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Campaign Finance - Smith, Derek - 9/7/2007 C-1 Pursuant to Section 67-7003(c1),Idaho Code. No contribution shall be received or expenditure Rev.04/05 g (TA��a . Q• ARM made by or on behalf of a candidate or political committee until the candidate or political C committee appoints a political treasurer and certifies the name and address of the treasurer to the tiuES City Clerk. APPOINTMENT AND CERTIFICATION OF POLITICAL TREASURER FOR CANDIDATES AND COMMITTEES (Please Print or Type) Certification is for: (check appropriate box) ( ► q ❑r CANDIDATE: '���� � Name of Candidate Home Phone Work Phone Cell Phone l -Cx (1C)Lt 1 Office Soug it Term Seat(if any) t l 6 ,t, ' ,, 1,v k E . tp / Mailing Address of Candidate ��ctJ a,) etAkc A) t l'Q 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 I 1>e e.a q hereby certify and appoint the following individual who is a registered Name of Candidate or Cominittee Chap an elector of the State of Idaho as the political treasurer for the above named candidate or committee: plc �vUt�I al 6 k b� r4-7t 44> , 99 Name of Political Tr surer Home Phone Work Phone Cell Phone l / ,tki\ Mailing Address of Poll asurer k‘c. e pce , kk) E-4 e-mail Address I. Ake Si 'caw ofCan. at:o ntWe 'Vr a� 1 ,,4L ereby accept the appointment as the political treasurer for the above Name of Politic. reasu named candidate or committee: RECEIVED& FILED RETURN THIS FORM TO: CITY OF EAGLE Sharon Bergmann 'N--k-ALL l l ' L City of Eagle Signe tore of Political Treas+ "r P.O.Box 1520 SEP 0 7 2007 Eagle ID 83616 File: Route to: �— :::!::...t 25 2007 12: 08PM HP LASERJET FAX 3634550 i p. 1 •▪ • II ■ ■ ■ c-I -it- Pursuant to Section 67-7003(0),Idaho Code. No contribution shall be received or expenditure Rev.04/05 07 °1i- ! made by or on behalf of a candidate or political committee until the candidate or political e 'Arg_. committee appoints a political treasurer and certifies the name and address of the treasurer to the "I O City Clerk. APPOINTMENT AND CERTIFICATION OF POLITICAL TREASURER FOR CANDIDATES AND COMMITTEES (Please Print or Type) Certifica on is for: (check a ipropriate box) --I; C , , �— '" q . Work Phone Cell P tie--I; C DIDATE: Name of Candidate Home hone oLh3eIt —li p Seat(if any) Office Sought Term (2)`l' --fa T°k1-2-35LC S /14 LI-)41 E A(Ctil, 1-b 't (001 Mailing Address of Candidate L[> y>\1 VA kJ 6 N , &n N\ e-mail Address ❑ Misc zUaneous Name of Committee ❑ Mea' e ID Canal date/Measure Cell Phone Name of Committee Chairman Home P' Work Phone Mailing Address e-mail Address CERTIFICATION AND APPOINTMENT I `: • ! LA a ,hereby certify and appoint the following individual who is a registered Na r of Candidate or Comnii ee Chairman electo of the State of Idaho as the political treasurer for the above named candidate or committee: i +ter , Name of Political Treasurer $.,<E1---11 (4, otrte Phone I Work Phone Cell Phone 7 2� E , Cc co-. 4i;(/\, r`AL) M46 Mailing Address of Political Treasurer P/ N\'\U14Zi\ e-mail Address 9 AV i . - 11.114 Signature of ate• e or Ca!mime w'oiruta I J (,. j\ , hereby accept the appointment as the political treasurer for the above Name of Political Treasurer named candidate or committee: RETirIRN THIS FORM TO: , Sharon Bergmann Cj Signature o olltical Treasurer City of Eagle P.O.Box 1520 Eaale1D 83616 i , l i 1 .3 i ' d ,kY. c- ip, coe kt 10 2007 3: 13PM HP LASERJET FAX 3634550 p. l • e RECEIVED & FILED 1 • • CITY OF EAGLE • ..•/ C-2 '- r OCT 1 0 2007 s Rev.06/04 ', P CAMPAIGN FINANCIAL DISCLOSURE REPORT ,,,-. r - SUMMARY PAGE (Please Print or Type) File: Route to: Section Name of nandidate or Political CoPinittee and Chairperson Office Sought(if candidate) Term/ t9 Mailing • �rdress ❑ Check if address change City and Zip Home Phone Work Phone Name of I.Idiem!Treasur .-. liK ( 1011 Mailing,ikutz o Check if address change City end Zip Home Phone Work Phone llb , ► a . E (G q '')— 6_-e ) - (7 . 4-414: Section --' TYPE OF REPORT Directio To indicate the type of report being filed,fill in the appropriate dates and check the appropriate box(es). See the instructi. .1 manual for reporting periods and due dates. This report is for the period from op / / hrough V& / * / w October 10 Pre-General Report 7 Day Pre-General Report ❑ 30 Day Post-General Report ra Annual Report Is this report an amendment? ❑ Yes U1 No Is this a Termination Report? ❑Yes [Pl o Section STATEMENT OF NO CONTRIBUTIONS OR EXPENDITURES Directio -: if you had no contributions or expenditures during this reporting period,check the box next to the statement below, fill in the appr•'Hat- dates and sign this report. Be sure to carry forward the appropriate"Calendar Year to Date"figures in Column II, Section 1 . It' 'hereby certify that I have received no contributions and have made no expenditures during this reporting period from dg / VI / `3sc>`/-through (0 / ( t /�' Section SUMMARY To reach s our Calendar Year to Date figure: Add this report's COLUMN I COLUMN H Column:1 figures to the Column II figures of your previous report This Period Calendar Year to Date (except .' line 6). $ XXXXXX $ Line ]: i ; h on Hand January 1,This Year* $ $ XXXXXX Line 2: :nter Cash Balance at Close of Last Reporting Period** $ $ Line 3: l(otal Contributions(Enter amount from page 2) $ $ Line 4: ubtotal(Add lines 1,2 and 3) $ $ Line 5: I otal Expenditures(Enter amount from page 2) $ $ Line 6: t ash Balance at Close of Period(Subtract line 5 from line $ 4)** I Line 7: outstanding Debt to Date This soil e figure should be entered on line 1 of all reports filed this calendar year. **You lust report the cash on hand at both the beginning of the reporting period and the close of the reporting period. Note th.,the closing cash balance for the current reporting period appears on the next report as beginning cash on hand. Section V CERTIFICATION R• rn This Rcport To: Sharon Bergmann 1 lace' Si-it.1-tf ,hereby certify that the information t,. •of FMilin1 Tr.n..1 City of Eagle in this report is a true,complete and correct Campaign Financial Disclosure Report as P.O.Box 1520 Eagle ID 83616 required by law. one: (208)939-6813 ax: (208)939-6827 Signature ofolit a P l Treasrrr I. Oct. 30 2007 12: 47PM HP LASERJET FAX 363'• -11;-EivE fit ( llr ,::) p 2 CITY OF EAGLE ��* b I� Rev.06/04 i;pi Orr, CAMPAIGN FINANCIAL DISCLOSURE RE ORT °C I f4:Ii:,s SUMMARY PAGE Flle: (Please Print or Type) Route to: Section Name of nand to or Political Cop`agti�e and Chairperson Office Sought(if candidate) Term`I �i D� .1,!�. 1^� �T \Y ilk� q't'r �'L 1 s ` T -1 d.Oti&JE( L Mailing • d.teas ❑ Check if address change City and Zip Home Phone Work Phone I I ea t -e4_ �A<LCF .ttg101 to `i 9— • .>ro 2 , t1 ,®Sr- Name of'• itical Treasure _:ice -rr kS'41 Mailing •ri.re. 0 Check if address change City and Zip --__, Home Phone Work Phone t to I L ► .: 1 it. ■ �o t' Cluj— 0 CI , 44,15� Section ti TYPE OF REPORT • Direction: To indicate the type of report being filed,fill in the appropriate dates and check the appropriate box(es). See the instructioial manual for reporting periods and due dates. i This report is for the period from _I / 1 f_/ ' ti through r4> / .stp / II October 10 Pre-General Report 7 Day Pre-General R port ❑ 30 Day Post-General Report al Annual Report IIs this report an amendment? ❑ Yes 13 No Is this a Termination Report? ❑Yes Cil4To Section 11 STATEMENT OF NO CONTRIBUTIONS OR EXPENDITURES Direction If you had no contributions or expenditures during this reporting period,check the box next to the statement below,fill in the appro.' at dates and sign this report. Be sure to carry forward the appropriate"Calendar Year to Date"figures in Column II, Section 1 i. i I hereby certify that I have received no contributions and have made no expenditures during this reporting period I from_ ,—�� /IL r through i� _L._ r Section SUMMARY To reach �'our Calendar Year to Date figure: Add this report's COLUMN I COLUMN II Column I Agures to the Column II figures of your previous report This Period Calendar Year to Date (except o +line 6). I S XXxXX t $ Line 1: CI h on Hand January 1,This Year* $ $ XX? X Line 2: E`ter Cash Balance at Close of Last Reporting Period** $ 6a`O $ Line 3: T'tal Contributions(Enter amount from page 2) $ r a I►(` 1 $ t• t 1 ' Line 4: S 1.total(Add lines 1,2 and 3) $ I pp M $ 4 4 y� Line 5: T1 al Expenditures (Enter amount from page 2) $ Or t-. a t $ Line 6: Cth Balance al Close of Period(Subtract line 5 from line $ 4)** Line?: O tstanding Debt to Date *This sam figure should be entered on line 1 of all reports filed this calendar year. **You rnu report the cash on hand at both the beginning of the reporting period and the close of the reporting period. Note that t e closing cash balance for the current reporting period appears on the next report as beginning cash on hand. Section V CERTIFICATION Batumi This Report To: S ` roll Bergmann I � . r .,� ,hereby certify that the information ity of Eagle orraabl inac.7 o.Bo:1510 in this report is a true,complete and correct Campaign Financial Disclosure Report as ogle ID 83616 required by taw, pho e: (208)939-6813 fa (208)939.6817 :1..,0'c „81.;..1 . o,Ynature of Political Treasur'ar Oct 30 2007 12: 47PM HP LASERJET FAX 3634550 p. 3 DETAILED SUMMARY PAGE P Name Of Candidate� o or Committe Report IC� f overi g the Period 1, c? 9e. 1'7 .. dR!'l C F m I a / l /'+ i to UNITEMLZED CONTRIBUTIONS Contributions of Fifty Dollars($50.00)or Less This Period Total Total Number S Amount$ I t-13 UNITEMIZED EXPENDITURES Expenditures of Less Than Twenty-Five Dollars($25.00)This Period Total Total Number 1 Amount$ 3(42 e� Total This Period ` I Number of Schedule A pages Attached Contributions Unitemized Contributions($50 and less)from top of page $ ` Itemized Contributions(total all Schedule A sheets) $ �0 8-® Total Contributions(also enter this figure on page 1, Section IV,line 3) $ w--0 j Number of Schedule B pages Attached Expenditures Unitemized Expenditures(less than$25)from top of page $ 3(0 ,,'] Itemized Expenditures(total all Schedule B sheets) $ 1 1 (0 o (gyp Expenditures to Reduce Accounts Payable(total all Schedule.C-2Bs—Payment this Period) $ d Total Expenditures(also enter this figure on page 1,Section IV, line 5) 5 I1 r+ / 4 � lA Number of Schedule C-2B pages Attached Incurred Expenditures Outstanding Balance from previous period(from previous report,page I,Section IV, line 7) Amount Incurred this period(Total all Schedule C-2Bs—Amount Incurred this Period) +$ r 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 $ I I Oct 30 2007 12: 47PM HP LASERJET FAX 3634550 p. 4 1 PI ` )1.4- 1 . 1 SCHEDULE A Cage of I ITEMIZED CONTRIBUTIONS 1 I 1 I of more than Fifty Dollars($50.00)this period Name of Candidate or Committee Column A Column B Column C Da Full Name,Mailing Address and Zip Code Cash or 1 In-Kind _ Recap or of Contributor/Lender _ Check _ (non-monetary) Loans -\0 /41 '1 l :E. -Li $ I 'rr ` ! $ $ °L e ❑ Gen-al ..-(t °. .4 T:e VA V,14 $ I SO, EPIZ. 5 $ q lc. 1,"0, �` Calends Year 7b Dena Calendar Tear To Dare Calendar Year To Dare t/lO IO1 2. ddPrlLl.t `...!/ -IL e-t.r` �!ay.� .es 1op. t �. $ S - C.3 v..1 , vi\koe.REpc Te ❑ Gen- al \ S "r � '+r; $ $ �.Sr R a i.. Cola+dor Year to Me Calendar Year To Date - Calendar raw 7b DOA 1 Q /11 61 3. 401,-14-e v. t tkl Sc-0 4 $ i;' at', $ $ ❑ Gen- . 1't'E & y G e., Lp $ :11 tom) $ $ Calendar Year To Date Calendar Year To Deere Calendar Year To Dare 4. / $ $ $ ❑ Gen- .l $ $ $ Calendar Year To Dan Calendar Year To Lie Calodm Tear To Dan 5. _ / _ $ $ $ El Ge Ial $ $ $ Calendar Year To Dare CaferdrrYear Ta Date Colada Yen-To Dare 6. $ $ $ ❑ Gen-,:1 $ S $ 1 Calendar Year To Data Calendar Tear lb Dent Calendar Tear To Dare If 7. / _ $ $ $ ❑ Gen-I,, $ $ $ Calendar Year To Dale Calendar Tear Tb Dime Calendar Year To Date 8. / $ $ $ ❑ Ge - al $ $ $ Colander Year To Dena Calendar Year To Dorn Calendar Tear To Dare 9. • / - $ $ $ ❑ Ge =e : $ $ $ Calendar Year To Lime Calendar Year To Dare Calendar Year To D o 10. / - $ $ $ ❑ Gen al $ $ $ Calendar fear To Dale Calendar Year To Dare Calendar Year To Dole Subtotals of Columns A,B&C 1! Oct 30 2007 12: 47PM HP LASERJET FAX 3634550 p. 5 f i F I)) il- 1 C-4 Rev.I 03 sz,!- INDEPENDENT EXPENDITURES (Please note the definition of independent expenditure and.Section 67-6611,Idaho Code—reverse side.) 'i� o TOTALING MORE THAN $100 MADE IN SUPPORT OF OR IN OPPOSITION TO '47, . ANY ONE CANDIDATE, POLITICAL COMMITTEE OR MEASURE Full Name "1", 1,k 41-, Telephone No.: 1,..Dt— 111 d Mailing As ress and Zip Code: 9 k - 1 . RI l,.,d ,f9 oil /l I 4,1 4 TYPE OF REPORT --_`E7 7 Day Pre-General Statement ❑ 30 Day Post-General Statement Total Expe diture(s): $ 11(,o • Di ITEMIZED EXPENDITURES IN EXCESS OF FIFTY DOLLARS Date Full Name, Mailing Address and Zip Code Candidate or Measure Amount Of Recipient Supported or Opposed of Expenditure _10 /ltiy t. E1Vl L-C. I b 1)3 I L 0--W bl ;LEE. $ ( b 14 , f C Purpose o ' bove Expenditure: WI--k "c( .4.4Le. g Og)41,1:: (' &Usk 2. ENDS JQtl-, 1 .Egrir - 1t. / V ' 1 E , dLE. 1 ) <6 lcd 93 - �a43� . dit2a41/44.7r $ -1-) t e,, Purpose o ,. bove Ex enditure: , i► .. l_ 3. I / / j $ - Purpose of Above Expenditure: 1 4. / / $ Purpose of Above Expenditure: I 5. I / / I $ I Purpose of kbove Expenditure: RETURN T f IS FORM TO I, C. 6,4\ -___ hereby c rtify that the information contained herein is Sharon Bergmann true, complete d correct. pity of Eagle i P,O.Box 1520 C, .` ,y a F)agle ID 83616 .4.,e Signature I I Dec 03 2007 1 : 52PM HP LASERJET FAX 3634550 p. 2 C.2 Rev,06/0 ,:„.,,-;!_w.,..,t , CAMPAIGN FINANCIAL DISCLOSURE REPORT '' ,Al SUMMARY PAGE i'A'• - A , : 2007 , (Please Print or Type) File: _ Section Route to: Name of I andidate or Political Copscnittee and Chairperson ' Office Sought(if candidate) Term y n • 1' I P2‹ 1e ,\ r•\ I ( QWJC( L yC+r�s Mailing ress ❑ Check if address change City and Zip Home Phone Phone Name of iolitical Treasure W -(1. it Mailing • ..reisk ❑ Check if address change City and Zip Home Phone Work Phone Section TYPE OF REPORT • Directio .: To indicate the type of report being filed,fill in the appropriate dates and check the appropriate box(es). See the instructs• al manual for reporting periods and due dates. t` This report is for the period from _'�,p /_ 1 / ea hrough___ �_/ 1147, / i• October 10 Pre-General Report 7—Day Pre-General R port 30 Day Post-General Report II Annual Report IIs this report an amendment? ❑ Yes l3 No Is this a Termination Report? ❑Yeso Section II STATEMENT OF NO CONTRIBUTIONS OR EXPENDITURES Directio : If you had no contributions or expenditures during this reporting period,check the box next to the statement below,fill in the ap. .p natq dates and sign this report. Be sure to carry forward the appropriate"Calendar Year to Date"figures in Column II, Section I F. I' I hereby certify that I have received no contributions and have made no expenditures during this reporting period f r o m / yam/ ":through =/ , / t_ Section I SUMMARY To reach ,our Calendar Year to Date figure: Add this report's COLUMN I COLUMN II Column Figures to the Column II figures of your previous report This Period Calendar Year to Date (except o line 6). Line l: a: h on Hand January I,This Year* $ � � �D $ Line 2: : ter Cash Balance at Close of Last Reporting Period** s$31 1 �,,..67.6( $ •O XXXXXX Line 3: •tal Contributions(Enter amount from page 2) $ S�+�R U ' Line 4: btotal(Add lines 1,2 and 3) (6 ?. Line S: 'tai Expenditures(Enter amount from page 2) $ ( i'6Q. $ `,0©a w Line 6: •; h Balance at Close of Period(Subtract line 5 from line $ 4)** Line 7: • tstanding Debt to Date *This s. figure should be entered on line 1 of all reports filed this calendar year. **You m t report the cash on hand at both the beginning of the reporting period and the close of the reporting period. Note that ii e closing cash balance for the current reporting period appears on the next report as beginning cash on hand. Section V _ CERTIFICATION Ref This Report To: )Ai area Bergmann I — ,hereby certify that the information City vtEagle cre1e7:).Tmi.., P.O.o �_1520 in this report is a true,complete and correct Campaign Financial Disclosure Report as gk ID 63616 required by IoW. ph,oe: (208)939-6613 F�: (2011)939817 � rr` „(22._Qtee"v/ I oignarure of Poleal Treasur'r Dec 03 2007 1 : 52PM HP LASERJET FAX 3634550 p. 3 • DETAILED SUMMARY PAGE Name of Candidate or Committee � Report Covering. Period 70�r°ft .1" 114 Fllm/ 0:/�( /�� to er�lf�„ 1 w71 FCC' UNITEMIZED CONTRIBUTIONS Contributions of Fifty Dollars(;$50.00)or Less This Period Total Total Number 3 Amount$ 'a UNITEMIZED EXPENDITURES Expenditures of Less Than Twenty-Five Dollars($25.00)This Period Total Total Number ,I' Amount$ tit: 402 , Total This Period Number of Schedule A pages Attached Contributions Unitemized Contributions($50 and less)from top of page $ 15 , 0 p Itemized Contributions(total all Schedule A sheets) $ 1 S • b-b Total Contributions(also enter this figure on page 1, Scction IV,line 3) $ Number of Schedule B pages Attached Expenditures Unitemized Expenditures(less than$25)from top of page $ I), Itemized Expenditures(total all Schedule B sheets) $ COIS• I p Expenditures to Reduce Accounts Payable(total all Schedule C-2Bs—Payment this Period) $ Total Expenditures(also enter this figure on page 1,Section IV,line 5) $ e 7/. 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-213s—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 $ Dec 03 2007 1 : 52PM HP LASERJET FAX 3634550 p. 4 SCSI:DUL'A ITEMIZED CONTTRIBUTIONS Page f lof I of more than Fifty Dollars($50.00)this period Name of Candidate or Committee Column A _ Column B _ Column C Dated Fall Name,Mailing Address and Zip Code Cash or In-land Receipt For , �.�,`Pa' of Contributor/Lender Check (non-monetary) _ / / 1 f(4.A 1 $ + S $ ❑ Genea1 $ I ®-o S $ Cakralcor rear To axle Calendar Year TO Aar Caledar Dor To Doe • _ / / _ 2 1�EQCar l Em.4,eE.S $ $ -0,I v $ : :: p ` � ( $ $ S:a ■ bit, $ k.) IPA 11 ' CaleoS0 Year 7b Dow Calendar Year Tit Dare Calendar Tray To Dar $ $ $ Calendar Fear r'Dame Cobaeor Teo-To Date Coleador Year To£bk 4. / / _ $ $ $ ❑ General \f.. S $ $ Calendar f To Dart Ca1eeder Year To TON Calendar Year To Dome i 5. I / $ $ $ r` 1 ❑ General S $ • $ Calendar Tear To Dam Cadembr Year To oak Calendar Year To Dare 6. / / S S $ ❑ General $ S $ Celeriac roar To Die Cede dar Year To Dale Calendar Tor To D rot 7. / 1 1 $ $ $ ❑ General p S $ $ Calendar Year 7b Aare Calendar Tear To Ana Coke o,Tow To Dot, 8. t / / % $ $ $ ❑ General S $ $ad Cndar her ToDate Calendar Year ToDrr Calm a drrYaTvDare 9. .--) / / _ $ S $ ❑ General $ S $ Calendar Year To Doe Calendar Year Tb Date , Calendar Two To love 10. / / ; $ $ $ ❑ General $ -$ $ Calendar Year TO Dote Cakndo-Year To Dale Calendar lent To Do,. Subtotals of Columns A,1141 C $ 10-0, S ‘i ,D-ft $ i 1 Dec 03 2007 1 : 52PM HP LASERJET FAX 3634550 p. 5 C-4 Rev.11103 INDEPENDENT EXPENDITURES (Please note the definition of independent expenditure and Section 67-6611,Idaho Code—reverse side.) TOTALING MORE THAN $100 IN c0.r MADE IN SUPPORT OF OR IN OPPOSITION TO ANY ONE CANDIDATE, POLITICAL COMMITTEE OR MEASURE Full Name: 1.-y k 1 Telephone No.: 1).4,1&-- 111 43 ara Mailing Address and Zip Code: -K1 , g,i L, if E 4i i 14 TYPE OF REPORT ® 7 Day Pre-General Statement ❑ 30 Day Post-General Statement Total Expeiditure(s): $ to 2 `z w 1 0 ITEMIZED EXPENDITURES IN EXCESS OF FIFTY DOLLARS Date Full Name,Mailing Address and Zip Code Candidate or Measure Amount Of Recipient Supported or Opposed of Expenditure 1. El, .t Ik"/S• _VA ktt " S Purpose of Above Expenditure: ,M ` C itt Ads j Li s)-A C _,. . 2. EV LAPS IS t!(L):),Wei tExtfirl, N / C/L1 E LE 1b. < � ) C (939- L4 3 L&! r $ "ec.iJ ;1 Purpose ofAbove Expenditure: L9'ri ;L 4Cs ij w&t1 VO4 I 3. / / _ $ Purpose of Above Expenditure: 4. / / $ Purpose of Above Expenditure: 5. / / $ Purpose of Above Expenditure: RETURN THIS FORM TO: I, 1.W C. 64\1/4V._ ,hereby c rtify that the information contained herein is Sharon Bergmann true, complete d correct ity. of Eagl 20 + �A . .e O.Sox 15 ogle ID 83616 signature Jan 30 2008 5: 41PM HP LASERJET FAX 3634550 P. 3 C-2 tt�_r Rev.06104 my CAMPAIGN FINANCIAL DISCLOSURE REPORT Via, SUMMARY PAGE (Please Print or Type) • Section I Name of 1 .ndidate or Polit' Committee and Chairperson Office Sought(if candidate) Terns l� � l Mat ing • °dress ❑ Check if address change City and Zip X I Home Phone Work Phone Name of:,liticalTr as:"-r 1 A�/�r Mailing ,1 dress o Check if address change City and Zip &I+(a Home Phone Work Phone 1)-`�-�'i. f ,Q ) �ez s-r. i Z lig',-i t Al- ca 4'7,,13A2_. Section II TYPE OF REPORT Directio ••: To indicate the type of report being filed,fill in the appropriate dates and check the appropriate box(es). See the instructs• al manual for reporting periods and due dates. This report isi for the period from j / ij'� /mil through t-j / 1 i, / O II October 10 Pre-General Report ❑ 7 Day Pre-General'Report "-0 30 Day Post-Gen ral Report O Annual Report IIs this report an amendment? ❑ Yes ❑ No Is this a Termination Report? 0 Yes ❑ No Section I I STATEMENT OF NO CONTRIBUTIONS OR EXPENDITURES Directio : If you had no contributions or expenditures during this reporting period,check the box next to the statement below,fill in the appr.+Hate dates and sign this report. Be sure to carry forward the appropriate"Calendar Year to Date"figures in Column II, Section II . iI I hereby certify that I have received no contributions and have made no expenditures during this reporting period from / / through / / . Section SUMMARY To reach our Calendar Year to Date figure: Add this report's COLUMN I COLUMN II Column figures to the Column[1 figures of your previous report This Period Calendar Year to Date (except ., line 6). $ XXXXXX $ Line 1: il sh on Hand January 1,This Year* $ $ XXXXXX Line 2: nter Cash Balance at Close of Last Reporting Period"* I $ $ Line 3: otal Contributions(Enter amount from page 2) $ $ Line 4: 'lubtotal(Add lines 1,2 and 3) $ $ Line 5: total Expenditures(Enter amount from page 2) $ $ Line 6: 11. h Balance at Close of Period(Subtract line 5 from line $ 4)** • . Line 7: is utstanding Debt to Date *This s:. e figure should be entered on line 1 of all reports filed this calendar year. "You t 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 Re rn This Report To: rr 1 a Bergmann I �(1,.�"' V• �N - ,hereby certify that the information twnec ITren,r,,i City of Eagle in this report is a true,complete and correct Campaign Financial Disclosure Report as P.O.Hoz 1520 Eagle 1D 83616 required by law. p one: (208)939-6813 (208)939-6827 ■ \ G (... :ge.A1 4 azure ofPo 0 cal Treasurer • Jan 30 2008 5: 41PM HP LASERJET FAX 3634550 P. 2 • C-2 _i_r"-. Rev.06/04 it ,,, CAMPAIGN FINANCIAL DISCLOSURE REPORT 7r ,,e �i SUMMARY PAGE (Please Print or Type). Section I Name of' .ida0e or Political Committee�Chairperson ` OW=Sought(if candidate) Term ��k' bU,J( it 4 -Liok Mailing • .dress ❑ k it addressmange City and Zip Home Phone Work Phone s,r-i trc),-- G'• °a 11.-,,---1)--1-.K.--d Name of, i,tical Treasurer Mailing `,dress A❑Check if address change City and Zip ) �� Home Phone Work Phone *)- s`%£ 0 AfC�E. � 1 I_t'1044`o U1,--11 ' alv 5---, t7 , section t TYPE OF REPORT Directio •: To indicate the type of report being filed,fill in the appropriate dates and check the appropriate box(es). See the instructis al manual for reporting periods and due dates. This report is for the period from / /1) through / k i / 11 October 10 Pre-General Report 0 7 Day -Gene Report 0 30 Day Post-General Report :3 Annual Report IIs this report an amendment? ❑ Yes ❑ No Is this a Termination Report? ❑Yes ❑ No Section II STATEMENT OF NO CONTRIBUTIONS OR EXPENDITURES Directio : If you had no contributions or expenditures during this reporting period,check the box next to the statement below,fill in the Appr•.date dates and sign this report. Be sure to carry forward the appropriate"Calendar Year to Date"figures in Column II, Section 1i . I hereby certify that I have received no contributions and have made no expenditures during this reporting period from_11_2_14_, (i through ) t).. /'3 t / 01 . Section SUMMARY To reach our Calendar Year to Date figure: Add this report's COLUMN I COLUMN II Column figures to the Column II figures of your previous report This Period Calendar Year to Date (except . line 6). $ XXXXXX $ Line 1: ■i: h on Hand January 1,This Years $ $ xxxxxX Line 2: inter Cash Balance at Close of Last Reporting Period** $ • $ Line 3: otal Contributions(Enter amount from page 2) $ $ Line 4: 'lubtotal(Add lines 1,2 and 3) $ $ Line 5: otal Expenditures(Enter amount from page 2) $ $ Line 6: ill. h Balance at Close of Period(Subtract line 5 from line $ 4)" I Line 7: 9 utstanding Debt to Date *This s.9 I e figure should be entered on line 1 of all reports filed this calendar year. "You ust report the cash on hand at both the beginning of the reporting period and the close of the reporting period. Note tha the closing cash balance for the current reporting period appears on the next report as beginning cash on hand. Section V CERTIFICATION Rc,urn Thin Report To: I J '(�l� �. y Sharon Be a t���(' ,hereby certify that the information City of Eagle in this report is a true,complete and correct Campaign Financial Disclosure Report as P.O.Box 1520 , Eagle ID 83616 required by law. plvoe: (208)939-6813 hi: (208)939-6827 ` witvejl& J \ r , Signature a -, ca!Treasurer