HomeMy WebLinkAboutCCDR: Tina D'Aversa (2)N
SEC FORM CCDR
REV 01/2006
State of Georgia RECEIVED
Campaign Contribution Disclosure Report
1. Report Type 2. Filing is being made on behalf of Select One): Filing office us only
(select one) Pq Candidate or Public Official' EC
Office Sought or Held:
[� Original Report (Include county, mum' ipality, district, post orjudicial circuit) CTrY CLERK
Committee Name: OF MILTON
Amended Report Use Earlier of Post
Amendment #
Report of Organization or Person Other than Candidate's Campaign Committee Mark or Hand
Delivered Date
3. Identifying and Contact Information
cl �J t j c 5 A (2) t-�
Full Name of Candidate or Non -Candidate Campaign Committee s�ynn ,Tojjdaff's Date
(3) 3 S LZ Lei u Lr �—r4 Cls ��I t M, 14% A
Mailingflddress I City State Zip Code
(4) ( 9 S 1- o i, 1-) 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? E]Yes (6) If so, is the committee registered with the State Ethics Commission? ❑ 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)
76 days before Primary
F� 15 days before
Run -Off, (year)
Special Primary,
FV Dec. 31, 2(%a�year)
June 30, (year)
�6 days before General
(year)
Run -Off, (year)
*Persons elected to office in each year following
0 September 30, (year)
[:]6 days before Special
15 days before
the year which the election occurs
'Persons leaving office with excess funds until
Primary Run -Off,
Special (year)
such funds are expended as provided in the Act
F_j October 25, (year)
(year)
*Unsuccessful dates with funds,
who receive contributions to retire debt incurred,
[:]6 days before Special
Dec. 31, (year)
until such funds are expended, or such unpaid
F1 December 31, (year)
Run -Off, (year)
debts are satisfied (December 31 filing only)
Verification by Oath or Affirmation
State of County of
'Ai V &
*�� ,! t being duly sworn (affirm), depose and say
that the informatior, 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 elegy
Sworn to and subscribed before me on _ e3. , 20_6g
of Notary Public JZArN'-;.TTE R MARCHIAFAVA
I ' ':.ry Public, Fulton Co., GA
._, sston Expires August 29, 2008
Commission expires
;LTIES: Any person who knowingly fails to
with or who knowingly violates any of the provisions of the Ethics in Government Act shall be guilty of a misdemeanor.
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 followingcontributions, includingCommon 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
2
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
40
in the cash amount column (Line 13 of previous report, or total funds left over at
j"III
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.
Each such contribution must be listed on the "Listed Contributions Received" page.
3a
All loans received this period.
e
y
3b
Interest earned on campaign account this period.
a NM
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.
5
Total contributions reported this period.
(Line 3 + 3a + 3b + 4)
6
Total contributions to date. Total to be carried forward to next report of this reporting cycle".
(Line 2 + 5)
EXPENDITURES MADE
I have:
In -Kind
7
No expenditures to report.
Value
Cash Amount
The followingexpenditures 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.
)1
f►`�j
(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 rep rting period.
11
Total expenditures reported this period.
Line 9 + 10)
12
Total expenditures to date. Total to be carried forward to next report of this reporting cycle.
(Line 8 + 11)
13
Net balance on hand.
5
(Line 6 - Line 12)
t
* O.C.G.A. 21-5-34(b)(1)(D)(ii) A reporting cycle shall commence on January I of the year in which an elect
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
(II) On December 31 of the year in which such election was held if such candidate is unsuccess
(III) If such candidate is successful and seeks reelection or seeks election to some other office he current rep
reelection or for some other office begins
Public Officer/Candidate/Non-Candidate Committee Name
to be held for the public office to which a candidate
some other office;
cycle shall end when the reporting cycle for
SEC FORM CCDR
REV 01/2006
State of Georgia
Campaign Contribution Disclosure Report
Outstanding Indebtedness
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 I + 2 + 3 - 4 - 5 - 6)
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)
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 (Primary, General, Special, Special Primary,
Run -Off Special Primary)
Public Officer/Candidate/Non-Candidate Committee Name
'2Gp ZC0�_
ary, Run -Off General, Run -Off Special,
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
Cycle**
Cash
Amount
In -Kind Contributions
Received Date
Contribution Type*
a. Occupation
b. Employer
Estimated Value
Description
Page Total $0 $_0_
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 ReAeived on Loan)
** Election Cycle (Primary, General, Special, Special Primary, Run- ri , 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 $101.00 or More
List Name and Mailing Address Expenditure Date Occupation and Place Expenditure Purpose Amount Paid
of Recipient Expenditure Type* of Employment
i
O TY \J )l `
U.
L b 5
t:� a$ (1
t_" 6, �C
$
$
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
SEC FORM CCDR
REV 012006