Roy Campaign Doc

8/3/2019 Roy Campaign Doc

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COPY RECESEEC FORM 20 DN|E ,/TIME:'4TOWNSTJMMARYPAGE

. NAIIE OF Cr}Nf]\TITTEEiPaul Roy 2011

TP?^(rtpFp Nn1\fnItde FEsl JeffreyI

MLdt

CoeSultx

3. TREASTIRM.ADDRESSStleet .+(xEes80 Washington Ave. Crt] Seymour State CT 06483.I. ELECTIONIREFRENDTAI DATE S OIIFTCE SOTJGTIY {Comblat onlv if Ctndirl*e Committeel 6. DISTRICTI\'LqIBERinlr'dd}f})j 11t08t2011 First SelectmanT. CANDIDATE NAIUtr fcon ptds' ottlv il Cstditlate ot Expknofrrn, Cornntittee)Trde Paul \fl Lmt Roy iuttirP Ta-pln ftF ESrLtIlT .lalaL fka rl;v\f.i Januaq' l0 liling { 7th da1' preceding primaq' {" 7th da}- preceding ret-erendum r Initial Contributit.ru or Disbursement(P.{Cs O^Ll')Ili April l0 tiling f 30 da1's following primary- {* .15 dal's lbllorving retbrendun .f Arnerdment tcr.fi Julr- l0 tiling f, 7th da1'preceding election f Deficit T1-pe.f Report:f' October l0 tiling {l; l2th dal preceding election i* Terminatioa(State Cedtml Committex On\)'-. indepentlent EsJrendinrre?r-#;;;."- -''-t:eil"L, : i J5 da1 s ibllorring electit'rnntrt held in No'r ernber

o DI'Bf(lTt arffir?iuDftBegrnning Date

a7rc1tz0fi thnrEnding Date

09/30/2011

IO. CIIRTTF"ICTITION

I herebl' certih ancl state" under penalties of talse statement. that all of the intbrmation set tbrth on this ltemized Cnmpaign FinanceDisclosure Statement tbr tlre period cor-ered is true. accruate and complete.

Jeffrey iil. Coe lonilz0ll.PRINT N"\I\IE OF SIGNER D.{TE (mm dd,lllT[ TRE.\STIRER (SIGN.{TIIRE)

PEI.\LT|' FOR.II{ISE SZITE:}IENT IS PTNISIIIBLE BI- FI}{E ^*OT TO EXCEEDSLOOO, OR I]IPFdSOiiJTEXT FOR );OT }IORE TE.4}' ONE T'8.1R, OR BOTH.


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SEAC FORJ}I20Itcm ized Crmpaign Flnance Disclosurc Statcm cntCONNECTICUT STATE ELECTIONS ENX'ORCEIIENT COMMISSIONRev. l/0l$ Page 2 of l?F,i Ah,{E ]oF', aa}}vllrdf I"T!'ls FI[;INtiIIIIE IIATF

1U11ftA11Paul Roy 201 1 COLUMN AThic Ptriffl COLUMN BAEsresateI l. Balanee on hand Januan- I of current 1 ear frrr Ongoing and Pag" Committees ORBalanc.e on haod Aom dal Committee nas ibnned lbr all other committees $0.0012. Balance on hand at the beeinnhs of Reoortinc Period $0.00

13. Contributions received t-rom Individuals (Sections A and B) $0.00 $6,631.0014- Receiots from Other Commiftees (Sections Cl and C2) $0.00 $0.0015. Othor Monetan Receipts lSections D-K) $0.00 $103.00l6a. Total Small Food and Beremge Receipts at Fair (Section Ll ) Ttm,n Committees O!\Ll' $0.00 $o.oo16b. Total Proceeds from Small Purcbases at Tag Sale s, Auctions or Other Sales (Section L2) $0.00 $388.00l6c llunicipal and TmnTotal Purchass rrf Ar{r-ertisino in a Progranr BrnL- (Section |.11 Aommittea 0lif .l' $o.oo $0.0017. Total Monetary Receipts {add totals for lines l3-l6c) $0.00 $7,122.0018. Subtotals{addtotalsinline12+linelTinColunnAandinlinell+lTinColumoB) $0.00 $7,122.0019. Expenses Paid bl"Committee {Section P) $0.00 $2,908.0020. Balance on hand at clos of Reporting Period isubtract line 19 fron line 18 in both l-olumns) $0.00 $4,214.0021.In-Kind Donations not Considerd Contributions Receir.ed {Section L4) $o.oo $822.0022. In-Kind Coatributions Received (Section M) $0.00 $0.002-3. Re&rndable Deposit to Telephone Companl- (Section N) $0.00 $0.00

24. Receipts of Organization Expenditures (Section 0) $0.00 $0.0025. Beeinnins Loan Balance $0.00 $0.00

25a. * Lc,ans Received (section D) $0.00 $0.0025b. * InterestandPeaaltiesonLoan $0.00 $0.0025c. - Par-ments on Loan $0.00 $0.0025d. Total Otttstandins Loan Amount $0.00 $0.0026. Campaigo E:ipeoses Paid trv Caodidate (Section Q) s0.00 $187.0027. Espenses Incurred on Comnittee Credit Card iSection R) $o.oo $0.00

28- Exoenses Incurred br- Committee Durins this Period but Not Paid {Section S) $0.0028a. Total Outstanding Expenses Incurred b1'Committee *ill Unpaid (Section S) $0.00


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L I}IOFTETARYRICEIPTS (Sectftrnc A-I(l Pase 3 of 17IL{IV'EOFCOMMIrIEE IILINGIXIEDATEPaul Roy 2011 1A11n0/1A. 'rCI$l Contributions from Small Contributors-Receiyed this Period ONLY_($ae tnffiicttons fq ddartfon dEnaII Contiktar) Srbtotal Section.A $ 0.09

B. Itemized Contributionc fmm IndlvidudsLg$trleGonmy Fl'stThersa l\tr hmrFalOereuionMinuts Clinic .{mo{nt ofC;attibsfion

$100.00

171Skcd


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L MONETARYRECEIPTSSection B. Additional PaseTY"T.O5,.REPORT1w11t2811aul Roy 291 I B. Itemb:ed Contributions fmmlndivifrualsLdNmc

VYisneskiFtnttSusan htr Itinsi*rl CrccumtionHuman Resolrces Speciali$ Amoonl ofContributior

$40.00

lwFtDgst-awcs473 Rimmon Hill Rd .;1t)-Bemn Fdls CTwtt !$ r- rNeo&to3 ftaE rll EmP& CIState of CTls r:olrtitator a lobhli*t spou*eor dependeot child oin to6tyi.ti

"' T*r'- No If contrihilios i* itr **ccs$ of $40O to r candidats commi8s for o chiet' executive olleer of amunicipatiq does cootr&rlor of bu$iders helshe ie rsror:iated n'ittr hate a eoatmcl rtith caidnuahiralitqraHatmorettan$5.000? .-' -r'e .i. NoIslbisconbibutiqassociatedni$a':.;; l'erfundraising*r'entlistediaSstiorll? : . NoIfiu. list Erent * 08/15/201 1Iscoatitntuagrincipalofashtecodraetororpmsg*tir-e*trtecontactor? i. r.'e*Ifu.indicaferrhicbtreq:borbre$*s : Noofgovernrcnt&cconh"rctbnill: i-..Lrer:uli'r'e : Legishtite

L!*}odof coakibution:lr. r'ash i.., P*rgonalChoii i ,. (-redir.DebitC$d i, hpollDedr*im :-'\looely(}rdlr lriuc xsctf{l08r15fs11 $40.00-.g@tec{:Wl

Bums FrstJdrn !{ krocjpal Qs.e:upatlonSales Amount ofContribrlrforn

$40.00

9 ilominonood .qBeacon Falls CT :IP L({05403 meorEmPt4-sGabrieli Truck SalesIs cortibotor a lobbfist spousaor d?odd hild of a lobblirl?

t' -r-es,t No If contributior h ia escerr of ${00 to a randidale commisee for a chfu{ exectth'e o$cer of amnicipafirydoee cqr*ihrtoror bu$inels herefteb assoeiated rrithhare a cortrct rtilhscidmorbipelitvrahedatmrcthansS.00o? ld f'er :j5' NoIstlb conributbn ssocisted rrith afiullloiing cr-enl lirtd h S.etior Ll?{f1*:. lirt Eteut # 08/15/2001

l-.rNo-i

IrcolbibotoraprbcipaloflstaterxntractororproslrectiTestatecost*tor? :-, lcsffter. indicatcniichblanchorhrilh* l: Noof gorernnreot the coffact is $ith: .ii Ercr:sth'e l-l Legi*lathelvftrlod of corkiSutinn:t"i Cash if, Ptrsonnl Che{& i,'r t-reditrDebit Card i:. Prlroll Dedu*ioa [^; \looe-rOrder r,IE Xrecrfa{l0u15r2011 $40.00

rE[drs:IirE

Li$I\hma Coyne !trstJamgNII Plrqral C\.ruF6tonAttomw .{nount ofColtribution

$200.00

alJwtilr Jucsa -tuqG51 lnca Drive -lsTrumbull CT;trte :p {l&le0661 l xm or !mF&t!.etGoyne, von Kdln, Brady & FriesNoIrcoobibutoralobbyirlspousa tcdcpcndentchildofalobbyid? .i Is Ifcontrihfion is in escess of${00 to r candklatesomoitee fora chicfurecutir-e off*er oflmunicipalitl'dors u:onk&stororbileiness her*lpis rsrorlisd lsi&hs\'a contract sith*oidmunhioditv$hsdrtrnotetian$5.000? ii. Ter . : No

Is thir eolbibution assocfuted $ith afridrairing ereni li*ted in Section L l?{tJ's. listEl'ent* 08/151201 1fcsNo Is contihlor a trriacipal of o rtate codroetor or prospectire state conbtstor? I . ; l,.e*Ifiw. indicate ntich hrancb orbsaches t : No

of goremmeot tlrt contnst h $ith: i, Ereeuth'e -. Legirlatirelrlethod of contibotion:

:"- rlcsh l;i Pereonal(,'he,*'.. C'reditDebitCad l-, hpollDedn*ion i'i h.Ioney0rderL|{lS KCe$rl

08/15/201 1sEralBBc{ur|m*

$m0.00Coe :IlStDavid

lrtr hmcrpal thcrmtrtmRetired .-Lmount ofCotrlribrtion

$40.00

s&i[ nucsr -{uq6\ FlLv lD6re -TGreatMeadowRd Sa-marr CT alp (.'(1de06483 N06e ot E'nPlr}}'crRetiredi-'l r-esri: N0k contrib{rtor a bbbfist. spousaor d+pendent child olu toftl'# If contribution b foi esr:ess of $4{X} to t rtndidde somnittes for a cbief cxecuth'e oftir:er of amunieipalit-r docs r:ontribulsr or busines* hels$e is so:itted rriti harc a conbact rrith e ilidnuniciprtitrrafuedatmacthan$5.000? l-' :*E* til NoIc tlis conbibution as*ocistedrtith afrn&ri*ing etent tigtd ir Sectiotl,l?{/t'c*. listEted* 0U15nA11

ll Te*'"1 No Ir contihtor a princfual of r sbte {sntaclor or pmsper:the rtate conhrclor? l- r-xfyys.indicaten'bichbranchorbr"aehc* il' Noof govemrcnt l&e contrilot ii rri&: {l Eserrrtite i- i Lcgi*trtir-eI\lslhod of contibdion:i-, Csh ,i.l Per*oaal(hsji ll CreA&OebitCard i"l PrgollHuctioa - Moae,.'Ordcr lrew 08tt5n0t1 Aggreg0E con[$mrrEw.00

Hain* rrtrltFrank nll hre$at Qcqpau(lrrRalired -{mount ofContribltfun

$50.00

IWNDEGTSNffiI Castle SL -:rqSsvmour )reCT :rp L:od.06483 i.{lllhe !11 .EmPlOt'{Retirdb contrihutor a lotblist. rpousc- ,::ordependent child ofa lobbyisfl l;r 1-csNo If contribntkm is itr cnce*e of $,fi]O to a caldidats cosnitter for a chid esecutile ollcer ofamuoicipalit-t doer codributor or busisess helshe ir associatcd nith hn'e a coatn'act rti& saidmudeioalitr rahed atmore than $J.000? ;_'Ies ..' NoIrtliscontibutionassocirtednidla l:' l'esfuadrai*ing etent listed ir Sertionll? ['r NoJ(fJ.*s. listEr"ec* 08t15/201 1

Is coatilotor a prin+ipal of a strte colka:tor or prospctir e stale conbtctot?ffw. indicatc rrtich bras,;h os bt rchcsof gorernment the co$blst is wilh: : r Er*uit'e ::i Legblatilrl'efNo

Itle*hod of costibuticn:['.t crsh ir. PergomlChs* : i ('rditjDbitcard ['-. Pa}rollfiedur*ioo F lrtoncyorder IJa3i xcefc08/1512011 *teglte co'lllruurora$50.mSUBTOTAL Sectiqr &This Pae $370.00

Pnge

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of '-


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I. MONETARY RNCEIPTS- Section B. Additional Pagq TY?EOFREPORTPaul Rcy2011 1A11/2911B. Itemized Contributions from IndividualcL*lilane Bsnardhi FirstCindy IT kir&-t{lat {:LrlrpatisrAdmin .{norat ofcontrihlion

t4 Kosev Lans Sevmourjrtl rgltcCT 0648:l Name {n rnrPrq'rfovvn ofSeymou

$100.00

b contrilstor a lobtr.r{st spou*c,or depedeu clitd of a lobbybf fesNo If cmfibution ic in et':esc of $,100 to a modllatc coomi$ee &c r chMeri*atire dher of anoaicipalitl does corsibubr or businerr hclshe ia **ociated nith hare a ccrtrar:t with eaidqunhipalitytatuedetmrelhar$5.000? :-:l'cs i.'': Nols thb coqhibrtioa *sociated n'ilh af16{6iring el:nt listed in $ectfulq Ll?f1u. lisrEvenl+ 08J15/2011

:;;1'cs:- No Ir coatihtor a primipel of a slrte ':oabrctor or pro*pcctire strt oontactor? i . l'e*I/;w. hdicate*hidrbraochorbran:b .; Noofgoruaosntlheeotractbnit}: i*.8-recoth'e'' Legi*lath'eil&sltod of eontbutiotr:: . t'arh ,;, PcrsonalCledi i]. e.reditDebitCarrl ;..,h3tollDedoctim l: UmeyO*er uat R6crse{l08t1s2011 i*teSSesoKtME$100.00

Averill FustRoealie N,II [tlnc{al l-}$crrF1oonSalEs .{mount sfContrlbrtioa

$80.00

ffi)trett.+dfes38 N. Bmham Lane _:rD'Sepnour ruLCT 4rr,.(u906483 :{olle of EnFlfl'erSelf-emdoyedls contribolor r bb$Jist spou**.r dcpearler* r:hiftl cfa lot$lirt? TesNc If contributioft is in esc*ss of S40O to a caadidate comnifi* for I chief eiecuth'e ol]'icer of Imuniclpalit-v doe* contribotor or bwitrss hetsh fo nssoebted nith hare I coatract rrith saidmunhioalih'rahedatmor,ethan$5.00tr1 .li Ycs liii NoIl thb eoabibution assotliatedrritt afrndrririq etant li*ted in Se$ionl,l?I/l'eo. lirt Elen * O8l15fZA11 ::

l-ea[1 No Is conGibutor a priacigal ofe etats corh*:tor or prorpeetive stel cotrtfl{*or? :-' 1'es{f;w. indicae ntichbranchorbrmc[r* I i Noofgolernmsnttheconhactislritfo: ti' Erecutir= l-.,LegielatircL!*lrod of conhibntioa:ff Cssb :1. PersomtChe* ::-*' CrditiDebitCrrd i-.. PalrottDeduetion F-t lr.Ioney(Her l'#swgNm04n512011 tg:8trRgilE GmsrwRW$80.00

Coe flxsLoresr [{l te*rprl i-LictlFilt{XtRetirsd Amoult ofCortribltiol

$40.00

sletnilt )reer,{o0f e$37 Great Msa&w Road _;rl1.Seymour iliteCT -tp L ru(06483 \ame ol loDlc!'rlRetiredb contrihrtor a lobbvirl spolw.ord?erdd ciild nio fodb*e TesNo If contribstioo b in ssc.ss of $:K)0 to a candidatccommitee for I dtidercrcuti\'. ot'icer of amonicip*litrdoer contrilutor or b$siness ler'shc b $socistcd n-ilh hor:e a goatracd n'ith saidnuni:ipaliryrebedatrmrcthan$5.$00{,..l r*c* ii, NoIrthiscolhibotionaesociatedrritha r: \'e*irndniring srvot listed in $eetionll? ,'. No{f}.d'- lirt El'ert * 08/15/201 1

Iscortibotoraprincilnlofastdeos&&{ororprospe$h?siatcontractor? r- l'e*^fpr. indicdenhielrbra*:&orbru:her 'r Noofgoternneatlteconhactis$ith: i. Ese'Joth'e,".Legislatit'eLldhod ofcontibstion:j". Clsh {'i PEreonrl Chedi ' . CrcdilDetrit {]ird j. Prrroll Dedu*ioa i 'i }tone-v Order

IffSSW08t15/2011

.-tgg!gae !'ontrtDuqffi$/!0.00

Garofolo brBlJamee AI PlmcrFd QceuFilrcnProfessor Amount ofContributiol

$80.00

I-tq'Seymour(trlselElnl )Ireel .{alrlf es

163 Bunoay Rd FulteCTarp L-ode08183

Nar$e oI .EmploJ'sSulfpm CT State Univ.ls coabihrtor a hbbyist. spousaot dcpendent child ofa lobbf ist? l!{ 'l'esNo Iicontributiu is ir e*cerg of $dO0 to I candidate condiffeg for a chief secutir-c ollicer of nmuniuipati$ doa eonbibutor or blshess hejsb b ltaociated n'ith barr a co$ract rith saidnrudcioatirrrahedatmorcttan$5.{XX}? i:'Tes .$l No&thbconnib{rtbnssocinted$itha l': lcsftadrdring etot listed in Sectioall? ' . NoI/J'er. listR"entc 08/15J201 1

Is contibutcr a prinr:ipal of a sttte conilrrstor or pmslnctire state conhador?Iflus. iadicate ntieh brnnch or brm$e*olgorvnmtlbecontr.etifrrith: lllErersrtir= i-lLegisl*h'el-l r*esi:' l.lo

Ilethod of eonbibution:i , Cgsh sl Pe,rronal Ch*,;k i:l CrediuDebit C.ard i I Palroll Huction I lrloney Order t&B xec$e{l08115/201 1 iEEIElirEcwun]M$m'ooGeeek flIsSaundra I,II Pr$tcrpnl

()cclpahstReUrcd Aglotlnt ofCoatrlbutiol

$40.00

3TColonv Rd Seymour:is'iL1teCT

.Sr (_'ftle0&$83 Nsme $t.!,nrpln]'erReliredb contributor a lobb-r.iat spoue"ndcpmdcd child of a lobbl.b8 '-' fes If contribrsiotr is in ercess of$400 to n candidatc r;omoittee fot e chl* crFcuth'e officer ofamunieigalig does co*ih$or ot bnsinese he.trhs b ssochted rrithhate a cortnct rrith saidmunicipalit-vvahrcdrtmorethan$5.000?'rf' l'es ::;i NoIr t&b contitutbn ssociated nilh afrrdraising er-ent listd in Sction L l?

{fr.ds. list El'nl + Oe11512011l'BsNo 'lesrNos conbihto aprincipal of a sltte r:o!iln:tot orP$sPecth'e strte ronhletor?{f;ur. indicate whie.h bra*h or bra:hc*olgoremnent the co8act is rrith: ':-t Ese,nrth'e ]i-r Legishth-

Itlc{rod of contibutisn:[-t Ca*h ;; Perso!.11(te* :']'i trredit/Dthitcard [' PrlrollDc&ctim [T lloneyorder lr{rg t{i:ctYgJ08t15I2011 rggreln& rarnsHffi$40.00SU3trCITAL Sectim &'This Pap $340.00

Pnqe of


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L MONETARY RECEIPTSwreoiREroRT

Paul Roy2O11 19-11t2O11B. Itemized Cmtributionsfrom IndividualsLa*tNoe Grarde ! rslCerct t{ Pttncipql C|is+otlttttCustomer SenrbE

$40.00

Amortnl ofCorrrihrtios347 Sdttl Main St. -:rt-vSayrow ttaleCT :|PL(U06483 Nane (rr tilFt(l}-erOEM Contolsb contrlbnsor I lobbli*t *pousec depedcnt ebild oia totb$d t-esNo If r:stribution is il errccss of $-lO0 to a candidals .:osrnitte for a chid *ecuth'e offrcer of am*nicigatiS doc* u'odribrtor or brusines* he'she b axochted rrith bsts r r,'ontrct wi& saidnunir:ipali{rrelu+d lt more t&an $5.000? l-' Ye* i:., No

Isihb*oohihtionassociatedwi$a :;; l's&ndrai*inger-er:tlistedio$o*bnLl? i. NoI/.per. Ilsl Erent * 0811512011ls conbibutor a principnl of r Ebto so&a,{or or prospecth- stat llonbrqtor? i- , teaflt- hdicderrhieh branch or branche Noof gor.ernent ltre coohact is $ith: ;'l- Execqth'e :* Legislatire

\Iethod of conbibution::'.. CasS'i, Personrtt:hs'di : -. CrcUitOeUltCard l'. hlroltDcdnctiol l-' ilIoncy ffier us xncerFe{l091s2011 .{Sqrcgae c(uulm(N$40.{x}L8'Nf,N Singh r!:rH. Pnet \.fi Pfsrc{tal CL'ci$ttmReseardl Ghsmist .{mount of{lontribution

$80.00

52Davis Rd irt}'Seyrnour CTrtluc :rF Lode0&183 (4 Ertrlrtl\Cytacb c'oatibstor a hbblirl rpouse.ordfprndid child ofa lob&y'irP .i'" r*esl;r No Ifconbibution ir b *lrces3 of$400 !o a caadidate*ommifi.fo*a cbiefcsecslh'e officer ofanudcipality does r'onbibutor or bosinlss hd# is n$ocisted lriitl har'. c contrast nith sddomfoipoli$tahed aroore rhar S3.008 I.i }'s lr5 NoIs ttb c'ortribntion aseo,ehted rrith Ifuadnising o'eot listed ir $s:tion L l?I/.14. lbt Evefr * ggl15l201t

l"egNo::t"l k coatibutor a principal orFa etate coaira,lor or prospecth-e shte conh*tor9 i ; Te*t*er. &dicnte rrhirfi bnnch or lxam[es , ;-' Noof gotemment the corfract is reilb: ;'.' Exe,:uthe ::-i Legistati\-e

hlclhod of r'onbbution:[r r-esn .'i. Fcrsond Chedi l:'r CrediuDebit Cud i. hltoltDdo*ior fi h.IoneyO.det I;lc KeGll'eO08/1mfi1 rggrryEREsFum$80.00Gru&ias rwRichard h,II Pritrryil CtcupstrrnRElircd -dmount of(lontribution

$40.00

t@KI JUdt -1gWS29 Rimrnon SL r'ls$eymour itrteCT ll{r i- t1$e05483 :aame(rMplo]'t

Retiredls 'rontributor a lobblist, spours.r depqndnt child ofa lobbl*fl ilTesrl No If conkibulion ir in escegs of $400 to a candirlatr comrnit*c for a ehief erccutive o$ser of amuaicipali$' doer codibttor or bnslress hlsh ir rssoeide{ sith hare l corkact rtith saidmonicioalih'rtbedetmorethac$1"000?,-lfe* l- NoIs ah& conhihf,tion assoeiated n-ith .furdraising cr;elt listdd irr Section Ll?I/,ycr. list Etec * Ogl15l2011

YesNo Ir contitntor a prhciral of l state coafuactor or prospectirc shte colrbrctor? l- ; Yesfyar" indicaterrLichbranclrorbram&es . Noofgortromrtthecor&actigrrilh: ii.Exc,xth'e :-.Legislath'eI{eitod ofconhibutior:-. fa$h 'i; Pemonal Cher* : . CrcditDebit Crrd 1 " Pagoll Dcdu*ion 'll tvlonc'y Ords

DAle fi$Ce$'ed08/15/2011

ASCrl$lF COnqFrurts$40,00

Smith FKAlloneo Ntl ttb*rpal(,DcoDf,tonRelired .l.mount ofContribution

$100.00

rKiuluers{ffi t(-.u!' l)6rcI Hunters Lana Savmour CT "|8 l'Ne0a$3 Nrme t}I tsmplrlJ-erRetiradil 1'esrt- Nob csatributor a lobbyist rpcuse.or dcpmdent ciild ofa lobhyist? If contribution is itr esr:ess of 3,100 b a candidate commitee for a chicf e$ecuth e o&icer of amunicipaliry does codributor or burinss heishe b Ns$oci$ed nith let's I coo&*ct ri& *aidnu$icipali{rnHatmorethaa$5-000{t f Tes iTl NoIs tl& coabibution associated n'ith a s,1 l'eefindraising oent listd in Slctionl"l? .^. NoIl;'c*. li.st Er-ent ; Ogl15l2D11

f,reonilibotoraprincipalorfartater:ontar:tororgrospctirestateconhactor? tjl lesfpw. indieatewhichhanchorbrancfis .l Nooigor:*nmat lS* contnct fu $ilh: i- I Esq:oth'e i'l fegislntheIUetiod of contibution:i'I Carh Fl Pe*mel Cherji {': CrcditDebit Card ,-l Pa}roll Dedu,*iqr - Ilo$ey Qrder Lx[ tf,i;c$.ac08f15t2011 A8ftgBe coll[n}u{rrIrs$100.00

Horbal FnstMichael N{t PrurclFlt-[WA&onLend Survwof .lmounl ofCortribution

$40.00

gwal iueal.tut[8s12 Oakwood Dr. 1t]'$eynpur xatCT :lP (-rode06483 Nlnre otElr1Flo!'erSdf-erndowds conbibutor a lobbfisl rpouse.r dcpendent cbild of a lotrbl** fesNo If cmtribr*ioo is il cxscsr of $400 to o ceudklate r:omnittee for a chif enecutie of icer of nmonicipali5' doea coofoibutor or brrsioess her*he is tssocist*d $i& hate a cootract with saidmuahipali8rahedatmoretlan$5.000? :a f-s :ia No

Lg thb colbibntion asrasiated $ih rfiurdraishg cvent li*tcd in Se'rtiol Ll?Ii'cr. lbt Er-e* * A8l 151201 1l'csNoil h contibutr a priacipal of a sbte sotrfrctor ot ptospel'th-e stnte conhactor?trts" indicrterddch brarch or branchesof gor'*rnnelt the controct is n-ili: t '' Ese,:uth'e ]*i Legislathe

TesNo

illettod of coqtibntion:[*r fagh ';:i Persornl Chedi ::' ' credit'Debit card I Prqoll Dedu,iiotr Ff \tuey OrderL)iIId KECCtrd

08il15n011rgg.egirF

$40.fl)SUBTOTAL $ecrim LThis Pas $300.00

Plge

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7/40

L MONETARYRECEIPTSSection B. ALditiond P?ggTY}EOTREPORTPaulRoy2011 lU1ilz011B. Itemized Contributions from IndividualsLastNee Fl'stDonna l\tr hinciml tlqrrnalionSecretrary

$40.00

.lmootrt efContnibotioa7 Kozev Lane Sevmffnr.!- IttcCT :lP L:t\t06483 Nane or rmPFtcrTown ofSeynow

ls eosbibstor I lotrblisi. spouse.ordepeaded child ofr lobbl.irt? YesNo If contrih:tiod iB h


8/40

I. MONETARY RECEIPTSseclionB.@TEF . . -,,. ..- TYPE:OFREPORTPaul Roy 2011 1W1112O11B. Itemized Contributlons from IndivirlualsL:r*Nane Bemardini FilstCiindv I\tr Ptinp'ualfJs'r:natirrnAdmh Assistant

$50.00

Aeo$nt ofContributftn14 Kozev Lane $eyrpur.:lq' CT :,tF r-o(re06483 lWC OI tmpln{'clTmnof $eynotr

Is contrib*or a lobbybl. rpous* r". 1*esordepeadentchildofalobb3:ir9 :i, l,Io If coahibutiol b io eeccers of $400 to a eandidate rcodalise fora chiof ess:ulh.e ofiicer ofansnicipalitl. does coatibulor or blsiness helshc is issociated 'nitb hare a eonhact witb saidmonhip.lit-r$tued atoole than 35.0O0? lf. f e* i;, NoIs this con&ihtiDn srs*hted rrlt afrndrairhg er"ent listsd in liestion L l?I/;'ds. Ibt El'!t * 09/09/2011

;.: Y3.No Ir coakibulor a priacipll of a *tate conb**or or proslncth e rtate conba'itor?Ifnr. iadicate rr{ici bran& or bruskofgot*mdtheco*actisnith: ri.Executive .-. Legbleth'eYerNo

I\.trdfr od of conkibutioa:; . c'ash :;; Pcrsomlfhe'i: ;'.. Credit'Dcbitcard i, httollDeduction i: I\ho:'fuq u0l KeceFnI0910912011 dgEr:gnacotrsrruw$165.00Blake FtstKaren T,II Prirpl Cl:rrryafrr:nAltormy Aoount ofConlriburho

$25.00

ffiil;ueel.{gdes19 Blrchupod Dr. htfAnsonia rutrSCT :rF{-ode06401

Nme or Emprq'erWelch Teodosio Stand< & Blakek contributor a lobblirt spouseotdepearle* child of r lotib$rt? ." Yer',rt No U contribdion h in cxces of $400 to r candidatc coomi$ce fora chiet'.:scsnth-e ollicer of nnrnicipllig doer cootributor or bleiner* Hshe b xsoci*ed rtiti h*t l corbact nith saklmuairipalih rabed at mre than $5.{XX}? Xi' r*es j-, NoIs thb coabibnrtbu *sochted rtith afirndnfoing er.+nt listed in $ectionl,l?t/;'cl. li$tEl'eott Ogl09l201 1

\esNoi Is coabihtor a principal of a stfite con8lqtor or pmspectire etate contstctor? ,''' tesfgw. indi*de nbich braruh or brm:bcs lr-, Noof governnent the uonlnrt b n'ith: l'l Erer:nthre ia Legislath=lrle*lrod of conhihution;[-t r-as] 'i. Pcrsond cheeli i' ' f.rcditDehit card i'. Parrolt Dedscti$ l'-i lr{onc!'ordcr

,.rate xaccli:e{ogtlgtzoll 388legrGRnqmrffi$2s.00Coe 'H David l\{I Pn L'rF{rl {-\*r&oglmRetircd .{mount ofContribatha

$40.00

sxEISIil )geel .{g(ri}ss7 Great Meadow Rd ltrSaymour iulleCT :lI! t-{1de06483 Na$c r]l lmtrh} cIRetired[r conlributor a lobbfist. epouse.r dependent r*ild of a lobbl.bt? ! , l!'s'ti No If contrihr$ion is in escest of $.ltl0 to a caadidatccossilte for r c$ief drelrrti\e offisr of amudcipality doc* costributor or busiucss hsishc is rsssliafed rrith hare a conbaet n'idr soidnunbipalib'r'alued atnrorc th*n $5.000? l"l r*ea 11. lrto

Is ddr cortibution a*sociated rritl aSndniring event lirt*d in SectionLt?fJ'cs. li*t Erer:s 09/09120't 1q: Ys:-. No I* canbibotor a principal of a sble cordrector or prospccth't state sotrhsctor? l- , Tesdflw"iadicaterhichbranchorbremfu . Noof gorernnrent dre eoatnr:t ig rrith: fl. Exurnth'" i'. Legirtntir-e

Irlcdrod of gonbibutio$:4". cash ij Per*omlCbeck -. creditDebitcard J. hpollDeduction : iLlone.vorder

HFffiGFR09/09/2011

iggr8filll cotralFuNtrs$228.00

LdNiuB Conroy !ltrilFnancis \,ll Plucnal{fmnatrrrRetired Amount of{lontribrtion

$40.00

tr3sKrtElnr )ueil.{diris F,1$ lJrireloTskokoratst Saymour CT lrP lfrle06483 NArb ot!,mp!s:efRefiredtgcont.ibutoralobblirl.apou*e. LI 1,-esor dcfodnr cbild of a totrbl.irfl ii-' No If conbihtirm ia in esrcss of $d00 to I surdidntc commiter for a qhie'f executive ofiicer of amunicigalilvdox conhibutororblsbess he/sheis n*sochted rrilbhalea corftact ririthsaidmunicionlitrr.abedatnorethm$5.000? r-. l'es nl Nols tlis conFibution associntedsitr Ifiindmiaing erent listed ia Seetio{Ll?I$'cr. listEfcnit* 09/09/201 1

$l legl-' No {l t..esi' ]\ioIr conuiheltor a princigal orfa state conaar*or or Pr$pcth? $trte conhar*or?{fttr. indicate trticb bnrch orbramhesoigorerlmentthecontrastis$ith: ill Ltecuth'e i-lLegislath'eltldhod of conbibution:

1- : Cash {tl Persmal Chdadi 1,1 CrsditiDbit Card .l Palroll Deducion a Nlore-v Order lrflc ltGcelveq0ey09r2011 Sgge$llO clrnlnFuBolls$40.sDioo Cvnthial.rst I\'tr PnncFal

{'}cupat({rAPEDIS Amount of(lontribution18 Caniaqe Dr Sevmour,:tt! turttCT :rir L'r\le06483 Nrmc 0I lnrFh}'erL*com

$25.00

Lr ccntrilnrtor a lobbf i*t spouse.ndegendent child of a lotrbl-ist? -' Iesit No If ,:ontributiod is in csqdss of $4m b a caadllete u'ommitee &ra chi:f esecoth'e o,ffrcerof rmunicipdig does contributor or blsiress h6;shs is rsociated with hale a conFael n-ith saidauniciiralityrohedotmorethro$5,000? .t':' Yeg lii No&lhircontibntioaassocirtedrrilho :i l'csfrndnising e\ent listed in Sectioll.l? [-r No{/ye. lial Event + 09/091201 1

ls contsibalot a principal of a state codrartot or prosp*:th= strte cotrhilctor? i -t TcsIfus.hdi.x*n'hichbnecborbraashes 1r Nooigorernnrent lhe codrlct is $iti: i '' &:ecuth'e :-i Legistlth?Lldhod of sortributisa:!'it-ffL ::*d PersaaalChec& :;'i (-leditDebiteild [, pg1.rollfu&*ion Fhtoaqrorcet udcKecqvd09r0sr2011 .{sgrtEc { $25.00

S{]BTOTAL Scclim B'This Pffie $180.00Pagc

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9/40

I. MONETARY RECEIPTSSecfion B. Additional Pase i10t1'l'2911aul Roy 201 1B,, Itemize{ Contributions frtrm llrulivitluals

LastNaile Fries FirslCollEgnIUI kmrrpal OccuitauonAttomev

$100.00

Amount ofContribution107 Soruce St. Seymourilti ttateCT

llp t.!tse06483 1\U Ot l$Plrl}CiCoyne, von Kuhn, Brady & Friesls contributor a lobbfist. spouseor deperdent child ofa lobbfst? f; YesNo If contribution is io esees of $4O0 to a candidate eoarmitee for a ehiof esecutite oflreer of amunicipalitl' does coatributor or business he'she is associated n'ith har-e a coffrast n-ith saidmunicipalitr ralued at rnore than $5.000? C Yes {, ttio

Ie this contibution assosiated \r ith afirndraising er-ent listsd in Seetioc Ll?It''es" listE\-nt+ 09/09/2011iij Yes.t No Is contibutor a principal of a shte contraetor or prospectire state conhacior? f. YesIf'eo. indicite n'hich branch or bra$ehes fl Nooiiovernment the coobaet is n-ith: {. Executh-e f. Legislative

Nlethod of poaFrbution :f. cash f; Persoral Checli ii. Credit'Debit Card i{. Palroll Dedu*ioa la, \Ioney order Date Kece*'etf,09r09t201 1 .{eigregate conErDutsons$100.00Garofolo iLst I \trJames I hrlrryal tlccupats(rnProfessor Amount ofContribution(slgufl JEeer.+dqs

163 Bunoav Rd,lqSevmour CT ,rP

L os06483lame oI Bmplq'erSouthem CT State Univ.

$40.00

ls aontributor a lobbli.st. spouse.or dependent child ofa lobbrisfi i Iesli3, No Il' conhibutioa is in excess of S-lO0 to a candidate committee tbr a chief esecutir"e offieer of amuoicipaliq'does contributor or business hershe is associoted n'ith hare a conhact rtith saidnuniciiali* ralued at more than $5$00? lfi :*es ifr NoIs tbis ,roqtibution associated $ith a lfl lesfrndraising er.ent listed in Sectionll? Ft NoIfi'es. list Er.ent * 09/09/201:l Is contibutor a prineipal of a

state sonttactor or prospectil e sttte contactor'l f' r*esIfi'es.iodicitet'hichbranchorbranches 'fi Nool gor ernment the ,rontract is rr-ith: .fl Executir-e lfi Legislative\.lethod of conEihution:Ki Cash fl" Personal Clheck lfl Credit'Debit Card f: PaFoll Deductior F Nlone-v Order Date Recen..edo9/09t2011 $120.00

LtrtNafte KulasFtrst I NxSteven I hncrpal OccupauonAttomey Amoutrt ofContributiol

$40.00

Ksrde$ral street,+dd$s31 Skokorat St.'rq'Seymour ,tAteCT :rp Lod,e06483 }lame lal EmPlq'eIMay & Kulas PC

Is cootributor a lobb5ist. spouse.or depeldent child ofa lobblist? fl :*es;'' No If conhibution is in ericess of $JOO to a candidate somtniftec for a chiet^ exeluth-e officer of amunicipalilv does contributor or business hershe is assot)iated sith hare a Qonhact n-ith saidmunicioalitv valued at more than $5"000? f. Yes f: Nols this conhibution associated with aftndraising e'rent listed in Sectionll?Igrer. listErent = 091091201 1

{: resf. No Ls contibutor a principal of a state contractor or Prospscti\ts stlte *ontaclor? {i fesfy'er. indicate rvhich branch or brancher f. Nooigovernnrent 6e conbact is n'ith: f, Esecutir-e f. Legislatiteuate KecelYeq

og/09/20't 1.{ggreg:arw conurDwotr

$&4.00Haines Fust I ltfiFrank I &inclpal LiccupstronRetired -A.mount ofContribution

$40.00

tsrdeilnl xrcet.+oqres F.lt) lJre8 Castle St. Seaour CT arp eode06483 Jme or lmPrQ] erRetiredfl Yesr!. Nols conhibutor a lobbfist. spouse.ot dependent child ofa lotrbf isti Il: iontitutioa ls in sreess of $4O0 to a caodidate qonmitee for a ,rhief executir-e officer of amunicipalitv does ,rontributor or business he'she is associated n'ithhare a Qontact with saidmunieipalit-rr-aluedatmorethan$5,000? C: r*es f: NoIs this ,ronbibution associated rvith afimdmising etent listed in SectionLl?I 'e$. list Erent * 09/09/201 1

{il Yesi]]No Is conhibutor a prineipal of a state contractor or prosPecti\t state contactor? {.l Yesf;'es. indicate s'hich branch or branches {l Nooigorernruent dre contract is n-ith: fl Executire fi Legislatir-eIUethod of contibution:fi, t'ash {-l Personal Check fl CreditDebit Card fl Pa}toll Deduction fl IUoney Order ute KseFec09/09t2011 -l8lega corurguEQ$$e0.00

MitterFust I \tr

Navnit IPrncrpal {-lcfirFatronDir., Genetics Lab .{monnt ofContribution

$25.00

KSSrUennAr Jtret -{d(trcs77 Brookfield Rd Seymourl1h CT

:P Lee0a+83Naare of Emplqer

Labcorp.f Yeslfi Nols contributor a lobbf ist, spcuse.or dependeat child oiu totttl'lrti If contdbution is in esicess of $100 to a gandidate somrni$ee for a chief executire officer of amunicipalilv does contributor or busisess he,she is associated nith harc a contract n-ith saidmunicipalib-rabed at more than $5,000? .'0 Yes i6 No.'f; Yesltt NoIs this conhibution a,cgociated $ith afundraising er"ent listed in Section Ll?

{f1'es. list Event * 09109/201 tls conbibutor a principal of a state contrtstor or prospDti\ state contactor',) f' t:esf1'a, indicate nhich branch or braoches fi Nooigoremment the cootract is nith' f, Executive lfi Legislatir-e

h.Iethod of contibution:H"i Castr F. PersonalChech ',fi c'reditDebilCard F Pa-rrollDeductioa F Ntoael'Order Llate .K$en'eilosr0g/2011

.{ggregnle rlrnErDuBlrN$25.00

.SUBTOTAL Setidl B-Tlrts Page $245.00Page

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10/40

I. MOI\TETARY RECEIPTSSection B. Addifional PasePaul Roy 201 1

B: Itemized Contributions from lndividualsL#tNme Potash FiIstCarmelita \.fl ?rurcrpal 0cupatqlRetired .{mount ofContributiou

$40.m

K6lwat Dqtrr -{qcs23 Glen Cirle -rq'Seymour CT)hle JtIr !tE:08+si NAm Or EmPra5'erRetired

Is conhibutor a lobbrisl spouse.or dependent child of a lobbf ist? YesNo{'.{. U "o"ttit*i* i* i" escess of $4O0 to a eandidate coomittea for a shief esecutive officef of amunicipalitl.does contributor or business he.ghe is associated sith har-e a conhact nith saidmunicipalitr.vahredatmorethan$5"000?'f: Yes f, NoIs thir conkibutiol associated r-ith a f] Yesfurdraising event llsted in Sectionlt? C NofJ'es" list Evest + 09/091201 1

Is coatibutor a principal of a shte coakactor or prospe,ctire state cotrbactor?I/1o. indicate l'hich branch ol branchesoiiovernment &e eonbact is *-ith: f. Lxeeutire f. Legislatir-ef. r*es{- No

lrlethod of conhibution:C. t-ash fil Personal Cherd; f . CreOit'Dehit Card C. Parroll Deduction l{- Nlonel'(Her IJaIe Kece$es091091201 1 -tregare

conqFuu(rs$40.00

LNt Nilre RoyFifttPaul

I\{I Prs,;lpal Ctccupa!0nFirst Selectman .{mount ofContribution

$50.00

Kesldetaru )ueer -{utres80 Washinoton Ave.lib-Seymour

mreCT :lP rlq06483Name ot bilpllrl'erTown of Seyrnour

Is conhibutor a lobblist. spouse, il Yesor dependent child of a lobb-vist? lS' No h'"""tttb"tir" ir in qrcess of$4S0 to a candidate sommi$ee for a ehief esecotite officer ofamunicipalit-r does coatributor or husiness hershe is associated $ ith hare a contraet n"ith saidmunieipalitv valued at more than $5.000? 3-' Yes :f' No'.f Yes[fi NoIs this coahibution associated n-ith afundraising er.ent listed in Section Ll?Ifi'cr. list Erent * 0910-91201 1YesNols coatibutor a principal of a state conhactor or prospectir-e state con&actor',) {rfJ6. hdi;te $'hich bnnch or branches '.fioigor-eroment the conkaet is rvith' fi Executh:e lfi Legislative

Ilethod of cortributioo:Kl Cash f. Personal Cheeli :i Credit'Debit Card F. Palroll Deduction F' \'Ione3'Order l)ate Rerrved09/09/201 1ngEltgdrc t

$170.00[ast]il Simpson FustJames \,II ?rincrpal rlcetpatonPrincioal AmouBt ofContribution

$40.00

K6lderf$l Sheet -ld,f ess4 Falbo Dr. $eymour]Ib' ;tateCT 3pLde06483 \arue oI tsmplclerTown of Waterbury

Ig soltributor a lobbfist. spouse.or depended child ofa lobbyist?i-f YesNo tf ""nttibutio ir in excess of ${00 to a calrdidate committee for a chief executir-e offrcer of amunicipalitl.doeg coahibutor or businEss heishe is associated $-ith ha\.e a contract n-it& saidmuni)ipalit\.'vahed at more thao $5.000? f. fes f, No

ls this contribution associated with afundraising event listed in SectionLl?Ifi'er. listEvent # 09/091201 1

{31 YxlNo Is contributor a principal of a state conbaator or prospectire state conhactor? {, fe"f1,es. indieate nliich branch or branche$ f , Nooilor-emment the contract is n'ith, f. Executir-e f. LegislativeIr.Iethod of conhibution:f. Cash Si Personal Check {: Ctedit'Debit (--ard f, Palroll Deduction ll lt{oney Order

Uate Kece$ ed09/09/201 1

{ggregate canElDu[Qs$40.00

Skurati rstRonald N{l Principal ClccupationRegistar Amount ofCmtributioo

$40.00

Rsldenhnl Steet.\dte:s t-)t]' lJhte19 Gln Circle Seymour CT LIP LNC06483 Name oI Empto,\-HTmrn of Seymour

Ig eontributor a lobb3'ist spouse.or dependent child of a lobbf ist?

l Yesh. No If c"ntdb.tio i" in er*-- o? $d00 to a caadidate commi$ee for a ebief executi\-e o*icel of amudcipality does conhitrutor or busbess her'she is associated Jrith ha\''e a corhact rtith *aidmunicipalitvraluedatmorethan$5.000? f' Yes l*l NoIs this contibution aqsociated $ ith afirndraising e'r-elt listed in Section Ll?It'(,r. list E ent *

{il r*e.g{*l No ts conhibutor a principal of a state *ontractor or prospectirc state contractor?f.1'es. indicate rr-hich branch or brafirhesoi'ior-crnnent lhe conhast is sith: dll Esedsti\-e fl Legislatirr{,] Iesfl No

N.Iethod of contibutiol:fl, Cash $':l Personal Checli ill Credit'Detrit Card {) Payoll Deduction f lrlonel'Order Uate Kffel\-eil09/09/201 1lgxe8BE ct)nErDuq(rN

$80'00Stanek

rustFredIUl hincrpal ctcupaurxAttomey .{mount ofContribution

$25.00

lsrdersrat $tet Aotres22 N. Benham Rd.:rb.Sevmour

itsRCT

.rP rluc06483Name ol !r1pl$'6rWech Teodosio Stanek & Blake

No'{i#t

Is conhibutor a lobb5tst spouse.or dependent child ofa tobbf isti fes It'"*ttiUd* is i" crices* of $4O0 to a candidate conrmiftee for a chif esesutir-e office{ of anunicipaliq. does contributor or busioess heishe is associated rvith have a contract rvith saidmunicipalit-rrahred atmore thaa $5"000? lf r*es lfl NoIs this contibution assosiated n ith afundraising erent liste{ in Section L l?I/ler. list Event * 0Si091201 1

l-esNo{an Is conhibutor a priacipal of a state contractor or prospecti-e state contrsatot? f' Yesflvs, fudicate which branch ot branches fi Nooi lor-erament the cootract is $ith: fi Eseeutive 'ii Legislatilelrlethod of conhibution:

Ea Cash tr penonal Cheuk 'fi CreditDebit Card F- Palroll Deductioo F lrlonel'Order Date Kecerved09r0s12011AgglegaE conErBu[om

$25'00SUBTOTAL Section BThis !19 $195.00

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11/40

Paul Roy 2O'11

I. MONETARY RECEIPTSSection B. Additional Paee ffiF10t11t2s11B.' Itemfued Contributions from Indivfuluals

LastName Stanek FrslKaren I\{l :nnclpal OccupatsonRetired -lmount ofContributiotr

$25.00

Kestcel{$l JEei Aogress22 N. Bneham Rd Seymour.'rD CT'EIe irP l.e00483NAnre ot EnrprcS'elRetired

Is contributora lobblisl spouse. C. Yesordepeadentchildofalotrbyist? {r, No If corbibution is in excess of $lO0 to a caldidate coarmittee for a shief esecutil'e officer of amunicipali!'does contfibutof or business he;she is associated r*'ith harc a contracl with saidmunicipalit-vrahredatmorethaa$5.000? i", fes $, NoIs tbis conhibnrtion associated with afundraising event listed in Section Ll?{/l'es. list Erent + 09109/2011

,:: Y*.r. No Is contibutor a principal of a state contrastor or Ptospective state contaetor',)fler. indicate ntich braneh or branchesolgovernment tle conbact is n-ith: {. Etecutir-e {. Legislatirrei. I"tf* No

Nlethod of contribution:i. Cash 6., Personal Chedi l. CreditiDebit Card lt*, purtoll *O,rclion lli lrlonel'Order flate KecerFed09/09/201 1 -agelegate contrlbuafirs$55.00Stauffer tffit

I\11Christine lncpal OccupatsonRealtor AmouEt ofContribution

$50.00

21 Briohtwood Dr. ilq'Woodbridge tateCT :rp Lrrde06525iame oMPlo)-erself-employed

Is contributora lobblist spouse,or dependent child ofa lobb-r'ist?.f. r"es16lNo If contribution is in eJrcess of $400 to a candidate conmitee for a chief esecuti\ e officer of aorunicipalitl- does conhibutor or business hershe is asso,)iated n-ith harri a conFact rtith saidmuairipali&' r'alued at more than $5"000? f' le's lfr No

Is rtris mntribution msociated q-ith afuodraising event listed in SectionLl?fy'es. list Event * 091091201 I PYesKi No Is cootributor a principal of a statc cootractor ot prosPectht state con$astor? f' }*"*f'.es. indiciten'hichbranchorbranches lf' Nooigorernment &e contract is rtith: ilr Esecutive fi Legislative

Nlethod of sontibution:61 Cash ii Personal Che{k :l' Credit Debit Card Fl Palrolt Dedu*ion F' \{one1- order Date K*rvo0s/09r2011 Ag-elegale comrouoQm$50.00

Stelma Fifft I \trJohn I krncipal (:iccupauoDSuoervisor .lmount ofContributior

$25.m

tsxlefiat Jlrer.{d&ess3 Oriole Lane :lNSeymour )uI9CT 1rP LDalet)648i!Nme 0l Smplc!'erGW lnd. Westem GT

Is contributor a lobblist. spouse. r.:or dependent child ofa lobbtist? r5l YesNo If cootribution is in oicess of $400 to a candidate comrnitee tbr a chief executive ofticer of amunicipalitl' does contributor or business hershe is associated rrith har-e a ,ronh&ct n-ith saidmunieipalitl- ralued at more than $5.000? f, res f,; NoIs this contibution associated r-it} afuldraising er-ent listed in Sectioo L l?!fi'es" list Event; 09/091201 1

YesNofI -l,-esNoIs conhibutor a pdncipal of a state conhastor or prospecti\-e state conbastor? {:.Ifi'es, inclicite n-hich branch or branches t-oi'gotornrueat 6s contract is n-ith, f. Esscuth'e f. L"gi*lutit'.\{othod of eontibution:f. t-'asn tr. Personal Checli i- CreditDebit Card f, Partoll Deduction {-l lrlone-v Order !)are Kecelv{09/09/2011

.lgglegste contsrbutrons$25.00

La$ Nanre StrumelloI lrsiEdward \II PnncrFal OccupattonRetired Amount ofContribution

$25.00

{srdedral Street Atidss IJt}' lJtate188 Mountain Rd Sevmour CT lrp LNe06483 lame !)t gmplo-\:erRetiredls contributnr a lobbfist spouse.r deperdeat child ofa lobbl'bt? il-l tes'l No Ifr;ontribution is in ercess of$lO0 to a candidate committee for a chiefesecuti\-e ofriser ofamunicipali$' does contributor oc business hershe is associated *-ith har-e a eontraat $-ith taidmunicipalitl'rahedatmorethan$5'000? fl Yes fil NoIsthisconbibutionassociated$itha fi.] Yesfirndraising er-ent listed in Section Ll? f . No{f}'er. list Elent + 09109/201 1

ls conbibutor a principat of a state conbactor or prospecti\? state codEactor? C.l r*esI$'es. indicate w*ch branch or branches {1l Noolgor-e,rnment the contract is s'ith: fl Esecuti\e f' Legislatile

\Iedrod of contibution:f , Cash 6':l Personal Check fl Credit'Debit Card r*l Patroll Deduction f \IoneJ'Order Date Recell'ed09109/2011 ugeRrE $25.00TrybusLastNane

Fffit ll.trKarl I

Pmcrpal L)!'cupa!onlnstructor

$25.00

..Lmount ofContlibutio[fwuel]B )rcgt.tgqgs

20 Old Ansonia Rd SevmourirN J{ateCT

lrP !44906483

Na$e or lmProterUconnIs contrihutor a lobbfist spouse,or dependent child ofa lobtrl-ist?

'il' Yeslffr No tf contribution ie in ericess of ${O0 to a candidate commitee for a chief esecutire officer of amtnicipatit-r. does conhibutor or btrsiness he,she is associated n'ith hale a contraet *'ith saidruunicipalitvralued atmore thao $5"000? If' :r-es ',fi No\-sNoIs this contibntion associated n ith afirndraising er-eat listed in Section Ll'?I/r'er. list BYent * 09/091201 1:f,ti-' Is eonhibutor a principal of a state soltractor

or prospctile state conhaetot? f,' festf'd. iadi;te $iich branch or branches lfi Nooigoreroment the contract is sith: '1fi E:ieeutive 5i Legislati'eL,fethod of contibutiotr:Fi Cash $- Personal Check lfl e-redit'Dettit card F Pa5roll Deduction F lrtronel- tlrder Date RtreFel,09/0912011

lggregate conrlbuorxrs$25.00

SLTBTOTAL Sectim BThis Prge- $150.00Page _ of


12/40

I. MOh{ETARY RECEIPTSSection B. Additional PasePaul Roy 201 1 1U11t2011

B., Itemized Contributioas from IndividualcLastNme Valeski FtrstDawn l.tl Prrrcipal OcrrpationAsst. Public Works .{mount ofContribution

$50.00

20 Osprev Dr. -1S'Sevmour 'BICCT arp Llode06483 L\Ug QMplq 9IToan ofSeyrnourIs conkibutor a lobbyis( spouse, f . r-esor dependent child of a lotrb-visf? lr, No If contribution is in eseess of $4O0 to a caadidate gommittee for a chief executire officer cf gmunicipalitl- does coatribulor or business he'she is associated rrith hare a contsact rtith saidouoicipali{. rrlue at qrore than $5.000? fl Yes !i, No

Is thb conhibution associated $ ith afirndraisiag event listed io Section L l?yyel listEvert+ 09109/201 1f, Tes.f. No Iscoatibutoraprincipalofastatecontractororprospcctirestatecootactor? f. Tesfy'es. indicate n-hich bran{rh or braocles f* Noof govemment the coniract is *-ith: f. Erecuti'e f. Legislatir-e

\lethod of ponhibution:f. Cash f , Personal C.heck i. Credit'Debit Card ii, Paltoll Dedur)tioo ]f. Irlonel'Order @r9KWgIro09/09/201 1 {gggatB conErDuuos$50.00Last Nane lMlhelmy FUStMaureen rlt ?nncrpal ocdrpabonDist Mqr -{mount ofContributlon

$50.00

116 Maole St. lq'Seymour ilareCT .lI) rgqc0B+83 lame ot bmFt(l}irMetro-NorthIs cortn'butor a lobb1ist, spouse.or deperdent child ofa lobbr.ist? 3

-t,-esNofr If conhibution is in sxcess of $.1O0 to a candidate commifiee for a chief sxecutive officer of amunicipali$' does conhibutor or business hershe is assosiated sith hare a contract n'ith saidmunicipali!.raluedatmorsthao$5,000? Irt fes,fi No

Is thb conhibution associated n'ith afrndraising er.ent listed ia Section Ll',)I*'er. list Etent e 091091201 1 lfrYesFNo Is contributor a principal of a state contlaetor or prospati\ state c$nkactor'.) f, l*esIfizs.indicaten'hichbranchorbran*hes ifr Noof gor-ernment the eoctraqt i$ rr-ith: ji' lxecutive lfi Legislatir-e

Nlethod of conhibutioa:E? Cash .{. Personal Check li t-reditDebit Card F- Parroll Dsduction [fl Nlonev Order Ilate Kecelvedo9/09J201 1 .tg*qrc,srE ceurwqrTs$s0.00

Garofolo :uslJames \{I Itulcrpal occupatronProfessor Amount ofContribution

$300.00

Glmunl J&eet Ao&es1&3 Bunsav Rd

.rBSevmour CT 1lP L;lrde0648i:| NAme or iJmptcS-erSouthem CT State Univ.ls conhibutor a lobblisl spouse, fi Yssordependentchildofalobhvist? f, No If contribution is in cncess of $lO0 to a candidate comrnittee for a chief executite offrcer of amunicipalif' does contributor or business hetshe is associated rr-ith harc a rrontract $'ith saidmunicipalih ralued atmore than $5.000? fl r*es {, No

Is this conkibution associated rvith afitndraising elent listed in SestionLl?I/.1'es. list Event * _

r YesNot. I* 'Jootibutor a principal of a state gontractor of prospecti\ state conEactor',).If,es. indicate n'hich bratch or branchoeol golernment the contract is nith: i*- Esecutive f,. Legislatir-et.i I$f. No

IUethod of contibution:f. Cash dti Personal Checli {. C--redirDebit Card L Partoll Deduction f. lr.Ionev C)rder l"r?lt KeeIFelJ09/13/201 1 tIggldrgr(rtrul9uuQs

$420.00Last Na$e Simpson !mtJudith \tr Principal (trupationRetired .{mount ofContribution

$s0.00

lsuru *ee[ -{qqffi !-.lt)- IJtat5 Walnut St. Sevmour CT :lp L:oft06483 \ee or tsmPrct'etRetiredLq coatributor a lobbSisl spouseor dependent chila oia totUrlrti e'ltr: YesNo If conhibution is in ex'ress of $400 to a candidate committee for a chief executive officer of amunicipalit-l' does contributor or business he.rshe is associated rr ith har-e a ,ronhact \$ith saidmunicipalitvralued atmore than $5.000? f' Yes f,l No

Is this coltibution associated $idl afirndnisirg event listed in Section L l?f,'eJ. list Event: 09/30/2011.t ; Ies{*l No Is contibutor a priacipal of a state contlactor or prcspeti1-e state corta,rtor? f.l :*es{f.r'es. iadicate *'hich btanch or branehes ll-' Noof gorernnreat the contract is sith: ill Lxe,ruti\e f . Legislatire

h'[et$od of conaibution:{, Cash fl Personal Check fl Credit:Dehit Card i*l Pavroll Deductioo f lrlone-v Order !/al Kecen etlo9t21t2011 $110.00Gridzias ! rstRichard III kmcrpal O:cupatrmRetired .{mount ofContribution

$90.00

tuguil JEet.aoqN29 Rimmon St. -lq'Sevmour *aItCT

alp Lrode0a+&3

Name ot llmpl0.TerRatiredIs contributor a lobb$sl spouseor dependent u'hild oin tolf3i*ti ?l' Yes'.$r No If contritr$ion is in eicess of ${00 to a pandidate com"orittee for a chief executir-e offrcer of amunicipalilv does cootributor or business heishe is associated with hare a conkact rrith saidmunicipali!'r-alued at nrore than $5"000? ,r_r I gs .,.+ 1\o

Is this cootibution associated with afundraising erent listed in Section L l?{fi'er. list Er-eat * 09/30/201 1F Yesfi, No Is conbihutor a principal of a shte conhactor or pro*pectir e state conhactor',) f' fes.Ifi,es. indicate s'hieh branch or branches Ir Noofgovernrnentlhecontractis(-ith: fl Esecutir-e lfiLegislatir-e

Ile*hod of contibutioa:$i Cash fi Personal ChE* .'f-r Credit'Debit Card [i Parroll Dedu*ion F \Ionev Order I)aIe K$eredo9t21t2011 AggIente cont rbudore$130.00SLIBTOTAL Settiori B'This Pae $580.00

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13/40

I. MONETARY RECEIPTSSection B. Additional PaseB. Itemiied Contributions from Indii'idual*

i10t11t201',1aul Roy 201 1LastNase Welch FrrstTom Ltr Pnncpal Ocrup*titrnAtorney

$100.00

-Lmount ofcontrib{tion47 Old Shelbn Rd --I]Shelbn CT 06484 llrurs Qr EUPR-_a srWelch Teodosio Stanek & Blake

Is eonhibutor a lobbfist. spouseor depeodent *hild oia lotb-visf r' YesNo6, If eontribution is in ur,Jess of ${OO to a candidate '}ommite for a chief esecutir-e oti rer ofmunicipali$.'does contributor or business he''she is associated with hare a contract n-ith saidnruaicipali!-r'ahred atmore than $5.000? 'f' Yes l, No alsthiscontibutionasso*iatedx-itha Sj Yesfirndraising etent listed in Sectionll? f. NoIf'a. list Event * 09130/2011

Is conhibutor a principal of a state eonhactor or prospectir-e state conbaqtor? fl . .t*esIfi'ns- indicate rrLich branch or branJhes f Noof gor-ernnent the contract is'n-ith: f. Executite f. LegistatireNlelhod of contibrtion:f. Castr :tl Personal Chedi fl. CreditDebit Catd L Parroll Deduction li. ltloner Order Irate l(sereoagt?1nafi {Iegate contrbuoons$100.00

CoyneLLst Name nslKevin N.II Plncrpal OccupanonAtorney ^{mount ofC0ntribution

$320.00

401 Davis Rdjlt]'Fairfield CT 06825

L\me or rlmProlqCoyne, von Kuhn Brady & Friesle contributor a lobblisl spouse,or dependent ehild ofa lobbyisP C r*es,t.: No If conhibution is in encess of $.1O0 to a candidate comnri&ee for a dtief executir-e officer of amunicipalit-v does sontributor or business hershe is associated \r ith hare a eontract n"ith saidmunicipalih'r'alued at more than $5.000? 'F, Yes lir No

Is lhis confibution associated with afrndraising er-ert listed in Section Ll?Ifi'es. list Er.ent; 09130/201 1'f; YesFNo Is conbibutor a priocipal of a state !-ontactor or prospecti\- state conhaetor',) I' Ve.f;'es. indicate n'hich branch or btanches .fl Noof gor ernmelt the contract is rtith: li Lrecutir-e lfr Legislatir-e

\{ethod of conaibution:ffi Cash 'fl, Penonal Ched; lfl CreditiDebit Card 3*- Pa-rroll Deduction f{: Nlone-v Order uare Kecereo09121/2411 $320.00LastNmre Stanek l{slKaren N,U PrmcFal {)ccuFatonRetired Amount ofContribution

$90.00

KSlGnUat blreel .loflress22 N. Benham Rd }wSeyrnour ;lateCT :rtr Lrode06483 Nme ot !$ptc}'erRetiredr . lesior NoIs contdbutor a lobbfist. spouse"or dependent child ofa lobbr.ist? If contribution is in excess of $400 to a candidate tJommitee for a chief executir-e officer of amulicipalif' does cortributor or business he;she is associated rrith hare a conhact with saidmunicioalitr valued at more &an $5.000'] f. Yes fi NoIs this contibution associated n ith afirndraising er-ent listed ifl SectionLl?Ifi'er. list Er.ent * 09/301201 1

fi. I'esC lto Is confiibutor a principal of a state conhactor or prospcti\ stat conhactor? {r Yes{fi,es. indie*te n'hich branch or branche$ f. Noof gotemment thE conkaet is $ith: f,. Executive f. Legislatir-e\Iethod of *onbibution:f, Cash Sl Personal Check {. Credit Debit Card 9*, Partoll Deducrioo i. \Ionel Order HIEKrcST'Ro9t21t2Q11 tggregaG clrnEpwom$145.00

La$tNme Twon ![stJohn a{l krnclpal C]ecupaborRetird Amount ofContribution

$4s.00

[qsilRr Ner.iqqs F-ts lmre2O Hotchkiss Ten. Ansonia CT lIP L,NE06401 r ur suPru)Retiredls coatibutor a lobblist. spouse.rr dependent child ofa lobbl.ist? l.] resfl No If sontribution is in ercess of $400 to a sandidate qom$ittee for a chief enecutive othcer of aounicipalilr. does conkibutor or bsshess he:, he i, associated rrith harc a eonbact \rith saidmunicipalitl'ralued at more than $5,000:) r- I es t!, l\oIs thb coahibution associated n ith afirndraising errent listed in Section L l?Ifi'es. list Event = 09/30/2011

dil r*esfl No {-.i I esfl NoLs contibutol a principal of a state cortractor or pfospecti\-e state 'JonbactorJ.fy'g. indicate u'hich branch or branchesof gor.ernment the t)onkact is $ith: fl Esecutive {1i Legislatir-e\{ethod of conhibution:f' Cash $'l Personal Che,rk fl Credit,Debit Card fl Parroll Deduction fl lrlonev Order Date Ksel'edo9l2'u2911 r8SreeaE ulinq $45.00

LoPrestiirst

Anthony\.ll ltnrclPal CbcupaionRetired

$45.00

.{mount ofContribntion35 Kalhv Dr.

'rf'Sevmour CT

)BTC .{, L.rus06483 Nameor l]nprq'erRetired

ls conkihutor a lobbyisl r*o*".rr dependent child ofa lobbl*ist? 'f Yes..' No lf conbibution is in ericess of $400 to a sandidate committee lbr a chief esecutl'e offrcer of amunicipatiq- does contributor or business he;she is associated nit$hare a contract n'ith saidmunicipali!'raluedatmorethan$5,000? ifi Yes ltil NoIs this contibution associated n'ith afundraising elent listed in Section L 1?{/r'dr" list ErEnt + 09J30/201 1

.f l-esC, No Is conhibutor a principal of a state contrastor or prospcti\ state cotrhactorJ I YesIfi'es. indicate n-hich branch or branctres l{1 Noof gor-ernment the contract is $ith: ii Esecutive lfl Legislatir-eNleftod of contributiol:F t'ash fi Personal Check '.f, credirDebit Card F' Palroll Deduction F \Ionel'order Date &eceseda9121120'11 t:grggaF cQruouu!tr$4S.OO

SLIB?GTAL Srcttorr &,This Paec $600.00Page -_.- of

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14/40

L MOTETARY RECEIPTSSection B. Additional Pase19t11t2011aul Roy 2011 B, Itemized'eontributions from Individuals

LmtName Condon FkstKevinNII Prircipal 0ccurratroaAtomey

$50.00

-{mount ofContributiontsroat JusI -aw$30 Laural Lane -iR-Oxford CT

;trile :rp !.reo&72 l\U Ot EmproJerCondon & SmithIs c+ntributor a lobbl.ist. spouse,or dependent child ofe lobbf isP flfi. YesNo If conkibution is in ercess of $ilOO to a eandidate committee for a ehief esEcutir-e officet of amunicipalit_v does conhibutor or business hershe is associated rrith hare a contract rsith saidarunicipalig.raluedatmoretlan$5"000? l-. Yes f: No

1-esNoq;.f.Is this contibution associated with afoadraising er-ent listed in Section L l?ti'er. list E\-ent * 09/30/201 1

Is eontributor a principal of a skte cosbaetor or prospectis state contactor? f . YesIf'es. iadicite s-hich bransh or branches {* Nooiioverument the coabaet is n'ith t. Executh'e f. Legislath-eNlethod of contibution:C: clsl fi, Personal Check f, Creait'Debit Card f, Pat'roll Deduction lf. Nlonel'Order l.)ate !{setreda9/2112011 {:8Iee3E COnErouqLrD$50.00

Phelan t EstMariel\II Prncrpal Cha:pattrnAtomey .{mo*nt ofcontIibution

$45.00

(slctrIlta Jusr -{wes19 Cedar Dr. irq'Killingworth CT;tate :{l UNE06419

or grPru) srPullrnan & ComleyIs sonhibutor a lobbvist, spouseor depeadent child ofa lobbybti f reslsl No It' itonhibution is in qicess of $.100 to a caadidate commifiee for a chid esecutire officel of amunicipalitl' does eontributor or business hsshe is associated rtith hal"e a contract n ith saidnrunicipalitl' r'alued at more than $5.000? if-' te l,' No

Is this conhibutiol asso,Jiated n-ith afrndraising er.ent listed in Section Ll?In'er. listErerts 091301201 1 fi YEsFNo Is cootibutora principal of a state codrastor or prospecti\ e state contactor? {'{f1es. indieiten'hichbraachorbranches :flol gol'ernoent the coatract is rtith: f' Esecutirr; lfl Legislative YesNo

Nlethod of contribution:F Cash if. Personal Chec& F.l Credit Debit Llard 3l Patrotl Deduclion fi \loney Order !)ate Kecelved09t21t2011 $45.mLastNme Trybus 1

[StKarl

AT tmcrpal !)ccupatrsllnstructor Amount ofContribution

$45.00

slgcrunt nrser.aNN2O Old Ansoflia Rd

'rtlSeymour CTxaae ,!p!]e06483

\ame ot lJlnprq'erUconnIs contributor a lobblist. spous*. {*l Yesordependentchild ofa lobbyist? f, No Il- contritrution is in ericess of $.1O0 to a candidate committee for a chief executive ofti,Jer ofamunicipalig.' does contrihutor or business hershe is associated with hate a conEact rvith saidmnnicioalitr"rahred atmore tftan $5,000? A Yes F, No

Is this contitlution associated n ith afiindmising elent listed in Section Ll?{fi'sr. listEr-ent + 09130/201 1f;l lesCNo Is conhibutor a prinuipal ofa state conkactor o{ prosPeltive state contraqtor?Ifi'es. indicate n-hic$ braneh or bratchesolgovernment &e contract is $ith: f, Eseoutirre f. Legislatirc

lij resf". NoIr.fethod of contibution:i Ca* frj Personal Chedi {-ll CreditrDebit Card f, PaFoll Deduction fl Nlore-v Order Date Rwe*'edo9t2lna11 igElcEgtc u([u&,uaus$70.00

CoeF lrsaDavid l\il ltrncrpal

()c$rpauonRetired -\mount ofContribution

$100.00

K$roenlnl ilrcet j\o&ffi F:l[' lJareTGreatMeadowRd Seymour CT 4rP Lllrde06483 Nele or .ErDproJ'etRetiredh contrihutor a lobbS.ist, spouse" f,:l r*esxdependentchildofa lobbf ist? l No If conhibution is in espess of $4O0 to a candidate commifiee lbr a chief esecuth'e officer ofaorunicipalig' does contributor or business heishe is associated n-ith harrE a contra,rt \Tith saidmunicipalit-r'ralued at more than $5,000? C'Yes 6l No

fu rhis conhibution associated with aixrdraising er-ent listed in Se,)tioa L l?r1'gr, |tu1f,1'ga1 * 09/301201 16l Yesfl No f.l Yesfl NoIs contibutor a principal of a state contractor or prospecti\? state coltactor?Ifi'er" indicate rrhieh branch or branchesoi gor-ernment the conkact is n ith: f.l Esecutir-e {ll Legi.slatile

\{et6od of contibution:{*, Crsh trl Personal Check fl t-redit Debit Csd fl pa'r'roll Deduction fl Nlonel' Order Date Rsesed091281201 1 -{SelegAte crlntrlDunom$328.00Wsneski

FustSusan

Ntr Prncipal OccupatnnHuman Resource Specialist .{mount ofContribution

$45.m

1e$rgerfl at xr*r -{odess473 Rimmon HillRd .lS'Beacon Falls CT:$ L:Oft06403

Name (rl lnlplotorState of GT

[s coatributor a lobblist. spouseor dependent child ofa lobbl-isP YesNo If contributiotr ia itr encesg of ${00 to a candidate eommittee for a chief executi\-e office'r of amunicipalitl does conhibutor or business hershe is assoeiated $ ith have a uontract s"ith saidmunicipalit-vraluedatmorethan$5.000? "f r*es 3a NoYesNo:ftl JIs this conkibution associated n'ith afindnising er-ent listed in Section Ll?Ifi'es. fist EIent = 091301201 1

Is contibutor a principal of a shte coohactor or proslleqtive state sontaator? !"-*' r*esfy,es, ildiciten'hichbranchorbranchs lfi Nooigoleroment the contract is $ith: lfi Ese,Jutile 5i Legislative

Nlethod of conhibution:&i Cash fi Personal Cherk '-fi Credit"Debit Card F Paltoll Deducfioa F \tone1'order !)ate Kserfec091281201 1 .{ggregaBcotrErouuotB

$85.00SIIBTOTAL $ectim BThis Pasc $285.00

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15/40

MONETARY RECEIPTSSection B. Additional Pace:1011 1/201 1aul Roy 20'l l

L

B. Itemized Coniributions from IndividualsLstNmr FirstTheresa \,II Pnncg,al (:hcupatlonMinute Clinic .\mount ofContribution

$135.00

tgemar DEst -+ws177 Skokorat St. .:rq'Seyrnour CTfiale ::P LNE0a+83 Nme ol !mprc5'sAPRN

Is conhibutor a lobhlisl spouse.or dependent child ofa lobbf irt? Nor'fr: Ys If cootributior is in ercess of $dOO to a candidate ,rommittee tbr a chiefeiecutire oftieer ofamunieipati['does co$tributor or busioe*s he'she is assorriated $ith hav" a conhact n-ith saidmunicipalit-vrahred atmore ftaa $5.000? 'i', Yes f: NoIs this eontibution associated x'ith afundraisiog event listed in Seetion L l'lI/;.es. list Etent + 09130/2011 a

fesNo{E Is coahibutor a principal of a shte cotrhactor or Prospectir-e state contador? l. Yes.f}.as" hdicate rrhich branch or branches f Noolgor-ernment the contract is rr'ith: f. E:recutir-e f Legislatil'elile{hod of conhibutior:ii, Cash ti: Personal Chedi {1. CreAit'DeUlt Card if Pawoll Deductioo 'I-. Irlonel'Order Date Keees-ed09128/201 1 tggregate conE lbunons$235.00

Fries FustColleen{l hmcrpalOcmptionAfiomey

$55.00

Amount ofContributionK$lcefflal ilIet -{geffi107 Spruce St.

Ittt'Seymour CT*ate :E cod06483 Nanre

oI !,mFro)-{Coyne von Kuhn Brady & FriesIs contributor a lobbrist. spouse,or depeodent child ofa lobbyirf? C r*eslO l.io If contribution is in excess of $4O0 to a candidate committee for a chiet- esecutire oficer of amunicipali$. does eontributor or business heishe is associated rr-it,h har-e a cootract rvith saidmunicipalitvrahred at more than $5"000? lfii Yes .fi No

Is tftis conhibution associated rrith n ',1i Tesfundraisinger-enttstedinsectionll? F No.I/)'.'s. list E\-ent * 09130801 1Is contibutor a princigal of a state ,rontraqtor or prospecti\ state colrhac*cr? fi t*esIfi'es. indicite n'hich branch or branches ifi Noo?gotemment the eonlraet is with: i{' Executir-E lfi Legistatite

Nfethod of contibution:F Cash f. Personal (Aedr '.fl CreditDebit Card C Payoll Deduction F' hlore!'order Date Rwere.io912u2011 {ggregac conErDuEoN$187.00L6t NXIne Demmino

t,retMary Ntr hurcrpal OccupatonEducator .{mount ofContribution

$50.00

lgwl Dg9et.tqqc$100 Walnut St. .'ltl'Seymour CTAI :rpL.Nc06483 ) 0l lJmPrq'etSeymour Bd of Ed.

Is cortributor a lobbl.isl spouseor depeldent child ofa totbvi"t? No; Yes If contrihution is in excess of $400 to a candidate sommiftee for a chief executil-e ofti:er of amunicipaliq'dox conkibutor or business hershe is associated'rvith hale a coatract n'iti saidmunicioalitt'ralqed at orore thal $5,000? f, Yes f. No{3t"

Is this conhibution aqsociated n-ith aftrndraising e'r'ent listed in Section Ll?fyer" listBlent * 09130/201 1

YesNo Is contibutor a principal of a state conhactor or prospecti\-e state contactor?!r.1'o" indicate which braoch or branehesoigolernnrenttheeontractisrtith, f.Executive f.Legislatir-er ; lgsf- No

It'fetlod of eonbibution:It Curtr fl Personal Cheak C, Crcdit Oebit Card f, Parroll Deduction ll lvlooel'Order !)ate Kseredost28t2011 :tggle8nte compuuoN$s0'00Gesek f-stSzudra

\{I hmcipal t)qcurtatronRetired ,{mount ofContributiotr

$45.00

tesloerural >treet -{doress F.rq lJerE37 Colony Rd Seymour CT llP Lfr]e06483 lame ol Empl.r)'erRetiredIs colkibutor a lobbfisl spouse.or dependert child of a lobbf ist? Nofth_. Yes I1'contribution is in ercess of $.1O0 to a qandidate corumi$ee for a chief executir-e offieer of amunicipalitl' does contributor or business hershe is assoeiated rtith hate a contract s'ith saidmunicipali{'raluedatmorethaa$5.000? i]. Yes i-{ No

Is this cnnhihutinn associated *'ith aftindraishg er-ent list*d in Sectioa Ll?tt]'cs. list Elent n 09130/201 1S-] Yes{-' No C] r"est_. l\oIs conhibutor a princigal of a state cootracto! or piosperti\ e state contartor?f1m. indicate shich branch or braaqhesoi- gor-ernment dre contract is with: f;l Executir-e {11 Legislative

lvlethod of coabibution:{-: Cash *il Personal Cherk !]l CreditDebit Card fl PaFoll Deduction fl ilIooe1'[hder Lrate K*etreo09t2f]/24fi r\gtr.aG cm[DuuQD$93.00LastNam

ConroyF$st

Anna\tr Pmcpal Clcmpahon

Retired.{mount ofContribution

$e0.00

Ke$deilru )ueet.-tooress167 Skokorat $t. Seymour

lltr *aleCT :ry lwe08483 )'lanre lrl lmPlcl'elRetiredIs sonhibutor a lobblisl spouse"or dependent child ofa lobbv.ist? C Yeslfri No ff coniribution is ir escess of $dO0 to a candidate committee tbr a chief executite officer of amunicipalitl' does contributor or btrsiness hershe is associated n-ith hale a contract n ith saidmunicipalit-vvaluedatmorethat$5,000? i* Yes F, No

Is this conhibutiol associated rr ith a&rndraising event listed in Section L I?Ifi'es. list Er-ent * 09/30/201 1

'{1- l'esF-i No Ls coctib{rtor a princigal of a state corrhactor orprospectir-e state conhactor?

f1'es, indicate n-hich braach or branchoso?lorernnrent the co$kaet is $ith: fi Executive lli Legislatisef'Yssfr No

Nle*hod of conbibution:SlCash fi personalClhe,r;k .'{i Credit,Debitcard lfl Pa]rollDeduction Fltlonel'Order J-)ate Kecefeu09/281201 1 -tegnE uQnElw[eD$90.00SIIBTOTAL Sctim FThir PaEe $375.00

Pase of


16/40

I. MONETARY RECEIPTSS"1W111201'lraur t(oy

LutNme Firstlrene\fi lPrmrpal (rccuPI Retireo Contributior

GliffiafSt*t.\ddress28 Northstar Dr.lib-Scvmartl

jtate lzlPu(McT l0e+e3 trase of Emplc5'stetired

$20.00

r a chief esecuti\-e officr of-affiilitill";* ",.:;;:bfy:.."".".:,l;;X,0."0. "n1*lli*oo**j^= " conhact $ith saids coahibutor a hbhfist. sPousaor deperdent cbild ofa lobb1'ht? r: -r-esNo,Is thb aoatibution assosiated Ttith a : l-esirndraisine ereat listed in Section L l'l f. NoIfi'es. lisi Etent * !9/30/201 1

Is contibutor a PrinciPal of a stIfies. indicate shich brancof gor-ernnrent the contracl Irte ,hor )oohactor

of prcspecta-e $tate gonIracroribraruhesth: {' Executire f'. Legislatir-e fNo\sseeate conElbuaoos

\le{hod of coatibution:tr n -r-L--r- f ' .erd lil parroll Deduction ,'{-. I[oney Otder 09t28/2011 $20.00?fincFal OccuPabonFletirerl

Amount ofContributionBlazet ustJane Natre ot gnplq'rRetired

$100.00

ffiffiISilAil&ess21 Glen Girc,le litvSevmouritate lZlF L o,Jcr I oe+e3E.ffifffi.-tt* lb. a chief executhe ofllcer oJ a,*Lo" l"t*L i* ussociated with har-e a contrast n ith said< {x}o'l .!'fr t'x '.ff NoI-*"tit t*"ttttfist.sPouse' t'.or depeodent ,:hild oi a lotrblist? :f' -t,"esNo tt-contribution rs ln exceslmunicipaliq' does conhibt ltor or bt

Is this contsibotion associatEd with a F Yesfrndraising er-ent listed in Seetion L l") C' Norr.,- u.i u,---t = f}Or"nr?O{ 1 Iseonbibutor a principal of a shte contractor or p(ospdstr\3 state s}ntracror; 3 ' r sIf rc- inclicate n{rich branch or branqhes l{*' No"ii'-Ll-l"iu"#;;;;lh, r, s*"fr'" nL:ttu

lr'{ethod of conhibutionl"SCJ-'r-.p:;;;;ic,",* lfr credicDebitcard f. Pa5rollDeduc*ion [fi \'rosevorder-=------4Date Reclved

091281/2011\gg:egate clrntrrDuBw

$100'00Pnncrpal OccuPatonAdmin Asst.

.{mount oflontributiol

$90.00

BernardiniFirstllinr{v \,tr

-lp L.mle06483 SanJ-I-Enpl))uTown ofSeYmourlFntial Street Aditess14 Kozev LaneiltlSeymour CT

0 to a candidate comoifiee for a chief esecutn'e o$rcer or at*iu"*t n"g. it associated rrith har-e a goilract n-ith saidq5 oool r*l Yes -f, Noffiu6bb-t'i*tipoo*.. d*l Yesor depeadent child oia lobbf i*tt f,, No Ifcontributron $ mqxcel

municipalitl' does contril rlltor or

rs this ,rontibution associated n-ith afrrndraisine event listed in Section L l?Ifi'es. lisiEr-ent= 09/30/201 1 YesNoF ls coatributor a principal of a state contractor or ptospeetircstate contractor j ! ': I e$lfrrss.indicaterthichbranchorbranuhes fl No"ii"-;il"t *t"*tt Ji,"tttt' f' n.t""tl''

lrle{hod of conhibution:- i- curn fi, personal Che"g C. cr, .'lir,I)Phir lart {-- Parroll Deduqtion trl N'loney Order a9l2a2u1 $255.00ffiffici"""p;tt;Lettor Canisr Amount ofContributionBilodeau iustMarcia lJureCTta lp alode06401 ffiIEFFtrUSPS

$45.00

[ffiffiISEeet.rd*s14 Momingsiar Dr

F:tr)'Anso "TidG;ffi; f*;"hief exec$tive offtcr of ahetshe is associatd $'ith hare a gontrnst $ith saidC'Yes iil No[s contributor a lobb-r'ist' spouse* a.p."O."i"ftifO oi' u tot Ulire Noclr!. Yes If gontfltrutlol ls s o"*o,. *'"

municioalih'does conhibutor or br---' -rl^r:i-,--r,-.t .r -nrr then $rsbesst 0tx)?

{il Iesf' NoIs this contibution associated t"ith afundnising ercnt listed in Section Ll?f1.ar. list Er-ent * O9/3Cl/201 1Is contibutor a principal of a state colhactor or prospctl'e state 'Jonralxol i r-r r sIfres. indicateshichbranchorbranehes fl No

"ii".='"*""io.;ot"o-,,; "ttn' f: E= 'itlethod of conhibution:ii Cash ff] Personal Check C-' Credit'Det ritCard fl Paltoll Deducrion C Nlooey Ordet 09t2u2A11 $45.00PrrnclFal ClccuPatlonAttomeY Amount ofContribu6oa

$100.00

MoherbrstMichaetffiiEFfSFI.\d':kes

163 Brent Hill Rd. C!arrmnt1rh ttateCT

1{r (-ode06483 FffiEiIFPL1'erDaniel Skuret PCexecutir-e officer ofa;#$;t$+l;+fbf::.-::f i'ffiX heshe is-rssociateqJ''*l^"' contract with saids coatributor a lobbf ist. spouse.; ;-";;.J "htld oi' u totuui,ti .'f r-es'.{tr No

{a ltri't uos thb contibution asscciated with afrrndraising evect listed in Seetion Ll? ls eolhibutor a prilcipal of a state contractor orprospeetive state coltraetor " t-' I sltrla$. hdicate $tich branch or branches . 'fl No;i:":;;;e.-;;;.i i* *ith, .rr Esecuti'e in L"si'lut"'-'JJ fi \Ione5'Order Eie Reeived0!|/2812011

\&segate contsrbutloN$100.00vtethod of contibution:-F|?;i-'fl PersonalCheck :{i (--reditDebitCard F Pa5'roll Deduction# SUBTOTAL Section FThis P1g1Pnge

-

$355.00of


17/40

I. MONETARY RECEIPTSSeetion B. Additional Pase1A11nOfiaul Rov 201 1

8., : ftemi:zcd Contributfuns frqm IndivirlualsLdtNme Potash FirstDaniel lf Pnncrpal OccupaaonAssembler -{mount ofContributioa

$45.00

K6rdenflal steet A(ktes23 Glen Circle Jrq'Seymour CTjlale ,lP !.rus0e+83 Name

ot Smplq erThule, lncIs cootributor a lobblist. spouse.or dependent child ofa lobbyist? YesNo.. If *rt ib"tir" i" i" *"*s of $,100 to a candidate commitee for a chief executh'e offreer of amunicipalit5.'does contributot or business hershe is associated qith har-e a conhact with saidmuoicipalitl- ratued at more than $5.000? i. Yes f, No -..'-'---

Is this eontibution associated *ith l fr.. Yesfirndraisinger.entlistedinSectionll? f. NoIfu, listEventii 0S/3q?Qlj-Is eonbibutor a principal of a state qonhaetor or prospectire state coctactor? f. Yesfy:r.indicitentichbranchorbranches f Nooiiovernmeottheconfactisrtith: l.Lrecutive i:Legislatir-e

Nlethod of conhibutiol:C: Casn , PersonalChecli C. CreditDebitCard f, PalrollDeductioo .'f. Nlone1'Ordet DateRsered09/28/201 1

-igg:egate contlbunola$'15'00

Potash FffitCarmetitaN'II Itinclpal QccupatonRetird ADrount ofContribution

$90.00

lB$leilral street.{d{trs23 Glen Circle]rt''Seymour CT

tta! ,IP L{M06483Nme ot .Emplq erRetired

Is conhibutor a lobblist spousaor dependent ehild ofa lobbyist? Non Ies ffi"ti* i" i" .\--t. of $4o0 to a ctndidate commisee for a chief eswutir-e offiser of amunicipali[' does conhibutor or business he,she is associated with hare a cootract rvith saidmuoicipalit-v ralued at more than $5'000? l{i Yes Q !! ''=.-Is ttb contibution a*sociated with afundraising er-eat listed in Section Ll?I/;'es. listEvent+ 09/301201 I '.f

YesSi No Is contsibutor a principal of a state consactor or prospectil-e state *on&actor? f' Vesfym" hdicatewhichbranchorbranehes lft Nooiiorernment the contraet is *-it&: 'fl Esecuth'e fi L3gqt",i*-Nlethod of conhibution:('iCash F. personalChe,li lfl CreditDebitCard CPa3rollDeductioa Fi \.lme1'Order

Date Rrcesed09128t2011

,{ggtegati l'onEloullolls$130'00

RichardFirstCrystal

\{I Prirnrpd rlccupanonSbn Maker Amount ofContributiol

$90.00

(sr(telltlal ;teet.{d(res4 Emerv $t.-lt}-Seymour CT

MI :rP (:otle0a$3 I otgBplcT'erNu-age DesiEns, lncfi Yesf, NoIs conhibutor a lobbfist. spouse,or dependent child ofa lobbl:isfl If *"ttitr"ti"r ir i" s.l"*s of $400 to a candidate commitee tbr a chief exeeutir e officer of amunicipali$' does coatributor or busin*s heishe is asscciated rdth hare a contract rlith saidmuni,:ipalitv vahred at more than $5"000? fl r*es f: NoIs this eonbibution associated n'ith afirndraising etent listed in Section Ll?

{f1.'es. list Er-ent * 09/301201 1l'esNo Is eontibutor a principal of a state contractor or prospectire state conhsctor'JIf,es. indicate n"hich braneh or braachetoigoternment fte cootract is $ith; f. Executile f.I.:gftutl:

l.le8{No

Irle*hod of contribution :L cash trj Personal Chsok {. CreditiDebit Card f, PaFoll Deduction fl lrloae!'order Dat Rece$ed0gt28na11AggIegA: C(rnrtouuoffi

$90.00Charmel

FtrstPatrick l\[ hrn rpal()ccrFatonPres. & CFO .{mount ofContriblltion

$90.00

lesiiLntinl steet.{d&e* F t}- ls:ate1OO W. Meadow Rd Hamden CT lrP LOse06518 Nme oI lrsployerGrifnn HosD.

Is eonhibutor a lobblist, spouseor dependent child of a lobblxti Nofll! Yes ffi a candidate commi$ee for a chief exe')utive offtcer of amuricigalitl. does contributor or business her she is asso,riated with har-e a contraet n"ith saidmunicipalitrtalued atmore than $5.000? f Yeg fl NoIs tlis contibution associated n-ith afundraising elent listed in Section Ll?{fy'es. list Er-ent * 09301201 1

*i-t Yesfl No Is conbibutor a prineipal of a state contractor or prospectir $tate contactol? Cl YesIfius. indicate rr-hicb branch or branches fl ltooilosernment the conbact is nith: {l Executive fl LegislotireNlethod of ,ronkibution:f , Cael f,'J Personal Che.Ji {:l CreUit OeUit Card fl Pa!'roll Deduction fl \{one-r Order D*te Keceredo9t28t2011 +SIegnte $90.00

LastNameWeaving

FtrstJason

\,II ?trncrpal Occupattrn&vns I GetUsedParts.com LLC

Amount ofContribution

$4s.00

(esr'Jentral litseet Arl{tress12 Eleanor Rd

:R lstate lztP L'odseymour lcr loo483 ){dne oi Emplq erself-employedb coohibutor a lobbf ist, spouse. 'f Yesor dependent child of a lobb-rist? l,t' No If ""rhibr"r.r ir it *"t*t of $d00 to a candidate eomndltee for a chief sse'Juti\e oftter of amuoicipaliq- does conkibntor or business he,she is associated rvith hali- a ,:ontract rtith saidnunicipalilr'r'afued at more thar $5"000? lfr tes F No

Is thb contribution associated n'ith airndraising etent listed in Section Ll?Ifi,es" list Etent * 091301201 1F Ie"fiNo Is conbibutor a priocipal of a state cotttsactof or pfospectil'e state contradof? {]' r*esfys. indicate nhlich branch or branches fi Nooiiorernment the contract is t-ith: 'fi fresuti\ '3'i LeSilllt!1-

Itlethod of cootibution:fi Cash R Personal Check '.fl CreditDebit Card (f Payoll fleducrioa F hlone.r'Order I)at KeceFeda9t28t2911 +tegaEcoNrou(lN

$45.00STTBTOTAL Section BThis $g $360.00

Page

-of *


18/40

aO1!{L,llTTFrE,:' lParrl Rov 201

L MONETARY RECEIPTSSection B. Additional Page-10/11/20',t 1

I 'l llrr lr!'i !f-

: R' :riprn$iprt Cnntritrutions'from Indivfufuals 'WallacaLstNme

Fk$tStanleyT{I PrncEal (JcspanmMail CaniBr -{mount

ofContributionResrde$$l Ste.t Addrffi13'l lnwood Rd

16 1stateTirmhutl lCf .ry !,wr06611 ffiifiIE$pEsUSPS

$4s.00

executile ofticer ofa*.,*elputitl,.ao",conkibutororbusioesshelsheis$soeiatedsithhar.eacontrsctrtithsaid----r-r'--r:i-.,^r,-t .r.'ara tten S5.O00? 'f . fes : NoIs contributor a lobb;-isl sPouse,or dependent child ofa lobbl'bt? f. Tesr, No

Is tiis eonkibution msociated rrith a fl: lesfirndraisinc ercnt listcd in Section L t? l. Notr..* r;.i c,-** = n0ran/?nl 1Is contsibutor a princigal of a state coltractof or PfosPeltn-e state eooracror I ! I wIfvas. hdicaterrtichbraoshorbranches tr No

"iir.=t"-*iU""ootu,rtito'ith' { Executite f Legislativo , ,, ..'lrlooev Ordet

Date Receivddo9t2a2011Ag-qegaie contrbuu!1ns

$4s.00Iethod of ,:ontibution:'1* ^-..t iti D-*^-.r {-h*l- f' r-."AitiDebit lard . , arroll Deduclion Prmcrpal QccuPatonCPA Amount ofCoBtribution

$45.00

Sawicki, Sr.[,trstWlliam

Gr alStretAd&ess13 Lantem Dr.;tateCT]b'qavm.)lr ,IPL]e0a[83

ffiETsplo't'sMaranm, LLPesecutive ofticer ot-a;;"ip.lil;;* contributor or business heishe ieassosiated*ith hare a conlra.)t $-ith said-. ..L,---L-^J-r-.^--*.-et{VM? .t{i Ye ?n Nols cortributor a lobbltst' spouse- a-.p*4..t-ftifa oia toUt-virti YesNot..'

Is this conkibution associated $'ith afrndraisins er-ent listed in Sestion L l?rr.,- li"; Fr.Fnt = nqr3nf7ol 1 P.Yes$-' No ls coltributor a

principal of a state cootractor or prospectil'e state contagtor? ! I r eslfles. indicatewhiehbranchorbranehes "fi No"ii"..t -*lo"".on"*it*1tl' fi E*""otu fl:fblfi#N[ettod of confibttion:"fr;[f -.S. t.*"*icL".:tc. lf Credit'Debit Card 3*. Pa*oll Deduction E*' \Ione.v ordEr---=----r-r-Date Reserved

0912812011\seggte c0nEltluuoN

$45'00Kozey

FintDonna\tr lPrinclpal ()ccupatlonI Secretarv loutribulioa

$25.00

ffiffiia=l$Ft.{d*es7 Kozev Ln th PtateSeymour IGT :p ti* lName Lrt lmplq el06483 I TownofSeymourI" *ntibtt * t"ttbjitt, spouse. f I Yesordependentchildoialot'bfist? f. No

a ehit^esecutir-e oflrcor offfiili1il *il:;:i":bf::L::b*?fiXhershe Ls associat't ]ltl^= ' qontnct.ith saidIsthiseontibutionassosiated$iths'i, Yesfrndraisine e,;ent listed in Sectiou L l? f. Norr..," ti"i rr-*r = O9/30/201 1

Is conkibutor a principal of a state contractor or prospective state corrha')tfl itj lfffrss- indicite which braoch or branches . ' I\o"ii".=#*"iit- "ontract is trith: il' Eseeutir-e f^ Lesislati\',e" ..-,."..--.

Nlone-t OrtlerDate Recel\'ed

ost2u2a11Asgregst

$65.00r{ethod of sonbibutioo:f ..."r f;'p*^-"lclre"t {. CreditiDebit ,'ard f, nrroll Dedustioa f ffiGcupaA;-Barista .{mount ofContributionKalako JustMelanie lJBreCTr :rpsue06483 SAitEtEnprya-Starbucks

$4s.00

Glffiial steet.ld&es7 Third Ave.

l-jlD9eymo ffitiveoffirerofa

she is assoeiated with hare a contract n'ith snidft Yes l Nolg *oqtributor a lobbf ist. spouse.or dependent rhild ofa lobbvist? {li! YesNo If contributiol s ln sisessor lrrru

munieipaliq'does conhibutor or bu,----: -:l--r:*..--k,J .r mne thrn S' siness he,i_000?ls this eonhibution asso,liated with a S] ltsfundraisingerentlistedirSectionLl? fl NoI/-ac lict Ftenf * n0/lnltnl 1

Is contibutor a principal of a state contractor or pro$pectire state coltractor i {- ' r 6Ifree, indicate *-hich braoch or branches#;;;;;d.;*"t'Ir'Ione-v Order

Dat Receri'e,J091301201 t iggregnte conEmalrD$45.00{ethod of eontitrution:*' n--r l D*^-.r aki,'L- frt t-*,tit,Debit Crd {'l ?alroll Deduction

PrrncrFal OccuPanonVhe-Pres. .{mountof IContribution I

$45.00

LastNarueHarmeling

l'fstKristenffifsrtral Street -{d,tess27 Patrick Dr.

il- lstatesavmorrr lCf :qr L:oile06483 ffi;EEmp$erHanhon GrouPexecuth'e officer of'a;*'*[l ::i:]"::1*f"x'"ffi * *' T#.,y:.*.,1''$]'* a contract with saidg contributor a lobb1ist" spouse.or dependeat child of a lobb,rist? No.m Yesb this conhibution associated s'ith afirndraising erent listed in Section Ll?1

lf 1-esl{ lloFrIs con&ibutor a principal of a state contractor or prospective state snbacto{'l i-' I sI/r.as. iodieate'$-hichbranchortrranches -. 'fi No"i!.''!'"-*id "'

F \Ione1'otderDate R*enetl

0913012011.{ggregnle c$rrDuus

$420.00lethod of contibution:Fi";t ls, ienonalChecli "f' crcdit'Debitcard [r Pagoll Deduciirro

-

SSBIOTAI.Sq{ FlldsPasPage _.__

$205.00-of-


19/40

L MONETARY RECEIPTSSection B. Additional t1U1112011Paul Roy 201 1 from Indivitlu Amount ofContributiol

$50.00

32 Smith St., APt. 3Gr-il"uii'i"ft.a at more tbaa $5-000? 'fi r*es f'' No

a chiefexecuth-e officer ofa;;6;ttt;"* conhibutor or bwiaess hershe is;ssoeiated withhar-e a conha':t s-ith saids"oanibutorolobbfislspouse" I: Yesordependentchildoialobbyist? f,. NoIs eontibutor a prineipal of a state colhaetor or prospective state ccnbactor?lfrer. indicate nhich branch or branches

rir i".=tt-*ia. ";;"t i* "@Is ttis conbibdtion associatedI'iith a trj Yes

frndraisinc erent [sted il Sction]-l? i- NoIf,es. lisi Event = 09/30i201 1hlethod of conbibution:' A.61[f,- e^. F"*"*f Cfr""t !-,. Cr"AitOetit Card 5. Palroll Deduction l: Irtoney Order Amount ofContribution

$85.m

r a chief eseeuti\ e officer of a;;"rp"lild"* contributor or businese hErshe i$ as19':iatefvil\hare a coatract with saidratuedatmorethan$5'000?'J-' Ies p!{"b ".ttihrt- " tbbl*t' sPouse' l' Yoor dependent child ol a lobb;'ist? lfl No

Is contibutor a principal of a state conbactor or pfospesti\ rtate conbactor?Ifrss. indicate n hich branch or branches"ii..=t"-"tit" contraet is rtith: I Erecutive fi Legislative

Is this eoatibution associated with a F Yesfrndraising er-ent listed in Sectionlll fl' NoIfi'a. listEvent + 09/3Cl/201 1Ntethod of confr ibution:' F";i- -n p"r."""f Cftuck :fi CreditDebit Card 'fl. Pa'oll Deduirtion F-' trIotrey Order Amount ofContribufion

$50.00

ee for a chief erecutite ofticer of a;;;;li$;;;;;ontributor.or blsiness heahe is associate$ri{fare a conhact s-ith saidi"il.ri*.rfu"a at more than $5"000? f, tes f NoIs sontributor a lobb1ist. spouse. fl f*ordependertchildoialobbviqt? f, NoIs conbibutor a prineipal of a state consactot or FfosPe':tile stnte conbsclor?If lc. indi,:ate rrhich braoch or branches;i [;.eirnreni,il *rrrtu-t i* t*ittt' f ' Esecuth'e f ' Legislath'e

Is this contibution associated \r ith a {; Yesfrndraising event listed in Sectionll? f. No!!.es. lisiEreat* 09l/30/201 1.dmount ofContribution

$90.00

347 Scuth Main St. Seymour C.tii" executile officer ofa;;$;ft].. ;".- contibutor or business heishe isrssoeiated with hare a consact n-ith said;ilffii';;heJaimorethan$5$oo? f Yes rl NoIs conkibutor a lobblisl sPouseor dependent child ofa lobbS'istiIs eonhibutor a princlral of a state coltractor or ProsPectil e state coabactor?I^'cs. indicate shich branch or brun"htt ^, - .."ii"-"-"Ja;;;"*", b"tft' f: E

Is this contibution associated rtith a S] \'e$firndraisinger-e*tlistedinsectionlt? fl NoIf'es. listB'r-ent * 09/30/201 1.{mount ofCotrtrib$tion

i chiefexesuti$ officerofa;;"tp.ttil;*;nhibutor-or brsiness he she isrssoci:rttlJ'tl^= u corrbact $-ith saidi"i'""rit-'r"f,t"dutmorethao$5.000? "$r-es lS NoIs conbibrtor a lobbJ-ist. spouse.dependent child of a lobb-r-ist?

Is conhibutor a principal of a state codractor or prospcth-e state coatraclor? f' fes^-L-^*.k-. lfi NoIfr'es. indicate n'hich branch or branches"ii"t'.tr*""it"-";*;"tth, {'E**'i-"IsthisconbibutionassociatEdnitha'F \sirndnising event listed in Seetionll? Sj NoIfi'es. listEvent+ 09/301201 1Ir.te$od of conhfuution:K] Cash '.f. Personal Checli fr CreditDebit Card &* Palroll fleductioa F \tone--s Order

SUBTOTAL Sectisr FThis ?r


20/40

Paul Roy 201't

I, MONETARY RECEIPTSSection B. Additional PIndtviduals

1A11n011.\mount ofContributiol

$320.00

Nafls and Young Engineem, lnc193 White Hallow Rdffi t'o a eaodidate comodgee for a chief executir-e oftlcer of amunicipaliS.does cootributor or busiaess he,sbe is associated $ith ha\e a contraet rrith saidmunicipatq ratued atmore than $?O

lsconbibutoralobbfist,spouse. f, Yesordependentchildofa lotbvisP f, NoIs contributu a principal of a state conbactor ot prospectir-e state eonbactorl i*. Yes- If;;.Aaitit""tti"t tmn"trorbranehes f Nooii-'.ror**tecosfractis$ith: f,E*""@

Is this eonEibution associated with a f' Yesfundniring er-ent listed in Seetion Ll? 'il. No16'r.listE\-ent* qqBQr2q]lNtethod of conbibution:f.in*l s., i*rsonat check F*. Credit'Debit Card it, Payoll Nuction l{-i \Ione}'order Amount ofContributiotr

$?00.00

Welcfr Teodosio Stanek & Blake111 Great Hill Road ffi a candidate committee for a chief esecutir-e officer of anruoicipal!.' does coakibutor or busiless hershe is associated,sith hare a conkact rvith saidioatinvahredatmorethan$5"000? [F' Yes i' No[g 'ronhibutor a lobbf ist, spouse, C' -fesor dependont child of a lobbyist? 'O Uo

Is coobibutor a principal of a state conhactor or prosPecti\-e $tate contactor? f' fe*/f yes" indicate nhirh brasch or branches 'ft Nooi Lo.-ernment the conlract is $ith: 'f' Eseeutive fi LegislativeIs this 'rontibution associated $ith afuadraising event listed in Section Ll?Ifi'es. listEr-ent + 09/30/20'til lethod of contibution:n C*l- F, Per"onal check fl creait'Debit card C PaFoll Deduction Fl Irlouey Ordet Amount ofContribufion

$45.00

; for a chiefexeeutive ofticer ofamudcipali6 does cootributor.or blsiless hEishe is associated :rithbar-e a contract lr-ith saidiciiralitrtaluedatmorethan$5.000? f. Yes f, No

Is cootributor a l,obblist. spouse" {-l Yesordependentchildoialo6tyist: f, NoIs contibutor a principal of a state contraetor or prospesti\- stat conkfictor"rfy'e*. indicate which bnnch or branchesoiiol-.n"** O" contract ie with: f. Esecutir-e f. Legislative

Is lLisqontsibution associated n'ith afirndraising er-ent listed in Section I.l1f1'er, list Er-ent * 09130/201 1fi, YesfNo

\,lethod of contsibution :f. C"rn {tj iersonal Che,}k {. CredirDebit Card f. Pa$otl Deduction |l \Ione,v Order Amount ofConfiibution

$107.00

4 Falbo Dr. If conhibution is in arcess of $4O0 to a candidate commrttee toI a cblet execuln'e olltcer oImunieipalit-v does eontributor or business he,she is associated,rritlr harc a contract n ith saidmunicipalit-v'rahred at more than $5"00{? f tes l No

committee for a chief executire ofticEr of aIscoatributoralobbfist.spouse. fl Yesordependettchildofalobbvist? l NoLs conhibutor a principal of a state contractor or prospectise state cotrtactor?{f;'es. indicate which bralch or branehesoiior.ntru.ot U. contract is nith: ill Esecutite fll Legislatirc

Is this contibution associateds-ith a fil Yesfirndraising er-ent listed ia Seetion L l? f I NoIfi'rs" list E\-rnt * 0S130/201 1Nlethod of conhibution:fl cash Sl Personal Che,rli i:l Credit'Debit Card t'l Paltoll Deduction A lrlone-v (hder .{mount ofContribution

$60.00

ffi ,;andidate comnriuee for a chi"f executive officer nf amunicipalit-v tloes contributor or business hershe is associated:rith harrr a coffact rtith saidiciialin talued at more than $5$00? ''f' Tes ',ft No

coanibutor a lobb-r'ist. spo$se.dependert ehild of a lobbf ist?

Is contibutor a princigal of a state conhactof of prospectfis state eontaclol? !f' Yes* 'fi*. i"ai"i" ,irtiich branch or branches 'fi Nooig*=.nm*t6tcontractisrvith: iil Executir-e I}L*gislative "Is this contribution associated rvith afundraising event tisred in Section Ll?dfJ'es. list E\-ent + 09/30/201 1

5. resF-l NoItlethod of cortribution:- Ki curt lf. Personnl chec&. 'fi creditDebit card [fl Pa]roll Dedustion F lrlone:- order


21/40

MONETARY RECEIPTSSection B. Additional PaeeI. i,F.fii:illilidiirPaul Rov 201 1 1At11t2911

S. Itemized Contributions froq-Il4nrdgql*LastNamc Richard F$stCrystal

t\{I bncrpal OccupatiturSign Maker

$153.00

Amount ofContribationiesrftd$l Stteet Adftes4 Emery St.

lttl'Seymour

itateCT .4!-Ne06483

Na$e ot Emplq'dNu-age Designs, LLCIs contributor a lobbf ist" spouse,or dependent child ofa lobbfist? { Yesf No If ""lkibtti"t i" i" *".-t "f $4OO to a candidate committee for a chief esecutic officer of amudcipaliq.'does contributor or business he:she is associated $ith hale a contract rvith saidmunicipalih'vafuedatmorethan$5.000? f Yes f,l !{o.--'..._--

Is ttis conhibutiou associated n'ith afirodraisiag er-ont listed in Sectiol Ll?f1.er. list Event + 0gl3O/2O11irj YeslC No Is conbibutor a principal of a state coohaeto{ or prospcti3 state conbactor? {.'- ii"t.indiclten-hichbranchorbranches -oiior-ernment te contreet is $ith: f. e'r.*,1* f- t -g"t"

lsNo

Nlethod of conhibution:h Ca$ fl PersonalCheck lli Cr.ditD"UitCard l, Pa3totlDeductiou f- Irloney0rder DateRqJesed

091301201 1.lggegate c0nE ltruilom

$243.00Niezelski

FrstJoeT{I Prrncpal (tcrpaaonSales Amount

ofContribltion

$126.00

(e$cettnl JtIee[ Aqcres't30 Skokorat St. Seymour;tatcCT

:lpllre08+83)'lame ot lnpkYer

St. Anthont's Book /GiftsIs contributor a lobbl*t spou*e,or depeodent child ofa lobbyist?

( )esItr No ffi to acandidatecommitteefora shief executi\-e officerof amunieipatirl- does sonkibutor or bBiness heishe is associoted n'ith har-e a contract rvith saidmunicioalitr tahred at more than $5'000? lf Yes icr NoIs thb contibution associated with a 'f,' Yesftradraisinger-entlistedinseetionll? F NoIfi'c. listEved * 0g[30j-2Q11

Is conhibutor a princigal of a state cotltastor or prospeti'|-e state eolEaclor? f' I.es- lfl*.indie;en-hichbranchorbranches fl Nooig.to.t* Os cootract is $ith: if' Exer:utire lllt Legislath-elrlethod of confribution:

K1 Cash lf. Personal ChecL 'fl CredirDebit Card f. PaFoll Deduction F' h{oaeJ'Order flate RecrYd0913l/2011{ggregale coll[rwBrlm

$126.00[asaffi--Roy Fi6tEvelyn Itr hmcrpal CtctpatnmRetird Amount ofContribution

$75.00

Resldenhal s:tet .{{l([ess80 Washington Ave. -]ltiSeymour CT}Ialc !p Lo{e06483 Name

ofEmployuRetiredIs soahibutor a lobblist, spouse,or dependent child ofa lobbvist? YesNoi-'l ffito a caadidate commitee for a chief esecutir"e offieor of amunicipaliq. does contributor or business hejshe is associated n ith ha\.e a contract rrith saidmulricipalih. valued at more than $5'000? fl tes f, No

Is this conkibution assoeiated $ith afirndraising etent listed in Section L l?Ifi.es. listEr-ent* 09/30201 1fr: \esiNo Is conhibutor a princigalof a shtecontractof of pfospecth'estatesontactof? ilj r*es- -fii,er, aioi"it .r*ch branch or braoches f. Nooiiorernrnentfrecontractiswith: (.Executise l!g$q:-

Nlethod of eontibution :f, Ca"tr f,j Persoaal Chesk {- Credit'Debit Card f. Parroll Deduction {*l lvtoae-v Order I)ate Kserved09130/201 1Aggleg$E clrNlruulrs

$315.00Valeski FEtDawn

\.tr Prmcrpal t]ccupatonAsst Public Works .{mount ofContribution

$55.00

Rsidedial SSet.\d,iess20 Osorev Or SeymourPErcCTK.rb

4lp Lse06483Name ot EnPlc')erTown of Sevmour

Is eontibutot a lobbSisl spouse.or depordent child of a lobbf ist? lll Yesf,l No ffi ,Jindidate eoormi$ee for a chief ese,:uti\ E officer of nmunicipaliq' does contributor or business he'she ia assopiated nith har-e a conha.)t n'ith saidmunicipali!.vafuedatmorethan$5.000? f' fes ffl Nor] Yesr:: NoIs this conhibution assooiated n'itb afirndraisiag el-ent listed in Section L 1?{f}.es. list Elent * 09/30/201 1

Is conbibutor a princiral of a state conhaetor or prospective state uonbartor?fl,es, indicate *-hich branch or branchesoigol'ernnrent the co!*ract is rr-ith: fl EseTtive-fl I-3gis!:tileL, lesfl No

l\lethod of contibution:i. Ca"n fl Personal Check fl t-redit Debit Card fl Paltoll Deduction f Nlonel' Order llate Rece$.ed09130/201 1\gregate

$105.00LstNrm FIst

-\fl Prncrpal tl}tcup:um .{mount ofContribution

lesldeDtnl Stseet A$tess ;rt\ itate [Z$ Ltrile N[frEoiFplc-r'erls conhibutor r lobb-visl spouse.rr dependent child of a tohb.r'isfi 'f' Yeslfi No ffito a caadidatecommitteefora chief erecutive officerof amunicipalitl'does conhibutor or business he'she is associated rvith hare a contrret rrith saidmuoicipalitvtahed atmore thao $5'000? ',$ r*es if: No

{. tesin uoIs thb conhibution associated $ith afirndraising er-ent listed in Seetion Ll?f}'es. list Er-ent ;iF fesir NoIs conaibutor a principal of a state coltractor of prospeetive state cotrtrftctor?Ift'es. indicate n{rich branch or branchesoi io. ernment &e eont

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