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Oct 10 Pre-General Report (Amended) - Butler, Mark - 10/13/2011 RECEIVED & Fn.d i yri` CAMPAIGN FINANCIAL DISCLOSURE REPORT CITY(�F Eq �/o� i ,, SUMMARY PAGE '" ; f�; (Please Print or Type) OCT t qtr.. , 3 Zit 4 .' . Section I File: N. of Ca idate litical Committee and Chairperson 0 •ught(if .ndid.e '' o: ILMIT"„� , € A►�` . —bier i \ 3A Mating Address and Zip "ome• • "o • •ne 1 .IA 0 W(Xs itla rill (Z.d it tv 2O 139 iii Name of Poetical Treasur rYUvicte rt,usc Mailing Address City and Zip Home Phone Work Phone 21131 K) Condit, br (" le Stei ip 20Yel3�33v4�.0S-2�+ci Ltcin Change of address for: Candidate or Political Committee Political Treasurer ❑ 9 Section II TYPE OF REPORT This filing is an: i'!,. Original Amendment I This report is for the period from 0l Si 1 through 9 /"22Ze) / 11 . 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. ❑ 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 1.0(p•'h $ Line 4:Subtotal(Add lines 1,2 and 3) $1 (0 Le ._ $ Line 5:Total Expenditures(Enter amount from line 11,page 2) $/4 6o-7�, ci $ Line 6:Enter Ending Cash Balance(Subtract line 5 from line 4) --- $ -6—`CI.VC.O $ 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 // 413 j l,��(/te �+ �/�— ,hereby certify that the information in this City of Eagle Name of Politics reasurer PO Box 1520 report is a true,complete and correct Campaign Financial Disclosure Report as required by law. Eagle,ID 83616 (208)939-6813 Fax:(208)939-6827 �' Signature of Political Treasurer Page 1 DETAILED SUMMARY Name of Candidate or Committee: 'OCVV 3 -- Total This Period , ] Contributions 1 j. Unitemized Contributions($50 and less) #of Contributors + $ ?j0( -- 2 Itemized Contributions(Total of all Schedule A sheets) + $ 61-17) _-- 30 In Kind Contributions(Total of all Contribution amounts from Schedule C sheets) + $ .2, ® Loans(Total of all New Loan amounts from Schedule D sheets) + $ 50 Total Contributions(Transfer this figure to page 1, Section IV, Line 3) $1 to 62 2i Expenditures 6 Unitemized Expenditures($25 and less) #of Expenditures I + T. Itemized Expenditures(Total of all Schedule B sheets) + $443 LL , LI g In Kind Expenditures (Total of all Expenditure amounts from Schedule C sheets) + O $ LS CD: Loan Repayments(Total of all Loan Repayment amounts from Schedule D sheets) i + CD: Credit Card and Debt Repayments(Total of all Repayment amounts from Schedule E sheets) + $ 11 Total Expenditures(Transfer this figure to page 1, Section IV, Line 5) = $Lj 5(, 5 Loans, Credit Cards and Debt 12 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) + $ O 14 New Credit Card and Debt incurred this reporting period (Total of all New Incurred Debt amounts from Schedule E sheets) + $ 15 i Subtotal - $ • 16 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 17 (Total of all Debt Repayment amounts from Schedule E sheets) - $ 1 g Total Outstanding Balance at close of this period (Transfer this figure to page 1, Section IV, Line 7) = $ O— • Pledged Contributions_ — '--1 19 O Unitemized Pledged Contributions($50 and less) #of Pledges +_$ q)7 Itemized Pledged Contributions this Period (Total of all Schedule F sheets) + $ Total Pledged Contributions this period __ Page 2 SCHEDULE A Page of ITEMIZED CONTRIBUTIONS I I of more than Fifty Dollars($50.00)this period Name of Candidate or Committee: KciA 6m-l t( 1 1 Date Received , Full Name,Mailing Address and Zip Code of Contributor Cash or Check I 0 P 1 i I ft,a rv:B ut l e r T $ zoo I 0 d Washavvi Ind Cao l e ID e 3(e 1 Calendar Year-To-Date 0 , 1 , 1( 2. I�h.i I * Rctaae V�,s C� $ l(X _ 2(, 3) UPI COI i& t Ci-e IO S3Ce1Lo Calendar Year-To-Date ell 8 i Oil 121 ve(s ie lbr Lck.9it It) 03 (Q.I CQ $ Calendar Year-To-Date 4' J ci n e C v-1 st-t -e_ $ 1006 — _0/12/ 1 I l u b t kJ Par L Lv1 I — E9 if I‘ r33I I tp $ Calendar Year-To-Date b. Dan I eIi-_ g- T)eMeestev $ 2 -�>_ 12/--1-1-g I bo i F rc, l L n T /.� 1 $ is e I D E 31 I _ _ __� .__� _ _�_�_ 1 Calendar Year-To-Date g1Cer�ko. DTPeu 1 I $ l � -1 0 �` I ro VIGts KoL. 1 CC D V 3(,Q I L I Calendar Year-To-Date 11 7. Je 4 &i rsC, - {$ ICo - g I lei iz___. E S-tut-e 5-1- -'Vk. I l.. 10 Q I l(J Calendar Year-To-Date 8, MAIN C1ccr 1$ too O,2 II l 2,20 cp N , C v,w -ew CA ' C (1 Me n I Calendar Year-To-Date S 1111H-19' U Ctwi(il. Dctitt. _ Is 20 0 — � /� ,^ _w_ 'l�j I e 10 3( 1 W Calendar Year-To-Date 1 all 10:Th v► V�a-S V 1 ►✓��1ttr �! � (1ll � i$ 1OO i I � 1 I10 015, W \I rile #300 $ , mo 1@ l 3-1 V2, Calendar Ye ar-(o-Date Total This Page: ` W Transfer the combined total of a'i Schedule A pages to the Detailed Summary on page 2 line 2. SCHEDULE A Page of 2. ITEMIZED CONTRIBUTIONS of more than Fifty Dollars($50.00)this period 'Name of Candidate or Committee: mal/k --Bv- fr IDate Received i Full Name,Mailing Address and Zip Code of Contributor Cash or Check I 1.el(en q- awri . Q13ev1 $ 100 - 10 2311 2 1,2.1 V\J Ptsion, l Nn evi c `f n ID Le L1 Calendar Year-To-Date • 2.0,e 11ct 0 bell $ 100 -- s�23 � � 1 1 - 1 SW 5w` s (A.Cle3 is it. 4 A I B SCE(Li 2 Calendar Year-To-Date 13. J aY1 4 A-cta-wts 1 $ -. I 120, fey a1de Pa'(- a1 {_ Calendar e • t 1 _ _ _�-dar Ye 4, E 'lie ceate r Tro perti es $ 56X) �2 a_I t 6 • SG�✓1- Pabt v Ave Albany CA- -1_0___ _�_ Calendar Year-To-Date ►� 1 5 I�e( it l . y vi f1oW t' $ llo — { I S f O 3 1 1 I s Calendar Year-To-Date r.Cre2-011° P-ePi� I �' t Q> ! ;II 61 wR i k3ide D I �'z 31,91U - Calendar Year-To-Date _ I Er.[ lY 9" Kiw►.r�e.►�►�� essier $awi ! I bi. s. I' oon.beawo Wc4y , -- 4jte_ta. scou $ Calendar Year-To-Dale ` 8. 2erd� ��\Ia_n vt be VDU{dcort-F- $ 100 131 L 1_ 1011 5, mow{ 1 s la,►/c1 Way Ei / - • b '3 l _ i 1p Calendar Year-To-Date 0 i I 1 Qe , - C CCLB -1"l-e,r $ 1SO -3IS -9-er( 1)r ® ' e Ii s� L 0 Calendar Year-To-Date l J L q / 1 I l�aok °�-CG.�'l thce (L C�1-e'y $ L C - -- --1L 21-15-5 J C i-cc ac v a Dr ( Calendar Year-To-Date Thai This Page: [$ 11 00 , Transfer the combined total of tall Schedule A pages to the Detailed Summary on page 21ine 2. SCHEDULE A Page of ITEMIZED CONTRIBUTIONS 3 l Li of more than Fifty Dopars($50.00)this period Name of Candidate or Committee: Rctr v Built( Date Received 1 Full Name,Mailing Address and Zip Code of Cont;ibutor r Cash or Check q , 1 i 1. o-I-h i l I Kvilg Vlts , 1,LC $ 260-- . cal 6 ILi ve✓side D r $ 1 aJ 1e ID S3(e1[X Calendar Year-To-Date i� , 2 , i i 2, JOsep Nadel $ 260 — - 19 Stco419oct.rd CA---� $ ,0 t Vat 1 t/y C 1 9411-1 l J Calendar Year-To-Date or is- iii 3. 12-0-Y a- Ual nvi � , —, 1�0 1 O 1 W COW vv1A- 7 _Eacj_i_ (/3(d Calendar Year-To-Date 12019C17-t- C`Y C G vVtarca DeM 3-D L cnd s cc i 9 '� X01113111 2 fiver d Ora Ct `2 Calendar Year-TO -C afe f I?il . °�I Lct1 CIS a e C°6- ' rtv15) ( L C- I 0 o -- R I Balld- Y Lo $ Ea- I e �`t) nU 3L I La Calendar Year-To-Date ( 1 / I br' . �e l y ►' l l�r�i( � f $ '000 — -------1 1_-7 Sec_ COurr ry LI/ $ l C V o f t I• W l Y LAn c12- i p Q Calendar Year-To-Date 91_� 11 7. 1,i cL 4 5bwtd y VzgL&i r ✓ e. $ /00 -- I I po 3(>L �O1 EGt"CJ 1 c i n i �(f21 t Calendar Year-To-Dale . Naito 4 �.IavlIMe YIt � q il&r-1 i- loot .l 6 inlay ��/t /�fi e T1 D S-3 R i J $Calendar Year-To-Date F 1 l.. lUG 1 �(' ie 20 1Li S+evevl Parry I 10o - ° . Qoa I e rye INS $• 1 __ O -_ O� Calendar Year-To-Date a , 21; 11 1tJ.Q2o►pert N o V C v $ G _ _ -- Lt a5 I K mare 5 t Lvi $ 1 , 'Hp 1,Q Calendar Year-To-Date _ Total This Page: $ 60—" 1 Transfer the combined total of s Schedule A pages to the Detailed Summary,on page 2 line 2. SCHEDULE A aq to Li ITEMIZED CONTRIBUTIONS of more than Fifty Dollars; >5O.00)this period j NaTe of Candidate or Committee: ivcrk- aut Ie.r _ Date Received I Full Name,Mailing Address and Zip Code of Contributor Cash or Check q i �� I I 1. G1eor e -I- Aikn IVlanr I►G,h l i�1 e t CSC 1 c ,l�l� -cr n .roor ce Co.( � 9 I _ $ 12_1 Li I2 Alit S rV(/� •(/� 0 2 3 6 6 1 Calendar Year-To-Date I B2. a av16ev $ 100 - I l5l l l 1 s t e t ale. Dr -aV\e. (0 3(Q I(i Calendar Year-To-Date _I_ / s k— a Calendar Year-To-Date ICalendar Year-To-Date 1 $ % i r. Calendar Year-To-Date I 1 i $ Calendar Year-To-Date +. $ 1 I ' $ Calendar Year-To-Date $ r . i Calendar Year-To-Date 9 $ 1 / $ Calendar Year-To-Date 10. $ / I $ $ Calendar Year-To-Date 1 _ Total This Page: $ 100 -- Transfer the combined total of all Schedule A pages to the Detailed Summary,on page 2 line 2. SCHEDULE B 'Page of ITEMIZED EXPENDITURES Twenty-Five Dollars($25.00)or more this period Name of Candidate or Committee: M ■.e Purpose Codes A Al Travel Expenses(Airfare,Fuel,Lodging&Mileage) N Newspaper&Other Periodical Advertising B Broadcast Advertising(Redo,TV&Internet) 0 Other Advertising(Yard Signs,Buttons,etc.) C Contributions to Candidates&PAC's P Postage D Donations&Gifts S Surveys&Polls E Event Expenses T Tickets(Events) F Food&Refreshments U Utilities G General Operational Expenses W Wages,Salaries,Benefits&Bonuses L Literature,Brochures,Printing Y Petition Circulators M Management Services Z Preparation&Production of Advertising Date Spent Full Name,Mailing Address and rip Code of Recipient Purpose Code Cash or Check 1.MC— Eamit 1n-tb.infier POBo)c2:2e.(-1' 1\-1 t-12.0 e) NI Dis ( 167, . 2-5/4ris 2 -Fit 1011 101 e 3L1f1A- St 0 — S -11-1 evus rdo -po Bo-A qct MO owtpck_ 10 S 62 4-brapiccaliv specktv/ Ci 11 L-tcluq) G -PtYlrovvi ,likilctioA. Z 225 1 / 1( BOI-5r ID 03-r10 a Prt4i- It avuter 0 Topartgt- Canvoirt Pi 0)/ 2-3/ 1 unco-stivo{-44.A_ GA 00311 — 6- &p/e4 SY11T444 "0 .Ce5 LOY 1°1 I I eag ID '0362ite _le_ V4 200 --$ 7' 7111 t Po Box dzo 9 / ss3tk.1(.42 $ 8. rti ci (12 i Topaytotx- atnvon pi $ 90st3 c'1cAk5Kfri ett.k. Cv+ 9-Srrvvn C i 162) 51-afe 51- / / Ecioie, ID 8-3L-4 (.0 (JA 1 ii po ico:is Lib() . - Nje_ I D K?) 101L9 $ Total This Page: $ 20—r( 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: (\ACCt7 _ $(-Flt'! 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 9, 1 -1 / 11 �3ox I 1 o 0 It'30 --- t6t 1t; (0 2,LQ ItD $ 2. .� D ofi 1 I t vo�ax ie..g,oroo 0 cstfl � , / _ $ 211 Da(la DC/6-2.12r5 33 1wG 0 �I - St c2 _Lou 3 ,- a / / 5 / " 13bis- ID y'311 /4 $ ��� — 4.eive Sriis.1.tn...4- v -ssocco e 91s , L (Jt�2 N M c-huts t.a✓ e 04 2 �o l ea it t0 t3 � 1. (0 $ 5.B tsftr- 1 / 0 / 11 Got tk. E State St- F 5 c)4' e_a to to �3tet(p $ 6. Ct 0 — — r2- 1 toss Cole. $ 18341 7. I IRCU q 3032E 5-laie St- r �_ ,�2, 1 t e I D is3t�e t tv $ 101 8.j�e$rt Yy-FeilCrs 2 ( 15 o E 5trAdi-e St -* I(AP _ � � l tP ID Z-3tWWLo z $ � �� 9. -Pr1'1--t1NUY�S 01 III ZC ->�. e �-fi' Sv e L 2,1 � 1e. to CQ I � _ $ 10.ldh0 Ir epergalevt-F Ne s g ci, I I c 3p 2626L1 3 Ce I it N $ 25-3_ Total This Page: $ 163 42- Transfer the combined total of all Schedule B pages to the Detailed Summary on page 2 line 7. SCHEDULE C Page. of IN-KIND CONTRIBUTIONS and EXPENDITURES Name of Candidate or Committee: M/'i 1/'' Purpose Codes lJ� A All Travel Expenses(Airfare,Fuel,Lodging&Mileage) N Newspaper&Other Periodical Advertising B Broadcast Advertising(Redo,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 1. Contributor Name, Mailing Address and Zip Code l ) D CA-V I CIAO CO [01/4 —he $ •Z� Z fl vlfi.ti tAi ,)any$ R o t tj i' I D �$ �O l Calendar Year-To-Date Expenditure Name, Mailing Address and Zip Code Purpose Code IDett vt Coca 1 cL-f-c- _ 2t2'1 Cc t{yy Unit `�1, 0 ID 2. Contributor Name, Mailing Address and Zip Code / / $ $ Calendar Year-To-Date Expenditure Name, Mailing Address and Zap 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 Zap 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 $67 2 to the Detailed Summary,page 2 line 8) Contributor Total: '" (Transfer the combined total of all Contributors on Schedule C pages $ • Z.--0 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 must 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 _ I I Amount: Amount: $ $ 2. Date: Date: I I _ I / Amount Amount $ $ 3. Dale: Date: I I _ I / Amount Amount: $ _ $ 4. Date: Date: I I I I Amount Amount $ _ $ 5. Date: Date: / I _ / I Amount: Amount $ _ $ 6. Date: Date: / / _ I I Amount: Amount $ _ $ 7. Date: Date: I / _ I I Amount: Amount: $ $ Previous Received Interest Repayments Ending Balance Previous Total $ Received Total: (Transfer the combined total of all received loans to the $ Detailed Summary,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 to 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 E-1.However,only Repayments of Debt during this reporting period appear in the Expenditure Section of the Detailed Summary Page. Any creditor(s)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 Zap 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: _ / I I I Amount Amount $ $ 2. Date: Date: I I I I Amount Amount $ $ 3. Date: Date: I I I I Amount Amount $ $ 4. Date: Date: I I I I Amount Amount $ $ 5. Date: Date: I I I I Amount Amount $ $ 6. Date: Date: _ 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: fA ct rk. 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 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 I Interest Accrued&Finance Charges Y Petition Circulators L Literature,Brochures,Printing Z Preparation&Production of Advertising M Management Services Date Incurred Full Name,Mailing Address and Zip Code of Expenditure Purpose Code Amount 1. / / $ 2. / / $ 3. / / $ 4. / / 5. / / $ 6. / / $ 7. / / $ 8. / / $ 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: IAA airL 13 Ole( 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 contribution. Date Pledged Full Name,Mailing Address and Zip Code of Contributor Amount Pledged 1. / / 2. / 3. / / 4. / / 5. / / 6. / 1 7 ! / 8. / / 9. / / 10. ! / 11. / Total Amount of Pledged Contributions: $ Transfer the combined total of all Schedule F pages to the Detailed Summary on page 2 line 20.