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Malloy - 30 Day Post General Amend 1CAMPAIGN FINANCIAL DISCLOSURE REPORT SUMMARY PAGE (Please Print or Type) RECEIVED FEB 0 6 2012 C_2 CITY 01- Rev. 10107 CITY CLERKS OFFICE Name of Candidate or Political Committee and Chairperson Oftloe Sought (if candidate) Seat(d any) Patrick Malloy $ 0.00 aimg rens ury and Lip Home Phone work Pflone 4446 North Abruzzo Avenue Meridian 83646 559-2631 559-2631 Name of Polilical I reasurer Dale H. Bracken Mailing Address City and Zip ome one o P one 712 E. Kaibab Trail Drive Meridian 83646 818-378-6871 818-387-6871 Change of address for: Candidate or Political Committee ❑ Political Treasurer Section II TYPE OF REPORT This filing is an: ❑ Original 8 Amendment This report is for the period from 10 124 12011 through 11 118 12011 ❑ October 10 Pre -General Report ❑ 7 Day Pre -General Report 30 Day Post -General Report ❑ Annual Report Is this a Termination Report: ❑Z 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 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 II figures of your previous report (except on line 6). This Period Calendar Year 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) $ 1,070.72 "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 fled. 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 Dale H. Bracken , 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. ;z Signature of Political Treasurer Page 1 to Date $ XXXXXX $ 0.00 $ 1,286.27 $ XXXXXX $ 0.00 $ 3,089.00 $ 1,286.27 $ 3,089.00 $ 1,286.27 $ 3,089.00 $ 0.00 $ 0.00 $ 1,070.72 "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 fled. 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 Dale H. Bracken , 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. ;z Signature of Political Treasurer Page 1 DETAILED SUMMARY Nameof Candidate or Committee: Patrick Malloy 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) © Umtemized Expenditures ($25 and less) # of Expenditures 6.00 O Itemized Expenditures (Total of all Schedule B sheets) ® In -Kind Expenditures (Total of all Expenditure amounts from Schedule C sheets) O Loan Repayments (Total of all Loan Repayment amounts from Schedule D sheets) 10 , Credit Card and Debt Repayments (Total of all Repayment amounts from Schedule E sheets) (ID; Total Expenditures (Transfer this figure to page 1, Section IV, Line 5) Loans, Credit Cards and Debt 1P Outstanding Balance from previous reporting period -- -- — .. New Loans received during this reporting period 13 (Total of all New Loan amounts plus Accrued Interest from Schedule D sheets) 14 New Credit Card and Debt incurred this reporting period (Total of all New Incurred Debt amounts from Schedule E sheets) 15 ; Subtotal 16 : Repayments of Loans made during this reporting period (Total of all Loan Repayment amounts from Schedule D sheets) 17 Repayments of Credit Card and Debt this reporting period (Total of all Debt Repayment amounts from Schedule E sheets) 18 Total Outstanding Balance at close of this period (Transfer this figure to page 1, Section IV, Line 7) Pledged Contributions 1g Unitemized Pledged Contributions ($50 and less) #of Pledges Itemized Pledged Contributions this Period (Total of all Schedule F sheets) Total Pledged Contributions this period-- $0.00 eriod Page 2 $0.00 + $1,802.55 + $0.00 + $ 0.00 _ $1,802.55 - $-260.00 - $-471.83 $1,070.72 $ 0.00 SCHEDULE A Page o ITEMIZED CONTRIBUTIONS 1",age of more than Fifty Dollars ($50.00) this period Name of Candidate or Committee: Patrick Malloy Date Received Full Name, Mailing Address and Zip Code of Contributor Cash or Check / I 1. $ $ ❑ General Calendar Year -To -Date 2. ❑ General Calendar Year -To -Date / I 3. $ $ ❑ General Calendar Year -To -Date 4. ❑ General Calendar Year -To -Date 5. ❑ General Calendar Year -To -Date r / 6. $ $ ❑ General Calendar Year -To -Dare 7. $ ❑ General Calendar Year -To -Date 8. $ ❑ General Calendar Year -To -Date 9. ❑ General Calendar Year -To -Date / I 10. $ ❑ General Calendar Year -To -Dale Total This Page: $ 0.00 Transfer the combined total of all Schedule A pages to the Detailed Summary on page 2line 2. SCHEDULE B ITEMIZED EXPENDITURES Twenty -Five Dollars ($25.00) or more this period Name of Candidate or Committee: Patrick Malloy age o 1 1 1 Purpose Codes Full Name, Mailing Address and Zip Code of Recipient Purpose Code 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 Dale Spent Full Name, Mailing Address and Zip Code of Recipient Purpose Code Cash or Check 11/04/11 — 1 Winco Foods, Meridian, ID #0048 F $ 54.46 11 /04/11 2 Modern Printers, 714 N. Main, Meridian, ID 83680 L $ 80.00 3. F 10 / 31 / 11 — KahootZ Steak and Ale House, 1603 N. Main Street, Meridian, ID 83642 $ 42.73 10/28/ 11 — 4 Office Depot, 3545 E. Fairview Ave., Meridian, ID 83642 L $ 97.32 10/27/11 — 5 Staples, 6299 Eagle Road, Boise, ID 83713 L $ 32.59 10 / 26 /11 — 6 Bridgetower CPU, 3120 W. Belltower Dr. Ste 175, Meridian, ID 83646 P 00 $ 88.00 7 P 10 /27 /11 Bridgetower CPU, 3120 W. Belltower Dr. Ste 175, Meridian, ID 83646 $ 88.00 8. 9. 10. Total This Page: $483.10 Transfer the combined total of all Schedule B pages to the Detailed Summary on page 2 line 7. SCHEDULE C age o IN-KIND CONTRIBUTIONS and EXPENDITURES 1 11 Name of Candidate or Committee: Patrick Malloy Contributor Name, Mailing Address and Zip Code Purpose Codes A All Travel Expenses (Airfare, Fuel, Lodging & Mileage) N Newspaper & Other Periodical Advertising B BroadcastAdvertising (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 1. Contributor Name, Mailing Address and Zip Code Calendar Year -To -Date ❑ General Expenditure Name, Mailing Address and Zip Code Purpose Code $ 2. Contributor Name, Mailing Address and Zip Code $ Calendar Year -To -Dale ❑ General Expenditure Name, Mailing Address and Zip Code Purpose Code $ 3. I I Contributor Name, Mailing Address and Zip Code $ $ Calendar Year -To -Dale ❑ General Expenditure Name, Mailing Address and Zip Code Purpose Code 4. I I Contributor Name, Mailing Address and Zip Code $ Calendar Year-TaDale ❑ General Expenditure Name, Mailing Address and Zip Code Purpose Code $ 0.00 Expenditure Total: (Transfer the combined total of all Expenditures on Schedule C pages $ O o 0 to the Detailed Summary, page 2line 8) Contributor Total: (Transfer the combined total of all Contributors on Schedule C pages $O o0 to the Detailed Summary, page 2line 3) 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 InterestAccrued 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, Patrick Malloy 4446 Abruzzo Avenue 260.00 Date: // 0.00 Dale: to /61 /2011 0.00 Amount: Amount: Meridian, ID 83646 $0.00 $ 260.00 p Date: Date: Amount: Amount: 3 Date: Date: Amount: Amount: 4 Date: Date: Amount: Amount: $ $ 6 Dale: Dale: Amount: Amounl: 6 Date: Date: Amount: Amount: $ $ 7 Date: Date: Amount: Amount: Previous Received Interest Repayments Ending Balance Previous Total $ 260.00 Received Total: (Transfer the combined total of all received loans to the $ 0, 00 Detailed Summary, page 2line 4) Interest Total: $0 Repayments Total: (Transfer the combined total of all loan repayments to the $ 260.00 Detailed Summary, page 2 line 9 & 16) Ending Balance Total: (NOTE: Transfer the combined total of all Accrued Interest and Received Loans to the Detailed Summary, page 2 line 13) SCHEDULE E CREDIT CARDS and DEBT Each incurred expense not yet paid (Le, credit card purchases and debt) should be listed on a separate line. Each time you make purchases with a credit card or incur debt, it is considered to be a separate item. However, you will maintain a single item for each credit card and add purchases to that item. Each Creditor listed below with a New Debt amount must have a Schedule E-1 accompanying it. The Schedule E-1 lists where and when the debt was incurred. Credit Cards are considered debt to the campaign. Regardless of whether the credit card is repaid when the statement is received, all credit card transactions will appear on Schedule E and E-1. However, only Repayments of Debt during this reporting period appear in the Expenditure Section of the Detailed Summary Page. Any creditor(s) with a balance(s) appearing on the last report must be listed below with the amount in the Previous Balance column. Any new debt should be listed in the New Debt column, including any accrued interest. If a payment was made on the debt, list it in the Repayments column. Note: Any debt 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 Debt less any Repayments of Debt. Name, Mailing Address and Zip Code of Previous Balance of New Debt amount Repayments of Debt Balance outstanding Creditor debt at the end of the incurred during this during this reporting at the end of this (Candidate, Individual or Business) last reporting period reporting period period reporting period 1, 1,542.55 Date: Date: 1,542.55 P.W&M.11.y4446Ab,.Avenue Median, ID 83646 Amount: Amount: $ $ 2. Dale: Dale: Amount: Amount: 3. Dale: Date: Amount: Amount: 4, Dale: Date: Amount: Amount: 5. Date: Date: Amount: Amount: 6. Dale: Date: Amount: Amount: $ $ Previous Incurred Repayments Ending Balance Previous Total: $1, 542.55 Incurred Total: (Transfer the combined total of all incurred debt to the $ 0.00 Detailed Summary, page 2line 14) Repayments Total: (Transfer the combined total of all debt repayments to the $ 0.00 Detailed Summary, page 2 line 10 & 17) Ending Balance Total: $ 1, 542.55 SCHEDULE E-1 CREDIT CARD and DEBT ITEMIZATION Name of Creditor from ScheduleE:Patrick Malloy Page o 1 1 Each Creditor listed on Schedule E with a New Debt amount must have a Schedule E-1 accompanying it. The Schedule E-1 lists where and when the debt was incurred. Purpose Codes A All Travel Expenses (Airfare, Fuel, Lodging & Mileage) B Broadcast Advertising (Radio, TV & Internet) C Contributions to Candidates & PAC's D Donations & Gifts E Event Expenses F Food & Refreshments G General Operational Expenses I Interest Accrued & Finance Charges L Literature, Brochures, Printing M Management Services N Newspaper & Other Periodical Advertising 0 Other Advertising (Yard Signs, Buttons, etc.) P Postage S Surveys & Polls T Tickets (Events) U Utilities W Wages, Salaries, Benefits & Bonuses Y Petition Circulators Z Preparation & Production of Advertising Dale Incurred Full Name, Mailing Address and Zip Code of Expenditure Purpose Code Amount ri 1. $ z. 3. II $ 4. 5. 6. 7. 8. r / $ 9. Total This Page: $ 0.00 The total of itemization for this creditor should equal the new loan amount listed on Schedule E for this creditor. SCHEDULE F Page o PLEDGED CONTRIBUTIONS BUT NOT YET RECEIVED 1 1 Name of Candidate or Committee:Patrick Malloy Directions: Complete this schedule if you were promised and agreed to accept a contribution during this reporting period but have not actually received the money, goods or services offered before the end of the reporting period. Do not include these entries on Schedule A until you actually receive the contribution. Pledged For Date Pledged Full Name, Mailing Address and Zip Code of Contributor Amount Pledged ❑ General f 1. 2. ❑ General 3. ❑ General 4. ❑ General 5. ❑ General 6. ❑ General 7. ❑ General 6. ❑ General 9. ❑ General 10. ❑ General 11. ❑ General Total Amount of Pledged Contributions: $ 0.00 Transfer the combined total of all Schedule F pages to the Detailed Summary on page 2 line 20.