Oct 10 Pre-General Report - Butler, Mark - 10/11/2011 REG 1VtC t'F 1,E ,) --
C1TY OF EAGLE
CAMPAIGN FINANCIAL DISCLOSURE REPORT C-2
, 1. " .. SUMMARY PAGE" ev.10/07
f tR (Please Printor'Type) File:
rr � ' Route tu:
Section I
NrAof Can ite or- olitical,Committee and Chairperson OfiKe$ u ht(if c ndidate,)n(� I Seat(if any)ut Ma ling Address � Cit and Zip Home P on ork Phone
1 (I t o J .Sinai il 12d 1e '3(l ( 2O R39 i i/
Naftte of Political Treasure
r aticie ru,SG-
Mailing Address City and Zip Home Phone Work Phone
2(1)31 W Conti-c( Dr Ecwle (31Lcilp 2,r93T330(p2oA2t-Ict 1-10
Change of address for: Candidate or Political Committee Dil Political Treasurer ❑
Section II TYPE OF REPORT
This filing is an: )4 Original ❑ Amendment 22n,�
This report is for the period from )l Si I 1 through 1 I"X,1 _! t 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: 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.
0 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) $ 1 0 UX L 2-") $ 1 10(/ --2,C
Line 4: Subtotal(Add lines 1,2 and 3) $1 IOU -2c-k $ lU UJ- !-
Line 5:Total Expenditures(Enter amount from line 11, page 2) $ (1a>� c D' $144-1611 ,�(� !
Line 6: Enter Ending Cash Balance(Subtract line 5 from line 4) $2.(Q14-1, 9 I $Z I L1 • t I
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 /� GI 1/1.x" '/lAC
City Clerk I, �� `e II 1, V� � hereby certify that the information in this
City of Eagle Name of Politicaljreasurer
PO Box 1520 report is a true,complete and correct Campaign Financial Disclosure Report as required by law.
Eagle, ID 83616
(208))939-68-68
(2013 ---)11. —'
Fax:(208)939-6827 Signature of Political Treasurer
Page 1
DETAILED�^� ''`'��`� ��" ," `'
.1� '
Name OfC3nd�a�OrCOmmh�e: VU\ / �, ��»^-
� » iQ�y ~_' [�VL'\ �\/�
Total This Period
Contributions 1
0 Unitemized Contributions($50 and less) #of Contributors ux
0 1 Itemized Contributions(Total of all Schedule A sheets) I + $ (071.50 —
\D| In-Kind Contributions(Total of all Contribution amounts from Schedule C sheets)
0 Loans(Total of all New Loan amounts from Schedule D sheets)
\1/i Total Contributions (Transfer this figure mpage 1, Section IV, Line u/ = S .-Doti ,_26
Expenditures ,
01 Unitemized Expenditures($25 and less) #of Expenditures 1
0 '~^'z~~ Expenditures(Total ~' all Schedule -sheets)
0�__� d Expenditures(Total of all Expenditu --- ' m Schedule C ee
/�\'
\�/ Loan Repayments(Total of all Loan Repayment amounts from Schedule D sheets
�7�| C�d�C8� and Deb (Total 8mnunb�omSohHd�eEnhee�\ | + $
\�y� � ` - Repayment sheets)
�� ��| E Expenditures (Transfer this figure to 1, Section C�/ �4
v-vL_�__ ' ' k' . +� "
, Loans, Credit Cards and Debt 1
0 Outstanding Balance from previous reporting period ,
0| New Loans received during this reporting period
(Total of all New Loan amounts plus Accrued Interest from Schedule D sheets) I
0 New Credit Card and Debt incurred this reporting period
(Total of all New Incurred Debt amounts from Schedule E sheets) + $
0/
g Repayments of Loans made during this reporting period
(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) , - $
��' Tb�| Out�8ndingBalance 8td0S8Of this p9hOd (Transfer UliS�guo3b} p8ge1 Se:don |\( Line 7\ |
Pledged Contributions ,
0 Unitemized Pledged Contributions($50 and less) #of Pledges + $
@ Itemized Pledged Contributions this Period (Total of all Schedule F sheets) ' + $
V�/L_-_ ���_-_______-__�,_-__�-_L�-_ ���_�_____]
® this period $ |
������ �����
Page 2
SCHEDULE A Page of
I l'i
ITEMIZED CONTRIBUTIONS 1
of more than Fifty Dollars($50.00)this period
1 Name of Candidate or Committee: y" r
________
; _ 1
Date Received 1 Full Name,Mailing Address and Zip Code of Contributor Cash or Check
RikairY_ -9 eler Zoo -
el 9 / W lot-to ((Jaskol/4 Rd ,
Ca, It tD S3(e( $
Calendar Year-To-Date
* RCulcte.. A-cirtitsck_d $ IOC _
" i 2.4(p31 (AI COyti-e-ticr
10 53(e1L, $
! Calendar Year-To-Date
----1
$ 6-op -
S11 2-,1 tiZi Vcr5 i'Cle br
03 ( 1 $
4 Calendar Year-To-Date
I , J ct n e cift ns5--i-i'-e_ $ 1006 _
ed_z_i_t___, ) co 8 i kJ pa r y..._ LI/
EaDlt tk ) .. CQ. Itp $ ,
Calendai Yew-To-Date
_
111 I
0. Da,ni.eli-e- R. De flilecst-e 1," i s 200 __.
0/ ;
--- I DO' 'F t.D■rcut L 11
$
_ ' e t D 6311 (2 1 Calendar Year-To-Date
$ 1 bo -
I r5-0 Le_ S-- pro Itt as V,a_
1
is
emit10 (b (.0Le 1 Calendar Year-To-Date
7.
0 / Ile/ 11 Je-" (If t $ 1 Co — 1
1 17.1:5 E Sfa,te. S+ 1
I$
0 I (c) Calendar Year-To-Date-
°8, Kciv-\,) C tar ‘ , s_ 100 -
I- .220(.0 N el feawevu C,--I*7
$
Calendar Year-To-Date
---1
':::4, • ,
0 ,n i 1 1 If i 01)yi et Dctfer _ Is 200 —
,
byc ,E Lagvock.. 51710fe D( 1
Is
if Jr-, 0 6 cci #
0/ 10/111 Tho mlics ei Dater Calendar Year-To-Date
1
i Is 10 0 ---
WOIX\I rfit 4-300 i $
1 I :Bo i• a t U J 02. Caler,dar ,aar-To-Date
'H-
i
i Total This Page: I $ 2c )—
Transfer the combined total of all Schedule A pages to the Detailed Summary on page 2 line 2.
SCHEDULE A Page —737
2
ITEMIZED CONTRIBUTIONS
of more than Fifty Dollars($50.00)this period
!Name of Candidate or Committee: maa.:, Ealtr
1 Date Received I Full Name,Mailing Address and Zip Code of Contributor Cash or Check
r -
0123ii tellt n ci- Totlivnk 013e1 $ ioo -
1 $
1 Merictiayl ID 62 LI(p Calendar Year-To-Date
S 15 \Q„e‘,a 0 i seri $ too -
13) 5 inI 6'1'k. S tki lc B
i IA - -16111 ID Sc3Lei-12 $
Calendar Year-To-Date
h"---
i 0 120i I 1 a joh a A-cla-114 $ 16 -
1 11,eLi 01.cte Pay'L P1 1
_ . $
• ' I , Calendar Year-ToThte
..■
1 0 125 I 1 4' a t ie Cenhr Trbpex-tits $__,.. 60:
-SL-1,• sotlik. pa_bt O 'Ave
4110arty, Cil- 61 41019 $
Calendar Year-To-Date
2-7 () .---
H t--
IfYilt -y n a flavieD
/ $ -715- _
coos E wiali-Yte\I c-i--
1 a--"-ajle_ 1.0 $
Calendar Year-To-Date
,.
e ,w1,, tcy,sto,,,__,Q,,,,,---Tho(ni-on $ 200—
,
-161 IA/ R)4(1v5oe Dir $
1 . A ' I (6319.A_U Calendar Year-To-Date
I---
7. c)-1-hy 9- \<.i 4419-el Ki Qii5-5-ler $ 15-00 -
0t1 161 5 KOORbeRY14 W6L-V
$
amle ID e) (.Q. Up Calendar Year-To-Dale
2.erc..t..-4- &la,\/antft. -be flitoataxt-l- —1- .
S/31/11 loll 5. iA-vwiliccocil IAMy
$
Faale, 10 (plir) Calendar Year-To-Dale I
0 i 31, 1 1 ' .eoecccL:BG1(.41-er $
\Ai Et ttns 9-er'{y br
$
iLboise ID e- -103 Calendar Year-Th-Date
ill 1 ii 1 I a if\A CA *eaft6 ite che'y
, 2/-65 wCvlampa,911,E Dr
Eovgle 10 i53LilL $
Calendar Year-To-Dale
TOi2i This Page: $ Iwo —
Transfer the combined total of a Schedule A pages to the Detailed Summary on page 2 line 2.
SCHEDULE A ° 9
1 3 '
ITEMIZED CONTRIBUTIONS
of more than Fift.,f Dollars($50.00)this period
Name of Candidate or Committee: Rada_ Built r
Date Received I Full Name,Mailing Address and Zip Code of Contributor Cash or Check
—11' .00-1-1/1 i 1 I Kviigia-t5 La-
q1 di i , $ 260—
----- ----
gel 6 12i vev5icte Dr
$
. __Eajle. If) S3(ells Calendar Year-To-Date
ci / 2- ill - Joseph Na11 $ 260 —
L2 5trAmoarcl CA-- $
iA 'It vailev clot- 61(--1611_1 _ Calenda Year-To-Date
9 ii a 12-c"/ ' i- Vaki RA Cb-kate- $ /00 —
101 tiv CO
$
__Hackcite (0 S3( ik_____ Calendar ear-To-Date
11 / 13, 11 4' IZOlocrt Cal/ROY-02 OBA 3-D Lariciscopro 9 $ 5-00 _
26%) NJ eiyer. rail Qd
0 ranco, Ci6c- °I 28(f2G- $
Calendar'rear-To-Cafe
. ._
i 5' Eagit Laytasccupe Conik-acre){5, LI-L $ 100 —
1 / 12-1 It I 39, 1 Nr -Bck,flart-kine LP')
Eatie tp Z(5U1L, $
Calendar Year-To-Date
, 6. 0e1 v 144 . cy-cui
11161 iib; 11 f . $ boo —
.g..7_-1 Se ck_ Cou6-try Di
$
(A,1(1c,R0 Santa_ ivtot_vgctn , I crz,Lec-K Calendar Year-To-D,ale
ill 611 K1c-r—Qi- Sanctv Vzaj (AA NrIrt. $ 100
/ i
po Zo*, 01
i Emtc 1p ic. i/21L.0 $
Calendar Year-To-Date
n f -
n q- iv 60104 4 haAckvi Mevr r It t
'1. Atoll (002 NI alcto tnIoty
$
arjte, ID aW,_(i -4- Calendar Year-To-Date
kit , 9s—evey, ParrNi
2u0a -pertraLe. vOc ,y is
1 ' 0115-e___L0 6_43.7k22_ Calendar Year-To-Date
1 1 21 li 10 Q_Obert N)a,tirca_ $ Iba-
, / i i
11--0 .51 NI k-avva(e5+ LAI
$
i LE LA (D 3 Le I Lo Calendar Year-To-Date
1------
i Total This Page: $ 2.0 60--- I
Transfer the combined total of all Schedule A pages to the Detailed Summary on page 2 line 2.
SCHEDULE A Page of
Li
ITEMIZED CONTRIBUTIONS
of more than Fifty Dollars($50.00)this period
Nan of Candidate or Corrililittee: Aka r
Date Received Full Name,flailing Address and Zip Code of Contributor Cash or Check
eor() e Aqui 01/1kn e Dahl irter ioo
•Daihtingtir co-
g
12_1 ti 12-4A s
(\kum Pa-- ID 2) 3 LeS 1 Calendar Year-To-Date
2. „bAt11, 1 0 -
/15/11 G VD-A ErAoit Dr
$
tO g-3(kIle
Calendar Year-To-Date
3.
/ 1
$Calendar Year-To-Date
T—11–;
Calendar Year-To-Date
5.
$
Calendar Year-To-Date
6.
$
Calendar Year-To-Date
/
Calendar Year-To-Date
8.
/
Calendar Year-io-Date
H $
$
Calendar Year-To-Date
Calendar year-To-Date
Total This Page: I $
Transfer the combined total of all Schedule A pages to the Detailed Summay on page 2 line 2.
SCHEDULE B Page of
ITEMIZED EXPENDITURES
Twenty-Fare Dollars($25.00)or more this period
Name of Candidate or Committee: M al/ bc&i- e
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&PACs 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,Maila►g Adctess and Zip Code of Recipient Purpose Code Cash or Check
1.Thc ta.0 I e In-former
PUBo,cz Z —
S11` , - �ct 1e, ID Le.1 (/ $ Cr
2.5i' n5Z �-t
0 [Oil Io 9 e 3i-I St —
3. H-ed rck- ki e Lj 0
Bo, cit-l4 S
0 P i got, .____
/ )° , U �rpc to 0 -362C52- $
4.Lrap ill1c&1L /
57ea-V- ►v C
L-1 t Ue G A-(1c0Ar Juvic-hblet Dr' 225 —
u / 21 / tt 3oisr ID 03V1(v I- $
5. Pr iit 1C Atter
� �0 -1 � ;�pc ►�gc
— can vo v ?i
LT- c
/ 23/ i Yt c 1 /v 0{44A_ OA 11311 $
6. Ci,-f\i of _ le
OA ii 4j.eo E 61 3cQ (o
7. 111e E c i e- I nkli te,
I I Po Box 2-2 IV LI ZU --
11 / �aOit. tO (t3tedtp $
8.p n vi+ �.1ft-t'l,vt.-r
9 iQ it I 01(213 To pan 0 Crx,njo Y Pt Ho 'fil-5/ / 'vi(�t.*5 U1!o -lN C►� I. I I D $
9.S ervv n W I 1 I i Ct,►vt 5�
63 State 51 1 �1
ci / 1 / t) Far: le. ID 83( I (p $
10.1CV61,C) MCd(a.,POh1.611t1'1C
PC i30 >< I`2„;1S 3(0 --
/ I ��31 I 10
Total This Page: $21-139 2-
Transfer the combined total of all Scheele B pages to the Detailed Summary on page 2 line 7.
SCHEDULE B Page of
ITEMIZED EXPENDITURES
Twenty-Five Dollars($25.00)or more this period
Name of Candidate or Committee: AAC✓L. $(--ii-1- r
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
,.Valley vv\es
��3ox 11 0 0 11;-30 —
:o- (0 (Mello $
2. H0 t- Dot
i1 h o) �� acs
0
21 1 —
, / Da11a s Tx� SZ � $
3.ail�LSD�`�- St- �
` 015e_ ID Y3"1 $ '��
4•ei c Sal I �55GCt C cs tg
�� N N i cLla ut,s �t ne 200 -
9 1 0 / 1 I oa 1� tO �3(QUo �' $
5.B r-
te
1 , 0 , 1 t 1�a E s-�,-E-c �-t- F $ S3 oto
ewe I 0 3(Q L(o
6. atC0
206' a CO le ed
� (2, 1 b $ IIg3 ;
7. Vj1VlCo
/12/ 11 3032_ E skuit. S1- -715-A91e DMoto $ l °�
$.jYne Yy+e1tixs
2 1 1 15(60 E 5-toot st I v(0
ECtcl lf. I0 g3to1Lo $
9. PI'1'✓1iVVUylcs
/ arm (c 1O ce 1 (a $
1o1 CV0 1Rd. ependrrt-F Nees
(� II 3o) 26L)c N 2/3—
i I/ C1� to 3(�14 $
Total This Page: $ 1635: 4-2,
Transfer the combined total of all Schedule B pages to the Detailed Summary on page 2 line 7.
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. vet Sm xxi cute >
8 L SZ _�'c-C'u- rue.it �a1� Ce 1.(P $ 260 --
2.
$
3.
I I $
4.
/ / $
5.
I I $
6.
/ I $
7.
/ / $
8.
/ / $
9.
/ / $
10.
/ / $
Total This Page: $ 200 - -
Transfer the combined total of all Schedule B pages to the Detailed Summary on page 2 line 7.
SCHEDULE C Page I
IN-KIND CONTRIBUTIONS and EXPENDITURES
Name of Candidate or Committee: (t t rt del Itr
Purpose Codes " `��
A All Travel Expenses(Airfare,Fuel,Lodging&Mileage) N Ne sp er&Other Periodical Advertising
B Broadcast Advertising(Radio,TV&Internet) 0 OtherAdvertising(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 Zp Code
t / I5/ I I plea-WI GRO CO �GLfe $ ,
2121 .-hit Jay $
Q 5 e t D '6-.3109 Calendar Year-To-Date
Expenditure Name, Mailing Address and Zip Code Purpose Code
$ 0
2. Contributor Name, Mailing Address and Zip Code
/ / $
Calendar Year-To-Date
Expenditure Name, Mailing Address and Zip Code Purpose Code
3. Contributor Name, Mailing Address and Zip Code
/ / $
Calendar Year-To-Date
Expenditure Name,Mailing Address and Zip Code Purpose Code
4. Contributor Name, Mailing Address and Zip Code
/ / $
$
Calendar Year-To-Date
Expenditure Name, Mailing Address and Zip Code Purpose Code
$
Expenditure Total:
(Transfer the combined total of all Expenditures on Schedule C pages $
to the Detailed Summary,page 2 line 8)
Contributor Total: $5-tie
(Transfer the combined total of all Contributors on Schedule C pages t�J
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 crust 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:
I l _ l I
Amount Amount:
$ $
2. Date: Date:
I I _ / /
Amount Amount
$ _ $
3. Date: Date:
/ / / /
Amount Amount
$ _ $
4. Date: — Date: — –
/ / _ 1 /
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 $
Received Total:
(Transfer the combined total of all received loans to the $
Detailed Sunman,page 2 line 4)
Interest Total: $
Repayments Total:
(Transfer the combined total of all loan repayments to the $
Detailed Summary,page 2 line 9&16)
Ending Balance Total: $
(NOTE:Transfer the combined total of all Accrued Interest and Received Loans ito 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 El.However,only Repayments of Debt during this reporting period appear in the Expenditure Section of
the Detailed Summary Page.
Any creditors)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:
I I I I
Amount Amount
_ $ $
4. Date: Date:
I I I I
Amount Amount
_ $ $
5. Date: Date:
/ / I /
Amount Amount
$ $
6. Dade: Date:
l I I I
Amount Amount
$ $
Previous Incurred Repayments Ending Balance
Previous Total: $
Incurred Total:
(Transfer the combined total of all incurred debt to the $
Detailed Summary,page 2 line 14)
Repayments Total:
(Transfer the combined total of all debt repayments to the $
Detailed Summary,page 2 line 10&17)
Ending Balance Total: $
SCHEDULE E-1 Page of
CREDIT CARD and DEBT ITEMIZATION
Name of Creditor from Schedule E: r i-1-1 eta
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 Newspwer&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,Mailer Address and Tip Code of E pencitrre Purpose Code Amount
1.
/ / $
2.
/ / $
3.
/ / $
4.
/ / $
5.
I I $
6.
I I $
7.
I I $
8.
I I $
9.
/ ( $
Total This Page: $
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: M a,v-
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 contrbution.
Date Pledged Full Name,Mailing Address and Zip Code of Contrtwior Amount Pledged
1.
/ /
2.
/ /
3.
/ /
4.
/ /
5.
/ /
6.
/ /
7.
/ /
8.
/ /
9.
/ /
10.
/ /
11.
/ /
Tot Amount of Pledged Contributions: $
Transfer the combined total of all Schedule F pages to the Detailed Summary on page 2 line 20.