State of Rhode Island and Providence Plantations

Size: px
Start display at page:

Download "State of Rhode Island and Providence Plantations"

Transcription

1 State of Rhode Island and Providence Plantations Board of Elections Campaign Finance Division 5 Branch Avenue, Providence, Rhode Island 294 Tel. (41) Fax (41) SUMMARY OF CAMPAIGN ACTIVITY Name of Candidate, Political Party, Political Action Committee JUAN M PICHARDO Key# ATLANTIC AVENUE Mailing Address (if different) City/Town, State and Zip Code PROVIDENCE, RI 297 City/Town, State and Zip Code Telephone Number Daytime Telephone Number Fax Number (41) If Candidate Office Sought: State Senator, State Senator, State Senator, State Senator, State Senator, Stat Party Affiliation if any: Reporting Period (Dates): Period Beginning: 4/1/215 Period Ending: 6/3/215 SUMMARY OF ACTIVITY FOR PERIOD 1. Beginning Cash Balance $ 1, Cash Disbursements, continued 2. Cash Receipts f. Other Disbursements a. Contributions From: 1. Aggregate 2,58. a. (s) 2,58. b. (Political Parties) 5. Ending Cash Balance $ 5,13.14 c. (Political Action Committees) 2. s 1,5. 3. Political Parties 4. Political Action Committees 1, Loan Proceeds 6. Payroll off 7. Interest Received 8. State Off 9. Refund/Rebate 1. Party Building 11. Matching Public Funds 12. Other 13. Returned Contributions 14. Returned s b. Other: 3. Total Cash 6, Cash Disbursements a. Aggregate Expenses b. Campaign Expenses 1,68.66 c. Repayment of Loans d. Account Payable Repayments e. Other CAMPAIGN FUND STATUS 6. Report of In-Kind Contributions 7. Cash $ 5, Other Assets 9. Total Assets $ 5,13.14 LIABILITIES AND FUND BALANCE 1. Liabilities a. Accounts Payable b. Loans Payable c. Other Liabilites $ 14, , Total Liabilities 3, Total Fund Balance $(24,931.27) 13. Total Liability / Fund Balance 5,13.14 CF-2 Rev. 3/2

2 Name of Person Filing Report I HEREBY CERTIFY THAT THIS REPORT OF CAMPAIGN CONTRIBUTIONS AND EXPENDITURES AND THE SUPPORTING DOCUMENTS ARE TRUE AND CORRECT. Title of Person Filing Report X Signature of Person Date Address of Person Filing This Report SUBSCRIBED AND SWORN TO BEFORE ME THIS Day of 2 X Notary Public

3 Key # 4,6 Full Name of Candidate or Committee JUAN M PICHARDO SCHEDULE OF CONTRIBUTIONS RECEIVED Reporting Period From: 4/1/215 To: 6/3/215 Other Aggregate - 6/1/215 6/1/215 2,58. Various aggregated contributions from individuals under $1. 5/12/215 6/1/ Rosa 82 Ralph St. Hernandez Providence RI 299 Retired 82 Ralph St. Providence RI 299 6/5/215 6/1/ Gianfranco 134 Atwells Ave. Marrocco Providence RI 293 Marrocco Group Providence RI 293 6/24/215 6/26/ Susan 211 Jacob St. Mills Seekonk MA Mills Coffee Broad St. Providence RI 297

4 6/5/215 6/13/ Joseph W 26 Crawford Ave. Walsh Warwick RI 2889 Government Strategies Inc 335 Centerville Rd, Bldg 4 Warwick RI /22/215 6/24/ Gayle J. 2 King Philip Rd Wolfe Narragansett RI 2882 Government Strategies Inc RI 6/8/215 6/13/ ATU COPE SPECIAL HOLDING ACCOUNT (Ama 525 WISCONSIN AVENUE NW WASHINGTON DC 216 6/8/215 6/13/ CARE OF BLUE CROSS & BLUE SHIELD OF 5 EXCHANGE ST PROVIDENCE RI 293 6/5/215 6/1/ COVENTRY TEACHERS ALLIANCE LOCAL 17 3 HAZEL STREET COVENTRY RI 2816

5 6/5/215 6/1/ CRANSTON FIREFIGHTERS LOCAL 1363 COPE P.O. BOX 1358 CRANSTON RI 291 6/5/215 6/1/ IBEW LOCAL 99 (International Brotherhood o 22 AMFLEX DRIVE CRANSTON RI /5/215 6/1/ One Providence One Park Row, 5th Floor Providence RI 295 6/11/215 6/13/ PROVIDENCE TEACHERS COPE 99 CORLISS STREET PROVIDENCE RI 294 6/5/215 6/13/ RI AFL-CIO 194 SMITH STREET PROVIDENCE RI 298

6 6/13/215 6/13/ RI ASSOCIATION OF NURSE ANESTHETISTS PA 1 WORTHINGTON ROAD CRANSTON RI 292 6/5/215 6/1/ RI FEDERATION OF TEACHERS COPE 356 SMITH STREET PROVIDENCE RI 298 6/5/215 6/1/ RI HOSPITALITY C/O DALE VENTURINI CRANSTON RI 291 6/19/215 6/26/ RI LABORERS' PUBLIC EMPLOYEES 41 SOUTH MAIN STREET PROVIDENCE RI 293 6/5/215 6/1/ TWIN RIVER (formerly Lincoln Park ) 1 TWIN RIVER ROAD LINCOLN RI 2865 CF-3 Rev. 3/2

7 SCHEDULE OF EXPENDITURES Key # Full Name of Candidate or Committee Reporting Period 4,6 JUAN M PICHARDO From: 4/1/215 To: 6/3/215 # Expenditure Date Payment Date Disbursement Type 5/8/215 Aggregate Expenditure Other $ various expenses under $1. Food, Gas, bank fees, taxi # Expenditure Date Payment Date Disbursement Type 6/4/215 Campaign Expenditure Fundraising Expenses $ Food for fundraiser Brass Monkey Restaurant 8 Allens Ave. Providence RI 295 # Expenditure Date Payment Date Disbursement Type /7/215 Campaign Expenditure Donations (All Others) $5. Donation for Miss. RI - Anea Garcia Anea Garcia 48 Castle Drive Cranston RI 292 # Expenditure Date Payment Date Disbursement Type 5/7/215 Campaign Expenditure Other $147. Web Page Nation Builder 52 S Grand Ave. 2flr Los Angeles RI 971 # Expenditure Date Payment Date Disbursement Type 5/11/215 Campaign Expenditure Fundraising Expenses $397. Stamps

8 USPS 24 Corliss St. Providence RI 294 CF-4 Rev.3/2

State of Rhode Island and Providence Plantations

State of Rhode Island and Providence Plantations State of Rhode Island and Providence Plantations Board of Elections Campaign Finance Division 5 Branch Avenue, Providence, Rhode Island 294 Tel. (41)222-2345 Fax (41)222-4424 www.elections.state.ri.us

More information

State of Rhode Island and Providence Plantations

State of Rhode Island and Providence Plantations State of Rhode Island and Providence Plantations Board of Elections Campaign Finance Division 5 Branch Avenue, Providence, Rhode Island 294 Tel. (41)222-2345 Fax (41)222-4424 www.elections.state.ri.us

More information

State of Rhode Island and Providence Plantations

State of Rhode Island and Providence Plantations State of Rhode Island and Providence Plantations Board of Elections Campaign Finance Division 5 Branch Avenue, Providence, Rhode Island 294 Tel. (41)222-2345 Fax (41)222-4424 www.elections.state.ri.us

More information

State of Rhode Island and Providence Plantations

State of Rhode Island and Providence Plantations State of Rhode Island and Providence Plantations Board of Elections Campaign Finance Division 5 Branch Avenue, Providence, Rhode Island 294 Tel. (41)222-2345 Fax (41)222-4424 www.elections.state.ri.us

More information

State of Rhode Island and Providence Plantations

State of Rhode Island and Providence Plantations State of Rhode Island and Providence Plantations Board of Elections Campaign Finance Division 5 Branch Avenue, Providence, Rhode Island 294 Tel. (41)222-2345 Fax (41)222-4424 www.elections.state.ri.us

More information

State of Rhode Island and Providence Plantations

State of Rhode Island and Providence Plantations State of Rhode Island and Providence Plantations Board of Elections Campaign Finance Division 5 Branch Avenue, Providence, Rhode Island 294 Tel. (41)222-2345 Fax (41)222-4424 www.elections.state.ri.us

More information

State of Rhode Island and Providence Plantations

State of Rhode Island and Providence Plantations State of Rhode Island and Providence Plantations Board of Elections Campaign Finance Division 5 Branch Avenue, Providence, Rhode Island 294 Tel. (41)222-2345 Fax (41)222-4424 www.elections.state.ri.us

More information

State of Rhode Island and Providence Plantations

State of Rhode Island and Providence Plantations State of Rhode Island and Providence Plantations Board of Elections Campaign Finance Division 5 Branch Avenue, Providence, Rhode Island 294 Tel. (41)222-2345 Fax (41)222-4424 www.elections.state.ri.us

More information

State of Rhode Island and Providence Plantations

State of Rhode Island and Providence Plantations State of Rhode Island and Plantations Board of Elections Campaign Finance Division 5 Branch Avenue,, Rhode Island 294 Tel. (41)222-2345 Fax (41)222-4424 www.elections.state.ri.us SUMMARY OF CAMPAIGN ACTIVITY

More information

State of Rhode Island and Providence Plantations

State of Rhode Island and Providence Plantations State of Rhode Island and Providence Plantations Board of Elections Campaign Finance Division 5 Branch Avenue, Providence, Rhode Island 294 Tel. (41)222-2345 Fax (41)222-4424 www.elections.state.ri.us

More information

State of Rhode Island and Providence Plantations

State of Rhode Island and Providence Plantations State of Rhode Island and Providence Plantations Board of Elections Campaign Finance Division 5 Branch Avenue, Providence, Rhode Island 294 Tel. (41)222-2345 Fax (41)222-4424 www.elections.state.ri.us

More information

State of Rhode Island and Providence Plantations

State of Rhode Island and Providence Plantations State of Rhode Island and Providence Plantations Board of Elections Campaign Finance Division 5 Branch Avenue, Providence, Rhode Island 294 Tel. (41)222-2345 Fax (41)222-4424 www.elections.state.ri.us

More information

State of Rhode Island and Providence Plantations

State of Rhode Island and Providence Plantations State of Rhode Island and Providence Plantations Board of Elections Campaign Finance Division 5 Branch Avenue, Providence, Rhode Island 294 Tel. (41)222-2345 Fax (41)222-4424 www.elections.state.ri.us

More information

State of Rhode Island and Providence Plantations

State of Rhode Island and Providence Plantations State of Rhode Island and Providence Plantations Board of Elections Campaign Finance Division 5 Branch Avenue, Providence, Rhode Island 294 Tel. (41)222-2345 Fax (41)222-4424 www.elections.state.ri.us

More information

State of Rhode Island and Providence Plantations

State of Rhode Island and Providence Plantations State of Rhode Island and Providence Plantations Board of Elections Campaign Finance Division 5 Branch Avenue, Providence, Rhode Island 294 Tel. (41)222-2345 Fax (41)222-4424 www.elections.state.ri.us

More information

Campaign Finance & Public Disclosure Board

Campaign Finance & Public Disclosure Board Campaign Finance & Public Disclosure Board First Floor South. Centennial Office Building. 658 Cedar Street. St. Paul MN 55155-1603. 800/657-3889. TTY 800/657-3529 Committee Information: Report of Receipts

More information

CAMPAIGN FINANCE REPORT WISCONSIN LOCAL COMMITTEE

CAMPAIGN FINANCE REPORT WISCONSIN LOCAL COMMITTEE COMMITTEE IDENTIFICATION Name of Committee CAMPAIGN FINANCE REPORT WISCONSIN LOCAL COMMITTEE Is this report an Amendment? n Yes Anna for Dane Address P.O. Box 6094 City, State, ZIP Monona, WI, 53716 OFFICE

More information

Annual Event Financial Accounting Report For Events More Than $5,000

Annual Event Financial Accounting Report For Events More Than $5,000 Annual Event Financial Accounting Report For Events More Than $5,000 Tre Hargett Secretary of State Division of Charitable Solicitations, Fantasy Sports, and Gaming Department of State State of Tennessee

More information

TRANSMITTAL INFORMATION For All Business Filings

TRANSMITTAL INFORMATION For All Business Filings JAY DARDENNE SECRETARY OF STATE STATE OF LOUISIANA SECRETARY OF STATE Commercial (225) 925-4704 (225) 922-0435 Fax Administrative Services (225) 925-4704 (225) 925-4726 Fax Uniform Commercial Code (225)

More information

CANDIDATE S REPORT. (to be filed by a candidate or his principal campaign committee) 40th day after general. Annual (future election)

CANDIDATE S REPORT. (to be filed by a candidate or his principal campaign committee) 40th day after general. Annual (future election) CANDIDATE S REPORT (to be filed by a candidate or his principal campaign committee) 1.Qualifying Name and Address of Candidate 4011 Laurel St. New Orleans, LA 70118 2. Office Sought (Include title of office

More information

1 Name of organization Employer identification number Patriot Majority

1 Name of organization Employer identification number Patriot Majority A For the period beginning 10/18/2012 and ending 11/26/2012 B Check applicable box: Initial report Change of address Amended report Final report 1 Name of organization Employer identification number Patriot

More information

CAMPAIGN FINANCE REPORT WISCONSIN LOCAL COMMITTEE

CAMPAIGN FINANCE REPORT WISCONSIN LOCAL COMMITTEE CAMPAIGN FINANCE REPORT WISCONSIN LOCAL COMMITTEE Is this report an Amendment? YES NO NO COMMITTEE IDENTIFICATION Name of Committee Amos Roe for School Board Address PO Box City, State, ZIP Madison WI

More information

Texas Ethics Commission P.O.Box Austin, Texas (512) Steve. Salazar. Rosario. Rodriguez

Texas Ethics Commission P.O.Box Austin, Texas (512) Steve. Salazar. Rosario. Rodriguez CANDIDATE / OFFICEHOLDER FORM C/OH CAMPAIGN FINANCE REPORT Cover Sheet pg 1 The C/OH Instruction Guide explains how to complete this form. 3. CANDIDATE / OFFICEHOLDER NAME 1. ACCOUNT # (Ethics Commission

More information

CAMPAIGN CONTRIBUTION AND EXPENDITURE REPORT For County, Municipal and School Board Candidates

CAMPAIGN CONTRIBUTION AND EXPENDITURE REPORT For County, Municipal and School Board Candidates CAMPAIGN CONTRIBUTION AND EXPENDITURE REPORT For County, Municipal and School Board Candidates Check if this report is an amendment This report should be filed with the County Clerk of the county in which

More information

CAMPAIGN FINANCE REPORT WISCONSIN LOCAL COMMITTEE

CAMPAIGN FINANCE REPORT WISCONSIN LOCAL COMMITTEE CAMPAIGN FINANCE REPORT WISCONSIN LOCAL COMMITTEE Is this report an Amendment? YES NO COMMITTEE IDENTIFICATION Name of Committee Friends of Kelly Danner Address 3553 Heather Crest City, State, ZIP Madison,

More information

Office of the Auditor General

Office of the Auditor General EMPLOYEES' RETIREMENT SYSTEM OF THE STATE OF RHODE ISLAND Employees Retirement System Cost-Sharing Plan Schedules of Employer Allocations Schedules of Pension Amounts by Employer (for Fiscal 2018 Employer

More information

Employees Retirement System of Rhode Island

Employees Retirement System of Rhode Island ANNUAL CONTINUING STATEMENT This Continuing Statement must be completed and submitted to the person referenced below on or before June 1, 2018 except for the Medical Update which may be submitted at any

More information

FINAL CAMPAIGN CONTRIBUTION AND EXPENDITURE REPORT For State and District Candidates Only For assistance in completing

FINAL CAMPAIGN CONTRIBUTION AND EXPENDITURE REPORT For State and District Candidates Only For assistance in completing FINAL CAMPAIGN CONTRIBUTION AND EXPENDITURE REPORT For State and District Candidates Only To be filed with: Mark Martin, Secretary of State For assistance in completing this form contact: Arkansas Ethics

More information

EMPLOYEES' RETIREMENT SYSTEM OF THE STATE OF RHODE ISLAND

EMPLOYEES' RETIREMENT SYSTEM OF THE STATE OF RHODE ISLAND EMPLOYEES' RETIREMENT SYSTEM OF THE STATE OF RHODE ISLAND Employees Retirement System Cost-Sharing Plan Schedules of Employer Allocations Schedules of Pension Amounts by Employer June 30, 2016 Measurement

More information

Name of Applicant Soc Sec # _ / / Marital Status (Circle One): Single Married Divorced Widow(er) Name of Spouse Date of Birth / / Soc Sec # _ / /

Name of Applicant Soc Sec # _ / / Marital Status (Circle One): Single Married Divorced Widow(er) Name of Spouse Date of Birth / / Soc Sec # _ / / PLAN NUMBER 766570 20 IBEW LOCAL 102 SURETY FUND C/O I.E. SHAFFER & CO. 830 BEAR TAVERN RD 2 ND FLOOR PO BOX 1028 TRENTON NJ 08628-0230 PHONE (800)792-3666 FAX (609) 883-7560 Application for Benefits (Please

More information

CANDIDATE S REPORT. (to be filed by a candidate or his principal campaign committee) 40th day after general. Annual (future election)

CANDIDATE S REPORT. (to be filed by a candidate or his principal campaign committee) 40th day after general. Annual (future election) CANDIDATE S REPORT (to be filed by a candidate or his principal campaign committee) 1.Qualifying Name and Address of Candidate 481 John Edwards Rd. 2. Office Sought (Include title of office as well LA

More information

application for separation refund

application for separation refund application for separation refund IMRF Form 5.10 (Rev. 01/08) separation refunds This application is for a total refund of your IMRF member contributions. You should file this form only if you are not

More information

CANDIDATE S REPORT. (to be filed by a candidate or his principal campaign committee) 40th day after general. Annual (future election)

CANDIDATE S REPORT. (to be filed by a candidate or his principal campaign committee) 40th day after general. Annual (future election) CANDIDATE S REPORT (to be filed by a candidate or his principal campaign committee) 1.Qualifying Name and Address of Candidate 2. Office Sought (Include title of office as well LA House Union/Lincoln 12

More information

Officeholder/Candidate Information 1. Name of Officeholder/Candidate

Officeholder/Candidate Information 1. Name of Officeholder/Candidate CAMPAIGN CONTRIBUTION AND EXPENDITURE REPORT FOR DEBT RETIREMENT Year of Election: (Note: This is the year of the election for which you are seeking to retire campaign debt) NOTE: The campaign contribution

More information

State of Rhode Island and Providence Plantations DEPARTMENT OF BUSINESS REGULATION Division of Insurance 233 Richmond Street Providence, RI 02903

State of Rhode Island and Providence Plantations DEPARTMENT OF BUSINESS REGULATION Division of Insurance 233 Richmond Street Providence, RI 02903 State of Rhode Island and Providence Plantations DEPARTMENT OF BUSINESS REGULATION Division of Insurance 233 Richmond Street Providence, RI 02903 INSURANCE REGULATION 62 PLAN OF AUTOMOBILE INSURANCE RATING

More information

IDENTITY THEFT PACKET

IDENTITY THEFT PACKET IDENTITY THEFT PACKET Teller # Date Received: Account Number: IDENTITY THEFT PACKET 1 Valued Member: Thank you for contacting Educational System Federal Credit Union regarding the suspected theft of your

More information

COMMITTEE OR FUND INFORMATION REPORT OPTIONS

COMMITTEE OR FUND INFORMATION REPORT OPTIONS Minnesota Campaign Finance and Public Disclosure Board Suite 190. Centennial Office Building. 658 Cedar Street. St. Paul MN 55155-1603. www.cfboard.state.mn.us Email at: cfb.reports@state.mn.us. Report

More information

Wisconsin Department of Regulation & Licensing

Wisconsin Department of Regulation & Licensing Mail To: P.O. Box 8935 1400 E. Washington Avenue Madison, WI 53708-8935 Madison, WI 53703 FAX #: (608) 261-7083 E-Mail: web@drl.state.wi.us Phone #: (608) 266-2112 Website: http://drl.wi.gov DIVISION OF

More information

First Name: MI Last Name: Address: City, State & Zip Code: Telephone Number: Date of Birth:

First Name: MI Last Name: Address: City, State & Zip Code: Telephone Number: Date of Birth: Plan No. 003514 WD 20 IBEW LOCAL 400 ANNUITY FUND C/O I.E. SHAFFER & CO. 830 BEAR TAVERN RD 2 ND FLOOR PO BOX 1028 TRENTON NJ 08628-0230 WITHDRAWAL REQUEST Participant Data (Please Print) Social Security

More information

State of West Virginia Campaign Financial Statement (Long Form) in Relation to the 2012 Election Year

State of West Virginia Campaign Financial Statement (Long Form) in Relation to the 2012 Election Year State of West Virginia Campaign Financial Statement (Long Form) in Relation to the 2012 Election Year Candidate or Committee Name Candidate or Committee's Treasurer Political Party (for candidates) Treasurer's

More information

Donor Advised Funds. Forms Booklet

Donor Advised Funds. Forms Booklet Donor Advised Funds Forms Booklet The U.S. Charitable Gift Trust c/o Renaissance Administration LLC, 8910 Purdue Road, Suite 500, Indianapolis, IN 46268 Charitable Giving Made Easy The U.S. Charitable

More information

Teachers Survivors Benefit Cost-Sharing Plan

Teachers Survivors Benefit Cost-Sharing Plan EMPLOYEES' RETIREMENT SYSTEM OF THE STATE OF RHODE ISLAND Teachers Survivors Benefit Cost-Sharing Plan Schedule of Employer Allocations Schedule of Pension Amounts by Employer Dennis E. Hoyle, CPA Auditor

More information

IBEW LOCAL 102 SURETY FUND C/O I.E. SHAFFER & CO. 830 BEAR TAVERN RD 2 ND FLOOR PO BOX 1028 TRENTON NJ PHONE (800) FAX (609)

IBEW LOCAL 102 SURETY FUND C/O I.E. SHAFFER & CO. 830 BEAR TAVERN RD 2 ND FLOOR PO BOX 1028 TRENTON NJ PHONE (800) FAX (609) PLAN NUMBER 766570 72 IBEW LOCAL 102 SURETY FUND C/O I.E. SHAFFER & CO. 830 BEAR TAVERN RD 2 ND FLOOR PO BOX 1028 TRENTON NJ 08628 PHONE (800)792-3666 FAX (609) 883-7560 Application For Financial Hardship

More information

Send all required documents (including this checklist) to:

Send all required documents (including this checklist) to: hsainsurance.com Fallon Community Health Plan Fallon Senior Plan Companion Care To ensure that your applications are processed as quickly as possible, just follow this checklist 1 Employer completes and

More information

CANDIDATE S REPORT (to be filed by a candidate or his principal campaign committee)

CANDIDATE S REPORT (to be filed by a candidate or his principal campaign committee) CANDIDATE S REPORT (to be filed by a candidate or his principal campaign committee) 1.Qualifying Name and Address of Candidate 1124 Wedgewood Drive 2. Office Sought (Include title of office as well as

More information

Use black or blue ink when completing this form. For questions regarding this form, contact Service Provider at

Use black or blue ink when completing this form. For questions regarding this form, contact Service Provider at Account Reduction Loan Application 403(b) Plan Use black or blue ink when completing this form. For questions regarding this form, contact Service Provider at 1-866-467-7756. Princeton Community Hospital

More information

CHARITABLE SOLICITORS PERMIT APPLICATION FEE: $0

CHARITABLE SOLICITORS PERMIT APPLICATION FEE: $0 CITY OF BAYTOWN City Clerk s Office 2401 Market Street Baytown, Texas 77520 Phone: (281) 420-6504 Fax: (281) 420-5891 Web: www.baytown.org FOR OFFICE USE ONLY Date Received: Date Processed: CHARITABLE

More information

COMMITTEE S REPORT. 40th day after general. Annual (future election) Amendment to prior report. 333 Texas Street Suite Shreveport, LA 71101

COMMITTEE S REPORT. 40th day after general. Annual (future election) Amendment to prior report. 333 Texas Street Suite Shreveport, LA 71101 COMMITTEE S REPORT (filed by committees that support or oppose one or more candidates and/or propositions and that are not candidate committees) 1. Full Name and Address of Political Committee 400 Edwards

More information

Loan Application. Instructions. Questions? Call for assistance. About You

Loan Application. Instructions. Questions? Call for assistance. About You Loan Application 47 USC DEFINED CONTRIBUTION PLAN Instructions Please print using blue or black ink. This request must be authorized by your employer. Please forward this form to your benefits/human resources

More information

CAMPAIGN FINANCE DISCLOSURE FORM CERTIFICATION OF CANDIDATES FOR STATE OFFICE, GENERAL ASSEMBLY, COUNTY OFFICE AND LOCAL OFFICE

CAMPAIGN FINANCE DISCLOSURE FORM CERTIFICATION OF CANDIDATES FOR STATE OFFICE, GENERAL ASSEMBLY, COUNTY OFFICE AND LOCAL OFFICE CAMPAIGN FINANCE DISCLOSURE FORM Page 1 of 2 CERTIFICATION OF CANDIDATES FOR STATE OFFICE, GENERAL ASSEMBLY, COUNTY OFFICE AND LOCAL OFFICE CANDIDATE NAME: Robert Frenier ADDRESS: 85 Town Farm Road TOWN:

More information

FBN Requirements (SB 1467)

FBN Requirements (SB 1467) FBN Requirements (SB 1467) Effective January 1, 2015, pursuant to Senate Bill 1467, the Los Angeles County Registrar/Recorder County Clerk s Office will require a Notarized Affidavit of Identity form to

More information

TAX CREDIT AND INCENTIVE REPORT

TAX CREDIT AND INCENTIVE REPORT DEPARTMENT OF REVENUE Division of Taxation TAX CREDIT AND INCENTIVE REPORT Rhode Island General Law (RIGL) requires the Division of Taxation to annually report the names, address and amount of tax credits

More information

RI QUARTERLY REPORT 2012 Q1 Q2 Q3 Q4

RI QUARTERLY REPORT 2012 Q1 Q2 Q3 Q4 Foreclosures in RI QUARTERLY REPORT 2 2 2 saw an.2 percent drop in the number of residential foreclosure deeds filed in Rhode Island compared to 2, and a 36 percent decline from 2, when data was first

More information

A list of all Rhode Island licensed salespersons and brokers of the corporation. A completed Corporate Power of Attorney Form (Non-residents only).

A list of all Rhode Island licensed salespersons and brokers of the corporation. A completed Corporate Power of Attorney Form (Non-residents only). State of Rhode Island and Providence Plantations Division of Commercial Licensing REAL ESTATE CORPORATION, PARTNERSHIP, AND LLC REQUIREMENTS For those seeking to change the status of your individual Broker

More information

Account Extension. Address New Permanent Alternate

Account Extension.  Address New Permanent Alternate Account Reduction Loan Application 403(b) Plan ISD NO 15 403(B) RETIREMENT PLAN 1014495-01 Use black or blue ink when completing this form. For questions regarding this form, contact Service Provider at

More information

Page 2. November 17, Retirement Board 50 Service Avenue, 2nd Floor Warwick, RI Dear Members of the Board:

Page 2. November 17, Retirement Board 50 Service Avenue, 2nd Floor Warwick, RI Dear Members of the Board: Page 2 November 17, 2016 Retirement Board 50 Service Avenue, 2nd Floor Warwick, RI 02886-1021 Dear Members of the Board: Subject: GASB 67 and 68 Reporting - Actuarial Information Dear Members of the Board:

More information

FBN Requirements (SB 1467)

FBN Requirements (SB 1467) FBN Requirements (SB 1467) Effective January 1, 2015, pursuant to Senate Bill 1467, the Los Angeles County Registrar/Recorder County Clerk s Office will require a Notarized Affidavit of Identity form to

More information

2. Filing is being made on behalf of (Select One): Candidate or Public Official Atlanta City Council Member District 4

2. Filing is being made on behalf of (Select One): Candidate or Public Official Atlanta City Council Member District 4 Page 1 of 8 CFC-CCDR 1/14 Georgia Government Transparency and Campaign Finance Commission 200 Piedmont Avenue S.E. Suite 1402 West Tower Atlanta, GA 30334 404-463-1980 www.ethics.ga.gov 1. Report Type

More information

Campaign Contribution Disclosure Report

Campaign Contribution Disclosure Report SEC FORM CCDR REV 01/2014 1. Report Type (Select One) * Original Report Amended Report Amendment # 2. Filing is being made on behalf of (Select One): * Candidate or Public Official Office Sought or Held:

More information

Page 2. August 31, Retirement Board 50 Service Avenue, 2nd Floor Warwick, RI Dear Members of the Board:

Page 2. August 31, Retirement Board 50 Service Avenue, 2nd Floor Warwick, RI Dear Members of the Board: Page 2 August 31, 2017 Retirement Board 50 Service Avenue, 2nd Floor Warwick, RI 02886-1021 Dear Members of the Board: Subject: GASB 67 and 68 Reporting - Actuarial Information Dear Members of the Board:

More information

Identity Theft Packet

Identity Theft Packet Identity Theft Packet Teller number Date received Account number Revised: 12.12.17 Identity Theft Packet Page 1 Valued Member: Thank you for contacting Educational System Federal Credit Union regarding

More information

CANDIDATE S REPORT (to be filed by a candidate or his principal campaign committee)

CANDIDATE S REPORT (to be filed by a candidate or his principal campaign committee) CANDIDATE S REPORT (to be filed by a candidate or his principal campaign committee) 1.Qualifying Name and Address of Candidate 4939 Saint Roch 3. Date of Election 2. Office Sought (Include title of office

More information

CANDIDATE S REPORT (to be filed by a candidate or his principal campaign committee)

CANDIDATE S REPORT (to be filed by a candidate or his principal campaign committee) CANDIDATE S REPORT (to be filed by a candidate or his principal campaign committee) 1.Qualifying Name and Address of Candidate 4000 Dumaine St. New Orleans, LA 70119 2. Office Sought (Include title of

More information

Campaign Finance Report

Campaign Finance Report PAGE 1 Commonwealth of Pennsylvania Campaign Finance Report (NOTE: This report must be clear and legible. It may be typed or printed in blue or black ink.) Filer Identification Number : 20120063 Report

More information

AUTO BODY REPAIR SHOPS APPLICATION AND INSTRUCTIONS DECEMBER 31, DECEMBER 31, 2012 INSTRUCTIONS

AUTO BODY REPAIR SHOPS APPLICATION AND INSTRUCTIONS DECEMBER 31, DECEMBER 31, 2012 INSTRUCTIONS STATE OF RHODE ISLAND AND PROVIDENCE PLANTATIONS Department of Business Regulation Division of Commercial Licensing and Racing and Athletics Telephone (401) 462-9506 John O. Pastore Center FAX (401) 462-9645

More information

V-1 Verification Worksheet

V-1 Verification Worksheet Your FAFSA was selected for a process called verification. Federal Regulations require we ask you to confirm information you reported on your FAFSA before financial aid may be awarded. To verify that you

More information

September 24, Retirement Board 50 Service Avenue, 2nd Floor Warwick, RI Dear Members of the Board:

September 24, Retirement Board 50 Service Avenue, 2nd Floor Warwick, RI Dear Members of the Board: September 24, 2018 Retirement Board 50 Service Avenue, 2nd Floor Warwick, RI 02886-1021 Dear Members of the Board: Subject: GASB 67 and 68 Reporting - Actuarial Information Dear Members of the Board: This

More information

TITLE 230 DEPARTMENT OF BUSINESS rregulation

TITLE 230 DEPARTMENT OF BUSINESS rregulation 230 RICR 20 05 12 TITLE 230 DEPARTMENT OF BUSINESS rregulation CHAPTER 20 INSURANCE SUBCHAPTER 05 PERSONAL LINES AUTOMOBILE AND HOMEOWNERS INSURANCE PART 12 Municipal Liens on Fire Insurance Proceeds 12.1

More information

EMPLOYEES' RETIREMENT SYSTEM OF THE STATE OF RHODE ISLAND

EMPLOYEES' RETIREMENT SYSTEM OF THE STATE OF RHODE ISLAND EMPLOYEES' RETIREMENT SYSTEM OF THE STATE OF RHODE ISLAND Employees Retirement System Cost-Sharing Plan Schedules of Employer Allocations Schedules of Pension Amounts by Employer June 30, 2015 Measurement

More information

o Check here if address has changed (3) 10 Number:

o Check here if address has changed (3) 10 Number: (1) Lorry Woods Campaign Name (2) PO Box 347921 Address (number and street) Miami, FL 33234 CAMPAGN TREASURER'S REPORT SUMMARY City, State, Zip Code o Check here if address has changed (3) 10 Number: (4)

More information

Recipient Committee Campaign Statement Cover Page (Government Code Sections )

Recipient Committee Campaign Statement Cover Page (Government Code Sections ) Recipient Committee Campaign Statement Cover Page (Government Code Sections 84200-84216.5) Date of election if applicable: (Month, Day, Year) Date Stamp FORM Page 1 of 12 For Official Use Only COVER PAGE

More information

CAMPAIGN FINANCE REPORT LOCAL COMMITTEES OF WISCONSIN

CAMPAIGN FINANCE REPORT LOCAL COMMITTEES OF WISCONSIN CAMPAIGN FINANCE REPORT LOCAL COMMITTEES OF WISCONSIN Is This Report an Amendment: Yes No Instructions for completing schedules are on the back of each schedule. COMMITTEE IDENTIFICATION Name of Committee

More information

Filer ID (Filer ID that begins with the letter C ) Organization or Person Other than Candidate s Campaign Committee Committee Name:

Filer ID (Filer ID that begins with the letter C ) Organization or Person Other than Candidate s Campaign Committee Committee Name: Page 1 of 10 1. Report Type (Select One) Original Amendment Amendment # Georgia Government Transparency and Campaign Finance Commission 200 Piedmont Avenue S.E. Suite 1402 West Tower Atlanta, GA 30334

More information

COMMISSIONER OF FINANCIAL INSTITUTIONS COMMONWEALTH OF PUERTO RICO

COMMISSIONER OF FINANCIAL INSTITUTIONS COMMONWEALTH OF PUERTO RICO COMMISSIONER OF FINANCIAL INSTITUTIONS COMMONWEALTH OF PUERTO RICO MEMORANDUM To: From: Subject: Broker-Dealers Securities Division Registration Requirements Forms that should be on file with the FINRA

More information

City State Zip Code County. Report Information. No If you answered no, attach an explanation. Ending Inventory Statement

City State Zip Code County. Report Information. No If you answered no, attach an explanation. Ending Inventory Statement Form CG-8 Revised 3-04 SF-45387 Organization Name (Please type or print) Indiana Annual Bingo and/or Pull Tab License Financial Report Do Not Write Above This report must be filed by the 10th day of the

More information

Your Retirement Benefits

Your Retirement Benefits Your Retirement Benefits 1 What is your Retirement Benefit? Members of the Employees Retirement System of Rhode Island have a Hybrid Retirement Benefits Plan made up of a Defined Benefit plan (Pension

More information

BANKING REGULATION 8 CHECK CASHERS. This regulation is promulgated pursuant to the authority granted in R.I. Gen. Laws

BANKING REGULATION 8 CHECK CASHERS. This regulation is promulgated pursuant to the authority granted in R.I. Gen. Laws Table of Contents State of Rhode Island and Providence Plantations DEPARTMENT OF BUSINESS REGULATION Division of Banking 1511 Pontiac Avenue, Bldg. 69-2 Cranston, RI 02920 BANKING REGULATION 8 CHECK CASHERS

More information

State of Rhode Island and Providence Plantations

State of Rhode Island and Providence Plantations State of Rhode Island and Providence Plantations Board of Elections Campaign Finance Division 5 Branch Avenue, Providence, Rhode Island 294 Tel. (41)222-2345 Fax (41)222-4424 www.elections.state.ri.us

More information

Finance Checklist and GAB - Campaign Finance Overview Local Candidates

Finance Checklist and GAB - Campaign Finance Overview Local Candidates TOWN OF VERNON WAUKESHA COUNTY WISCONSIN 2018 Finance Checklist and GAB - Campaign Finance Overview Local Candidates (For additional resources and information please visit the Wisconsin Elections and Ethics

More information

APPLICATION FOR DEALERS LICENSE

APPLICATION FOR DEALERS LICENSE INSTRUCTIONS FOR APPLICANTS IN MAKING FIRST APPLICATION FOR DEALERS LICENSE APPLICATION MUST BE ACCOMPANIED BY ALL OF THE FOLLOWING DOCUMENTS: 1. *THE PROPOSED DEALERSHIP NAME MUST BE APPROVED BY THIS

More information

Provide Vanguard Charitable account information and identify all registered owners of the assets being donated. Account name

Provide Vanguard Charitable account information and identify all registered owners of the assets being donated. Account name Make a contribution Use this form to contribute to your philanthropic account. Contributions are irrevocable upon acceptance by Vanguard Charitable. If you require extra space, include additional sheets.

More information

CAMPAIGN FINANCE REPORT

CAMPAIGN FINANCE REPORT Commonwealth of Pennsylvania CAMPAIGN FINANCE REPORT (MOTE: This report must be clear and legible. It may be typed or printed in bfua or black ink.) Filer Identification Number: N»m«of Filing Comm tt*e,

More information

Covering Calendar Year: Mailing Address: Street or P.O. Box City County State Zip code. ( )

Covering Calendar Year: Mailing Address: Street or P.O. Box City County State Zip code. ( ) CFC PFD Rev. 1/14 STATE OF GEORGIA PERSONAL FINANCIAL DISCLOSURE STATEMENT 200 Piedmont Avenue S.E. Suite 1402 West Tower Atlanta, GA 30334 404-463-1980 www.ethics.ga.gov Local Location Code: Original

More information

Report of the Advisory Council for Locally Administered Pension Plans. May 2018 General Treasurer Seth Magaziner, Chair

Report of the Advisory Council for Locally Administered Pension Plans. May 2018 General Treasurer Seth Magaziner, Chair Report of the Advisory Council for Locally Administered Pension Plans May 2018 General Treasurer Seth Magaziner, Chair ACKNOWLEDGEMENTS The annual production of this report has been a collaborative effort

More information

Texas Ethics Commission P.O.Box Austin, Texas (512)

Texas Ethics Commission P.O.Box Austin, Texas (512) Texas Ethics Commission P.O.Box 12070 Austin, Texas 78711-2070 (512) 463-5800 1-800-325-8506 SPECIFIC- COMMITTEE FORM SPAC CAMPAIGN FINANCE REPORT COVER SHEET PG 1 The SPAC Instruction Guide explains how

More information

Application For Financial Hardship Distribution (Please Print or Type) Name of Applicant Social Security # Street Address.

Application For Financial Hardship Distribution (Please Print or Type) Name of Applicant Social Security # Street Address. IBEW LOCAL 456 ANNUITY FUND C/O I.E. SHAFFER & CO. 830 BEAR TAVERN RD 2 ND FLOOR PO BOX 1028 TRENTON NJ 08628-0230 PHONE (800)792-3666 FAX (609) 883-7580 Application For Financial Hardship Distribution

More information

JOSEPH A. KEOUGH JR.* JEROME V. SWEENEY III* SEAN P. KEOUGH* STACI L. KOLB JEROME V. SWEENEY II OF COUNSEL

JOSEPH A. KEOUGH JR.* JEROME V. SWEENEY III* SEAN P. KEOUGH* STACI L. KOLB JEROME V. SWEENEY II OF COUNSEL KEOUGH & SWEENEY, LTD. ATTORNEYS AND COUNSELORS AT LAW 41 MENDON AVENUE PAWTUCKET, RHODE ISLAND 02861 TELEPHONE (401) 724-3600 FACSIMILE (401) 724-9909 www.keoughsweeney.com RAYNHAM OFFICE: 90 NEW STATE

More information

CAMPAIGN FINANCE REPORT STATE OF WISCONSIN CF-2

CAMPAIGN FINANCE REPORT STATE OF WISCONSIN CF-2 COMMITTEE IDENTIFICATION Filing Period Name: Name of Committee/Corporation: Street Address: July Continuing 2018 604 West Stout Street City, State and Zip: CAMPAIGN FINANCE REPORT STATE OF WISCONSIN CF-2

More information

CHARITABLE ORGANIZATIONS APPLICATION

CHARITABLE ORGANIZATIONS APPLICATION State of Rhode Island and Providence Plantations DEPARTMENT OF BUSINESS REGULATION Securities Division Charitable Organization Section 1511 Pontiac Avenue, Bldg. 69-2 Cranston, Rhode Island 02920 FILINGS

More information

CHARITABLE SOLICITATIONS PERMIT QUESTIONNAIRE. Applications may be turned in at any time Monday Friday from 8:00 a.m. to 5:00 p.m.

CHARITABLE SOLICITATIONS PERMIT QUESTIONNAIRE. Applications may be turned in at any time Monday Friday from 8:00 a.m. to 5:00 p.m. CHARITABLE SOLICITATIONS PERMIT QUESTIONNAIRE 1. When can I turn in the application? Applications may be turned in at any time Monday Friday from 8:00 a.m. to 5:00 p.m. 2. How much does it cost, and who

More information

A Letter to Our Stockholders

A Letter to Our Stockholders Annual Report A Letter to Our Stockholders As we close the books on an eventful, I wish to highlight some of the many positives accomplished during the year. Last year began with the completion of our

More information

457 Deferred Compensation Plan Employee Enrollment Form Page 1 of 4

457 Deferred Compensation Plan Employee Enrollment Form Page 1 of 4 IMPORTANT NOTICE: Before you begin to fill out this form, please remove it from the enrollment book. Carefully tear perforation along the left edge, keeping the parts together. NCR 457 Deferred Compensation

More information

CAMPAIGN TREASURER'S REPORT SUMMARY. D Check here if no other IE or EC reports will be filed. (5) Report Identifiers

CAMPAIGN TREASURER'S REPORT SUMMARY. D Check here if no other IE or EC reports will be filed. (5) Report Identifiers CAMPAGN TREASURER'S REPORT SUMMARY ( 1 ) Gary Resnick Name (2) 2800 NW 10 Avenue Address (number and street) Wilton Manors, FL 33311 City, State, Zip Code 0 Check here if address has changed (4) Check

More information

CANDIDATE / OFFICEHOLDER CAMPAIGN FINANCE REPORT

CANDIDATE / OFFICEHOLDER CAMPAIGN FINANCE REPORT CANDIDATE / OFFICEHOLDER CAMPAIGN FINANCE REPORT FORM C/OH COVER SHEET PG 1 The C/OH Instruction Guide explains how to complete this form. 1 2 Total pages filed: 9 3 CANDIDATE / MS / MRS / MR FIRST MI

More information

State of Rhode Island and Providence Plantations DEPARTMENT OF BUSINESS REGULATION 1511 Pontiac Avenue, Bldg Cranston, Rhode Island 02920

State of Rhode Island and Providence Plantations DEPARTMENT OF BUSINESS REGULATION 1511 Pontiac Avenue, Bldg Cranston, Rhode Island 02920 State of Rhode Island and Providence Plantations Division of Commercial Licensing REQUIREMENTS/APPLICATION FOR REAL ESTATE BROKERS The following Requirements apply to Rhode Island Residents and Non-residents.

More information

State of New Jersey Department of Banking & Insurance. Annual Report Worksheet for Sales Finance Companies. Year Ending December 31, 2017

State of New Jersey Department of Banking & Insurance. Annual Report Worksheet for Sales Finance Companies. Year Ending December 31, 2017 State of New Jersey Department of Banking & Insurance for Sales Finance Companies New Jersey Department of Banking & Insurance Division of Banking Attn: Sharon Davis -- 5 th floor 20 West State Street

More information

2. Filing is being made on behalf of (Select One): Candidate or Public Official Chairman of Cobb County Commission

2. Filing is being made on behalf of (Select One): Candidate or Public Official Chairman of Cobb County Commission Page 1 of 8 CFC-CCDR 1/14 Georgia Government Transparency and Campaign Finance Commission 200 Piedmont Avenue S.E. Suite 1402 West Tower Atlanta, 30334 404-463-1980 www.ethics.ga.gov 1. Report Type 2.

More information

Office of the Auditor General

Office of the Auditor General EMPLOYEES' RETIREMENT SYSTEM OF THE STATE OF RHODE ISLAND Teachers Survivors Benefit Cost-Sharing Plan Schedule of Employer Allocations Schedule of Pension Amounts by Employer June 30, 2017 Measurement

More information

CANDIDATE S REPORT. (to be filed by a candidate or his principal campaign committee) State Representative Multiple Dist th day after general

CANDIDATE S REPORT. (to be filed by a candidate or his principal campaign committee) State Representative Multiple Dist th day after general CANDIDATE S REPORT (to be filed by a candidate or his principal campaign committee) 1.Qualifying Name and Address of Candidate 296 Belle Pointe Dr. Ruston, LA 71270 3. Date of Primary 2/23/2019 2. Office

More information

Upon successfully passing the examination, candidates must submit the following:

Upon successfully passing the examination, candidates must submit the following: State of Rhode Island and Providence Plantations Division of Commercial Licensing REQUIREMENTS/APPLICATION FOR REAL ESTATE SALESPERSONS The following Requirements apply to Rhode Island Residents and Non-residents.

More information