HomeMy WebLinkAboutCampaign Finance Records - Finance report - Clark for Council - 9/29/2016POLITICAL COMMITTEE`i Y OF CfP1E,C���,11s€ONLY
CITY OF Glendale
CAMPAIGN FINANCE REPORT ��I, SIEP 29 AM 11'
2016 August/November Regular Election
Clark for Council
1.
Full Name of Committee
8628 W. Cavalier Drive
Address
Glendale, AZ 85305 Maricopa 623-772-9795
City ZIP Code County Phone
2.
Joyce Clark for city council
Sponsoring Organization or Candidate and office
Joyce Clark for city council - Yucca district
Name of Candidate and Office Sought (if applicable)
clarkjv@aol.com None -
E -Mail Address Fax #
4. REPORTING PERIOD (Please check app•opriate box) DUE BETWEEN
❑ January 31 Report - For Period of thru December 31, 2015 January 1, 2016 and February 1, 2016
❑ June 30 Report - For Period of January 1, 2016 thru May 31, 2016 ....... ..... .. ..... June 1, 2016 and June 30, 2016
❑ Pre -Primary Election Report - For Period of June 1, 2016 thru August 18, 2016 August 19, 2016 and August 26, 2016
W1Post -Primary Election Report - For Period of August 19, 2016 thru September 19, 2016 September 20, 2016 and September 29, 2016
❑ Pre -General Election Report - For Period of September 20, 2016 thru October 27, 2016 October 28, 2016 and November 4, 2016
❑ Post -General Election Report - For Period of October 28, 2016 thru November 28, 2016. ... November 29, 2016 and December 8, 2016
❑ **January 31 , Report - For Period of November 29, 2016 thru December 31, 2017 ......... . .. .... January 1, 2018 and January 31, 2018
5. SUMMARY
Column A
Column B
Total This Reporting
Election Period
Period
Total To Date
0
5a Surplus from Previous Campaign (or at time Statement of Organization was
filed for the new committee)
$5090.77
5b Cash on Hand at the Beginning of this Reporting Period
5c Total Receipts (from corresponding columns on Detailed
$310.00
$13391.80
Summary Page, Line 8)
5d Subtotal [add Lines b and c for Column A and add lines
$5400.77
$13391.80
a and c for Column B]
0
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
$3498.67
$11489.70
Detailed Summary Page, Line 18)
$1902.10
$1902.10
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).
**Other reports will be due before this reporting period if a special or recall election is held prior to the next general election.
Revised 5/15
DETAILED SUMMARY PAGE Page 2
OF RECEIPTS AND DISBURSEMENTS 2. ID#
1. Committee Name: Clark for Council
16-01
3. Report covering period from 08/19/2016Thru 09/19/2016
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 ScheduleA-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 [subtract4(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 otherforms of receipts (Total from Schedule F-1)
8. Total Receipts [add 4(f), 5(c), 6, and 7]
COLUMN A
THIS PERIOD
COLUMN B
CAMPAIGN TO DATE
10. Independent Expenditures (Total from Schedule D-1)
$310.00
$9615.00
0
$1095.00
0
$1250.00
$310.00
$11960.00
0
0
$310.00
$11960.00
0
$996.80
0
0
0
$996.80
0
$435.00
0
0
$310.00
$13391.80
DISBURSEMENTS
9. Expenditures for operating expenses (Total from Schedule D)
$3498.67
$1054.70
10. Independent Expenditures (Total from Schedule D-1)
0
0
11. Value of In-kind expenditures (Total from Schedule E)
0
$435.00
12. Loans made by reporting committee (Total from Schedule D-2)
0
0
13. (a) Repayment of loans made or guaranteed by candidate (Total from Schedule D-4)
0
0
(b) Repayment of all other loans (Total from Schedule D-5)
0
0
(c) Total Loan Repayments [add 13(a) and 13(b)]
0
0
14. Transfers to other political committees (Total from Schedule D-6)
0
0
15. Any other disbursement (Total from Schedule D-7)
0
0
16. Subtotal disbursements [add lines 9, 10, 11, 12, 13(c), 14, and 15]
$3498.67
$11489.70
17. Rebates, refunds and other offsets to operating expenses (Total from Schedule D-3)
0
0
18. Total disbursements [subtract line 17 from line 16]
$3498.67
$11489.70
19. Total Outstanding Debts owed by Reporting Candidate or Political Committee (Schedule F-3)
0
0
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.
Type or Print Name�of
0
I Signature of Treasurer or Candidate or Designating Individual Date 0
CONTRIBUTIONS more than $50 -from INDIVIDUALS* SCHEDULE A
2. ID#
16-01
1. Committee Name
Clark for Council
3. Report covering period from Aug. 19, 2016 thru Sept. 19,2016
4
CONTRIBUTIONS
DATE
RECEIVED
AMOUNT
RECEIVED
THIS
PERIOD
CUMULATIVE
TOTALTHIS
CAMPAIGN
TO DATE
NAME, ADDRESS, OCCUPATION AND EMPLOYER OR CONTRIBUTOR
4a.
LAST FIRST MI
Monaghan Dawn
8/20/2016
$110.00
$110.00
STREET ADDRESS
3632 N. Hooper Court
CITY STATE ZIP
Buckeye AZ 85396
OCCUPATION
Reti red
EMPLOYER
NA
b.
LAST FIRST MI
Davis Nick
8/23/2016
$200.00
$200.00
STREET ADDRESS
3306 N. 61st Place
CITY STATE ZIP
Scottsdale AZ 85251
OCCUPATION
Owner
EMPLOYER
Davis Enterprises
C.
LAST FIRST MI
STREET ADDRESS
CITY STATE ZIP
OCCUPATION
EMPLOYER
d.
LAST FIRST MI
STREET ADDRESS
CITY STATE ZIP
OCCUPATION
EMPLOYER
e.
LAST FIRST MI
STREET ADDRESS
CITY STATE ZIP
OCCUPATION
EMPLOYER
5.
ENTER TOTAL ONLY IF LAST PACE OF SCHEDULE A [If last page of Schedule A, transfer total to Detailed
Summary Page Line 4(z), Column A]
$310.00
$310.00
11
*If contributions of $50 or less are listed with contributors name, address, occupation and employer on Schedule A, do not include Page of
them on Schedule A-1.
CONTRIBUTIONS of $50 or less - AGGREGATE TOTAL* SCHEDULE A-1
Clark for Council
1. Committee Name
2. ID#
16-01
August 19, 2016 September 19, 2016
3. Report covering period from thru
4. Aggregate Total of Contributions of $50 or less
DESCR!PTION
AMOUNT
RECEIVED THIS
PERIOD
CUMULATIVE
TOTAL THIS CAMPAIGN TO DATE
5. TOTAL THIS PERIOD [Transfer total to Detailed Summary Page, Line 4(b),
0
6. CUMMULATIVE TOTAL THIS
$1095.00
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
Clark for Council
1. Committee Name
2. ID#
16-01
August 19, 2016 September 19, 2016
3. Report covering period from thru
4
CONTRIBUTIONS
AMOUNT
RECEIVED
THIS
PERIOD
CUMULATIVE
TOTALTHIS
CAMPAIGN TO
DATE
IDENTITY OF CONTRIBUTOR AND DATE RECEIVED
4a
ID #
NAME, ADDRESS, CITY, STATE AND ZIP
DATE RECEIV
b.
ID #
NAME, ADDRESS, CITY, STATE AND ZIP
DATE RECEIVED
C.
ID #
NAME,AD3h ESS, CITY, STATE AND ZIP
DATE RECEIVED
d.
ID #
NAME, ADDRESS, CITY, S TE 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]
0
$1250.00
Schedule B Page_of_
CANDIDATE LOANS
SCHEDULE C
1.
Committee Name
Clark for Council
2. ID #
16-01
3.
Report covering period from August 19, 2016 thru September 19, 2016
4.
LOANS MADE OR GUARANTEED BY CANDIDATE
DATE
RECEIVED
AMOUNT
RECEIVED
CUMULATIVE
TOTAL THIS
CAMPAIGN
TO DATE
NAME AND ADDRESS FROM WHOM RECEIVED
4a.
NAME, ADDRESS, CITY, STATE, AND ZIP
Joyce Clark
03/15/2016
$996.80
$996.80
8628 W. Cavalier Drive
Glendale, AZ 85305
DESCRIPTION
Candidate loan
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, transfertoal to Detailed Summary Page, Line 5(a), Column A]
0
$996.80
Schedule C Page_of '
OTHERLOANS
1. Committee Name Clark for Council
3. Report covering period from August 19, 2016 thru September 19, 2016
SCHEDULE C1
2. ID#
16-01
4
ALL OTHER LOANS
DATE
LOAN RECEIVED
AMOUNT
OF LOAN
CUMULATIVE
THIS
AMPA IGN
CAMP
TO DATE
NAME AND ADDRESS OF EACH INDIVIDUAL (OR NAME, ID#AND AD --DRESS 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 ENDO R OR GUARANTOR OF LOAN, ADDRESS, CITY, STATE, ZIP, AND ID#
DESCRIPTION
4b
NAME OF PERSON OR COMMITTEE MAKING LOAAN ADDRESS, CITY, STATE, ZIP, AND ID#
NAME OF ENDORSER OR GUARANTOR OF LOAN, ADDRESS, CITY, S TE, 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 [If las: page of Schedule C-1, transfer total to Detailed Summary
Page, Line 5(a), Column A]
O
Page_of '
EXPENDITURES FOR OPERATING EXPENSES* SCHEDULE D
2.!D#
16-01
1. Committee Name Clark for Council
3. Report covering period from August 19, 2016 thru September 19, 2016
4
EXPENDITURES
DATE
AMOUNTOF
EXPENDITURE
THE
NAME AND ADDRESS TO WHOM EXPENDITURE (DISBURSEMENT) WAS MADE
MADE
EXPENDITURE
4a.
NAME, ADDRESS, CITY, STATE AND ZIP
08/25/2016
$423.21
Premier Graphics
4141 W. Clarendon Avenue
Phoenix, AZ 85019
DESCRIPTION OF ITEMS OR SERVICES PURCHASED
printing
4b.
NAME, ADDRESS, CITY, STATE ANDZiP
08/25/2016
$400.52
Premier Graphics
4141 W. Clarendon Avenue
Phoenix, AZ 85019
DESCRIPTION OF ITEMS OR SERVICES PURCHASED
printing
4c.
NAME, ADDRESS, CITY, STATE AND ZIP
08/25/2016
$380.02
Premier Graphics
4141 W. Clarendon Avenue
Phoenix, AZ 85019
DESCRIPTION OF ITEMS OR SERVICES PURCHASED
printing
4d.
NAME, ADDRESS, CITY, STATE AND ZIP
08/25/2016
$195.70
Premier Graphics
4141 W. Clarendon Avenue
Phoenix, AZ 85019
DESCRIPTION OF ITEMS OR SERVICES PURCHASED
printing
4e.
NAME, ADDRESS, CITY, STATE AND ZIP
08/25/2016
$249.08
Premier Graphics
4141 W. Clarendon Avenue
Phoenix, AZ 85019
DESCRIPTION OF ITEMS OR SERVICES PURCHASED
printing
4f.
NAME, ADDRESS, CITY, STATE AND ZIP
08/25/2016
$1669.14
Premier Graphics
4141 W. Clarendon Avenue
Phoenix, AZ 85019
DESCRIPTION OF ITEMS OR SERVICES PURCHASED
printing
5
ENTER TOTAL ONLY IF LAST PAGE OF SCHEDULE D [If last page of Schedule D, transfertotal to Detail Summary Page Line
9, Column A]
*Expenditures, other than a contract, promise or agreement to make an expenditure resulting in credit
Page_of —
EXPENDITURES FOR OPERATING EXPENSES* SCHEDULE D
1. Committee Name
Clark for Council
2. I D#
16-01
3. Report covering period from August 19, 2016 thru September 19, 2016
4
EXPENDITURES
DATE
AMOUNTOF
EXPENDITURE
THE
NAME AND ADDRESS TO WHOM EXPENDITURE (DISBURSEMENT) WAS MADE
MADE
EXPENDITURE
4a.
NAME, ADDRESS, CITY, STATE AND ZIP
Grassroots Partners LLC
08/29/2016
$121.20
2942 N. 24th Street
Phoenix, AZ 85016
DESCRIPTION OF ITEMS OR SERVICES PURCHASED
calling
4b.
NAME, ADDRESS, CITY, STATE AND ZIP
8/29/2016
$59.80
Office Max
9320 W. Northern
Glendale, AZ 85305
DESCRIPTION OF ITEMS OR SERVICES PURCHASED
office supplies
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 Z!P
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
$3498.67
9, Column A]
*Expenditures, other than a contract, promise or agreement to make an expenditure resulting in credit
Page =of=
INDEPENDENT EXPENDITURES*
Clark for Council
1. Committee Name
3. Report coverina period from August 19, 2016
SCHEDULE D-1
2. ID#
16-01
thru September 19, 2016
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 URCHAS
enefitte
Lpposed
CANDIDATE OFR.GE SOUGHT YEAR OF ELECTION
4b.
NAME, ADDRESS, CITY, STATE AND ZIP
PURPOSE AND DESCRIPTION OF PURCHAS
enefitte
kpposed
CANDIDATE OFFICE SOUGHT YEAR OF ELECTION
4c.
NAME, ADDRESS, CITY, STATE AND ZIP
PURPOSE AND DESCRIPTION OF PURCHAS
enefitte
LIpposed
CANDIDATE OFFICE SOUGHT YEAR OF ELECTION
5.
ENTER TOTAL ONLY IF LAST PAGE OF SCHEDULE D-1 (if last page of Schedule D-1, transfer total to Detailed Summary Page Line 10, Column A]
0
"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 campai n committee or agent of that candidate.
�
Signature of Treasurer
NAMES, OCCUPATIONS AND EMPLOYERS AND AMOUNT CONTRIBUTED BY EACH OF THE THREE TOP CONTRIBUTCRS WITHIN THE LASTI AMOUNT
SIX MONTHS
Schedule D-1 Page—of
LOANS MADE BY REPORTING COMMITTEE SCHEDULE D-2
2. ID#
16-01
1. Committee Name Clark for Council
3. Report covering period from August 19, 2016 thru September 19, 2016
4
LOANS MADE BY THE REPORTING COMMITTEE
DATE
LOAN MADE
AMOUNT
OFTHELOAN
NAME, ADDRESS AND ID# OF COMMITTEE TO WHOM LOAN (DISBURSEMENT) WAS MADE
4a.
NAME, ADDRESS, CITY, STATE, ZIP, AND ID#
45.
NAME, ADDR ,CITY, STATE, ZIP, AND IC#
4c.
NAME, ADDRESS, CITY, STATE, Z
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 [Transfertotal to Detail Summary Page Line 12, Column A]
0
Page -1 of 1
4a.
:1
4b.
4c.
4d.
4e.
4f.
OFFSETS TO OPERATING EXPENSES * SCHEDULE D-3
2. ID#
16-01
1. Committee Name Clark for Council
3. Report covering period from August 19, 2016 thru September 19, 2016
REBATES, REFUNDS AND OTHER OFFSETS TO OPERATING EXPENSES
DATE
REFUND
RECEIVED
AMOUNT
OF THE
REFUND
NAME AND ADDRESS FROM WHOM REFUND OR REBATE WAS RECEIVED
NAME, ADDRESS, CITY, STATE, AND ZIP
DESCRIPTION REFUND
NAME, ADDRESS, CITY, S TE, 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 OFREFUND
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 Lire '7 Column A] 0
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 Clark for Council
3. Report covering period from August 19, 2016 th
SCHEDULE D-4
2. ID#
16-01
September 19, 2016
REPAYMENT OF LOANS MADE OR GUARANTEED BY CANDIDATE
DATE
AMOUNT OF
REPAYMENT
MADE
THE
REPAYMENT
NAME AND ADDRESS TO WHOM REPAYMENT (DISBURSEMENT) WAS MADE
NAME, ADDRESS, CITY, STATE, AND ZIP
NAME, ADDRESS, CITY, STATE, AND ZIP
T
4��
trv.
�b
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 D4 [Transfer total to Detail Summary Page, Line 13(a), Column A]
0
1 f
Schedule D-0 Page_of
1. Committee Name
REPAYMENT OF ALL OTHER LOANS SCHEDULE D-5
Clark for Council
2. ID#
16-01
3. Report covering period from August 19, 2016 thru September 19, 2016
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, ATE, ZIP AND ID#
40.
NAME, ADDRESS, CITY, STATE, ZIP AND ID#
4d.
NAME, ADDRESS, CITY, STATE, ZIP AND ID#
4e.
NAME, ADDRESS, CITY, STATE, ZIP AND ID#
4'.
NAME, ADDRESS, CITY, STATE, ZIP AND ID#
5.
ENTER TOTAL ONLY IF LAST PAGE OF SCHEDULE D-5 [Transfertotal to Detailed Summary Page, Line 13(b), Column A]
0
Page 1 of I
TRANSFERS TO OTHER POLITICAL COMMITTEES
1. Committee Name
Clark for Council
3. Report covering period from August 19, 2016
SCHEDULE D-6
2. ID#
16-01
September 19, 2016
4
TRANSFERS MADE BY THE REPORTING COMMITTEE
DATE TRANSFER
AMOUNT OF THE
MADE
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 ANC ID#
4b.
NAME, ADDRESS, CITY, ATE, ZIP AND ID#
4c.
NAME, ADDRESS, CITY, STATE, ZIP AND ID# n �4
k
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 -G [Transfer total to Detailed Summary Page, Line 14, Column A]
1\
0
Page of '
ANY OTHER DISBURSEMENT SCHEDULE D-7
2. ID#
16-01
Clark for Council
1. Committee Name
August 19, 2016 September 19, 2016
3. Report covering period from
4.
ANY OTHER DISBURSEMENTS
DATE
DISBURSEMENT
MADE
AMOUNT OF THE
DISBURSEMENT
NAME, ADDRESS AND ID# OF COMMITTEE TO WHOM
DISBURSEMENT WAS MADE; DESCRIPTION
4a.
NAME, ADDRESS, CITY, STATE, ZIP AND ID#
DESCRIPTION
4b.
NAME, ADDRESS, CITY, ST F, 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 total to Detailed Summary Page Line 15 Column A]
Page -of
IN-KIND CONTRIBUTIONS and EXPENDITURES SCHEDULE E
Clark for Council
1. Committee Name
2. ID#
16-01
August 19, 2016 September 19, 2016
3. Report covering period from thru
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
CONTRIBUTION
EXPENDITURE
DESCRIPTION
OCCUPATION
EMPLOYER""".1", "o
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
0
Line 6, Column A]
6.
ENTER TOTAL IN-KIND CONTRIBUTIONS ONLY IF LAST PACE OF SCHEDULE E [If last page of Schedule E, transfer total to Detailed Summary Page
0
Line 11, Column A]
1 1
Page_of _
DIVIDENDS, INTEREST, AND OTHER RECEIPTS
1. Committee Name Clark for Council
3. Report covering period from August 19, 2016
SCHEDULE F-1
2. ID#
16-01
September 19, 2016
4
DIVIDENDS, INTEREST AND OTHER FORMS OF RECEIPTS
DATE
AMOUNT
AMOUNT
OFTHE
RECEIVED
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 RECEIPT
4b.
ITY, ATE, ZIP AND ID#
NAME, ADDRESS, CITY,'
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"�.�
5. 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 Q
�]
Page_Of ._
OFFSETS TO CONTRIBUTIONS RECEIVED *
Committee Name
Clark for Council
3. Report covering period from August 19, 2016
SCHEDULE F-2
2. ID#
16-01
September 19, 2016
4
REFUNDS AND OTHER OFFSETS TO CONTRIBUTIONS RECEIVED
DATE
AMOUNT
REFUND
OF THE
MADE
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#
"N\
DESCRIPTIO11,KUND
4b,
NAME, ADDRESS, CITY, TATE, ZIP AND ID#
DESCRIPTION OF REFUND N°
�e.
4c.
NAME, ADDRESS, CITY, STATE, ZIP AND ID#
"
DESCRIPTION OF REFUND`S
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 total to Detailed Summary Page, Line 4(E), Column A]
Includes return of contributions received by reporting committee
u
1 1
Page_of —
DEBTS AND OBLIGATIONS (Excluding Loans) SCHEDULE F-3
1. Committee Name
Clark for Council
2. ID#
16-01
August 19, 2016 September 19, 2016
3. Report covering period from thru
4
DEBTS AND OBLIGATIONS
OUTSTANDING
OUTSTANDING
BALANCE
AMOUNT INCURRED
PAYMENTTHIS
BALANCE AT CLOSE
NAME AND ADDRESS OF INDIVIDUAL (OR NAME,
BEGINNING
THIS PERIOD
PERIOD
OF THIS PERIOD
ADDRESS AND ID# OF THE POLITICAL
THIS PERIOD
COMMITTEE) TO WHOM DEBT IS OWED
4a.
NAME, ADDRESS, CITY, STATE, ZIP AND ID#
DESCRIPTION DEBT
4b.
NAME, ADDRESS, CITY, AATE, ZIP AND ID#
DESCRIPTION OF DEBT
4c.
NAME, ADDRESS, CITY, STATE, ZIP AND ID#
OF DEBT
�.
[DESCRIPTION
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 [Transfertotal to Detail Summary Page Line 19, Column A]