HomeMy WebLinkAboutTermination Report 04-25-2024FtRr,s,ro,NE TOWN CLERK
9950 Park Avenue
Firestone, CO 80-520
To,wnClerk( Firs stoad"O.gov
11h: (303) 531-6264
F`ax: (720) 713-4106
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REPORT OF CONTRIBUTIONS NND EXPENDITURES
Article XXV11 I of the Colorado Constitution and Title. LArticle 45 ofthe Colorado Revised Statute (C.R.S.)
Full Name of Committee/Person: 7-)-) e-> �4 ( 0 N C-
--As.`Show n on ReenOMoti
Address of Committee[Person:
A
City, State & Zip Code:
R, ?,CS 76 "1 r-, ,
Committee Type:
Name and Address of Financial NT C,gz�- D 1 —1
Institution I I ? I f r— 17. 2-< AA,\4 R en 4. r-;", I
COMMITTEE,H) NUMBER
Type, of Report
Regularly Scheduled Filing
Amended Filing. I his amends previous report t1led on (date)
Subinit changesOT I leWinformationONLY
Termination Re 1 1. (Tertnination Reports MUS'l I lose a klonetary Balwice of Zero in Line 5)
L1Check this box if this Report Contains f-Jectioneering Communications Infon-nation
Reporting Period, Covered: Through
Date Date
Declared Total Spending (if applicawe)
1 Art. XX V1 11 , Sec . 40)l
Totals Detailed Su maary Page
I Funds on (land at the Be -inning of Reporting Period (nionctaiy only)
2 Total Monetary Contributions (line i i) $
Total of Monetary Contributions & Beginning Amount (fine I -� line?)
4 Total Monetary Expenditures (line. 19)
—5 —f-ward—s on I fan—daitj—ieF,,ud of Reporting Period (monetam) (line 3 -- line 4)
The appropriate officer shall impose a penalty of S50 per day for each day that a report is filed late.
[Art. XXVII I See. 10(2)(a)1
Authorization {Mmust. be co m leted by either t1w R q J,;Tered Agent OR, tLi�L �Candidq�te, I hereby certilj, and declare, under
joenalty qf1mijiny, that to the best qf utv knoivleckge or beflt.fall contributiom received strain g this reportingperiod,
including aqy contributions received in thejbrm qj'ntembershij) elites tran.�I�rred bly a inenibership or ganifation. areftoin
permissihle sources.
Print Registered Agent's Name:
Registered Agent's Signature. #I
Print Candidate Name: �IJ C
Candidates Signature: 4-,\ Date:
To wn Oerk CPF forin: 1212023
Full Name of Committee/Person: __N
Current
Reporting Period:
Through
Funds onhand at the beginning of reporting period (Monetary Only)
6
Itemized Contributions $20 or More 1C.R.S. 1-45- I 08(l)(a)]
(From Schedule -A")
7
Total of Non -Itemized Contributions
(Cori tribtitions ol'$19.99and Less)
8
Loans Received
{From Schedtite
9
Total of OrtherReceipts
$
(Interest, Dividends, etc.)
10
Returned Expenditures (from recipient)
(From Schedtile "D")
Total Mon tan, Contributions
(Total of lines 6 through 10)
Total Non -Monetary Contributions
(From Staternent ot'Non-Monetary Contributions)
13
Total Contributions
(Lkw I I + line 12)
14
Itemized Expenditures $20 or More [C.R.S, 1-45-108(l)(a)1
(Frorn Schedule "B")
15
Total of Non -Itemized Expenditures
$
(EApenditares of'$19.99 or Less)
16
Loan Repayments Made
*'C")
$
(From Schedide
17
Returned Contributions (To donor)
$
(Please list on Schedule "D")
18
Total Coordinated Non Monetary (in -kind) Expenditures
so
(Candidatc/Candidate Committee & Political 1'arties only)
19
Total Monetary Expenditures
$
(Fotai of -Braes 14 throtigh 171)
20
Total Spending
$
(Line 18 + line 19)
Fireswne Town Clerk CPF forni: 12/2023
Schedule A — Itemized Contributions Statement ($20 or more)
Full Name of Committee/Person. I --t-43tv -- -- - ----- - --- -----
WARNING: Please read the instruction page for Schedule "A" before completing!
PLEASE PRINTITYPE
1. Date Aqeq tad_
4, Name (Fast, First): — -----
-2. -Ccrutribtltion\Arut. 5. Address:
6, City/State/Zip:
I Aggrpoot—eAan\lt- \17.Deseription:
, �etk box ii— 8. �"'m player (if applicable. mandato.rv):
Check
e ring
ione 9. Oc upation (if applicable,jrnandatoi:y):
Communication I \
I. Date Accented
4. Name (].cast, 'irst):
2. Contribution Arnt. 5. Address:
$ 6. City/Stafe/Zip:
3. Aggregate Arnt. *
$ 7, Description: A
8, Employer(il'applicable. t' 1):
Check box if
" f qect-ioneering 9. Occupation (if applicable. rnanVd,rvl:
Communication
1. jDjqtc�-A "ce ted
4. Name (Fast, First):
2. Contribution Amt. 5. Address:
6. City/State/Zip:
7. Description:
8. Employer (if applicable,nit aiidatory)a
r--l"heck box if
Lj�
Electioneering 9. Oce upation (i f app I icabl e. marl (lato ry):
Communication
L Date Accepted
4. Name (Last, First):
2. Contribution Arnt.
5. Address:
$
6. City/ Late/Zip:
3. A�g grcatg_Amt.
7. Description:
8. Employer (it'applicable,olan D: atM
d-
F"'heck
box if
t7ectioneering
9. OCCUpatioti (if applicable, mandatory):
Communication
For contribution limits within a committee's election cycle or contribution cycle, please refer to the following Colorado Cowtitutional cites: Candidate
Committee Art. XXV111, See, 2(6): Political farts` Art. XXVIII, See, 3(3), Political Committee Art XXV111, See 3(5); Small Donor Committee Art.
XXV111, See, 2(14,),
Firestone ToNvii Clerk CPF form : 12/2023
Sebedule 11 — Itemized Expenditures Statement (S20 or more
[1-45-108(1)(a), CK&I
Full Name of Committee/Person: ro P-3 _011
1. Date Ex aended
V 4. Name;
2. 'ATIO�Iit
5. Address:
$ 6. City/Stale/Zip:
Itpient is (optic alj:
Committee
ee 7. Purpose of Expenditure;
FINon-Committee 'L,-V'heck box if Electioneering Communication
I . D
4 N,
2, Amount
5. Addres
3,Reclplent is OPC,Onal�
6, Citom'/State/zi
Committee
oI I 4itt _L -PL
7, Purpose of Expe in, -e:
x
Non -Committee
ox it. 1,
Check box if Election C ring tin ion
1. Lute Extended
4, Narnc
5. Address:
2. Amount
$
I n pient is (optional):
6, City/State/Zip:
E]Committee
7, Purpose of Expenditure:
Non -Committee
E](_
_--heck
box if Electionecrin,g Communication
1, Date Fx L -iqnO d
4. Nanne:
2.A"Ot"t
5. Address:
$
6, City/State/Zip:
3.1
nCounnittee
pieta is (optionaly
EINpan-Committee
7, Purpose of Expenditure:
O"heck box if Electioneering Communication
I Date Expended
4. Name:
2, Amount 5. Address:
3, pient is (optional)
6, City/State/Zip:
: ,
Committee 7 Purpose of E'xpenditrrre:
9Non-Conimittee 10cHeck box if Electioneering Conirn unication
__j
Schedule C - Leans
C,andithiteCommittees only
Tull Marne ofC'crnmittee/Perestln; .�
LOANS - Loans Owed by the Committee
(U,sc<a separate schedule for each loan. This ftartn is for line iteln .and 16 of the Detailed tttnniary. Rep rl.)
inliarI Irlti(an corned from such reports shall be sold rear used by € ny person for the purpose ors lic ping r 7ttt °it�t'tfsx is r file sni` cc t'imc.rcial
Purls 'e [Art, XXV111, see, 9(ell Notwithstanding any other section of this article to the contrary, a candidate's candidate crartu ittec may receive a
Bates fr, n a financial institution Organized under state or federal laNN if the lotus hears tare usual and ctnstunrary interest rate, ns made on a'basis that
ass 'es repayment, is evidenced by awritten instrument. and is subject to due (late or amortization schedule [Art, XXV111, Sec. y(ll))
LOAN SOU
'Name (Last; first or tion):
Address _
City/State/Zip:
Original Amount of Loran:
\ 411, tl-
Loan Amount Received This Reporting eri
Principal Amount Paid This Reporting Peritr �
Interest Amount Paid This Reporting Period. $
Amount Repaid This Reporting period:
t tnutnnt Repaid is stern of Principal & Interest entered on Denul Surrnrnary)
Outstanding Balance: $ _
TERMS OF LOAN:
Interest Tate:
Total of All Loans This Reporting
Period:
(Place Oil titre it Of DCtailCd Summary Report)
Total Repayinet7ts Made: —_
(Sum ofSebedule C: )cages, Place on line l6of
Detailed `sunrnaary)
Date Loan Deceivers
LIST ALL ENDORSERS OR GUARANTOR O 1
__ _.
Full i�laxn - �—�_ Aclrss, t�°, trite, :i
Due Tate for Final Payment
Firestone Town Clerk C"PF limns: 1 /2023
Schedule D — Returned Contributions & Expenditures
Full Name of Committee/Person:
Returned Contributions
(Previous ); reported on Schedule A - - Contributions occelved and then returned to donors)
2, Date Returned
I Aniount
4. ti L_U,%µr
5. Address:
6. City/State,/Zip:
7. Purpose: —
4. Name (Last-Fim):
5. Address:
6. City/ Stat
7. Purpose:
r
Returned Expenditures
(Previous�y rel)orted on Schedide B —ExIjenditures returned or rfnnded to the committee)
FiTesioneTown Clerk (:PF forin: t2/2023
Statement of NonylV onetary ntrib utican
[Art, X VIII, See. 2(5)(a)(11)(111')& Sm 5(3) &'1-45-1€ 8(l). C, , ,1
Full Name ►t Committee/Person: b M4A
1. Date Provided
4. Name (1 ist, First):2.
dclre:i:
Fair llazk t Value
6. City/State/Zip:
7. Description:
on:
,' ntpltt er (if applicabic. mandatorry ):
Check box if
eMoneering 9. C)cJon (it applicable,rrjandatdm):
Communication
lti. lit box ifCoordinated with a Candidate/C:. ndidate Committee or Cat
1. Date Provided
0
4.
�.h
�. address; wy
?. Fair Market Value4y:
6, City/State,/Zip:
7. Description:
. l�lY1IJ1C7Ve[`(il`rlp�lictti�lc.,iTt�tttd3ttttit-�1. �`�, .,_._.�.�
a heck box it'
—ectionecrjtto
9. Occctpation (if applicable, engndatory ): �
a
Cornniunicatiian
E]C"heck late: ifCoordinated CandidCommittee
l(. with a e/C'andidate or Political Party.
1. date Provided
4, Name (Last. First):
5. Address:
2. Fair Market Value
st}
t}. 1..::it�'ft wAt Llt Vr` l`,.tp" _. 'm.4-_._...�..:�..... �...:_.
3. �^.aCG'.ti12t.
f. Description-,.—,-,,._.__..,W.._..,....._.....::....... .a......,.., ::..�,_......_
�M1
lt. Employer (It al7[71tcrtl?le,'TliT1C'1�]tCI.C�l;
Check box if
Electioneering
9. Occupation on (il appllcal')Ie. rnandaforv). �.
C'.can] tT7 t711ICat'lurs
10. ❑Check box if Coordinated with a Candidate/Candidate Committee or Politic ahParty.
Note: If coordinated, then contribution
Most also he reporled as a non-nionL`lary ex enditurc on Detailedl Sunanar . Art., '" .XVIII.See, 2(9) states. ..,E\peod11
that are controlled by or coordinated
with a candidate or candidate's agent are deemed to he both contributions by tlsc maker rat the expendifi fe.S, and ex endin
the candidate comnattee;,,
l irestotie Town Clerk C'PF form- 112023