CAMPAIGN FINANCIAL DISCLOSURE REPORT Rev.5/'11 ot (it milB ... · John Carver milB{t{(ilca'ffit...
Transcript of CAMPAIGN FINANCIAL DISCLOSURE REPORT Rev.5/'11 ot (it milB ... · John Carver milB{t{(ilca'ffit...
CAMPAIGN FINANCIAL DISCLOSURE REPORT
SUMI'ARY PAGE(Pbase Print or TYPe)
Change of addess for: Candidate or Political Commitbe E Political Treasuer trSeclion ll TYPE OF REPORT
Rev.5/'11
Thb f,ino b an: tr Oidnd E Amendnmt
nis cp; is mhe pedod **t-11 -|7---112
_trrargh 12 131 112
El.7$ey+eBimaffR€pod-
0 7 Day Re€eneral Report
El-3aw?rftryR€rtE 3OOaye6-** **,,
fl October 10 PreGeneral Report
I Annud Report
Wly)fs tris a Temination ReDort E Yes g No
Sedion lll STATEMENT 0F NO CoNTRIBLTflONS OR EXPENDITURESDirections: lf you had no contibutbns or eponditjres du,ing hb raporling period, drocl he box next b h6 statem€nt below and sign his rwort
Be sure to cany forrard he flpropdate "Cdendar Year to Datd fuures in Column ll, Seclion lV
tr | har€by cedify frat I hav€ receiv€d no contibulbns and have mde no eryendifur€s dudng $b rpoding p€riod.
Seciion lV SUMMARY
To madl your Calendar Year to Dab figure: Add his reporfs Column I
figurcs b fie Cdumn ll figures of your previds rEpdt (except on line 6).
Line 1: C6h on Hand January 1, This Cdendar Yeaf
Une 2: Enbr Beginning C6h Balance*
Une 3: Tobl Contributions (Enbr amount from line 5, page 2)
Line 4: glbbhl (Add lines 1, 2 dd 3)
Line 5: Tobl Expenditures (Ent6r amount from line 11, page 2)
Une 6: Enbr Ending C6h Balance (Sobfact line 5 fton line 4)
Line 7: Oubhnding Deb! b Dab (Enbr amount fiom line 1 I, pag€ 2)
$2775.9411521.63
3913.O1 11521.69
$ 3913.01 11521.63
0l
U$_
COLUMN I
this Psdod
$ /OOCXXX
$ 1137.07
co{_uMN ilCalendar Year
b Dab.00
mcofi
This sane fuure strculd be enbEd on line 1 of dl reporb fied bb cdendar yed.*This is tle &ure m line 6 of he l6t Camp4tn FinaEid Dbdo6rrr6 Repdt fl6d. f his b lour fist eport, fib anount is 0.Note: The closing cash balance for he curent reporling p€rbd epears on he next report a6 fle boginning cash on hand.
arp ot Cadkt& q Poffil C tlf08eed Ck*perso.lJohn Carver milB{t{(ilca'ffit
Distki (it ary)
MarrB AddcrF730 W. Claire St.
Lry aE z!Meridian. E3&2
t|(nB ttrtt968-4097
w('|( rl|ql€90&3320
Nrne ot lt Ea |lgluf€fDiane Westerberg
llai[E Add€ss
7175 Delwood Dr.uv am 4pBoise. 83709
HOnE HnB362-25G)
w(fx|.tEne88&6667
Socton V
"'8efl.\rsurg-.,S..rsbCd€tate-PoBoret?2o-
3obe.l+83720{080PheRcre6FS+2852FuJf;81ffi82
Diane Westerberol, - . he@by oertify fiat fie inbrmation in his
Na||E d Pdthal Trcasu€r
hS;{
DETAILED SUMMARY
Name of Cardirlate or ComII*[ee.John Carver, ACHD
.t
+
+
t
6)@ac\
@/F\
@@@@@@
@
@
@
@
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Confibutiqs
Unitemized Contributions ($50 ard less) # of Contributors
Itemized Contihttorns (lbtal of all Schedule A steeb)
ln-Kind Contributions (Tobl of all Confibution amounb frcm Schedule C sheets)
Loans (Total of all New Loan amounts from Sciedule D sheels)
Total Contibutions (Transfer this figurc to page 1, S€ction lV Line 3)
Exoendifures
Unitemized Experditues (Less than $25) # of Exoendihres
Itemized Expenditures (Total of all Schedule B sheets)
In-Kind Expenditures (Total of atl Expenditure amounts fiom Schedule C sheets)
Loan Repaymenb (Total of all Loan Repayrnent amounb fiom Scheduh D sheeb)
Credit Card and Debt Repaynenb (Total of all Repayment amounts from Schedule E sheeb)
Total Expenditures (Transbr this figure to page 1, Section lV Line 5)
Loans, Credit Cards and Debt
Oubtanding Balance fiom previous r€porling period
New Loans received during this reporting perM(Total of all New Loan amounb plus Accrued Interest from Scfedule D sheets)
New Credit Cafd and Debt incuned tiris reporting period(Total of all New lncuned Debt amounb from &hedule E sheeb)
Subtotal
Repaymenb of Loans made during this reporting period
(Total of all Loan Repayment amounts ftom Schedule D sheeb)
Repayrnenb of Crcdit Card and Debt this reporting period
(Total of all Debt Repayment amolnts from Sc*ndule E sheets)
Total Outstanding Balance at close of this period (Transfer his figure to page 1, Section IV, Line 7)
Pledged Confibutions
Unitemized Pledged Contributions ($50 and less) # of Ptedges
Itemized Pledged Contributions this Period (Total of all Schedule F sheeb)
Total Pledged Contibutions fris period
+
+
+
Total lhis Period
$
92000,00
9775,9ac
92775.94
0
g 190.07
E Z/5.9a
g 2197.0o
9750.0o
93913.01
93722.94
^0
^-775.94o
92947.00
-2197.N
^ 750.00
QU
+u+$
Paqre 2
SCHEDULEA
ITEMIZED CONTRIBUTIONSof more han Fifty Dolhrs ($50.00) his pefiod
Name of Candidate or Corm'rtbe. John Carver, AGHD
he Receircd Fd Nfl€, l,lailing Add€66 .rS Zp Coft of Cotfibdor Cadr a Ch€ck
12512II
r Jes€e TaYor" 851 W. Frofi rf809
Bois€. lD 88702
2000.00$
$C€hndarYs-Tooab
tr Primary
E GerBral
IIz.
$
$C*rFY€ar-ToIh
tr Primary
trGerBal
II1
$
$CffiY€r-ToIh
B Pdmarytr Genexal
tt4.
$
$Csl€||d{ Y€a.-To{}ab
tr Prknary
tr General
II $
$CC€ndar Y€sr-ToOab
tr ftimarytr General
ttb.
$
$Cdefih Ye6.-Tolale
tr PrimaryEGerual
ttI.
$
$Cahndar Y€{-To{ab
tr Ptimary
tr Gercnal
tt8.
$
$CahodaYs-ToOab
tr Primary
tr General
II9.
$
$CMYs-IoDab
tr ftimarytr Gercral
tt10.
$
$CMYs-IoOab
tr Primarytr Gereral
Tobllhb Page: $20m.00Transfu he aombined toH of dl Sdledule A pages to he DetaiM Summsy on page 2 line 2.
SCHEDULE B
ITEM]ZED EXPENDITURESTwenty-Five Dollae ($25.00) or morc his pedod
Narne of Cand6ab ff Commilee'John Carver, ACHD
Pumose Codes
A AllTrav€l Exponses (Aiftrs, Fuel, LoQkE & Mileags)
B BoadcastAdvertising (Radio, TV & Intemet)
C Confibutions to CandkJabs & PAC'S
D Donalions & Gifrs
E Event FreensesF Food & RefeshmenbG General Qorational Exp€nses
L Librature, Brochutes, ftinlingM ManagffiFnt SE vites
N Newspapor & Otrer P€riodicalAdvertishg
O OherMveflising (Yard Sigs, Buttons, etc.)
P Po6hgeS Surveys & Polls
T Trckeb (Ev€nb)
U Utilities
W Wages, Saltries, Benefib & Bonusss
Y Petilion CirdrlabrsZ PFpratbn & Prcdudir of Adroiliting
0ate Spent Fufi Nane, Me*ling Address and Zp Code d Redpiern Rrpce Code C6h or Chect
12 28 12
1. Diane Westerberg7175 Delwood Dr.Boise. lD 88709
w
190.07I
2.
$2
$
4.
$
$
o.
$
_J_!_ $
8.
s
J___t_
o
$
10.
$
Td This Page: $190.07
Transftr fie cor ined bbl of dl Sdledule B pa9s6 b he Dehiled Summfly on page 2 line 7.
SCHEDULE C
IN-KIND CONTRIBUTIONS and EXPENDITURES'l
Nanre of Candidab 61 e6ppi6es. Jottn Carver, ACHD
Pumoso Codes
A AllTravel Expenses (Airfane, Fuel, Lodging & Mileage) N NetYspaper & Ohet PedodicalAdtnrlising
B Broa@Adwli*ng (Radio, TV & lntwrEt) O OfiterAdvedk*E {Ydd S|SF, tulbns' eb.)C Contihitions b Candidabs & PAC'S P P06tage
D Donatims & Giifu S Surveys & Pdls
E Errent E)Oense6 T I'€keb (Ev€nb)
F Food&Refi€shrEnb U Utilities
G Generd Operational Expenses W Wag€s, Sdaiu, Benefib & Bonuses
L Ubrature, B.od|ures, Printing Y Petilitn Ci]urhb|sM Man4emont Servicss Z Preparation & Prcduclion of Ad\crlising
1' ,, u i2
tr Primary
E Genenal
ffiwal9ff' M"ling Addr€Gs atd 4 code
400 Fairway Dr.Pocatello. lD 8:!201
775.94$
$775.94
C*darY€ar-TeDaG
$ffFrqp$pg iilailing Addrs ad Zp Code
730 W. Claire St.MerHian.8642 775.94
$
Purpose Code
_t__J_tr Primary
tr General
Confibubr Nare, tUailing Addrcss and Zp Code$
$Cal€ndar Y€€r-To{h
Expenditue Name, lvlafling Addrcss ad Zp Code
$
Purpose Code
J.
tr Pdmary
tr General
Contibubr Narc, lvhiling Addrcss ard Zp Code$
$C*rbr Yer-To{}rte
Expenditue Name, irailing Address atd Zp Code
$
Pupose Code
tr Pdmarytr GerBral
Contibubr Name, l&iling Addrcss and Zp Codel
$C€lendar Y€r-To{hb
ExpendituG Narne, ti{ailing AddFss and Zp Code
$
Purpose Code
E)@enditure Total:
Fransfer tlF combin€d btd of dl beendiures on Sdedule C page6lo lhe Defihd Srmm*v ne.tc ? line 8l
$z/s.94
Oransbr fie @mHned toH of all Conbibuhs r
b tn6 DeHed &Il
Contitubr Tobl:m Sd€dule C pages
nmay, page 2 Sne 3)
$ 775.94
SCHEDULE D - LOAIIS
Any loar(s) witr a bdarce(s) 4peairg m he hd |€F.l rrK be fisbd bdor rih t|e dnolr h tle Reyi(||s Bdanog cotnn. Any mw loat dnolnb
$6ufO d f'bed h fr6 em t-oer otrmn.lny hbr€gi dtred dnid be ISd h t|e Inbr€dlocrued cofism. f a p4fli€nt was made on he loal' li6t
it in fre Repaynsrb colnrn. tlob: Ary br hat E Ggrid h ftl in 8 ploriflls tapoling pe$.d th nd md b be hbd. fhe Chb8tdng
Bdance coflrls| b tE Pt€viotNt Bdare pla oeu 1d|5 ad eued hged less aty rcpafgrb.
e*r fJ|ta* U yo.,t.tteuigt shcffi be bbd sqarabry. Edr lhc a loar b received er' yil lodl rmey b $e caflry{n, it mlst be |isbd 6 a
,.p*.eie*. fi*,r,*narmrnarytenCamuiUntOaanewibmfiuntatl-6nrler.Yor.lttElEIfteangf5"ye,Y-11-:gi,rn m a 6666* rukirg a 6at b hb or h6r orn carryign, loorrs frlm aty t€nG caild ocoed cmttolin f,dib lai, out in
Sedbn 67S610A, ld*o cod6, e{en if it b r€Pd h tt.
Nale, lrdirgMd€ss ad zPCo& of Lqtdet
(Caxid*, hdnidnl or Bu*|ess)
Prsvirrs Eddredbd|at$eed oftF bsrwditg p€*rd
tl6rldrammlGc(nrcd dtiB ttb
r€poritg petud
Etrd *arucdrfniE t*t
r€po.frg pedd
@tm€ntsdL@ldrhg ftb ]€port|g
pedod
B&Feilbtarfig att|e €nd dfib
reoqtim D€tbd
1. John Garver730W. CNaire StMeddian, lD &!642 0
2JtoJ12_Arflqrt! 2197.00
2.
Amrtt_t_t_
Arlurt$
?
Amrt_t_t_
ftIllnt$
4.
Afunt Arunt$
5.
Arrnntt
_J_t_Armnt
$
6.
-J_t_Ann.rtt
kurt$
_J__J_At|Irl|t Amnt
$
ft€vins
ftEvbus Recened tr €€t n+ay|rent En*rg Bdatce
$o
(Trdl€gtl|e ofithed ffi dd €cei!€d lErs b $ 2r97.ooLr9ues ourrrr*ty, [r8e 4 ]t€
hEeS go
$rsFftr$e sntitod bbl dd loe repaynEG b so uq1. qrrErnrr aurlrrrt l'4B a r|, v q
EtcrgBshme 6o(NOTE: TraBtu he codined M of d Acflred hb'Ed $d Receh/ed toaE b f'|e Deded Sor|Insv, paqe 2 |irp i3l
SCHEDULE E - CREDIT CARDS and DEBT
Name of Candilab or Committee:
ea* inarned erye*rse mt yet palt (i.e. creda cdd Fndrases fld d€t{) shorb be lisbd m a s€pamb Sne. Eedl lime yol make pudEs€8 wilh a
ctedit card or incur dabt, it is consldered b be a separate item. Howe\rer, you will rnaintain a single ign fur each credit catd ild add pjrd|ases to hat
ibm. Edr Cr€diw lisbd bolorv wih a Na.y D€bt anuJnl must have a Sdedule E-1 mmpan$ng it. Tte Sdledulo E-l lbts whei€ and h€tr the
debt rY6 incuned.
Credit Cards are cd|sidercd debt to fie canp{*rn. R€gadl€ss of trdr€trF. he ctodit card h rep€*t i$€n the sbboEnt is recdv€d, ail s€dit catd
fansactions will rypsar on Sdredule E and E-1. However, d y Repaymenb of Debt dudng his repofting pedod appear in ho Expenditure Sedion of
tle D,e&iled Summary Page.
Any cr€dib(s) wih a balanoqs) appeadng on he ht repo{t must be lid€d bdow wib the {nount in the Previo$ Balance column. Any new debt
shoutd be listed in he New Debl column, induding any accrued inble3t F a paym€nt was mde on t\e debt list it in tle Repaynenb column. l,lote:
Any debt fiat was repdd in full h a f,rsvius reportiu pedod does not ne€d to be ftsbd. the OubtmdirE Bd ce column is t't€ PEvious
Balanco plus tlew Dobt hs6 any Repayn€nb of Debt
Name, Mailing Address and Zp Code ofCrcdibr
(Candidate, lndivirjual or Business)
Prcvious Bdance ofdebt at he end of hel6t rcporting pedod
New D€bt amount
inomed dudng hisreporting period
Repaynrnb of Debt
du.ing fiis reporling
oelitd
Balance oubt{dingat ho €rd of hisrcporting perbd
.t. UOOTSIeP Ulrecr40o Fairway Dr.Pocatello, lD 83201
'btnLZryii-1'f
Date:12J_\12_Amo0nt:
$ 750.00
z, Date:
Anount
$
m:
AIIEUnl:t
Date:
Amount
$_
he:
Amounl:e
4. Date:
Amo0nt:
$
Dde:
Amounl:
$_Date:
Amount:
$
Dde:
Amount
$
o. Date:
Anoont:
$
he:
&nount:
$
Previo{s ToH:
ftevious Inqtn€d Repayn€nb Ending Balance
$o
(Transfer the mmuned btal (
Dehibd S
lnol]|€d Tobl:f dl inffred debt lo heummaY. Daoe 2lirF 14)
$o 775,qf
0ransftr he c{rnbined toH ofDehiled Suml
Ropayrnsnb ToH:dl debt repaym$b b henanr. oee 2 line 10 & 1n
$75O.0O
Ending Bdance Tobl: $0