The URL can be used to link to this page

Home My WebLink AboutCampaign Finance Records - Finance report - Chavira for Glendale - 1/29/2016POLITICAL COMMITTEE CITY OF GLENDALE CAMPAIGN FINANCE REPORT 2015 November Special Election 1. Chavira for Glendale Full Name of Committee 6118 N 88th Ave Address Glendale 85305 Maricopa (623)872-9509 city ZIP Code County Phore 2 Chavira for Glendale Sponsoring Organization or Candidate and office Sam Chavira for Glendale City Council Name of Candidate and Office Sought (if applicable) info@chaviraforglendale.com N/A E -Mail Address Fax # FOR OFFICE USE ONLY ITY'OCLERK FGLENDAL.E 16 JAN 29 Ply 3: 14 4. REPORTING PERIOD (Please check appropriate box) DUE BETWEEN ❑ January 31 Report - For Period of "thru December 31, 2014. January 1, 2015 and January 31, 2015 ❑ June 30 Report - For Period of January 1, 2015 thru May 31, 2015 ........... . .. ................ June 1, 2015 and June 30, 2015 ❑ Pre -Election Report - For Period of June 1, 2015 thru October 22, 2015 .. ... .... . October 23, 2015 and October 30, 2015 ❑ Post -Election Report - For Period of October 23, 2015 thru November 23, 2015 November 24, 2015 and December 3, 2015 ❑/ January 31, Report - For Period of November 24, 2015 thru December 31, 2015 *. January 1, 2016 •. and January 31, 2016 =< 5. SUMMARY Column A Column B Total This Election Period Reporting Period Total To Date $39.27 5a Surplus from Previous Campaign (or at time Statement of Organization was filed for the new committee) $1,431.14 5b Cash on Hand at the Beginning of this Reporting Period 5c Total Receipts (from corresponding columns on Detailed $16,250.00 $33,590.00 Summary Page, Line 8) $17,681.14 $33,590.00 5d Subtotal [add Lines b and c for Column A and add lines a and c for Column B] 6a Total Debts and Obligations from Previous Campaign Committee at Beginning of this Election Period (or at time Statement of $0.00 Organization was filed for the new committee) [Do not add or subtract this line from the other lines] $1,010.00 $16,958.13 6b Total Disbursements (from corresponding columns on Detailed Summary Page, Line 18) $16,671.14 $16,671.14 7. Cash on Hand at Close of Reporting Period [Subtract Line 6b from Line 5d "Insert date which is 21 days after date of last election (A.R.S. §16-913). "This will depend on the year next election is held. The "due between" year will be the year of an election and the date following "December 31" will be the immediately prior year Revised 9/14 DETAILED SUMMARY PAGE Paqe 2 Ur KECEIPTS AND DISBURSEMENTS 1. Committee Name: Chavira for Glendale 3. Report covering period from 11 /24/15 Thru 12/31/15 2. ID# 12-13 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 (Total 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 71 DISBURSEMENTS 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 loans 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)] 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) COLUMN A THIS PERIOD COLUMN B CAMPAIGN TO DATE $5,000,00 $17,695.00 $0.00 $315.00 $11,250.00 $15,580.00 $16,250.00 $33,590.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $16,250.00 $33,590.00 $1,010.00 $16,958.13 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $$0.00 $0.00 $0.00 $1,010.00 $16,958.13 $0.00 $0.00 $1,010.00 $16,958.13 $0.00 $0.00 20. 1 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. Judy McCoy Chavira Type or Pr rt N e of Treasurer c - Sign ure of Trea er or bandidate or Esignating individual Date CONTRIBUTIONS more than $50 -from INDIVIDUALS* 1. Committee Name Chavira for Glendale 3. Report covering 11 /24/15 p g period from 12/31/15 SCHEDULE A 2. ID# 12-13 4 CONTRIBUTIONS DATE RECEIVED AMOUNT RECEIVED THIS PERIOD CUMULATIVE TOTALTHIS CAMPAIGN TO DATE NAME, ADDRESS, OCCUPATION AND EMPLOYER OR CONTRIBUTOR 41. LAST FIRST MI Becker Mark 12/04/15 $5,000.00 $5,000.00 STREETADDRESS 5950 E Caballo Dr CITY STATE ZIP Paradise Valley AZ 85253 OCCUPATION Owner EMPLOYER Becker Boards b. LAST FIRST MI STREET ADDRESS CITY STATE ZIP OCCUPATION EMPLOYER C. LAST FIRST MI STREETADDRESS CITY STATE ZIP OCCUPATION EMPLOYER d. LAST FIRST MI STREET ADDRESS CITY STATE ZIP OCCUPATION EMPLOYER e. LAST FIRST MI STREETADDRESS CITY STATE ZIP OCCUPATION EMPLOYER 5. ENTER TOTAL ONLY IF LAST PAGE OF SCHEDULE A [If last page of Scheduie A, transfer total to Detailed Summary Page Line 4(z), Column A] $5,000.00 `If contributions of $50 or less are listed with contributor's name, address, occupation and employer on Schedule A, do not include Page 1 of 1 them on Schedule A-1. CONTRIBUTIONS of $50 or less - AGGREGATE TOTAL* SCHEDULE A-1 Chavira for Glendale 1. Committee Name 11/24/15 3. Report covering period from 4. Aggregate Total of Contributions of $50 or less 12/31/15 2. ID# 12-13 DESCRIPTION AMOUNT PERIOD CUMULATIVETHIS CUMULATIVE TOTAL THIS CAMPAIGN TO DATE 5. TOTAL THIS PERIOD [Transfer total to Detailed Summary Page, Line 4(b), 6. CUMMULATIVE TOTAL THIS Column A] CAMPAIGN TO DATE [Transfer total to Detailed 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. CONTRIBUTIONS FROM POLITICAL COMMITTEES SCHEDULE B Chavira for Glendale 1. Committee Name 11/24/15 3. Report covering period from 12/31/15 2. I D# 12-13 4 CONTRIBUTIONS AMOUNT RECEIVED THIS PERIOD CUMULATIVE TOTAL THIS CAMPAIGN TO DATE IDENTITY OF CONTRIBUTORAND DATE RECEIVED 4a ID # 1797 NAME, ADDRESS, CITY, STATE AND ZIP UFCW99 2401 N Central Ave Phoenix, AZ 85012 $6,250.00 $6,250.00 DATE RECEIVED 12/23/2015 b. ID # 1227 NAME, ADDRESS, CITY, STATE AND ZIP Arizona Pipe Trades 469 3109 N 24th St Phoenix, AZ 85016 $5,000.00 $5,000.00 DATE RECEIVED 12/28/2015 C. ID # NAME, ADDRESS, CITY, STATE AND ZIP DATE RECEIVED d. ID # NAME, ADDRESS, CITY, STATE AND ZIP DATE RECEIVED e. ID # NAME, ADDRESS, CITY, STATE AND ZIP DATE RECEIVED f. ID # NAME, ADDRESS, CITY, STATE AND ZIP DATE RECEIVED g. ID # NAME, ADDRESS, CITY, STATE AND ZIP DATE RECEIVED h. ID # NAME, ADDRESS, CITY, STATE AND ZIP DATE RECEIVED i. ID # NAME, ADDRESS, CITY, STATE AND ZIP DATE RECEIVED 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] $11, 250.00 CANDIDATE LOANS SCHEDULE C 1. Committee Name Chavira for Glendale 2. ID # 12-13 3. Report covering period from 11 /24/15 thru 12/31/15 4. LOANS MADE OR GUARANTEED BY CANDIDATE DATE RECEIVED AMOUNT RECEIVED CUMULATIVE TOTALTHIS CAMPAIGN TO DATE NAME AND ADDRESS FROM WHOM RECEIVED 4a. NAME, ADDRESS, CITY, STATE, AND ZIP DESCRIPTION b. NAME, ADDRESS, CITY, STATE, AND ZIP DESCRIPTION C. NAME, ADDRESS, CITY, STATE, AND ZIP DESCRIPTION d. NAME, ADDRESS, CITY, STATE, AND ZIP DESCRIPTION e. NAME, ADDRESS, CITY, STATE, AND ZIP DESCRIPTION f. NAME, ADDRESS, CITY, STATE, AND ZIP DESCRIPTION 5. ENTER TOTAL OF LOANS MADE OR GUARANTEED BY CANDIDATE ONLY IF LAST PAGE OF SCHEDULE C [If last page of Schedule C, transfer total to Detailed Summary Page, Line 5(a), Column A] Schedule C Page of 1 OTHER LOANS 1. Committee Name Chavira for Glendale Report covering period from 11/24/15 thru 12/31/15 SCHEDULE C1 2. 1 D# 12-13 4 ALL OTHER LOANS DATE LOAN RECEIVED AMOUNT OF LOAN CUMULATIVE TOTAL THIS CAMPAIGN TO DATE NAME AND ADDRESS OF EACH INDIVIDUAL (OR NAME, ID# AND ADDRESS OF THE POLITICAL COMMITTEE) OR LOAN, AND ANY ENDORSER OR GUARANTOR OF LOAN. 4a NAME OF PERSON OR COMMITTEE MAKING LOAN, ADDRESS, CITY, STATE, ZIP, AND ID# NAME OF ENDORSER OR GUARANTOR OF LOAN, ADDRESS, CITY, STATE, ZIP, AND ID# DESCRIPTION 4b NAME OF PERSON OR COMMITTEE MAKING LOAN, ADDRESS, CITY, STATE, ZIP, AND ID# NAME OF ENDORSER OR GUARANTOR OF LOAN, ADDRESS, CITY, STATE, ZIP, AND iD# DESCRIPTION 4c NAME OF PERSON OR COMMITTEE MAKING LOAN, ADDRESS, CITY, STATE, ZIP, AND ID# NAME OF ENDORSER OR GUARANTOR OF LOAN, ADDRESS, CITY, STATE, ZIP, AND ID# DESCRIPTION 4d NAME OF PERSON OR COMMITTEE MAKING LOAN, ADDRESS, CITY, STATE, ZIP, AND ID# NAME OF ENDORSER OR GUARANTOR OF LOAN, ADDRESS, CITY, STATE, ZIP, AND ID# DESCRIPTION 5. ENTER TOTAL ONLY IF LAST PAGE OF SCHEDULE C-1 [1f last page of Schedule C-1, transfer total to Detailed Summary Page, Line 5(a), Column A] Page_of EXPENDITURES FOR OPERATING EXPENSES* SCHEDULE D 1. Committee Name Chavira for Glendale 3. Report covering 11/24/15 p g period from thrn 12/31/15 2. I D# 12-13 4 EXPENDITURES DATE AMOUNT OF EXPENDITURE MADE THE EXPENDITURE NAME AND ADDRESS TO WHOM EXPENDITURE (DISBURSEMENT) WAS MADE 4a. NAME, ADDRESS, CITY, STATE AND ZIP City of Glendale 5850 West Glendale Ave Glendale, AZ 85301 12/4/2015 $10.00 DESCRIPTION OF ITEMS OR SERVICES PURCHASED Late fee: Post -Election campaign finance report 4b. NAME, ADDRESS, CITY, STATE AND ZIP PB Consulting, LLC 15825 N 9th Ave. Phoenix, AZ 85023 12/31/2015 $1,000.00 DESCRIPTION OF ITEMS OR SERVICES PURCHASED Account management fee 4c. NAME, ADDRESS, CITY, STATE AND ZIP DESCRIPTION OF ITEMS OR SERVICES PURCHASED 4d. NAME, ADDRESS, CITY, STATE AND ZIP DESCRIPTION OF ITEMS OR SERVICES PURCHASED 4e. NAME, ADDRESS, CITY, STATE AND ZIP DESCRIPTION OF ITEMS OR SERVICES PURCHASED 4f. NAME, ADDRESS, CITY, STATE AND ZIP DESCRIPTION OF ITEMS OR SERVICES PURCHASED 5 ENTER TOTAL ONLY IF LAST PAGE OF SCHEDULE D [If last page of Schedule D, transfer total to Detail Summary Page Line 9, Column A] $1 ,010.000 'Expenditures, other than a contract, promise or agreement to make an expenditure resulting in credit Page_of_ INDEPENDENT EXPENDITURES* Chavira for Glendale 1. Committee Name 3. Report covering period from 11 /24/15 thru 12/31/15 SCHEDULE D-1 2. ID# 12-13 4 INDEPENDENT EXPENDITURES DATE EXPENDITURE MADE AMOUNT OF THE EXPENDITURE IDENTIFY RECIPIENT OF EXPENDITUREAND CANDIDATE WHO IS BENEFITTED OR OPPOSED 4a. NAME, ADDRESS, CITY, STATE AND ZIP PURPOSE AND DESCRIPTION OF PURCHAS enefitte osed CANDIDATE OFFICE SOUGHT YEAR OF ELECTION 4b. NAME, ADDRESS, CITY, STATE AND ZIP PURPOSE AND DESCRIPTION OF PURCHR enefitte osed CANDIDATE OFFICE SOUGHT YEAR OF ELECTION 4c. NAME, ADDRESS, CITY, STATE AND ZIP PURPOSE AND DESCRIPTION OF PURCHAS enefitte Ipposed CANDIDATE OFFICE SOUGHT YEAR OF ELECTION 5. ENTER TOTAL ONLY IF LAST PAGE OF SCHEDULE D-1 [If last page of Schedule D-1, transfertotal to Detailed Summary Page Line 10, Column A] "SEE A.R.S. § 16-901(14). I certify, under penalty of perjury, that the above stated independent expenditure(s) was not made in cooperation, consultation or concert with or at the request or suggestion of any candidate or any campaign committee or agent of that candidate. Signature of Treasurer NAMES, OCCUPATIONS AND EMPLOYERS AND AMOUNT CONTRIBUTED BY EACH OF THE THREE TOP CONTRIBUTORS WITHIN THE LASTI AMOUNT SIX MONTHS Schedule D-1 Pagel of 1 LOANS MADE BY REPORTING COMMITTEE Chavira for Glendale Committee Name Report covering period from 11/24/15 thru 12/31/15 SCHEDULE D-2 2. ID# 12-13 4 LOANS MADE BY THE REPORTING COMMITTEE DATE LOAN MADE AMOUNT OF THE LOAN NAME, ADDRESS AND ID# OF COMMITTEE TO WHOM LOAN (DISBURSEMENT) WAS MADE 4a. NAME, ADDRESS, CITY, STATE, ZIP, AND ID# 4b. NAME, ADDRESS, CITY, STATE, ZIP, AND ID# 4c. NAME, ADDRESS, CITY, STATE, ZIP, AND ID# 4d. NAME, ADDRESS, CITY, STATE, ZIP, AND ID# 4e. NAME, ADDRESS, CITY, STATE, ZIP, AND ID# 4f. NAME, ADDRESS, CITY, STATE, ZIP, AND ID# 4g. NAME, ADDRESS, CITY, STATE, ZIP, AND ID# 4h. NAME, ADDRESS, CITY, STATE, ZIP, AND ID# 4i. NAME, ADDRESS, CITY, STATE, ZIP, AND ID# 5. ENTER TOTAL ONLY IF LAST PAGE OF SCHEDULE D-2 [Transfer total to Detail Summary Page Line 12, Column Al Page of 1_.. 4a. 4b, 4c. 4d. 4e. 4f. OFFSETS TO OPERATING EXPENSES* 1. Committee Name Chavira for Glendale 3. Report covering period from 11/24/15 12/31/15 SCHEDULE D-3 2. ID# 12-13 REBATES, REFUNDS AND OTHER OFFSETS TO OPERATING EXPENSES DATE REFUND RECEIVED AMOUNT OF THE REFUND NAMEAND ADDRESS FROM WHOM REFUND OR REBATE WAS RECEIVED NAME, ADDRESS, CITY, STATE, AND ZIP DESCRIPTION OF REFUND NAME, ADDRESS, CITY, STATE, AND ZIP DESCRIPTION OF REFUND NAME, ADDRESS, CITY, STATE, AND ZIP DESCRIPTION OF REFUND NAME, ADDRESS, CITY, STATE, AND ZIP DESCRIPTION OF REFUND NAME, ADDRESS, CITY, STATE, AND ZIP DESCRIPTION OF REFUND NAME, ADDRESS, CITY, STATE, AND ZIP DESCRIPTION OF REFUND 5. ENTER TOTAL ONLY IF LAST PAGE OF SCHEDULE D-3 [If last page of Schedule D-3, [transfer total to Detailed Summary Page Line 17 Column A] Includes return of contributions made by reporting committee Schedule D-3 Page 1 of 1 .... 4a. 4b. 4c, 4d. 4e. 4f. REPAYMENT OF CANDIDATE LOANS 1. Committee Name Chavira for Glendale 3. Report covering 11/24/15 p g period from 12/31/15 SCHEDULE D-4 2. ID# 12-13 REPAYMENT OF LOANS MADE OR GUARANTEED BY CANDIDATE DATE REPAYMENT MADE AMOUNT OF THE REPAYMENT NAME AND ADDRESS TO WHOM REPAYMENT (DISBURSEMENT) WAS MADE 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 D-4 Transfer total to Detail Summary Page, Line 13(a), Column A] Schedule D-4 Page_of REPAYMENT OF ALL OTHER LOANS SCHEDULE D-5 1. Committee Name Chavira for Glendale 3. Report covering period from 11/24/15 12/31/15 2. ID# 12-13 4 REPAYMENT OF ALL OTHER LOANS DATE REPAYMENT MADE AMOUNT OF THE REPAYMENT NAME AND ADDRESS OF INDIVIDUAL (OR NAME, ID#AND ADDRESS OF THE POLITICAL COMMITTEE) TO WHOM REPAYMENT (DISBURSEMENT) WAS MADE 4a. NAME, ADDRESS, CITY, STATE, ZIP AND ID# 4b. NAME, ADDRESS, CITY, STATE, ZIP AND ID# 4c. NAME, ADDRESS, CITY, STATE, ZIP AND ID# 4d. NAME, ADDRESS, CITY, STATE, ZIP AND ID# 4e. NAME, ADDRESS, CITY, STATE, ZIP AND ID# 4f. NAME, ADDRESS, CITY, STATE, ZIP AND ID# 5. ENTER TOTAL ONLY IF LAST PAGE OF SCHEDULE D-5 [Transfer total to Detailed Summary Page, Line 13(b), Column A] Page 1 of _f TRANSFERS TO OTHER POLITICAL COMMITTEES 1. Committee Name Chavira for Glendale 3. Report covering 11/24/15 g period from 12/31/15 SCHEDULE D-6 2. ID# 12-13 4 TRANSFERS MADE BY THE REPORTING COMMITTEE DATE TRANSFER MADE AMOUNTOFTHE TRANSFER NAME AND ADDRESS OF INDIVIDUAL (OR NAME, ID# AND ADDRESS OF THE POLITICAL COMMITTEE) TO WHOM REPAYMENT (DISBURSEMENT) WAS MADE 4a. NAME, ADDRESS, CITY, STATE, ZIP AND ID# 4b. NAME, ADDRESS, CITY, STATE, ZIP AND ID# 4c. NAME, ADDRESS, CITY, STATE, ZIP AND ID# 4d. NAME, ADDRESS, CITY, STATE, ZIP AND ID# 4e. NAME, ADDRESS, CITY, STATE, ZIP AND ID# 4f. NAME, ADDRESS, CITY, STATE, ZIP AND ID# ENTER TOTAL ONLY IF LAST PAGE OF SCHEDULE D-6 [Transfer total to Detailed Summary Page, Line 14, Column A) Page 1 of 1 ANY OTHER DISBURSEMENT Chavira for Glendale 1. Committee Name 11/24/15 3. Report covering period from 12/31/15 SCHEDULE D-7 2. 1 D 12-13 4. ANY OTHER DISBURSEMENTS DATE DISBURSEMENT MADE AMOUNT OF THE DISBURSEMENT NAME, ADDRESS AND ID# OF COMMITTEE TO WHOM DISBURSEMENTWASMADE; DESCRIPTION 4a. NAME, ADDRESS, CITY, STATE, ZIP AND ID# DESCRIPTION 4b. NAME, ADDRESS, CITY, STATE, ZIP AND ID# DESCRIPTION 4c. NAME, ADDRESS, CITY, STATE, ZIP AND ID# DESCRIPTION 4d. NAME, ADDRESS, CITY, STATE, ZIP AND ID# DESCRIPTION 4e. NAME, ADDRESS, CITY, STATE, ZIP AND ID# DESCRIPTION ENTER TOTAL ONLY IF LAST PAGE OF SCHEDULE D-7 [Transfer tota! to Detailed Summary Page Line 15 Column A] Page_of IN-KIND CONTRIBUTIONS and EXPENDITURES SCHEDULE E Chavira for Glendale 1, Committee Name 11/24/15 3. Report covering period from thru 12/31/15 2. ID# 12-13 4 IN-KIND CONTRIBUTIONS and EXPENDITURES DATE FAIR MARKET VALUE NAME AND ADDRESS OF INDIVIDUAL (OR NAME, ADDRESS AND ID# OF THE POLITICAL COMMITTEE) FROM WHOM RECEIVED OR TO WHOM GIVEN 4a. NAME, ADDRESS, CITY, STATE, ZIP AND ID# CONTRIBUTION EXPENDITURE DESCRIPTION OCCUPATION EMPLOYER 4b. NAME, ADDRESS, CITY, STATE, ZIP AND ID# CONTRIBUTION EXPENDITURE DESCRIPTION OCCUPATION EMPLOYER 4c. NAME, ADDRESS, CITY, STATE, ZIP AND ID# CONTRIBUTION EXPENDITURE DESCRIPTION OCCUPATION EMPLOYER 4d. NAME, ADDRESS, CITY, STATE, ZIP AND ID# CONTRIBUTION EXPENDITURE DESCRIPTION OCCUPATION EMPLOYER 5. ENTER TOTAL IN-KIND CONTRIBUTIONS ONLY IF LAST PAGE OF SCHEDULE E [If last page of Schedule E, transfer total to Detailed Summary Page Line 6, Column A] 6. ENTER TOTAL IN-KIND CONTRIBUTIONS ONLY IF LAST PAGE OF SCHEDULE E [If last page of Schedule E, transfer total to Detailed Summary Page Line 11, Column A] 1 1 Page_of — DIVIDENDS, INTEREST, AND OTHER RECEIPTS 1. Committee Name Chavira for Glendale 3. Report covering 11/24/15 p g period from 12/31/15 SCHEDULE F-1 2. ID# 12-13 4 DIVIDENDS, INTEREST AND OTHER FORMS OF RECEIPTS DATE AMOUNT RECEIVED AMOUNT OFTHE RECEIPT NAME AND ADDRESS FROM INDIVIDUAL (OR NAME, ADDRESS AND iD# OF THE POLITICAL COMMITTEE) FROM WHOM RECEIPT WAS RECEIVED 4a. NAME, ADDRESS, CITY, STATE, ZIP AND ID# DESCRIPTION OF RECEIPT 4b. NAME, ADDRESS, CITY, STATE, ZIP AND ID# DESCRIPTION OF RECEIPT 4c. NAME, ADDRESS, CITY, STATE, ZIP AND ID# DESCRIPTION OF RECEIPT 4d. NAME, ADDRESS, CITY, STATE, ZIP AND ID# DESCRIPTION OF RECEIPT 4e. NAME, ADDRESS, CITY, STATE, ZIP AND ID# DESCRIPTION OF RECEIPT 4f. NAME, ADDRESS, CITY, STATE, ZIP AND ID# DESCRIPTION OF RECEIPT ENTER TOTAL ONLY IF LAST PAGE OF SCHEDULE F-1 [If last page of Schedule F-1, transfer total to Detailed Summary Page Line 7 Column A Page_of OFFSETS TO CONTRIBUTIONS RECEIVED * SCHEDULE F-2 1. Committee Name Chavira for Glendale 3. Report 11/24/15 p g period from 12/31/15 2. ID# 12-13 4 REFUNDS AND OTHER OFFSETS TO CONTRIBUTIONS RECEIVED DATE REFUND MADE AMOUNT OF THE REFUND NAME AND ADDRESS OF INDIVIDUAL (OR NAME, ADDRESS AND ID# OF THE POLITICAL COMMITTEE) TO WHOM REFUND WAS MADE 4a. NAME, ADDRESS, CITY, STATE, ZIP AND ID# DESCRIPTION OF REFUND 4b. NAME, ADDRESS, CITY, STATE, ZIP AND ID# DESCRIPTION OF REFUND 4c. NAME, ADDRESS, CITY, STATE, ZIP AND ID# DESCRIPTION OF REFUND 4d. NAME, ADDRESS, CITY, STATE, ZIP AND ID# DESCRIPTION OF REFUND 4e. NAME, ADDRESS, CITY, STATE, ZIP AND ID# DESCRIPTION OF REFUND 4f. NAME, ADDRESS, CITY, STATE, ZIP AND ID# DESCRIPTION OF REFUND 5. ENTER TOTAL ONLY IF LAST PAGE OF SCHEDULE F-2 [If last page of Schedule F-2, transfer tots to Detaued Summary Page, Line 4(E), Column A] Includes return of contributions received by reporting committee 1 1 Page of DEBTS AND OBLIGATIONS (Excluding Loans) SCHEDULE F-3 1. Committee Name Chavira for Glendale 11/24/15 3. Report covering period from thru 12/31/15 2, ID# 12-13 4 DEBTS AND OBLIGATIONS OUTSTANDING BALANCE BEGINNING THIS PERIOD AMOUNT INCURRED THIS PERIOD PAYMENTTHIS PERIOD OUTSTANDING BALANCE AT CLOSE OF THIS PERIOD NAME AND ADDRESS OF INDIVIDUAL (OR NAME, ADDRESS AND ID# OF THE POLITICAL COMMITTEE) TO WHOM DEBT IS OWED 4a. NAME, ADDRESS, CITY, STATE, ZIP AND ID# DESCRIPTION OF DEBT 4b. NAME, ADDRESS, CITY, STATE, ZIP AND ID# DESCRIPTION OF DEBT 4c. NAME, ADDRESS, CITY, STATE, ZIP AND ID# DESCRIPTION OF DEBT 4d. NAME, ADDRESS, CITY, STATE, ZIP AND ID# DESCRIPTION OF DEBT 4e. NAME, ADDRESS, CITY, STATE, ZIP AND ID# DESCRIPTION OF DEBT 5. ENTER TOTAL OUTSTANDING BALANCE AT CLOSE OF THIS PERIOD ONLY IF LAST PAGE OF SCHEDULE F-3 [Transfer total to Detail Summary Page Line 19, Column A]