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Home My WebLink AboutCCDR: Rick Mohrig (2)SEC FORM CCDR REV 01/2006 State of Campaign n Contribut oReport Disclosure Re ort Georgia &.- VE. P .g 1. Report Type 2. Fqng is being made on behalf of (Select One): Filing office use only (select one) Candidate or Public Official 9 2nn1 Office Sought or Held: C -•-r-9 W� Original Report (Include county, municipality, adstrict, post orjudicial circuit) Committee Name: CITY CLERK ❑ Amended Report a1sTVL?1VeAb#MN Report of Organization or Person Other than Candidate's Campaign Committee Mark or Hand Amendment # Delivered Date 3. Identifying and Contact Information (1) &CcAed /�1�,�iri�i (2) �7 D Full Name of Candidate or Non -Candidate Campaign Comkiee Today's Date (3) 139D,5- &lQ -ice rye = ; Pfr /-bn 3 000V Mai��linngAddress / City State Zip Code and / or ( ) - 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 (6) If so, is the committee registered with the State Ethics Commission? 0 Yes (7) If so, complete the following: 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) March 31, (year) [:]6 days before Primary F-] 15 days before Run -Off, (year) Special Primary, ❑ Dec. 31, (year)� iYune 30, IM7 (year) [--16 days before General (year) Run -Off, (year) •Persons elected to office in each year following September 30, (year) Ej6 days before Special 15 days before the year in which the election occurs Primary Run -Off, Special, (year) *Persons leaving office with excess funds until such funds are expended as provided in the Aa October 25, (year) (year) 'Unsuccessful candidates with excess funds, or F-]6 days before Special Dec. 31, (year) who receive contributions to retire debt incurred, until such funds are expended, or such unpaid ❑ December 31, (year) Run -Off, (year) debts are satisfied (December 31 filing only) Verification by Oath or Affirmation State of Cj 'A ��/fJ /j County of j I t`C F- on e- 5 e �Qr✓1.1A i'01 , being duly sworn (affirm), depose and say that the information in this report form is complete, true, aVdcorrect. Further, I affirm that the contents in this report are the same as the contents in the electronic filing submitted, if also electronically filed. Sworn to and subscribed before me on 2007 f i re of Notary Public JEANETTE A MA IAFAVA Nota fy Public, Fulton Co., GA My Cwwni$WM ExplreS August 29, 2009 My Commission expires PENALTIES: Any person who I a. §<nature of Candidate b. Organization/ChairpervTreasurer fails to comply with or who knowingly violates any of the provisions of the Ethics in Government Act shall be guilty of a misdemeanor. SEC FORM CCOR State of Georgia Campaign Contribution Disclosure Report Summary Report CONTRIBUTIONS RECEIVED /ntributions I ha In -Kind 1 to report. 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 sought, 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. 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. 3a All loans received this period. 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 on the "Listed Contributions Received" page. Total contributions reported this period. 5 (Line 3 + 3a + 3b + 4) Total contributions to date. Total to be carried forward to next report of this reporting cyclet 6 (Line 2 + 5) EXPENDITURES MADE Ilia In -Kind 7 �pend�rere�p Value Cash Amount ort: Total expenditures made and reported prior to this reporting period. If this is the 8 first report of this Reporting Cycle*, ENTER 0. Line 12 of previous report) 9 Total amount of all expenditures of $101.00 or more made in this reporting period. 10 Total amount of all separate expenditures of less than $101.00 each that were made in this reporting eriod. 11 Total expenditures reported this period. Line 9 + 10 Total expenditures to date. Total to be carried forward to next report of this reporting cycle t 12 (Line 8 + 11) 13 Net balance on hand. (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; err+ (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 OR SEC FORM CCDR RPV n1 nnn6 State of Georgia Campaign Contribution Disclosure Report Outstanding Indebtedness (OPTIONAL) Election Cycle*;�(l &&a 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. 7 Total indebtedness at the close of this reporting period. I(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 OMcer/Candidate/Non-Candidate Committee Name SEC FORM CCDR 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 �jo $ Page Total $ $ 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 Page of 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 Page Total $ 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 Page of d SEC FORM CCDR REV 01/1006 State of Georgia Campaign Contribution Disclosure Report Addendum Statement The Addendum Statement should be used for explanation of any additional information needed to complete an accurate filing of this report. Public Officer/Candidate/Non-Candidate Committee Name Page