Ty Palmer (termination)DocuSign Envelope ID:64313718-4COE-43A1-9ABO-iC7772B12CBE
CAMPAIGN FINANCIAL DISCLOSURE REPORT
SUMMARY PAGE
(Please Print or Type)
r
Section I
C-2
Rev. 10/07
Name of Candidate or Political Committee and Chairperson
Office Sought (if candidate)
Seat (if any)
Elect Ty Palmer
City Council Seat 3
to Date
ai ing Address
City and Zip
Home Phone
Work hone
1236 E Pisa St
Meridian 83642
208-954-6432
$ 1,844.66
Name of Political Treasurer
Jason Monks
Mailing Address
City and Zip
Home Phone
Work Phone
3865 S. Black Cat Road
Nampa 83687
208-870-7127
Change of address for: Candidate or Political Committee ❑ Political Treasurer ❑
Section II TYPE OF REPORT
This filing is an: ■ Original ❑ Amendment
This report is for the period from 01 /01 /19 through 12 /31 /19
❑ 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 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)
COLUMN I
COLUMN II
This Period
Calendar Year
to Date
$ XXXXXX
$ 1,740.04
$ 1,740.04
$ XXXXXX
$ 104.62
$ 104.62
$ 1,844.66
$ 1,844.66
Line 5: Total Expenditures (Enter amount from line 11, page 2) $ 1,844.66 $ 1,844.66
Line 6: Enter Ending Cash Balance (Subtract line 5 from line 4) $ 0.00 $ 0.00
Line 7: Outstanding Debt to Date (Enter amount from line 18, page 2) $ 0.00
*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
Jason Monks , 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.
/—DocuSigned by:
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DocuSign Envelope ID: 64313718-4COE-43A1-9ABO-1C7772B12CBE
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DETAILED SUMMARY
Name of Candidate or Committee: Elect Ty Palmer
Expenditures
Total This Period
Contributions
In -Kind Expenditures (Total of all Expenditure amounts from Schedule C sheets)
Unitemized Contributions ($50 and less) # of Contributors 1
+ $0.00
Itemized Contributions (Total of all Schedule A sheets)
+ $104.62
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)
= $104.62
Expenditures
+ $0
+ $1,844.66
Unitemized Expenditures ($25 and less) # of Expenditures 7
Itemized Expenditures (Total of all Schedule B sheets)
In -Kind Expenditures (Total of all Expenditure amounts from Schedule C sheets)
+ $0
Loan Repayments (Total of all Loan Repayment amounts from Schedule D sheets)
+ $0
Credit Card and Debt Repayments (Total of all Repayment amounts from Schedule E sheets)
+ $0
Total Expenditures (Transfer this figure to page 1, Section IV, Line 5)
= $1,844.66
Loans, Credit Cards and Debt
Outstanding Balance from previous reporting period
+ $0.00
New Loans received during this reporting period
+ 0.00
$
(Total of all New Loan amounts plus Accrued Interest from Schedule D sheets)
New Credit Card and Debt incurred this reporting period
+ $0.00
(Total of all New Incurred Debt amounts from Schedule E sheets)
Subtotal
= $0.00
Repayments of Loans made during this reporting period
$ 0.00
(Total of all Loan Repayment amounts from Schedule D sheets)
Repayments of Credit Card and Debt this reporting period
$ 0.00
(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)
_ $0.00
Pledged Contributions
Unitemized Pledged Contributions ($50 and less) # of Pledges 0 + $0.00
Itemized Pledged Contributions this Period (Total of all Schedule F sheets) + $0.00
Total Pledged Contributions this period = $0.00
Page 2
DocuSign Envelope ID: 64313718-4COE-43A1-9ABO-1C7772B12CBE
SCHEDULE A Page o
ITEMIZED CONTRIBUTIONS 3 4
of more than Fifty Dollars ($50.00) this period
Name of Candidate or Committee: Elect Ty Palmer
Date Received
Full Name, Mailing Address and Zip Code of Contributor
Cash or Check
3 /15/ 19
1
Ty Palmer
1236 E Pisa St
Meridian, ID 83642
104.62
$ 104.62
❑ General
Calendar Year -To -Date
/ I
2.
�
$
❑ General
Calendar Year -To -Date
3.
$
❑ General
Calendar Year -To -Date
4.
$
❑ General
Calendar Year -To -Date
5.
$
❑ General
Calendar Year -To -Date
6.
$
❑ General
Calendar Year -To -Date
7.
$
❑ General
Calendar Year -To -Date
8.
❑ General
Calendar Year -To -Date
9.
$
❑ General
Calendar Year -To -Date
I /
10.
$
$
❑ General
Calendar Year -To -Date
Total This Page:
$ 104.62
Transfer the combined total of all Schedule A pages to the Detailed Summary on page 2 line 2.
DocuSign Envelope ID:64313718-4COE-43A1-9ABO-iC7772B12CBE
Transfer the combined total of all Schedule B pages to the Detailed Summary on page 2 line 7.
Date Spent
SCHEDULE B
Page o
Purpose Code
Cash or Check
4
14
The Roosters Eatery
ITEMIZED EXPENDITURES
F
Twenty -Five Dollars ($25.00) or more this period
Name of Candidate or Committee: Elect Ty Palmer
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
Transfer the combined total of all Schedule B pages to the Detailed Summary on page 2 line 7.
Date Spent
Full Name, Mailing Address and Zip Code of Recipient
Purpose Code
Cash or Check
1.
The Roosters Eatery
F
720 Park Blvd #101
1
/25/19
Boise, ID 83712
$ 8.78
2.
State of the City Tickets
E
2
6 19
33 E. Broadway Ave
21.60
Meridian ID 83642
$
3.
MYAC - City of Meridian
D
33 E. Broadway Ave
2
/ 15 / 19
Meridian, ID 83642
$ 250.00
4.
Southwest Airlines
A
2702 Love Field Drive
533.50
2
/ 19 / 19
Dallas, TX 75235
$
5.
Red Lion Hotel
A
1501 Arlington Blvd
3
/ 7 / 19
Arlington, VA 22209
$ 95.13
6.
National League of Cities
E
660 North Capitol St NW
3
/ 8 /19
Washington, DC 20001
$ 460.00
7.
Red Lion Hotel
A
1501 Arlington Blvd
3
/15/ 19
Arlington, VA 22209
$ 475.65
8.
9.
10.
Total This Page:
$1,844.66
Transfer the combined total of all Schedule B pages to the Detailed Summary on page 2 line 7.