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Campaign Finance-General Election - Semanko, Norm - 9/3/2009FILED CITY OF EA4LE DECLARATION OF CANDIDACY SEP 0 3 2009 Flier I, the undersigned, affirm that I am a qualified elector of the City of EagtM Idaho, and that I have resided in the City of Eagle for at least thirty (30) days. I hereby declare myself to be a candidate for the office City Council, for a term of four (4) years, to be voted for at the election to be held on the 3rd day of November, 2009 and certify that I possess the legal qualifications to fill said office, and the my residence address is 237 Go, ,R; ."..rr � 1 �'- ei -p $?3 4, f Subscribed and sworn to before me this 00111110, T4 in = IG SOF IDA\° ,: 111111100` Candidates Signature 3 day of 5eP� , 2009 Notary Public for the State of Idaho Residing at: = ' L7 My Commission Expires: 121812.4/ a. -- OFFICIAL USE ONLY Before accepting this Declaration of Candidacy, the City Clerk (or designee) must verify the following. This Declaration is accompanied by: The attached Petition of Candidacy signed by at least five qualified city electors with the attached verification from the county clerk, OR tom' A nonrefundable filing fee of $40. -- 00 341 % The City Clerk (or designee) must verify that the person submitting this declaration is a qualified city elector as defined in Idaho Code 50-402(c) and that the residence address provided above matches the address on the individual's voter registration. This declaration was accepted by on 9/.3`09 Date 619-0p(_, Name, Title K:\Clerks\ELECTION\General Election 2009\Declaration of Candidacy\Declaration of Candidacy.doc IP Veiled 01 Col e or`` at ID. `l&w Time RECEIVED & FILED CITY OF EAGLE APPOINTMENT AND CERTIFICATION OF POLITICAL TREASJRERSEP 0 3 2009 oe i Rev.s o FOR CANDIDATES AND COMMITTEES Fu.: ' ,,4 (Please Print or Type) Route to: r.4T r o'1 4` Pursuant to Section 67-6603(c1), Idaho Code. No contribution shall be received or expenditure made by or on benair of a � candidate or political committee until he or she appoints a political treasurer and certifies the name and address of the treasurer to the Secretary of State. Certification is for(check appropriate box below): mof Norm Semanko • CANDIDATE: CaNa ndidaete Phone:Home 208-938-8286 Phone: 208-344-6690 pholne: 208-863-7921 Office Seat(if Sought: City Council applicable c �3�i // Ems) Candidate 3 7 w. /N!/ 'TV-C J f, `�l'' r ( r1 Mailing address: P.O. Box 538, Eagle, ID 83616(<<:,12 c Candidate address: semanko @rmci.net Name of COMMITTEE: Committee: Name of Committee Chairman: Miscellaneous: I Home Work Cell Phone: Phone: Phone: Measure: 0 Committee Mailing address: Candidate/Measure: Chairman email address: CERTIFICATION AND APPOINTMENT Norm Semanko I, , do hereby certify and appoint the following individual who is a registered elector of Name of Candidate or Committee Chairman the State of Idaho as the political treasurer for the above named candidate or committee: Name of Norm Semanko Political Treasurer: Home 208-938-8286 phone: 208-344-6690 Pholne:208-863-7921 Phone: Treasurer 23 / L . R1Jv Trco I DI l.a , -P g3ti(G (A..,-he.) Mailing address: P.O. Box 538, EagleD 83616 C Treasurer email address: semanko@rmci.net Signature of Candida e r Committee Chairman Norm Semanko , do hereby accept the appointment as political treasurer for Name of Political Treasurer the above named candidate or committee. Sign f Political Treasurer RECEIVED& FL CITY OF EAGLE �-1� CAMPAIGN FINANCIAL DISCLOSURE REPORT 0L 1 0 8 2009 0-2 ig Rev. 10/07 SUMMARY PAGE File: "4 4 'kY (Please Print or Type) Route to• y/ Section I Name of Candidate or Political Committee and Chairperson Office Sought Of candidate) Seal(if any) ,■1 C;-1-� Cb no' £a Ie Mailing Add Address SP_m a n k City and Zip Home Pho e u G �Work Phone `9 7. 0.of Political Treasurec3� ��r�le ?3G/G 732% V2-$6 ff j. 112-1 IV Or rb\ _P tde.nlGa �/ Mailing Address City and Zip Home Phone Work Phone I-0, 6n 2 538' fie/ rp k3k ' 3 Oy'G t' -7-w Change of address for: Candidate or Political Committee ❑ Political Treasurer D Section II TYPE OF REPORT This filing is an: X Original ❑ Amendment This report is for the period from ! / (23 / b 7 through 17 130 / 0?. x October 10 Pre-General Report ❑ 7 Day Pre-General Report ❑ 30 Day Post-General Report ❑ Annual Report Is this a Termination Report: ❑ Yes 1.2 No Section III STATEMENT OF NO CONTRIBUTIONS OR EXPENDITURES Directions: If you had no contributions or expenditures during this reporting period,check the box next to the statement below and sign this report. Be sure to carry forward the appropriate"Calendar Year to Date"figures in Column II,Section IV. )‹..I hereby certify that I have received no contributions and have made no expenditures during this reporting period. Section IV SUMMARY To reach your Calendar Year to Date figure: Add this report's Column I COLUMN I COLUMN II figures to the Column II figures of your previous report(except on line 6). This Period Calendar Year to Date Line 1:Cash on Hand January 1,This Calendar Year* $ XXXXXX $ Line 2:Enter Beginning Cash Balance** $ $ XXXXXX Line 3:Total Contributions(Enter amount from line 5,page 2) $ $ Line 4:Subtotal(Add lines 1,2 and 3) $ $ Line 5:Total Expenditures(Enter amount from line 11,page 2) $ $ Line 6:Enter Ending Cash Balance(Subtract line 5 from line 4) $ $ Line 7:Outstanding Debt to Date(Enter amount from line 18,page 2) $ *This same figure should be entered on line 1 of all reports filed this calendar year. **This is the figure on line 6 of the last Campaign Financial Disclosure Report filed. If this is your first report,this amount is 0. Note:The closing cash balance for the current reporting period appears on the next report as the beginning cash on hand. Section V I, AL,f r►. ,5"2 Vh a Ilko ,hereby certify that the information in this Name of Political Treasurer report is a true,complete and cor -ct Campaign Financial Disclosure Report as required by law. i Signat of Poli t al Treasurer 'Ige 1 DETAILED SUMMARY Name of Candidate or Committee: Total This Period Contributions O Unitemized Contributions($50 and less) #of Contributors + $ O Itemized Contributions(Total of all Schedule A sheets) + $ In-Kind Contributions(Total of all Contribution amounts from Schedule C sheets) + $ ® Loans(Total of all New Loan amounts from Schedule D sheets) + $ 50 Total Contributions(Transfer this figure to page 1, Section IV, Line 3) = $0.00 Expenditures © Unitemized Expenditures($25 and less) #of Expenditures + $ _......... O Itemized Expenditures(Total of all Schedule B sheets) + $ ® In-Kind Expenditures(Total of all Expenditure amounts from Schedule C sheets) + $ O Loan Repayments(Total of all Loan Repayment amounts from Schedule D sheets) + $ 10 Credit Card and Debt Repayments(Total of all Repayment amounts from Schedule E sheets) + $ 11 Total Expenditures(Transfer this figure to page 1, Section IV, Line 5) _ $0.00 Loans, Credit Cards and Debt 12 Outstanding Balance from previous reporting period + $ New Loans received during this reporting period 13 (Total of all New Loan amounts plus Accrued Interest from Schedule D sheets) + $ New Credit Card and Debt incurred this reporting period 14 (Total of all New Incurred Debt amounts from Schedule E sheets) + $ 15 Subtotal = $0.00 Repayments of Loans made during this reporting period 16 (Total of all Loan Repayment amounts from Schedule D sheets) - $ Repayments of Credit Card and Debt this reporting period 0 (Total of all Debt Repayment amounts from Schedule E sheets) - $ 18 Total Outstanding Balance at close of this period (Transfer this figure to page 1, Section IV, Line 7) = $0.00 Pledged Contributions 1 g Unitemized Pledged Contributions($50 and less) #of Pledges + $ Itemized Pledged Contributions this Period (Total of all Schedule F sheets) + $ ®' Total Pledged Contributions this period = $0.00 Page 2 SCHEDULE A Page of ITEMIZED CONTRIBUTIONS of more than Fifty Dollars($50.00)this period Name of Candidate or Committee: Date Received Full Name,Mailing Address and Zip Code of Contributor Cash or Check 1. / / $ ❑ General Calendar Year-To-Date 2. / / $ ❑ General Calendar Year-To-Date 3. / / $ $ ❑ General Calendar Year-To-Date 4. / / $ ❑ General Calendar Year-To-Date 5. / / $ $ ❑ General Calendar Year-To-Date 6. / / $ ❑ General Calendar Year-To-Date 7. / / $ $ ❑ General Calendar Year-To-Date 8. $ / I $ ❑ General Calendar Year-To-Date 9. / I $ $ ❑ General Calendar Year-To-Date 10. I / $ $ ❑ General Calendar Year-To-Date Total This Page: $0.00 Transfer the combined total of all Schedule A pages to the Detailed Summary on page 2 line 2. SCHEDULE B Page of ITEMIZED EXPENDITURES Twenty-Five Dollars($25.00)or more this period Name of Candidate or Committee: Purpose Codes A All Travel Expenses(Airfare, Fuel,Lodging&Mileage) N Newspaper&Other Periodical Advertising B Broadcast Advertising(Radio,TV&Internet) 0 Other Advertising(Yard Signs,Buttons,etc.) C Contributions to Candidates&PAC's P Postage D Donations&Gifts S Surveys&Polls E Event Expenses T Tickets(Events) F Food&Refreshments U Utilities G General Operational Expenses W Wages,Salaries,Benefits&Bonuses L Literature,Brochures,Printing Y Petition Circulators M Management Services Z Preparation&Production of Advertising Date Spent Full Name,Mailing Address and Zip Code of Recipient Purpose Code Cash or Check 1. / / $ 2. / / $ 3. / / $ 4. / / $ 5. / / $ 6. / / $ 7. / / 8. / I $ 9. 1 / 10. I I $ Total This Page: $0.00 Transfer the combined total of all Schedule B pages to the Detailed Summary on page 2 line 7. SCHEDULE C Page of IN-KIND CONTRIBUTIONS and EXPENDITURES Name of Candidate or Committee: Purpose Codes A All Travel Expenses(Airfare, Fuel,Lodging&Mileage) N Newspaper&Other Periodical Advertising B Broadcast Advertising(Radio,TV&Internet) 0 Other Advertising(Yard Signs,Buttons,etc.) C Contributions to Candidates&PAC's P Postage D Donations&Gifts S Surveys&Polls E Event Expenses T Tickets(Events) F Food&Refreshments U Utilities G General Operational Expenses W Wages,Salaries, Benefits&Bonuses L Literature,Brochures, Printing Y Petition Circulators M Management Services Z Preparation&Production of Advertising 1. Contributor Name, Mailing Address and Zip Code / / $ ❑ General Calendar Year-To-Date Expenditure Name, Mailing Address and Zip Code Purpose Code $ 2. Contributor Name, Mailing Address and Zip Code / / $ $ ❑ General Calendar Year-To-Date Expenditure Name, Mailing Address and Zip Code Purpose Code $ 3. Contributor Name, Mailing Address and Zip Code / / $ ❑ General Calendar Year-To-Date Expenditure Name, Mailing Address and Zip Code Purpose Code 4. Contributor Name, Mailing Address and Zip Code / / $ ❑ General Calendar Year-To-Date Expenditure Name, Mailing Address and Zip Code Purpose Code $ 0.00 Expenditure Total: (Transfer the combined total of all Expenditures on Schedule C pages $0.00 to the Detailed Summary,page 2 line 8) Contributor Total: X0.00 (Transfer the combined total of all Contributors on Schedule C pages to the Detailed Summary,page 2 line 3) SCHEDULE D LOANS Each Lender to your campaign should be listed separately. Each time a loan is received or you loan money to the campaign, it must be listed as a separate item.Each new loan from any Lender must be listed as a new item from that Lender.You may have the same Lender listed more than once. Except for a candidate making a loan to his or her own campaign, loans from any Lender cannot exceed contribution limits laid out in Section 67-6610A,Idaho Code,even if it is repaid in full. Any loan(s)with a balance(s)appearing on the last report must be listed below with the amount in the Previous Balance column.Any new loan amounts should be listed in the New Loan column.Any interest accrued should be listed in the Interest Accrued column. If a payment was made on the loan,list it in the Repayments column. Note: Any loan that was repaid in full in a previous reporting period does not need to be listed. The Outstanding Balance column is the Previous Balance plus new loans and accrued interest less any repayments. Name, Mailing Address and Zip Previous Balance New Loan amount Interest accrued Repayments of Loan Balance Code of Lender of loan at the received during this during this during this reporting outstanding at (Candidate, Individual or Business) end of the last reporting period reporting period period the end of this reporting period reporting period 1. Date: Date: 10 /13 /08 / / Amount: Amount: $ $ 2. Date: Date: / / / / Amount: Amount: $ $ 3 Date: Date: / / / / Amount: Amount: $ $ 4. Date: Date: I / / / Amount: Amount: $ $ 5 Date: Date: / / / I Amount: Amount: $ $ 6. Date: Date: / / I / Amount: Amount: $ $ 7 Date: Date: / / / / Amount: Amount: $ $ Previous Received Interest Repayments Ending Balance Previous Total. $0.00 Received Total: (Transfer the combined total of all received loans to the $ 0.00 Detailed Summary,page 2 line 4) Interest Total: $0 Repayments Total: (Transfer the combined total of all loan repayments to the $0.00 Detailed Summary,page 2 line 9&16) Ending Balance Total: $O,O (NOTE:Transfer the combined total of all Accrued Interest and Received Loans to the Detailed Summary,page 2 line 13) SCHEDULE E CREDIT CARDS and DEBT Each incurred expense not yet paid (i.e. credit card purchases and debt)should be listed on a separate line. Each time you make purchases with a credit card or incur debt,it is considered to be a separate item.However,you will maintain a single item for each credit card and add purchases to that item. Each Creditor listed below with a New Debt amount must have a Schedule E-1 accompanying it. The Schedule E-1 lists where and when the debt was incurred. Credit Cards are considered debt to the campaign. Regardless of whether the credit card is repaid when the statement is received, all credit card transactions will appear on Schedule E and E-1. However,only Repayments of Debt during this reporting period appear in the Expenditure Section of the Detailed Summary Page. Any creditor(s)with a balance(s)appearing on the last report must be listed below with the amount in the Previous Balance column.Any new debt should be listed in the New Debt column,including any accrued interest. If a payment was made on the debt,list it in the Repayments column. Note: Any debt that was repaid in full in a previous reporting period does not need to be listed. The Outstanding Balance column is the Previous Balance plus New Debt less any Repayments of Debt. Name, Mailing Address and Zip Code of Previous Balance of New Debt amount Repayments of Debt Balance outstanding Creditor debt at the end of the incurred during this during this reporting at the end of this (Candidate, Individual or Business) last reporting period reporting period period reporting period 1. Date: Date: I l I / Amount: Amount: $ $ 2. Date: Date: / / / / Amount: Amount: $ $ 3, Date: Date: / / / / Amount: Amount: $_ 4. Date: Date: / / / / Amount: Amount: $ $ 5. Date: Date: l I I / Amount: Amount: $ $ 6. Date: Date: / / / / Amount: Amount: $ $ Previous Incurred Repayments Ending Balance Previous Total: $0.00 Incurred Total: (Transfer the combined total of all incurred debt to the $0.00 Detailed Summary,page 2 line 14) Repayments Total: (Transfer the combined total of all debt repayments to the $0.00 Detailed Summary,page 2 line 10& 17) Ending Balance Total: $0.00 SCHEDULE E-1 Page of CREDIT CARD and DEBT ITEMIZATION Name of Creditor from Schedule E: Each Creditor listed on Schedule E with a New Debt amount must have a Schedule E-1 accompanying it.The Schedule E-1 lists where and when the debt was incurred. Purpose Codes A All Travel Expenses(Airfare, Fuel, Lodging&Mileage) N Newspaper&Other Periodical Advertising B Broadcast Advertising(Radio,TV&Internet) 0 Other Advertising(Yard Signs, Buttons,etc.) C Contributions to Candidates&PAC's P Postage D Donations&Gifts S Surveys&Polls E Event Expenses T Tickets(Events) F Food&Refreshments U Utilities G General Operational Expenses W Wages,Salaries, Benefits&Bonuses I Interest Accrued&Finance Charges Y Petition Circulators L Literature,Brochures, Printing Z Preparation&Production of Advertising M Management Services Date Incurred Full Name,Mailing Address and Zip Code of Expenditure Purpose Code Amount 1. / I 2. I / $ 3. / / $ 4. / / 5. / / 6. I I $ 7. I / 8. I I 9. 1 I $ Total This Page: $0.00 The total of itemization for this creditor should equal the new loan amount listed on Schedule E for this creditor. SCHEDULE F Wage of PLEDGED CONTRIBUTIONS BUT NOT YET RECEIVED Name of Candidate or Committee: Directions:Complete this schedule if you were promised and agreed to accept a contribution during this reporting period but have not actually received the money, goods or services offered before the end of the reporting period. Do not include these entries on Schedule A until you actually receive the contribution. Pledged For Date Pledged Full Name,Mailing Address and Zip Code of Contributor Amount Pledged 1. ❑ General 2. ❑ General 3. ❑ General / / 4. ❑ General / 5. ❑ General / / 6. ❑ General / / 7. ❑ General 8. ❑ General / / 9. ❑ General / / 10. ❑ General 11. ❑ General Total Amount of Pledged Contributions: $ 0.00 Transfer the combined total of all Schedule F pages to the Detailed Summary on page 2 line 20. RE-CI:WED & FILED 011Y OF EAGLE ..1--fire, CAMPAIGN FINANCIAL DISCLOSURE REPORT r�:, C-2 , L T 2 7 2009ev.10/07 7�� � .�^'.,, SUMMARY PAGE 'i` a ;,lf'e (Please Print or Type) FITS: '' ' 1°/' Route to: Section I Name of Candidate or Political Committee and Chairperson Office Sought(if candidate) Seat(if any) Norm Semanko City Council Eagle Mailing Address City and Lip Home Phone Work Phone P.O. Box 538 Eagle, ID 83616 208-938-8286 ,208-863-7921 Name of Political Treasurer Norm Semanko Mailing Address City and Zip Home Phone Work Phone P.O. Box 538 Eagle, ID 83616 208-938-8286 208-863-7921 Change of address for: Candidate or Political Committee ❑ Political Treasurer ❑ Section II TYPE OF REPORT This filing is an: E Original ❑ Amendment This report is for the period from 10 j 01 /09 through 10 /18 /09 . ❑ October 10 Pre-General Report ❑ 7 Day Pre-General Report ❑ 30 Day Post-General Report ❑ Annual Report Is this a Termination Report: ❑ Yes 12 No Section III STATEMENT OF NO CONTRIBUTIONS OR EXPENDITURES Directions: If you had no contributions or expenditures during this reporting period,check the box next to the statement below and sign this report. Be sure to carry forward the appropriate"Calendar Year to Date"figures in Column II,Section IV. ❑ I hereby certify that I have received no contributions and have made no expenditures during this reporting period. Section IV SUMMARY To reach your Calendar Year to Date figure: Add this report's Column I COLUMN I COLUMN II figures to the Column II figures of your previous report(except on line 6). This Period Calendar Year to Date Line 1:Cash on Hand January 1,This Calendar Year* $ XXXXXX $ 0.00 Line 2:Enter Beginning Cash Balance** $ 0.00 $ XXXXXX Line 3:Total Contributions(Enter amount from line 5,page 2) $ 3,545.00 $ 3,545.00 Line 4:Subtotal(Add lines 1,2 and 3) $ 3,545.00 $ 3,545.00 Line 5:Total Expenditures(Enter amount from line 11,page 2) $ 1 ,133.65 $ 1,133.65 Line 6:Enter Ending Cash Balance(Subtract line 5 from line 4) $ 2,411 .35 $ 2,411 .35 Line 7:Outstanding Debt to Date(Enter amount from line 18,page 2) $ 0.00 *This same figure should be entered on line 1 of all reports filed this calendar year. **This is the figure on line 6 of the last Campaign Financial Disclosure Report filed. If this is your first report,this amount is 0. Note:The closing cash balance for the current reporting period appears on the next report as the beginning cash on hand. Section V Norm Semanko ,hereby certify that the information in this Name of Political Treasurer report is a true,complete an correct Campaign Financial Disclosure Report as required by law. Signatu tical Treasurer Page 1 DETAILED SUMMARY Name of Candidate or Committee: Norm Se m a n ko Total This Period Contributions Unitemized Contributions($50 and less) #of Contributors 1-00 + $50.00 2O Itemized Contributions(Total of all Schedule A sheets) + $2,800.00 30 In-Kind Contributions(Total of all Contribution amounts from Schedule C sheets) + $695.00 0 Loans(Total of all New Loan amounts from Schedule D sheets) + $0.00 50 Total Contributions(Transfer this figure to page 1, Section IV, Line 3) = $3,545.00 Expenditures 0 Unitemized Expenditures($25 and less) #of Expenditures too + $21.20 Itemized Expenditures(Total of all Schedule B sheets) + $417.45 In-Kind Expenditures(Total of all Expenditure amounts from Schedule C sheets) + $695.00 g0 Loan Repayments(Total of all Loan Repayment amounts from Schedule D sheets) + $0.00 10 Credit Card and Debt Repayments(Total of all Repayment amounts from Schedule E sheets) + $0.00 11 Total Expenditures(Transfer this figure to page 1, Section IV, Line 5) = $1,133.65 Loans, Credit Cards and Debt 12 Outstanding Balance from previous reporting period + $0.00 13 New Loans received during this reporting period (Total of all New Loan amounts plus Accrued Interest from Schedule D sheets) + $0.00 New Credit Card and Debt incurred this reporting period 14 (Total of all New Incurred Debt amounts from Schedule E sheets) + $0.00 15 Subtotal = $0.00 Repayments of Loans made during this reporting period 16 (Total of all Loan Repayment amounts from Schedule D sheets) - $0.00 Repayments of Credit Card and Debt this reporting period 17 (Total of all Debt Repayment amounts from Schedule E sheets) - $0.00 1 g Total Outstanding Balance at close of this period(Transfer this figure to page 1, Section IV, Line 7) = $0.00 Pledged Contributions 1g Unitemized Pledged Contributions($50 and less) #of Pledges 0.00 + $0.00 Itemized Pledged Contributions this Period (Total of all Schedule F sheets) + $0.00 Total Pledged Contributions this period = $0.00 Page 2 SCHEDULE A Page of ITEMIZED CONTRIBUTIONS 1 1 of more than Fifty Dollars($50.00)this period Name of Candidate or Committee: Norm Semanko Date Received Full Name,Mailing Address and Zip Code of Contributor Cash or Check 10 01 /09 1. Rose Law Group $ 200.00 6223 N. Discovery Way, Suite 200 200.00 Boise, ID 83713 $ ▪ General Calendar Year-To-Date 10/13/09 2.Old Town 1 LLC $ 300.00 839 E. Winding Creek Dr., #201 300.00 Eagle, ID 83616 $ E General Calendar Year-To-Date 10 16 09 3. Idaho Association of Realtors $ 1 ,000.00 I I The Realtors Political Action Committee 301 S. Capital Blvd. $ 1 ,000.00 RI General Boise, ID 83702 Calendar Year-To-Date 10 16 09 4 Barry Peters $ 100.00 _/ / Attorney at Law, P.A. 101 Eagle Glen Lane, Suite A $ 100.00 ▪ General Eagle, ID 83616 Calendar Year-To-Date 10 17 09 5. Carol Jean Thompson $ 100.00 / / 4831 Willow Creek Rd Eagle, ID 83616 $ 100.00 General Calendar Year-To-Date 10 17 09 6.Yesterday Properties, LLC $ 100.00 / / 148 N. 2nd St., Suite 101 Eagle, ID 83616 $ 100.00 El General Calendar Year-To-Date 10/17 ,09 Building Contractors Association of Southwest Idaho $ 1 ,000.00 6206 N. Discovery Way, Suite A Boise, ID 83713 $ 1 ,000.00 ▪ General Calendar Year-To-Date 8. $ / / $ ❑ General Calendar Year-To-Date 9. / / ❑ General Calendar Year-To-Date 10. / / $ ❑ General Calendar Year-To-Date Total This Page: $2,800.00 Transfer the combined total of all Schedule A pages to the Detailed Summary on page 2 line 2. SCHEDULE B Page of ITEMIZED EXPENDITURES 1 Twenty-Five Dollars($25.00)or more this period Name of Candidate or Committee:Norm Semanko Purpose Codes A All Travel Expenses(Airfare,Fuel,Lodging&Mileage) N Newspaper&Other Periodical Advertising B Broadcast Advertising(Radio,TV&Internet) 0 Other Advertising(Yard Signs, Buttons,etc.) C Contributions to Candidates&PAC's P Postage D Donations&Gifts S Surveys&Polls E Event Expenses T Tickets(Events) F Food&Refreshments U Utilities G General Operational Expenses W Wages,Salaries,Benefits&Bonuses L Literature,Brochures, Printing Y Petition Circulators M Management Services Z Preparation&Production of Advertising Date Spent Full Name,Mailing Address and Zip Code of Recipient Purpose Code Cash or Check 1. 0 10/02/09 Signs Etc., 910 E. Franklin Rd., #102, Meridian, ID 83642 $ 134.51 2. N 10/13/09 Eagle Independent, P.O. Box 339, Star, ID 83669 $ 115.00 3. F 10/16/09 Mai Thai, 78 Eagle River St., Eagle, ID 83616 $ 44.31 4. L 10/17/09 Staples, 6299 Eagle Road, Boise, ID 83713 $ 41 .62 5. 10/17/09 Albertsons, 250 S. Eagle Rd, Eagle, ID 83616 31 .08 6. E 10/17/09 Pizza Hut, 398 S. Eagle Rd, Eagle, ID 83616 50.93 7. / / 8. / / $ 9. / / $ 10. / / $ Total This Page: $4 1 7.45 Transfer the combined total of all Schedule B pages to the Detailed Summary on page 2 line 7. SCHEDULE C Page of IN-KIND CONTRIBUTIONS and EXPENDITURES 1 �1 Name of Candidate or Committee:Norm Semanko Purpose Codes A All Travel Expenses(Airfare,Fuel, Lodging&Mileage) N Newspaper&Other Periodical Advertising B Broadcast Advertising(Radio,TV&Internet) 0 Other Advertising(Yard Signs, Buttons,etc.) C Contributions to Candidates&PAC's P Postage D Donations&Gifts S Surveys&Polls E Event Expenses T Tickets(Events) F Food&Refreshments U Utilities G General Operational Expenses W Wages,Salaries,Benefits&Bonuses L Literature, Brochures, Printing Y Petition Circulators M Management Services Z Preparation&Production of Advertising 1. Contributor Name, Mailing Address and Zip Code 695.00 10 02109 Norm Semanko $ P.O. Box 538 $ 695.00 General Eagle, ID 83616 Calendar Year-To-Date Expenditure Name, Mailing Address and Zip Code Purpose Code Norm Semanko 0 P.O. Box 538 695.00 Eagle, ID 83616 $ 2. Contributor Name, Mailing Address and Zip Code / / $ ❑General Calendar Year-To-Date Expenditure Name, Mailing Address and Zip Code Purpose Code $ 3. Contributor Name, Mailing Address and Zip Code / / $ ❑ General Calendar Year-To-Date Expenditure Name, Mailing Address and Zip Code Purpose Code $ 4. Contributor Name, Mailing Address and Zip Code / / $ ❑ General Calendar Year-To-Date Expenditure Name, Mailing Address and Zip Code Purpose Code $ 0.00 Expenditure Total: (Transfer the combined total of all Expenditures on Schedule C pages $695.00 to the Detailed Summary,page 2 line 8) Contributor Total: t 9 5.0 0 (Transfer the combined total of all Contributors on Schedule C pages to the Detailed Summary,page 2 line 3) SCHEDULE D LOANS Each Lender to your campaign should be listed separately. Each time a loan is received or you loan money to the campaign, it must be listed as a separate item.Each new loan from any Lender must be listed as a new item from that Lender.You may have the same Lender listed more than once. Except for a candidate making a loan to his or her own campaign, loans from any Lender cannot exceed contribution limits laid out in Section 67-6610A, Idaho Code,even if it is repaid in full. Any loan(s)with a balance(s)appearing on the last report must be listed below with the amount in the Previous Balance column.Any new loan amounts should be listed in the New Loan column.Any interest accrued should be listed in the Interest Accrued column.If a payment was made on the loan,list it in the Repayments column. Note:Any loan that was repaid in full in a previous reporting period does not need to be listed. The Outstanding Balance column is the Previous Balance plus new loans and accrued interest less any repayments. Name,Mailing Address and Zip Previous Balance New Loan amount Interest accrued Repayments of Loan Balance Code of Lender of loan at the received during this during this during this reporting outstanding at (Candidate, Individual or Business) end of the last reporting period reporting period period the end of this reporting period reporting period 1 Date: Date: / / / / Amount: Amount: $ $ 2 Date: Date: / / I I Amount: Amount: $ $ 3 Date: Date: I l I / Amount: Amount: $ $ 4. Date: Date: I I / I Amount: Amount: $ $ 5. Date: Date: I I l / Amount: Amount: $ $ 6. Date: Date: / / / I Amount: Amount: $ $ 7 Date: Date: / / / I Amount: Amount: $ $ Previous Received Interest Repayments Ending Balance Previous Total: $0,00 Received Total: (Transfer the combined total of all received loans to the $ 0,00 Detailed Summary,page 2 line 4) Interest Total: $0 Repayments Total: (Transfer the combined total of all loan repayments to the $0,00 Detailed Summary,page 2 line 9&16) Ending Balance Total: $0.00 (NOTE:Transfer the combined total of all Accrued Interest and Received Loans to the Detailed Summary,page 2 line 13) SCHEDULE E CREDIT CARDS and DEBT Each incurred expense not yet paid(i.e.credit card purchases and debt)should be listed on a separate line. Each time you make purchases with a credit card or incur debt,it is considered to be a separate item.However,you will maintain a single item for each credit card and add purchases to that item. Each Creditor listed below with a New Debt amount must have a Schedule E-1 accompanying it. The Schedule E-1 lists where and when the debt was incurred. Credit Cards are considered debt to the campaign. Regardless of whether the credit card is repaid when the statement is received, all credit card transactions will appear on Schedule E and E-1.However,only Repayments of Debt during this reporting period appear in the Expenditure Section of the Detailed Summary Page. Any creditor(s)with a balance(s)appearing on the last report must be listed below with the amount in the Previous Balance column.Any new debt should be listed in the New Debt column, including any accrued interest. If a payment was made on the debt,list it in the Repayments column. Note: Any debt that was repaid in full in a previous reporting period does not need to be listed. The Outstanding Balance column is the Previous Balance plus New Debt less any Repayments of Debt. Name, Mailing Address and Zip Code of Previous Balance of New Debt amount Repayments of Debt Balance outstanding Creditor debt at the end of the incurred during this during this reporting at the end of this (Candidate,Individual or Business) last reporting period reporting period period reporting period 1. Date: Date: / I / I Amount: Amount: $ $ 2. Date: Date: I / / / Amount: Amount: $ $ 3. Date: Date: / I / I Amount: Amount: $ $ 4 Date: Date: 1 I I I Amount: Amount: $ $ 5. Date: Date: I / / / Amount: Amount: $ $ 6. Date: Date: / I I / Amount: Amount: $ $ Previous Incurred Repayments Ending Balance Previous Total: $0.00 Incurred Total: (Transfer the combined total of all incurred debt to the $0.0 0 Detailed Summary,page 2 line 14) Repayments Total: (Transfer the combined total of all debt repayments to the $0.00 Detailed Summary,page 2 line 10&17) Ending Balance Total: $0.00 SCHEDULE E-1 Page of CREDIT CARD and DEBT ITEMIZATION I� Name of Creditor from Schedule E: Each Creditor listed on Schedule E with a New Debt amount must have a Schedule E-1 accompanying it.The Schedule E-1 lists where and when the debt was incurred. Purpose Codes A All Travel Expenses(Airfare,Fuel, Lodging&Mileage) N Newspaper&Other Periodical Advertising B Broadcast Advertising(Radio,TV&Internet) 0 Other Advertising(Yard Signs,Buttons,etc.) C Contributions to Candidates&PAC's P Postage D Donations&Gifts S Surveys&Polls E Event Expenses T Tickets(Events) F Food&Refreshments U Utilities G General Operational Expenses W Wages,Salaries, Benefits&Bonuses I Interest Accrued&Finance Charges Y Petition Circulators L Literature, Brochures,Printing Z Preparation&Production of Advertising M Management Services Date Incurred Full Name,Mailing Address and Zip Code of Expenditure Purpose Code Amount 1. / / $ 2. / / 3. / / 4. / / $ 5. / / 6. / / $ 7. / / 8. / / 9. / / $ Total This Page: $0.00 The total of itemization for this creditor should equal the new loan amount listed on Schedule E for this creditor. SCHEDULE F Page of PLEDGED CONTRIBUTIONS BUT NOT YET RECEIVED Name of Candidate or Committee: Norm Semanko Directions:Complete this schedule if you were promised and agreed to accept a contribution during this reporting period but have not actually received the money, goods or services offered before the end of the reporting period. Do not include these entries on Schedule A until you actually receive the contribution. Pledged For Date Pledged Full Name,Mailing Address and Zip Code of Contributor Amount Pledged 1. ❑ General 2. ❑ General / / 3. ❑ General / / 4. ❑ General 5. ❑ General 6. ❑ General 7. ❑ General 8. ❑General 9. ❑ General / / 10. ❑ General 11. ❑ General / / Total Amount of Pledged Contributions: $ 0.00 Transfer the combined total of all Schedule F pages to the Detailed Summary on page 2 line 20. RE IVED : F 29__ CITY OF EAGLE •-7Ea° CAMPAIGN FINANCIAL DISCLOSURE REPORT C-i r -- SUMMARY PAGE DEC 0 3 2009 Rev.10/0t I f. Ai ''zf (Please Print or Type) File: Sd; 'I Route to: a= Section Il Name of Candidate or Political Committee and Chairperson Office Sought(if candidate) Seat(if any) Norm Semanko City Council Eagle Mailing Address City and Lip Home Phone Work Phone P.O. Box 538 Eagle, ID 83616 208-938-8286 208-863-7921 Name of Political Treasurer Norm Semanko Mailing Address City and Zip Home Phone Work Phone P.O. Box 538 Eagle, ID 83616 208-938-8286 208-863-7921 Change of address for: Candidate or Political Committee ❑ Political Treasurer 0 Section II TYPE OF REPORT This filing is an: 8 Original ❑ Amendment This report is for the period from 10 119 /09 through 11 /13 /09 . ❑ October 10 Pre-General Report ❑ 7 Day Pre-General Report ❑ 30 Day Post-General Report ❑ Annual Report Is this a Termination Report: ❑ Yes p No Section III STATEMENT OF NO CONTRIBUTIONS OR EXPENDITURES Directions: If you had no contributions or expenditures during this reporting period,check the box next to the statement below and sign this report. Be sure to carry forward the appropriate"Calendar Year to Date"figures in Column II, Section IV. ❑ I hereby certify that I have received no contributions and have made no expenditures during this reporting period. Section IV SUMMARY To reach your Calendar Year to Date figure: Add this report's Column I COLUMN I COLUMN II figures to the Column II figures of your previous report(except on line 6). This Period Calendar Year to Date Line 1:Cash on Hand January 1,This Calendar Year* $ XXXXXX $ 0.00 Line 2:Enter Beginning Cash Balance** $ 2,411 .35 $ XXXXXX Line 3:Total Contributions(Enter amount from line 5,page 2) $ 5,165.00 $ 8,710.00 Line 4:Subtotal(Add lines 1,2 and 3) $ 7,576.35 $ 8,710.00 Line 5:Total Expenditures(Enter amount from line 11,page 2) $ 3,106.38 $ 4,240.03 Line 6:Enter Ending Cash Balance(Subtract line 5 from line 4) $ 4,469.97 $ 4,469.97 Line 7:Outstanding Debt to Date(Enter amount from line 18,page 2) $ 0.00 *This same figure should be entered on line 1 of all reports filed this calendar year. **This is the figure on line 6 of the last Campaign Financial Disclosure Report filed. If this is your first report,this amount is 0. Note:The closing cash balance for the current reporting period appears on the next report as the beginning cash on hand. Section V Norm Semanko ,hereby certify that the information in this Name of Political Tr surer report is a true,complete and c rect Campaign Financial Disclosure Report as required by law. Signature o itical Treasurer Page 1 DETAILED SUMMARY Name of Candidate or Committee: Norm Semanko Total This Period Contributions O Unitemized Contributions($50 and less) #of Contributors 7.00 + $315.00 0 Itemized Contributions(Total of all Schedule A sheets) + $4,450.00 O In-Kind Contributions(Total of all Contribution amounts from Schedule C sheets) + $400.00 0 Loans(Total of all New Loan amounts from Schedule D sheets) + $0.00 50 Total Contributions(Transfer this figure to page 1, Section IV, Line 3) = $5,165.00 Expenditures © Unitemized Expenditures($25 and less) #of Expenditures 2.00 + $22.02 70 Itemized Expenditures(Total of all Schedule B sheets) + $2,684.36 0 In-Kind Expenditures(Total of all Expenditure amounts from Schedule C sheets) + $400.00 0 Loan Repayments(Total of all Loan Repayment amounts from Schedule D sheets) + $0.00 10 Credit Card and Debt Repayments(Total of all Repayment amounts from Schedule E sheets) + $0.00 11 Total Expenditures(Transfer this figure to page 1, Section IV, Line 5) = $3,106.38 Loans, Credit Cards and Debt 12 Outstanding Balance from previous reporting period + $0.00 13 New Loans received during this reporting period 0.00 (Total of all New Loan amounts plus Accrued Interest from Schedule D sheets) + $ 14 New Credit Card and Debt incurred this reporting period (Total of all New Incurred Debt amounts from Schedule E sheets) + $0.00 15 Subtotal = $0.00 16 Repayments of Loans made during this reporting period (Total of all Loan Repayment amounts from Schedule D sheets) $O.00 17 Repayments of Credit Card and Debt this reporting period (Total of all Debt Repayment amounts from Schedule E sheets) $0.00 1 g Total Outstanding Balance at close of this period(Transfer this figure to page 1, Section IV, Line 7) = $0.00 Pledged Contributions 1 g Unitemized Pledged Contributions($50 and less) #of Pledges 0.00 + $0.00 g0 Itemized Pledged Contributions this Period (Total of all Schedule F sheets) + $0.00 • Total Pledged Contributions this period = $0.00 Page 2 SCHEDULE A Page of ITEMIZED CONTRIBUTIONS 1 12 of more than Fifty Dollars($50.00)this period Name of Candidate or Committee:Norm Semanko Date Received Full Name,Mailing Address and Zip Code of Contributor Cash or Check 10/22/09 1.Risch Pisca, PLLC $ 200.00 407 West Jefferson Street Boise, ID 83702 $ 200.00 E General Calendar Year-To-Date 10 23 09 2.Gerald Pera $ 100.00 665 E. Antigua Dr. Meridian, ID 83642 $ 100.00 IN General Calendar Year-To-Date 10 26 09 3.Givens Pursley LLP $ 400.00 P.O. Box 2720 Boise, ID 83701 $ 400.00 El General Calendar Year-To-Date 10,27 09 4. Ramon Yorgason $ 100.00 6200 North Meeker Place Boise, ID 83713 $ 100.00 ® General Calendar Year-To-Date 10 27 09 5'Gary Allen $ 100.00 1602 Garfield St. Boise, ID 83706 $ 100.00 E General Calendar Year-To-Date 10 30 09 s.Amy M. Dickerson $ 250.00 288 S. Golden Eagle Ln Eagle, 1D 83616 $ 250.00 ® General Calendar Year-To-Date 10 30 09 7.John A. Priddy $ 250.00 10376 Hinsdale Ct. Boise, ID 83704 $ 250.00 B General Calendar Year-To-Date 8. Edward Priddy $250.00 10,30/09 P.O. Box 4817 Boise, ID 83711 $ 250.00 8 General Calendar Year-To-Date 11 02 09 9. Eisenberg Company $ 200.00 2231 E. Camelback Road, Suite 215 Phoenix, AZ 85016 $ 200.00 El General Calendar Year-To-Date 10 Boise Hunter Homes $ 300.00 _11 i_03/_09 1025 S. Bridgeway Place, Suite 290 Eagle, ID 83616 $ 300.00 E General Calendar Year-To-Date Total This Page: $2,150.00 Transfer the combined total of all Schedule A pages to the Detailed Summary on page 2 line 2. SCHEDULE A Page of ITEMIZED CONTRIBUTIONS 2 12 of more than Fifty Dollars($50.00)this period Name of Candidate or Committee:Norm Semanko Date Received Full Name,Mailing Address and Zip Code of Contributor Cash or Check 11 03 1.Mark Tate $ 1 00.00 /03 09 1918 E. Spring Meadow Ln Boise, ID 83706-6126 $ 1 00.00 8 General Calendar Year-To-Date 11 /05/09 2.James C. Tucker $ 200.00 2758 N. Limerick PI Eagle, ID 83616 $ 200.00 Iiil7 General Calendar Year-To-Date 11 07 09 3.James G. Harrison, Ill $ 1 ,000.00 169 S. Main St., #401 New City, NY 10956-3315 $ 1 ,000.00 ▪General Calendar Year-To-Date 11 07 09 4.Angela L. M. Harrison $ 1 ,000.00 / /- 169 S. Main St., #401 New City, NY 10956-3315 $ 1 ,000.00 ® General Calendar Year-To-Date 5. / / ❑ General Calendar Year-To-Date 6. I I $ - ❑ General $Calendar Year-To-Date 7. / / ❑ General $Calendar Year-To-Date 8. / / ❑ General Calendar Year-To-Date 9. / / ❑ General $Calendar Year-To-Date 10. I I $ ❑ General $Calendar Year-To-Date Total This Page: $2,300.00 Transfer the combined total of all Schedule A pages to the Detailed Summary on page 2 line 2. SCHEDULE B Page of ITEMIZED EXPENDITURES 1 Twenty-Five Dollars($25.00)or more this period Name of Candidate or Committee:Norm Semanko Purpose Codes A All Travel Expenses(Airfare,Fuel,Lodging&Mileage) N Newspaper&Other Periodical Advertising B Broadcast Advertising(Radio,TV&Internet) 0 Other Advertising(Yard Signs, Buttons,etc.) C Contributions to Candidates&PAC's P Postage D Donations&Gifts S Surveys&Polls E Event Expenses T Tickets(Events) F Food&Refreshments U Utilities G General Operational Expenses W Wages,Salaries, Benefits&Bonuses L Literature, Brochures,Printing Y Petition Circulators M Management Services Z Preparation&Production of Advertising Date Spent Full Name,Mailing Address and Zip Code of Recipient Purpose Code Cash or Check 1. P Eagle Main Post Office, 141 N. Palmetto Ave., Eagle, ID 83616 $ 44.00 10/19/09 2. o 10/20/09 Signs Etc., 910 E. Franklin Rd., #102, Meridian, ID 83642 $ 27.24 3. F 11 /03/09 Willowcreek Grill, 1065 E. Winding Creek Dr., Eagle, ID 83616 $ 148.82 4. N 11 /03/09 Valley Times, P.O. Box 1790, Eagle, ID 83616 $ 50.00 5. 11 /09/09 AutoSort, P.O. Box 191025, Boise, ID 83719-1025 $ 1 ,914.30 6. M 11 /13/09 Greg Smith & Associates, 682 Nicklaus, Eagle, ID 83616 $ 500.00 7. / / 8. / / 9. / / 10. / / Total This Page: $2,684.36 Transfer the combined total of all Schedule B pages to the Detailed Summary on page 2 line 7. SCHEDULE C Page of IN-KIND CONTRIBUTIONS and EXPENDITURES 1 I1 Name of Candidate or Committee: Norm Semanko Purpose Codes A All Travel Expenses(Airfare,Fuel, Lodging&Mileage) N Newspaper&Other Periodical Advertising B Broadcast Advertising(Radio,TV&Internet) 0 Other Advertising(Yard Signs,Buttons,etc.) C Contributions to Candidates&PAC's P Postage D Donations&Gifts S Surveys&Polls E Event Expenses T Tickets(Events) F Food&Refreshments U Utilities G General Operational Expenses W Wages,Salaries, Benefits&Bonuses L Literature,Brochures,Printing Y Petition Circulators M Management Services Z Preparation&Production of Advertising 1. Contributor Name, Mailing Address and Zip Code 400.00 10/30/09 Norm Semanko $ P.O. Box 538 $ 1 '095.00 El General Eagle, ID 83616 Calendar Year-To-Date Expenditure Name, Mailing Address and Zip Code Purpose Code Norm Semanko 0 P.O. Box 538 400.00 Eagle, ID 83616 $ 2. Contributor Name, Mailing Address and Zip Code / / $ $ ❑ General Calendar Year-To-Date Expenditure Name, Mailing Address and Zip Code Purpose Code $ _ 3. Contributor Name, Mailing Address and Zip Code / / ❑General $Calendar Year-To-Date Expenditure Name, Mailing Address and Zip Code Purpose Code $ 4. Contributor Name, Mailing Address and Zip Code / / ❑ General $Calendar Year-To-Date Expenditure Name, Mailing Address and Zip Code Purpose Code $ 0.00 Expenditure Total: (Transfer the combined total of all Expenditures on Schedule C pages $4.00 00 to the Detailed Summary,page 2 line 8) Contributor Total: $400.0 0 (Transfer the combined total of all Contributors on Schedule C pages to the Detailed Summary,page 2 line 3) SCHEDULE D LOANS Each Lender to your campaign should be listed separately. Each time a loan is received or you loan money to the campaign, it must be listed as a separate item.Each new loan from any Lender must be listed as a new item from that Lender.You may have the same Lender listed more than once. Except for a candidate making a loan to his or her own campaign, loans from any Lender cannot exceed contribution limits laid out in Section 67-6610A, Idaho Code,even if it is repaid in full. Any loan(s)with a balance(s)appearing on the last report must be listed below with the amount in the Previous Balance column.Any new loan amounts should be listed in the New Loan column.Any interest accrued should be listed in the Interest Accrued column.If a payment was made on the loan,list it in the Repayments column. Note: Any loan that was repaid in full in a previous reporting period does not need to be listed. The Outstanding Balance column is the Previous Balance plus new loans and accrued interest less any repayments. Name, Mailing Address and Zip Previous Balance New Loan amount Interest accrued Repayments of Loan Balance Code of Lender of loan at the received during this during this during this reporting outstanding at (Candidate, Individual or Business) end of the last reporting period reporting period period the end of this reporting period reporting period 1. Date: Date: / / / / Amount: Amount: $ $ 2. Date: Date: / / / / Amount: Amount: $ $ 3 Date: Date: I I I / Amount: Amount: $ $ 4. Date: Date: / / / / Amount: Amount: $ $ 5 Date: Date: / / / / Amount: Amount: $ $ 6. Date: Date: / / / / Amount: Amount: $ $ 7. Date: Date: / / / / Amount: Amount: $ $ Previous Received Interest Repayments Ending Balance Previous Total: $0,00 Received Total: (Transfer the combined total of all received loans to the $ 0.00 Detailed Summary,page 2 line 4) Interest Total: $ Repayments Total: (Transfer the combined total of all loan repayments to the $0,00 Detailed Summary,page 2 line 9& 16) Ending Balance Total: $0.00 (NOTE:Transfer the combined total of all Accrued Interest and Received Loans to the Detailed Summary,page 2 line 13) SCHEDULE E CREDIT CARDS and DEBT Each incurred expense not yet paid(i.e.credit card purchases and debt)should be listed on a separate line. Each time you make purchases with a credit card or incur debt,it is considered to be a separate item.However,you will maintain a single item for each credit card and add purchases to that item. Each Creditor listed below with a New Debt amount must have a Schedule E-1 accompanying it.The Schedule E-1 lists where and when the debt was incurred. Credit Cards are considered debt to the campaign. Regardless of whether the credit card is repaid when the statement is received, all credit card transactions will appear on Schedule E and E-1. However,only Repayments of Debt during this reporting period appear in the Expenditure Section of the Detailed Summary Page. Any creditor(s)with a balance(s)appearing on the last report must be listed below with the amount in the Previous Balance column.Any new debt should be listed in the New Debt column,including any accrued interest. If a payment was made on the debt, list it in the Repayments column. Note: Any debt that was repaid in full in a previous reporting period does not need to be listed. The Outstanding Balance column is the Previous Balance plus New Debt less any Repayments of Debt. Name, Mailing Address and Zip Code of Previous Balance of New Debt amount Repayments of Debt Balance outstanding Creditor debt at the end of the incurred during this during this reporting at the end of this (Candidate, Individual or Business) last reporting period reporting period period reporting period 1. Date: Date: / / / / Amount: Amount: $ $ 2. Date: Date: / / / / Amount: Amount: $ $ 3. Date: Date: / / / / Amount: Amount: $ $ 4. Date: Date: / / _ / / Amount: Amount: $ $ 5. Date: Date: / / / / Amount: Amount: $ $ 6. Date: Date: / / / / Amount: Amount: • $ $ Previous Incurred Repayments Ending Balance Previous Total: $0.00 Incurred Total: (Transfer the combined total of all incurred debt to the $0.00 Detailed Summary,page 2 line 14) Repayments Total: (Transfer the combined total of all debt repayments to the $0.00 Detailed Summary,page 2 line 10&17) Ending Balance Total: $0.00 SCHEDULE E-1 -Page of CREDIT CARD and DEBT ITEMIZATION I� Name of Creditor from Schedule E: Each Creditor listed on Schedule E with a New Debt amount must have a Schedule E-1 accompanying it.The Schedule E-1 lists where and when the debt was incurred. Purpose Codes A All Travel Expenses(Airfare,Fuel,Lodging&Mileage) N Newspaper&Other Periodical Advertising B Broadcast Advertising(Radio,TV& Internet) 0 Other Advertising(Yard Signs,Buttons,etc.) C Contributions to Candidates&PAC's P Postage D Donations&Gifts S Surveys&Polls E Event Expenses T Tickets(Events) F Food&Refreshments U Utilities G General Operational Expenses W Wages,Salaries,Benefits&Bonuses I Interest Accrued&Finance Charges Y Petition Circulators L Literature, Brochures, Printing Z Preparation&Production of Advertising M Management Services Date Incurred Full Name,Mailing Address and Zip Code of Expenditure Purpose Code Amount 1. / / 2. / / 3. / 1 4. / / $ 5. / / 6. / / 7. / / 8. / 1. $ 9. / /_ Total This Page: $0.00 The total of itemization for this creditor should equal the new loan amount listed on Schedule E for this creditor. SCHEDULE F Page of PLEDGED CONTRIBUTIONS BUT NOT YET RECEIVED Name of Candidate or Committee: Norm Semanko Directions:Complete this schedule if you were promised and agreed to accept a contribution during this reporting period but have not actually received the money, goods or services offered before the end of the reporting period. Do not include these entries on Schedule A until you actually receive the contribution. Pledged For Date Pledged Full Name,Mailing Address and Zip Code of Contributor Amount Pledged 1. ❑ General / / 2. ❑ General 3. ❑ General / / 4. ❑ General 5. ❑ General / / 6. ❑ General / / 7. ❑General / / 8. ❑ General / / 9. ❑ General 10. ❑General / / 11. ❑ General Total Amount of Pledged Contributions: $ 0.00 Transfer the combined total of all Schedule F pages to the Detailed Summary on page 2 line 20. RECEIVED & FILED CAMPAIGN FINANCIAL DISCLOSURE REPORT CITY OF EAGLFc_2 t SUMMARY PAGE Rev.10/07 (Please Print or Type) 2ud1 �=a File: Section I Route.trr Name of Candidate or Political Committee and Chairperson Office Sought(if candidate) Ccar(if any) i Norm Semanko City Council Eagle Mailing Address City and Lip Home Phone Work Phone P.O. Box 538 Eagle, ID 83616 208-938-8286 208-863-7921 Name of Political Treasurer Norm Semanko Mailing Address City and Zip Home Phone Work Phone P.O. Box 538 Eagle, ID 83616 208-938-8286 208-863-7921 Change of address for: Candidate or Political Committee ❑ Political Treasurer ❑ Section II TYPE OF REPORT This filing is an: B Original ❑ Amendment This report is for the period from 11 /14 /09 through 12 /31 ,09 ❑ October 10 Pre-General Report ❑ 7 Day Pre-General Report ❑ 30 Day Post-General Report ❑ Annual Report Is this a Termination Report: ❑ Yes p No Section III STATEMENT OF NO CONTRIBUTIONS OR EXPENDITURES Directions: If you had no contributions or expenditures during this reporting period,check the box next to the statement below and sign this report. Be sure to carry forward the appropriate"Calendar Year to Date"figures in Column II,Section IV. ❑ I hereby certify that I have received no contributions and have made no expenditures during this reporting period. Section IV SUMMARY To reach your Calendar Year to Date figure: Add this report's Column I COLUMN I COLUMN II figures to the Column II figures of your previous report(except on line 6). This Period Calendar Year to Date Line 1:Cash on Hand January 1,This Calendar Year* $ XXXXXX $ 0.00 Line 2:Enter Beginning Cash Balance** $ 4,469.97 $ XXXXXX Line 3:Total Contributions(Enter amount from line 5,page 2) $ 0.00 $ 8,710.00 Line 4:Subtotal(Add lines 1,2 and 3) $ 4,469.97 $ 8,710.00 Line 5:Total Expenditures(Enter amount from line 11,page 2) $ 0.00 $ 4,240.03 Line 6:Enter Ending Cash Balance(Subtract line 5 from line 4) $ 4,469.97 $ 4,469.97 Line 7:Outstanding Debt to Date(Enter amount from line 18,page 2) $ 0.00 *This same figure should be entered on line 1 of all reports filed this calendar year. **This is the figure on line 6 of the last Campaign Financial Disclosure Report filed. If this is your first report,this amount is 0. Note:The closing cash balance for the current reporting period appears on the next report as the beginning cash on hand. Section V Norm Semanko , hereby certify that the information in this Name of Political Treasurer report is a true,complete a d correct Campaign Financial Disclosure Report as required by law. Signature o F' Treasurer Page 1 CAMPAIGN FINANCIAL DISCLOSURE REPORT SUMMARY PAGE (Please Print or Type) Section I Name of Candidate or Political Committee and Chairperson Norm Semanko Mailing Address P.O. Box 538 Name of Political treasurer Norm Semanko Mailing Address P.O. Box 538 Change of address for: Candidate or Political Section 11 city ana up Eagle, ID 83616 City and Zip Eagle, ID 83616 Committee 0 Political Treasurer TYPE OF REPORT This filing is an: 17 Original 0 Amendment This report is for the period from 01 / 01 / 10 through 12 /31 /10 ❑ October 10 Pre -General Report ❑ 7 Day Pre -General Report ❑■ Annual Report Is this a Termination Report: ❑ Yes ❑✓ No RECEIVED & FILED CITY OF EAGLE JAN 3 1 23fl Filo• Route tc • Office Sought (if candidate) City Council dome vnone 208-863-7921 Home Phone 208-863-7921 C-2 Re . 10/07 Seat (if any) Eagle work Pncme 208-863-7921 Work Phone 208-863-7921 ❑ 30 Day Post -General Report Section III STATEMENT OF NO CONTRIBUTIONS OR EXPENDITURES Directions: If you had no contributions or expenditures during this reporting period, check the box next to the statement below and sign this report. Be sure to carry forward the appropriate "Calendar Year to Date" figures in Column II, Section IV. ❑p I hereby certify that I have received no contributions and have made no expenditures during this reporting period. Section IV SUMMARY To reach your Calendar Year to Date figure: Add this report's Column I COLUMN I figures to the Column II figures of your previous report (except on line 6). This Period Line 1: Cash on Hand January 1, This Calendar Year* Line 2: Enter Beginning Cash Balance*" Line 3: Total Contributions (Enter amount from line 5, page 2) Line 4: Subtotal (Add lines 1, 2 and 3) Line 5: Total Expenditures (Enter amount from line 11, page 2) Line 6: Enter Ending Cash Balance (Subtract line 5 from line 4) Line 7: Outstanding Debt to Date (Enter amount from line 18, page 2) $ 4,469.97 $ 0.00 $ 4,469.97 $ 0.00 $ 4,469.97 $ 0.00 COLUMN II Calendar Year to Date $ 4,469.97 $ xxx>oa $ 0.00 $ 4,469.97 $ 0.00 $ 4,469.97 *This same figure should be entered on line 1 of all reports filed this calendar year. *"This is the figure on line 6 of the last Campaign Financial Disclosure Report filed. If this is your first report, this amount is 0. Note: The closing cash balance for the current reporting period appears on the next report as the beginning cash on hand. Section V Norm Semanko . hereby certify that the information in this Name of Political Treasurer report is a true, complete and correct Campaign Financial Disclosure Report as required by law. /\l Signature &"Pelilfcal Treasurer Page 1