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Home My WebLink AboutCampaign Finance Records - Finance report - Committee to Elect Lauren Tolmachoff - 9/22/2014POLITICAL COMMITTEE FOR OFFICE USE ONLY CITY/TOWN OF Glendale 0 T Y C L E ilF 'K' CAMPAIGN FINANCE REPORT C 0 F G 1. E N C l is 1- E 2014 August/November Regular Election 4 , ,r s u. rl 4 Iwo 1 1 Committee To Elect Lauren Tolmachoff Full Name of Committee P.O. Box 10072 Address Glendale, Az. 85311 City ZIP Code County Phone 2 Lauren Tolmachoff- Glendale City Council -Cholla District 3A. ID# Sponsoring Organization or Candidate and office Lauren Tolmachoff-Glendale City Council -Cholla District ❑ Primary Name of Candidate and Office Sought (if applicable) electlaurentolmachoff@gmail.com General P -Mail Address Fax # 4. REPORTING PERIOD (Please check appropriate box) DUE BETWEEN January 31 Report -For Period of * thru December 31, 2013 .................................. January 1, 2014 and January 31, 2014 June 30 Report - For Period of January 1, 2014 thru May 31, 2014 ..................... . .............................. June 1, 2014 and June 30, 2014 P -Primary Election Report - For Period of June 1, 2014 thru August 14, 2014 ................................. August 15, 2014 and August 22, 2014 Post -Primary Election Report - For Period of August 15, 2014 thru September 15, 2014 ................... September 16, 2014 and September 25, 2014 Pre -General Election Report - For Period of September 16, 2014 thru October 23, 2014 ........................ October 24, 2014 and October 31, 2014 Post -General Election Report - For Period of October 24, 2014 thru November 24, 2014 .................... November 25, 2014 and December 4, 2014 **January 31 , Report - For Period of November 25, 2014 thru December 31, 2015 ................................. January 1, 2016 and January 31, 2016 5. SUMMARY Column A Column) B Total This Reporting Election Period 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 5c Total Receipts (from corresponding columns on Detailed Summary Page, Line 8) 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 Organization was filed for the new committee) [Do not add or subtract this line from the other lines] i A Q �e ZI 6b Total Disbursements (from corresponding columns on Detailed Summary Page, Line 18) '+ n fl t+ a a 7. Cash on Hand at Close of Reporting Period [Subtract Line 6b from Line 5d1 *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 3/14 DETAILED SUMMARY PAGE Page 2 OF RECEIPTS AND DISBURSEMENTS 2. ID# 14-6'3 at 1. Committee Name: % 4 1✓yi wx-Primary 3. Report covering period from r t Thru Q' ' i General RECEIPTS COLUMN A COLUMN B THIS PERIOD CAMPAIGN TO DATE 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)] §OL 00 (e) Refund of contributions (Total from Schedule F-2) r (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) 4jA 7. Dividends, interest, and other forms of receipts (Total from Schedule F-1) 8. Total Reyeipts [add 4(f), 5(c), 6, and 7] 0U ® (o T:5 DISBURSEMENTS 9. Expenditures for operating expenses (Total from Schedule D) (V' p cl'D • w 10. Independent Expenditures (Total from Schedule D-1) 11. Value of In-kind expenditures (Total from Schedule E) W 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 161 19, Total Outstanding Debts owed by Reporting Candidate or Political Committee (Schedule F-3) 20. I clzrtif under penalty of perjury, that I have exarNed the contents of this campaign finance report and to the best of my knowledge and belief it is true and Type or Pr t Name of Tre re Signature of Treasurer or Candidate or Designating Individual ate CONTRIBUTIONS more than $50 -from INDIVIDUALS* SCHEDULE A 2. ID# l ...-� Primary General 1. Committee Name ( ' 3. Report covering period from �_`. �� thru_ 4 CONTRIBUTIONS DATE RECEIVED AMOUNT RECEIVED THIS PERIOD CUMULATIVE TOTAL THIS CAMPAIGN TO DATE NAME, ADDRESS, OCCUPATION AND EMPLOYER OR CONTRIBUTOR 4a, LAST FIByF-- MI gaer J�/l'1 STREET ADDRESS py nd�� CITY STATE ZIP J-4 A -z- V!"DC6 OCCUPATION� i re EMPLOYER b. LAST FI MI /� ®r t? STRE�;DD - 7 Uj Ix CITY� I STT �I 9309 OCCU f e o 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 STREET ADDRESS CITY STATE ZIP OCCUPATION EMPLOYER 5. ENTER TOTAL ONLY IF LAST PAGE OF SCHEDULE A [If last page of Schedule A, transfer total to Detailed Summary Page Line 4(z), Column A] L/ *If contributions of $50 or less are listed with contributor's name, address, occupation and employer on Schedule A, do not include Page t of them on Schedule A-1. CONTRIBUTIONS of $50 or less -AGGREGATE TOTAL* SCHEDULE A-1 2. ID# V Primary .11 General 1. Committee NameSmm4ka4DEkk 3. Report covering period from f' I S_I I q thru A 4. Aggregate Total of Contributions of $50 or less DESCRIPTION AMOUNT RECEIVED THIS PERIOD 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 g 1 �• 6 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. CORTRIBUTIONS FROM POLITICAL COMMITTEES SCHEDULE 9 1Committee Name _ 3. Report covering period from 'G1 IS1 4 IS -114 RECEIVED THIS ]/CAMPAI(GN PERIOD 6TAL THIS TO DATE T IDENTITY OF CONTRIBUTOR AND DATE RECEIVED 4a ID # NAME, ADDRESS, CITY, STATE AND ZIP DATE RECEIVED b. ID# NAME, ADDRESS, CITY, STATE AND ZIP DATE RECEIVED 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 IP 7 DATE RECEIVED f. ID# NAME, ADDRESS, CITY, ST EANDZIP 7 DATE RECEIVED 7 DATE RECEIVED 7 DATE RECEIVED i. ID# N E, 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] CANDIDATE LOANS SQHEDULEC 1. Committee Name Nrn tn Au,, 4) atA L". rM- ( 0 ff &6aw 2. ID# Primary General 3. Report covering period from th ru, q TI -s-- F I 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 (A&rpA —rb t w1dit4f— &rin-a-+ DESCRIPTION C&M PU I MA 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 ( OTHERLOANS SCHEDULE C1 2. ID# Primary General Committee Name /} Report covering period from S` thru �__! �.�_'_� 4 ALL OTHER LOANS CUMULATIVE DATE AMOUNT TOTAL THIS NAME AND ADDRESS OF EACH INDIVIDUAL (OR NAME, ID# AND ADDRESS OF THE POLITICAL COMMITTEE) OR LOAN, AND ANY ENDORSER OR GUARANTOR LOAN RECEIVED OF LOAN CAMPAIGN OF LOAN. TO DATE 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, S TE, ZIP, AND ID# NAME OF ENDORSER OR GUARANTOR OF LOAN, ADDR S, CITY, STATE, ZIP, AND ID# DESCRIPTION 4d NAME OF PERSON OR COMMITTEE MA NG LOAN, ADDRESS, CITY STATE, ZIP, AND ID# NAME OF ENDORSER OR GU ANTOR OF LOAN, ADDRESS, CITY, STATE, ZIP, AND ID# DESCRIPTION 5. ENTER TOTAL ONLY IF LAST PAGE OF SCHEDULE C-1 [If last page of Schedule C-1, transfer total to Detailed Summary Page, Line 5(a), Column A] Page I off 'EXPENDITURES FOR OPERATING EXPENSES* SCHEDULE D 2. ID# jq�� Primary A Genera U t) m,� �� -6 an+ (Auc -Tc) I FZ 1, Committee Name 3. Report covering period from thru 41w 14 4 EXPENDITURES DATE EXPENDITURE AMOUNT OF THE NAME AND ADDRESS TO WHOM EXPENDITURE (DISBURSEMENT) WAS MADE MADE EXPENDITURE 4a. NAME, ADDRESS, CITY, STATE AND ZIP _PDA qf��1� I.1" DESCRIPTION OF ITEMS OR SER ESPURCHASED V' i �:-®Q Cft 4b, NAME, ADDRESS, CITY, STATE AND ZIP 'Pk DESCRIPTION OF ITEMS OR SERVICES PURCHASED 4c. NAME, ADDRESS, CITY, STATE AND ZIP L/" �r k I DESCRIPTION OF ITEMS OR SERVICES PURCHASED SAV -6 I 4d. NAME, ADDRESS, CITY, STATE AND ZIP DESCRIPTION OF ITEMS OR SERVICES PU SED 4e. NAME, ADDRESS, CITY, STATE AND ZIP 71 DESCRIPTION OF ITEMS OR SERVICES PU1!1AVSE1b 4f. NAME, ADDRESS, CITY, STATE AND ZIP qo 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] *Expenditures, other than a contract, promise or agreement to make an expenditure resulting in credit Page_L,fl-- EXPENDITURES FOR OPERATING EXPENSES* SCHEDULE D 2. ID# Primary Committee General Report covering period from 91IS'(11 thru 4 EXPENDITURES DATE EXPENDITURE MADE AMOUNT OF THE EXPENDITURE NAME AND ADDRESS TO WHOM EXPENDITURE (DISBURSEMENT) WAS MADE 4a. NAME, ADDRESS, CITY, STATE AND ZIP N'�tj nc N DESCRIPTION OF ITEMS OR SERVICES PURCHASED U 4b. NAME, ADDRESS, CITY, STATE AND ZIP DESCRIPTION OF ITEMS OR SERVICES PURCHASED 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 Al *Expenditures, other than a contract, promise or agreement to make an expenditure resulting in credit Page Z"5f 2. ID# (4-63 Committee Name LMM 4a' Ulu r-4 rbIt nkchbw � Report covering period from 6 lI I q 1 thru 01 /pJ 1 1 4 4 INDEPENDENT EXPENDITURES DATE AMOUNTOF EXPENDITURE THE MADE:- EXPENDITURE IDENTIFY RECIPIENT OF EXPENDITURE AND CANDIDATE WHO IS BENEFITTED OR OPPOSED rte, 4a. NAME, ADDRESS, CITY, STATE AND ZIP PURPOSE AND DESCRIPTION OF PURCHAS enefitte osed CANDIDATE OFFICE SOUGHT YEAR OF ECTION 4b. NAME, ADDRESS, CITY, STATE AND ZIP ZZ PURPOSE AND DESCRIPTION OF PURCHAS [enefix IDEposed CANDIDATE OFFICE SOUL YEAR OF ELECTION 4c. NAME, ADDRESS, CITY, STATE AND ZIP PURPOSE AND DESCRIP N OF PURCHAS pposed CANDIDATE —T OFFICE SOUGHT YEAR OF ELECTION 5. ENTER TOTAL NLY IF LAST PAGE OF SCHEDULE D-1 [If last page of Schedule D-1, transfer total 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 independentexpenditure(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 Page I of L -OANS MADE BY REPORTING• D 222 Committee Name r1 t4ZAO 4 3. Report covering period from �l 11Q L 4 LOANS MADE. BY THE REPORTING COMMITTEE 1-1 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# 46 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, D ID# 4h. NAME, ADDRESS, CITY, ST , ZIP, AND ID# 4i. NAME, ADDRESS, CI , STATE, ZIP, AND ID# 5. ENTER TOTAL ONLY IF LAST PAGE OF SCHEDULE D-2 [Transfer total to Detail Summary Page Line 12, Column A] Page ( of I 4a. 4b. 40. 4d. 4e. OFFSETS TO OPERATING EXPENSES * Committee Name 3. Report covering period from SCHEDULE D-3 REBATES, REFUNDS AND OTHER OFFSETS TO OPERATING EXPENSES DATE ,s' REEUN RECEI D AMOUNT OF THE REFUND NAME AND 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 ZI DESCRIPTION OF REFUND 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—�_of/ 4a. 4b. 4c. 4d. 4e, 4f. 1. Committee Name REPAYMENTOF ""LOANS 3. Report covering period from � � thru ' ! / ' Y REPAYMENT OF LOANS MADE OR GUARANTEED BY CANDIDATE DATE REPAYMENT MADE AMOUNT OF THE EPAYMENT 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 Pagej_of REPAYMENT OF ALL OTHER LOANS SCHEDULE D-5 2. ID# Primary aJ Committee Namet Report covering period from 1 "T1 thru 4 REPAYMENT OF ALL OTHER LOANS DATE AMOUNT OF REPAYMENT THE MADE 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 # 5. ENTER TOTAL ONLY IF LAST PAGE OF SCHEDULE D-5 [Transfer total to Detailed Summary Page, Line 13(b), Column A] Page—Lof TRANSFERS TO OTHER POLITICAL COMMITTEES SCHEDULE D-6 Primary General 1. Committee Name m 144p, 3. Report covering period from _ .i._' i� thru—__! 4 TRANSFERS MADE BY THE REPORTING COMMITTEE DATE TRANSFER MADE AMt' OF THE TRANSFER NAME AND ADDRESS OF INDIVIDUAL (OR NAME, ID# ANDADDRESS 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 I oft F-INMIN w M. ■ r 1. Committee NamP.�( 3. Report covering period from i9tiq� thru /U SCHEDULE D-7 to Primary General 4. ANY OTHER DISBURSEMENTS DATE DISBURSEMENT MADE AMOUNT OF THE DISBURS ENT 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, 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 D ID# DESCRIPTION ENTER TOTAL ONJIIF LAST PAGE OF SCHEDULE D-7 [Transfer total to Detailed Summary Page Line 15 Column A] Page 1 of IN-KIND CONTRIBUTIONS and EXPENDITURES SCHEDULE E f Primary 1. Committee Name �r m QCT 11�General 3. Report Covering period from I J NJ Iq thru q 4 IN-KIND CONTRIBUTIONS and EXPENDITURES DATE MARrET 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 EMP YER 4c. NAME, ADDRESS, CITY, STATE, ZIP AND ID# CONTRIBUTION EXPENDITURE DESCRIPTION OCCUPATION EMPLOYER 4d. NAME, ADDRESS,CITY, STAT IP 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 Al 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] Pagetof(_ DIVIDENDS, INTEREST, AND OTHER RECEIPTS SCHEDULE F-1 2. ID# Primary A cis General 1. Committee Name UO M..M j'(4*1Z mgktT 3. Report covering period from _thru 4 DIVIDENDS, INTEREST AND OTHER FORMS OF RECEIPTS DATEOL AMOUNT RECEIVED qO Uf NT 1 �OFTH E 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 z 4d. NAME, ADDRESS, CITY, STATE, ZIP AND ID# z DESCRIPTION OF RECEIPT 4e. AND ID NAME, ADDRESS, CITY, STATE, ZIP 7 DESCRIPTION OF RECEIPT Z 4f. NAME, ADDRESS, CITY, STA(, ZIP AND ID# DESCRIPTION OF RECEIPT 5. ENTER TOTAL ONLY IF LAST PAGE OF SCHEDULE F-1 [if last page of Schedule F-11, transfer total to Detailed Summary Page Line 7 Column A OFFSETS TO CONTRIBUTIONS RECEIVED * SCHEDULE F-2 2. ID# l �� Primary =General Committee Name _ li%i�') i �—�-C _AN Report covering period from thru l J 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# DESCRIPTION OF REFUND 4b. NAME, ADDRESS, CITY, STATE, ZIP AND ID# i 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 A 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 Page_1___of I DEBTS AND OBLIGATIONS (Excluding Loans) SCHEDULE F-3 ( 1. Committee Name —R__—__'~'eriod ' 4 DEBTS AND OBLIGATIONS OUTSTANDING OUTSTANDING BALANCE AMOUNT INCURRED PAYMENT THIS 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 OF DEBT 4b. NAME, ADDRESS, CITY, STATE, ZIP AND lD# 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, S ;7 NDID# DESCRIPTION OF D7 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] / /