Foley For Mayor 10-27

SEEC FORM 20

Itemized Campaign Finance Disclosure Statement COMMISSION CONWNCTTCUT ST,{TE, UI,NCTIONS ENT'ORCEM INT

I oflT

Rev. 1/08

SUMMARY PAGE \ -\

i1

d\* Lst T

!{f:

/ \i i 3.

t

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TREASURERADDRESS Addres.""".-".-t

Ll,

itir_=f,f-

'jj {V;1u;1i

fl

January 10 filing

fl

April

tr

July 10 filing

E

October

D

Independent ExPenditure ElElectron tr

10

filing

n

7th day Preceding Primary

tr

7th day preceding referendum

E lnitial

fl

30 days following PrimarY

tr

45 days following referendum

I

I

Deficit

fl

Termination

pltft

l0 filing

piiman

{'* t',

auy preceding election

il

12th day Preceding election

!

45 days following election not held in November

Contribution or Disbursemenl eACs

oNL')

Amendment to Type ofRePofi:

(Stile Cenial Cummiltees OnlY)

Beginning Date

ii

l a I d; {1 f.}<-,1', -ffi

Statement, that all of the information I hereby certifu and state, under penalties of false and aomplete' Oi..ioror. Statement for the period covered is true, accurate

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t It

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FOR FALSE

ficrth on this Itemized Campaign Finance

/'t

PRINTNAME OF SIGNER

TREASURER OR DEPUTY TREASL]RER (SIGNATURT)

PENALTY

se1

TO EXCEED STATEMENT IS P(]NISHABLE BY FINE NOT ioR Nor MzRE rIuN oNE vEAR' oR BorH

sl,iol,bRlMinISoNMENr

itjijii

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pr':

SEEC FORM 20 Itemized Campaign Finance Disclosure Statement CONNECTICUT STATE ELDCTIONS f, Ntr'ORCEMENT COMMTSSION Rev.

Page 2 of 17

1108

SUMMARY PAGE TOTALS NAME OF COMMTTTFE

A AJ*x.. -Ee-lnfi;nt^ *{-t'ltr7 ,{Ai{WqorZc{d

FII-ING DI'F- DATE

i

e>

la t /Zl:x>'

UULUMN A

LJ

UULUMN

This Period 1l Balance on hand January 1 of cunent year for Ongoing and Party Committees OR

$ f,. c,-

Balance on hand from day Committee was formed for all other committees

tl;,;4s-.?l $ l, s*ef. c,c t'8, 7g t'.o;,

12. Balance on hand at the besinnina of Reoorlins Period I3

.

rJ

Assresate

Contributions received from lndividuals (Sections A and B)

* /atc, (;ci

14. Receiots from Other Committees (Sections Cl and C2) 15. Other Monetary Receipts (Sections D-K)

q I s?

<.r;

* lsz

c'(-j

l6a. Total Small Food and Beverage Receipts at Fair (Section Ll) Town Committees ONLY 1

6b. Total Proceeds from Small Purchases

l6c

at

Tas Sales, Auctions or Other Sales (Section L2)

Tofal Prrc-hases of Advertisins in a Prosram Book (Section

17. Total Monetary Receipts (add totals for lines

L3\

* ff"a,

+qtcl.oc,

Municipal and Town Committees ONLY

l3-l6c)

18. Subtotals (add totals in line 12 + line 17 in Column A; and in line 1l + 17 in Column B) 19. Expenses Paid by Committee (Section P) 20. Balance on hand at close ofReporting Period (Subtract line 19 from line 18 in both Columns)

"l,b?c'..c sL/:,vti.?l *'4 h

,S

t*

1

(.! ()

QrL qi

21. In-Kind Donations not Considered Contributions Received (Section L4)

{t gS .Lt\23. Relirndable Deposit to Telephone Company (Section

*

?,

Y

&'.,

8'"c

&4,.1c-ts

uE,s

{L

fi ?1 6

tr crr

n?

it

t oi qa.vf

N)

24. Receipts oforganization Expenditures (Section O)

\-: 25. Besinnine Loan Balance 25a.

-F

Loans Received {section D)

25b.

*

Interest and Penalties on Loan

25c.

-

Payments on l-oan

25d. Total Outstandine Loan Amount

--_

26. Campaign Expenses Paid by Candidate (Section Q)

tJ r.. J. \L2sJ

27. Expenses Incured on Committee Credit Cald (Section R)

q--

28. Exoenses Incurred bv Committee During this Period but Not Paid (Section

$)

28a. Total Outstanding Expenses Incurred by Committee still Unpaid (Section S)

Y ,:,,!-

ta

L;+tr " oi

I.

MONETARY RECEIPTS (Sections A-K)

\IAME OF COMMTTEE

ll 'l'otal siu...' i&L\,r''rrrirrt '* A.

i*4 !-n -t

[J: l'I16offi'

for definition of Small Contribuor)

d{or'ra !AJi r*r *

Ii

>F*t -12, Lfi'tr, e 5bAdd.9SS

tr

is contributr{r a lobbyist, spouse, or dependeYt child of a lobbyrst?

tr

Is this contribution associated with lundraising event listed in Section .Ifyes, list Event # Method of contribution:

tr Cash p

Check

Personal

E

J5

Yes

fl

Payroll Deduction

I

(.-

[s contributor a lobbyist, spouse, or dependent child of a lobtryist?

tr Cash p

LutFme

Aln,'{

E

Yes

Check

D

branches

spoude, I Yes ordependentchildofalobbyist? P *o

Is confibutor a lobbyist,

D Cash F*ersonal Check

'TfiTo'v

I FNo

*flffi

tn

I

, ;tate

,t:

Aggregate coutnbutloDs

/a"u-,

3ry:l

r...

rrp L9u€

I

# Ae . .*r:

i i'i''?::.i,'-= rs'tr:)

Amount of Contribution

'*

tlC,,i th

i&

rto,

fl Yes Ano I Executive U Legislative

Is contributor a principal ofa state contractor or prospective state fyes, indicate which branch or branches of govemment the contract is

I

-

D

a lobbyist, spouse,

F

ls this contribution associated with f'undraising event listed in Section fyes, list Event #

I

Palroll Deduction

I

with:

cont{actor?

Yes

No

iltrto,f"r'

t*f c61zm* F

Money Order

(-

)rincioal

MT

i),r,,J d

ftQ.

)r dependent child ofa lobbyist?

E Cash finersonal Check

Money Order

EYes E

Yes

t

Method of contribution:

I

No

contributi@lis in excess of $400 to a candidate committee lor a ch ief executive Sf cer of a l'J municipality does contributor or business he/she is associated with have a ct-rntract frith said mumcipality valued at more than $5,000? No

CreditlDebit Card

JusI Aotress

contrib@r

Payroll Deduction

Yes

Aqgf egal€ contribulions

I

ff, 3 $tlr 4.,?s i$fi ss.r (e5rosua

E

-hr-l:. If

t1s

fl fl

contractor?

ofgovemmentthecontractiswith: DExecutive ELegislative

Ioi,{ r,

Address

Method of contribution:

&;5-n*

[ Yes E

Is contributor a principal ofa state confactor or prospective state fyes, indicate which branch or

Credit/Debit Card

Is this contribution associated with a fundraising event listed in Section L1? f1es, list Event #

Amount of

Contribution

e

1

:

Personal

,

I

$5,000?

a fl Yes Ll? F *o

\.1 *rt"rlr ru,. l&'ll

DhNme

I

-dl'{Ln.-^*

is in excess olM00 to a candidate committee for'a chief executive officer of a municipality does contributor or business helshe is associated with have a contract with said municipality valued at more than No

t,'^ f,';)n

:ilrffi

n'-*

i*,-J .

No

Princifal Qgcuparior

+.

;lde

Yes

If contribut{!}r

ENo

Is this contribution associated with Fundraising event listed in Section fyes, list Event # Method ol contribution

Jx.ri;=-

I

[ F

^ffi,'#*;::

"&Vf#,1-:o*,+

Money Order M^

Address

Int_

branches with: tl

Credit/Debit Card

X-i)lc,.l"'*s.\,'* )t

* 53..t

or bmpro)'7

-*1^

ls contributor a principal ofa state contractor or prospective state contractor? f/es, indical€ which branch or of govemment the contract is Executive E tcgislative

No

L).<"-t\,+l-*

(esldsrual 5trret

Amount of Contribution

Ifcontribr-(idn for a'chief executive ofircer ofa munioipality does contributor or business he/she is associated with have a contract with said municipaliry valued at more than $5,000? EYes D No

No

I F

\me

Ip Lode

itale

"'11.."{ is in excess of $400 to a candidate committee

Yes

a Ll?

"""$li3l'l-l

,h

.ltli'{me--

s

, h}rrr,,

$ ?ti . c,o

Subtotal Section -i

Fust^

a9$dgnn&

<esrdfl ttal

{}

/t1

B. Itemized Contributions from Individuals

t*'S";

'it

,("'crq

Contriffi*tions liot'1Smalt Contribdtors-Received this Period ONLY

(See instructiotts

(.

Page 3 of 17 lN,TNG DIJF, DATF

{

..) itate

f tr

llp Lode

'i?.r4

57'

.

c'.r Amount of

,

J.r^': r *-0'i*

Contribution

frrli"i 'Rir,* fios'-

Nme of Emolorer

/ttllv(ii

lf

Occupatior

t,

.-

E'1l0.tr

contribution is in excess of M00 to a candidate committee lor a chief execulive olhcer of a municipality does contributor or business he/she is associated with have a contract with said municipality valued at more than $5,000? D Yes E- No

a fl Yes L1? *" F

Is contributor a principal ofa state contractor or prospective state fyes, indicate which branch or

branches

contractor? E

Yes

F

Wo

ofgovernmentthecontractiswith; EExecutive flLegislative uale Kecqved

I

Crexiit/Debit Card

D

Payroll Deduction

fl

Money Order

rofts-lzrl(Y? frT,:;;,,,'r., SUBTOTAL Section B-This Pagt

f svi'.,x

TOTAL of additional Section B Pages / / Sii.ert TOTAL OF ALL CONTRIBUTIONS FROM INDWIDUALS (Seetions A &B) (Enter total on Line 13 of Summary Pase)

'/,:,::-cr'

I- MONRTARY RHCRIPTS (Secfinns A-K) {AMF, OF COMMITTF,F,

H Nt;e? i1r tl/r^ A.

*

i 11 *

Page 3 of 17

iI] ING DI

{'*': e tt J,5.r- iVlt':iilr,--)'ael'?

I

g t;r)-O6

Subtotal Section A

/See instructiare for definition of Small Contributor)

NA TF

h.1 | ? firiq

t it

Total Contributlons frordgmall Contribrltors-Received this Period ONLY

TF

B. Itemized Contrihutions from Individuals La{t

Nme

l\re,'Y L"" i'f"i*qT"H',-' t o.-r

fl

FNo a

fyes. list

Event

#_

Casn plfersonal Check

fl F

Yes

Is contributor

No

fyes,

fl

spouse, fl p-

a Q$byist, or dependent child of a lobbyist?

I Payroll Deriuotion fl Ftst€ . \r:

Stpersonal Check

lrp Uode

$go,or:

Is contributor a principal ofa state contrastor or prospective state contractor? f]es, indicate which branch or branches E Executive Legislative of govemment the contract is

Yes

wilh:

E

n

Credit/Debit Card

Payroll Deduction

L

fl

fl

Yes

F"o

roltzlZt"s ffru;:.;.

Money Order

*P.

'lvlrt*.*-*-o

Principal

Ocopariou

M r] fi t-f Nme oEmlover hb.r.r."to,

-J-1.7-rfu^q"--,..-

t.

SrSr A4tresil

ai 3 {& ;t K;nzE5v--.

Is contributor a lobbyist, spouse, or dependent child of a lobbyist?

itate

&rtu*c

1p

Llode

C{*god

lr

Lo,rmu,n,L {'stlrto

I Yes Y'No

contrastor? U

Is contributor a principal ofa state conuactor or prospective state

Ifstes,indicatewhichbranchorbranches E oigovemment the contract is with: E Executive f) Legislative r Date Rrceived

D Casn Sfersonal Check E Credit/oebit Card E

Payroll Deduction

I

Money Order

Itt*-.

>KAre'/1

EI

*

Yes

n

municipality valued at more than Yes

?h. lip

lol;e Ocopation /r-,:rfi Pr[rcip*]

Ke l-i

Yes No

ApgreBale aootnbuttons

H

IsZ

<E: Amount of Contribution

4

r-r lL

$1[i

Nme of Employtr

Code

CEt'l6

rL'

'\*lc\-

$5,000?

E Yes D

with:

E

Date R€eived

Credit,Debit Card

No

Is contributor a principal of a stiato contractor or prospective state contractor? I/-yes, indicate which branch or branches Executive E Legislative of govcmment the coniract is

F*o

Method of contribution:

E Cash $fersonal Check n

*.>

in excess of $400 to a candidate committee lor a chief executive ofFtcer of a If contribution municipality does contributor or business he/she is associated with have a contract with said

F"u

Is this contribution associated with a fimdraising event listed in Section Ll? fyes, list Event #

r; itate

f),rh.^

,,^rt cr

Is contributor a lobbyist, spouse, or dependent child oia lobbyrst?

FriB'

excess of $400 to a candidate committee trr a chief executive officer ofa municipality does contributor or business he/she is associated with have a contract with said municipality valued at more than $5,000? E Yes fl No

Method of contribution:

-8

Amount of Contribution

Ifcontnbutionis in

Yes

FNo

Is this contibution associated with a fundraising event listed in Section L1 ? I/yes, list Event #

?'.f*

Nme ol hmDlovu

ffn: d;",-,..?, r, l{,. ( :xrf'\

t')r" Lr l!(

excess of $400 to a candidate committee lor a chiefexecutive officer of! municipality does contributor or business heishe is associated with have a contract with said [ Yes E No municipality valued at more than $5,000?

No

'*frTL,''pl-',,^

*"'':*- *Y*'^T,

Amount of Contributi,on

K( n /*,|-fr,-

,ryl

l(

?g ec,: 4=,

Prircipdpccupatiog

Date Received

Method of contribution:

GSTCSUA

MI

fl Yes F rso

Ifcontributionls in

Yes

F"o

#_

F3*c,-0';

Aggregate contnbuhols

tol c1 I Zcc=I

Money order

)late

l),^g*

fl

Is this contribulion associated with a t-undraising event listed in Section L1?

tr Cash

ii"

ofgovernmentthecontractiswith: EExecutive lLegislative

Addess

Event

fj

-1t,3*i

a principal ofa slate contractor or prospective state contractor? indicate which branch or branches

Credit/Debit Card

ff^#u* rl-eru rla* lesld&bdset i;q ffi;;ls*"-tf rfr4.

Ifyes.list

t

t 'l)'.,i .t;':;f-' rlri " -T,,di.," t

Nme or EmDlovg

1ip Code

municipality does contributor or business he/she is associated wrth have a contract with said municipatity valued ai more than $5,000? E Yes I No

"{

Is contributor

/-r

Date Regeived

Method of contribution:

n

State

Contribution

If contributiofls in excess of$400 to a candidate committee for a chief executive officer ofa

Yes

fundraisingeventlistedinSectionLl?

Amount of

c_.

J) p,-A*

,*,ltQ^c

Is contributor a lobbyist, spouse" or dependent child of a lobbyist? Is this contribution associated with

MI.

Vrzlrtj n -'ry--

I

Payroll Deduction

I

Money order

lo/zz l2 .r'J

A

E

Yes

Fto

ggregate contrlbutrons

*'152 oe

SUBTOTAL Seetion B-This Pagt Frpo.ou.

TOTAL of additional Section B Pages F 5Qf.ccr TOTAL OF ALL CONTRIBUTIONS FROM I|{DMDUALS (Sections A &B) (Erter total on Line 13 of Summnry Page)

Pl

s-{....-

MONETARY RECEIPTS (Sections A-K) \AME OF COMMITTF,F,

,*+

A.

Page 3 of 17

FII,ING DIIE DATE

F;i.,ii F-r,-" r.li''il-l r'4i ^ r."rf"u: u..; J]'- f"tr|a os trl'"- .*rj*-'rr,d? Total Contribu6ons from'Small Contripufors-Received this Period ONLY Subtotal Section

lSee instractiotts fot defrnition ofSmall Contributar)

i

t't f.a--) /:2 it'.,<:: g 116, r..S

B. Itemized Contributions from Individuals tast

Fi6l--

)me

f"1

r"l

*v-

I \,,

spouse, fl D

Is contributor a lobbyist,

ordependentchildofalobbyist?

a

ls this r.:cntribution associared with

fundraising event listed in Section Ll

If

yes,lkr Evenr

r ,;{ t$_

Casn

'p+ersonat

;

Contribution rfaqe or

ttal9

:rp Lode

!t'7

l':{,d i}

_

tf contribrrtiq{ is in excess of 5400 to a candidate committee lor a chiefexecutive ofhcer ofa municipatin"toes contributor or business he/she is associated with have a contract with said municipality valued at more than $5,000? E Yes No

?

F;'{i}

,;e,

fl

Is contributor a principal ol a state contractor or prospeotive state -I/yes, indicate which branch or branches

$.Yes

E

No

oonFactor?

il E

Yes

No

ofgovernmentthecontractiswith: EExecutive ILegislative Aggregate contnbutrQls

Check

[J

Cre
tl

Payroll Deduction

fl

I r":! i

Money Order

Firsr

{=

l}{'r.'"

* r :-ei.

r.'.-'i Amount of

Plincipal Occupatiou

,41

i"-?1Yl.rLt

Contribution

Itv'\

rtate

'J,)i ,' f >-*

Iscontributoralobbyist,spouse, 0rdependentchildofalobbyist? Is this contribution associated with tundraising event listed rn S-ection

, "|.*'t

fl F

No

'$ tr

/';f.

$J

*itk

Yss

Is contributor a principal ofa state contractor or prosp€ctivg statg fyes, indicate which branch or branches

No

E

D Payroll fosi )

^Iaff {* t"{ii'seli-}'r

fl

Is contributor a lobbyist, spouse, or dep€ndent child of a lobbyist?

a

I E

Money order

t

itale

,, i

it'/ i I /ri.rs-:

Yes

No

Aggfegate contnbutlons

$"/.r ?i "et,',

Principal Occupation

Amount of

Contribution

4s&

Nme of Employet

lip Code

f,,'btl*

ofa state contmctor or prosp€ctive state indicate which branch or

Is contributor a principal

No

fyes,

branohes

contractor?

ofgovernmentthecontractisviith: IExecutive !Legislative

#

.,,*

fl

Payroll Deduction

fl

{{:ftsl2rr.= ^l

Money order MI

First

[ Yes D No

Aggregale c@fibut1qs

Dat€ R*eived

Credit/Debit Card

-6t Nme

Yes

C

a candidate committee for a chief executive officer of a municipality does contributor or business he/she is associated with have a contract with said municipality valued at more than $5,000? il Yes E No

Method of contribution:

E Cash p-fersonal Check fl

*

If contritruthh is in excess of $400 to

Yes

ENo

lundraisingeventlistedinSsctionLl?

E

ML-

fTi t+ 1q J k *-lt-

(esrdental Str€l Address

Is this contribution asso{riated with

Deduction

Credit,oebit Card

Lasr

contraclor? [

ofgovernmentthecontractiswith: EExecutive DLegislative Date Reeived

$rPersonal Check

i3,

If contrib$iild is in exoess of $400 to a candidate commiftee for a chief executive ofTicer oi a municipality does contributor or business he/she is associated with have a contract viith said municipaliry- valued at more than $5,000? [J Yes fl No

Yes

a Ll?

Nme ot bnployer

:lp Loog

Method of contribution:

I/yes, list Event

{ rrd( .-1,r,r.,I\

No

i' f i^l iil;a

I Cash

Emplolq -

\i lA,,r,

Yes

L6tlgue

f;'es. Iist Event#

Amount of

t_

''**,r'i}v,

Method of contribution:

u

{{,

l,.F-: ri

t

s

jt''e:'o

Principal'Ocwpation

Amount of

Contribution jrty

Lesdeltial Sheet Address Is contritrutor a lobbyist,

spouse, E E

ordependentchildofalobbyist?

a

fyes,

4ip Code

If contribution is in excess of M00 to a candidate commiftee for a chief executive officer of

tto

municipality does contributor or business he/she is associated with have a contract with said municipality valued at more than $5,000? D No

branches with:

No

Date Re€ived

Method of contribution: Personal

Check

n

a

EYes

Is contributor a principal of a state contIactor or prospective state contractor? fyes, indicate which branch or of govemment the contract is E Executive Legislative

Yes

Iist Event #

D Cash D

Nme of lrplQyer

Yes

I fundraisingeventlistedinSectionLl? [ Is this {ronfibution associated with

fate

CreditDebit Card

I

Payroll Deduction

E

[l

[ I

Yes

t'to

Aggregate contnbuuons

Money Order

SUBTOTAL Section B-This Pagt

TOTAL of additional Section B Pages TOTAL OF ALL CONTRIBUTIONS FROM INIDMDUALS {Sections A &B\ (Enter total on Line 13 of Summary Pase)

&i5r,oa

tl,

r"ti.t,o

6,.s"=s ..'.

I.

MONETARY RECEIPTS (Sections A-K)

Paue 4 of

$AMEOF COMMITTEE

fu}€irr: "'r:r*L...i,.-;r'rl ,,J

rr<.'.

u

--.. #ard<.'r .{*'rt"* }t}''iaL..ir-rr'---" .Jdr :{i} Ct. tontributions frLm Other Committees

Nme of Comittee

,i,. or, , o t" t-l-. J i'i,' ljg. u- o. i 3tr-,:.1 ,,az r'\ I .;"tr' .- } t

,rn., Addr*s

57";3-,itale

;

Huir $ l-e .,t

Nme of

I /tr/S*}

J'}i^,ti*,,

Nme of Tremuq

- fe ^.::,,-,,

r' r..l r'o..

i l

L.ir,,,. i-l/.-"

lundraising event listed

a D yes lfyes,list in Section Ll?"F No Event#_

Date Reaeived

Aggregate Coutdbutious

Amount of Contribution

[s this contribution associated with

',j

'{

City

Zip Code

L'(8^ I

"--

,-. !

- 'i,-. I L,/ ^.l"= Lr ,r'I t_ ,

&'

1u;;i:

\me ofTreafftr

Cornmittee

affiess

rii Ir {-'r' , -,-,: fi {"!

Amount of Contribution

a fl yes lfyes,list [ No Event #

lit]

State

Zip Code

Date Received

-

fr-

Is this contribution associatedwith fun&aising event listed in Section L1?

Aggregate Cootributions

Nme of Treasuq

Nme of Comittee \offoss

firndraisingevent listed in Section

tt tl

li ]*

lstate

lzip

Code

rl

{me

Committee

Addrms

Amount of Contribution

a E Yes fyes,

Is this contribution associated with

Nme of

I

FII ,TNG DI TF DA TF.

Ll? fl No

list Event#

of Treaffer

fl yes lfyes,list Ll? E No Evenr #

Amount of Contribution

Isthiscontributionassociatedwitha fundraising event listed in Section

Cit!

Statc

Zip Code

Date Received

Contributions lASeresate

Nme

Nme of Comittee

\ddress

of Treasuq

lls this contribution associaled with a event listed in Section Ll ? llundraising

liry

Zip Code

Nme of Treasug

Nme of Comittee

Address

Is this contribution associated

wilh

fundraising eventlisted in Section City

State

Received

Zip Code lDate

(-l {me

flaiml.

rr

1s Ilar

of Clomittee

Amount of Contribution

Cotrributims lAeereeate

f< or Srrrnlrrc

Tliafrihrrfinnc

finm

nflrar

f-nmmi*foo<

)ale Received

itate

rty

Zip Code

ot (

! I

Amount ofReceipl

Reimbursement for shared Payment for goods and

expense E Surplus

services

Distribution

.trme of Treasuer

)afe Recqved

Address

-rty

a E yes fyes, list Ll? D No Event#

Nme of Treasuer

Addrcss

\me

Amount of Contribution

fl yes fyes. list E No Evenr #_

rtate

Zip Code

D

I

Amount ofReceipt

Reimbursement for shared Payment lor goods and

expense

services

fl

Surplus

Distribution

SUBTOTAL Section C-This Page

TOTAL of additional Section Tf)TAL f)tr' ALL COMMITTI'.[., CONTRIBI]TIONS AND RECRTPTS (Entpt totnl nn Linp

S/r*o..',;

C Pages

14 of Summnrv Pase)

fi."t n 6 .ert

[,'i;'4tt)

II.

{ue

Al*,.,-,', 6<-
()

of

aesrqqilra JregI

4

* Ftt+ *, ,&',- illoi+or'*.rlq,rcdr I tb/,s^l/2,.r,5

Lz. Pfdceeds from Ta[ Sale, Auction, or Other Sale of Donated Items

Puchser Laj+Nme

Intlividuals|)NLY)

Ra,a*-** r!'e-

Yo t ,, ,", i ,,

Aocless

(a

/l

/+Lw

'\,i,lr.* {l .f€< i-lri r*3

tle LrY hi

.&,

)Iale

f'-

*

s:.,,rn

#*"0

MT

Date

lX,,V rY

E

RE€ived .

Aggregate Amount of Purchases

t0la€, /ziir+,

s 55.':+

MT

Method of payment: E Cash Personal Check Date Reeived Evmt #

E

Method of payment: E Cash Personal

E

E

-riy

Credit/Debit Card

itate

4ip Code

Credit/Debit Card

Aggregate Amount of Purchases

Puchased

{me of Puchaser Individuals

Last

Nffie

!'rst

MI

E

oNLn

(esrdmhal Street Addess

ltm

Check

Tl $i.irF

(Individaals ONLY) Resrdertial Street Address

Method of payment: E Cash Personal

li

ZipCo&

First V

Nme of Puchaser last Nme

Itw

Page 8 of 17

FII,IN("i DIIE DATE

NAME OF COMMITTF-E

i+

FTINDRAISING EVENT ACTIWTY

litt'

itate

Date Received

4ip Code

Check

Credit/Debit Card

Aggregate Amount of Purchases

Event #

Pwchased

{me of Puchffiff

Last

Nme

M

Firsl

Melhod of payment:

D Cash E

Tadiiduals ONLY)

lity

{esidential Stueet Address

Itate

Zip Code

Personal

Check

fl

Credit/Debit Card

Purchass

Evmt #

Date Re@ived

Aggregate Amount of

ltems Puchased

Nue

of

Puchmer

Last

Nme

First

MI

Residiltial Street Address

tiffi

Method of payment:

ECash E

(Indiidauls ONLY) -ity

;tate

[f

Credit{DebitCard

Elent #

Dale Recaived

1ip Code

PersonalCheck

Aggregate Amount of Purchases

ltuchased

!st

LstNme

'{meofPwhrer

M]

Method ofpalnnent; E Cash Personal

E

'Individusls ONLY) Kesldeutlal Street Address

lt!

itale

Zip Code

Jate Recelved

Check

E

CrediilDebit Card

Aggregate Amount of

Puruhass

Event #

Item Puchased ,lme of Pwchmer

Lst Nme

First

Method of payment: D Cash D Penonal

Indiiduals ONLYI (esidential Strest Address

Itffi

lity

rtarc

Check

E

CredilDebit Card

Aggregate Amount of

Purchas

1ip Code

Date Rccaived

fl

Zip Code

Method ofpayrnent: Personal Check Cash Date Reeived F,vent #

fl

Zip Code

Method of payment: E Cash Personal Check Date Reeived EveDt #

lvent #

Purchased

of Purchaser Last Nme 'Individtals ONLY)

{me

KesldeDtral

Str*t

A{idress

Firsi

E

fl

li!

itate

Credit/Debit Card

Aggregate Amount of Purchases

Itsm Puchased

{meofPuchcs LstNue

First

E

Tndividuals ONLq
St€t

Addrcss

rty

;tate

Credit{Debit Card

Aggregate Amount of Purchases

ltems Puchapd

SUBTOTAL Section L2-This Page

frrj'.*,

TOTAL of additional Section L2 Pages

TOTAL OF ALL SMALL PURCIIASES FROM TAG SALES, AUCTIONS OR OTHER SALES OF DONATED ITf,MS lFnta

lntnl nn f .ine f 6h nf ,lnmmnn Pnoe)

rfS". o*

III. \IAMF .)F CNMMITTF'I]

ftir,",, ,&-c'1"-rrtirr(,

*

NONMONETARY RECEIPTS

'.fr,i.€,.t .LL,, t t lu.G(i/'-

U

Page

t,< y't'l

/2rtt'.fi

lvt. ln-fina Coniributions

6,

ft

JJ-r,

.

: a f^ i 1.'-) t*-l ,-r

spouse, I Yes $.No

Fair Market

f/

acq'

NaFe^

lo r ri ril^ n

pr:l_Jo

T)'+r*

Description of

if't !

Il-Khd

fl Yes

l{r',-*,* t-4

.[l fi n

i",i.ti l{,

frs-,

*s*r**{

tk"rrt".!* Fair Market Contribution

Comminee o4,het (Applicable only

to Referendum

sf, a.

Committees)

Dexription of ln-Kind Contribution

I

.r."'

grt

tt t t

f
K.

$"^'e:t*'"*

*r*:.*o Fair Market

Type ofContributor: ;laie

.

spouse, E

Value of this

Individual

fl Yes I

$5,000?

D Yes qF. No

iln ir r€-{rr.1 Fa lt.-t _\: Address i.'i J{: vr,a'-s ( k ,' .# h-n.b*

p.. El Q

{L

Zip Code

&; Vrs

Value of this

Individual Committee Olher lApplicable only to Refoendum Committe$)

Yes

If cortribution is in excess of $400 to a candidate committee for a chief executive oflicer of a

SElJf,{o

municipaliry, does contributor or business he/she is associated with have a contract with said municipaliry valued al more than $5,000? E yes E No

I

ls this contribution associated with a

tufu'/7c'*4

rF

is in excess of $400 to a candidate committee for a chief executive officer of a municipalitl does contribulor or business he/she is associated with have a contract with said No municipality valued at more than

iI

Date Re€ived

;-1,+

If coltribution

Ifyes, lbtEvenl#

Is contributora loLrbyist, or dependent child of a lobbyist?

fundraising event listed in Section I./yes, list Event #

Ll?

Yes

F"o

Desuiption of In-Kind Contribution

falz
I{a

nci k(i'r'lr.e-

)ralE_

a;-

f .r*,-.l- lb",-

Is contributor a loUbyist, spouse, or dependent child ofa lobbyist?

fl

Yes

P*o

4rp Looe

er,

V {6

4r-

")4 jt Fair Market Value of this

lndividual

Contribufion tt

Committee Other (Applicable only to Refaudum Cammiftees)

$5,000?

#_

-f]

Yes

P"o

Nme

fl Yes

Dewription of tn-Kird Contribution .

7 ta,rrs.(tr'.! rr lzur-u-(6lr-3 Eai"r"^).^, l"r. /.o.".d "rt*s

4ggregate cootnbulrons

ts.-t

Fair Market

Type ofContributor:

itate

-rty

Is contribulor a lobbyist, spouse, or dependent child of a lobbyist? Date Received

I

Yes

ENo

3')+{

$

is in excess of $400 to a candidate committee for a chief executive o{ficer of a municipality does contributor or business he/she is associated with have a contract with said municipality valued at more than E No

fundraising event listed in Section L1? Ifyes,list Event

Jtreet Address

E{..f?

If conifibution

Is this contribution associated with a

IrlZu'{Za.*

'rq. fi I

Contribution

tq

{ggregate sontnt utrans

Type ofContributor: heet Addrss

r?;*

4

Contribution

I uode

4:I lr

Is this confribution associated with a fundraising event listed in Section Ll ?

Sheet

Contribution

Committee OIher (Applicable oilly to Referexdum Committees)

Type ofContributor:

spouse, I Yes \s.*o

ofz .fi z a"t

Yes

F

Is contributor a lobbyist, or dependent child ofa lobbyist?

i

?

E

Ft.i E i-l-

r: r/aX* Sir-

)ate Rereived

/..t,

".',4 I JL'r"C

$5,000?

Is this contribution associated with fundraising event lisied in Section Ll fyes, list Event #

)ueq AgqeSL

i

4rp Code

is in excess of$400 to a candidate committee for a chiefexecutive officer ofa municipality does contributor or business he/she is assooiated with have a contract with said municipality valued at more than Eb.No

a

)ate Received

i-i

q../

Value of this

Individual

ft fl n

Ifcqfitribution

ls contributor a lobbyist, or dependent ohild of a lobbyist?

I c/ I

ttate

i * rt)*",

L3;:-g'^ '; '!*;

17

?ILING DI]E DATE

)JCrt

Type ofConfibutor: )reet AddIAss

1l of

lip

! E n

Code

Value of this

Individual Committee OIhet (Appficable unly ts Refqendum Committea)

Contribltion

If contribution is in excess of

$400 to a candidate committee lor a chiefexecutive officer of a municipality does contributor or business he/she is associated with have a contract with said municipality valued at more than $5,000? E Yes [] No

Is this contribution associated with a fundraising event listed in Section Ll fyes. f ist Event H

?

D Yes lNo

Aggr9gate coilnbutlors

De*ription of In-Kind Contributiqn

_

I

SUBTOTAL Section M-This Page

qs'.qs

TOTAL of addifional Section M Pases

Qf-v \

I on Line 22 of Summnrv Pase) (NOTE: This se.lion rcIers only lo advunees of dcposits b! individaals from

TOTAL OF ALL IN-KIN1D CONTRIBUTIONS (Enter total

N. Refundable Deposit to Telephone Company Last

Nme of hrdividual

ResideDhal Sffeet

Nme

Fi6t

Address

lL rly

persmal funds to benefit the comtniftee, not depnits made by the commiltee.) MI Amount of Date Deposit Made Deposit

)tate

I

Zrp Code

:=-

ft.l"t.L(_

3-

1].

of telephone compuy

Steet Ad&ess

Ciryt

State

i!

Zip Code

Total Section N (Enter total on Line 23 of Summrv Page)

ri

r\

IV.

EXPENDTTURES

Page 13 of 17 FII ING il]F

{AMF, OF COMMITTEF,

Fl hr'rrr', 'T4r:trt,r,llrr(: U

Nanq4fPayee

-D-r

-1"

'3ili'ht

-, ',{r,'

o {*

tbrcode)

-y'a5f- /+., rl D.rr\

Independent

E

Organization

(see

)ate of Palmerl State

..tlt,-b" c1-. u,escqprron . I Srlitiv,ttr i i ,l' J

Cardidate(s) Nme (if appltcable)

lype of Expenditure (if applicqble). I Coordinated with reimbursement sought E Coordinated without reimbursement sought

fl

I ln/.X:/?tlt->ri

P. Exbenses Paid bv'Committee

r* JU

/'o : / )t'lta*l-e

rwpose oI LlpeDdlilre

G',1€'i.G"-r?'htirx-..'lrr-T

{J

DATF.

arp

I ol

Looe

S{e

q/5"

t: {,fi

l,*.*{*.r

d-r {'&t*#r,i<,r

'p,check #=-i

E

Evefi

#

E

,Dffice{ought

I

Supported

opposed

$

il,c.

)ate of Palment I

,

C'ry,

4rp Looe

Jtate

l):.rbu

Elcheck #

h

,n I 'r t L't+Y' /X

L-I

10:..-

i),

e L;

i ; *, h

;

rrt,

r,"l)

Ctl

(;,''.

l.l d,"I.{r''zi'lt"r,*'e,* U Supported

Office Sought

Cardidate(s).$me (if applicsble)

Type of Exlrcnditure (if tppltcablel. E Coordinated with reimbursement sought Coordinated without reimbursement sought Independent

E

Opposed

Organization (see Instructions)

trn trs trc tro trn Nmot-Pavee / -llIi-, ,:*{i-a,^ }:i*-.',r

$

itale

{

fu.&u

D-':,rn

ff')r"b.i

Iype of Expenditure (if applicsble): E Coordinated with reimbursement sought fl Coordinated without reimbursement sought

vlethod ofPayment

Amount

fal'Sf7al:q Ecrr"ct* /ctj

S er?.

)ate of Palment

i

Jgsnplou t

Ixpmdme

E Independent D Organization

k-

,,

Zip Code

E

{y"yt 8l

Event #

t:,i,",-

tJait* I ,.ler-',.|.6rr-'.1* Offie

tmdidate(s) Nme (if swlicable)

U

Sought

fl

Supported opposed

(see InsTructions)

^*"lt)[,Lir {.('.-r )uefi Adtrlss.

$

A.*1;T fl

State

,rP

or raymenr

tc'{g {1rct;

LOqg

{r frtu{itti' Z'ih,lt* i t r-,, F/.ttre I frrnd.,,ru.,r{-t J-kr"b.J

fype of Expenditure gf spplicable): I Coordinated with reimbursement sought I Coordinated without reimbursement sought

fl I

,6e

1*]l.e .,. cit'

tr'i l{td}+:; C-e'.ir#

rurpose or tsrym4lmt

ao

Debit card

tra tr]n flc fln trr

{bycode;

4 i,, erv. se

D"bit curd

Event #

tbcoad /),;)711

rurpose oI (by code)

Amount

Method of Payment

t t{15-ftos1

Pu4)ose ol Bxpen&ture

I fl fl

frFy?.sT

Oi-

Debit Card

Instructions)

!s trc nn trr \meol'P3yee I t \ I G I $€ '-{ {t isg i :;i"l; ni{

Amount

Method of Payment

Cmffdate(s)lilme (if applicable)

Offica Sought

vremoo or faymenr

Kcr,""r.+f Qts E Debit Card

{'r

q

r.cv

F-vmt #

E E

Supported opposed

Independent

Organization

"

(see

Instructions)

NmeofPavee,

/

Vr.i

!'

ll.q du,Lrl;shi 11t

--, -) Ad&pss I r"tirr, -- tr

Street

{bycode)

6}

$

tr,r trB nc nD flE

* f\J$,'*JS

)ate of PalmeDt

ItaIe

4,1p

Code

c(eV'J y

t olsle ?

Lt. & n&* #i'i o1.o r')rrtJ' ;,ir;y,>qn- 4,{-i

fype of Expenditure (if applicable). E Coordinated with reimbursement sought n Coordinated without reimbursement sought

caididatd(s) Nme (if applbable)

Office Sought

Amount

Method of Payment

/OG Fc'""t* n Debil card

{

tJ\b,etr

Evmt #

ISupported EOpposed

El Independent

I

Organization

(see

Instructions)

tr,1 Un Dc

Dl Dr

$

SUBTOTAL Section P-This Page

TOTAL of additional Section P Pages TOTAL OF ALL EXPENSES PAID BY COMMITTEE (Enter total on Line 19 of Summary Page)

fr

).9qr2,

csi"

dar,',i

Fi.tr-? nl

TV. EXPENDITURES NAME OF COMMTTTFF,

fr

hJ.eer)'Bes=j/'lnine a)

Nme ollal,ge

\.1*. 0/< Adffess '

rrreet

t

/t:;

-

tr-ct*'ct {-;*}Jkuuf-.}@? I

i&/.A'l/LriaQ

P. txnenses Paid Lv Committee )ate ofPayment

s

N" *11o,.,.r, rurpose oI ixpmdrture (by code) fi *r*iif ft:

il,*

cj+-

'J-h

itate

Pi

rl:q

ffi:t

l-(tw',ott',

Zip Code

nhri

.

Method of Payment

t alzt le1

iY

[]

Check

Amount

frfit.?

#_

'pDebitCard 11d(t.3.

t-,'t l.nri,od.t .i'l= [t"J3*t) Offie

Cmdidare(s) Nalhe (if applicable)

Iype of Expenditurc (d applicabte) D Coordinated with reimbursement sought f] Coordinated without reimbursement sought

I fl

Page 13 ol 17 FII-TNG DIIF. DATF,

EveDt #

Ll

Sought

E

Supported Opposeci

lndependent

Organrzation

(see

Inslruetions)

trl Dn trc trn trr lme rav€ 5lzr.ot.<s :,q\ I)j.l" -, Ulff"iil. * #rr-rerr Sr,ra Jescnpt,on

s /are or ralmenr

oI

rurposc or Dxpcllulufe

(bycode)

;\ -A-f ff

I

*t

ype of Expenditure (if applieable): E Coordinated with reimbursement sought E Coordinated without reimbursement sought Independent

:

ci itate

_I

L)4

oro12

Cardidate(s)

o', ,'

n

ii: [zof

Zip Code

&-vrr

DG, n,A ,, , ,

Nme

*s

'*94

Method ol Payment

ze\

Amount

H',;rlei

E Check #=FftlitcarP-

sj

,

Ev€nt #

) U Supported

Office Sought

fl

(if applicable)

opposed

fl

E

Organization

(see

Inslructions)

$

tra En trc trn trn )ate ol Palment

Name ofPayee

lity

Sfeet Addrss

rupos€

01

bxponfrnu9

ilate

1,rp

E

eode

n

)escription

Amount

Vlethod of Payment

check # Debit card

Event #

(by code)

Iype of Expenditure (if applicable): fl Coordinated with reimbursement sought E Coordinated without reimbursement sought I hdependent I Organization (see Instructions)

fl^

Cmdidate{s) Nme (if tpplicable)

Ofica Sought

LJ Supported

I

opposed

$

FIR nr- T'ln n

NMe ol Pavee

-)ate

Street Ad&ess

itate

City

ot Pament

E

Zip Code

I

)euiption

rurposg oI ixpmdrture (by code)

Type of Expenditurc (if applicabler. D Coordinated with reimbursement sought Coordinated without reimbursement sought E Independent

Amounl

Method ot Payment

#-

Check Debrt Card

Event #

Cmdidate(s) Nme (if applicable)

Oflice Soughl

Ll Supported

E

opposed

tl I

Organization

(see

Inslructions)

trl trB t]c nD ! )ate of Pament

Nme of Payee Sheet Address

ilate

Cir)-

n

Zip Code

E

rurlJosc or DxP6uNe

fty

)escription

I

Ev

check

#_

Debit Card

ent #

code)

lype of Expenditure (if app6eable): D Coordinated with reimbursement sought fl Coordinated without reimbursement sought

E

AmOunt

Method of Payment

Cardidate(s)

Nme

(if applicable)

Office Sought

lSupported [J opposed

Independent

Organization

(see

Instructions)

Uat]BtrctrDtr

$

SUBTOTAL Section P-This Page

TOTAL of additional Section

P Pages

br-'r:.cif [;,,iva nri

TOTAL OF ALL EXPENSES PAID BY COMMITTEE @nter total on Line 19 of Summary Page) I

?

s'd,

i.ei,l

IV.

EXPENDITURES

Page 15 of 17

]II.ING

\IAMF. OF C(^IMMITTFF,

* ti.;e,,- Arr.*r1r1'lr'\e 1)

E'o/u:

R

.i Cr..' /thct,-rt* =Jcz-1q I

ofVeldor

( rr.F

. {?",tFl

5

Gt\

Sreet Address

iU* :tlaven l7''*

Purpose ol Expelditure

(bycode)

Jq -C}l-H

Nme of Vendor

€+a

o l+.-.,

ffii"ru"rftu*o,' [t,. Purpose of Expro$ture

(bycode)

$ fl

vi.a

Master

Card I

Discover t] American Express

Other

-

A er*

State

-ip Code

crf,.ft V J)r' ,',i H t"r'^ P4'r tr) t4n"6l-",*1. 'Yt\* -i

.

rof ar izx>q

(*/\

D..-b"+

ci.

Zip Code

CE\

Street Address

State

Date of Trusaction

City

Purpose ofExpelditue (by code)

Descnption

State

Eveut #

Date of Trilsaction

cib"

State

EveDt #

Nme of Vendor

Date ofTrmsaction

State

Purpose of Expurditue

Amounl

1ip Code

F,velt #

)escription

of Vsrdor

Sheef Addr€ss

Amount

lip Code

)ercription

Chty

Amount

Zip Code

Nme of Vmdor

Purpose ofErpendinue (by code)

Amotrnt

Eveilt #

Sheet Address

Street Ad&ess

Evsrt #

lip Code

Nme of Vendor

Purpose of Expmditure (by code)

ta;<-r. sS

N

Purpose of Expmditue (by code)

Street Address

* 3q7.56

Date ofTrmsastion

Date ofTrarsactiol

City'

Amount

Fxent #

tc:lzuf z^e<>\

(ucll_cGou5")) I 'r f.ayyroa ,tn i.ar,..:l au.l-4

Descriptior

l:Zf

a,::*

Nme olVeudor

{me

El

2l

S+a O l<s

;;;;;

/-z)/znrrz

Type of Credit Card:

frs{t. ' &trr Y.t ;fB(-- lt ^tt 6 Sl.1_ge""',X L r*'r-ltu-

[-u\c

Nane

xl

DATE

Exnens[s Incurred on Committee Credit Card

Nnme of Issuins Institulion

{jr -l\Or'br,i

f

DITF-

I)aie ofTrdrsaction

cit-

State

Amount

1ip Code

Eveni #

)gscnption

(by ode)

Nme of Veldor

Steet Address

Purpose ofExpenditure (by code)

Date ofTrmsactiou

City

)escnptior

State

Amount

Zip Code

Event #

SI'BTOTAL Section R-This Page TOTAL of additional Section R Pages

ToTAI,otr.AI.I,ExPF],NsE'SINCl]RREDoNCoMMITTEECREDITCARD(Enter!ojpIo@

nl"iPc\ :%

fr

*:s. as

TV. EXPENDITURES

Page 17 of 17

]II,ING DI]F. DATF-

NAME OF COMMITTEE

*

IVaro

Ea-l v,lfii nv - -lit, tt {:>,- lUhclC,f 3tX9 in la's Jz ,'lre-n tEIt"*Hri"" to cJmmittee workers and consuttants "in"i-dorr*ments Fqsl ^ ta( 'W'ztxg l/Ytiilreiin MI

Lasl Nme of Worker/Consultill

FZt ['7,,, 11

lrcoa')fayre

Vr'.;

pr; n

'*a.

\ose

l*

VYLau

of Expmdinrre

bvcode)6

tdzi I

-C)Tfl

t., /r ; Yrr.)C fU'.\

r)

U

C,a

Type of Expendrture (if appticLbte) . Coordinated with reimbursement sought D Coordrnaled without reimbursement sought Independent E Orsanization 6ee lnsiructions) r.

Scr,ecr*(] ] Debit card

fif.

B

r".*,

e.lV z-r

lass

kc, rnt C*dtd"@)N*" 44 ; ( n "',J o .r *s

I !

Ofice Sought

(if appltctble)

fl

(/

p Code

Citj.'

Qf #z,,ril,, A"v --7--

';;F* I '0AA

Method of Payment

Supported Opposed

I

-

s

na I-'ln l-lc l-ln [f

MI

First

Seconda4 Pal

Date ofPaymelt

Purpose of Expmditure (by code)

ee

n n

#-

Check Debir card

Zip Code

State

City

itreet Address

Amounl

Method of Payment

Descriptior

Cedidate(s) Nue (f applicable)

Type of Expenditure (if applicable). Coordinated with reimbursement sought E Coordinated without rsimbursemenl sought hdependent

n ! fl

E E

Office Sought

Supported Opposed

(see Instrudions) Organization -

$

I-la l-ln l-lc l-ln En

Last

MI

First

Nme of Worker/Consltmt

Date of Palmeut

ol -bxpmdture 'upose 'by

Secondary Paye

code)

fl fl

Check

#=-

tebit card

Zip Code

Slate

City

Itreet Ad&ess

Amounl

Method of Payment

Derription Cmdidate(s) Nme (if qpplicable)

Type ofExpenditurc (d appltuable): D Coordinated with reimbursement sought Coortiinated without reimbursement sought Independent

Offioe Sought

f|

Supported

E

Opposed

fl I

E

(see Inslructions) Oreanization -

nr

Secoldary

$

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First

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SUBTOTAL Section T-This Page

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