Treg Berntrc req
obi .n
Section I
CAMPAIGN FINANCIAL DISCLOSURE REPORT
SUMMARY PAGE
(Please Print or Type)
C-2
Rev, 12/14
Name �of Candidate or Political Co ittee and Chairperson
-I t -S& A'-' r, l
Office Sought (if candidate)
District (if any)
Mailing Address
S. l 6i/"/\j �,.
City and Zip
(M riv
Home Phone
Vy)
or one
01�- �Yo�
ame of PoliticalI reasurer
ailing ress
City and Zip
Home Phone
Work Phone
Change of address for: Candidate or Political Committee ❑ Political Treasurer ❑
Section IITYPE OF REPORT
This filing is an: Original ❑ Amendment
This report is for the period from Z�_ throughll��.
❑ October 10 Pre -General Report
❑ 7 Day Pre -General Report ❑ 30 Day Post -General Report Annual Report
Is this a Termination Report: ❑ Yes X( 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 11, Section IV.
P/'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 $ Z ( (48 - (So
Line 2: Enter Beginning Cash Balance** $ $ XXXXXX
Line 3: Total Contributions (Enter amount from line 5, page 2) $ $ _
Line 4: Subtotal (Add lines 1, 2 and 3) $ $ lob
Line 5: Total Expenditures (Enter amount from line 11, page 2) $ $
Line 6: Enter Ending Cash Balance (Subtract line 5 from line 4) $ $ /0� • (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
Please remit to: ��
City Clerk's office I, l ►vii F / • 6 b/ 1 , hereby certify that the information in this
City of Meridian Name of Political Treasurer
33 E. Broadway Ave. report is a true, complete and c ct Campaign Financial Disc sure Report as required by law.
Suite 104
/�,
Meridian, ID 83642
(208)888-4433
cityclerk@merldiancity.org Signature of Political Treasurer
Paae 1
Declaration of Candidacy a u,
(Q - (MV71— the undersigned, affirm that I am a qualified elec6 the City
Meridian, State of Idaho, and that I have resided in the city for at least thirty (30) days. I hereby declare myselb
be a candidate for the office of 611Y C €JC(L- for a term of years, to be voted for at the
election to be held on the 7th day of November, 2017, and certify that I possess the legal qualifications to fill said
office, and that my residence address is
's Signature
Subscribed and sworn to before me this a day of '` t'',141��-
co
Signed
qp
Notary Public in and for the State of Idaho
D
9
s residing at J
' My Commission expires
0666600*
OFFICIAL USE ONLY
CITY CLERK
Before accepting this Declaration of Candidacy, the City Clerk (or designee) must verify:
This declaration is accompanied by:
The attached Petition of Candidacy signed by at least five qualified city electors with the attached verification
from the county clerk,
OR
XA nonrefundable filing fee of $40.
The City Clerk (or designee) must verify that the person submitting this declaration is a qualified city elector as defined in
Idaho Code 50-402(c) and that the residence address provided above matches the address on the individual's voter
registration. ✓ I
This declaration was accepted by `' 1 `
Name, Title
on or A at w
Date Time
After the close of the candidate filing period, a copy of this form must be transmitted immediately to the County Clerk to
assist in ballot preparation.
COUNTY CLERK
Upon receipt of this Declaration of Candidacy, stamp the date and time of receipt on the front of this document. This
document is to be used for ballot preparation.
�A� ski APPOINTMENT AND CERTIFICATION OF POLITICA ER C-1
Rev. 1115
FOR CANDIDATES AND COMMITTEES
(Please Print or Type) f
Pursuant to Section 67-6603(cl), Idaho Code. No contribution shall be recd� 0j re made by or on behalf of a
candidate or political committee until he or she appoints a political treasurer and ceriifie�_ress of the treasurer
to the Secretary of State,
Certification is for (check appropriate box below):
Name of
0 CANDIDATE: Candidate: t+Ue �� L/l1' N j �V
Home Work Cell
Phone: Phone: Phone: (� `1
— — - -- --- — - — I --
Office *�
Sought: I C VJ l v C L
Candidate
Mailing address: C2 ` S , `�' � � �� iJ
Candidate
email address: 1$c iv—'"(! (ri !M I" L,
Name of
❑ COMMITTEE: Committee:
Name of Committee
Chairman:
Miscellaneous: ❑ Home Work Cell
Phone: Phone: Phone:
Measure: ❑
Committee
Candidate/Measure: Mailing address:
---- ------ ---- ----
Chairman
email address:
CERTIFICATION AND APPOINTMENT
I, '� ►� (pit; (GvT do hereby certify and appoint the following individual who is a registered elector of
Name of Candidate or Committee Chairman
the State of Idaho as the political treasurer for the above named candidate or committee:
----------- --- -- --- --
Name of - ---_ - __- -- - ---- _ }
Political Treasurer. [Ji O A & L ifs v
Home Work Cell � _�� '6
Phone: Phone: Phone:
Treasurer '�1
Mailing address ZL 70 �C✓�I�i.0 �12 1�(� 1��7 -1 f✓� &-N (a
Treasurer
Residence address:
Treasurer )Please remit to:
email address: D (_� O A L J �i L A I
A
City Clerk's Office
City of Meridian
33 E. Broadway Ave. g ature of C� didate or Committee Chairman
Suite 104
Meridian, ID 83642
(208) 8884433 I, _ b 0,0 V. do hereby accept the appointment as political treasurer for
clerk@meridiancity.org Name of Pollticajeasurer
the above named candidate or committee.
Signature of`Po tical Treasurer
f
4 G4't o+
r
Sectional
CAMPAIGN FINANCIAL DISCLOSURE REPORT
SUMMARY PAGE
(Please Print or Type)
C-2
Rev. 12/14
' s
Name of Candidate or Political Committee and Chairperson
Office Sought (if c an 6 ida
District (if any)
Treg Bernt
City Council4
$ 9,750.00
Mailing Address
i an ipome
one
or e
531 S. Tiburon
Meridian, ID 83642
208-409-7400
$ 0.00
Name of PoliticalTreasurer
Brad Hoaglun
Mailing Address
City and Zip
Home Phone
Work Phone
2470 W. Trestle Drive
Meridian, ID 83646
208870-8237
Change of address for: Candidate or Political Committee ❑ Political Treasurer ❑
Section II TYPE OF REPORT
This filing is an: 2 Original ❑ Amendment
This report is for the period from 0610112017 through 09/30//2017
® October 10 Pre -General Report
❑ 7 Day Pre -General Report ❑ 30 Day Post -General Report ❑ Annual Report
Is this a Termination Report: ❑ Yes 2 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*
$ XXXX X
Line 2: Enter Beginning Cash Balance**
$ 0.00
Line 3: Total Contributions (Enter amount from line 5, page 2)
$ 9,750.00
Line 4: Subtotal (Add lines 1, 2 and 3)
$ 9,750.00
Line 5: Total Expenditures (Enter amount from line 11, page 2)
$ 8,783.06
Line 6: Enter Ending Cash Balance (Subtract line 5 from line 4)
$ 966.94
Line 7: Outstanding Debt to Date (Enter amount from line 18, page 2)
$ 0.00
$ 0.00
$ XXXXXX
$ 9,750.00
$ 9,750.00
$ 8,783.06
$ 966.94
*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
Please remit to:
City Clerk's Office
City of Meridian
33 E. Broadway Ave.
Suite 104
Meridian, ID 83842
(208) 888.4433
clerk@meridlancity.org
Brad Hoaglun
Name of Political Treasurer
report is a true, complete and correct Campaign
Page 1
Signature
hereby certify that the information in this
Report as required by law.
Treasurer
0
0
10
11
12
13
14
15
16
0
18
DETAILED SUMMARY
Name of Candidate or Committee: Treg Bernt
Expenditures
�Total This Period
Contributions
+ $64.09
Unitemized Contributions ($50 and less) # of Contributors 0
+ $0.00
Itemized Contributions (Total of all Schedule A sheets)
+ $9,750.00
In -Kind Contributions (Total of all Contribution amounts from Schedule C sheets)
+ $0.00
Loans (Total of all New Loan amounts from Schedule D sheets)
+ $0.00
Total Contributions (Transfer this figure to page 1, Section IV, Line 3)
_ $9,750.00
Expenditures
_
Unitemized Expenditures (Less than $25) # of Expenditures 4
+ $64.09
Itemized Expenditures (Total of all Schedule B sheets)
In -Kind Expenditures (Total of all Expenditure amounts from Schedule C sheets)
+ $8,718.97
+ $0.00
Loan Repayments (Total of all Loan Repayment amounts from Schedule D sheets)
+ $0.00
Credit Card and Debt Repayments (Total of all Repayment amounts from Schedule E sheets)
+ $0.00
Total Expenditures (Transfer this figure to page 1, Section IV, Line 5)
_ $8,783.06
Loans, Credit Cards and Debt
Outstanding Balance from previous reporting period
+ $0.00
New Loans received during this reporting period
+ $ 0.00
(Total of all New Loan amounts plus Accrued Interest from Schedule D sheets)
New Credit Card and Debt incurred this reporting period
+ $0.00
Total of all New Incurred Debt amounts from Schedule E sheets
Subtotal �^
_ $0.00
Repayments of Loans made during this reporting period
- $0.00
(Total of all Loan Repayment amounts from Schedule D sheets)
Repayments of Credit Card and Debt this reporting period
$0.00
(Total of all Debt Repayment amounts from Schedule E sheets)
Total Outstanding Balance at close of this period (Transfer this figure to page 1, Section IV, Line 7)
_ $0.00
Pledged Contributions
Unitemized Pledged Contributions ($50 and less) # of Pledges
Itemized Pledged Contributions this Period (Total of all Schedule F sheets)
+ $0.00
+ $0.00
Total Pledged Contributions this period
= $0.00
Page 2
SCHEDULE A Page o
1 2
ITEMIZED CONTRIBUTIONS
of more than Fifty Dollars ($50.00) this period
Name of Candidate or Committee:Treg Bernt
Date Received
Full Name, Mailing Address and Zip Code of Contributor
Cash or Check
06
/15
/17
1.Treg Bernt 531 S. Tiburon, Meridian, ID 83642
$ 100.00
$ 100.00
Calendar Year -To -Date
06
/19
/17
2. Promising Horizons 403 W. Cherry Lane, Meridian, ID 83642
100.00
$,
$ 100.00
Calendar Year -To -Date
06
/19
/17
3. Vintage Road Photographers 731 S. Thornwood Way, Meridian, ID 83642
500.00
$
500.00
Calendar Year -To -Date
06
21
17
4. Brighton Corporation 12601 W. Explorers Drive #200, Boise, ID 83709
$ 1,000.00
$ 1,000.00
Calendar Year -To -Date
07
26
17
5.ALIC Properties 4195 W. Chinden Blvd, Garden City, ID 83714
$ 1,000.00
$ 1,000.00
Calendar Year -To -Date
07
26
17
6.Ozzy's Car Company 4195 W. Chinden Blvd, Garden City, ID 83714
$ 1,000.00
$ 1,000.00
Calendar Year -To -Date
07
26
I
17
I
7. Bitterroot Holdings LLC 13965 W. Chinden, Boise, ID 83713-1457
$ 1,000.00
$ 1,000.00
Calendar Year -To -Date
07
/26
/17
8. L & K Carpet One 129 N. 2nd Avenue, Pocatello, ID 83201
$ 1,000.00
$ 1,000.00
Calendar Year -To -Date
07
26
17
9. Ken and Renae Bernt 478 University Drive, Pocatello, ID 83201
$ 1,000.00
$ 1,000.00
Calendar Year -To -Date
08
/22
/17
10. Blackrock Homes 1979 N. Locust Grove, Meridian, ID 83646
1,000.00
$
$ 1,000.00
Calendar Year -To -Date
Total This Page:
$7,700.00
Transfer the combined total of all Schedule A pages to the Detailed Summary on page 2 line 2.
SCHEDULE A Page °
2 2
ITEMIZED CONTRIBUTIONS
of more than Fifty Dollars ($50.00) this period
[Name of Candidate or Committee:Treg Bernt
Date Received
Full Name, Mailing Address and Zip Code of Contributor
Cash or Check
08
/22
/17
1. C15 LLC P.O.Box 1610, Eagle, ID 83716
$ 1,000.00
$ 1,000.00
Calendar Year -To -Date
08
/31
/17
2. Matthew Schultz P.O. Box 1115, Meridian, ID 83680
150.00
$
$ 150.00
Calendar Year -To -Date
09
/14
/17
3. Meridian Fire Fighters IAFF Local 4627 P.O.Box 456, Meridian, ID 83680
500.00
$
500.00
Calendar Year -To -Date
09
/18
/17
4. Scott and Tawna Love 2370 Bowstring, Meridian, ID 83642
150.00
$
150.00
Calendar Year -To -Date
09
/18
/17
5. Ann Bowen 3067 Autumn Way, Meridian, ID 83642
150.00
$
$ 150.00
Calendar Year -To -Date
09
/27
/17
6. Winston H. Moore 1940 S. Bonito Way Ste 160, Meridian, ID 83642
100.00
$
$ 100.00
Calendar Year -To -Date
7.
$
$
Calendar Year -To -Date
8.
$
$
Calendar Year -To -Date
9.
$
Calendar Year -To -Date
10.
$
Calendar Year -To -Date
Total This Page:
$2,050.00
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
Page o
1 2
Name of Candidate or Committee: Treg Bernt I
Purpose Codes (anter up to ;3 purpose codes per txpenditure.)
Date Spent
FullName, Wiling Address and Zip Code ot Recipienturpose
A
All Travel Expenses (Airfare, Fuel, Lodging & Mileage)
N
Newspaper & Other Periodical Advertising
B
Broadcast Advertising (Radio, TV, Internet & Telephone)
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
H
Independent Expenditures
Y
Petition Circulators
L
Literature, Brochures, Printing
Z
Preparation & Production of Advertising
M
Management Services
Transfer the combined total of all Schedule B pages to the Detailed Summary on page 2 line 7.
Date Spent
FullName, Wiling Address and Zip Code ot Recipienturpose
o e s)
Cash or Check
1. Cash and Carry 1700 W. Shoreline Drive, Boise, ID 83702
E
06
19
17
87.33
2. Cash and Carry 1700 W. Shoreline Drive, Boise, ID 83702
E
06
21
17
266.83
3. Signs Etc. 910 E. Franklin #102, Meridian, ID 83642
O
06
21
17
228.96
4. Salute Apparel 200 N. Maple Grove #224, Boise, ID 83704
O
06
21
17
244.88
5. Bryant Ideas 149 S. Adkins Way #101, Meridian, ID 83642
O
06
21
17
200.00
6, Cash and Carry 1700 W. Shoreline Drive, Boise, ID 83702
E
06
23
17
64.74
7, Rocky Mountain Roll 865 Taylor Avenue, Meridian, ID 83642
E
06
23
17
68.90
8. Dairy Days Parade P.O.Box 862, Meridian, ID 83680
E
06
30
17
75.00
I
I
$
9. Meridian Parks and Recreation 33 East Broadway #206, Meridian,
E
ID 83642
07
26
17
264.20
10. UPS Store 104 E. Fairview Avenue, Meridian, ID 83642
L
08
01
17
291.50
$
Total This Page:
$1,792.34
Transfer the combined total of all Schedule B pages to the Detailed Summary on page 2 line 7.
SCHEDULE B
ITEMIZED EXPENDITURES
Twenty -Five Dollars ($25.00) or more this period
Name of Candidate or Committee: Treg Bernt
Purpose Codes (Enter up to 3 purpose codes per Expenditure.
A All Travel Expenses (Airfare, Fuel, Lodging & Mileage) N Newspaper & Other Periodical Advertising
B Broadcast Advertising (Radio, TV, Internet & Telephone) 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
H Independent Expenditures
Y
Petition Circulators
L Literature, Brochures, Printing
Z
Preparation & Production of Advertising
M Management Services
Page o
2 2
Transfer the combined total of all Schedule B pages to the Detailed Summary on page 2 line 7.
Date Spent
FullName, Mailing Address and Zip Code ot RecipientPurpose
Code(s)
Cas or Check
1, Complete Marketing Solutions 1911 Tracy Court, Meridian, ID
M
83646
08
11
17
837.20
2. UPS Store 104 E. Fairview, Meridian, ID 83642
L
08
15
17
92.75
3. City of Meridian 33 E. Braodway, Meridian, ID 83642
G
08
30
17
40.00
4, Salute Apparel 200 N. Maple Grove #224, Boise, ID 83704
O
08
31
17
190.80
5. Bryant Ideas 149 S. Adkins Way #101, Meridian, ID 83642
O
08
31
17
137.80
6. Eric Cawley 1911 Tracy Court, Meridian, ID 83646
M
09
02
17
896.04
7, Artech Screen Printing 520 E. Franklin, Meridian, ID 83642
O
09
11
17
4,194.42
8. D & B Supply 1725 E. Fairview, Meridian, ID 83642
G
09
22
17
182.66
I
I
$
9. US Post Office 1200 N. Main, Meridian, ID 83642
P
09
27
17
274.40
10, UPS Store 104 E. Fairview, Meridian, ID 83642
L
09
28
17
80.56
/
/
$
Total This Page:
$ 6,926.63
Transfer the combined total of all Schedule B pages to the Detailed Summary on page 2 line 7.
CAMPAIGN FINANCIAL DISCLOSURE REPORT
SUMMARY PAGE
(Please Print or Type)
Section I
Ir
C-2
Rev. 12/14
-f-
Name of Candidate or Political Committee and Chairperson
Office Sought (if candidate)
istrict (if any)
Treg Bernt
City Council
COLUMN[
Mailing Address
City and Zip
Home one
Work Phone
531 S. Tiburon
Meridian, ID 83642
208-409-7400
Name of PoliticalTreasurer
Brad Hoaglun
Mailing Address
City and Zip
Home Phone
Work Phone
2470 W. Trestle Drive
Meridian, ID 83646
208-870-8237
XXXXXX
Change of address for: Candidate or Political Committee ❑ Political Treasurer ❑
Section II TYPE OF REPORT
This filing is an: ❑ Original ❑ Amendment
This report is for the period from 10/01/2017 through 10/2212017
❑ October 10 Pre -General Report
® 7 Day Pre -General Report ❑ 30 Day Post -General Report ❑ Annual Report
Is this a Termination Report: ❑ Yes 10 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 ll, 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[
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
$
0.00
Line 2: Enter Beginning Cash Balance**
$ 966.94
$
XXXXXX
Line 3: Total Contributions (Enter amount from line 5, page 2)
$ 6,100.00
$
15,850.00
Line 4: Subtotal (Add lines 1, 2 and 3)
$ 7,066.94
$
15,850.00
Line 5: Total Expenditures (Enter amount from line 11, page 2)
$ 1,089.33
$
9,872.39
Line 6: Enter Ending Cash Balance (Subtract line 5 from line 4)
$ 5,977.61
$
5,977.61
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 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
Please remit to:
City Clerk's office I Brad Hoaglun hereby certify that the information in this
City of Meridian Name of Political Treasurer
Suite B0oadway Ave. report is a true, complete and correct Campaign Financial Disclosure Report as required by law.
Meridian, ID 83642
(208) 888-4433
clerk@meridiancity.org Signature f P litical Treasurer
Page 1
12
13
14
15
16
17
18
DETAILED SUMMARY
Name of Candidate or Committee: Treg Bernt
Expenditures
Total This Period
Contributions
+ $13.91
_
Unitemized Contributions ($50 and less) — # of Contributors
Itemized Contributions (Total of all Schedule A sheets)
In -Kind Contributions (Total of all Contribution amounts from Schedule C sheets)
+ $ 0.00
+ $ 6,100.00
+ $ 0.00
Loans (Total of all New Loan amounts from Schedule D sheets)
+ $ 0.00
Total Contributions (Transfer this figure to page 1, Section IV, Line 3)
_ $ 6,100.00
Expenditures
Unitemized Expenditures (Less than $25) # of Expenditures 1
+ $13.91
Itemized Expenditures (Total of all Schedule B sheets)
+ $1,075.42
---------------------------------- ---
In-Kind Expenditures (Total of all Expenditure amounts from Schedule C sheets)
+ $ Ov00
—
Loan Repayments (Total of all Loan Repayment amounts from Schedule D sheets)
+ $ 0.00
Credit Card and Debt Repayments (Total of all Repayment amounts from Schedule E sheets)
+ $ 0.00
Total Expenditures (Transfer this figure to page 1, Section IV, Line 5)
_ $1,089.33
Loans, Credit Cards and Debt
Outstanding Balance from previous reporting period
+ $ 0.00
New Loans received during this reporting period
+ $ 0.00
(Total of all New Loan amounts plus Accrued Interest from Schedule D sheets)
New Credit Card and Debt incurred this reporting period
+ $ 0.00
(Total of all New Incurred Debt amounts from Schedule E sheets)
Subtotal
= $ 0.00
Repayments of Loans made during this reporting period
_ $ 0.00
(Total of all Loan Repayment amounts from Schedule D sheets)
Repayments of Credit Card and Debt this reporting period
_ $ 0.00
(Total of all Debt Repayment amounts from Schedule E sheets)
Total Outstanding Balance at close of this period (Transfer this figure to page 1, Section IV, Line 7)
$ 0.00
Pledged Contributions
Unitemized Pledged Contributions ($50 and less) # of Pledges 0 + $ 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 Page o
ITEMIZED CONTRIBUTIONS 1 1
of more than Fifty Dollars ($50.00) this period
Name of Candidate or Committee: Treg Bernt
Date Received
Full Name, Mailing Address and Zip Code of Contributor
Cash or Check
10 / 02 / 17
1 - ISU Cunningham & Associates 2230 W. Everest Lane #100, Meridian, ID 83646
$ 500.00
$ 500.00
Calendar Year -To -Date
10 / 02 / 17
2. Joe and Sharon Borton 4398 W. Red Grass Court, Meridian, ID 83646
$ 200.00
$ 200.00
Calendar Year -To -Date
10 09 17
1 Aaron and Chelsie THompson 528 S. Trunnel Aveenue, Meridian, ID 83642
$ 150.00
$ 150.00
Calendar Year -To -Date
10 / 09 / 17
4. Building Contractors Association of Southwest Idaho 6206 N. Discovery Way
Suite A, Boise, ID 83713
$ 1,000.00
$ 1,000.00
Calendar Year -To -Date
10 / 09 / 17
5. UHFG Insurance Political Action Committee PO Box 7777, Meridian, ID 83680
$ 250.00
$ 250.00
Calendar Year -To -Date
10 10 17
6. C. Wright Contruction Company Inc. 1320 S. Black Cat, Meridian, ID 83642
$ 1,000.00
$ 1,000.00
Calendar Year -To -Date
10 / 10 / 17
7' BHH, LLC 1025 S. Bridgeway Place, Suite 290, Eagle, ID 83616
$ 1,000.00
$ 1,000.00
Calendar Year -To -Date
10 / 19 / 17
8. Idaho Association of Realtors Inc The Realtors Political Action Committee$
10116 W. Overland Road, Boise, ID 83709
1,000.00
$ 1,000.00
—
Calendar Year -To -Date
10 20 17
9- Timber Creek Recycling LLC 2623 S. Hillis PI Meridian, ID 83642
$ 1,000.00
$ 1,000.00
Calendar Year -To -Date
10.
Calendar Year -To -Date
Total This Page:
$ 6,100.00
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
Page o
1 1
Name of Candidate or Committee: Treg Bernt I
trurpose uoaes ttnter up to 3 purpose coaes per txpenaiture.)
Mailing Address and Zip Gode ot Recipienturpose
o e s)
A
All Travel Expenses (Airfare, Fuel, Lodging & Mileage)
N
Newspaper & Other Periodical Advertising
B
Broadcast Advertising (Radio, TV, Internet & Telephone)
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
H
Independent Expenditures
Y
Petition Circulators
L
Literature, Brochures, Printing
Z
Preparation & Production of Advertising
M
Management Services
4.
a e SpentIII
Mailing Address and Zip Gode ot Recipienturpose
o e s)
Uash or UhecK
1 UPS Store 10400 Overland Road, Boise, ID 83709
L
10 11 17
145.75
2. D & B Supply 1725 E. Fariview, Meridian, ID 83642
0
10 12 17
179.67
/ /
Is
3. Complete Marketing Solutions 1911 Tracy Court, Meridian, ID 83646
M
10 13 17
750.00
4.
5.
6.
7.
8.
9.
10,
Total This Page:
$ 1,075.42
Transfer the combined total of all Schedule B pages to the Detailed Summary on page 2 line 7.
CAMPA|GNFINANCIAL DISCLOSURE REPORT
SUMMARY PAGE
(Please Print or Type)
C2
Rov, 12U4
��
������
�
cnangeotaddress for Candidate mPolitical Committee O Political Treasurer 0
Section 11 TYPE OFREPORT
Thisfiling isan: [] Original [] /yUendnmo1
This report |mfor the period from 10/23/2017 ____Nmmgh 1/ .
[] 7Day Pre -General Report
Isthis mTermination Report: O #w
N 3ODay Post -General Report
�04
[] October 10Pre-General Report
0 Annual Report
Section III STATEMENT OfNDCONTRIBUTIONS 0REXPENDITURES
DkmoU000 Kyou had nocontributions (x expenditures during this reporfrig period, check the box next hothe 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 terUfy that | have received rmcontributions and have made no expendituresduring ^ thbmpmtin period.
Section IV SUMMARY
To reach your Calendar Year hDate figure: Add this report's Column |
CDLUWNi COLUMN 11
figures iothe Column || figures ofyour previous report (except online W.
This Period Calendar Year
to Date
Line 1:Cash ooHand January 1.This Calendar Year�
$ $ 8.00
Line 2:Enter Beginning Cash Ba|anou°^
$ 5'977^81 $ XyyXXy
Line 3:Total Contributions (Enter amount from line 5,page 2\
3 575'00 � 18.426'00
Line 4:Subtotal (Add lines 1.2and 3\
6'552'61 & 18.425.08
Lim S:Total Expenditures (Enter amount from line 11.page 2)
$ 4,693.31% _14'585.70
Uma 8: Enter Ending Cash Balance /Sobhd
aUm* 5 from line 4>
$ 1 `8GS'38 $ 1,859.30
Line 7:Outstanding Debt hDate (Enter amount h0mline 18.page 2>
$ 0`08
*This should bwentered ooline 1of all reports filed this calendar year,
~This iuthe figure online 80ithe last Campaign Financial Disclosure Rriled. U
this ioyour first report, this amount is0.
Note: The closing cash balance for the current reporting period appeatn on the next report axthe beginning cash nnhand,
Section V
Please remit w'
City Clerk's Office
City of Meridian
$3 E. Broadway Ave.
Suite 104
Meridian, |D83V42
(208) 80$,4433
c|ork@merWimncity.o,g
BradHoaglUD
[
report is a true, complelciand correct Campaign Fin
Page
Signature
hereby oeftify that the information in this
re Report ,is required by la%
Treasurer
14
15
16
0
18
DETAILED SUMMARY
Name of Candidate or Committee: Treg Bernt
Expenditures
Total This Period
Contributions
+ $10.80
Unitemized Contributions ($50 and less) # of Contributors
+ $ 0.00
Itemized Contributions (Total of all Schedule A sheets)
+ $ 575.00
In -Kind Contributions (Total of all Contribution amounts from Schedule C sheets)
+ $ 0.00
Loans (Total of all New Loan amounts from Schedule D sheets)
+ $ 0.00
Total Contributions (Transfer this figure to page 1, Section IV, Line 3)
_ $ 575.00
Expenditures
Unitemized Expenditures (Less than $25) # of Expenditures 1
+ $10.80
Itemized Expenditures (Total of all Schedule B sheets)
+ $4,682.51
In -Kind Expenditures (Total of all Expenditure amounts from Schedule C sheets)
+ $ 0.00
Loan Repayments (Total of all Loan Repayment amounts from Schedule D sheets)
+ $ 0.00
Credit Card and Debt Repayments (Total of all Repayment amounts from Schedule E sheets)
+ $ 0.00
Total Expenditures (Transfer this figure to page 1, Section IV, Line 5)
= $4,693.31
Loans, Credit Cards and Debt
Outstanding Balance from previous reporting period
+ $ 0.00
New Loans received during this reporting period
(Total of all New Loan amounts plus Accrued Interest from Schedule D sheets)
+ $ 0.00
New Credit Card and Debt incurred this reporting period
(Total of all New Incurred Debt amounts from Schedule E sheets)
+ $ 0.00
Subtotal
= $ 0.00
Repayments of Loans made during this reporting period
(Total of all Loan Repayment amounts from Schedule D sheets)
_ $ 0.00
Repayments of Credit Card and Debt this reporting period
(Total of all Debt Repayment amounts from Schedule E sheets)
_ $ 0.00
Total Outstanding Balance at close of this period (Transfer this figure to page 1, Section IV, Line 7)
_ $ 0.00
Pledged Contributions
Unitemized Pledged Contributions ($50 and less) # of Pledges 0
+ $ 0.00
Itemized Pledged Contributions this Period (Total of all Schedule F sheets)
+ $ 0.00
Total Pledged Contributions this period
= $ 0.00
Page 2
Page o
SCHEDULE A
ITEMIZED CONTRIBUTIONS 1 1
of more than Fifty Dollars ($50.00) this period
Name of Candidate or Committee: Treg Bernt
Date Received
Full Name, Mailing Address and Zip Code of Contributor
Cash or Check
10 / 30 / 17
1. Matthew Schultz P.O.Box 1115, Meridian, ID 83680
$ 150.00
$ 300.00
Calendar Year -To -Date
11 / 07 / 17
2. Joshua and Julie Cummings 5945 N. Senita Hills, Meridian, ID 83642
$ 125.00
$ 125.00
Calendar Year -To -Date
11 / 17 / 17
1 H -Wire Technology Solutions 12608 S. 125 W. Ste C, Daper, UT 84202
$ 300.00
$ 300.00
Calendar Year -To -Date
/ i
4.
$
Calendar Year -To -Date
5.
Calendar Year -To -Date
6.
Calendar Year -To -Date
7.
$
Calendar Year -To -Date
8.
$
$
Calendar Year -To -Date
9.
Calendar Year -To -Date
10.
Calendar Year -To -Date
Total This Page:
$ 575.00
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
Page o
1 2
Name of Candidate or Committee: Treg Bernt I
rurpose uoaes (inter up to 3 purpose codes per txpenaiture.)
Date Spent
A
All Travel Expenses (Airfare, Fuel, Lodging & Mileage)
N
Newspaper & Other Periodical Advertising
B
Broadcast Advertising (Radio, TV, Internet & Telephone)
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
H
Independent Expenditures
Y
Petition Circulators
L
Literature, Brochures, Printing
Z
Preparation & Production of Advertising
M
Management Services
79.05
Transfer the combined total of all Schedule B pages to the Detailed Summary on page 2 line 7.
Date Spent
FullName, Mailing Address and Zip Code ot Recipienturpose
o e s)
Cash or Check
1 • Cash and Carry 1700 Shoreline, Boise, ID 83702
F
10
26
17
88.91
/
/
$
2. D&B Supply 1725 E. Fariview, Meridian, ID 83642
O
10
27
17
79.05
I Artech Printing 520 E. Franklin, Meridian, ID 83642
O
10
27
17
64.42
4. Papa Johns 1800 S. Meridian Road, Meridian, ID 83642
F
10
28
17
47.68
5. Thorne Printing 623 12th Avenue, Nampa, ID 83686
L
10
30
17
728.64
6. UPS Store 104 E. Fairview, Meridian, ID 83642
L
10
31
17
97.36
7. Autosort 7286 W. Airway Ct, Boise, ID 83709
P
11
01
17
1,095.25
8• Complete Marketing Solutions 1911 Tracy Court, Meridian, ID 83646
M
11
03
17
750.00
9. Complete Marketing SOlution 1911 Tracy Court, Meridian, ID 83646
M
11
08
17
750.00
/
/
$
10. Boutique de Fleur Flowers 471 E. Amalie Court, Meridian, ID 83642
D
11
10
17
247.60
$
Total This Page:
$ 3,948.91
Transfer the combined total of all Schedule B pages to the Detailed Summary on page 2 line 7.
SCHEDULE B
ITEMIZED EXPENDITURES
Twenty -Five Dollars ($25.00) or more this period
Page o
2 2
I Name of Candidate or Committee: Treg Bernt I
rurpose uoaes (tmer up to a purpose codes per txpenaiture.)
ullName, MaHing Address and Zip Code ot Recipienturpose
o e s)
A
All Travel Expenses (Airfare, Fuel, Lodging & Mileage)
N
Newspaper & Other Periodical Advertising
B
Broadcast Advertising (Radio, TV, Internet & Telephone)
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
H
Independent Expenditures
Y
Petition Circulators
L
Literature, Brochures, Printing
Z
Preparation & Production of Advertising
M
Management Services
5.
Date Spen
ullName, MaHing Address and Zip Code ot Recipienturpose
o e s)
Cash or Check
1 • Complete Marketing Solutions 1911 Tracy Court, Meridian, ID 83646
N
11 13 17
733.60
2.
3.
4.
5.
6.
7.
8.
9.
10.
$
Total This Page:
$ 733.60
Transfer the combined total of all Schedule B pages to the Detailed Summary on page 2 line 7.
4t�
Section I
CAMPAIGN FINANCIAL DISCLOSURE REPORT
SUMMARY PAGE
(Please Print or Type)
Name of Candidate or Political Committee and Chairperson
This Period
Office Sought (if candidate) District (if any)
I
Treg Bernt
City Council
Mailing Addresscy
At app
d i
Rome Phone
Work Phone
531 S. Tiburon
Meridian, ID 83642
208-409-7400
$
Name of PolitiralTyeas urer
'Line ice. Contributions (Enter amount from line 5, page)
$ 266.66
$
Brad Hoaglun
-Wail—ing
Line 4: Subtotal (Add lines I � 2 and 3)
2125.96
$ 5
$
Address
L-11"'Ine 5: Total Expenditw,-es (Enter amount from line'1,11 page 2)
ity andip
Home Phone
14, 83.
550
Wo_iR hone
2470 W. Trestle Drive
Meridiani ID 83646
208-870-8237
$ 2� 108. 16
$
Change of address for: Candidate or Political Committee 0 Political Treasurer 0
Section ll TYPE OF REPORT
This filing is an: W Original 11 Amen dmen,,t
This report is for the period from 11118/2017 )'hrcu,,-,,,,,,h 12/23,1 f,2_017
11111111111,11 12 1 1p�� I
t1i �i I ir�111�11
[] 7 Day Pre -General Report [] 30 Day Post -General Report [M AnnualRepol
Is this a Termination Report: [J No
S
_"," PE N DITFectio, lfll STATEMENT OF NO CONTRIBUTIONS 0RLc:JX ij, 14, U RES
Directions: if you had no contributions or expenditures during this reporting period, check the boNX_ next to the stater hent beio�ft,7 and sign this report.
Be sure to carry forward the appropriate "Calendar Year to Date" figures in Column H, Section IV.
El I hereby certify that I have received no contributions and have mades no e)fWriditures diluriiintg "Khis reportingg period,
Section IV S U � A, FF 1
To reach your Calendar Year to Date figure: Add this report's Column I COLUMN COLUMN 11
figures to the Column 11 figures of your previous report (except on line 6).
This Period
Calendar Year
to Date
L e I . C a s h o n H a n, d J a'} n u a ry I h i s C a'�� e i d -21 r Ye:n, a r*
$
0.00
Line 2: EFEntier Beginning Cash Ballance"
$ 11859-30
$
XXXXXX
'Line ice. Contributions (Enter amount from line 5, page)
$ 266.66
$
162691.68
Line 4: Subtotal (Add lines I � 2 and 3)
2125.96
$ 5
$
16691. 66
—
L-11"'Ine 5: Total Expenditw,-es (Enter amount from line'1,11 page 2)
$ 17.80
14, 83.
550
,
Line 6: Enter Ending Cash Balance (Subtracti iline 5 from line 4)
$ 2� 108. 16
$
2; 108.16
Line 7: Outstanding Debt to Date (Enter amount from line 18,P age 2)
$ 0.00
*This same figure should be entered on line I 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 arnount is 0.
Note: The closing ccash baiance for the current reporting period appears on the next report as the beginning cash on hand,
Please remit to:
City Clerk's Office i,83rad glun hereby certify that the information in thl,,s
City of Meridian Name of Political Treasurer
33 E. Broadway Ave. repo6rt is a true, complete and correct Campaign Financial Disclosure Report as required by 11Oviv.
Suite 104
Meridian, ID 83642
-4433
(208 ) 8 88
clerk@merldiancity.org Signature _P Iritical Treasurer
Page 1
DETAILED SUMMARY
Name of Candidate or Committee:
Total This Period
Contributions
Unitemized Contributions ($50 and less) # of Contributors __________ + $
Itemized Contributions (Total of all Schedule A sheets) + $
In-Kind Contributions (Total of all Contribution amounts from Schedule C sheets) + $
Loans (Total of all New Loan amounts from Schedule D sheets) + $
Total Contributions (Transfer this fi gure to page 1, Section IV, Line 3) = $
1
2
3
4
5
Expenditures
Unitemized Expenditures (Less than $25) # of Expenditures __________ + $
Itemized Expenditures (Total of all Schedule B sheets) + $
In-Kind Expenditures (Total of all Expenditure amounts from Schedule C sheets) + $
Loan Repayments (Total of all Loan Repayment amounts from Schedule D sheets) + $
Credit Card and Debt Repayments (Total of all Repayment amounts from Schedule E sheets) + $
Total Expenditures (Transfer this fi gure to page 1, Section IV, Line 5) = $
6
7
8
9
10
11
Pledged Contributions
Unitemized Pledged Contributions ($50 and less) # of Pledges __________ + $
Itemized Pledged Contributions this Period (Total of all Schedule F sheets) + $
Total Pledged Contributions this period = $
19
20
21
Page 2
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 sheets) + $
New Credit Card and Debt incurred this reporting period
(Total of all New Incurred Debt amounts from Schedule E sheets) + $
Subtotal = $
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
(Total of all Debt Repayment amounts from Schedule E sheets) - $
Total Outstanding Balance at close of this period (Transfer this fi gure to page 1, Section IV, Line 7) = $
12
13
14
15
16
17
18
SCHEDULE A
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
$ _______________
$ _______________
Calendar Year-To-Date
____/____/____
Primary
General
9.
$ _______________
$ _______________
Calendar Year-To-Date
____/____/____
Primary
General
8.
$ _______________
$ _______________
Calendar Year-To-Date
____/____/____
Primary
General
1.
$ _______________
$ _______________
Calendar Year-To-Date
____/____/____
Primary
General
2.
$ _______________
$ _______________
Calendar Year-To-Date
____/____/____
Primary
General
3.
$ _______________
$ _______________
Calendar Year-To-Date
____/____/____
Primary
General
4.
$ _______________
$ _______________
Calendar Year-To-Date
____/____/____
Primary
General
5.
$ _______________
$ _______________
Calendar Year-To-Date
____/____/____
Primary
General
6.
$ _______________
$ _______________
Calendar Year-To-Date
____/____/____
Primary
General
7.
$ _______________
$ _______________
Calendar Year-To-Date
____/____/____
Primary
General
10.
Total This Page: $
Page of
Transfer the combined total of all Schedule A pages to the Detailed Summary on page 2 line 2.
APPOINTMENT AND CERTIFICATION OF POLITICAL TREASURER c
Rev. 08/077
t� FOR CANDIDATES AND COMMITTEES
o
r) �� (Please Print or Type)
Pursuant to Section 67-6603(cl), Idaho Code. No contribution shall be received or expenditure'mpds by orbehalf of a
candidate or political committee until he or she appoints a political treasurer and certifie(fitne and address of the treasurer
to the Secretary of State,«FF
Certification is for (check appropriate box below): 1, Ks 0,C ifC7
1 Name of
CANDIDATE: l Candidate; - -_ (
Home Work Cell
Phone: Phone: Phone: off. j
Office Seat (if
Sought: t applicable)
Candidate
Mailing address; ( PIC ivi k� � �' -t r` 1 10 '
Candidate
email address: ) f a f
Name of
❑ COMMITTEE: ,Committee:
i Name of Committee
i Chairman:
Miscellaneous: El !Home Work Cell
Phone: Phone: Phone:
Measure: 1-1 lCommittee
Mailing address:
Candidate/Measure: El
Chairman
email address:
CERTIFICATION AND APPOINTMENT
do hereby certify and appoint the following individual who is a registered elector of
Name of Candidate or Committee Chairman
the State of Idaho as the political treasurer for the above named candidate or committee:
Name of �-
Political Treasurer: t
1 Home Work Cell t
Phone: Phone: Phone: }
Treasurer i
Mailing address: { t A d ,_I
I Treasurer
I email address: ) CI'
-
ignature f Candidate or Committee Chairman
I, f do hereby accept the appointment as political treasur for
Name of Political Treasurer
the above named candidate or committee= t
ignature of Political Treasurer
CAMPAIGN FINANCIAL DISCLOSURE REPORT
SUMMARY PAGE
(Please Print or Type)
Section I
C-2
Rev, 12/14
Name of ndi to or P litical ommi a and Chairperson
I/
Office Sought if candidate)
District (if any)
c.
Mailing ressi
17 <x .
an Zip
l
Home on
o one
Name o o Uca reasurer
g f
Mailing Address
a
City and Zip
t
Home Phone
'' q
WO—K Phone
i
Change of address for: Candidate or Political Committee ❑ Political Treasurer ❑
Section II TYPE OF REPORT
This filing is an: ' Original ❑ Amendment
This report is for the period from , through / - /l
❑ 7 Day Pre -General Report
Is this a Termination Report: ❑ Yes
❑ 30 Day Post -General Report
❑ October 10 Pre -General Report
Annual 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,
Iess
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
figures to the Column II 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 I
COLUMN II
This Period
Calendar Year
to Date
$ XXXXXX
$ Ll 09f
$ ( F
$ XXXXXX
$ �—
$ —
$
$
$
$ _
$01 V,$
$_
*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
Please remit to:
City Clerk's Office
City of Meridian
33 E. Broadway Ave.
Suite 104
Meridian, ID 83642
(208)888.4433
cityclerk@meridiancity.org
I, rt hereby certify that the information in this
Name of Political Treasurer
report is a true, complete and correct Campaign Financial Disclosur Report as require by law,
( 1,41-1 A—
Page 1
re of Political Treasurer