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8/6/2019 Kerekes SEEC Filing July 10
1/46
SEEC FORM 20
Itemized Campaign Finance Disclosure Statement
Rev. 1/08
Office Use OnlyCONNECTICUT STATE ELECTIONS ENFORCEMENT COMMISSION
Electronic Filing
Page 1 of 46
SUMMARY PAGE
1. NAME OF COMMITTEE
2. TREASURER NAME
Committee To Elect Jeffrey Kerekes
3. TREASURER ADDRESS
4. ELECTION DATE
7. CANDIDATE NAME
8. TYPE OF REPORT
9. PERIOD COVERED
10. CERTIFICATION
5. OFFICE SOUGHT (if applicable) 6. DISTRICT CODE (if applicable)
Title
Title
First
First
MI
MI
Last
Last
Suffix
Suffix
Street Address City State Zip Code
harry I David
441 Chapel St Apt 1-6 New Haven CT 06511-5844
Mayor
Mr Jeffrey P Kerekes
July 10 Filing - Original
Beginning Date Ending Date
06/04/2011 thru 06/30/2011
I hereby certify and state, under penalties of false statement, that all of the information set forth on this
Itemized Campaign Finance Disclosure Statement for the period covered is true, accurate and
complete.
PRINT NAME OF THE SIGNER DATE CERTIFIED
07/08/2011 10:20:49 am
PENALTY FOR FALSE STATEMENT IS PUNISHABLE BY FINE NOT TO EXCEED $1,000,
OR IMPRISONMENT FOR NOT MORE THAN ONE YEAR, OR BOTH.
SIGNATURE
Electronic Filing harry David
8/6/2019 Kerekes SEEC Filing July 10
2/46
Page 2 of 46
SUMMARY PAGE
SEEC FORM 20Itemized Campaign Finance Disclosure Statement
CONNECTICUT STATE ELECTIONS ENFORCEMENT COMMISSION
Rev. 1/08
TOTALS
NAME OF COMMITTEE FILING DUE DATE
COLUMN A
This Period
COLUMN B
Aggregate
11. Balance on hand January 1 of current year for Ongoing and Party
Committees OR Balance on hand from day Committee was formed for all other
12. Balance on hand at the beginning of Reporting Period
13. Contributions received from Individuals (Section A and B)
14. Receipts from Other Committees (Sections C1 + C2)
15. Other Monetary Receipts (Section D-K)
16c. Total Purchases of Advertising in a Program Book (Section L3)
18. Subtotals (add totals in line 12 + line 17 in Column A and in line 11 + 17 in Column B)
19. Expenses Paid by Committee (Section P)
16b. Total Proceeds from Small purchases at Tag Sales, Auctions or Other Sales (Section L2)
20. Balance on hand at close of Reporting Period (Subtract line 19 from line 18)
21. In-Kind Donations not Considered Contributions Received (Section L4)
22. In-Kind Contributions Received (Section M)
23. Refundable Deposit to Telephone Company (Section N)
24. Receipts of Organization Expenditures (Section O)
25. Beginning Loan Balance
25a. + Loans Received (Section D)
25b. + Interest and Penalties on Loan(s)
25c. - Payments on Loan(s)
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 by Committee During this Period but Not Paid (Section S)
28a. Total Outstanding Expenses Incurred by Committee still Unpaid (Section S)
$0.00
$0.00
$2,875.00 $2,875.00
$0.00 $0.00
$0.00 $0.00
16a. Total Small Food and Beverage Receipts at Fair (Section L1)
17. Total Monetary Receipts (add totals for lines 13-16c)
$0.00 $0.00
$0.00 $0.00
$0.00 $0.00
$2,875.00 $2,875.00
$525.16 $525.16
$0.00 $0.00
$0.00 $0.00
$0.00 $0.00
$0.00 $0.00
$0.00 $0.00
$0.00 $0.00
$0.00 $0.00
$0.00 $0.00
$0.00 $0.00
$0.00 $0.00
$0.00 $0.00
$3,095.91
$3,095.91
$2,875.00 $2,875.00
Committee To Elect Jeffrey Kerekes Original 07/11/2011
$2,349.84 $2,349.84
8/6/2019 Kerekes SEEC Filing July 10
3/46
Page 3 of 46
I. MONETARY RECEIPTS (Section A-K)
AME OF COMMITTEE FILING DUE DATE
Committee To Elect Jeffrey Kerekes Original 07/11/2011
A. Total Contributions from Small Contributors-Received this Period ONLY
(See instructions for definition of Small Contributor) Subtotal Section $0.00
B. Itemized Contributions from Individuals
First Name MI
Jeffrey
Residential Street Address
43 Lyon St
City
New Haven
State Zip Code
CT 06511
Date Received
06/12/2011
Principal Occupation
Name of Employer
Is this contribution associated with afundraising event listed in Section L1?
Yes
NoIf yes, list Event #
Is contributor a lobbyist, spouse,
or dependent child of a lobbyist?
Aggregate Contribution
$10.00
Amount of
Contribution
$10.00
Last Name
Kerekes
_ Cash _ Money Order_ Personal Check Credit/Debit CardX
Yes_
NoX
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 associated with have a
contract with said municipality valued at more than $5000?
_
Yes
X
No
Is contributor a principal of state contractor or prospective state contractor?
If yes, indicate which branch or branches of
government the contract is with:
_
Yes No
_
_ Executive Legislative_
_ Payroll Deduction
Method of Contribution
_
X
First Name MI
Tim
Residential Street Address
483 Central Ave
City
New Haven
State Zip Code
CT 06515
Date Received
06/14/2011
Principal Occupation
Name of Employer
Is this contribution associated with a
fundraising event listed in Section L1?Yes
NoIf yes, list Event #
Broadstripes, LLC
Software Developer
Is contributor a lobbyist, spouse,
or dependent child of a lobbyist?
Aggregate Contribution
$100.00
Amount of
Contribution
$100.00
Last Name
Holahan
_ Cash _ Money Order_ Personal Check Credit/Debit CardX
Yes_
NoX
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 associated with have acontract with said municipality valued at more than $5000?
_
Yes
X
No
Is contributor a principal of state contractor or prospective state contractor?
If yes, indicate which branch or branches of
government the contract is with:
_
Yes No
_
_ Executive Legislative_
_ Payroll Deduction
Method of Contribution
_
X
First Name MI
Duncan
Residential Street Address
79 Bishop St
City
New Haven
State Zip Code
CT 06511
Date Received
06/14/2011
Principal Occupation
Name of Employer
Is this contribution associated with a
fundraising event listed in Section L1?Yes
NoIf yes, list Event #
Self Employed
Entrepreneur
Is contributor a lobbyist, spouse,
or dependent child of a lobbyist?
Aggregate Contribution
$100.00
Amount of
Contribution
$100.00
Last Name
Goodall
_ Cash _ Money Order_ Personal Check Credit/Debit CardX
Yes_
NoX
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 associated with have a
contract with said municipality valued at more than $5000?
_
Yes
X
No
Is contributor a principal of state contractor or prospective state contractor?
If yes, indicate which branch or branches of
government the contract is with:
_
Yes No
_
_ Executive Legislative_
_ Payroll Deduction
Method of Contribution
_
X
8/6/2019 Kerekes SEEC Filing July 10
4/46
Page 4 of 46
I. MONETARY RECEIPTS (Section A-K)
AME OF COMMITTEE FILING DUE DATE
Committee To Elect Jeffrey Kerekes Original 07/11/2011
B. Itemized Contributions from Individuals
First Name MI
Gilian Robin
Residential Street Address
177 Everit St
City
New Haven
State Zip Code
CT 06511
Date Received
06/14/2011
Principal Occupation
Name of Employer
Is this contribution associated with a
fundraising event listed in Section L1?Yes
NoIf yes, list Event #
Retired
Former Lawyer
Is contributor a lobbyist, spouse,
or dependent child of a lobbyist?
Aggregate Contribution
$340.00
Amount of
Contribution
$340.00
Last Name
Roush
_ Cash _ Money Order_ Personal Check Credit/Debit CardX
Yes_
NoX
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 associated with have a
contract with said municipality valued at more than $5000?
_
Yes
X
No
Is contributor a principal of state contractor or prospective state contractor?
If yes, indicate which branch or branches of
government the contract is with:
_
Yes No
_
_ Executive Legislative_
_ Payroll Deduction
Method of Contribution
_
X
First Name MI
David
Residential Street Address
99 Avon
City
New Haven
State Zip Code
CT 06511
Date Received
06/14/2011
Principal Occupation
Name of Employer
Is this contribution associated with a
fundraising event listed in Section L1?Yes
NoIf yes, list Event #
The Green Life Guides
Dir Technical Operations
Is contributor a lobbyist, spouse,
or dependent child of a lobbyist?
Aggregate Contribution
$50.00
Amount of
Contribution
$50.00
Last Name
Streever
_ Cash _ Money Order_ Personal Check Credit/Debit CardX
Yes_
NoX
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 associated with have a
contract with said municipality valued at more than $5000?
_
Yes
X
No
Is contributor a principal of state contractor or prospective state contractor?
If yes, indicate which branch or branches of
government the contract is with:
_
Yes No
_
_
Executive Legislative
_
_ Payroll Deduction
Method of Contribution
_
X
First Name MI
Kimberly
Residential Street Address
25 Clark St Apt 2
City
New Haven
State Zip Code
CT 06511
Date Received
06/14/2011
Principal Occupation
Name of Employer
Is this contribution associated with afundraising event listed in Section L1?
Yes
NoIf yes, list Event #
Is contributor a lobbyist, spouse,
or dependent child of a lobbyist?
Aggregate Contribution
$20.00
Amount of
Contribution
$20.00
Last Name
Nucifora
_ Cash _ Money Order_ Personal Check Credit/Debit CardX
Yes_
NoX
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 associated with have a
contract with said municipality valued at more than $5000?
_
Yes
_
No
Is contributor a principal of state contractor or prospective state contractor?
If yes, indicate which branch or branches of
government the contract is with:
_
Yes No
_
_ Executive Legislative_
_ Payroll Deduction
Method of Contribution
_
X
8/6/2019 Kerekes SEEC Filing July 10
5/46
Page 5 of 46
I. MONETARY RECEIPTS (Section A-K)
AME OF COMMITTEE FILING DUE DATE
Committee To Elect Jeffrey Kerekes Original 07/11/2011
B. Itemized Contributions from Individuals
First Name MI
Harry
Residential Street Address
441 Chapel St Apt 1-6 New Haven
CT 06511 USA
City
New Haven
State Zip Code
CT 06511
Date Received
06/14/2011
Principal Occupation
Name of Employer
Is this contribution associated with a
fundraising event listed in Section L1?Yes
NoIf yes, list Event #
Retired
Retired
Is contributor a lobbyist, spouse,
or dependent child of a lobbyist?
I
Aggregate Contribution
$340.00
Amount of
Contribution
$340.00
Last Name
David
_ Cash _ Money OrderX Personal Check Credit/Debit Card_
Yes_
NoX
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 associated with have a
contract with said municipality valued at more than $5000?
_
Yes
X
No
Is contributor a principal of state contractor or prospective state contractor?
If yes, indicate which branch or branches of
government the contract is with:
_
Yes No
_
_ Executive Legislative_
_ Payroll Deduction
Method of Contribution
_
X
First Name MI
Gary
Residential Street Address
30 Birch Dr
City
New Haven
State Zip Code
CT 06515
Date Received
06/14/2011
Principal Occupation
Name of Employer
Is this contribution associated with a
fundraising event listed in Section L1?Yes
NoIf yes, list Event #
Self Employed
Sales/Marketing
Is contributor a lobbyist, spouse,
or dependent child of a lobbyist?
Aggregate Contribution
$340.00
Amount of
Contribution
$340.00
Last Name
Doyens
_ Cash _ Money OrderX Personal Check Credit/Debit Card_
Yes_
NoX
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 associated with have a
contract with said municipality valued at more than $5000?
_
Yes
X
No
Is contributor a principal of state contractor or prospective state contractor?
If yes, indicate which branch or branches of
government the contract is with:
_
Yes No
_
_
Executive Legislative
_
_ Payroll Deduction
Method of Contribution
_
X
First Name MI
Thomas
Residential Street Address
22 Hallock St
City
New Haven
State Zip Code
CT 06519
Date Received
06/15/2011
Principal Occupation
Name of Employer
Is this contribution associated with afundraising event listed in Section L1?
Yes
NoIf yes, list Event #
Retired
Is contributor a lobbyist, spouse,
or dependent child of a lobbyist?
Aggregate Contribution
$100.00
Amount of
Contribution
$100.00
Last Name
Ahern
_ Cash _ Money OrderX Personal Check Credit/Debit Card_
Yes_
NoX
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 associated with have a
contract with said municipality valued at more than $5000?
_
Yes
X
No
Is contributor a principal of state contractor or prospective state contractor?
If yes, indicate which branch or branches of
government the contract is with:
_
Yes No
_
_ Executive Legislative_
_ Payroll Deduction
Method of Contribution
_
X
8/6/2019 Kerekes SEEC Filing July 10
6/46
Page 6 of 46
I. MONETARY RECEIPTS (Section A-K)
AME OF COMMITTEE FILING DUE DATE
Committee To Elect Jeffrey Kerekes Original 07/11/2011
B. Itemized Contributions from Individuals
First Name MI
Robyn
Residential Street Address
21 Lyon St
City
New Haven
State Zip Code
CT 06511
Date Received
06/15/2011
Principal Occupation
Name of Employer
Is this contribution associated with a
fundraising event listed in Section L1?Yes
NoIf yes, list Event #
CWA
Secretary
Is contributor a lobbyist, spouse,
or dependent child of a lobbyist?
Aggregate Contribution
$50.00
Amount of
Contribution
$50.00
Last Name
Hayes
_ Cash _ Money OrderX Personal Check Credit/Debit Card_
Yes_
NoX
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 associated with have a
contract with said municipality valued at more than $5000?
_
Yes
_
No
Is contributor a principal of state contractor or prospective state contractor?
If yes, indicate which branch or branches of
government the contract is with:
_
Yes No
_
_ Executive Legislative_
_ Payroll Deduction
Method of Contribution
_
X
First Name MI
Douglas
Residential Street Address
73 Huntington Rd Unit B
City
New Haven
State Zip Code
CT 06512
Date Received
06/15/2011
Principal Occupation
Name of Employer
Is this contribution associated with a
fundraising event listed in Section L1?Yes
NoIf yes, list Event #
Is contributor a lobbyist, spouse,
or dependent child of a lobbyist?
Aggregate Contribution
$25.00
Amount of
Contribution
$25.00
Last Name
Ledewitz
_ Cash _ Money Order_ Personal Check Credit/Debit CardX
Yes_
NoX
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 associated with have a
contract with said municipality valued at more than $5000?
_
Yes
X
No
Is contributor a principal of state contractor or prospective state contractor?
If yes, indicate which branch or branches of
government the contract is with:
_
Yes No
_
_
Executive Legislative
_
_ Payroll Deduction
Method of Contribution
_
X
First Name MI
Rebecca
Residential Street Address
18 Rock St
City
New Haven
State Zip Code
CT 06511
Date Received
06/15/2011
Principal Occupation
Name of Employer
Is this contribution associated with afundraising event listed in Section L1?
Yes
NoIf yes, list Event #
Is contributor a lobbyist, spouse,
or dependent child of a lobbyist?
Aggregate Contribution
$25.00
Amount of
Contribution
$25.00
Last Name
Turcio
_ Cash _ Money Order_ Personal Check Credit/Debit CardX
Yes_
No_
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 associated with have a
contract with said municipality valued at more than $5000?
_
Yes
_
No
Is contributor a principal of state contractor or prospective state contractor?
If yes, indicate which branch or branches of
government the contract is with:
_
Yes No
_
_ Executive Legislative_
_ Payroll Deduction
Method of Contribution
_
X
8/6/2019 Kerekes SEEC Filing July 10
7/46
Page 7 of 46
I. MONETARY RECEIPTS (Section A-K)
AME OF COMMITTEE FILING DUE DATE
Committee To Elect Jeffrey Kerekes Original 07/11/2011
B. Itemized Contributions from Individuals
First Name MI
William
Residential Street Address
206 W Rock Ave
City
New Haven
State Zip Code
CT 06515
Date Received
06/16/2011
Principal Occupation
Name of Employer
Is this contribution associated with a
fundraising event listed in Section L1?Yes
NoIf yes, list Event #
Is contributor a lobbyist, spouse,
or dependent child of a lobbyist?
Aggregate Contribution
$25.00
Amount of
Contribution
$25.00
Last Name
Taylor
_ Cash _ Money OrderX Personal Check Credit/Debit Card_
Yes_
No_
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 associated with have a
contract with said municipality valued at more than $5000?
_
Yes
_
No
Is contributor a principal of state contractor or prospective state contractor?
If yes, indicate which branch or branches of
government the contract is with:
_
Yes No
_
_ Executive Legislative_
_ Payroll Deduction
Method of Contribution
_
X
First Name MI
Patricia
Residential Street Address
206 W Rock Ave
City
New Haven
State Zip Code
CT 06515
Date Received
06/16/2011
Principal Occupation
Name of Employer
Is this contribution associated with a
fundraising event listed in Section L1?Yes
NoIf yes, list Event #
Is contributor a lobbyist, spouse,
or dependent child of a lobbyist?
Aggregate Contribution
$25.00
Amount of
Contribution
$25.00
Last Name
Taylor
_ Cash _ Money OrderX Personal Check Credit/Debit Card_
Yes_
No_
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 associated with have a
contract with said municipality valued at more than $5000?
_
Yes
_
No
Is contributor a principal of state contractor or prospective state contractor?
If yes, indicate which branch or branches of
government the contract is with:
_
Yes No
_
_
Executive Legislative
_
_ Payroll Deduction
Method of Contribution
_
X
First Name MI
Allan
Residential Street Address
115 Everit
City
New Haven
State Zip Code
CT
Date Received
06/16/2011
Principal Occupation
Name of Employer
Is this contribution associated with afundraising event listed in Section L1?
Yes
NoIf yes, list Event #
Is contributor a lobbyist, spouse,
or dependent child of a lobbyist?
Aggregate Contribution
$10.00
Amount of
Contribution
$10.00
Last Name
Brison
_ Cash _ Money OrderX Personal Check Credit/Debit Card_
Yes_
No_
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 associated with have a
contract with said municipality valued at more than $5000?
_
Yes
_
No
Is contributor a principal of state contractor or prospective state contractor?
If yes, indicate which branch or branches of
government the contract is with:
_
Yes No
_
_ Executive Legislative_
_ Payroll Deduction
Method of Contribution
_
X
8/6/2019 Kerekes SEEC Filing July 10
8/46
Page 8 of 46
I. MONETARY RECEIPTS (Section A-K)
AME OF COMMITTEE FILING DUE DATE
Committee To Elect Jeffrey Kerekes Original 07/11/2011
B. Itemized Contributions from Individuals
First Name MI
Frank
Residential Street Address
98 Hughes St
City
New Haven
State Zip Code
CT 06512
Date Received
06/16/2011
Principal Occupation
Name of Employer
Is this contribution associated with a
fundraising event listed in Section L1?Yes
NoIf yes, list Event #
Self
Retired
Is contributor a lobbyist, spouse,
or dependent child of a lobbyist?
Aggregate Contribution
$200.00
Amount of
Contribution
$200.00
Last Name
Martone
_ Cash _ Money OrderX Personal Check Credit/Debit Card_
Yes_
NoX
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 associated with have a
contract with said municipality valued at more than $5000?
_
Yes
X
No
Is contributor a principal of state contractor or prospective state contractor?
If yes, indicate which branch or branches of
government the contract is with:
_
Yes No
_
_ Executive Legislative_
_ Payroll Deduction
Method of Contribution
_
X
First Name MI
Beth
Residential Street Address
38 Daniel St
City
Milford
State Zip Code
CT 06460
Date Received
06/17/2011
Principal Occupation
Name of Employer
Is this contribution associated with a
fundraising event listed in Section L1?Yes
NoIf yes, list Event #
Is contributor a lobbyist, spouse,
or dependent child of a lobbyist?
Aggregate Contribution
$25.00
Amount of
Contribution
$25.00
Last Name
Royer
_ Cash _ Money OrderX Personal Check Credit/Debit Card_
Yes_
No_
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 associated with have a
contract with said municipality valued at more than $5000?
_
Yes
_
No
Is contributor a principal of state contractor or prospective state contractor?
If yes, indicate which branch or branches of
government the contract is with:
_
Yes No
_
_
Executive Legislative
_
_ Payroll Deduction
Method of Contribution
_
X
First Name MI
Pei
Residential Street Address
43 Lyon St
City
New Haven
State Zip Code
CT 06511
Date Received
06/17/2011
Principal Occupation
Name of Employer
Is this contribution associated with afundraising event listed in Section L1?
Yes
NoIf yes, list Event #
Is contributor a lobbyist, spouse,
or dependent child of a lobbyist?
Aggregate Contribution
$10.00
Amount of
Contribution
$10.00
Last Name
Ye
_ Cash _ Money Order_ Personal Check Credit/Debit CardX
Yes_
No_
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 associated with have a
contract with said municipality valued at more than $5000?
_
Yes
_
No
Is contributor a principal of state contractor or prospective state contractor?
If yes, indicate which branch or branches of
government the contract is with:
_
Yes No
_
_ Executive Legislative_
_ Payroll Deduction
Method of Contribution
_
X
8/6/2019 Kerekes SEEC Filing July 10
9/46
8/6/2019 Kerekes SEEC Filing July 10
10/46
Page 10 of 46
I. MONETARY RECEIPTS (Section A-K)
AME OF COMMITTEE FILING DUE DATE
Committee To Elect Jeffrey Kerekes Original 07/11/2011
B. Itemized Contributions from Individuals
First Name MI
Aaron
Residential Street Address
PO Box 207063
City
New Haven
State Zip Code
CT 06520
Date Received
06/22/2011
Principal Occupation
Name of Employer
Is this contribution associated with a
fundraising event listed in Section L1?Yes
NoIf yes, list Event #
Is contributor a lobbyist, spouse,
or dependent child of a lobbyist?
Aggregate Contribution
$25.00
Amount of
Contribution
$25.00
Last Name
Goode
_ Cash _ Money Order_ Personal Check Credit/Debit CardX
Yes_
No_
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 associated with have a
contract with said municipality valued at more than $5000?
_
Yes
_
No
Is contributor a principal of state contractor or prospective state contractor?
If yes, indicate which branch or branches of
government the contract is with:
_
Yes No
_
_ Executive Legislative_
_ Payroll Deduction
Method of Contribution
_
X
First Name MI
Ethel
Residential Street Address
50 Autumn St
City
New Haven
State Zip Code
CT 06511
Date Received
06/22/2011
Principal Occupation
Name of Employer
Is this contribution associated with a
fundraising event listed in Section L1?Yes
NoIf yes, list Event #
Self employed
Book Illustrator, reading
tutor
Is contributor a lobbyist, spouse,
or dependent child of a lobbyist?
Aggregate Contribution
$100.00
Amount of
Contribution
$100.00
Last Name
Berger
_ Cash _ Money Order_ Personal Check Credit/Debit CardX
Yes_
NoX
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 associated with have a
contract with said municipality valued at more than $5000?
_
Yes
X
No
Is contributor a principal of state contractor or prospective state contractor?
If yes, indicate which branch or branches of
government the contract is with:
_
Yes No
_
_
Executive Legislative
_
_ Payroll Deduction
Method of Contribution
_
X
First Name MI
Dana
Residential Street Address
157 Church St
City
New Haven
State Zip Code
CT 06510
Date Received
06/23/2011
Principal Occupation
Name of Employer
Is this contribution associated with afundraising event listed in Section L1?
Yes
NoIf yes, list Event #
Is contributor a lobbyist, spouse,
or dependent child of a lobbyist?
Aggregate Contribution
$15.00
Amount of
Contribution
$15.00
Last Name
Ciccone
_ Cash _ Money Order_ Personal Check Credit/Debit CardX
Yes_
No_
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 associated with have a
contract with said municipality valued at more than $5000?
_
Yes
_
No
Is contributor a principal of state contractor or prospective state contractor?
If yes, indicate which branch or branches of
government the contract is with:
_
Yes No
_
_ Executive Legislative_
_ Payroll Deduction
Method of Contribution
_
X
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I. MONETARY RECEIPTS (Section A-K)
AME OF COMMITTEE FILING DUE DATE
Committee To Elect Jeffrey Kerekes Original 07/11/2011
B. Itemized Contributions from Individuals
First Name MI
Beth
Residential Street Address
100 N Main St
City
Essex
State Zip Code
CT 06426
Date Received
06/23/2011
Principal Occupation
Name of Employer
Is this contribution associated with a
fundraising event listed in Section L1?Yes
NoIf yes, list Event #
Middlesex Hospital Outpatient Center
Radiographer
Is contributor a lobbyist, spouse,
or dependent child of a lobbyist?
Aggregate Contribution
$100.00
Amount of
Contribution
$100.00
Last Name
Crain
_ Cash _ Money Order_ Personal Check Credit/Debit CardX
Yes_
NoX
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 associated with have a
contract with said municipality valued at more than $5000?
_
Yes
X
No
Is contributor a principal of state contractor or prospective state contractor?
If yes, indicate which branch or branches of
government the contract is with:
_
Yes No
_
_ Executive Legislative_
_ Payroll Deduction
Method of Contribution
_
X
First Name MI
MARY
Residential Street Address
183 W Rock Ave
City
New Haven
State Zip Code
CT 06515
Date Received
06/23/2011
Principal Occupation
Name of Employer
Is this contribution associated with a
fundraising event listed in Section L1?Yes
NoIf yes, list Event #
Self
Content Editor
Is contributor a lobbyist, spouse,
or dependent child of a lobbyist?
Aggregate Contribution
$50.00
Amount of
Contribution
$50.00
Last Name
FAULKNER
_ Cash _ Money Order_ Personal Check Credit/Debit CardX
Yes_
NoX
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 associated with have a
contract with said municipality valued at more than $5000?
_
Yes
_
No
Is contributor a principal of state contractor or prospective state contractor?
If yes, indicate which branch or branches of
government the contract is with:
_
Yes No
_
_
Executive Legislative
_
_ Payroll Deduction
Method of Contribution
_
X
First Name MI
Paolo and Laurie
Residential Street Address
1515 State St
City
New Haven
State Zip Code
CT 06511
Date Received
06/23/2011
Principal Occupation
Name of Employer
Is this contribution associated with afundraising event listed in Section L1?
Yes
NoIf yes, list Event #
YNHH
APRN
Is contributor a lobbyist, spouse,
or dependent child of a lobbyist?
Aggregate Contribution
$200.00
Amount of
Contribution
$200.00
Last Name
DeSiato
_ Cash _ Money OrderX Personal Check Credit/Debit Card_
Yes_
NoX
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 associated with have a
contract with said municipality valued at more than $5000?
_
Yes
X
No
Is contributor a principal of state contractor or prospective state contractor?
If yes, indicate which branch or branches of
government the contract is with:
_
Yes No
_
_ Executive Legislative_
_ Payroll Deduction
Method of Contribution
_
X
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I. MONETARY RECEIPTS (Section A-K)
AME OF COMMITTEE FILING DUE DATE
Committee To Elect Jeffrey Kerekes Original 07/11/2011
B. Itemized Contributions from Individuals
First Name MI
Michelle
Residential Street Address
75 Bishop
City
New Haven
State Zip Code
CT 06511
Date Received
06/25/2011
Principal Occupation
Name of Employer
Is this contribution associated with a
fundraising event listed in Section L1?Yes
NoIf yes, list Event #
Yale University
Editor
Is contributor a lobbyist, spouse,
or dependent child of a lobbyist?
Aggregate Contribution
$100.00
Amount of
Contribution
$100.00
Last Name
Komie
_ Cash _ Money OrderX Personal Check Credit/Debit Card_
Yes_
NoX
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 associated with have a
contract with said municipality valued at more than $5000?
_
Yes
X
No
Is contributor a principal of state contractor or prospective state contractor?
If yes, indicate which branch or branches of
government the contract is with:
_
Yes No
_
_ Executive Legislative_
_ Payroll Deduction
Method of Contribution
_
X
First Name MI
Paul
Residential Street Address
20 Lyon St
City
New Haven
State Zip Code
CT 06511
Date Received
06/26/2011
Principal Occupation
Name of Employer
Is this contribution associated with a
fundraising event listed in Section L1?Yes
NoIf yes, list Event #
Is contributor a lobbyist, spouse,
or dependent child of a lobbyist?
Aggregate Contribution
$25.00
Amount of
Contribution
$25.00
Last Name
Walsh
_ Cash _ Money OrderX Personal Check Credit/Debit Card_
Yes_
No_
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 associated with have a
contract with said municipality valued at more than $5000?
_
Yes
_
No
Is contributor a principal of state contractor or prospective state contractor?
If yes, indicate which branch or branches of
government the contract is with:
_
Yes No
_
_
Executive Legislative
_
_ Payroll Deduction
Method of Contribution
_
X
First Name MI
Chris
Residential Street Address
1 Lyon St
City
New Haven
State Zip Code
CT 06511
Date Received
06/26/2011
Principal Occupation
Name of Employer
Is this contribution associated with afundraising event listed in Section L1?
Yes
NoIf yes, list Event #
Is contributor a lobbyist, spouse,
or dependent child of a lobbyist?
Aggregate Contribution
$20.00
Amount of
Contribution
$20.00
Last Name
Randall
_ Cash _ Money OrderX Personal Check Credit/Debit Card_
Yes_
No_
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 associated with have a
contract with said municipality valued at more than $5000?
_
Yes
_
No
Is contributor a principal of state contractor or prospective state contractor?
If yes, indicate which branch or branches of
government the contract is with:
_
Yes No
_
_ Executive Legislative_
_ Payroll Deduction
Method of Contribution
_
X
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I. MONETARY RECEIPTS (Section A-K)
AME OF COMMITTEE FILING DUE DATE
Committee To Elect Jeffrey Kerekes Original 07/11/2011
B. Itemized Contributions from Individuals
First Name MI
PEIJUN
Residential Street Address
224 W Dryden St Apt 404
City
Glendale
State Zip Code
CA 91202
Date Received
06/26/2011
Principal Occupation
Name of Employer
Is this contribution associated with a
fundraising event listed in Section L1?Yes
NoIf yes, list Event #
Advancive Technology Solutions
IT Consultant
Is contributor a lobbyist, spouse,
or dependent child of a lobbyist?
Aggregate Contribution
$100.00
Amount of
Contribution
$100.00
Last Name
YE
_ Cash _ Money Order_ Personal Check Credit/Debit CardX
Yes_
NoX
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 associated with have a
contract with said municipality valued at more than $5000?
_
Yes
X
No
Is contributor a principal of state contractor or prospective state contractor?
If yes, indicate which branch or branches of
government the contract is with:
_
Yes No
_
_ Executive Legislative_
_ Payroll Deduction
Method of Contribution
_
X
First Name MI
Rachel
Residential Street Address
92 Lyon St
City
New Haven
State Zip Code
CT 06511
Date Received
06/26/2011
Principal Occupation
Name of Employer
Is this contribution associated with a
fundraising event listed in Section L1?Yes
NoIf yes, list Event #
Is contributor a lobbyist, spouse,
or dependent child of a lobbyist?
Aggregate Contribution
$10.00
Amount of
Contribution
$10.00
Last Name
Mekeel
_ Cash _ Money Order_ Personal Check Credit/Debit CardX
Yes_
No_
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 associated with have a
contract with said municipality valued at more than $5000?
_
Yes
_
No
Is contributor a principal of state contractor or prospective state contractor?
If yes, indicate which branch or branches of
government the contract is with:
_
Yes No
_
_
Executive Legislative
_
_ Payroll Deduction
Method of Contribution
_
X
First Name MI
Mark
Residential Street Address
132 Mansfield St
City
New Haven
State Zip Code
CT 06511
Date Received
06/26/2011
Principal Occupation
Name of Employer
Is this contribution associated with afundraising event listed in Section L1?
Yes
NoIf yes, list Event #
Is contributor a lobbyist, spouse,
or dependent child of a lobbyist?
Aggregate Contribution
$25.00
Amount of
Contribution
$25.00
Last Name
Abraham
_ Cash _ Money Order_ Personal Check Credit/Debit CardX
Yes_
No_
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 associated with have a
contract with said municipality valued at more than $5000?
_
Yes
_
No
Is contributor a principal of state contractor or prospective state contractor?
If yes, indicate which branch or branches of
government the contract is with:
_
Yes No
_
_ Executive Legislative_
_ Payroll Deduction
Method of Contribution
_
X
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Page 14 of 46
I. MONETARY RECEIPTS (Section A-K)
AME OF COMMITTEE FILING DUE DATE
Committee To Elect Jeffrey Kerekes Original 07/11/2011
B. Itemized Contributions from Individuals
First Name MI
Louis
Residential Street Address
548 Middletown Ave
City
North Haven
State Zip Code
CT 06473
Date Received
06/27/2011
Principal Occupation
Name of Employer
Is this contribution associated with a
fundraising event listed in Section L1?Yes
NoIf yes, list Event #
Is contributor a lobbyist, spouse,
or dependent child of a lobbyist?
Aggregate Contribution
$25.00
Amount of
Contribution
$25.00
Last Name
St. George
_ Cash _ Money OrderX Personal Check Credit/Debit Card_
Yes_
No_
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 associated with have a
contract with said municipality valued at more than $5000?
_
Yes
_
No
Is contributor a principal of state contractor or prospective state contractor?
If yes, indicate which branch or branches of
government the contract is with:
_
Yes No
_
_ Executive Legislative_
_ Payroll Deduction
Method of Contribution
_
X
First Name MI
Mo
Residential Street Address
120 Longhill Ter
City
New Haven
State Zip Code
CT 06515
Date Received
06/27/2011
Principal Occupation
Name of Employer
Is this contribution associated with a
fundraising event listed in Section L1?Yes
NoIf yes, list Event #
Is contributor a lobbyist, spouse,
or dependent child of a lobbyist?
Aggregate Contribution
$10.00
Amount of
Contribution
$10.00
Last Name
Sila
_ Cash _ Money OrderX Personal Check Credit/Debit Card_
Yes_
No_
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 associated with have a
contract with said municipality valued at more than $5000?
_
Yes
_
No
Is contributor a principal of state contractor or prospective state contractor?
If yes, indicate which branch or branches of
government the contract is with:
_
Yes No
_
_
Executive Legislative
_
_ Payroll Deduction
Method of Contribution
_
X
First Name MI
Patricia
Residential Street Address
119 Dwight St
City
New Haven
State Zip Code
CT 06511
Date Received
06/27/2011
Principal Occupation
Name of Employer
Is this contribution associated with afundraising event listed in Section L1?
Yes
NoIf yes, list Event #
Is contributor a lobbyist, spouse,
or dependent child of a lobbyist?
Aggregate Contribution
$40.00
Amount of
Contribution
$40.00
Last Name
Kane
_ Cash _ Money OrderX Personal Check Credit/Debit Card_
Yes_
No_
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 associated with have a
contract with said municipality valued at more than $5000?
_
Yes
_
No
Is contributor a principal of state contractor or prospective state contractor?
If yes, indicate which branch or branches of
government the contract is with:
_
Yes No
_
_ Executive Legislative_
_ Payroll Deduction
Method of Contribution
_
X
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Page 15 of 46
I. MONETARY RECEIPTS (Section A-K)
AME OF COMMITTEE FILING DUE DATE
Committee To Elect Jeffrey Kerekes Original 07/11/2011
B. Itemized Contributions from Individuals
First Name MI
David
Residential Street Address
97 Lyon St
City
New Haven
State Zip Code
CT 06511
Date Received
06/27/2011
Principal Occupation
Name of Employer
Is this contribution associated with a
fundraising event listed in Section L1?Yes
NoIf yes, list Event #
Is contributor a lobbyist, spouse,
or dependent child of a lobbyist?
Aggregate Contribution
$25.00
Amount of
Contribution
$25.00
Last Name
Stolar
_ Cash _ Money OrderX Personal Check Credit/Debit Card_
Yes_
No_
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 associated with have a
contract with said municipality valued at more than $5000?
_
Yes
_
No
Is contributor a principal of state contractor or prospective state contractor?
If yes, indicate which branch or branches of
government the contract is with:
_
Yes No
_
_ Executive Legislative_
_ Payroll Deduction
Method of Contribution
_
X
First Name MI
Susan
Residential Street Address
97 Lyon St
City
New Haven
State Zip Code
CT 06511
Date Received
06/27/2011
Principal Occupation
Name of Employer
Is this contribution associated with a
fundraising event listed in Section L1?Yes
NoIf yes, list Event #
Is contributor a lobbyist, spouse,
or dependent child of a lobbyist?
Aggregate Contribution
$10.00
Amount of
Contribution
$10.00
Last Name
Kremser
_ Cash _ Money OrderX Personal Check Credit/Debit Card_
Yes_
No_
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 associated with have a
contract with said municipality valued at more than $5000?
_
Yes
_
No
Is contributor a principal of state contractor or prospective state contractor?
If yes, indicate which branch or branches of
government the contract is with:
_
Yes No
_
_
Executive Legislative
_
_ Payroll Deduction
Method of Contribution
_
X
First Name MI
Lennart David
Residential Street Address
44 Lyon St
City
New Haven
State Zip Code
CT 06511
Date Received
06/27/2011
Principal Occupation
Name of Employer
Is this contribution associated with afundraising event listed in Section L1?
Yes
NoIf yes, list Event #
Is contributor a lobbyist, spouse,
or dependent child of a lobbyist?
Aggregate Contribution
$10.00
Amount of
Contribution
$10.00
Last Name
Rapp
_ Cash _ Money OrderX Personal Check Credit/Debit Card_
Yes_
No_
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 associated with have a
contract with said municipality valued at more than $5000?
_
Yes
_
No
Is contributor a principal of state contractor or prospective state contractor?
If yes, indicate which branch or branches of
government the contract is with:
_
Yes No
_
_ Executive Legislative_
_ Payroll Deduction
Method of Contribution
_
X
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D. Loans Received this Period
I. MONETARY RECEIPTS (Section A-K)
NAME OF COMMITTEE FILING DUE DATE
Committee To Elect Jeffrey Kerekes Original 07/11/2011
Street Address City State Zip Code
Date Received
Name of Cosigner/Guarantor
Amount
Received
Name of Lender
Street Address City State Zip Code
Is there a
cosigner or
Guarantor of
this loan?
Yes
No
Source of Loan:
Bank
Individual
Candidate
Other
Committee
Total of Section D
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E. Receipts from Entities other than Individuals or Other Committees (Referendum Committees ONLY)
I. MONETARY RECEIPTS (Section A-K)
AME OF COMMITTEE FILING DUE DATE
Original 07/11/2011Committee To Elect Jeffrey Kerekes
Street Address
City State Zip Code
Amount
Received
Name
Date Received
Aggregate Contributions
Total of Section E
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Page 21 of 46
F. Amount Transferred from Affiliated Business Treasury (Business Entity Committees ONLY)
I. MONETARY RECEIPTS (Section A-I)
NAME OF COMMITTEE FILING DUE DATE
Committee To Elect Jeffrey Kerekes Original 07/11/2011
AmountDate of ReceiptIs this transaction associated with a fundraising event listed in Section L1?
Yes No If yes, list Event #
Total of Section F
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K. Miscellaneous Monetary Receipts not Considered Contributions
I. MONETARY RECEIPTS (Section A-K)
NAME OF COMMITTEE FILING DUE DATE
Committee To Elect Jeffrey Kerekes Original 07/11/2011
Street Address Cit State Zip Code
Description
Amount
Received
Name Date of Transaction
Total of Section K
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Page 28 of 46
L2. Proceeds from Tag Sale, Auction, or Other Sale of Donated Items
II. FUNDRAISING EVENT ACTIVITY
AME OF COMMITTEE FILING DUE DATE
Committee To Elect Jeffrey Kerekes Original 07/11/2011
Zip CodeStateCityResidential Street Address
Method of payment:e of the Purchaser Aggregate
Amount of
PurchasesLast Name
First Name MI
Event #
Items Purchased
Personal CheckCash Credit/Debit Card
Date Received
(Individuals ONLY)
Total of Section L2
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Page 33 of 46
O. Non-Monetary Receipts of Organization Expenditures Made By
Legislative Leadership, Legislative Caucus, and Party Committee
III. NONMONETARY RECEIPTS
NAME OF COMMITTEE FILING DUE DATE
Committee To Elect Jeffrey Kerekes Original 07/11/2011
Street Address Date Notice Received
Description of Donation
Fair Market
Value of
Donation
Name of Committee
City State
Name of Treasurer
Aggregate DonationsZip Code
Purpose of Expenditure
A B C D E
Total of Section O
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Page 37 of 46
R. Expenses Incurred on Committee Credit Card
IV. EXPENDITURES
NAME OF COMMITTEE FILING DUE DATE
Committee To Elect Jeffrey Kerekes Original 07/11/2011
Street Address City State Zip Code
Name of Vendor Amount
Name of Issuing Institution
Date of Transaction
Event #
Type of Credit Card:
Purpose of Expenditure (by code)
Description
Visa Master Card Discover American Express
Other
Total of Section R
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Page 44 of 46
S. Expenses Incurred By Committee but Not Paid During this Period
IV. EXPENDITURES
NAME OF COMMITTEE FILING DUE DATE
Committee To Elect Jeffrey Kerekes Original 07/11/2011
Street Address City State Zip Code
Description
Name of Creditor Date Incurred Amount Incurred
(Estimate or
Actual)
Purpose of
Expenditure (by
code
Event #
Candidate(s) Name (if applicable) Office SoughtType of Expenditure (if applicable)
A B C D E
Supported
OpposedCoordinated with reimbursement sought
Coordinated without reimbursement sought
Independent
Docuprint
Organization (see Instructions)
27 Whitney Ave New HavenCT 06510
06/22/2011
OFFICE
_
_
$0.50
_ _ _ _ _
_
_
_
_
Copies
Street Address City State Zip Code
Description
Name of Creditor Date Incurred Amount Incurred
(Estimate or
Actual)
Purpose of
Expenditure (by
code
Event #
Candidate(s) Name (if applicable) Office SoughtType of Expenditure (if applicable)
A B C D E
Supported
OpposedCoordinated with reimbursement sought
Coordinated without reimbursement sought
Independent
JM Signs
Organization (see Instructions)
6304 S Tex Pt HomosassaTX 34448
06/27/2011
A-SIGN
_
_
$1,525.50
_ _ _ _ _
_
_
_
_
Yard Signs
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Page 45 of 46
S. Expenses Incurred By Committee but Not Paid During this Period
IV. EXPENDITURES
NAME OF COMMITTEE FILING DUE DATE
Committee To Elect Jeffrey Kerekes Original 07/11/2011
Street Address City State Zip Code
Description
Name of Creditor Date Incurred Amount Incurred
(Estimate or
Actual)
Purpose of
Expenditure (by
code
Event #
Candidate(s) Name (if applicable) Office SoughtType of Expenditure (if applicable)
A B C D E
Supported
OpposedCoordinated with reimbursement sought
Coordinated without reimbursement sought
Independent
Hour 48 Hour Print
Organization (see Instructions)
33 Farnsworth St BostonMA
06/27/2011
A-SIGN
_
_
$866.87
_ _ _ _ _
_
_
_
_
Door Hangers
Street Address City State Zip Code
Description
Name of Creditor Date Incurred Amount Incurred
(Estimate or
Actual)
Purpose of
Expenditure (by
code
Event #
Candidate(s) Name (if applicable) Office SoughtType of Expenditure (if applicable)
A B C D E
Supported
OpposedCoordinated with reimbursement sought
Coordinated without reimbursement sought
Independent
Hour 48 Hour Print
Organization (see Instructions)
33 Farnsworth S BostonMA
06/28/2011
A-SIGN
_
_
$37.39
_ _ _ _ _
_
_
_
_
Door Hangers
Total of Section S $3,095.91
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IV. EXPENDITURES
AME OF COMMITTEE FILING DUE DATE
Committee To Elect Jeffre Kerekes Original 07/11/2011
T. Itemization of Reimbursements to Committee Workers and Consultants
Street Address City State Zip Code
Secondary Payee
AmountName of Worker/Consultant Date of Payment Method of Payment
Purpose of Expenditure
Check #
Debit Card
Other Candidate(s) Name Office Sought
Description
Supported
Opposed
Type of Expenditure (if applicable)
Coordinated with reimbursement sought
Coordinated without reimbursement sought
Independent
Organization (see Instructions)
A B C D E
Total of Section T