REPORT OF CONTRIBUTIONS AND EXPENDITU (C.R.S ) / ", Dennis Hisey for County Commissioner District 4. IThrough I Novemher?9?

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1 Colorado Secretary of State Elections Division 1700 Broadway, Ste. 270 Denver, Ph: (303) x 3 Fax: (303) Full Name of CommitteelPerson: Address of CommitteelPerson: City, State & Zip Code: Committee Type: Name and Address of Financial nstitution REPORT OF NTRBUTONS AND EXPENDTU (C.R.S ) / ", \'1.. ".' Dennis Hisey for County Commissioner District 4 ", "-..,..., _~._."J..."./" As Shown On Registration 24 Circle C Road Fountain, Candidate UMB Bank 502 Security Blvd, Security, SOS D NUMBER (state committees ONLY): Type ofreport D Regularly Scheduled Filing. D Amended Filing. This amends previous report filed on (date) Submit changes or new information ONLY D Termination Report. (Termination Reports MUST Have a Monetary Balance ofzero in Line 5) D Check this box if this Report Contains Electioneering Communications nformation., Reporting Period Covered: Octoher ~ Declared Total Spending (ifapplicable) [Art. XXVlll, Sec. 4(1)] _ Through Novemher?9?O()~ Totals Detailed Summary Page Funds on Hand at the Bet!:innine: of Reporting Period (monetary only) 2, Total Monetary Contributions (line 11) 1, Total of Monetary Contributions & BC2innine: Amount(line 1 + line 2) 4, Total Monetary Expenditures (line 19) Funds on Hand at the End of Reportine: Period (monetary) (line 3-line 4) 3, The appropriate officer shall impose a penalty of 50 per day for each day that a report is filed late. [Art. XXVll Sec. 10(2)(a)] Authorization (Must be completed by either the Registered Agent OR the Candidate): hereby certify and declare, under penalty of perjury, that to the best ofmy knowledge or beliefall contributions received during this reporting period, including any contributions received in theform ofmembership dues transferred by a membership organization, arefrom permissible sources. Print Registered Agent's Name: --"".:B:::t''''--'-"''--'''''''''''"''''''~--/ ,A Registered Agent's Signature: ---l..<~k-\::,o'l..1jl.-"74~...,," : 12/3/08 _ Print Candidate Name: -----j'-----'i~~~~_r..., Candidates Signature: '-----t : j}/f'1t'~ Colorado Secretary of State Form Rev. 04/07

2 DETALED SUMMARY Full Name of Committee/Person: Dennis Hisey for County Commissioner District 4 Current Reporting Period: Octoher R Tbrougb Novemher 29.?OOR Funds on band at tbe beginning of reporting period (Monetary Only) 2, temized Contributions 20 or More [C.R.S (1 )(a)] 1, (Please Jist on Schedule "A") 7 Total of Non-temized Contributions (Contributions 01'19.99 and Less) 8 Loans Received (Please Jist on Schedule "C') 9 Total ofother Receipts (nterest, Dividends, etc.) 10 Returned Expenditures (from recipient) (Please list on Schedule '"D") 11 Total Monetary Contributions 1, (Total of lines 6 through 10) 12 Total Non-Monetary Contributions (From Statement ofnon-monetary Contributions) 13 Total Contributions 1, (Line + line 12) 14 temized Expenditures 20 or More [CR.S (1)(a)] (Please Jist on Schedule "B") 15 Total of Non-temized Expenditures (Expenditures of19.99 or Less) Loan Repayments Made (Please list on Schedule "C") 17 Returned Contributions (To donor) (Please list on Schedule "D") 18 Total Coordinated Non-Monetary Expenditures (Candidate/Candidate Committee & Political Parties only) 19 Total Monetary Expenditures (Total of lines 14 through 17) 20 Total Spending (Line 18 + line 19) Colorado Secretary of State Form Rev. 04/07

3 LOANS - Loans Owed by the Committee (Use a separate schedule for each loan. This form is for line item 8 and 16 of the Detailed Summary Report.) [No information copied from such reports shall be sold or used by any person for the purpose ofsoliciting contributions or for any commercial purpose. Art. XXVl, Sec. 9(e)] Notwithstanding any other section of.this article to the contrary, a candidate's candidate committee may receive a loan from a financial institution organized under state or federal law ifthe loan bears the usual and customary interest rate, is made on a basis that assures repayment, is evidenced by a written instrument, and is subject to a due date or amortization schedule [Art. XXV, Sec. 3(8)] LOAN SOURCE Name (Last, First or nstitution): Dennis Hisey for C ommissioner District 4 Address: ~ ~2"--4'_C=ir=c1=e 'C~R""o""a:>!.d_ City/State/Zip: ~F-"'o=un=ta=i=n"-,C=O--=80=8,,--,-17 Original Amount of Loan: _--,4,-,-,,8~4,-,,9..:...1,--,7, _ nterest Rate: Total of All Loans This Reporting Loan Amount Received This Reporting Period: Period: (Place on line 8 of Detailed Summary Report) Principal Amount Paid This Reporting Period: nterest Amount Paid This Reporting Period: Amount Repaid This Reporting Period: Total Repayments Made: (Amount Repaid is sum of Principal & nterest entered on Detail Summary ) (Sum of Schedule C pages, Place on line 16 of Detailed Summary) Outstanding Balance: 4, TERMS OF LOAN: 11/30/08 Oate Loan Received Due for Final Payment LST ALL ENDORSERS OR GUARANTORS OF TlUS LOAN Full Name Address, City, State, Zip Amount Guaranteed Colorado Secretary of State Fonn Rev. 08/06

4 Schedule A - Contributions October 27 through November 29, 2008 Last First M.1. Address City Greene Jeff 3180 Ox Cart Drive Colorado Springs E Paso County Administrator Oakwood Homes 4908 Tower Road Denver Cygnet Land 31 N. Tejon Street, Suite 500 Colorado Springs Mangy Moose Real Estate 7025 Campus Drive Colorado Springs Turner Scott 6965 Blue River Way Colorado Springs President, UMB Bank - Security, Branch St Zip Amt /28/ /28/ /18/2008 1, /18/ /18/ , Aggregate this cycle , Non-temized Contributions (- 20) Last First M.1. Address City St Zip Amt Aggregate this cycle ---- None --- Political Party Committees Contributions Name Address City St Zip Amt this cycle

5 Schedule B - Expenditures October 27 through November 29, 2008 Payment to Address City St Zip Purpose Amt Xpedx 2443 N. Union Blvd Colorado Springs AT&T 1785 E. Cheyenne Mtn BlvcColorado Springs Office Depot 1922 Southgate Rd Colorado Springs Affordable Flags 3905 S. Hwy 85/87 Colorado Springs Office Depot 1922 Southgate Rd Colorado Springs Friends of the NRA P.O. Box Colorado Springs UMB Bank 205 Security Blvd Security Colorado Agri-Feed 4625 Park Vista Blvd Colorado Springs H&H Tire 5770 S. Hwy 85/87 Colorado Springs Schreck nk 940 Withington Dr. Colorado Springs Fountain Valley News P.O. Box 400 Fountain Ftn Valley Chamber of Commer P.O. Box 201 Fountain EPCRW 1810 Kodiak Dr Colorado Springs Bags Phone Supplies Flags Supplies Dinner Service Charge Post Puller Tire Repair T-Shirts Ad Annual Holiday Dinner Christmas Brunch 10/27/ /27/ /27/ /28/ /28/ /28/ /31/ /3/ /8/ /12/ /14/ /28/ /28/ Non-temized Expenditures (- 20) None ---- Misc