7 Day Pre General MoberlyP+sem CAMPAIGN FINANCIAL DISCLOSURE REPORT RECEIVEDRev.1 -2
SUMMARY PAGE
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Section I� CITY OF0Vr Zp—
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Name of Candidate or Political Committee and Chairperson
Office Sought (if candidate eat(if any)
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Home on
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City and Zip
Home Phone
Work Phone
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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 10 101 / C3 through 10 J 20 lam.
❑ October 10 Pre -General Report
❑ Annual Report
Is this a Termination Report: ❑ Yes
X7 Day Pre -General Report
$I No
❑ J
❑ 30 Day Post -General Report
Section III STATEMENT OF NO CONTRIBUTIONS OR EXPENDITURES
Directions: If you had no contributions or expenditures during this reporting period, check the box next to the statement below and sign this report.
Be sure to carry forward the appropriate "Calendar Year to Date' figures in Column II, Section IV.
❑ 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)
COLUMNI
This Period
$ XXXXXX
g 4.44.3a
$ %M on>
$ 5-T4 3a
$
$ '1012i•�O
COLUMN II
CalendarYear
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.
Jaycee Holman /
City Clerk I; - k f it �r 1 hereby certify that the information in this
Ci. Broady of way
�meo[Polific ITreasurer
33 E. Broadway Ave.
Meridian ID 83642 report is a true, complete and correct Campaign Financial Disclosure Report as required by law.
(208) 888-4433
Fax: (208) 888-4218
jholman@meridiancilyorg —SignaturedMolitical Treasurer
Pa 1
12
13
14
15
16
0
18
DETAILED SUMMARY
Name of Candidate or Committee:
J
Expenditures
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 figure to page 1, Section IV, Line 3)
_ $
Expenditures
Unitemized Expenditures ($25 and less) # of Expenditures_
+ $_
Itemized Expenditures (Total of all Schedule B sheets)
+ $ .Z
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 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 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 figure to page 1, Section IV, Line 7)
_ $ �—
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
Page 2
SCHEDULEA age o
ITEMIZED CONTRIBUTIONS
of more than Fifty Dollars ($50.00) this period
Name of Candidate or Committee: �,'o" S
Date Received
Full Name, Mailing Address and Zip Code of Contributor
Cash or Check
la 1�t13
1 Let a Xla �5les�tm C�Ss�
Kstl � �-cst�n`oes�_ ��
$ \Cam
Calendar Year -To -Date
2.
$
Calendar Year -To -Date
3.
Calendar Year -To -Date
!/—
4.
$
Calendar Year -To -Date
I !
5.
$
$
Calendar Year -To -Date
_lam_
6.
$
Calendar Year -To -Date
! !
7.
$
$
Calendar Year -To -Dale
8.
$
Calendar Year -To -Dale
! I
9.
$
$
Calendar Year -To -Date
! I
10.
$
Calendar Year -Te -Date
Total This Page: is
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 page°
Cash or Check
ITEMIZED EXPENDITURES
Twenty -Five Dollars ($25.00) or more this period
Name
of Candidate or Committee:
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
�ASSJ (dsY�o `
2,
3.
4.
5.
6.
7.
8,
9.
10.
Total This Page:
$
Transfer the combined total of all Schedule B pages to the Detailed Summary on page 2line 7.