ACCEPTED Elections Divis ion Department of State Space Below For Office Use Only 1700 Broadway, Ste. 270 OCT 12 2009 Denver, CO 80290 Ph: (303) 894-2200 x3 Fax: (303) 869-4861 THORNTON CITY CLERK WWW.sos.state.co.us REPORT OF CONTRIBUTIONS AND EXPENDITURES (C.R.S. 1-45-108) Full Name of CommitteelPerson: Committee to Elect Lynne Fox As Shown on Registration Address of CommitteelPerson: 4262 E. 130th Drive City, State & Zip Code: Thornton, CO 80241 Committee Type: Candidate Name of Financial Institution: 1st Bank Address of Financial Institution: 3390 E 104th Ave, Thornton, CO 80233 SOS In NUMBER (state committees ONLY): N/A Type of Report: [X] Regularly Scheduled Filing. 00 October 13,2009 (21 days prior to the November 3,2009 Municipal Election) D October 30, 2009 (Friday prior to the November 3, 2009 Municipal Election) D December 3,2009 (30 days after the November 3,2009 Municipal Election) D Annual- candidates from prior election held on ------------------ D Amended Filing. This amends previous report filed on (date) Submit changes or new information ONLY D Termination Report (Termination Reports MUST have a Monetary Balance of Zero in Line 5) Reporting Period Covered: 2/1/09 Through 10/8/09 date date Declared Total Spending (if applicable): [Art. N/A xxvm, Sect. 4 (I)] Totals Detailed Summary Page 1 Funds on Hand at Beginning of Reporting Period (monetary only) $0.00 2 Total Monetary Contributions (line II) $7,369.77 3 Total of Monetary Contributions & Beginning Amount (line 1+ line 2) $7,369;77 4 Total Monetary Expenditures (line 19) $7,369.77 5 Funds on Hand at End of Reporting Period (monetary) (line 3 -line 4) $0.00 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 Agent OR the Candidate) I hearby certify and declare, under penalty of perjury, that to the best of my knowledge or belief all contributions received during this reporting period, including any contributions received in the form of membership dues transferred by a membership organization, are from permissible sources. Print Registered Agent's (Treasurer's) Name: Richard Delaney Registered Agent's (Treasurer's) Signature: _ Print Candidate Name: Lynne Fox Lj --=::_" .... -------,,--------------------------.,..-------- C· I .,..-; /OL q j/."\ 0 J Candidate's Signature: ;:......;...YJ..:....:0_ .:.-' _ Date: _-J----:-_u......:.I d
48
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Lynne Fox - 2009 City of Thornton City Council Campaign Contributions
Campaign contributions to Lynne Fox for the 2009 Thornton City Council elections.
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~OOlOOAU.Y ACCEPTEDElections Division Department of State Space Below For Office Use Only 1700 Broadway, Ste. 270 OCT 12 2009Denver, CO 80290 Ph: (303) 894-2200 x3 Fax: (303) 869-4861 THORNTON CITY CLERK WWW.sos.state.co.us
REPORT OF CONTRIBUTIONS AND EXPENDITURES (C.R.S. 1-45-108)
Full Name of CommitteelPerson: Committee to Elect Lynne Fox As Shown on Registration
Address of CommitteelPerson: 4262 E. 130th Drive
City, State & Zip Code: Thornton, CO 80241
Committee Type: Candidate
Name of Financial Institution: 1st Bank
Address of Financial Institution: 3390 E 104th Ave, Thornton, CO 80233
SOS In NUMBER (state committees ONLY): N/A
Type of Report:
[X] Regularly Scheduled Filing.00 October 13,2009 (21 days prior to the November 3,2009 Municipal Election)
D October 30, 2009 (Friday prior to the November 3, 2009 Municipal Election)
D December 3,2009 (30 days after the November 3,2009 Municipal Election)
D Annual- candidates from prior election held on -----------------
D Amended Filing. This amends previous report filed on (date)
Submit changes or new information ONLY
D Termination Report (Termination Reports MUST have a Monetary Balance ofZero in Line 5)
Reporting Period Covered: 2/1/09 Through 10/8/09 date date
Declared Total Spending (if applicable): [Art. N/Axxvm, Sect. 4 (I)]
Totals Detailed Summary Page
1 Funds on Hand at Beginning of Reporting Period (monetary only) $0.00 2 Total Monetary Contributions (line II) $7,369.77 3 Total of Monetary Contributions & Beginning Amount (line 1+ line 2) $7,369;77 4 Total Monetary Expenditures (line 19) $7,369.77 5 Funds on Hand at End of Reporting Period (monetary) (line 3 -line 4) $0.00
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 Agent OR the Candidate) I hearby certify and declare, under penalty of perjury, that to the best of my knowledge or belief all contributions received during this reporting period, including any contributions received in the form of membership dues transferred by a membership organization, are from permissible sources.
Print Registered Agent's (Treasurer's) Name: Richard Delaney
* For contribution limits within a conunittee's election cycle or contribution cycle, please refer to the following Colorado Constitutional cites: Candidate Committee Art. XXVlll, Sec. 2(6); Political Party Art. XXVlll, Sec. 3(3); Political Conunittee Art. XXVlll, Sec 3(5); Small Donor Conunittee Art. xxvm, Sec. 2(14).
-----------------------------
Schedule A . Itemized Contributions Statement ($20 or more) Page 2
Full Name of CommitteelPerson: Committee to Elect Lynne Fox
Reporting Period Covered: ___2/_1I_0_9__...lIThrOugh 1 10_/8_/0_9__ date date
PLEASE PRINTffYPE
1 Date Accepted 4 Name (Last, First): Berg, Jennifer
6/812009 5 Address: 2141 Baseline Rd, Apt 20
2 Contribution Amount 6 City/State/Zip: Boulder, CO 80302
* For contribution limits within a committee's election cycle or contribution cycle, please refer to the following Colorado Constitutional cites: Candidate Committee Art. xxvm, Sec. 2(6); Political Party Art. xxvm, Sec. 3(3); Political Committee Art. xxvm, Sec 3(5); Small Donor Committee Art. xxvm, Sec. 2( 14).
Schedule A -Itemized Contributions Statement ($20 or more) Page 3
Full Name of Committee/Person: Committee to Elect Lynne Fox
Reporting Period Covered: L....-__ 2/_1_/O_ 9 IThrOUgh 1L....-__10~/_8/_0_9_......J date date
PLEASE PRINTITYPE
1 Date Accepted 4 Name (Last, First): Burnell, Steve
* For contribution limits within a committee's election cycle or contribution cycle, please refer to the following Colorado Constitutional cites: Candidate Committee Art. XXVIII, Sec. 2(6); Political Party Art. XXVIII, Sec. 3(3); Political Committee Art. XXVIII, Sec 3(5); Small Donor Committee Art. XXVIII, Sec. 2(14).
Schedule A -Itemized Contributions Statement ($20 or more) Page 4
Full Name of CommitteelPerson: Committee to Elect Lynne Fox
Reporting Period Covered: ___2_/~1/_09 IThrough 1 10-:-/8_/0_9 ___ mre mre
PLEASE PRINTffYPE
1 Date Accepted 4 Name (Last, First): Claman, Henry N.
* For contribution limits within a committee's election cycle or contribution cycle, please refer to the following Colorado Constitutional cites: Candimte Committee Art. xxvm, Sec. 2(6); Political Party Art. xxvm, Sec. 3(3); Political Committee Art. xxvm, Sec 3(5); Small Donor Committee Art. xxvm, Sec. 2(14).
Schedule A -Itemized Contributions Statement ($20 or more) PageS
Full Narne of Cornmittee/Person: Committee to Elect Lynne Fox
, Reporting Period Covered: ,---__2/_1_/0_9 •IThrough 1__l_0~/8_/0_9_.......... date date
PLEASE PRINTffYPE
1 Date Accepted 4 Name {Last, First): Deines, Teri
811012009 5 Address: 4265 E 119th Place, Apt H
2 Contribution Amount 6 City/State/Zip: Thornton, CO 80233
* For contribution limits within a committee's election cycle or contribution cycle, please refer to the following Colorado Constitutional cites: Candidate Committee Art. XXVUI, Sec. 2(6); Political Party Art. XXVUI, Sec. 3(3); Political Committee Art. XXVUI, Sec 3(5); Small Donor Committee Art. XXVUI, Sec. 2(14).
Schedule A - Itemized Contributions Statement ($20 or more) Page 6
Full Name of CommitteelPerson: Committee to Elect Lynne Fox
Reporting Period Covered: ___2_/_1I_09 IThrough 1 10....,.../8_/0_9__ date date
PLEASE PRINTffYPE
1 Date Accepted 4 Name (Last, First): Dickersin, Kay
* For contribution limits within a committee's election cycle or contribution cycle, please refer to the following Colorado Constitutional cites: Candidate Committee Art. XXVill, Sec. 2(6); Political Party Art. XXVill, Sec. 3(3); Political Committee Art. XXVill, Sec 3(5); Small Donor Committee Art. XXVill, Sec. 2(14).
Schedule A -Itemized Contributions Statement ($20 or more) Page 7
Full Name of CommitteelPerson: Committee to Elect Lynne Fox
Reporting Period Covered: L--__2/7'"l/:-09 1Through 11.--__ 1_ 0/,....8/_0_9_---' dille dare
PLEASE PRINT/TYPE
1 Date Accepted 4 Name (Last, First): Fletcher, Adelaide
$ 300.00 9 Occupation (if applicable, mandatory): Service Coordinator
* For contribution limits within a committee's election cycle or contribution cycle, please refer to the following Colorado Constitutional cites: Candidate Committee Art.
XXVIII, Sec. 2(6); Political Party Art. XXVIII, Sec. 3(3); Political Committee Art. XXVIII, Sec 3(5); Small Donor Committee Art. XXVIII, Sec. 2(14).
Schedule A -Itemized Contributions Statement ($20 or more) PageS
Full Name of Committee/Person: Committee to Elect Lynne Fox
Reporting Period Covered: ___2/~1I_0_9__....JIThrOUgh 1,-__10-:-/8_/0_9__ date date
PLEASE PRINTffYPE
1 Date Accepted 4 Name (Last, First): Fox, Ronald
61712009 5 Address: 2710 E 125th Cr
2 Contribution Amount 6 City/State/Zip: Thornton, CO 80241
* For contribution limits within a committee's election cycle or contribution cycle, please refer to the following Colorado Constitutional cites: Candidate Committee Art. xxvrn, Sec. 2(6); Political Party Art. xxvrn, Sec. 3(3); Political Committee Art. XXVIII, Sec 3(5); Small Donor Committee Art. xxvrn, Sec. 2(14).
Schedule A - Itemized Contributions Statement ($20 or more) Page 9
Full Narne of CornrnitteelPerson: Committee to Elect Lynne Fox
Reporting Period Covered: ___2_/,:","l/_09 IThrough 1,--_,;;.;10;.../8;.../0:...:.9__1
PLEASE PRINTffYPE
1 Date Accepted
912512009
2 Contribution Amount
$ 100.00
3 Aggregate Amount*
$
1 Date Accepted
61712009
2 Contribution Amount
$ 25.00
3 Aggregate Amount*
$
1 Date Accepted
5/31/2009
2 Contribution Amount
$ 50.00
3 Aggregate Amount*
$ 200.00
1 Date Accepted
61712009
2 Contribution Amount
$ 100.00
3 Aggregate Amount*
$ 200.00
date date
4
5
6
7
8
Name (Last, First): Gerrity, Martha
Address: 8620 SW 80th Ave
City/State/Zip: Portland, OR 97223
Description Check
Employer (if applicable, mandatory): Portland VA Hospital
9 Occupation (if applicable, mandatory): Business Systems Analyst
4
5
6
7
8
Name (Last, First): Gormley, Mark
Address: 13650 Clermont Ct
City/State/Zip: Thornton, CO 80602-6964
Description Check
Employer (if applicable, mandatory): SHAW
9 Occupation (if applicable, mandatory): Business Systems Analyst
* For contribution limits within a committee's election cycle or contribution cycle, please refer to the following Colorado Constitutional cites: Candidate Committee Art. xxvm, Sec. 2(6); Political Party Art. xxvm, Sec. 3(3); Political Committee Art. xxvm, Sec 3(5); Small Donor Committee Art. xxvm, Sec. 2(14).
Schedule A - Itemized Contributions Statement ($20 or more) Page 10
Full Name of CommitteelPerson: Committee to Elect Lynne FoX;
Reporting Period Covered: '--__2/_11_0_9_._---lIThrough 1 IO~/8_/0_9__ ~re ~re
PLEASE PRINTffYPE
1 Date Accepted 4 Name (Last, First): Gormley, Mark
7/15/2009 5 Address: 13650 Clermont Ct
2 Contribution Amount 6 City/State/Zip: Thornton, CO 80602-6964
* For contribution limits within a committee's election cycle or contribution cycle, please refer to the following Colorado Constitutional cites: Candi~te Conunittee Art. xxvm, Sec. 2(6); Political Party Art. XXVill, Sec. 3(3); Political Conunittee Art. XXVill, Sec 3(5); Small Donor Conunittee Art. XXVill, Sec. 2(14).
Schedule A -Itemized Contributions Statement ($20 or more) Page 11
Full Name of CommitteelPerson: Committee to Elect Lynne Fox
Reporting Period Covered: '---_---'-2/~1_/0_9---IThrOngh 1L....-_..;;,1_0/..;;,8/....;.0.;..9_---I date date
PLEASE PRINTfTYPE
1 Date Accepted 4 Name (Last, First): Hoffecker, Lilian
512812009 5 Address: 7876 S Niagra Way
2 Contribution Amount 6 City/State/Zip: Englewood, CO 80112
* For contribution limits within a committee's election cycle or contribution cycle, please refer to the following Colorado Constitutional cites: Candidate Committee Art. XXVIII, Sec. 2(6); Political Party Art. XXVIII, Sec. 3(3); Political Committee Art. XXVIII, Sec 3(5); Small Donor Committee Art. XXVIII, Sec. 2(14).
Schedule A -Itemized Contributions Statement ($20 or more) Page 12
Full Name of CommitteelPerson: Committee toElect Lynne Fox
Reporting Period Covered: ---,-__2_/_1/_09__;.....IThrough 1 10_/8_/0_9__ ~re ~re
PLEASE PRINTITYPE
1 Date Accepted 4 Name (Last, First): Johnson, Helen
512812009 5 Address: 812 Harrison 5t
2 Contribution Amount 6 City/State/Zip: Denver, CO 80206
* For contribution limits within a committee's election cycle or contribution cycle, please refer to the following Colorado Constitutional cites: Candidate Committee Art. xxvrn, Sec. 2(6); Political Party Art. xxvrn, Sec. 3(3); Political Committee Art. xxvrn, Sec 3(5); Small Donor Committee Art. xxvrn, Sec. 2(14).
Schedule A -Itemized Contributions Statement ($20 or more) Page 13
Full Name of CommitteelPerson: Committee to Elect Lynne Fox
Reporting Period Covered: ___2_/:-l/_09 IThrOUgh 1_·__1_0-:-/8_/0_9_----J1 date date
PLEASE PRINTffYPE
1 Date Accepted 4 Name (Last, First): Kelly, John
6/712009 5 Address: 4252 E l30th Dr
2 Contribution Amount 6 City/State/Zip: Thornton, CO 80241
* For contribution limits within a committee's election cycle or contribution cycle, please refer to the following Colorado Constitutional cites: Candidate Committee Art. xxvm, Sec. 2(6); Political Party Art. xxvm, Sec. 3(3); Political Committee Art. xxvm, Sec 3(5); Small Donor Committee Art. xxvm, Sec. 2(14).
Schedule A -Itemized Contributions Statement ($20 or more) Page 14
Full Name of CommitteelPerson: Committee to Elect Lynne Fox
Reporting Period Covered: ___2_/:-1I_09 IThrough 1 10_/8_/0_9_""",,mre mre
PLEASE PRINTffYPE
1 Date Accepted 4 Name (Last, First): Martin, Sharon
7/312009 5 Address: 2423 S Racine Wy
2 Contribution Amount 6 City/State/Zip: Aurora, CO 80014
* For contribution limits within a committee's election cycle or contribution cycle, please refer to the following Colorado Constitutional cites: Candimte Committee Art. xxvm, Sec. 2(6); Political Party Art. xxvm, Sec. 3(3); Political Committee Art. xxym, Sec 3(5); Small Donor Committee Art. xxvm, Sec. 2(14).
Schedule A . Itemized Contributions Statement ($20 or more) Page 15
Full Name of CommitteelPerson: Committee to Elect Lynne Fox
Reporting Period Covered: ___2_/_1I-,-09 IThrough 1 1O~/8_/0_9__ date date
PLEASE PRINTffVPE
1 Date Accepted 4 Name (Last, First): Nadeau, Melissa
6/13/2009 5 Address: 11766 Coal Creek Heights Dr
2 Contribution Amount 6 City/State/Zip: Golden, CO 80403-8506
* For contribution limits within a committee's election cycle or contribution cycle, please refer to the following Colorado Constitutional cites: Candidate Committee Art. xxvrn, Sec. 2(6); Political Party Art. xxvrn, Sec. 3(3); Political Committee Art. xxvrn, Sec 3(5); Small Donor Committee Art. xxvrn, Sec. 2(14).
Schedule A -Itemized Contributions Statement ($20 or more) Page 16
Full Name of CommitteelPerson: Committee to Elect Lynne Fox
Reporting Period Covered: ___2_/:-l/_09 IThrOUgh 1 10_/8_/0_9_. __ date date
PLEASE PRINTffYPE
1 Date Accepted 4 Name (Last, First): Powell, Sheila
7/13120ocr 5 Address: 12951 Lafayette St. #C
2 Contribution Amount 6 City/State/Zip: Thornton, CO 80241
* For contribution limits within a committee's election cycle or contribution cycle, please refer to the following Colorado Constitutional cites: Candidate Committee Art. XXVIII, Sec. 2(6); Political Party Art. XXVIII, Sec. 3(3); Political Committee Art. XXVIII, Sec 3(5); Small Donor Committee Art. XXVIII, Sec. 2(14).
Schedule A - Itemized Contributions Statement ($20 or more) Page 17
Full Name of CommitteelPerson: Committee to Elect Lynne Fox
PLEASE PRINTffYPE
1 Date Accepted
812012009
2 Contribution Amount
$ 20.00
3 Aggregate Amount*
$
1 Date Accepted
912612009
2 Contribution Amount
$ 48.00
3 Aggregate Amount*
$
1 Date Accepted
5123/2009
2 Contribution Amount
$ 200.00
3 Aggregate Amount*
$ 250.00
1 Date Accepted
6/7/2009
2 Contribution Amount
$ 25.00
3 Aggregate Amount*
$ 250.00
Reporting Period Covered: '--__2/_1_/0_9__....IThrOUgh 1 10_/8_/0_9__ ~re ~re
Schweppe, Sue 4 Name (Last, First):
5 Address: 4790 Old Post Ct
6 City/State/Zip: Boulder, CO 80301
7 Description Cash
8 Employer (if applicable, mandatory):
9 Occupation (if applicable, mandatory):
Soderberg, Pat 4 Name (Last, First):
5 Address: 1002 E 133rd Way
6 City/State/Zip: Thornton, CO 80241
7 Description Charge (Paid for PO Box renewal)
8 Employer (if applicable, mandatory):
9 Occupation (if applicable, mandatory):
Solano, Manuel and Judy 4 Name (Last, First):
5 Address: 14789 Harrison St
6 City/StatelZip: Brighton, CO 80602
7 Description Check
8 Employer (if applicable, mandatory): Solano Law Offices and State of Colorado
9 Occupation (if applicable, mandatory): Attorney and State Representative
Solano, Manuel and Judy 4 Name (Last, First):
5 Address: 14789 Harrison St
6 City/State/Zip: Brighton, CO 80602
7 Description Check
8 Employer (if applicable, mandatory): Solano Law Offices and State of Colorado
9 Occupation (if applicable, mandatory): Attorney and State Representative
* For contribution limits within a committee's election cycle or contribution cycle, please refer to the following Colorado Constitutional cites: Candi~te Committee Art. XXVill, Sec. 2(6); Political Party Art. XXVill, Sec. 3(3); Political Committee Art. XXVill, Sec 3(5); Small Donor Committee Art. XXVill, Sec. 2(14).
Schedule A - Itemized Contributions Statement ($20 or more) Page 18
Full Name of Committee/Person: Committee to Elect Lynne Fox
Reporting Period Covered: ___2/_I_/0_9__...lIThrough 1 1O~/_8/_0_9__ date date
PLEASE PRINTffYPE
Solano, Manuel and Judy I Date Accepted 4 Name (Last, First):
8/1012009 5 Address: 14789 Harrison St
2 Contribution Amount 6 City/State/Zip: Brighton, CO 80602
$ 25.00 7 Description Check
3 Aggregate Amount* 8 Employer (if applicable, mandatory): Solano Law Offices and State of Colorado
9 Occupation (if applicable, mandatory): Attorney and State Representative
Stoner, Tamara
$ 250.00
I Date Accepted 4 Name (Last, First):
8/312009 5 Address: 3349 Tejon St
2 Contribution Amount 6 City/StatelZip: Denver, CO 80211
9 Occupation (if applicable, mandatory): $ -lll14 * For contribution limits within a committee's election cycle or contribution cycle, please refer to the following Colorado Constitutional cites: Candidate Committee Art. XXVIII, Sec. 2(6); Political Party Art. XXVIII, Sec. 3(3); Political Committee Art. XXVIII, Sec 3(5); Small Donor Committee Art. XXVIII, Sec. 2(14).
Schedule A . Itemized Contributions Statement ($20 or more) Page 19
Full Narne of Cornrnittee/Person: Committee to Elect Lynne Fox
Reporting Period Covered: ___2_/:-1/_09_·__IThrough 1_·_~10.;.,./8.;.,./0;.;.9_· __
PLEASE PRINTffYPE
1 Date Accepted
711512009
2 Contribution Amount
$ 50.00
3 Aggregate Amount*
$
1 Date Accepted
8/2012009
2 Contribution Amount
$ 25.00
3 Aggregate Amount*
$
1 Date Accepted
617/2009
2 Contribution Amount
$ 20.00
3 Aggregate Amount*
$ 40.00
1 Date Accepted
7/1512009
2 Contribution Amount
$ 20.00
3 Aggregate Amount*
$ 40.00
~re ~re
4
5
6
7
8
Name (Last, First): Tade, Eric
Address: 2404 E 145th Ct
City/State/Zip: Thornton,CO 80602-7310
Description Cash
Employer (if applicable, mandatory):
9 Occupation (if applicable, mandatory):
4
5
6
7
8
Name (Last, First): Talley, David
Address: 3048 W 24th Ave
City/State/Zip: Denver,CO 80211
Description Cash
Employer (if applicable, mandatory):
9 Occupation (if applicable, mandatory):
4
5
6
7
8
Name (Last, First): Tonsager, Dennis
Address: 2559 E 126th PI
City/State/Zip: Thornton,CO 80241
Description Check
Employer (if applicable, mandatory):
9 Occupation (if applicable, mandatory):
4
5
6
7
8
Name (Last, First): Tonsager, Dennis
Address: 2559 E 126th PI
City/State/Zip: Thornton, CO 80241
Description Check
Employer (if applicable, mandatory):
9 Occupation (if applicable, mandatory):
* For contribution limits within a committee's election cycle or contribution cycle, please refer to the following Colorado Constitutional cites: Candi~te Committee Art. xxvm, Sec. 2(6); Political Party Art. xxvm, Sec. 3(3); Political Committee Art. xxvm, Sec 3(5); Small Donor Committee Art. xxvm, Sec. 2(14).
Schedule A -Itemized Contributions Statement ($20 or more) Page 20
Full Name of Committee/Person: Committee to Elect Lynne Fox
Reporting Period Covered: L..-__2/_1_/O_9 1Through 1L..-__l_0/~8/_0_9__. _ wre wre
PLEASE PRINTffYPE
1 Date Accepted 4 Name (Last, First): Traditi, Lisa
7/2/2009 5 Address: 485 Bexley Street
2 Contribution Amount 6 City/State/Zip: Highlands Ranch, CO 80126
* For contribution limits within a committee's election cycle or contribution cycle, please refer to the following Colorado Constitutional cites: Candiwte Committee Art. xxvrn, Sec. 2(6); Political Party Art. xxvrn, Sec. 3(3); Political Committee Art. xxvrn, Sec 3(5); Small Donor Committee Art. xxvrn, Sec. 2(14).
Schedule A - Itemized Contributions Statement ($20 or more) Page 21*
Full Name of CommitteelPerson: -:C:....:o:..:IllIll1==::..:·t:.:.;te:..:e....:t..;;.o.;;;E:le:c::t::L::y::nn:::e:F::::o:x== --========~-
Reporting Period Covered: ___2/_11_09 1Through1__:....:10,;.;/8;;../0;.;..9_----, date date
PLEASE PRINTffYPE
1 Date Accepted 4 Name (Last, First): Vigil, Robert
6/7/2009 5 Address: 14707 Detroit Way
2 Contribution Amount 6 City/State/Zip: Thornton, CO 80602
* For contribution limits within a committee's election cycle or contribution cycle, please refer to the following Colorado Constitutionnal cites: Candidate Committee Art. xxvm, Sec. 2(6); Political Party Art. xxvm, Sec. 3(3); Political Committee Art. xxvm, Sec 3(5); Small Donor Committee Art. xxvm, Sec. 2(14)
* Schedule A - Itemized Contributions Statement ($20 or more) Page 22
. . .
Full Name of CommitteelPerson: ....=....::..::=:.:::.:;.:.,:":....:.=...=:.:...:...:.:::::::.:t..:::::.:....::....:..:..:.--..,;".Committee to Elect Lynne Fox --..,;,,. _
Reporting Period Covered: date
PLEASE PRINTrrYPE
1 Date Accepted 4 Name (Last, First): Zimmerman, Paul
6/7/2009 5 Address: 12943 Columbine Circle
2 Contribution Amount 6 City/State/Zip: Thornton, CO 80241
* For contribution limits within a committee's election cycle or contribution cycle, please refer to the following Colorado Constitutionnal cites: Candidate Committee Art. XXVIII, Sec. 2(6); Political Party Art. XXVIII, Sec. 3(3); Political Committee Art. XXVIII, Sec 3(5); Small Donor Committee Art. XXVIII, Sec. 2(14)
Statement of Non-Monetary Contributions [Art. XXVIII, Sect. 2, (5) (a) (II) (III), Sect. 5, (3)]
[C.R.S. 1-45-108 (1)]
Full Name of CommitteelPerson: Committee to Elect Lynne Fox
~====~~----;::::::======~ Reporting Period Covered: I 2/1/09 Through 10/8/09
date date
Total Itemized Expenditures: I $220.00 I r-
PLEASE PRINTrrYPI
1 Date Provided 4 Name (Last, First): Delaney, Judy 5/23/09 5 Address: 11180 Clermont Cir
2 Fair Market Value 6 City/State/Zip: Thornton, CO 80233
IOn Check box if Coordinated with a Candidate/Candidate Committee or Political Partv.* * Note: If coordinated, then contribution must also be reported as a non-monetary expenditure on Detailed Summary. Art. xxvrn, Sec. 2(9) states: " ...Expendltures that are controlled by or coordinated with a candidate or candidate's agent are deemed to be both contributions by the maker of the expenditures, and expenditures by the candidate committee."
Schedule B • Itemized Expenditures Statement ($20 or more) [C.R.S. 1-45-108-(1) (a)]
Full Name of CommitteelPerson: Committee to Elect Lynne Fox
Reporting Period Covered: '---__2_/_11_09-'.-,.",------,I Through 1"'--__1O~/8-/0-9---
PLEASE PRINTffYPE
1 Date Expended
4/19/09 2 Amount
$ 25.09
3 Recipient is (optional):
D Committee
D Non-Committee
1 Date Expended
4121109 2 Amount
$ 50.00
3 Recipient is (optional):
D Committee
D Non-Committee
1 Date Expended
5/6/09 2 Amount
$ 899.99
3 Recipient is (optional):
D Committee
D Non-Committee
1 Date Expended
5/8/09 2 Amount
$ 27.00
3 Recipient is (optional):
D Committee
D Non-Committee
illre
Total Itemized Expenditures: 1
illre
--'-_7_'...2_0_2__.8_3_
4
5
6
Name (Last, First):
Address:
City/State/Zip:
Staples
14458 Delaware St Suite 600
Westminster, CO 80020
7 Purpose of Expenditure: Office supplies
4
5
6
Name (Last, First):
Address:
City/State/Zip:
Thornton Festivals and Events
11151 Colorado Blvd
Thornton, CO 80233
7 Purpose of Expenditure: Booth rental at Thorntonfest
4
5
6
Name (Last, First):
Address:
City/State/Zip:
Gamino Printing
1090 S Raritan St
Denver, CO 80233
7 Purpose of Expenditure: Campaign Cards and Remittance Envelopes
4
5
6
Name (Last, First):
Address:
City/State/Zip:
City of Thornton
9500 Civic Center Drive
Thornton, CO 80229
7 Purpose of Expenditure: Copies of candidate reports
Schedule B - Itemized Expenditures Statement ($20 or more) Page 2
Full Name of Committee/Person: Committee to Elect Lynne Fox
Reporting Period Covered: L.....-__2;.../l_/0_9 1 Through [ 10~/8_/0_9_.__
PLEASE PRINTffYPE
1 Date Expended
5/13/09 2 Amount
$ 226.07
3 Recipient is (optional):
D Committee
D Non-Committee
date date
4
5
6
Name (Last, First):
Address:
City/State/Zip:
Fun Services Inc
12345 Huron St
Westminster, CO 80234
7 Purpose of Expenditure: Promotional items balloons
1 Date Expended 4 Name (Last, First): Fun Services Inc
2 5/15/09 Amount 5 Address: 12345 Huron St
$ 141.31 6 City/State/Zip: Westminster, CO 80234
3 Recipient is (optional):
D Committee
D Non-Committee
7 Purpose of Expenditure: Helium tank rental
1 Date Expended 4 Name (Last, First): United Chinese Restaurant
2 6/7/09 Amount 5 Address: 4150 E 128th Ave
$ 539.60 6 City/State/Zip: Thornton, CO 80241
3 Recipient is (optional):
D Committee
D Non-Committee
7 Purpose of Expenditure: Campaign kickoff event
1 Date Expended
6/13/09 2 Amount
$ 38.09
3 Recipient is (optional):
D Committee
D Non-Committee
4
5
6
7
OfficeMaxName (Last, First):
Address: 801 E I 20th Ave
City/State/Zip: Thornton, CO 80233
Purpose of Expenditure: office supplies
Schedule B -Itemized Expenditures Statement ($20 or more) Page 3
Full Name of CommitteelPerson: Committee to Elect Lynne Fox
Reporting Period Covered: 1_· 2_/1.../0.....9--'---'-_1 Through 1 10_/8_/0_9 _
PLEASE PRINTffYPE
1 Date Expended
6/13/09 2 Amount
$ 114.21
3 Recipient is (optional):
D Committee
D Non-Committee
1 Date Expended
6/14/09 2 Amount
$ 30.49
3 Recipient is (optional):
D Committee
D Non-Committee
1 Date Expended
6/16/09 2 Amount
$ 121.90
3 Recipient is (optional):
D Committee
D Non-Committee
1 Date Expended
6/23/09 2 Amount
$ 72.00
3 Recipient is (optional):
D Committee
D Non-Committee
date date
Costeo4 Name (Last, First):
5 Address:
6 City/State/Zip: Thornton, CO
7 Purpose of Expenditure: office supplies, postage
OffieeMax4 Name (Last, First):
5 Address: 801 E 120th Ave
6 City/State/Zip: Thornton, CO 80233
7 Purpose of Expenditure: copies, office supplies
Candy Creek Inc4 Name (Last, First):
5 Address: Three Osage Road
6 City/State/Zip: Canton, MA 02021
7 Purpose of Expenditure: promotional item, candy
4 Name (Last, First):
5 Address:
6 City/State/Zip:
7 Purpose of Expenditure:
USPS
Aurora, CO 80010
postage stamps
Schedule B -Itemized Expenditures Statement ($20 or more) Page 4
Full Name of CommitteelPerson: Committee to Elect Lynne Fox
Reporting Period Covered: L....-,--_2_/_1I_09 1 Through 1L....-__1_0/~8/_0_9
PLEASE PRINTffYPE
1 Date Expended
6/25/09 2 Amount
$ 194.11
3 Recipient is (optional):
D Committee
D Non-Committee
1 Date Expended
6/25/09 2 Amount
$ 100.00
3 Recipient is (optional):
D Committee
D Non-Committee
1 Date Expended
7/1109 2 Amount
$ 786.36
3 Recipient is (optional):
D Committee
D Non-Committee
1 Date Expended
7/2/09 2 Amount
$ 28.00
3 Recipient is (optional):
D Committee
D Non-Committee
date date
_
4
5
6
Name (Last, First):
Address:
City/State/Zip:
KSE Imprints-M
1000 Chopper Circle
Denver, CO 80204
7 Purpose of Expenditure: promotional items, t-shirts
4
5
6
Name (Last, First):
Address:
City/State/Zip:
American Cancer Society
7 Purpose of Expenditure: campaign event, relay for life
4
5
6
Name (Last, First):
Address:
City/State/Zip:
Gamino Printing
1090 S Raritan St
Denver, CO 80223
7 Purpose of Expenditure: Brochures
4
5
6
Name (Last, First):
Address:
City/State/Zip:
USPS
Aurora, CO 80010
7 Purpose of Expenditure: Postage
Schedule B -Itemized Expenditures Statement ($20 or more) Page 5
Full Name of Committee/Person: Committee to Elect Lynne Fox
Reporting Period Covered: ___2/-:-1_/0....;.9 1 Through 1'---__10_/8_/0_9 _
PLEASE PRINTffYPE
1 Date Expended
7/8/09 2 Amount
$ 56.00
3 Recipient is (optional):
D Committee
D Non-Committee
1 Date Expended
7120/09 2 Amount
$ 23.98
3 Recipient is (optional):
D Committee
D Non-Committee
1 Date Expended
7122/09 2 Amount
$ 28.00
3 Recipient is (optional):
D Committee
D Non-Committee
1 Date Expended
4/9/09 2 Amount
$ 49.00
3 Recipient is (optional):
D Committee
D Non-Committee
~re ~re
USPS4 Name (Last, First):
5 Address:
6 City/State/Zip: Aurora, CO 80010
7 Purpose of Expenditure: Postage
FedEX Kinko's4 Name (Last, First):
5 Address: 13700 Colfac Ave Suite F
6 City/State/Zip: Aurora, CO 80011
7 Purpose of Expenditure: Copies
4 Name (Last, First):
5 Address:
6 City/State/Zip:
7 Purpose of Expenditure:
USPS
Aurora, CO 80010
postage
4
5
6
7
Name (Last, First): USPS
Address:
City/State/Zip: Northglenn, CO 80233 9998
Purpose of Expenditure: Post box rental (6 months)
Schedule B -Itemized Expenditures Statement ($20 or more) Page 6
Full Narne of CornrnitteelPerson: Committee to Elect Lynne Fox
Reporting Period Covered: ___2_/1_/0_9 1 Through 1 1O~/8_/0_9__-",
PLEASE PRINTffYPE
1 Date Expended
8/8/09 2 Amount
$ 56.00
3 Recipient is (optional):
D Committee
D Non-Committee
1 Date Expended
8/9/09 2 Amount
$ 31.15
3 Recipient is (optional):
D Committee
D Non-Committee
1 Date Expended
8/9/09 2 Amount
$ 68.96
3 Recipient is (optional):
D Committee
D Non-Committee
1 Date Expended
8/13/09 2 Amount
$ 991.02
3 Recipient is (optional):
D Committee
D Non-Committee
date date
4 Name (Last, First):
5 Address:
6 City/State/Zip:
7 Purpose of Expenditure:
USPS
Aurora, CO 80010 7238
Stamps
Office Max4 Name (Last, First):
5 Address: 801 E 120th Ave
6 City/State/Zip: Thornton, CO 80233
7 Purpose of Expenditure: office supplies
4 Name (Last, First):
5 Address:
6 City/State/Zip:
7 Purpose of Expenditure:
Costco
Thornton, CO
office supplies
4
5
6
7
Name (Last, First): Color Graphix
Address: 33 S Fox
City/State/Zip: Denver, CO 80223
Purpose of Expenditure: campaign signs
1
Schedule B - Itemized Expenditures Statement ($20 or more) Page 7
Full Name of CommitteelPerson: Committee to Elect Lynne Fox
Reporting Period Covered: 2/-:-1_/0_9__---'1 Through 1 10-:-/8_/0_9
PLEASE PRINTffYPE
1 Date Expended
8/14/09 2 Amount
$ 894.03
3 Recipient is (optional):
D Committee
D Non-Committee
___date date
4
5
6
Name (Last, First):
Address:
City/State/Zip:
Gamino Printing
1090 S. Raritan St
Denver, CO 80223
7 Purpose of Expenditure: brochures
1 Date Expended
8/11/09 2 Amount
$ 56.00
3 Recipient is (optional):
D Committee
D Non-Committee
4 Name (Last, First):
5 Address:
6 City/State/Zip:
7 Purpose of Expenditure:
USPS
Aurora, CO 80010 7238
stamps
1 Date Expended
8/17/09 2 Amount
$ 56.00
3 Recipient is (optional):
D Committee
D Non-Committee
1 Date Expended
8/17/09 2 Amount
$ 31.33
3 Recipient is (optional):
D Committee
D Non-Committee
USPS4 Name (Last, First):
5 Address:
6 City/State/Zip: Aurora, CO 80010 7238
7 Purpose of Expenditure: stamps
FedExKinko's4 Name (Last, First):
5 Address: 13700 E Colfax Ave Suite F
6 City/State/Zip: Aurora, CO 80011
7 Purpose of Expenditure: printing
Schedule B - Itemized Expenditures Statement ($20 or more) PageS
Full Name of CommitteelPerson: Committee to Elect Lynne Fox
PLEASE PRINTffYPE
1 Date Expended
8/25/09 2 Amount
$ 121.39
3 Recipient is (optional):
D Committee
D Non-Committee
1 Date Expended
8/13/09 2 Amount
$ 56.00
3 Recipient is (optional):
D Committee
D Non-Committee
1 Date Expended
9/11109 2 Amount
$ 20.60
3 Recipient is (optional):
D Committee
D Non-Committee
1 Date Expended
9/29/09 2 Amount
$ 56.00
3 Recipient is (optional):
D Committee
D Non-Committee
Reporting Period Covered: '--__2_/1_/09 1 Through 1__......:..:10;;;.;/8::.../09:::..::......"'--_ date date
4 Name (Last, First): Robodial.org LLC
admin @ robodial.org
campaign calls
5 Address:
6 City/State/Zip:
7 Purpose of Expenditure:
4 Name (Last, First):
5 Address:
6 City/State/Zip:
7 Purpose of Expenditure:
USPS
Aurora, CO 80010
postage stamps
4 Name (Last, First):
5 Address:
6 City/State/Zip:
7 Purpose of Expenditure:
Ace Hardware
3851 E 120th Ave
Thornton, CO 80233
campaign sign supplies
4 Name (Last, First):
5 Address:
6 City/State/Zip:
7 Purpose of Expenditure:
USPS
Eastlake, CO 80614
postage stamps
Schedule B - Itemized Expenditures Statement ($20 or more) Page 9
Full Name of CommitteelPerson: Committee to Elect Lynne Fox
PLEASE PRINTffYPE
1 Date Expended
10/3/09 2 Amount
$ 70.46
3 Recipient is (optional):
D Committee
D Non-Committee
1 Date Expended
9/28/09 2 Amount
$ 269.30
3 Recipient is (optional):
D Committee
D Non-Committee
1 Date Expended
9/26/09 2 Amount
$ 48.00
3 Recipient is (optional):
D Committee
D Non-Committee
1 Date Expended
10/6/09 2 Amount
$ 358.39
3 Recipient is (optional):
D Committee
D Non-Committee
Reporting Period Covered: 1_··__·....;;;2;.,;/1;.,;/09~__1 Through 1__--.,;;;..1O;;.;,./.;;.;.8/..;;.;09~__ date date
4 Name (Last, First): Costeo
16375 N Washington
Thornton, CO 80023
office supplies
5 Address:
6 City/State/Zip:
7 Purpose of Expenditure:
4 Name (Last, First):
5 Address:
6 City/State/Zip:
7 Purpose of Expenditure:
Color Graphix
33 S Fox St
Denver, CO 80223
campaign signs
4 Name (Last, First):
5 Address:
6 City/State/Zip:
7 Purpose of Expenditure:
USPS
280 E First Ave
Broomfield, CO 80020
post box rental
4 Name (Last, First):
5 Address:
6 City/State/Zip:
7 Purpose of Expenditure:
Offiee Max
801 E 120tM.ve
Thornton, CO 80233
copies
Schedule B - Itemized Expenditures Statement ($20 or more) Page 10
Full Name of Committee/Person: Committee to Elect Lynne Fox
PLEASE PRINTffYPE
1 Date Expended
10/7/09 2 Amount
$ 21.00
3 Recipient is (optional):
D Committee
D Non-Committee
1 Date Expended
10/6/09 2 Amount
$ 136.00
3 Recipient is (optional):
D Committee
D Non-Committee
1 Date Expended
10/8/09 2 Amount
$ 310.00
3 Recipient is (optional):
D Committee
D Non-Committee
Reporting Period Covered: __""-~2/;..;;1;..;/09;.;..... 1 ...... __... __1 Through __........;;.1O_/...;.;8/09~date date
4 Name (Last, First): University of Colorado HSC Library
12950 E Montview Blvd
Aurora, CO 80045
copies
5 Address:
6 City/State/Zip:
7 Purpose of Expenditure:
4 Name (Last, First):
5 Address:
6 City/State/Zip:
7 Purpose of Expenditure:
Robodial.org
admin @ robodial.org
telephone calling service
4 Name (Last, First):
5 Address:
6 City/State/Zip:
7 Purpose of Expenditure:
MetroNorth Newspapers
PO Box 350070
Westminster, CO 80035
newspaper advertisement
I Date Expended 4 Name (Last, First):
5 Address: 2 Amount
$ 6 City/State/Zip:
3 Recipient is (optional):
7 Purpose of Expenditure:D Committee
D Non-Committee
Schedule C - Loans
Full Name of CommitteelPerson: Committee to Elect Lynne Fox
Reporting Period Covered: 1 2/~1_/0_9 date
_ Through 10/8/09 date
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. XXVllI, Sec. 9(e)] Notwithstanding any other section of this article to the contrary, a candidate's candidate committee may receive a loan from a fmancial 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): _F_o_x-'-,_L....y_nn_e _
Address: 4262 E. BOth Drive
City/State/Zip: Thornton, CO 80241
Original Amount of Loan: $ 2,482.62 Interest Rate: -%--'---"'---"--------------- ---------- Total of All Loans This Reporting
Loan Amount Received This Reporting Period: $2,482.62
Period: $2,482.62 (Place on line 8 of Detailed Summary Report)
Principal Amount Paid This Reporting Period: $0.00
Interest Amount Paid This Reporting Period: $0.00
Amount Repaid This Reporting Period: (Amount Repaid is sum of Principal & Interest entered on Detail Summary)
$0.00·· Total Repayments Made: $0.00 .. (Sum of Schedule C pages, Place on line 16 of Detailed Summary)
Outstanding Balance: $2,482.62
TERMS OF LOAN: 10/8/09 Date Loan Received Due Date for Final Payment
LIST ALL ENDORSERS OR GUARANTORS OF THIS LOAN
Full Name Address, City, St., Zip Amount Guaranteed
Elections Division Department of State 1700 Broadway, Ste. 270 Denver, CO 80290 Ph: (303) 894-2200 x3 Fax: (303) 869-4861 www.sos.state.co.us
,ONDITIONALLY ACCEPTED
OCT 30 2009
THORNTON CITY CLERK
REPORT OF CONTRIBUTIONS AND EXPENDITURES (C.R.S. 1-45-108)
Space Below For Office Use Only
Full Name of CommitteelPerson: Committee to Elect Lynne Fox As Sho\\n on Registration
Address of Committee/Person: 4262 E. 130th Drive
City, State & Zip Code: Thornton, CO 80241
Committee Type: Candidate
Name of Financial Institution: 1st Bank
Address of Financial Institution: 3390 E 104th Ave, Thornton, CO 80233
SOS ID NUMBER (state committees ONLY): N/A
Type of Report:
[i] RegUlallYsrhedUled Filing. October 13,2009 (21 days prior to the November 3,2009 Municipal Election)
[i] October 30,2009 (Friday prior to the November 3,2009 Municipal Election)
D December 3,2009 (30 days after the November 3,2009 Municipal Election)
D Annual - candidates from prior election held on -------------------,
D Amended Filing. This amends previous report filed on (date)
Submit changes or new information ONLY
D Termination Report (Termination Reports MUST have a Monetary Balance ofZero in Line 5)
Reporting Period Covered: 10/9/09 Through 10/25/09I---;-:---- date date Declared Total Spending (if applicable): [Art.
N/AXXVlll, Sect. 4 (I)]
Totals Detailed Summary Page
1 Funds on Hand at Beginning of Reporting Period (monetary only) $0.00 2 Total Monetary Contributions (line II) $5,100.00 3 Total of Monetary Contributions & Beginning Amount (line 1+ line 2) $5,100.00 4 Total Monetary Expenditures (line 19) $3,114.32 5 Funds on Hand at End of Reporting Period (monetary) (line 3-line 4) $1,985.68
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 Agent OR the Candidate) I hearby certify and declare, under penalty of perjury, that to the best of my knowledge or belief all contributions received during this reporting period, including any contributions received in the form of membership dues transferred by a membership organization, are from permissible sources.
Plateau 470 LLC (Clarke Carlson) Name (Last, First):
Address: 1790 Platte St
City/State/Zip: Denver, CO 80202
Description Check
Employer (if applicable, mandatory):
Occupation (if applicable, mandatory):
• For contribution limits within a committee's election cycle or contribution cycle, please refer to the following Colorado Constitutional cites: Candidate Committee Art. XXVIII, Sec. 2(6); Political Party Art. XXVIII, Sec. 3(3); Political Committee Art. XXVlII, Sec 3(5); Small Donor Committee Art. XXVIII, Sec. 2(l4).
Schedule A -Itemized Contributions Statement ($20 or more) Page 2
Full Name of Committee/Person: Committee to Elect Lynne Fox
Reporting Period Covered: L....__I_0.,..../9_/0_9__IThrough 1__ 1_ 0...,../2_5/_0_9__ date date
PLEASE PRINTffYPE
I Date Accepted 4 Name (Last, First): CSCEW SMALL DONOR COMMITTEE
10/22/2009 5 Address: 5660 Logan St
2 Contribution Amount 6 City/State/Zip: Denver, CO 80216
• For contribution limits within a committee's election cycle or contribution cycle, please refer to the following Colorado Constitutional cites: Candidate Committee Art. XXVIII, Sec. 2(6); Political Party Art. XXVIII, Sec. 3(3); Political Committee Art. XXVIIl, Sec 3(5); Small Donor Committee Art. XXVIIl, Sec. 2(14).
Schedule B - Itemized Expenditures Statement ($20 or more) [C.R.S. 1-45-108-(1) (a)]
Full Name of Committee/Person: Committee to Elect Lynne Fox
Reporting Period Covered: 10..,./9_/0_9__.....J1 Through 1 1_0/...,-2_5/_09
Full Name of Committee/Person: Committee to Elect Lynne Fox
Reporting Period Covered: 1 IO~/~9/_0_9 _ Through 10/25/09
date date
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: $ %......;:;...------------- Interest Rate: ------...;..:..--Total of All Loans This Reporting
Amount Repaid This Reporting Period: $0.00 Total Repayments Made: $0.00 (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
Schedule D - Returned Expenditures & Contributions
Full Name of Committee/Person: Committee to Elect Lynne Fox
Reporting Period Covered: 11....-_1_o/_9_/o_9__ Through 10/25/09 1
date date
Total Returned Contributions: I $
Total Returned Expenditures: I_$~ ====== _ Returned Contributions
(Previously reported on Schedule A - Contributions accepted and then returned to donors)
PLEASE PRINTrrYPE
1 Date Accepted 4
2 Date Returned 5
6
3 Amount 7
$
Name (Last, First):
Address:
City/State/Zip:
Purpose:
1 Date Accepted 4
2 Date Returned 5
6
3 Amount 7
Name (Last, First):
Address:
City/State/Zip:
Purpose:
$
Returned Expenditures (Previously reported on Schedule B - Expenditures returned or refunded to the committee)
PLEASE PRINTrrYPE
1 Date Expended 4 Name (Last, First):
Address:
City/State/Zip:
Comment (optional):
2 Date Returned 5
6
3 Amount 7
$
1 Date Expended 4
2 Date Returned 5
6
3 Amount 7
Name (Last, First):
Address:
City/State/Zip:
Comment (optional):
$
Statement of Non-Monetary Contributions [Art. XXVlll, Sect. 2, (5) (a) (II) (lll), Sect. 5, (3)]
[C.R.S. 1-45-108 (I)]
Full Name of CommitteelPerson: Committee to Elect Lynne Fox
;::::::::::::::::==~~------;:::::========~ Reporting Period Covered: I 10/9/09 Through 10/25/09
date date
Total Itemized Expenditures:IL... $~9_9_6_.6_3_ PLEASE PRINT/TYPI
I Date Provided 4 Name (Last, First): S.E.I.U. Local 105, Small Donation Committee
10/25/09 5 Address: 2525 W. Alameda Ave
2 Fair Market Value 6 City/State/Zip: Denver, CO 80219
$996.63 7 Description: stafftime (phone bank, literature drop oft)
10 n Check box if Coordinated with a Candidate/Candidate Committee or Political Party.* • Note: Ifcoordmated, then contnbutlOn must also be reported as a non-monetary expendIture on DetaIled Summary. Art. XXVlll, Sec. 2(9) states: " ... Expendltures that are controlled by or coordinated with a candidate or candidate's agent are deemed to be both contributions by the maker of the expenditures, and expenditures by the candidate committee."
Elections Division .,()['!uiif:IONALLY ACCEPTED Space Below For Office Use Only
1700 Broadway, Ste. 270 Denver, CO 80290
Department of State
DEC 03 2009Ph: (303) 894-2200 x3 Fax: (303) 869-4861 www.sos.state.co.us THORNTON CITY CLERK
REPORT OF CONTRIBUTIONS AND EXPENDITURES (C.R.S.I-45-108)
Full Name of Committee/Person: Committee to Elect Lynne Fox As Shown on Registration
Address of Committee/Person: 4262 E. BOth Drive
City, State & Zip Code: Thornton, CO 80241
Candidate
1st Bank
3390 E 104th Ave, Thornton, CO 80233
Committee Type:
Name of Financial Institution:
Address of Financial Institution:
SOS ID NUMBER (state committees ONLY): N/A
Type of Report:
[i] Regularly Scheduled Filing.D October 13,2009 (21 days prior to the November 3,2009 Municipal Election)
D October 30, 2009 (Friday prior to the November 3, 2009 Municipal Election)
IX I December 3,2009 (30 days after the November 3,2009 Municipal Election)
D Annual - candidates from prior election held on -------------------,
D Amended Filing. This amends previous report filed on (date)
Submit changes or new information ONLY
00 Termination Report (Tennination Reports MUST have a Monetary Balance of Zero in Line 5)
Reporting Period Covered: 10/26/09 Through 11/28/09 date date
Declared Total Spending (if applicable): [Art. N/AXXVIII, Sect. 4 (I)]
Totals Detailed Summary Page
I Funds on Hand at Beginning of Reporting Period (monetary only) $1,985.68
2 Total Monetary Contributions (line II) $0.00
3 Total of Monetary Contributions & Beginning Amount (line 1+ line 2) $1,985.68 4 Total Monetary Expenditures (line 19) $1,985.68 5 Funds on Hand at End of Reporting Period (monetary) (line 3 - line 4) $0.00
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) (an
Authorization (Must be completed by either the Registered Agent OR the Candidate) I hearby certify and declare, under penalty of perjury, that to the best of my knowledge or belief all contributions received during this reporting period, including any contributions received in the form of membership dues transferred by a membership organization, are from permissible sources.
Print Registered Agent's (Treasurer's) Name:
Registered Agent's (Treasurer's) Signature:
Print Candidate Name: Lynne Fox ---='-~----....,.....----------------------j""'------.,.-------
Candidate's Signature: LJ,,~P1. Sr4.
DETAILED SUMMARY
Full Name of Committee/Person: Icommittee to Elect Lynne Fox
Current Reporting Period: 110/26/09 Through 111 /28/09
Funds on hand at the beginning of reporting period (Monetary Only): $1,985.68
6 Itemized Contributions $20 or More [CRS 1-45-108(1)(a)]
(Please list on Schedule "A") $0.00
7 Total of Non-Itemized Contributions
(Contributions of $19.99 and Less)
8 Loans Received
(Please list on Schedule "C") $0.00
9 Total of Other Receipts (Interest, Dividends, etc.)