state of georgia campaign contribution disclosure … form ccdr rev o.v2008 state of georgia...

SEC FORM CCDRREV O.V2008

State of GeorgiaCampaign Contribution Disclosure Report

I. Report Type(Select One)

[3 Original Report

i I Amended Report

Amendment #

2. Filing is being made on behalf of (Select One):

0 Candidate or Public Official

Office Sought or Held: Muscoqee County At-Larqe Representative(Include county, municipality, district, post or judicial circuit)

Committee Name: Committee to Elect Cathy Williams, School Boa

[ I Report of Organization or Person Other than Candidate's Campaign Committee

Filing office use onlj

Use Earlier of Post

Mark or HandDelivered Date

3. Identifying and Contact Information

(l)Cathleen WilliamsFull Name of Candidate or Non-Candidate Campaign Committee

(3)864 Blandford Avenue Columbus

(2) Oct 1.2010Todm-'s Date

GA 31906Mailing Address

(4) (706) 323-0999

Zip Code

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? 0 Yes Q No (6) If so, is the committee registered with the State Ethics Commission? [7] Yes | | No

(7) If so, complete the following: Charles Forbes Davis

4. Period for which you are Reporting

My Non Election Year

| [June 30, (year)

DDec. 31, (year)

•Persons elected to office in each year following

•Persons leaving office with excess funds until

,ebis ire satisfied (December 31 filing only)

My Election Year

d March 31, (year)

D June 30, (year)

\7\ September 30. 2010 (year)

Q October 25, (year)

I | December 3 1 , (vcar)

Run-Offs(Report required only if you arc in a Run-Off

Elecuonj

[_J 6 days before Primary

Run-Off, (year)

Q 6 days before General

Run-Off, (year)

Q 6 days before Special

Primary Run-Off,

(year)

Q 6 days before Special

Run-Off. (year)

Special Elections

Election)

1 | 1 5 days before

Special Primary,

(year)

[~~| 1 5 days before

Special, (vear)

D Dec. 31, (year)

10-05-10 Astate ot Georaia

Verification by Oath or Affirmation

rv O I - S O - O LCounty of Muscoqee

T. Cathleen Williams , being dulv sworn (affirm), depose and say

that the information in this report form is complete, true, and correct. Further, I affirm that the contents in this reportare the same as the contents in the electronic filing submitted, if also electronically filed.

Sworn to and subscribed before me on , 20

Signature on File

Signature of Notary Public

Siqnature on Filea. Signature of Candidate3. Organization/Chairperscm/Treasiirer

SEC FORM CCDR


Summary ReportCONTRIBUTIONS RECEIVED

i

2

3

3a

3b

3c

3d

4

5

6

G I have no contributions to report.[7] 1 have the following 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 Q in the in-kind columnand list any net balance on hand brought forward from the previous reporting cyclein the cash amount column (Line 13 of previous report, or total funds left over atyear end of previous cycle); or

C. If this filing is the second or subsequent fiiintz of this Reporting Cvcle. list totalsfrom Line 6 of previous report in both the in-kind and cash amount columns.

Total amount of all itemized contributions received in this reporting period which areIsted on the "Itemized Contributions" page.

All loans received this reporting period.

Interest earned on campaign account this reporting period.

Total amount of investments sold this reporting period.

Total amount of cash dividends and interest paid out this reporting period.

Total amount of all separate contributions of less than S 10 LOO received in thisreporting period and not listed on the "Itemized Contributions" page.'Common Source" contributions must be aggregated on the "Itemized Contributions" page.Total contributions reported this period.(Line 3 -r 3a + 3b + 3c - 3d + 4)Total contributions to date. Total to be carried forward to next report of this reporting cycle*.

(Line 2 + 5)

In-KindEstimated Value

Cash Amount

$8,764.86

$7,717.00

$3,173.00

$10,890.00

$19,654.86

EXPENDITURES MADE

7

8

9

10

u12

["] I have no expenditures to report.[7] I have the following expenditures to report:

Total expenditures made and reported prior to this reporting period. If this is theA. First report of this Reporting Cycle*, ENTER 0.B. Second or subsequent filing ENTER Line 1 2 of previous report.

Total amount of all itemized expenditures made in this reporting period which arelisted on The "Itemized Expenditures" pase.Total amount of all separate expenditures of less than S 1 0 1 .00 that were madein this reporting period and not listed on the "Itemized Expenditures" page.Total expenditures reported this period.(Line 9 + 10)Total expenditures to date. Total to be carried forward lo next report of this reporting cycle*.

(Line 8 4- 1 1 )

In-KindEstimated Value

Cash Amount

$1,472.19

$14,514.07

$160.70

$14,674.77

$16,146.96

INVESTMENTS1314

15

Total value of investments held at the beginning of this reporting period.

Total value of investments held at the end of this reporting period.

Net balance on hand,(Line 6- 12 + 14) $3,507.90

Public Officer/Candidate/Nan-Candidate Committee Name

e shall end when the reporting cycle for n

Cathy Williams

SEC HORM CCDRREV 03,2008


Outstanding Indebtedness

Election Cycle*: Election Year:

i

2

3

4

5

6

7

Outstanding indebtedness at the beginning of this reporting period.

Loans received this reporting period.

Deferred payment of expenses this reporting period

Payments made on loans this reporting period.

Credits received on loans this reporting period.

Payments this reporting period on previously deferred expenses.

Total indebtedness at the close of this reporting period.(Line 1+2 + 3 - 4 - 5 - 6 )


1

2

3

•I

5

6

7







Total indebtedness at the close of this reporting period.(Line 1 + 2 + 3 - 4 - 5 - 6 )


i

2

3

4

5

6

7







Total indebtedness at the close of this reporting period.

(Line 1 + 2 + 3 - 4 - 5 - 6 )

Amount

Amount

Amount

1 Election Cycle (Primary. General. Special. Special Primary, Run-Off Primary, Run-Off General, Run-Off Special,

Run-Off Special Primary)

Public Officer'fandidate'Non-Cnndiclatf Committee Name Cathy Williams

SiiC 1 Oi!M CCDRREV 3 2008


Itemized ContributionsMust list contributions received by a single contributor for which the aggregate total is $101,00 or more

Note: Loans are no onger reported in "Itemized Contributions" section. See Loan Reporting section below.

Full Name of ContributorMailing Address(Affiliation of Committee if any)

Guy Sims1431 Millington RoadColumbus, GA 31904

Pete RobinsonP. 0. BOX 807Fortson, GA 31808

Richard LaneP.O. Box 8144Columbus, GA 31908

Christopher Brazell3901 Eve CourtColumbus, GA 31904

-rank Holbrook37041 2th AveColumbus, GA 31904

Contributor

Received DateContribution Type*

Occupation &Employer

Retired

Attorney

Retired

HVAC Contractor

ElectionCycle**

CashAmount

$115.00

$200.00

$250.00

$150.00

$200.00

Itemized Contributions Page Total $ 915.00

In-Kind Contributions

Estimated Value

Description

$

Loan Reporting

Name of LenderMailing Address

Date of LoanAmount of LoanElection Cycle**

Person(s) responsible for Occupation &repayment of loan Place of Employment

Mailing Address Fiduciary Relationship***

I .

2.

2

Reference: OCGA $ 21-5-34(b)(l) Loan Page Tota $

SEC FORM CCDR


Itemized ExpendituresMust list expenditures made to a single recipient for which the aggregate total is S101.00 or more

List Name and Mailing Addressof Recipient

Board of ElectionsMuscogee County

Muscogee Education ExcellenceFoundation (MEEF)

CHS Softball Boosters

3romoVisions

Better Way Foundation

Imprints

Jan Pease Marketing

CBS Outdoor

Expenditure DateExpenditure Type*

Occupation &Employer

Expenditure Purpose

Qualifying Fee

Contribution

Sign

T-Shirts

Contribution

Yard Signs

:-shirts

Signs

Amount Paid

S 360.00

$ 100.00

S 250.00

$ 479.79

S 100.00

S 2,434.22

$ 1,003.13

$ 8,000.00

Page Total S 12,727.14

Expenditure Type (Expenditure. In-Kind, Loan Repayment, Refund, Reimbursement, Credit Card, 3rd Party, Deferred Payment,

Payment on Deferred Expense, Investment)

_Cathy_VVi[!iams_

SEC FORM CCDRRev 3/2008


Investments Statment

1. Investment NameAccount Number

Institution/PersonHolding Account _

Mailing Address

Value at beginning of reporting period

Value at end of reporting period $

City-, State, Zip

Difference in value $

Interest Paid Out $

Cash Dividends $

Investment TransactionsDate Person(s) Involved in Transaction Value of investment purchased Value of investment sold Loss

2. Investment NameAccount Number

Institution/PersonHolding Account _

Mailing Address

Value at beginning of reporting period $

Value at end of reporting period $

City, State, Zip

Difference in value $

Interest Paid Out $

Cash Dividends $

Investment TransactionsDate Person(s) Involved in Transaction Value of investment purchased Value of investment sold Profit

Total value of investments....aLbeginiiing.of,repo_rtirig period $

Total value of investments at end of reporting juried $

Total difference in value $

Page Total Cash Dividends: $

Page Total Interest Paid Out: $

Page Total Profit: $

Page Total Loss: $

Cathy Williams

SEC FORM CCDRREV Oj':008


Addendum StatementThe Addendum Statement should be used for explanation of any additional information needed to complete an accurate tiling of this report.

Horace Williams, Eufaula, AL, Retired, Primary, $101.00

Miriam Tidwell, Medical Executive, Primary, $1,000.00

Sam Andras, 166 Commerce Street, Montgomery, AL, Architect, Primary, $500

George Wade, PO BOx 5626, Cols. 31906, Business Owner, Primary $250

Steve Butler, 6935 Hilltop Ct., Columbus, 31904, Retired, primary, $500

Bob Poydasheff, Retired, primary, $101.00

Jack Key. Realtor, primary, $150

David Lewis, Beverages, primary, $150

JacKie Lowe, Utility Executive, primary, $250

Ben Pike, Retired, primary, 5200

Jason Alexander, 1411 Belfast Ave, Cols. Ga, Electrical Contractor, primary, $250

Hal Kirven, 6817 Copper Oaks Rd, Columbus, 31904, Retired, primary, $250

M. L. Hallock, 557 Spring Harbor Drive, Cols. 31904, Retired, primary $200

Cunningham Insurance, 3025 University Ave/Suite C-2, Columbus, GA 31907, primary, $250

R-Pac, Realtors PAC, Columbus Board of Realtors, primary, $500

Ken Henson, 6801 River Road Building W, Columbus, GA 31904Attorney, primary, $500

Sam Rawls, 6001 River Road, 400, Cols. 31904lnsurance Executive, primary, $250

Daphne Dove-Pierce, Retired, primary, $200

Michael Eddings, P. O. box 807, Cols. 31902, Attorney, primary. $500

Charles Davis, Insurance Broker, primary, $150

Newton Aaron, 803 1st Ave, Cols. 31901 Construction Contractor, primary, $250

Jim Butler, P.O. Box 2766, Columbus, 31902, Attorney, primary, $200

Norene Marvels, School Board Member, primary, $100

total contributions, this page $6,802

Imprints, expenditure, yard signs, $1222.93

Jan Pease Marketing, expenditure, printed materials $464.00

Unity with Pam, expenditure, advertisement $100

total expenditures, this page $1,786.93

Cathy Williams

state of georgia campaign contribution disclosure … form ccdr rev o.v2008 state of georgia...

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