October 10 Pre GeneralS ra
Section I
CAMPAIGN FINANCIAL DISCLOSURE REPORT
SUMMARY PAGE
(Please Print or Type)
C-2
Rev. 12/14
Name of Candidate or Political Committee and Chairperson
Office Sought (if candidate)
District (if any)
Donna Lusignan
City Council - seat 1
Mailing Address
City and zip
Home one
Work Phone
1033 W Verbena Drive
Meridian 83642
(619)922-3851
Name of Political Treasurer
Fay Clare
Mailing Address
City and Zip
Home Phone
Work Phone
723 W Redwood Lane
Nampa 83651
(208)230-0644
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 08/26/2019 through 09/30/2019 /
0 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 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
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
This Period
$ XXXXXX
0
$ 695.00
$ 695.00
$ 333.55
$ 161.45
$ 200.00
COLUMN II
Calendar Year
to Date
XXXXXX
*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
Fay Clare
I,
hereby certify that the information in this
Name of Political Treasurer
report is a true, complete and correct Campaign Financial Disclosure Report as required by law.
Page 1
Signature of Political Treasurer
DETAILED SUMMARY
Jame of Candidate or Committee:
Total This Period
Contributions
1� Unitemized Contributions ($50 and less) # of Contributors 3 + $ 95.00
20 Itemized Contributions (Total of all Schedule A sheets) + $ 400.00
30 In -Kind Contributions (Total of all Contribution amounts from Schedule C sheets) + $ 0
® Loans (Total of all New Loan amounts from Schedule D sheets) + $ 200.00
50 Total Contributions (Transfer this figure to page 1, Section IV, Line 3) _ $ 695.00
Expenditures
Loans, Credit Cards and Debt
Unitemized Expenditures (Less than $25) # of Expenditures
+ $10.06
+ $ 323.49
Itemized Expenditures (Total of all Schedule B sheets)
In -Kind Expenditures (Total of all Expenditure amounts from Schedule C sheets)
+ $ 0
Loan Repayments (Total of all Loan Repayment amounts from Schedule D sheets)
+ $ 0
Credit Card and Debt Repayments (Total of all Repayment amounts from Schedule E sheets)
+ $ 0
Total Expenditures (Transfer this figure to page 1, Section IV, Line 5)
= $ 333.55
Pledged Contributions
Loans, Credit Cards and Debt
Unitemized Pledged Contributions ($50 and less) # of Pledges
12
Outstanding Balance from previous reporting period
+ $ 0
13
New Loans received during this reporting period
200.00
+ $
(Total of all New Loan amounts plus Accrued Interest from Schedule D sheets)
0
14 New Credit Card and Debt incurred this reporting period
(Total of all New Incurred Debt amounts from Schedule E sheets)
+ $
15 Subtotal
= $ 0
16 Repayments of Loans made during this reporting period-
0
(Total of all Loan Repayment amounts from Schedule D sheets)
$
Repayments of Credit Card and Debt this reporting period
0
(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)
_ $ 200.00
Pledged Contributions
Unitemized Pledged Contributions ($50 and less) # of Pledges
+ $ 0
Itemized Pledged Contributions this Period (Total of all Schedule F sheets)
+ $ 0
Total Pledged Contributions this period
= $ 0
Page 2
SCHEDULE A Page o
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
08 31 19
1 Cheryl Bobbitt
12528 Montana Drive
Frisco Texas 75035
100.00
$
$100.00
Calendar Year -To -Date
09 03 13
2 Crystine Goebel
3017 Newton Lane
Johnson City TN 37604
100.00
$
$ 100.00
Calendar Year -To -Date
09 12 19
3 Charles R. Brevick
Nancy K. Brevick
729 Capistrano Place
San Diego CA 92109-8104
200.00
$
$ 200.00
Calendar Year -To -Date
4.
Calendar Year -To -Date
5.
Calendar Year -To -Date
6.
Calendar Year -To -Date
I /
7.
$
$
Calendar Year -To -Date
8.
$
$
Calendar Year -To -Date
I /
9.
$
$
Calendar Year -To -Date
I /
10.
$
$
Calendar Year -To -Date
Total This Page:
6400.00
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 of
I Name of Candidate or Committee: I
rurpose uoaes (Enter up to :j purpose codes per Expenditure.)
Full Name, Mailing Address and Zip Code of Recipient
1jurpose 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
Date Spent
Full Name, Mailing Address and Zip Code of Recipient
1jurpose o e s)
Cash or Check
1 SuperCheap Signs
L
9200 Waterford Centre Blvd, STE 100
09 18 19
Austin TX 78758
297.00
2 Staples
L
6299 Eagle Road
09 20 19
Meridian ID 83713
26.49
I I
$
3.
4.
5.
6.
7.
8.
9.
10.
Total This Page:
$ 323.49
Transfer the combined total of all Schedule B pages to the Detailed Summary on page 2 line 7.
SCHEDULE D - LOANS
Name of Candidate or Committee:
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 period
period
the end of this
reporting period
reporting period
1. Donna Lusignan
1033 W Verbena Drive
Date:
09 /16 /19
Date:
Amount:
$ 100.00
Amount:
$
Meridian ID 83642
0
0
100.00
2. Donna Lusignan
Date:
Date:
1033 W Verbena Drive
09 /18 /19
Meridian ID 83642
0
Amount:
0
Amount:
100.00
$ 100.00
$
3
Date:
Date:
Amount:
Amount:
4
Date:
Date:
Amount:
Amount:
5
Date:
Date:
Amount:
Amount:
6
Date:
Date:
Amount:
Amount:
7
Date:
Date:
Amount:
Amount:
$
$
Previous Received Interest Repayments Ending Balance
Previous Total $ 0.00
Received Total:
(Transfer the combined total of all received loans to the $ 200.00
Detailed Summary, page 2 line 4)
Interest Total: $ 0.00
Repayments Total:
(Transfer the combined total of all loan repayments to the $ 0.00
Detailed Summary, page 2 line 9 & 16)
Ending Balance Total: $ 200.00
(NOTE: Transfer the combined total of all Accrued Interest and Received Loans to the Detailed Summary, page 2 line 13)