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Monks - Oct 10 Pre General Amend 2CAMPAIGN FINANCIAL DISCLOSURE REPORT SUMMARY PAGE (Please Print or Type) ct-aY(ce RECEI7.r ReY 1 02 NOY 13 2011 CITY OFC>WEa CITY CLERKS OAkL Name of Candidate or Political Committee and Chairperson Office Sought (if candidate) Seat (if any) Jason Monks Mayor I N/A Mailing Address Guyan ip Home Phone wor K Friona 1002 W. Washington Meridian 83642 871-7127 871-7127 Warns of Political Treasurer Keith Thurgood ai mg ess City an p oma hone Work Phone 1233 W. 7th St. IMeridian 83642 888-5236 887-5300 Change of address for: Candidate or Political Committee ❑ Political Treasurer El Section II TYPE OF REPORT This filing is an: ❑ Original 8 Amendment This report is for the period from 9 /12 12011 through_2 ____j30__L2011 12011 ❑E 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 CalendarYear 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 CalendarYear to Date Line 1: Cash on Hand January 1, This CalendarYear' $ XXXXXX $ 0.00 Line 2: Enter Beginning Cash Balance * $ 0.00 $ XXXXXX Line 3: Total Contributions (Enter amount from line 5, page 2) $ 4,100.00 $ 4,100.00 Line 4: Subtotal (Add lines 1, 2 and 3) $'4,100.00 $ 4,100.00 Line 5: Total Expenditures (Enter amount from line 11, page 2) $ 3,489.50 $ 3,489.50 Line 6: Enter Ending Cash Balance (Subtract line 5 from line 4) $ 610.50 $ 610.50 Line 7: Outstanding Debt to Date (Enter amount from line 18, page 2) $ 4,557.50 *This same figure should be entered on line 1 of all reports fled 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 Polfiical Treasurer report is a true, complete and correc{Campaign Fina dal D' lesore Report as required bylaw. /rl�/d )g,Mr7 �— -/ign� o olitical Treasurer Page 1 14 15 16 17 18 DETAILED SUMMARY Name of Candidate or Committee: Jason Monks Expenditures Total This Period Contributions _ + $0.00 Unitemized Contributions ($50 and less) # of Contributors 0.00 + $ 0.00 Itemized Contributions (Total of all Schedule A sheets) + $0.00 In -Kind Contributions (Total of all Contribution amounts from Schedule C sheets) + $0.00 Loans (Total of all New Loan amounts from Schedule D sheets) + $4,100.00 Total Contributions (Transfer this figure to page 1, Section IV, Line 3) _ $4,100.00 Expenditures Unitemized Expenditures ($25 and less) # of Expenditures 0.00 + $0.00 Itemized Expenditures (Total of all Schedule B sheets) + $3,489.50 In -Kind Expenditures (Total of all Expenditure amounts from Schedule C sheets) + $0.00 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) + $0.00 al Expenditures (Transfer this figure to page 1, Section IV, Line 5) Fm _ $3,489.50 Loans, Credit Cards and Debt Outstanding Balance from previous reporting period + $0.00 New Loans received during this reporting period (Total of all New Loan amounts plus Accrued Interest from Schedule D sheets) + $ 4 100.00 New Credit Card and Debt incurred this reporting period (Total of all New Incurred Debt amounts from Schedule E sheets) $ 457.50 + _- Subtotal = $4,557.50 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) $0.00 0 00 Total Outstanding Balance at close of this period (Transfer this figure to page 1, Section IV, Line 7) _ $4,557.50 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 age Of ITEMIZED CONTRIBUTIONS 1 1 of more than Fifty Dollars ($50.00) this period Name of Candidate or committee: Jason Monks Data Received Full Name, Mailing Address and Zip Code of Contributor Cash or Check 1 ! 1. $ ❑ General Calendar Year -To -Dale 2. $ ❑ General Calendar Year -To -Dale 3. $ ❑ General Calendar Year -To -Date I 1 4. $ ❑ General Calendar Year To -Dale / I 5. ❑ General CalandarYear-To-Date r r 6. $ ❑ General Calendar Year -To -Dale 7. $ ❑ General Calendar Year -To -Date / I 8. ❑ General Calendar Year -Male r I 9. $ ❑ General Calendar Year-T"ale 10. ❑ General Calendar Year -To -Date Total This Page: $0.00 Transfer the combined total of all ScheduleA pages to the Detailed Summary on page 2 line 2. SCHEDULE B ITEMIZED EXPENDITURES Twenty -Five Dollars ($25.00) or more this period Page o 1 1 IName ofCandidate orCommittee: Jason Monks I 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 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 Date Spent Full Name, Mailing Address and Zip Code of Recipient Purpose Code Cash or Check 1. 0 09/28!11 Wright Signs, 145 W. 14th St., Ogden, UT 84404 $ 3,489.50 2. I / $ 3. ! 1 $ 4. / 1 $ 5. 6. 1 / $ 7. 8. I / $ 9. I / $ 10. Total This Page: $ 3,489.50 Transfer the combined total of all Schedule B pages to the Detailed Summary on page 2 line 7. SCHEDULE C IN-KIND CONTRIBUTIONS and EXPENDITURES Name of Candidate or Committee: Jason Monks � Purpose Codes A All Travel Expenses (Airtare, 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 Mane ementServices 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 9 Contributor Name, Mailing Address and Zip Code $ ❑ General Calendar Year-To-0ale Expenditure Name, Mailing Address and Zip Code Purpose Code 2. Contributor Name, Mailing Address and Zip Code ❑ General Calendar Year -To -Date Expenditure Name, Mailing Address and Zip Code Purpose Code $ 3, Contributor Name, Mailing Address and Zip Code $ / I Calendar Year -To -Dale ❑ General Expenditure Name, Mailing Address and Zip Code Purpose Code 4, Contributor Name, Mailing Address and Zip Code Calendar Year -To -Date ❑ General Expenditure Name, Mailing Address and Zip Code Purpose Code $ Expenditure Total: h (Transfer the combined total of all Expenditures on Schedule C pages to the Detailed Summary, page 2 line S) Contributor Total: (Transferthe combined total of all Contributors on Schedule C pages to the Detailed Summary, page 2 line 3) $O.00 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 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 Interestaccrued Repayments of Loan Balance Code of Lender of loan at the received during this dudng 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 0.00 Date: os /14 /11 0.00 Date: 100.00 Amount Amount 1002 W. Washington Meridian, ID 83642 100.00 $ 0.00 2 0.00 Date: 09 / 27 / 11 0.00 Date: / /_ 2,000.00 Amount Amount $ 2,000.00 $ 0.00 3 0.�0 Date: 09 /29 /11.00 Date. / /_ 2,000.00 Amount: Amount Jdsm M1bMw.1WP W.WmMn�Im,M1W'.I�Ai6l2 $ 2,000.00 $ 0.00 4. Date: Date: Amount Amount 5 Date: Date: Amount Amount Date: Date: 6. Amount Amount 7 Date: Date: ---L—L— --L—L— Amount Amount $ $ Previous Received merest Repayments Ending Balance Previous Total $ 0.00 Received Total: $ 4 100.00 (Transfer the combined total of all received loans to the � 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 2 line 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 2line 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 Rem. Each Creditor listed below with a New Debt amount must have a Schedule E-1 accompanying it. The Schedule EA 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 Balance outstanding Creditor debt atthe end of the incurred during this ting at the end of this (Candidate, Individual or Business) last reporting period reporting period reporting periodDate: 1. 0.00 oe foo /11457.50 LRepaymentsDebt Amount MeetareN, B ofq 2BB a. CepW BNd, BONS. m 93re2 $ 457.50 2. Date: Date: Amount Amount 3. I ( Date: Amount 4 I I Date: 1 I Amount 5 I I Date: I I Amount 6. I I Date: Amount Incurred Previous Total: I $ 0.00 Date: Amount Date: Amount Dale. Amount Date: ---L--J--- Amount /Amount Incurred Total: (Transfer the combined total of all incurred debt to the $ 457.50 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) Balance Ending Balance Total 1$457.50 SCHEDULE E-1 CREDIT CARD and DEBT ITEMIZATION age =1 12 1 Name of Creditor from Schedule E: Mastercard 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) N Newspaper & Other Periodical Advertising B BroadcastAdvertising (Radio, TV & Internet) 0 OtherAdverfising (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 I Interest Accrued & Finance Charges Y Petition Circulators L Literature, Brochures, Printing Z Prepamlion & Production of Advertising M Management Services 4. Date Incurred Full Name; Melling Address and Zip Code of Expenddure Purpose Code Amount 1. B 09/19/11 --- EyeOpen Network, 1861 N. Wildwood St., Boise, ID 83713 $ 450.00 2 G 09 27 11 1 1 --- Office Depot, 3545 E. Fairview, Meridian, ID 83642 $ 7.550 3. 4. / r --- $ 5. 1 I $ 6. 7. — 8. 9. $ Total This Page: $ 457.50 The total of itemization for this creditor should equal the new loan amount listed on Schedule E for this creditor. SCHEDULE F g° ° 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 Auntil you actually receive the contribution. Pledged For Data Pledged Full Name, Mailing Address and Zip Code of Contributor Amount Pledged 1. ❑ General 2. ❑ General 3. ❑ General f 4. ❑ General 5. ❑ General 6. ❑ General 7. ❑ General 8. ❑ 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.