Received SEP ! 3 CITY CLERK. fah n kakt-! UY1. 6 j- qj

Transcription

1 Received Littleton SEP ! 3 REPORT OF CON , C. R. S.) Full Name of /Person: I C)( n yl D J 1 As Shown On Registration J CITY CLERK fah n kakt-! UY1 Address of /Person: 4 6o \ tt/ t t`n' xlaie i City, State & Zip Code: t V1 g U l a 8 Type: s f Space Below For Office Use Only URES fefr Name and Address of Financial a 1 6 j- qj Institution lam'' 1 Qri nce,,, U ig SOS ID NUMBER( state and county committees): Type of Report SI, Regularly Scheduled Filing. Amended Filing. This amends previous report filed on( date) Submit changes or new information ONLY Termination Report. ( Termination Reports MUST Have a Monetary Balance of Zero in Line 5) 1 Check this box if this Report Contains Electioneering s Information Reporting Period Covered: i3 Through f : 1' eq{ 3 1 Declared Total Spending( if applicable) $ Art. XXVIII, Sec. 4( 1)] Date Totals Detailed Summary Page 1 Funds on Hand at the Beginning of Reporting Period( monetary only) 2 Total Monetary Contributions( line 11) 7(0 / 0 3 Total of Monetary Contributions& Beginning Amount( line 1 + line 2) C070 4 Total Monetary Expenditures( line 19) a 33(9, 5 Funds on Hand at the End of Reporting Period( monetary)( line 3 line 4) The appropriate officer( City Clerk) shall impose a penalty of$ 50 per day for each day that a report is filed late. Art. XXVIII Sec. l0(2)( a) I Authorization (Must be completed by either the Registered Agent OR the Candidate): I hereby certint and declare, under penalty ofperjuty, that to the best of my knowledge or beliefall contributions received during this reporting period, including any contributions received in the form ofmembership dues transferred by a membership organization, arefrom permissible sources. Date Print Registered Agent' s Name: de/ Y iet. 3 Registered Agent' s Signatu C' JC- / /' r Date: ' Print Candidate Name: r i

2 DETAILED SUMMARY Full Name of / Person: l9` 7 Y7 ( Z-1' o,, V7''7 Current Reporting Period: r w41,e Through 3 oe9/ 3 6.vf..., zy ; 0/3 Funds on hand at the beginning of reporting period( Monetary Only) $ 0 6 Itemized Contributions$ 20 or More [C. R. S. l ( 1)( a)] Please list on Schedule" A") J `, 7 Total of Non-Itemized Contributions Contributions of$ and Less) l' Loans Received Please list on Schedule" C") 9 Total of Other Receipts Interest, Dividends, etc.) 0 10 Returned Expenditures( from recipient) if Please list on Schedule" D") J" 11 Total Monetary Contributions Total of lines 6 through 10) Total Non- Monetary Contributions j From Statement ofnon-monetary Contributions) 13 Total Contributions c(-( 1,2 1, ( 0 - Line 11+ line 12) 14 Itemized Expenditures$ 20 or More [C.R.S ( 1)( a)] $ Please list on Schedule` B") Total of Non- Itemized Expenditures yr Expenditures of$ or Less) 16 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 & Political Parties only) 19 Total Monetary Expenditures Total of lines 14 through 17) c9130, 3 D,. ' 20 Total Spending Line 18+ line 19) J 3o

3 Schedule A Instructions NOTE: In addition to the reporting requirements of 1- specific type, as follows: , C. R. S., please note provisions for No political party shall accept aggregate contributions from any person, other than a small donor committee as described in paragraph ( b) of this subsection( 3), that exceed three thousand dollars per year at the state, county, district, and local level combined, and of such amount no more than twentyfive hundred dollars per year at the state level [ Art. XXVIII (Amendment 27)( Section 3. ( 3)( a)] Candidate, Issue, Political Party and Political ( PC) Required to disclose occupation and employer for all $ 100 or more contributions made by natural persons. ( Art. XXVIII, Sec. 7) Small Donor Accepts contributions of no more than $ 50 per year, FROM NATURAL PERSONS ONLY. Art. XXVIII, Sec. 2( 14)( a)] Electioneering s Reporting Required to disclose occupation and employer for all $250 or more contributions made by natural persons. ( Art. XXVIII, Sec. 6) Corporate and Labor Organization funding are prohibited. (Art. XXVIII, Sec. 6) Prohibitions on next page. Please refer to Article XXVIII, Section 3 of the Colorado Constitution for complete contribution limits and prohibited contributions.

4 PROHIBITED CONTRIBUTIONS Art. XXVIII, Sec. 3 & C. R.S ] No candidate' s candidate committee shall accept contributions from, or make contributions to, another candidate committee. No person shall act as a conduit for a contribution to a candidate committee. It shall be unlawful for a corporation or labor organization to make contributions to a candidate committee or a political party, and to make expenditures expressly advocating the election or defeat of a candidate; except that a corporation or labor organization may establish a political committee or small donor committee which may accept contributions or dues from employees, officeholders, shareholders, or members. No candidate committee, political committee, small donor committee, or political party shall knowingly accept contributions from: Any natural person who is not a citizen of the United States; A foreign government; or any foreign corporation that does not have the authority to transact business in this state pursuant to article 115 of title 7, C. R.S., or any successor section. No candidate committee, political committee, small donor committee, issue committee, or political party shall accept a contribution, or make an expenditure, in currency or coin exceeding one hundred dollars. No person shall make a contribution to a candidate committee, issue committee, political committee, small donor committee, or political party with the expectation that some or all of the amounts of such contribution will be reimbursed by another person. No person shall be reimbursed for a contribution made to any candidate committee, issue committee, political committee, small donor committee, or political party, nor shall any person make such reimbursement except as provided in subsection( 8) of this section. [ Art. XXVIII, Sec. 3( 8)]

5 Schedule A- Itemized Contributions Statement ($ 20 or more) C. R.S_ ( 1)( a)] Full Name of /Person: Join C DerIA. 1a W a-a.2t / Joh it LA.)a i' /' JJ L: 11-1 e' K WARNING: Please read the instruction page for Schedule " A" before completing! 4. Name( Last, First): /' T q +- woo r' 2. Contribution Amt. 1 D a `1 Co 1 tom' k- Z- 00 OU ( t fj 1, D 01.Z (' 3. Aggregate Amt. ADO- oa 7. Description: ACJY1C...6 Y1 pp 8. Employer( ifapplicable, mandatory): I ( e 6, / Electioneering 9. Occupation (if applicable, mandatory): r' e h re d i 4. Name( Last, First): 6 tr e' e.t t la t l) Cx 1/ 1 l/ 1 Z15 f 2. Contribution Amt. p J D ti 1 Z 0(7 U` L, i Cf, W b(: ( O? 7. Description: ( tcry1ma. 1Ytk BBD 8. Employer( if applicable, mandatory): r{? Electioneering 9. Occupation( if applicable, mandatory): h t(e. j I 4. Name( Last, First): Rue p red 2. Contribution Amt t44 c\a,t A\ tc I OCR' 00 L l 1 W 1 2 Z' C) 7. Description: d C CJY\ 8. Employer( if applicable, mandatory): 1 t^ e d Electioneering 9. Occupation( if applicable, mandatory): r-e d t 1 t ` ` 4. Name( Last, First): V/ eb Va. U Cl_V1. l 1 2. Contribution Amt. 4 C' po V\ O- -62 ill"& ( a L gip I a? 16: 07`4 itx r 7. Description: C CrY\O-k ( Sly, &i N'V web J I-, 8. Employer( if applicable, mandatory): l. Vl/ Chl) A Electioneering 9. Occupation( if applicable, mandatory): 1`. ka4ite_t 2 yqu+i( n ut)-e b hoc3fi k Vl (,;( Y1 L ZrVI CUỳv(

6 Schedule A- Itemized Contributions Statement($ 20 or more) C. R. S ( 1)( a)] Full Name of / Person: JOh vl Oefuja5 Wate'IYI ) hyi(a v)refy ' 1K WARNING: Please read the instruction page for Schedule " A" before completing! i r 4. Name( Last, First):.\ Ai G{Y) rka LC VtfLL 2. Contribution Amt. D 1 b b C 7 b 1 t*l J 1Y t 7. Description: CAfJYll c R 8. Employer( if applicable, mandatory): U...)(1/ l ae Yt..) Electioneering 9. Occupation( if applicable, mandatory): phew? i - A -- f OE,-/ 4. Name( Last, First): ec, De1) 1t ]] 2. Contribution Amt. At QO C Pc 0 2L d L cv_ z00, 00 ke1y1 F. 7. Description: YIC.- l OY1 8. Employer( if applicable, mandatory): L t c' LAJ d Electioneering 9. Occupation ( if applicable, mandatory): t& A / OU_5Y 4. Name( Last, First): `` vy P? i''. 2. Contribution Amt. Z '4 t C C Qt.- 1, a( i(( a t-cj M, Description: CkaY)Ck C\ 8. Employer( if applicable, mandatory): ACC"e- P SA-- Electioneering 9. Occupation( if applicable, mandatory): () Pei) l Or:/ 1/14 p 4. Name( Last, First): C Z k ) 2. Contribution Amt A GL.v- N 1 -- C LICE n 0 6. City/State/Zip: (-- C.-- g O ` 5t 0 7. Description: CA CfY CN\ 8. Employer( if applicable, mandatory): r t.-. Electioneering 9. Occupation( if applicable, mandatory): 1

7 Schedule A- Itemized Contributions Statement($ 20 or more) C. R. S. l ( l)( a) 1 Full Name of erson: ' John U: G` xjyi fi n ohv Ocruda S 7 WARNING: Please read the instruction page for Schedule " A" before completing! 0 2. Contribution Amt. ( 0 4. Name( Last, First): 1 ` / LIZ.iff1 ji 5IICQ i' J!- J L t1f.kcpv Description: C Nvyaher' Employer( ifapplicable, mandatory): l. Q./ d Electioneering 9. Occupation( if applicable, mandatory): i%/''- t `. 4. Name( Last, First): V) WIC, 2. Contribution Amt. LQS 4(12 6.,( R, r I LOO. 00 L D DC Electioneering 7. Description: cli2mo CNV_. 8. Employer( if applicable, mandatory): / / 9. Occupation( if applicable, mandatory): C O\ re d t'' f-p Q' i 4. Name( Last, First): 6 rb ē, j( L4V) n // 2. Contribution Amt. to k' i ot,. 1Pes v j' 4-50 :00 (: C }' t-kf%yl 95Q 7. Description: CA,N,- tr, 8. Employer( if applicable, mandatory): re- 1+ Electioneering 9. Occupation( if applicable, mandatory): Y` Ch`_ 4. Name( Last, First): CA abi, wr g 3013 r kr 2. Contribution Amt. S -LC) ki`q/ lt' t-" l 00 ({, 1 C/ v 1 3. Aggregate Amt. 7. Description: y^y.x- 1 G OY\ i' 8. Employer( if applicable, mandatory): 1 a/ vv _ 1 CO Xa 0 Electioneering 9. Occupation( if applicable, mandatory): L

8 Schedule A- Itemized Contributions Statement($ 20 or more) Full Name of /Person: thl/1.f,j Yl 1CLTt(L Jofri in jl1. a WARNING: Please read the instruction page for Schedule " A" before completing! c,/ o Name( Last First)// bi Yi 4 g1 LL` r l 2. Contribution Amt. ' J, dedarr JV J City/State/ Zip: //Vl 6 KO 01.. I Q Aggregate Amt. * 7. Description: C`,( ll'1ay e 8. Employer( if applicable, mandatory): --, Jc(rnGQ Electioneering 9. Occupation( if applicable, mandatory): ca/ V ch.e5 44 li 3o Name( Last, First): Pe j/ b i' et y 2. Contribution Amt a1 0.)0.) E p t P F- OO 0v L 61 (. 7. Description: dq l-1,c, l O I- Q 8. Employer( if applicable, mandatory): l I ' 15 I{) C-. Electioneering 9. Occupation( if applicable, mandatory): Pt v- ir) Dt re ' tinr- O r A 4. Name( Last, First): / 4 bj}' 71, /( 6 2. Contribution Amt. ( a ( Q/ 6&Y(' l WOd I I 9 00 L/ e-, 7. Description: dem Gam /' 6-4,$ 8. Employer( if applicable, mandatory): 2di r d Electioneering 9. Occupation( if applicable, mandatory): r\e- 1` /`- d i FO ) a Name( Last, First): ate n,. / All e / 2 i ` J, v 2. Contribution Amt.? 3o f 60.ob 6. Aggregate Amt. * 1% 7. Description: C City/ State/ Zip: L`7im GO go 1 0 bn 8. Employer( if applicable, mandatory): 6/(. Electioneering 9. Occupation( if applicable, mandatory): j, ' `/ ci

9 Schedule A- Itemized Contributions Statement ($20 or more) C. R. S ( 1)( a)] Full Name of / Person: Jain n d- m Czt, t-i-lcitil / Jevi n i WARNING: Please read the instruction page for Schedule " A" before completing! PLEASE PRINT/ TYPE 9' N I 2. Contribution mt. l 4-1 I W 7-() A-- 4. Name( Last, First): U MOO L- L' 7. Description: 8. Employer( if applicable, mandatory): 9. Occupation (if applicable, mandatory): Electioneering Lt d t WI 2-V ell kilā,, i i f j. 4. Name( Last, First): i ' W Y- t " 1 ly I g V.1} ci W1& P ( A ci I L"0. CA: ( t,1uy1, L La Contribution Amt. A egate Amt. * 7. Description: 101A-Ct (. 1 NA- 8. Employer( if applicable, mandatory): NQ, 1/ e. Electioneering 9. Occupation( if applicable, mandatory): If- Q k 1 4,. 4. Name( Last, First):.) h et6/ 1) ej ` e / e Ci/ C 2. Contribution Amt. `' W6/ 6j 5. C/!a.- I 3v (- i? ilf2. v 0 r 7. Description: C'vOY)C El Electioneering 8. Employer( if applicable, mandatory): 9. Occupation (if applicable, mandatory): 1 tfired C 1.'61, l3 2. Contribution Amt. 7* C0 CRJ / 4 r/ Zp atl ' 1 97 Li 7 L 17% 1 / r/ Y7 09 i 4. Name( Last, First): 6th-f02/ Vet ( C) 4 1/), Cllet Mi& 7. Description: *. f,` 7///:/ "). eza e no f4 I C ĊI 0)4 it- 16-() L1 37 / ti Od3 Ce..6-: "//ti 8. Employer( if applicable, mandatory): "` Electioneering 9. Occupation( if applicable, mandatory):, r. 446,7 6` 7(7

10 Schedule A- Itemized Contributions Statement($ 20 or more) C. R. S ( 1)( a)] Full Name of / Person: n CC, Dy, tcv- 1I/ / ad WARNING: Please read the instruction page for Schedule " A" before completing! i 4. Name( Last, First): %.---, 4 J V 11 i0 ; / 3 2. Contribution Amt. 6 L66 C,J O fl d d ōo. Dv tt 7. Description: l_v l e-22 ( Jf 8. Employer( if applicable, mandatory): 0"`., 7`- e.d Electioneering 9. Occupation( if applicable, mandatory): r.e. fri /"{- 01 _! 3 y, 4. Name( Last, First): S 1 2. Contribution Amt ). P J.'eir5 D" 3. Aggregate Amt. l" 676/ av 7. Description: C11-P/ YC..Cx.- - r.(fy(_, 8. Employer( if applicable, mandatory): l/a Ct Electioneering 9. Occupation( if applicable, mandatory): ff7/4 d n i / 3 4. Name( Last, First): '' 6f t, 2. Contribution Amt. r 3 CJ c.<j / 1/4, 2,( Yj 5-0 v L i'. VittA Description: C ) U v l () 8. Employer( if applicable, mandatory): 1 P-6 CI Electioneering 9. Occupation (if applicable, mandatory): x,17 p.e, d 4 Name( Last First): Y T 17 /3. 2. Contribution Amt. 7U q? 5 eo h l 9o" ov Gt illeir/y/ 1 r0 I -e 7. Description: r 0 Electioneering 8. Employer( if applicable, mandatory): reii- U! 9. Occupation (if applicable. mandatory): i`.

11 Schedule A- Itemized Contributions Statement($ 20 or more) C. R. S ( 1)( a)] Full Name of /Person: WARNING: Please read the instruction page for Schedule " A" before completing! 1. Date Acce ted M, J5 4. Name( Last, First): - vl-(i(/ t. l3 2. Contribution Amt. ( IS 77 3 /-/! lei., COt- DO- DO C! f tirm Y O/ c2 V 7. Description: p lj n 1, Q 8. Employer( if applicable, mandatory): i--66-' L Electioneering 9. Occupation( if applicable, mandatory): re /'Z " e- U 1 n / /-- 4. Name( Last, First): A l der l (. Y] C rt Contribution Amt. 0 LI q W h,e -, d, e., - 1d d'"/ 00 1/ 116- fr-4 1 to V0 0 Aggregate Amt. * 7. Description: C Q-f 7 del. 8. Employer( if applicable, mandatory): e ft,at.ci Electioneering 9. Occupation( if applicable, mandatory): re 1 /` e l / 9, 1 5 4_ Name( Last, First): r-/ l'c " C' vi ci' Z i 2. Contribution Amt. f i ti /. 5 C,C..!` 7j J77 r' DO. 00 I r tfeie.ḟ i 1-V- 7. Description: Cjervl4 h.c'7y( goe) 6C 8. Employer( if applicable, mandatory): f eti p1/ 4- e Cl' Electioneering 9. Occupation( if applicable, mandatory): r ē /- 7 i' 4. Name( s Last, First): C' 2. Contribution Amt. 67- c 5 hj "$- Oa% CO 1%I Iz 'i 0 XV/ 7 3. Aggregate Amt. C " C, 7. Description: de'yu0 J 7l'''l 8. Employer( if applicable, mandatory): 0. /1)dO0 6 2_ 11Z' Electioneering 9. Occupation( if applicable, mandatory):,/, A 7 fc//a' Yt. 1' j

12 I Schedule A- Itemized Contributions Statement($ 20 or more) C. R.S. l ( l)( a)] Full Name of / Person: J[>0 i'1a_90../ 00Y) 6 M4v( WARNING: Please read the instruction page for Schedule " A" before completing! 1. Date Accepted 4 Name( Last, First): ti 2. Contribution Amt. 11(4, q 6. City/State/ Zip: G Description: G GQ,, 8. Employer( ifapplicable, mandatory): 9"e/ o Electioneering 9. Occupation( if applicable, mandatory): / Lh Aid p4 rndi h` y 4, C. 10; ) 4. Name( Last, First): 4/ h ė-/ l C 1,, g ; / 2. Contribution Amt. Q f1 MOO c1 / r C c 0 0 [ fir Description: C / l,a/ ZI/ YL, Electioneering 8. Employer( if applicable, mandatory): 9. Occupation( if applicable, mandatory): 1. Date opted 4. Name( Last, First): Q y 2. Contribution Amt. 0) L` )`ftt/ n' i1 GD 7O/ O Electioneering 7. Description: 8. Employer( if applicable, mandatory): Poi 9. Occupation( if applicable, mandatory): n y /- -,, 4. Name( Last, First): 2. Contribution Amt. Electioneering 7. Description: 8. Employer( if applicable, mandatory): 9. Occupation( if applicable, mandatory):

13 rt Schedule B- Itemized Expenditures Statement ($20 or more) l ( l)( a). C. R. S.] Full Name of / Person:. Oh( 1 J6'1 n IJ cyi L.ill&k n c'; 1 2. I c. 6 I ,LI 5. Pc i(\c=e, "- i- -- t I a 0 Recipient is( optional): El Pri la k 6 f C 1'P C K 5 y' i, Electioneering va 'vi. J,/ y 6?- 7 d 3 q W. Q.t b 6f- " c ile, Q2a 7 II q Zi'f - Go I lac I et f\e/n' 2i%z i& e.. 1'% 0 Electioneering q j ' i i<a el( kepil; rcat, de/ e' Az i k 5960 IW ba r n9 di 1)/ C El 1& 1' e^cg r1c..rvl. ' j Eel Electioneering 9, 6. / 5 y / 114")116 yv 0f d n 3-% k,,` a'i4` 3r; juipi, 207$ / 76/ c;, 0 '/ Arci 6i q. / q. /3 560.oo Electioneering CabrO It C 6g.Uri.Lt 42 CI; C(...) q/ i Cj p A C. lli d I la:4( i6 2' y el) / i/ We/ 0Y) / 1`7 iee1/ 7 C( 4- Z4-. 4c I r.:. 6L(.4t ' cwo a Electioneering

14 Schedule B- Itemized Expenditures Statement($ 20 or more) ( I)( a), C. R.S.] Full Name of / Person: 1. Date Ex ended I f l ` sf j oo of) 7 a 1f.: 26 I OO 0( YC7 elr' ' la vif Zo. I Electioneering 417,0142e VLy 369 6? ma / h C I l, le G< t-/- I l CC i GO MO 0 t Electioneering Electioneering Electioneering Electioneering

15 Schedule B- Itemized Expenditures Statement($ 20 or more) I ( l)( a), C. R. S.] Full Name of / Person: Electioneering Electioneering Electioneering 4_ Name: Electioneering 6. City/State/ Zip: Electioneering

16 Schedule B- Itemized Expenditures Statement($ 20 or more) l ( 1)( a). C. R. S.] Full Name of / Person: Electioneering Electioneering Electioneering 6. City/State/Zip: Electioneering Electioneering

17 Schedule B - Itemized Expenditures Statement($ 20 or more) ( 1)( a), C. R. S.] Full Name of / Person: Electioneering Electioneering Electioneering Electioneering Electioneering

18 Schedule B- Itemized Expenditures Statement($ 20 or more) I ( 1)( a), C. R. S.] Full Name of / Person: Electioneering Electioneering Electioneering Electioneering Electioneering

19 Schedule B- Itemized Expenditures Statement($ 20 or more) ( 1)( a), C. R. S.] Full Name of / Person: Electioneering Electioneering 6. City/State/ Zip: Electioneering 6. City/State/ Zip: Electioneering Electioneering

20 Schedule B- Itemized Expenditures Statement($ 20 or more) ( 1)( a). C. R.S. j Full Name of / Person: 6. City/State/ Zip: Electioneering 6. City/State/ Zip: Electioneering Electioneering Electioneering Electioneering

21 Schedule C - Loans Full Name of / Person: Wr l Gc. LOANS- Loans Owed by the 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 Name ( Last, First or Institution): Address: City/ State/Zip: Original Amount of Loan: $ Interest 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: $ 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: Date Loan Received Due Date for Final Payment LIST ALL ENDORSERS OR GUARANTORS OF THIS LOAN Full Name Address, City, State, Zip Amount Guaranteed

22 Schedule D Returned Contributions & Expenditures Full Name of / Person: Returned Contributions Previously reported on Schedule A Contributions accepted and then returned to donors) PLEASE PRINT/ TYPE 4. Name( Last, First): 2. Date Returned 3. Amount 7. Purpose: 4. Name( Last, First): 2. Date Returned 3. Amount 7. Purpose: Returned Expenditures Previously reported on Schedule B Expenditures returned or refunded to the committee) 4. Name( Last, First): 2. Date Returned 3. Amount 7. Comment( Optional): 4. Name( Last, First): 2. Date Returned 3. Amount 7. Comment( Optional):

23 Statement of Non- Monetary Contributions Art. XXVIII, Sec. 2( 5)( a)( II)( III)& Sec. 5( 3)& ( 1), C. R.S.] Full Name of / Person: hn t 11 L p) 471 l63 PLEASE PRINT/ TYPE h d iri de/net/5 ' 5r d Lrr 1. Date Provided 4. Name( Last, First): 2. Fair Market Value 3. Aggregate Amt. Description: 8. Employer( if applicable, mandatory): Electioneering 9. Occupation( if applicable, mandatory): 10. Coordinated with a Candidate/ Candidate or Political Party. * 1. Date Provided 4. Name( Last, First): 2. Fair Market Value 3. Aggregate Amt. Description: 8. Employer( if applicable, mandatory): Electioneering 9. Occupation( if applicable, mandatory): 10. Coordinated with a Candidate/ Candidate or Political Party. * 1. Date Provided 4. Name( Last, First): 2. Fair Market Value 3. Aggregate Amt. Description: 8. Employer( if applicable, mandatory): Electioneering 9. Occupation( if applicable, mandatory): 10. Coordinated with a Candidate/ Candidate 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."