Colorado ecn:ary of S1a1c Electons D vson 1700 RroJdway, Ste. 200 Dcm cr, CO 80290 Ph: (303) 894-2200 exl. 6383 Fax: (303) 869-4861 Ema l: cp01elp@sos.s1arc.co.us www.snsstatc.co. us REPORT OF CONTRBUTONS AND EXPENDTURES Space Aclmv For Olfo.:c OCT 31 2017 ' ~Onl y Full Name of Commttee/Person: Address of Commttee/Person: Cty, State & Zp Code: Commttee Type: Name and Address of Fnancal nsttuton SOS fd NUMBER (slate and coun ty co mmuec ~): 3J- - OS J t{.- b ( ( Type of Report ~gularly Scheduled Flng. D Amended Fl ng. Ths amends prevous report fl ed on (date) Submt changes or new nfonnuton 0 LY D Tennnaton Report. (Termnaton Reports MUST Have : Monetary Balance of Zero n Lne 5) D Check ths box f ths Report Conta ns Electoneerng s n fo1maton Through ( 0 {<t"/ b ~,.P Declared Total Spendng (r applcable) [An. XXV lll.sec. 4( 1)) ~- ---------~ Funds on Hand at the Be nnn of Re Perod (monetary only) 2 Total Monetar Contr butons (lne 11 ) 3 Total of Monetar Contrbutons & Be nn n Amount (lne + lne 2) The a p1>roprate offcer shall mpose a penally or 50 per day for each day that a report s llcd late. [Art. XX V Sec. 10(2)(a )l Authorzaton (Must he completed by ether the Regslered Agent OR the Cundd;te): hereby certfy and declare, 1111der penalty of perjury, that to the best of my knml'ledge or belef all contrbutons receved durng ths reportng perod, 11c/11d11g any co11trh11tons receved 11 tre form of me111be1:fhp dues transferred by a membershp orga 11wto11. are from permssble sources. Canddates Sgnature:
Current Reportng Perod:!J fl 3 { :J-0 Cl Through Funds on hand at the begnnng of reportng perod (Monclary Only) EKDS 6 temzed Contrbutons 20 or More [C.R.S. -45-108(1)(a)] / lp 66. oa (Please lst on Schedule "A") 36 1 7 Total of Non-temzed Contrbutons (Contrbutons of 19.99 and Less) 8 Loans Receved (Please lst on Schedule "C") 9 Total of Other Recepts (nterest, Dvdends, etc.) 0 {) a 10 Returned Expendtures (from recpent) 0 (Please lst on Schedule "D") l] Total Monetary Contrbutons & o o. tj 0 (Total of lnes 6 through 10) 12 Total Non-Monetary Contrbutons {) (From Statement of Non-Monetary Contrbutons) 13 Total Contrbutons ( & oo. oo (Lne 11 +lne 12) 14 temzed Expendtures 20 or More fc.r.s. 1-45-lO&(t)(a)J 30 q (. r2 0 (Please lst on Schedule "B") 15 Total of Non-temzed Expendtures {Expendtures of 19.99 or Less) 0 16 Loan Repayments Made (Please lst on Schedule "C") 0 17 Returned Contrbutons (To donor) (Please lst on Schedule "D") 18 Total Coordnated Non-Monetary Expendtures (Canddate/Canddate Commttee & Poltcal Partes only) 0 0 19 Total Monetary Expendtures 2&;q (. c+o (Total of lnes 14 through 17) 20 Total Spendng (Lne 8 + lne 19) 309 /.d-0 Colorado Secretary of State Form Rev. 12/09 1
Schedule A- temzed Contrbutons Statement (20 or more) [C.R.S. l-45-108(l)(a)] WARNNG: Please read the nstructon page for Schedule "A" before completng! PLEASE PRNTtrYPE (:) l 4. Name {Last, Frst): -L_:::.::::...-!-L.!--L~~~...L.=:.+--==-!!...:::..:::...:=::...~~j, -J-..LJ.,...::::::... ~..._-+-->-..._--'---4 5. Address: 03~ B (;;ft_<;; fl~, ~, 6. Cty/State/Zp : c C~~ A.AALJ 1 ~ 2?() {( J- -~_.._1... ~=--------------------------- 1-=:-------~.P.A'---,...G="'=------------------ Electoneerng 9. Occupaton (f applcable, mandatory):-------------------- -. Date Accepted { 0 -;ro / ~~- oo ~- Asroo.Aomb. D Check box f Electoneerng 1. Date Accepted ( O/J-0/11 a~o T ()l) 3. Aggregate Aml. * {t;1j. ro D Check box f Electoneerng _...:...:C::::...;::::...:~~..,.,_L~a_-1!4~o------------ 9. Occupaton (f applcable, mandatory): _=n ' 4. Name (Wt, F«t) llt-v 1:5#J_ f'.'..s, cl,.. ""--/'-tf '--"_C; =-f<y +->=~------------- 5. Addres" 3 2:..~ re (AA l)v H - ---1 UJ ~ rf?j()~ CN ( ):'.. 8. Employer (f applcable, mandatory>: (! v5;fu}j/\ 6\ VVV(JY\_tV\J J0~ '::>~as 9. Occupaton (f applcable, mandatory): o~ Vl.QA,/ 1. Date Accepted l a J-0 { 1 7 --1--=-~-L~-"-l..J...:::~-:-L-~-..L-!.-..:::::..=...::::L a~o. orj s /t;;0.oo D Check box f Electoneerng 5. Address: --=---,,--'--"-------'---'---r.--'--=--------------- --1:::~~,_, =:,.:;,,_.::..>.LJ.--1-1--->c:::-=---""--{J- 6 :.. r_ d-- ---~-~~...!:.-."""T"'!-:----.-l-----=-------...----- -f----1~"'-'"'--..j"-'--=-~-"-----'"--'"'--''--!:::o=...-.::..._ Vt_c. 9. Occupaton (f applcable, mandatory): _J.. L-~=-~--t.-Jf...!..~~::;._::; _ For contrbuton lmts wlhn a commttee's electon cycle or conubuton cycle, plca~e refer lo lhe followng Colorado Consttutonal ctes: Canddate Commttee Art. XXVlll, Sec. 2(6): Poltcal Party Art. XXVlll. Sec. 3(3): Poltcal Commllcc Art. XXVlll, Sec 3(5): Small Donor Commttee An. xxvm. Sec. 2(14). Colorado Secretary of Stale Form Rev. 12109
Schedule A - temzed Contrbutons Statement (20 or more) [C.R.S. l-45-108(1 )(a)j Full Name of Commttee/Person: WARNNG: Please read the nstructon page for Schedule "A" before completng! PLEASE PRNTfl'YPE. Date Accepted /0 /tzj/t! ; oo.f/v ' 4. Name(Las1,Frs1): -rt~s, cja~ 5. Address: L CAJ-wK l (l,~ {)C{ft/f111 ; [ 0 g {) { d- ] ~ - Aggregate Amt.* \f2mp-j f-==--------l 8. Employe.r (f applc:e~datory) : E.~ s~.~l - Electoneerng 9. Occupaton (f applcable, mandatory): -+--'V( '--";...:"-''--'<---''---'-----1-------------. Date Accegted! 5. Address: Electoneerng 9. Occupaton (f applcable, mandatory): 1. Date Accegted 5. Address: Electoneerng 9. Occupaton (f applcable, mandatory): 1. Date Accegted T 5. Address: Electoneerng 9. Occupaton (f applcable, mand!tory): For contnbuton lmts wthn a commttee's electon cycle or conlrbuuon cycle, please refer to the followng Colorado Consutuuonal ctes: C31ld1dale Commttee An. XXVlll, Sec. 2(6); Poltcal Party An. XXVlll. Sec. 3(3); Poltcal Commltce An. XXVlll, Sec 3(5): Small Donor Commllcc An. xxvrn. Sec. 2(14 ). Colorado Sccrclary of Slate Fonn Rev. 12109
Schedule B - temzed Expendtures Statement (20 or more) [l-45-108(l)(a), C.R.S.] Full Name of Commttee/Person:,,...,,,~--'-----"'--~-'-=c..::,_-4-~--'-...J..J/.--'"'~_,._,,;z...:>..~-=:::.._-- PLEASE PRNTffYPE 1. Date Expended 0 13 q Lf oo 3.Recpent s (optonal): D Commttee '-f lf, (J (J 3.Recpent s (optonal): D Commttee 7. PurposeofExpenclture:.,,.._-=---'---=----'-~-=-_._~-=-------- Electoneerng 1------1--''-------1,,_..._..,_"""""'...o.=;--'-',_...+--'--"""~-----+---------- 3_Rec ent s (optonal): D Commttee 7. Purpose of Expendture: --J---1.---'---L..->...<L..--'-L--""-~..::...:::--'-...:q.--=::: -------- Electoneern 5, ()-0 1----"'-------16.Cty/State/Zp: ~--~----------- 3. RD~:~t~~tonal): 7. Purpose of Expendture:,C""'-'tf '---'-... cb """""-. -l-f_.._(... Jd; ~L-..L<--==--... fu --=;;...=... <;.c... 1. Date Expended Electoneern 5. Address:---------------------------- 1----------1 --------- ------------ --- 3.Recpent s (optonal): D Commttee 7. Purpose of Expendture:----------------------- 0 Non-Commttee D Check box f Electoneerng Colorado Secretary of State Form Rev. 12/09