George Temple Funds

8/3/2019 George Temple Funds

1/24

SEEC'FORMItcmized CampaignCONNEC'TICU'I' STATERev. l/0820Finance Disclosure StatemcntELECTIONS ENFORCEMENT COIITMISSION

Do Nor!F49.&6i&gstsr

SUMMARY PAGEOXFORD TOGETHER 2011

3, TRTASURER ADDRtrSS459 CHESTNUT TREE HILL RD

4. E LECTION/BqFERENDUM DATE11t08t2011 FIRST SELECTMAN

7. CANDIDATE NAI}18

C, January l0 filingO April l0 filingfi July l0 tltingff. October l0 filing-. Independent Expendituref Primary C Ele.r,on

fi 7th day preceding primaryG 30 days following primaryC 7th day preceding election0 l2th day preceding election(State Centrul Comminees Only)t:45 days following electionnot held in November

Ci Tthday preceding referendumli: 45 days lollowing referendumC DeficitC Termination

fi lnitial Contribution or Disbursementc"J".i.-;

f'-b

(PACs oNLY)Amendment to *\f1"=Typ$pf krjpo(pf;-.i - c-)_a

'r. Gt\:!i-a "- '*

Beginning Date Ending Date

09t0212011 thru finlnf/-1I hereby certify and state, under penalties of false statement, that all of the information set forth on this lternized Campalgn Financeisclosure statement for the peiiod covered is tru", accurate and complete.

R.[trrOR DEPUTY TR EASURER (SIONA'fURE) PRINT NAME OF SICNER

PEN.,ILTY FO&. FALSE ST,ITE]'TENT IS PIJNISHABLE BY FINE NOT TO EXCEED$I,OOO, oR I*IPRIS)N*TENT FoR Nor )roRE i}i.iN our YE,4R, oR I}TTH-


2/24

FORM 20Campaign Finance Disclosure StatementSTATE ELECTIOn*S ENFORCEIVIENT COMMISSION .'- Page 2 of 1?l/0E !!!!!l=:l ! !!SilMililf,FTOTALS nATEOF COMMIT-TEE

TOGETHER 201 1_-EOTUMN A

This Period-TOLUMN B

Aggregate$0.001. Balance on hand ranuary I :f ."'1::t l:li i1' ::9X:t"fl*ff?":H,Ti:"Balance on hano lrom oay r-ulrttttttLss *o" ^"""-* $5,787.39

12, Balance on hand at the begtnnlng or ncpu""'s r "13. Contributions received from Individuals (Sections A and B)

$4,950.00 $11,845.00$1,500.00 $1,500.00

14. Receiots from Other Commtttees (secttons u t attu v' t(onrinnc n-K) $0.00 $700.00

l6a. Total small Food and Beverage Receipts at Fair (Section Ll) Torvn ccrnninees oNlY$0.00 $0.00$0.00 $0.00l.c /Qectinn T.2-]6b. Total Proceeds lrom Small Purchases at t ag latss' n'*"""" "' ""'-' *-'-- '-MuniciPal and TownD^^r. /ea^ri^n | 1\ (ommitleeS ONLY $2,350.00 $2,350.00

$8,800.00 $16,395.0017. Total $14,587.39 I sro'395.001 8. Subtotals (add totals in line l2 $3,890.59 s5,698.2019. BxPenses rato oY

rDannrtino Periori (suhtract line l9 from line l8 in both Columns) s10.696.80 $10,696.80lv$0.00 $0.00Cnnsidered Contributions Received (Section L4)

$250.2122. In-Kind Contributions Received (Section M)^^ h . --- r^Lr^ n^-^6i+ rn Telcnhone Comnanv (section N)

$250.21$0.00 $0.00

$0.00 $0.001.4 pa.cihls nl ( lrpanlzallon E,xpetluttutur r-"'""" -rrc o--i--i^- I ^.n Ralancc

$0.00 $0.00$0.00 $0.00

25a. * Loans Received (Sectton u)25b. * Interest and Penalties on Loan

$0.00 $0.00

$0.00 $0.00$0.00

25d. Total Outstanding t-qgq 4mo111l$0.00

9401.42 $1,494.55

!)S)

$0.00 $0.00$0.00$0.00

28a. Total Outstandlng Expen U'


3/24

MoNETARY RECEIPTS (Sections A-K) Page 3 of l7OF COMMITTFE FIT ING NTIF, DATE

Oxford Together 2011 10t1312011A. 'Iotal Contributions from Small Contributors-Keceived thls rerlod uNl,Y(See instructions for definition of Small Conrributor) Subtotal Sectlon $ 0.00

B. ttemized Contributions fxqm IndividualsNameCapace Vincent MI Itincioal OccuoationAccountant Amount ofContribution

$100.00

Addrcssff\pr.du.r |'< \rn bn- )ity Shelton ilateCT lip Coder'\/^ll.A\t Namc ol hmDlovers ilA,r, {-ev\ \contributor a lobbyist, spouse, Ct Yesdependent child ofa tobbyist? lii No tnmittee for a chief executive otficer of arnunicipality does contributor or business he/she is associated with have a confact with saidmunicipality valued at more than $5,000? C Yes C: No

this contribution associated rvith a Q Yesevent listed in Section Ll? (j NoIfyes,lisr Event # 3

ls contributor a principal ofa state contractor or prospective state contractor?Ifyes,indrcate which branch or branchesoiiovernment the contract is with: C: Executive fi Legislativei YesGNo

of corrtrrbution:{l':Cash .Q PersonalCheck CCrediVDebitCarcl CPayroll Deduction {i.MoneyOrderDatE Received

1A10712011Aggrcgate contnttutlons

$100.00NameCarver

FirstTanya MI Principal OccuoationOffice Management Amount ofContribution

$50.00

Strect Address1 old moosehill rd oxford

itatcCT atp Looe06478,{ame oi EmployerOxford Science

contributor a lobbyist, spouse, C Yeschild ofa lobbyist? C Wo lf """t"brtr" "-t .-t"* oe S+OO to a candidate committee for a chief executive offioer of amunicipaliry does contributor or business he/she is associated with have a contract with saidmunicipality valued at more than $5,000? Ci Yes G Nothis contribution associated with a S, Yesevent listed in Section Ll? !i NoIfyes,list Evcnt # 3

ls contributor a principal ofa state contractor or prospective state contractor?fyes, indicate which branch or branchesoi'gou.rnrn"nt the contract is with: C Executive C LegislativeC] YesCNo

of contribution:C Cash O Penonal Check C Credit/Debit Card C Payroll Deduction G Money Order Date Reccived10t0712011Aggregate contnbuttons

$150,00First MI Principal Occupation Amount ofContribution

$0.00

Strcct Address Jity rfatCCT1ip Code Name of Employer

contributor a lobbyist, spouse, ll:l Yeschild ofa lobbyist? l': No If ".rtrib"tt;; is in excess of $400 to a candidate committee for a chief executive officer of amunicipality does contributor or business helshe is associated with have a contract with saidmunicipality valued at more than $5,000? C Y"s F, Nothis contribution associated with a

event lrsted in Section Ll?Ifyes,list Event # _C YesC lto Is contributor a principal ofa state contractor or prospective state contractor?/yes, indicate which branch or branchesoigovemment the contract is with: C Executive fi Legislative

(-rn YesNoof contribution:C Cash f. Personal Check C: CreditlDebit Card C Payroll Deduction G Money Order Date Rcccived Aggrcgate contnbuhons$0.00

Name MI Principal 0ccrrnation Amount ofContribution

s0.00

Addrcss -rty )rareCT ',ip Code lName ot bmPloyercontributor a lobbyist, spouse, C YesC: No If "ottt.ibWion i. in excess of 5400 to a candidate committee for a chief executive officer of amunicipality does contributor or business he/she is a-ssociated with have a contract with saidmunicipality valued at more than $5,000? C Yes O Nos this contribution associated with aundraising event iisted in Section L1?Ilyes, list Event # _

fj Yesf; No Is contributor a principal of a state contractor or prospective state contractor?fyes, indicate which branch or branchesoigou"*rlr"nt the contract is with: C Executive C. Legislative.ft YesCNo

of contribution:C Cash f; Personal Check C Credrt/Debit Card C, Payroll Deduction C N{oney Order f)ate Rcccivedn ggrcgatc conlnbuttons

$0'00SUBTOTAL Section B-This Page $150.00

TOTAL of additional Sectlon B Pages [email protected](SectlonsAr9 4qto,


4/24

I. MONETARY RECEIPTS (Sections A-K) Page 4 of l7\IAME OF COMMITTEE FILING DUE DATEOxford Together 2011 10113t2011C!, Contributlons from Other Committees'{ame of Commifiee

GOP 4 Name ofTreasurcrPaul Pimentel125 Gilman St ls this contributron associated with a C yes /fyes, listfundraising event listed in Section L I ? G N16 Eygnl a Amount of Contribution

s1,500.00Bridgeport

I Statel.' Zip Co


5/24

ions A-K) Psqe 5 of 1?OF COMMITTF,F FTI.lNN DUE DATE

Oxford Together 2Q11 10t13t2A11D. Loans Received this Period

of Lcndcr Source of Loantfr sunk C Candidate.C Individual .C otherCommittee

Is there a Cosigneror Guarantor ofthls loan?Cl. Yes (ifyes li.sr-^*- --.1 ,,H*


6/24

Oxford Together Z01lIlAnonymous Contribul

RY RECEIPTS (Sections A K) Page 6 of 17:ILING DUE DATE lo'l1attniOnS lsoeclfv dollar amottnt n, tilt4 ,bnnil'st)ate Receiycd Amount $0.00 s0.00 Amount Received

0.00

g1 5i11, $0.00 55 6;16 $o.oocoins $0.00 g1s 6;11 $0.00

51 5111, $o.oo 55 6i11, $o.oocoins $0.00 g1s 5;11 $0,00

.I- Infererf frnm fl eposlts in Authorized AccountsDate Received$0.00 $0.00 TotalAmount Received

0.00

Name of lnstiiurion Name of lnstitutionStreet Addrcss

!'ity ffi lcrl try Srate lzio CoOecrtK. Miscellaneous lvlonetarv Recelnfs nnf Cnncirtara.t r. tributlonsName

Date ofTransaction Amount Received

$0.00

Srcet Addrcss CityCT

Zrp Code

Name Date ofTransaction Amount Received

$ $0.0cCity

CTZip Code

Dcscriprion

Date ofTransaction Amount Received

$ $0.00

treet Addrcss CityCT

Ltp eo{Je

Total Section K s 0.00Summary of Other Monetary Receipts (Sections D-K)

Loans Kecetved ttlts pcriod (Section D) 0.00.prr rr urr l!*'es orner rnan rndividuars or Other committees (section E) + 0.00lulareo ttusiness l rclsury (Scction F) + 0.00rom Anlllared Labor Union or Other Organization Treasury (Scction G) + 0.00nss ol rne Usndidate Received this period (Section H) + 0.00norrym{rusLonlnDutlons (section l) + 0.00Lreposrs lrl Authorized .,lccounts (Section J) + 0.00erary Kecetpts not Considered Contributions (Sectlon K) + 0.00vr vurGr lvlutrErarJi r1ecetpls (Add $eetions D-K)total on Line lS of Summary page) 0.00


7/24

II. FUNDRAISING EVENT ACTIVITY1A\AZU1Oxford Together 2011

Lt. Fundraiser Event InformationLocation; SrcctAddress436 Quaker Farms Rd10t07t2011I: (All Committees)

this fundraising event hosted at a personal residence? S Yes (fyas, go to Section L4 In-kind Donations not Considertd Contributions" una.otplete required information lbr purchases rlade by host(s) for food'beverage and invitations.)

this lundraiser include items donated by a business entity of up to00 or items donaled by an individual ol up to $50?

$yes ({yes, go to section L4 In-kind Donntions not consldered contributionsand complete required information.)a tag sale, auction, or other sale of donated itemspurchases t'rom an individual olup to $50?

(tfy,rt, eo to Section L2 Proceeds from Tag Sale, Auetion, or Other Sale of

(lfyes, go to Section L3 Purchases ofAdvertising Space ln a Program Bookand conrplete required infonnation )

(Town Commiltees and Municipal Canclidate Committees ONLY)th.r. purchases ofadvertising space in a ptogtam book associated $3: (Town Committees ONLY)your committee sell food or beverage at a fair or similar mass

hetd within the state?O Y.s (fyes, enter Total Receipts from small Purchases herel I $ t- I

Location: StleetAddrcss

l: (All Commiaees)this fundraising event hosted at a personal residence? Q yes (fyes, go to section L4 In-klnd Donations not considered contributions: uni.o.plete required information for purchases made by host(s) for food,

beverage and invitations )

this fundraiser include items donated by a business entity of up toI 00 or items donated by an individual ol up to $50?

$yes (I/yes, go to section L4 In-kind Donations not considered contributionsand complete required information.)this fundraiser a tag sale, auction, or other sale of donated itemspurchases from an individual ofup to $50? (Ifyes, go to Section L2 Proceeds from Tag Sale, Auctlon, or Other Sale ofDonated ltems.)

(Ifyes, go to Section L3 Purchases of Advertising Space in a Program Bookand complete required information )

,, 9""" C"^.lttees and Municipal Candidate Committees ONLY)ttte.. purchases of advertising space i; a program book associated 0 Yesthis fundraiser? * NoJ: (To*,n Committees ONLY)committee sell food or beverage at a lair or similar mass

held within the state?C! Yes (fyes, enter Tntal Receipts from srnall Purchaself5f I $ 0O0 I

SUBTOTAL Sectlon Lt (Town Committees ONLY) Total Receipts-ThisTOTAL of addltional Sectlon Lr Pages

TOTAL OF ALL RECEIPTS FROL SECTION Ll (Enter total on Line 16a of suntmqry


8/24

II. FUNDRAISING EVENT ACTIVITY Paqe 8 of 17NAME OF COMMITTEE IILING DUE DATEOxford Together 2011 10t13t2011L2. Proceeds from Tag Sale, Auction, or Other Sale of Donated ltems{arne ofPucharer Last NameIurtividuals ONLY) First MI Method of payment:O Castr Q Personal Check f. CrediVDebit Card AggregateAmount ofPurchases

$0^00

Kesldentlal Street Addrcss :tly !IAICCT lip Code Datc Recclvcd Event #tem Purchasedrlarne ofPurchaser Last Name'Individuals ONLY) lrnl MI N{ethod olpayment:G Cash Q Personal Check ti CreditlDebir Card AggregateAmount ofPurchsses

s0.00

Lcsidcntial Strect Addrcss jlty rlateCT Zip Code Date Reccived Event #

Itcms Purchascd

'{ame of Purcharer Last Nnfrd'Indiviiluals ONLY) l. t rsl MI Method ofpayment:F Ca.h {i. Personal Check C Credit/Debrr Card AggregateAmount ofPurchases$0.00

{csrdentlal Srrect Address jrty ttateCT lip Code Date Reccivcd Event #ItemE ['urchssed

,lame of purchroer Last Namc'Individuals ONLY) First MI Method of payment:G Cash {3 Personal Check fi CrediVDebit Card AggregateAmount ofPurchascs$0.00

Resrdential Strect Addrcss _ rfy )IAICCT

lip Code Date Recerved Evenl #tcms Purchased

Name ofpurchaser Lat Name(Individuals ONLY) First MI Method of payment:0 Cash Q Personal Check Credit/Debir Card AggregateAmount ofPu rchases

$0.00

Rcsidential Strcet Address 'ity itateCT Zip Code Datc Received Evelt #Items Purchased

Name ofPurchaser Last Nams(Indivitlutls ONLY) llrct MI Method of payment:C,Cash !i Personal Check (- CredivDebir Card AggregateAmount ofPurchases$0.00

Residcntial Strcct Address - rry tIa(eCT Zip Code Llate Recelved Evcnt #tcms Purchased'Jamc ofPurchaser Lasl Nnme'lndivitlusls ONLY) F-irst Method of payment:G Cash * Personal Check {] CredilDebit Card AggregateAmount of

Pu rchnses

$0.00

IAI )rreet Aoolgss .ttYCT Zip Code Datc Rcccived Evmt #Items Purchased

'{ame of Purchaser [-ast Name'Individuals QNLI) First Method of payme nt:C Cash $ Personal Check C. CredirrDebit Card AggregateAmount ofPurch ases$o.oo

Rc$rdcntlal Strcct Addrcss - tty tulgCT Zip Codc Date Received Evsrt #Itcms Purchasd

Name of Purchascr Lst Nehe(Indivitluuls 0NLY) Firsl Me thod of payrnent:{l Cash S Personal Check |] CrediVDebit Carrl AggregateAmount ofPurch ases$0.00

i{csidcntral Strcet Addrcss -'i tv )tarcCT

4ip Code IJate Recclvcd Fvcnt #Itcms Puchascd

SUBTOTAL Sectlon L2-Thls Page $0.00TOTAL of addltlonal Section L2 Pager $0.00

TOTAL OFALL SMALL PURCHASES FROM TAG SALf,,S! AUCTIONS OR OTHER SALES OF DONATED ITEMS{Fnlot b}nl nn f iaa I Ah nf (nsantr Dn-at $0.00


9/24

II. FUNDRAISING EVENT ACTIVITY Page 9 of 17OF f.rrMMITTFF F'TT TN(i nlIF. DATE

Oxford Togethet 2011 10t13120 1Ll. Purchases of Advertising in a Program Book (Municipal Candidote and Town Commiaees ONLY)

Mohegan Sunt'USlnes!EntityQ YesGNo

Date Received10l07l2ar AggregatePsrch*esfor All Events

$250.00

Amount ofPurchase$250.00reet Address CityUncasville

StateCT

Zip Code Event #3

of PurchaserB and B Transportation

BusinesrEntitytef.":

YesNo

Date Reccived10rc712011

Aggregatc Purchrocsfor All Events$250.00

Amount ofPurchase$250.00rect Address

road -rtybethanyStalc

CTZip Codc06524

Event #.)

of Purchroer Oxford Lumber BusinessEntity& Yesl-,No

Date Received10t0412011

Agg.regate PurchLseslor All Evcnts$250.00

Amount ofPurchase$250.00tret Address

13 Oxford Roadrry

oxfordSrate

CTzrp Code06478

Evcnt #3

of Purchsscr Select Realty BusinessEntityS Y"tLi No

Date Rccciverl10t07 t2011

i\ggrcgatc Purchccslor AII Evcnts

$125.00

Amount ofPurchase$125.00trect Address

Pine Stl-t tyBristol

s tatcCT

Zip Code Evcnt #3

of PurchmcrSpirits of 67

BusinessEntityF[ y.'l lNo

Date Rcccived10t07t2a11

Aggregatc Putchsesfor All Events$50.00

Amount ofPurchase

$50.00trcet AddressRoad

jrtyOxford

StateCT

Zip Code06478

Event #3

Glendale at OxfordBusinessEntityG Yes(}no

Date Reccivcd1010712411

Agglegate Purchuesfor All Events

$250.00

Amount ofPurchases250.00treet Addrcss

1 137 Seaview AvelityBridgeport

StateCT

Zip Code06607

Event #3

of Purch6er Bens MowingBusinessEntity[.]$ YesNo

Date Rcceived10t0712011

Aggrcgate PurchucsIbr All Evcnts

$250.00

Amount ofPurchase$250.00trcct Addrcss99 Highland ave

jrtybeacon falls

StateCT

Zip Code06403

Evcnt #3

of PurchmerPrecision Glass

JusinessEntity0 Y"tGNo

Date Rcccived1010712011

\ggrcgate Purchasesfor All Events

$75.00

Amount ofPurchase

$75.00trcer Addrcss43 Old State Road -ltyOxfordState

CTZip Code06478

Event #3

of Purchrocrkaminsky Transport

BusinessEntity{jl,i y.t(JNo

Date Receivcd1010712011

Aggregatc Purchascfor All Evmts

$250.00

Amount ofPurchlse$250.00trcet Addrcss2 Klarides Village Dr

-'rrySeymour

StateCT

z rp Code06483

Evcnt #3

of Purchasct Oxford ScienceBusinessEntityff-.i yes13 No

Datc Rcceivcd10to7t2011

Aggrcgatc Purchascrfor All Evcnts$250.00

Amount ofPurchase$250.00trcet r\ddrcss

178 christian st-ltyoxford

StatcCT

Zip Co,Je06478

Evetrt #3

of PurchascrBrookside

BusinessEntity(!t Yestl No

Date Rcceivcd

1At0712011Aggrcgatc Purchasctfor All Evcnts

$100.00

Amount of['urchase$100.00trc etAddrc s3oxford road

rtyoxford

StateCT

Lrp Coda06478

Evcnl #3

Purcha-rctPSI

IlusinessEntityS YesCNo

Datc Rcccivcd1AA712011

Aggrcgate Purchucrfor All Evcnis

$250.00

Amount ofPurch ase$250.00trcet Addrcss2 Klarides Village Dr

-lrlySeymour

StaleCT

Zip Code Evcnt #

SUBTOTAL Section L:-Thls Page $2,350.8TOTAL of additlonal Section L3 Pager $0.00

TOTAL OF ALL PLTRCHASES OF ADITRTISINC IN A PROGRAM BOOK (ENIET IO!A!!'' liNL !!::ISUN'MAry PATE) $2,350.m


10/24

II. FUNDRAISING f,VENT ACTIVITY Page l0 of l7IJAME OF COMMITIEE IILING DUE DATOxford Together 2011 10113t20 1

t4. In-Kind Donations Not Considered ContributlonsName of Donot l5o ** plr [r\ r .,Fe-rrc.*h Donation ffIndividualgiven by: G Business Entity Falr MarketValue of Donatior

$0.00{}(" fl,n b^, E F..\^4- kl City r1'tC"^ ^ A )BteCT c6 \)g {ggrcgate vslue for this cvent$0'00Description ot dbnationtlio nC hrovr.-s-- rol> I tr

Evcnt # \3Name of Donor Donation fllndividualgiven by: llt Business Entity Fair ll{arketValue of Donatior$0.00Address -lV 5lateCT

Zip Corlc Aggre8ate value for this evtnt$0.00

Description of donation ljatc Kecelved l.:vent *Namc of l)onor Donation fJ tndividualgiven by: C! Business Entity !'air iVlarketValuc of Donation

$0.005lreet Addtess Crty 5tat

CTZrp Code Aggregate value for this cvcnt

$0.00Description of donation uate Kecelveo Evcnt #

Namc of Donor Donation f-llndividualgiven by: l? Business Entiry ['air NlarketValue of Donatior$0.00

Jrect Addtcss Ity )IAICCT

Zrp Code Aggrcgate value for this evcnt$0.00

Dcscnptron ol donstion Date Recelvcd Event #

Name of Donor Donation {Jlndividualgiven by: Q Business Entity Fair MorketValue of Donation$0.00

iJfreet Address City StateCT

Zip Codc Aggregate value for this cvcnt$0.00

Description of donation lJatc Recclved Uvcnt #

Name of Donor Donation {lilndividualgiven by: $ Business Entiry

Fair MarketValue of Donatior

$0.00Street Addrcss City )talc

CT1-rp Uode Aggregatc value for this cvcnt

$0'00Dcscnptlon ol donation Datc Received Event #

Name of Donor Donation fi Individualgiven by: G Business Entity Fair MarketValue of Donatior

$0.00)rrcer Aocrcss L rfy Statc

CTLtp Code ASgrcgate value for this evcnt

$0.00Dcscriplion of donation ijale Kecetved Event #

Name of Donor Donation l- lndividualgiven by: C: Business Entity Fair MarketValue of Donation$0.005trel

Addrcss Ciry StatcCT

7.ip Code Aggrcgate valuc for this evcnts0 00

Dcscription of donation IJate Rcceived [vcnt #

SUBTOTAL Sectlon L.rThls Page $0.00TOTAL of *dditional Section L,t Pages $0.00

TOTAL OF ALL IN.KTND Df}NATIONS NOT CONSIDERf,D CONTRIBUTIONS (En\er lotal on LIne 21 of Summarv Page) $0.00


11/24

III. NONMONETARY RECEIPTS Page ll oflTAMF, OF COMMtT"fFF FILING DUE DATE

OXFORD TOGETHER 201 1 10t1a2afM. tn-Kind ContritrutionsJAMES HARD Tlpe of Contributor:S Individual$ Comrnittee* Other (sppticable only lo Reterendum Committes)

Fair MarketValue of thisContribution

$250.21

336 OXFORD RD I CityOXFORD StatcCT ip Code06478contributor a lobbyist, spouse, fr Yeschikl ofa lobbyist? t*; No If conritulion is in excess of $400 to a candidate committee for a chief executive oflcer of amunicipality does contributor or business he/she is associated with have a contract rvith saidmunicinalitv valued at more than $5,000? fi Yes fr No

atc Receivcd0812412011

ls this contribution associated wrth aftrndraising event listed in Section Ll?Ifyes,list llvent # _erl' YesNo Dcscription of ln-Krnd Contribution \ggregalc contrloullons$250.21

Type of Contributr:r:ft tndividuali] Cornnrittee'fi Other (Appliceble only to Referendum Commitlees)l.air MarketValue of thisConlribution

$0.00

treet Ad(lrcss tY )l atcCT Ztp Codecontributor a lobbyist, spouse,dependeni child ofa lobbyist? u YesNo ff..rnttiUuiiun is in excess of$400 to a candidate committee for a chiefexecutive ofllcer ofamunicipality does contributor or business he/she is associated with have a contract with saidmunicipality valued at more than $5,000? fi Yes (r No

atc Rcccivcd ls this contribution associated with afundraising event listed in Section L I ?fyes. list Event # .-{j YesNo_] Dcscrrption of In-Kind Contribution

Aggregate conlfl Dullons

s0.00anre Type ofContributor:

C) tndividual!. ; Lommrtteefi Other (.4pplicable only to Relercndum Committees)['air MarketValue of thisContribution

$0.00

itrcct Address ,lty 5tateCT 1io Codes contributor a lobbyist, spouse, D Yeschild ofa lobbyist? {i, t'to If*"triUution is in excess of$400 to a candidate committee for a chiefexecutive olficer ofarnunicipality, does contributor or business he/she is associated with have a contnct with saidrnunicibality valued at more than $5,000? C Yes C No

lsrhiscontriLrutionassociatedwitha ftr Yesfundraising event listed In Section L I ? ft NoIfyes,list Evenr # _Dcscription of In-Kind Contribution {ggrcgate contnbullons

$o.ooNane Type olContributor:fi Individualfi Committee$ Other (Applicrble only to Relererulum Commiltees)

Fair MarketValue of thisContribution)IAICCT lrD Codels contributor a lobbyist, spouse, $ Yesordepenclentchildofalobbyist? G No if mniribution is in excess of $400 to a candidate committee for a chief executive officer of amunicipality does contributor or business he/she is associated with have a contract with saidmunicipality valuecl at more than $5,000? C Yes f No

ls this contribution associated with a !, Yesfundraising event listed in Section Ll? ltf Nof ;'es, list Event # _Dcscription of [n-Kind Contribution Aggregate conmDunons

$0.00Name Type ofContributor:{-,; Individual! , Lommlttee{] Other (lpplicable only ttt Relerendum Committees)

Fair NlarketValue of thisiircct Addrcss -rW rtateCT ZID LOdC

$0.00

Is contributor a lobbyist, spouse,or dependent child of a lobbyist? C YesNo lfcontribution is in excess of$400 to a candidate

committee for a chiefexecutive officer ofamunicipaliry does contributor or business heishe is associated with have a contrac! with saidmunicipality valued at rnore than $5,000? C Yes O No

ate Rcccivcd Is this contribution associated with alundnising event listed in Section L l '?fyes, list Event # _f] YesCj lvo Dcscription of hr-Kind Contribution

\ggrcgarc$0.00

SUBTOTAL Sectlon M-This Page $250.21TOTAL of additional Section M Pager $0.00

TOTAL OF ALL IN-KIND CONTRIBUTIONS (Enter total on Line 22 of Sammary PqCe) $250.21Refundable Deposit to Telephone Company 7N67'f; fhis section refers only to advances of deposits by indhtiduals frompersoncl funds to befqllt the "ennittee, ndt.-&st Namc of ln{llvldual First l'' Datc Dcposit Made Amount ofDeposit

$0.00

Rcsl.lcntlxl Strccl Aildrcss ,!DCTUrtyNamc of tclcphonc conrpulystrat .r[1iiis City SlateCT

Zip Codc

Total Sectlon N ($nt"r totql ", Lin, 2 $0.00


12/24

III. NONMONETARY RECEIPTS Page l2 of l7VAME OT COMMITTEE- " . TILING DUE DATEOXFORD TOGETHER 201 1 1AnAzU1O. Non-Monetary Receipts of Organization ExpenditureiMadeByLegislative Leadership. Legislative Caucus. and Partv CommitteeNare of Commitle e (Legislative l.eadersnip, teghloAr" CuM, orrd ?utrf Crwi Name ol I reasureritreet Addtcss Date Noticc Received Fair l.arket Valueof Donation

$0.00

lity StateCT Zip Code

Aggrelate Donations$o'oo

LJcscnplion of Donution lurpose of Expcndrtute (see inslractions)|iaGBCcl]'Dt-i'EName ofCommittee (Legislative Leadership, Legislative Caucas, und Par1t Committees On-LY) ,Jame ofTrcasurcr

Strect Addrcss Date Noticc Rcceivcd Fsir Market Valueof Donation

$0.00

:ityCT Zip Code \ggregate Donalions$0.00

Description of Donation Purpose of Expenditure (set irctructions)|1l *s fic Sn f'rName of Committce (Legisktive Leailership, Legislutive Caacus, und Pug Comminees ONLYI Name ofTreasurcritrcet Address Date Notice Rcccivcd Fair Ntarket Valueof Donation

$0.00

)ity State CT Zip Code {ggregate Donationg$0.00)cscription of Drrnation Prrpose of Expcnditure (see instuctiorc)faCB{ic{1of":eName of Committee (Legislative Lcalership, Legislative Caucus, and Party Commioees ONLy) Name of Treasureritreet Addrcss uate Noflce Kecelveo Fair Market Valueof Donation

$0.00

)ityCT Zip Code Aggrcgate Donations$0.00lescription of Donation Purpose of Expenditure (see instructions)

r,A r'B r c {.rD ( ENamc of Committee (Legislative Leadership, Legislative Caucus, and Parg Comminees ONLY) Name of Trcasureritrcct Address Llate Noticc Received Fair Market Valueof Donation

$0.00

lity StateCT Zip Code Aggrcgste Donations$0.00

Jcscnption ol Donation Purposc of Expcnditurc (see instructiont)Cl tlrB f] c f D {:EName of Comminec (Legislative Leudership, Legislative Cuucus, und Psfit Commiftees ONLY) Name of Treasurcrtrcct Addrcss Datc Noticc Receivcd Fair Nlarket Valueof Donation

$0.00

i iry Statc cr Z.ip Code Aggrcgstc Donations$0.00uescnplon or mnalon Purpose of E.rpmdibsre (see instructions)i5 I .fig {:c CrD nEN{mc ol Llommittce (Leg*lstiv Lesdrship, Legislative (.auus, und Partt Committees Oa"LY) :\ame ot I rcasutct;trcct Address [)ate Noticc Rcccivcd Fair $larket Valuof Donation

$0.00

)ity StateCT Zip Codr Aggregate Donations$0.00

)cscrlptl0r ol l)onahon !urposc of Ixpcndi&!tc (ve inttuttions)r. ,\ (. B (.,c i D !'ETotal Section O (Enter total on Line 24 of Sammam PaBe) s0.00


13/24

IV. EXPENDITURES Page 13 of l7AMEOF COMMITTEE ]II INT"} NITIi NATF

Oxford Together 2011 1At1A2ArP. Expenses Paid bv Committee

of Pavee' Arrow Printers )a!c of Psyrent9t15t2011

fvlethod ofPaymentGCheck# '10061007fl; oebit card

Amount

s 1 ,414.70

tleei AddreSS11 main st ansonia CTarp uooe

06401ot bxpcodrturecodc) a-Sign signs and door hangers Evcnt,of Expenditure 1( qplicabte):| , Coordinated with reimbursement soughtC: Coordinated without reinrbursement soughtf. ln,lepenrJentl-. Organization (see InstruLtions){. a CB ec CD CE

Cudidate(s) Nane(ifapplicable) Office Soughl fl SupportedEI opposed

OI l'a!('e- Postmaster Derby9t15t2011

Method ot I'aynrentie Check *. 1009fr Debit card

Amount

s 722.Q7

Aooressstr Cityderby r6IeCT4rp Uode06418ol Expcndlurccode) a-dm Jescnpllon post card mailing Evcnt #

of Erpendiru re (f appliL.ablel:{ . Coordinated rvith rcimburserucnt soughtC Coordinated without reimbursement soughtC lndependent{ Organization (see Itrsrructions).f.:a q; s ljc Cn fir

Candidatc(s) Name(il applicable) Office Sought LJ SunnortedLl opposed

of Pavcc' Valley Publishing )ate of Paymenl Method of Paymentfilchect* 1010G oebit cardAmount

$ 1,003,82

r\ooressfrancis st Cityderby \tateCT Zip Code06418oI Lxpendfure a-dm printing 500 copies of direct mail BYcnt #ype of Expenditu rc (if applicqb le) :C Coordrnated with reinrbursement soughti Coordinated without reimbursement ;ughtft lndeoen,l.nte Organization (see Instructions)C,a {i: n {]:c {lo On

Candidatc{s) Name(ifapplicable) Office Sought n Supportedfl opposed

ol ravcc' Village of oxford greens Jat ot Payment9t14t2011Method ot Payment

lChect* 10116 Debit CardAmount

65.00

AddrgSSgreens CityOxford Statecr Zrp Code05478r,\pcnolrwccodc) a-news Jcscnptlon newspaper ad Event #

of Expendiilre (if applicuble):Coorclinated with reimbursement soughtCoordinated rvithout reimbursement soughtIndependentOrganization (s ee I ns tu ctions)r.A r.B r.c !'D r:E

Candidate(s) Name(tf applicable) Office Sought E SupportedE Opposed

of Pavce' Schreibers )atc ofPaymcnt9127t2A11

Mcthod of Paymentl;i Check # 1 01 3l:. Debit Card

Amount

s 300.00

quaker farms rd ciryoxford tateCTalP Loog06478

codc) FNDR Pig and roasting 2of Expenditure (dqplicfile):

Coordinater1 with rcimbursement soughtCoordtnated without reimbursenrent soughtlndependentC, ,r ftn f:C CD CE

CandidatEs) Nane(if applicable) Office Sought ! SupportedDopposed

SUBTOTAL Sectlon P-Thls Page $3,505.59TOTAL of addltional Seetlon P Pase* eF5;es

TOTAL OF ALL EXPENSES PAID BY COMMITTAE (Enter total on Line 19 of Summary Page) wffi;


14/24

IV. EXPENDTTURES Page l4 of l7{AME OF COMMITTEE FII,ING DUE DATE

Oxford Togethet 2011 10113t201O. Campaiqn Expenses Paid by Candidate

Name of Payee (Nume of Vendorwho csndi.latepaid ditu"ru W^l^^r1 Date of Paymcnt10t04t2411

Is Reirnbursement Claimed?G Y"sONo

Amount

$127.23itreet Address - rryderbyllareCT arp Looe0641 8

rurposc oI txPenu!ae(by codc) OVHD Dcscnption prepaid phones for campaign calling lvcnt #Name of Payee (Name of Vendor who candidate paid dir""rtl W ^l*^r1

l)ate of Psyment0912412011

Is Reimbursement Claimed?{t: Y.,fNo

Amount

$122.54Strcet Adalress rryderbytate

CT1rp Uode

0641 8rurPose ol bxpenoltufe(by code) OVHD Dcscription office supplies Evcnt #Name of Payce (Name of l/endor who cundilate pail dir"t,rt) big y Date ot l'ayment

09t2612011Is Reimbursenrent Claimed?

6-, Yesif l.loAmount

$94.28)treet AoqresS403 main street -rtyansonia Statc CT zrp L.oo06401rurpose oI b,xpen6rrufe(by code) FNDR Dcscription paper supplies, deli, for fundraiser Event # 2Name ot Payee (Nsme trJ yen.lor ||ho cqndidate pttd .lt ", tY OXfOfd liqUOf oI raymclrr

0912412011Is Reimbursement Claimed?

G Yes'O NoAmount

$57,37Sireet Acoress19 oxford rd - rtyoxford CT ZipCode

06478Furpose or bxpcnolrure(by coclc) FNDR Description liquor for fundraiser 2

Dete of Paymcnt ls Reimbursement Claimed?C Yes('No

Amount

$0.00Strcet Address , try CTZrp Code

rurpose ol bxpenolture(by code) DescriptionEvcnt #

Name of Payce (Name of Vendor who candidate paid direclly) Date of Payment Is Reimbursement Clairned?ll:. Yes(l: No

Amount

$0.00Street Addrcss :ity )BIgCT Zry Coderurpose or bxpensrrure(by codc) Dcscription Evcnt #

Namc of Payee (Name of Yendot |9ho cantlidate pqid .lireclly) Datc of Paymcnl ls Reinrbursement Claimed?(--a yesCNo

Amount

$o.ooStrect Addrcss Urty CT Zip Coderurpose ol Dxperulruu(by code) Desfiiption

gvcnt #

Name of Payec (Nane oJ l/end* who candidqle psitl dircclly) Date of Payment Is Reimbursement Claimed?C YesfNo

Amount

$0.00s'tlcet rlddrcsS Crly CTZip Code

rurPose 0i cxPctrsIurE(by codel DescriptionHvcnt t

Namc of Payec (Name of Vendor who candidute poid ttirectly) [-)ate of Paymcnt Is Reimbursement Claimed?(_' Y es(.i No

Amount$0.005trcct Address L'rty )IaicCT Zip Code

I'Urpose ol rxpenorrurc(by code) Dcscriptionhvent tl

SUBTOTAL Section Q-This Page $401.42TOTAL of additlonal Section Q Pages $0.00

TOTAL OF ALL EXPENSES PAID BY CANDTDATE (Enter total an Line 26 olS!41nt!!l!!89 $401.42


15/24

IV. EXPENDITURES Page t5 of 17OF COMMI-I"TFF ;N ING T'IlE DATE

xford Togethet 2011 10t13t2011R. Exnenses Incurred on Committee Credit Card

of Issuing Institution Type of Credit Card:Q visa f, Master Card C Discover l] American Express{l other

of Vendor Dale of Trmsaction ilmount

$0.00Address City StateCT

Zip Code

of Expcndilurecodc))escription Evcnt #

of Vendor Date of Trmsaction Amount

$0.00Crty itatCT

lip Codc

of Expcnditurecodc)Description Event #

Vcnilor Date ofTransaction Amount

$0.00A.ldress City State

CT1ip Code

of Expenditurecode)

)cscription Event #

of Vcndor Datc of Trmsaction Amount

$0.00Addrcss City StateCT

lip Code

of Expenditurccode)

)cscriplion Evcnt #

of Vendor Date ofTransaction Amount

$0.00Addrcss City StateCT

Zip Code

of Expcnditurecode)

)escription Evcnt #

of Vcndor Date of Trmsaction Amount

$0.00Ad{lress City State

CTZip Code

of Expcnditurccodc))escription [vcnt #

of Vcndor Datc of Trmsaction Amount

$o.ooCity )taae

CTlip Code

of Expcnditurccodc))cscription Event #

of Vcndor Date ofTransaction '\mount

s0.00City Jtatc

CT4ip Code

oi Expcncliturccodc))cscription Event #

SUBTOTAL Sectlon R-Thlr Page $o.ooTOTAL of additlonal Sectlon R Pages $0.00

TnTAI, of,. AI,I, F.,XPRNSES INCURRED ON COMMTTTEE CREDIT CAHD (EnteTtoJ*I ON LiNE 27 Of SUMMqTV PASCI $0.00


16/24

IV. EXPENDITURES Page l6 of l?NAME OF COMMTITEE :ILING DUE DATE

Oxford Together 2011 10t13t2C 11S. Expenses Incurred by Committee but Not Paid Durins this Period

Nsme of Crcditor Datc lncuned Amount Incurred(Estimdte or Acruql)

$0.00

Street Addrcss Event #

City StateCT

,lt Uode ,'andidate(s) Name (ifupplicable) Ullice Sought

.(}supponcdl]cpposed

aurposc ot tlxpcndtturelby codc) Type of Expendir.irc ifqpplicabte):( ' Coordinateri with reimbursement soughtC Coordrnated without reimbursement soughtlescnption G tndependentC Oreanization kee Instructions)-G;rfinfCf,nl'.nName of Creditor l)ate lncuned Amount Incurrec(Estimate or..1lrul)

$0.00

Strcet Address Evetrt #

City StateCT

1ip Code Cmdidatc(s) Name (if applictble) Office Sought

'lSsupportedi!!)pposed

rurPose or tsxpcnolrurelby code) Type of Expendif'tre (i! spplicsble)iC Coordinated with reimbursement sought

C Coordinated without reimbursement sousht)cscription l-. In,lependentf Orsanization kee Instructions)( Al.Bl:cr Dr.:EName of Creditor Date Incuncd Amount Incurrer(Estimate ot Aclual)

$0.00

Strcet Address Event #

City StateCT

Zip Code andidate(s) Name (y' applicable) Officc Sought

$supportedfi.Cpposed

Purpos of Expcnditure(by code) Type of Expendit$e (if applica b!e) :C Coordinated with reimbursement soughtC Coordinated witbout reimbursement sousht)escription cf, IndependentOrsanization kee I nslructions)"l'la f.B 1]c Cuf;rName of Crcditor Date Incuned Amount Incurret(Estimate ot.4ctusl)

$0.00

Strect Address Evcnt #

City StateCT

Zip Code Candidatc(s) Name (ifapplicable) Officc Sought

C. supported(l'cpposed

'urpose of Expcnditurcby code) 'ype of Expenditure (if app licab te) :C Coordinated with reimburserrent soughtf. Coordinated without reimbursement sousht)cscri ption Ct Intlenendentf. Oreanizction kee Instactions)"t. n f B Cc {:D'CESUBTOTAL Sectlon S-Thls Pase $0.00

TOTAL of addltional Section S Pnses s0.00TOTAL OF ALL trXPNNSES INCURRED BY COMMITTEE DUNING TIIIS PERIOD BUT NOT PAID(Enter total on Line 28 of Sammary Page) $0.00

Prevlourly reported Expenseg Unpaid snd still Outstandlne $0.00TOTAL OF ALL EXPENSES INCURRED BV COMMITTEE BUT NOT PAID (Enter ronl on Line 28a of Sunmarv Pose) $0.00


17/24

IV. EXPENDITURES Prge 17 of l7OF COMMITTEE FN,INC DIIE DATE

Oxford Togethet 2011 10t13t2011T. Itemization of Reimbursements to Commlttee Workrs and Consultants

Name of WorkerlConsultmt Fint MI Date of Payrent Method of PaymentC Check #-_-__--_-C Debir Card

Amount

s $0.00

Payce )urpose of Expenditureby codc)Address Cily

CTZip Code

of Expendiftre (if applicable):Coordinated with reimbursement soughtCoordinatecl rvithout reimbursement soughttndcpentlentOrganrzation (see Inslruclions)a-) .t i) n flc .ln'.t11n

Candidarc(s) Name(ifapnlicable) Office Sought l,Supported{l Opposed

of Worker/Cotrsultant First MI Date ofPaymenl Method of Payment

C Check #_G Debit cardAmount

s $0.00

t'a),ee Purpose of Expcndirure(by code)Address City CT Zip Codc

of Expenditure (if opplirub!e):Coordinated with reimbursement soughtCoordinated without reimbursement JoughtIndepentientOrganization (see Instr uctions)- r:.A !-_B Cc Co {..e

Candldate(s) Nmc(dapplicable) Officc Sought C, SupportedC. opposed

First MI Date of Payment Method of Payment:{l check #.f! Debir Card

Amount

s $0'00

Pai.i )urpose of Expcnditureby code)Addrcss Crty CT Zip Code

of Expendiru re (if upplicable):-l Coordinared with reimbursement soughtCoordinated without reimbursement soughtlndenendentOrganization (see l,nstruclions)- C.^ f_B.nc f nf r

Candidate(s) Name(dtpplicablel Officc Sought f-'; SupportedC Opposed

First MI Date ofPavmcnl Method of Payment(.Lheck4C Debit cura

Amount

s $0.00

Pa;,r: Purpose of Expcnditure(by codc),^ ciry State Ztp Codept ion

of Expenditvre (if tpplicuble):Coordinated with reimbursernent soughtCoordinated without reinrbursement soughtlnrlependentC)rganization (see Instructiotts)C.r .CB !'ic CD.c,Fl

Candrdate(s) Nam(if applicable) Of{icc Sought ll) Suppo*edli; Opposed

SUBTOTAL Sectlon T-Thlr Page $0.00TOTAL of additlonal Section T Pages $0.00

TOTAL OF ALL REItrIBURSf,MENTS TO COMMITTEE WORKERS AND CONSULTANTS $0.00


18/24

Oxford Together 2011

I. MONETARY RECEIPTSSection B. Additional p8,. Itemized Contributions frory fnAiviAnafs

,tmount ofContribution

$100.00

4 Nancy Lynn LaneIs contriburor a toUfy*tlpiillor dependent child oia totrOyisti r, No If contrrbution't,n .'..;municipality does conrriburor o, b.-ul,l9rr rr.lrrr.-i., *-"."i.iivith have a contracr with saiclunicipality valued at more than $5.000? - l-i*''" fl N"J urrs rurirnDunon assocrated with a f, yesfundraisingevent Iisted in Secrion Ll? f, N"fyes, list tlvent #Is this contribution associated with a ls contributor a principal of a state eor)tracror or prorp".r,u".,ofililil--filIfyes,indtcate which branch or branchcs r. r,r L,l4irgltgs a- rrolgovemmentthecontrectiswith. f. Executive (- l_egrsiatrve I NoMethod ofcontribut on.J-.,Cash {i. I'ersonal Check f . C-redir/Debir Clard L payroll Detiuction .f: Money Order

.\mount ofConlritrution

$500.00

Is contributor a toUty*-t,$6Gor dependent ehild oia lobhyist? ,n No ll'ann,.'but',,nmunicipality does contributor or busi".* 'r.irn"-i, *1"".ui.i *,,r,., have a contra* with saidunicrpalrty ralued ar more than g5,000? .tr?".'"":C ru"s this conlilbulron Jss(rclatcd \vlth a /. y;rundral\rng crent listcd rn Secrron L L) ;t liofyes, list Event # Is contributor a principal of a state conrractor or prospective ,,uilu**i-?llIfles,indicate rvhich branch orbranches .{ .,ofgovernment the contract is with fl Executive fi Legisrative llt NnMethod oicontrrhrt,u,,F 'w"nn o"L,,t card fr Payroll Deduction ,.fi Money order

Amount ofContribution

$100.00

dependent child oia iobbyisti l;j N;contriburor a tuUUyGq$IQ , ,'.on,rrOr,romuniciparitv does conrributor o'b^u-rirg* h;r;r; r.;;;;;;iivith have a contract with saidunicipality valued at more than $5,000? - l-v"r-'-?; rv.s this contr"ibution associated with a lij Gfundraising event listed in Section L l? C fV"Ifyes,list Event # 3 Is contriburor a princrpal old state contractor or prorp".riu. ,*il_.,-IIi-EGfyes, rndrcate whrch branch or branchesnf gou.rnm"nt ttt".ontiu"il, *iti,""-'- r*, Executive l. Legislative t Noethod of contnbutionl.Cash t.p,'."^.", Personal Check f. Credit/Debit Card l, payroll Deduction rl Money Order 10t07t2a11P.incipal OmuoatG' ,Lmount ofContribution

$100.00

1 old Moosehill rd ott' -lstat"crconlnbrrtor d I,'btryist-ffi.dependent child of a Iobbyistr r!.1 wo l f conrrr bul ronmunicipality does contributor or h^usiness rr"^rr" ir .tr".ii.ilvith have a contract wirh saidunicipalrty valued at rnore rhan $5,000? - C;'V*'""i-: *"thrs contributtorr assocrated rvilh a ,t"l y;event listed in Sectron l_ I ? {*. No3 ls contriburora principal of a state conrraclor or prospecrive roilililiJ-T,' ilfyes, indicate which brancn or branchesofgovcrnment the contract is wifh: fl Executive fi l-egislative fl xoof contribution'il personar check fr credit/Debitcard rr payrot Detiuction ir Money order 1At07t2a1

child ola lotrbyisr? :lf, Noa tot [G, Jffi ll'contrjhutiontt,n "unicipality does contributor or bu,siness r,"/rn. ,r "rr*"i..t ivrth hare a contract rvith saidunicrpalrrv valued .rr more than gj,000? - -,* 'V*"'']"f, n"contributlon assocratctl with a f yesevenr listed in Section LI.l lr.l NoIist Er.ent # 3 ls coninbutor a prineipai of a state eonlracror or prospectrve .,"iliilor--fGf1es. rnrlrcate * hrch branch or hrane he s . .- r !orgovernment the cclnrract is $ith: fi Erecutive .ii t.cgisiatrve - !r Noof conlrrhulroncash li persrnal chcck '' crcdrtrDebit card rf' pavrot De,r.retion F, r\{oney 'rder tua7p011



19/24

I. MONETARY RECEIPTSSection B. AdditionatB- Itemiied Contributions. from In

aiir:ji::.:;'.::.|!-ll:,Oxford Together 2011


$50.00

Is contributor a Iobbyist, spouse.or dependent child of a iohby-ist? tr; lio

ilcor.rtribution is in excess of $400 to a carrdidate committie for a ct ief srecuttt;mmunlcipality does contributor or business he/she is associated with have a contract with saidmunicrpality valued at more than $5.000? f yes 61 No

ls this contrrbution associated rvith a ri; yesfundraising event listed in Sectron L l'l l*: Nofyes, irst tivent # 3ls contributor a principal ofa state contractor or prospective slate contractor? f. y.syl'e.c, rndicate which branch or branches f Noofgovernment the contract is with: C Executive {- LegrslativeMethod olcontribution:|, castr 6. Personal check f CredrvDebit card f. payroll Deduction ?l Money order

Amount ofClontribution

$100.00

condon and Savitt PCcontributor a lobbyist, spouse,child ola lobbyist? .6, No lfcontribution is in excess of$400 to a candidate committee for a chiet'i*ecutiue t trceioGmunicipality does contributor or business he/she is associated with have a contract with saidmunrcipality valued at more than $5.000? lfi Yes G woIs this contribution associated wrth a f, yesfundraising event listed in Section L I 'J lft NoIf.yes,list Event # 3

Is contnbutor a principal ofa state contractor or prospctive state contractor? fi yesfyes, indicate which branch or branches .lir Noof govemment the contract is rvirh: .f;i: Executive ifl Leeislativeln castr ii Personal check lf' credit/Debit card C payroll Deductron C. Money order 10t07t2011


$50.00

conlr:butor a lobby ist. spouse. f'l ye,child of a lobbyist'/ 6. No llcontribution is in excess oi$400 to a candidate commrttee to, a cnieiexe"ut,uetfrc.r.iumunicipality does contributor or business he/she is associated with have a contract with sardmunrotpality valued at more than $5,000? C, Ycs I' NoIs this contribution associated with a li.] yesfundraising event Iisted rn Section L l? f. NoIfyes,list Hvent # 3

Iscontributoraprincipal ofastatecontractororprospectivestjatecontractor'? fi ye,Ifyes, indicate which branch or branches f-. Noof govemment the contract is with: C Executive f. LegislativeMethod of contributron:i. cash 1:, Personal check f. credit/Debit card f, payroil Deduction {.-. Monev order Received10t07t2a11Amount ofContribution

$150.00

639 Quassapaug Rd Watertowncontributor a lobbyist, spouse, {ll yeschrld of a lobbyistlT fl No Ifcontribution is in excess oi$400 to a can


20/24

MONETARY RECEIPTSSection B. Additional paseI.Oxford Together 2011 30 days following primaryB. Itemized fnitrihr.t;^ns frnn 1-n:i;::rLast Nme

Macchio FirstMichael1rp t.ode06478

t,nnclpal OccupationNme of Emplol e r

,lmount ofC0otribution

$50.00

Kosrdfltral Sreet Address25 Silano Drive .-irr -lS-urcxford lCrrt;

Is cunrrrburor o tot Uj;l ,ffi,or depentJent eh r ld ot'a l obhi r st .,

YesNo

llcontr:bution is in excess rfmunicipality d(xs contributor or business he/she is rssociated with have a contract wrth saidmunicipaliry'valued at more thiin $5,000? f, yes fi No

fundraising event listed in Section L I ?fyes, lrst Event # 3 t-eso Is contributor a principal ofa state contractor or prospcctive state contractor? f. y..,fyas, indicate rvhrch branch or branches {-, ^-ofgovernment the contract is with: {=; Executrve f Legislative

3.1 G;'"il;;;r*ri Check c credivDebitcarrJ f, pavrolr Deduction .i rVroney order | { ggregate contnbutiJii-1oto7t2o11 I $s0.00Cayer Bernard

I rrst \.{tM Principal OccupationDrywall Amount ofContribution

$100.00

ictroenual jtreet .A.ddress61 Greenbriar Road , rtyoxford CTrlate ip(lode

46478 NAme ot bmployerSelfls contriburor a lobbyist. spoLrse, i--TEor dependenr child of a lobbyist? 16 No Ifcontribution is in excess of'municipality does contrrbutor ot business he/she is associated lvith have a contract with saidmunicipality valued at more rhan 95,000? lC yes .6 Not'undraising event Iisted rn Section l_ I ?Ilyes,list Event # J lff N,

ls contributor a principar ofa state contractor or prospective state contractor'/ {*, yesIfyes, indicate rvhich branch or branches .+ Noof govemment the contract is with: i Executive .fi LegislatrveMethod of contribution:ld', Cash f Personal Check ii, Credit/Debit ard C ayroll Deduction C; Money Order Date Rcceived TQres.rc;mE"il;^10t07t2011 | $100.00ast Nene Persson Glenlrsl lv{ I Principal OccupationPaying Amount ofContribution

$100.00

124 Hawley Road , ltyOxford CTJtate arP Loqe06478 Name ot tmployerSelfs contributor a lobbyrsr. ,poL,se, --Tfl[r dependenr chrld ot a lobbl rst? 6. No lfcontribution 'r ,n.*..* olmunicipaiity does contributor or business he/she is associated with have a contract with saidmunicrpaliw valued at more than $5 000? {*.: v^" r"tr xr^Is thrs contribution associated with a ill yesfundraising event listecl in Section L I ? C NoIfyes,list Event # 3ls contributor a principal ola state contractor or prospective state contractor?Ifyes, indicate rvhich br:rnch or branchesofgovemmentlhecontractiswith: f; Executive f.Legislative

l, Yesf''. NoMethod oicontnbution:i Cash il Personal Check f; Credit/Debir Card f; Payroll Deduction Cl Money Order Date Received1UA7t2011 Aggregare conmDutlons$100.00Nmo Griffin trastBilt MI Principal OccupationConstruction Amount of(lontrihufinnsroennat Jtreet,Address ' .--F;,y-3 Tetlak Lane Oxford lS*"rcT 4rp Lode06478 \me ol bmployerSelfcontributor a lobbyist, rpour., --ET-Gchrld ofa lobbyisr? fl No Ifcontributron is in excess ofmunicipality dos contributor or business he/she is zssociated with have a contract with saidmunicipality valued at more than $5,000? C yes fl tiothis contrrbution assocrated with aevent listed in Section L I l)fyes, list Event # 3 iil Yesi-. No ls contributor a principal ofa state contractor or prospective state contractor? Cl yesIfyes,indicate which branch or branches Cl fVoofgovemment the contract is rvith: {j Erecutive Ci Legislativeof contribution:f . Cash 6'l Personal Check fl Credit/Debit $100.00ard {'l 'ayrerll Dcduction il Money Or


21/24

AMF OF C{}MMIT"|FFOxford Together2All

B.

I. MONETARY RECEIPTSSection B. Additionsl Pn


22/24

MONETARY RECEIPTSSection B. Additional PaseL OFREPORA 1:- -oxford Together 2011 : :' ir: -';;;;l=;' ' 30 days foilowing primaryB. Itemized Contrihufinnc frnm fndivirt*oto"j

Last liameOlson FirstG Jeffrey lll I t'rircipal OccupatiuI Entertainer Amount ofContribution

$250.00

Kesldflttal Slreet Address336 Oxford Road rtvOxford itateCT r rP L ode I Name ot F rnpl(,\ er06478 lSelf-SixovusIs contrrbutor a lobbvrst. spuuse,or depcnrlenr chrld ofa Iobhyrst'l

r YesNo

If cont'burion rs in ercess of s40o to u canffiiffiE, u.[Gil*..rt.. oEilEmunicipality does conrributor or business he/she is associated rvith have a contract with saidmunicipality valued at more rhan $5,000? I, yes {ij NoIs this contribution associated \,vith a i.t yesf'undrarsing event listed in Section L I ? i-' Nof;,es, list Event # 3 contractor?LegtslattveIs contributor a principal ofa state contractor or prospeclive/1'es, indicate rvhrch branch or branchesofgovernment the contract rs with: t Executive

slate {i YesNofvlethod of contributron.tl. C*h 6. Personal Check fl CreditiDebit Card f. payroll De


23/24

L MONETARY RECEIPTSSection B. AdditionalOxford Together 2011

B, Item,\mount ofContribution

Is contributor a lobbyist, rpouse, ---F-l[or deprndent child ofa lobbyisr? f. No If contribution tr'o.*..* ot'rnunicipality does contributor or business heishe is associated with have a conlract with saidmunicipalrty valued at more than $5.000? ft yes fi No

fye,r. list Event # 3Is this contributron associated with a #: yeslundraising evenr I rsted rn Section L I ? l-: No ls conlributor a principal ola state contractor or prospective state contractor? f. y.,f1,es, indicate which branch or branches ,*, ltoofgovernment the contract is with: f, Executive f L.egislativeMethod of contriburion:5^. cash f,, Personar check f creditrDebit Card l. payroil Deductron 1r Money order 14107t2011

Amount ofContrihution

$'100.00

47 Thomson roadIs conlnbutor a lolrb1rst. spo*q----F-TEor dependent child ofa lobbyist? .6. No municipality valued at more than $5,000? lfl yes .G t Jo

llcontnbution rs in excess oi'Jmunicipality does contributor or business he/she is associated rvith have a contract with saidIs this contribution associated rvrth a f yeslundraisrng cvcnt listed in Section I I l ,f., ruoIfyes,list Event # 3 Is contributor a princrpal ola state contractor or prospectlve state contractor? fr yesIJyes"indicate rvhrch branch or branches $ f.foolgovemment the contract is with: iJ Executive lfi LegislativeMethod of contribution:.ftCash f Personal Check i6 Credit/Debit Card Cr payroll Deduction lfr Money Order


$100.00

12 Jensen Farm Rd B and B transportationcontributor a lobbyrsr. spousc,,s contflbutor a lobbyist, spouse, fl yesdependent child of a lobbyist'1 {i, t,to If contrrb'tion is in excess of $400 to a candidateiom.liiF6, u.i,iiii*.*u* omGffimunicipality does contnbutor or business he/she is associated with have a contract with sardmunicipality valued at more than $5.000? f. yes fi Nols this contribution associated with a {i; yesfundraisingeventlistedinSectionLl'l f, NoIfyes,list Evenr # 3 Is contributor a principal ofa state contractor or prospective stat contractor? {^, ya,Ifyes, indicale which branch nr branches f, fVoolgovernment the contract is with: f: Executive C LegislativeMethod of contribution:f. Cash il I'ersonal Check f', CrediVDebit Card i payroll Deduction C Monev Order 10107t2011Amount ofContribution

$500.00

496 Town Street E Haddam lCfdependent chiid of a lobbyisr,? fl trlocontrrburor a lohhyrsr. tpo*., ---CT-Vil llcontributron is in excess 'i$400unicipality does contributor or business he/she is msociated with have a contract with saidmunicipalrty valued at rnore than $5,000? C-. yes el woIs this contnbution associated ,,vith a itl yesundraising event listed in Section Ll'l f-' Noff;'es, list Event # 3

Is contributor a principal ofa state contractor or prospective state contractor? cl yesItyes. rndicate which branch or branches t-l Noof govemment the contraet is wrth: {]l Executive Cl t_egrslative0f contribultonl''. Cash f,l I'ersonal Chcck fl CretliyDebit Card i^,. payroll Deductron fl Monev Order

,\mouot ofc0ntribution

$200.00

1 Jensen Farm Rdtjcpcndenr chrld oi a rodHf,ti' ..i, \,rcontilbutor a lubhl rst, ,pouse. 'a y*

municipalily valued at more thar $5,000? '6 yes G NoIl'c.ntribution rs in ercess oi$+00 to i.*municipalrty docs contributor or trusiness hclshe is rusociated rvith have a contract rvith saiii

this conrrihurion associared rvith a ,i yesevent listed in Section l_ I ,l .f, NufJ'es, Iist tivenl # Jfs cont.butor a pr'incipal ofa state contractor or prospective srate contlactor ) i yesfyes, indicate whrch branch or branches t Noof govemment the contract is wrth: I' E.e.ut,ue .fi Legislativeolcontriburionifi Cash ri Personal Check li' Cre{itrDehir Card il payro}l Derjucrron |i l\,t6nev Order 14t47t2011

SUBTOTAL Section B-This


24/24

\iAMEOF COMMITTEEIV. EXPENDITURESSection p. Additional page

v/\r vnu | \Jutr I HtrK zt)11" JOE KEWALIS

10t13t2011

-

ommitteeliate ot Payment

09t27t2011Method of Paymeni6 Cneck * 1014C: Debit Card

Amount

$ 100.00

Sffi Lrlv 1c,",-oxFoRD l"'"bt ,lp Lode06478rtrrposc ol !xpcnditure(by codc) FNDR uescflptlon ICE CREA--....t-..--- M TRUCI Evcnt # 2TYDe of Exnenrlinrro{^. Coorrlinared *i,f.r ,.iriUurr.,,,ent souglL Coordinated without reinrbursement sot Independentf' Organization (see Insltactions)(1 ,f t-.B a.C 11Dtght

C;n

(i! applicnble) ght tr S"pp"n.dD Opposedi\amc or rayeeffi ljatc of Payme nt ^4etnod ot Paymentl:, Check #tl nebit Cara ---

;lmount

$ 0.00

ily Statecr Zip Codeby codc) Description Evcnl #Ipe of HxpenrJiru rc fiJ appticubt\:I Coordinated rvith reirnbursemenr soul(

Coordinared without rcinrbursernent sI ' IndependentC Organization (see Instractions)ll,A 0B Cc lothrlu Eht

E

(ifapplicuble) sought ns"pp"rt",lEopposed

Paycc

Zip CodeDatc of Paymcnt Method of Payment

C, Check #f Debit Cura--- |,\mount

s 0.00

treel Addrcss City 5tateCTor hxnendtitrc

code) uescnplon----r--- Er cnt #of Expendirure (if uppticubte):.( ' Coordinated with rcimbursemcnr sougl( ' Coorditrated without reimbursement so.t t Indenendent,(1 Orgun,zation (see I nstrucrions)r, s l'C t-'D

ug ht

E

(d applicabte) Jought E SupporteaE Opposed

I

raymenl Method of Payment.C Check #{-, Debit Card

Amount

s 0.00

JrateCT

arp Code

re tivent #of Expendit:rrle (if 6ppticahte):

- t Coordinated with rcimbursemcnt sough,Coordinatcd rvithout rcilnburselnent sourlndependentOrganiz:tion (see Instructions)nA fi S t.,C {.:D

(ifapplicable)ght

Cn

Utrrc Sought -Es,,pp"n"dE opposed

ot payce --lri Datc of Paymcnt Method of Payment! : Check #{-'oebit ciro

Anrount

0.00

ltutc llip Codccrlol Expcnditurceodc) JescrrI

bvcnt #ol' E)ipendrrure ( if qplil uhle,l :Crrordinared u ith rcimbursemcnt sought('uordinatcd u.jthout rcimbursentcnt souBlndcpc.ndentOrganrzarion lsee lnsuuctions)C C (-''-, r

(ifupplicabte) Soughl D SupportetlEOppose

George Temple Funds

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