Reporting Period Covered: 02/25/2017 Through. Please complete applicable schedules prior to completing the information in the following table.
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1 REPORT OF CONTRIBUTIONS AND EXPENDITURES Full Name of Committee/Person: As Shown on Registration Address of Committee/Person 3578 Hartsel Dr, E340 City, State & Zip Code: Colorado Springs, CO, Committee Type: Political Name of Financial Institution: Home Loan State Bank Address of Financial Institution City, State & Zip Code of Financial Institution Grand Junction, CO, Type of Request X Regularly Scheduled Filing. Amended Filing. This amends previous report filed on (date) Submit changes or new information ONLY Final Filing. Reporting Period Covered: 02/25/2017 Through 03/15/2017 Date Date Please complete applicable schedules prior to completing the information in the following table. Totals Detailed Summary Page 1 Funds on Hand at the Beginning of Reporting Period (monetary only) $ Total Monetary Contributions (line 11 of Detailed Summary) $90, Total of Monetary Contributions & Beginning Amount (line 1 + line 2) $90, Total Spending (line 20 of Detailed Summary) $72, Funds on Hand at the End of Reporting Period (monetary) (line 3 - line 4) $17, Authorization (Must be completed by either the Registered Agent OR the Candidate): I hereby certify and declare, under penalty of perjury, that to the best of my knowledge or belief the information or statements on this form, including all schedules, statements, and attachments, are true and correct, and that to the best of my knowledge or belief all contributions received during this reporting period including any contributions received in the form of membership dues transferred by a membership organization are from permissible sources. Print Registered Agent's Name: Registered Agent's Signature: Print Candidate Name: Candidate's Signature: Denise Laugesen (Submitted Electronically) Date: 03/15/2017 (Submitted Electronically) Date: 03/15/2017
2 Detailed Summary Full Name of Committee/Person: Current Reporting Period: 02/25/2017 Through 03/15/2017 Funds on hand at the beginning of reporting period (Monetary Only) $ Itemized Monetary Contributions $20 or More $90, Total of Non-Itemized Contributions ($19.99 or Less) $0.00 (Number of Contributions of $19.99 or Less: 0) 8 Loans Received $0.00 (Please list on Schedule "C") 9 Total of Other Receipts $0.00 (Interest, Dividends, etc.) 10 Returned Expenditures (from recipient) $0.00 (Please list on Schedule "D") 11 Total Monetary Contributions $90, (Total of lines 6 through 10) 12 Total Non-Monetary Contributions $0.00 (From Statement of Non-Monetary Contributions Schedule "A-2") 13 Total Contributions $90, (Line 11 + Line 12) 14 Itemized Expenditures $20 or More $72, (Please list on Schedule "B") 15 Total of Non-Itemized Expenditures $0.00 (Expenditures of $19.99 or Less) 16 Loan Repayments Made $0.00 (Please List on Schedule "C") 17 Returned Contributions (To donor) $0.00 (Please list on Schedule "D") 18 Closeout Distributions $0.00 (Balance must be zero. Please attach Schedule E.) 19 (Intentionally Left Blank) 20 Total Spending $72, (Lines 14 through 17)
3 Schedule A -1 - Itemized Contributions Statement ($20 or More) Full Name of Committee/Person: WARNING: Please read the instruction page for Schedule "A" before completing! Please Print/Type 4. Description: 5. Employer (mandatory if employed): 6. Occupation (mandatory if employed): 7. Date Accepted: 8. Aggregate Amount this Election Cycle: 9. Contribution Amount this Reporting Period: 4. Description: 5. Employer (mandatory if employed): 6. Occupation (mandatory if employed): 7. Date Accepted: 8. Aggregate Amount this Election Cycle: 9. Contribution Amount this Reporting Period: 4. Description: 5. Employer (mandatory if employed): 6. Occupation (mandatory if employed): 7. Date Accepted: 8. Aggregate Amount this Election Cycle: 9. Contribution Amount this Reporting Period: Colorado Citizens Protecting our Consitution, 5910 S. University Blvd, C18, #254 Greenwood Village, CO, wire transfer 03/07/2017 $30, $30, Colorado Citizens Protecting our Consitution, 5910 S. University Blvd, C18, #254 Greenwood Village, CO, wire transfer $70, $40, Colorado Citizens Protecting our Consitution, 5910 S. University Blvd, C18, #254 Greenwood Village, CO, wire transfer $90, $20, Schedule A-1 Page - 1 of 1
4 Schedule B - Itemized Expenditures Statement ($20 or more) Full Name of Committee/Person: Please Print/Type Howe Creative, 8528 Davis Blvd., Suite North Richland Hills, TX, Half of TV Advertising Production 03/07/2017 $1, Home Loan State Bank, Grand Junction, CO, Wire Fees 03/07/2017 $15.00 Cottrell Printing, Cottrell Center #150, 7255 S. Havana Street Centennial, CO, Printed advertisement supporting Crow-Iverson $1, Orange Media, LLC, 412 N Main St Ste 100 Buffalo, WY, TV Advertising Placement $30, Majority Strategies, Kenan Drive, Suite 145 Jacksonville, FL, Design Services $ Schedule B Page - 1 of 3
5 Wizbang Solutions, 6747 E 50th Ave. Commerce City, CO, Direct Mail $14, Home Loan State Bank, Grand Junction, CO, Wire Fees $15.00 Orange Media, LLC, 412 N Main St Ste 100 Buffalo, WY, TV Advertising Placement $9, Home Loan State Bank, Grand Junction, CO, Wire Fees $15.00 Howe Creative, 8528 Davis Blvd., Suite North Richland Hills, TX, nd Half of TV Advertising Production $1, Windover Media, P.O. Box 543 Monument, CO, Consulting $2, Schedule B Page - 2 of 3
6 Percipient Strategies, PO Box Washington, DC, Consulting and Research $10, Schedule B Page - 3 of 3
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