HomeMy WebLinkAboutCCDR: Rick MohrigSEC FORM CCDR
REV 01/2006
State of Georgia
My Election Year
Campaign Contribution Disclosure Report
Special Elections
(Report required only if you are in a Special
Election)
1. Report Type
2. Filing is being made on behalf of (Select One):
office use only
(select One)
�andidate or Public Official ,�'^A
Sought Held: C� %Y /►"ill lft C-0 6WAct )NW vl.
ZFifinjg
4 3W
Report
Office or
district, circ
❑ Dec. 31, (year)
riginal
(Include county, municipality, post orjudicial
(year)
Amended Report
Committee Name:
Post
Amendment #
Report of Organization or Person Other than Candidate's Campaign Committee
Mark or Hand .
Delivered Date
3. Identifying and Contact Information
❑ 15 days before
(1) fcl4ur yvt 1, (2). /DIo7
Full Name of Candidate or Non -Candidate CampaigWotommittee Today's Date
���D ��le�'we d v"u- Jy%r 300p�
Primary Run -Off,
(3) rl
"Persons leaving office with excess funds until
such funds are expended as provided in the Act
Mailinng� Address City State Zip Code
(4)�0) l (y,3g and / or ( ) -
(year)
Contact Phone Number (We will understand the release of this information as permission to callyour office if necessary)
*Unsuccessful candidates with excess funds, or
(5) If a Candidate or Public Official, is there a palgn committee (one or more persons) to make campaign transactions, keep the financial
records o
campaign, or file the reports? Yes (6) If so, is the committee registered with the State Ethics Commission?
(7) If so, complete the following: & rom is Q n lrC� /i` t �a�i' 1'q , �/� hh / c,O Gl
es
M4 _04 Ve)
Name of Chairperson and /or Treasurer of Committee
Run -Off, (year)
4. Period for which you are Reporting
debts are satisfied (December 31 filing only)
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)
Ej6 days before Primary
15 days before
Run -Off, (year)
Special Primary,
❑ Dec. 31, (year)
June 30, (year)
F__16 days before General
(year)
Run -Off, (year)
"Persons elected to office in each year followingeptember
30,ow)7(year)
76 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 Act
F-] October 25, (year)
(year)
*Unsuccessful candidates with excess funds, or
F-16 days before Special
Dec. 31, (year)
who receive contributions to retire debt incurred,
until such funds are expended, or such unpaid
❑December 3l, (year)
Run -Off, (year)
debts are satisfied (December 31 filing only)
Verification by Oath or Affirmation
r
State of Cf (j4Z f A County of tq qc)n
I, 61'cl G rd C !r l c7 p I being duly sworn (affirm), depose and say
that the information in this report form is comp ete, 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.
Sworn to and subscribed before me onQ/t8 20�
r
6at.rPublic
JEANET'TE R MARCHIAFAVA
Notary Public, Fulton Co.. GA
y Commission expires Lty omm" 'n €=;:rirEs August 2%2=
NALTIES: Any person who knowingly fails to comply with or who knowingly violates any of the r
a. Signature of Candidate
b. Organization/Chairpersonfrreasurer
of the Ethics in Government Act shall be guilty of a misdemeanor.
IM
SEC FORM CCDR
REV 01/2006
State of Georgia
Campaign Contribution Disclosure Report
Summary Report
CONTRIBUTIONS RECEIVED
I have:
In -Kind
1
No contributions 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
2
and list any net balance on hand brought forward from the previous reporting cycle
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
/t�{
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.
Each such contribution must be listed on the "Listed Contributions Received" page.0
3a
All All loans received this period.
3b
Interest earned on campaign account this period.
AFS„ "r
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
"Listed
95
S-0.00
on the Contributions Received" page.
5
Total contributions reported this period.
o
Linea+3a+3b+4)
6
Total contributions to date. Total to be carried forward to next report of this reporting cycle*.
uQ
3 "I 0z)
Line 2 + 5
/ .
EXPENDITURES MADE
I have:
In -Kind
7
tLa expenditures to report.
Value
Cash Amount
The following expenditures to report:
8
Total expenditures made and reported prior to this reporting period. If this is the
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.
2r QD
✓
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.
OP
9 + 10
���'
12
Total expenditures to date. Total to be carried forward to next report of this reporting cycle t
Line 8 + 11)
13
Net balance on hand.
�00
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;
Vrr/ (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
SEC FORM CCDR
REV 01/2006
State of Georgia
Campaign Contribution Disclosure Report
Outstanding Indebtedness (OPTIONAL)
1
Outstanding indebtedness at the beginning of this period.
2
Loans received this period.
,Z 2ptl r o�
3
Deferred payment of expenses this period
4
Payments made on loans this period.
3 4T 0
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)
0"' M 4 01, WN't
Outstanding indebtedness at the beginning of this period.
1
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)
1 I 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 (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 ° Lh or Q _74 - L A it '
pq
SEC FORM CCDR
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)
Contributor
Election
C cle**
Cash
Amount
In -Kind Contributions
Received Date
Contri ution Type*
a. Occupation
b. Employer
Estimated Value
Description
1►Ji LQAAd (Owp& J _
6 Du "w
ft 4,qr & A3e53�
6 7
,��-�rPeQ
Ce►te m
$ -cv
$
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or`lyn `%�i
11� �oS Wneh 1R�Qjo_V&ef
/�1P1ars Eta 366n-
g $' b 7
Q. R AcG ��^' T
b,Sp� t4ft �
$
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mo ,C vCJ n
167
rl W C.. / /4r-
���
Aorq
$ OD
Ot
$
L[LI
Al tom; .1e) A-
9 f fid- o
q nPtj5va
b, zk��s�
�($�
$
��
AA q
S 1� 4rl bP�S
r�
e. 7,�� ,�srrs
$
3 g5"AWQ�cCA `-
14/PY{ ZT4
1(3 fO
sc'(es
6 _Sef�- tai
SVD.00
M�#fes
Pa C4 IY\
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.AI kare,4(oil 6P,
a tq"0-
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1"iL) Pro
00
$
��
S !,w �� var4-
7 �el��
Ap
- �vkoz
(0 ( �U
$
$
Ififfiro,
Page Total $ 3 5 q?' 0Q $
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 Y"� VQ�� (" �t// l'"v Page of
IN
SEC FORM CCOR
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)
Contributor
Election
Cycle**
Cash
Amount
In -Kind Contributions
Received Date
Contribution Type*,
a. Occupation
b. Employer
Estimated Value
Description
G 430JW RKT4k,1
,AJ pk,,,44q C4 31ZD (
/g b7
Yr_TreQ _
$
� (
CK&716_G7C 6
75-6C`r-i' ii AA(M.�
til v%
q C sKl�aHt
$
$
2aK
S1IgV_ C4 36 o _�--
r
Ge"4
$ 1006, co
$
0UiiA
I~t /ftoL�
$
$
$
$
$
$
$
$
$
Page Total s 15-D•1%�
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 I `c / d 'i ;9"W� A1,9411 Page —9L of
A
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
'T' 0-F'K(t
13o,oD Nez&66 X14
A/' f0"/ Gk ��
V'� Id 7
C
�
$ 3 qO OD
��p(A;-
1—bW
b'9111113 / z>61
► 3 6r%l
F/3//b7
Pt��"'aP''�'
�Q�cy�1►�ri-� b-�
h
$ 3 70.60
Loh Y%y�hl�
-Nar Cb mrn -
�k7� wet(
43/0 7
ccvosc; -t-4 1-
C ra a4j1)7f
$ l
t Wop,_T_40
` � ax Ca�hm
fiu�
� �i�
S x(75
A -`u erAI&A 30 -�,O
9 (Q %D%
Cod �'ic.�i �(^�"
CWs�.c.i � � �r�
$ Ira)� DCS
&1Ap
#Plwl�e�IC4 36C�a'S
9�g67
WW
Q7
ST sly hs, �u
,WX 1
V*P 7
S6AI Co
$
Page Total 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(dr f �J�l (' 'l/�� % Page 1 of