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Monks - 7 Day Pre General Amend 1a CAMPAIGN FINANCIAL DISCLOSURE REPORT RECEIVED C-2 ' SUMMARYPAGE NOV 2 3 2011 Rev. 10107 b (Please Print or Type) CITYurvn qur CITY CLERKS OFFICE Section I Name of Candidate or Political Committee and Chairperson Office Sought (if candidate) Seat (if any) Jason Monks Mayor N/A acing ess Cityan p Home Phone Work Phone 1002 W. Washington Meridian 83642 871-7127 871-7127 Name of Political Treasurer Keith Thurgood ailing ess yand p Home hone Work Phone 1233 W. 7th St. Meridian 83642 888-5236 887-5300 Change of address for: Candidate or Political Committee ❑ Political Treasurer Section II TYPE OF REPORT This filing is an: ❑ Original 13 Amendment This report is for the period from 10 /01 72011 through 10 123 12011 ❑ October 10 Pre -General Report ❑ Annual Report Is this a Termination Report: ❑ Yes ❑i 7 Day Pre -General Report ❑✓ No ❑ 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 SUP 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 COLUMN II This Period Calendar Year to Date $ XXXXXX $ 0.00 $ 610.50 $ XXXXXX $ 8,185.00 $ 12,285.00 $ 8,795.50 $ 12 89556 /2� ZP5 6V $ 2,925.36 $ 6,414.86 $ 5,870.14 $ 8 r44 ::W70.1'4 $ 4,200.79 *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 Keith Thurgood 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. SigrinTure of Political Treasurer Page 1 T 0 14 15 16 17 18 W r�i ro DETAILED SUMMARY Name of Candidate or Committee: Jason Monks Contributions Unitemized Contributions ($50 and less) # of Contributors 3-00 1 Total This Period + $85.00 + $15.00 + $1,452.86 Itemized Contributions (Total of all Schedule A sheets) + $1,000.00 + $7,100.00 + $ 0.00 In -Kind Contributions (Total of all Contribution amounts from Schedule C sheets) + $457.50 + $1,000.00 _ $2,925.36 Loans (Total of all New Loan amounts from Schedule D sheets) $'457.50 + $0.00 _ $4,200.79 Total Contributions (Transfer this figure to page 1, Section IV, Line 3) _ $8,185.00 Expenditures 1 Unitemized Expenditures ($25 and less) # of Expenditures 1 00 Itemized Expenditures (Total of all Schedule B sheets) + $15.00 + $1,452.86 In -Kind Expenditures (Total of all Expenditure amounts from Schedule C sheets) + $1,000.00 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) + $457.50 Total Expenditures (Transfer this figure to page 1, Section IV, Line 5) _ $2,925.36 Loans, Credit Cards and Debt + $0.00 + $0.00 Outstanding Balance from previous reporting period + $4,557.50 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) + s100.79 Subtotal -- --— --- -- =-$4,658.29 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) $'457.50 Total Outstanding Balance at close of this period (Transfer this figure to page 1, Section IV, Line 7) _ $4,200.79 Pledged Contributions Unitemized Pledged Contributions ($50 and less) # of Pledges 0.00 Itemized Pledged Contributions this Period (Total of all Schedule F sheets) + $0.00 + $0.00 Total Pledged Contributions this period --—-- -- _ _ $0.00 Page 2 'i 0 SCHEDULE A ITEMIZED CONTRIBUTIONS of more than Fifty Dollars ($50.00) this period Name of Candidate or Committee:, Jason Monks Date Received Full Name, Mailing Address and Zip Code of Cont ibutor Cash or Check 10/03/11 1 Deborah Monks 3548 E. Grandview St. Mesa, AZ 85213 $1,000-00 $ 1,000.00 Calendar Year -To -Dale 9 General 1011031' 11 2. Jon Monks 3548 E. Grandview St. Mesa, AZ 85213 $ 1,000.00 $ 1,000.00 Calendar Year-To-Dala —! 9 General 10103111 3. Madisen Monks 3548 E. Grandview St. Mesa, AZ 85213 $ 1,000.00 $ 1,000.00 CalendarYear-TaDate 9 General 10/04 11 /� 4. Leslie Palmer 1524 N. Meridian Rd. Meridian, ID 83642 $ 200.00 $ 200.00 9 General Calendar Year -To -Date 10 07 11 1— 5. Cathie Thurgood 1233 W. 7th St. Meridian, ID 83642 $ 200.00 $ 200.00 —/ 9 General Calendar Year -To -Dale 10 09 11 �!— 6. Chandler R. Monks 3548 E. Grandview St. Mesta, AZ 85213 $ 1,000,00 $ 1,000.00 Calendar -Year-To Dale IN General 10 09 11 L 7. Sharia M. Monks 3548 E. Grandview St. Mesa, AZ 85213 $ 1,000.00 $ 1,000.00 Calendar Yew -To -Date 9 General 10119 Ll 1 8-TheBlind Gallery 2053 E. Fairview Ave. Suite 109 Meridian, ID 83642 $1,000-00 $ 1,000.00 Calendar Year -To -Date 13 General 10 19 11 9, Southern Nevada Oxygen 187 N. Gibson Rd. Henderson, NV 89014 $ 500.00 $ 500.00 9 General Calendar Year -To -Dale 10/19 11 �— 10. Marshall K. Coryell Trust 2133 SE 3rd Way Meridian, ID 83642 $ 100.00 $ 100.00 R General Calendar Year -lb -Dale Total This Page: $7,000.00 Transfer the combined total of all Schedule A pages to the Detailed Summary on page 2 line 2. FIA SCHEDULEA ITEMIZED CONTRIBUTIONS of more than Fifty Dollars ($50.00) this period Name of Candidate or committee: Jason Monks Date Received Full Name, Mailing Address and Zip Code of Contributor Cash or Check 10120 111 1 Cole Clifford 613 W. Cagney St. Meridian, ID 83646 $100.00 $ 100,00 BGeneral Calendar Year -To -Dale 2. $ $ ❑ General Calendar Year -To -Date / I 3. $ ❑ General Calendar Year -To -Dale 4. $ ❑ General Calendar Year -To -Dale / ! 5. $ ❑ General Calendar Year -To -Date I ! 6. $ $ ❑ General Calendar -Year -To -Date I / 7. $ $ ❑ General Calendar Year -To -Date 8. $ ❑ General Calendar Year -To -Date 1 1 9. $ $ ❑ General Calendar Year -To -Dole ! / 10. $ $ ❑ General Calendar Year -To -Date Total This Page: $100.00 Transfer the combined total of all ScheduleA pages to the Detailed Summary on page 2line 2. Date Spent SCHEDULE B age o ITEMIZED EXPENDITURES 1 1 Twenty -Five Dollars ($25.00) or more this period Name of Candidate or Committee:,Jason Monks Cashor Check Purpose Codes 1. Wright Signs, 145 W. 14th St., Ogden, UT 84404 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 Manaaement Services Z Preparation & Production of Advertising Date Spent Full Name, Mailing Address and Zip Code of Recipient Purpose Code Cashor Check 10103/11 — 1. Wright Signs, 145 W. 14th St., Ogden, UT 84404 o $ 480.87 100711 — 2. KPG LithoGraphics, 106 W. 32nd St., Garden City, ID 83714 L $ 270.51 10 11 11 / 3 Home Depot, 1100 So. Progress, Meridian, ID 83642 O $ 87.98 10113/11 4. Wright Signs, 145 W. 14th St., Ogden, UT 84404 O $ 613.50 5. 6. $ 7. -- $ 8 —— 9. 10. 1 1$ Total This Page: $ 1 ,452.86 Transfer the combined total of all Schedule B pages to the Detailed Summary on page 2line 7. SCHEDULE C IN-KIND CONTRIBUTIONS and EXPENDITURES Name of Candidate or committee:, Jason Monks age o 1 1 Purpose Codes Contributor Name, Mailing Address and Zip Code 1,000.00 A All Tmvel Expenses (Airfare, Fuel, Lodging & Mileage) N Newspaper & Other Periodical Advertising B Broadcast Advertising (Radio, TV & Internet) 0 OtherAdvertising (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 ofAdvertising 1. 10/06/ 11 Contributor Name, Mailing Address and Zip Code 1,000.00 Ty Palmer $ 1524 N. Meridian Rd. 1,000.00 19 General Meridian, ID 83642 $ Calendar Year-To-0ale Expenditure Name, Mailing Address and Zip Code Purpose Code Zibz.Biz - Ty Palmer Z 1524 N. Meridian Rd. Meridian, ID 83842 $ 1,000.00 2. Contributor Name, Mailing Address and Zip Code _//_ $ ❑ General $ Calendar Year -To -Dale Expenditure Name, Mailing Address and Zip Code Purpose Code $ 3. Contributor Name, Mailing Address and Zip Code ! ! $ ❑ General $ Calendar Year -To -Dale Expenditure Name, Mailing Address and Zip Code Purpose Code $ 4. Contributor Name, Mailing Address and Zip Code / ! $ ❑ General $ Calendar Year -Mate Expenditure Name, Mailing Address and Zip Code Purpose Code $ 0.00 Expenditure Total: (Transfer the combined total of all Expenditures on Schedule C pages $ 000 00 to the Detailed Summary, page 2 line 8) $1000'00 Contributor Total: (Transfer the combined total of all Contributors on Schedule C pages , to the Detailed Summary, page 2 line 31 SCHEDULE D • IL 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 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 (Candidate, Individual or Business) of loan at the end of the last received during this reporting period during this reporting period during this reporting period outstanding at the end of this reporting period reporting period 1- Jason MonksDate: 1002 W. Washington Meridian, ID 83642 100.00 Date: 100.00 Amount amount $ 2. 2,000.00 Date: ! ! Date. ! ! 2,000.00 amount: Amount. A,o Wm .lmw.wasag .Wmm. 10e 2 $ $ 3. 2,000.00 Date! ! Date! ! 2,000.00 Amount amount ,mni Manka, 1W2w.wR &e ..&11l .ID& 2 4. Date: Date: Amount Amount 5. Date: Date: Amount amount 6. Date: Date: Amount amount 7. Date: Date: 1 ! L ! Amount: Amount Previous Received Interest Repayments Ending Balance Previous Total $ 4,100.00 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 $ 0.00 Detailed Summary, page 2 line 9 & 16) Ending Balance Total: $4,100.00 (No I t: 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 (i.e. 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 reporgng period period reporfing period 1" 457.50 D is 10 , 1t M10 aw. 19 tt 100.79 Meat Td, a of q 280 s. capW Blue., fti . le 83)02 Amount Amount $ too.79 $ as7.so 2. Date: Date: l 1 I l Amount Amount 3. Date: Date: Amount Amount 4. Date: Date: l 1 l 1 Amount Amount $ $ 5. Data. Date: Amount Amount 0_ Date: Date: Amount Amount $ $ Previous Incurred Repayments Ending Balance Previous Total: $457.50 Incurred Total: (Transfer the combined total of all incurred debt to the $100.79 Detailed Summary, page line 14) Repayments Total: (Transfer the combined total of all debt repayments to the $ 457.50 Detailed Summary, page 2line 10 & 17) Ending Balance Total: $100.79 SCHEDULE E-1 CREDIT CARD and DEBT ITEMIZATION ge o 1 1 Name of Creditor from Schedule E: Mastercard C..,.6 r•...Af-1 dnd — Qn]%.A. do F vAf, . KI.. n>hf am. mf mnsf have a Schedule F-1 arsamnanvinn it The Schedule E4 lists where and when the debt was incurred. Purpose Codes A All Travel Expenses (Airfare, Fuel, Lodging & Mileage) B BroadcastAcivertising (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 Date Incurred Full Name, Mailing Address and Zip Code of Expenditure Purpose Code Amount 1. 0 10 18/ 11 Home Depot, 1100 So. Progress, Meridian, ID 83642 100.79_ 1 $ 2. — 3. I / --- $ 4. $ 5. $ 6. 7. $ 8. 9. $ Total This Page: $100.79 The total of itemization for this creditor should equal the new loan amount listed on Schedule E for this creditor. SCHEDULE F Fage ° PLEDGED CONTRIBUTIONS BUT NOT YET RECEIVED 1 Name of Candidate or Committee:JaSOn Monks 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 1. ❑ General 2. ❑ General 3. ❑ General 4. ❑ General 5. ❑ General 6. ❑ General 7. ❑ General 8. ❑ General 9. ❑ General 10. ❑ General ❑ General 11. 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.