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CCDR: Burt Hewitt (5)
y SEC FORM CCDR State of Georgia Campaign Contribution Disclosure Report 1. Report Type 2. Filing is being made on behalf of (Select One): JR 13o (Select one) ❑ Candidate or Public Official I l� Office Sought or Held: MI 1'{b1'1 vaci ` (posf- 7 FEB 2 1 ❑ Original Report (Include county, munkipality, district, post orjudicial circuit) Amended Report Committee Name: Fr� ends of Go r `f- aeLmI tt U tt Amendment # ❑ Report of Organization or Person Other than Candidate's Campaign Committee Delivered liv� t� 3. Identifying and Contact Information (1) Iy I)G ©L)W brL_ 4Sy'r-TT (2) 2 J1k/0� Full Name of Candidate or Non -Candidate Campaign Committee( Today's Date (3) �� any ilio G_ Mailing Address City State Zip Code (4) 4A SW - ,�;b ( q and / or (4W) 5,9> - Z7 S Contact Phone Number (We will understand the release of this information aspermission 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 (6) If so,, i 121 he committee registered with the State Ethics Commission? Yes (7) If so, complete the following: B t) e ( (1 Gyix TT - Name of Chairperson and/or Treasurer of Committee 4. Period for which you are Reporting You Must Check Only One Box My Non Election Year My Election Year Run -Offs (Report required only if you min a Run -Off Election) Special Elections (Report required only if you are in a Spedal Election) F-1 June 30, (year) E] March 31, (year) ❑6 days before Primary ❑ 15 days before Run -Off, (year) Special Primary, Dec. 31, (year) E] June 30, (year) ❑6 days before General (year) Run -Off, (year) -Persons elected to office m each year follmving E] September 30, � (year) ❑6 days before Special ❑ 15 days before iheyearinwbichthe election occurs Primary Run -Off, Special, (year) -Persons leaving office with me= fimds unfit such fiords are expended as provided in the Act . ❑October 25,(year) (year) *Unsuccessful candidates with excess ands, or ❑6 days before Special ❑ Dec. 31, (year) who receive contributions to retire debt incanted, until such funds weexpanded, orsuch unpaid ❑December 3l, (year) Run -Off, (year) debts are satisfied (December 31 filing only) Verification by Oath or Affirmation State of &0" c z— County of LTD li I 14 r w being duly swom (affirm), depose and say- that ay_that the information in this report form is complete, true, and correct. Further, I affirm that the contents in ibis report are the same as the contents in the electronic filing submitted, if also electronically filed. Swoon to and subscribed before me on 200t Si tore of Notary Public JEANETTE R MARCHIAFAVA Notary Public, Fulton Co., GA y Commission expires My Commission Expires August 29,2M cok— &Signature of Candidate b. Organization/Chairperson/Treasurer fails to comply with or who laowingly violates any of the provisions of the Ethics in Govemnent An shall be guilty of a misdemeanor. M , ' 1, SEC FORM CCDR ---1- State of Georgia Campaign Contribution Disclosure Report Outstanding Indebtedness (OPTIONAL) Election Cycle*: GerNerw Election Year: _ 2 71 Amount 1 Outstanding indebtedness at the beginning of this period. 2 Loans received this period. 7 3 Deferred payment of expenses this period f7 4 Payments made on loans this period. 0 5 Credits received on loans this period. D 6 Payments this period on previously deferred expenses. 0 7 I(Line Total indebtedness at the close of this reporting period. I + 2 + 3 - 4 - 5 - 6) e N83,.7< 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. I(Line I + 2 + 3 - 4 - 5 - 6) 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. 17 Total indebtedness at the close of this reporting period. (Line l+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/Candidate/Non-Candidate Committee Name tri en o s 0r �7u^ SEC FORM CCDR REV 01/2006 State of Georgia Campaign Contribution Disclosure Report Summary Report CONTRIBUTIONS RECEIVED I 1 have: No contributions to report. In -Kind Value Cash Amount The following contributions, includin Common Source, to report: A. If this is the first time to file a disclosure report for the current office sou¢ht. 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 from Line 6 of previous report in both the in-kind and cash amount columns. 3 Total amount of all contributions of $101.00 or more received in this reporting period. D Each such contribution must be listed on the "Listed Contributions Received" page. a S Ua 3a All loans received this period. y D3S.1� 3b Interest earned on campaign account this period. 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 /00 700 on the "Listed Contributions Received" page. Total contributions reported this period. 5 (Line 3 + 3a + 3b + 4) 6 Total contributions to date. Total to be carried forward to next report of this reporting cyclet i 350 y (Line 2 + 5) 1 EXPENDITURES MADE 7 I have: No expenditures to report. In -Kind Value Cash Amount The following expenditures to report: Total expenditures made and reported prior to this reporting period. If this is the 8 fust report of this Reporting Cycle*, ENTER 0. b Q Line 12 of previous report) 9 Total amount of all expenditures of $101.00 or more made in this reporting period. ybgs Total amount of all separate expenditures of less than $101.00 each that were made --� 10 in this reporting eriod. 11 Total expenditures reported this period. Line 9 + 10) Total expenditures to date. Total to be carried forward to neer report of this reporting cycle 12 (Line 8 + 11) 13 Net balance on hand. Van "') D (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 canaraate 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 (III) 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 T i 1 L� �' 44 J r eW c CR!` VnRM rITR REV 01/2006 State of Georgia Campaign Contribution Disclosure Report Listed Contributions Received of $101.00 or More Full Name of Contributor Mailing Address (PAC Affiliation if applies) 33 s �h l l Q i M, It �GAr Contributor Election C cle** Cash Amount $ In -Kind Contributions - Received Date Contribution Type* a. Occupation b. Employer W- Estimated Value Descrition Sn K4 $ 100 -OCA 0 1 M 9. w 131A69" Z` I 01 4- 5ht e Vy Vol L- v� g63S,'71> .. $ La $ $ $ $ $ $ $ $ $ $ Page Total T • Ps $ Z50 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) Public Officer/Candidate/Non-Candidate Committee Name 1 �S © J i"`�ti Page __�__ of SEC FORM CCDR 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 411uelbcd. coM Iso 5'A Ave Sa4su".1 AL 31,5-)-L M����s►� $ 109-140 S4i rrups C loth i,) Cer Ll�to B tzn�a. -Tfe •, '" 1 0 imc,44 q 14 �o 60 57 S ir"T 46 CV' L t 4�C'�r9aa. 'Tfa, i �t $ Com-- �6ox Z-0%-L2N7i A• kms, Sc ZRft2 I Lal b� Ow Sa ��� A& P01 9101b 7 �2. $% 00 $ $ $ Page Total D o 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 1 �i�(��0f Bj _r ' ` Page_ ___ of --L