Paternoster - Annual Report 2012�a`r jrd!•�.
CAMPAIGN FINANCIAL DISCLOSURE REPORT
SUMMARY PAGE
(Please Print or Type)
RECEIVED
FEB 19 2012 Rev. 1a107
CITY OF L>vlminx
CITY CLERKS OFFICE
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Change of address for: Candidate or Political Committee ❑ Political Treasurer • ❑
$action'll TYPE OF REPORT
This fli Ing Is an: ❑ Original ❑ Amendment y
This report is for the period from through I ditJAI.
0 Oclobef 10 Pre -General Report ❑ 7 Day pre -General Report ❑ 30 Day Post -General Report
Annual Report
Is (his,a Termination Report: 16 Yes 0 No
Section III STATEMENT OF NO CONTRIBUTIONSOR EXPENDITURES
Directions: If.you had no contributions or expendituresduring this reporting, period, check the box next to the statement below arid 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.
To reach your Calendar Year to Date figure: Add this reporPs Column I
figures to the Column It figures your previous report (except on line 6).
Line 1: Cash on Hand January 1, This Calendar Year'
Lino 4 $nler beginning Cash Balance''
Line 3: Total Contributions'(Enter amount from line 5, page 2)
Line A; Subtotal (Add lines 1, 2'and 3)
Llne 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 amountfrom line 10, page 2)
'This same figure should be entered on line 1 of all reports filed this of
33 E.
rent reporting period appears on the
ir,10114, kAoe6
Name of IlfiMITmas
report is a true, cpm Iet nd comet
r
f , /rPage 1
led. It this is your first report, [his amount is 0..
next report as the beginning cash on hand.
hereby certify that the information in this
COLUMN I
COLUMN 11
This Period
CalendarYear
to Date
$
XXXXXX
$
O, a)
$
n;
$
XXXXXX
$"
._
$
w.
$ ,
$
^j
$
led. It this is your first report, [his amount is 0..
next report as the beginning cash on hand.
hereby certify that the information in this
12
13
14
15
16
17
18
DETAILED SUMMARY
Name of Candidate or committee, �� Y��fp
Loans Credit Cards and Debt
+
Unitemized Expenditures ($25 and less) # of Expenditures
Total Tfiis Period
Itemized Expenditures (Total of all Schedule B sheets)
$
Contributions
Unitemized Contributions ($50 and less) # of Contributors
+ $
+
$
Itemized Contributions (Total of all Schedule A sheets)
^ r
+
$
In -Kind Contributions (Total of all Contribution amounts from Schedule C sheets)
Loans (Total Wait New loan amounts from Schedule D sheets)
_ _
Repayments of Loans made during this reporting period
(Total of all Loan Repayment amounts from Schedule D sheets)
+
+
$
$
Tota( Contributions (Transfer this figure, to page 1 $Ktion IV Line 3)
Total Outstanding Balance at close of this period (Transfer this figure to page 1, Section IV Line 7)
$Tern
Loans Credit Cards and Debt
+
Unitemized Expenditures ($25 and less) # of Expenditures
+ $
Itemized Expenditures (Total of all Schedule B sheets)
$
In Kind Expenditures (Total of all Expenditure amounts from Schedule C sheets)
iLoan Repayments (Total of all Loan Repayment amounts from Schedule D sheets)
+ $
+ $
Credit Card and Debt Repayments (Total of all Repayment amounts from Schedule E sheets)
Total Expenditures (Transfer this figure to page 1, Section IV Line 5) T
+
, $ t o r
Loans Credit Cards and Debt
+
_
Outstanding Balance from previous reporting period T
�._
+ $:7„�
_
New Loans received during this reporting period
(Total of all New Loan amounts plus Accrued Interest from Schedule D sheets)
+ $ 0
New Credit Card and Debt incurred this reporting period
f
(Total of all New Incurred Debt amounts from Schedule E sheets)
+ $ �J
� � �
Subtotal
- — — -- —�- ---- —
V$ �..
_ _
Repayments of Loans made during this reporting period
(Total of all Loan Repayment amounts from Schedule D sheets)
$ (#
Repayments of Credit Card and Debt this reporting period
(Total of all Debt_Repayment amounts from Schedule E sheets)
���
$ .�*✓ `� �
Total Outstanding Balance at close of this period (Transfer this figure to page 1, Section IV Line 7)
$Tern
Pledged Contributions
Unitemized Pledged Contributions ($50 and less) # of Pledges
+
Itemized Pledged Contributions this Period (Total of all Schedule F sheet&)
+ $
Total Pledged Contributions this period
Page 2
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, youwill maintain a single item foreach 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,lo the campaign Regardless of whelher 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 Delaigd Summary Page, _ _
Any crodilor(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 [he 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 Tull in a previous reporting period does not need to be listed. The outstanding Balance column is the Previous
Bolance plus New Debt less any Repayments of Debt.
Name, Mailing Address and Zip Code of
Previous Balance of
NewlDebt 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
A141L2Date:
Date;
Amount'
iA f•,,,, i . _
s-
2,
2.
Dale:
Dater
Amount:
Amount`
3,
Date:
Dalo:
Amount:
Amount:
4.
Dale:
Dale:
Amount
Amoubt
5.
Dater
Dale:
Amount:
Amount:
6.
Dale:
Date;
Amount!
Amount
Previous Incurred Repayments Ending Balance
Previous Total: $
Incurred Total;
$
,(Transfer the combined total of all incurred debt to the a
Detailed Suirmary, page 2line 14)
Repayments Total
(Transfer the combined total of all debt repayments to the $ L -a a
Detailed Summary, page 2line 10'& 17)
Ending Balance Total: $ 0