,,..,,.,- t<lprnn ()j. ( O\TRJBI TIO\S A\D EXl'F\l>ln RES. . \uthori1ation. \ddrcss of Connniw t/pnson ( ity. Stak & Zip Code.

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1 ;,. '! l,z: '" t<lprnn ()j. ( O\TRJBI TIO\S A\D EXl'F\l>ln RES 1 l >' I '.\. ' \ddrcss of Connniw t/pnson ( ity. Stak & Zip Code ( 'ommitkc Type: '<amt :rnd Addn'' of Finan\:ial 111,titution Reporting Period Cu\tn:d l~j22;92:_~i~jjij~-- 1>t'dan d Total Spcndin!! of. pplirahit'j j.\rt \\\"lll,,,,,,: 1: 1 l S! rnhl,,n 1 Luhi al the Hc~:.111ni1ig,,f R<.:j»lrtlll);'. l\:n d.,,,..,, 1ir: ""'' 1 l,,\al \1d1d;ir; Cuntribwi,1ri:-..,inc I'; f\,tal uf Ln~.21, l \pc:nditurcs' ~ h;nzh "H! Lu1d ;n tlw L11d_Pr!{i:Jh nint'.!'t'ripd 'u r.c'"'' dii c: ; 1i:i. 1.. \uthori1ation I ht apprqpri:ite offi\'tr,hall irnfh"!'.1 ptnall_, of ~;;;o p<'r d:i\ f r e:1d1 day tha! a rqwrt j, rlkd Lilt. I \rl \'\\Ill.'we I0(2)(a)I, ' f} f l ~ ',,' ',' '., : { J \ f /: l; f { <.'n;'fu-:u;;: d::~ / :;ljfi )~1Ji~ )'/\,i ~ ( ~ti'«.! r~. n~;:\~[;,;,. \:,;;r; /\.. r: ' \:mu:,,..,,.,- i l:lk ID-oD-lb

2 DETAILED SUMMARY Current Reporting Period: Through Funds on hand at the beginning of reporting period (Monetary Only) / /.-1 q 7. 1 ;)._ 6 Itemized Contributions 20 or More [C.R.S. l (l)(a)] I OD DO (Please list on Schedule "A") 7 Total of Non-Itemized Contributions (Contributions of19.99 and Less) 8 Loans Received (Please list on Schedule "C") 0,()Q I 'J5D.DO o,oo 9 Total of Other Receipts (Interest, Dividends, etc.) 10 Returned Expenditures (from recipient) (Please list on Schedule "D") 0, DO 11 Total Monetary Contributions / 351>. D 0 (Total oflines 6 through 10) 12 Total Non-Monetary Contributions 300~ 00 (From Statement ofnon-monetary Contributions) 13 Total Contributions I (p5d. DO (Line 11 +line 12) 14 Itemized Expenditures 20 or More [C.R.S. l (l)(a)] I t.e 41P. o Cp (Please list on Schedule "B'') 15 Total of Non-Itemized Expenditures I Id- (Expenditures of or Less). Loan Repayments Made (Please list on Schedule "C"). Returned Contributions (To donor) (Please list on Schedule "D") 18 Total Coordinated Non-Monetary Expenditures 0 oo (Candidate/Candidate Committee & Political Parties only). 19 Total Monetary Expenditures I~ '17, I <:6 (Total of lines 14 through I 7) 20 Total Spending (Line 18 + line 19) I ~Jf?. /co Colorado Secretary of State Form Rev. 12/09

3 Schcdult.\ lkmi1\'.d ( 'ontributions Statement (S20 or more) ('!<.\.!--~~.ii:?<{! ll<)j Full,am : nf('fjmrnittcc:pcr~on: /Ud~t'/ fotcl-fo-rarv~ij'i &~1 \ WAR:\!'\(;; Pl1.~ast read tht irndruction Jagc for Schedule ''A'' bcforc rnmpkting{ Pl.L\sE l'rl'\li n Pl: H l\arm:<l i\l i"" el)t>\rte~s, D0v e...,\dd1-z:,, 3'~D tj 81 st Dr1v e,,arvaota.,, 1 co 8~< Ch.ea - eontrtb1a+1011 f < \'LP'.l\'<..'ri1~~. 1 'it~l!!l!\l\li{]~l!; (.,,rijrib\.1.t.1.,!u...,\.1n.t ( if.:<.:k bua it :d.'"lh:cr!n~, z \li1d~i!jl\!1,,.~(.tll>,f\) t "; ( li.. : \ '.., i ~ \ ) \ i! l L,(.LtHk;:r=11:.' <... rnni:niniccnwn (' h~.:..j, bu.\. 1! t J.:t.:! ionl't:ri n~~ ( ;!:n:=t" l..\hh:r;.i ::J>="!~n.:tL....,.L,.,,..,...,\ _!:.. ~ i..::-~nu :)LU= n -.'.\.1~ pl:i:-,. i~<~:r i.. i t!i..: ( "\'-,\"l!t ~:;) (,'iji'.n:ih:-;,\i' \\\."!! ~I\;"

4 Sdu:dule B - Itemized Expenditures Statement f S20 or mo rd 1-1'.-1<1.;1!)(,U C.R.<,! /O-/i-16 -\m11u1:t ~ )/OJ./. 11 ~ J\c...:1pii:nt 1:-. «q1r11 r.,i; ~-.) ( PJ'lllfllt1CC, \ ornin ittee -l. Name: ::i. :\ddrc~< " ;\ddrcss: '.,,.. 3.Ri..--cipterit i -~ qi; ti1.i1u'.r { 'nr11rnitlt'<.:

5 Schedule C - Loans Full Name of Committee/Person /JloJ)ey FacJ., fur A ruad.tl Ci~ ~I 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 of soliciting contributions or for any commercial purpose. [Art. XXVIII, 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 if the 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. XXVIII, Sec. 3(8)] LOAN SOURCE Interest Rate: 0 Loan Amount Received This Reporting Period: } I d..6d. DD Principal Amount Paid This Reporting Period: D Interest Amount Paid This Reporting Period: 0 Amount Repaid This Reporting Period: D (Amount Repaid is sum of Principal & Interest entered on Detail Summary) Total of All Loans This Reporting bo Period: ' '250, (Place on line 8 ofdethed Summary Report) Total Repayments Made: Q (Sum of Schedule C pages, Place on line 16 of Detailed Summary) Outstanding Balance: TERMS OF LOAN: Date Loan Received Due Date for Final Payment LIST ALL ENDORSERS OR GUARANTORS OF TIDS LOAN Full Name ;).50.DD Colorado Secretary of State Form Rev. 12/09

6 Statement of Non-Monetary Contributions [Art. XXVIII, Sec. 2(5)(a)(II)(III) & Sec. 5(3) & (1), C.R.S.] Full Name of Committee/Person:,.ftJ~a PLEASE PRINT/TYPE I. Date Provided /D-'J.0-lb 2. Fair Market Value 3/JO,OO 3. Aggregate Amt.... o... e~f--jfo~rlv~fu... c.,a~o-y-"')a.ji&~-t-:::..t~i+'--+~~&~l.ul,,,._..c"""'--'-. l \~ D Check box if Electioneering Communication I. Date Provided 10. D Check box if Coordinated with a Candidate 4. Name (Last, First): , 5. Address: 2. Fair Market Value City/State/Zip: 3. Aggregate Amt. D Check box if Electioneering Communication I. Date Provided 2. Fair Market Value 3. Aggregate Amt. D Check box if Electioneering Communication 7. Description: Employer (if applicable, mandatory): 9. Occupation (if applicable, mandatory): IO. D Check box if Coordinated with a Candidate/Candidate Committee or Political P * 4. Name (Last, First): 5. Address: 6. City/State/Zip: 7. Description: 8. Employer (if applicable, mandatory): 9. Occupation (if applicable, mandatory): 10. D Check box if Coordinated with a Candidate/Candidate Committee or Political Party. * *Note: If coordinated, then contribution must also be reported as a non-monetary expenditure on Detailed Summary. Art. XXVIII, Sec. 2(9) states:"... Expenditures that are controlled by or coordinated with a candidate or candidate's agent are deemed to be both contributions by the maker of the expenditures, and expenditures by the candidate committee." Colorado Secretary of State Form Rev. 12/09