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Home My WebLink AboutCCDR - 10/25/2009 - CCDR: Karen Thurman (4) (Migrated from Optiview)SEC FORM CCDR SEEO REV 06/2009 State of Georgia Campaign Contribution Disclosure Report - Statewide Elected 1. Report Type 2. Filing is being made on behalf of (Select One): (Select One) ❑ Candidate or Public Official Office Sought or Held: Milton City Council - District 1 Filing office use only 30 = 17 Original Report (Include county, municipality, district, post orjudicial circuit) Committee Name: Thurman For Milton CITY CLERK ❑ Amended Report OrIHEf ❑ Report of Organization or Person Other than Candidate's Campaign Committee Mark or Hand Amendment # Delivered Date 3. Identifying and Contact Information (1) Karen C. Thurman (2) 09/30/09 Full Name of Candidate or Non -Candidate Campaign Committee Today's Date (3) 310 Lake Bend Court Milton Georgia 30004 Mailing Address City State Zip Code (4) X104 ) 790 - 2874 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 []No (6) If so, is the committee registered with the State Ethics Commission? ❑� Yes ❑No (7) If so, complete the following: Terri Lawson 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 ❑ 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 occurs Primary Run -Off, Special, (year) -Persons leaving office with excess funds until such funds are expended as provided in the Act p October 25, 2009 (year) (year) *Unsuccessful candidates with excess funds, or ❑ 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 Georgia County of Fulton 1, Karen C. Thurman .�� uls s £firm), depose and say that the information in this report form is complete, true, and y Y fit% the contents in this report are the same as the contents in the electronic filing submitt$" o `' Mob et a 9 , ' • Sworn to and subscribed before me on 2g� :?' JULY • /1 ani P-4y� 2 �r t, , Signature of Notary Public A•.9�/� [date •ehairperson/Treasurer My Commission expires oZ iD b ��qN1 *11 PENALTIES: Any person who knowin y fails o comply with or who knowingly violates any of the provisions of the Ethics in Government Act shall be guilty of a misdemeanor. SEC FORM CCDR SEED REV 06/2009 State of Georgia Campaign Contribution Disclosure Report - Statewide Elected Executive Officer Summary Report CONTRIBUTIONS RECEIVED 1Cash ❑ I have no contributions to report. In -Kind Amount El I have the following contributions, including Common Source, to report: Estimated Value 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 2 and list any net balance on hand brought forward from the previous reporting cycle in the cash amount column (Line 15 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 of this Reporting Cycle, list totals 750 13440 from Line 6 of previous report in both the in-kind and cash amount columns. 3 Total amount of all itemized contributions received in this reporting period which are listed on the "Itemized Contributions" page. 3000 3a All loans received this reporting period. 3b Interest earned on campaign account this reporting period. 3c Total amount of investments sold this reporting period. 3d Total amount of cash dividends and interest paid out this reporting period. Total amount of all separate contributions of less than $101.00 received in this 4 reporting period and not listed on the "Itemized Contributions" page. 400 "Common Source" contributions must be aggregated on the "Itemized Contributions" page. 5 Total contributions reported this period. O 3400 (Line 3 + 3a + 3b + 3c + 3d + 4) 6 Total contributions to date. Total to be carried forward to next report of this reporting cyclet (Line 2 + 5) 750 16840 EXPENDITURES MADE 7 ❑ I have no expenditures to report. In -Kind Cash Amount ❑� I have the following expenditures to report: Estimated Value Total expenditures made and reported prior to this reporting period. If this is the 8 A. First report of this Reporting Cycle*, ENTER 0. 750.00 7385.75 B. Second or subsequent filing ENTER Line 12 of revious re ort. 9 Total amount of all itemized expenditures made in this reporting period which are O.00 7589.30 listed on the "Itemized Expenditures" page. 10 Total amount of all separate expenditures of less than $101.00 that were made in this reporting eriod and not listed on the "Itemized Expenditures" page. 11 Total expenditures reported this period. 750.00 7589.30 Line 9 + 10 12 Total expenditures to date. Total to be carried forward to next report of this reporting cycle*. 750.00 14975.05 (Line 8 + 11) INVESTMENTS 13 Total value of investments held at the beginning of this reporting period. 0.00 14 Total value of investments held at the end of this reporting period. 15 Net balance on hand. 0.00 Line 6 - 12 + 14) * O.C.G.A. 21-5-34(b)(1)(D)(ii) A reporting cycle shall commence on January l 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; 11Y►' (11) On December 31 of the year in which such election was held if such candidate is unsuccessful; or (QI) 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. Karen C. Thurman Public Officer/Candidate/Other Than Candidate Committee Name pq SEC FORM CCDR SEEO REV 06/2009 State of Georgia Campaign Contribution Disclosure Report - Statewide Elected Executive Officer Outstanding Indebtedness Election Cycle*: General Election Year: 2009 Amount 1 Outstanding indebtedness at the beginning of this reporting period. 6929 2 Loans received this reporting period. 3 Deferred payment of expenses this reporting period 4 Payments made on loans this reporting period. 5 Credits received on loans this reporting period. 6 Payments this reporting period on previously deferred expenses. 7 Total indebtedness at the close of this reporting period. I(Line I + 2 + 3 - 4 - 5 - 6) 6929 Election Cycle*: Election Year: Amount 1 Outstanding indebtedness at the beginning of this reporting period. 2 Loans received this reporting period. 3 Deferred payment of expenses this reporting period 4 Payments made on loans this reporting period. 5 Credits received on loans this reporting period. 6 Payments this reporting 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 reporting period. 2 Loans received this reporting period. 3 Deferred payment of expenses this reporting period 4 Payments made on loans this reporting period. 5 Credits received on loans this reporting period. 6 Payments this reporting 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 Ofcer/Candidate/Other Than Candidate Committee Name Karen C. Thurman SEC FORM CCDR SEED REV 6/2009 State of Georgia Campaign Contribution Disclosure Report - Statewide Elected Executive Officer Itemized Contributions Must list contributions received by a single contributor for which the aggregate total is $101.00 or more Note: Loans are no longer reported in `Itemized Contributions' section. See Loan Reporting section below. 0 Mark if associated*with a regulated entity Full Name of Contributor Mailing Address (Affiliation of Committee if any) Contributor Election Cycle*** Cash Amount In -Kind Contributions Received Date Contribution Type** Occupation & Employer Estimated Value Description 17 See attached list 1. 2. Reference: OCGA j 21-5-34(b)(1) Loan Page Total $ o Regulated Entity Page Total Regulated Entity Total Itemized Contribution Page Total $3000 $ 0.00 Loan Reporting Name of Lender Mailing Address Date of Loan Amount of Loan Election Cycle*** Person(s) responsible for repayment of loan Mailing Address Occupation & Place of Employment Fiduciary Relationship**** 1. 2. 1. 2. Reference: OCGA j 21-5-34(b)(1) Loan Page Total $ o * Any person who may be employed by a regulated entity, including a person in whose name a license or lease is held, or who is an officer of a regulated entity ** Contribution Type (Monetary, In -Kind, Common Source, Credit Received on Loan) *** Election bra+**** Cycle (Primary, General, Special, Special Primary, Run -Off Primar , Run -Off General, Run -Off Special, Run-OfSpecial Primary) Ifany such persons shall have a fiduciary relationship to the lending institution or party making the advance or extension of credit Public Officer/Candidate/Non-Candidate Committee Name Page of R4 SEC FORM CCDR SEED REV 06/2009 State of Georgia Campaign Contribution Disclosure Report - Statewide Elected Executive Officer Itemized Expenditures Must list expenditures made to a single recipient for which the aggregate total is 5101.00 or more List Name and Mailing Address of Recipient Expenditure Date Expenditure Type* Occupation & Employer Expenditure Purpose Amount Paid Beacon Media 10/02/09 Advertising 515 East Crossville Road, Suite #350 Roswell, GA $ 1250.00 Expenditure Signs 2 Fit 10/09/09 Magnets & Banner 106 E 34th Street $ 445.90 Boise, Idaho 83714 Expenditure HEG, LLC 10/13/09 Consulting, printing & 2774 Royal Oaks Drive mailing $ 4180.60 Pensacola, FL 32504 Expenditure All About Signs 10/21/09 Signs 4371 Roswell Road $ 381.60 Marietta, GA 30062 Expenditure Appen Newspaper 10/20/09 Advertising 319 North Main Street Alpharetta, GA 30009 $ 513.50 Expenditure Aluma Panel 10/02/09 Stakes 2410 Oak Street West $117.70 Cumming, GA 30041 Expenditure Beacon Media 10/15/09 Advertising 515 East Crossville Road $ 700.00 Roswell, GA Expenditure Page Total $ 7589.30 * Expenditure Type (Expenditure, In -Kind, Loan Repayment, Refund, Reimbursement, Credit Card, 3rd Party, Deferred Payment, Payment on Deferred Expense, Investment) Public Officer/Candidate/Other Than Candidate Committee Name Karen C. Thurman Page of SEC FORM CCDR SEEO Rev 6/2009 State of Georgia Campaign Contribution Disclosure Report - Statewide Elected Executive Officer Investments Statement 1. Investment Name Account Number Institution/Person Holding Account Mailing Address City, State, Zip Value at beginning of reporting period $ Value at end of reporting period $ Difference in value $ Interest Paid Out $ L Cash Dividends $ Investment Transactions Date Person(s) Involved in Transaction Value of investment purchased Value of investment sold Profit Loss 2. Investment Name Account Number Institution/Person Holding Account Mailing Address City, State, Zip Value at beginning of reporting period $ Value at end of reporting period $ Difference in value $ Interest Paid Out $ Cash Dividends $ Investment Transactions Date Person(s) Involved in Transaction Value of investment purchased Value of investment sold Profit Loss Total value of investments at be ig nning of reporting period $ Total value of investments at end of reporting period $ Total difference in value $ Page Total Cash Dividends: $ Page Total Interest Paid Out: $ Page Total Profit: $ Page Total Loss: $ Public Officer/Candidate/Other Than Candidate Committee Name Karen C. Thurman Page of SEC FORM CCDR SEEO REV 06/2009 State of Georgia Campaign Contribution Disclosure Report - Statewide Elected Executive Officer 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/OtherThan Candidate Committee Name Karen C. Thurman Page of SEC FORM CCDR REV3/2008 State of Georgia Campaign Contribution Disclosure Report Itemized Contributions Must list contributions received by a single contributor for which the aggregate total is $101.00 or more Note: Loans are no longer reported in "Itemized Contributions" section. See Loan Reporting section below. Full Name of Contributor Mailing Address Mailing Address (Affiliation of Committee if any) Contributor Election Cycle** Cash Amount In -Kind Contributions Received Date Contribution Type* Occupation & Employer Estimated Value Description Meredith Randall 410 Powers Court Ave, Milton, GA 10/21/2009 Retired General 150 check Holt Garrard 4115 Little Falls Drive, Cumming, GA 10/5/2009 Retired General 200 check Roger Lusby 5604 Bahia Mar Circle, Stone Mountain, GA 10/12/2009 CPA Frazier & Deeter General 500 check Ronald Wallace 13090 Freemanville Road, Milton, GA 10/24/2009 Owner Olde Blind Do General 1000 check J C Hines 80 Milton Avenue, Alpharetta, GA 10/10/2009 Vet Alpharetta Animal Hos General 200 check William R. Collins 610 Athlone Court, Milton, GA 10/20/2009 Investor MultiVest, Inc. General 500 check Solomon Senior Living Holdings, LLC 48 Old Roswell St, Alpharetta, GA 10/25/2009 Senior Living General 250 check Susan Wieland 3245 Nancy Creek Rd, NW, Atlanta, GA 10/1/2009 Community Volunteer Self-employed General 200 check $ 3,000 $ Itemized Contributions Page Total