SEIIC FORM 20 /ji.

i,tr,Ji:,,q\
Itenrizctl Carnpnign Firranee Disclosure Sllterncrrl
.,,. iri
co\\E(r'lcr tst.\tELlfcrto,\sENFORCINIENIco.\r\lrsslo\ i:,
\. '...i"..:.., I

I I

Rer./0E l j ': " .,:,9 I Nor grrt o,

'<1,'1 "-/ Do Nol
Do Nlark in
rn Thrs ro.." For
Ttr.s Space r I

t,.+7' I o:l-Eil:sldr
!s 8d!
O{llcial I p.,,a r r l
^r

SUMMARY PAGE
I. .\A]\IE OF CO\I}I ITTEE

loennv DEMocRATtc rowN coMMtrrEE

Title First ivl l Last Sullix

Dr ANITA D DUGATTO
3. TREASURER ADDRESS
Steet Address Crty State Zip Code

69 ELIZABETH STREET DERBY CT 0641 I

4. ELECTION/RE FERENDUI\I IJATE 5. OFFICE SOUGHT (Completi only if Condidate 6. DISTRICT:N.UMBIR
Cori4mittee)
( mni/dd,/yl wJ

1 1/03/2009
7. CANDIDATE N AME (Comptet's: saly if Qandidute"or Exploratorr Comniittee)
Title First N{I Lasl Sufllx

8. TYPF. OF RFPORT r'Chcrl Ono Rnv\

C January l0 filing O 7th day preceding primary C) 7th day preceding referendum lli Initial Contribution or Disbursement
(PACs ONLt)
il Aprii l0 filing (.) 30 days fbllow'ing prirnary lli 45 days loilosing referendunr
. Amendment to
O July l0 iiling (l Tth day preceding election O Deficit Type of Report:

C October 10 iiling ti l2th day preceding election (.11 Termination 7th pfe-glggtign
l.\uti ( cnttlt L,'unitti.'s Otb)
C) lndependent Expenditure
o p|,n.'t -
-f.' "
n..,i". (145 dal's lbllorving eiectiotl
not held in Noven-rber

9. PERIOD COVERED

Beginning Date Ending Date

10/01/2009 thru lol20l2oog

IO. CF',RTIF'ICATION

lhereby certify and state, under penalties olfalse statement, that all of the information set forth on this Itemized Campaign Finance
Disclosure Statement for the period covered is true, accurate and complete.

SURER OR DEPUTY ER (SIGNATUITE,l PRINT NAME OF SIGNER

pENALry FoR FALSE srArEMENr ts puNTsHABLE By FINE Nor ro EXCEED tESg 0[T I{: *il *
$1,OOO, OR ITIPMSONMENT FOR NOT MORE THAN ONE YEAR, OR BOTTI,
SEEC FORM 20
Itemized Campaign Finance Disclosure Statement
CONNECTICUT STATE ELECTIONS ENFOITCENII]N'f CONIMISSION
R*'. 1/08 Page 2 of l7
SUMMARY PAGE
TOTALS
Ni A MF NE I-.)]\/{I,{TT"TFE FILNGIDU.E.DATE
1012712009

UULUMN A UULUMN -TJ

DERBY DEMOCRATIC TOWN COMMITTEE
This Period Aggregate
ll Balance on hand January I of current year for Ongoing and Party Committees OR
$467.72
Balance on hand lrom day Committee was fon.ned lor all other committees

$1,322.97
12. Balance on hand at the of Period

$0.00 $11,235.00
I 3 Contrihntions received frnm lndividrral Sect A arrd B

$0.00 $65.00
14. Receinls lrom Other Committees (Sections C1 and C2

$o.oo s250.00
I 5. Other Monetary Receipts (Sections D-K)

$0.00 $572.00
16a. Total Small Food and Beverage Receipts at Fair (Section L|) Town Committees ONLY

$0.00 $0.00
16b. Total ProceedsftomsmallPurchasesatTagSales,AuctionsorOtherSales(SectionL2)
Municipal and Town $0.00 $0.00
15c Tntal Prrrchases of Ad Rook Comtnittees ONLY

$0.00 $12,122.00
17. Total Monetary Receipts (add totals lor lines l3-l6c)

$1,322.97 $12.589.72
18. Subtotals(addtotalsinline12+linelTinColurnnA; andinlinell+lTinColumnB)
$372.50 $11,266.75
19. Expenses Paid by Committee (Section P)

s950.47 $1,322.97
{20.BalanceonhandatcloseofReportingPeriod(Subtractlinel9lromlinel8inbothColumns)

21. In-Kind Donations not Considered Contributions Received (Section L4)

$0.00 $0.00

$0.00 s0.00
22. In-Kind Contributions Received (Section M)

$0.00 $0.00
I 23. Refundable Deposit to Telephone Company (Section N)

$0.00 s0.00
24. Receipts ofOrganization Expenditures (Section O)

$0.00 $0.00
25. Begiruring Loan Balance

$0.00 $0.00
25a. * Loans Received (section D)

$0.00 $0.00
25b * Interest and Penalties on Loan

$0.00 $0.00
25c. - Payments on Loan

$0.00 $0.00
25d. Total Outstanding Loan Amount
$0.00 s0.00
26. Campaign Expenses Paid by Candidate (Section Q)

$0.00 $0.00
27. Expenses Incurred on Commitlee Credit Card (Section R)

$0.00
I.n"-ad hr, /-nmmittcp I),rr Nnt Paid /Sectinn S

$2,926.69
28a. Total Outstanding Expenses Incurred by Conimittee still Unpaid (Section S)
 IV. EXPENDITURES Page i3 of 17
JT\i\,I F OF COl\4 N,l TTTF,F :TI:TNG DIIF DATF
DERBY DEMOCRATIC TOWN COMMITTEE 10t27t2009

P. Exnenses Paid bV CommittCe

Nane orPaYee )ate ofPayment I'lethod of Payment Anrount
DERBY puBLrc scHooL
Sheet Address Cirv lSrate lip Code 10t21t2409 {Ii check #-544
9 GARDEN PLACE
l-uqlose ol Lxpenorture
oEaev I oolr
cr 0641 B {-.t Debit card
lp Event #
(by code) DEBATE DEBATE LOCATION

fype ol Expenditure (if appticabte) .

Candidate(s) Nare Oflice Sought U Supported
Ci Coordinated rvith reirlbursement sought
(if upplicuble) D opposed
Oi Coordinated without reimbursement sought
CJ Independenr
l-i Organization (see I nstruclizns)
100.00
0r iliB f*lc CID CIE
- MERIT INSURANCE
)ate ol Paymeat Method of Payment Amount

)treet ddr ess C'ty Zip Code 1012212009 iii Chect *- 545
lState
lOOO LAFAYETTTE BLVD BRIDGEPORT I CT 06604 (: Debir Card
ruryose oI cxpenorrure
(bi code) DEBATE
.
Descriotion
INURANCE COVEMGE
Event #

Type ol Expenditure (i[ applicabIe) .

Cardidate(s) Nme OfIice Soughl Ll Suppo*ed
C Coordinated with reimbursement sought (iJ upplicuble) fl opposed
O Coordinated without reimbursement sought
I lndepenocnr
i Organization (see Instruclions)
s 272.50
fjl OB Oc CiD s:E
Name of Payee )ate of Palment Method of Payment Amount

Sbeet Address Crty lSrate Zip Code Ci Check #.-

lcr Ci Debit card
Purpose of bxpendtture )escription Event #
(by code)

Tl pe of-Expenditwe (if applicabte). Cmdidate(s) Nane Oflice Soughl LJ Supported

C Coordinated rvitir reimbursernent sought
(if upplicable) I Opposed
(l Coordinated rvitlrout reinibursement sought
C Independent

Ce Dn Cc !**in Cr
s 0.00

Nane ol Payft Jate oI ravnenl Method ot layment Amounl

ciry S tate 4lP LOog lli Check #-

CT n Debir Card
i'urpose ol bxpendrture lJescrrplroD Lvent #
(by code)

'fype of Expenditwe (if upplicnblc). Cardidate(s) Nanie Oflice Sought ! Supponed

lO Coordinated with reimburseinent sought
(if applictblc) ! Opposed
rJ Coordinated without reimbursement sought
iC Independent
C Organizatron (see Inslruclions)
i;A i:B ilC flD riF
s 0.00

Nane of Payee )ate ofPayment Method of Payment Amounl

Sreel AddJess ,rty lstate Zip Code iii Check #--

CT il.1 Debit card
Purpose ot Lxpendrture uescfl ptron Evetrt #
(by codc)

Type of Expenditurc (if applicable). Candidate(s) Nane Oflice Sought fl Supported

'O Coordinated with reimbursement sought (iJ upplicublc) D Opposed
'C Coordinatecl without reimbursement sought
C Independent
{t Organization (see Instructions) 0.00
Cl !lB Cic CD CE
$372.50

$0.00
TOTAL of addiiional Section P PagCs

i6ilitil;tnr rnn s t s pA$ it' ioMruirpf'?Hd i tiit' ii ui' i''l i aj:3'iiii aW it

ti : $372.50