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CCDR: Burt Hewitt (3)
a SEC FORM CCDR rmv cutwo State of Georgia Campaign Contribution Disclosure Report _ 1. Report Type 2. Filing is being made on behalf of (Select One): IR PeMlYPI (Select one) Candidate or Public Official Office Sought or Held: M 11+0* 1 C t4�4 CDUr7c 1 I, Po -%f- q Original Report (Include county, L FEBmunicipality, district, post orjudicial circuit) A 1 [� Amended Report Committee Name: Ff I C01 O iy t �' 42w 1 t 1 G Use Earlier of Post Report of Organization or Person Other than Candidate's Campaign Committee Ciftlex~ Amendment # I ____ it IMN 3. Identifying and Contact Information (1) �y �JG "eLmnM 0sV_vyrT-T Full Name of Candidate or Non -Candidate Campaign Committee ,M (3) GA Mailing Address City State (2) 2 l k Job Today's Date Zip Code (4) (kih So -Sb (I and / or (4oq) 59) - L-75-1 Contact Phone Number (We will understand the release of this information as permission to call your office if necessary) (5) If a Candidate or Public Official, is there a campaign committee (one or more persons) to make campaign transactions, keep the financial records of the campaign, or file the reports? © Yes Q(6) If so, is the committee registered with the State Ethics Commission? 121Yes (7) If so, complete the following: 3 o Q-3-- Orgv-ix Tr Name of Chairperson and/or Treasurer of Committee 4. Period for which you are Reporting You Must Check Only One Boa My Non Election Year My Election Year Run -Offs (Report required only if you are in a Run -Off Elecfiw) Special Elections (Report required only if you are in a Special Election) June 30, (year) March 31, (year) M6 days before Primary 15 days before Run -Off, (year) Special Primary, MDec. 31, (year) June 30, (year) [:]6 days before General (year) Run -Off, (year) -Persons elected to office in each year following M September 30, (year) []6 days before Special 15 days before the year inwhichthe election occurs Primary Run -Off, Special, (year) -Persons leaving office with excess finds until such fiords am expanded as provided w the Act �7 , ' t[ ' October 25, (AI (year) (year) -Umuccessfulcandidates wah==afunds, or Y F]6 days before Special E]Dec. 31, (year) who receive contributions to retire debt incurred, until such funds we expended, or such wpaid QDecember 31, (year) Run -Off, (year) debts are satisfied (December 31 filing only) Verification by Oath or Affirmation State of 9- 1 Z" County of F L Z K 1, IJ of T 1 J W 1 being duly swore (aT=), depose and say that the information in this report form is complete, true, and correct. Further, I affirm that the contents in this report are the same as the contents in the electronic filing submitted, if also electronically filed. Swore to and subscribed before me on Si lure of Notary Public &a Signature of Candidate JEANEITE R MARCHIAFAVA b.Organization/Chairpersonfrreasurer K'otary Public, Fulton Co., GA My Commission expires MY Commission Expires August 29, 2009 PENALTIES: Any person who knowingly fails to comply with or who knowingly violates any of the previsions of the Ethics m Cmvnement Act shall be guilty of a misdemeanor. SEC FORM CCDR REV 01— State of Georgia Campaign Contribution Disclosure Report Outstanding Indebtedness (OPTIONAL) Election Cycle*: Cenerud Election Year: 7tXM_ Amount 1 Outstanding indebtedness at the beginning of this period. 5. S 9035. 2 Loans received this period. 0 3 Deferred payment of expenses this period 11000-60 0 4 Payments made on loans this period. 5 Credits received on loans this period. d 6 Payments this period on previously deferred expenses. 0 7 Total indebtedness at the close of this reporting period. (Line 1 +2+3 -4-5 -6) 3 0 35,757 Election Cycle*: Election Year: Amount 1 Outstanding indebtedness at the beginning of this period. 2 Loans received this period. 3 Deferred payment of expenses this period 4 Payments made on loans this period. 5 Credits received on loans this period. 6 Payments this period on previously deferred expenses. 7 Total indebtedness at the close of this reporting period. (Line 1+2+3-4-5-6) Election Cycle*: Election Year: Amoun 1 Outstanding indebtedness at the beginning of this period. 2 Loans received this period. 3 Deferred payment of expenses this period 4 Payments made on loans this period. 5 Credits received on loans this period. 6 Payments this period on previously deferred expenses. 17 Total indebtedness at the close of this reporting period. (Line 1+2+3-4-5-6) * Election Cycle (Primary, General, Special, Special Primary, Run -Off Primary, Run -Off General, Run -Off Special, Run -Off Special Primary) Public Officer/Caudidate/Non-Candidate Committee Name —r i en p S Of &A f SEC FORM CCDR My OIIZUSW State of Georgia Campaign Contribution Disclosure Report Summary Report CONTRIBUTIONS RECEIVED 1 I have: No contributions to report. In -fid Value Cash Amount The following contributions, including Common Source, to report: A. If this is the first time to file a disclosure report for the current office soueht, ENTER 0 in both columns (one time only); or B. If this is the first report of this Reporting Cycle*, ENTER 0 in the in-kind column and list any net balance on hand brought forward from the previous reporting cycle 2 in the cash amount column (Line 13 of previous report, or total funds left over at year end of previous cycle); or C. If this filing is the second or subsequent filing or this Reporting, Cycle, list totals 350. 0 _ T) 35, 1 S FrLine 6 of previous report in both the in-kind and cash amount columns. Total amount of all contributions of $101.00 or more received in this reporting period. 3 Each such contribution must be listed on the "Listed Contributions Received" page. �j C(V© , by 3a All loans received this period. Q 3b Interest earned on campaign account this period. 0 Total amount of all separate contributions of less than $101.00 each that were 4 reported in this reporting period. "Common Source" contributions must be aggregated Zb0 bo �� on the "Listed Contributions Received" page. • 5 Total contributions reported this period. tib 00 (Line 3 + 3a+3b+4) 6 Total contributions to date. Total to be carried forward to next report of this reporting eyelet 656. (Line (Line 2 + 5) EXPENDITURES MADE 7 I have: No expenditures to report. In -fid Value Cash Amount The following expenditures to report: Total expenditures made and reported prior to this reporting period. If this is the 8 first report of this Reporting Cycle*, ENTER 0. S, G I Line 12 of previous report) 9 Total amount of all expenditures of $101.00 or more made in this reporting period. 000 o O 10 Total amount of all separate expenditures of less than $101.00 each that were made 91 in this reporting period 11 Total expenditures reported this period. 1009 g (Line 9 + 10) 12 Total expenditures to date. Total to be carried forward to next report of this reporting eyelet (Line 8 + 11) 13 Net balance on hand. 165q, (Line 6 - Line 12) * O.C.G.A. 21-5-34(b)(1)(D)(ii) A reporting cycle shall commence on January 1 of the year in which an election is to be held for the public office to which a candidate seeks election and shall conclude: (I) At the expiration of the term of office if such candidate is elected and does not seek reelection or election to some other office; (II) On December 31 of the year in which such election was held if such candidate is unsuccessrul; or (11I) If such candidate is successful and seeks reelection or seeks election to some other office the current reporting cycle shall end when the reporting cycle for reelection or for some other office begins Public Officer/Candidate/Non-Candidate Committee Name 1 1 e��S oL &4 geu,)A SEC RF.V FORM CCDR 01/2006 State of Georgia Campaign Contribution Disclosure Report Listed Contributions Received of $101.00 or More Contributor In -Kind Contributions Full Name of Contributor Mailing Address Received Date a. Occupation Election Cash Estimated Value C Amount Description PAC Affiliation if applies) Contribution Type* b. Employer cle** (11urr++� E Lw, k 03 a Rao Z SO OU $ f% 16,)(A `)(A 5+; L 1611, islit,C�$ l $ 2Sb,Go f'j IM iy�� 16 IY b r�F�.-� �t $ $ p't;�4&rt i b prafu k ka , m �i i !►16�. �`'• l i 6 7 b/ z j $ $ M L 10w3opvl M $ 53.w $ $ $ $ $ $ Page Total 1430,60 s 2\ L 0 Pj The Act requires all public officers, candidates, and campaign committees to list contributions received and expenditures made which are individually $101.00 or more and to disclose the total amount of all contributions received and expenditures made which are individually less than $101.00. * Contribution Type (Monetary, In -Kind, Loan, Common Source, Credit Received on Loan) * * Election Cycle (Primary, General, Special, Special Primary, Run -Off Primary, Run -Off General, Run -Off Special, Run -Off Special Primary) ,,,, Q ] Public Officer/Candidate/Non-Candidate Committee Name' ""S C% U (4 �� page _� __ of 1 N SEC FORM CCDR REV 01/2006 State of Georgia Campaign Contribution Disclosure Report Listed Expenditures Made of $101.00 or More List Name and Mailing Address of Recipient Expenditure Date Expenditure Type* Occupation and Place of Employment Expenditure Purpose Amount Paid cMP g 1�_— - qVV- 13 bs � P, I �,. , C-�� io iJ� I ►�P �� - r��� $ ld�. c� i�..V' to $ $ $ $ $ $ $ Page Total $ �•C�v The Act requires all public officers, candidates, and campaign committees to list contributions received and expenditures made which are individually $101.00 or more and to disclose the total amount of all contributions received and expenditures made which are individually less than $101.00. * Expenditure Type (Expenditure, In -Kind, Loan Repayment, Refund, Reimbursement, Credit Card, 3rd Party, Deferred Payment, Payment on Deferred Expense) Public Officer/Candidate/Non-Candidate Committee Name i— 1 C%n& 0 (Lou' I Page__ __ of—L