Initiative/referendum Receipt And Expenditure Report Page 2

Type of Report:

Initiative/Referendum

Interim

___

Monthly

Receipt and Expenditure Report

___ Yearly

Committee Name:

Address:

Telephone:

E-Mail:

Summary

Receipts for paid advertising this filing period:

Under $1,000 ............................................................... $_______________________

Over $1,000 ............................................................... $_______________________

Total Receipts for this filing period: ................................ $_______________________

Total Expenditures (actual and promised) for paid

advertising for this filing period: ...................................... $_______________________

Dated this ____ day of _________________________________, 20_____.

__________________________________

__________________________

Chairman

Treasurer

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Parent category: Business