HomeMy WebLinkAboutBohen 4 OV - Termination Statement - 10/28/2024OCT 272*12:4? 1.0V
Finance — Can&dare Gidde
APPENDIX D - SAMPLE LOCAL TERMINATION STATEMENT
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COMMITTEE INFORMATION:
STATE Of ARIZONA
COMMITTEE TERIMINATION
STATEMENT
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Tm.e.m Tim Bohen. -
DECIMATION AND SIOW RES.
COMMmu ID NUMBER
OVTC 20-o5
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STATE OF ARIZONA COMMITTEE ID NUMBER
COMMITTEE CAMPAIGN
` OVTC 20-05
*. FINANCE REPORT
COMMITTEE INFORMATION (required):
Committee Information: Committee Name: Bohen 4 OV
CAN
)IDATE INFORMATION (only if filinq as a candidate committee):
Office Sought. ❑ County Office: ❑ Special District Office:
Ei Cityrrown Office: Oro Valley Town Council ❑ School Board District:
Cumulative Report:
❑ Check here if this is the candidate committee's first, cumulative report for the election cycle. Also select appropriate Reporting Period below.
Cumulative reporting period start date (which supersedes the start date for the Reporting Period selected below):
REPORTING PERIOD (check one):
REPORTING PERIOD REPORT DUE
FINANCIAL SUMMARY (required):
Activity I Cash Activity This I Election Cycle to
Reporting Period Date
(a) Committee value at the beginning of this reporting period (i.e. ending balance from the
previous reporting period)
$ 16.35
(b) + Total receipts (from "Summary of Receipts," line 13 (cash column) for this reporting period)
$ 16.00
$ 6,067.33
(c) - Total disbursements (from "Summary of Disbursements," line 16 (cash column) for this reporting period)
$ 32.35
$ 7,855.72
(d) = Balance at close of reporting period
$ 0.00
f ,
❑ Check here if filing no financial activity during the reporting period. Lines (a)-(d) still must be completed, but only this cover page and the
following page need to be filed.
Committees with financial activity must file the cover page, summary of receipts, summary of disbursements, and any schedules that contain
financial activity. Arizona Secretary of State Revision 9/28/23; League Update 03/25/24 (fillable format)
Tim Boren
1�
STATE OF •
FINANCE REPORT
Under A.R.S. § 16-926(B)(5), a campaign finance report must be
certified by the committee treasurer under penalty of perjury that
the contents of the report are true and correct.
By filing this report, you certify that, under penalty of perjury, you
have examined the contents of this report, and the contents are
true and correct.
Timothy Bohen Oxea"202410,281742`0000-0 o0
COMMITTEE ID NUMBER
Cii 20-05
10/28/2024
Printed Name of Committee Treasurer Signature of Committee Treasurer Date
Arizona Secretary of State Revision 9/28/23
STATE OF ARIZONA
COMMITTEE CAMPAIGN
FINANCE REPORT
SUMMARY OF RECEIPTS (Schedule A):
COMMITTEE ID NUMBER
OVTC 20-05
/ Receipts Cash Equity
1. Monetary Contributions Received
(a) In -State Individuals -More than $100
(b) In -State Individuals - $100 or Less (Aggregate)
(c) Out -of -State Individuals
(d) Candidate Committees
(e) Political Action Committees r
(f) Political Parties
(g) Partnerships
(h) Corporations & Limited Liability Companies (PACs & Political Parties only)
(i) Labor Organizations (PACs & Political Parties Only)
(j) Candidate's Personal Monies (Candidate committees only)
(k) Monetary Contributions Subtotal (add 1(a) through 1(j))
(1) Refunds Given Back to Contributors
(m) Net Monetary Contributions (subtract 1(l) from 1(k))
2. Loans
(a) Loans Received
(b) Forgiveness on Loans Received
(c) Repayment on Loans Made
(d) Interest Accrued on Loans Made
(e) Loans Subtotal (cash: add 2(a), 2(c) & 2(d))
3. Rebates and Refunds Received
4. Interest Accrued on Committee Monies
5. In -Kind Contributions Received;
(a) In -State Individuals -More than $100
(b) In -State Individuals - $100 or Less (Aggregate)
(c) Out -of -State Individuals
(d) Candidate Committees
(e) Political Action Committees
(f) Political Parties
(g) Partnerships
(h) Corporations & Limited Liability Companies (PACs & Political Parties only)
(i) Labor Organizations (PACs & Political Parties only)
Q) Candidate's Personal Assets or Property (Candidate committees only)
(k) In -Kind Contributions Subtotal (equity: add 5(a) through 50)
6. In -Kind Donations Received (Non -contributions) (Political Parties Only)
7. Extensions of Credit
(a) Extensions of Credit Received -
(b) Payments on Extensions of Credit Received
(c) Net Extensions of Credit (subtract 7(b) from 7(a))
8. Joint Fundraising / Shared Expense Payments Received
9. Payments Received for Goods / Services
10. Outstanding, Accounts Receivable / Debts Owed to Committee z
11. Transfer In Surplus Monies / Transfer Out Debt (use cash and/or equity asappllcable)
12. Miscellaneous Receipts (use cash and/or equity asapplicable) $16.00
13. Total Receipts (cash: add 1(m), 2(e), 3-4, 8-9, 11-12; equity: add 2(b), 5(k), 6-7(c), 10-12) $16.00
Arizona Secretary of State Revision 9/28/23
STATE OF ARIZONA
a COMMITTEE CAMPAIGN
FINANCE REPORT
SUMMARY OF DISBURSEMENTS (Schedule B):
COMMITTEE ID NUMBER
OVTC 20-05
/ Disbursements
1. Disbursements for Operating Expenses
Cash
Equity \
2. Contributions Made
(a) Candidate Committees
(b) Political Action Committees
(c) Political Parties
(d) Partnerships
e Corporations & Limited Liability Companies PAC & Political Parties Only)
(f) Labor Organizations (PAC & Paitical Parties only)
(g) Monetary Contributions Subtotal (add 2(a) mmugh 2(f))
(h) Contribution Refunds Provided to the Reporting Committee
(i) Monetary Contributions Total(sul*aa 2(h) from 2(c))
3. Loans
(a) Loans Made
(b) Loan Guarantees Made
(c) Forgiveness on Loans Made
(d) Repayment of Loans Received
(a) Accrued Interest on Loans Received
(1) Total Loans (cash: add 3(a), 3(d) & 3(e); equity: add 2(b) & 2(c))
4. Rebates and Refunds Made (Non-C nanbutio*
5. Value of In -Kind Contributions Provided
(a) Candidate Committees
(b) Political Action Committees
(c) Political Parties
(d) Partnerships
e Corporations & Limited Liability Companies (PAC & Political Panes only)
(Q Labor Organizations (PAC & Poetcai Pames only)
Contributions Subtotal (add a though r))
6. Independent Expenditures Made
7. Ballot Measure Expenditures Made
8. Recall Expenditures Made
9. Support Provided to Party Nominees (Pascal Parties only)
10. Joint Fundraising / Shared Expense Payments Made
11. Reimbursements Made
12. Outstanding Accounts Payable / Debts Owed by Committee
13. Transfer Out Surplus Monies / Transfer In Debt (use roan and or equity as apWlcable)
14. Miscellaneous Disbursements
15. Aggregate of Disbursements - $250 or Less
$32.35
16. Total Disbursements (cash, add L 2(1), 3(A. &-11 Is 1315, equity: add 3(n), 5(9), & 12-13)
$32.35
Arizona Secretary of State Revision 9/28/23
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MISCELLANEOUS RECEIPTS:
COMMITTEE ID NUMBER
OVTC 20-05
SCHEDULE A(12)
Cumulative Cumulative
Source Information Amount Amount this Amount this
Reporting Period Election Cycle
Name
Schedule A(12), page_ of
1
$16.00
$16.00
$16.00
100 N Tyron Street
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Charlotte
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ZIP
28255
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Reverse October 2024 Bank Fee
Racept Dare
10/13/24
2
Name
StreM FbJrtee
Cily
%h
ZIP
Receipt Type
Receipt Date
3
Nerve
Street REbw
CRY
6rete
ZIP
Reulpl type
Receipt Dah
4
Name
Street AJdeaa
CAy
Slere
21P
Receipt Type
Reaeiq Date
lame'
ZIP
LEnter
Receipt Dah
ast page of schedule$16.00
ivetl this period to 'Summary or Receipts,' line 12)
$16.00
Arizona Secretary of State Revision 9/28/23
AGGREGATE OF DISBURSEMENTS — $250 OR LESS:
STATE OF ARIZONA COMMITTEE ID NUMBER
COMMITTEE CAMPAIGN OVTC 20-05
FINANCE REPORT
SCHEDULE B(15)
Cumulative Amount this Reporting Cumulative Amount this Election
Period Cycle
$32.35
$5,422.73
Cumulative of Disbursements - $250 or Less
$32.35
$5 422.73
Enter total only if last page of schedule
(transfer Me total received this period to "Summary of Disbursements; line 15)
1 1
Schedule B(15), page_ of
Arizona Secretary of State Revision 9128/23
Bohen Campaign Pre -General Election Finance Report 10-19-24
Table of Contents
Page Subject
Committee & Candidate Information, Reporting Period, Financial Summary
2 Treasurer Certification
3 Summary of Receipts
4 - Summary of Disbursements
39 Miscellaneous Receipts
t
69 Aggregate of Disbursements - $250.00 or Less
Bohen Pre -General Election Table of Contents 10-19-24
10/29/2024