HomeMy WebLinkAboutCCDR - 10/25/2009 - CCDR:Bernard Wolff (Migrated from Optiview)SEC FORM CCDR
REV 03/2008
State of Georgia
Campaign Contribution Disclosure Report
c,� r
(J
. Report Type
2. Filing is being made on behalf of (Select One):
Filing o ice use only
(Select One)
Candidate or Public Official
CLERIC
Office Sought or Held: AQA,41"AA'
It'1L
FL"X
Original Report
(Include county, municipality, district, post orjudictal circuit)
June 30, (year)
Amended Report
Committee Name: ' �� �� t.lJ IC,�Ltgr�
' L°pwoiZ�
Use Earlier of Post
Report of Organization or Person Other than Candidate's Campaign Committee
Mark or Hand
Delivered Date
Amendment #
September 30, (year)
F-16 days before Special
r-1 15 days before
Special, (year)
the year in which the election occurs
3. Identifying and Contact Information
Primary Run -Off,
(2) 1'2/-.ZDIp
Full Name of Candidate or Other Than Candidate Campaign Committee \ Today's Date
® October 25, '(year)
(3) /eeW 4A5=1�Y /4d b� CL�AIl I �- ��D7K`
]Dec. 31, (year)
Mailing Address City State Zip Code
December 31, (year)
(4) (??O) 1jj! X9&.E 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
State Ethics Commission?
repords of the
Yes
campaign, or file the reports? 9 Yes R (6) If so, is the committee registered with the
(7) If so, complete the following: R vis a `' W % li,;P,,FF j- &,&"y
Name of Chairperson and/or Treasurer of Committee
4. Period for which you are Reporting
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
F-1 15 days before
Run -Off, (year)
Special Primary,
Dec. 31, 14d (year)
June 30, (year)
F16 days before General
(year)
Run -Off, (year)
"Persons elected to office in each year following
September 30, (year)
F-16 days before Special
r-1 15 days before
Special, (year)
the year in which the election occurs
Primary Run -Off,
-Persons leaving office with excess funds until
such funds are expended as provided in the Act
•Unsuccessful candidates with excess funds, or
® October 25, '(year)
(year)
[:]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
County of
1 I7LAP�F being duly sworn (affirm), depose and say
that tte—`mforination 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.
to and
of
Commission
ZI , 20j�)
public 19 : W = a. Signature of Candidate V 1,
' 11201 0 �� ` b. Organization/Chairpersonfrreasurer
n fl Asa rsilEtd� olA�th or who knowingly violates any of the provisions of the Ethics in Govemment Act shall be guilty of a
E
SEC FORM CCDR
REV 03/2008
State of Georgia
Campaign Contribution Disclosure Report
Summary Report
CONTRIBUTIONS RECEIVED
1
❑ I have no contributions to report.
In -Kind
Estimated Value
Cash Amount
❑ I have the followins 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 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
from Line 6 of previous report in both the in-kind and cash amount columns.
46
Total amount of all itemized contributions received in this reporting period which are
8'Sg,3
3
listed on the "Itemized Contributions" page.
3a
All loans received this reporting period.
d
3b
Interest earned on campaign account this reporting period.
3c
Total amount of investments sold this reporting period.
f
Q
3d
Total amount of cash dividends and interest paid out this reporting period.
u; ,
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.
"Common Source" contributions must be aggregated on the "Itemized Contributions" page.
11
Total contributions reported this period.
5
(Line 3 + 3a + 3b + 3c + 3d + 4)
Total contributions to date. Total to be carried forward to next report of this reporting cycle"
Cl
6
Line 2 + 5
EXPENDITURES MADE
�
❑ I have no expenditures to report.
In -Kind
Estimated Value
Cash Amount
❑ 1 have the following expenditures to report:
Total expenditures made and reported prior to this reporting period. If this is the
8
A. First report of this Reporting Cycle*, ENTER 0.
B. Second or subsequent filing ENTER Line 12 of previous Mort.
Total amount of all itemized expenditures made in this reporting period which are
9
listed on the "Itemized Expenditures" page.
Total amount of all separate expenditures of less than $101.00 that were made
10
in this reporting eriod and not listed on the "Itemized Expenditures" page.
11
Total expenditures reported this period.
h
Line 9 + 10
Total expenditures to date. Total to be carried forward to next report of this reporting cycle`
12
Line 8 + 11)
INVESTMENTS
13
Total value of investments held at the beginning of this reporting period.
14
Total value of investments held at the end of this reporting period.
Net balance on hand.
N O
F '
Line 6 - 12 + 14
• 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
.„t conclude:
1) At the expiration of the term of office if such candidate is elected and does not seek reelection or election to some other office;
x(11) On December 31 of the year in which such election was held if such candidate is unsuccessful; or
(111) 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/Other Than Candidate Committee Name 2A& 9r4aW Y-2
SEC FORM CCDR
.F flIMAR
State of Georgia
Campaign Contribution Disclosure Report
Outstanding Indebtedness
1 Outstanding indebtedness at the beginning of this reporting period.
2 Loans received this reporting period. s<�
3 Deferred payment of expenses this reporting period
4 Payments made on loans this reporting period. rp
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) , 23
Outstanding indebtedness at the beginning of this reporting period.
2 Loans received this reporting period.
3 Deferred payment of expenses this reporting period
I Payments made on loans this reporting period.
5 Credits received on loans this reporting period.
6 Payments this reporting period on previously deferred expenses.
Total indebtedness at the close of this reporting period.
7 (Line 1+2+3-4-5-6)
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.
Total indebtedness at the close of this reporting period.
7 (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/Other Than Candidate Committee Name
Lo
cn-
SEC roma CCaR
Rry 3i?oos
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
(Affiliation of Committee if any)
Contributor
Election
Cycle**
Cash
Amount
in -Kind Contributions
Received Date
Contribution Type*
Occupation &
Employer
Estimated Value
Description
P 0 eta
Jbled ��0
2 'W
&c rAd"
�, dd
6045'li
Reference: OCGA § 21-5-34(b)(1) Loan Page Total $
Itemized Contributions Page Total $ $
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***
leco
2.
�, dd
2.
Reference: OCGA § 21-5-34(b)(1) Loan Page Total $
* Contribution Type (Monetary, In -Kind, 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)
*** If any such person(s) shall have a fiduciary relationship to the lending institution or party making the advance or extension of credit
Public Officer/Candidate/Other than Candidate Committee Name 26LA6 t Paee of
SEC FORM CCDR
REV 03/2008
State of Georgia
Campaign Contribution Disclosure Report
Itemized Expenditures
Must list expenditures made to a single recipient for which the aggregate total is $101.00 or more
List Name and Mailing Address
of Recipient
Expenditure Date
Expenditure Type*
Occupation &
Employer
Expenditure Purpose
Amount Paid
N
Page Total $
Expenditure Type (Expenditure, In -Kind, Loan Repayment, Refund, Reimbursement, Credit Card, 3rd Party, Deferred Payment,
Payment on Deferred Expense, Investment)
Public Officer/Candidatet0ther Than Candidate Committee Name Page of
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SEC FORM CCDR
Rev 3/2008
State of Georgia
Campaign Contribution Disclosure Report
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 $
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 beginning 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 Page of
4, '
SEC FORM CCDR
- .11 -
State of Georgia
Campaign Contribution Disclosure Report
Addendum Statement
F -The Addendum Statement should be used for explanation of any additional information needed to complete an accurate filing of this report.
Public Officer/Candidate/Other Than Candidate Committee Name Page of