'4, 01. Co frfr, )4,1 2. Acronym or Abbreviated Name (if any. a HAVE EXAMINED THIS STATEMEN. TO e ea rer. siff. e /col. E Post-Convention.
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1 OP A POLITICAL COMMITTEE State Eorm 460E (R , Indiana Election Commission (IC ) (CFA-4) Summary Sheet INSTRUCTIONS: Please type or print ass:stance in completing this form, see IS THIS AN AMENDM ons o t s evers formation on this fo TOTAL PAGES IN ENTIRE CFA-4 REPORT COMMITTEE INFORMATION I Full Name of Committee (as or Statement of Organization) Co frfr, )4,1 2. Acronym or Abbreviated Name (if any 3. Committee Telephone Number 2_7415"0 1 -?7S Mailing Address (address whe e all campaign finance correspondence Is received) E Check if this is a new address City, State, ZIP Code 6. Part ffiliation (if applicable) He\ o-n 4 ti C_I-Ce- CANDIDATE INFORMATION (For Candidate's Committees Only) 7. Full e of Candidate (include any nickname) C-Cin Itemized (use Schedule A) 15 b. Unitemized 5o. Add lines 15a and 15b in both columns 15. Add fines 13 and 1 5c in Column A and lines 14 and 15c in Column B 17b. Add lines 17a and 17b in both columns EXPENDITURES 13. Casn on nand and investments at close of this reportmg period (subtract 1 is from 16 in both columns) 19. Debts OWED BY the committee (use Schedule 0) 20 Debts OWED TO the committee (use Schedule Et SUBTOTAL TOTAL , 2-S- / / 3 (Note - These amounts include in-kind expenditures and loan repayments.) 17a Itemized (use Schedule (5) (Public Question. use Schedule C) / 9a 17b. Unitemizeo CC e /col /4.--Fc) 20)--y-ei5 17 Check if this is a new name e -ft- jork-e_c 0 Office Sought (Include gi riot number, f an Not required for exploratory committee.) 11. Ch k one: nn 141t-re-Pnn-iary Pre-Election Annual 12. Reporting Period' t ( 41. C t rattmcl 41/0 TYPE OF REPORT Nomination E the- '4, 01 Finaltisbanus Committee (lines le. )9. and 20 must bete) I Outgoing Treasurer (within I nays am d Stareme From I ot 5 Through: T / 2 IS 13. Cash on hand and/investments at the beginning of this reporting pert 14. Gash on hand and investments January 1, current year. CONTRIBUTIONS AND RECEIPTS (Note' these amounts include in-kind contributions and loans, as well as cash contributions.) 8. Party Affiliation or If Independent Candidate 1 ()mot 10. County e5idence nizelion) /CC., SUBTOTAL /46 TOTAL itolfilpeetc46 CONVENTION CANDIDATES ONLY Check one: Pre-Convention E Post-Convention COLUMN A This Period COLUMN B Year to Date! CERTIF Signet Nonatureof a HAVE EXAMINED THIS STATEMEN. TO e ea rer siff applica CERTIFICATION E aesrfr M 0 LEDGE' An}c B1411.r it Tit ke---ce:c Siker RUE. CORRECT AND COMPLRTET I I Date 37' f r WARNIN -(Any intarmation con, s report may no De copied for sale or used for any coonmer:lei purpose. (IC 3.945) erson w o knowingly Des a fraudulent moon commits class D felony. (IC i A person wnc fails to the a complete or accurate repon as recruited ny Ins Indiana Lamoaion Finance Law commits a Class 0 misdemeanor. ric 2-14-f-14) ana may be subiect tc. ermines (IC IC IC 3-9-a-IS) D te Vi\OF'FICE USE ONLY
2 1 REPORT OF RECEIPTS AND EXPENDITURES State Form 4605 (P13/ Indiana Election Commission f IC ) (CFA-4 SCHEDULE A-1) CONTRIBUTIONS BY INDIVIDUALS Itemized and INSTRUCTIONS: LIST ONLY CONTRIBUTIONS BY INDIVIDUALS ON THIS SCHEDULE. Please type or print legibly IN BLACK INK all information on this schedule. For assistance in completing this scheduie, see instructions on the reverse sloe. This schedule is used to document contributions and receipts totaled on ;TEM 15a of the Summary Sheet. All cumulative contributions nom individuals OVER $100 per contributor, within a calendar year MUST be itemized on this schedule over $200. if regular party committee), All cumulative receipts, such as loan proceeds and repayments, refunds, rebates, returns of deposit, proceeds from sales, interest or other income) OVER $100 per contributor, within a calendar year. MUST oe itemized on this schedule (over $200 if regular party committee). A contributor's occupation is required it an individual makes at least $1,000 in contributions curing the calendar year. Otherwise, this is optional. 1. CONTRIBUTOR'S FULL NAME AND OCCUPATION TYPE OF CONTRIBUTION COLUMN A COLUMN B DATE FULL MAILING ADDRESS OR OTHER RECEIPT AMOUNT THIS CUMULATIVE RECEIVED PERIOD YEAR-TO-DATE RECEIVED BY ±dki0 j / C'Vre-C (3, 7 A r CA, 5t-. 1 tc.-rn. YLt V'S 5 4-A6) 3 2-'0 : 0 Direct In-Kinci (describe) L.../ _... interest /Loan / era oe A V ( - Contributors Occupation (if reouired) 2. 14d.t- -0 j, /0 vim e r 7 /21 1 ch 6--..,_ 5+, i ri-r-c-in >i, /1---i g.69?z-d, : Direct In-Kind Idescripe) 3 J5/ 2,5- ' Interest r 11- (0- Contributor's Occupation (iireoured) 3. Contnoutions Direct In-Kind (describe) Otner Receipts: IN Interest Loan Contributor's Occupation (ifrequired) 4. Direct In -Kind (describe) i Contributor's Occupation required D Interest E Loan D Misc (specify) i 5. in Direct 7. 7 In-Kind (describe; 1 Contributcris Occupation (i/ recurred' Otne Receipt; 7 Interns 7 Loar Misc. (specify SUBTOTAL THIS PAGE OF SCHEDULE A $ TOTAL Or ALL PAGES OF SCHEDULE A ON THE LAST PAGE ONLY (Enter total on ITEM 15a of the Summary Sheet) $
3 , 1 REPORT OF RECEIPTS AND EXPENDITURES State Form 4606 (R13(11-05i Indiana Election Commission (IC ) (CFA-4 SCHEDULE A-2) CONTRIBUTIONS BY CORPORATIONS Itemized and INSTRUCTIONS: LIST ONLY CONTRIBUTIONS BY CORPORATIONS ON THIS SCHEDULE, Please type m print legibly IN BLACK INN all information on this schedule. For assistance in completing this scheduie. see instructions on hie reverse side. This schedule is used to document contributions ant receipts totaled on ITEM 15a of the Summary Sheet. All cumulative contributions from corporations OVER $100 per contrioutor, within a calendar year MUST be itemized on this schedule (over $200, if regular party committee). All cumulative receipts, (such as loan proceeds and repayments, refunds, rebates. returns of deposii, proceeds from safes, interest or other income) OVER $100 per contrioutor, wttnin a calendar year, MUST be itemized on this scnedule (over $200 if regular party committee). CONTRIBUTOR'S FULL NAME AND TYPE OF CONTRIBUTION COLUMN A COLUMN B DATE FULL MAILING ADDRESS OR OTHER RECEIPT AMOUNT THIS CUMULATIVE RECEIVED PERIOD I YEAR-TO-DATE RECEIVED BY Direct In-Kind!describe) Otner Receipts. E Interest Loan 2. : Direct In-Kind (describe). Interest Ell Loan Misc (specify) - E Direct; In-Kind (describe) : interest Loan misc. (specify) 4. : Direct In-Kind (describe) : Li Interest Loan m.se. (specify) Direct r, Li In-Kind idescopet iri, Interest Loan Misc (specify,: SUBTOTAL THIS PAGE OF SCHEDULE A $ TOTAL OF ALL PAGES OF SCHEDULE A ON THE LAST PAGE ONLY (Enter total on ITEM 15a of the Summary Sheet)
4 State. orm 4606 (813/ Indiana Election Commission (13; ) INSTRUCTIONS: LIST ONLY CONTRIBUTIONS BY LABOR ORGANIZATIONS ON THIS SCHEDULE. Please type or mint i legibly IN BLACK INK all information on this schedule, For assistance in =Dieting this schedule, see instructions on tne reverse side. This schedule is used to document contributions and receipts totaled on ITEM 15a of the Summary Sheet. At cumulative contributions from labor organizations OVER $100 per contrioutor. within a caiencar year MUST be itemized on this schedule (over $200. if regular party committee). All cumulative receipts, (such as loan proceeds and repayments. refunds, reoates, returns of deposil, proceeds from sales, interest or other income) OVER 5100 per contributor, within a calendar year, MUST be itemized on this schedule (over $200 if regular party committee). (CFA-4 SCHEDULE A-3) CONTRIBUTIONS BY LABOR ORGANIZATIONS Itemized and Page of CONTRIBUTOR'S FULL NAME AND FULL MAILING ADDRESS (street, number, city, state. ZIP cede) TYPE OF CONTRIBUTION COLUMN A COLUMN B DATE OR OTHER RECEIPT AMOUNT THIS CUMULATIVE RECEIVED PERIOD YEAR-TO-DATE RECEIVED BY controutions Direct In-Kind (carte) Interest Li Loan Misc. (specify; 2.. Direct In-Kind (oesonoe) Other Receiots interest 1," Loan miss (specify). Direct In-Kind (describe) Lj Interest Loan Misc ISPECifyi. Direct (Describe) interest L Loan Misc. (specify! Direct E mescrine) Interest 7 Loan 11; Misc (specify SUBTOTAL THIS PAGE OF SCHEDULE A $ TOTAL OF ALL PAGES OF SCHEDULE A ON THE LAST PAGE ONLY $ (Enter total on ITEM 15a of the Summary Sheet)
5 REPORT OF RECEIPTS AND EXPENDITURES State Form 4606 (R ) Indiana Election Commission NC ) (CFA-4 SCHEDULE A-4) CONTRIBUTIONS BY POLITICAL ACTION COMMITTEES Itemized and INSTRUCTIONS: LIST ONLY CONTRIBUTIONS BY POLITICAL ACTION COMMITTEES ON THIS SCHEDULE. Please Mee or print legibly IN BLACK INK at information on this scheduie. For assistance in completing this schedule, see instructions on the reverse side. This schedule is used to document contributions and receipts totaled on ITEM 15a of the Summary Sne,et All cumulative contrioutions from political action committees OVER 51 DO per contrioutor, within a calendar year MUST be itemized on this schedule (over $200, if regular party committee) All transfers-in and in-kind contributions regardless of amount irom political action committees MUST be itemized on this schedule. All cumulative receipts, (such as loan proceeds and repayments, refunds, rebates, returns of deposit, proceeds from sales, interest or other income) OVER $100 per contributor, within a calendar year, MUST be itemized on this schedule (over $200 if regular party committee). Page of CONTRIBUTOR'S FULL NAME AND FULL MAILING ADDRESS TYPE OF CONTRIBUTION OR OTHER RECEIPT LI Direct COLUMN A AMOUNT THIS PERIOD COLUMN Et DATE CUMULATIVE RECEIVED YEAR-TO-DATE RECEIVED BY In-Kind Nressnwei Interest Loan Misc tspenly1 2 ': Li Direct In- Kind (describe) Interest Loan Contnoutions Dress: In-Kind (describe) Interest Lin Lear Misc. (spec/1y) Direci in-kind (oescnbe, Interest Loan Misc. (specify,:. Direct In-Kinc (describe Interest J Loan Misc. ;specify SUBTOTAL THIS PAGE OF SCHEDULE A TOTAL OF ALL PAGES OF SCHEDULE A ON THE LAST PAGE ONLY (Enter total on ITEM 15a of the Summary Sheet) $
6 State Form 4606 (R ) Indiana Election Commission (IC ) INSTRUCTIONS: LIST ONLY CONTRIBUTIONS BY ORGANIZATIONS OTHER THAN CORPORATION LABOR ORGANIZATIONS, 1 POLITICAL ACTION COMMITTEES AND INDIVIDUALS ON THIS SCHEDULE. Please type or print legibly IN BLACK INK all information on this scnedule. For assistance in completing this schedule. see instructions on the reverse side. This schedule is used to document contributions and receipts totaled on ITEM 15a of tie Summary Sheet. All cumulative contributions from other entities OVER I $100 per contributor, within a calendar year MUST be itemized on this schedule over $200, if regular party committee). All transfers-in and rn-kind contributions regardless of amount from candidate's, legislative caucus, and regular party committees MUST be itemized on this schedule. Ali cumulative receipt, (such as loan proceeds and repayments, refunds, rebates, returns of deposit, proceeds from sales, interest or other income) OVER $100 per contributor, within a calendar year. MUST be itemized on this schedule (over $200 if regular party committee). (CFA-4 SCHEDULE A-5) CONTRIBUTIONS BY OTHER ORGANIZATIONS - Itemized and CONTRIBUTOR'S FULL NAME AND TYPE OF CONTRIBUTION COLUMN A COLUMN B DATE RECEIVED FULL MAILING ADDRESS OR OTHER RECEIPT AMOUNT THIS CUMULATIVE RECEIVED BY PERIOD YEAR-TO-DATE. Direct In-Kind (describe) Page of : Interest U Loan 2. Direct In-Kind (describe) ' Interest Loan Direct In-Kind (describe) : Interest Loan 4. Direct In-Kind (describe) ' Interest Loan : Direct MI In-Kind (describe) U Interest iii Lean SUBTOTAL THIS PAGE OF SCHEDULE A $ _._. SCHEDULE _ OF N THE LAST PAL,:.. ONLY $ (Enter total on ITEM 15a of the Summary Sheet) I
7 OF 'A POLITICAL COMMITTEE State Form 4606 (R^ ) Indiana Election Commission (IC INSTRUCTIONS: Please type or mint legibly IN BLACK INK all information on this schedule, For assistance in comporvi this schedule, see instructions on the reverse side. This schedule is used to document expenditures totaled on ITEM ra of the Summary Sheet. All cumulative expenses paid to individuals. businesses, labor organizations and other entities OVER $100 per recipient, within a calendar year MUST be itemized on this schedule (over $200, if regular party committee': All cumulative expenses, including in-kind. regardless of amount paid to political committees, (such as transters-out from candidate. legislative caucus, political action, or regular party committees) MUST be itemized on this schedule. (CFA-4 SCHEDULE B) ITEMIZ O EXPENDITURES dr. Page of RECIPIENT'S NAME AND MAILING ADDRESS o I RECIPIENT'S OCCUPATION OFFICE SOUGHT (if applicable) 44, for TYPE CIF EXPENDITURE and PURPOSE (be specific) Direct in-kind R-Fa-rmeni o` Debt Returned Contribution Other Puriose: /4"/ 41-C-f-^ COLUMN A AMOUNT THIS PERIOD COLUMN B CUMULATIVE YEAR TD DATE /7(tr/75-75 DATE OF EXPENDITURE 313 Ift5 Code C /9- V eie f M-yes 54, /1-- 1-'i fti-e4-- E Direct ment of Deb! in-lend Returned Contribution Daher )41.-tiod styles 67c;,--0 Coae 1 UP 5, 40- bran co "Cfc'e Aue. oan,,n, / Cooe ze-744p4 it vsnoti Oe-c-ficete A nea. 19G1 1%)) 5 "1--- ern r CE 5 Direct In-Kind [ThraTment of Debt Returned Contributtcr 0ther /Z - "SC'i Direct In-Kind g-farnent of Debt Returned Contribution aher ct441 of ree 2 47t57,19 7.,eid,cr9 2J2l, cu Code Direct In-Kinc Payment o' Deb' 5 Returned Cordnovtior Other Cote E Direct E In-Kind Payment of Debt Returned Contribution Other ' Cone Drecr E Payment of Dan! Resurteo Contrioution 0 Diner Ramose SUBTOTAL THIS PAGE OF SCHEDULE B TOTAL OF ALL PAGES OF SCHEDULE B ON THE LAST PAGE ONLY (Enter total on ITEM 17a of the Summary Sheet)
8 State Form 4606 (R ) Indiana Election Commission (IC ) INSTRUCTIONS: Piease type or print legibly IN BLACK INK ali information or this schedule. For assistance in completing this schedule, see instructions on the reverse side. All cumulative expenses or transfers-out, regardless of I amount paid to political committees supporting or opposing a public question. MUST be itemized on this schedule. (CFA-4 SCHEDULE C) ITEMIZED EXPENDITURES For Public Questions FILE NUMBER Page of I Enter Text of Public Question PUBLIC QUESTION INFORMATION Type of Question: Statewide Local! Position: 72, Supported Opposed RECIPIENT'S NAME AND MAILING ADDRESS (sheet, number, city, state, ZIP code) RECIPIENT'S OCCUPATION TYPE OF EXPENDITURE and PURPOSE (be specific) COLUMN A AMOUNT THIS PERIOD COLUMN B CUMULATIVE YEAR4O-DATE DATE OF EXPENDITURE Corte 1 Direct In-Kind Payment of Debi Returned Contribution DO1 her Papoose. Code Direct in-kind Payment of Der Returned Contribution 0 'Diner : Code Direct in-kind Payment of Debt Returned Contribution pther : Cope I Direct in-kind Parser of Debi Returned (-purr:naos :liner Coce Direct ri in-kind Payment of Deb: Returnee Contributor 0 01 her Pumas a' : Coce I 0 Direct indeint Paymeni of Deb. Returned Contrioulips Other SUBTOTAL THIS PAGE OF SCHEDULE C $ TOTAL OF ALL PAGES OF SCHEDULE C ON THE LAST PAGE ONLY (Enter total on ITEM 17a of the Summary Sheet)
9 i REPORT OF RECEIPTS AND EXPENDITURES State Form 4606 (R ) Indiana Election Commission (IC ) (CFA-4 SCHEDULE D) DEBTS OWED BY THIS COMMITTEE INSTRUCTIONS: Please type or print legibly IN BLACK INK all information on this schedule. For assistance in completing the schedule. see instructions on the reverse side. List all debts and loans, reoardiess of the amount OWED BY the committee curing the reporting period. include all amounts awed for or to lend institutions, indiviouals, credit purchases, committee credit card accounts etc Lisf each vendor paid by credo card issued in the name of the committee in the ENDORSER'S column. A lenders occupation is required if an individual makes 'pans of at least $1,000 curing the calendar year. Otherwise, this is optional. FILE NUMBER CREDITOR'S OR LENDER'S NAME & MAILING ADDRESS (street, number, city', state, ZIP code) ENDORSER'S OR VENDOR'S NAME & MAILING ADDRESS (it any) AMOUNT NATURE OF DEBT DATE DEBT INCURRED CUMULATIVE PAID YEAR-TO-DATE OUTSTANDING BALANCE THIS PERIOD,..ENDEP... OCCUPATION it 1.:NDE.F.'S DC, SlION LENDER'S OCCUPATION ENDER'S rupation _ENDERS 000LU.. 1-.' ION OCCLIDATION a:curcio,. SUBTOTAL THIS PAGE OF SCHEDULE D $ TOTAL OF ALL PAGES OF SCHEDULE DON THE LAST PAGE ONLY (Enter total on ITEM 19 of the Summary Sheet)
10 State Form 4606 (P13/11-05)?. Indiana Section Commission (IC ) (CFA-4 SCHEDULE E) DEBTS OWED TO THIS COMMITTEE INSTRUCTIONS: Please type or print legibly IN BLACK INK all information on this schedule. For assistance in compiehng this schedule, see instructions on the reverse side. List all debts and loans, regardless of Ire amount. OWED TO the committee tiring the reporting period. Include all amounts the committee has loaned to others. Page of BORROWER'S NAME & MAILING ADDRESS COSIGNER'S NAME & MAILING ADDRESS (if any) ORIGINAL AMOUNT NATURE OF DEBT DATE DEBT INCURRED CUMULATIVE OUTSTANDING PAID BALANCE THIS YEAR-TO-DATE PERIOD SUBTOTAL THIS PAGE OF SCHEDULE E TOTAL OF ALL PAGES OF SCHEDULE E ON THE LAST PAGE ONLY (Enter total on ITEM 20 of the Summary Sheet) 1 s
COMMITTEE INFORMATION. ' 1 - ) 1 - lc
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