Upload
jeff-quinton
View
218
Download
3
Embed Size (px)
Citation preview
Campaign Finance Report Summary Sheet
Part 1
Final Report (Check if you intend to close the account. This cannot be a final report if a cash balance or outstanding obligation remains)
Date
(Date amendment is being filed
Transaction Period This Report covers transactions beginning
Date
04/08/201402/24/2014 and ending .
.)Amendment #
Bank Account Name Bank Account Number Bank Account Balance*
*As of the report transaction ending date.Total
$2,808.10
Part 2
Part 3
Contributions – Schd 1, Col A $3,250.00
Ticket Purchases – Schd 1, Col B $0.00
Federal Committees – Schd 1, Col C $0.00
Political Clubs – Schd 1, Col D $500.00
MD Candidate and Slate Accounts – Schd 1A, Col E
$0.00
MD Party Central Committees – Schd 1A, Col F $0.00
MD Political Action Committees – Schd 1A, Col G $0.00
Non-Federal Out-of-State Committees – Schd 1A, Col H
$0.00
Other – Schd 1B, Col I $0.00
Loans – Schd 3, Col K $0.00
Enter Total in Part 4 (Total Receipts)
Salaries & Other Compensation – Schd 2, Col N $0.00
Rent & Other Office Expenses – Schd 2, Col O $0.00
Field Expenses – Schd 2, Col P $190.20
Media – Schd 2, Col Q $0.00
Printing & Campaign Materials – Schd 2, Col R $642.50
Direct Mailing by Mail House – Schd 2, Col S $0.00
Postage – Schd 2, Col T $9.20
Purchase of Equipment – Schd 2, Col U $0.00
Fundraising Expenses – Schd 2, Col V $0.00
Transfers Out – Schd 2, Col W $0.00
Loan Repayment – Schd 2, Col X $0.00
Other – Schd 2, Col Y $100.00
Returned Contribution – Schd 2, Col Z $0.00
Enter Total in Part 4 (Total Expenditures)
Receipts Expenditures
Failure to provide all the information required by this form will be regarded as a FAILURE TO FILE.
Page of1 9
Current Amended Deleted
Maryland State Board of Elections
Report Due Date :
Entity Number :Name of Entity :
04/15/2014
01010031 Ciliberti, Barrie Citizens for
Filing Period Name : 04/08/2014 Spring Report Gubernatorial
Part 7
Under penalty of perjury, we declare that we have examined this report, including the accompanying schedules, and to the best of our knowledge and belief they are complete and accurate.
(Date)
(Date)
Signature of Treasurer
Signature of Chairman
Warning
Failure to provide all information required by this form will be regarded as a failure to file.
Kendall, Linda Sue 04/14/2014
04/14/2014
Prior Balance Report calculated cash balance from Part 4 of your prior report.
Total Receipts $3,750.00 Total of Part 3 Receipts
Total Expenditures $941.90 Total of Part 3 Expenditures
Cash Balance $2,808.10 This is your report calculated cash balance. Carry forward this balance to your next report.
+
-
=
$0.00
Part 4
Part 6
Outstanding Loan Balance – Schd 3, Col L $0.00
Outstanding Bills Due – Schd 3, Col M $0.00
Total Outstanding Obligations $0.00
Part 5
Value of In-Kind Contributions – Schd 1B, Col J $0.00
Value of In-Kind Expenditures – Schd 2, Col AA $0.00
Failure to provide all the information required by this form will be regarded as a FAILURE TO FILE.
Page of2 9
Current Amended Deleted
Maryland State Board of Elections
Report Due Date :
Entity Number :Name of Entity :
04/15/2014
01010031 Ciliberti, Barrie Citizens for
Filing Period Name : 04/08/2014 Spring Report Gubernatorial
ContributionsA - Contributions other than ticket purchases from Individuals, Corporations, etc.
SCHEDULE - 1
(see schedules 1A and 1B for other types of Income)
Received From
Date Received
Name and Address of Contributor ADMIN
Aggregate to Date
Paid by Contributions Amount
04/01/2014 Ciliberti, Christopher 19679 Pelican Ct., Ashburn, VA 20147
$100.00 Cash $100.00
Other
04/01/2014 Ciliberti, Steven 3333 University Blvd West, Unit 511, Kensington, MD 20895
$100.00 Cash $100.00
Other
03/20/2014 Cruz, Jose A14022 Natia Manor Drive, North Potomac, MD 20878
$500.00 Check $500.00
Il Porto Other
03/05/2014 Kendall, Richard A2030 Dixon Road, Frederick, MD 21704
$250.00 Check $250.00
Retired
03/13/2014 Mardirossian, Armen 9204 Rose Anne Pl., Gaithersburg, MD 20877
$300.00 Check $300.00
Il Porto Other
03/04/2014 Monocacy Crossing Inc.4424-A Urbana Pike, Frederick, MD 21704
$1,000.00 Check $1,000.00
03/04/2014 Regan, Ronald K3998 Tabler Road, Frederick, MD 21704
$1,000.00 Check $1,000.00
Monocacy Crossing Inc. Other
Total $3,250.00
Failure to provide all the information required by this form will be regarded as a FAILURE TO FILE.
Page of3 9
Current Amended Deleted
Maryland State Board of Elections
Report Due Date :
Entity Number :Name of Entity :
04/15/2014
01010031 Ciliberti, Barrie Citizens for
Filing Period Name : 04/08/2014 Spring Report Gubernatorial
ContributionsD - Contributions from Political Clubs (include ticket purchases)
SCHEDULE - 1
(see schedules 1A and 1B for other types of Income)
Received From
Date Received
Name and Address of Contributor ADMIN
Aggregate to Date
Paid by Contributions Amount
03/06/2014 Hough for Delegate143 Fiona Way, Brunswick, MD 21758
$250.00 Check $250.00
Price Per Ticket: # of Tickets:
03/06/2014 Kathy Afzali-Delegate9820 Fox Road, FREDERICK, MD 21702
$250.00 Check $250.00
Price Per Ticket: # of Tickets:
Total $500.00
Failure to provide all the information required by this form will be regarded as a FAILURE TO FILE.
Page of4 9
Current Amended Deleted
Maryland State Board of Elections
Report Due Date :
Entity Number :Name of Entity :
04/15/2014
01010031 Ciliberti, Barrie Citizens for
Filing Period Name : 04/08/2014 Spring Report Gubernatorial
ExpendituresP - Field Expenses
SCHEDULE - 2
(see schedules 1A and 1B for other types of Income)
Date Check No. Name and Address of Payee (The payee is the person who is the ultimate recipient of campaign funds)
Name and Address of Reimbursee (The reimbursee is the person who received the campaign check as a reimbursement for the expenditure. The reimbursee must be a campaign worker.)
ADMIN
Amount
03/20/2014 0000 Barrie Ciliberti Campaign fund3741 Spicebush Drive, Frederick, MD 21704
$190.20
Expenditure Purpose: Meeting Expenses
Remarks: Gas, toll, meals etc.
Total $190.20
Failure to provide all the information required by this form will be regarded as a FAILURE TO FILE.
Page of5 9
Current Amended Deleted
Maryland State Board of Elections
Report Due Date :
Entity Number :Name of Entity :
04/15/2014
01010031 Ciliberti, Barrie Citizens for
Filing Period Name : 04/08/2014 Spring Report Gubernatorial
ExpendituresR - Printing and Campaign Materials
SCHEDULE - 2
(see schedules 1A and 1B for other types of Income)
Date Check No. Name and Address of Payee (The payee is the person who is the ultimate recipient of campaign funds)
Name and Address of Reimbursee (The reimbursee is the person who received the campaign check as a reimbursement for the expenditure. The reimbursee must be a campaign worker.)
ADMIN
Amount
03/31/2014 101 T.C.C. Printing616 6th Ave. S., Seattle, WA 98104
$642.50
Expenditure Purpose: Printing - Brochures
Remarks:
Total $642.50
Failure to provide all the information required by this form will be regarded as a FAILURE TO FILE.
Page of6 9
Current Amended Deleted
Maryland State Board of Elections
Report Due Date :
Entity Number :Name of Entity :
04/15/2014
01010031 Ciliberti, Barrie Citizens for
Filing Period Name : 04/08/2014 Spring Report Gubernatorial
ExpendituresT - Postage
SCHEDULE - 2
(see schedules 1A and 1B for other types of Income)
Date Check No. Name and Address of Payee (The payee is the person who is the ultimate recipient of campaign funds)
Name and Address of Reimbursee (The reimbursee is the person who received the campaign check as a reimbursement for the expenditure. The reimbursee must be a campaign worker.)
ADMIN
Amount
03/20/2014 US Post OfficeBuckeystown Pike, Buckeystown, MD 21702
$9.20
Expenditure Purpose: Postage
Remarks:
Total $9.20
Failure to provide all the information required by this form will be regarded as a FAILURE TO FILE.
Page of7 9
Current Amended Deleted
Maryland State Board of Elections
Report Due Date :
Entity Number :Name of Entity :
04/15/2014
01010031 Ciliberti, Barrie Citizens for
Filing Period Name : 04/08/2014 Spring Report Gubernatorial
ExpendituresY - Other
SCHEDULE - 2
(see schedules 1A and 1B for other types of Income)
Date Check No. Name and Address of Payee (The payee is the person who is the ultimate recipient of campaign funds)
Name and Address of Reimbursee (The reimbursee is the person who received the campaign check as a reimbursement for the expenditure. The reimbursee must be a campaign worker.)
ADMIN
Amount
04/01/2014 102 Barrie Ciliberti Campaign fund3741 Spicebush Drive, Frederick, MD 21704
$35.00
Expenditure Purpose: Meeting Expenses
Remarks: reimburse gas expense
04/01/2014 102 Lincoln/Reagan DinnerSouth St, Frederick, MD 21701
$65.00
Expenditure Purpose: Meeting Expenses
Remarks:
Total $100.00
Failure to provide all the information required by this form will be regarded as a FAILURE TO FILE.
Page of8 9
Current Amended Deleted
Maryland State Board of Elections
Report Due Date :
Entity Number :Name of Entity :
04/15/2014
01010031 Ciliberti, Barrie Citizens for
Filing Period Name : 04/08/2014 Spring Report Gubernatorial
Amendments Summary
Report No Filed date Report Type
1 04/14/2014 Original
Failure to provide all the information required by this form will be regarded as a FAILURE TO FILE.
Page of9 9
Current Amended Deleted
Maryland State Board of Elections
Report Due Date :
Entity Number :Name of Entity :
04/15/2014
01010031 Ciliberti, Barrie Citizens for
Filing Period Name : 04/08/2014 Spring Report Gubernatorial