October 10 Pre General Report - Preston, Naomi - 10/13/2015❑ 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 II, 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 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*
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)
$ XXXXXX $
$
$ 3,z`
$ 7( d
$ 3,
$ '-
XXXXXX
$
$
$ 3773
$ 3
*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.
V
Sharon Bergmann
Clerk- Treasurer
City of Eagle
PO Box 1520
Eagle ID 83616
(208) 939 -6813
Fax: (208) 939 -6827
sharon @cityofeagle.org
9
I, I ffum I ft— _ ��ereby certify that the information in this
Name of Political-Treasurer
report is a true, complete and correct Campaign Financial
Page 1
of
as requyed by law.
RECEIVER & FILED
CAMPAIGN FINANCIAL
DISCLOSURE REPORT
CITY OF 5ACLE c-
°{�
re
SUMMARY PAGE
Rev. 1010
OCT 13 2015
(Please Print or Type)
File:
Section I
I Route to:
Name of Canoidate or Political Committee i rson
/ l s
Office Sought if sand
-Wailing Address
.
I
i y and Zip
EA6zz
5-v/ S 25<
WorK ljnone
2-6k 13 S67
ame of o itica reasurer
N M
-1175Ming
X12 s
Aaaress
320 �,
City
and Lip
hkJ__S1(L
Home Phone
s79
Work Phone
939
Change of address for:
Candidate or Political Committee
❑ Political Treasurer
❑
Section II
TYPE OF REPORT
This filing is an: ` WOriginal ❑ Amendment
This report is for the period I 1 through 1 1
❑ 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 II, 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 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*
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)
$ XXXXXX $
$
$ 3,z`
$ 7( d
$ 3,
$ '-
XXXXXX
$
$
$ 3773
$ 3
*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.
V
Sharon Bergmann
Clerk- Treasurer
City of Eagle
PO Box 1520
Eagle ID 83616
(208) 939 -6813
Fax: (208) 939 -6827
sharon @cityofeagle.org
9
I, I ffum I ft— _ ��ereby certify that the information in this
Name of Political-Treasurer
report is a true, complete and correct Campaign Financial
Page 1
of
as requyed by law.
SCHEDULE A Page
ITEMIZED CONTRIBUTIONS
of more than Fifty Dollars ($50.00) this period
Name of Candidate or Committee:
Date Received
Full Name, Mailing Address and Zip Code of Contributor
Cash or Check
to K'*
Z- YNA16 5ISY-A-d Et-- Iq011l CPII 61t,
$ tea. 6V
1200 7fo� -
E� Y 6 3 `
$ .
` U `� / f'
Calendar Year-To-Date
2 �r 1 ' �' l �� / "� v ✓
$
1SL��I
�C
Calendar Year - To-Date
7 IWAPY
$ 2—e-0• OD
3 3 Z d�008t -
$ ,SOV. Ov
& j G
Calendar Year-To-Data
G15(f
$
Y31, /
Calendar Year-To-Date
5.
$
Calendar Year - To-Date
6.
I I
$
Calendar Year - To-Date
7.
I I
$
$
Calendar Year - To-Date
8.
$
$
Calendar Year - To-Date
9.
$
Calendar Year - To-Date
10.
I I
$
Calendar Year - To-Date
Total This Page: is
�.
Transfer the combined total of all Schedule A pages to the Detailed Summary on page 2 line 2
SCHEDULE B
ITEMIZED EXPENDITURES
Twenty -Five Dollars ($25.00) or more this period
Name of Candidate or Committee:
Purpose Codes
Fuu Name, Mailing Address and Zip Code of Recipient
Purpose Code
A
All Travel Expenses (Airfare, Fuel, Lodging & Mileage)
N
Newspaper & 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
Date Spent
Fuu Name, Mailing Address and Zip Code of Recipient
Purpose Code
Cash or Check
,2
Po�oX Z2�
l`/
$3 0j�
2. 5 �
3.
4.
I I
$
5.
I I
$
6.
7.
8.
9.
10.
Total This Page:
$
Transfer the combined total of all Schedule B pages to the Detailed Summary on page 2 line 7.
) A
1.
SCHEDULE C age °
IN -KIND CONTRIBUTIONS and EXPENDITURES
Name of Candidate or Committee:
23 S- Gv hl V6
Purpose Codes
vim/ (o
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
1.
Contributor Name, Mailing Address and Zip Code
2
23 S- Gv hl V6
vim/ (o
Calendar Year- To-Date
Expenditure Name, Mailing Address and Zip Code
Purpose Code
z �67 � x'371
2.
Contributor Name, Mailing Ad ress and Zip Code
J�
$
$
Calendar Year- To-Date
Expenditure Name, Mailing Address and Zip Code
Purpose Code
3.
Contributor Name, Mailing Address and Zip Code
$
CalendarYear- To-Date
Expenditure Name, Mailing Address and Zip Code
Purpose Code
4.
Contributor Name, Mailing Address and Zip Code
J
$
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:
(Transfer the combined total of all Contributors on Schedule C pages $ , p
to the Detailed Summa age 21ine 3
SCHEDULE D
LVHtV /
Name of Candidate or Political Committee: &&-O yl AffS%0N
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 InterestAccrued 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
2.
3.
4.
5.
6.
�/ / P uate, j uate:
/vppJ��7Z/ ! ✓�/��'�c- �% �l .L l l
an:�-OD,06 —�- Amount:�,�� r
$
Amount:
I /
Amount:
Amount:
/ l
Amount:
Amount:
Amount:
Amount:
Amount:
I /
Amount:
Amount:
7. Date: Date:
l l I I
Amount: Amount:
$
Previous
Previous Total 1 $
(Transfer the combined total of all received loans to thel $
Detailed Summary, page 2 line 4)
Received
Interest
Interest
(Transfer the combined total of all loan repayments to
Detailed Summary, page 2 line 9 &
Ending Balance
(NOTE: Transfer the combined total of all Accrued Interest and Received Loans to the Detailed Summary, page 2 line 13)
Balance
SCHEDULE E
CREDIT CARDS and DEBT
Name of Candidate or Political Committee: &12!n /!V/ /
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 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
Creditor debt at the end of the
(Candidate, Individual or Business) last reporting period
1.
2.
0
4.
5.
6.
Previous
Previous Total: I $
New Debt amount
incurred during this
reporting period
Date:
Amount:
Date:
Amount:
$
Date:
Amount
$
Date:
Amount:
Date:
Amount:
Date:
Amount
$
Incurred Total:
(Transfer the combined total of all incurred debt to the 1 $
Detailed Summary, page 2 line 14)
Incurred
Repayments Total:
(Transfer the combined total of all debt repayments to the $
Detailed Summary, page 2 line 10 & 17)
Repayments of Debt
during this reporting
period
Date..
Amount
Date:
Amount:
Date:
Amount:
Date:
Amount:
Date:
Amount:
$
Date:
1 /
Amount
$
Ending Balance Total: 1 $
Balance outstanding
at the end of this
Ending Balance
SCHEDULE F e of
PLEDGED CONTRIBUTIONS BUT NOT YET RECEIVED
Name of Candidate or Committee: A17'01)/1
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.
—I -1
3.
I /
4.
I /
5.
6.
7.
s.
9.
I 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.
SCHEDULE E -1
CREDIT CARD and DEBT ITEMIZATION
Name of Creditor from Schedule E: AMORI PXES?-01�
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 Codes
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
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
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.
I /
$
3.
4.
5.
$
6.
— / —/
$
7.
I I
$
8.
9.
$
Total This Page: Is
The total of itemization for this creditor should equal the new loan amount listed on Schedule E for this creditor.