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DETAILED
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CITY CLERK
REPORT OF CONTRIBUTIONS AND EXPENDITURES
(To be used by Candidate Committees, Political Committees, Issue Committees and Political Party Committees)
OR OmCE USE ONLY
1. FULL NAME OF CONMTTEE (as shown on statement of organization)
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2. NAME OF FINANCIAL INSTITUTION
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ADDRESS 0 check if different than previously reported
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ADDRESS
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3. SECRETARY OF STATE LD. NU1vfBER
CITY. STATE and ZIP CODE
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4. Did you accept Voluntary Spending Limits? (State Candidate Committees
DYes
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5. TYPE OF REPORT (County and Municipal Elections)
Pre-election Reports
21 days before election (10/12/99) "
(City of Fort Collins only)
14 days before election (10/19/99)
Post-election Reports
30 days after election (12/2/99)
Annual (November 1 of each year)
Friday before election (10/29/99)
Termination Report
0 Other (specify)
6. REPORTING PERIOD COVERED I~(
Is this report an Amendment 1 0
COLUMN A
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THRU
This Rept Period
FUNDS ON HAND AT BEGINNING OF REPORTING PERIOD
(from
Line 21)
\NO
COLUMN B
Calendar Year-Ie-Date
XXXXXXXXXXX
TOTAL CONTRIBUTIONS (from Line 16)
TOTAL EXPENDITURES
Y
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10.
FUNDS ON HAND AT CLOSE OF REPORTING PERIOD
xxxxxxxxxx
11.
Debt and Obligations Owed BY the Committee
XXXXXXXXXX
12. Pled es Owed TO the COmmIttee
XXXXXXXXXX
I certify that I have examined this Report of Contributions and Expenditures and to the best of my knowledge beliefit is true, COrTect and complete. I understand
submission offaIse , erroneous, or incomplete information may be subject to sanctions in accord with CRS 1 5- 1 .
PRINT NM1E OF REG. AGENT~\1(SUMMARY SHEET - REV
12197)
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