Town of. Castle Rock COLORADO COMMITTEE REPORT OF CONTRIBUTIONS AND EXPENDITURES

Size: px
Start display at page:

Download "Town of. Castle Rock COLORADO COMMITTEE REPORT OF CONTRIBUTIONS AND EXPENDITURES"

Transcription

1 pf-c VED Town of Castle Rock COLORADO i i.t ji Castle Rock '"Wfi Clerks Office COMMITTEE REPORT OF CONTRIBUTIONS AND EXPENDITURES ACommittee Registration form must be filed with the Town Clerk prior to taking ;my contributions for a candidate or an issue, or making any expenditures on behalf ofacandidate oran issue. Formation ofa Committee requires that a separate bank account be opened in the name of the Committee, and that all contril > expenditures be reported on the forms provided by the Town Clerk. utions, contributions in kind, loans, and NAME OF COMMITTEE: Registered Agent: Phone Number: ~^0 3' ^ ^ ^ 3 Z ^ A/ ^ Candidate Committee Committee Type Name ofcommittee's Bank: Regularly Scheduled Filing Issue Committee Blimended Filing. This amends previous report filed on n Termination Report (Termination Reports MUST Have a Zero REPORTING PERIOD - Beginning Date; T/ Zf/e Ending D Balance) i te / // ZciS BEGINNING BALANCE $. Contributions (+) Contributions In Kind (+) Loans(+) Expenditures/Expenditures In-Kind (-) ENDING BALANCE $_ %ZZ-.'6lp I hereby certify thattothe best ofray knowledge and belief all contributions received and all expenditures made duringthis reporting period are accurately reflected in this report Registered Agent's Name: Icy 2J, Registered Agent's Signature: Date: /cp-/. IfApplicable Candidate Name: Candidates Signature:. Date:

2 Detailed Report of CONTRIB (Includes funds spent by the Candidate for Expenditures - list as a C Name of Committee: % UTIONS ontribution and as an Expenditure) EM C s L CR / ly. 7^fo /cpy Date Accented: h2diil3 $ A>cP ^ ^3 / <^<s. </2^ ^ ^ / Ob Sc f/~ 7 7*-/ P L /V- (^CR t?y IP-^'7'^'S /r- K a 'h ^ ^ J2cp-yc. / ^ >A/l^ M ^ls2l II /o- *7 5 ^ ^ n S>o/'^'o io- "11% S X'^O ja l~l- A g. ^ o 'yalt^ 71,^/, ^ O ^

3 DetaUed Report of CONTRIBUTIONS (Includes funds spent by the Candidate for Expenditures - list as acontribution and as an Expenditure) Name of Committee: 3" --j j / r~ / 1 Amount; 1 Date Accented: S

4 Detailed Report of CONTRIB (Includes funds spent by the Candidate for Expenditures - list as ac Name of Committee: d- fz/4es UTIONS ontribution and as an Expenditure) _ 6 / 7 0> ^=9^ /C _ ^^ ft ^-^ta ^ -r % I /^.4-/.. g) c) / O3 1 Amount; $ Date Accented: $

5 Detailed Report of EXPENDITURES (Include Value ofexpenditure made from In-Kind Contributions or money spent by the Candidate) Name of Committee: ^ Date Expended: /c? 7//^ PAYABLE TO; Purpose/Description: Date Expended: PAYABLE TO: Purpose/Description: Date Expended: PAYABLE TO: Purpose/Description: Date Expended: PAYABLE TO: Purpose/Description:

6 Tvr'^Tr:r.g^;;;^/V'j Detailed Report of CONTRIBUTIONS (Value ofan In-Kind Contribution is also recorded Name of Committee: IN KIND ider Expenditures). Committee to Elect Charlfes Fletcher _ Estimated Value; Nature ofcontribunon:. Estimated Value: Nature ofcontribution: A.. X Estimated Value: Nature ofcontribution: _ Estimated Value: Nature ofcontribution:

7 Detailed Report of LOANS MName of trcommittee. rtpp- Committee to Elect Charl e^ s Fletcher Date Received Date Received: Address; Date Received: Date Received: Amount City/State/Zip Date Received City/State/Zip ^!gsb:^amxexg!sat>mi^3sswsaaamjiiasmiisfmbmm3:s!amests*

8 Receipt for Charles Fletcher ill Account ID: Payment Date Oct 11, 2018,12:08 AM Payment Mettiod Vlsa*6530 Reference Number: WX7ZAJ2BR2 Transaction ID Paid $95.94 USD This is your monthly bill. Product Type Facebook Campaigns Event: Charles For Mayor Listening Session #3 From Sep :00 PM tooct , 12:00 AM Event: Charles For MayorListening Session #3 650 Impressic Post: "The Denver Home Builder's Association invited..." From Sep :00 PM to Oct :00 AM Post: The Denver Home Builder'sAssociation invited..." 658 Impressit ms Charles Mayor adi From Sep :00PM to Oct :00 AM $ ,769 Impres $9.63 Event: Listening Session #2 FromSep :00PMto Oct :00 AM Event: Listening Session #2 622 Impressi Post: Thank you for all your support, here's something..." FromSep 13, :00 PM to Oct 10, 2018, 12:00AM Post: Thank you for allyour support, here's something Impre: sions $11.08 $11.08 Event: Charles For Mayor Listening Session #4 From Sep :00 PMto Oct , 12:00AM Event: Charles For Mayor Listening Session # Impre >sions $14.48 $14.48 CharlesForMayor.com 1 FromSep :00 PMto Oct :00 AM $ Impressions $10.65 Post: "I am super excited to announce a unique..." From Sep 13,2018,10:00 PMto Oct :00 AM Post: "Iam super excited to announce a unique Impres: iions $3.00 $3.00

9 Event: Castle Rock Mayor Round-table From Sep :00PM to Oct ,12:00 AM Event: Castle Rock Mayor Round-table 276 Impression $3.74 $3.74 Post: "I am super excited to announce a unique..." FromSep :00 PMto Oct :00 AM Post: "Iam super excited to announce a unique..." 436 impressions $3.53 $3.53 Event: Mayor OA From Sep :00 PMto Oct :00 AM Event: Mayor OA 435 impressior $6.16 $6.16 Post: "I am super excited to announce a unique..." From Sep , 10:00 PM to Oct :00 AM Post: "I am super excited to announce a unique Impressiot is $3.67 $3.67 Facebook. inc 1601 Willow Road Dort ^ A Q,1 OOK. (.4 CO

INDEPENDENT EXPENDITURE REPORT ( (4), C.R.S.)

INDEPENDENT EXPENDITURE REPORT ( (4), C.R.S.) Colorado Secretary of State Elections Division 1700 Broadway, Ste. 200 Denver, CO 80290 Ph: (303) 894-2200 ext. 6383 Fax: (303) 869-4861 Email: cpfhelp@sos.state.co.us www.sos.state.co.us Space Below For

More information

REPORT OF CONTRIBUTIONS AND EXPENDITURES w. 4th ave lakewood co 80226

REPORT OF CONTRIBUTIONS AND EXPENDITURES w. 4th ave lakewood co 80226 SAVE FORM Once you have saved the form, please submit the form as an email attachment to the City Clerk at margre@lakewood.org City Clerk's Office Lakewood Civic Center 480 S Allison Parkway Lakewood,

More information

LJ Amended Filing. This amends previous report filed on (date)

LJ Amended Filing. This amends previous report filed on (date) Colorado Secretary of State Elections Division 1700 Broadway, Ste. 200 Denver, CO 80290 Ph: (303) 894-2200 ext. 6383 Fax: (303) 869-4861 Email: cpfbelp@sos.statc.co.us www.sos.state.co.us j Full Name of

More information

REPORT OF CONTRIBUTIONS AND EXPENDITURES

REPORT OF CONTRIBUTIONS AND EXPENDITURES Full Name of Committee/Person Address of Committee/Person (as shown on registration) City, State & Zip Code Committee Type Name and Address of Financial Institution Type of Report: Regularly Scheduled

More information

REPORT OF CONTRIBUTIONS AND EXPENDITURES ( , C.R.S.)

REPORT OF CONTRIBUTIONS AND EXPENDITURES ( , C.R.S.) Colorado Secretary of State Elections Division 1700 Broadway, Ste. 200 Denver, CO 80290 Ph: 303) 894-2200 ext. 6383 Fax: 303) 869-4861 Email: cpfhelp@sos.state.co.us www.sos.state.co.us REPORT OF CONTRIBUTIONS

More information

Election Campaign Financing By-law

Election Campaign Financing By-law Re: Item No. 4 Election Campaign Financing By-law Regional Council 02-Oct-18 Legislative Context Municipal Elections Act Sections 49 A and B are still in effect and support the base of Campaign Finance

More information

REPORT OF CONTRIBUTIONS AND EXPENDITURES

REPORT OF CONTRIBUTIONS AND EXPENDITURES City Clerk's Office Lakewood Civic Center 480 S Allison Parkway Lakewood, CO 802263127 Phone: 3039877080 Fax: 3039877088 TDD: 3039877057 REPORT OF CONTRIBUTIONS AND EXPENDITURES Full Name of Committee

More information

CITY OF ROCHESTER, NEW HAMPSHIRE INVITATION TO BID

CITY OF ROCHESTER, NEW HAMPSHIRE INVITATION TO BID CITY OF ROCHESTER, NEW HAMPSHIRE INVITATION TO BID The City of Rochester, New Hampshire, is accepting sealed bids for a Ballistic Vest. Bids must be submitted in a sealed envelope plainly marked: Sealed

More information

MULTIPLE-VENDOR EVENT PROMOTER INFORMATION

MULTIPLE-VENDOR EVENT PROMOTER INFORMATION Town of Parker Sales Tax Administration Address: PO Box 5602 Website: www.parkeronline.org/salestax Email: salestax@parkeronline.org Denver, CO 80217-5602 Phone: 303.805.3228 Fax: 303.805.3219 MULTIPLE-VENDOR

More information

I Through I IC/ u~ / d-0 II

I Through I IC/ u~ / d-0 II Colorado Secretary of State Elections Division 1700 Broadway, Ste. 200 Denver, CO 80290 Ph: (303) 894-2200 ext. 6383 Fax: (303) 869-4861 Email: cpfhclp@sos.state.co.us WWW.SOS.State.co.us REPORT OF CONTRIBUTIONS

More information

I Full Name of Committee/Person:

I Full Name of Committee/Person: Colorado Secretary of State Elections Division 1700 Broadway, Ste. 200 Denver, CO 80290 Ph: (303) 894-2200 ext. 6383 Fax: (303) 869-4861 Email: cpfhelp@sos.state.co.us www.sos.state.co.us Full Name of

More information

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

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

More information

Articles of Incorporation for a Nonprofit Corporation filed pursuant to and of the Colorado Revised Statutes (C.R.S.

Articles of Incorporation for a Nonprofit Corporation filed pursuant to and of the Colorado Revised Statutes (C.R.S. Document must be filed electronically. Paper documents will not be accepted. Document processing fee $50.00 Fees & forms/cover sheets are subject to change. To access other information or print copies

More information

CITY OF DEERFIELD BEACH Request for City Commission Agenda

CITY OF DEERFIELD BEACH Request for City Commission Agenda Item: CITY OF DEERFIELD BEACH Request for City Commission Agenda Agenda Date Requested: 02/21/12 Contact Person: Charles DaBrusco, Director of Environmental Services Description: Renewal of Co-Op Purchase

More information

REPORT OF CONTRIBUTIONS AND EXPENDITURES ( , C.R.S.)

REPORT OF CONTRIBUTIONS AND EXPENDITURES ( , C.R.S.) Colorado Secretary of State Elections Divi sion 1700 Broadway, Ste. 200 Dcm cr, CO 80290 Ph: (303) 894-2200 ext. 6383 fox: (303) 869-4861 Email: cp01elp@sos.statc.co.us www.sos.state.co.us Full Name of

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 2. Office Sought (Include title of office as well as parish, city, town and/or

More information

- ly 24v,D. ickii1e dali K&V6,- Ontario. C. /i (oqi1(//ov. I3 (0 iiv6 7i &-r. Financia Statement. Auditor s. Report

- ly 24v,D. ickii1e dali K&V6,- Ontario. C. /i (oqi1(//ov. I3 (0 iiv6 7i &-r. Financia Statement. Auditor s. Report All candidates must complete Boxes A, B, C, D, E and F and Schedule All candidates must complete Schedules 2, 3 and 4 as Instructions 9. Amount paid to clerk (from Box E) 7 8. Contributions refunded to

More information

ARTICLE 13 SCIENTIFIC AND CULTURAL FACILITIES DISTRICT

ARTICLE 13 SCIENTIFIC AND CULTURAL FACILITIES DISTRICT Document 1 of 20 CULTURAL FACILITIES DISTRICT ARTICLE 13 SCIENTIFIC AND CULTURAL FACILITIES DISTRICT Editor's note: For a discussion of the difference between service authorities authorized by section

More information

, 2011, and ending. F Group Exemption D Application pending SACRAMENTO CA

, 2011, and ending. F Group Exemption D Application pending SACRAMENTO CA Form 990-EZ Department of the Treasury Internal Revenue Service Short Form Return of Organization Exempt From Income Tax Under section 501 (c), 527, or 4947(a)(1) of the Internal Revenue Code (except black

More information

REPORT OF CONTRIBUTIONS AND EXPENDITURES ( , C.R.S.)

REPORT OF CONTRIBUTIONS AND EXPENDITURES ( , C.R.S.) Retumto: Beth A. Hedberg, MMC City Clerk City ofedgewater 2401 Sheridan Boulevard Edgewater, CO 80214 720-763-3002 Fax: 303-238-7192 REPORT OF CONTRBUTONS AND EXPENDTURES (1-45.108, C.R.S.) Space Below

More information

APPENDIX A BLANK DISCLOSURE REPORTS

APPENDIX A BLANK DISCLOSURE REPORTS APPENDIX A BLANK DISCLOSURE REPORTS C-1 Appointment and Certification of Political Treasurer C-2 Campaign Disclosure Forms Detailed Summary Page C-4 Independent Expenditures C-5 48 Hour Notice of Contributions/Loans

More information

Billing Statements and Understanding Fees Authorized Users Payment Plans Schedule Protection and Dropping Schedules Payment Options 1098-T Tax

Billing Statements and Understanding Fees Authorized Users Payment Plans Schedule Protection and Dropping Schedules Payment Options 1098-T Tax Billing Statements and Understanding Fees Authorized Users Payment Plans Schedule Protection and Dropping Schedules Payment Options 1098-T Tax Documents Paperless Billing Refund Processing 3 rd Party Invoicing/Tuition

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 1827 Gentilly Blvd 2. Office Sought (Include title of office as well as parish,

More information

Carers Week 12th 18th June Save the Dates. Wired as part of the ACE group will be hosting events throughout Carers Week.

Carers Week 12th 18th June Save the Dates. Wired as part of the ACE group will be hosting events throughout Carers Week. WIRED Carers Support Carer Connectors Building Carer Friendly Communities Wirral Carers E-news Issue: 17-6 Date: 10/05/17 Find Us Follow Us Carers Week 12th 18th June 2017 Save the Dates Wired as part

More information

Water and Sewer Service Charges. Average Monthly Charge - Single Family Residence Current 2018 Proposed 2019 $ Change % Change $9.82 $42.

Water and Sewer Service Charges. Average Monthly Charge - Single Family Residence Current 2018 Proposed 2019 $ Change % Change $9.82 $42. To: Mayor and City Council From: Charles Ozaki, City and County Manager Prepared by: Pat Soderberg, Finance Director Kim Pfeifer, Revenue Manager Billie Reyes, Billing and Accounts Administrator Meeting

More information

A G E N D A. 2. M inutes o f th e l a s t m eetin g ( p r e v io u s ly c i r c u l a t e d ).

A G E N D A. 2. M inutes o f th e l a s t m eetin g ( p r e v io u s ly c i r c u l a t e d ). Dawson House, Great Sankey Warrington WA5 3LW Telephone Penketh 4321 F1/B1 8 th December 1981 To: Members o f th e R e g io n a l F i s h e r i e s A d v iso ry C om m ittee: (M essrs. T.. A. F. B arn

More information

ir Ontario --~ --z_o re/t 7,;/-z_ o Financial Statement - Auditor's Report Candidate - Form 4 Municipal Elections Act, 1996 (Section 88.

ir Ontario --~ --z_o re/t 7,;/-z_ o Financial Statement - Auditor's Report Candidate - Form 4 Municipal Elections Act, 1996 (Section 88. . f):--:;> ir Ontario Ministry of Municipal Affairs Financial Statement - Auditor's Report Candidate - Form 4 Municipal Elections Act, 1996 (Section 88.25) Instructions All candidates must complete Boxes

More information

P S A B & S C H O O L B O A R D F I N A N C I A L R E P O R T I N G

P S A B & S C H O O L B O A R D F I N A N C I A L R E P O R T I N G P S A B & S C H O O L B O A R D F I N A N C I A L R E P O R T I N G G E N E R A L G U I D E Ministry of Education P S A B & S C H O O L B O A R D F I N A N C I A L R E P O R T I N G A G E N E R A L G

More information

FOR CANDIDATES AND COMMITTEES (Please Print or Type)

FOR CANDIDATES AND COMMITTEES (Please Print or Type) C-1 APPOINTMENT AND CERTIFICATION OF POLITICAL TREASURER Rev. 11/17 FOR CANDIDATES AND COMMITTEES (Please Print or Type) Pursuant to Section 67-6603(c1), Idaho Code. No contribution shall be received or

More information

3. COMMITTEE MAILING ADDRESS 4. COMMITTEE TELEPHONE NUMBER 1204 South Bridgewood Drive

3. COMMITTEE MAILING ADDRESS 4. COMMITTEE TELEPHONE NUMBER 1204 South Bridgewood Drive Missouri Ethics Commission COMMITTEE DISCLOSURE REPORT COVER PAGE C180543 M.E.C. ID NO. INSTRUCTIONS ON REVERSE SIDE 2. FULL NAME OF COMMITTEE 1. DATE OF REPORT OFFICE USE ONLY 3. COMMITTEE MAILING ADDRESS

More information

BID RESPONSE FORM. Heritage School HVAC System Replacement. The above scope of work to be performed at the dollar amount(s) stated herein.

BID RESPONSE FORM. Heritage School HVAC System Replacement. The above scope of work to be performed at the dollar amount(s) stated herein. BID RESPONSE FORM In compliance with solicitation dated April 26, 2018, the undersigned proposes to furnish all labor equipment and materials and perform all work in strict accordance with all requirements

More information

t"- Ontario Financial Statement Auditor's Report Form 4 Municipal Elections Act, 1996 (Section 78) bvs Date Filed in the Clerk's Office (yyyy/mm/dd)

t- Ontario Financial Statement Auditor's Report Form 4 Municipal Elections Act, 1996 (Section 78) bvs Date Filed in the Clerk's Office (yyyy/mm/dd) t"- Ontario Ministry of Municipal Affairs and Housing Financial Statement Auditor's Report Form 4 Municipal Elections Act, 1996 (Section 78) Instructions: All candidates must complete Boxes A and B. Candidates

More information

How Do People Change the World?

How Do People Change the World? How Do People Change the World? THIS CHANGES EVERYTHING Official Book & Film Study Guide 36 Learning Objectives Students will: Describe the impact of citizens who have taken action to address various problems

More information

Application Form. for funds managed by Allianz Global Investors GmbH Branch Luxembourg and Allianz Global Investors Ireland Limited.

Application Form. for funds managed by Allianz Global Investors GmbH Branch Luxembourg and Allianz Global Investors Ireland Limited. IN COOPERATION WITH: Application Form for funds managed by Allianz Global Investors GmbH Branch Luxembourg and Allianz Global Investors Ireland Limited Page 1 of 9 Fax Application form to: + 352 2460 4458

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 4701 St. Roch Avenue New Orleans LA 70122 2. Office Sought (Include title

More information

LX Ontario. Financial Statement Auditor's Report Form 4 Municipal Elections Act, 1996 (Section 78)

LX Ontario. Financial Statement Auditor's Report Form 4 Municipal Elections Act, 1996 (Section 78) LX Ontario Ministry of Municipal Affairs and Housing Financial Statement Auditor's Report Form 4 Municipal Elections Act, 1996 (Section 78) Instructions All candidates must complete Boxes A, B, C, D, E

More information

STATEMENT OF NO CONTRIBUTIONS OR EXPENDITURES

STATEMENT OF NO CONTRIBUTIONS OR EXPENDITURES C-2 CAMPAIGN FINANCIAL DISCLOSURE REPORT Rev. 11/17 SUMMARY PAGE (Please Print or Type) Section I Name of candidate or Political Committee and Chairperson Office Sought (if candidate) District (if any)

More information

X? ad Box B: Summary of Campaign Income and Expenses. t/x" Ontario. L o t_ ae, 0

X? ad Box B: Summary of Campaign Income and Expenses. t/x Ontario. L o t_ ae, 0 t/x" Ontario Ministry of Municipal Affairs and Housing Financial Statement Auditor's Report Form 4 Municipal Elections Act, 1996 (Section 78) Instructions All candidates must complete Boxes A, B, C, D,

More information

NOTICE OF PROPOSED ORDINANCE

NOTICE OF PROPOSED ORDINANCE NOTICE OF PROPOSED ORDINANCE Pursuant to Section 7-3 of the Town of Castle Rock Home Rule Charter, notice is hereby given that the Town Council will consider adoption of the following named and described

More information

Renewal Application. Performance Schools

Renewal Application. Performance Schools Renewal Application Performance Schools Letter of Intent to Renew Please provide a copy of the Board Resolution expressing formal intent to apply to CSI for renewal with this completed document on or before

More information

Before you register with us, please familiarise yourself with the following:

Before you register with us, please familiarise yourself with the following: Dear Client Thank you for choosing Mom s Link to be a part of this exciting time in your life. We look forward to efficiently assist you with your maternity claim, affording you more time for the most

More information

LittletonsRececr ed , C. R.S.) Check this box if this Report Contains Electioneering Communications Information

LittletonsRececr ed , C. R.S.) Check this box if this Report Contains Electioneering Communications Information LittletonsRececr ed REPORT OF CONTRBUTONS AND EXPENDTURES DEC 2313 1-45- 108, C. R.S.) Full Name of Committee/Person: Address of Committee/Person: r As Shown On Registration r 1 y y E/ 4 k C it City, State&

More information

WHEREAS, the proposed budget has been submitted to the Board of Directors of the District for its consideration; and

WHEREAS, the proposed budget has been submitted to the Board of Directors of the District for its consideration; and LGID # 66572 RESOLUTION TO ADOPT 2018 BUDGET, APPROPRIATE SUMS OF MONEY, AND AUTHORIZE THE CERTIFICATION OF THE TAX LEVY THE RIDGE AT HARMONY ROAD METROPOLITAN DISTRICT NO. 2 A RESOLUTION SUMMARIZING REVENUES

More information

tft Ontario I ek b 1 C H.t Financial Statement Auditor s Report L Supplementary filing including finances after December 31 (or c6 /3-3qz-7l

tft Ontario I ek b 1 C H.t Financial Statement Auditor s Report L Supplementary filing including finances after December 31 (or c6 /3-3qz-7l All candidates must complete Boxes A, B, C, D, E and F and Schedule 1 All candidates must complete Schedules 2, 3 and 4 as All surplus funds (after any refund to the candidate or his or her spouse) shall

More information

PERSONAL ACCIDENT CLAIM FORM

PERSONAL ACCIDENT CLAIM FORM APPENDIX E Completion Notes PERSONAL ACCIDENT CLAIM FORM 1. If a claimant is unable to claim personally, the claim form may be completed on his/her behalf. 2. A claim must be submitted within a reasonable

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

CITY COUNCIL AGENDA MEMORANDUM

CITY COUNCIL AGENDA MEMORANDUM City and County of Broomfield, Colorado CITY COUNCIL AGENDA MEMORANDUM To: From: Prepared by: Mayor and City Council Charles Ozaki, City and County Manager Debra Baskett, Transportation Manager Dave Shinneman,

More information

REPCO BANK EMPLOYEES PENSION FUND. Space for affixing attested passport size photograph

REPCO BANK EMPLOYEES PENSION FUND. Space for affixing attested passport size photograph (RCB/Pension/12) REPCO BANK EMPLOYEES PENSION FUND FORM OF APPLICATION FOR GRANT OF FAMILY PENSION ON THE DEATH OF AN EMPLOYEE / PENSIONER (To be submitted in duplicate) Space for affixing attested passport

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

Internal Revenue Service P.O. Box 2508, Room 4106 Cincinnati, OH 45201

Internal Revenue Service P.O. Box 2508, Room 4106 Cincinnati, OH 45201 Department of the Treasury Internal Revenue Service Date: Employer ID number: Person to contact: Contact telephone number: Contact fax number: Employee ID number: Dear The IRS is instituting an optional

More information

n I did not accept any contributions or incur any expenses other than the nomination fee. ( Complete Box A and B only)

n I did not accept any contributions or incur any expenses other than the nomination fee. ( Complete Box A and B only) ft Ontario. Ministry of Municipal Affairs and Housing Financial Statement Auditor' s Report Form 4 Municipal Elections Act, 1996( Section 78) Instructions: All candidates must complete Boxes A and B. Candidates

More information

AGENDA ITEM SUMMARY January 2, 2018 City Council

AGENDA ITEM SUMMARY January 2, 2018 City Council Agenda Item 20 AGENDA ITEM SUMMARY January 2, 2018 City Council STAFF Mike Beckstead, Chief Financial Officer John Duval, Legal Cyril Vidergar, Legal SUBJECT Items Relating to Broadband Facilities and

More information

CLAIMS AND DISBURSEMENTS

CLAIMS AND DISBURSEMENTS LEGAL COMPLIANCE AUDIT GUIDE Introduction Municipal transactions involving an account, claim, or demand made for any property or service which can be itemized in the ordinary course of business and disbursements

More information

Short Form. Return of Organization Exempt From Income Tax

Short Form. Return of Organization Exempt From Income Tax Form 990-EZ Department of the Treasury Internal Revenue Service Short Form OMB. 1545-1150 Return of Organization Exempt From Income Tax Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue

More information

Employee Engagement through Strategic Shift. Yvette White

Employee Engagement through Strategic Shift. Yvette White Employee Engagement through Strategic Shift Yvette White About Microsoft Our Mission Empower every person and every organization on the planet to achieve more Our Strategy Build best-in-class platforms

More information

Board Summary Report

Board Summary Report Date: March 24 th, 2015 Board Summary Report To: From: Subject: Board of County Commissioners Todd Weaver, Budget Manager 2015 Reappropriation of 2014 Budget Request and Recommendation The purpose of this

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

TO: HONORABLE MAYOR AND. FROM: Toni J. Taber, CM1 SUBJECT: SEE BELOW. DATE: November 5, Approval of Adjusted Campaign Contribution Limits.

TO: HONORABLE MAYOR AND. FROM: Toni J. Taber, CM1 SUBJECT: SEE BELOW. DATE: November 5, Approval of Adjusted Campaign Contribution Limits. COUNCIL AGENDA: 11-17-15 ITEM: 2.11, CITY OF SAN IPSE Memorandum CAPITAL OF SILICON VALLEY TO: HONORABLE MAYOR AND CITY COUNCIL SUBJECT: SEE BELOW SUBJECT: FROM: Toni J. Taber, CM1 DATE: November 5, 2015

More information

^>. H^^-zo/^ ^^^^ ^/ //Q/ Date (yyyy/mfti^ Financial Statement - Auditor's Report Candidate - Form to. ^0: 0(i

^>. H^^-zo/^ ^^^^ ^/ //Q/ Date (yyyy/mfti^ Financial Statement - Auditor's Report Candidate - Form to. ^0: 0(i ^>. ^-^ /"\i^-'-»i/.;^ Ministry of Municipal Affairs Financial Statement - Auditor's Report Candidate - Form 4 Municipal Elections Act, 1996 (Section 88.25) Instructions All candidates must complete Boxes

More information

Request to change your insurance cover

Request to change your insurance cover Crescent Wealth Superannuation Fund Request to change your insurance cover Crescent Wealth Superannuation Fund will reduce or cancel your Death, Total and Permanent Disablement (TPD) and/or Income Protection

More information

County-wide Shared Services Initiative. Guidance Document

County-wide Shared Services Initiative. Guidance Document County-wide Shared Services Initiative Guidance Document Table of Contents Program Overview... 1 Participants... 1 Plan Development and Submission... 2 Plan Contents... 4 State Support... 5 Appendix A...

More information

DISTRICT OF COLUMBIA BOARD OF ETHICS AND GOVERNMENT ACCOUNTABILITY PUBLIC FINANCIAL DISCLOSURE STATEMENT

DISTRICT OF COLUMBIA BOARD OF ETHICS AND GOVERNMENT ACCOUNTABILITY PUBLIC FINANCIAL DISCLOSURE STATEMENT FOR INTERNAL USE ONLY THIS FORM MAY BE COMPLETED AND SUBMITTED ELECTRONICALLY AT: www.bega.dc.gov BEGA STAFF INITIALS BEGA ID# DISTRICT OF COLUMBIA BOARD OF ETHICS AND GOVERNMENT ACCOUNTABILITY PUBLIC

More information

> By-law No. 10/2010 Form 4 - Audited

> By-law No. 10/2010 Form 4 - Audited THE CITY OF WINNIPEG FORM 4 AUDITED FINANCIAL STATEMENT REFERENCE: SECTION 21(1) CAMPAIGN EXPENSES AND CONTRIBUTIONS BY-LAW NO. 1012010 1 of 14 Campaign Period Surplus (Deficit) ((A) - (B)) $ -530.77 Total

More information

Form CPF M 102: Campaign Finance Report Municipal Form Office of Campaign and Political Finance

Form CPF M 102: Campaign Finance Report Municipal Form Office of Campaign and Political Finance Commonwealth of Massachusetts Form CPF M 102: Campaign Finance Report Municipal Form Office of Campaign and Political Finance Fill in Reporting Period dates: Beginning Date: Ending Date: File with: City

More information

COURT OF APPEALS, STATE OF COLORADO 2 East 14 th Avenue Denver, Colorado 80203

COURT OF APPEALS, STATE OF COLORADO 2 East 14 th Avenue Denver, Colorado 80203 COURT OF APPEALS, STATE OF COLORADO 2 East 14 th Avenue Denver, Colorado 80203 Appeal from Board of Assessment Appeals, State of Colorado Presiding Judges Diane M. Devries and Amy J. Williams Case No.

More information

RESOLUTION NO A RESOLUTION OF THE CITY COUNCIL OF THE CITY OF CASTLE PINES, COLORADO, CERTIFYING THE MILL LEVY

RESOLUTION NO A RESOLUTION OF THE CITY COUNCIL OF THE CITY OF CASTLE PINES, COLORADO, CERTIFYING THE MILL LEVY RESOLUTION NO. 12-69 A RESOLUTION OF THE CITY COUNCIL OF THE CITY OF CASTLE PINES, COLORADO, CERTIFYING THE MILL LEVY WHEREAS, the City Manager serving as the City Budget Officer prepared and presented

More information

B. ADDITIONS TO THE AGENDA Potential Shift in East Montpelier Fire Department Quarterly Meeting Concept

B. ADDITIONS TO THE AGENDA Potential Shift in East Montpelier Fire Department Quarterly Meeting Concept East Montpelier Selectboard Meeting APPROVED (08/21/17) MINUTES August 7, 2017 at the Town Office Selectboard (SB) members present: Carl Etnier (recording secretary), Seth Gardner, Gene Troia, Kim Swasey,

More information

STATE OF COLORADO FISCAL RULES

STATE OF COLORADO FISCAL RULES Rule 5-1 TRAVEL 1. Authorities 2. Definitions 3. Rule 4. Travel Authorization 5. Travel Advance 6. Traveling Away from Home 7. Non-Allowable Travel Expenses 8. Certification and Approval 9. Reimbursement

More information

FEDERAL RESERVE BANK OF NEW YORK Fiscal Agent of the United States

FEDERAL RESERVE BANK OF NEW YORK Fiscal Agent of the United States FEDERAL RESERVE BANK OF NEW YORK Fiscal Agent of the United States Circular No. 8917 September 15, 1980 TREASURY TO AUCTION 2-YEAR AND 4-YEAR NOTES TOTALING $7,500 MILLION To All Banking Institutions,

More information

REPORT OF CONTRIBUTIONS AND EXPENDITURES [C.R.S ]

REPORT OF CONTRIBUTIONS AND EXPENDITURES [C.R.S ] Colorado Secretary of State Elections Division 1700 Broadway, Ste. 270 Denver, CO 80290 Ph: (303) 894-2200 x 6383 Fax: (303) 869-4861 www.sos.state.co.us REPORT OF CONTRIBUTIONS AND EXPENDITURES [C.R.S.

More information

i ~ z 21 Open to Public Inspection & 20 Form 990 EZ

i ~ z 21 Open to Public Inspection & 20 Form 990 EZ Form 990 EZ Department of the Treasury Internal Revenue Service Short Form OMB No. 1545-1150 Return of Organization Exempt From Income Tax Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue

More information

LINC Logistics LLC - Corporate Office Issue: Version 3.1 Procedures Manual SUBJECT: Section 1.0 BUSINESS CONTROL Date: March 13, 2013

LINC Logistics LLC - Corporate Office Issue: Version 3.1 Procedures Manual SUBJECT: Section 1.0 BUSINESS CONTROL Date: March 13, 2013 1.4 OPERATIONS DEVELOPMENT SCOPE This procedure describes how the company: Develops new or amends existing operational processes. Arranges for adequate resources for a launch. The Operations Project team

More information

Creating a Six Sigma Super Highway for Delivering Results

Creating a Six Sigma Super Highway for Delivering Results Creating a Six Sigma Super Highway for Delivering Results Don L Redinius MBB, President and COO Savvi International Corporation 0. 2 0.18 0.16 0.14 0.12 0. 1 0.08 0.06 0.04 0.02 0 1 2 3 4 5 6 7 8 9 1 0

More information

SECURITIES AND EXCHANGE COMMISSION Washington, D.C SCHEDULE 13G. Under the Securities Exchange Act of 1934 (Amendment No.

SECURITIES AND EXCHANGE COMMISSION Washington, D.C SCHEDULE 13G. Under the Securities Exchange Act of 1934 (Amendment No. FORM SC 13G SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549 SCHEDULE 13G Under the Securities Exchange Act of 1934 (Amendment No. )* Riot Blockchain, Inc. (Name of Issuer) Common Stock, no par

More information

'º i. t > i,,r Ontario. Ch--a ~ ~(S /Q'3/ élj. ù~1llc:>r.

'º i. t > i,,r Ontario. Ch--a ~ ~(S /Q'3/ élj. ù~1llc:>r. . I'):.:: t > i,,r Ontario Instructions: Ministry of Municipal Affairs and Housing Financial Statement - Auditor's Report Form 4 Municipal Elections Act, 1996 (Section 78) All candidates must complete

More information

CORPORATE PERFORMANCE DASHBOARD. August 2010

CORPORATE PERFORMANCE DASHBOARD. August 2010 Quality care for you, with you CORPORATE PERFORMANCE DASHBOARD August 21 Approved by the Board of Directors on 3 th September 21 1 CONTENT: Page Introduction 3 Targets: 1 st OP Appointment 4 Diagnostic

More information

Public Works Department 305 West Third Street, East Wing, Third Floor Oxnard, California Tel

Public Works Department 305 West Third Street, East Wing, Third Floor Oxnard, California Tel Public Works Department 305 West Third Street, East Wing, Third Floor Oxnard, California 93030 Tel 805.385.880 OXNARD WASTEWATER TREATMENT PLANT MAIN ELECTRICAL BUILDING TRANSFORMER REPLACEMENT PROJECT

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

What happens if my bid is in excess of the aggregation limits?

What happens if my bid is in excess of the aggregation limits? To all prospective tenderers for CRA8 quota shares BACKGROUND INFORMATION RELATING TO THE TENDERING OF QUOTA SHARES This fact sheet provides answers to many of the questions that may arise on the process

More information

U Corporation U Trust Association U Other

U Corporation U Trust Association U Other ShortForm Return of Organization Exempt From Income Tax Form 990-EZ Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue Code (except private foundations) Department of the Treasury Internal

More information

t('~ :> r Ontario D I did not accept any contributions or incur any expenses other than the nomination fee. (Complete Box A and B only)

t('~ :> r Ontario D I did not accept any contributions or incur any expenses other than the nomination fee. (Complete Box A and B only) t('~ :> r Ontario Instructions: Ministry of Municipal Affairs and Housing Financial Statement - Auditor's Report Form4 Munlcipal Elections Act, 1996 (Section 78} All candidates must complete Boxes A and

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

ImII Revenue, Expenses, and Changes In Net Assets or Fund Balances (see t~e instructions for Part I) '"

ImII Revenue, Expenses, and Changes In Net Assets or Fund Balances (see t~e instructions for Part I) ' Form 990-EZ Department of the Treasury Internal Revenue Service Short Form Return of Organization Exempt From Income Tax Under section 501 (c), 527, or 4947(a)(1) of the Internal Revenue Code (except black

More information

TOWN OF HIGH LEVEL SPECIAL COUNCIL MEETING. Monday, May 15 th, :00 p.m.

TOWN OF HIGH LEVEL SPECIAL COUNCIL MEETING. Monday, May 15 th, :00 p.m. TOWN OF HIGH LEVEL SPECIAL COUNCIL MEETING Monday, May 15 th, 2017 7:00 p.m. "We will strive to improve our community's quality of life by providing a safe, sustainable environment through planning, communication

More information

PEDDLER S PERMIT APPLICATION

PEDDLER S PERMIT APPLICATION Permit Number: Issued: Fee: $35.00 Check#: Cash: THE TOWN OF CENTREVILLE 101 LAWYERS ROW CENTREVILLE, MD 21617 410-758-1180 FAX 410-758-4741 WWW.TOWNOFCENTREVILLE.ORG Applicant Name: Applicant Address:

More information

FEDERAL RESERVE BANK OF NEW YORK. T ex t o f F ed era l R eg ister N otices

FEDERAL RESERVE BANK OF NEW YORK. T ex t o f F ed era l R eg ister N otices FEDERAL RESERVE BANK OF NEW YORK Circular No. 8873 July 11, 1980 C O M P L E T IO N O F P H A S E -O U T O F C R E D IT R E S T R A IN T PR O G R A M T ex t o f F ed era l R eg ister N otices To All Member

More information

Heylo Housing launch (22 March 2017)

Heylo Housing launch (22 March 2017) Heylo Housing launch (22 March 2017) Good evening, I d like to congratulate those who organised tonight s launch on their choice of venue. Holding an event that focuses on the importance of house building

More information

THE GEORGE WASHINGTON BATTLEGROUND POLL

THE GEORGE WASHINGTON BATTLEGROUND POLL THE GEORGE WASHINGTON BATTLEGROUND POLL A national survey of 1,000 Registered Likely Voters Do you feel things in the country are going in the right direction, or do you feel things have gotten off on

More information

LOAN APPLICATION. Street Address City/Town Prov Postal code. Loan amount requested $ Length of Amortization Funds on hand $

LOAN APPLICATION. Street Address City/Town Prov Postal code. Loan amount requested $ Length of Amortization Funds on hand $ LOAN APPLICATION Section A Legal name of church/agency PID# Street Address City/Town Prov Postal code Mailing Address if(different than street address): Tel : Fax email Website Loan amount requested $

More information

I. APPLICANT AGENCY PROJECT TITLE. Project Director. Address AMOUNT REQUESTED

I. APPLICANT AGENCY PROJECT TITLE. Project Director. Address AMOUNT REQUESTED For Official Use Only: Received Approved Denied Duplicates Services Yes No Application Number Amount Awarded Victim Rights Act Yes No V/S or L/E Project Duration to Services to Victims Yes No Previously

More information

EMPLOYEES PROVIDENT FUND SCHEME,

EMPLOYEES PROVIDENT FUND SCHEME, Regn. No FORM 19 (For Office use only) GROUP NO: OFFICE AT: EMPLOYEES PROVIDENT FUND SCHEME, 1952 Form to be used by a Major Member of the Employees Provident Scheme, 1952 for claiming the Employees Provident

More information

t > ~-- r- Ontario D I did not accept any contributions or incur any expenses. (Complete Boxes A and B only)

t > ~-- r- Ontario D I did not accept any contributions or incur any expenses. (Complete Boxes A and B only) l')h, t > r- Ontario Instructions Ministry of Municipal Affairs Financial Statement - Auditor's Report Candidate - Form 4 Municipal Elections Act, 1996 (Section 88.25) All candidates must complete Boxes

More information

REQUEST FOR QUOTE (RFQ) MOWING SERVICES AND GROUNDS MAINTENANCE US 290 BUSINESS PARK

REQUEST FOR QUOTE (RFQ) MOWING SERVICES AND GROUNDS MAINTENANCE US 290 BUSINESS PARK REQUEST FOR QUOTE (RFQ) MOWING SERVICES AND GROUNDS MAINTENANCE US 290 BUSINESS PARK Quote Due: Thursday August 30, 2012 10 A.M. QUOTE MAY BE DELIVERED TO: City of Brenham Purchasing Services 200 West

More information

FOLLOW-UP REPORT Department of Excise and Licenses Office of Marijuana Policy Audit

FOLLOW-UP REPORT Department of Excise and Licenses Office of Marijuana Policy Audit FOLLOW-UP REPORT Department of Excise and Licenses Office of Marijuana Policy Audit December 2017 Office of the Auditor Audit Services Division City and County of Denver The Auditor of the City and County

More information

Castle Rock Downtown Development Authority (CR DDA)

Castle Rock Downtown Development Authority (CR DDA) Castle Rock Downtown Development Authority (CR DDA) Financial Statements As of March 31, 2016 And the Three Months Then Ended Accountants Compilation Report Board of Directors Castle Rock Downtown Development

More information

ARV'AM-, C:i cf-~1 Committee Type:

ARV'AM-, C:i cf-~1 Committee Type: Colorado Secretary of State Elections Division 1700 Broadway, Ste. 200 Denver, CO 80290 Ph: (303) 894-2200 ext. 6383 Fax: (303) 869-4861 Email: cpfhelp@sos.state.co.us www.sos.state.co.us REPORT OF CONTRBUTONS

More information

The following statement was issued by the Treasury Department:

The following statement was issued by the Treasury Department: igitized for FRASER ttp://fraser.stlouisfed.org/ ederal Reserve Bank of St. Louis FEDERAL RESERVE BANK OF NEW YORK Fiscal Agent of the United States Circular No. 9184 November 12, 1981 TREASURY TO AUCTION

More information

Ontario. /< -z._' Financial Statement - Auditor's Report Form 4 Municipal Elections Act, 1996 (Section 78)

Ontario. /< -z._' Financial Statement - Auditor's Report Form 4 Municipal Elections Act, 1996 (Section 78) t ~ r ::> Ontario Ministry of Municipal Affairs and Housing Financial Statement - Auditor's Report Form 4 Municipal Elections Act, 1996 (Section 78) Instructions: Al candidates must complete Boxes A and

More information

Short Form. Return of Organization Exempt From Income Tax

Short Form. Return of Organization Exempt From Income Tax l efile GRAPHIC p rint - DO NOT PROCESS I As Filed Data - I DLN: 93492135034948 Form 990 -EZ Short Form OMB 1545-1150 Return of Organization Exempt From Income Tax Ij Under section 501 (c), 527, or 4947(

More information