October 10 Pre General Report - Keep, Kevin - 10/10/2015CAMPAIGN FINANCIAL DISCLOSURE REPORT
SUMMARY PAGE
(Please Pri nt or Type)
Section I
RECEIVED $, FILED
CITY OF EAGLE
OCT 10 2015 Rev. t
rile:
Route to:
Name of Candidate or Political Committee and Chairperson
Office Sought (if candidate)
Seat ( any
KCMI".l KQ*1P
C"4 (awa ca ".
to Date
d mq ress I City and Zip b
Home Hhone
Work Hhone
Name of ` tPolitical reasurer
V "t-Top- 1-�
TvF5jN-n`gTc2ress
City and Zip
ome Phone
or one
4 wlc >,+cZ��tiJwt 1�,,.._
CGsl� buibt�
'V`b•"%'N°t-11-6
"1l\N•9St66�\
Change of address for: Candidate or Political Committee ❑ Political Treasurer ❑
Section Il TYPE OF REPORT
This filing is an: I;k Original O Amendment
This report is for the period from `) / 1 o / 1 S_ through k t3 / l 0
October 10 Pre - General Report
❑ Annual Report
Is this a Termination Report: ❑ Yes
❑ 7 Day Pre - General Report
❑ 30 Day Post - General Report
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 11, Section IV.
❑ 1 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
figures to the Column 11 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)
COLUMN]
COLUMN II
This Period
Calendar Year
to Date
$ XXXXXX
$ D
$ ®
$ XXXXXX
$ L
$ I Ja
$
$
$
$
$ �' 1l _
$ x.11
`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.
Rpfi rrn Thiq Rpnnrt o' iSection V
Sharon Bergmann
Clerk- Treasurer
City of Eagle A _ -h«.t..... ,hereby certify that the information in this
PO Box 1520 Name of Political Treasurer
ro ort is a true, complete and correct (- naign Financial Disclosure Report as required by law.
Eagle iD 08360 16 p� p r
(208) 939 -6813
Fax: (208) 939 -6827
Sharon @cityofeagle.or9 Signature of Political Treasurer
Paae 1
SCHEDULE A Flage o
ITEMIZED CONTRIBUTIONS 1
of more than Fifty Doliars ($50.00) this period
Name of Candidate or Committee: I --IE-
Date Received
Full Name, Mailing Address and Zip Code of Contributor
Cash or Check
C) i I%/ l 5'
—
1 ,e,% 1r. 4�
W,io %
$ ao
$
Calendar Year - To-Date
sbj V
$
Calendar Year -To -Date
3.
t \\pp \81
`CO.�
$0
$ V�
Calendar Year-To-Date
i
4.
a �
$
Calendar Year -To -Date
5.
Calendar Year -To -Date
6.
$
Calendar Year -To -Date
r !
7.
$
Calendar Year -To -Date
8.
$
Calendar Year -To -Date
9.
$
Calendar Year - To-Date
10,
Calendar Year - To-Date
Total This Page;
$ k
Transfer the combined total of all Schedule A pages to the Detailed Summary on page 2 line 2.
DETAILED SUMMARY
game of Candidate or Committee: Lcq I"
Q
Contributions
U Unitemized Contributions ($50 and less) p # of Contributors
O Itemized Contributions (Total of all Schedule A sheets)
3� In-Kind Contributions (Total of all Contribution amounts from Schedule C sheets)
T Loans (Total of all New Loan amounts from Schedule D sheets)
5 Total Contributions (Transfer this figure to page 1, Section IV, Line 3)
Expenditures _
Unitemized Expenditures ($25 and less) # of - Expenditures
7� Itemized Expenditures (Total of all Schedule B sheets)
® In -Kind Expenditures (Total of all Expenditure amounts from Schedule C sheets)
g� Loan Repayments (Total of all Loan Repayment amounts from Schedule D sheets)
@ Credit Card and Debt Repayments (Total of all RaNayiiient amounts from Schedule E Sheets)
11 Total Expenditures (Transfer this figure to page 1, Section IV, Line 5)
Total This Period
+ $ p
+ $ b
+ $
+ $ Cj
+ $ d ._.._....
+ $ o
$..Iilr.
Pang 9
Loans, Credit Cards and Debt
Q)
Outstanding Balance from previous reporting period
+ $
O
13
New Loans received during this reporting period
�
(Tots! of all New Loan amounts plusAccrued 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)
+, $
Qj
Subtotal
_ $
D
Repayments of Loans made di ;ring this reporting period
(Total of all Loan Repayment amounts from Schedule D sheets)
$
17
Repayments of Credit Card and Debt this reporting period
(Total of all Debt Repayment amounts from Schedule E sheets)
- $
1L
Total Outstanding Balance at close of this period (Transfer this figure to page 1, Section IV, Line 7)
_ $
v
Pledged Contributions
1 g
Unitemized Pledged Contributions ($50 and less) ij # of Pledges 0
+ $
®
Itemized Pledged Contributions this Period (Total of all Schedule F sheets)
+ $
Total Pledged Contributions this period
= $
Q1
Pang 9
Date Spent
Full Name, Mailing Address and Zip Code of Recipient
SCHEDULE B age o
Cash or Check
ITEMIZED EXPENDITURES
Twenty -Five Dollars ($25.00) or more this period
Name of Candidate or Committee:
vs�
J
Purpose Codes
A
All Travel Expenses (Airfare, Fuel, Lodging & Mileage) N
Newspaper & Other Periodical Advertising
B
Broadcast Advertising (Radio, TV & Intemet) 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
Generdl Opeiatiorial Expenses
W
Wages, Saianes, Berieirts & 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. caste � nkos ira.r
-L!%-
111 K-
'�•�.'� %4
East. \V
vs�
$ 44q.do
2.
'I'\
°1CLa
�ocoo'
/Na /oq,-
G at
$
3.
$
4.
1
$
5.
! 1
$
6,
i
rI 1
$
7.
—�
Is
'8.
I
9.
'
r i
$
10.
Total This Page:
$ 01.9 ,
Transfer the combined total of all Schedule B pages to the Detailed Summary on page 2 line 7
SCHEDULE C I Page o
IN -KIND CONTRIBUTIONS and EXPENDITURES
[Name of Candidate or Committee:
Purpose Codes
Contributor Name, Mailing Address and Zip Code
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
Literdture, BfULIlUreS, Priiltltlg
Y
Petti0rl i,I1CUidiUrS
M
Management Services
Z
Preparation & Production of Advertising
1.
Contributor Name, Mailing Address and Zip Code
�1,
$
Calendar Year -To -Date
Expenditure Name, Mailing Address and Zip Code
Purpose Code
2.
Contributor Name, Mailing Address and Zip Code
/ 1
$
$
Caiendar Year -To -Dale
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 Coda
Purpose Code
4.
Contributor Name, Mailing Address and Zip Code
1 I
$
Calendar Year -To -Date
Expenditure. Name, Mailing Address and Zip Code
Purpose Code
$
Expenditure Total:
(Transfer the combined total Expenditures Schedule C Is
of all on pages
i
to the Detailed Summary, page 2 line 8)
Contributor Total: $
(Transfer the combined total of all Contributors on Schedule C pages
to the Detailed Summary, page 2 line 3)
SCHEDULE D
LOANS
!dame of Candidate or Po!itica! Committee: ICJ rrj 15F 4r
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.
.4ny !oan(s) :h+ith a balances) appearing on the last repert must be listed below with the amount, in the Previous Balance Column. Ant, near! 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:
Amount:
Amount:
$ --
2
Date:
Date:
I I
! l
Am0ur..t
Amount:
$
3
Date:
Date:
r r
I I
Amount
Amount:
x
w
4
Date:
Date:
I !
I 1
Amount
Amount:
5
Date
Date.
Amount:
Amount
6
Date-
Date:
l i
Amount:
Amount:
7
Date:
I I
Date:
I r
Amouni.
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:I
-
(Transfer the combined total of all loan repayments to thel $
Detailed Summary, page 2 line 9 & 16) --- ---
Ending Balance Total: $
1 &10TC• T--f., fh. nnmhin.rf fntal of all Annri i.rl IM—f and D-4—q I Wane to +hi n.+oH.A Cm —.7 lino 1Zi
SCHEDULE E
CREDIT CARDS and DEBT
Dame of Candidate or Political Committee: 1N Uff
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 tie 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 Coda of
Creditor
Previous Balance of
debt at the end of the
New Debt amount
incurred during this
Repayments of Debt
during this reporting
Balance outstanding
at the end of this
(Candidate, Individual or Business)
last reporting period
reporting period
period
reporting period
1.
Date:
Date:
Ainount..
Amount.
2.
Date:
Date:
Amount:
Amount:
$
$
3.
Date:
Date:
Amount:
Amount:
4.
Date:
Date:
Amount:
Amount:
5.
Date:
Date:
Amount:
Amount:
6.
Date:
Date:
Amount:
Amount:
Previous Incurred Repayments Ending Balance
Prayious- 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
CREDIT CARD and DEBT ITEMIZATION
Name of Creditor from Schedule E:
Page o
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 Cudes
Full Name, Mailing Address and Zip Code of Expenditure
Purpose Code
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.
4
! I
$
5.
r I
$
6.
1 I
$
7
1 !
$
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 I Fage o
PLEDGED CONTRIBUTIONS BUT NOT YET RECEIVED
Name of Candidate or Committee; �J 1 t!
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.
I I
2,
3.
/ I
4.
5.
6.
7.
I /
8.
/ I
9.
1 I
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.
Tracy Osborn
From: Victor Miller <victor @VBM4.com>
Sent: Saturday, October 10, 2015 5:01 PM
To: Tracy Osborn
Subject: RE: Candidate & Campaign Finance Reporting information
Attachments: scan0110.pdf
Tracy —
Please see Kevin Keep's first financial report...
Blessings,
Victor B. Miller IV
President
True North Consulting L.L.C.
917 - 952 -6601
From: Tracy Osborn [mailto:tosborn(5cityofea Iq e.org]
Sent: Wednesday, September 09, 2015 11:39 AM
To: Craig D. Soelberg; Janet Buschert; Jeff Laughlin; Jim Reynolds; Joanne Pence; Kevin Keep; Mike Olsen; Naomi
Preston; Rick Murphree; Shane Curry; Shelby Phillips; Stan Bastian; Stan Ridgeway; Terri Soelberg; Victor Miller; Zach
Pence
Subject: Candidate & Campaign Finance Reporting information
Hello Candidates & Treasurers
Attached are the critical dates for the submittal of Campaign Finance Reports. This information, as well as the
necessary forms and manuals, can be found on the City's website www.cityofea lg e.org.
Please confirm that the person you appointed as Treasurer receives this information, as some appointment forms
did not include their e-mail addresses.
Have a great day!
Tracy E. Osborn, CMC
Sr. Deputy Clerk/Treasurer
City of Eagle, Idaho
660 E. Civic Ln.
Eagle, ID 83616
208 - 939 -6813 ext. 201