HomeMy WebLinkAboutCampaign Filing 3 - Ann Mullins Aspen Mayor ow kp
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CITY OFASPEN
CAMPAIGN REPORT FORM
REPORT OF CONTRIBUTIONS AND EXPENDITURES
C.R.S. 145-108
Full Name of Committee/Person: n M"M
c
As Shown On Re istration
Address of Committee/Person:
City,State& Zip Code: Q
O
Committee Type:
Name and Address of Financial
Institution g,
Q
Type of Report (it/ ( W11
Regularly Scheduled Filing.
Amended Filing. This amends previous report filed on(date)
Submit changes or new information ONLY
Termination Report. (Termination Reports MUST have a Monetary Balance of Zero in Line 5)
Reporting Period Covered: Through 3 / %
Date Date
Totals Detailed Summary Page
1 Funds on Hand at the Beginning of Reporting Period (monetary $ / /
only) 6
2 Total Monetary Contributions $
/6W Sb- CIO
3 Total of Monetary Contributions & Beginning Amount $
C>�� 7
4 Total Monetary Expenditures 2— 9
5 Funds on Hand at the End of Reporting Period (monetary) $
The appropriate officer shall impose a penalty of$50 per day for each day that a report is filed late.
[Art. XXVIII Sect. 10 (2) (a)]
Authorization (Must be completed by either the Registered Aeent OR the Candidate)
Print Registered Agent's(Treasurer's)Name:
Registered Agent's(Treasurer's) Signature: J Date: -13 / / y
Candidate's Signature: //il'C G� -- Date: /
DETAILED SUMMARY
Full Name of Committee/Person: Am41H
Current Reporting Period: // Through
6 Funds on hand at the beginning of reporting period (Monetary only)
7 Itemized Contributions S20 or More [CRS 145-108(1)(a)] $
(Please list on Schedule"A")
i
8 Total of Non-Itemized Contributions $
(Contributions of$19.99 and Less) /
9 Loans Received $ (/
(Please list on Schedule"C")
10 Returned Expenditures(from recipient) $ C/
(Please list on Schedule"D")
11 Total Monetary Contributions $ (�
12 Total Non-Monetary Contributions $
b
13 Total Contributions $
14 Itemized Expenditures$20 or More [CRS 1-45-108(1)(a)] $
(Please list on Schedule`B")
15 Total of Non-Itemized Expenditures $
(Expenditures of$19.99 or Less)
16 Loan Repayments Made $ V
(Please list on Schedule"C") /
17 Returned Contributions (To donor) $ 1.
(Please list on Schedule"D") /7
18 Total Monetary Expenditures $
(Total of lines 14 through 17)
19 Total Spending $
(line 12+line 18) ��
Schedule A—Itemized Contributions Statement($20 or more)*
CRS 145-108 1 a
Full Name of Committee/Person: �21 awl
/]i� 4"'
WARNING: Please read the instruction page for Sched e "A" before completing!
PLEASE PRINT/TYPE
1. Date Accepted
L
����j 4.Name (Last,First):
2.Contribution Amts 5. Address: G}1 �,
1 6. City/State/Zip:
3. Aggregate Amt.
$ 7. Occupation and Employer:
1.Date Accepted ,
4.Name(Last,First): /
2.Contribution Amt. 5. Address: G
6. City/State/Zip:
3. Aggregate Amt. 4:v Ly
$ 7. Occupation and Employer: 1
1. Date Accepted
t�12 e `G 4.Name(Last,First): 4
2.Contribution Amt. 5. Address:,
$ /�)i!� 6. City/State/Zip:
Co
3. Aggregate Amt.
$ 7.Occupation and Employer.
1.Date Accepted
r
r 4.Name(Last,First):
2. Contri ution Amt. 5. Address:
$ /00
6. City/State/Zip:
3. Aggregate Amt.
$ 7. Occupation and Employer:
* Occupation and Employer only required on each person who has made a contribution of$100 or more
to a candidate committee, political committee, issue committee or political party.
1.Date Accepted .,
4.Name(Last,First):
2.Contribution Amt. 5. Address:
t/(J 6. City/State/Zip: Z®�J
3. Aggregate Amt.
$ 7. Occupation and Employer: r'i Gni
1.Date Accepted
`` 4.Name(Last,First):
/ c/ /
2.Contribution Ami 5. Address:
$ SSD 7
6. City/State/Zip:
3. Aggregate Amt.
$ 7. Occupation and Employer: 1� -
1. Date Accepted
/ 4.Name(Last,First): mat 4ailC/
2.contrib�ugtion Amt. 5. Address: A)
6. City/State/Zip:
3. Aggregate Amt. &,L�z
$ 7. Occupation and Employer: f/ Ye
1. Date Accepted
4.Name(Last,First): 7
�P
2.Contribktion ArAt. 5. Address:
/6-0 - 6. City/State/Zip:
3. Aggregate Amt.
$ 7. Occupation and Employin
1.Date Accepted
4.Name(Last,First):
2.Contribution Amt. 5. Address:
6. City/State/Zip:
3. Aggregate Amt.
$ 7. Occupation and Employer:
* Occupation and Employer only required on each person who has made a contribution of$100 or more
to a candidate committee,political committee, issue committee or political party.
Schedule B—Itemized Expenditures Statement($20 or more)
CRS 1-45-108(1) a)
Full Name of Committee/Person: /fl, It, /// 1 S
PLEASE PRINT/TYPE '
1. Date/Expended 3. Name (Last,First): A�
Gf Zlf�9 4. Address:
2. Amount 5. City/State/Zip:
6. Purpose of Expenditure:
1.Date Expended 3. Name(Last,First):
4. Address:
2. Amount 5. City/State/Zip:
6. Purpose of Expenditure:
1. Date Expended 3.Name(Last,First):
4. Address:
2. Amount 5. City/State/Zip:
$
6. Purpose of Expenditure:
1. Date Expended 3.Name(Last,First):
4. Address:
2.Amount 5. City/State/Zip:
6. Purpose of Expenditure:
1. Date Expended 3. Name(Last,First):
4. Address:
2. Amount 5. City/State/Zip:
6. Purpose of Expenditure:
Statement Of Non-Monetary Contributions
[Art.XXVIII, Sect 2,(5)(a)(II)(III),Sect.5,(3)]
CRS 1-45-108(1)]
Full Name of Committee/Person: A,&
PLEASE PRINT/TYPE
1.Date Provided: 4.Name(Last,First):
2.Aggregate Amt.:
5. Address:
$ 6. City/State/Zip-
3. Fair Market Value:
$ 7. Description:
1.Date Provided: 4.Name(Last,First):
2.Aggregate Amt.: 5. Address:
$ 6. City/State/Zip-
3. Fair Market Value:
$ 7. Description:
1. Date Provided: 4.Name (Last,First):
2.Aggregate Amt.: 5. Address:
$ 6. City/State/Zip:
3. Fair Market Value:
$ 7. Description:
1.Date Provided: 4.Name(Last,First):
2.Aggregate Amt.: 5. Address:
$ 6. City/State/Zip-
3. Fair Market Value:
$ 7. Description:
1. Date Provided: 4.Name(Last,First):
2.Aggregate Amt.: 5. Address:
$ 6. City/State/Zip-
3. Fair Market Value:
$ 7. Description:
Schedule D—Returned Expenditures & Contributions
Full Name of Committee/Person: &//
Returned Expenditures
(Previously reported on Schedule B—Contributions then returned from recipient)
PLEASE PRINT/TYPE
1. Date Accepted: 4.Name(Last,First):
2. Date Returned: 5. Address:
b. City/State/Zip:
3. Amount:
$ 7. Comment:
1. Date Accepted: 4.Name(Last,First):
2. Date Returned: 5. Address:
6. City/State/Zip:
3. Amount:
$ 7. Comment:
Returned Contributions
(Previously reported on Schedule A—Contributions returned to donors)
PLEASE PRINT/TYPE
1. Date Accepted: 4.Name(Last,First):
2. Date Returned: 5. Address:
6. City/State/Zip-
3. Amount:
$ 7. Purpose:
1. Date Accepted: 4.Name(Last,First):
2. Date Returned: 5. Address:
6. City/State/Zip-
J. Amount:
$ 7. Purpose:
Schedule C—Loans
This form details loans received and repaid by the committee/party (Money received by committee from a financial institution
and/or repayment of a loan to a financial institution.)
Full Name of Committee/Person:
LOANS-Loans Owed by the Committee
(Use a separate schedule for each loan.This form is for line item 9 and 16 of the Detailed Summary Report.)
[No information copied from such reports shall be sold or used by any person for the purpose of soliciting contributions or for any commercial purpose.
Notwithstanding any other section of this article to the contrary,a state candidate's candidate committee may receive a loan from a financial institution
organized under state or federal law if the loan bears the usual and customary interest rate,is made on a basis that assures repayment,is evidenced by a written
instrument,and is subject to a due date or amortization schedule Article XXVII,Sec.3(8).
LOAN SOURCE
Name(Last,First or Institution):
Address:
City/State/Zip:
Original Amount of Loan:$ Interest Rate:
Loan Amount Received This Reporting Period: $ Total of All Loans This Reporting Period:
Principal Amount Paid This Reporting Period: $
Interest Amount Paid This Reporting Period: $ (Place on line 9 of Detailed Summary Report)
Amount Repaid This Reporting Period: $ Total Repayments Made: $
(Amount Repaid is sum of Principal&Interest entered on Detail Summary)
(Sum of Schedule C pages,Place on line 16 of Detailed Summary)
Outstanding Balance: $
TERMS OF LOAN:
Date Loan Received Due Date for Final Payment
LIST ALL ENDORSERS OR GUARANTORS OF THIS LOAN
Full Name Address,City, St., Zip Amount Guaranteed
CITY OFASPEN
CAMPAIGN REPORT FORM
STATEMENT OF PERSONAL EXPENDITURES BY A CANDIDATE
[CRS 1-45-108&CRS 1-45-109,SOS Rules 4.13]
(For use by a candidate who has not received any contributions,but has made expenditures of personal funds.)
Name of Candidate:
Address of Candidate:
City, State, Zip Code:
Office Being Sought:
Report Period:Beginning Date Ending Date
Total amount of Non-Itemized Expenditures ($19.99 or less): $
Expenditures exceeding $19.99 shall be itemized and listed below.
Date Ex ended Amount Name of Recipient Address
City State Zip Comment/Purpose
Date Expended Amount Name of Recipient Address
City State Zip Comment/Purpose
Date Expended Amount Name of Recipient Address
City State Zip Comment/Purpose
I certify to the best of my knowledge this Statement of Expenditures is true and correct.
Signature of Candidate Date
r r Ps
`rp low
CITY OF ASPEN
CAMPAIGN REPORT FORM
CANDIDATE STATEMENT OF NON-RECEIPT OF CONTRIBUTIONS
OR
NON-EXPENDITURE OF FUNDS
[CRS 1-45-108(1)&CRS 1-45-1091
(For use by a candidate who has not received any contributions nor made any expenditures. No
expenditures have been made on behalf of the candidate.This form is also for use by candidates that
do not have a campaign committee.)
Name of Candidate:
Address of Candidate:
City, State, Zip Code:
E-Mail address:
Report Period:
Beginning Date: Ending Date:
CONTRIBUTIONS RECEIVED OR RECEIVABLE DURING THIS REPORTING
PERIOD
$ 0.00
EXPENDITURES MADE OR INCURRED DURING THIS REPORTING PERIOD
$ 0.00
I , affirm that no person received
contributions on my behalf or made any expenditures on my behalf. No contributions
have been pledged to me or on my behalf. I have not received any contributions nor have
I made or incurred any expenditures on my own behalf during this election reporting
period.
Candidate Signature Date