D Termination Report. (Terminat ion Repmts MUST Have a Monetary Bal ance of Zero in Line 5)

Transcription

1 Colorado Sccn:tary nf S1a1.: Eicc1io 11s Di vision 1700 Bro.1Jway, Sic. 200 Dcn"cr, CO Ph : (303) ex t. 6J83 FJx (303) \\l\'i.' \V.sc1:..statc.co. us Space flclo 11 For Olliec u,c Onl) REPORT OF CONTRIBUTIONS AND EXPENDITURES ( , C R S.) Committee Type: Name and Address of Financial I J:2 I...,./ So 2 5 /:::J..;=> ) n1 ~Tn_s t_it_ut_i_o_n 'tc~""""""'''""=y> '' '!:J/Ll~_Vl '/C,f/ '_/ Y/!l. _la.u_s_y. ''b._""""")h~«~j1 '4'<1~'4"'.,!j.'el"'Ci6"'<D'v..Jf::::J' SOS ID NUMBER ('Lale and cuunt y c1>11 11niltee,): I ~' Type of Report ~eg ul a rly Scheduled Filing. D Amended Filing. This amends previous report filed on (date) Submit change., or new informati on ONLY D Termination Report. (Terminat ion Repmts MUST Have a Monetary Bal ance of Zero in Line 5) D Check this box if this Repo rt Contains Electi oneering s Information Reporting Period Covered: j g /1 q /17 ~~7+'~7~0~,llc~'~ Declared Total Spending (il' applicabk) I [Art.XXYlll,Scc 4( 1)1 ~. ~ j Through I /{) /1.;;;.._. /r?, ~~"C._,. &+_J Totals Detailed Summar Pa ge Funds on Hand al the Beoinnin <T of Re ortin o Peri od (monetary onl y) 2 Total Monetar Contributions (line 11 ) 3 Total of Monetar Contributions & Be 0 innino Amount (line I+ line 2) 5 Funds on I land at the End of Re orlino Period (monetary ) (line :i line 4) The appropriate officer shall impose a penalty of 50 per day for each day that a 1eport is filed late. [Art. XXVTTT Sec. 10(2)(a)l 11 10/;3/;1 I I

2 DETAILED SUMMARY Current Reporting Period: I CJ / 10 / l J Through I f 0 j1z_/t1 Funds on hand at the beginning of reporting period (Monetary Onl y) ~q 6 Itemized Contributions 20 or More [C.R.S. l45108(j)(a)j (Please list on Schedule "A") ~ Total of NonItemized Contributions (Contributions of and Less)... 8 Loans Received (Please list on Schedule "C") ~ 9 Total of Other Receipts (Interest, Dividends, etc.) 10 Returned Expenditures (from recipient) (Please list on Schedule "D") 11 Total Monetary Contributions (Total of lines 6 through I 0) dj50~01j 12 Total NonMonetary Contributions (From Statement of Non Monetary Contributions) 150 rj () Total Contributions (Linc 11 + line 12) ZOfZ50.oO 14 Itemized Expenditures 20 or More [C.R.S. J45 108( l)(a)j (Please list on Schedule "B") 15 Total of NonItemized Expenditures (Expenditures of or Less) Loan Repayments Made 16 (Please list on Schedule "C") Returned Contributions (To donor) 17 (Please list on Schedule "D") 18 Total Coordinated NonMonetary Expenditures (Candidate/Candidate Committee & Political Parties only) c2 4. 3~ 19 Total Monetary Expenditures 131. ;S (Total of lines 14 through 17) 20 Total Spending (Line 18 + line 19) Colorado Secretary of State Fo rm Rev. 12/09

3 Schedule A Itemized Contributions Statement (20 or more) [C.R.S (1 )(a)] WARNING: Please read the instruction page for Schedule "A" before completing! PLEASE PRINT/fYPE 4. Name (Last, First) : :_.r:o::..!d=:...yl _!._:::==t./=1!/_0::_!, lfft!...:...!'.,~ f2. C+on+tn~'bu~ti+onA~rnt.~ 5. Address: f I J kt7 V1,) 6 4rfh_ 'P / 1=~'='""'l Av\l+D47 lo 3. Aggregate Amt. * /, 1. _.._0~w~6... t_j:.. ""=~ 11 ;)11 b~ ff 2_7) N bet /I Atvt6! ~!NJ 9. Occupation (if applicable, mandatory):.j~?. _ 1. Date Accepted / I. /. J ff' 11 fi~~)""ytyo m ) ftr f2. C'o'ntrib_u.tio._n_A'rnt.~ 5. Addres8' :J 1 dzi h u I I'.) ncy [± >~~~< 5o ~~ A,_A r 1 k\'}2,<~ ~ LJz::, X=crx:;/5 ~ Aggregate Amt. * =C~11... fl:._.~( "'=~~,,, Jell+ I rbt.:!7.t f!at, 'J?oor:s IA.){!_,,, ~ 9. Occupation (if applicable, mandatory): '' I Y.ff. :...:V=f'ft c...c± '"" L/0,,,::?J :::_+'C ' J 7 q /?b/(j 1. Date Accented 2. Contribution Arnt. /DO 3. Aggregate Amt. * r C.o DVlLi vi..e. 9. Occupation (if applicable, mandatory): Vf1_)1 Vl d ~cx::lj LlJl:SS6L' ( he41 Urb?Ja ) 5. Addiess' / 3 ~ DY t=:< 0 Check box if ~ 9. Occupation (if applicable, mandatory):,_/!) _'(, '"' /f,,_t_.6_.'f._,'(&f T For contribution limits within a committee's election cycle or contribution cycle, please refer to the following Colorado Constitutional cites: Candidate Committee An. XXVlll, Sec. 2(6); Political Party An. XXVlll, Sec. 3(3); Political Committee An. XXVlll, Sec 3(5); Small Donor Committee Art. XXVIJI, Sec. 2(14). Colorado Secretary of State Fo rm Rev. 12/09

4 , Schedule A Itemized Contributions Statement (20 or more) I ~ [C.R.S (1 )(,)I Full Name of Committee/Person: WARNING: Please read the instruction page for Schedule "A" before completing! PLEASE PRINTffYPE 3. Aggregate Arnt. * I. Date Acee ted 10 tf \( 2. Contribution Amt Aggregate Amt. * 1 9. Occupation (if applicable, mandatory): 0 Check box if 9. Occupation (if applicable, mandatory): 2. Contribution Amt. 5. Address: It L\=g f bcf ~ ft\)(_ 1_ l_o_o_. ~ 6. City/State/Zi ~ k'da7 7 1LJ 8ooo7 3. Aggregate Arnt.* D ~ 7. Description: 8. Employer(ifa~pp~lic~ab~lc~. n~1a~ndm~ory~):~~~. ~~~~~ ~~l ~~~~~~~~~~~ 0 Check box if V. 9. Occupation (if applicable, mandatory): _J ; _+_,_lz..=~::...= 7 "''f_t>_e:_,,_tj_i\ For contribution limits within a committee's election cycle or contribution cycle, please refer to the following Colorado Constituti onal cites: Candidate T Committee Art. XXVlll, Sec. 2(6): Political Party Art. XXV lll, Sec. 3(3): Poli tical Committee Art. XXVlll, Sec 3(5): Small Donor Committee Art. XXVIII, Sec. 2(14). l..~ Colorado Secretary of State Fo rm Rev. 12/09

5 Schedule A Itemized Contributions Statement (20 or more) [C.R.S (1 )(a)] WARNING: Please read the instruction page for Schedule "A" before completing! PLEASE PRINTtrYPE f/1tr R6 L LI 6/\J :: ~~::::<}:::~'~~ ~ ~ 2. Contribution Amt 3. Aggregate Amt * L D Y'Ltd ~ i.,o=checkboxif1 8. Employer(if pplk blo,m'"d"om"&~ ICA) <i/ \/g::,lf.a.m ~1W/6ifh1 9. Occupation (if applicable, mandatory):.:::.. ) 1. Date Accepted 2. Contribution Amt 5. Address: 3. Aggregate Amt * 0 Check box if 1. Date Accepted 9. Occupation (if applicable, mandatory): 2. Contribution Amt. 5. Address: 3. Aggregate Amt. * 0 Check box if 9. Occupation (if applicable, mandatory): : For contnbution limits wathm a conumttec's elecuon cycle or contnbuuon cycle, please refer to the following Colorado Consutuuonal cites: Candidate T Committee Art. XXVlll, Sec. 2(6); Political Party Art. XXVlll, Sec. 3(3); Political Committee Art. XXVlll, Sec 3(5); Small Donor Committee Art. XXVIIT, Sec. 2(14). Colorado Secretary of Slate Form Rev

6 , Statement of NonMonetary Contributions [Art. XXVITI, Sec. 2(5)(a) (TI)(ITI) & Sec. 5(3) & ( 1), C.R.S.] Full Name of AJ M/rek/ /_!AJh/ dr(br kabk PLEASE PRINTrfYPE I. Date Provided IO I J ll 2. Fair Market Value 1'6o 3. Aggregate Amt. 4. Name (Last, First): 5. Address: }Dtf(;)_O );\_) /qfh /;Jtu_J Arvfrbf4 ld ~ Description :~~~~~'~~~~~ ~~~~~~~~~~~~~~~~,Lo~ja} ~~U~. ~A,,,~S=< 9. Occupation (if applicable, mandatory): _,D~"'Lo ='Vl :.._.: ~' Check box if Coordinated with a Candidate/Candidate Committee or Political Part * '... I. Date Provided 2. Fair Market Value 3. Aggregate Amt. 5. Address: 8. Employer (if appli cable, mandatory): 9. Occupation (if applicable, mandato ry): Check box if Coordinated with a Candidate/Candidate Committee or Political Party. * I. Date Provided 2. Fair Market Value 3. Aggregate Amt. 5. Address: 9. Occupation (if appli cable, mandatory): Check box if Coordinated with a Candidate/Candidate Committee or Political Party. * Note: [f coordinated, then contribution mu ~ t also be repon ed as a nonmonetary expenditure on Detailed Summary. Art. XXV!!I, Sec. 2(9) states: "... Expenditures that are controlled by or coordinated wi th a candidate or candidate's agent are deemed to be both contributions by the maker of the expenditures, and expenditures by the candidate committee. " Colorado Secretary of State Form Rev. 12/09

7 Schedule B Itemized Expenditures Statement (20 or more) [145108(l)(a), C.R.S.] Full Name of Committee/Person: JM /JiJ/uf e,tf //Jt.Jhi*GJd /,L~lf= PLEASE PRINT/fYPE 1. Date Exgended q /.x; /r7 4. Name: lff bh1vdi~ 2. Amount 5. Address: 55~/ r nn t1. I bt YI Vt t ( 0 8o:z/7 3.Recipient is (optional): > 7. Purpose of Expenditure: Tb~ l!µvc:/_5 D Committee D NonCommittee I 0 Check box if q ;) I 4. Name: s72d? LA,,VVJ +7v1 Vl~aj._ Sf >2. Amount... ~~1 5. Address: L/ ;i 5 'r, k UY VI l~ Si '3~ ~D 6. city/state/zip: Dtn~v lo 8'oz/ ~ 3.Recipient is (optional): 0 Committee 7. Purpose of Expenditure: _,.,51..=9+«YJ +S_, D NonCommittee 1. Date Exgended ID /;,, Amount 0 Check box if 4. Name: =(!_'Cf_D P, _ R.. _ l_t\j_ l_ t l\)_ L,,., ~ c:_,_ 5. Address: ~3S J /t!,,yjn'/5.ov) ~ I',_ 3.Recipient is (optional): D Committee 0 NonCommittee 0 Check box if ( ""'"' 6_. =5+l j) ~ V&Y [CJ So 2 / 2 7. Purpose of Expenditure: ~ UvJd 4. Name: PAy pf:v, "39 <' / _ >2.~A~m.ount~~< 5. Address: d2j/ A)/ ~.,.?=+< SJLJ Jose, t 4 q(!i;~; S 3.Recipient is (optional): / _J ; D Committee 7. ~oseofexpenditure :vnhnt f4'1fyltn/+[6 (fl!oyy'otzonlz ) D NonCommittee D. / Check box if Electioneerin Commurtication. 1. Date Exgended 4. Name: ~~ 2. Amount 5. Address: ~..., 3.Recipient is (optional): D Committee D NonCommittee 7. Purpose of Expenditure: 0 Check box if Colorado Secretary of State Form Rev. 12/09