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Monks - 7 Day Pre GeneralCAMPAIGN FINANCIAL DISCLOSURE REPORT SUMMARY PAGE (Please Print or Type) ,REcE.TvE C-2 OCT 2 8 2011 1ttyU7 CITY Or UW ori CITY CLERKS OFFICEA Name of Candidate or Political Committee and Chairperson Office Sought (9 candidate) Seat (6 any) Jason Monks Mayor N/A acing dress yan Zip ome one w ane 1002 W. Washington Meridian 83642 871-7127 871-7127 Name of Political Treasurer Keith Thurgood Mailing Addi City an Zip Home Phone 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: 8 Original ❑ Amendment This report is for the period from 10 101 12011 through 10 123 /2011 ❑ October 10 Pre -General Report ❑M 7 Day Pre -General Report ❑ 30 Day Post -General Report ❑ Annual Report Is this a Termination Report: ❑ Yes ❑d 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 reports 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 CalendarYear* $ XXXXXX $ 0.00 Line 2: Enter Beginning Cash Balance** $ 371.47 $ XXXXXX Line 3: Total Contributions (Enter amount from line 5, page 2) $ 8,185.00 $ 12,285.00 Line 4: Subtotal (Add lines 1, 2 and 3) $ 8,556.47 $ 12,656.47 Line 5: Total Expenditures (Enter amount from line 11, page 2) $ 2,910.36 $ 6,638.89 Line 6: Enter Ending Cash Balance (Subtract line 5 from line 4) $ 5,646.11 $ 6,017.58 Line 7: Outstanding Debt to Date (Enter amount from line 18, page 2) $ 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 Thur900d , hereby certify that the information in this Name of Political Treasurer report is a true, complete and c drecl Campaign Financial Disclosure Report as required by law. '4—`Signat olihcal Treasurer Page 1 14 15 16 17 18 f rN DETAILED SUMMARY Name of Candidate or Committee: Jason Monks Expenditures Total This Period Contributions + $0.00 Unitemized Contributions ($50 and less) # of Contributors 3.00 + $ 85.00 Itemized Contributions (Total of all Schedule A sheets) + $7,100.00 In -Kind Contributions (Total of all Contribution amounts from Schedule C sheets) + $1,000.00 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) _ $8,185.00 Expenditures Unitemized Expenditures ($25 and less) # of Expenditures o.00 + $0.00 Itemized Expenditures (Total of all Schedule B sheets) + $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) $ 457.50 Loans, Credit Cards and Debt 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) + $100.79 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) Pledged Contributions Unitemized Pledged Contributions ($50 and less) # of Pledges 0.00 + $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 ageo ITEMIZED CONTRIBUTIONS 1 12 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 10/ 03� 11 1. Deborah Monks 3548 E. Grandview St. Mesa, AZ 85213 $ 1,000.00 $ 1,000,00 CalendarYear-To-Date _ 9 General 10/031 11 2. Jon Monks 3548 E. Grandview St. Mesa, AZ 85213 $ 1,000.00 $ 1,000.00 Calendar Year -To -Dale 9 General 10/03/11 3. Madisen Monks 3548 E. Grandview St. Mesa, AZ 85213 $ 1,000.00 $ 1,000.00 CalendarYear-To-Dale 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 5. Cathie Thurgood 1233 W. 7th St. Meridian, ID 83642 $ 200.00 $ 200.00 9 General Calendar Year -To -Date 10 09 11 8. Chandler R. Monks 3548 E. Grandview St. Mesa, AZ 85213 $ 1,000.00 $ 1,000.00 CalendarYear-To-Date 9 General 10 09 11 -_-J 7. Shade M. Monks 3548 E. Grandview St. Mesa, AZ 85213 $ 1,000.00 $ 1,000.00 9 General Calendar Year -To -Date 10 / 19 Ll 1 8, The Blind Gallery 2053 E. Fairview Ave. Suite 109 Meridian, ID 83642 $1,000.00 $ 1,000.00 Calendar Year -To -Dale 9 General 10/19/ 11 9. Southern Nevada Oxygen 187 N. Gibson Rd. Henderson, NV 89014 $ 500.00 $ 500.00 9 General Calendar Year -To-Date 10/19/11 10. Marshall K. Coryell Trust 2133 SE 3rd Way Meridian, ID 83642 $ 100.00 $ 100.00 9 General CalendarYear-To-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. SCHEDULE A aee e z 12 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 10 20 11 / 1. Cole Clifford 613 W. Cagney St. Meridian, ID 83646 $ 100.00 $ 100.00 _/ 9 General Calendar Year -To -Date / I 2. $ $ ❑ General Calendar Year -To -Date 1 1 3. $ ❑ General Calendar Year -To -Date / I 4. $ ❑ General Calendar Year -To -Date 5. $ ❑ General Calendar Year -To -Date 6. ❑ General Calendar Year -To -Dale ! I 7. $ ❑ General Calendar Year -To -Date l / 8. $ ❑ General Calendar Year -To -Date I / 9. $ ❑ General Calendar Year -To -Dale 10. $ ❑ General Calendar Year -To -Dale Total This Page: $100.00 Transfer the combined total of all Schedule pages to the Detailed Summary on page 2line 2. SCHEDULE B age o ITEMIZED EXPENDITURES 1 1 Twenty -Five Dollars ($25.00) or more this period Name of Candidate or committee: Jason Monks 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 L Literature, Brochures, Printing M Management Services N Newspaper & Other Periodical Advertising 0 Other Advertising (Yard Signs, Buttons, etc.) P Postage S Surveys & Palls T Tickets (Events) U Utilities W Wages, Salaries, Benefits & Bonuses Y Petition Circulators Z Preparation & Production of Advertising Date Spent Full Name, Mailing Address and Zip Code of Recipient Purpose Code Cash or Check 10/03/ 11 1. Wright Signs, 145 W. 14th St., Ogden, UT 84404 o $ 480.87 2. L 10107/ 11 KPG LithoGraphics, 106 W. 32nd St., Garden City, ID 83714 $ 270.51 3. D 10/11 /11 Home Depot, 1100 So. Progress, Meridian, ID 83642 $87.98 10/ 13/ 11 4. Wright Signs, 145 W. 14th St., Ogden, UT 84404 O $ 613.50 5. 6. I I $ 7. 8. 9. 1 I $ 10. Total This Page: $1,452.86_ Transfer the combined total of all Schedule B pages to the Detailed Summary on page 2 line 7. SCHEDULE Cage o IN-KIND CONTRIBUTIONS and EXPENDITURES 1 1 Name of Candidate or Committee:, Jason Monks 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 L Literature, Brochures, Printing M Management Services N Newspaper & Other Periodical Advertising O 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 1. 10/06/11 Contributor Name, Mailing Address and Zip Code 1,000.00 ,000.00 $ Ty Palmer 1524 N. Meridian Rd.$ 1 ,000.00 8 General Meridian, ID 83642 Calendar Year -To -Dale Expenditure Name, Mailing Address and Zip Code Purpose Code Zibz.Biz - Ty Palmer Z 1524 N. Meridian Rd. Meridian, ID 83642 $1,000.00 2. Contributor Name, Mailing Address and Zip Code I / $ ❑ General $ Calendar Year -To -Date 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 -To -Date 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) $ 1 000.00 , Contributor Total: (Transfer the combined total of all Contributors on Schedule C pages to the Detailed Summary, page 2 line 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 mustbe listed belowwith the amount in the Previous Balancecolumn. Any new loan amounts should be listed in the New Loan column. Any interest accrued should be listed in the InterestAccrued column. If a paymentwas 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. Jason Monks 1002 W. Washington Meridian, ID 83642 100.00 Date: / / Date: / / 100.00 Amount: Amount: $ 2. 2.000.00 Date: Date: 2,000.00 Amount Amount: Jam MR . ip12W.Waeti,igld,.WWW.109 2 $ $ 3. 2,000.00 Date: / r Data: / / 2,000.00 Amount: Amount: Jew Mwks. 102W. WWWglm. McMm 0 83M2 $ $ 4. Date: Date: I_I l l Amount Amount 5. Date: Date: Amount Amount: 5 Date: Date: Amount: Amount: 7. Date: Date: r_1 I I 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 2 line 4) Interest Total: $ 0 Repayments Total: (Transfer the combined total of all loan repayments to the $ 0.00 Detailed Summary, page 21ine 9 & 16) Ending Balance Total: $4,100,00 (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 (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 reporting period period reporting period 1. 457.50 Date: 10 /18 /11 Date: 10 /1e /11 100.79 Mast r N, B of A, 280 S. Caput BIM., Bolsa, 10 W02 Amount: Amount: $ 100.70 $ 457.50 2. Date: Date: Amount: Amount: 3. Date: Date: Amount: Amount: 4. Date: Date: I l I l Amount: Amount: 5. Date: Date: Amount: Amount: g. Date: Date: Amount: Amount: Previous Incurred Repayments Ending Balance Previous Total: $457.50 Incurred Tolal: (Transfer the combined total of all incurred debt to the $100.79 Detailed Summary, page 2line 14) Repayments Total: (Transfer the combined total of all debt repayments to the $ 457.50 Detailed Summary, page 2 line 10 817) Ending Balance Total: $100.79 SCHEDULE E-1 CREDIT CARD and DEBT ITEMIZATION Name of Creditor from Schedule E: Mastercard age 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 Date Incurred Full Name, Mailing Address and Zip Code of Expenditure Purpose Code Amount 1' 0 10/18x11 Home Depot, 1100 So. Progress, Meridian, ID 83642 $100.79 2. 3. 4. 5. 6. r r $ 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 Fage o PLEDGED CONTRIBUTIONS BUT NOT YET RECEIVED 1 1 Name of Candidate or Committee:Jason Monks Directions: Complete this schedule if you were promised and agreed to accept a conbibution 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 enbies 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 1. 2. ❑ General 3. ❑ General 4. ❑ General 5. ❑ General 6. ❑ General 7. ❑ General 8. ❑ General 9. ❑ General 10. ❑ General 11. ❑ General f Total Amount of Pledged Contributions: $0'00 Transfer the combined total of all Schedule F pages to the Detailed Summary on page 2line 20.