fec received form 3 and disbursements for an authorized...
TRANSCRIPT
r FEC
FORM 3
REPORT OF RECEIPTS AND DISBURSEMENTS
For An Authorized Committee
RECEIVED
AH!0:i46 Office Use Only
^^f-tUMAlLCENTER 12FE4M5
n
1. NAME OF COMMITTEE (In full)
TYPE OR PRINT Example: If typing, type over the lines.
n/liKiKi l^'?|i^l^l^lilVlA|^^l \F\n\N IC.|<?INI/;I^|/:H^.^I i i i i i i i i 1
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
ADDRESS (number and street) iPi/Oi \l\l\3\ 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
ADDRESS (number and street)
i i 1 1 1 1 1 . 1 1 Ill 1 1 1 1 i Ill Check if different than previously reported. (AGO) !Di<?iA/i / iPi/Vi>\iWi 1 1 1 i 1 1 1 1 1 1 IA/,£1
1 i\ 0 3
ii 0
2. FEC IDENTIFICATION NUMBER
c oo S i 10 / i
CITY STATE
3. IS THIS REPORT
yNEW (N) OR
AMENDED (A)
4. TYPE OF REPORT (Choose One)
(a) Quarterly Reports:
April 15 Quarterly Report (Q1)
July 15 Quarterly Report (Q2)
^ October 15 Quarterly Report (Q3)
January 31 Year-End Report (YE)
Termination Report (TER)
(b) 12-Day PRE-Election Report for the:
Primary (12P) General (12G)
Convention (12C) Special (12S)
M M / D D / Y Y Y Y
Election on
(c) 30-Day POST-Election Report for the:
General (3GG) Runoff (30R)
M M/DD/YYYY
Election on
ZIP CODE STATE • DISTRICT
\0i3.
Runoff (12R)
in the State of
Special (30S)
in the State of
M M/DD/YYYY
5. Covering Period 0 1 O I Jl. O I through M U / n, D / Y Y Y Y,
O H 3o A 6 ! H-
I certify that I have exam/ned this Report and to the best of my knowledge and belief it is true, correct and complete.
Type or Print Name of Treasurer P/LLc! E \S 111 V /I ̂
Signature of Treasurer Date yp • > 3 ' J a/"^
NOTE: Submission of false, erroneous, or incomplete information may subject the person signing this Report to the penalties of 2 U.S.C. §437g.
L FE5AN018
Office Use Only
FEC FORM 3 , (Revised 02/2003) j
li
1 5 0
2: 9
r FEC Form 3 (Revised 02/2003)
SUMMARY PAGE of Receipts and Disbursements
n Page 2
Write or Type Committee Name
^hLL/yAM
M
Report Covering the Period: From: ^
1 M/DO/Y YYY MM/DO/XY Y YI
7 OJ To: 3 0 <Xo l -H-
COLUMN A This Period
COLUMN B Election Cycle-to-Date
6. Net Contributions (other than loans)
(a) Total Contributions
(other than loans) (from Line 11(e)).... , 1,E3>S.
(b) Total Contribution Refunds (from Line 20(d))
6 ̂ 0 O/ 5 ' 5 • .
(c) Net Contributions (other than loans) (subtract Line 6(b) from Line 6(a))
7. Net Operating Expenditures
(a) Total Operating Expenditures
(from Line 17) , ;<?,/<?
(b) Total Offsets to Operating
Expenditures (from Line 14) 0 ^
1 J •
o ̂ 3 3 •
(c) Net Operating Expenditures (subtract Line 7(b) from Line 7(a))
8. Cash on Hand at Close of Reporting Period (from Line 27)
9. Debts and Obligations Owed TO
the Committee (Itemize all on
Schedule C and/or Schedule D) , (Day
y "5 » ' •
10. Debts and Obligations Owed BY
the Committee (Itemize all on
Schedule C and/or Schedule D) , / ^,S6
For further information contact:
Federal Election Commission 999 E Street, NW
Washington, DC 20463
Toll Free 800-424-9530 Local 202-694-1100
L FE5AN018
J
r FEC Form 3 (Revised 12/2003)
DETAILED SUMMARY PAGE of Receipts
n Page 3
Write or Type Committee Name
SULLiyAN F/iR naNA/iESS
MM/OO/YYYY
Report Covering the Period: From: O "} O I ^ O I To: M M / D D
0^ So <^0/.^
1 I] Q 5 1 3 G 2 9 2 3
I. RECEIPTS
11. CONTRIBUTIONS (other than loans) FROM:
(a) Individuals/Persons Other Than Political Committees (i) Itemized (use Schedule A)
(ii) Unitemized
(ill) TOTAL of contributions from individuals ^
(b) Political Party Committees
(c) Other Political Committees (such as PACs)
(d) The Candidate (e) TOTAL CONTRIBUTIONS
(other than loans) (add Lines 11(a)(iii). (b), (c), and (d))..
12. TRANSFERS FROM OTHER
AUTHORIZED COMMITTEES
13. LOANS: (a) Made or Guaranteed by the
Candidate
(b) All Other Loans
(c) TOTAL LOANS
(add Lines 13(a) and (b))
14. OFFSETS TO OPERATING
EXPENDITURES (Refunds, Rebates, etc.)
15. OTHER RECEIPTS
(Dividends, Interest, etc.)
16. TOTAL RECEIPTS (add Lines 11(e), 12, 13(c), 14, and 15) ^ (Carry Total to Line 24, page 4)
COLUMN A Total This Period
COLUMN B Election Cycle-to-Date
, ./ ^,^7 S, t 111.^- , . y 5,^' /
, / 7 9.^^
c> ̂ J 5 '
5 ) •
7 7
, 3 3.,\
O 5 5 ' •
- O J ) •
, / 0,0 0 0.''^ ,, . / ^,5-^3
o ̂ J J •
• , ./ 0,0 QO.J^ , 7
O ̂ O ^
' J • ? - J "
o ̂ 5 5 •
o ^ 5 J •
L FE5AN018
J
r FEC Form 3 (Revised 02/2003)
DETAILED SUMMARY PAGE of Disbursements
n Page 4
1 A 0
I 1 2 A
II. DISBURSEMENTS COLUMN A Total This Period
17. OPERATING EXPENDITURES
18. TRANSFERS TO OTHER
AUTHORIZED COMMITTEES
19. LOAN REPAYMENTS:
(a) Of Loans Made or Guaranteed
by the Candidate
(b) Of All Other Loans
(c) TOTAL LOAN REPAYMENTS (add Lines 19(a) and (b))
20. REFUNDS OF CONTRIBUTIONS TO:
(a) Individuals/Persons Other Than Political Committees
(b) Political Party Committees
(c) Other Political Committees (such as PACs)
(d) TOTAL CONTRIBUTION REFUNDS
(add Lines 20(a), (b), and (c))
21. OTHER DISBURSEMENTS
22. TOTAL DISBURSEMENTS (add Lines 17, 18, 19(c), 20(d), and 21) ^
tS',1 SI
I S. I^J
a
0^
o ̂
0 ̂
o ̂
0(^
o o
COLUMN B Election Cycle-to-Date
Si-,D S-
1,0 OO
1,0 0 0
3,e &
o
O
d^
o
o
O
III. CASH SUMMARY
23. CASH ON HAND AT BEGINNING OF REPORTING PERIOD.
24 TOTAL RECEIPTS THIS PERIOD (from Line 16, page 3)
25. SUBTOTAL (add Line 23 and Line 24)
26. TOTAL DISBURSEMENTS THIS PERIOD (from Line 22)
27. CAS^H ON HAND AT CLOSE OF REPORTING PERIOD (subtract Line 26 from Line 25)
I 1,0 sg.
I 1,S3
Ig'.l St.
/ ^,7 / 3. o 9.
L FE5AN018
J
SCHEDULE A (PEG Form 3) ITEMIZED RECEIPTS
Use separate schedule(s) for each category of the Detailed Summary Page
FOR LINE NUMBER; (check only one)
PAGE /
11a lib 11c
12 13a .13b
lid
li- MS Any Information copied from such Reports and Statements may not be sold or used by any person for the purpose of soliciting contributions or for commercial purposes, other than using the name and address of any political committee to solicit contributions from such committee.
NAME OF COMMITTEE (In Full)
hAfi-K ^ULLI\/AN FnH A-aNAkEfi 2.
J 0 ? 1 3 G
2: 9 2 E:
Full Name (Last, FIrsL Middle Initial)
^KKOUJ , Mailing Address '
CH state Zip Code
A/£ FEC ID number of contributing c federal political committee.
Name of Employer Occup^lon
&e.H TiSr nn Receipt For:
Primary V General
Other (specify)
Election Cycle-to-Date
. .<XSo.^
Date of Receipt M M y n D / Y y V V
0 7 / / Xo ! f
Amount of Each Receipt this Period
. : ,XSO.
Full Name (Last, First, Middle Initial)
B. Mailing Address
17a OlC £. J—OaJryj KPJ
Uor) iphan
State . Zl(
NX L 3 Code
Prf-rf ?2-FEC ID number of contributing federal political committee. c Name of Employer
Hati \e^ -SorAy/' rc.
Occupation
fc.oh
Date of Receipt
M M / D D / Y y y Y
o e OQ, xo / f
Amount of Each Receipt this Period
,'ioo.y'
Full Name (Last, First, Middle Initial)
Mailing Address
^ laH- P/z City
Orr\a.h^ state
N£ Zip Code
FEC ID number of contributing federal political committee. c Name of Employer Occupation
/A: (vy
Date of Receipt
M M ! D D i V - Y Y • Y
o I Xo / f
Amount of Each Receipt this Period
, .XSo. oo ̂
Receipt For: Primary
Election Cycle-to-Date General
Other (specify) ^ J 6 O Go
SUBTOTAL of Receipts This Page (optional). o
TOTAL This Period (last page this line number only).
FEC Schedule A (Form 3) (Revised 02/2009)
SCHEDULE A (PEG Form 3) ITEMIZED RECEIPTS
Use separate schedule(s) for each category of the Detailed Summary Page
FOR LINE NUMBER: | PAGE ^ OF (check only one)
11a lib 11c 12 13a 13b
lid
14 n 15 Any information copied from such Reports and Statements may not be sold or used by any person for the purpose of soliciting contributions or for commercial purposes, other than using the name and address of any political committee to solicit contributions from such committee.
NAME OF COMMITTEE (In Full)
hAI^K, Sui^LjyAN
1 A 0
1 3 G
2: 9 2 G
Full Name (Last, First. Middle Initial)
A. 2;ye-rn,., rarJ Maitinn AHHroce ^ Mailing Address '
Po Eo/ City _ ,
Dunn State Zip Code
FEC ID number of contributing federal political committee.
Name of Employer
Receipt For:
Primary Q^eneral Other (specify)
Occupation
1 n Election Cycle-to-Dati
,S8 I • / o
Date of Receipt M ; D 0 / Y V y Y
ol 3 I X6 I i-
Amount of Each Receipt this Period
• , , ."i i-.oS
Full Name (Last, First, Middle Initial)
B. \Nf.ar\i'.ir I nmy Mailing A^ress /
1 f6S \A/ ///ir- n 3-f- A pi 5 0)1 City
pyarir!
' State Zip Code
FEC ID number of contributing federal political committee. c Name of Employer
^-F Occupation
rllre c3r>
Date of Receipt
M M / D O / Y Y Y Y .
7 :^2 3^ I ^
Amount of Each Receipt this Period
s'o.od:
Receipt For: Primary •4
Election Cycle-to-Date General
Other (specify) ,53 f.^ XD Full Name (Last, First, Middle initial)
C. lui / /TO Mailing Address '
/11 XS' ShaJo P)e.r^2 RcJ City 7 state Zip Code
Lfc^JX FEC ID number of contributing federal political committee. c Name of Employer
v./f Occupation
Date of Receipt
M M / o D / • y y y Y
0 <?. 0 5 P-0 / -y-
Amount of Each Receipt this Period
, 3.0 0,
Receipt For:
Primary General Other (specify)
Election Cycle-to-Date
SUBTOTAL of Receipts This Page (optional).
TOTAL This Period (last page this line number only).
FEC Schedule A (Form 3) (Revised 02/2009)
SCHEDULE A (PEG Form 3) ITEMIZED RECEIPTS
Use separate schedule(s) for each category of the Detailed Summary Page
FOR LINE NUMBER: (check only one)
PAGE 3 OFo'
11a lib 11c lid
12 13a 13b 14 Ms Any information copied from such Reports and Statements may not be sold or used by any person for the purpose of soliciting contributions or for commercial purposes, other than using the name and address of any political committee to solicit contributions from such committee.
NAME OF COMMITTEE (In Full)
hA(^K ^U^LiyAN
1 ^1 0 5
J, 3 Gl
2 91 '•^1 L 1
Full Name (Last, First, Middle Initial)
A. A nc. n Mailing Address
City
2- in<L^<iln. I V
State Zip Code
FEC ID number of contributing federal political committee.
Name of Employer
KLU^T- r\j Receipt For:
Primary fpf" General Other (specify)
Occupation
Date of Receipt M M / D-D / Y V y y
0^11 Xo ! "/-
Amount of Each Receipt this Period
1,0 0 0.
Full Name (Last, First, Middle Initial)
B. Mailing Address '
iH-o^ vj K 31 City
LkkVD T^L^ANJI State
ME Zip Code
)oEEO\ FEC ID number of contributing federal political committee. C
Name of Employer
Al£ D^pio-f Occupation
prc^rtim 3 irccfoi^
Date of Receipt
M M/DD/yyyy
O ^ I i-
Amount of Each Receipt this Period
, . ' \XI 3
Primary Other (specify)
[^( Election Cycle-to-Date
General
,3 ! Full Name (Last, First, Middle Initial)
C. Mailing Address
City State Zip Code
FEC ID number of contributing federal political committee. c Name of Employer Occupation
Date of Receipt
MM / 0 0 / Y y y y
Amount of Each Receipt this Period
Receipt For:
Primary Q General Other (specify)
Election Cycle-to-Date
SUBTOTAL of Receipts This Page (optional).
TOTAL This Period (last page this line number only)
FEC Schedule A (Form 3) (Revised 02/2009)
SCHEDULE B (PEG Form 3) ITEMIZED DISBURSEMENTS
Use separate schedule(s) for each category of the Detailed Summary Page
FOR LINE NUMBER: (check only one)
PAGE OF
17 18 19a
20a 2ab 20c
19b
21
Any information copied from such Reports and Statements may not be sold or used by any person for the purpose of soliciting contributions or for commercial purposes, other than using the name and address of any political committee to solicit contributions from such committee.
NAME OF COMMrrrEE (In Full)
SUI^LI\JAN
1 4 Q
1 3 Q
9 2 8
Full Name (Last, First, Middle Initial)
A. hULi.l AAN KATr Mailing Address
/111 £. .2^^ Si City
na s state
Nd. Purpose of Disbarsement
rr c,6NSnUi-r!N r.
Zip Code
Candidate Name
Office Sought:
State: N t.
LLIKJ A Kl vK House Disbur;
DO } Category/
Type House
Senate
President
District: Q 3
Disbursement For Primary General Other (specify)
Date of Disbursement
M . / 0' 0 /' V Y Y V
^ s. • ^ .! "f. Amount of Each Disbursement this Period
5".. ̂
Full Name (Last, First, Middle Initial)
B.
Mailing Address
City State Zip Code
Purpose of Disbursement
Candidate Name Category/ Type
Date of Disbursement
• M M / D D . Y • V • Y Y
/Vmount of Each Disbursement this Period
Office Sought:
State:
House Senate President
Disbursement For Primary General
Other (specify)
District:
Full Name (Last, First, Middle Initial)
C.
Mailing Address
City State Zip Code
Purpose of Disbursement
Candidate Name Category/ Type
Date of Disbursement
M ' ' M ; O D / Y ' Y V Y
Amount of Each Disbursement this Period
Office Sought:
State:
House Senate President
District:
Disbursement For Primary General Other (specify)
SUBTOTAL of Disbursements This Page (optional). .s 8- 5. e a.
TOTAL This Period (last page this line number only).
FE5AN018 FEC Schedule B (Form 3) (Revised 02/2009)
SCHEDULE B (PEG Form 3) ITEMIZED DISBURSEMENTS
Use separate schedule(s) for each category of the Detailed Summary Page
FOR LINE NUMBER: (check only one)
PAGE OF
17 18 19a 19b
20a 20b 20c 21
Any Information copied from such Reports and Statements may not be sold or used by any person for the purpose of soliciting contributions or for commercial purposes, other than using the name and address of any political committee to solicit contributions from such committee.
NAME OF COMMITTEE (In Full)
Full Name (Last, Rrst, Middle Initial)
Cnos/ Date of Disbursement
.S-, '.A / D c ; 7- V Y V
0 .?. b s A- 0 ! At Mailing AddrAs ^
Date of Disbursement
.S-, '.A / D c ; 7- V Y V
0 .?. b s A- 0 ! At 01^ Statj Zip Code
/IrAn.cl d-slahr! A/AT Amount of Each Disbursement this Period
OO^ . Purpose of Disbursement
C^eirr\p/i nr\/i Ae. r 161 Lc: 6 P If Category/
Type
Amount of Each Disbursement this Period
OO^ .
Candidate Nkme v_/ ^
A ̂ r\, 6 P If Category/
Type
Amount of Each Disbursement this Period
OO^ .
1 4 0
Senate
President H Primary "v'j General
i Other (specify)
Full Name (Last, First, Middle Initial)
2: B. Date of DIsbursemeilt
r.;' M / • Li 0 -• V V Y
2' Mailing Address
i\
Date of DIsbursemeilt
r.;' M / • Li 0 -• V V Y
City State Zip Code Amount of Each Disbursement this Period
Purpose of Disbursement
Category/ Type
Amount of Each Disbursement this Period
Candidate Name Category/ Type
Amount of Each Disbursement this Period
Office Sought:
State:
House
Senate
President
Disbursement For: Primary
Other (specify)
General
District:
Full Name (Last, Rrst, Middle Initial)
C,
Mailing Address
City State Zip Code
Purpose of Disbursement
Candidate Name Category/ Type
Date of Disbursement
. U i , O O ' i • V V Y Y
Amount of Each Disbursement this Period
Office Sought:
State:
House
Senate
President
Primary
Other (specify)
General
District:
SUBTOTAL of Disbursements This Page (optional). 00^
TOTAL This Period (last page this line number only).
FESAN018 FEC Schedule B (Form 3) (Revised 02/2009)
SCHEDULE B (PEG Form 3) ITEMIZED DISBURSEMENTS
Use separate schedule(s) for each category of the Detailed Summary Page
FOR LINE NUMBER: (check only one)
PAGE OF
17 18 19a 20a 20b 20c
19b 21
Any information copied from such Reports and Statements may not be sold or used by any person for the purpose of soliciting contributions or for commercial purposes, other than using the name and address of any political committee to solicit contributions from such committee.
NAME OF COMMITTEE (In Full)
MAg/< SULI-I\JAN Full Name (Last, First, Middle Initial)
k K\j N RaJin Mailing Address
City
^k: (?„.)/ / state Zip Code
Purpose of Disbursement ^
raaio /A a !s ! a Oof Category/
Type
Candidate Name V
Mark. ^eA}li\/an
Oof Category/
Type
Date of Disbursement
MM/OD/ YYYY
0 ^ 17 J.0 I ^
1 4 Q
1 3 0
2;
Amount of Each Disbursement this Period
L.,7 3'5:
Office Sought:
State: t-
/House Senate President
District: Q N3
Disbursement For: Primary [^^eneral Other (specify)
9
1
Full Name (Last, First, Middle Initial)
B. knrr FM Date of Disbursement
Mailing Address
t-'f- H-ih ; 7'ih) k
City
Purpose of Disbursement ry irseme
State Zip Code
5-2, Amount of Each Disbursement this Period
Irc^cJlo ndidate Name >J Candidate I
U>~k
state:
ice Sought:
Al£
oo f Category/
Type
1,0 ^
House Senate President
Disbursement For:
Primary
District: 0 3
0 General
Other (specify)
C.
Full Name (Last, First, Middle Initial)
Ai R ^ ^ArWn Mailing Address <-> r-i
3 5-3A Ave. ] PO S/Ok: City ' State ' Zip Code
Date of Disbursement
M M, / D D I I Y Y Y
/ 7 ^6 ! ^
Purpose of Disbursement
State Zip Code
Candidate tAtjln / n f
lidate Name yj
Office Sought:
State: Ai ^
House
Senate
president
District: ^
Disbursement For: Primary
Amount of Each Disbursement this Period
OOy
Oof Category/
Type
J ! O.
0 i2 General Other (specify)
SUBTOTAL of Disbursements This Page (optional). .^,55 1:^
TOTAL This Period (last page this line number only).
FE5AN018 FEC Schedule B (Form 3) (Revised 02/2009)
SCHEDULE C (PEG Form 3) LOANS
Use separate schedule(s) for each category of the Detailed Summary Page
PAGE OF
FOR LINE NUMBER: (check only one) 13a
13b
NAME OF COMMITTEE (In Full)
MAIl^^ AULLI\IAt4 FOR. LOAN SOURCE Full Name (Last, First, Middle Initial)
Mailing Address
City Stat.
Election:
Primary
General
Other (specify) ^
Original Amount of Loan Cumulative Payment To Date Balance Outstanding at Close of This Period
TERMS Date Incurred Date Due Interest Rate Secured:
MM/DD/ YYYY MM/OD/YY YY
. % (apr) Yes No
List All Endorsers or Guarantors (if any) to Loan Source
1. Full Name (Last, First, Middle Initial) Name of Employer
Mailing Address Occupation
City State ZIP Code
Amount Guaranteed Outstanding:
2. Full Name (Last, First, Middle Initial) Name of Employer
Mailing Address Occupation
City State ZIP Code
Amount Guaranteed Outstanding:
3. Full Name (Last, First, Middle Initial) Name of Employer
Mailing Address Occupation
City State ZIP Code
Amount Guaranteed Outstanding:
4. Full Name (Last, First, Middle Initial) Name of Employer
Mailing Address Occupation
City State ZIP Code Amount Guaranteed Outstanding:
SUBTOTALS This Period This Page (optional).
TOTALS This Period (last page in this line only).
Carry outstanding balance only to LINE 3. Schedule D. for this line. If no Schedule D, carry forward to appropriate line of Summary.
FE5AN018 FEC Schedule C (Fortn 3) (Revised 02/2003)
SCHEDULE C-1 (FEC Form 3) LOANS AND LINES OF CREDIT FROM LENDING INSTITUTIONS Federal Election Commission, Washington, D.C. 20463
Supplementary for
Information found on
Page of Schedule C
NAME OF COMMITTEE (In Full)
Al/)^/; SULLIVAN FaK
FEC IDENTIFICATION NUMBER
C 0 OS 1 7 O 1 J
LENDING INSTITUTION |LENDER) Full Name
Amount of Loan
) )
Interest Rate (APR)
% • Mailing Address J
k cite Incur#® i or Established
M
1 M / D D / Y Y Y Y
1 M / D D / Y Y Y Y
City State Zip Code / V Date Du^-^
1 M / D D / Y Y Y Y
1 M / D D / Y Y Y Y
J
1
1 2 9
!
B. If line of credit. Total Outstanding
Amount of this Draw: , , . Balance: J' J
C. 1 (^re other p
No
art! ies secondarily liable for the debt incurred?
Yes (Endorsers and guarantors must be reported on Schedule C.)
A. Has loan been restructured? No ^ Yes If yes, date originally incurred
D. Are any of the following pledged as collateral for the loan: real estate, personal property, goods, negotiable instruments, certificates of deposit, chattel papers, stocks, accounts receivable, cash on deposit, or other similar traditional collateral?
If yes, specify: No Yes
What is the value of this collateral?
Does the lender have a perfected security
interest in it? No Yes
E. Are any future contributions or future receipts of interest income, pledged as
collateral for the loan? No Yes If yes, specify: What is the estimated value?
A depository account must be established pursuant to 11 CFR 100.82(e)(2) and 100.142(e)(2).
Location of account:
Date account established: M M / D D / Y
Address:
City, State, Zip:
F. If neither of the types of collateral described above was pledged for this loan, or if the amount pledged does not equal or exceed the loan amount, state the basis upon which this loan was made and the basis on which it assures repayment.
G. COMMITTEE TREASURER
Typed Name DATE MM/DO /YYVV
Signature
DATE MM/DO /YYVV
H. Attach a signed copy of the loan agreement.
TO BE SIGNED BY THE LENDING INSTITUTION: I. To the best of this institution's knowledge, the terms of the loan and other information regarding the extension of the loan
are accurate as stated above. II. The loan was made on terms and conditions (including interest rate) no more favorable at the time than those imposed for
similar extensions of credit to other borrowers of comparable credit worthiness. III. This institution is aware of the requirement that a loan must be made on a basis which assures repayment, and has
complied with the requirements set forth at 11 CFR 100.82 and 100.142 in making this loan.
AUTHORIZED REPRESENTATIVE
Typed Name
Signature Title
DATE M M /
FE5AN018 FEC Schedule 0-1 (Form 3) (Revised 02/2003)
SCHEDULE D (PEG Form 3) DEBTS AND OBLIGATIONS Excluding Loans
(Use separate schedule(s)
for each numbered line)
PAGE OF
FOR LINE NUMBER: (check only one) 9
10
NAME OF COMMITTEE (In Full)
1 A Q
], '£ G
3
City State
POMlPHAN ALt
A. Full Name (Last, First, Middle Initial) of Debtor or Creditor
tAatk •s9)ulh\/a.. LZk_
Nature of Debt (Purpose):
Mailing Address
90S" H\fjv :L Zip Code
Outstanding Balance Beginning This Period
O O O .
Amount Incumed This Period Payment This Period
I 0,0 o o. o
Outstanding Balance at Close of This Period
O I 1 ^ ^ oo^ , ! X,Soo. B. Full Name (Last, First, Middle Initial) of Debtor or Creditor
Mailing Address
City State Zip Code
Nature of Debt (Purpose):
Outstanding Balance Beginning This Period
> j "
Amount Incurred This Period Payment This Period Outstanding Balance at Close of This Period
C, Full Name (Last, First, Middle Initial) of Debtor or Creditor
Mailing Address
City State Zip Code
Nature of Debt (Purpose):
Outstanding Balance Beginning This Period
J J •
Amount Incumed This Period Payment This Period Outstanding Balance at Close of This Period
1) SUBTOTALS This Period This Page (optional).
2) TOTALS This Period (last page this line number only).
3) TOTAL OUTSTANDING LOANS from Schedule C (last page only)..
4) ADD 2) and 3) and carry forward to appropriate line of Summary Page (last page only)
/ 0.
3
/ ^,5-0 O.
o ̂
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FEC Schedule D (Form 3) (Revised 02/2003)
FE5AN018
FEC FORM 3Z (File with Form 3) CONSOLIDATION REPORT OF RECEIPTS AND DISBURSEMENTS (To Be Used By A Principal Campaign Committee)
Name of Principal Campaign Committee (In Full)
tAKe-K SU.LLIVAN
Pof. tONt^ESS
Report Covering Period: From;
MM;DD/YYVY
0 1 0 ! J i-
To:
M M / D 0 ' / Y Y Y Y
o'f 3(3 Xoz-i-
Committee Name
(a) Line No. 11 (a)
Total Contributions From Indiv./Persons Other Than
Political Committees
(b) Line No. 11(b)
Total Contributions From Political Party
Committees
A 1^33.25 0^
B Column Total Last Page 0 nlv 3X,n^.Xf 0^ B Column Total Last Page 0 3X,n^.Xf 0^
(c) Line No. 11(c)
Total Contributions From Ottier Political
Committees
(d) Une No. 11(d)
Total Contributions From The Candidate
(e) Line No. 11(e)
Total Contributions
(f) Line No. 12
Total Transfers From Other Authorized
Committees
(g) Line No. 13(a)
Total Loans Made or Guaranteed by the Candidate
(h) Line No. 13(b)
Total All Other Loans
A 0^ 18 3^,3 5 0^ lo^ooo.oo 00^
B 0^ n^.Xf 0^ (TOO, 00 0^
(i) Line No. 13(c)
Total Loans
G) Line No. 14
Total Offsets to Operating
Expenditures
(k) Line No. 15
Total Other
Receipts
(1) Line No. 16
Total Receipts
(m) Line No. 17
Total Operating
Expenditures
(n) Line No. 18
Total Transfers to Other Authorized
Committees
A ! 0,000. oo 0^ 0^ /7, 835.35 181.00 0^
B 5Oo,0d 0^ cy fH-, ^ 7 0^ (0)
Line No. 19(a) Total Loan Repayments
of Loans Made or Guaranteed by Ttie Can
didate
(P) Line No. 19(b)
Total Loan Repayments of All Other Loans
(q) Line No. 19(c)
Total Loan Repayments
(r) Line No. 20(a)
Total Contribution Refunds to
Individuals/Persons
(S)
Line No. 20(b) Total Contribution Refunds to Political Party Committees
(t) Une No. 20(c)
Total Contribution Refunds to Other
Political Committees
A 00^ 00^ 0^ fOO/
B 00^
/,ooo.oo 1,000,00 0^^ 00^
(u) Line No. 20(d)
Total Contribution
Refunds
(V)
Line No. 21 Total Other
Disbursements
(w) Line No. 22
Total Disbursements
(X)
Line No. 23 Cash on Hand Beginning of
Reporting Period
(y) Line No. 27
Cash on Hand Close of
Reporting Period
(z) Une No. 9
Debts & Obligations Owed TO the
Committee
A 0^ 0^ /f", 18 hoo /7, OS8. It /4, 7/3 .oc, OOy'
B 0^ 00^
(aa) Line No. 10
Debis & Obligations Owed BY ttie
Committee
(bb) Line No. 6(c)
Net Contributions
(cc) Line No. 7(c) Net Operating Expenditures
A 5 00-OO 7, 18, m. 00
B /p., soo.oo 0 i-5, XOi
FE5AN018 FEC Form 3Z (Revised 02/2003)
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Federal Election Commission ENVELOPE REPLACEMENT PAGE FOR INCOMING DOCUMENTS
The FEC added this page to the end of this filing to indicate how it was received.
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Date of Receipt Received from House Records & Registration Office
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Date of Receipt or Postmarked Other (Specify):
^ tolifh-f P)REPARER DATE PREPARED (8/2013)