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Home My WebLink AboutCC2021-02 - Smith - Annual ReportReceived electronically 01/11/2022 - EAK STATE OF ARIZONA .� _ COMMITTEE CAMPAIGN , . FINANCE REPORT 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 confents 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. �inda Lull Printed Name of Committee Treasurer �� Signature of Committee Treasurer COMMITTEE ID NUMBER CC2021-02 t- //-a��a� Date Arizona Secre�ary of State Revision 7/31/21 (filiable formal) STATE OF ARIZONA COMMITTEE ID NUMBER � , ' COMMITTEE CAMPAIGN CC2021-02 FINANCE REPORT x r SUMMARY OF RECEIPTS (Schedule A): Receipts 1. Monelary Conlributions Received (a) In-Slale Individuals - More lhan ^5100 (b) In-Siate Individuals - $100 or Less �n99re9aie� (c) Out-of-State Individuals (d) Candidate Committees (e) Political Action Committees (fl Political Parties (g) Partnerships (h) Corporalions & limited Liability Companies �Pncs a am�acai aanies on�y� (i) Labor Organizalions �Pncs s Poii��cai aanies oniy> Q) Candidate's Personai Monies �candma�e commn�ees oniy� (k) Monetary Conlributions Subtolai �aaa ��a)mro�gn t�p (i) Refunds Given Back lo CoNributors (m} Nel Monetary Conlributions �sumaa i�p fmm i�k�� 2. Loans (a) Loans Received (b) Forgiveness on Loans Received (c) Repaymenl on Loans Made (d) Inleresl Accrued on Loans Made (e) Loans Subtotal �casi�: aad 2�a�, 2�c� s 2�ap 3. Rebales and Re(unds Received 4. Interest Accrued on Committes Monies 5. In-Kind Contributlons ReceWed (a) In-State Indivlduals - More than "5100 (bj In-State IndNiduals - �100 or Less �n�9«9am� (c) Oul-of-State Individuals (d) Candidate Committees (e) Political Action Committees (� Political Parties (g) Partnerships (h) Corporations & Limited Liability Companies �Pncs a Poencai aanies oniy� (ij Labor Organizations �anc: s Poru�ai aan�� o�iy� Q) Candidate's Personal Assels or Property �candmaie commn�eeso�iy� (k) Iil-KIf1dCO11lfII1UlIOfISSIJI]IO(8I(eqvily:add5(e)Ihmugh5Q)) 6. In-Klnd Dona�lons Received �Nomcomdb�oons)�Poou�ai Panies oniy) 7. Extensfons of Credll (a) Extensions of Credil Received (b) Paymenls on Extensions of Credif Recelved (c) Net Extensions of Credit (sumracn�b�rrom 7�a�� 8. Joini Fundraising! Shared Expense Payments Recelved 9. Payments Recelved for Goods / Servlces 10. Outsianding AccouNs Receivable / Debts Owed to Commlttee 11. Transfer In Surpius Monles / Transfer Out Debt �use casn andmreq��ry asapPr�anie� 12. MiscellaneousReceip�s��sacashaneioraq�iryasePPii�ania) 73. TO121 R8C81P15 (cash: add i(m), 2(a), 3-0, 8-9, 11-12; equlty: add 2(b), 5�k), 6-7(c), 10.12) Cash Q 111 11 5250.00 �000.00 7250.00 7250.00 7250.00 EqW(y \ � � I I � ____— � � I � I I � I � � � � � � � I � � � � � � I � � � � I � I � � I � � / Arizona Secretary of State Revision 7/31/21 (fillable formai) STATE OF ARIZONA ' COMMITTEE CAMPAIGN FINANCE REPORT x � x SUMMARY OF DISBURSEMENTS (Schedule B): Dlsbursements 1. Disbursements for Operating Expenses 2. CoNributions Made (aj Candidate Committees (b) Polilical Action Commiltees (c) Polilicai Parties (d) Partnerships (e) Coroorations & Limited Liabilitv Companles (anc s Pouucai aamas oni» (� Labor Organizations �anc a Poii�cai Pa�ues oniy� (gj MonefaryContributionsSubtotal(ada2(e)mrougn2(r�) (h) Contribution Refunds Provided to the Reporting Commiftee (i) MonetaryContributionsToial�sub��a2pi�tmmz�y�� 3. Loans (a) Loans Made {b) Loan Guaranlees Made (c) Forgiveness on Loans Made (d) Repayment of Loans Received (e) Accrued Inlerest on Loans Received (f� TOf31L0811S(cash:atld3(a),3(d)83(e);equity:add2(6)82(c)) 4. Rebates and Refunds Made �No�-co�mbuuons) 5. Value of In-Klnd Contdbutions Provided (a) Candidate Commi�tees (b) Political Aclion Commiltees (c) Political Parties {d) Partnerships (ej Corporalions & Limited Llabllily Companies �pqca Poiwcai panias o�iy) � (� Labor Organizations (Pnc a ponucai Pames onry) I (g) COO1fibU110fISSUf1fOf2I(add5(a)Ihrough5(Fll I 6. independent Expenditures Made 7. Ballot Measure Expenditures Made 8. Recall Expendilures Made I 9. Support Provided to Party Nominees �aommai aanies oniy) 10. Jolnl Fundraising / Shared Expense Payments Made 11. Relmbursements Made 12. Outstanding Accounts Payable / Debts Owed by Committee 13. Transfer Out Surplus Monles / Transfer In Debt (use casn andmr equ�ry as apprcawe� 14. Miscellaneous Disbursements I �15. Aggregate of Disbursemenis -^5250 or Less I "IS. TOI3I DISbUfSZfilE01S (cash: adtl i, 2(Ij, 3(�, 6-11 & 13-15; eqoity add 3(�, 5(g), $ 12-15) I Cash 1000.00 1000.00 COMMITTEE ID NUMBER CC2021-02 EqWry I I I � I � ( � 1 \ I / C9 I / Arizona Secrelary of Slale Revision 7/37/21 ((illable format) STATE OF ARIZONA S5 = COMMITTEE CAMPAIGN . � , FINANCE REPORT MONETARY CONTRIBUTIONS RECEIVED FROM IN-STATE INOIVIDUAIS - MORE THAN $100 DURING ELECTION CYCLE:" COMMITTEE ID NUMBER CC2021-02 SCHEDULE A(1)(a) Individual Contri6ulor Information Name pale Conlnhullon NeceNeJ Steven & Yvonne Varqo 10/07/2021 SLealPtltlress 13835 N Mesquite � ��y Fountain Hills o��oado� Realtor/Housewife Nxme svea�nae�e:: ` ciry ocapaaon Name StreetAtldress � Cily o«�veoo� Lane Slalo ZIP AZ 85268 Employer Self Emploved Oate ConNbW on Recelvxd Slete ZIP Employe� Dale Cnnlnb Won RectJvetl Slate Employer ZIP Neme WleConNbWon R¢celwd SVeBIMtlfe59 � Qty Sla�e ZIP Occupahon Emplayat Neme pzta ConNbWon Recelvad SItBBiMdlE59 0 Qty S�ele ZIP Occupeoon Employer Enler total only if last page of schedule (Iransfer the total received this pedod to "Summary of Recelpts," line 1(a)) Cumulative Cumulalive ` Amounl this Amount this Reporting Period Elecllon Cycle � ��.�� 1000.001000.00 `If in-stale individual con[ributions 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 _ Amount Received 1000.00 Arizona Secrelary of State Revision 7/31/21 (fillable formal) STATE OF ARIZONA ,�' ' COMMITTEE CAMPAIGN . � . FINANCE REPORT MONETARY CONTRIBUTIONS RECEIVED FROM OUT-OF-STATE INDIVIDUALS Schedule A(7)(c), page_ of _ Individual ConUi6utor Information NAme �aie conmtmmn aeceiwa Idol & Jill Mitchell 10/21/2021 sUee��a,�. 21 Grandview Dr � ��v s�a�a z�� Macomb IL 61455 Occopauon Employer Doctor/Retired Nurse Blessing Health Sys Name oamcomm�wonRe��vea Douglas T Mergenthaler 12/08/2021 $tr881Atltllfi55 1201 Monster Rd SW Ste 350 ` Qry Slale zlP Renton WA 98057 occupauon emqoyer President Ashton Capital Name Date ConNbWon ReceNetl SVealAddress City Slate ZIP 4 SveelAEdress 5 qty S(ete ZIP ottupebon empioyer Enler total only if last page of schedule (Vans(er lhe total received ihis period to "Summary of Recelpts," line 1(c)) \ Ertiplay¢r Oalo ConNbWon RecNvetl Slate 21P Employer IDaleConNbWonReccvetl Cumulative Cumulative� Amounllhis Amounithis Reporting Period Eiection Cycle 250.00 COMMITTEE ID NUMBER CC2021-02 SCHEDULE A(1)(c) • 111 11 5250.00 5250.00 / Arizona Secretary of Stale Revision 7/3V21 (fillable formaQ Amount Received 250.00 , 5000.00 STATE OF ARIZONA ' COMMITTEE CAMPAIGN d FINANCE REPORT . . MONETARY CONTRIBUTIONS FROM CANDIDATE'S PERSONAL MONIES: Oa�o ConinbWon Recelvad 11/7/2021 Candidale Information Nzme Kelly Smith SvmtAdde¢ss 16537 Arroyo Vista Dr ��v Fountain Hills OccupaAon Realtor/Candidate Name SUeelAdtlress City Occopafion Slele ZIP AZ 85268 Employer Independent Contractor ( oale ConNbWon Recelvea Stato 21P Empioyer Cumulative Cumulative ' Amountthis Amountthis Reporting Period Election Cycle COMMITTEE ID NUMBER CC2021-02 SCHEDULE A(1)(j) , � 1 � � � Name �ale G n�nbMon RecNwd svea�nm�en. 3 pry Slala ZIP Oc<opa6on Employar Namo �a�a ConNbWon Recelved SlreelAtltlress 4 City Stala 21P OccupaAon Emp�oyel Name Date CqnlnbWon Rttelved SlreetAtldress 5 qty Slale ZIP Occupation Employer Enter total only if last page of schedule (transfer the to�ai received this period fo "Summary of Receipts; Ilne 1Q)) Schedule A(1)Q), page_ of _ 1000.00 1000.00 Arizona Secrelary of State Revision 7/31/21 (fillable formal) Amount Received 1000.00 STATE OF ARIZONA COMMITTEE CAMPAIGN � � » FINANCE REPORT DIS6URSEMENTS FOR OPERATING EXPENSES: COMMITTEE ID NUMBER CC2021-02 SCHEDULE 8(1) Recipient Information Name Disbursomontoala Green Leaf.Video 11/17/2021 SvoatAdaress Orlando Brown 480-221-8594 � �,�v s�A�a ��N AZ Typeo(OperzlmgExpensePa:tl NomEkCoralWrposo?(PALtendPoGYcaIPaNesQ�ly) Video & drone service ❑ Name Disbmmmant oale � Slreel ACOress G Qty �yae or opeaa�s �roe��e Pa'�a Neme �SVeetAdtlress Slate I21P NomElectorai Ruposo9 (PACs and Po'v�wl PaNes Only) ❑ OlSbvrsement0ale J Ci�y Type of Opemting Evpensa PaIJ Name SVeelAddress QI_. Aaaress 5 E�ense Peld Slale ].IP NomEleUo�al WPose4 (PACs and POFpcL PaNes Qily) ❑ �isbursemonl0ata State ZIP NomElectoral 4LryaeR (PA(k and Po4Ucal PaNes Only) ❑ Cumulative Cumulative\ Amount Paid Amount this Amount this Reporting Penod Election Cycle 1000.00 1000.00 O Cash ❑ Credit ❑ Cash ❑ Credll ❑ Cash � O Credit ❑ Cash ❑ Credit Oisbursement0ala Stele ZIP ❑ Cash ❑ Credl� NomElectorai Pwpose4 (PACs ena PoNCL PaNes �nry) ❑ only if last page of schedule totaldis6ursedthlsperiodto"SummaryofDisbursemeNs,"linet) ��.�� Q�.�� Schedule B(1), page_ of _ / — � Arizona Secretary o(State Revision 7l31/21 (fiilable format)