SCHEDULE 1-A
Contributions Including Loans from Individuals
IN-KIND CONDUIT DATE LAST FIRST ADDRESS CITY ST ZIP OCCUPATION AMOUNT YTD
01/26/21 Rodgers Kelly 5850 Charon Ln 104 Madison WI 53718 $ 100.00 $ 100.00 01/26/21 Strayhorn Home 362 Lyonnais Dr. St. Louis MO 63141 $ 25.00 $ 25.00 01/26/21 Foster Susan 5373 E Wheatland Vincennes IN 47591 $ 25.00 $ 25.00 01/26/21 Tramel Lynn 220 W.Stonegate Rd. Peoria IL 61614 Retired $ 250.00 $ 250.00 01/26/21 Tramel Roger 220 W. Stonegate Rd. Peoria IL 61614 Retired $ 250.00 $ 250.00 01/26/21 Yeager benjamin 3730 N hermitage ave Chicago IL 60613 $ 100.00 $ 100.00 01/26/21 Tramel Drew 807 N Main Street Wheaton IL 60187 $ 100.00 $ 100.00 01/26/21 Reyes Christine 2643 West Washington Blvd Chicago IL 60612 $ 100.00 $ 100.00 01/26/21 Howard Scott 930 Rogers St Downers Grove IL 60515 $ 100.00 $ 100.00 01/26/21 Brock Joanne 5308 Cumnor Rd Downers Grove IL 60515 $ 100.00 $ 100.00 01/27/21 Nelson John 5407 north Kenwood ave Indianapolis IN 46208 $ 200.00 $ 200.00 01/27/21 Schober Lindsey 5953 38th Ave SW Seattle WA 98126 $ 100.00 $ 100.00 01/28/21 Gehrke Michael 5709 Indian trace Madison WI 53716 $ 50.00 $ 50.00 01/28/21 Rankins Jonathan 2321 Albion Pl St. Louis MO 63104 $ 100.00 $ 100.00 01/28/21 Montana Erin 537 Davis Downers Grove IL 60515-3057 $ 100.00 $ 100.00 01/28/21 Bagel John 4430 N Clark #508 Chicago IL 60649 $ 99.00 $ 99.00 01/29/21 Lalor Tom 5701 Indian Trace Madison WI 53716 $ 50.00 $ 50.00 01/29/21 Halter Michael 1006 Eddy Ct. Wheaton IL 60187 $ 100.00 $ 100.00 01/29/21 Beach Michael Ave Chicago IL 60647 $ 100.00 $ 100.00 01/29/21 Wagner Dan 1926 Hampton Drive Wheaton IL 60189 $ 100.00 $ 100.00 01/29/21 Liegel Simon S11960 Williams Rd Spring Green WI 53588 $ 100.00 $ 100.00 01/29/21 Oakley Paul 1906 Glen Echo Rd. #150373 Nashville TN 37215
President of Tiny Might
Communications $ 500.00 $ 500.00 01/30/21 Ewald Matthew 621 Flock Avenue Naperville IL 60565 $ 100.00 $ 100.00 01/31/21 Blase Michael 2324 Oakton st. Apt 2 Park Ridge IL 60068 $ 25.00 $ 25.00 01/31/21 Myers Brandon 5714 Indian Trce Madison WI 53716 $ 100.00 $ 100.00
01/31/21 Carlson Kevin 1835 W Eddy St Chicago IL 60657 $ 100.00 $ 100.00 01/31/21 Ewan Eric 1914 Jessica Ct Wheaton IL 60187 $ 50.00 $ 50.00 01/31/21 Jennings John 808 Adams St. Lockport IL 60441 $ 100.00 $ 100.00
SCHEDULE 1-B
Contributions from Committees
SCHEDULE 1-C
Other Income and Commercial Loans
SCHEDULE 2-A
Gross Expenditures
SCHEDULE 2-B
Contributions to Committees
SCHEDULE 3-A
Incurred Obligations Excluding Loans
DATE NAME ADDRESS CITY ST ZIP PURPOSE
Outstanding Balance Beg of Period
New Obligations
SCHEDULE 3-B
Loans: Individual, Committee or Commercial
DATE NAME ADDRESS CITY ST ZIP
Outstanding Balance Beg
of Period This PeriodNew Loans
Cumulative Payments This
Period
Outstanding Balance End
of Period Name and AddressGuarantor (if any)
$ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ -
SCHEDULE 4
·
·
·
·
·
DATEDATE Endorser, Guarantor, or Creditor AMOUNT
LOAN OR DEBT FORGIVENESS
I hereby forgive all personal loans or have assumed responsibility for any and all debts of my campaign committee.
A committee may terminate its registration and reporting requirements if the committee will no longer receive contributions, make disbursements or incur obligations, and the obligations and cash balance have been reduced to zero.
Candidates may not terminate prior to the election in which they are participating.
Please read carefully and, if necessary, indicate how residual committee funds have been disposed of or if outstanding loans or obligations have been forgiven. Sign and date the termination request at the bottom of this page.
Make sure the termination box on the cover page of this report is checked.
Please note: An audit must be completed and all obligations, including settlement offers, fulfilled before termination can be granted. All records must be maintained until 3 years after the date of an election in which the registrant participates, even if termination is granted. (Per Wis. Stats. 11.0201(4), 11.0301(4), 11.0401(4), 11.0501(4), 11.0601(4), 11.0801(4), 11.0901(4))
DISPOSAL OF RESIDUAL FUNDS
RECIPIENT
TERMINATION REQUEST
THIS INFORMATION SHOULD ALSO BE INCLUDED ON SCHEDULE 2-A AND/OR 2-B.
AMOUNT
TERMINATION REQUEST. I hereby request that the committee registration be terminated. I declare that the committee has not incurred any obligations and does not anticipate incurring any. The committee does not anticipate receiving any further contributions or making any disbursements. I further state that the cash balance has been reduced to zero and that all remaining funds have been disposed of in the manner prescribed by law.
