HomeMy WebLinkAboutReport of Contributions and Expenditures 3-4-2024FIRY-S'nAFTOWN CURK
9951) Park Avenue
Firestone, CO 80520
rown(.'Icrk(4)1=itestoneCO,g(,ai�
IN (303) 531-6264
Fax: (720) 7t,14106
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REPORT OF CONTRIBUTIONS AND EXPENDITURES
Article XXVIll of the Colorado Constitution and Title 1, Article 45 of the Colorado Revised Statute (C.R,S.)
AdUress al lUorninitteetry rson:
City, State & Zip Code:
t,yz-.5�j cc>
Committee Typex
Name and Address of Financial
Institution
COMMITTEE ID NUMBER
Type of Report
0 'Regularly Scheduled Filing.
r"Ww"
LiAmended Filing. This amends previous report filed on (date)
Subant changes (it new inforniation ONLY
rennination Roort. (Termination Repons, MUST Have a Monclary, Balance ol'Zero in Line 5)
L 'Check this box if this Report Contains Electioneering Communications Information
i
Reporting Period Covered.- e:2�) ij�] Through
--bate ratte
Declared Total Spending (a applicabie)
],art. XXV111, See. 4(l)]
Totals Detailed Summary Pagt
Funds on Hand at the BelKinning (ItReporting Period (monetary only)
--fo-talMonetart' Contributions (line t i) $
Total of Monetary Contributions& Beginning Amount (line 14, line 2) $ 7
Total Monetary Expenditures (line t9) (::) , C>
_,)(I are 3 - line 4) $
The appropriate officer shall impose a penalty of S150 per day for each day that a report is filed laW
I lArt. XXVIII See. 14)(2)(tol
Authorization Must be comnleted by either the Reeistered Ap-ent (W the Candidate): I hereby certify and declare, under
penaln, ofpeijury, that to the hest qf no, knowledge or beliqf all contributions received during this reporting period
including aur, contributions received in thefirm of membership dues transferred by a membership organization, are ftorn
permissible sources.
C V_V <2N
Print Registered Agent's Name:
Registered Agent's Signature:--r l
_Date:_13�
Print Candidate Name:
n5oijr1w Date:
Firc,stonc, Town Clerk CPF fonw 12P2023
DETAILED SUMMARY
Full Name of Committee/Person-
CurrentReporting,Period:
ThroughL
Funds on hand at the beginning of reporting period (Monetary Only)
6
Itemized Contributions $20 or More (CA.. 1-45-108(l)(a1)
-A-)
$
(From Schedule
7
Total of Non -Itemized Contributions
$
(Con tributions of $ 19.99 and Less)
Loans Received
$
(From Schedule "C")
9
Total of Other Receipts
$
(Interest, Dividends. cic.)
10
Returned Expenditures (from recipient)
(Frorn Schedule "D")
I I
Total Monetary, Contributions
(Total of lines 6 through 10)
12
Total Non one Contributions
$
(From Statement of Non -Monetary Contrihutions)
13
Total Contributions
(,bane I I + line 12)
14
Itemized Expenditures $20 or More [C.R.S. 1-45-1 08(l)(a)]
$
(From Schedule "B")
15
Total of Non -Itemized Expenditures
$
(Expenditures of $19.99 or ixis)
16
"an Repayments Made
"C")
$
(From Schedule
'17
Returned Contributions (To donor)
.. . .............
$
I::::_
. .. . . .... . ... . ........ .... ---- - --- ---------
(Please list on Schedule "T")
18
Total Coordinated Non - Monetary (in -kind) Expenditures
$
&
(Candidate/Candidate Committee & Political Parties only)
19
Total Monetary Expenditures
('1"ond of I roes 14 through 171
20
Total Spending
$
(Line IS + line 19)
Fircswne Town Clerk CPF form- I 1,P2023
FttlMweofC4tatttuttt��rson:
WARNING. Pl"se "ad the W01ruction p4ge. f6r Sthedult "A� be&r6 t6tnPwtft4!
1. Ehae �Acce t�ed
4. Name (LaSL FirA)- 123�v
C
2. Contribution Ann.
5. Address:
6. City/StaWhp:
C-0
3, Aggrggate Ann.
$
7. Description-
8. Employer (if appli,�ab
qheck
box if
ec-t—ione—ering
9. Occupation
Communication
1. Date Accepted
A�)
4. Name (Last, First):
2. Contribution Amt.
5. Address; A
6°ity/State/Zip:
I A site gaeAmt.,
7. Description: —
Pl(A
S. Employer (if applicable.MlladLato
1;
It ek, box if
eIctli'mi eert n g
9, Occupation (if applicable, mgpdatorl):
Communication
I
1. Qate Ag "eted
7_j
k—
4. Name (Last, First):
4�
—?a ontribut n Amt.
ii-
5. Address: —
6. City/State/hp: )�/A
3. Angre ate Amt.
7. Description: AI/A
8, Fmpicayer(ii7applicible.niand_ator�.,):
heck box if
ectioneering
9. Occupation (if applicable, MApdator
Communication
1, Date Acce led
A
4. Nato e (Last, First):
ttrttribcatit it Amt.,
5. Address.:
'b�
6. City/State/Zip.
3. A Te te Aint-
gy,ga
/A
7. Description:
Employer 6fapplicabJc,MMdter C6I
'heck box if
A -
ectioneering
9. Occupation (if applicable, _tat andatorv):
Communication
* For contribution firmts within a committee's election cycle or cAmiribution cycle, ple aw refer it) the fellow in Colorack) Constitutional cites : Candidate
Comnattet Art, XXVIIL Ste, 2(0)-1 Political Party Art, VIII, See, 3(3),Political CommitIce Art, XXVIII, Sec 3(s)-, Small DoFwr Committee Art.
XXVIII, See 2(14).
F-remote Town Clerk, CPF foon: 112023
Schedule — Itemized Expenditures Statement r ore)
Full Name ofComi itt / e on
1. Da ende
.Name:
. Amount 5.,Address. _
t.
6 'ity / tate/Zip-.
3stcommittee
trient r (O i rral}
7. Purpose ofExpenditure:
---
Non-Committee
Y�iCommunication c
1. Date xnettded
. Naar :
2. mount 5, Address:
40
3.t ec pient is (optional).
6. City/State/Zip:
Committee 7, Purpose of Expenditure:
Non -Committee heck box if Electioneering Communication
1. Date Ex e ded
,.Name:
2. Amon, 5, Address: 9/A
City/State/Zip:
a. pien is (optional):
`+artrrrtittee 7. Purpose ofExpenditure;
1wlcsrt-Co►trmitt e heck box if lectinrteera nm rrrrieatirrrr
I. Date x ended
. Trrr;
:::�� A
qA--
. mount 5. Address:
A.
6 City/State/Zip.
3. 'pie�is(�(o_xptional)-
rammittee 7. Pur°po tat pendi trre:
Non -Committee 1 e k box if Electioneering Communication
1 irate Ex s►de -�_�._..
i 4. Name:
. Amount i. address:
! &
City/State/Zip
it / tate/ ip
. ioe,nt i (optional):
rnittee 7, Purpose of penditure:
lfG-trmitt e ®
heck box if ElecLioneering Communication
Full Name of Comm ittee/Person:
Schedule C - Loans
Candidate Couninitt"s only
M
I
LOANS - Loans Owed by the Committee
(Use a separate schedule for each loan. Thais, forin is for line item 8 and 16 truths Detailed Summary Report-)
[No information copied from such reports shall he sold or used by any person for the purl aw orsoliching contributions or for any ownruercial
purpose, [Art, XXV111, See, 9(cf] Notwithstanding any other section of this article to the contrary, at candidate's candidate. committee may mceive a
to front at financial institution orgaarzed under stale or federal law if the loan bears the usual and custrurraty interest rate, is made on a tra: is that
assures repayntent, is evidence by a written instrument, and is subject to a due date or, amortization schedule I Art, XXVII 1, Skee 3(g))
LOANSOURCE
Name (Last, First or Institution)' . l(A
Address:
city/state/Zip: 10i"10
Original Arnount of Loan: $ Interest Rate:
Loan Amount Received 7bis Reporting Period: $'rotal of All Loans'11fis Reporti
Period: $
d.d& Aport)
(Place (in line 8 (if DetailedS, ry R,.
Principal Amount Paid This Reporting Period,,
Interest Amount Paid This Reporting period: S A
Anfriant Repaid This Reporting Period- $,-- A--_ Total Repayments Made:
(Amount Repaid is surge of Principal & Interest entered cut Detail Summary) (Sum of Schedule C pWs. PWc on line 16 of
Detailed Summary)
Outstanding Balance: $
TERMS OF LOAN: W�J/A47 ?V
ate Loan Received Due Date for 11" Payment
LIST ALL ENDORSERS OR GUARANTORS OF THIS LOAN
Firesix.me rown Clerk CPF tbrm 1212023
Schedule D — R4urnW Contributions & Experklitlarvoi
Full Name of Committee/Person.
Retumed Contributions
(Previously rep orled on Schedule A -- (7ontributions acceptetl and then returned to donors)
'LEASE, PRINTITWE
C. Date Acceoted 4. Name (l,ast, First)'.
Al ft
2. gate Returned
_ ed 5. Address: w
i ()u
moun & Ciry/State/zip:
7. PUrpoSe;
$ AIIA
4. Name (1-ast, First),
2. Date Returns 5. Address:
/)h
�_,mount 6. City/Stat�r e/Zip: V/ A
$ 7. Purpose
Returned Expenditures
(Previowly reportecl on Schedule B ExpenditureF retumed or refunded to the commisle e)
PLEASE PRINT/TYPE
1. Date tided
N
40*1 4 . ame (1,11SL First):
Ex77
1 Date Rd ed 5. Address:
I Amount 6s city/state/zip:
$ 7. Comment (optional):
1, Date E e ded
4. Name (Last, First):
2. Date Rent tad . Address-
Unt
6, City/State/Zip-
7. Comment (Optional):
$
Firestone Town Clerk CPF ronn: lV2023
Statement of Non -Monetary Contributions
[Art. XXVIIJ. See, 2(5)(a)(11)(111)& See, 5(3)& 145-l08(l)XR.Sj
Full Name of Committee/Person:
PLEASE PRINTrFYPE
1. Date Provided 4, Name (t,ast, firso:
5. Address-
2. Fair Market Value
6. it/tadipa
A 14 IV
7, Description-, /V
8, Employer (if applicable, Mg!Ldate rjf
�wc7tioncerufg 9, Occupation (if applicable,mLi-ndamaj:
Communication 10 heck box if Coordinatedwith a Candidate/Candidate Committee or Political Paj
- ----------------
1. bate Provided
13
1 4. Name (Last, First);
--JqA --- S. Address-
2. Fair Market Value
6. City/State/Zip:
7. Description-,
8, Employer (ifaprdicabje.mmpjqucrc):
9, Occupation (irapplicabic, Lnaijdat�o
etioneering Ig
Communication -10, kheck box if Coordinated with a Candidate/Candidate Committee, or Political Party.
1. Date Provided 4. Name (1,wa,1°1nst):
5. Address.,
2, Fair Market Value
6. City/ Stat e/Zip-..
3. A ate Arta. 7. Description:
$ � e IL
8, Employer (WapplicableMLindatory):
9/A
05eck(box if to, _mqndqtqrv)I-
Electioneering
9, Occupation (if applicab YA
Communication 11), []Check box if Coordinated with a Candidate/Candidate Committee or Political party.
Note, I Own contribution musa also be reported us a non-moneutry cx1virditutc on lktailcd Nununmy Art. XXVIII, See, 2(9)statcs.
that are controlled by or coardinated with a candidate of candidate's agent are deemed to be hoth Linviributions by the maker of the expenditures, and expenditures by
the candidate connnittee."
Firestone Town Clerk CPF forrn' I 2PN23