Report History
This Original filed:	6/10/2013 4:03:10 PM	{displayed below}

Report of Bank Deposit (C3) - $700.00 on 5/3/2013
filed 6/10/2013 4:03:10 PM by phillloyd

Committee Name	Tim Burgess for Mayor
Mailing Address	603 Stewart Street Suite 819 Seattle, WA 98101
Office Sought	MAYOR
Candidate	Tim Burgess
Treasurer	Philip Lloyd

Source of Funds	First Date Received	Last Date Received	Amount	Aggregate
Anonymous	//	//	$ 0.00	$ 0.00
Candidate	//	//	$ 0.00	$ 0.00
Loans	//	//	$ 0.00
Miscellaneous	//	//	$ 0.00

Source of Funds	First Date Received	Last Date Received	Number	Amount
Contributors of $25 or Less				$ 0.00

Itemized Contributions - Required for Contributors of more than $25.00
Receipt Date	Name & Address	Employer & Occupation	Amount	Aggregate
5/3/2013	Anne B. Counts Seattle, WA 98109	None Seattle, WA Retired	$100.00	$100.00
5/1/2013	Bert Green Seattle, WA 98112	dba Bert Green Seattle, WA Physician	$200.00	$700.00
5/2/2013	Mary Bess Bess Kelly Seattle, WA 98199	None Seattle, WA Retired	$100.00	$100.00
5/1/2013	Sara Levin Seattle, WA 98118	United Way of King County Seattle, WA Vice President	$200.00	$700.00
5/3/2013	Langdon S. Simons Jr. Seattle, WA 98101	None Seattle, WA Retired	$100.00	$200.00
Subtotal - Itemized Contributions			$700.00

Total Deposit	$700.00
Deposit Date	5/3/2013

Report Certified By	Phil Lloyd
Date Certified	6/10/2013 4:03:10 PM
Treasurer's Daytime Telephone Number	(206) 382-5552

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