HomeMy WebLinkAboutPost-Primary Election ReportPOLITICAL COMMITTEE
CITY OF Fou^m^/////i
CAMPAIGN FINANCE REPORT
2016 August/November Regular Election
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Full Name of Committee --
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Address
City —ZIP Code County
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County •fhone
Sponsoring Organization or Candidate and office
Name of Candidate and Office Sought (if applicable)
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E-Mail Address
4.REPORTING PERIOD (Please check appropriate box)
FOR OFFICE USE ONLY
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DUE BETWEEN
i January 31 Report -For Period of "thru December 31,2015 January 1,2016 and February 1,2016
j i June 30 Report -For Period of January 1,2016 thru May 31,2016 June 1,2016 and June 30,2016
I Pre-Primary Election Report -For Period of June 1,2016 thru August 18,2016 August 19,2016 and August 26,2016
I V\Post-Primary Election Report -For Period of August 19,2016 thru September 19,2016 September 20,2016 and September 29,2016
i Pre-General Election Report -For Period of September 20,2016 thru October 27,2016 .
|j POSt-General Election Report-For Period of October 28,2016 thru November 28,2016
j j **JanUary31,Report -For Period of November 29,2016thru December 31,2017
October 28,2016 and November 4,2016
November 29,2016 and December 8,2016
January 1,2018 and January 31,2018
5.SUMMARY Column A
Total This Reporting
Period
Column B
Election Period
Total To Date
5a Surplus from Previous Campaign (or at time Statement of Organization was
filed for the new committee)
5b Cash on Hand at the Beginning of this Reporting Period H ?.2>*
5c Total Receipts (from corresponding columns on Detailed
Summary Page,Line 8)
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5d Subtotal [add Lines b and c for Column A and add lines
a and c for Column B]0*^2.Z$
6a Total Debts and Obligations from Previous Campaign Committee at
Beginning of this Election Period (or at time Statement of Organization was
filed for the new committee)[Do not add or subtract this line from the other
lines]
6b Total Disbursements (from corresponding columns on
Detailed Summary Page,Line 18)o
7.Cash on Hand at Close of Reporting Period [Subtract
Line 6b from Line 5d]
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Insert date which is 21 days after date of last election (A.R.S.§16-913).
**Other reports will be due beforethis reporting periodifa special or recallelectionis held prior to the nextgeneral election.
Revised 5/15
DETAILED SUMMARY PAGE
�F RECEIPTS AND DISBURSEMENTS
1 ��9 ! (/ / _ N `..�.�(�,iss�/� I
1. Committee Name: ���� � ���
3. Report covering period from Thru
RECEIPTS
4. Contributions other than loans and in-kind:
(a) Individuals - more than $50 (Total from Schedule A}
(b) Individuals - aggregate $50 or less (Total from Schedule A-1 }
(c} Political Committees (Tota! from Schedule B)
(d) Subtotal Contributions [add 4(a), 4(b), and 4(c}]
(e) Refund of contributions (Total from Schedule F-2}
(f) Total Contributions Other than Loans and In-kind [subtract 4(e) from 4(d)]
5. (a) Loans made or guaranteed by candidate (Total from Schedule C)
(b) All other loans (Total from Schedule C-1)
(c) Total Loans [add 5(a} and 5(b}]
6. In-kind contributions (Total from Schedule E}
7. Dividends, interest, and other forms of receipts (Total from Schedule F-1)
8. Total Receipts [add 4(f), 5(c), 6, and 7]
DISBURSEMENTS
Pa�e 2
2. ID#
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COLUMN A COLUMN B
THIS PERIOD CAMPAIGN TO DATE
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9. Expenditures for operating expenses (Total from Schedule D}
10. Independent Expenditures (Total from Schedule D-1)
11. Value of In-kind expenditures (Total from Schedule E)
12. Loans made by reporting committee (Total from Schedule D-2)
13. (a) Repayment of Ioans made or guaranteed by candidate (Total from Schedule D-4}
(b) Repayment of all other loans (Total from Schedule D-5)
{c} Total Loan Repayments [add 13(a) and 13(b)J
14. Transfers to other political committees (Total from Schedule D-6)
15. Any other disbursement (Total from Schedule D-7)
16. Subtotal disbursements [add lines 9, 10, 11, 12, 13(c), 14, and 15]
17. Rebates, refunds and other offsets to operating expenses (Total from Schedule D-3)
18. Total disbursements [subtract line 17 from line 16]
19. Total Outstanding Debts owed by Reporting Candidate or Political Committee (Schedule F-3) �
, � � _'�-
20. I certify, under penalty of perjury, that I have examined the contents of this campaign finance report and to the best of my knowledge and belief it is true and
complete. � �
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Type or Print Na Tre s
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�n re of Trea�er or Candidate or Designating Individual Da�te
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C4NTRIBUTIONS of $50 or less - AGGRE�ATE TOTAL*
SCHEDULE A-1
2. ID#
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1. Committee Name " � � � •
3. Report covering period from
4. Aggregate Total of Contributions of $54 or less
AM4UNT
DESCRIPTION RECEIVED THIS
PERIOD
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5. TOTAL THIS PERIOD [Transfer total to Detailed Summary Page, Line 4(b), 6. CUMMULATIVE TOTAL THIS
Column A] CAMPAIGN T� DATE
� ransfer total to Detailed C�
� � �
✓
Summary Page, Line 4(b),
Column B]
*If contributions of $50 or less are listed with contributor's name and address on Schedule A, do not include them on this schedule.
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CUMULATIVE
TQTAL THIS CAMPAIGN T� DATE
,
CONTRIBUTIONS FROM POLITICAL COMMITTEES
SCHEDULE B
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1. Committee Name � �''`'� S 1 �'� �OV' ��J1! �� /
3. Report covering period from thru
4
4a ID #
J'l3�-
DATE RECEIVED
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b. ID #
DATE RECEIVED
c. ID #
DATE RECEIVED
d. ID #
DATE RECEIVED
e. ID #
DATE RECEIVED
f. ID #
DATE RECEIVED
g. ID #
DATE RECEIVED
h. ID #
DATE RECEIVED
i. ID #
DATE RECEIVED
CONTRIBUTIONS
IDENTITY OF CONTRIBUTOR AND DATE RECEIVED
NAME, ADDRESS, CITY, STATE AND ZIP �
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NAME, ADDRESS, CITY, STATE AND ZIP
NAME, ADDRESS, CITY, STATE AND ZIP
NAME, ADDRESS, CITY, STATE AND ZIP
NAME, ADDRESS, CITY, STATE AND ZIP
NAME, ADDRESS, CITY, STATE AND ZIP
NAME, ADDRESS, CITY, STATE AND ZIP
NAME, ADDRESS, CITY, STATE AND ZIP
NAME, ADDRESS, CITY, STATE AND ZIP
5. ENTER TOTAL ONLY IF LAST PAGE OF SCHEDULE B [If last page of Schedule B, transfer total to
Detailed Summary Page, Line 4(c), Column A]
AMOUNT
RECEIVED
TH IS
PERIOD
��c�
� U �
CUMULATIVE
TOTAL THIS
CAMPAIGN TO
DATE
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Schedule B Page of_