30 Day Post-General - Shoushtarian, Al - 12/8/20112083428868
Shoushtarian
CAMPAIGN FINANCIAL DISCLOSURE REPORT
SUMMARY PAGE
(Please Print or Type)
3
CITY OF EAGLE
JC -2
011 07
File:
Rout® b
Section I I -i
NaAd Of Political Coffmftee and Chaeperson office Sought (if candidate) Seat (rf any)uW
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ana ap Hp
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City and Zip Home Phone Work Pfi&*—
V mavu uauutwbb IVI. %,wiuroare or ronucai wmmntee u Political Treasurer ❑
Section II - TYPE OF REPORT
This filing is an: Original ❑ Amendment
This report is for the period from _� / through I
❑ October 10 Pre -General Report ❑ 7 Day Pre -General Report 30 Day Post -General Report
❑ Annual Report
Is this a Termination Report: ❑ Yes ❑ No
Section III STATEMENT OF NO CONTRIBUTIONS OR EXPENDITURES
Directions: -tfyou -had no contributions or expenditures during this reporting period, check the box next to the statement below andusign 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
P
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' $ X000= $
Line 2: Enter Beginning Cash Balance's $ C) $ XXXJt)O(
Line 3: Total Contributions (Enter amount from line 5, page 2) $ 144. Pu $ 7Z. q
Line 4: Subtotal (Add lines 1, 2 and 3) $ $ /. X "% -4
Expenditures 5: Total enditures (Enter amount from line 11, page 2) $ D:� $ ��
Line 6: Elmer Ending Cash Balance (Subtract One 5 from line 4) $ Q $
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 fine 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.
SectionV
Sharon Bergmann
City Clerk
City of Eagle
PO Box 15217
Eagle, ID 83616
(208) 939-6813
Fax: (208) 9396827
)PpOrt
hereby certify that the information in this
Name of Political Treasurer
r is a flue, complete and correct Campaign Financial Disclosure Report as required bylaw.
Page 1
12/2011
DETAILED SUMMARY
Name of Candidate or Committee:
#0736 P.001 /001
Totallhis Period
Contributions
Unitemized Contributions ($50 and less) # of Contributors
+ $
Itemized Contributions (Total of all Schedule A sheets)
In -Kind Contributions (Total of all Contribution amounts from Schedule G sheets) V
+ $ C)
Loans (Total of all New Loan amounts from Schedule D sheets)
$
(1) Total Contributions (Transfer this figure to page 1, Section IV, Line 3)
$
Expenditures
J:
Uniternized Expenditures ($25 and less) # of Expenditures
C)
Itemized Expenditures (Total of all Schedule B sheets)
+ $
In -Kind Expenditures (Total of all Expenditure amounts from Schedule C sheets)
+ $
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 4
Total Expenditures (Transfer this figure to page 1, Section IV, Line 5)$ 1 ;
Loans, Credit Cards and Debt
C2 Outstanding Balance from previous reporting period
13 New Loans received during this reporting period
(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)
Subtotal
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
17 (Total of all Debt Repayment amounts from Schedule E sheets) $
Total Outstanding Balance at close of this period (Transfer this figure to page 1, Section IV, Line 7) $
Pledged Contributions
Uniternized Pledged Contributions ($50 and less) # of Pledges
Itemized Pledged Contributions this Period (Total of all Schedule F sheets)
Total Pledged Contributions this period
Page 2
$ 0,
12/08/2011 15:20 2083428868
Shoushtarian
SCHEDULE A
ITEMIZED CONTRIBUTIONS
of more than Fifty Dollars ($50.00) this Deriod
#0732 P.002 /003
age o
Fme of Candidate or Committee:
Date Received
Full Name, Mailing Address and Zip Code of ContnWor
Cash or Check 3
f3 a 2 141
4..a l 43 (01 6
$ 50. 010
$
Calendar Year-To•Da
2.
$
t,l�,i gat' 1b
$�a°•°°
Calendar Year To -Date
t 1 g R.). tak&'- X4L
Ca Year To Date
4.
Calendar Year -To -Date
5.
$
$
Calendar Year -To -Date
6.
$
Calendar Year-To-0ate
7.
$
Calendar Year -To -Date
$
Calender Year -To Date:
9.
$
$
Calendar Year-ToR*
10.
$ l
CalendarYear-T
Total This Page:
$N
Transfer the combined total of all Schedule A pages to the Detailed Summary; on page 2 fine 2.,
12/08/2011 15:20 2083428868
Shoushtarian
SCHEDULE 6
ITEMIZED EXPENDITURES
Twenty -Five Dollars ($25.0) or more this period
Name of Candidate or Committee-
Purpose Codes
A All Travel Expenses (Airfare, Fuel, Lodging & Mileage)
B BroadcastAdvertising (Radio, N & Internet)
C Contributions to Candidates & PAC's
D Donations & Gifts
E Event Expenses
F Food & Refreshments
G General Operational Expenses
L Literature, Brochures, Printing
M Management Services
N Newspaper & Other Periodical Advertising
0 Other Advertising (Yard Signs, Buttons, etc.)
P Postage
S Surveys & Polls
T Tickets (Events)
U Utilities
W Wages, Salaries, Benefits & Bonuses
Y Petition Circulators
Z Preparation & Production of Advertisina
#0732 P.003 /003
17l
Date Spent
Full Name, Mailing Address and Zip Code of Recipient
Purpose Code
Cash
or Check i
'
1 .I, 06f ,JS
N
<<�—rd
mss-
I
$
3.
4. -
$
5.
6.
7.
8.•
9.
$
10.
Total This Page:
Transfer the combined total of all Schedule B pages to the Detailed Summa on page 2 One 7,