10# Aggregate Alan and Myra Erwin 1. 134 Nutley St. $ 50.00 Ashland, OR 97520 9/16 /04 Retired $ Nancy Richardson 2. $ 10.00 9/16/04 $ 30-- 3. -- Code 2 CA CA I~ 4. 0.00 CA 5. 0.00 CA See Instructions on Back and in Campaign Finance Manual Page Totals (Add all amounts with the same contribution type. Do not include aggregates.) S-D- Cash (CA) ~ - ___ . Accounting Period Totals (Complete only for last page and transfer these amounts to the Summary Statement, PC 1.) Cash (CA) $ 670.00 Enter on Summary Statement, Colunm A., Line 1 In-Kind (IK) $~- 1" .&24_ In-Kind (IK) $. 0 - -=30.. Enter ~ Summary Statement, Colunm A., Lines 4 and 9 pe2 Loans Received (LR) Loans Received (LR) $_ Enter on S Cash Contributions, Loans Received and In-Kind PC2 Rev, 12/03 Candidate or Political Committee Name: Committee to Elect Cate Hartzell Election: 0 Primary 20_ Report: ~ 1 st Pre-election o General 20_ o 2nd Pre-election SEE BACK FOR INSTRUCTIONS AND CODE DEFINITIONS CODE 1: Contributor Type B Business Entity C Political Committee (includes business and union PACs) F Candidate's Immediate Family (includes candidate) I Individual L Labor Organization o Other P Political Party Committee Une# Date Received 1. 9/13/04 2. 9/11/04 3. 9/08/04 4. 9/5/04 5. 9/15/04 See Instructions on Back and in Campaign Finance Manual PC2 Name and Address of Contributor Occupational Information or Contributing Committee's 10# Richard Seidman C(~vf f:n4fL~ u-J0t Ashland, OR 97520 l Committee ID Number: Page ~ of~ o Other _ o Post -election o 20_ September Supplemental CODE 2: Contributic.n Type CA Cash CO Cosigner Obligation IK In-Kind LR Loan Received Amount of Contribution Contributor Aggregate Code 1 Code 2 $ 50.00 Accounting Period Totals (Complete only for last page and transfer these amounts to the Summary Statement, PC 1.) Cash (CA) $ Enter on Summary Statement, Column A, Line 1 Fundraiser $ Bill Street $ Ashland, OR 97520 $ Alice Suter 575 Dogwood Way Ashland, OR 97520 $ $ Pharmacist Sunni Vianni Ashland, OR 97520 $ Page Totals (Add all amounts with the same contribution type. Do not include aggregates.) Cash (CA) $ 235.00 In-Kind (IK) $- In-Kind (IK) Loans Received (LR) $ _ CA 40.00 CA 30.00 CA 100.00 CA 15.00 $- Enter on Summary Statement, Column A, Lines 4 and 9 Loans Received (LR) $_ Enter on S Line 2 Candidate or Political Committee Name: Committee to Elect Cate Hatzell Election: 0 Primary 20_ Report: ~ 1st Pre-election Cash Contributions, Loans Received and In-Kind PC2 Rev. 12/03 Committee ill Number: Page 1 of~ o General 20_ o 2nd Pre-election o Other _ o Post -election o 20_ September Supplemental SEE BACK FOR INSTRUCTIONS AND CODE DEFINmONS CODE 1: Contributor Type B Business Entity C Political Committee (includes business and union PACs) F Candidate's Immediate Family (includes candidate) I Individual L Labor Organization o Other P Political Party Committee Une# Date Received 1. 9/6/04 2. 3. 4. 9/1 0/04 5. 9/10/04 See Instructions on Back and in Campaign Finance Manual pe2 CODE 2: Contributicm Type CA Cash CO Cosigner Obligation IK In-Kind LR Loan Received Name and Address of Contributor Occupations/Information or Contributing Committee's 10# Ken Crocker 134 Nutley St. Ashland, OR 97520 photographer John Fricker 1101 Paradise Ashland, OR 97520 Amount of Contribution Contributor Code 1 Aggregate $ 75.00 $ CA $ 25.00 $ CA $ 50.00 $ CA Bill Greenstein 191 N. Wightman Ashland, OR 97520 retired CA Realator Marge and Hal Jamis , ( / 60 Golden Spike W 'j /;/ Ashland, OR 975 U/ 0.00 Tom Marvin 499 Iowa St. Ashland,Or 97520 35.00 $ CA Page Totals (Add all amounts with the same contribution type. Do not include aggregates.) Accounting Period Totals (Complete only for last page and transfer these amounts to the Summary Statement, PC 1.) Cash (CA) $ Enter on Summary Statl:ment, Column A, Line 1 Cash (CA) $ 385.00 In-Kind (IK) $- In-Kind (IK) $ Enter on Summary Statl:ment, Column A, Lines 4 and 9 Loans Received (LR) $ _ Loans Received (LR) $_ Enter on S