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CCDR: Burt Hewitt
,.a••,. SEC FORM CCDR State of Georgia Campaign Contribution Disclosure Report . 1. Report Type 2. Filing is being made on behalf of (Select One): �y (Select One) ❑ Candidate or Public Official REXT Office Sought or Held: l I fc n C- tkq CoanL ► I aoS t% q ❑ Original Report (Include county, 1municipalliity, district, post orjudicial circuit) FEB 2 1 LWo Amended Report Committee Name: Fra enf�_S of t� , - 4L j i � Use Earlier of Post Amendment # / [:]Report of Organization or Person Other than Candidate's Campaign Committee ��N 3. Identifying and Contact Information (l) L1yL)G DV` nrlr 4Svy=�T-T (2) Full Name of Candidate or Non -Candidate Campaign Committee Today's Date (3) 134 �T (� ny i2b ftl►Iln GPf zaw`f Mailing Address City State Zip Code (4) ( b -A SW - S6 ( q and / or (4tq) 59> - Z7 SI Contact Phone Number (We will understand the release of flus information as permission to callyour 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 �J (6) If so, ia s the committee registered with the State Ethics Commission? Yes (7) If so, complete the following: [, i) Q 1 (�Gyjx 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 are in a Run -Off Election) Special Elections (Report required only if you are in a Special Election) ❑June 30, (year) F-1 March 31, (year) ❑6 days before Primary ❑15 days before Run -Off, (year) Special Primary, ❑Dec. 31, (year) ❑June 30, (year) ❑6 days before General (year) Run -Off, (year) -Persons elected to office in each year following ❑ September 30, (year) ❑6 days before Special ❑ 15 days before the year in which the election oecuta Primary Run -Off, Special, (year) *Persons leaving office with excess fiords until such fiords are expended as provided in the Act ❑ October 25, (year) (year) - •Unsuccessful candidates with a cess fiords, or ❑6 days before Special ❑Dec. 31, (year) wbo receive contributions to retire debt incurred, until such fi�dsamexpeoded,orsuch uopaia ®December3l,�(year) Run -Off, (year) debts aro satisfied (Deeember 31 fling only) Verification by Oath or Affirmation State of County of�'lll."CZ� li being duly sworn (affirm), 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. Swom to and subscribed before me 20n� k 6�01,11(4 6t".fN. Public PUIA- JEANETTE R MARCHIAFAVA Notary Public, Fulton Co., GA Commission expires Cm. vnlrnc August 29, 2009 who knowingly fails to comply with or who }aowingly violates any of the d Signature of Candidate b. Organization/Chairperson/Treasurer of the Ethics in Govemmem Act shall be guilty of a misdemeanor. w SEC FORM CCDR REV OI/ZOUb State of Georgia Campaign Contribution Disclosure Report Outstanding Indebtedness (OPTIONAL) Election Cycle*: Cerv� Election Year: —2,U71 Amount 1 Outstanding indebtedness at the beginning of this period. 2 Loans received this period. aai7 5 0 0 3 Deferred payment of expenses this period 0 4 Payments made on loans this period. 0001 UO 5 Credits received on loans this period. 0 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) y3101 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: 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. j 7 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/Candidate/Non-Candidate Committee Name a sur SEC FORM CCDR F"01/2006 State of Georgia Campaign Contribution Disclosure Report Summary Report CONTRIBUTIONS RECEIVED 1 I have: No contributions to report. In -Kind 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 souelit, 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. ecia co Each such contribution must be listed on the "Listed Contributions Received" page. I Q75 3a All loans received this period. psi a 7,5.Ott 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 r on the "Listed Contributions Received" page. 5 Total contributions reported this period. 7`S (Line 3 + 3a + 3b + 4)2 6 Total contributions to date. Total to be carried forward to next report of this reporting cycle*. Q (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. 5 1 VT .7 (Line 12 of previous report) 9 Total amount of all expenditures of $101.00 or more made in this reporting period. 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. q 30 - (Line 9 + 10) ��i 12 Total expenditures to date. Total to be carried forward to next report of this reporting cycle*. Line8+11) 13 Net balance on hand. 3 J 30, 33 (Line 6 - Line 12) * O.C.G.A. 21-5-34ftl)(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 tens 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 hq (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 l �%��� �� U i) �� eUjI N QPr FnR M CMR REV o7/2006 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) Contributor Election Cycle" Cash Amount In -Kind Contributions Received Date Contribution Type* a. Occupation b. Employer Estimated Value Description earl S-Mrl i01 -J)ar�'7 iZO M 116 &Pf W1 j llb U.- 4.6 t�, � �t� $ 400,00h $ k'j M herle. 7:S -&V,,,% -u, Moo I}�1.�{� 217 V IL7�2�� $ 06. to $ 6: $ Zbo i 7�rbf'�1 �1� I �a,j" ( � ® 7 1pj I� &4, f CT $ 7� $ Low -a; o'9ver'4- 57.S3 Cha*,P,� 0-1115 (-� c I I SIb1 0_ -�� �� ,- �. �,,, �r ► �� $ $ 3�S Qa Tv, kJ C �,� G, t�s $ $ qM o0 Aa ,-f-i- 2 - Ca`j,,J 21=� a 7a¢- ���t terns V2n I hU�61� $ $ $ Page Total $ 3Z7s q 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) , • ,.� l Public Officer/Candidate/Non-Candidate Committee Name 1 1 i G �`g i� �� w Page -I—of / !S W SEC FORM CCDR rc^.v �iicwo State of Georgia Campaign Contribution Disclosure Report Listed EXDenditures 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 (v rr®11-W �Is. 40"W61 too �s � ('c�-{cr-, sh.3r M L6 j fv335 11 ik of i'larl y i� J J g'5 %. q S jV1a�k= £ �ct.1w Mood i2o ( (A � $ FL (.�,G-� 1��-� 11 ► Z o ��j $ Z 75�, Ob oh/p $ 1000.00 $ $ $ Page Total $ 43615'S' 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 nV ` Page—Lof_L