Section H is applicable to Candidate Committees
ONLY. In Section H, report a candidate’s
donation of his or her personal funds into the committee’s account
without the expectation
of repayment. The donation of funds with the expectation of repayment is a loan
from the candidate and must be reported in Section D “Loans Received this Period.”
Date of Receipt: Record the date that the transaction was received by the committee.
This date may differ from the date written on the check or the date of deposit.
Method of Payment: Check the appropriate box indicating the way in which the transaction
was received, either Cash, Personal Check, or Credit /Debit Card.
Amount: Record the amount of the receipt.
In Section J, record all interest earned on any committee account during this reporting
period.
Date Received: Record the date that the interest was credited to the committee’s
account.
Name of Institution, Street Address, City, State, and Zip Code: Enter the
banking institution’s name and address.
Amount: Record the amount of the interest credited to the committee’s account.
TOTAL AMOUNT RECEIVED: generated by eCRIS.
In Section K, record miscellaneous monetary receipts NOT considered contributions.
Examples include rebates, credits, and refunds.
Name, Street Address, City, State, and Zip Code: Enter the donor’s name and address.
Date of Transaction: Record the date that the funds were received by the committee.
Description: Describe the reason
for the monetary receipt. EXAMPLE: Refund of security deposit from banquet hall.
Amount Received: Record the amount of the receipt.
In Section L1, assign a unique event number in the box marked “Event #”generated by
eCRIS for each event by entering the date in which the event was held (mmddyy) together with
a letter, in alphabetical order (A through Z) at the end of the date reported, to identify
the order in which the events were held. If there is only one event held on a single day, the
letter assigned will be "A".
EXAMPLE: If two events were held on the same day, March 8, 2011, the following
would be reported on the form: 1st fundraiser Event # 030811A 2nd fundraiser Event
# 030811B
The purpose of assigning this unique number is to link the committee’s receipts and expenditures associated
with this particular event.
Event #: Record the unique "Event Number" for the specific event using the format described above.
Description: Provide a brif description of the event.
Was this fundraising event?: Check the appropriate Yes or No box to indicate whether or not the event
was a fundraiser.
Street Address, City, State, and Zip Code: Enter the address of the venue where the event was held.
Subpart 1: ALL COMMITTEES:
Was this event hosted at a personal residence?: Check the appropriate “Yes” or “No” box.
If the event was held at an individual’s personal residence, check off the “Yes”
box, and proceed to Section L5 to complete the itemization required for “In-Kind
Donations not Considered Contributions Associated witha a House Party.”
Did the fundraiser include goods or services donated by a business entity of up to $200 or items donated by an individual of
up to $100?: If the event inlcudes goods or services donated by a business entity with a value of up to $200 or
items donated by an individual with a value of up to $100, check the Yes box, and proceed to Section L4
"In-Kind Donations Not Considered Contributions" to complete the itemization required."
Was this fundraiser a tag sale, auction or other sale of donated items with purchases from an individual of up to $100?:
If the event was a tag sale, auction, or other sale of donated items, check the Yes box, and enter the total receipts from the
sale of donated items. The receipts are NOT contributions provided the total purchase of all items by one individual does not
exceed $100 per event. However, if an individual pruchases an aggregate emount at a particular event in excess of $100, the entire amount is a
contribution and i reported as a contribution in Section B.
Subpart 2: PARTY COMMITTEES, MUNICIPAL CANDIDATES AND POLITICAL COMMITTEES OTHER THAN
EXPLORATORY COMMITTEES: Were purchases of advertising space in a program
book or sign(s) at a fundraising affair sponsored by a party committee, municipal candidate or political committee (other than an
exploratory committee), check the Yes box, and proceed to Section L3 to complete the itemization required for "Purchases of
Advertising Space in a Program Book or on a Fundraiser Sign"
Subpart 3: TOWN COMMITTEES ONLY:
Did you sell food or beverage at a fair or similar mass gathering held within the state with this fundraiser?:
Enter the total receipts from the sales of food or beverage at a fair or similar mass gathering (i.e. county
fair, strawberry festival, etc.) not hosted by the town committee, held within the state, that are not considered
contributions to the committee. The sale of food and beverage at these venues to
one individual which is $50 or less is NOT a contribution to the committee, and
may be added together with all such proceeds from the event and reported as “Total
Receipts from Small Purchases” in this section. If the sale to one individual, however,
is in excess of $50, then the entire purchase is deemed a contribution and is reportable
in Section B, “Itemized Contributions from Individuals.”
Section L3 is applicable to fundraiser events for party committees, municipal candidates and political committees. Exploratory committees and Judge of Probate candidate committees may not make use of the Advertising Program Book or Sign exception. The amounts reported in this section are NOT contributions provided the total purchase price of advertising space in a program book or on a fundraiser sign does not exceed $250 for a business entity or $50 for other persons (other persons includes individuals, sole proprietorships, other committees, labor unions or other organizations, and trade or professional associations which receive their funds exclusively from membership dues). The $250/$50 exemption applies to aggregate purchases of advertisements in program books or signs at fundraisers from the same party or ongoing political committee in a calendar year or from the same candidate committee or durational political committee in an election cycle.
Name of Purchaser, Street Address, City, State,
and Zip Code: Enter the purchaser’s name and address. The Treasurer may enter an
alternate address in lieu of an individual’s residential address only if the contributor
has made known to the Treasurer that the contributor is in the Address Confidentiality
Program pursuant to General Statutes § 54-240(a) or has protected address status
under General Statutes § 1-217. Business Addresses or Post Office Boxes are not
acceptable for residential street address.
Purchase Made By: Check the appropriate box to indicate the source of the purchase, either Business Entity, Individual/sole proprietorships, or Other. “Business entity” includes the following...Stock corporations, banks, insurance compa-nies, business associations...partnerships, joint ventures, private foundations...trusts or estates...corporations… “Other” includes other committees, labor unions or other organizations, and trade or professional associations which receive their funds exclusively from membership dues.
Date Received: Record the date that the payment for the Ad Book or sign was received by
the committee
Event #: Use the Unique "Event #" originally reported in Section L1.
Amount of Program Ad Purchase:
Record the amount of the purchase of advertising in a program book for this event.
Amount of Sign Purchase: Record the amount of the purchae of advertising on a fundraiser sign for this event.
Aggregate Purchases for All Events: Add up the total of all advertising purchases made by the same purchaser, includ-ing this purchase, during the calendar year for party committees and ongoing political committees or during the election cycle for municipal candidates and durational political committees, and record the total amount.
In Section L4, report the donation of items to a committee in connection with a fundraising affair that are
NOT contributions. These items include: Personal property with a value up to $100 donated by an individual for a fundraiser
and goods or services donated by a business entiry with a value up to $200 for a fundraiser (the business must be in the business or
selling those items, i.e. a package store can donate a bottle of wine).
Name of Donor, Street Address,
City, State, and Zip Code: Enter the donor’s name and address. The Treasurer may
enter an alternate address in lieu of an individual’s residential address only if
the contributor has made known to the Treasurer that the contributor is in the Address
Confidentiality Program pursuant to General Statutes § 54-240(a) or has protected
address status under General Statutes § 1-217. Business Addresses or Post Office
Boxes are not acceptable for residential street address.
Donation Given By: Indicate
the source of the donation, either Individual or Business Entity or Sole Proprietorship. "Business entiry" includes the
following....Stock corporations, banks, insurance companies, business associations...partnerships, joint ventures,
private foundations...trusts or estates...corporations... "Sole proprietorship" includes sole proprietorships and
solely owned professional corporations.
Fair Market Value of Donation: Record the fair market value of the donated item(s).
Date Received: Record the date that the committee received the item(s).
Description of Donation:
Provide a brief description of the item(s) donated. Each item should be reported
separately, unless the donor gives multiple of the same item (i.e. 25 books).
Aggregate Value for this Event: Add up the total of all of the individual’s or business’
donations for this event and record the amount.
Event #: Use the unique "Event #" originally reported in Section L1.
In Section L5, report the donation of items to a committee by the host(s) of a house party held at a personal residence. This
event may either be a fundraising affair or a non-fundraiser (meet and greet).
These items inclue: The cost of invitations, food or beverages voluntarily provided to a candidate or committee by an individual
hosting an event at the individual's residence or community room at the residence, provided the cumulative value is not in excess of $400 with respect
to any single event (or $800 with respect to an event hosted by two or more individuals at a host's residence). Note that,
as to the house party exemption, an individual is limited to $800 in cumulative value of total expenses per election cycle
in the case of multiple parties held for the same candidate, slate, or durational political committee and $800 per calendar year
in the case of multiple parties held for a party committee or ongoing political committee.
While the host(s) must generally pay for all costs associated with the event in order to make use of the house party exemption, a
candidate or committee may now pay for a portion or all of the costs of the invitation for the event. Such invitation costs paid for
by the committee do NOT count against the $400/$800 aggregate limits.
If the event is NOT a fundraising affair, attendees of the event are allowed to bring food or beverages to the event without these
donations being considered a contribution so long as they do not exceed $50 in value. Treasures must no longer itemize the receipts
of such food and beverage provided for a non-fundraiser as long as the aggregate value of the food and beverage does not exceed
$50.
Name of Host, Street Address, City, State and Zip Code: Enter the host's name and residential address. The treasurer
may enter an alternate address in lieu of an individual's residential address only if the contributor has made known to the treasurer
that the contributor is in the Address Confidentiality Program pursuant to General Statutes 54-240(a) or has protected address status
under General Statutes 1-217. Business Addresses or Post Office Boxes are not acceptable for residential stree address.
Is this event supporting more than one candidate or committee?: Check the appropriate Yes or No box to indicate
whether or not the house party was supporting more than one candidate or committee. If Yes, complete Itemization in Addendum L5:
Record the Event # as assigned in Section L1
Description of Donations: Provide a brief description of the item(s) donated.
Fair Market Value of Donation: Record the fair market value of the donated items (food, beverage, invitation, etc.)
Event #: Use the "Event #" originally reported in Section L1 to indicate the unique "event number".
Aggregate Value of this Event--all hosts: Record the aggregate fair market value of all house party related expenses made
by all hosts for this event.
Aggregate Value for all Event--this host/candidate: Record the aggregate fair market value of all house party related
expenses made by this host to this candidate, slate, or durational political committee for the election cycle or to this party
committee or ongoing political committee for the calendar year.
In Section M, report separately each In-Kind Contribution received by the committee
during the period covered by this statement. In-Kind Contributions include the provision
of goods, services, or other items at no charge or at less than fair market value,
to the committee. Volunteer services by individuals are not considered In-Kind Contributions.
The contribution limits and restrictions which apply to a particular contributor
apply to the combination of monetary and non-monetary contributions. In-Kind Contributions
made by the same contributor must be aggregated together to determine if the contribution
limit has been exceeded.
EXAMPLE: John Doe’s contribution limit to an ongoing political committee is $1,000 per year. If John Doe
contributes $200 worth of stationery to the committee (an In-Kind Contribution),
he may only make an additional $800 contribution to the committee during the calendar
year, whether in the form of a monetary contribution or contribution In-Kind, or
any combination thereof.
Name, Street Address, City, State, and Zip Code: Enter
the contributor’s name and address. The Treasurer may enter an alternate address
in lieu of an individual’s residential address only if the individual contributor
has made known to the Treasurer that the contributor is in the Address Confidentiality
Program pursuant to General Statutes § 54-240(a) or has protected address status
under General Statutes § 1-217. Business Addresses or Post Office Boxes are not
acceptable for residential street address.
Type of Contributor: Check the appropriate
box for the source of the In-Kind Contribution, either Individual, Committee, Sole Proprietorship or
Other. Only referendum committees may accept an In-Kind Contribution from an entity
other than an individual / sole proprietorship or committee. "Sole Proprietorship" includes sole proprietorships and solely
owned professional corporations. "Other" includes business entities, labor organizations and other
preexisting organizations and associations.
Is the contributor a principal of a state contractor or prospective state contractor?: Check the appropriate
Yes or No box. If Yes, indicate which branch or branches of governement the contract is with. Applicable only to party committees or
political committees authorized to contribute to statewide or General Assembly candidates. Please Note: These committees
are prohibited from receiving contributions from principals of state contractors. Information regarding these prohibitions is available
on the Commissions's website
www.ct.gov/seec
Fair Market Value of this Contribution: Record
the fair market value of the donated item.
Is contributor a lobbyist, spouse, or dependent child of a lobbyist? Answer the
questions by checking the appropriate Yes or No box. Please Note: Certain committees
are limited in the amount and timing of the lobbyist contributions they may receive.
Information regarding these limitations is available on the Commission’s website
www.ct.gov/seec
If the committee filing this statement is a candidate committee for the Chief Executive
Officer of a municipality (i.e. Mayor, First Selectman): If the aggregate contributions
from an individual are in excess of $400, the Treasurer must indicate if the individual
or “business with which he/she is associated” has a contract with that municipality
and the contract is valued at more than $5,000, by checking off the appropriate
box. “Business with which he is associated” means the contributor is a director,
officer, owner, limited or general partner, or stockholder of 5% or more of business.
Date Received: Record the date that the In-Kind Contribution was received by the
committee.
Is this contribution associated with an event reported in Section L1?: Check the appropriate
Yes or No box. If Yes, Add new one or select from drop down.“Event
#”.
Description of In-Kind Contribution: Provide a brief description of the In-Kind
Contribution.
Aggregate Contributions: Add up the total of all contributions to date and record
the amount. When determining the aggregate contribution amount for an individual,
the total of the individual’s monetary contributions as reported in Sections A and
B must also be included in this total. When determining the aggregate contribution
amount from a committee, the total of the committee’s monetary contributions as
reported in Section C must also be included in this total.
Section N refers only to a refundable deposit by an individual from personal funds
to benefit the committee, not deposits made by the committee. If the committee made
the deposit to the Telephone Company, it is reported in Section P as an expense
of the committee and the refund of the deposit is reported in Section K “Miscellaneous
Monetary Receipts not Considered Contributions.”
If the deposit is non-refundable
to the individual, it is an In-Kind Contribution and must be reported in Section
M.
Last Name, First Name, Middle Initial, Residential Street Address, City, State,
and Zip Code: Enter the name and address of the individual who made the deposit
from personal funds.
Name of Telephone Company, Street Address, City, State, and
Zip Code: Enter the name and address of the telephone company to which the refundable
deposit was paid.
Date Deposit Made: Record the date that the deposit was made using
the individual’s personal funds.
Amount of Deposit: Record the amount of the deposit.
In Section P, separately report each expenditure made from the committee’s single
checking account during the period covered in this statement. Each time a committee
issues a check or uses the committee debit card the transaction must be entered
here. When a committee makes an expenditure that benefits a different candidate
or committee, an indication must be made to identify the expenditure as either “coordinated
with reimbursement sought,” “coordinated without reimbursement sought,” “independent,”
or as “organization.”
If the purpose of the expenditure is a reimbursement to the tresurer, a committee worker or
consultant, or a candidate being funded by a town committee or a slate committee or if there is a consultant who has paid secondary payees,
the original purchase or payment made by the committee worker or consultant must
also be reported in Section T, “Itemization of Reimbursements and Secondary Payees.”
If the purpose of the expenditure is a reimbursement to a candidate being funded by a candidate committee or
exploratory committee, the original purchase made by the candidate must also be reported in Section Q, “Campaign Expenses
Paid by Candidate.”
Name of Payee, Street Address, City, State, and Zip Code: Enter
the payee’s name and address.
Date of Payment: Record the date that the payment was made by the committee.
Method of Payment: Check the box to indicate the method
of payment, either Check (with accompanying check number), Debit Card or Electronic Funds Transfer (EFT). EFT's are direct debit
payments, sometimes called electronic checks, for which a business debits the bank account for payment for
goods or services.
Amount: Record the amount of the expenditure.
Purpose of Expenditure: Note the purpose of the expenditure using the Expenditure
Code Addendum select from drop down.
Description: Provide a brief description of the expenditure. Certain expenditure
codes require a description as set forth in the Expenditure Code Addendum select from drop down.
Event #: If the expenditure is associated with an event, record the “Event #” add new one or select from drop down.
Expenditure #:To be completed when the expenditure is Coordinated with reimbursement sought, Coordinated
without reimbursement sought, Independent or Organization. Assign a unique Expenditure #, beginning with the number 0001
and continue sequentially. The purpose of assigning this unique number is to link the committee's expenditure with
their itemization is Section P Addendum (see instruction below).
Type of Expenditure: Check the appropriate box to note whether the expenditure is None of the below, Coordinated with reimbursement sought (joint expenditure), Coordinated without reimbursement sought (in-kind contribution), Independent, or Organization. Unless “None of the below” is selected, complete the Section P Addendum. Where these terms are used in Section P and in Sections R, S, and T, they mean the following:
None of the below - to be checked only when the expenditure is none of the below, such as when it is an expenditure made by your committee directly to another committee or candidate (i.e. an expenditure coded as POC (payment to another committee), CNTRB (contribution to another committee), or SRPLS (surplus distribution to another committee)) or the expenditure does not in any way involve another committee or candidate (i.e. an expenditure the committee has made to lease office space for itself only, coded as OVHD (overhead)). If the expenditure by your committee is not made directly to another committee or candidate but still involves another committee or candidate, then one of the four below boxes will be checked – see descriptions of these boxes below for more information.
Coordinated with reimbursement sought – an expenditure made by your committee in cooperation or consultation with another committee or candidate for which you seek reimbursement – i.e. a joint expenditure. Note that an expenditure must be reimbursed within a reasonable amount of time to avoid becoming an in-kind contribution. The Commission has said that reimbursements received within 45 days of the date of the expenditure will not be considered an in-kind contribution.
Coordinated without reimbursement sought – an expenditure made by your committee in cooperation or consultation with a candidate or another committee for which you do not seek reimbursement. This is an in-kind contribution to which all applicable limits and prohibitions apply.
Independent – an expenditure made by your committee promoting the success or defeat of a candidate or committee that is made without the consent, participation, or consultation of the candidate or committee or agent thereof.
Organization – an expenditure that may only be made by a legislative leadership, legislative caucus or party commit-tee for the benefit of a candidate or candidate committee. If the expenditure is an organization expenditure, check off the box marked “organization” along with the appropriate circle (A—D) indicating the purpose of the organization expenditure:
A: Party Candidate Listing —includes the preparation, display, mailing, or other distribution of a party
candidate listing. A party candidate listing is a communication that lists the name or names of candidate(s)
for election to public office, is distributed by public advertising, and is made to promote the success or defeat
of any candidate or slate of candidates seeking the nomination for election or election, or for the purpose of
aiding or promoting the success of defeat of any referendum question, or the success of defeat of any political
party. Please Note: Party candidate listings may not solicit funds for or on behalf of a candidate committee.
B: Party Building Document —includes a document created and maintained by a legislative leadership,
legislative caucus or party committee for the general purposes of party or caucus building in printed or
electronic form that is provided to a candidate who is a member of the party that has established the party
committee or who is a member of the party of the caucus or leader who has established the legislative caucus
or legislative leadership committee, whichever is applicable. The document may include the following: a
party platform; an electronic page providing merchant account services to be used by a candidate for the
collection of on-line contributions; a copy of an issue paper; a list of registered voters and voter identification
information; and information relating to the requirements of campaign financing.
C: Campaign Event —includes only campaign events at which a candidate or candidates
are present.
D: Advisory Services —includes payment for the services of an advisor to provide assistance relating to
campaign organization, financing, accounting, strategy, law or media.
If this expenditure benefits another candidate and is either a coordinated, independent
or organization expenditure, complete the Section P Addendum:
Record the Expenditure # as assigned in Section P. Check the appropriate box, Supported or Opposed, to indicate
whether the candidate(s) or committee(s) was/were supported or opposed by the expenditure. Record the toral
amount of the expenditure.
Name of Candidate or Committee; Office Sought; Cost Allocated to Candidate or Committee: Report the candidate(s) or Committee(s) name
and office sought for whom the coordinated, independent or organization expenditure was make. Record the amount of the total
expenditure allocated to the candidate or committee.
In Section Q report any campaign expenses paid directly from personal funds of the
candidate. This section is to be completed by both candidate and exploratory committees.
Each candidate must submit to the campaign Treasurer an accounting of any campaign
expense paid directly from their personal funds by the close of the reporting period
during which these payments were made. The Treasurer must indicate whether the candidate
is seeking reimbursement.
Any expense, irrespective of amount, for which the candidate
seeks reimbursement must be reported. In addition, any candidate expense more than
$50 must also be reported, even if the candidate does not wish to be reimbursed.
Exceptions are limited to telephone calls, transportation costs, and meals for which
the candidate does not seek reimbursement. Report the Committee Check used to actually
reimburse the candidate in Section P, “Expenses Paid by Committee.” Please Note:
Any campaign expense paid with the personal funds of a candidate who has designated
an exploratory committee, a political slate committee or a town committee as his/her
sole funding source, is required to be reimbursed by that committee or these expenses
are considered contributions and must be within the applicable aggregate limits
for an individual contributing to the given committee. See the Commission’s website
www.ct.gov/seec for contribution limits.
Name of Payee, Street Address, City, State,
and Zip Code: Enter the name and address of the vendor, person or entity that the candidate paid directly.
Date of Payment: Record the date that the expenditure was made by the candidate.
Is Reimbursement Claimed? Check the appropriate Yes or No box.
Purpose of Expenditure: Note the purpose of the expenditure using the Expenditure Code.
Description: Provide a brief description of the expenditure. Certain expenditure
codes require a description as set forth in the Expenditure Code.
Event #: If the expenditure is associated with an event, record the "Event #" as reported in Section L1.
Amount: Record the amount of the expenditure.
In Section R, report each expense charged on the committee-issued credit card by
an authorized cardholder. Payments made using the committee debit card must be recorded
in Section P.
Each credit card charge is to be disclosed in the reporting period
in which it is made, even if payment of the balance was made within the same reporting
period. If an outstanding balance remains on the credit card, the committee must
report this balance in Section S, “Expenses Incurred by Committee but Not Paid During
this Period.” See detailed instructions in Section S.
Name of Issuing Institution:
Enter the name of the financial institution that issued the credit card.
Type of
Card: Check the appropriate box to denote the type of credit card.
Name of Vendor, Person or Entity,
Street Address, City, State, and Zip Code: Enter the name and address of the vendor, person or entity being paid with the committee credit card.
Date of Transaction: Record the date that the credit card charge was made by the
committee.
Purpose of Expenditure: Note the purpose of the credit card charge using the Expenditure
Code.
Description: Provide a brief description of the item(s) charged.
Certain expenditure codes require a description as set forth in the Expenditure
Code.
Event #: If the expenditure is associated with an event, record the "Event #" as reported in Section L1.
Amount: Record the amount of the expense charged on the committee credit card.
Expenditure # To be completed only when the expenditure is Coordinated with reimbursement sought, Coordinated without
reimbursement sought, Independent or Organization. Assign a unique Expenditure #, beginning with the number 0001 and continue sequentially.
The purpose of assigning this unique number is to link the committee's expenditure with their itemization in Section R Addendum
Type of Expenditure: Check the appropriate box to note whether the expenditure is None of the below, Coordinated with reimbursement sought (joint expenditure), Coordinated without reimbursement sought (in-kind contribution), Independent, Organization. Unless “None of the below” is selected, complete the Section R Addendum.
For an explanation of these terms, please see the instructions for "Type of Expenditure" in Section P.
Record the Expenditure # as assigned in Section P. Check the appropriate box, Supported or Opposed, to indicate
whether the candidate(s) or committee(s) was/were supported or opposed by the expenditure. Record the toral
amount of the expenditure.
Name of Candidate or Committee; Office Sought; Cost Allocated to Candidate or Committee: Report the candidate(s) or Committee(s) name
and office sought for whom the coordinated, independent or organization expenditure was make. Record the amount of the total
expenditure allocated to the candidate or committee.
In Section S, separately report each expense incurred but not paid as of the close
of the reporting period covered by this statement. When uncertain of the exact amount
of the expense, the Treasurer should make a good faith estimate of the amount incurred.
If there is an outstanding balance on a credit card, the outstanding amount must
be reported in this section along with the name of the issuing institution as the
creditor. A committee worker to whom the committee owes a reimbursement or payment
for services rendered should also be reported in this section.
When a committee
incurs an expense that benefits a different candidate or other committee (party
committee, political committee, candidate committee), the Treasurer must indicate
whether the expense incurred is either “coordinated with reimbursement sought,”
“coordinated without reimbursement sought,” “independent” or an “organization” expenditure.
Name of Creditor, Street Address, City, State, and Zip Code: Enter the creditor’s
name and address.
Date Incurred: Record the date that the expense was incurred by
the committee.
Description: Provide a brief description of the expenditure. Certain expenditure
codes require a description as set forth in the Expenditure Code.
Amount Incurred: Record the amount of the expense incurred (estimate or actual).
Event #: If the expenditure is associated with an event, record the "Event #" as reported in Section L1.
Purpose of Expenditure: Note the purpose of the expense incurred using the Expenditure
Code.
Expenditure #: To be completed only when the expenditure is Coordinated with reimbursement sought,
Coordinated without reimbursement sought, Independent or Organization. Assign a unique Expenditure #, beginning
with the number 0001 and continue sequentially. The purpose of assigning this unique number is to link the
committee's expenditure with their itemizaiton in Section S Addendum.
Type of Expenditure: Check the appropriate box to note whether the expenditure is None of the below, Coordinated with reimbursement sought (joint expenditure), Coordinated without reimbursement sought (in-kind contribution), Independent or Organization. Unless “None of the below” is selected, complete the Section S Addendum.
For an explanation of these terms, please see the instructions for "Type of Expenditure" in Section P.
Record the Expenditure # as assigned in Section S. Check the appropriate box, Supported or Opposed, to indicate whether
the candidate(s) or committee(s) was/were supported or opposed by the expenditure. Record the total amount of the expenditure.
Name of Candidate or Committee; Office Sought; Cost Allocated to Candidate or Committee: Report the candidate(s') or committee(s')
name(s) and office(s) sought for whom the coordinated, independent or organization expenditure was made. Record the amount
of the total expenditure allocated to the candidate or committee.
If a candidate forgives an outstanding expense which was made to his/her own candidate
committee, proper reconciliation must be made as follows:
1. On line 28a of the
Summary Page Totals, reflect the total amount of the outstanding expenses once the
candidate has forgiven their portion; if the candidate is the only outstanding expense
to the committee, this balance would be zero.
2. In Section Q, “Campaign Expenses
Paid by Candidate,” report the candidate’s name as payee and the amount which is forgiven
and the date the expense(s) were forgiven as the date of payment.
In Section T, report each instance in which the treasurer, a committee worker or consultant, or candidate being funded
by a town committee or a slate committee pays a secondary payee (vendor, person or entity) for committee-related expenses with
their own personal funds. Whether a committee writes a single check
to reimburse an individual for combined expenses, or multiple checks to reimburse
the individual for each expense, the committee must report each expense made by
the committee worker or consultant separately. Report the Committee Check used to
actually reimburse the committee worker or consultant in Section P, “Expenses Paid
by Committee.”
EXAMPLE: John Doe purchased $100 of lumber at Home Depot to make lawn signs, and
$50 in stamps from the U.S.P.S. The committee reimbursed him for those expenses
using committee check number 102.
1. The payment to John Doe is recorded in Section
P, “Expenses Paid by Committee” with John Doe as the payee, together with the purpose
of the expenditure coded as “RCW,” the amount of $150, and committee check number
102 reported.
2. In Section T, “Itemization of Reimbursements and Secondary Payees” the Treasurer would record John Doe, as the name of the worker;
Home Depot as the name of the vendor along with Home Depot’s address, the date that
John Doe paid Home Depot, the amount of $100 as paid to Home Depot by John Doe.
3. On the next entry of Section T, John Doe’s name would again be listed as the
name of worker, U.S.P.S. is entered as the name of the vendor along with the U.S.P.S.
address, the date that John Does paid U.S.P.S., the amount of $50 as paid to U.S.P.S.
by John Doe.
Last Name of Worker/Consultant, First Name, and Middle Initial: Enter the name of the worker
or consultant being reimbursed.
Date of Payment to Vendor, Person or Entity: Record the date that the committee worker or
consultant paid the vendor, person or entity.
Method of Payment: Check the box to indicate the method of payment used to reimburse the
committee worker, either check (with accompanying committee check number), Debit Card or Electronic Funds
Transfer (EFT). EFT's are direct debit payments, sometimes called electronic checks, for which a business
debit the bank account for payment for goods or service.
Name of Vendor, Person or Entity Paid by Committee Worker/Consultant, Stree Address, City, State
and Zip Code: Enter the name and address of the vendor, person or entity that was paid by the
committee worker or consultant.
Payment to Reimburse Committee Worker/Consultant as reported in Section P: Check the box to
indicate the method of payment by the committee to reimburse the worker/consultant, either Check (with accompanying check
number), Debit Card or Electronic Funds Transfer (EFT). EFT's are direct debit payments, sometimes called
electronic checks, for which a business debits the bank account for payment for goods or services.
Purpose of Expenditure: Note the purpose of the expenditure made by the committee workers or
consultant by using the Expenditure Code.
Description: Provide a brief description of the item purchased from the vendor, person or entity by the
committee worker or consultant. Certain expenditure codes require a description as set forth in the Expenditure Code.
Event #: If the expenditure is associated with an event, record the "Event #" as reported in Section L1.
Amount: Record the amount of the expenditure reported for this transaction.
Expenditure #: To be completed only when the expenditre is Coordinated with reimbursement sought,
Coordinated without reimbursement sought, Independent or Organization. Assign a unique Expenditure #, beginning
with the number 001 and continue sequentially. The purpose of assigning this unique number is to link the committee's expenditure
with their itemization in Section T Addendum.
Type of Expenditure: Check the appropriate box to note whether the expenditure is None of the below, Coordinated with reimbursement sought (joint expenditure), Coordinated without reimbursement sought (in-kind contribution), Independent or Organization. Unless “None of the below” is selected, complete the Section T Addendum.
For explanation of these terms, please see the instructions for "Type of Expenditure" in Section P.
Record the Expenditure # as assigned in Section T. Check the appropriate box, Supported or Opposed, to indicate whether the
candidate(s) or committee(s) was/were supported or opposed by the expenditure. Record the total amount of the expenditure.
Name of Candiate or Committee; Office Sought; Cost Allocated to Candidate or Committee: Report the candidate(s') or committee(s')
name(s) and office(s) sought for whom the coordinated, independent or organization expenditure was made. Record the amount of
the total expenditure allocated to the candidate or committee.
A. Total Contributions from Small Contributors