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HomeMy WebLinkAboutCCDR - 1/11/2010 - CCDR: Al Trevillyan (Migrated from Optiview)SEC FORM CCDR REV 03/2008 State of Georgia Campaign Contribution Disclosure Report: 1. Report Type 2. Filing is being made on behalf of (Select One): ning ofoe use only (Select One) 0 Candidate or Public Official Office Sought or Held: Milton City Council 0 Original Report (Include county, municipality, district, post orjudicial circuit) Amended Report Committee Name: f-1� Use Earlier of Post E]Report of Organization or Person Other than Candidate's Campaign Committee M0* or Hand Amendment # Delivered Date 3. Identifying and Contact Information (1) Al Trevillyan (2) 12-31-09 Full Name of Candidate or Other Than Candidate Campaign Committee Today's Date (3) 1975 Birmingham Road, Milton, GA 30004 Mailing Address City State Zip Code (4) (770) 410 - 1193 and / or (770) 241 - 5366 Contact Phone Number (We will understand the release ofthis information as permission to call your office ifnecessary) (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? a Yes ❑ (6) If so, is the committee registered with the State Ethics Commission? ❑ Yes ❑ (7) If so, complete the following: Al Trevillyan Nam gjChainperson and/or Treasurer of Committee 4. Period for which you are Reporting My Non Election Year My Election Year Run -Orfs (Report required onh' if you are in a Run -Off ©ectiao) Special Elections (Re)ort inquired only ifyou are in a Special Election) E] 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 toofficeineach yearfollouing ❑September 30, (year) a6 days before Special ❑15 days before *1Oym "SChtheelection 0Cs *Persona leaving office with amasss nada omit PrimaRun-Off,, ry S tial, ear � (year) such funds are expanded as provided in the Act •umeceiv c candidates with torft debtess nds,or"�t71� a'ho receive contributions m retire debt incurred. ❑ Octo 2g (Year) �� (year) 6 days before Special ❑ Y Pf' Dec. 31, (year) until such finds are expanded, or such unpaid debts 31 filing ' � /y�� ' a a • -"') Run -Off, ear (year) are satisfied (December only) a e JWcati Alb Fath or Affirmation too *: 12 2010 !a: ` �,�• State of '•���0 ; County of;00n '> ••NC0.a4E•• ♦�� I> • " `�� being duly sworn (affirm), depose and say that the information in this reportform orrect. Further, I affirm that the contents in this report are the same as the contents in the electronic ° 1Atte!, if also electronically filed. Swom to and subscribed before me on / / 20l ���=liarflL.lL!! l� i of otary &blic Commission expires to comply with Of who knVwingty violates l•""� a � vel a. Signature of Candidate b. Organization/ChairpersomTreasurer of the @ddcs in Coveaumrat Act shall be guilty of a nusdaneasm. SEC FORM CCDR REV 03/2008 State of Georgia Campaign Contribution Disclosure Report Summary Report CONTRIBUTIONS RECEIVED 1 ❑ 1 have no contributions to report. In-Kmd I have the following contributions, including Common Source to rt: Estimated Value Cash Amount A. If this is the first time to file a disclosure report for the current office soueht. 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 filiLig of this ReportingCycle, list totals 325.00 3185.00 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. 333.32 0 3a All loans received this reporting period. 0 3b Interest earned on campaign account this reporting period. 0 3c Total amount of investments sold this reporting period. 0 3d Total amount of cash dividends and interest paid out this reporting period. 0 Total amount of all separate contributions of less than $101.00 received in this 4 reporting periodandnot listed on the "Itemized Contributions" page. 454.09 291.07 Common Sourcecontributions must be aggregated on the "Itemized Contributions" page. 5 Total contributions reported this period. Line3+3a+3b+3c+3d+4 787.41 291.07 6 Total contributions to date. Total to be carried forward to next report of this reporting cycle t Line 2 + 5 1112.41 1 3476.07 EXPENDITURES MADE 7 ❑ I have no expenditures to report. th-Kin El I have the following expenditures torert: Estimated Value Cash Amount Total expenditures made and reported prior to this reporting period. If this is the 8 A. First report of this Reporting Cycle*, ENTER 0. 0 4 424.71 B. Second or subsequent filing ENTER Line 12 of previous rt. 9 Total amount of all itemized expenditures made in this reporting period which are listed on the "Itemized Expenditures" page. 0 2057.29 10 Total amount of all separate expenditures of less than $101.00 that were made in this reporting period and not listed on the "Itemized Expenditures" page. 0 20.04 11 Total expenditures reported this period. (Line 9+ 10 0 2,077.33 12 Total expenditures to date. Total to be carried forward to next report of this reporting cycle". Line 8 + 11 0 6,502.04 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. 15 Net balance on hand. (Line 6 - 12 + 14 * O.C.G.A. 21-5-34(bx IXDxii) A reporting cycle shall commence on January 1 of the year in which an election is to be held for the public offs a 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; (11) On December 31 of the year in which such election was held if such candidate is unsuccessful; 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 repotting cycle for reelection or for some other office begins. Public Officer/Candidate/other Than Candidate Committee Name SEI; FORM CCDR REV 3J?uuh ' State of Georgia Campaign Contribution Disclosure Report Itemized Contributions Must list contributions received by a single contributor for which the Aggrallft total is $101.00 or more Note: Loans are no bnger reported in "Itemized Contributions" section. See Loan Re rting 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 Julie Zahner Bailey Genral 333.32 Calling Post 2. Reference: OCGA § 21-5-34(b)(1) Loan Page Total $ 2,000,00 Ty * Contribution T e (Moneta I K' d C F_ r 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*** AI Trevillyan 10/1/09 I' a Trevilyan 1975 Birmingham Road Milton, GA 30004 Retired Chemist 2,000.00 2. Genral 1. 2. Reference: OCGA § 21-5-34(b)(1) Loan Page Total $ 2,000,00 Ty * Contribution T e (Moneta I K' d C ry, n- in , ommon 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) 4 *** 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 Page of