[ l REPORT OF CONTRIBUTIONS AND EXPENDITURES. Issue Committee Central Bank & Trust

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1 RECEIVED ELECTRONICALLY CITY CLERK'S OFFICE [ l 2015 Feb 18 01:33 pm CITY REPORT OF CONTRIBUTIONS AND EXPENDITURES OF COLORADO SPRINGS Full Name of Committee/Person: Colorado Springs Government Watch - IC As Shown On Reaistration Address of Committee/Person: PO Box 543 City, State & Zip Code: Monument, CO Committee Type: Name of financial Institution: Issue Committee Central Bank & Trust Address Of Financial Institution: 1 S. Nevada Ave. #200 City, State & Zip Code financial Institution: Colorado Springs, CO T pe of Report egularly Scheduled Filing. mended Filing. This amends previous report filed on (date) Submit changes or new information ONLY Oinal Filing. Reporting Period Covered: '12128/2014 Through '-lo_21_1_0_12_0_1_s, Date Date Please complete applicable schedules prior to completing the information in the following table Funds on Hand at the Beginning of Reporting Period (monetary only) 000 Total Monetary Contributions (line 11 of Detailed summary) Total of Monetary Contributions & Beginning Amount (line 1+line Total Spending (line 20 of Detaned Summary) 14, Funds on Hand at the End of Reporting Period (monetary) (line 3- line 4) ( 4 f 22.00) Totals Detailed Summary Page 0 Authorization!Must be completed by either the Registered Agent OR the Candidate!: I hereby certify and dee/ore, 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 ore from permissible sources. ~ - ev"i ~ ~~t\ Print Registered Agent's Name: v Print Candidate Name: Registered Agent's Signature: ~~ -= Date:!) t tfif f 5 Candidates Signature: Date: Office of the City Clerk- City of Colorado Springs Rev.....

2 DETAILED SUMMARY Colorado Springs Government Watch - IC f u II N ame o f C omm ltt ee /p erson: Current Reporting Period: l... 1_21_2_a_12_0_14 ~ Through: I 02/10/2015 Funds on hand at the beginning of reporting period (Monetary Only) 0.00 Itemized Monetary Contributions 20 or More 6 (Please list on Schedule "A-1") Total of Non-Itemized Contributions (19.99 or Less) 7 (Number of Contributions of or Less I I, 14, Loans Received (Please list on Schedule "C") Total of Other Receipts (Interest, Dividends, etc.) Returned Expenditures (from recipient) (Please list on Schedule "D") Total Monetary Contributions 11 (!2tgl of ll!l!iti 6 tflroygb. 12) 14, Total Non-Monetary Contributions 12 (From Statement of Non-Monetary Contributions Schedule "A-Z') Total Contributions 13 (Line 11 + line 12) Itemized Expenditures 20 or More 14 (Please list on Schedule "B") Total of Non-Itemized Expenditures 15 (Expenditures of or less) 16 Loan Repayments Made (Please list on Schedule "C") Returned Contributions (To donor) 17 (Please list on Schedule "D") 14, , Closeout Distributions 0.00 {Balance must be zero. Please attach Schedule E.) 19 ( Intentionally left Blank) 20. Total Spending (lines 14 through 17) 14, Office of the City Clerk - City of Colorado Springs Rev...

3 Schedule A 1 - Itemized Contributions Statement (20 or More) Full Name of committee/ Person: Colorado Springs Government Watch - IC WARNING: Please read the instruction page for Schedule "A" before completing! PLEASE PRINT/TYPE l. Name (Last. First): Colorado Springs Government Watch 2. Address: PO Box City/State/Zip: Monument, CO Description: Contribution from General Treasury Funds 5. Employer (mondgtorv if employed): _N_l_A 6. Occupation (mandgtorv jf employed): _N_/_A 7. Date Accepted: _1_21_2_8_/2_0_1_4 8. Aggregate Amount This Election Cycle: _8_9_7_._0_ Contribution Amount This Reporting Period: 1. Name (Last. First): Colorado Springs Government Watch 2. Address: PO Box City/State/Zip: Monument, CO _ Description: Contribution from General Treasury Funds 5. Employer (mondatorv if employed}: _N_/_A 6. Occupation (mondgtorv if employed): _N_l_A 7. Date Accepted: _0_1_10_4_12_0_1_5 a. Aggregate Amount This Election Cycle: _5_,_1_3_3_._0_0 4, Schedule A-1 Itemized Contributions Statement (20 or more) Poge_of Office of the City Clerk - Gty of Colorado Springs Rev....

4 - l. Name (Last. FirstJ: Colorado Springs Government Watch 2. Address: PO Box City/State/Zip: Monument, CO Description: Contribution from General Treasury Funds 5. Employer (mandatory if employed): _N_f_A 6. Occupation (mandqtory if employed): _N_/_A 7. Date Accepted: _1_/1_1_1_2_0_15 8. Aggregate Amount This Election Cycle: _1_4_:,_1_2_2_._0_0 8, Contribution Amount This Reporting Period: 1. Name (Lost First): Address: 3. City/State/Zip: 4. Description: 5. Employer (mqndatqn if employed): 6. Occupation (mandatory if employed): Date Accepted: 8. Aggregate Amount This Election Cycle: Contribution Amount This Reporting Period: 1. Name (Lost. First}: 2. Address: 3. City/State/Zip: 4. Description: 5. Employer (mandatory if employed): Occupation (mandatory if employed): Date Accepted: Aggregate Amount This Election Cycle: Contribution Amount This Reporting Period: c Schedule A-1 Itemized Contributions Statement (20 or more) Page of Office of the City Clerk - City of Colorado Springs -4- Rev......

5 Schedule A-2 - Statement of Non-Monetary Contributions Full Name of committee/ Person: Colorado Springs Government Watch - IC PLEASE PRINT/TYPE 1. Name (last. First): Address: 3. City/State/Zip: 4. Description: 5. Employer /mondotqn If employed}: Occupation (mondatorv if employed}: Date Provided: Aggregate Amount: Fair Market Value: 1. Name (last. First): Address: 3. City/State/Zip: Description: 5. Employer lmandotorv if employed): Occupation (mondgtory if employed}: Date Provided: Aggregate Amount: Fair Market Value: Schedule A-2 Statement of Non-Monetay Contributions (20 or more) Poge of Use additional pages os necessary Office of the City Clerk - City of Colorado Springs Rev....

6 1. Name (Last, First): 2. Address: 3. City/State/Zip: 4. Description: Employer (mandatorv jf employed): Occupation (mandatorv if employed!: Date Provided: 8. Aggregate Amount: 9. Fair Market Value: 1. Name (Last, First): Address: 3. City/State/Zip: Description: Employer (mandqtorv if emploved}: Occupation (mandatory if employed): Date Provided: Aggregate Amount: 9. Fair Market Value: 1. Name (Last First): Address: 3. City/State/Zip: Description: Employer (mandatory if employed): Occupation Cmandatorv if emplovedl: Date Provided: Aggregate Amount: 9. Fair Market Value: Schedule A-2 Statement of Non-Monetary Contributions (20 or more) Page of Office of the City Clerk - City of Colorado Springs Rev....

7 I Schedule B - Itemized Expenditures Statement (20 or more) I Full Name of Committee/ Person: Colorado Springs Government Watch - IC PLEASE PRINT/TYPE i. Name (Last, First): GOTV Canvassing 2. Ad dress: 740 S. Mill Ave., Suite City/State/Zip: Tempe, AZ Purpose of Expenditure: Signature Gathering 5. Date Expended: 12/28/ Amount: l. Name (Last First): GOTV Canvassing 2. Address: 740 S. Mill Ave., Suite City/State/Zip: Tempe, AZ Purpose of Expenditure: Signature Gathering 5. Date Expended: 01 /04/ Amount: 4, Name (Last. First): GOTV Canvassing 2. Address: 740 S. Mill Ave., Suite City/State/Zip: Tempe, AZ Purpose of Expenditure: Signature Gathering 5. Da te Expended: 01 /11 / Amount: 8, Schedule B Itemized Expenditures Statement (20 or more I Poge_of_ Office of the City Clerk - City of Colorado Springs Rev ,...

8 l. Name (Last. First): Address: 3. City/State/Zip: Purpose of Expenditure: Date Expended: Amount: 1. Name (Last. First): 2. Addre~: City/State/Zip: 4. Purpose of Expenditure: Date Expended: Amount: 1. Name (Last, First): Address: 3. City/State/Zip: Purpose of Expenditure: Dote Expended: 6. Amount: Schedule B Itemized Expenditures Statement (20 Of more) Page of Office of the City Clerk - City of Colorado Springs Rev

9 Full Name of Committee/Person: Colorado Springs Government Watch - IC LOAN SOURCE Name!Last, First or Institution): Address: City/State/Zip: Original Amount of Loan:, Interest Rate: o/o Total of All Loons This Reporting Loan Amount Received This Reporting Period:. Period:, Principal Amount Paid This Reporting Period: c.. _ (Place on line 8 of Detailed Summary Report) Interest Amount Paid This Reporting Period: Amount Repaid This Reporting Period: Total Repayments Made: (Amount Repaid is sum of Principal & Interest entered on Detail Summary] (Sum of Schedule C pages, Place on line 16 of Detailed Summary) Outstanding Balance:, TERMS OF LOAN: Dote Loon Received Due Dote for final Payment LIST All ENDORSERS OR GUARANTORS OF THIS LOAN Full Name Address, Citv, State, ZiD Amount Guaranteed Schedule C loans Poge of Office of the City Clerk - City of Colorado Springs Rev

10 Schedule D - Returned Contributions & Expenditures Full Name of committee/ Person: Colorado Springs Government Watch - IC PLEASE PRINT/TYPE Returned Contributions (Previously reported on Schedule A - Contributions accepted and then returned to donors) 1. Nome (Last, First): 2. Address: 3. City/State/Zip: Purpose: 5. Date Accepted: Date Returned: 1. Name (Last, First): 2. Address: City/State/Zip: Purpose: 5. Date Accepted: Date Returned: Name (Lost, First): 2. Address: City/State/Zip: 4. Purpose: 5. Date Accepted: 6. DateRetumed: Schedule D Returned Contributions Page of Office of the City Clerk - City of Colorado Springs Rev

11 1. Name (Last, First): 2. Address: 3. City/State/Zip: 4. Purpose: 5. Date Accepted: 6. Date Returned: 1. Name [Last, First): Addre~= City/State/Zip: 4. Purpose: 5. Date Accepted: 6. Date Returned: Name (Last. First): Address: City/State/Zip: 4. Purpose: 5. Date Accepted: 6. Date Returned: Schedule D Returned Contributions Page of Office of the City Clerk - City of Colorado Springs Rev....

12 Full Name of committee/person: Colorado Springs Government Watch - IC LOAN SOURCE Name (Last. First or Institution): Address: _ City/State/Zip: _ Original Amount of Loan: Interest Rate: % TotoJ of AU Loons This Reporting Loan Amount Received This Reporting Period:. Period:. Principal Amount Paid This Reporting Period:. (Place on line 8 of Detailed Summary Report) Interest Amount Paid This Reporting Period: ' Amount Repaid This Reporting Period:. Total Repayments Made:. (Amount Repoid is sum of Principal & Interest entered on Detail Summary) Outstanding Balance:. {Sum of Schedule C pages. Place on line 16 of Detailed Summary) TERMS OF LOAN: Date Loon Received Due Dole for Final Payment LIST All ENDORSERS OR GUARANTORS OF THIS LOAN Full Nome Address, CHv, State, Zlo Amount Guaranteed Schedule C Loans Page of Office of the City Clerk - City of Colorado Springs Rev

13 PLEASE PRINT/TYPE Returned Expenditures (Previously reported on Schedule B - Expenditures returned or refunded to the committee) 1. Name (Last. First): 2. Address: 3. City/State/Zip: Comment (Optional): Date Accepted: Date Returned: Name (Last. First): 2. Address: 3. City/State/Zip: 4. Comment (Optional): Date Accepted: 6. Date Returned: l. Name (Last. First): 2. Address: 3. City/State/Zip: 4. Comment (Optional): Date Accepted: 6. Date Returned: Schedule D Returned Expenditures Page of Office of the City Clerk - City of Colorado Springs Rev

14 1. Name (Last First): Address: 3. City/State/Zip: 4. Comment (Optional): Date Accepted: Dote Returned: Nome (Last. First): 2. Address: 3. City/State/Zip: 4. Comment (Optional): Date Accepted: 6. Date Returned: Name (Last. First): 2. Address: 3. City/State/Zip: 4. Comment (Optional): Date Accepted: 6. Date Returned: Schedule D Retumed Expenditures Poge of Use odditionot pages os necessary Office of the City Clerk - City of Colorado Springs Rev....

15 Schedule E - Closeout Distributions (To b e completed after the election Is certified. Complete the Detailed Summary before completing this Schedule E) l Funds on Hand at the Beginning of Reporting Period (from detaned summary, monetary only) 2 Total Monetary Contributions for the Reporting Period (detailed summary. line 11) 3 Total Funds (line 1 +line2) 0.00 Expenditures During the Reporting Period: a Itemized Expenditures 20 or More (From detailed summary line 14) Total of Non-Itemized Expenditures (From b 4 detailed summary line 15) c Loan Repayments Made (From detailed summary line 16) 5 6 d Returned Contributions (To donor)(from detailed summary line 17) Total Expenditures (total of a. b. c. and d) 0.00 Total Contributions to Charitable organizations (attach list showing the Name. Address. and amount contributed to each Charitable organization) Funds retained for a future election (list financial institution in which the funds will remain) 7 Total of lines 4, 5, and Subtract line 7 from line 3 (Result must be zero) and enter on line 18 of 0.00 the detailed Summarv Schedule E Closeout Distributions Office of the City Clerk - City of Colorado Springs Rev...