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CAMPAIGN FINANCIAL DISCLOSURE REPORT
SUMMARY PAGE
(Please Print or Type)
rage: 1, it
CITY OF EAGLE
DEC 0 2 2011
File: C-2
Rouse to.
Name of Candidate or Political Committee and Chairpersonoe
!Y �r
Sought (if candidate)
b .If
Seal (i1 any)
I
Wring res-
13go I
City a zip
1 83b1b
Home M01116
g "b �I�g
Work Prione
A9 -Wo -KI If
ama o7olitical I reasurer
Ma" More=
1 bq5 S. NjMrLa,S • 1!0IMan,
pHome
1, 8 (�
Phone
U-U-3-76-16W_ZD8
Work Phone
- 9RR-1
1
Change of address for. Candidate or Political Committee ❑ Political Treasurer U
Section II TYPE OF REPORT
This filing is an: ❑ Original ❑ Amendment
This report is for the period from ID /� through 1 I 1
❑ October 10 Pre -General Report ❑ 7 Day Pre -General Report 01 30 Day Post -General Report
❑ Annual Report
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 and sign this report.
Be sure to cavy 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 Sur
To reach your Calendar Year to Date figure: Add this report's Column I
figures to the Column II figures of your previous report (except on line 6).
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)
*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
Return This Report To:
Sharon Bergmann
City Clark
City of Eagle
PO Box 1520
Eagle, ID 83616
(208) 9396813
Fax (208) 939-6827
I, ` /11e epn l `O AA d- hereby certify that the information in this
Name of Political Treasurer
report is a true, complete)and correct Campaign JnaKia1Disclosure Report as required by law.
Page I
Political Treasurer
COLUMN I
COLUMN II
This Period
Calendar Year
to Date
$
XXXXXX
$
$
$ XXXXXX
-10-
$ 3-15. o �-
$
$
$ -15.09,'
$
$'31-5.0crl-
*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
Return This Report To:
Sharon Bergmann
City Clark
City of Eagle
PO Box 1520
Eagle, ID 83616
(208) 9396813
Fax (208) 939-6827
I, ` /11e epn l `O AA d- hereby certify that the information in this
Name of Political Treasurer
report is a true, complete)and correct Campaign JnaKia1Disclosure Report as required by law.
Page I
Political Treasurer
UtC _We_ W11 15:0 f
From:Kathleen Roma Assoc To:9396827
CAMPAIGN FINANCIAL DISCLOSURE REPORT
SUMMARY PAGE
(Please Print or Type)
CITY OF EAGLE
DEC U 2 2011
pFile; �2
Iii
Name of Can al
Pofiecal committee and Chairperson
'n
Office Sought d candidate) •
Seat (If any)
e
u
Wailing ss
l3 0 i�• wva
r an Zip
i g3t�l(o
ome a
-gq0- 1�g
one
l-�-v1g
ame 01 FolitiCalreasurer
a
,ng MUM
l t)% S • AV) Stu- 60
City and Zip
e MI(O
Home Phone
ZD%- 376- I ;L
work Phone
9- ftT-1�
Change of address for: Candidate or Political Committee O Political Treasurer ❑
Section II TYPE OF REPORT
This filing is an: ❑ Original ❑ Amendment
This report is for the period from I I I_t 9 / I II _ through I I / 3 DJJ —I.
❑ October 10 Pre -General Report
[p Annual Report
❑ 7 Day Pre -General Report ❑ 30 Day Post -General Report
Is this a Termination Report: 1% 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 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 ' SUP
To reach your Calendar Year to Date figure: Add this reports Column I
figures to the Column II figures of your previous report (except on line 6).
Une 1: Cash on Hand January 1, Thls 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)
COLUMN I
This Period
$ XXXXXX
$
$ -�
$
COLUMN II
Calendar Year
to Date
'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
Return This Report To:
Sharon Bergmann
City Clerk
City of Eagle
PO Box 1520
Eagle, ID 83616
(208) 9396813
Fax: (208) 939-6827
I, 9f,4 OLM/1 _ , hereby certify that the information in this
Name of Poetical Treasurer
report is a true, complete and correct Campaign Financial Disclosure Report as required by taw.
Page 1
Treasurer