HomeMy WebLinkAboutReport of Contributions and Expenditures 4-3-2024FIRESTONE TOWN CLERK opauc Dt;iuw ior %jawe use kiray
9950 Park Avenue
Firestone, CO 80520 —TOWN OF —FIREST%
TownClerk@FirestoneCO.gov
Ph: (303) 531-6264 Town Clerk's office
Fax: (720) 713-4106
www.fffestoneco.Rov FIRESTONE APR 012024
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REPORT OF CONTRIBUTIONS AND EXPENDITUR ES�e
j Received tT T���,V
Article XXVIII of the Colorado Constitution and Title 1, Article 45 of the Colorado Revised S � � �by�
Full Name of Committee/Person:
Aq Shnwii nn RPaiqtrntinn
Address of Committee/Person:
City, State III & Zip Code:
sy
Committee Type:
Name and Address of Financial
ARegularly Scheduled Filing.
e-�
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)
Check this box if this Report Contains Electioneering Communications Informatic
Reporting Period Covered: Throueh
Declared Total Spending (if applicable}
[Art. XXV111, See, 4(1)]
Totals Detailed Summary Page
1
Funds on Hand at the Beginning of Reporting Period (monetary only)
$
2
Total Monetary Contributions (line 11)
$
3
Total of Monetary Contributions & Beginning Amount (line i + line 2)
$
4
Total Monetary Expenditures (line 19)
$
5
1 Funds on Hand at the End of Reporting Period (monetary) (line 3 — line 4)
$
e appropriate officer shall impose a penalty of $50 per day for each day that a report is filed late.
[Art. Y—XVH1 See. 10(2)(a)]
Authorization (Must be completed by either the Registered Agent OR the Candidate) I hereby certify and declare, under
penalty ofperjury, that to the best of my knowledge or belief all contributions received during this reporting period,
including any contributions received in the form -of men be' dues transferred by a membership organization, are
permissible sources.
Print Registered Agent's Name:
Registered Agent's
Print Candidate Name:
Candidates Signature:
Firestone Town Clerk CPF form: 12/2023
DETAILED SUMMARY
Full Name of Committee/Person:
Current Reporting Period: 2 Through Z
2-
Funds on hand at the beginning of reporting period (Monetary only)
$
6
Itemized Contributions $20 or More [C.R.S. 1-45-108(1)(a)]
$
(From Schedule "A")
7
Total of Non -Itemized Contributions
$
(Contributions of $19.99 and Less)
8
Loans Received
(From Schedule "C")
$
9
Total of Other Receipts
$
(Interest, Dividends, etc.)
10
Returned Expenditures (from recipient)
$
(From Schedule "D")
11
Total Monetary Contributions
$
(Total of lines 6 through 10)
12
Total Non -Monetary Contributions
$
(From Statement of Non -Monetary Contributions)
13
Total Contributions
(Line 11 + line 12)
$
14
Itemized Expenditures $20 or More [C.R.S. 1-45-108(1)(a)]
$
(From Schedule `B")
15
Total of Non -Itemized Expenditures
(Expenditures of $19.99 or Less)
$
16
Loan Repayments Made
$
(From Schedule "C")
17
Returned Contributions (To donor)
$
(Please list on Schedule "D")
18
Total Coordinated Non -Monetary (in -kind) Expenditures
(Candidate/Candidate Committee & Political Parties only)
$
19
Total Monetary Expenditures
$
(Total of lines 14 through 17)
20
Total Spending
$
(Line 18 + line 19)
Firestone Town Clerk CPF form: 12/2023
Schedule A - Itemized Contributions Statement ($20 or more)
1
Full Name of Committee/Person:w _ V1
WARNING: Please read the instruction page for Schedule "A" before completing!
PLEASE PRINT/TYPE
1. Date Accepted
I
4. Name (bast, First): Iv
5. Address:
2. Contribution Amt.
$
6. City/State/Zip:
3. Aggregate Amt. *
7. Description:
$
8. Employer (if applicable, mandatory'ET):
9. Occupation (if applicable, mandatory):
Check box if
ectioneering
Communication
1. Date Accepted
4. Name (Last, First):
5. Address:
2. Contribution Amt.
$
6. City/State/Zip:
3. Ag regate Amt. *
7. Description:
$
8. Employer (if applicable, mandatory):
9. Occupation (if applicable, mandatory):
PecCheck box if
tioneering
Communication
1. Date Accepted
4. Name (Last, First):
5. Address:
2. Contribution Amt.
$
6. City/State/Zip:
3. Aggregate Amt.
7. Description:
$
8. Employer (if applicable, mandatory):
9. Occupation (if applicable, mandatory):
r-ICheck box if
E ectioneering
Communication
1. Date Accented
4. Name (Last, First):
5. Address:
2. Contribution Amt.
$
6. City/State/Zip:
3. Aggregate Amt.
7. Description:
$
8. Employer (if applicable, mandatory):
9. Occupation (if applicable, mandatory):
heck box if
ectioneering
Communication
* For contribution limits within a committee's election cycle or contribution cycle, please refer to the following Colorado Constitutional cites: Candidate
Committee Art. XXVHl, See. 2(6); Political Party Art. XXVIII, Sec. 3(3); Political Committee Art. XXVIII, Sec 3(5); Small Donor Committee Art.
XXVIII, Sec. 2(14).
Firestone Town Clerk CPF form: 12/2023
Schedule B - Itemized Expenditures Statement ($20 or more)
[1-45-108(1)(a), C.R.S.]
Full Name of Committee/Person:
PLEASE PRINT/TYPE
1. Date Expended
id -
All4. Name:
5. Address:
2. Amount
$
6. City/State/Zip:
7. Purpose of Expenditure:
heck box if Electioneering Communication
3.�,ont is (optional):mmittee
Non -Committee
1. Date Expended
4. Name:
5. Address:
2. Amount
$.Recipient is (optional):
Committee
EJNon -Committee
6. City/State/Zip:
7. Purpose of Expenditure:
E]check box if Electioneering Communication
1. Date Expended
4. Name:
5. Address:
2. Amount
$
City/State/Zip:
3.Iecipient is (optional):
�JJCommittee
'-'Non-Committee
6.
7. Purpose of Expenditure:
n
`-'Check box if Electioneering Communication
1. Date Ex ep nded
4. Name:
5. Address:
2. Amount
$
6. City/State/Zip:
3. pient is (optional):
:]Committee
Non -Committee
7. Purpose of Expenditure:
Elcheck box if Electioneering Communication
1 Date Expended
4. Name: - A/9
5. Address:
2. Amount
$
6. City/State/Zip:
3.11tecjpient is (optional):
[E Committee
'-'Non-Committee
7. Purpose of Expenditure:
heck box if Electioneering Communication
Firestone Town Clerk CPF form: 12/2023
Schedule C - Loans
Candidate Committees only
Full Name of Committee/Person: 12
LOANS - Loans Owed by the Committee
(Use a separate schedule for each loan. This form is for line item 8 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. [Art. XXVIII, Sec. 9(e)] Notwithstanding any other section of this article to the contrary, a 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 [Art. XXVIII, Sec. 3(8)]
LOAN SOURCE
Name (Last, First or institution):
Address:
City/State/Zip:
Original Amount of Loan: $
Loan Amount Received This Reporting Period:
Principal Amount Paid This Reporting Period:
Interest Amount Paid This Reporting Period:
Amount Repaid This Reporting Period: $
(Amount Repaid is sum of Principal & Interest entered on Detail Summary)
Outstanding Balance: $
TERMS OF LOAN:
Interest Rate:
Date Loan Received
Total of All Loans This Reporting
Period: $
(Place on line 8 of Detailed Summary Report)
Total Repayments Made: $
(Sum of Schedule C pages, Place on line 16of
Detailed Summary)
Due Date for Final Payment
LIST ALL ENDORSERS OR GUARANTORS OF THIS LOAN
Full Name Address, City, State, Zip Amount Guaranteed
Firestone Town Clerk CPF form: 12/2023
Schedule D — Returned Contributions & Expenditures
Full Name of Committee/Person: I r ��1 �� 8 ✓�
Returned Contributions
(Previously reported on Schedule A — Contributions accepted and then returned to donors)
PLEASE PRINT/TYPE
1. Date Accevted
2 q2 N
b �re
4. Name (Last, First): / �
5. Address: `1. F)7l�p
2. to eturned7 —" [ j —
6. City/State/Zip: r t" K.`,
7. Purpose: 5,941S —
3. Amount
$ l �5' G
1. Date Accepted
4. Name (Last, First):
5. Address:
2. Date Returned
6. City/State/Zip:
7. Purpose:
3. Amount
$
Returned Expenditures
(Previously reported on Schedule B — Expenditures reZI
r refunded to the committee)
PLEASE PRINUTYPE
1. Date Expended
4. Name (Last, First):
5. Address:
2. Date Returned
6. City/State/Zip:
7. Comment (Optional):
3. Amount
$
1. Date Expended
4. Name (Last, First):
5. Address:
2. Date Returned
6. City/State/Zip:
7. Comment (Optional):
3. Amount
$
Firestone Town Clerk CPF form: 12/2023