Rt;CEVEO C-2 Rev11/17 Section CAMPAGN FNANCAL DSCLOSURE REPORT SUMMARY PAGE (Please Print or Type) istrict (if any) JUN O 6 2017 : OZ-" <i,\\,l;, 3i8 Work Phone ;;kf tli J2tJ Change of address for: Candidate or Political Committee Political Treasurer Section This filing is an: D Original This report is for the period from TYPE OF REPORT Amendment oy 3 O A_ through 0~ :ZS l /L D 7 Day Pre- Report D 7 Day Pre- Report ~ o Day Post- Report D30 Day Post- Report Doctober 10 Pre- Report Annual Repmt D Semi Annual report (Statewide Candidates Only) s this a Tennination Rep01t? D Yes D No Section STATEMENT OF NO CONTRBUTONS OR EXPENDTURES Directions: f you have no contributions or expenditures during this reporting period, check the box next to the statement below and sign this report Be sure to cany forward the appropriate "Calendar Year to Date" figures in Colwnn, Section N D hereby certify that have received no contributions and have made no expenditures during this reporting period Section V SUMMARY oreach your Calendar Year To Date figure: Add this reports Column figures to the Column T fi res of our revious re ort exce t on line 6) Line 1 Cash on Hand January 1, This Year* Line 2 Enter Cash Balance ** ine 3 Total Contributions (Enter amount on line 5, Page 2) ine 4 Subtotal (Add lines l, 2 and 3) Line 5 Total Expenditures (Enter amount from line 11, P&ge 2) ine 6 Cash Balance at Close of Period (Subtract Line 5 from Line 4)** ine 7 Outstanding Debt to Date (Enter amount from line 18, page 2) COLUMN This Period COLUMN Calendar Year To Date * This same figure should be entered on Line 1 of all reports filed this calendar year ** This is the figure on line 6 of the last Campaign Financi;ll Disclosure Report filed f this is your first report,-thls amount is 0 Note: The closing cash balance for the current reporting pe1iod appears on the next report as beginning cash on hand Return This Report to: Joseph W Larsen Cassia County 1459 Overland Ave Burley, 83318 2088785240 2088788825 Section V CERTFCATON, /lruk~ D@/4J fefe Jiereby ce1tify that the infonnation in this reporti a true, complete and con-ect Campaign Finance Disclosure Report as required by law
DETALED SUMMARY PAGE ~me of Candidate or Committee: Lt2cA1AP-D,6B- K Contributions rrotal This Period 1) Un-itemized Contributions (50 and less) # of Contributors i+ (2) temized Contributions {Total of all Schedule A sheets) + ):13S:oo (3) n-kind Contributions (Total of all Contribution amounts from Schedule C sheets) + :4) Loans (Total of all New Loan amounts from Schedule D sheets) +- (5) Total Contributions (Transfer this figure to page 1, Section V, Line 3) i= s /33S:oo!Expenditures 6) Un-itemized Expenditures (25 and less) # of Expenditures i+ 7) temized Expenditures (Total of all Schedule B sheets) f+ "f(j 5: 0 <) (8) n-kind Expenditures {Total of all Expenditure amounts from Schedule C sheets) + 9) Loan Repayments (Total of all ~oan Repayment amounts from Schedule D sheets) + 10) Credit Card and Debt Repayments (Total of all Repayment amounts from Schedule E sheets) i+ (11) Total Expenditure~ (Transfer this figure to page 1, Section V, Line 5) = 5 0 t; DO!Loans, Credit Cards and Debt "12) Outstanding balance from previous reporting period ft 513/3S-: ti~ 1 13) New Loans received during this reporting period (Total of all New Loan amounts plus Accrued nterest from Schedule D sheet) + (14) New Credit Card and Debt incurred this reporting period + (Total of all New ncurred Debt amounts from Schedule E sheets) ~15) Subtotal F (16) Repayments of Loans made during this reporting period r- (Total of all Loan Repayment amounts from Schedule D sheets) 17) Repayments of Credit Card and Debt this reporting period - (Total of all Debt Repayment amounts from Schedule E sheets) :18) Total Outstanding Balance at close of this period (Transfer this figure to page 1, Section V, Line 7 F - SOS:oO 1, 1 46 <{<;/ S/J S:o o S11 ~ 1,!Pledged Contributions (19) Un-itemized Pledged Contributions (50 and Jess) # of Pledges + 1 (20) temized Pledged Contributions (Total of all Schedule F sheets) ; + (21) Total Pledged Contributions this period +
SCHEDULE A TEMZED CONTRBUTONS Of more than flfly dollars (5000) this period Name of Candidate or Committee: L J! Gb&ll!!-D a,;cj:: of Date Received 5"t 31 /8 Full Name, Mailing Address and Zip Code of Contributor/Lender 1 llhy_!c,li;c/{ 53~ 7Ffi;N JRtU 6v,et&(r ;;:::tj 1f33/,5 2 :ii"el ~/)/i>s ~ g J/1, /JJESi S-t cl 5"o-Jli Ju tl ~ ::rt:, i 73/B SJ 8 lg ~- r~vi;- cj/<ll)cpl::, 5/fl & 57 J /; )~ j, 1/ ~ ~U,l!Tf!N /lrj~ l3vfclcf ~ &3J JS 14 :TvNt: rrilr:1,1,/ N ul!tft Joo WEs r t3u ru ei, Y:-D 8 3 3 q 5 ijl1a1s l>ffpl~w Joo/ A tl4j n~ 01<w~ fivl!/,el-1 ~tl r?33 S 6 5!1</1 i l)c=voa1 /rvclrrill SS lues-r ;l7 A Sr 6vt2LCZ-, :rtj ~33/i? 57 JS!J<J 7 Jd~~",,4-ssc(; of /calfcr5 :hie- /O//t, {,)) Ot1eRlAJA /ecaj 6o15c 76 5??7C9 8 \ 9 10 Total This Pa2e: Cash or Check sow ()4()! {tj6co tl~ -0<1 ~(J-0() ~-01 2SAV z,r~rt, sa v<j SO OG! S:ll~t2Q ~_(}() {hyj,t}0 L<ZJD 00 Caleqder year To Date ~alendar year To Date L""l1 C;,,OCi Transfer the combined total of all Schedule A pages to the Detailed Summary on page 2, line 2
Name of Candidate or Committee: SCHEDULE B TEMZED EXPENDTURES Of Twenty-Five Dollars (2500) or more this period Uo,<J,4,e ll!jeek Purpose Codes A All Travel Expenses (Airfare, Fuel, Lodging & Mileage) B Broadcast Advertising (Radio, TV & nternet) C Contributions to Candidates & PACs D Donations & Gifts E Event Expenses F Food & Refreshments G Operational Expenses L Literature, Brochures, Printing M Management Services N Newspaper & Other Periodical Advertising 0 Other Advertising (Yard Signs, Butto11s, etc) P Postage S Surveys & Polls T Tickets (Events) U Utilities W Wages, Salaries, Benefits & Bonuses Y Petition Circulators z Preparation & Production of Advertising Date SJ?ent Full Name, Mailing Address and Zip Code of Recipient Purpose Code Cash or Check _ J _!i_1 i L 1111: r1ru s f1o, Nc!Ws &,~ S7f8 -t;;,t~ nils ;t::f) ~ 3i03 Q 3 ~_/_ 4 _/_/_, 5 ~ s 6 _; / - 7 ) 5l>5",<!)0 8 -, 9 ~ _ /_ 10 _/_ /_ Total This Page 3o5-oo Transfer the combined total of all Schedule B pages to the Detailed Summary on page 2, line 7,; 1, :,
SCHEDULEE CREDT CARDS and DEBT Each incurred expense not yet paid (ie credit card purchases and debt) should be listed on a separate line Each time you make purchases with a credit card or incur debt, it is considered to be a separate item However, you will maintain a single item for each credit card and add purchases to that item Each Creditor listed below with a New Debt amount must have a Schedule E-1 accompanying it The Schedule E-1 lists where the debt was incurred Credit Cards are considered Debt to the campaign Regardless of whether the credit card is repaid when the statement is received, all credit card transactions will appear on Schedule E and E-l However, only Repayments of Debt during this reporting period appear in the Expenditure Section of the Detailed Summary Page Any creditor(s) with a balance(s) appearing on the last reporl must be listed below with the amount in the Previous Balance column Any new debt should be listed in the New Debt column, including any accrued interest 1f a payment was made on the debt, list it in the Repayments column NOTE: Any debt that was repaid in full in a previous reporting period does not need to be listed The Outstanding Balance column is the Previous Balance plus New Debt less any Repayments of Debt Name, Mailing Address and Zip Code of Previous Balance of debt New Debt amount Repayments of Debt Balance Lender at the end of the last incurred during this during this reporting Outstanding at the end of this Candidate, ndividual or Business reporting period reporting period period reporting period LC1tprra_L CJ11! Date: Date: f!l/- 118 -l 17 ti! (!;~ l:joso/ G-r;, cf -7;,rws-0,,11 a 4171, 5135, cjj SoS:06 os,c> 0 12 -/ Date: Date: 513~{~ -! 3 Date: Date: 14 Date: Date: 5 Date: Date:! 6 Date: Date: Previous Total!> s Previous ncurred Repayments Ending Balance Sl:/3S:Y8 ncurred Total: (Transfer combined total of all incurred debt to the Detailed Summary, page 2, line 14 ():;,",oo Repayments Total: (Transfer the combined total of all debt repayments to the Detailed fls: 0 () Summary, page 2, line LO & 17) Ending Balance Total: S-13S: </3
!Name of Creditor from Schedule E: SCHEDULE E-1 CREDT CARD and DEBT TEMZATON z~~ M6 tfr<? Each Creditor listed on Schedule E with a New Debt amount must have a Schedule E-1 accompanying it The Schedule E-1 lists where and when the debt was incurred Page of Purpose Codes A All Travel Expenses (Airfare, Fuel, Lodging & Mileage) B Broadcast Advertising (Radio, TV & nternet) C Contributions to Candidates & PACs D Donations & Gifts E Event Expenses F Food & Refreshments G Operational Expenses nterest Accmed & Finance Charges L Literature, Brochures, Printing M Management Services N Newspaper & Other Periodical Advertising 0 Other Advertising (Yard Signs, Buttons, etc) P Postage S Surveys & Polls T Tickets (Events) U Utilities W Wages, Salaries, Benefits & Bonuses Y Petition Circulators Z Preparation & Production of Advertising Date ncurred Full Name, Mailing Address, and Zip Code of Expenditures Purpose Code Amount -ftlc t///fl;s A/~ S- _!j_j J_ff_ /Jo~ St/J ri,,~, h-1/r ;ij f,~<3 t/ 12 _ /_!_ ~~(XJ 3 14 _!_/_ 5 6 _!_ /_ 7 _/_/_ 8 _ /_!_ 9 \ Total This Page The total of itemization for this creditor should equal the new loan amount listed on Schedule E for this creditor
~, :-~: -:, - _, ;,;, _1: _ 1, : _ 0 \ - t-5,; Rl)V 11/17 _, 48- HOUR NOTCE t,16y l 7,7 0lfl :of contrjlut10nsjlqans RECEVED Of One Th~usaild Dollars: (1,000~00) i>rfyl61:e ~ ::~:\ i~ -r-h~i -: - - ::Oii~ctj~p~: u~~_tlris rorm W r~po~t apy c<:ntcibutiqn ofolle t!iousw?d _dollars (1,900) or in ore r~c~ive~ afie; th~ b~~rp~ U,61h) day befor~, Qut lot _J)lOT~ tpan foify;eignt hours oefote, any piin:iary 6:r geijeral election: Notjficijtion must lje made :W}thinforty~e,ighf( 48) hours~ftet receipt of such eonfributio~ {S~ct;ion 67;66Q_7(c), daho Cc;i~e:) : ::_ >- :_ >: ; 0 ;, Eli~tiorr : Qe1\~raJ EJectioh ~ 2018 Elections -_ : 48 Hour Notice i,:equfre~ for contributions reqeived: Aprii 30, 2018 t~ ougb MAY 12:; 2018 bcfobei-22, 2018 through N6vember3 s, ~o 18 This requirenieiit applies to all types ofconttibutiori~,- ineluding btif n<>flmµted to: : - Cash contributions n-kfud contrihutio~ Loans Cont;ributfons ()r personal io~ mad~ by the candidate t istrict (JfApplicablc),: Date Received Full Name, Mailing Acldr-essari~ Zip Coi,e of Cash m;-ch~ck CoJ:ttributor/Lender fu-kind <Non,moitetary) Loan, ~ -r - 12 3 -,, " Sl,l~~i~ ijep9r:t To: JosepfJ W Larsen Cassia County 1459 Overlan,d Ave Burley, 83318 2088785240 20s~ a1s 8825 : 1, fk,81/, JdJ/~ /J,c/:;tL, hereby ~ mfy ~at 1! infu"!,ti~n m thfa Name of olihcal Trepsurer, report is true, compl!;}te and correc t -