Monks - Termination ReportCAMPAIGN FINANCIAL DISCLOSURE REPORT
SUMMARYPAGE
(Please Print or Type)
RECEIVED
JAN 1 3 101.1007
CITY OF Li
T
14
15
16
18
DETAILED SUMMARY
Name of Candidate or Committee: Jason Monks
Expenditures
Total This Period
Contributions
+ $0.00
Unitemized Contributions ($50 and less) If of Contributors 0.00
+ $0.00
Itemized Contributions (Total of all Schedule A sheets)
+ $111.17
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)
+ $0.00
Total Contributions (Transfer this figure to page 1, Section IV, Line 3)
= $111.17
Expenditures
_
Unitemized Expenditures ($25 and less) # of Expenditures 0.00
+ $0.00
Itemized Expenditures (Total of all Schedule B sheets)
+ $111.17
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
Total Expenditures (Transfer this figure to page 1, Section IV, Line 5)
= $111.17
Loans, Credit Cards and Debt
_
Outstanding Balance from previous reporting period
+ $3,404.28
New Loans received during this reporting period
(Total of all New Loan amounts plus Accrued Interest from Schedule D sheets)
+ $0.00
0.00
New Credit Card and Debt incurred this reporting period
(Total of all New Incurred Debt amounts from Schedule E sheets)
+ $ 0 00
_
Subtotal
$3,404.28
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
Total Outstanding Balance at close of this period (Transfer this figure to page 1, Section IV, Line 7)
_ $ 3,404.28
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 page o
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 Conldbutor
Cash or Check
11/25/11
1.
Shelly Monks
1002 W. Washington
Meridian, ID 83642
$ 111.17
$111.17
9 General
Calendar Year -To -Dale
/ I
2.
$
$
❑ General
Calendar Year -To -Data
3.
$
❑ General
CalendarYear-To-Date
I I
4.
$
❑ General
$
Calendar Year -To -Dale
/ I
5.
$
❑ General
$
Calendar Year -To -Dale
6.
❑ General
$
Calendar Year -To -Dale
7.
❑ General
$
Calendar Year -To -Dale
r r
8.
$
$
❑ General
CalendarYear-To-Dale
9.
❑ General
$
Calendar Year -To -Dale
10.
❑ General
$
Calendar Year -Tc -Date
Total This Page:
$111.17
Transfer the combined total of all Schedule pages to the Detailed Summary on page 2 line 2.
Date Spent
SCHEDULE B0
ITEMIZED EXPENDITURES 1 1
Twenty -Five Dollars ($25.00) or more this period
Name of Candidate or Committee: Jason Monks
Cash or Check
Purpose Codes
O
A
All Travel Expenses (Airfare, Fuel, Lodging & Mileage)
N
Newspaper & Other Periodical Advertising
B
BroadcaslAdverfising (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.
O
11 11
Home Depot, 1100 So. Progress, Meridian, ID 83642
78.09
/21 /
$
2.
G
11 /21 /11
US Bank, Cherry Lane Office, 220 W. Cherry Lane, Meridian, to 83642
$ 33.08
3.
4.
5.
6.
I I
$
7.
I /
$
8.
9.
/ I
$
10.
I /
$
Total This Page:
$111.17
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
age o
Name of Candidate or Committee:
Contributor Name, Mailing Address and Zip Code
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
1.
Contributor Name, Mailing Address and Zip Code
❑ General
$
Calendar Year -To -Dale
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
$
❑ 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 FOO 0
to the Detailed Summary, page 2 line 8)
$0 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 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 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
(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 Monks
1002 W. Washington
Meridian, ID 83642
1,404.28
Dater/
Date: / /
1,404.28
Amount:
Amount:
$
2.
2,000.00
Date: r /
Date: / /
2,000.00
Amount
Amount:
,asm Wb 'low w. Wa~M, wmPo '10 MU2
3.
Date:
Date:
Amount:
Amount:
$
$
4.
Date:
Date:
Amount:
Amount:
5.
Date:
Date:
Amount:
Amount:
$
$
6.
Date:
Date:
Amount:
Amount:
7,
Date:
Date:
Amount:
Amount:
$
$
Previous Received Interest Repayments Ending Balance
Previous Total $ 3,404.28
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 2 line 9 & 16)
Ending Balance Total: $ 3,404.28
(NO FE: 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
Creditor
(Candidate, Individual or Business)
1.
2.
3.
4.
5.
6.
Previous Balance of
debt at the end of the
Previous
Previous Total: 1$0.00
New Debt amount
incurred during this
Date:
I
Amount:
Data.
Data.
--1--J---
Amount:
Amount:
Date:
Date:
Amount:
Amount:
Date:
Date:
1
I
I
Amount:
Date:
I
_1
Amount
Date:
Amount
Incurred
Incurred Total:
(Transfer the combined total of all incurred debt to the $ 0.00
Detailed Summary, page 2 line 14)
Repayments of Debt
during this reporting
Date:
l l
Amount:
Date:
I I
Amount
Date:
I
_!
Amount
Data.
!IAmount:
--1--J---
Amount:
Date:
Amount:
Date:
/
1
Amount:
Repayments Total:
(Transfer the combined total of all debt repayments tc the $ 0.00
Detailed Summary, page 2line 10 & 17)
Balance outstanding
at the end of this
Balance
Ending Balance Total: 1$0.00
SCHEDULE E-1
CREDIT CARD and DEBT ITEMIZATION
Name of Creditor from Schedule E:
ge o
tacn creanor listed on Scneauie t with a New Uedt amount must have a Schedule t-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 BroadcastAdvertising (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,
2.
3.
4.
—� �—
$
5.
6.
7.
$
8.
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 age of
PLEDGED CONTRIBUTIONS BUT NOT YET RECEIVED
Name of Candidate or Committee:
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
f
10.
❑ General
1
11.
❑ General
J
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.