HomeMy WebLinkAboutCampaign Filing 3 - Adam for Aspen '1'�►`��
RECEIVED Clerk CEIVED
MAR 1 2019
C I T y rJI- ;'.....
CAMPAIGN REPORT FORM
RU'PORT OF CONTRIBUTIONS AND 3CXRDI NDffTURES
C.R.S.I-45-108
Full 1Varne of Committee/person:
ALfl , t-i a -figtw4
As Shown On Registration
Address of Committee/Person: 135.� Jf l fll,A) �� ,R
City,State&Zip Code:
7Wc rJ CZ) V�I I
Committee Type:
Flame and Address of Financial
Institution ftowc mtjlL IoOO E. -�{, tCl� S � Co
Tyne of Report
Regularly Scheduled Filling.
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)
Ueporting Period Covered: 07 Q - Iq __I Through 3/ � /11
Date
Date
1 Funds on gland at the Beginning of Deporting Period (monetary $ Totals Detailed Summa Page
only)
2 Total Monetary Contributions $
ys'v
3 Total of Monetary Contributions ani Beginning Amount --$7-
4
4 Total Monetary Expenditures $ r � 47 7 • 03
Yl � .2
5 Fends on iHla�ndl at tdue E td of ISeporting Period (monetary) $
�{ I � 0 ,
FThe appropriate officer shall impose a penalty of$50 per day iior each day that a report is filed late.
[Art. �III Sect. 10 (2) (a)l
AUtlhoa'ization Must be completed by either the Registered A,,ent®I2 the Candidate
Print Registered Agent's(Treasurer's)Name: A.:.
Registered Agent's(Treasurer's)Signature: .
Date:
Candidate's Signature: %:•
"� — Date:
DETAILED SUMMARY
Full Name of Committee/Person: AM
Current Reporting Period: �la(a 119 Through 3Z, 119
6 Funds on hand at the beginning of reporting period (Monetary only)
7 Itemized Contributions$20 or More [CRs 1-45-108(1)(a)] $
(Please list on Schedule"A")
S Total of Non-Itemized Contributions $
(Contributions of$19.99 and Less)
9 Loans Received $
(Please list on Schedule"C")
10 Returned Expenditures(from recipient) $
(Please list on Schedule"D")
11 Total Monetary Contributions $
�•O o 0
12 Total Non-Monetary Contributions $ J
13 Total Contributions $
yea . o0
14 Itemized Expenditures$20 or More [CRS 1-45-108(1)(a)] $
(Please list on Schedule"B")
�f 4
15 Total of Non-Itemized Expenditures
(Expenditures of$19.99 or Less) „
16 Loan Repayments Made $ �1
(Please list on Schedule"C") O
17 Returned Contributions (To donor) $
(Please list on Schedule"D")
18 Total Monetary Expenditures $
(Total of lines 14 through 17) r ,q
19 Total Spending $ `� ]
(line 12+line 18)
Schedule A—Itemized Contributions Statement($20 or more)*
[CRS 1-45.108(1)(a
Full Name of Committee/Person:
WARNING: Please read the instruction page for Schedule "A" before completing!
PLEASE PRINT/TYPE
1.Date Accepted
4.Name (Last,First):
2.Contribution Amt.
5. Address:
3. Aggregate Amt. 6. City/State/Zip:
$ 7. Occupation and Employer:
F
Date AcceptedF4.Name(Last,First):
Contribution Amt.
$ dress:
3. Aggregate Amt. 6. City/State/Zip:
$ 7. Occupation and Employer:
1.Date Accepted
4.Name(Last,First):
2. Contribution Amt. 5. Address:
3. Aggregate Amt. 6. City/State/Zip:
$ 7. Occupation and Employer:
FAggregate
ted
4.Name(Last,First):
n Amt.
5. Address:
6. City/State/Zip:
Amt.
7. Occupation and Employer:
Occupation and Employer only required on each person wbU $
to a candidate committee, political committee, issue coho has made a COritrltlOri Of 100 01 more
mmittee or political party.
Schedule B—Itemized Expenditures Statement($20 or more)
CRS 1-45-108(1) a)
Full Name of Committee/Person: ADA rt b i Sc.N
PLEASE PRINT/TVPE
1.Date Expended 3.Name (Last,First): r-
Q�
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:
I.Date Expended 3.Name(Last,First):
4. Address:
2.Amount 5. City/State/Zip:
$
6. Purpose of Expenditure:
Statement Of Non-Monetary Contributions
[Att.XXVIII, Sect 2,(5)(a)(1I) ;III),Sect.5,(3)]
CRS 1-45-108(1
Full Name of Committee/Person: A Q i "4�
PLEASE PRINT/TYPE w
1.Date Provided: 4.Narne (Last,First):
5. Address:
2. Aggregate Amt.:
$ 6. City/State/Zip:
3. Fair Market Value:
$ 7. Description:
1. Date Provided: 4.Narne (Last,First):
2.Aggregate Amt.:
5. Address:
$ 6. City/State/Zip:
3. Fair Market Value:
$ 7. Description:
1.Date Provided: 4.Narne (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.Narne (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: A-rh
Returned Expenditures
(Previously reported on Schedtde B—Contributionst{ren returned from recipient)
PLEASE PRINT/TYPE
1.Date Accepted: 4.Name(Last,First): NZ
2. Date Returned: 5. Address:
6. 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):
kit)
2. Date Returned: 5. Address:
Amount: 6. City/State/Zip:
3.
$ 7. Purpose:
1.Date Accepted: 4.Name(Last,First):
2. Date Returned: 5. Address:
3. Amount:
6. City/State/Zip:
$ 7. Purpose:
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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 load to a financial institution.)
Full Name of Committee/Person: nA,M
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 infonnfront ation copied frosuch 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): NG
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 sunnnuy P.epuu)
Amount Repaid This Reporting Period: $ Total Repayments Made:$
(Amount Repaid is stun of Principal&interest entered on Detail Summary)
(Stun of Schedule C pages,Place on tine 16 of Detailed Suttunary)
Outstanding Balance: $ _
TERMS OF LOAN:
Date Loan Received Due Date for Final Payment
LIST ALL ENDORSERS OR GUARANTORS OF THIS LOAN
Full Name Address,Ci St.,Zi
Amount Guaranteed