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Palmer, TyCAMPAIGN FINANCIAL DISCLOSURE REPORT SUMMARY PAGE ( Please Print or Type) x• Section I C-2 Rev. 10/07 Name of Candidate or Political Committee and Chairpersons Office Sought (A candidate) Seat (if any) lett TV Palmer Citv Council Seat 3 MM Address ane Phone Wom Mwe 1236 E Pisa St Meridian 83642 208-954-6432 arae of Political Tremurer Jason Monies Wiling Address city ana tip Horne Phone Phone 3865 S. Black Cat Road Nampa 83687 1208-870-7127 Change of address for: Candidate or Political Committee © Political Treasurer ❑ Section 11 TYPE OF REPORT This filing is an: 8 Original ❑ Amendment This report is for the period from _011,01 118 through 12 131 118 ❑ 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 111 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. ❑ 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 11 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 $ 126.18 Line 2: Enter Beginning Cash Balance" $ 126.18 $ XXXXXX Line 3: Total Contributions (Enter amount from line 5, page 2) $ 2,000.00 $ 2,000.00 Line 4: Subtotal (Add lines 1, 2 and 3) $ 2,126.18 $ 2,126.1$ Line 5: Total Expenditures (Enter amount from line 11, page 2) $ 386.14 $ 386.14 Line 6: Enter Ending Cash Balance (Subtract line 5 from line 4) $ 1,740.04 $ 1,740.04 Line 7: Outstanding Debt to Date (Enter amount from line 18, page 2) $ 0.00 'This same figure should be entered on line 1 of all reports fled this calendar year. "*This is the figure on line 6 of the last Campaign Financial Disclosure Report filed. If this is your rirst reporl, 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 Jason Monies Name of Political treasurer report is a true, complete and garrect G hereby certify that the information in this Disclosure Report as required by law. DETAILED SUMMARY Name of Candidate or Committee: Elect Ty Palmer Contributions 0 Unitemized Contributions ($50 and less) # of Contributors n Q Itemized Contributions (Total of all Schedule A sheets) 30 In -Kind Contributions (Total of all Contribution amounts from Schedule C sheets) ® Loans (Total of all New Loan amounts from Schedule D sheets) 50 Total Contributions (Transfer this figure to page 1, Section IV, Line 3) Expenditures Q Unitemized Expenditures ($25 and less) # of Expenditures n O Itemized Expenditures (Total of all Schedule B sheets) n In -Kind Expenditures (Total of all Expenditure amounts from Schedule C sheets) ® Loan Repayments (Total of all Loan Repayment amounts from Schedule D sheets) 1 p 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) Loans, Credit Cards and Debt _ Outstanding Balance from previous reporting period New Loans received during this reporting period (Total of all New Loan amounts plus Accrued Interest from Schedule D New Credit Card and Debt incurred this reporting period (Total of all New Incurred Debt amounts from Schedule E sheets) Subtotal_ - 16 Repayments of Loans made during this reporting period (Total of all Loan Repayment amounts from Schedule D sheets) Q Repayments of Credit Card and Debt this reporting period (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) Total This Period + $ 0.00 + $ 2,000.00 + $0.00 + $ 50.00 = $ 2,050.00 + $0.00 + $211.14 --� + $ 0.00 + $175.00 + $ 0.00 $ 386.14 + $ 0.00 50.00 + $ + $ 0.00 = $ 50.00 $175.00 $ 0.00 = $ 0.00 Pledged Contributions 19 Unitemized Pledged Contributions ($50 and less) # of Pledges n + $0.00 ® itemized Pledged Contributions this Period (Total of all Schedule F sheets) +�$ 0.00! Total Pledged Contributions this period= $ 0.00 Page 2 SCHEDULE A 3 ITEMIZED CONTRIBUTIONS of more than Fifty Dollars ($50.00) this period Name of Candidate or Committee: Elect Ty Palmer Date Received Full Name, Mailing Address and Zip Code of Contributor Cash or Cheek 12 1• Sold Buggy Privately to: Sarah H (Eagle, Idaho) $ 2,000.00 1151118 $ ❑ General CaiendarYearTo-Date 2. 1 1 $ $ ❑ General CaiendarYearTo-Date 3. 1 I $ ❑ General CalendarYear-To-Date 4. 1 I $ $ ❑ General CaiendarYear-To bte 5. I 1 $ $ ❑ General Calendar Year -To -Date 6. 1 f $ ❑ General Calendar Year To -Date 7. 1 1 $ $ ❑ General CalendarYear•To-Date a. 1 1 $ 0 General Calendar Year -To -Date 9. 1 1 $ $ 0 General CalendarYear-To-Dale 10. 1 1 $ $ ❑ General Calendar Year -To -Date Total This Page: $2,000.00 Transfer the combined total of all Schedule A pages to the Detailed Summary on page 2 line 2. Date Spent Full Name, Mailing Address and Zip Code of Recipient SCHEDULE B ase o Purpose Code ITEMIZED EXPENDITURES 4 6 Cash or Check Twenty-Five Dollars ($25.00) or more this period Name of Candidate or Committee: Elect Ty Palmer 1. Auto Owners Insurance - Buggy Insurance 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. Auto Owners Insurance - Buggy Insurance G 1 9 18 6101 Anacapri Blvd 82.24 1 I Lansing, MI 48917 $ 2. Kahootz Steak & Ale House F 10 3 18 1603 N Main 5t 38.66 I I Meridian, ID 83642 $ 3. Auto Owners Insurance - Buggy Insurance G 12 31 18 6101 Anacapri Blvd 90.24 1 1 Lansing, MI 48917 $ 4. 5. I I $ 6. 1 ! $ 7. 1 I $ 8. ! 1 $ 9. I 1 $ 10. I 1 $ .4 211.14 Total This Page: $ Transfer the combined total of all Schedule B pages to the Detailed Summary on page 2 line 7. 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 peaiod period the end of this reporting period reporting period 1. Ty Palmer $125.00 Date: 10102/18 $0.00 Date: 12/31 118 $0.00 1236 E Pisa St Meridian, ID 83642 Amount: 50.00 Amount: 175.00 $ 2 Date: Date: f 1 1 f Amount: Amount: 3 Date: Date: 1 1 1 1 Amount: Amount: $ 4. Date: Date: 1 1 1 f Amount: Amount: S 5 Date: Date: 1 1 I 1 Amount: Amount: 6. Date: Date: I f 1 f Amount: Amount: 7 Date: Date: Amount: Amount: Previous Received Interest Repayments Ending Balance Previous Totat $125.00 Received Total: 50.00 $ (Transfer the combined total of all received loans to the Detailed Summary, page 2 lure 4) Interest Total: $ 0.00 Repayments Total 175.00 $ (Transfer the combined total of all loan repayments to the Detailed Summary, page 2 line 9 & 16) Ending Balance Total: $ 0.00 (NOTE: Transfer the combined total of all Accrued Interest and Received Loans to the Detailed Summary, page 2 line 13)