Campaign Finance - Shoushtarian, Al - 9/7/2007 Cl- +7?� Pursuant to Section 67-7003(c1),Idaho Code. No contribution shall be received or expenditure
Rev.04105 made by or on behalf of a candidate or political committee until the candidate or political
�� comb appoints a political treaSraix and certifies the ranee and address of the treasurer to the
-', {'�k City�" RECEIVED& FILED
'+� CITY OF EAGLE
APPOINTMENT AND CERTIFICATION OF POLITICAL TREAS ' 'R SEP 0 7 2007
FOR File:
CANDIDATES AND COMMITTEES Route to
(Please Print or Type)
Certification is for:
(check appropriate box) C j\ O • s ht c C(\ 94//_ 2 5 /
CANDIDATE: Name of Candidate Home Phone Work Phone Cell Phone
c' y coo ()
Office Sought Term Seat(if any)
Mailing Address of Candidate
JCsI0 [-C*—eZ ( 401• ce
e-mail Address
COMMITTEE:
❑ Miscellaneous - Name of Committee
❑Measure
❑Candidate/Measure
Name of Committee Chairman Home Phone Work Phone Cell Phone
Mailing Address
e-mail Address
CERTIFICATION AND APPOINTMENT
,hereby certify and appoint the following individual who is a registered
Name of Candidate or Committee Chairman
elector of the State of Idaho as the political treasurer for the above named candidate or committee:
101 ti,v i SNoost4 : 12-; Ad q4/ ZS ci 3
Name of Political Treasurer Home Phone Work Phone ell Phone
1119 N. g- Ce _• " e
� � 3 /6
Mailing Address of Political Treasurer
e-mail A
aft
Signature of Candidate or antnitiee Chairman
AIM
I joA M4.41 Hoc SH-P4e , hereby accept the appointment as the political treasurer for the above
Name of Political Treasurer
named candidate or committee:
art
RETURN THIS FORM TO: 1 _:..._► /.4k �tg
Sharon Bergmann , lorSignantreef POlifiali Treasurer
City of Eagle
P.O.Box 1520
Eagle ID 113616
tict 10 07 05: 06p Shoushtarian 208-342-8868 p. 1
;YE:.
■■..■ RECENED & FILED
CITY OF EAGLE
C-z rtW i-,
Rev-Q6/04 6:,-*,1:1--,-}-1 OCT 0"' ri CAMPAIGN FINANCIAL DISCLOSURE REPORT O 1 0 2007
It.4,2P SUMMARY PAGE
(Please Print or Type) File:
Section 1 Route to:
i Name of Candidoc or Political Committee and Chairperson Office Sough((if candidate) Term
,AL S outsh-Vacv'rtir\ City co�tkve1,( 4
Moiling Address U Check if address change City and Zip Home Phone Work Phone
1/19 tI E-cz ( c_ R_el r4.CR_ X36/( 336 -5996 9Y/-1Sy/
Name of Political Treasurer
(
c 0(Z-YV\ Si/V.O VSk ci kl'1 C1 I,-\
Mailing Address ❑ Check if address change City and Zip Honic Phone Work Phone
It(el ( 6 Inc& c 1e Y3 ,i4 336,—SI ci6 f
Section iI
TYPE OF REPORT
Directions: To indicate the type of report being filed,fill in the appropriate dates and check the appropriate box(es). See the
instructional manual for reporting periods and due dates.
This report is for the period from I / 1 /lJ]7 through % / 36) / 0
JOctober 10 Pre-General Report ❑ 7 Day Pre-General Report ❑ 30 Day Post-General Report
❑ Annual Report
Is this report an amendment? ❑ Yes ❑ No Is this a Termination Report? ❑ Yes ❑ 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,fill in
the appropriate dates 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
from / / through / /
Section IV SUMMARY
To reach your Calendar Year to Dale figure: Add this report's COLUMN I COLUMN II
Column I figures to the Column II figures of your previous report This Period Calendar Year to Date
(except on line 6).
$ XXXXXX $ V
Line l: Cash on Hand January I,This Year* �/
$ �/ $ XXXXXX
Line 2: Enter Cash Balance at Close of Last Reporting Period**
Line 3: Total Contributions(Enter amount fi-om page 2)
$Line 4: Subtotal(Add lines 1,2 and 3)
Line 5: Total Expenditures(Enter amount from page 2) $ 150. 5
Line 6: Cash Balance at Close of Period(Subtract line 5 from line $
4)*"
Line 7: Outstanding Debt to Date
*This same figure should be entered on line I of all reports filed this calendar year.
**You must report the cash on hand at both the beginning of the reporting period and the close of the reporting period.
Note that the closing cash balance for the current reporting period appears on the next report as beginning cash on hand.
Section V CERTIFICATION
Return This Report To:
Sharon Bergmann I- � - SklouS(-(Tt4(Q jdA./,hereby certify that the information
City of Engle �.,rr u,.,n•„„�,
P.O.Do:1520 in this report is a true,complete and correct Campaign Financial Disclosure Report as
Eagle ID 83616 required by law.
phone: (208)939-6813
fax: (2(18)939-6827 g
Sr-na ure o 'u/ificol Treasurer
Oct 10 07 05: 06p Shoushtarian 208-342-8868 p. 2
SCHEDULE B Page of
ITEMIZED EXPENDITURES —I---1--of Twenty-Five Dollars($25.00)or more this period
Name of Candidate or Committee H r 5 kQ 0 5�� fl�v,�
I Column A Column B
Cash or In-kind
Full Name,Mailing Address and Zip Code Check Cas or (uoo monetary)
Date Of Reel Sent
I. /yr a/dab c (5)4-10(13, (009 �
9 ,d5, U� ochr ,r, iouv 55901
Pu , ,se of Above Ex 1 oditur
Purpose of Above Expen I re: -- -
3.
$ $
Purpose of Above Expenditure: _
4.
I
$ $
Purpose of Above Expenditure: — I
5.
$ $
/ /
Purpose of Above Expenditure:
6,
$ $
Purpose of Above Expenditure:
7.
$ $
/ /
Purpose of Above Expenditure:
is.
/ / _ S $
Purpose of Above Expenditure:
9.
/ 1 Ill $ $
-
re:Purpose of Above Expenditure:
$ s 150,15-`1
Subtotals of Columns A&B _
Total Tbis Page(add columns A&B)
Oct 10 07 05: 06p Shoushtarian 208-342-8868 p. 3
SCHEDULE A I Par I of i
ITEMIZED CONTRIBUTIONS
of more than Fifty Dollars($50.00)this period
Name of Candidate or Committee l
/7L 5) L u ..---(S� k'r t ct`} _ Column A Column B Column C
Dote/ Full Name,Mailing Address and Zip Code Cash or In-Kind Loans
Receipt For
of Contributor/Lender Check (non-monetary)
/k/0 I. 41 SYYushtarlan $ $ 16'3113 $
❑ General $ $ $
rnleminrrm-r>nr Calnxmrr,rn 1I a •nlr,dn-Ten:1.Lime
2. $ $ $
/ /
❑ General ralcudnr Ten:1B Dow Calm-for Few r,()arc enLvn4.r Teo:To Daft'
3. $ $ $
❑ General $Inalm In,,7n We. I ,dm/or rear To Ow $nl.ndar rear 1. O,n
rt 1 $
/ /
❑ General (oleok rI'mr lo Dom (akrnk, Farr Jo Dale ($ak clor Tnn TO l.Nne
5. $ $ $
/ / _
D General Calendar Ten,'To Dole �mfar Year Ji,Don $Ir, Wnrrrrvmlkrr-
6. I S $
/ / _ $
❑ General $odor rear rn Dole I ($rea.tnr rem.,LAM $Endo.Tcnr To ac.
_— 7 $ $ $
/ /
❑ General f,�,•nlnufar I'n, In floe ('nler.Nr Year To 1hm ($nlndar.gr in lxac
8.
/ / $ $
❑ General $alndnr Fret 1n paw (1dcminr rrurT Urrrc Calendar Icar 7.,Da:
9. $
/ / $ $
❑ General $a7:,n/nr Nor rn Dore $rlr,rlm Nu:71 loon ($blrmG,,rear 71.Owe
10. $ $ $
/ /
O General ($'alndnr Ern:Id Dow (de,.7nr Tear I,,flair ($'a4,dar Ira:T Dore
Subtotals of Columns A,B&C $ $ 10-7,/ I
Oct 10 07 05: 06p Shoushtarian 208-342-8868 p. 4
DETAILED SUMMARY PAGE
Rcpon Clove/rill the Period I
Name of Candidate or Committee t: m / !U_ to
1 UNITEMIZED CONTRIBUTIONS
Contributions of Fifty Dollars($50.00)or Less This Period
1 Total 1J Total
I �n)ounl$ ! 1 U, I
ill''II
( (/ Illhiiiii b
UNITEMIZED EXPENDITURES
Expenditures of Less Than Twenty-Five Dollars($25.00)This Period
Total Total Z._
Number _— Amount$
Total This Period
____t___Number of Schedule A pages Attached
Contributions $ r Li
I Unitemized Contributions($50 and less)from top of page _ I ^�d
Itemized Contributions(total all Schedule A sheets) 5 1 o 3t I .
Total Contributions(also enter this figure on page[,Section IV,line 3)
$ 150. /36/
t ` Number of Schedule B pages Attached J
Expenditures $$ �(/f,
Unitemized Expenditures(less than$25)from top of page
Itemized Expenditures(total all Schedule B sheets) P770.
Expenditures to Reduce Accounts Payable(total all Schedule C-2Bs-Payment this Period) $ 7
Total Expenditures(also enter this figure on page 1,Section IV,line 5)
$ ,50.69.
Number of Schedule C-2B pages Attached
Incurred Expenditures
Outstanding Balance from previous period(from previous report,page I.Section IV,line $
7) Y
Amount incurred this period(Total all Schedule C-21-is-Amount Incurred this Period)
+T
Subtotal _,
Payment this Period(Total all C-2Bs-Payment this Period)
-$ f;0
Total Outstanding Balance nt close of this period(enter on page I,Section IV.line 7)
r Number of Schedule C-2A pages Attaches
Pledged Contributions
Amount Pledged this Period
k4. ■ ;,t 29 07 09: 56p Shoushtarian 208-342-8868 p. 1
RECEIVED& FILED --
■�■ CITY OF EAGLE
CI i 207
�"ti .:',.�_;
CAMPAIGN FINANCIAL DISCLOSURE, REPORT
` iry -" SUMMARY PAGE
File:��- _._,..
Route to: ...._
(]'lease Print or type) _..a.,___...............
Section 1
Name of Candidate or Political Committee and
Chairperson Office oneht(i f candidate) Tenn
Al S ko N.,'51,c���'Z'%,t" c [f-y c c,A c i
/ yep ri
Moline Adthess 0 Check if address change City and Zip !ionic Phone Work Phone
j i 161 n1. C-41..tL ilck ea--- (-5 (S.2)0 ._)(r-_-S17 ci & (i117-2-7Cv l
Name of Political Trea"..ner
JO ifil4 nll 5 ii,USNll.4 if,AtU
Mailing Address ❑ Check if address change City and Zip dome]'hone Work Phone
i11°■ N . ccL Lvti e4.-"i t'33 "-,i‘ '6 36- ..5-1z; E:
Section 11
TYPE OF REPORT
Directions: To indicate the type of report being filed, fill in the appropriate dates and check the appropriate box(es). See the
instructional manual for reporting periods and due dates.
This report is for the period from /C ' 0 i L'7 through /C ! /z i 6, 7
❑ October I D Pre-General Report ❑ 7 Day Pre-General Report 0 30 Day Post-General Report
❑ Annual Report
Is this report an amendment? ❑ Yes ❑ No Is this a'fermination Report? ❑Yes ❑ 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, fill in
the appropriate dates and sign this report. Bc 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
from i through / i
Section N SUMMARY
To reach your Calendar Year to Dale figure. Acid Ibis report's COLUMN I COLUMN II
Column l figures to the Column II figures of your previous report 'Phis Period Calendar Year to Date
(except on line 6).
$ XXXXXX $
Line I: Cash on I land January I.This Year* y XXXXXX
Line 2: Enter Cash Balance at Close of Last Reporting Period"
$ $
Line 3: Total Contributions(Enter amount from pace 2) $ $ //,%/5, t 1.
Line 4: Subtotal(Add lines I,2 and 1) f
Line 5: Total Expenditures(Enter amount from page 2) $- 's 'C 5-'r 3, .1
Line 6: Cash Balance at Close of Period(Subtract line 5 from line
a)°
kk
Line 7: Outstanding Debt to Date
*This same figure s:lould be entered on line I of tilt reports filed this calendar year.
**You must report the cash on hand at both the beginning of the reporting period and the close of the reporting period.
Note that the closing cash balance for the current reporting period appears on the next report as beginning cash on hand.
Section V CERTIFICATION
Return This Report To:
Sharuu Bergmann I `mac',.ra r 1r, 1`i-1 - ,)110;,1,5 ii..'�i-I ■(",...,-\.___-• ,hereby certify that the information
City 01 Eagle in this report is a true_complete and correct Campaign Financial Disclosure Report as
P.O.Box 1520
Engle ID 83616 required by law.
phone; (208)939-6913
fox: (208)939-6827 t� C. \ 1 �.i
.C'n ucfure of Pa ilical Treas u•er
Oct 29 07 09: 56p Shoushtarian 208-342-8868 p. 2
SCHEDULE A Page 1 e,'
ITEMIZED CONTRIBUTIONS
of more than Fifty Dollars($50.00)this period
Name of Candidalc or Committee f
M- S 1'\C L.).)1 ,-t-C 1 (14-v-
Colunt A Column B Column C _
Date/ Full Name,Mailing Address and Zip Code Cash or In-Kind
Receipt For - of Contributor/Lender Check (non-monetary) Loans
k// ./ CT 1 Cc 11 fvi —I, 'c--t1 Pc r icItcl t"(c, arc
A c:-t-tb A FL --
❑ Gcncreli , '�' ��
'L- -5 C-'!( L•3 c r .-,_ .—F+-� .?-07s 7-5 0 I $r nlrr 6ir Prat ?17n- $(aloir6u-)"mr In Darr l'nlrrdn•1'rnr l i t l.,mr
2. A
IC/ 3/ L ' ti Shr/L`�71'Ct-eLClLLV\ Q S $ 267 . 7a s
\\\: IA • i G—1?\
❑ General c� 3[ (C $ $ yLe . 3 i $
(n,,,r-nrlrnr/ . nr lio r_
I'n/r,rr4n
1
❑ General S 1 S 5-L-3 > `1.- $
I rdrn,!ru)rnr lir 1111': i,lrnrdar:1711.n,(bit, (nlrndm Rrar in We
!l•
f t$i C1 $ ; $ 2.:35. '73 $
❑ General $ $ ?S"/, 2.A 1 s
r"ulnulnr Taut 1 n l INr r'nlrm(nr Tint'i,//oft r nlrndnr Pear lir Irate
5.
fS37
a/ L c /U -1 s s L , s
❑ General
('n/rr.ih,t 1'rnr In Or,r. ('nhnrin,I'rut l-u llnr, (-nlrrrrinr 1'rnr'!'n ixnr
/6 l`i / c7 $ $ ft-
❑ General
$ $ `i70- ?7 $
('rrL i.�l.,,1'rrn'I.lhr. !iJ��n,l,r.1'rnr 7.,/I.,r ('nlr,ulnr)'r•.r 7'..!.Iota
(c ilc, e7 7 $ s fc3 .. i2
cif
❑ General S $ /C75 , i s
I nlrrulnr 1'.r„7.,ll.r•. "idr,nlnr 1'rnr 1'r.!),rc ('irlrurinr Trot 1'r,i;We
s.
/c / /Lie $ ' s 17e -2-6
❑ General $ : $ 1 i q5 . 35 $
(r,1,nrl„rI-,,,,�„-i:ire',;.. rnl;,r,hn❑.n,'ii,n:,,, I,drminr I'v,rr lb Onlr
.
9• 7
fc/15/ c1 s $ ( 7e ” $
❑ General $ $ it/(5-_ (` ) s
r'„/:.�./�..1':•.,/..l.r�.r� !'„I.��../.�.I'..,.-7:./l:.rr r'..lrnrl.rr l'r�..r-71•�Mlr
I 0. a
/ / .r/ S D r
-
D General $ ' $ $
nrrrrr,lrn I-n,1..ihr:r „1„rrr, r,!o: r„rr.ndnr 1 xrlr
Subtotals of Columns A,B&C S ec ec $ 1 f�'5- ( I— s —
Oct 29 07 09: 56p Shoushtarian 208-342-8868 p. 3
SCHEDULE B Lrace or
ITEMIZED EXPENDITURES
of Twenty-Five Dollars($25.00)or more this period
Name of Candidate or Committee
Column A Column B
Full Name.Mailing Address and Zip Code Cash or In-kind
Date + Of Recipient _ Check (non-monetary)
I
I. A \ `7 .cfc 502_`f G'1-!-45-'4.- :}'T. T.--?(',. .-,c. (�
to/3/ o7 – � $ , S2_w- / , 72-
Pm• ose of Above Ex enditure:
/e1-31C11 V i S [ a_ ‘76'i\--k- i -re,),i.,n 5f e/1 /-ici-S - v Z/Zj $ g ff'3 •, i Z
Purpose of Above Expenditure:
3. ?: ='r er.i �F- 1 .11;'-
Purpose of Above Expenditure: _
' 'I. —12 iii• t,/, hi.,:,,y Cif.
101 e 7 il v1/4.+6 S c?I-Zt c:,i s_? –— — $ s ! am .. 3 7
Purpose of Above Expenditure: ----___..__--
5. 5C-e-f C e..y.: fir, -17e.--t:'�S_c_
iC/ , i97 4(1/41— 5` n - - $ s rc17 - _3ci
Purpose of Above Expenditure:
6. r)s a-i'-j � v=1 vA.-1L, .
T � i
1 C i/tit OR I i5 fc` .- T+ I∎� '--{, ; �-t��r,, ri4 . .,4tizi $ :� 1�3 - 2-
Purpose of Above Expenditure:
7. :6-C2 y £ L -_ S r . -1-S(1.-s_.:,__
6/ 2-/ e 1 , ass S;`6^ ---.. $ s f.7a .2-
Purpose of Above Expenditure: ___
3. A i,C-C.' Sc.-,^t 7 Z'iw- W. i-1 i(L&t 1 7 C;�• r
i 161 127 1 --R,cl Sx -- . $ 500 .c'c ti
Purpose of Above Expenditure: _ — -
9./1
jeil51 7 , AE S■ty(\ - $ s 17e . L(c
Purpose of Above Expenditure: _ ---
Subtotals of Columns A& B `>; 5.c.-C'-.CCU S 1 Z(es-.o3
Total This Page(add columns A&B $ $ I/-M.5- e3
•=c 06 07 04: 58p Shoushtarian 208-342-8868 p. l
�� CITY OF GAGILe
ti'■•
DEC 0 5 2007
C-2 al,y3;,,,
Rev.o6�aa � z. CAMPAIGN FINANCIAL DISCLOSURE REPORT Filo:
Oil=•y''' % SUMMARY PAGE Route to:
(Please Print or Type)
Section I —---
Name of Candidate or Political Committee and Chairperson Office Sought(if candidate) Term
pr_ sk_oos�c-ta,c ch. v. �- COnc,.\ (( yr -
Mailing Address o Check if address change City and Zip D=i3�//.4 Home Phone Work Phone
1\\Ck IA • X 44A R-A -s 336v_ S 4 f ( (-?-S0/
Name of Political Treasurer
JO IJ/J 4-&E SllO U s tr&Ct-C,'o..v► _ —
Mailing Address 0 Check if address change City and Zip Home Phone Work Phone
Section II
TYPE OF REPORT
Directions: To indicate the type of report being filed, fill in the appropriate dates and check the appropriate box(es). See the
instructional manual for reporting periods and duc dates.
This report is for the period fi'om /0 / 2 Z / O 7 through // / /6 / O 7
❑ October 10 Pre-General Report ❑ 7 Day Pre-General Report ❑ 30 Day Post-General Report
❑ Annual Report
Is this report an amendment? ❑ Yes "No Is this a Termination Report? ❑ Yes 13/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,fill in
the appropriate dates and sign this report, Be sure to carry forward the appropriate"Calendar Year to Dale"figures in Column II,
Section IV.
❑ I hereby certify that I have received no contributions and have made no expenditures during this reporting period
from / / through / / .
Section IV SUMMARY
To reach your Calendar Year to Date figure: Add this report's COLUMN I COLUMN II
Column 1 figures to the Column 11 figures of your previous report This Period Calendar Year to Date
(except on line 6).
$ XXXXXX $
Line 1: Cash on Hand January 1,This Year* $ O Q
Line 2: Enter Cash Balance at Close of Last Reporting Period**
$
Line 3: Total Contributions(Enter amount from page 2) FaO $
Line 4: Subtotal(Add lines 1,2 and 3) $ $
Line 5: Total Expenditures(Enter amount from page 2) $ ei 0 $
Line 6: Cash Balance at Close of Period(Subtract line 5 from line $
4)**
Line 7: Outstanding Debt to Date
*This same figure should be entered on line I of all reports filed this calendar year.
**You must report the cash on hand at both the beginning of the reporting period and the close of the reporting period.
Note that the closing cash balance for the current reporting period appears on the next report as beginning cash on hand.
Section V CERTIFICATION
Return This Report To:
Sharon Bergmann I J O B N 4/A t 1 1 4 4• 3Woc ,. -, fb i44n/ ,hereby certify that the information
City of Engle in this report is a true,complete and correct Campaign Financial Disclosure Report as
P.O.Do:1520
Engle ID 83616 required by law.
phone: (208)939-6813 ‘ 1
fox: (208)939.6827 `—■ Lan
Signature of Polit! 1 Treasurer
Dec 06 07 04: 58p Shoushtarian 208-342-8868 p . 2
SCHEDULE B
ITEMIZED EXPENDITURES I Page of
of Twenty-Five Dollars($25.00)or more this period
Name of Candidate or Committee
AL 5/y- v5)1-tars
Column A Column B
Date Full Name,Mailing Address and Zip Code Cash or In-kind
Of Recipent
l - i - Check (non-monetary)
141toSc�►n-f- 370 p
/a /31/07 725 4C ay Cm u $ 217.6,
Purpose of Above Expenditure:
2.
/0 2y ,7 Za-44--�.o � .� e `'{. 1 O, , / 2 c fi
a(
Purpose of Above Expenditure:
3.
l l!6/07 v&Ue y mimes
p. • pox (7 90 5.w _a . B3((6 $ `/9-
Purpose of Above Expenditure: I /
4 co nsery vow voters for moo( r4G�'o *k►,d
1 1 11'711 o 7 ; 4. ,o - 28%4 Bar's-c �c�( 3370/ J $ s 3p . o0
la
Purpose of Above Expenditure:
5.
/ /
Purpose of Above Expenditure:
6.
/ /
Purpose of Above Expenditure:
7,
/ / — I$
I $
Purpose of Above Expenditure:
/ /
R.
5
Purpose of Above E xpenditure:
9. —
/ /
$ S
Purpose of Above Expenditure:
Subtotals of Columns A&B $ _35"o . I o $ Soo .o0
Total This Page(add columns A&B) $ $ �O. I D
Dec 06 07 04: 58p Shoushtarian 208-342-8868 p . 3
SCHEDULE A I Page I of I
ITEMIZED CONTRIBUTIONS
of more than Fifty Dollars($50.00)this period
Name of Candidate or Committee
/4L _SIA 6 tl.Si'v-1464Vi
Column A Column B Column C
Date/ Full Name,Mailing Address and Zip Code Cash or In-Kind
Receipt For of Contributor/Lender Check (non-monetary) Loans
/I /4/ 01 P.O.Co t'�5" -i etAA'ot/X vp' c3�(Or.1a $ $ 3 c . eve $
❑ General
1 .O. x Zvl ,/, Bc ir-e . - ` 8377/
$ $
Calendar rrnr-Ti,Dale Calendar Year 7a Dane Calendar fear in Darr'
/ /
2. AL n! �14,ov �czrl ' $ $ $ 3 So.ro
❑ General (rl,�Q�,,[,�"� �� �Q�/ /!•
_ o— ` (J 3 Y`1[J Cnhndar rear la Dale 1(l'ah radar Year la liner Calendar rear hi,Ian.
3.
/ / $ $ $
❑ General $ I $ $
-_-_ Calendar ran 7a Dada i Calendar fear To tare ('nkanlar Year I,,Dale
4.
/ / $ $ $
❑ General $ $ $
Calendar rear 1 n Dale Calendar rear lit Dare Calendar rear 7a Dade
5.
_ / ] $ $ $
❑ General $ R $
Calendar Year 7,,Dare Calendar rear 7i,Darr ('alendar Year 7r Dare
6.
/ / _ $ $ $
❑ General $ $ $
Calendar ii,.r 7C,Darr Calendar Yen,-71,Dare Calendar rear to Daly
7.
/ / $ $ $
❑ General $ $ $
I',,kadi r rr,,,la hale ('nkndnr fear 7i1 Dare I irleruIae YearTi Dale
8.
/ / $ $ $
❑ General $ $ $
Calendar rear 7n Dear Calendar rear lii lane Calendar Penn.74 Dare
9.
/ / $ $ $
❑ General $ $ $
I'aln..a.r fear 7,,friar C idrndar rear 7r Dale a ales,r Yea-Ti r Dore
10.
_ / I $
$ $
❑ General $
I $
Calendar rear 74 Dare I l olrndnr fear lie Unr,• Calendar rear 7n lino
Subtotals of Columns A,B&C j $ J4()D . 00 $ 350. l 0
Dec 06 07 04: 58p Shoushtarian 208-342-8868 p. 4
DETAILED SUMMARY PAGE
LName or Condidate or Committee Report overin the Period
. SIn.o UsVA-�c��� ra/ Kei,�7�Qy to
UNITEMIZED CONTRIBUTIONS
Contributions of Fifty Dollars($50.00)or Less This Period
Total Total
Number Amount$
UNITEMIZED EXPENDITURES
Expenditures of Less Than Twenty-Five Dollars($25.00)This Period
Total Total
Number - Amount$
----- ----..-..._-------
Total This Period
Number of Schedule A pages Attached
Contributions
Unitemized Contributions($50 and less)from lop of page $
Itemized Contributions(total all Schedule A sheets) $ ‘So . r a
Total Contributions(also enter this figure on page 1,Section IV,line 3) $ 6 so . To
Number of Schedule B pages Attached
Expenditures
Unitemized Expenditures(less than$25)from top of page $
Itemized Expenditures(total all Schedule B sheets) $ / Sc ' /6
Expenditures to Reduce Accounts Payable(total all Schedule C-2Bs-Payment this Period) $ �P
Total Expenditures(also enter this figure on page I,Section IV,line 5) $
Number of Schedule C-2B pages Attached
Incurred Expenditures
Outstanding Balance from previous period(from previous report,page 1,Section IV,line
7)
$
Amount Incurred this period(Total all Schedule C-2Bs-Amount Incurred this Period) +$
Subtotal =$
Payment this Period(Total all C-2Bs-Payment this Period) -$
Total Outstanding Balance at close of this period(enter on page 1,Section IV, line 7) =$
Number of Schedule C-2A pages Attaches
Pledged Contributions
Amount Pledged this Period _ $
C-2
Rev.06/04 0.t"k1, CAMPAIGN FINANCIAL DISCLOSURE REPORT
y SUMMARY PAGE
(Please Print or Type)
Section I
Name of Candidate or Political Committee and Chairperson Office Sought(if candidate) Term
AL S ho ush 71 c/-i �i•-\ C 2�`Y C 0/ q vv_
Mailing Address ❑ Check if address change City and Zip Home Phone Work Phone 2-175
!!!9 n/. S-ac L FCC e_ g3G/4P 336-599 9qt
Name of Political Treasurer
JO 4-n n a.G- cJ '/ '^4 4 '‘et:-
Mailing Address ❑ Check if address change City and Zip Home Phone Work Phone
Section II
TYPE OF REPORT
Directions: To indicate the type of report being filed,fill in the appropriate dates and check the appropriate box(es). See the
instructional manual for reporting periods and due dates.
This report is for the period from 1( / 1 /_01 through I / 3 I l
❑ October 10 Pre-General Report ❑ 7 Day Pre-General Report ❑ 30 Day Post-General Report
EIVAnnual Report
Is this report an amendment? ❑ Yes ❑ No Is this a Termination Report? ❑Yes ❑ 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,fill in
the appropriate dates 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
from / / through / /
Section IV SUMMARY
To reach your Calendar Year to Date figure: Add this report's COLUMN I COLUMN II
Column I figures to the Column II figures of your previous report This Period Calendar Year to Date
(except on line 6).
$ XXXXXX $ O
Line 1: Cash on Hand January 1,This Year* $ $ XXXXXX
Line 2: Enter Cash Balance at Close of Last Reporting Period** $ ,�� _ $
Line 3: Total Contributions(Enter amount from page 2) $ o — $ ^O" —
Line 4: Subtotal(Add lines 1,2 and 3) $ $
Line 5: Total Expenditures(Enter amount from page 2) $ D _ $ _ 0
Line 6: Cash Balance at Close of Period(Subtract line 5 from line $ �j
4)**
Line 7: Outstanding Debt to Date
*This same figure should be entered on line 1 of all reports filed this calendar year.
**You must report the cash on hand at both the beginning of the reporting period and the close of the reporting period.
Note that the closing cash balance for the current reporting period appears on the next report as beginning cash on hand.
Section V CERTIFICATION
Return This Report To:
Heather Dawson I ,hereby certify that the information
City of Ha iley frame of Political Treasurer)
115 S.Main St.,Ste.H in this report is a true,complete and correct Campaign Financial Disclosure Report as
Halley ID 83333 required by law.
phone: (208)788-4221
fax: (208)788-2924
Signature of Political Treasurer