HomeMy WebLinkAboutCC2021-06 - Team Skillicorn - 2021 Annual ReportSTATE OF ARIZONA COMMITTEE CAMPAIGN FINANCE REPORT
COMMITTEE ID NUMBER
COMMITTEE INFORMATION (required):
CANDIDATE INFORMATION (only if filing as a candidate committee):
Office Sought: County Office:
City/Town Office:
Special District Office:_________
School Board District:_________
Cumulative Report:
Check here if this is the candidate committees first, cumulative report for the election cycle. Also select appropriate Reporting Period below.
Cumulative reporting period start date (which supersedes the start date for the Reporting Period selected below):
REPORTING PERIOD (check one):
REPORTING PERIOD REPORT DUE
2020 4th Quarter Report: October 18, 2020 to December 31, 2020 January 1, 2021 to January 15, 2021
2021 March Pre-Election Report (Local Only): January 1, 2021 to February 20, 2021 February 21, 2021 to February 27, 2021
2021 March Post-Election (Q1) Report (Local Only): February 21 to March 31, 2021 April 1, 2021 to April 15, 2021
2021 Quarter 1 Report: January 1, 2021 to March 31, 2021 April 1, 2021 to April 15, 2021
2021 May Pre-Election Report (Local Only): April 1, 2021 to May 1, 2021 May 2, 2021 to May 8, 2021*
2021 May Post-Election (Q2) Report (Local Only): May 2, 2021 to June 30, 2021 July 1, 2021 to July 15, 2021
2021 Quarter 2 Report: April 1, 2021 to June 30, 2021 July 1, 2021 to July 15, 2021
2021 August Pre-Election Report (Local Only): July 1, 2021 to July 17, 2021 July 18, 2021 to July 24, 2021
2021 August Post-Election (Q3) Report (Local Only): July 18, 2021 to September 30, 2021 October 1, 2021 to October 15, 2021
2021 Quarter 3 Report: July 1, 2021 to September 30, 2021 October 1, 2021 to October 15, 2021
2021 November Pre-Election Report (Local Only): October 1, 2021 to October 16, 2021 October 17, 2021 to October 23, 2021
2021 November Post-Election (Q4) Report (Local Only): October 17, 2021 to December 31, 2021 January 1, 2022 to January 15, 2022
2021 Quarter 4 Report: October 1, 2021 to December 31, 2021 January 1, 2022 to January 15, 2022
2022 March Pre-Election Report (Local Only): January 1, 2022 to February 19, 2022 February 20, 2021 to February 26, 2022
2022 March Post-Election (Q1) Report (Local Only): February 20, 2022 to March 31, 2022 April 1, 2022 to April 15, 2022
2022 Quarter 1 Report: January 1, 2022 to March 31, 2022 April 1, 2022 to April 15, 2022
2022 May Pre-Election Report (Local Only): April 1, 2022 to April 30, 2022 May 1, 2022 to May 7, 2022
2022 May Post-Election (Q2) Report (Local Only): May 1, 2022 to June 30, 2022 July 1, 2022 to July 15, 2022
2022 Quarter 2 Report: April 1, 2022 to June 30, 2022 July 1, 2022 to July 15, 2022
2022 Pre-Primary Election Report: July 1, 2022 to July 16, 2022 July 17, 2022 to July 23, 2022
2022 Post-Primary Election (Q3) Report: July 17, 2022 to September 30, 2022 October 1, 2022 to October 15, 2022
2022 Pre-General Election Report: October 1, 2022 to October 22, 2022 October 23, 2021 to October 29, 2022
2022 Post-General Election (Q4) Report: October 23, 2022 to December 31, 2022 January 1, 2023 to January 17, 2023*
Final Campaign Finance Report Prior to Committee Termination: End of Previous Period through Today’s Date Same Date of Termination
*Reporting deadline extended to next business day. A.R.S. §§ 1-243(A) and 1-303.
FINANCIAL SUMMARY (required):
Activity Cash Activity This Reporting Period Election Cycle to Date (a) Committee value at the beginning of this reporting period (i.e. ending balance from the
previous reporting period)
(b) + Total receipts (from “Summary of Receipts,” line 13 (cash column) for this reporting period)
(c) - Total disbursements (from “Summary of Disbursements,” line 16 (cash column) for this reporting period)
(d) = Balance at close of reporting period
Check here if filing no financial activity during the reporting period. Lines (a)-(d) still must be completed, but only this cover page and thefollowing page need to be filed.
Committees with financial activity must file the cover page, summary of receipts, summary of disbursements, and any schedules that contain financial activity.
Arizona Secretary of State Revision 7/31/21 (fillable format)
Committee Information: Committee Name: TEAM SKILLICORN
STATE OF ARIZONA COMMITTEE CAMPAIGN FINANCE REPORT
COMMITTEE ID NUMBER
Arizona Secretary of State Revision 7/31/21 (fillable format)
Under A.R.S. § 16-926(B)(5), a campaign finance report must be certified by the committee treasurer under penalty of perjury that the contents of the report are true and correct.
By filing this report, you certify that, under penalty of perjury, you
have examined the contents of this report, and the contents are true and correct.
Printed Name of Committee Treasurer Signature of Committee Treasurer Date
STATE OF ARIZONA COMMITTEE CAMPAIGN FINANCE REPORT
COMMITTEE ID NUMBER
Arizona Secretary of State Revision 7/31/21 (fillable format)
SUMMARY OF RECEIPTS (Schedule A):
Receipts Cash Equity
1.Monetary Contributions Received
(a)In-State Individuals - More than $100
(b)In-State Individuals - $100 or Less (Aggregate)
(c) Out-of-State Individuals
(d)Candidate Committees
(e)Political Action Committees
(f)Political Parties
(g)Partnerships
(h)Corporations & Limited Liability Companies (PACs & Political Parties Only)
(i)Labor Organizations (PACs & Political Parties Only)
(j)Candidate’s Personal Monies (Candidate Committees Only)
(k)Monetary Contributions Subtotal (add 1(a) through 1(j))
(l)Refunds Given Back to Contributors
(m)Net Monetary Contributions (subtract 1(l) from 1(k))
2.Loans
(a)Loans Received
(b)Forgiveness on Loans Received
(c)Repayment on Loans Made
(d)Interest Accrued on Loans Made
(e)Loans Subtotal (cash: add 2(a), 2(c) & 2(d))
3.Rebates and Refunds Received
4.Interest Accrued on Committee Monies
5.In-Kind Contributions Received
(a)In-State Individuals - More than $100
(b)In-State Individuals - $100 or Less (Aggregate)
(c) Out-of-State Individuals
(d)Candidate Committees
(e)Political Action Committees
(f)Political Parties
(g)Partnerships
(h)Corporations & Limited Liability Companies (PACs & Political Parties Only)
(i)Labor Organizations (PACs & Political Parties Only)
(j)Candidate’s Personal Assets or Property (Candidate Committees Only)
(k)In-Kind Contributions Subtotal (equity: add 5(a) through 5(j))
6.In-Kind Donations Received (Non-Contributions) (Political Parties Only)
7.Extensions of Credit
(a)Extensions of Credit Received
(b)Payments on Extensions of Credit Received
(c)Net Extensions of Credit (subtract 7(b) from 7(a))
8.Joint Fundraising / Shared Expense Payments Received
9.Payments Received for Goods / Services
10.Outstanding Accounts Receivable / Debts Owed to Committee
11.Transfer In Surplus Monies / Transfer Out Debt (use cash and/or equity as applicable)
12.Miscellaneous Receipts (use cash and/or equity as applicable)
13.Total Receipts (cash: add 1(m), 2(e), 3-4, 8-9, 11-12; equity: add 2(b), 5(k), 6-7(c), 10-12)
STATE OF ARIZONA COMMITTEE CAMPAIGN FINANCE REPORT
COMMITTEE ID NUMBER
Arizona Secretary of State Revision 7/31/21 (fillable format)
SUMMARY OF DISBURSEMENTS (Schedule B):
Disbursements Cash Equity
1. Disbursements for Operating Expenses
2. Contributions Made
(a) Candidate Committees
(b) Political Action Committees
(c) Political Parties
(d) Partnerships
(e) Corporations & Limited Liability Companies (PAC & Political Parties Only)
(f) Labor Organizations (PAC & Political Parties Only)
(g) Monetary Contributions Subtotal (add 2(a) through 2(f))
(h) Contribution Refunds Provided to the Reporting Committee
(i) Monetary Contributions Total (subtract 2(h) from 2(g))
3. Loans
(a) Loans Made
(b) Loan Guarantees Made
(c) Forgiveness on Loans Made
(d) Repayment of Loans Received
(e) Accrued Interest on Loans Received
(f) Total Loans (cash: add 3(a), 3(d) & 3(e); equity: add 2(b) & 2(c))
4. Rebates and Refunds Made (Non-Contributions)
5. Value of In-Kind Contributions Provided
(a) Candidate Committees
(b) Political Action Committees
(c) Political Parties
(d) Partnerships
(e) Corporations & Limited Liability Companies (PAC & Political Parties Only)
(f) Labor Organizations (PAC & Political Parties Only)
(g) Contributions Subtotal (add 5(a) through 5(f))
6. Independent Expenditures Made
7. Ballot Measure Expenditures Made
8. Recall Expenditures Made
9. Support Provided to Party Nominees (Political Parties Only)
10. Joint Fundraising / Shared Expense Payments Made
11. Reimbursements Made
12. Outstanding Accounts Payable / Debts Owed by Committee
13. Transfer Out Surplus Monies / Transfer In Debt (use cash and/or equity as applicable)
14. Miscellaneous Disbursements
15. Aggregate of Disbursements - $250 or Less
16. Total Disbursements (cash: add 1, 2(i), 3(f), 6-11 & 13-15; equity: add 3(f), 5(g), & 12-15)
STATE OF ARIZONA COMMITTEE CAMPAIGN FINANCE REPORT
COMMITTEE ID NUMBER
Arizona Secretary of State Revision 7/31/21 (fillable format)
MONETARY CONTRIBUTIONS RECEIVED FROM IN-STATE INDIVIDUALS - MORE THAN $100 DURING ELECTION CYCLE:* SCHEDULE A(1)(a)
Individual Contributor Information Amount Received
Cumulative
Amount this Reporting Period
Cumulative
Amount this Election Cycle
1
Name Date Contribution Received
Street Address
City State ZIP
Occupation Employer
2
Name Date Contribution Received
Street Address
City State ZIP
Occupation Employer
3
Name Date Contribution Received
Street Address
City State ZIP
Occupation Employer
4
Name Date Contribution Received
Street Address
City State ZIP
Occupation Employer
5
Name Date Contribution Received
Street Address
City State ZIP
Occupation Employer
Enter total only if last page of schedule
(transfer the total received this period to “Summary of Receipts,” line 1(a))
*If in-state individual contributions of $100 or less are listed on Schedule A(1)(b), do not include them on Schedule A(1)(a).
Schedule A(1)(a), page of
Arizona Secretary of State Revision 7/31/21 (fillable format)
STATE OF ARIZONA COMMITTEE CAMPAIGN FINANCE REPORT
COMMITTEE ID NUMBER
DISBURSEMENTS FOR OPERATING EXPENSES: SCHEDULE B(1)
Recipient Information Amount Paid Cumulative Amount this Reporting Period
Cumulative Amount this Election Cycle
1
Name Disbursement Date
Cash
Credit
Street Address
City State ZIP
Type of Operating Expense Paid Non-Electoral Purpose? (PACs and Political Parties Only)
2
Name Disbursement Date
Cash
Credit
Street Address
City State ZIP
Type of Operating Expense Paid Non-Electoral Purpose? (PACs and Political Parties Only)
3
Name Disbursement Date
Cash
Credit
Street Address
City State ZIP
Type of Operating Expense Paid Non-Electoral Purpose? (PACs and Political Parties Only)
4
Name Disbursement Date
Cash
Credit
Street Address
City State ZIP
Type of Operating Expense Paid Non-Electoral Purpose? (PACs and Political Parties Only)
5
Name Disbursement Date
Cash
Credit
Street Address
City State ZIP
Type of Operating Expense Paid Non-Electoral Purpose? (PACs and Political Parties Only)
Enter total only if last page of schedule (transfer the total disbursed this period to “Summary of Disbursements,” line 1)
Schedule B(1), page of
Arizona Secretary of State Revision 7/31/21 (fillable format)
STATE OF ARIZONA COMMITTEE CAMPAIGN FINANCE REPORT
COMMITTEE ID NUMBER
MONETARY CONTRIBUTIONS TO CANDIDATE COMMITTEES: SCHEDULE B(2)(a)
Candidate Committee Recipient Information Amount Contributed
Cumulative Amount this Reporting Period
Cumulative Amount this Election Cycle
1
Committee Name
Cash
Credit
Street Address
City State ZIP
Committee ID Number Date Contribution Made
2
Committee Name
Cash
Credit
Street Address
City State ZIP
Committee ID Number Date Contribution Made
3
Committee Name
Cash
Credit
Street Address
City State ZIP
Committee ID Number Date Contribution Made
4
Committee Name
Cash
Credit
Street Address
City State ZIP
Committee ID Number Date Contribution Made
5
Committee Name
Cash
Credit
Street Address
City State ZIP
Committee ID Number Date Contribution Made
Enter total only if last page of schedule (transfer the total disbursed this period to “Summary of Disbursements,” line 2(a))
Schedule B(2)(a), page of
Arizona Secretary of State Revision 7/31/21 (fillable format)
STATE OF ARIZONA COMMITTEE CAMPAIGN FINANCE REPORT
COMMITTEE ID NUMBER
MONETARY CONTRIBUTIONS TO POLITICAL ACTION COMMITTEES: SCHEDULE B(2)(b)
Political Action Committee Recipient Information Amount Contributed
Cumulative Amount this Reporting Period
Cumulative Amount this Election Cycle
1
Committee Name
Cash
Credit
Street Address
City State ZIP
Committee ID Number Date Contribution Made
2
Committee Name
Cash
Credit
Street Address
City State ZIP
Committee ID Number Date Contribution Made
3
Committee Name
Cash
Credit
Street Address
City State ZIP
Committee ID Number Date Contribution Made
4
Committee Name
Cash
Credit
Street Address
City State ZIP
Committee ID Number Date Contribution Made
5
Committee Name
Cash
Credit
Street Address
City State ZIP
Committee ID Number Date Contribution Made
Enter total only if last page of schedule (transfer the total disbursed this period to “Summary of Disbursements,” line 2(b))
Schedule B(2)(b), page of
Arizona Secretary of State Revision 7/31/21 (fillable format)
STATE OF ARIZONA COMMITTEE CAMPAIGN FINANCE REPORT
COMMITTEE ID NUMBER
MONETARY CONTRIBUTIONS TO POLITICAL PARTIES: SCHEDULE B(2)(c)
Political Party Recipient Information Amount Contributed
Cumulative Amount this Reporting Period
Cumulative Amount this Election Cycle
1
Committee Name
Cash
Credit
Street Address
City State ZIP
Committee ID Number Date Contribution Made
2
Committee Name
Cash
Credit
Street Address
City State ZIP
Committee ID Number Date Contribution Made
3
Committee Name
Cash
Credit
Street Address
City State ZIP
Committee ID Number Date Contribution Made
4
Committee Name
Cash
Credit
Street Address
City State ZIP
Committee ID Number Date Contribution Made
5
Committee Name
Cash
Credit
Street Address
City State ZIP
Committee ID Number Date Contribution Made
Enter total only if last page of schedule (transfer the total disbursed this period to “Summary of Disbursements,” line 2(c))
Schedule B(2)(c), page of
Arizona Secretary of State Revision 7/31/21 (fillable format)
STATE OF ARIZONA COMMITTEE CAMPAIGN FINANCE REPORT
COMMITTEE ID NUMBER
MONETARY CONTRIBUTIONS TO PARTNERSHIPS: SCHEDULE B(2)(d)
Partnership Recipient Information Amount Contributed
Cumulative Amount this Reporting Period
Cumulative Amount this Election Cycle
1
Partnership Name
Cash
Credit
Street Address
City State ZIP
Corporation Commission File Number Date Contribution Made
2
Partnership Name
Cash
Credit
Street Address
City State ZIP
Corporation Commission File Number Date Contribution Made
3
Partnership Name
Cash
Credit
Street Address
City State ZIP
Corporation Commission File Number Date Contribution Made
4
Partnership Name
Cash
Credit
Street Address
City State ZIP
Corporation Commission File Number Date Contribution Made
5
Partnership Name
Cash
Credit
Street Address
City State ZIP
Corporation Commission File Number Date Contribution Made
Enter total only if last page of schedule (transfer the total disbursed this period to “Summary of Disbursements,” line 2(d))
Schedule B(2)(d), page of
Arizona Secretary of State Revision 7/31/21 (fillable format)
STATE OF ARIZONA COMMITTEE CAMPAIGN FINANCE REPORT
COMMITTEE ID NUMBER
MONETARY CONTRIBUTIONS TO CORPORATIONS AND LLCs: SCHEDULE B(2)(e)
Corporation / LLC Recipient Information Amount Contributed
Cumulative
Amount this Reporting Period
Cumulative
Amount this Election Cycle
1
Corporation/LLC Name
Cash
Credit
Street Address
City State ZIP
Corporation Commission File Number Date Contribution Made
2
Corporation/LLC Name
Cash
Credit
Street Address
City State ZIP
Corporation Commission File Number Date Contribution Made
3
Corporation/LLC Name
Cash
Credit
Street Address
City State ZIP
Corporation Commission File Number Date Contribution Made
4
Corporation/LLC Name
Cash
Credit
Street Address
City State ZIP
Corporation Commission File Number Date Contribution Made
5
Corporation/LLC Name
Cash
Credit
Street Address
City State ZIP
Corporation Commission File Number Date Contribution Made
Enter total only if last page of schedule (transfer the total disbursed this period to “Summary of Disbursements,” line 2(e))
Schedule B(2)(e), page of
Arizona Secretary of State Revision 7/31/21 (fillable format)
STATE OF ARIZONA COMMITTEE CAMPAIGN FINANCE REPORT
COMMITTEE ID NUMBER
MONETARY CONTRIBUTIONS TO LABOR ORGANIZATIONS: SCHEDULE B(2)(f)
Labor Organization Recipient Information Amount Contributor
Cumulative Amount this Reporting Period
Cumulative Amount this Election Cycle
1
Labor Organization Name
Cash
Credit
Street Address
City State ZIP
Corporation Commission File Number Date Contribution Made
2
Labor Organization Name
Cash
Credit
Street Address
City State ZIP
Corporation Commission File Number Date Contribution Made
3
Labor Organization Name
Cash
Credit
Street Address
City State ZIP
Corporation Commission File Number Date Contribution Made
4
Labor Organization Name
Cash
Credit
Street Address
City State ZIP
Corporation Commission File Number Date Contribution Made
5
Labor Organization Name
Cash
Credit
Street Address
City State ZIP
Corporation Commission File Number Date Contribution Made
Enter total only if last page of schedule (transfer the total disbursed this period to “Summary of Disbursements,” line 2(f))
Schedule B(2)(f), page of
Arizona Secretary of State Revision 7/31/21 (fillable format)
STATE OF ARIZONA COMMITTEE CAMPAIGN FINANCE REPORT
COMMITTEE ID NUMBER
CONTRIBUTION REFUNDS RECEIVED: SCHEDULE B(2)(h)
Contributor Information Amount Refunded Cumulative Amount this Reporting Period
Cumulative Amount this Election Cycle
1
Committee Name Date Refund Received
Street Address
City State ZIP
Committee ID Number Date of Original Contribution
2
Committee Name Date Refund Received
Street Address
City State ZIP
Committee ID Number Date of Original Contribution
3
Committee Name Date Refund Received
Street Address
City State ZIP
Committee ID Number Date of Original Contribution
4
Committee Name Date Refund Received
Street Address
City State ZIP
Committee ID Number Date of Original Contribution
5
Committee Name Date Refund Received
Street Address
City State ZIP
Committee ID Number Date of Original Contribution
Enter total only if last page of schedule (transfer the total disbursed this period to “Summary of Disbursements,” line 2(h))
.
Schedule B(2)(h), page of
Arizona Secretary of State Revision 7/31/21 (fillable format)
STATE OF ARIZONA COMMITTEE CAMPAIGN FINANCE REPORT
COMMITTEE ID NUMBER
LOANS MADE: SCHEDULE B(3)(a)
Borrower Information Amount Loaned Cumulative Amount this Reporting Period
Cumulative Amount this Election Cycle
1
Borrower Name
Street Address
City State ZIP
Guarantor/Endorser Name Date Loan Made
2
Borrower Name
Street Address
City State ZIP
Guarantor/Endorser Name Date Loan Made
3
Borrower Name
Street Address
City State ZIP
Guarantor/Endorser Name Date Loan Made
4
Borrower Name
Street Address
City State ZIP
Guarantor/Endorser Name Date Loan Made
5
Borrower Name
Street Address
City State ZIP
Guarantor/Endorser Name Date Loan Made
Enter total only if last page of schedule (transfer the total received this period to “Summary of Disbursements,” line 3(a))
Schedule B(3)(a), page of
Arizona Secretary of State Revision 7/31/21 (fillable format)
STATE OF ARIZONA COMMITTEE CAMPAIGN FINANCE REPORT
COMMITTEE ID NUMBER
LOAN GUARANTEES MADE: SCHEDULE B(3)(b)
Guarantor Information Amount Guaranteed
Cumulative Amount this Reporting Period
Cumulative Amount this Election Cycle
1
Guarantor Name
Street Address
City State ZIP
Borrower Name Date Loan Guaranteed
2
Guarantor Name
Street Address
City State ZIP
Borrower Name Date Loan Guaranteed
3
Guarantor Name
Street Address
City State ZIP
Borrower Name Date Loan Guaranteed
4
Guarantor Name
Street Address
City State ZIP
Borrower Name Date Loan Guaranteed
5
Guarantor Name
Street Address
City State ZIP
Borrower Name Date Loan Guaranteed
Enter total only if last page of schedule (transfer the total received this period to “Summary of Disbursements,” line 3(b))
Schedule B(3)(b), page of
Arizona Secretary of State Revision 7/31/21 (fillable format)
STATE OF ARIZONA COMMITTEE CAMPAIGN FINANCE REPORT
COMMITTEE ID NUMBER
FORGIVENESS ON LOANS MADE: SCHEDULE B(3)(c)
Borrower Information
Amount Forgiven Cumulative Amount this Reporting Period
Cumulative Amount this Election Cycle
1
Borrower Name Date Forgiveness Made
Street Address
City State ZIP
Original Amount of Loan Amount Still Outstanding
2
Borrower Name Date Forgiveness Made
Street Address
City State ZIP
Original Amount of Loan Amount Still Outstanding
3
Borrower Name Date Forgiveness Made
Street Address
City State ZIP
Original Amount of Loan Amount Still Outstanding
4
Borrower Name Date Forgiveness Made
Street Address
City State ZIP
Original Amount of Loan Amount Still Outstanding
5
Borrower Name Date Forgiveness Made
Street Address
City State ZIP
Original Amount of Loan Amount Still Outstanding
Enter total only if last page of schedule (transfer the total disbursed this period to “Summary of Disbursements,” line 3(c))
Schedule B(3)(c), page of
Arizona Secretary of State Revision 7/31/21 (fillable format)
STATE OF ARIZONA COMMITTEE CAMPAIGN FINANCE REPORT
COMMITTEE ID NUMBER
REPAYMENT ON LOANS RECEIVED: SCHEDULE B(3)(d)
Lender Information
Amount Repaid
Cumulative
Amount this Reporting Period
Cumulative
Amount this Election Cycle
1
Lender Name Date Repayment Made
Street Address
City State ZIP
Original Amount Borrowed Amount Still Outstanding
2
Lender Name Date Repayment Made
Street Address
City State ZIP
Original Amount Borrowed Amount Still Outstanding
3
Lender Name Date Repayment Made
Street Address
City State ZIP
Original Amount Borrowed Amount Still Outstanding
4
Lender Name Date Repayment Made
Street Address
City State ZIP
Original Amount Borrowed Amount Still Outstanding
5
Lender Name Date Repayment Made
Street Address
City State ZIP
Original Amount Borrowed Amount Still Outstanding
Enter total only if last page of schedule (transfer the total disbursed this period to “Summary of Disbursements,” line 3(d))
Schedule B(3)(d), page of
Arizona Secretary of State Revision 7/31/21 (fillable format)
STATE OF ARIZONA COMMITTEE CAMPAIGN FINANCE REPORT
COMMITTEE ID NUMBER
ACCRUED INTEREST ON LOANS RECEIVED: SCHEDULE B(3)(e)
Lender Information Amount of Interest Accrued
Cumulative
Amount this Reporting Period
Cumulative
Amount this Election Cycle
1
Lender Name Date Interest Accrued
Street Address
City State ZIP
Original Amount Borrowed Amount Still Outstanding
2
Lender Name Date Interest Accrued
Street Address
City State ZIP
Original Amount Borrowed Amount Still Outstanding
3
Lender Name Date Interest Accrued
Street Address
City State ZIP
Original Amount Borrowed Amount Still Outstanding
4
Lender Name Date Interest Accrued
Street Address
City State ZIP
Original Amount Borrowed Amount Still Outstanding
5
Lender Name Date Interest Accrued
Street Address
City State ZIP
Original Amount Borrowed Amount Still Outstanding
Enter total only if last page of schedule (transfer the total disbursed this period to “Summary of Disbursements,” line 3(e))
Schedule B(3)(e), page of
Arizona Secretary of State Revision 7/31/21 (fillable format)
STATE OF ARIZONA COMMITTEE CAMPAIGN FINANCE REPORT
COMMITTEE ID NUMBER
REBATES AND REFUNDS MADE (NON-CONTRIBUTIONS): SCHEDULE B(4)
Recipient Information Amount Rebated / Refunded
Cumulative
Amount this Reporting Period
Cumulative
Amount this Election Cycle
1
Name of Original Payor Date Rebate/Refund Made
Street Address
City State ZIP
Corporation Commission File Number (if applicable) Original Payment Amount Date of Original Payment
2
Name of Original Payor Date Rebate/Refund Made
Street Address
City State ZIP
Corporation Commission File Number (if applicable) Original Payment Amount Date of Original Payment
3
Name of Original Payor Date Rebate/Refund Made
Street Address
City State ZIP
Corporation Commission File Number (if applicable) Original Payment Amount Name of Original Payor
4
Name of Original Payor Date Rebate/Refund Made
Street Address
City State ZIP
Corporation Commission File Number (if applicable) Original Payment Amount Name of Original Payor
5
Name of Original Payor Date Rebate/Refund Made
Street Address
City State ZIP
Corporation Commission File Number (if applicable) Original Payment Amount Name of Original Payor
Enter total only if last page of schedule (transfer the total disbursed this period to “Summary of Disbursements,” line 4)
Schedule B(4), page of
Arizona Secretary of State Revision 7/31/21 (fillable format)
STATE OF ARIZONA COMMITTEE CAMPAIGN FINANCE REPORT
COMMITTEE ID NUMBER
IN-KIND CONTRIBUTIONS TO CANDIDATE COMMITTEES: SCHEDULE B(5)(a)
Candidate Committee Recipient Information Amount Contributed
Cumulative Amount this Reporting Period
Cumulative Amount this Election Cycle
1
Committee Name
Street Address
City State ZIP
Committee ID Number Date In-Kind Contribution Made
2
Committee Name
Street Address
City State ZIP
Committee ID Number Date In-Kind Contribution Made
3
Committee Name
Street Address
City State ZIP
Committee ID Number Date In-Kind Contribution Made
4
Committee Name
Street Address
City State ZIP
Committee ID Number Date In-Kind Contribution Made
5
Committee Name
Street Address
City State ZIP
Committee ID Number Date In-Kind Contribution Made
Enter total only if last page of schedule (transfer the total disbursed this period to “Summary of Disbursements,” line 5(a))
Schedule B(5)(a), page of
Arizona Secretary of State Revision 7/31/21 (fillable format)
STATE OF ARIZONA COMMITTEE CAMPAIGN FINANCE REPORT
COMMITTEE ID NUMBER
IN-KIND CONTRIBUTIONS TO POLITICAL ACTION COMMITTEES: SCHEDULE B(5)(b)
Political Action Committee Recipient Information Amount Contributed
Cumulative Amount this Reporting Period
Cumulative Amount this Election Cycle
1
Committee Name
Street Address
City State ZIP
Committee ID Number Date In-Kind Contribution Made
2
Committee Name
Street Address
City State ZIP
Committee ID Number Date In-Kind Contribution Made
3
Committee Name
Street Address
City State ZIP
Committee ID Number Date In-Kind Contribution Made
4
Committee Name
Street Address
City State ZIP
Committee ID Number Date In-Kind Contribution Made
5
Committee Name
Street Address
City State ZIP
Committee ID Number Date In-Kind Contribution Made
Enter total only if last page of schedule (transfer the total disbursed this period to “Summary of Disbursements,” line 5(b))
Schedule B(5)(b), page of
Arizona Secretary of State Revision 7/31/21 (fillable format)
STATE OF ARIZONA COMMITTEE CAMPAIGN FINANCE REPORT
COMMITTEE ID NUMBER
IN-KIND CONTRIBUTIONS TO POLITICAL PARTIES: SCHEDULE B(5)(c)
Political Party Recipient Information Amount Contributed
Cumulative Amount this Reporting Period
Cumulative Amount this Election Cycle
1
Committee Name
Street Address
City State ZIP
Committee ID Number Date In-Kind Contribution Made
2
Committee Name
Street Address
City State ZIP
Committee ID Number Date In-Kind Contribution Made
3
Committee Name
Street Address
City State ZIP
Committee ID Number Date In-Kind Contribution Made
4
Committee Name
Street Address
City State ZIP
Committee ID Number Date In-Kind Contribution Made
5
Committee Name
Street Address
City State ZIP
Committee ID Number Date In-Kind Contribution Made
Enter total only if last page of schedule (transfer the total disbursed this period to “Summary of Disbursements,” line 5(c))
Schedule B(5)(c), page of
Arizona Secretary of State Revision 7/31/21 (fillable format)
STATE OF ARIZONA COMMITTEE CAMPAIGN FINANCE REPORT
COMMITTEE ID NUMBER
IN-KIND CONTRIBUTIONS TO PARTNERSHIPS: SCHEDULE B(5)(d)
Partnership Recipient Information Amount Contributed
Cumulative Amount this Reporting Period
Cumulative Amount this Election Cycle
1
Partnership Name
Street Address
City State ZIP
Corporation Commission File Number Date In-Kind Contribution Made
2
Partnership Name
Street Address
City State ZIP
Corporation Commission File Number Date In-Kind Contribution Made
3
Partnership Name
Street Address
City State ZIP
Corporation Commission File Number Date In-Kind Contribution Made
4
Partnership Name
Street Address
City State ZIP
Corporation Commission File Number Date In-Kind Contribution Made
5
Partnership Name
Street Address
City State ZIP
Corporation Commission File Number Date In-Kind Contribution Made
Enter total only if last page of schedule (transfer the total disbursed this period to “Summary of Disbursements,” line 5(d))
Schedule B(5)(d), page of
Arizona Secretary of State Revision 7/31/21 (fillable format)
STATE OF ARIZONA COMMITTEE CAMPAIGN FINANCE REPORT
COMMITTEE ID NUMBER
IN-KIND CONTRIBUTIONS TO CORPORATIONS AND LLCs: SCHEDULE B(5)(e)
Corporation / LLC Recipient Information Amount Contributed
Cumulative
Amount this Reporting Period
Cumulative
Amount this Election Cycle
1
Corporation/LLC Name
Street Address
City State ZIP
Corporation Commission File Number Date In-Kind Contribution Made
2
Corporation/LLC Name
Street Address
City State ZIP
Corporation Commission File Number Date In-Kind Contribution Made
3
Corporation/LLC Name
Street Address
City State ZIP
Corporation Commission File Number Date In-Kind Contribution Made
4
Corporation/LLC Name
Street Address
City State ZIP
Corporation Commission File Number Date In-Kind Contribution Made
5
Corporation/LLC Name
Street Address
City State ZIP
Corporation Commission File Number Date In-Kind Contribution Made
Enter total only if last page of schedule (transfer the total disbursed this period to “Summary of Disbursements,” line 5(e))
Schedule B(5)(e), page of
Arizona Secretary of State Revision 7/31/21 (fillable format)
STATE OF ARIZONA COMMITTEE CAMPAIGN FINANCE REPORT
COMMITTEE ID NUMBER
IN-KIND CONTRIBUTIONS TO LABOR ORGANIZATIONS: SCHEDULE B(5)(f)
Labor Organization Recipient Information Amount Contributed
Cumulative Amount this Reporting Period
Cumulative Amount this Election Cycle
1
Labor Organization Name
Street Address
City State ZIP
Corporation Commission File Number Date In-Kind Contribution Made
2
Labor Organization Name
Street Address
City State ZIP
Corporation Commission File Number Date In-Kind Contribution Made
3
Labor Organization Name
Street Address
City State ZIP
Corporation Commission File Number Date In-Kind Contribution Made
4
Labor Organization Name
Street Address
City State ZIP
Corporation Commission File Number Date In-Kind Contribution Made
5
Labor Organization Name
Street Address
City State ZIP
Corporation Commission File Number Date In-Kind Contribution Made
Enter total only if last page of schedule (transfer the total disbursed this period to “Summary of Disbursements,” line 5(f))
Schedule B(5)(f), page of
Arizona Secretary of State Revision 7/31/21 (fillable format)
STATE OF ARIZONA COMMITTEE CAMPAIGN FINANCE REPORT
COMMITTEE ID NUMBER
INDEPENDENT EXPENDITURES MADE: SCHEDULE B(6)
Expenditure Recipient Information Expenditure Amount
Cumulative
Amount this Reporting Period
Cumulative
Amount this Election Cycle
1
Recipient Name Mode of Advertising (TV, mail, etc)
Cash
Credit
Street Address
City State ZIP
Candidate(s) Supported (including % supported) Candidate(s) Opposed (including % opposed)
Date of First Publication, Display, Delivery, or Broadcast Election Month/Year
2
Recipient Name Mode of Advertising (TV, mail, etc)
Cash
Credit
Street Address
City State ZIP
Candidate(s) Supported (including % supported) Candidate(s) Opposed (including % opposed)
Date of First Publication, Display, Delivery, or Broadcast Election Month/Year
3
Recipient Name Mode of Advertising (TV, mail, etc)
Cash
Credit
Street Address
City State ZIP
Candidate(s) Supported (including % supported) Candidate(s) Opposed (including % opposed)
Date of First Publication, Display, Delivery, or Broadcast Election Month/Year
4
Recipient Name Mode of Advertising (TV, mail, etc)
Cash
Credit
Street Address
City State ZIP
Candidate(s) Supported (including % supported) Candidate(s) Opposed (including % opposed)
Date of First Publication, Display, Delivery, or Broadcast Election Month/Year Office Sought
Enter total only if last page of schedule (transfer the total disbursed this period to “Summary of Disbursements,” line 6)
Schedule B(6), page of
Office Sought
Office Sought
Office Sought
Arizona Secretary of State Revision 7/31/21 (fillable format)
STATE OF ARIZONA COMMITTEE CAMPAIGN FINANCE REPORT
COMMITTEE ID NUMBER
BALLOT MEASURE EXPENDITURES MADE: SCHEDULE B(7)
Expenditure Recipient Information Expenditure Amount
Cumulative
Amount this Reporting Period
Cumulative
Amount this Election Cycle
1
Recipient Name Mode of Advertising (TV, mail, etc)
Cash
Credit
Street Address
City State ZIP
Ballot Measure(s) Supported (including % supported) Ballot Measure(s) Opposed (including % opposed)
Date of First Publication, Display, Delivery, or Broadcast Election Month/Year
2
Recipient Name Mode of Advertising (TV, mail, etc)
Cash
Credit
Street Address
City State ZIP
Ballot Measure(s) Supported (including % supported) Ballot Measure(s) Opposed (including % opposed)
Date of First Publication, Display, Delivery, or Broadcast Election Month/Year
3
Recipient Name Mode of Advertising (TV, mail, etc)
Cash
Credit
Street Address
City State ZIP
Ballot Measure(s) Supported (including % supported) Ballot Measure(s) Opposed (including % opposed)
Date of First Publication, Display, Delivery, or Broadcast Election Month/Year
4
Recipient Name Mode of Advertising (TV, mail, etc)
Cash
Credit
Street Address
City State ZIP
Ballot Measure(s) Supported (including % supported) Ballot Measure(s) Opposed (including % opposed)
Date of First Publication, Display, Delivery, or Broadcast Election Month/Year
Enter total only if last page of schedule (transfer the total disbursed this period to “Summary of Disbursements,” line 7)
Schedule B(7), page of
Arizona Secretary of State Revision 7/31/21 (fillable format)
STATE OF ARIZONA COMMITTEE CAMPAIGN FINANCE REPORT
COMMITTEE ID NUMBER
RECALL EXPENDITURES MADE: SCHEDULE B(8)
Expenditure Recipient Information Expenditure Amount
Cumulative Amount this Reporting Period
Cumulative Amount this Election Cycle
1
Recipient Name Mode of Advertising (TV, mail, etc)
Cash
Credit
Street Address
City State ZIP
Supporting or Opposing Issuance of Recall Order? Candidate Sought to be Recalled
Date of First Publication, Display, Delivery, or Broadcast Office Held
2
Recipient Name Mode of Advertising (TV, mail, etc)
Cash
Credit
Street Address
City State ZIP
Supporting or Opposing Issuance of Recall Order? Candidate Sought to be Recalled
Date of First Publication, Display, Delivery, or Broadcast Office Held
3
Recipient Name Mode of Advertising (TV, mail, etc)
Cash
Credit
Street Address
City State ZIP
Supporting or Opposing Issuance of Recall Order? Candidate Sought to be Recalled
Date of First Publication, Display, Delivery, or Broadcast Office Held
4
Recipient Name Mode of Advertising (TV, mail, etc)
Cash
Credit
Street Address
City State ZIP
Supporting or Opposing Issuance of Recall Order? Candidate Sought to be Recalled
Date of First Publication, Display, Delivery, or Broadcast Office Held
Enter total only if last page of schedule
(transfer the total disbursed this period to “Summary of Disbursements,” line 8)
Schedule B(8), page of
Arizona Secretary of State Revision 7/31/21 (fillable format)
STATE OF ARIZONA COMMITTEE CAMPAIGN FINANCE REPORT
COMMITTEE ID NUMBER
SUPPORT PROVIDED TO PARTY NOMINEES (POLITICAL PARTIES ONLY): SCHEDULE B(9)
Benefitted Candidate Amount Cumulative Amount this Reporting Period
Cumulative Amount this Election Cycle
1
Candidate Name Date Benefit Provided
Street Address
City State ZIP
Type of Benefit Provided
Notes:
2
Candidate Name Date Benefit Provided
Street Address
City State ZIP
Type of Benefit Provided
Notes:
3
Candidate Name Date Benefit Provided
Street Address
City State ZIP
Type of Benefit Provided
Notes:
4
Candidate Name Date Benefit Provided
Street Address
City State ZIP
Type of Benefit Provided
Notes:
Enter total only if last page of schedule
(transfer the total disbursed this period to “Summary of Disbursements,” line 9)
Schedule B(9), page of
Arizona Secretary of State Revision 7/31/21 (fillable format)
STATE OF ARIZONA COMMITTEE CAMPAIGN FINANCE REPORT
COMMITTEE ID NUMBER
JOINT FUNDRAISING / SHARED EXPENSE PAYMENTS MADE: SCHEDULE B(10)
Recipient Committee Information
Payment Amount Cumulative Amount this Reporting Period
Cumulative Amount this Election Cycle
1
Committee Name Payment Date
Cash
Credit
Street Address
City State ZIP
Date of Joint Fundraising Event (if applicable) Type of Shared Expense (if applicable)
2
Committee Name Payment Date
Cash
Credit
Street Address
City State ZIP
Date of Joint Fundraising Event (if applicable) Type of Shared Expense (if applicable)
3
Committee Name Payment Date
Cash
Credit
Street Address
City State ZIP
Date of Joint Fundraising Event (if applicable) Type of Shared Expense (if applicable)
4
Committee Name Payment Date
Cash
Credit
Street Address
City State ZIP
Date of Joint Fundraising Event (if applicable) Type of Shared Expense (if applicable)
5
Committee Name Payment Date
Cash
Credit
Street Address
City State ZIP
Date of Joint Fundraising Event (if applicable) Type of Shared Expense (if applicable)
Enter total only if last page of schedule (transfer the total disbursed this period to “Summary of Disbursements,” line 10)
Schedule B(10), page of
Arizona Secretary of State Revision 7/31/21 (fillable format)
STATE OF ARIZONA COMMITTEE CAMPAIGN FINANCE REPORT
COMMITTEE ID NUMBER
REIMBURSEMENTS MADE: SCHEDULE B(11)
Recipient Information Reimbursement Amount
Cumulative Amount this Reporting Period
Cumulative Amount this Election Cycle
1
Name
Cash
Credit
Street Address
City State ZIP
Services or Goods Reimbursed Reimbursement Date
2
Name
Cash
Credit
Street Address
City State ZIP
Services or Goods Reimbursed Reimbursement Date
3
Name
Cash
Credit
Street Address
City State ZIP
Services or Goods Reimbursed Reimbursement Date
4
Name
Cash
Credit
Street Address
City State ZIP
Services or Goods Reimbursed Reimbursement Date
5
Name
Cash
Credit
Street Address
City State ZIP
Services or Goods Reimbursed Reimbursement Date
Enter total only if last page of schedule (transfer the total disbursed this period to “Summary of Disbursements,” line 11)
Schedule B(11), page of
Arizona Secretary of State Revision 7/31/21 (fillable format)
STATE OF ARIZONA COMMITTEE CAMPAIGN FINANCE REPORT
COMMITTEE ID NUMBER
OUTSTANDING ACCOUNTS PAYABLE / DEBTS OWED BY COMMITTEE: SCHEDULE B(12)
Debt Information Amount Cumulative Amount this Reporting Period
Cumulative Amount this Election Cycle
1
Name
Street Address
City State ZIP
Type of Account Payable or Debt Owed Date that Debt Accrued
2
Name
Street Address
City State ZIP
Type of Account Payable or Debt Owed Date that Debt Accrued
3
Name
Street Address
City State ZIP
Type of Account Payable or Debt Owed Date that Debt Accrued
4
Name
Street Address
City State ZIP
Type of Account Payable or Debt Owed Date that Debt Accrued
5
Name
Street Address
City State ZIP
Type of Account Payable or Debt Owed Date that Debt Accrued
Enter total only if last page of schedule (transfer the total received this period to “Summary of Receipts,” line 12)
Schedule B(12), page of
Arizona Secretary of State Revision 7/31/21 (fillable format)
STATE OF ARIZONA COMMITTEE CAMPAIGN FINANCE REPORT
COMMITTEE ID NUMBER
TRANSFER OUT SURPLUS MONIES / TRANSFER IN DEBT: SCHEDULE B(13)
Cumulative Amount this Reporting
Period
Cumulative Amount this Election Cycle
Recipient of Surplus Monies / Source of Transferred Debt
Recipient of Surplus Monies / Source of Transferred Debt
Recipient of Surplus Monies / Source of Transferred Debt
Recipient of Surplus Monies / Source of Transferred Debt
Recipient of Surplus Monies / Source of Transferred Debt
Total (transfer the total disbursed this period to “Summary of Disbursements,” line 13)
Schedule A(13), page of
Arizona Secretary of State Revision 7/31/21 (fillable format)
STATE OF ARIZONA COMMITTEE CAMPAIGN FINANCE REPORT
COMMITTEE ID NUMBER
MISCELLANEOUS DISBURSEMENTS: SCHEDULE B(14)
Recipient Information Amount Cumulative Amount this Reporting Period
Cumulative Amount this Election Cycle
1
Name
Cash
Credit
Street Address
City ZIP
Disbursement Type Disbursement Date
2
Name
Cash
Credit
Street Address
City ZIP
Disbursement Type Disbursement Date
3
Name
Cash
Credit
Street Address
City ZIP
Disbursement Type Disbursement Date
4
Name
Cash
Credit
Street Address
City ZIP
Disbursement Type Disbursement Date
5
Name
Cash
Credit
Street Address
City State ZIP
Disbursement Type Disbursement Date
Enter total only if last page of schedule
(transfer the total disbursed this period to “Summary of Disbursements,” line 14)
Schedule B(14), page of _
State
State
State
State
Arizona Secretary of State Revision 7/31/21 (fillable format)
STATE OF ARIZONA COMMITTEE CAMPAIGN FINANCE REPORT
COMMITTEE ID NUMBER
AGGREGATE OF DISBURSEMENTS – $250 OR LESS: SCHEDULE B(15)
Cumulative Amount this Reporting
Period Cumulative Amount this Election Cycle
Cumulative of Disbursements - $250 or Less
Enter total only if last page of schedule
(transfer the total received this period to “Summary of Disbursements,” line 15)
Schedule B(15), page of ______