Jones Finance

SEEC FORM 20
Itemized Campaign Finance Disclosure Statement

CONT{ECTICUT STATE ELECTTONS ENFORCE}fENT COMMTSSICN
Rev. 1/08
SUMMARY PAGE
Title
Fint
MI
Last
SuIfix
Ms
Street Address
Denese
City
Deeds
State
Zip Code
ffi
Iitle
65 Walnut Tree Hill Rd 11t08t2011

First
Shelton
CT
6. DISTRICTI{IIMBEB:
06484
:
i
:: 1/ .' 'r:
Ftf,i;18;BE6*6'Eiil#i;ii;ti,Thaiii#uii7i;3ti:::iil
Mayor of Shelton
MI
(mn/dd/yy1,y)
Lst
Chris r.,:;r':: ,: .irrii r iii l:rt ,: iira:1ti' rjri ifn, .i e ' aaPI. Rtrl llfiiE.4tllf {|ik'n}: =.:,, iil'. R;yin:i:'ii:.:i;i:
Mr
!*i January l0 filing
::: 7th day preceding Primary
tl-.:
Jones
!;
i:i
i. Fd fr-
f-)
'rlEq*
,ffi..lj4
: :A
\rrr
ti
7th day preceding referendum
at
Ciltri bufi oin#r Dirbur..t.nr tf/csoNLY$
::i April
10
filing
i:
fl
i:',
30 days following primary 7th day preceding election
ri.
; 45 days following referendum
fi
July 10 filing
Deficit
Termination
Type ofReport:
,li' October l0 fi1ing
l2th
day preceding election
(State Ceiltral Commifiees OnlJ))
'r,
In-dependent Expen diture {=r Election 'l-
Primary
j:45
days following election not held in November
Beginning Date
Ending Date
07t01t2011
thru
0913012011
'i
IO.
CERTTFICATION
i.a:l .
I hereby certifu and state, under penalties of false statement, that all of the information set forth on this ltemized Campaign Finance
Disclosure Statement for the period covered is true, accurate and complete.
Denese Deeds
ER OR DEPUTY TREASURER (SIGNATURE)
10t0812011
DATE (mm/dd/ynl,)
PRINT NAME OF SIGNER
PENALTY FOR FALSE STATEMENT IS PANISHABLE BY FINE NOT TO EXCEED il,OOO, OR IMPRISONMENT FOR NOT MORE THAN ONE YEAR' OR BOTH
i.:{
, 1
SEEC FORM 20
Itemized Campaign Finance Disclosure Statement
CONNECTICUT STATE ELECTIONS ENFOF.CEMENT COMMISSION
Rev. 1/08
Page 2 of 17
SUMMARY PAGE
TOTALS
mx#ghe'adx'mi#p#"
I
FEil$G;n:un,;flAtrlttil)i\;;;i:tl :::
:;.r,ti ::t'::lt
i!:
iiia!
:iai='
10t11t2011
Chris Jones for Shelton
COLUMN A
This Period
r3r
.....:t
UOLUMN B
Assresate
iz
ll_
Balance on hand January I of current year for Ongoing and Party Committees OR Balance on hand from day Committee was formed for all other committees
::: :. I :
i:1! ;,::4.:= i;;1j | ; ;aJ :
Qn nn
2.
$2,025.00
Balance on hand at the beeinnine of Reportine Period
13. Contributions received from Individuals (Sections A and B) 14. Receints from Other Committees (Sections Cl
15. Other Monetary Receipts (Sections D-K) 16a. Total Small Food and Beverage Receipts at Fair (Section
and C2)
$6,795.00 $0.00 $0.00 $o.oo $0.00 $1,100.00 $7,895.00 $9,920.00 $1,800.25
$7,520.00 $1,300.00 $0.00 $0,00 $0.00 $1,100.00 $9,920.00

$9,920.00 $1,800"24
$8,1 19.75
Ll)
Town Committees ONLY
l6b.
Total Proceeds from Small Purchases at Tag Sales. Auctions or Other Sales (Section L2)
Municipal and Town
16c. Total
Purchases
ofAdvertisins in
a Prosram Book (Section L3) Comnittees
ONLY
17. 'Iotal Monetary Receipts (add totals for lines l3- l6c)
1
8.
Subtotals (add totals in line 12 +
line
17 in Column P)
A; and in line I 1 + l7 in Column B)
19. Expenses Paid by Committee (Section
20. Balance on hand at close of Reporting Period (Subtract line

2
1
19
from line l8 in both Columns)
$8,119.75 $70.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00
SU,UU
. In-Kind Donations not Considered Contributions Received (Section L4)
$0.00
22. In-Kind Contributions Received (Section M)
$0.00 $0.00 $0.00 $0.00 $0.00

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

24. Receipts of Organization Expenditures (Section O)
25. Beeinnine Loan Balance
25a. *
Lorn" Received /section l-))

Interest and Penalties on Loan Payments on Loan
25b. *
25c. -
$0.00 $0.00
$0.00
25d. Total Outstanding Loan Amount

26. Campaign Expenses Paid by Candidate (Section Q) 27. Expenses Incurred on Committee Credit Card (Section R) 28. Expenses Incurred bv Committee During this Period but Not Paid (Section S) 28a. Total Outstanding Expenses Incurred by Committee still Unpaid (Section S)
$0.00
$0.00
I.
1
MONETARY RECEIPTS (Sections A-K)

10t11t2011
r
Page 3 of 17
:-.-i, i
t::t
L,ir
..,.
Iii'i"(seeinsrru&io'i,a"iniiffioofsilatlt
Chris Jones for Shelton 4..:r Tb--f,4l,C-ontiibutioriKl #,ofii:SlliiitfX..CoiltFlibuidr$rB+*biv.*ffthi$;fCf,i6.d,$NL$i
canrributor)': :,.1
Finl
t,'.
;; . ,: ' : , tiiii.{ Bliii,Iit-lilJtB'd:,

Last Name
i,', "' '1:i-bttalSectionI $ :.;,rt , _ , ] t ,hiitiiiiiE'rff6iflllnfli ' iltihl$iri';',,i;iri

-
540.00
a:at1:.
i
MI
rtate
Princinal Occuoation
Name of Ernployer
See Attached
lesidential Street Address
Amount of Contribution
lity
hp Cod
CT
Is contributor a lobbyisl spouse, Yes or dependent child of a lobbyist? C.i' No
Is this contribution associated with fundraising event listed in Section ffyes. list Event #
{:
If contribution
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 il; Yes No municipality valued at more than $5,000?
ft
a Ll?
.* *l
Yes
No
ls contributor a principal of a state contractor or prospective state contractor? Ifyes, indicate which branch or branches Legislative Executive of government the contract is
f*l Yes
with:
fi
ti
No
Method of contribution: il; Cash .{l: Personal Check

Last
Date Received
Aggregate contnbutlons
ilj
Credit/Debit Card
First
{13
Payroll Deduction
ili
Money Order MI
PrincipaJ Occupation
Name ol Employer
$0.00
$6,255.00
Nme
Street Address
lesidentlal
jrty
itate
1ip Code
CT
Is contributor a lobbyist,
ordependentchildofalobbyist?
Is this contribution associated with
spouse, ,iL Yes f No
Ifcontribution is in excess of5400 to a candidate committee for a chiefexecutive officer ofa municipality does contributor or business heishe is associated with have a contract with said i-j Yes f*i No municipality valued at more than
$5,000?
fundraising event listed in Section fyes. list Evenr # Method of contribution:

Last
a Ll?
fl
Yes
:it
No
Is contributor a principal ofa state contractor or prospective state contractor? Ifyes, indicate which branch or branches {lL Executive {lr: Legislative oi govemment the contract is
Yes
with:
{:r No $0,00
Date Received
Aggregate contnbunons
l" Cash {]l Personal Check il, CredirDebit Card il; Payroll
Nane
Firsl
Deduction E: Money Order

MI
itate ,rp Code Pnncipal Occupation Name ofEmployer
$0.00
Kesldentlal Street Address
-lty
CT
Is contributor a lobbyist, spouse, or dependent child ofa lobbyist?
il, .f: a Ll?
Yes
No
is in excess of $400 to a candidate committee for a chief executive officer ofa municipality does contributor or business he/she is associated with have a contract with said municipality valued at more than $5,000?
If contribution
fiYes ftNo
this contribution associated with fundraising event listed in Section Ifyes, list Event #
Is
f:
tr)
Yes t to
Is contributor a principal of a state contractol or prospective state contractor? Ifyes, indicate which branch or branches Legislative of government the contract is with: fl.r Executive
't-,
{_i Yes
No
*;
Method of contribution:
Date Received
Aggregar9
90rr[Du!ons
{, Cash #
Last
Personal
Check .l,]' CrediVDebit Card

I rrst
d*^l
Payroll Deduction
l..1,
Money Order MI
Principal Occrrlration Name ofEmployer
$0.00
$0.00
Nme
{esldential Street Address
iity
)Iate
Zip Code
CT
Is contributor a lobbyis! or dependent child of a lobbyist?
Is this contribution associated with
spouse, ?j f'
Yes
If contribution is in excess of$400 to a candidate committee for
a chief executive
officerof
t'lo
municipality does contributor or business helshe is associated with have ll: Yes .fi No municipality valued at more than $5,000? is contributor
a contract with said
fundraising event listed in Section fyes, list Event # Method of contribution:
if*rl Yes a L1? #l No
a principal ofa state contractor or prospective state contractor? Ifyes, indicate which branch or branches illl Executive {'. Legislative of govemment the contract is with: Date Received
.{.1
Yes
3* No
Aggregate contnbutrons
lf,Cash
:li t
.. ,]" ::
$ll'i Personal Check {l
CrediVDebit Card
,Fi;:I :t'd,.. t"-
iJ
Payroll Deduction
.i: ,:1 , .'
lli
-
Money Order
$0.00
$0.00
..t
:. l: :: , . -i:i .r j.':'
it
,.1 i,
..i
. . "-- -'r
.", :
I iitlli
I-!j:l.j
$6,255.00
'rOrnl
::
:l
.t.
Ll::-
of adaitionat Seciion n Fafes
$0.00
+^Tdg
O-R,A iilrc,tiwtnfsg+idmS
nxUru1Ne,ryrb$Al$:Giati;1*.; t):tE
iA;1i[1[1ffipp7a.1s of Sumiary prye)
$6,795.00
Chris Jones for Shelton 2011 Campaign Committee

I
B.Contributions from lndividuals over $50 in the Aggregate

Name Blanchette, Sieve 10 Princess Terrace Shelton , CT 06484
Employer
Blanchette's Sporting Goods
Occupation
VP
Lobbyist Status
Sales
fl
loooyltt
Loboyist
Spous
1---l Lobuyist Dependent
Date 1
Contribution associated with
Received
Type of Contribution
Amount
$50.00 $50.00
Event
EventNumber:
811712011 Credit Card
Aggregaie Contribution:
Name Bonitatebus, Joseph

5 Greystone Shelton , CT 06484
Employer
Retired
Occupation
Lobbyist Status
!
Date
louoyi.t I
Loooyi"tspous fLolbyistDependent
Received
Type
ofContribution
Amount
$100.00 $100.00
;-1
Event
EventNumber:
812212011 Personal Check Aggregate Conkibution:
Name Bragg, Henriette 85 Park Ave Shelton , CT 06484
Employer
Retired
Occupation
Lobbyist Status
fl loooyist f
Date Received
Type of Contribution 911612011 Personal Check 912612011 PersonalCheck 81812011 Personal Check Aggregate Conhibution:
Loooyist
spous
[-l
Lobbyist Dependent
Amount
$40.00 $25.00 $100.00
Vl
19
;1
Contribution associated with Event Contribution associated with Event Contribution associated with Event
EventNumber: 091 0201 1A
EventNumber: 0921201 1 A
EventNumber:
$'f6!i-00
e0 f.o
Name
Briner, Edith 15 Country Place Shelton , CT 06484
Employer
Retired
Occupation
Lobbyist Status
fl
Date
t-oooyist
Loooyist
spou" [-]
Loooyi"t Dependenl
Received
Amount
$35.00
l;
Event
EventNumber:
08262011A
812912011 Personal Check Aggregate Contribution:
Name
Calabro, Michelina 72 N. Benham Rd Seymour , CT 06483
Employer
Sona Bella
Occupation
MassageTherapist
Date
Lobbyist Status
[l
loooyirt
f]
loouyi"tspout f-]Loboyi"tD"p"no"nt
Received
Amount
$100.00
t1
Event
EventNumber: 0910201
1A
911612011 Cash
page
*a
-.,,j

Aggregate Contribution: $100.00
Name Calkins, Haniet 29 E Village Rd. Shelton , CT 06484
Employer
None
Occupation
Lobbyist Status
'
Retired
Lobbyrsr f]
Loboyist
Spous
Lobbyrst Dependent
Date
Received
Amount
$40.00
Event
EventNumber:
09102011A
911612011 Personal Check
Aggregate Contribution:
$4fIf
!
lYo.
c./
Name
Capinera, 15 Barbara Shelton , CT 06484
James Dr
Employer US Army Reserves

Date
Occupation Staff Admin.

Assistant
Lobbyist Status
f]
looovi"t
Looovitt
Spo's
Looovist Dependent
Received
Type of
Contribution Check Check
Amount
$20.00 $20.00 $40.00
g ;
Event Event
EventNumber:
O91O2O11A 911612011 Personal

8t2212011 Personal
Conkibution associated with
EventNumber:
Name Cargnel, Carolyn S 5 Country Walk Shelton , CT 06484
Employer
Prudential lnsurance
Occupation
AunityDept.
Date
LobbYist Status
i] loooyi.t []
Loouyistspou. !LoouyirtDependenl
Received
Amount
$30.00
Event
EventNumber:
08262011A
812912011 Cash Aggregate Contribution:
s30.00
Name Cayer, Jean 64 Cloverdale Ave Shelton , CT 06484
Employer
St. Vincents Hospital
Occupation
Laboratory
LobbYist Status
Loooyistspous f]Lobbyistoepenaent
Director f] Loooyi.t !
Date
Received
Amount
$100.00 $25.00
Personal Check 17 Contribution associated with Event EventNumber: 08262011A 8/2912011
Event
EventNumber:
09212011A
$J25fq-
J1>,4 si- lLouoyi"t

Dep"no"nt
Name Colapietro, Pasquale 24 Myrtle Ave. Ansonia , CT 06401
Employer
Retired
Occupation
Lobbyist Status
[]
Date
louoyi.t
Loooyist
spou.
Received
Amount
$60.00
Event
EventNumber:
08262011A
812912011 Cash
page 2

g
191
Contribution associated with Event Contribution associated with Event
EventNumber: 0910201 1A EventNumber: 0910201 1A
$40.00 $20.00 $120.00
9/16/2011 Cash
Name Conner, James 13 Mulberry Lane Shelton , CT 06484
Employer
Self-Employed
Occupation
Lobbyist Status
I
Date
Louuyi"t
Loouyi"tsporr ILoouyirtDependenl
Received
Amount
$100.00 $100.00
Conhibution associated with
Event
EventNumber:
81221201'1 Personal Check
Name Connors, Timothy 70 N. Benham Rd Seymour, CT 06483
Employer
Total Quality
Occupation
Contractor
Date
Lobbyist Status
l=] lotoyirt I
LouoyistSpous f]LobbyistDependent
Received
Amount
$100.00 $100.00
rZ
Event
EventNumber:
09102011A
Name Coughlin, Martin 10 Cayer Circle Shelton , CT -6484
Employer
Retired
Occupation
Lobbyist Status
Retired
Date
fl
t-ouuyirr
loooyi"t
spors [,]
Lobbyist Dependent
Received
Amount
$250.00 $250.00
Conkibution associated with
Event
EventNumber:
Name
Davis, Jane 77 West 24th Street 30B New York , NY 1 0010
Employer
Occupation
Lobbyist Status
Reiired
f,l louoyirt [-l

Date
Lobbyirt
spors l
-l
Lobbyist Dependent
Received
Amount
$100.00 $100.00
11
Event
EventNumber:
9/2612011 Personal Check

Name DeAngelis, Chris 45 Hubble Lane Shelton , CT 06484
Employer
Self-Employed
Occupation
Lobbyist Status
Excavator
Date
-l
loooYl"r
Loooyist
spous
Lobbyist Dependent
Received
Amount
$20.00
l7l
Event
EveniNumber:
08262011A
812912011 Cash
page 3

Aggregate Contribuiion:
$20.00
Name Deeds, 65 Walnut Tree Hill Shelton , CT 06484
Employer
Occupation
Senior
Lobbyist Status Louoyi"t
Denese
Rd
lnduskial Health & Safety Consultants, lnc.

Date
Consultant i_l
Loooyi"t
spous
f--.1]
t-oooyist Dependent
Received
Type of Contribution 81612011 Credit Card
Amount
$25.00 $25.00 $s0.00
; ;
Contribution associated with Contribution associated with
Event Event
EventNumber: EventNumber:
81512011 Credit Card Aggregate Contribution:
Name Douglas, Christopher 25 Laurel Glen Dr. Shelton , CT 06484
Employer
Encon lnc.
Occupation
Business
Lobbyist Status
Owner
mooyi"t !
Loooyist
spous
Loobyist Dependent
Date
Received
Amount
$100.00
Event
EventNumber:
9/1612011 Personal Check n-ggregai, Co-ntribution
_'-Sf OO.OO
Name Feeley, Joan

67 Adams Street
Employer
Shelton Public Schools
Occupation
Lobbyist Status
Teacher
Date
Loooyitr
f]
Loooyist
spous
f]
Lobbyist Dependent
Shelton , CT 06484
Received
Amount
$25.00
$50.00
g g
Event Event
EventNumber: EventNumber:
09212011A
912612011 Personal Check Personal Check
09'102011A 9/1612011
$75o'o
ai,Ot)
Lobbyist oepenoent
Name Finn, Harriet 29 East Village Rd Shelton , CT 06484
Employer
Retired
Occupation
Lobbyist Status
fj
Date Received
r-ouuyist
l,]
Loouyist
spous
fl
Type of Contribution 9116/2011 Personal Check

812212011 Personal Check Aggregate Contribuiion:
Amount
$2o.oo $250.00
u'. Contribution associated with Event EventNumber:
0911012011
Event
EventNumber:
$27fro0
3.+0 . o-4
l
Lobbyist Dependent
Name Finn, Jack 17 Piincess Wenonah Dr Shelton , CT 06484
Employer
Cirt of Shelton
Occupation
Registrar of
Lobbyist Status
Voters Il
t-oouYl"t
i l
t-oooyist
spous i
Date
Received
Amount
page 4

E
Event
$60.00
$60.00
Name Flannery, Joan 8 Partridge Lane Shelton , CT 06484
Employer
City of Stamford
Occupation
Teacher
Date
LobbYist Status
Loooyi"t
Louuvistspou. Iloooyi.tDependenl
Received
Amount
$20.00 $20.00
17
Event
EventNumber:
09102011A
gl1612011 Personal Check

Name Forlenzo, Karen 19 Haverhill Dr Shelton , CT 06484
Employer
Shelton Shoprite
Occupation
Chef
Date
LobbYist Status
Loooyi.t
Looovi"tspous [-]LoouvistDependent
Received
Amount
$20.00 $20.00 $40.00
E g
Event Event
EventNumber:
08262011A
812912011 Personal Check 911612011 Personal Check Aggregate Contribution:
1A
Name Fuller, David 48 Sunnybank Ave.

Stratford , CT 06614
Employer Birmingham Health Services

Date
OccuPation
Lobbyist Status
looovi"t
Marketing/Fund f]
Raising
roooyirt spous
Lobbyist Dependent
Received
Amount
$20.00 $20.00
Event
EventNumber:
09102011A
9/16/201
Cash
Name Gioiello, David

65 Walnut Tree Hill Shelton , CT 06484
Employer Rd
lndustrial Health & Consultants, lnc.
OccuPation
Lobbyist Status
Safety
Date
President
-l loooyt"t fl
Loooyi"t
spors
Lobbyist Dependenl
Received
Amount
$200.00 $200.00
Event
EventNumber:
Name Giordano, Frank 63 Hilltop Dr Shelton , CT 06484
Employer
New York Life lnsurance
Occupation
lnsurance
Lobbyist Status
Lobbyist i
Lobbyist
Spous
Lobbyrsi Dependent
Date Received
Amount
$30.00
E-
Event
EventNumber: 0910201 1A
9/1612011 PersonalCheck
page 5
j I

s30.00
Name Giordano, Jessica 20 Hilltop Drive Shelton , CT 06484
Employer
Shelton BOE
Occupation
Teacher
Lobbyist Status
-l rouoyi.t I
Tvpe of Contribution
Loooylst
Spous
Lobbyist Dependent
Date
Received
Amount
s40.00 s40.00
,g1
Event
1A
911612011 Cash
Name Haddad, David 1 0 Sunset Dr Shelton , CT 06484
Employer
Best Buy
Occupation
Lobbyist Status
Sales
Date
loooyitt
Loooyist
spous
Lobbyist Dependent
Received
Amount
s100.00
11
Event
EventNumber:
811312011 Credit Card
nssresrte c-Jntribution'
--s
oo.oo
Name Hallihan, Sean
Employer Olderman and Hallihan

Date
OccuPation
lnsurance Agent j
LobbYist Status
t-oouyist
]]
Loooyist
spous [iLobbvist
Dependenl
4 Richard Rd
Hamden , CT 06514
Received
Amount
$50.00 $50.00
;--l Contribution associated with
Event
EventNumber:
Name Hellauer, Edwin 40 Wakelee Ave Ext Shelton , CT 06484
Employer
Retired
Occupation
Lobbyist Status
f
Date
Louuyist
Loooyistspous nLobbyistDependent
Received
Amount
$40.00
$40.00
lT
Event
1A
Name Hopkins, Sr, Alan
Employer
Retired
Occupation
Lobbyist Status
[] loooyi"t !
Date Received
Loouyi"tspor" fjt-oouyi"tDependent
206 River Rd
Shelton . CT 06484
Type of Contribution 9116/2011 Cash Aggregate Contribution:
Amount
$40.00 $40.00
Event
EventNumber: 09'10201 1A
';i
page 6
i
Name

Employer
Shelton BOE
Occupation
Teacher
Date
LobbYist Status
Hussey, Tracy 11 Fawn Hill Rd Beacon Falls , CT 06403
loooyi"t I
Loooyi"tSpous ILoobvistDependent
Received
Amount
$100.00 $100.00
l7l
Event
1A
9/16/201
Cash
Aggregate Contribution
Name lbsen, Soren

14 Beech Tree Hill Shelton , CT 06484
Rd
occupation Employer Heidenreich lnnovations VP Business

DeveloPment Date
Lobbyist status
ll
louuvi"t
Louovi"tSpo's f-]LobbvistDependent
Received
Type of
Contribution Check
Amount
$100.00 $100.00
Event
EventNumber:
9l2Sl2O11 Personal
NameEmployeroccupationLobbyistStatus Managing Agency Group lnsurance Sales Jennings, Janet Rep 1078 Seminole Lane
Stratford , CT 06614 Date
rooovist
Loouvist
spous []Lobbvist
Dependenl
Received
Type of
Gontribution Check Check
Amount
$20.00 $25.00 $40.00
Jl la
Contribution associated with Contribution associated with Contribution associated with
Event Event Event
EventNumber:
EventNumber:
912612011 Personal 912612011 Personal 911612011
09212011A
-;
14
Cash
,$8dt^. -#54 u
Looovi"t
Name Jones, Marcia 90 Sunnyside Dr.

Shelton , CT 06484
Employer Birmingham Group

Date
Occupation Administrative I
Assistant
Lobbyist Status
louuvi.t
spous
Lobovist Depenoent
Received
Type of
Contribution Check Check Check
Amount
$35.00 $35.00 $35.00
17
Event
EventNumber: 091020'1
14
911612011 Personal
:r1 Contribution associated with Event EventNumber: 08262011A 812912011 Personal

71 Contribution associated with
Event
EventNumber:
09212011A
912612011 Personal
WaY
Lobbyrst
Name Kelley, Kathleen 7 Beardsley St. Shelton , CT 06484
Employer
Retired
Occupation
Lobbyist Status
I Loooyi.t
Spous
Lobbyist Dependenl
Date Received
Type of Contribution 811512011 Personal Check
Amount
$25.00
;-1 Contribution associated wiih Event
EventNumber:
page 7

$25.00
Name Kelley, Patrick 18 Johnson Ave Seymour, CT 06483
Employer
Goodhill Mechanical Contractors Date
Occupation
HVAC
LobbYist Status
Tech
Type
J- Loooyi.t i
ofContribution
Lobovist
Spous
-l
Lobbvist Dependent
Received
Amount
$50.00 $50.00
Event
1A
9/1612011 Cash
Name Kelly, Kathleen 1 Chamberlain Dr Shelton , CT 06484
Employer
Retired
Occupation
Lobbyist Status
I
Date Received
Loooyi.t
Lobbyrst
Spous
I I Looovist Dependenl
Type of Contribution 811512011 Personal Check Aggregate Contribution:
Amount
$50"00
11
Eveni
EventNumber:
$50.00
Name Kennedy, Thomas 37 Ten Coat Lane Shelton , CT 06484
Employer
CEA
Occupation
Field Rep
Lobbyist Status
[--] Loooyi"t |l
Loooyi.t
spors
Lobbvist Dependent
Date
Received
Amount
$40.00 $40.00
0826201 17 Contribution associated with Event EventNumber:
1A
812912011 Cash
Aggregate Conkibution: LobbYist Status
Name Knapik, Joseph 23 Stonewall Lane Shelton , CT 06484
Employer
Retired
Occupation
I
Date
Loooyi"t
Loooyist
Spous []Lobbyist
Dependent
Received
Amount
$40.00
:
17; Conkibution associated with
Event
EventNumber:
09102011A
Aggregate Coniribution
$40.00
Name Kocurek, Remy 15 Partridge Lane Shelton , CT 06484
Employer
Assistant Registrar of Voters
Date
Occupation
cityofshelton Received I
louuyi"t I
LobbYist Status
Loooyi.tspous l]LobbyistDependent
Amount
$40.00 $40.00
I Contribution associated with
Event
EventNumber:
page 8
B.eontributions from !ndividuals over $50 in the Aggregate

Name Loughery, John 51 Laurelwood Drive Shelton , CT 06484
Employer
Met Life
Occupation
lnsurance
Date
Lobbyist Status
l] loooyirt !
Type
Loboyirtspou. lLoooyi"tDependent
Received
ofContribution
Amount
$60.00 $60.00
:;
Event
EventNumber:
09102011A
9/1612011 Cash
Name Magel, Gretchen 17 Frank Dr Shelton , CT 06484
Employer
State of CT
Occupation Assisiant Clerk ]---l r-ouuvi.t l
Lobbyist Status
-]
Lobbyirtspors [--. LobbyistDependent
Date
Received
Amount
$40.00
i--r Contribution associated with

il
Event
EventNumber:
8/2312011 Credit Card

$40.00
Name Matto, Ralph J 88 Audobon Lane Shelton , CT 06484
Employer
BJB Rentals
Occupation
Owner
Lobbyist Status
lonoyi.t
il
Loooyist
spous
rf
Lobbyist Dependent
Date
Received
Amount
$1,000.00
Sf ,OOO.Oo
-r
Event
EventNumber:
--Abgregaie
Name Medinger-McWeeney, Felicity 104 Hillside Ave Shelton . CT 06484
Contribution: i!
Employer
City of Shelton
Occupation
SubstituteTeacher
Lobbyist Status
il
Louoyi"t
Loouyirtspors
iLooovistoepenoent
Date
Received
Amount
$s0.00
:
r-
Event
EventNumber:
912912011 Personal Check Aggregate Contribution
$50.00
Name Monahan, Grace 12 William St. Shelton , CT 06484
Empioyer
Occupation
Lobbyist Status 1--l louuyi"t
[j
Loooytst
spou.
Louoyirt Dependent
Date
Received
Amount
$50.00 $50.00
Event
EventNumber:
912712011 Credit Card Aggregate Contribuiion:
page 9
i Name

Employer
Self-Employed
Occupation
Contractor
Date
LobbYist Status
Moreno, Chris 11 Sawmill City Rd Shelron , CT 06484
Loooyi.t
f]
Loooyi"t Spous
Louoyist Depenoent
Received
Type of Gontribution
Amount
$30.00
$30.00
Event
EventNumber:
08262011A
Name Newman, Deborah 8943 Lakes Blvd West Palm Beach , FL 33412
Employer
Retired
Occupation
Retired
Lobbyist Status
-i Lotoyi"t fl
Loouyist
spou. f-l
loooyist Dependent
Date
Received
Amount
s500.00
$500.00
Coniribution associated with
Event
EventNumber:
Name Olderman, Howard 10 Dixon Street Milford , CT 06460
Employer
The Olderman and Agency
Occupation
Lobbyist Status
Hallihan
lnsurance
Producer
looovitt
fl
t-oooyist
spous
Loobyist Dependent
Date
Received
Amount
$50.00
r-
Event
EventNumber:
Name Pallister, Sara 166 River Road Shelton , CT 06484
Employer
St Vincents Medical
Center
Date
Occupation Registered Nurse I

Received
Lobbyist Status Looovi.t
Loouvist Spous
Loouvrst Dependent
Amount
$'100.00
;-1
Event
EventNumber:
811512011 Personal Check Aggregate Conhibution:
$100.00
Name Papst, Greg 21 Geissler Dr Shelton , CT 06484
Employer Self
Occupation f] Mortgage Broker

Date
LobbYist Status
loooyirt
f]
Loooyist
spous LlLobbyist
Dependent
Received
Amount
$100.00
:
y1 Contribution associated with Event EventNumber: 0826201'1A 812912011 Personal Check

$100.00
page 1 0
,i
Name
B.eontributions from lndividuals over $50 in the Aggregate

Employer
Shelton BOE
Occupation
Lobbyist Status
Pawlyk, Kerry
2 Ceaderstone Rd
Teacher
Date
[]
LoooYitt
Louoyist
spous
f]
Lobbyist Dependent
Oxford , CT 06478
Received
Amount
$40.00
$40.00
.zr Contribution associated with
Event
EventNumber:
08262011A
812912011 Cash
Name Pedros, Robert

8 Manitook Dr Oxford , CT 06478
Employer
Self-Employer
Occupation
Design
Lobbyist Status
LoouYi"t
Enginee; i]
Loooyirt
spous [
Lobbyist Dependent
Date Contribution associated with
Received
Amount
$60.00
$60.00
E1
Event
EventNumber:
09'102011A
911612011 Cash
Name Peterson, Mark 10 Brookpine Dr Shelton , CT 06484
Employer
City of Stamford
Occupation Teacher
Date
LobbYist Status
fl
Loloyirt
[J
looovistspous [
-lLooovistDependenl
Received
Amount
$100.00 $100.00
i Contribution associated with
Event
EventNumber:
Name Petro, Kathleen 85 Bridgeport Ave Shelton , CT 06484
Employer
Unemployed
Occupation
LobbYist Status
I
Date
louuyi"t
f]
roooyist
spous ,I]Loooyi"t
Dependent
Received
Amount
$100.00
lr
Event
EventNumber:
-Agtregate Gntrioul,on:-
--
-Sr oo.oo
Name Petro, Maureen 85 Bridgeport Ave.

Shelton , CT 06484
Employer United Healthcare

Date
occupation Coordination of
Benefits
Lobbyist Status
i--l r-ouovi"t l]
Lobbvist
Spout i]Loubvi"t D"peno"nt
Received
Type of
Contribution Cash Check
Amount
$20.00 $50.00 $45.00
$1
r7t Contribution associated with r

!
Event
EventNumber:
08262011A
812912011
Event EventNumber:
812212011 Personal
t,1 Contribution associated with Event EventNumber: O1212O11A 9t26/201'1
Cash
15.00
page
..!
Bd
B.Contributions from !ndividuals over $50 in the Aggregate

Name Ross, Burke 47 Christine Dr Shelton , CT 06484
Employer
Reiired
Occupation
Lobbyist Status
i=l loooyist f
Date
Loooyistspous ILobbyistDependent
Received
Amount
$50.00 $50.00
;l
Event
EventNumber:
Name
Ryan, George 25 Tower Lane
Employer
Curtis Ryan
Occupation
Business
Lobbyist Status
loooYi"t
Manager l]
l=l
Louuyist
spou"
Loooyi"t D"p"nu"nt
Shelton , CT 06484 Date
Received
Amount
$100.00
:
Event
EventNumber:
811512011 Personal Check Aggregate Contribution
$100.00
Name Sardo, Lisa 5 Hawley Dr Ansonia , CT 06401
Employer
Valley Medical
Occupation
Receptionisi
1-
LobbYist Status
r-ouuyi"t
l-
Loobyi"t
spous
Lobbyist Dependent
Date
Received
Type ofContribution
Personal Check
Amount
$50.00 $50.00
rt-l Contribution associated with
Event
EventNumber:
09102011A 9/16/2011
Name Spinelli, Ludwig 14 Willard Rd Shelton , CT 06484
Employer
Opiimus Health Care,
Occupation
Lobbyist Status
lnc.
Date
CEO
Louuyi.t
i]
LouoyistSpous ILobbyistDependent
Received
Amount
$50.00 s50.00
Event
EventNumber:
Name Swanson, Kelly 30 Forest Ave Shelton , CT 06484
Employer
Occupation
Lobbyist Status
il roooyist I
Date Received
t-ouoyist
spous
Lobbyist Dependent
Amount
$10.00 $10.00
Contribution associated with Event
EventNumber:
page 12
B.eontributions from lndividuals over $50 in the Aggregate

1
Name
Employer
Shelton Board of
Occupation
Lobbyist Status
Tickey, Darleen
6 Coachmans Lane Shelton , CT 06484
Education Principal
r-oooyi"t
loooyist
spou"
fl
loooyirt Dependent
Date Contribution associated with
Received
Amount
$50.00
1;1
Event
EventNumber:
09212011A

$50.00
Name Tickey, James 6 Coachman's Lane Shelton , CT 06484
Employer
Susan for CT
Occupation
Campaign Staff
LobbYist Status
loooyi"t f
loooyi"t
spors f-]
Lobbyist Dependent
Date
Received
Type
ofGontribution
Amount
920.00
Contribution associated with Event
EventNumber:
$20'
ff,O
Name
Employer
Ritch, Greenberg & PC
Occupation
Lobbyist Status
Valenii, Nicole
926 Litchfield Tpke Bethany , CT 06524
Hassan
Accountant
Loouyi"t
Louoyi"tspors !LoobyistDepenoent
Date
Received
Amount
$60.00 $60.00
Event
1A
9/16120'1
Cash
Name Walsh, Gail 42 L'Hermitage Dr. Shelton , CT 06484
Employer
Retired Teacher
Occupation
Lobbyist Status
!
Date
loooyi"t !
Loooyist
spous
f]
Lobbyist Dependent
Received
Type
ofGontribution
Amount
$50.00 $50.00
Event
1A

Name Walsh, Tim 42 L'Hermitage Dr. Shelton , CT 06484
Employer
Retired
Occupation
Lobbyist Status
I
Date
Louoyi"t
Louoyirt
spous
Loobyist Depenoent
Received
Type
ofContribution
Amount
$100.00 $100.00
El
Event
EventNumber:
09102011A
page 13
B.Gontributions from lndividuals over $50 in the Aggregate

Name Waters, John 261 Long Hill Cross Rd Shelton , CT 06484
Employer
Retired
Occupation
Lobbyist Status
f
Date Received
touoyi"t f
toooyistspous [LobbyistDependent
Type of Gontribution
812912011 Cash
Amount
$40.00 $40.00
p1 Contribution associated with
Event
EventNumber: 0826201 1A
Name Yamnicky, Janet 428 Long Hill Ave Shelton , CT 06484
Employer
Retired
Occupation
Lobbyist Status
{] Loouyirt I
Date
louuyist
spous
f]
Lobbvist Depenoent
Received
Amount
$60.00 $60.00
contribution associated with
Event
EventNumber:
09102011A
Name Zwaan, Carla 55 Cold Spring Cir Shelton , CT 06484
Employer
None
Occupation
LobbYist Status
f
Date
loooyi"t !
Louoyistspou. ILoboyi"tDep"na.nt
Received
Amount
$75.00 $75.00
171
contribution associated with
Event
EventNumber:
09212011A
9/2612011 Cash
$6,255.00
page 14
I.
:: ..
.:
MONETARY RECEIPTS (Sections A-K)

1011112011
Page 4 of 11
i
Name of Conmittee
rCl. Contribrilions frolir Other
]r:*
::: i
:t";.
Committees
,jjait
:l
::'a:a:aaa:n
ill:iit:1,+lii?.1;l-il:lii;l
Name of Treasurer
Address
ls this contribution associated with {'1,, Yes //yes, list fundraising event listed in Section L I ? No Event #
i.!
- rty
State
Zip Code
Date Received
Aggregate Contnbutlons
Name of Cornmittee
Name of Treasurer
Address
ls this contribution associated with
fundraisingeventlistedinSection
City
State
Ll? 3: No
Aggregate
:l-*!
Yes lfJes,list
Event#
Zip Code
Date Received
$o.oo $0.00
CT
Name of Committee
Name ofTreasurer
Address
t].i Yes If yes,list ls this contribution associated with lundraising event listed in Section Ll? f;.t No Event #
City
Name of Committee
l.'
I
State
cooe
Date Received
Aggregate Contfl btltlons
$0.00 $0.00
lzrr
\ame of I reasurer
Address
Is this contribution associated with fundraising event listed in Section L1?

State
a *,
i1. No
Yes If les,list
Event #
City
I
coae
Date Received
Aggregate
$0.00 $0.00
lcr
Narne of Committee Address
lzio
Name of Treasurer
ls this contribution associated with {-i, fundraising event listed in Section L1?
State
Yes //J,es, list

Event #
*l No
-rty
Zip Code
Date Received
Aggregate Contributions
$0.00 $0.00
CT
Name of Committee
Name of Treasurer
Address
ls this contribution assoeiated with a fundraising event listed in Section L1?

State
f;i Yes ,ili No
//yes, list
Event #
-tty
Zip Code
Date Received
Aggregate Contnbutlons
$0.00 $0.00
CT
+
Narne of Cornraittee
Cr
Rcimhrrrtprnpfrft
'
'1
- ..i
p".rt""+i
.r" Srr".rl,r*"T)isti'ihlrfions frOm otlrer Committeei

Name of Treasurer
Address
)ate Received
Amount of Receipt
tt'
State
Zip Code
!-r' Reimbursement for shared expeuse

.1{; Payment for goods and
Name ofTreasurer
services
iti
Surplus
Distribution
Name
ol
Cornmtttee
Address
)ate Received
Amount of Receipt
City
)tae
Zrp Code
ai Surplus I,ll Reimbursement for shared expense

.'i'
Payment for goods and Cf
$0.00
CT
services
Distribution
TRTflTA I C..*i^; {--Thic Paoe
so oo
$0.00 $0.00
TOTAL of'addifional Section e Pdges
TOTdi;nn'll;r,iovMrrtnF.
coNTRI:BI,ITiONS'AND npCrrFr:s.rritiirtotil on Line I4 0f simiffinrl Paii):,t
1.,tr;.:.
l. NIONETARY
RECEIPTS (Sections A-K)

10t11t2011
Pase 5 of 17
rlame
of Lender
State
Source of Loan:
Zip Code
Is there a Cosigner
lheet Address
ii Bank
::. Individual
or Guarantor of
l{l:: Candidate
Amount Received
CT
this loan? rll. Yes (if yes tist nonte and adclress ol
Cosigner Cuarctnlor)
lrl
other
Committee
$0.00
l-:: No
itreet Address
:'rty
)Iat
Zip Code
Date of Rceipl
CT
Nane ot Lender itreet Address
Source of Loan: -rty

)LALC
Is there a Cosigner
Amount Received
Zip Code
i.lj gank fli Candidate
or Guarantor of
this loan?
"di;.
CT
rlme of
Cosigner/Guarantor
Yes (if yes tist
!i.
- rty
JTAI
Individual
f.i
Other Cnmmittee
(losigner"Guarantor)
,fl
$0.00
No
Street Address
lip
Code
Date of Recelpt
CT
F.ii,
;:.:'ili,f
Li,
rP
ffifl'tffiia="
*==.ff6i
tniti iejitl
FF.it ffii{4[
)ate Received
1i-3i18
0.00
.4].F;if#d
Name of Entity
Street Address
Amount Received
Sity
sl ate
Zip Code
$0.00 $0.00
CT
Name of Entrty
Streef Address
)ate Received
Amount Received
City
Zip Code
$0.00 $0.00
CT
NmeiofE
iit
)ate Received
Street Address
Amount Received
I I I
crl
$0'00
Zip Code
Aggregate uonrnDunons
$0"00
$0.00 :lllilaffi riit#lii#=j

=.'4,$1;1;;;d$
Amount
lltd#Niiirfl ri'it*l
Date
rcHid$ffi rEf;:.4,.{fiiiii
Date of
iis$.iiili$:
0.00
of
Receipt
Amount
Receipt
Total Transfers
$0.00
ls this transaction associated with fundraising event listed in Section L
Is this transaction associated with fundraising event listed in Section
a tl yes If yes,list. L1? r-.1 No Event # _

"
$o'oo
a fli Yes If yes,lis:l 1? iJi No Event #
0.00
unio,r o"'oiilIFdta,H
Date ofReceipt
Date
of Receipt
i'u*ffiffi;;.; * ro,rl $o.oo
Total Transfers
Amount
Amount
s
I Otal
0^00
uarc uI t(ccglpt
Method of payment:
Method of payment:
Date ofReceipt
Amount Received
;-ll
Arnonnt
$0.00
{: f.
Cash Personal Check
Credit/Debit Card
Amount
$0.00
,l-i Personal Check
l*.
Cash
{li
Credit/Debit Card
0.00
Page 6
ofl7

,i i ._
10t1112A11
.. ntoithebills"received) :; ;.,
",
t:.:,.; I Olal
i'
'
)ate Received
Arnount
Date Received
$o.oo
91
$0.00
$1
Amount Received
6111,
$0.00
$s
rlrs Uiu
$0'00 $0.00
bius $0'00
$0
$s
bills
$0'00
coins $0.00
Date Received
Sro
coins
Date Received
00
516
6111 $0'00
0.00
llr:
:ji
il iiN:rlitrii:=i:i=
Amount
$0.00
Name of Instinltion
s0.00
Total Amount Received
ffi
Street Address
Street Address
City
State
Zio Code
City
State
ZtD Code
CT
CT
0.00
Nane
Date of Trmsactlon
Amount Received
Sfieet Ad&ess
City
State
Zip Code
CT
Description
$0.00
Nme
Date of Trmsaction
Amount Received
Sheet Address
City
Zrp Code
CT
Description
$0.00
Name Date ot lransactlon
Amount Received
Street Ad&ess
City
State
Zip Code
CT
Description
$0.00
-':
n: ' ,".i
;'
I
n
'
. I
iilt!:i.::i::'i i:rr l,
l'liS::= t=,lrailliri
r .: ,.1,' ',; - ,, , .
Toial Sectio4 k
$
0.00
0.00
Total Loans Received this Period (Section D) Total Receipts from Entities other than Individuals or Other Committees (Section E) Total Amount Transferred from Affiliated Business Treasury (Section F) Total Amount Transferred from Affiliated Labor Union or Other Organization Treasury (Section Total Amount of Personal Funds of the Candidate Received this Period (Section H) Total Amount of Anonymous Contributions (Section I) Total Amount of Interest from Deposits in Authorized Accounts (Section J)
+ +
0.00 0.00 0.00 0.00

0"00
G)
+
+
+
+
0.00 0.00
U,UU
Total Miscellaneous M0netary Receipts not Considered Contributions (Section K)
Tota! of Other iHenetary R-eceipts (Add SeCtions D-K) 'lEni*'alitr :I)iiii,15:...rd.Su,in@t:t,p"@

"
TI. FUNDRAISING EVENT ACTIVITY

Page 7 of 17
,'il i{;:
lity
n+ i;;i:,,.,"1l.. itlffiil;i,i;,ii,riE,
10t11t2411
:.iitfit(lir.l
l undraisins
Date
ofFund6iser
f,vent
Leller
Description
Location:
StreetAddress
itate
Zip Code
08t2612011 A Subpart I: (AII Committees)
Cocktail Party
Danny O's, 458 River Rd
Shelton
CT
06484
Was this fundraising event hosted at a personal
residence?
rli Yes
1l/yes, go to Section L4 In-kind Donations not Considered Contributions and complete required information for purchases made by host(s) for fbod'
beverage and invitations.)
*
Did this fundraiser include items donated by a business entity of up to $ I 00 or items donated by an individual of up to $50?
donated items
:, 1\()
tii'Yes
tit, No
1l/yes, go to Section L4 In-kind Donations not Considered Contributions

and complete required information )
{);Yes (lf l,es,go

13,No
with purchases from an individual ofup to $50?
to Section L2 Proceeds from Tag Sale, Auction, or Other Sale Items.) Donated
of
ffiftees purchases
ofadvertising space in a program book associated Cl Yes (Ifyes" go to Section L3 Purchases ofAdvertising Space in a Program Book Were there and complete required information.) with this fundraiser? rc No
{^*r
anel
Mutti"ipol
cnniiJ, co^îx"n oNLy
Subpart 3: (Town Committees ONLY) Did your committee sell food or beverage at a fair or similar mass
gathering held within the state?
Yes (If les,

No
enter
Total Receipts from small Purchases
heril
il
:,
til
ii,;:;,
Fundraising Event
Date ofFurdraiser
Letter
Description
Location:
StreetAddress
lity
State
Zip Code
09110t2011
Family Picnic
Holy Ghost Park, Nells Rock Rd
Shelton
CT
06484
Subpart
I:
(All Committees)
Was this fundraising event hosted at a personal residence?
fl
Yes (Ifyes, go to Section L4 In-kind Donations not Considered Contributions and complete required information fbr purchases made by host(s) lor food,
beverage and invitations.)
lll No
1_r Yes
$100 or items donated by an individual of up to $50?
(Ifyes, go to Section L4 In-kind Donations not Considered Contributions and complete required information.)
with purchases from an individual of up to
$50?
o1;;;* n.'o,
_,i_ves 'E No
iO
(lfyes, go to Section L2 Proceeds from Tag Sale, Auction, or Other Sale of

Donated Items.)
Weie there purchases of advertising space in a program book associated
i6
llr
Yes (Ifyes, go to Section L3 Purchases ofAdvertising Space in a Program Book

and complete required information.)
with this fundraiser?

Subpart 3: (Town Committees oNLv) Did your committee sell tbod or beverage at afair or similar mass gathering held within the state?
No
yes, enter Total Receipts
t{li Yes (If
from small Purchases here]
fr
No
$o.oo
::i ll
TOTAL
o'f
"JOitionuf
Section Lt Pages
$0.00 $0.00
M:n
TI. FUNDRAISING EVENT ACTIVTTY

?agel ofl7 iot11t2a11
i,ff iili+ffift di$$id$Fillfi

Fundraising Event #
Dare
#ft *#
ofFundraiser
Lelter
Description
l,ocation:
SheetAddress
i;;ir:!'r lity
!]ffi
li
iii+:i,r,'t+2i1;;f1ig
ifl ;,p?, g1if

State
Zip Code
09t21t2011
Subpart
Women for Chris
Liquid Lunch, 6 Research Drive liJ es (If yes, go to
Shelton
,CT
06484
I:
(All Committees)
Was this fundraising event hosted at a personal
residence?
'a. r :,t\()
Section L4 In-kind Donations not Considered Contributions and complete required information for purchases made by host(s) for food, beverage and invitations.) go to Section L4
Did this fundraiser include items donated by a business entity of up to $100 or items donated by an individual of up to $50?
Was this fundraiser a tag sale, auction, or other sale of donated items with purchases from an individual ofup to $50?
i3 Yes (fyar,
In-kind Donations not Considered Contributions
. .t
,J
and complete required information )
ijYes (fyes,
NO
No
go to Section L2 Proceeds
from Tag Sale, Auction, or Other Sale of
Donated Items.)
Subpart
(Town Commitlees and Municipul Csntlidate Committees ONLY) Were there purchases ofadvertising space in a program book associated ii Yes (Ifyes, go to Section L3 Purchases ofAdvertising Space in a Program Book and complete required information.) with this fundraiser? ,.u No
2:
Did your committee sell food or beverage at afair or similar

gathering held within the state?
mass
fl
Yes (If
No
yes, enler Total Receipts
from small purchases here)
{:
tttl::: ,tlliii 1i.=
t,:i:t..:rli
ii:+
Fundraising Event l)are of Fttndraiser
Lellel
Description
Location:
StreetAddress
lity
State
Zip Code
CT
Subpurt
I:
(AIl Committees)
Was this fundraising event hosted at a personal residence?
fr Yes
r_l
(lfyes, go to Section L4 In-kind Donations not Considered Contributions

and complete required information for purchases made by host(s) for food, beverase and invitations.) go to Section L4
No
Did this fundraiser include items donated by a business entity of up
to
f-l:
Yes ({fyes,
In-kind Donations not Considered ContriLrutions
and complete required information.)
Oo
es,gotoSectionL2ProceedsfromTagSale,Auction,orOtherSaleof
with purchases from an individual of up to Subpart
$50?
,=
Donated ltems.)
Weietherepurchasesofadvertisingspaceinaprogrambookassociated 4.1 Yes (Ifyes,gotoSectionL3PurchasesofAdvertisingSpaceinaProgramBook and complete required information ) with this fundraiser?
2:
(Town Committees and Municipal Candidate Committees ONLY)
;J tto aj
Subpat 3: (Town Commitlees ONLY)
Did your committee sell food or beverage at a fair or similar mass gathering held within the state?
Yes (If yes,
enter Total Receipts
from small purchases here.)
fiNo
:.,:: I
fagi
ti+ttll'.'r
j:i
$0.00
$0.00 $0.00
I ffi
TI. FUNDRAISING EVENT ACTI\TTY

10111DA11
Page 8 of 17
1:l1l.l+,,iir1ili,,i
iilflflffiit'rilj;
ofPurchasel Qndividuals ONLI)
Name
Last Name
i,;
First
MI
Zip Code
Method of payment:
* Cash {'
-lty
'IAIE Date
Personal
I
Check f Credit/Debit Card
Aggregate
Residential Street Address
Received
Amount of
Purchases
Event *
CT
Items Purchased
$o.oo
\,lane of Purchaser Last Name Firsl
'Individaals ONLY) {estdentral Street Address

ttems Purchased
MI
aip Code
Method of payment:
ii,Cash il
Porsonal
Check # Credit/Debit Card

vetrt #
Aggregate
Amount of
Purchases
-'rty
Jate Recerved
CT
$o.oo
! lrsl
{ame of Purchaser Last Neme
MI
)tate
hdividuak ONLI)
lesldenhal Street Address
tems ljurchased
Method of payment:
fr Cash fl:
Personal
Check
{l
Aggregate Credit/Debit Card
Amount of
Purchases
-lty
lip Code
Date Received
Event #
CT
$0.00
First
-'itv
Nane of Purchmer Last Narne
(Individaak ONLI)
MI
)Lat
Method of payment:
fr Castr f:
Zip Code
lJate Recerved
Personal
Check ; Credit/Debit Card
Aggregate
Amount of
Purchases
Resrdential Street Address
Event #
CT
tems Purchased
$0.00
Last
Nme of Purchasel (hrdividuals ONLI)
Nme
-'itv
Firsl hp Code
MI
Method of payment:
'Ji
'IAIC
Cash f
Personal
Check 'l
Aggregate
CrediUDebit Card
Amount of
Purchases
Resrdential Street Address
,ate Recelved
Event #
CT
Items Purchased
$0.00
Last Name
tsrrst
Nme of Purchaser (ndividaals ONLI)
M]
rtate
Method of payment: f-i' Cash f,,l: Perronut

Date Received
an.rO f.i
Aggregate
Credit/Debit Card
Amount of
Purchases
Kesrdentlal Street Address
.rry
Zip Code
lvent #
CT
Items Purchased
$0.00
First
{arne ofPurchaser Last Name Tndividuals ONLY) Kesldentlal Street Address

rrems Furchased
Method of payment:
f., Cash i.i,
Personal
Check f,
Aggregate
Credit/Debit Card
Amount of
Purchases
.irty
itafe
Zip Code
Date Kecerved
Event #
CT
$0.00
Name
/Individuals ONLI)
ofPurchaser LastNane
ilty
Firsl
ttare
Method of payment:
Kesldentlal Street Address

Items Purchased
fi Cash f,
Aggregate
Personal
Check #ri Credit/Debit
Card
Amount of
Purchases
Zip Code
Date Received
Event #
CT
$0.00
Last Narne
Nme of Purchaser (Indivitluals ONLI)
First
, rry
Method of payment:
il, Cash lii
Personal
g1'r*p
Aggregate
13, Credit/Debit Card
aesloenual Street Address

Items Prrrclrased
Amount of
Purchases
)IAIE
Zrp Code
ljate Recelved
Event #
CT $0"00
il
s,I,l:-B.To,T,"..l'..,$lg*;!tr,tll;,,r,.*qj
1:
::
$o.oo $0.00
$0.00
Tpf ,{Ij,Of
-:: ,
f FstDE
t::t
.1lf ionel,FCatjo.,t.L_.2.Pa$es
TOTAL OF ALL SMALL PURCHASES FROM TAG SALEi; LUCiTONS On Ornen SALES OF DONATED
tntnl nm I ino
I
riEnS
Pnotl
6h nf lnwwnm
{aMFoFC,oMM['TTrtl"t'
I ;;+tr;
j'.
II.
:] J :
FUNDRAISING EVENT ACTIVITY
Page 9 of 17
t t : ti
i,r .'
ii'
,'1,F.,-1,1
10/1112011
Name of Purchaser
buslncs! Date Received
See Attached
Street Address
Entity
City
State
Aggregate Purchases for All Events
Amount of
Purchase
Zip Code
CT
Narle of Purchaser
iil {i
Yes
Event #
$0.00
$1,100.H
Amount of
Purchase
No
Business Date Received
Entity
Street Address
lity
State
Zip Code
flt
CT
Nane of Purchaser
l,No
Yes
Event #
$0.00
Aggregate Ptlrchases for All Events
$0"00
Amount of
Purchase
Business
Date Received
Entity
Street Address
lity
State
Zip Code
4-l Yes
N
Event #
$0.00
Agglegate Purchases for All Events
$o.oo
Amount of
Purchase
CT
Name of Pnrchaser
No
Date Received
Business
Entity
Street Address
-1ty State
Zip Code
CT
Name of Purchaser
4t Yes f; No
Business
Event #
$0.00
$0.00
Amount of
Purchase
Date Received
Entity
Street Address
-rty
State
Zip Code
CT
Name of Purchaser
I tNo
fl
ves
Event #
$0.00
$0.00
Amount of
Purchase
Business
Date Received
Entity
Sfeet Ad&ess
liry
State
ZipCode
{li
'l-j
Yes
Event #
$0.00
Aggregate Purchases for Al1 Events
$0.00
Amount of
Purchase
CT
Nane of
Purchaser
No
Date Received
Business
Entity
Street Address
-lty
State
Zrp Cade
flJ Yes
Event #
CT
Name of Purchaser
iJ
No
Date Received
$0.00
$o.oo
Amount of
Purchase
Business
Entity
Street Address
lity
State
Zip Code
fl,
CT
Name of Purchaser
ft
Yes
Event #
No
Date Received
$0.00
Aggregate Purcbases for All Events
$0.00
Amount of
Purchase
Business
Entity
Street Address
:ity
State
Zip Code
t-.' Yes
Event #
$0"00
$0.00
Amount of
Purchase
CT
Nane of
PLrrchaser
'J'No
Business
Date Received
Entity
Street Ad&ess
lity
Stat
Zip Code
fi
Yes
Event #
CT
Name of Purchaser
ill, No
Business
Date Received
$0,00
Aggregate Purchaser for AII Events
$0.00
Amount of
Purchase
Entity
Street Address
City
State
Ztp Code
CT
Narne of Purchaser
lli
fi'Yes
No
Event #
$0.00
Aggregate Purchase for All Events
$0.00
Amount of
Purchase
Business
Date Received
Entity
Street Address
Jity
State
Zip Code
Yes
Event #
CT
#No
$0.00
$o.oo $1,100.Qfl g $o.oo
tb*u6h*ii:i*nnuiSUs
Ur:novnmrsrr'+c rN A pRocRAm noox?i"i,
t-
:ii.iiia=i6e iits ,ai'ni*jp;*3:
$1,100.qq
iri @
Jones for Senate 2006 Gampaign Committee
K(3) Purchase of Advertisement Space in Program Book

Name and Address Date
Received Amount 8t22t2011

Aggregate $250.00
Event #
A&A Auto 281 Bridgeport Ave Shelton , CT 06484
Contribution:
$100.00
$250.00
Blanchette Sporting Goods
8t22t2011
Aggregate
425 Bridgeport Ave

Shelton , CT 06484
Contribution:
$100'00
$100.00
Blueberry Farm 50 Birdseye St Unit 309 Stratford , CT 06615
Developers
811512011
Aggregate
Contribution:
$250.00
$100 00
Conner Printing
8t22t2011
Aggregate
226 Leavenworth Rd
Shelton , CT 06484
Contribution:
$250'00
$250.00
F&G
lndustrial
811512011
Aggregate
P.O. 46 Stratford , CT 06615
Contribution:
$50.00
$250.00
Frank Burdo and
8t22t2011
Aggregate
235 East Village Rd Shelton , CT 06484
Contribution:
$100.00
$50.00
Olderman and Hallihan 400 Main Street Ansonia , CT 06401
8t15t2011
Aggregate
Contribution:
$100.00
$ 1 ,1
00.00
page
*rd
II"
t:
FUNDRAISING EVENT ACTIVITY lfiiitfi{irn'i.i 6i4.#t

tvt t Izv
',Brufit irbti lt:fl$
given
I
Page 10 of 17
Name of Donor
ffi#$i
City
State
Donation .lllndividual
Fair Market
Value of Donation
Sona Bella Salon

Street Aooress
by: 6'
Business Entity
zrp Looe
Aggregate value for this event
187 Coram Ave

Descnption ol donation
Shelton
CT
06484
Date Recelved Event #
$0.00
09212011A.
n^ncti^n
given by:
$70.00
Hair Products Baskets - Door Prizes

Name of Donor
0912112011
i-) tndividrral
{*-}'.
Fair Market
Value of Donation
Business Entity
:ltreet Address
City
State
Zip Code
Aggregate valtre for this event
CT
Description of donation
Date Received Event #
$0'00
$0.00
Narne of Donor
Donation fllndividual
given
Fair Market
Value of Donation
by:
LJ Business Entity
Street Address
Sity
State
Zip Code
CT
Description of donation Jate Kecelved Evenl
$o'oo
$o.oo
Name of Donor
Donation
given
by: :l
::l lndividual
Business Entity
Fair Market
Value of Donation
Street Address
lify
State
Zip Code
CT
Date Recerved Event #
$0.00
$o.oo
Name ofDonor
Donation {t
given
by; il
Individual
Business Entity
Fair Market
Value of Donation
Street Address
City
State
Zip Code
CT
Description uf donation
s0.00
$o.oo
Name
of
Donor
Donation ii
given
by:
:iJ Business Entity
Individual
Fair Market
Value of Donatior
Street Address
City
Jtate
Zip Code
CT
$0.00
$o.oo
Nane ofDonor
zrp Looe
Donation
given
City
State
ti by: ii
tndividual
Business Entity
Fair Market
Value of Donatior
Street Address
\ggregate value for this event
CT
Descnption of donation )ate Received
Bvent #
$0.00
$0.00
Name
of
Donor
Donation {l.lndividual
given
Fair Market
Entify Value of Donation
by: [o Business
Jtreet Address
Sity
State
Zip Code
CT
ljescnption of donation
$0.00
$0.00
$70,00
tii l:::',:::=rli,;:i.ii
-,:,i::11
$0.00
c7n nn
.!
TII. NONMONETARY RECEIPTS

:
Name
Page
ll
of
17
1Ut11tzu'l
$l[+;li:!ir1;jirnitt
Type ofContributor: Individual Committee Other (Applicable onu to Referentlum Committees)
Fair Market
Value of this
itreet Address Is contributor a lobbyist, or dependent child ofa

)ate R-eceived
State
Zip Code
spouse, ll Yes lobbyist? .^' No

I^ +L:^ !urrLrruutrurl rJ rruJ ^^-r-:L,.+;^-
l''"
CT
?li fi ii
Contribution
tf contribL,tion is in excess of $400 to a candidate committee for a chief executive officer of
municipality does contributor or business he/she is.associated with have a contract with said a Yes {-*l No municipality valued at more than $5,000?
Description of tu-Kind Contribution L Aggregate contnbutrons
^--^îîÎ.,,;rLwrur a ^ oJUlrdLLu
fundraising event listed in Section
Ifyes" list Event

Name Sheet Address
#_
_
Ll?
No
Type ofContributor: Individual Cornmittee
$0.00
$0.00
Fair Market
Value of this
ttV
)l ate
Zip Code
Is contributor a lobbyist, or dependent child of a

Date Received
spouse, iln Yes lobbyist? ';i No
cornmittee for a chief executive officer of a municipality does contributor or business helshe is associated with have a contract with said ll, Yes No municipality valued at more than
CT ir i" eicess of $400 to a candidate tf.""trtb"ti*
lli 'fi Ii
Contribution
Other (Applicahle onl! to Referendum Committees)
$5.000?
ri
,: Is this contribution associated with a fundraising event listed in Section Ll? ii

Ifyes.
lisL Event #
Yes
Descriptron of In-Kind
ABgregate contfl Duhons
No
Type ofContributor: Individual Committee Other (Applicable anly
$0.00
$0.00
Fair Market
Value of this
Narne Street Address rty
Zip Code
ls contributor a lobbyist, or dependent child ola

Date Received
spouse, I lobbyist? '*'
Yes
No
a chief executive officer of a municipality, does contributor or business he/she is associated with have a contract with said Yes {1' No municipality valued at more than
CT If co"ttibrtt" tt t excess of $400 to a candidate committee for
f:, fr fr
Contribution
Referendum Com,nitiees)
$5,000? i'
ls this contribution associated with a fundraising event listed in Section L I ? Ifyes,list Event
#_
',:.
i}
Yes ttto
Description of In-Kind Contribution
A.ggregate con tn bu tlons
$0.00
Type ofContributor: Individual Committee Other (Applicoble onl! to Referendun Committees)
$0.00
Fair Market
Value of this
Nane
Street Address
State
Zio Code
CT
ls contributor a lobbyist,
i". f; {*;
Contribution
ordependentchildofalobbyist?
Date Received
spouse, d-: Yes lil; No
a chief executive officer of a municipality does contributor or business he/she is associated with have a contract with said .{]l Yes ,it No municipality valued at more than
tf -ntritrtlon is in excess of $400 to a candidate commiftee fbr
$5,000?
Is this contribution associated with fundraising event listed in Section L Ifyes.list Event
#_
a ii 1? !l
Yes
Description of ln-Kind Contribution
Aggregate confrlbutlons
No
Type ofContributor:
$0.00
Nane
Street Address
lar r iuarket
Value of this
litv
it ale
i.,
ZID Code
lndividual
Committee Other (Applicflble
onlJ)
Is contributor a lobbyist, or dependent child of a

Date Received
spouse, t: lobbyist? '*
Yes
No
officer of a """t.ib,x-t " municipality does contributor or business he/she is associated with have a contract with said l]. Yes t'-i No municipality valued at more than $5,000?
lf
CT ***cess of $400 to
fl,
f,.;
Contribution
to Referendum Commiuees)
a candidate committee for a chief executive
Is this contribution associated with a fundraising event listed in Section Ll? Ifyes.list Event
#_
it
Yes
Description of In-Kind Contnbution
Aggregate contfl butlons
No
$0.00
$0.00 $0.00
isuBtbiilL,seitiO'i
fi
M
Pages
il
ts:
Last Nane of Individual Firsl
{OfALrf irddifionhl.ssaiio* o*#ii*u+ibfii,'r#;lFiii,t'ii"Ei;;i'ti
$0.00 $0.00
|NOE: fhis sectio:n rderc anb lordtaryCe*.af dsposils,tJj.indiv-ifrialqfrom. petsonal.filnds lo ben Amount of Ml I Date Deposit Made
Deposit
Residential Street Address

Name of telephone cornpany Street Address
6
City
State
crl
State
Zio Code
Zip Code
$0.00
of
CT
totai s*tion,x'''{Entb'iioilst oi tine:zs
Sirywrv paseI
$0.00
.
III.
NONMONETARY RECEIPTS
10t1112011
.1.
Page 12
oflT
Tffi,'.H.
. .- ..I.'.' ":
::f, . l:,
, iHffi i;q'+$ffi
@ip,
;treet Address
- rO. Non-MonetaryReceipt$
l\x
of Organlzatlon r:,xpexolrr i, .f i.noi"totive i,eadershid! Lesislativ'e Caucus, and, Parti

Legislative caucus, and Paro Committees 0NLY) Name of Tremurer Date Notice Received
"
Fair Market Value

of Donation
City
Zip Code
Aggregate Donatjons
CT
)escription of Donation
$o oo
Purpose of .bxpendfiur e $ee
t*,
Pato committees 0NLY)
',lame of Treasurer
,t f'B fi C i;, g
Date Notice Recelved
u$tu crto Ls) f--t w
$0.00
Nu."
of
co..itt
ee (Legislative Leadership, Legislative caucns, and
itreet Ad&ess
State
Fair Market Value

of Donation
lity
Zip Code
Aggregate Donations
CT
$0'00
i* ,q, f* B f*'C ::' D {:'

oNLl)
Name of Treasurer
Prrpose of Expenditure (see instructions)
$0.00
N"ln"
"f
c"tr-tr *
(Legislative Leadership, Legislative caucus, and Party committees
itreet Address
State
Date Notice Received
Fair Market Value of Donation
lity
Zip Code
Aggregate Donations
CT
D-onati* Paily committees oNLY)
Name ofTreasurer
$0.00
ffi;F;onof
f.n { B t-'c f n 'l.l

Purpose of Expen dit\re (see instuctinns)
$0.00
Nu*" or co.lnin
ineet Address
ee (Legklative Leade$hip, Legistative caucus, and
Fair Market Value

of Donation
lity CT
Zip Code
\ggregate Donations
$0'00
Purpose of Expendilve (see
instuctions)
fil
Nme of Treasurer
{]rB f,c lli n
{1
$o.oo
N.."
"f
C.rnritt*
(Legislative Leadership, Legislative Caacus, a,td Parly Committees ONLY)
itreet Address
Fair Market Value of Donation
lity
Zip Code
Aggregate Donations
CT
)escription of Donatron
$o'oo
Purpose of Expendrt.$e (see instructions)
lA
Leadeiiip, tegislative
Caucus, and Party Committees ONLY)
- B ilc 'l'n flr
$o.oo
Nr"" rfCr..
itreet Address
Nane of TreasLrer
Fair Market Value

of Donation
)ity CT
Zip Code
\ggregate Donations
$0'00
Purpose of Expendit]UJe (see ittstructions)
ffiAptffi;i5*ti;
and Pat,) Comminees ONLY)
Name of Treasurer
'-",D'-'E -e .1B :C
$o.oo
Street Ad&ess
Fair Market Value

of Donation
lity
CT
Description of Donatiott
Zip Code
\ggregate Donations
s0.00
Prrrpose of Expenditlre (see ifistructioils)
'"a-B,c:-D-'E
Total Section O (Enter totnl on Line 24 of Summtry Pwe)
$0.00
$o.oo
IV.
" ..'',,. :,! , ,. -; t;:
,
EXPENDITURES
10111120"t1
Page 13 of 17
, ]
.l
*5;Ciilffi#i?ffi;ij'e,
)ate of Payment
Name of Pavee street Address
'
Metbod of Payment
Amount
PayPal lity
pfion
State
4ip Code
9t3012011
flr Check
Event #
#-_
{'', Debit Card
Purpose ot Expendlture (by code)
BNK
'
Fees to process on-line contributions

Candidate(s) Nane (if applicable)
fvpe of Expendilwe Qfapplicable): fl. Coordinated with reimbursement sought
Office Soughl
il
Supported
Oppose<i
fi f;
i*:
Coordinated without reimbursement sought Independent Organization (see I nstructions)
f',5'Y"' B
arne of Pavee
Street Address
g:,
C Cn ill:t
Jate or raylnell
s
Method ot Payment
tate
'13.60
'
Amount
Conner Printing
City
Zrp Code
7
t2712011
lii
226 Leavenworth Rd
rurpose or Expenorrure
(by
Shelton
ptron
CT
06484
Check
# 91 Debit card
Event #
code)
PRNT
Print Business Cards

Candidate(s) Narne
Iype of Expenditure ( if ilpplicable):

l"l: Coordinated with reimbursement sought i-i Coordinated without reimbursement sought
Office Soughl
U Supported
(tf tpplicable)
opposed
ii:
i-'lndependent Organization
(see
Instractions)
)ale of Payment
Name of Pavee Jtreet Address
!.:A r.-rB l.tc 'i-.rD iiE

Method of Payment Er check #-Q2 i-'i Debit Card
Event #
s
sl ate
166.95
Amount
Friends of John "Jack" Finn

City
alp Uode
7
t2712011
17 Princess Wenonah
H[rpose
(by
01 tsxpenolrure
Shelton
Description
CT
06484
code)
POC
Printing Joint Literature

Candidate(s) Nane
Type of Expenditt$e (if applicable): ,a Coordinated with reimbursement sought iJ Coordinated without reimbursement iught 1i Independent
Office Sougltt
lJ
(dapplictule)
Supported
opposed
fl
Organization
vee
(see
Instructions)
)ate ot Paymenl
i-Af,Bt-,C,*'D1l't
Metnod oI Hayment
',fir Check
s
)tate
Zip Code
100.00
Amount
Conner Printing
City
)reet
Adoress
812212011
226 Leavenworth Rd
rurpose oI gxpcnqltule
(by
Shelton
Descriotion
CT Labels, Flyers
06484
lJ
# Q3 Debit card
code)
PRNT
(if opplicflble):
'
Event #
T.ype
of Expenditwe
Candidate(s) Name
Office Sought
n
E
Coordinated wilh reimbursement sought [J. Coordinated without reimbursement sought 3"i Independent
lJ
(tf applicftle)
Supported Opposed
l:) Organization
Name
-A i".B f C .*tO r.e

)ate of Paymenl
(see I nstructions)
s
Method of Payment
State
252.05
Amount
of
Payee
Holy Ghost Park

Jtr99l AOOIeSS
Clty
,rp Looe
812212011
f, Check#
94
70 Nells Rock Rd
rurpose ol bxpendtture
(by
Shelton
Dtlon
CT
06484
{*: Debit Card 091 0201

1
code)
of Expenditure
FNDR
(if applicflble):
Rental of Park
Candidate(s) Name
Ty-pe
Office Sought
Supported
'J Coordinated without reimbursement sought ',l],lndependent

i'.) Organization . (see Instructions)
t-l Coordinated with reimbursement sought
(if applirable)
nOpposed
i'A
t:
!B
!t_.il
^ C t; D
l._, E
s
SUBTOTAL Section P-This Page TOTAL of additional Secfion P Pages
50.00 $s82.60 $0,00 $582.60
TOTAI. Onar"r, EXPENSES FAIff BY,eoUnalfrEn,lrn&t,Jaral'ot.'Lilte..I9,of,,$aqtwry.Page),
V.
EXPENDITTJRES
10t11t2011
Page 13 of 17
ilFffi.Klr.?,
;ni
ffi
t!/l:i
?!
Name ofPayee )Eeet Adoress
:i:
:;
:n ::)ttitjl:::i!. iii ;ir l;:i:::= aiii !:i
'
Ferguson and McGuire lnsurance

City
itate Zip Code
)ate ofPayment
Method of PaYment
Amount
812612011
rf
Check
# 95
32 HuntingtonPlaza
Purpose ot t xpenolture (by code)
Shelton
ption
CT
06484
f,' n.uit ciro

Event #
FNDR
lnsurance for Fundraiser

Candidate(s) Name
0910201 1A
Office Sought
Ivoe of Expenditure (if applicable):

'l*: Coordinated with reimbursement sought
Ll
(ij spplicable)
Suppofteo opposed
{i f:
Coordinated without reimbursement sought Independent

(see
{1 Organization
Name of Pavee Street Address
'
fla
Instructions) 'f-.
B f.j:c r: o f;n
City
!fate Lry Code
104.00
)ate ot Payrnenl
Method oI raymenl
Amount
City Stitchers
812612011
f,
101 Elizabeth Street

PurPose or Expenornre (by
Derby
otlon
CT
0641 I
Check #- 96 t;r Debit Card
Event #
code)
A-OTH
Tee Shirts
Candidate(s) Nane
fype of Expenditure (if applicable): li: Coordinated with reimbursement sought
Office Sought
Supported
(dapplicable)
lopposed
f, Coordinated
il.
without reimbursement sought

(see
f'
Independent
Organization
Name of Pavee Street Address
,-A r-:B '.C {,D
Instructions)
300.00 J*'E
)ate ofPayment
Method ofPayment
Amount
Holy Ghost Park

City
State
Z,lp
Code
th5t2a11
70 Nells Rock Rd
yurpose oI Bxpendlture
(by
Shelton
)escrintion
CT Park Rental
06484
f'
lfi chect + 97
Debit Card
code)
FNDR
applicable):
'
Event #
Iype of Expenditwe (if
Candidate(s) Name
Office Sought
fi Coordinated f: Coordinated
f,,i:
with reimbursemont sought without reimbursement sought

(see I nstructions)
(ifapplicable)
LJ Supporteo D opposed
!*'r Independent
Organization
q*, Nane of Pavee

Street Address
I f .B
flr
C fln 1 r
City
State
$
)ate ot Payment
400.00
Amounl
'
Method oI Payment
City Stitchers
l,lp Code
9t15t2011
iilChect+ 98
101 Elizabeth Street

nlrpose oI b,xpenolrure
(by
Derby
CT Tee Shirts
Cmdidate(s) Name
06418
t,
Debit Card
code)
A-OTH
'
Dtlon
Evenl #
Type of Expenditwe (if applicable): lfl Coordinated with reimbursement sought IS, Coordinated without reimbursement sought lfr Independent
Office Soughl
(if applicable)
LJ Supported D opposed
l{t Organization
Name
(see
Instructions)
)ate of Payment
324.00
Method of Payment
{rl f: B f:c .f.n il; o

of
Pavee
Amount
Conner Printing
Cr ty
)reer Aodress
il ate
CT Flyers
Candidatels) Nane (if applicable)
Zip Code
9t2512011
,f,
Chect< +-
99
226 Leavenworth Rd
rupose oI Lxpenollule
(by
Shelton
ptlon
06484
{li
Debit Card
Event #
code)
PRNT
09212011A
Office Sougltt
fype of Expenditure (if applicable)'. i:i Coordinated with reimbursement sought ',i Coordinated without reimbursement sought
Supported
!Opposed
i*i Independent
ill
Organization
i",',n !.iB i:: C i:D tl

l9:;
(see
Insttuctions)
s
E
42.54 $1,170.54 $0.00 $1,170.s4
TV. EXPENDITURES
i$j;r:-.';ldilf .iil ;
10t11t2011
l-...
.
Page 13
of17
rr;
t)itj:t!:t:.trN
it
i?i
Name of Pavee Street Addre
'
)ate of Payment
Method of Payment
Amount
Peoples United Bank

:iiry
1000 Bridgeport Ave

rurpose or Expelr0lurE (bv
Shelton
DescriDtion
code)
BNK
'
lcr
lState
Zry Code
911412011
{- necK #
06484
fll, Debit Card

Event #
Bank Fee, Checks

Candidate(s) Narne
fype of Expendit]ul'e ( i! applicdble):
Office Sought
d:
fi
fl'
Coordrnated with reimbursement sought Coordinated without reimbursement sought

Independent
(ifapplicable)
n n
Supported opposed
!-1;
Organization
(see
Instructions)
)ate of Payment Zip Code
fl A ll: B f:C il: O i'1. E

Cify )escription Office Sought
rtate
s
Method ot Payment
47.10
Amount
Narne of Payee Street Address
f;Check
Event #
#-
CT
Prrpose ot bxpenolilre (by code)
lli oebit card
lype of Expenditure (ij spplicable):

i..t Coordinated with reimbursement sought ill Coordinated without reimbursement sought {lr Independent
i'*-;
Candidate(s) Name
LJ Supported
(ifapplicable)
opposed
Organization
(see
:'jA i.-lB 1,,C {.D i.rE

Date of Pavment
Instructions)
s
Vethod of Payment
.rJ Check #, )tate
4rp Code
0.00
Amounl
Narne of Payee Street Address
City
CT
Purpose 01 bxpendrtue
f'
Office Sought
Debit Card
)mpiion
Candidate(s) Name (d applicable)
Event #
(by code)
Type of ExpenditlJe ( il applicable) : il; Coordinated with reimbursement sought lLl Coordinated without reimbursement sought f;l Independent
:*1
Ll Supported
Opposed
Organization
(see
f. l {i. B ,',C :^ n ji,E

)ate of Payment Ulty
Description
Jtate
Instructions)
s
Method of Payment
{i-. Check
0.00
Amount
Name of Pavee Street Address ,rp_Lode
CT
flrrpose oI txpenorrure
(bi, code)
l,
Office Sought
#-
Debit Card
Event #
Type of Expenditure (if applicable): :'lJ, Coordinated with reimbursement sought Coordinated without reimbursement sought Independent
Candidate(s) Name
il
E
(ifapplicahle)
Supported opposed
fi ll
3.'-i
Organization of
Payee
(see
Instructions)
frl ,1 B {::C
Name
Street Address
.f-tO
f*
s
e,
0.00
Amounl
Jate ofPayment
Method of Payment ;fl. Check il:OeUit Card

Event #
City )escription
)tate
zlp Lode
#--
CT
rurp0se 01 txpenoltlfe (by code)
Iype of Expenditve (if applicable):
1 Coordinated
wjth reimbursement sought
Candidate(s) Name (if qpplic0ble)
Office Sought
LJ Supporteo
EOpposed
il
!3: Coordinated without reimbursement sought
Independent
l',i Organization
!'':'A r-f B
(see I nstructions)
il:;
i. r
D {::
E
11
$
SUBTOTAL Section P-This Page
0.00
$47.1 0
'
TOTAL of additional Section P Pages

'o{sumnaw.. P'a*:)
$0.00
$47.1 0
rc:ril
oB
LEXPTNSEs
rarn sYion'{11{tfl.r;n,{Ettter,:lit*:ap Line-l
TV. EXPENDITURES
Ptge 14 of
17
1An1tzAr
$$udfiffiimh1$,*liai*#iffiri+;,:3a
Narne
ra
Is Reimbursement Claimed?
l it Yes {i No
Hvent #
iriii:r,iili
of
Payee /Name
of Vendor who candid\te paid dircctl!)
Date ofPayment
Amount
itreet Address
Purpose ot LKpendlture (by code)
lity
Description
)tate
41p Code
CT
$0.00
Name of Payee (Name of Vendor who candidate paid directly)

Street Adffess
Date of Payment
Amount
-lty
Description
State
1ip Code
CT
rupuse or Dxpgrrurturs
(by code) Name of Payee (Name Street Address bvent #
fli
f-r
Yes
No
$o.oo
ol
Vendor who candidale paid directlJ,)
Date of Payment
{^.,. Yes
Amount
-rty
Descnption
ital e
Zrp C ode
CT
rurpose or ExpencrRrre (by code)
Event #
'*
No
$0.00
Name of Payee (Name of Vendor who candidale paid dbectlj) Street Address
IJate oI Payment
Amount
3ity
)tale
Zip Code
i]
l_*r
Yes
CT
rurpose or rxpenorrore (by code)
Description Event #
No
$o.oo
Name of Payee lNc me of Vendor who condidale paid ditectly) Street Address
Date of Paynent
Amount
!rty
Description
itate
Zip Code
i3
i,i
Event #
Yes
Nro
CT
rlrpose ol
(by code) bxpendrture
$0.00
Name of Payee (Na,ne of Vendor who csndidate paid dbectly)

Street Address
Date of Palmenl
Amount
lify
Descnption
State
Ztp Code
il'
fl,
Event #
Yes
CT
rurpose oI Expenorure (by code) Name of Payee
{A
No
$0.00
ame of Vendor who cattdidate poid directly) Urty

State
Date of Payment
Amount
sfeet Address
rurpose ot bxpendlture
(by code)
Zip Code
Event #
CT
Descnption
f:
i*r
Yes
No
$0.00
Name
Sfieet Address
Date of Paymenl
ls Reimbursement Claimed?
Amount
City
)tate
Ztp Code
CT
rulJose
oT
fi il
Event #
Yes
No
$0.00
Expencrnlre
Description
(by code)
Narne of Payee (Na me of Verrdor who candidale Street Address
ptid directly)
Date of Paymenl
ls Reimbursement Claimed?
Amount
lity
Description
)taIe
Zrp Code Event #
CT
Purpose 01 bxpendrture
fi Yes fiNo
$o.oo
(by code)
$0.00
rij=,i 1,1 t i.-::rif..,
t''.,::,:i''l'.il
''li l.iiia!:j
TOT,AL of additicna! Section Q Pages
$0,00 $0.00
roiAi'o; Art ;iinNits+ern
a*:
clrvp-ii'
ffi
l:::::i:i;
TV" EXPENDITURES
10t11t2011
Page 15 of 17
Name of Issuing Institution
Type ofCredit Card:
Cl
Visa f.
other
Master
Card f;" Discover
{*-:
American Express
il
Name of Vendor
State
Date of Transaction
Amount
Street Address
City
1ip Code
CT
Purpose of Expenditure (by code) Name Description Event #
$0.00
of
Vendor
Date ofTransaction
Amount
Street Address
City
State
1ip Code
CT
Pnrpose of Expendiftlre (by code)
$0.00
Event #
)escription
Nme of
Vendor
Date of Transaction
Amount
Street Address
City
State
lip Code
CT
Purpose of Expendihrre (by code) Name ofVendor
$0.00
Event #
)escription
Date of Transaction
Amount
Street Address
City
State
1ip Code
CT
Purpose of Expenditure Description Event #
$o.oo
(by code) Name of Vendor

Date of Transaction
Amount
Street Address
City
State
Zip Code
CT
Purpose ofExpenditure
)escription
Event #
$o.oo
(by code)
Name ofVendor Date of Trmsaction
Amount
Street Address
City
State
Zip Code
CT
Purpose ofExpenditure (by code) Name
$0.00
Event #
)escription
of
Vendor
Date of Trmsaction
Amount
Sfreet Address
City
State
1ip Code
CT
Prrpose ofExpenditure (by code)
Name
$o.oo
Event #
)escription
of
Vendor
Date of Trmsaction
Amount
Street Address
City
State
Zip Code
CT
Purpose of Expenditure Description Event #
$0.00
.::.j
(by code)
.i, . , ,::.:.rr..::::it.t:::.:a.:
::
:.
::::.::
StI
BTTAF :seeiioii iRrT:q.LFqgi
q.o nn
TOTAL-of adA!$
$0.00 $0.00
tO:rnl,oFalu-nxppNsEdriNcuRRtD bNcOMMirTEEr.r.:wDlT CA&D.(Eiiieirbiilt on Lihb27 bf sumtiinn''P$se|
.. I
ffi
IV. EXPENDITURES
:F
Page 16 of 1?
10t11t20
Narne of Creditor
Date Incuned
Amount lncurred
(Estimate or Actual)
Street Address
Event #
City
State
Zip Code
Candidate(s) Name
(iftpplicable)
ottrce Sought
CT
t'urpose oI LXpenor[lle (by code)
Jescn ptron
Twne nf Fvncndittre
t ;
f annli?n hlal'
i-j
Coordinated with reimbursement sought Coordinated without reimbursement sought

Independent Organizatio!.! (see
*i
.*
{-'A'rB
Instucti,onsl
* ' C {.D{
liisuppott"d
1-:Opposed E Date Incuned
$0.00
Amount Incurred
(Estimate ot Actual)
Narne of Creditor
Street Address
Event #
City
State
Zip Code
janaiaate(s)
Nrn"
((appticahle)
office Sought
CT
Purpose of Expenditure (by code)
Type of Expenditlre (if flpplicable): i*, Coordinated with reimbursement sought jl.. Coordinated without reimbursement sought
Description
t. L
Independent
Organizatio!. (see Inslructions)
* i''A t B{.C i Di.E
lJ Supported lj,lpposed
Date Incuned
$0.00
Amount Incurred
(Estimate or Actual)
Name of Creditor
Street Address
Event #
City
State
Zip Code
Cmdidate(s) Name (if
applicable)
Office Sought
CT
Purpose of Expenditure (by code)
Type of Expenditure (if rp plicable): Coordinated with reimbursement sought Coordinated without reimbursement sought
:j fi
Jescilptlon
L.
Independent
,l. Orgalizatiol $ee Instuctions) *. -1,"1
fi:supported
.l
n-
B r_'C ,-
D {-.
iJlpposed
E Date lncrrned
$0.00
Amounf lncurrer
(Estintate or Actttfll)
Name of Creditor
Street Address
Event #
City
State
Zip Code
lindidate(s) Narne
(ifappticabte)
Office Soughl
CT
:urpose ot Expeildlture by code) Descnption
'ype of Expenditwe (if applicable): {.,r Coordinated with reimbursement sought Coordinated without reimbursement sought f-l Independent n*. Organization (see Instntctions) _.
f.
i " Supported
i*.3pposed
.l
$0.00
""'A ;- B .lC "- D.{
suBToiAi
s*ction
:r. s-ihis rag;'

S
$0.00 $o.oo $0.00

+
TOTAL of addiiion4l Section
',..
Paies
ro:.,,.1 o.FAI-fiT,'19'E!'SIs INCURRED BY COMMITTEE

,:.
DURTNG THIS PERIOD BUT NOT PAID (Enter tolal on Lifte 28 of Sunyrutry Page)
n.pa; $rUla',ani
tn,r*l;nn',ai,r.,nxpnfiSnql,iruCilndgn,nv'c.o*rMit?Ef:BgT:Nbr,irylD(Ente,rtitalonLineeSn:
,o 1iti
'
$0.00 $0.00
"
:
6
TV. EXPEN'DITURES
\4I Date of Parment
Page 17 of 17
10t11t2011
Last Narne of Worker/Consultant
First
Method of Payment
Amount
iecondaru Pavee
)urpose of Expenditure bv code)
f: f:
Check Debit Card
#-----
Street Address
City
Zip Code
CT
Description
Type of Expenditrtre (if applicahle)'. . Coordinated with reimbursement sought 1l: Coordinated without reimbursement sought f-f Independent
CandidateG) Name
Office Sought
l.,l;
(if aoplicablel
Supported Opposed
Organization
':4 fii B ttc:
(see
Inslructions)
'f: D 3;
E
First
s
M]
Date of Pavment
$0.00
Last Name of Worker/Consultant
Method of Payment
Amounl
iecondary Pa"ee
lurpose of Expendlture 'by code)
'ii
Check #
# oetit
Zip Code
cara
Street Address
City
CT
Description
Type of ExpenditLre ( d applicable): lili:Coordinated with reimbursement sought if.jr Coordinated without reimbursement sought f,, Independent
Candidate(s) Name (d applicable)
Office Sought
ilr Supported
flr Opposed
,fi Organization *
:':
(see
Instructions) a t R '!,c {^ D (* E
First vII
Date of Pavrnent
s
Method of Payment
)urpose of Expendlture by code)
$0.00
Last Name of Worker/Consultalt
Amount
Secondary Pa;cc
lflicheck
f" t nebit Zip Code
#
card
Street Address
City
State
CT
Tyne of Expendinne gf ap plic able) | f.l Coordinated with reimbursement sought fl' Coordinated without reimbursement sought 4 Independent
Candidate(s)
Nme
Office Sought
fr;Supported
(if applicable)
fiOpposed
Organization
i*;A iB
(see
Instructions)
r*,c f- nrÊ
First
$
MI
Date of Pavment
$0.00
Last Nane of Worker/Consultant
Method of Payment
Amount
Secondary Pa;,ee
Purpose ot Expendlture
iby code)
Street Address
il
Check #
i)'Debit card
ZipCode
City
state
Description
Type of Expendilure (if opplicable): 'il'r Coordinated with reimbursement sought il. il Coordinated without reimbursement sought :*r Independent
Candidate(s) Nane
Office Sought
(if applicable)
j-*t oPPosed
'{j
Supported
r'
Organization (see Inslructions)
i",:
A :i, B
{'j
:i',
D :i'i E
ri.,:.-r,i.;:r:::i ; ii.,,ij:=;la::t,,:-*l:::1..::r t::rt ij:i::":,:ij:,:,:
s
fOfAf"
fi:i I
$0.00 $0.00
of.aCO,iiionaf,secUon T Pages
.:'::..-l-1 :j,=,trtill: ll::::1,1, I
tr:,f
$0.00 $0.00
iiir
T('T^L
T:
ALL IEIMBU RSEMPXTS f
O COMMITTEE WORKERS .NND CONSULTANTS:

Jones Finance

Uploaded by

Document Information

Original Description:

Copyright

Available Formats

Share this document

Share or Embed Document

Sharing Options

Did you find this document useful?

Is this content inappropriate?

Copyright:

Available Formats

Jones Finance

Uploaded by

Copyright:

Available Formats

SEEC FORM 20

Itemized Campaign Finance Disclosure Statement

65 Walnut Tree Hill Rd 11t08t2011

7th day preceding referendum

Ciltri bufi oin#r Dirbur..t.nr tf/csoNLY$

30 days following primary 7th day preceding election

; 45 days following referendum

,li' October l0 fi1ing

day preceding election

(State Ceiltral Commifiees OnlJ))

In-dependent Expen diture {=r Election 'l-

days following election not held in November

PRINT NAME OF SIGNER

Chris Jones for Shelton

i:1! ;,::4.:= i;;1j | ; ;aJ :

$6,795.00 $0.00 $0.00 $o.oo $0.00 $1,100.00 $7,895.00 $9,920.00 $1,800.25

$7,520.00 $1,300.00 $0.00 $0,00 $0.00 $1,100.00 $9,920.00

Town Committees ONLY

Municipal and Town

a Prosram Book (Section L3) Comnittees

Subtotals (add totals in line 12 +

A; and in line I 1 + l7 in Column B)

19. Expenses Paid by Committee (Section

20. Balance on hand at close of Reporting Period (Subtract line

from line l8 in both Columns)

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

22. In-Kind Contributions Received (Section M)

$0.00 $0.00 $0.00 $0.00 $0.00

23. Refundable Deposit to Telephone Company (Section N)

25. Beeinnine Loan Balance

Lorn" Received /section l-))

25d. Total Outstanding Loan Amount

MONETARY RECEIPTS (Sections A-K)

Chris Jones for Shelton 4..:r Tb--f,4l,C-ontiibutioriKl #,ofii:SlliiitfX..CoiltFlibuidr$rB+*biv.*ffthi$;fCf,i6.d,$NL$i

;; . ,: ' : , tiiii.{ Bliii,Iit-lilJtB'd:,

i,', "' '1:i-bttalSectionI $ :.;,rt , _ , ] t ,hiitiiiiiE'rff6iflllnfli ' iltihl$iri';',,i;iri

Method of contribution: il; Cash .{l: Personal Check

spouse, ,iL Yes f No

fundraising event listed in Section fyes. list Evenr # Method of contribution:

Deduction E: Money Order

Kesldentlal Street Address

il, .f: a Ll?

Check .l,]' CrediVDebit Card

{esldential Street Address

If contribution is in excess of$400 to a candidate committee for

a contract with said

fundraising event listed in Section fyes, list Event # Method of contribution:

if*rl Yes a L1? #l No

$ll'i Personal Check {l

of adaitionat Seciion n Fafes

iA;1i[1[1ffipp7a.1s of Sumiary prye)

Chris Jones for Shelton 2011 Campaign Committee

B.Contributions from lndividuals over $50 in the Aggregate

1---l Lobuyist Dependent

811712011 Credit Card

Name Bonitatebus, Joseph

Contribution associated with

812212011 Personal Check Aggregate Conkibution:

Name Bragg, Henriette 85 Park Ave Shelton , CT 06484

EventNumber: 091 0201 1A

Contribution associated with

812912011 Personal Check Aggregate Contribution:

Contribution associated with

Chris Jones for Shelton 4..:r Tb--f,4l,C-ontiibutioriKl #,ofii:SlliiitfX..CoiltFlibuidr$rB+biv.ffthi$;fCf,i6.d,$NL$i