SEEC'FORM 20

Itcmized Campaign Finance Disclosure Statemcnt CONNEC'TICU'I'

Rev. l/08

STATE ELECTIONS ENFORCEMENT COIITMISSION

Do

Nor!F49.&6i&gstsr

SUMMARY PAGE
OXFORD TOGETHER 2011

3, TRTASURER ADDRtrSS

459 CHESTNUT TREE HILL RD

4. E LECTION/BqFERENDUM

DATE

11t08t2011
7.

FIRST SELECTMAN

CANDIDATE NAI}18

C, January l0 filing

fi
G

7th day preceding primary

30 days following primary

Ci Tthday preceding referendum

fi

lnitial Contribution or Disbursement

(PACs oNLY)

O April l0 filing

li:

45 days lollowing referendum

fi
-.

July l0 tlting

C 7th day preceding election

C Deficit C
Termination

c Amendment to *
Typ$pf krjpo(p
"J ".i

ff. October l0 filing

Independent Expenditure

0
C Ele.r,on

l2th day preceding election

(State Centrul Comminees Only)

f;-.i -

\f1"=

_a

c-)

f Primary

.-;
f'b

t:45

days following election

'r.
\:! i-a "-

Gt
'*

not held in November

Beginning Date

Ending Date

09t0212011 thru

finlnf/-1

I hereby certify and state, under penalties of false statement, that all of the information set forth on this lternized Campalgn Finance Disclosure statement for the peiiod covered is tru", accurate and complete.

R.[trrOR DEPUTY TR EASURER (SIONA'fURE)

PRINT NAME OF SICNER

$I,OOO,

PEN.,ILTY FO&. FALSE ST,ITE]'TENT IS PIJNISHABLE BY FINE NOT TO EXCEED oR I*IPRIS)N*TENT

FoR Nor )roRE i}i.iN

our

YE,4R,

oR I}TTH-

SEEC FORM 20
Rev,

CONNECTTCUT STATE ELECTIOn*S ENFORCEIVIENT

Itemized Campaign Finance Disclosure Statement COMMISSION

l/0E

SilMililf,F TOTALS
!!!!!l=:l
!!

.'-

Page 2 of 1?

nATE

NAME OF COMMIT-TEE

_-EOTUMN
1

OXFORD TOGETHER 201

r

This Period

-TOLUMN Aggregate

1. Balance on hand ranuary I :f

Balance

l:li i1' ::9X:t"fl*ff?":H,Ti:" on hano lrom oay r-ulrttttttLss *o" ^"""-*

$5,787.39

."'1::t

$0.00

r 12, Balance on hand at the begtnnlng or ncpu""'s

"
$4,950.00 $1,500.00

$11,845.00

(Sections A and B) 13. Contributions received from Individuals (secttons u 14. Receiots from Other Commtttees

$1,500.00 $700.00
$0.00

attu

v'

(onrinnc n-K)
at Fair (Section Total small Food and Beverage Receipts

$0.00 $0.00

l6a.
6b.

Ll)

Torvn ccrnninees

oNlY

Total Proceeds lrom Small Purchases

at t ag latss'

l.c n'*"""" "' ""'-' *-'-- /Qectinn T.2-] '-

$0.00 $2,350.00 $8,800.00

$0.00 $2,350.00
$16,395.00

MuniciPal and Town D^^r. /ea^ri^n | 1\ (ommitleeS ONLY

17. Total
1

$14,587.39 I
line l2 $3,890.59
oY

sro'395.00
s5,698.20 $10,696.80
$0.00 $250.21 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $1,494.55 $0.00

8.

Subtotals (add totals in

19. BxPenses rato

lv

rDannrtino Periori (suhtract line l9 from line l8 in both Columns)

Cnnsidered Contributions Received (Section L4)

s10.696.80 $0.00
$250.21

(Section M) 22. In-Kind Contributions Received

^^ h . --- r^Lr^ n^-^6i+

rn Telcnhone Comnanv (section

N)

$0.00 $0.00

1.4 pa.cihls nl ( lrpanlzallon E,xpetluttutur r-"'""" rc o--i--i^I

Ralancc

-r

$0.00
^.n

$0.00

25a. 25b.

* *

Loans Received (Sectton

u)
$0.00

Interest and Penalties on Loan

$0.00 $0.00

25d. Total Outstanding t-qgq 4mo111l

9401.42 $0.00 $0.00

!)
$0.00
28a. Total Outstandlng Expen

U'

S)

MoNETARY RECEIPTS (Sections A-K)

NAME OF COMMITTFE
FIT

Page 3

of l7

ING NTIF, DATE

A.

'Iotal Contributions from Small Contributors-Keceived thls rerlod uNl,Y

of Small Conrributor)

Oxford Together 2011

10t1312011

(See instructions for definition

Subtotal Sectlon

0.00

B.
Last Name

ttemized Contributions fxqm Individuals

MI

Itincioal Occuoation

Capace
{esiocntlal strcet Addrcss

Vincent

Accountant
ilate

Amount of Contribution

sr

ff\pr.du.r |'<

Is contributor a lobbyist, or dependent child ofa

spouse, Ct tobbyist? lii a Ll?

\rn bnYes

)ity

lip

Code

Namc ol hmDlover

Shelton

CT

r'\/^ll.A\t

ilA,r,

{-ev\

\
i
Yes

No

tnmittee for a chief executive otficer of a rnunicipality does contributor or business he/she is associated with have a confact with said C Yes C: No municipality valued at more than $5,000?
Yes

Is this contribution associated rvith fundraising event listed in Section Ifyes,lisr Event 3

Q (j

No

ls contributor a principal ofa state contractor or prospective state contractor? Ifyes,indrcate which branch or branches Legislative C: Executive oiiovernment the contract is

with:

fi

GNo
$100.00

lvtethod of corrtrrbution:
Last Name

DatE Received

Aggrcgate contnttutlons

{l':Cash .Q PersonalCheck CCrediVDebitCarcl CPayroll

First

Deduction {i.MoneyOrder
MI

1A10712011
Principal Occuoation

$100.00
Amount of Contribution

Carver
Kcsldcnlral Strect Address

Tanya
itatc
atp Looe

Office Management
,{ame oi Employer

old moosehill rd

oxford
Yes
Wo

CT

06478
to
a candidate

Oxford Science

Is contributor a lobbyist, or dependent child ofa

spouse, C lobbyist? C a Ll?

committee for a chief executive offioer of a """t"brtr" "-t municipaliry does contributor or business he/she is associated with have a contract with said Ci Yes G No municipality valued at more than $5,000?

lf

.-t"*

oe S+OO

Is this contribution associated with

S,

Yes

fundraising event listed in Section Ifyes,list Evcnt # 3 Method of contribution:

!i

No

ls contributor a principal ofa state contractor or prospective state contractor? fyes, indicate which branch or branches Executive C Legislative oi'gou.rnrn"nt the contract is

C]

Yes

with:

CNo
$150,00

Date Reccived

Aggregate contnbuttons

C Cash O

Penonal Check

Credit/Debit Card
First Jity

Payroll Deduction

Money Order
MI

10t0712011
Principal Occupation
Name of Employer

$50.00
Amount of Contribution

Last Name

{csldcntlal Strcct Address

Is contributor a lobbyist,

rfatC

1ip Code

CT
or dependent child

ofa

spouse, ll:l lobbyist? l':

Yes

No

is in excess of $400 to a candidate committee for a chief executive officer of a ".rtrib"tt;; municipality does contributor or business helshe is associated with have a contract with said C Y"s F, No municipality valued at more than $5,000?

If

Is this contribution associated with a fundraising event lrsted in Section Ll?

Ifyes,list Event

#_

C Yes C lto
C

Is contributor a principal ofa state contractor or prospective state contractor? /yes, indicate which branch or branches C Executive Legislative oigovemment the contract is

(-r Yes

No

with:

fi

Method of contribution:

Date Rcccived

Aggrcgate contnbuhons

C Cash f.

Personal Check C: CreditlDebit Card

Payroll Deduction

Money Order MI
Principal 0ccrrnation lName ot bmPloyer

$0.00

$0.00
Amount of Contribution

Lffit Name
{esldcnilal Strcct Addrcss

-rty

)rare

',ip

Code

CT
ls contributor a lobbyist,

ordependentchildofalobbyist?

spouse, C Yes C: No fj f;
Yes

i. in excess of 5400 to a candidate committee for a chief executive officer of a "ottt.ibWion municipality does contributor or business he/she is a-ssociated with have a contract with said C Yes O No municipality valued at more than $5,000?
If
Is contributor a principal of a state contractor or prospective state contractor?

Is this contribution associated with a lundraising event iisted in Section L1? Ilyes, list Event

.ft

Yes

No

#_

fyes, indicate which branch or branches oigou"*rlr"nt the contract is

with:

CNo
$0'00 s0.00 $150.00

Executive C. Legislative
n ggrcgatc conlnbuttons

Method of contribution: C Cash Personal Check

f)ate Rcccived

f;

Credrt/Debit Card C, Payroll Deduction

N{oney Order

SUBTOTAL Section B-This Page

TOTAL of additional Sectlon B Pages T0TALoFALLcoNTRIBuTIoNsFRoMlNDIvIDUALS(SectlonsAr9

rl3@.oo

4qto,

I.
\IAME OF COMMITTEE

MONETARY RECEIPTS (Sections A-K)

FILING DUE DATE

Page 4 of

l7

Oxford Together 2011

'{ame of Commifiee

10113t2011

C!, Contributlons from Other Committees

Name ofTreasurcr

GOP 4 125 Gilman St Bridgeport

Name of Committee

Paul Pimentel
ls this contributron associated with fundraising event listed in Section L I ? Zip
Co<1e

l.'
I

a C yes /fyes, list G N16 Eygnl a

IaesEsaGco;GuuiE;

Amount of Contribution

State

Date Reccived

06605

1An1t2A11
\ame

I
ol
I reasuref

s1,500.00
$
1

,5oo.oo

Addrcss

ls this contribution associated with a .(} yes Ifyes,lisr fundraising event listed in Section Ll? '& 1r,1e 6esn1 g
Zip Code
I

Amount of Contribution

City

Aggregatc Contrrbutions

Name of Comminee

I
Namc ofTreasurer

$0.00

so.oo

lls this contribution associated with fundraising event listed in Secrion Lt?
Urry State
I
I

t- No

C, yes /f

ves. list

Amount of Contribution

gvent

*
$0.00

Aggregatc Contributions

CT
Name of Commifice Name

I
ofTrcuurer
Is this contribution associared with fundraising event listed in Secrion Ll?

so.oo

Addrcss

a f yes /lrves. list C wo gvenr *

$0.00

Amount of Contribution

Crty

State

Zrp Code

$0,00
Name ofTreasurer

CT
Name of Committee

Is this contribution associated with

fundraisingeventlisted inSectionLl?

:ity

a fi yes Ifyes,list C No Event#

Aggregate Conributions

Amount of Contrihution

l.t
State

State

Zip Code

nrteRecei"cd

-l

$0.00 $0.00

Name of Committee

Vame ofTrcasurcr

Is this contribution associated with fundraising eventlisted in Section Ll?

*rty

Zrp Code

M..Reclta-l
Name of Treasurer

a f;; yes fyes, list fl N6 Eysnl g

Agglegate Conributions

Amount of Contribution

$0.00 $0.00

CT
\iamc of C0mmittce

C2. Reimbursements. Pavments.

otsurnlus Distributions from other Commiftees

late Rccelved

Address

Amount of Receipt

lily

Zip Code

CT
\sm
ot Commlttee

l-l

i{

Reimbursement for shared Payment for goods and

sewices

expense

,'

Surplus

$0.00

Distribution

,{ame of Trcmurei

Addrcss

Date Rcceivcd

Amount of Receipl

-'rty

l1 ate

Zip (lode

CT

?l .'{

Reirnbursement fbr shared Paynrent for goods and

services

expense

l]

Surplus

s0.00

Distribution Pago Pages

$
1

SUBT0TAL Sectlon C-Thts TOTAL of additlonal Sectlon C TOTAL OF ALL COMMITTEE CONTRIBUTION$ AND RECEIPTS (Enrer ntat on Line

$1,500.00
$0.00 ,500.00

14 of Sumntam pape)

ions A-K)
NAME OF COMMITTF,F
FTI.lNN DUE DATE

Psqe 5 of

1?

Oxford Together 2Q11

10t13t2A11

D. Loans Received this Period

iame of Lcndcr
lreci Address
,lamc of Cosigne r,icuarenior

Source of Loant -rty

lrp Looe

Is there a Cosigner
Candidate

fr sunk

or Guarantor of thls loan?

Cl. Yes (ifyes
li.sr

Amount Received

CT
.C Individual .C other
Committee
;treet Address - rry State

-^*- --.1 ,,H*<< nf Cosigner/Guuranlor)

$0.00

CNo

Zip Code

fareof nce-upt
Source of Loan: Is there a Cosigner

CT
\'lame of l-endcr

Amount Reccived

)trcel Address

irty

ll

lp Lose

,* Bank
C

C,l Candidate

or Guarantor of this loan?

C.i. Y es 1if 1,et lisr
C o s i gn e r,r(i
u r an I or)

CT
'lane of CosigncrlCuarantor Jity

Individual Cl other
l-ommiftee

$0.00

til

No

Street Addrcss

state

crl

Zip codc

Datc of Reccipt

Total Section D

000

n. nu..iot, from Entities

Name of Entity

other than Individuals or Other Committees rRelererdatt co""niffees

oNtn
Amount Received

Zip Code

$U.UU

CT

$0.00

Nm,ri

gntiry

Str;;il&iN
City
Zip Code

'GT;;GCT $0.00

Amount Received

$0.00

Namc of Entity

ffi
lrty
4rp Code

)ate Received

Amount Received

$0.00 $0.00

CT

Total Section E

s
,

0.00

F. Amount Transferred from Affiliated

Date of

Business Treasurv fBrsine^rs trnrirv Coranitlees

ONII?

Receipt

Amounl

Date of

Receipt

Amount

Total Transfers

$0.00
ls this transaction associated with findraising event listed in Section

s0.00
ls this transaction associated with fundraising event listed in Section

a l]'Yes lfyes,list Ll? fl Xo Event # -

a fi Yes Ll?G No

lf),es,lisr.
Event

#-

0'00

G. Amount Transferred gy6p Affiliated Labor Union or Other Orsanization Treasurv

Date of
Re

/orsanieatior Conittiltses oNr

ceipt

Date of Receipt

? Total 'I'ransfcrs

Amount

$0.00

Amount

s0.00

r
(Candidate Conmittees

0.00

H- Personal Funds of the Candif,als R;gceived, this Period

Date of Rece ipt lv{ethod ofpayment: Date of Receipt

ONLYI

Mcthod of payment:

Total Amount Received

t-.
Anlount

Cash

$0.00

t_

Personal Check CrcdiUDebit Card

Arnount

$0.00

C ft {i

Cash

Personal Check

crcdiriDebit Card

0,00

RY RECEIPTS (Sections
Oxford Together Z01l

K)
:ILING DUE DATE

Page 6 of 17

lo'l1attn
dollar amottnt n,
tilt4 ,bnnil'st

IlAnonymous Contribul iOnS lsoeclfv

)ate Receiycd
Amount

$0.00
g1

s0.00
51

Amount Received

5i11, $0.00

55 g1s

6;16
6;11

$o.oo

5111,

$o.oo

55 g1s

6i11, 5;11

$o.oo $0,00 0.00

coins $0.00
Date Received

$0.00

coins $0.00

.I- Infererf frnm

$0.00

fl eposlts in Authorized Accounts

$0.00
Name of lnstitution

Name of lnstiiurion

Total Amount Received

Street Addrcss

!'ity

ffi

lcrl
K.
City

try

Srate

crt

lzio

CoOe

0.00

Name

Miscellaneous lvlonetarv Recelnfs nnf Cnncirtara.t

r.

tributlons
Amount Received

Date ofTransaction

Srcet Addrcss

Zrp Code

CT

Name
Date ofTransaction

$0.00
Amount Received

City

Zip Code

CT
Dcscriprion

$
Date ofTransaction Street Addrcss

$0.0c

Amount Received

City

Ltp eo{Je

CT
Dcscription

$
Total Section K

$0.00 0.00

s
0.00

Summary of Other Monetary Receipts (Sections D-K)

Loans Kecetved ttlts pcriod (Section D)

.prr

rr

urr

l!*'es

orner rnan rndividuars or Other committees (section E)

lulareo ttusiness l

+
+

0.00 0.00 0.00 0.00 0.00

rclsury (Scction F)

rom Anlllared Labor Union or Other Organization Treasury (Scction nss ol rne Usndidate Received this period (Section H) norrym{rusLonlnDutlons (section l)
Lreposrs lrl Authorized .,lccounts (Section J)

G)

+ + +
+

0.00
0.00 0.00

erary Kecetpts not Considered Contributions (Sectlon K)

(Enter total on Line lS of Summary page)

ru!s. vr vurGr lvlutrErarJi r1ecetpls (Add $eetions D-K)

II.
Oxford Together 2011

FUNDRAISING EVENT ACTIVITY 1A\AZU1

Lt. Fundraiser Event Information

Location; SrcctAddress

10t07t2011 Subpurt I: (All Committees) Was this fundraising event hosted at a personal residence?

436 Quaker Farms Rd

S Yes (fyas, go to Section "

L4 In-kind Donations not Considertd Contributions una.otplete required information lbr purchases rlade by host(s) for food'

beverage and invitations.)

Did this lundraiser include items donated by a business entity of up to $ I 00 or items donaled by an individual ol up to $50?
Wur it'ris lundraiser a tag sale, auction, or other sale of donated items rvith purchases t'rom an individual olup to $50?

$yes

({yes, go to section L4 In-kind Donntions not consldered contributions

and complete required information.)

(tfy,rt, eo to Section L2 Proceeds from Tag Sale, Auetion, or Other Sale of

'rbp*Lt
W.r. th.r.

(Town Commiltees and Municipal Canclidate Committees ONLY) purchases ofadvertising space in a ptogtam book associated $

(lfyes, go to Section L3 Purchases ofAdvertising Space ln a Program Book

and conrplete required infonnation )

Subpart 3: (Town Committees ONLY) Did your committee sell food or beverage at a fair or similar mass gathering hetd within the state?

O Y.s (fyes,

enter Total Receipts

from small Purchases herel

I

$ t-

Location: StleetAddrcss

Subpart

l:

(All Commiaees)

Was this fundraising event hosted at a personal residence?

Q yes (fyes, go to section :

uni.o.plete

L4 In-klnd Donations not considered contributions required information for purchases made by host(s) for food,

beverage and invitations )

Did this fundraiser include items donated by a business entity of up to $ I 00 or items donated by an individual ol up to $50?
Was this fundraiser a tag sale, auction, or other sale of donated items with purchases from an individual ofup to $50?

$yes

(I/yes, go to section L4 In-kind Donations not considered contributions

and complete required information.)

(Ifyes, go to Section L2 Proceeds from Tag Sale, Auctlon, or Other Sale of Donated ltems.)

S"bp"rt

*.i"

,, 9""" C"^.lttees and Municipal Candidate Committees ONLY) ttte.. purchases of advertising space i; a program book associated 0 Yes (Ifyes, fundraiser? *
No

with this
Suboart

go to Section L3 Purchases of Advertising Space in a Program Book and complete required information )

i)id'you, committee sell food or beverage at a lair or similar mass

J:

(To*,n Committees ONLY)

C! Yes (fyes, enter Tntal

Receipts from srnall

Purchaself5f

0O0

gathering held within the state?

SUBTOTAL Sectlon Lt (Town Committees ONLY) Total Receipts-This

TOTAL of addltional Sectlon Lr

Pages

TOTAL OF ALL RECEIPTS FROL SECTION

Ll

(Enter total on Line 16a of suntmqry

II.
NAME OF COMMITTEE

FUNDRAISING EVENT ACTIVITY

IILING DUE DATE 10t13t2011

Paqe 8 of 17

Oxford Together 2011 ofPucharer

L2. Proceeds from Tag Sale, Auction, or Other Sale of Donated ltems
Last Name

{arne

First

Iurtividuals ONLY)
Kesldentlal Street Addrcss

MI
!IAIC

Method of payment:

:tly

O Castr Q
lip
Code Datc Recclvcd

Personal

Check

f.

Aggregate CrediVDebit Card

Amount of
Purchases

Event #

CT
tem
rlarne Purchased

$0^00
ofPurchaser
Last Name

'Individuals ONLY)
Lcsidcntial Strect Addrcss Itcms Purchascd

lrnl
jlty
rlate Zip Code

MI

N{ethod olpayment: G Cash Personal

Check

ti

Aggregate CreditlDebir Card

Amount of
Purchsses

Date Reccived

Event #

CT

s0.00
'{ame of Purcharer Last Nnfrd 'Indiviiluals ONLY)
l.
t

rsl

MI ttate

{csrdentlal Srrect Address

ItemE ['urchssed

jrty

Method ofpayment: F Ca.h {i. Personal

Date Reccivcd

Check C

Aggregate
Credit/Debrr Card

Amount of
Purchases

lip

Code

Event #

CT $0.00
,lame of

purchroer

Last Namc

'Individuals ONLY)
Resrdential Strect Addrcss
_

First rfy

MI
)IAIC

Method of payment:

G Cash {3
lip Code
Date Recerved

Personal

Check

fi

Aggregate CrediVDebit Card

Amount of
Purchascs

Evenl #

CT
tcms Purchased

$0.00
Name

ofpurchaser Lat

Name

First

(Individuals ONLY)
Rcsidential Strcet Address
Items Purchased

MI
itate

'ity

Zip Code

Method of payment: Cash Q Personal Check Datc Received Evelt #

Aggregate Credit/Debir Card

Amount of
Pu rchases

CT $0.00
ofPurchaser (Indivitlutls ONLY)
Name Last Nams

llrct
- rry

MI
tIa(e

Residcntial Strcct Address

tcms Purchased

Method of payment: C,Cash Personal

!i

Check

(-

Aggregate CredivDebir Card

Amount of
Purchases

Zip Code

Llate Recelved

Evcnt #

CT $0.00
'Jamc ofPurchaser Lasl Nnme 'lndivitlusls ONLY) IAI F-irst

)rreet Aoolgss

.ttY

Zip Code

Method of payment: G Cash Personal Check Datc Rcccived Evmt #

{]

Aggregate

CredilDebit Card

Amount of
Pu rchnses

CT
Items Purchased

$0.00
Purchaser 'Individuals QNLI)
'{ame of [-ast Name

First tty tulg

Rc$rdcntlal Strcct Addrcss

Zip Codc

Method of payme nt: C Cash Personal Check Date Received Evsrt #

Aggregate

C. CredirrDebit Card

Amount of
Purch ases

CT
Itcms Purchasd

$o.oo
Name of

Purchascr Lst Nehe

-'i tv

Firsl
)tarc

(Indivitluuls 0NLY)
i{csidcntral Strcet Addrcss Itcms Puchascd
4ip Code

Me thod

{l Cash S

of payrnent:
Personal

Check

|]

Aggregate CrediVDebit Carrl

Amount of
Purch ases

IJate Recclvcd

Fvcnt #

CT $0.00

SUBTOTAL Sectlon L2-Thls Page

$0.00 $0.00 $0.00

TOTAL of addltlonal Section L2 Pager TOTAL OFALL SMALL PURCHASES FROM TAG SALf,,S! AUCTIONS OR OTHER SALES OF DONATED ITEMS
{Fnlot b}nl nn f iaa
I Ah nf (nsantr

Dn-at

II.
NAMF OF f.rrMMITTFF

FUNDRAISING EVENT ACTIVITY

F'TT

Page 9 of 17

TN(i nlIF. DATE 10t13120

1

Oxford Togethet 2011

Ll.
Namc of Prmhaser
Street Address

Purchases of Advertising in a Program Book (Municipal Candidote and Town Commiaees ONLY)
t'USlnes!
Date Received

Mohegan Sun
City
State

Entity
Zip Code

10l07l2ar
Event #

Aggregate Psrch*es for All Events

Amount of
Purchase

Yes

$250.00
Aggregatc Purchrocs for All Events

$250.00
Amount of
Purchase

Uncasville
Name of Purchaser

CT

GNo
Entity

Businesr Date Reccived

B and B Transportation
Strect Address

10rc712011
Event # .)

-rty

Stalc

Zip Codc

te

Yes

$250.00
Agg.regate PurchLses lor All Evcnts

$250.00
Amount of
Purchase

22 old amity road

Namc of Purchroer

bethany

CT

06524

f.": No

Business Date Received

Oxford Lumber
Stret Address
1

Entity
rry Srate

10t0412011
Evcnt #

zrp C ode

13 Oxford Road

oxford

CT

06478

l-,No
Entity

&

Yes

$250.00
i\ggrcgatc Purchccs lor AII Evcnts

$250.00
Amount of
Purchase

**ame of Purchsscr

Business Date Rccciverl

Select Realty
Strect Address

10t07 t2011
Evcnt #

l-t ty

tatc

Zip Code

S Y"t
Li
No Entity

$125.00
Aggregatc Putchses for All Events

$125.00
Amount of
Purchase

22 Pine St
Name of Purchmcr

Bristol
Spirits of 67

CT

Business Date Rcccived

10t07t2a11
Event #

Strcet Address

jrty

State

Zip Code

246 Oxford Road

Namc of Purchroer

Oxford

CT

06478

l lNo
Entity

F[

y.'

$50.00
Agglegate Purchues for All Events

$50.00
Amount of
Purchase

Business Date Reccivcd

Glendale at Oxford
Street Addrcss
1

1010712411
Event #

lity

State

Zip Code

137 Seaview Ave

Bridgeport

CT

06607

(}no

Yes

$250.00
Aggrcgate Purchucs Ibr All Evcnts

s250.00
Amount of
Purchase

Namc of Purch6er

Business Date Rcceived

Bens Mowing
Strcct Addrcss

Entity

10t0712011
Evcnt #

jrty

State

Zip Code

99 Highland ave
Name of Purchmer

beacon falls

CT

06403

$ No
0

[.]

Yes

$250.00
\ggrcgate Purchases for All Events

$250.00
Amount of
Purchase

3
Date Rcccived

Jusiness

Precision Glass
Strcer Addrcss

Entity

1010712011
Event #

-lty

State

Zip Code

Y"t

43 Old State Road

Namc of Purchrocr

Oxford

CT

06478

GNo
Entity

$75.00
Aggregatc Purchasc for All Evmts

$75.00
Amount of Purchlse

Business Date Receivcd

kaminsky Transport
Strcet Addrcss

1010712011
Evcnt #

-'rry

State

z rp

Code

{jl,i

y.t

2 Klarides Village Dr
Nanrc of Purchasct

Seymour

CT

06483

(JNo
Entity

$250.00
Aggrcgatc Purchascr for All Evcnts

$250.00
Amount of
Purchase

Business Datc Rcceivcd

Oxford Science
Strcet r\ddrcss

10to7t2011
Evetrt #

-lty

Statc

Zip Co,Je

ff-.i yes

$250.00
Aggrcgatc Purchasct for All Evcnts

$250.00
Amount of ['urchase

178 christian st
Namc of Purchascr

oxford

CT

06478

13 No

Business Date Rcceivcd

Brookside
Strc etA ddrc s3 rty State

Entity
Lrp Coda

1At0712011
Evcnl #

oxford road
*'arre of Purcha-rct

oxford
PSI

CT

06478

tl

(!t

Yes

No

3
Datc Rcccivcd

$100.00
Aggrcgate Purchucr for All Evcnis

$100.00
Amount of
Purch ase

Ilusiness

Entity
-lrly
Stale

1AA712011
Evcnt #

Strcet Addrcss

Zip Code

Yes

2 Klarides Village Dr

Seymour

CT

CNo

$250.00

$250.00

SUBTOTAL Section L:-Thls Page

$2,350.8
$0.00

TOTAL of additlonal Section L3 Pager TOTAL OF ALL PLTRCHASES OF ADITRTISINC IN A PROGRAM BOOK
(ENIET

IO!A!!'' liNL !!::ISUN'MAry

PATE)

$2,350.m

II.
IJAME OF COMMITIEE

FUNDRAISING f,VENT ACTIVITY

IILING DUE DAT 10113t20
1

Page

l0 of l7

Oxford Together 2011

t4. In-Kind Donations Not Considered Contributlons

Name of Donot

l5o **

plr

[r\

r .,Fe-rrc.*h
City

Donation ffIndividual
given
)Bte

by: G

Falr Market
Value of Donatior

Business Entity

{}(" fl,n b^, E

Description ot dbnation
Name of Donor

F..\^4-

kl

r1'tC"^

CT

c6

\)g

{ggrcgate vslue for this cvent

$0'00
Evcnt #

$0.00

tlio

nC

hrovr.-s--lV
5late

rol> I tr
given
Zip Corlc

\3
Fair ll{arket
Value of Donatior
Business Entity

Donation fllndividual

by: llt

Address

Aggre8ate value for this evtnt

CT
Description of donation

$0.00
ljatc Kecelved
l.:vent

$0.00

Namc of l)onor

Donation fJ tndividual
given
Crty
5tat

by: C! Business Entity

$0.00

!'air iVlarket Valuc of Donation

5lreet Addtess

Zrp Code

Aggregate value for this cvcnt

CT
Description of donation uate Kecelveo Evcnt #

$0.00

Namc of Donor

Donation f-llndividual
given

['air Nlarket
Value of Donatior

by: l?

Business Entiry

Jrect Addtcss

Ity

)IAIC

Zrp Code

Aggrcgate value for this evcnt

CT
Dcscnptron ol donstion
Date Recelvcd

$0.00
Event #

$0.00

Name of Donor

Donation {Jlndividual
given

Fair Morket
Value of Donation

by: Q

Business Entity

iJfreet Address

City

State

Zip Codc

Aggregate value for this cvcnt

CT
Description of donation
lJatc Recclved Uvcnt #

$0.00

$0.00

Name of Donor

Donation {lilndividual
given

Fair Market
Value of Donatior

by: $

Business Entiry

Street Addrcss

City

)talc

1-rp Uode

Aggregatc value for this cvcnt

CT
Dcscnptlon ol donation
Datc Received Event #

$0'00

$0.00

Name of Donor

Donation fi
given
L

by: G

Individual
Business Entity

Fair Market
Value of Donatior

)rrcer Aocrcss

rfy

Statc

Ltp Code

ASgrcgate value for this evcnt

CT
Dcscriplion of donation ijale Kecetved Event #

$0.00

$0.00

Name of Donor

given

Donation l- lndividual by: C: Business Entity

s0 00

Fair Market
Value of Donation

5trel

Addrcss

Ciry

Statc

7.ip Code

Aggrcgate valuc for this evcnt

CT
Dcscription of donation
IJate Rcceived

$0.00

[vcnt

SUBTOTAL Sectlon L.rThls Page

$0.00 $0.00 $0.00

TOTAL of *dditional Section L,t TOTAL OF ALL IN.KTND Df}NATIONS NOT CONSIDERf,D CONTRIBUTIONS (En\er lotal on LIne 21 of Summarv

Pages

Page)

III.
\AMF, OF COMMtT"fFF

NONMONETARY RECEIPTS
FILING DUE DATE

Page

ll oflT

OXFORD TOGETHER 201

10t1a2af

M. tn-Kind Contritrutions
^*amc

JAMES HARD

Tlpe of Contributor:
City
I

Fair Market
Value of this

ffi

336 OXFORD

RD

Statc

ip Code

OXFORD

Is contributor a lobbyist, or dependent chikl ofa )atc Receivcd

spouse, fr Yes lobbyist? t*; No

CT 06478 If conritulion is in excess of $400 to a candidate committee for a chief executive oflcer of

S $ *

Individual
Comrnittee Other (sppticable only lo Reterendum Committes)
a

Contribution

municipality does contributor or business he/she is associated with have a contract rvith said fi Yes fr No municinalitv valued at more than $5,000?

0812412011
l'iore
itreet Ad(lrcss

ls this contribution associated wrth a ftrndraising event listed in Section Ll?

e
rl'

Yes No

Dcscription of ln-Krnd Contribution

\ggregalc contrloullons

Ifyes,list llvent

# _

$250.21
Type of Contributr:r:

$250.21 l.air Market

Value of this

tY

)l atc

Ztp Code

CT
ls contributor a lobbyist, spouse, or dependeni child ofa lobbyist? )atc Rcccivcd
Yes

ft i] 'fi

tndividual
Cornnrittee Other (Appliceble only to Referendum Commitlees)

Conlribution

No

a candidate committee for a chiefexecutive ofllcer ofa municipality does contributor or business he/she is associated with have a contract with said fi Yes (r No municipality valued at more than $5,000?

ff..rnttiUuiiun is in excess of$400 to

ls this contribution associated with a fundraising event listed in Section L I ? fyes. list Event

{j
(_]

Yes

Dcscrrption of In-Kind Contribution

Aggregate conlfl Dullons

No Type ofContributor: C) tndividual !. ; Lommrttee

# .-

s0.00

$0.00 ['air Market

Value of this

Nanre

:itrcct Address

,lty

5tate

1io Code

Contribution

CT
Is contributor a lobbyist, or dependent child ofa
Datc Rcccivcd

fi

Other (.4pplicable only to Relercndum Committees)

spouse, D lobbyist? {i,

Yes

t'to

If*"triUution is in excess of$400 to a candidate committee for a chiefexecutive olficer ofa rnunicipality, does contributor or business he/she is associated with have a contnct with said C Yes C No rnunicibality valued at more than $5,000?
I

lsrhiscontriLrutionassociatedwitha
fundraising event listed In Section L

Ifyes,list Evenr
Nane
Strcet Addrcss

#_

? ft

ftr

Yes

Dcscription of In-Kind Contribution

{ggrcgate contnbullons

No Type olContributor: fi Individual

)IAIC

$o.oo

$0.00
Fair Market
Value of this

lrD Code

CT
ls contributor a lobbyist,

fi $

Committee Other (Applicrble only to Relererulum Commiltees)

Contribution

ordepenclentchildofalobbyist?
Datc Rcccivcd

spouse, $ G

Yes

if

No

mniribution is in excess of $400 to a candidate committee for a chief executive officer of a municipality does contributor or business he/she is associated with have a contract with said C Yes f No municipality valuecl at more than $5,000?

ls this contribution associated with fundraising event listed in Section ;'es, list Event

#_

a !, Ll? ltf

Yes

Dcscription of [n-Kind Contribution

Aggregate conmDunons

No Type ofContributor: {-,; Individual ! , Lommlttee

$0.00
Fair Nlarket
Value of this

Name

iircct Addrcss Is contributor a lobbyist, spouse, or dependent child of a lobbyist?

Date Rcccivcd

-rW

rtate

ZID LOdC

CT C
Yes

{]

Other (lpplicable only ttt Relerendum Committees)

a candidate committee for a chiefexecutive officer ofa No municipaliry does contributor or business heishe is associated with have a contrac! with said O No municipality valued at rnore than \ggrcgarc Dcscription of hr-Kind Contribution Yes Is this contribution associated with a lvo lundnising event listed in Section L l '?

lfcontribution is in excess of$400 to

$5,000?

C Yes

fyes, list

Event

#_

f] Cj

$0.00

$0.00 $250.21 $0.00 $250.21

SUBTOTAL Sectlon M-This Page

TOTAL of additional Section M Pager

N. Refundable Deposit to Telephone Company

-&st Namc

TOTAL OF ALL IN-KIND CONTRIBUTIONS (Enter total on Line 22 of Sammary PqCe) 7N67'f; fhis section refers only to advances of deposits by indhtiduals from
personcl funds to befqllt the
First Urty
,!D

of ln{llvldual

Rcsl.lcntlxl Strccl Aildrcss

Namc of tclcphonc conrpuly

l''
Zip Codc

"ennittee, Datc Dcposit

ndt

Made

Amount of
Deposit

CT

strat .r[1iiis

City

Slate

$0.00
2

CT

Total Sectlon N ($nt"r totql

",

Lin,

$0.00

III.
VAME OT

NONMONETARY RECEIPTS
TILING DUE DATE

Page

l2 of l7

COMMITTEE- " .
1

OXFORD TOGETHER 201

1AnAzU1

O. Non-Monetary Receipts of Organization ExpenditureiMadeBy

Nare of

Legislative Leadership. Legislative Caucus. and Partv Committee

Commitle e (Legislative l.eadersnip,

teghloAr"

CuM,

orrd

?utrf

Crwi

Name

ol

reasurer

itreet Addtcss

Date Noticc Received

Fair l.arket Value of Donation

lity
LJcscnplion of Donution

State

Zip Code

Aggrelate Donations

CT

$o'oo
lurpose of Expcndrtute (see inslractions)

|iaGBCcl]'Dt-i'E
Name ofCommittee (Legislative Leadership, Legislative Caucas, und Par1t Committees On-LY)
,Jame

$0.00

ofTrcasurcr

Strect Addrcss

Date Noticc Rcceivcd

Fsir Market Value

of Donation

:ity CT
Description of Donation

Zip Code

\ggregate Donalions

$0.00

|1l *s fic Sn f'r

Name of Committce (Legisktive Leailership, Legislutive Caacus, und

Purpose of Expenditure (set irctructions)

$0.00

Pug

Comminees ONLYI

Name ofTreasurcr

itrcet Address

Date Notice Rcccivcd

Fair Ntarket Value

of Donation

)ity
)cscription of Drrnation

State

Zip Code

{ggregate Donationg

CT

$0.00
Prrpose of Expcnditure (see

instuctiorc)

faCB{ic{1of":e
Name of Committee (Legislative Lcalership, Legislative Caucus, and Party Commioees ONLy) Name of Treasurer

$0.00

itreet Addrcss

uate Noflce Kecelveo

Fair Market Value

of Donation

)ity

Zip Code

Aggrcgate Donations

CT
lescription of Donation

$0.00
Purpose of Expenditure (see instructions)

r,A r'B r c {.rD (

Llate Noticc Received

$0.00

Namc of Committee (Legislative Leadership, Legislative Caucus, and Parg Comminees ONLY)

Name of Trcasurer

itrcct Address

Fair Market Value

of Donation

lity
Jcscnption ol Donation

State

Zip Code

Aggrcgste Donations

CT

$0.00
Purposc of Expcnditurc (see instructiont)

Cl tlrB f] c f D {:E
Name of Comminec (Legislative Leudership, Legislative Cuucus, und

$0.00

Psfit Commiftees ONLY)

Name of Treasurcr

trcct Addrcss

Datc Noticc Receivcd

Fair Nlarket Value of Donation

iry

Statc

cr
uescnplon or mnalon
N{mc ol Llommittce (Leg*lstiv Lesdrship, Legislative (.auus, und Partt Committees Oa"LY)

Z.ip Code

Aggrcgstc Donations

$0.00
Purpose of E.rpmdibsre (see instructions)

i5
:\ame ot I rcasutct

I .fig {:c

CrD nE

$0.00

;trcct Address

[)ate Noticc Rcccivcd

Fair $larket Valu

of Donation

)ity
)cscrlptl0r ol l)onahon

State

Zip Codr

Aggregate Donations

CT

$0.00
!urposc of Ixpcndi&!tc (ve inttuttions)

r. ,\ (. B (.,c i D !'E

$0.00 s0.00

Total Section O (Enter total on Line 24 of Sammam PaBe)

IV.
NAMEOF COMMITTEE

EXPENDITURES
]II
INT"}

Page 13 of

l7

NITIi NATF

Oxford Together 2011

1At1A2Ar

P. Expenses Paid bv Committee

Nmc
!tleei
of Pavee
AddreSS

'

Arrow Printers
arp

)a!c of Psyrent

fvlethod ofPayment

Amount

uooe

9t15t2011

311 main st
rurPosc ot bxpcodrture (by codc)

ansonia
a-Sign

CT

06401

fl; oebit card

Evcnt,

GCheck# '10061007

signs and door hangers

Cudidate(s) Nane (ifapplicable)
Office Soughl

Type of Expenditure 1( qplicabte): , Coordinated with reimbursement sought C: Coordinated without reinrbursement sought ln,lepenrJent

fl

Supported

EI opposed

f.

l-.

Organization (see InstruLtions)

l\ame OI l'a!('e JlrecI Aooress

{.

a CB ec CD CE
Method ot I'aynrent
City r6Ie
4rp Uode

s
9t15t2011 ie
Check *.

,414.70

Postmaster Derby

Amount

1009

main str
rurpose ol Expcndlurc 'by code)

derby
Jescnpllon

CT post card mailing

Candidatc(s) Name (il applicable)

06418

fr

Debit card

Evcnt #

a-dm

I'vpe of Erpendiru re (f appliL.ablel: { . Coordinated rvith rcimburserucnt sought C Coordinated without reimbursement sought

Office Sought

LJ Sunnorted

Ll opposed

C lndependent { Organization (see Itrsrructions) .f.:a q; s ljc

Nrme of Pavcc

'

Cn fir
)ate of Paymenl

s
Method of Payment
\tate
Zip Code

722.Q7 Amount

Valley Publishing
City

)rrccr r\ooress

filchect* 1010
G oebit card
BYcnt #

7 francis st

derby
a-dm

CT

06418

(bycode)
f ype

rurposc oI Lxpendfure

printing 500 copies of direct mail

Candidatc{s) Name Office Sought

i ft e

of Expenditu rc (if applicqb le) : Coordrnated with reinrbursement sought Coordinated without reimbursement ;ught
lndeoen,l.nt Organization (see Instructions)

(ifapplicable)

fl

Supported

opposed

N4mc ol ravcc

'

C,a {i: n {]:c {lo On

Jat ot Payment

$
Method ot Payment
State

1,003,82
Amount

Village of oxford greens

City

5tlcgt AddrgSS

oxford greens
ruryose or r,\pcnolrwc (by codc)

Oxford
Jcscnptlon

cr

Zrp Code

9t14t2011

05478

lChect* 1011
Debit Card

a-news

newspaper ad
Candidate(s) Name (tf applicable) Office Sought

Event #

'fype of Expendiilre (if applicuble): .'0 Coorclinated with reimbursement sought O, Coordinated rvithout reimbursement sought

E E

Supported Opposed

i(l

Independent
(s

ifJ Organization
Name of Pavce

ee I ns

tu ctions)
)atc ofPaymcnt

r.A r.B r.c !'D r:E

65.00
Mcthod of Payment

'

Schreibers
ciry
tate alP Loog

Amount

9127t2A11

571 quaker farms rd

rurposc or bxpcnotrurc {by codc)

oxford

CT Pig and roasting

06478

l:.

l;i

Check

01 3

Debit Card 2

FNDR

l'ype of Expenditure (dqplicfile): '(} .G Coordinater1 with rcimbursement sought Coordtnated without reimbursenrent sought

CandidatEs) Nane (if applicable)

Office Sought

Supported

Dopposed

lndependent

C,

,r ftn f:C CD CE
SUBTOTAL Sectlon P-Thls Page

s
TOTAL of addltional Seetlon P Pase*

300.00 $3,505.59

eF5;es

TOTAL OF ALL EXPENSES PAID BY COMMITTAE (Enter total on Line 19 of Summary Page)

wffi;

IV.
{AME OF COMMITTEE
Oxford Togethet 2011

EXPENDTTURES
FII,ING DUE DATE 10113t201

Page l4 of

l7

O. Campaiqn Expenses Paid by Candidate

Name of Payee (Nume of Vendorwho csndi.latepaid

ditu"ru

W^l^^r1
llare
arp Looe

Date of Paymcnt

Is Reirnbursement Claimed?

Amount

itreet Address rurposc oI txPenu!ae

(by

rry

10t04t2411
lvcnt
#

Y"s

derby

CT

0641 8

ONo

$127.23

codc)

Dcscnption

OVHD

prepaid phones for campaign calling

Name of Payee (Name of Vendor who candidate paid Strcet Adalress rurPose ol bxpenoltufe (by code)

dir""rtl
W

l)ate of Psyment

Is Reimbursement Claimed?

Amount

rry

^l*^r1

tate

1rp Uode

0912412011
Evcnt #

{t: Y.,

derby
Dcscription

CT

0641 8

fNo

$122.54

OVHD
pail dir"t,rt)
-rty

office supplies
big

Name of Payce (Name of l/endor who cundilate

y
Statc

Date ot l'ayment

Is Reimbursenrent Claimed?

Amount

)treet AoqresS

zrp L.oo

09t2612011
Event #

6-, Yes

403 main street

rurpose oI b,xpen6rrufe
(by

ansonia
Dcscription

CT

06401
2
oI raymclrr

if

l.lo

$94.28

code)

FNDR
",

paper supplies, deli, for fundraiser

OXfOfd liqUOf
Zip Code

Name ot Payee (Nsme trJ yen.lor ||ho cqndidate pttd .lt Sireet Acoress
- rty

tY

Is Reimbursement Claimed?

Amount

0912412011

G
2

19 oxford rd
Furpose or bxpcnolrure (by coclc)

oxford
Description

CT liquor for fundraiser

06478

'O No

Yes

$57,37

FNDR

Dete of Paymcnt

ls Reimbursement Claimed?

Amount

Strcet Address rurpose ol bxpenolture (by code)

, try

Zrp Code

C
Evcnt #

CT
Description

('No

Yes

$0.00

Name of Payce (Name of Vendor who candidate paid direclly) Street Addrcss

Date of Payment

Is Reimbursement Clairned?

Amount

:ity
Dcscription

)BIg

Zry Code

ll:.

CT
rurpose or bxpensrrure (by codc) Evcnt #

(l:

Yes

No

$0.00

Namc of Payee (Name of Yendot |9ho cantlidate pqid .lireclly)

Strect Addrcss

Datc of Paymcnl

ls Reinrbursement Claimed?
(--a

Amount

Urty

Zip Code

yes

CT
rurpose ol Dxperulruu

CNo
gvcnt #

$o.oo

Desfiiption

(by code)
Name of Payec (Nane oJ l/end* who candidqle psitl dircclly) s'tlcet rlddrcsS rurPose 0i cxPctrsIurE (by codel Crly Zip Code
Date of Payment

Is Reimbursement Claimed?

Amount

CT
Description Hvcnt

fNo
t

Yes

$0.00

Namc of Payec (Name of Vendor who candidute poid ttirectly)

[-)ate

of Paymcnt

Is Reimbursement Claimed?

Amount

5trcct Address
I'Urpose ol rxpenorrurc (by code)

L'rty

)Iaic

Zip Code

(_'

CT
Dcscription hvent tl

(.i

es

No

$0.00

SUBTOTAL Section Q-This Page

$401.42 $0.00 $401.42

TOTAL of additlonal Section Q

Pages

TOTAL OF ALL EXPENSES PAID BY CANDTDATE (Enter total an Line 26 olS!41nt!!l!!89

IV.
{AMF OF COMMI-I"TFF

EXPENDITURES
;N ING T'IlE DATE

Page t5 of 17

Oxford Togethet 2011

10t13t2011

R.
Nante of Issuing Institution

Exnenses Incurred on Committee Credit Card

Type of Credit Card:

Q visa {l other
Narnc of Vendor

f,

Master

Card C

Discover

l]

American Express

Dale of Trmsaction

ilmount

Strcet Address

City

State

Zip Code

CT
Purpose of Expcndilure 1by codc) Nanre of Vendor Date of Trmsaction

)escription

Evcnt #

$0.00

Amount

Strecl Addrcss

Crty

itat

lip Codc

CT
Purgose of Expcnditure

Description

Event #

$0.00

(by codc)

\ame oi Vcnilor

Date ofTransaction

Amount

Street A.ldress

City

State

1ip Code

CT
Purpose of Expenditure (by code)

)cscription

Event #

$0.00

Name of Vcndor

Datc of Trmsaction

Amount

SFeet Addrcss

City

State

lip

Code

CT
Purposc of Expenditurc (by code)

)cscriplion

Evcnt #

$0.00

Name of Vendor

Date ofTransaction

Amount

Strect Addrcss

City

State

Zip Code

CT
Purposc of Expcnditure (by code) Name of Vcndor

)escription

Evcnt #

$0.00

Date of Trmsaction

Amount

Strcel Ad{lress

City

State

Zip Code

CT
Purpose of Expcnditurc

)escription

[vcnt

$0.00
#

(by codc) Namc of Vcndor

Datc of Trmsaction

Amount

City

)taae

lip

Code

CT
Pur;rosc of Expcnditurc

$o.oo
Event #

)cscription

(by codc)
Namc of Vcndor Date ofTransaction

'\mount

Slreet Addrcss

City

Jtatc

4ip Code

CT
Purposc

oi

Expcncliturc

)cscription

Event #

s0.00

{by codc)

SUBTOTAL Sectlon R-Thlr Page

$o.oo $0.00 $0.00

TOTAL of additlonal Sectlon R Pages

TnTAI, of,. AI,I,

F.,XPRNSES

INCURRED ON COMMTTTEE CREDIT CAHD (EnteTtoJ*I

ON LiNE

27 Of SUMMqTV PASCI

IV. EXPENDITURES
NAME OF COMMTITEE :ILING DUE DATE

Page

l6 of l?

Oxford Together 2011

10t13t2C

11

S. Expenses Incurred by Committee but Not Paid Durins this Period

Nsme of Crcditor
Street Addrcss Datc lncuned

Amount Incurred
(Estimdte or Acruql)

Event #

City

State

,lt

Uode

,'andidate(s) Name

(ifupplicable)

Ullice Sought

CT
aurposc ot tlxpcndtture

lby codc)

lescnption

Type of Expendir.irc ifqpplicabte): ( ' Coordinateri with reimbursement sought C Coordrnated without reimbursement sought G tndependent

C
Name of Creditor

Oreanization kee Instructions) -G;rfinfCf,nl'.n

.(}supponcd

$0.00
Amount Incurrec (Estimate or..1lrul)

l]cpposed
l)ate lncuned

Strcet Address

Evetrt #

City

State

1ip Code

Cmdidatc(s) Name (if

applictble)

Office Sought

CT
rurPose or tsxpcnolrure lby code)

Type of Expendif'tre (i! spplicsble)i

)cscription

l-.

Coordinated with reimbursement sought Coordinated without reimbursement sousht In,lependent

'lSsupported

Orsanization kee Instructions)

( Al.Bl:cr

Dr.:E

i!!)pposed
Date Incuncd

$0.00
Amount Incurrer
(Estimate ot Aclual)

Name of Creditor
Strcet Address

Event #

City

State

Zip Code

andidate(s) Name (y'

applicable)

Officc Sought

CT
Purpos of Expcnditure (by code)

)escription

Type of Expendit $e (if applica b!e) : C Coordinated with reimbursement sought C Coordinated witbout reimbursement sousht Independent

c f,

Orsanization kee I nslructions)

"l'la f.B 1]c Cuf;r

$supported
fi.Cpposed
Date Incuned

$0.00
Amount Incurret
(Estimate ot.4ctusl)

Name of Crcditor

Strect Address

Evcnt #

City

State

Zip Code

Candidatc(s) Name

(ifapplicable)

Officc Sought

CT
'urpose of Expcnditurc by code) )cscri ption

'ype of Expenditure (if app licab te) : C Coordinated with reimburserrent sought f. Coordinated without reimbursement sousht

Ct Intlenendent

f.

Oreanizction kee Instactions)

"t. n f B Cc {:D'CE

C. supported

(l'cpposed

$0.00

SUBTOTAL Sectlon S-Thls Pase

$0.00 s0.00
$0.00 $0.00 $0.00

TOTAL of addltional Section

S Pnses

TOTAL OF ALL trXPNNSES INCURRED BY COMMITTEE DUNING TIIIS PERIOD BUT NOT PAID
(Enter total on Line 28 of Sammary Page)

Prevlourly reported Expenseg Unpaid snd still Outstandlne TOTAL OF ALL EXPENSES INCURRED BV COMMITTEE BUT NOT PAID (Enter ronl on Line
28a of

Sunmarv Pose)

IV.
NAME OF COMMITTEE

EXPENDITURES
FN,INC DIIE DATE

Prge 17 of

l7

Oxford Togethet 2011

10t13t2011

T. Itemization of Reimbursements to Commlttee Workrs and Consultants

Lmt Name of WorkerlConsultmt
jccondary Payce

Fint

MI

Date of Payrent

Method of Payment

Amount

)urpose of Expenditure

by codc) Jtrcct Address

C
CT

Check Debir Card

#-_-__--_-

Cily

Zip Code

r/cscnplr0n

Type of Expendiftre (if applicable): (3 Coordinated with reimbursement sought C: Coordinatecl rvithout reimbursement sought

Candidarc(s) Name

Office Sought

l,Supported

(ifapnlicable)

{l

Opposed

l. L

tndcpentlent

Organrzation (see Inslruclions)

a-)

.t i) n flc

.ln'.t11n
First

s
MI
Date ofPaymenl

$0.00

Last Namc of Worker/Cotrsultant

Method of Payment

Amount

iccondary t'a),ee

Purpose of Expcndirure

(by code) itreet Address

C Check #_ G Debit card

Zip Codc

City

CT
Dcscription

Type of Expenditure (if opplirub!e): .fJ Coordinated with reimbursement sought .{ Coordinated without reimbursement Jought

Candldate(s)

Nmc

Officc Sought

(dapplicable)

C, Supported C. opposed

f'!

Indepentient

,(1 Organization

r:.A !-_B Cc Co {..e

First

( see

Instr uctions)

s
MI
Date of Payment

$0.00

Method of Payment

Amount

Jecondary

Pai.i

)urpose of Expcnditure by code)

:{l check #

.f! Debir Card

Zip Code

Strcct Addrcss

Crty

CT
Dcscription

Iwe
I

of Expendiru re (if upplicable): -l Coordinared with reimbursement sought fl Coordinated without reimbursement sought

Candidate(s) Name

Officc Sought

(dtpplicablel

f-'; Supported

C Opposed

I i

lndenendent

Organization (see l,nstruclions)

C.^ f_B.nc

f nf

r
First MI
Date ofPavmcnl

s
Method of Payment
Purpose of Expcnditure

$0'00

Amount

Sccondary Pa;,r:

(by codc) Strccl ,^

(.Lheck4 C Debit cura

Ztp Code

ciry

State

Dcscri pt ion

Type of Expenditvre (if tpplicuble): O Coordinated with reimbursernent sought .fr Coordinated without reinrbursement sought

Candrdate(s) Nam

Of{icc Sought

(if applicable)

ll) Suppo*ed li; Opposed

l. fr

lnrlependent

C)rganization (see Instructiotts)

C.r .CB !'ic CD.c,Fl

SUBTOTAL Sectlon T-Thlr Page

s
TOTAL of additlonal Section T
Pages

$0.00 $0.00 $0.00 $0.00

TOTAL OF ALL REItrIBURSf,MENTS TO COMMITTEE WORKERS AND CONSULTANTS

I.
Oxford Together 2011

MONETARY RECEIPTS Section B. Additional p

8,. Itemized Contributions frory fnAiviAnafs

4 Nancy Lynn Lane
Is contriburor a

,tmount of Contribution If contrrbution't,n

No

or dependent child

toUfy*tlpiill oia totrOyisti r,

a a Ll?

Is urrs contribution associated ,J this rurirnDunon assocrated with fundraisingevent Iisted in Secrion list tlvent # fyes, Method ofcontribut on. J-.,Cash {i. I'ersonal

f, f,

municipality does conrriburor o, b.-ul,l9rr rr.lrrr.-i., municipality valued at more than $5.000? yes

.'..;

l-i*''" fl

*-"."i.iivith

N"

have a contracr with saicl

N"

ls contributor a principal of a state eor)tracror or Ifyes,indtcate which branch or L,l4irgltgs ur

I olgovemmentthecontrectiswith. f. Executive (l_egrsiatrve

.f:
Money Order

branchcs

prorp".r,u".,ofililil--fil
r. ar, rr No

Check

. C-redir/Debir Clard

payroll Detiuction

$100.00
.\mount of Conlritrution

Is contributor a toUty*-t,$6G or dependent ehild oia

lobhyist? ,n

ll'ann,.'but',,n
No

ls this conlilbulron Jss(rclatcd \vlth a rundral\rng crent listcd rn Secrron L L) fyes, list Event # Method

/. y; ;t lio

municipality does contributor or busi".* *1"".ui.i *,,r,., have a contra* with said municrpalrty ralued ar more than 'r.irn"-i,.tr?".'"":C ru"

g5,000?

Is contributor a principal of a state conrractor or prospective

Ifles,indicate rvhich branch

oicontrrhrt,u,,F
o"L,,t card

'

ofgovernment the contract is with

orbranches
fl

Executive

,,uilu**i-?ll .{ llt ., Nn
fi Legisrative
$500.00
Amount of Contribution

w"nn

fr

Payroll Deduction ,.fi Money order

ls contriburor a

tuUUyGq$IQ
oia

or dependent child

iobbyisti l;j N; a l? lij G C fV"

fundraising event listed in Section L Ifyes,list Event 3

Is this contr"ibution associated with

, ,'.on,rrOr,ro municiparitv does conrributor o'b^u-rirg* municipality valued at more than

$5,000?

h;r;r; r.;;;;;;iivith -

l-v"r-'-?;

rv.

have a contract with said

Is contriburor a princrpal

fyes,

Method of contnbution l.Cash t.p,'."^." Check , Personal

nf gou.rnm"nt

old state contractor or prorp".riu. rndrcate whrch branch or branches

ttt".ontiu"il,

f.

,*il_.,-IIi-EG *iti,""-'- r*, Executive l. Legislative t

10t07t2a11
P.incipal OmuoatG'

No

Credit/Debit Card

l,

payroll Deduction

rl

Money Order

$100.00
,Lmount

1 old Moosehill ls conlnbrrtor d I,'btryist-ffi. or dependent child of a Iobbyistr r!.1 wo

thrs contributtorr assocrated rvilh fundraising event listed in Sectron l_ I
Is.

rd

ott'
l

of

Contribution

f conrrr bul ron

lcr -lstat"
$5,000? .tr".ii.ilvith have a contract C;'V*'""i-: *" fl
Executive
wirh said

Ifyes,listF:vent# 3

,t"l

y;
No

municipality does contributor or h^usiness rr"^rr" ir municipalrty valued at rnore rhan

{*.

ls contriburora principal of a state conrraclor or prospecrive Ifyes, indicate which brancn or branches

roilililiJ-T,'
fi l-egislative

Method of contribution il,cash personar

ofgovcrnment the contract is wifh:

fl xo
$100.00
Amount of Contribution

il

'il

check

fr

credit/Debitcard

rr

payrot Detiuction

ir

Money order

1At07t2a1

Is coltribrror a tot or dependent child

ola

[G, Jffi lotrbyisr? :lf, No

a LI.l f
yes

ll'contrjhutiontt,n

" municipality does contributor or bu,siness r,"/rn. ,r - -,*

municrpalrrv valued .rr more than

ls this contributlon assocratctl with fundraisrng evenr listed in Section

gj,000?

ivrth 'V*"'']"f, "rr*"i..t n"hare

a contract rvith said

f1'es, Iist Er.ent # 3

lr.l No

Method of conlrrhulron

ifi cash

li

ls coninbutor a prineipai of a state eonlracror or prospectrve f1es. rnrlrcate * hrch branch or hrane he s orgovernment the cclnrract is $ith: fi Erecutive

.,"iliilor--fG .
.ii
t.cgisiatrve

- .!r

No

persrnal

chcck

''

crcdrtrDebit card

rf' pavrot

De,r.retion

F, r\{oney

'rder

tua7p011

I.
Oxford Together 2011

MONETARY RECEIPTS Section B. Additionat

aiir:ji::.:;'.::.|!-ll:,

B- Itemiied

Contributions. from In
Amount of Contribution

Is contributor a Iobbyist, spouse. or dependent child of a iohby-ist?

tr; lio
ri; yes l*: No

ilcor.rtribution is in excess of $400 to a carrdidate committie for a ct ief srecuttt;m munlcipality does contributor or business he/she is associated with have a contract with said municrpality valued at more than $5.000? f yes 61 No
ls contributor a principal ofa state contractor or prospective slate contractor? yl'e.c, rndicate which branch or ofgovernment the contract is Executive {- Legrslative

ls this contrrbution associated rvith

fundraising event listed in Sectron L l'l fyes, irst tivent # 3

Method olcontribution:

branches with: C

f. y.s f No
$50.00
Amount of Clontribution

|, castr 6. Personal check f

CredrvDebit card

f.

payroll Deduction

?l

Money order

Is contributor a lobbyist, spouse,

condon and Savitt PC

is in excess of$400 to a candidate committee for a chiet'i*ecutiue t trceioG municipality does contributor or business he/she is associated with have a contract with said

or dependent child

ola

lobbyist? .6, No a
I

lfcontribution

munrcipality valued at more than $5.000?

Is this contribution associated wrth fundraising event listed in Section L If.yes,list Event 3

lfi Yes G

wo

'J

f, lft

yes No

Is contnbutor a principal ofa state contractor or prospctive state contractor? fyes, indicate which branch or of govemment the contract is .f;i: Executive ifl Leeislative

branches rvirh:

fi
.lir

yes
No

ln castr

ii

Personal

check lf' credit/Debit card C payroll Deductron C. Money order

10t07t2011

$100.00
Amount of Contribution

Is conlr:butor a lobby ist. or dependent child of a

spouse. f'l lobbyist'/ 6. a l?

ye,
No

llcontribution

is in excess

oi$400 to

a candidate commrttee

municipality does contributor or business he/she is associated with have a contract with munrotpality valued at more than $5,000? C, Ycs No

to,

cnieiexe"ut,uetfrc.r.iu
sard

I'

Is this contribution associated with fundraising event Iisted rn Section L Ifyes,list Hvent 3

li.]

yes
No

f.

Iscontributoraprincipal ofastatecontractororprospectivestjatecontractor'?

Ifyes, indicate which branch or

of govemment the contract

branches is with: C Executive f.

Received

fi

ye,
No

f-.

Legislative

Method of contributron: cash 1:, Personal

i.

check

f.

credit/Debit card

f,

payroil Deduction {.-. Monev order

10t07t2a11

$50.00
Amount of Contribution

639 Quassapaug

Is contributor a lobbyist, or dependent chrld of a lobbyistlT

spouse, {ll fl a ?

Rd

Watertown
yes
No

Ifcontribution is in excess oi$400 to a can<iidate .ornrittee for a chi*f"*ecutiuJotrceiffi municipallty does contributor or brusiness he/she is associated with have a contlact with said valued at more than 55.000.' C Yes {,*i No
yes
No
ls contributor a principal

ls this contributlon associated rvith fundraising event listed in Section I_I Ifyes,ltst Event J

fl f

ola

state contractor or prospective state

If.res, indicate which branch or

ofgovernment the contract

branches is rvith: Ci Executive fl

Date Received

contractor'?
Lesislative

fl

yes

{.1 No

Method of cotrlribution i'n,.1 {;l n.,,-^-.. I Castr fir Personal Check

fl

Credit/Debit Card

r'l

payrgll Deduction {-1 Money Order

10ta7no11

$150.00
Amount of Contrihution

ls contributor a lobbyist. or dependenr chiltl of a

spouse, f.l' lobbl*ist'l F a ?

yes
No

Park Trucking and contr

is in excess ol$400 to a candidate tbr u.frieietecutit,e.,rf"rcer of a " muntcipaitty does contrjbutor or business lre/she is associated with have a contract rvith said munre ipality valued at more rhan $5,0001 .'S No

lf contribution

c*ritt

ls this conlribution associafed rvrth f'undrarsing evenl listed in Section L I If,yes,list [:vent # 3
,11

f fl

Yes It

yes
No

ls contribulor a principal ofa state contractor or prospective state fyes, rndicate which branch or

olgovemment

branches the contract is with: C Executive l(*r l_egislative

Date Receir

contractof? fl

yes
t,{o

ai

Cash li

Personal

Check

lf'

('redilDetrit Card ll*. pavroll Deduction

frl

Fl

Monev Order

10t07t2011

$200.00

: SU&TOTAL Section B-This

,, L,__

I. MONETARY RECEIPTS Section B. Additional pase

Oxford Together 2011
Last

30 days following primary

Nme

B. Itemized fnitrihr.t;^ns
First

frnn 1-n:i;::r
t,nnclpal Occupation t.ode

Macchio
Kosrdfltral Sreet Address

25 Silano Drive
Is cunrrrburor o tot or depentJent eh r ld ot'a l obhi r st

.-irr
.,

Michael
1rp

Uj;l ,ffi,

t;

Oxford

Yes No

llcontr:bution is in excess

lCr -lS-urc rf

Nme of Emplol e r

,lmount of C0otribution

06478

municipality d(xs contributor or business he/she is rssociated with have a contract wrth said municipaliry'valued at more thiin $5,000? f, yes fi No
es

fundraising event listed in Section L I ? fyes, lrst Event 3

t-

Is contributor a principal

ofa state contractor or prospcctive state contractor? indicate rvhrch branch or ofgovernment the contract is {=; Executrve Legislative

fyas,

branches with:

f.
{-,

y..,
^-o

3.1

G;'"il;;;r*ri
Cayer
.A.ddress

Check

credivDebitcarrJ
I

f,

pavrolr Deduction

.i

rVroney

order
\.{t

1oto7t2o11
Principal Occupation

{ ggregate

contnbutiJii-

rrst

$s0.00

$50.00
Amount of Contribution

ictroenual jtreet

Bernard
,

M
rlate ip (lode
NAme

rty

Drywall
ot bmployer

61 Greenbriar Road
ls contriburor a lobbyist. or dependenr child of a

oxford
Ifcontribution is in
excess

spoLrse, i--TE lobbyist? 16 No

l_ I ?

CT
of'

46478

Self

municipality does contrrbutor ot business he/she is associated lvith have a contract with said municipality valued at more rhan 95,000? lC yes .6 No
N,

t'undraising event Iisted rn Section Ilyes,list Event J

lff

Method of contribution: ld', Cash Personal Check

ls contributor a principar ofa state contractor or prospective state Ifyes, indicate rvhich branch or of govemment the contract is Executive

branches with: i
Date

contractor'/ {*,

yes
No

.fi

.+
Legislatrve

ii,

Rcceived
Principal Occupation

Credit/Debit

ard C
lrsl

ayroll Deduction C; Money Order

lv{

Last Nene

10t07t2011 |
Paying
Name ot tmployer

TQres.rc;mE"il;^
$100.00 $100.00
Amount of Contribution

Persson 124 Hawley Road

contributor a lobbyrsr. ,poL,se, --Tfl[ rr dependenr chrld ot a lobbl rst? 6. No
s
,

Glen
lty
Jtate
arP

Loqe

Oxford
lfcontribution

CT

06478

,n.*..* ol

Self

municipaiity does contributor or business he/she is associated with 'r have a contract with said municrpaliw valued at more than $5 000? {*.: v^" r"tr xr^ yes No
ls contributor a principal ola state contractor or prospective state contractor? Ifyes, indicate rvhich br:rnch or branches
Date Received

Is thrs contribution associated with fundraising event listecl in Section L Ifyes,list Event 3

a
I

ill C

l,

Method oicontnbution: Cash Personal Check

ofgovemmentlhecontractiswith: f; Executive f.Legislative

1UA7t2011
Principal Occupation

f''.

Yes

No

il

f;

Credit/Debir Card
trast

f;

Aggregare conmDutlons

Payroll Deduction Cl Money Order

MI

Last

Nmo

$100.00

$100.00
Amount of (lontrihufinn

Griffin
Kesroennat

Jtreet,Address

'

.--F;,y- Bilt
Oxford

3 Tetlak

Lane

lS*"

4rp Lode

Construction \me ol bmployer

Is contributor a lobbyist, or dependent chrld ofa

rpour., --ET-G lobbyisr? fl No

rcT

06478

Self

Ifcontributron is in excess of
municipality dos contributor or business he/she is zssociated with have a contract with said municipality valued at more than $5,000? C yes

Is this contrrbution assocrated with a firndraisrng event listed in Section L I l) fyes, list Event 3

iil i-.

fl

tio

Yes No

ls contributor a principal

Ifyes,indicate which branch or

ofgovemment

Method of contribution: . Cash 6'l Personal Check

branches the contract is rvith: {j Erecutive Ci Legislative

Date Received

ofa

state contractor or prospective state

contractor? Cl yes

Cl

fVo

fl

Credit/Debit

ard

{'l

'ayrerll Dcduction

il

Aggregate mntnbutions

Money Or<jcr

10t07 t2a11
Princrpal Otrupatton Name ot L_mployer

l-ast Name

r'rrrr
davies

$100.00

Reslocnuat )|Ieet Addrcss

1'12

Pershing Dr
?:
Ycs

Ansonia
rr
rrr

ItY

Art
lsrare

lc
I q^l.br ur )+r/u

| \lt

$100.00
Amount of Contribution

Is contrrbulor a luhhvrst. sporrsc.

cf

1lp la)d6

Self
LU

or depxndent chrkl ol'a lohbr r>t'

No

municipalityvaluedarmorerhang5.0{10.1
fundraising event I isted in Secrron L I ?

a canoroate c'mmrttee lor a chref executive oficer of a municipality does contributor or business he/she is associated rvith have a contract rvrrh said

iijyes iS Xo

Ifyes.list !.vent

#J

j^,

Nr.

ls contributor a princrpal ofa state contractor or prospective slate f;'es, indicate qhich branch or

ofgovernment
:

i\,[ethr:d

lfi Cash a

ol ct)ntribution

branches the contract is *ith: .(1 Exeeutivc .fi Legrslative

ccer

contractor? ,.],

yes
fVo

ii

},erscnal Check

ltt

ved

Credivt)ebit

C'

ard ll-

Iri tyroll Deduction

Aggregate contdbutions

Money Order

1At07t2011

s50.00 BTOTAL Section B_Ihis paee

Page

$50.00

$400.00
of

I.
VAMF OF C{}MMIT"|FF

MONETARY RECEIPTS Section B. Additionsl Pn<rp

%
MI

Oxford Together2All
*-81-F:

30 dayr ; following primary

Principal Oeupation

s,ffi

i#

*ij,:s.t::r,i$ri:

B.
Last Nme

fferrrizerl finn+*it..,,it

iqrq d di*dii{i!,L,',,:,
Attorney
1rp Code

Labriola 185 RlgOs st

Is conrnburor u -.tty

David
i

tate

loutyor.lpoGl---F-E

Oxford
Iicontribution tr

1\ame oI hrrptoyer

Amount of Contributicn

CT

06478

or depcndent ehild ol'a hrhby

I< thio

rstq 6.
Ll?

tto

tn municipal ity does contributor or business he/she is associated with have a contract with said

.*l

Labriola & Labriola

aun[ipal]ty valued at more than $5,000,1

f, yes

Ot

t6

lundraising event lrsted in Section Ifyes,Itst Event 3

Method of contributron pcrsonal Check .t. Cash

ls contributor a principal ofa state contractor or prospectlye state contracto,? fyas, rndicate rvhich branoh or hranches ofgovernment the contract is Executive t.egislative

with:
I)rte

f.

Credrt Debrr l'ard

First

f:

C Receircd

f- Yes {- No
$150 00 $50.00
Arnount

Payroll Deductron

.f

Money Order
N,II

Last

Nme

1ot}7t2o11 |
Journalist
I

l.\ggredGiiimbiffi;of

pelton
Kesroennal Strcot r\ddress

Joanne
Llrly

Principal Occupation
Or

M
itale
:.rp

15 Perry lane
Is contributor a lobbyist, spouse,

L0oe

Ltnployer

r
'fL

oxford
Yes

CT
,)

06478

Self

or dependent r:hild

ofa lobbyist?

No

', s^rcs) ur lquu ro a canolgate commlttee tbr a chief executive officer of a municipality does contributor or business he/she is associated with have a contract with said municipalitv valued at more rh^n (i Oon? 'fi w^- * rr^
yes
ruo

Is this contribution associated with fundraising event listetl in Section L Ifyes,list Event 3

a
I

f, ln

Method ol contribution: lfi Castr .: personal

Name

Is contributor a principal ofa state contractor or prospectrve state oontractor? Ifyes, indicate which branch or trranches of govemment the contract is .0 Executive ,fi Legislative

with:

ff yes fiNo
$150.00 $100.00
Amount of Contribution

Check jf,

Date ReceivEd

CrediVDebit

ard Fl 'ayroll Deduction

First

Aggregate contributions

3i

Money Order

10/07t2011
Pnncipal Osupajion

Quoka
cenhal Street ,\ddress Ity

Michael
:lp Lode

Owner Hardware store

i\ame of Lntpioyer

158 Good HittRd

s contributor a lobbyist,

rr dependent child

ola

lobbyist? rn,

rpous",

- f; -!!l
No

Oxford
rr
rrr

CT

06478

Self

cAlsss ur D+\ru ro a canoloate commrttee ibr a chiefexecutive orTicer ofa munrcrpalrty does contributor or business he/she is associated wilh have a contract wirh said municipalrty valued at m0re than firu^

$5.000?

yo" (1

Is this contribution associated with

fundraisingeventlisted Ifyes,list Event # 3

*?, yes a inSectjonLl'/ fl No

ls contributor a principal ofa state contractor or prospectrve state /yes, indicate which branch or

ofgovemmentthecontractiswith:

brenches
Date Received

contractor?

Method of conh.ibution i*. Cash 6, personal Check

Last Name

Executive (tLegtslative

C y", e. N;
$100.00 $100.00
Amount of Contribution

i.

Credit/Debit Card
First

P.

ryroll Deduction f-i Money Order

Aggregate conributioni

10t07t2011
l,nnclDal OccuDation

Palutis

Vincent

Retired

zs Rees

Drive

Is contributor a lobbyist, or dependenr child ola

lobbyist? {j
|

rporr", ---fl-G
No

tX-ro
r'r f
N

fs$
sArs55 0r

1lP L_O0e

Name ot Employer

06478
.xuu

municipality valued at more than flndraising event listed in Section L fyes, list Event # 3
Method of contritrution: {-. Cash Personal Check

ro a canoroate commlttee rtrr a chief executrve officer of a municipality does contributor or business he/she is associated wr& have a contract with said

$5,0001
ofa

{f yes fi

No

Is contributor a prrncipal

Ilyes, indicate which branch or

ofgovernment the contract

state contractor or prospective state

branches is with. {ll Executive {ii Legrslative

Date Received

contractor? Cl yes

Cl

No

iil

fl

Credit/Debit

ard
First

il

)ayroll Deductitin

tl

Aggrctaste contributions

Money Order

10107

Lnst Nane

t20't

$100.00

$100.00 (lontribution
Amount of

Deluca
Kssrdenttal Street .{ddress

Louis

t'nnctpal L)ccupatt0o

477 Main Sireet

Is contributor a Iohbyirt,

or dependent child

ola

lobbyrst? ltr; No
l_ I

,po-.

woodbury icr
?
,{.,
Nc

ir)

Retired

lStare l,p

( ode

Namc of Employer

loozsa

tr !\,,,rr,(,urru. ,) r. crce ss 0r )4uu {o a candrdate committee t-or a chielexecutive of}.icer ola municipality dos contributor or trusiness he/she is assocrated with have a contrac! rvith saidmunrcipality v.alued at more rhan $5,000? yes .'fi
.{?, No ls eontributilr a principar clfa state contractor or prospective siate contractor? f.yes, indicate rvhich branch or ofgovernment the contract is Exesutive Legislative

f'undraising event listetl in Sectton tfyes,list Event # 3

lv{ethod

olcontribution:

brarches rvith: ll
Date Rcceived

.f,,

fi

yes

fi

N;
$50.00 $400.00

,n Cash

ii

l,ersonal Check

3l

Credit/Debit C nrd

ggregate contributions

3a

ayroll Deduction 3*i Money Order

14t07t2011

$50.00 Srction B-This pase

'

, SUBTOTAL

P^c,

bf " Qr_

L MONETARY RECEIPTS Section B. Additional Pase

oxford Together
Last liame

2011 ;;;;l=;' '

OFREPORA 1:- - -' : :' ir:

30 days foilowing primary

"j

B. Itemized Contrihufinnc frnm fndivirt*oto

lll
itate
r rP L

First

Olson
Kesldflttal Slreet Address
rtv

G Jeffrey
ode

I
I

t'rircipal Occupatiu

Entertainer
F

336 Oxford Road

Is contrrbutor a lobbvrst. spuuse, or depcnrlenr chrld ofa Iobhyrst'l Is this contribution associated \,vith f'undrarsing event listed in Section L I

Oxford
Yes

No

06478 lSelf-Sixovus If cont'burion rs in ercess of s40o to u canffiiffiE, u.[Gil*..rt.. oEilE municipality does conrributor or
CT
business he/she is associated rvith have a contract with said

Name ot

Amount of Contribution

rnpl(,\ er

municipality valued at more rhan

$5,000?
ofa
rs

I, yes {ij t

f;,es, list

Event

i.t i-'

No
{

yes
No

Is contributor a principal

/1'es, indicate rvhrch branch or

ofgovernment the contract

state contractor or prospeclive slate contractor? branches

with:
Date

Yes

No

Executive

fvlethod of contributron 6. Personal Check .tl.

Legtslattve

C*h

fl

CreditiDebit Card
I rasl

f.

payroll

De<Jr-rctron

.{-

Rewrved
I

lltoney Order

Last

\m
Pokladowski
12

Ml
tlate

lotoTtzotl I priicipal
Occupatm \ame ot htrrployer

l.tg$l@G;;nr'rbur6il$7s0.00 $250.00
Amount of Contribution

Lori
- rty

ls contributor a lobbyist, .pouse, --'{^ or dependent child of a

4pple Drive

lobbyist.l

ffi
fi. I

.fr, No

oxford CT lfcont'bution is in excess of$400 to u.un

06478

Ip

LOUe

nOf\.o trc rrlff n

yes
No

ls this contribution associated rvith lundrarsrng evenr lrsred rn Scction Ifyes,list Event J

a l.l?

municipality does contributor or business he/she is associated with have a contract with said municipality valued at more than $5.000? lf? yes . . No yes
wo
Is contributor a principal

ofa state contractor or prospective state contractor? Ifyes, indicate rvhich branch or branches ofgovernment the contract rs rvith: .* Executive fi Legislative
Date

lf'l

Cash ii

Personal Check

lfl

Credit/Debit Card
lrst

[:

payroll Deduction

Reccrved

ifi

Money Order
MI

10t07t2011 |
rnncrpat Uccupatlon

lfuc*s"rc

coiifid"iffis

$1s0.00

$100.00
Amount of Contribution

Gross
Kesroentrat Street Address

Mark
liry
nte
lrp Liode

retired
Name ot Employei

511 Quaker Farm Road

Is contributor a lobbyist, spouse, or dependent child ofa lobbyist?
I 11

Oxford
Yes No

CT

46478

llcontribution is in excess of$400 to u.undid

municipality does contributor or business helshe is associated with have a contract with said municipality valued at more than 95,000? C yes f, No yes
f.fo

Is this contribution associated with a fundraising event listed in Section L I ?

Ifyes,list Event

il, t'.

Method olcontrrbution: Cash fi, Personal Check

ls contributor a principal ola state contractor or prospective state contractor? Ifyes, indicate which branch or of govemment the contract is Executive Legislative

branches ii, with:

f.

C ye, (- N;
$200.00 $200.00
Amount of Contributlon

f.

f.

Credit/Debit Card
I lrst

Aggregate cortributions

tyroll Deduction Cl Money Order

L6t Nme

10t07t2411
ffinctoat UccuDatton

Jensen 21 Appte

Drive
L]

Is contributor a lobbyist, spouse, or dependent child ofa lobbyistr ls this contrrbution associaretl with f'undraising event listed in Section fyes, list Event 3

reOxford
Arnold

arp

{t

Yes

No

is in excess of $400 to u "un does contributor or business he/she is associated with have a contract with said municipality vah.red at more than No

ll contribution

]cf

( ode

Nam ot Lmploycr

06478

nuntcipality

$5,0001

a l.l?

C yes C

{irl yes

f.

No

iVlethod of conrribution: f.l Casir 6",r Personal

I-ast Name

ls c'ntributor a principal ofa srate contractor or prospective state contractor? Ifyes, inrJicate rvhich branch or ofgovernment the contract is {l.l Executive {il Legislative

branches wirh:

cl ill

yes
No

Check

f-'

Credit/Debir 'ard
trrst

t=

l )ayroll Deduction

,{ ggrcgat

co!ttributions

fl

Money Order
MI
4ip Code

10t07 t2a11 hnctpal

Occupatl0n

$100.00

$100.00
Amount of Contribution

Dempsey
Kestoental btHt,,lddress

Joseph

4 Sunrise Drive
Is contnbutor a lobbyist. spouse, or Jependent chrld,rfa lohbvrst" Is this contflbution as$ciated with
?:: Yes

Oxford
No

ItY

Retired
lSrate Narne of Employer

Cf

06478

furrdraisingeventlisted fyes, Iist Event # J

!{ethorJ tll- contr butrorr
r

inSectronLi,l lf,
check
1^' Credit/Debit

I r LUI ru r{rutrelr ls IIt cxce ss or }4uU lo a candldate commrtlee tbr a chief executive olllcer of a municipality tloes contributeir or business he/she is asscrciated rvrth have a contract with said municipality valued at more than $5,000? .?l yes fi No

ycs
N<,

ls contributor a pflncipal ola state contractor or prospective state conlractor? f.1'es. indicate rc-hich branch or of govemment the contract is lixecutive ]fi t.eeislative

branches with: i
Date Received

i], yes T No
$100.00 $50.00 qTnn nn
Page

i'i cash li

Personar

card If payroil Deduction f, Money order

,,\ggregate conlributions

1Q107

t2011
ct,

f : E r , r' r.'i

of

L
Oxford Together 2011

MONETARY RECEIPTS

Section B. Additional

B,

Item
,\mount of Contribution

Is contributor a lobbyist, or deprndent child ofa

rpouse, ---F-l[ lobbyisr? f. No

Is this contributron associated with lundraising evenr I rsted rn Section L

a
I

fye,r. list Event

5^.

#: l-:

If contribution tr'o.*..* ot' rnunicipality does contributor or business heishe is associated with have a conlract with said municipalrty valued at more than $5.000? ft yes fi No yes No
ls conlributor a principal ola state contractor or prospective state contractor? f1,es, indicate which branch or ofgovernment the contract is Executive L.egislative

branches with: f,

f. y.,
,*, lto

Method of contriburion:

cash f,,

Personar

check

creditrDebit Card

l.

payroil Deductron 1r Money order

14107t2011 Amount of Contrihution

47 Thomson road
Is conlnbutor a lolrb1rst. or dependent child ofa

spo*q----F-TE lobbyist? .6. No a l f

,f.,
yes
ruo

llcontnbution

rs in excess

oi'J

municipality does contributor or business he/she is associated rvith have a contract with said municipality valued at more than $5,000? lfl yes t Jo

Is this contribution associated rvrth lundraisrng cvcnt listed in Section I I Ifyes,list Event 3

.G

Is contributor a princrpal

Method of contribution: .ftCash Personal Check

IJyes"indicate rvhrch branch or branches olgovemment the contract is with: iJ Executive

ola

state contractor or prospectlve state

contractor? fr

yes
f.fo

lfi

$
Legislative

i6

Credit/Debit Card Cr payroll Deduction

lfr

Money Order

$'100.00
Amount of Contribution

12 Jensen Farm Rd
ls contributor lobbyist, Is contflbutor a lobbyrsr. spousc,, or dependent child of a lobbyist'1 ls this contribution associated with

spouse, fl {i, a

yes
t,to

B and B transportation
is in excess of $400 to a candidateiom.liiF6, municipality does contnbutor or business he/she is associated with have a contract with sard municipality valued at more than No

If contrrb'tion

u.i,iiii*.*u* omGffi
{^, ya,

{i; fundraisingeventlistedinSectionLl'l f, Ifyes,list Evenr # 3

Method of contribution: Cash I'ersonal Check

$5.000?

f. yes fi

yes No

Is contributor a principal ofa state contractor or prospective stat contractor? Ifyes, indicale which branch nr olgovernment the contract is Executive C Legislative

branches f: with:

f,

fVo

f.

il

f',

CrediVDebit Card

payroll Deduction

Monev Order

10107t2011

$100.00
Amount of Contribution

tpo*., ---CT-Vil or dependent chiid of a lobbyisr,? fl trlo

Is contrrburor a lohhyrsr.

496 Town

Street

Haddam

lCf
$5,000?
ofa
C-.

is in excess 'i$400 municipality does contributor or business he/she is msociated with have a contract with said

llcontributron

municipalrty valued at rnore than

a fundraising event listed in Section Ll'l ff;'es, list Event # 3

Is this contnbution associated ,,vith

itl f-'

yes el

wo

yes No

Is contributor a principal

rndicate which branch or of govemment the contraet is

Ityes.

state contractor or prospective state

Mcthod 0f contribultonl

branches wrth: {]l Executive Cl t_egrslative

contractor?

cl yes t-l No
$500.00
,\mouot of

''.

Cash

f,l

I'ersonal Chcck

fl

CretliyDebit Card i^,. payroll Deductron

fl

Monev Order

c0ntribution
1

Jensen Farm Rd

ls contilbutor a lubhl rst, or tjcpcndenr chrld oi a

rodHf,ti' ..i, \,r

a ,l

,pouse. 'a y* ,i yes .f, Nu

Il'c.ntribution

rs in ercess

oi$+00 to

Is this conrrihurion associared rvith lundraising event listed in Section l_ I

municipalrty docs contributor or trusiness hclshe is rusociated rvith have a contract rvith saiii municipalily valued at more thar $5,000? '6 yes G No
fs cont.butor a pr'incipal

i.*

fJ'es, Iist tivenl

#J

Method olcontriburion

ofa state contractor or prospective srate contlactor indicate whrch branch or of govemment the contract is E.e.ut,ue .fi Legislative

fyes,

branches wrth: I'

i t

yes

No

ifi Cash

ri

Personal

Check

li'

Cre{itrDehir Card

il

payro}l Derjucrron

|i

l\,t6nev Order

14t47t2011

$200.00

SUBTOTAL Section B-This

IV. EXPENDITURES
\iAMEOF COMMITTEE

Section p. Additional page

zt)11

v/\r vnu | \Jutr I HtrK

10t13t2011

"
Sffi

ommittee
JOE KEWALIS
Lrlv
liate ot Payment

Method of Paymeni

Amount

rtrrposc ol !xpcnditure (by codc)

oxFoRD
(i! applicnble)

1c,",-

,lp

Lode

l"'"bt

06478

09t27t2011

uescflptlon

6 Cneck * 1014 C: Debit Card

Evcnt #

FNDR

ICE CREA M TRUCI

--....t-..---

ght

TYDe

of Exnenrlinrro

t f'

{^. Coorrlinared *i,f.r ,.iriUurr.,,,ent sougl L Coordinated without reinrbursement so tght

Independent

tr

S"pp"n.d
Opposed

Organization (see Insltactions)

(1
i\amc or rayee

,f t-.B a.C

11D C;n
ljatc of ily
Description
State Payme nt

$
^4etnod

100.00
;lmount

ffi
by codc)

ot Payment

cr
Ipe

Zip Code

l:,

tl sought

Check # nebit Cara

---

Evcnl #

I (

I' C Organization
Paycc

of HxpenrJiru rc fiJ appticubt\: Coordinated rvith reirnbursemenr soul thr Coordinared without rcinrbursernent s lu Eht Independent

(ifapplicuble)

ns"pp"rt",l
Eopposed

ll,A 0B Cc lo

(see Instractions)

E
Datc of Paymcnt

$
Method of Payment C, Check # f Debit Cura--Er

0.00
,\mount

Streel Addrcss

City uescnplon

5tate

Zip Code

rurposc or hxnendtitrc (by code)

CT

cnt #

-fWe
.(

of Expendirure (if

uppticubte):

----r--(d applicabte)
Jought

.t t Indenendent

' Coordinated with rcimbursemcnr sougl ( Coorditrated without ' reimbursement so ug ht

E Supportea E Opposed

,(1 Orgun,zation (see I nstrucrions)

r, s

l'C

t-'D

E raymenl
Jrate arp Code

0.00
Amount

Method of Payment
.C Check #

irfl:::,;'ExPcnditurc Tpe of
i
-

-ln

re
(ifapplicable)

CT

{-, Debit Card

tivent # Utrrc

{ rlndependent .(i Organiz:tion

rame ot payce

(-' Coordinatcd rvithout rcilnburselnent sou ght

(see Instructions)

Expendit:rrle (if 6ppticahte): t Coordinated with rcimbursemcnt sough,

Sought

-Es,,pp"n"d
E
opposed

nA fi S t.,C {.:D Cn

s
Datc of Paymcnt

0.00
Anrount

fi;Fffii;i..-rurposc ol Expcnditurc (by eodc)

--lri
Jescrr

Method of Payment

ltutc

crl

llip

Codc

Check #

{-'oebit ciro
bvcnt #

uhle,l ( Crrordinared u ith rcimbursemcnt sought L ('uordinatcd u.jthout rcimbursentcnt souB hr Lt lndcpc.ndent { Organrzarion lsee lnsuuctions)
:

ype ol' E)ipendrrure ( if

qplil

(ifupplicabte)

Soughl

D Supportetl
EOppose<t

C C (-''-,

0.00

- Sectlon P-This Pasp

00.00

P,s{71

,rT I