CAMPAIGN FINANCE REPORT STATE OF WISCONSIN GAB-2...03/01/2012 Clifford, Keith 44 E Mifflin St Ste...
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2A. Gross Expenditures 2B. Contributions to Committees (Transfers-Out) TOTAL DISBURSEMENTS (Add totals from 2A and 2B) 2. DISBURSEMENTS $4,292.75 $4,292.75 $380.00 $380.00 $4,672.75 $4,672.75 Street Address: P.O. Box 930461 City, State and Zip: Verona, WI 53593 Filing Period Name: Covers all activity from 01/01/2012 through 06/30/2012 July Continuing 2012 Name of Committee/Corporation: Friends of Sondy Pope-Roberts CAMPAIGN FINANCE REPORT STATE OF WISCONSIN GAB-2 COMMITTEE IDENTIFICATION 1. RECEIPTS 1A. Contributions (Including Loans) from Individuals 1B. Contributions from Committees (Transfers-In) 1C. Other Income and Commercial Loans TOTAL RECEIPTS (Add totals from 1A, 1B and 1C) Column A This Period Column B Calendar Year-To-Date $7,269.01 $7,269.01 $2,450.00 $2,450.00 $13,143.59 $13,143.59 $22,862.60 $22,862.60 SUMMARY OF RECEIPTS AND DISBURSEMENTS GAB ID: 0103840 OFFICE USE ONLY CASH SUMMARY Cash Balance Beginning of Report Total Receipts Subtotal Total Disbursements CASH BALANCE END OF REPORT INCURRED OBLIGATIONS (Balance at the Close of This Period-3A) LOANS (Balance at the Close of This Period-3B) $5,731.96 $22,862.60 $28,594.56 $4,672.75 $0.00 $0.00 $23,921.81 * * I certify that I have examined this report and to the best of my knowledge and belief it is true, correct and complete. Type or Print Name of Candidate or Treasurer: Signature of Candidate or Treasurer Date: Daytime Phone: Van Gorden, Reed R NOTE: The information on this form is required by ss.11.06, 11.20, Wis. Stats. Failure to provide the information may subject you to the penalties of ss.11.60, 11.61, Wis. Stats. GAB-2 (Rev. 12/03) This form is prescribed by the Government Accountability Board, P.O. Box 7984, Madison, WI 53707-7984, 608-266-8005. * Cash Balance as reported by committee
Transcript of CAMPAIGN FINANCE REPORT STATE OF WISCONSIN GAB-2...03/01/2012 Clifford, Keith 44 E Mifflin St Ste...
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2A. Gross Expenditures
2B. Contributions to Committees (Transfers-Out)
TOTAL DISBURSEMENTS (Add totals from 2A and 2B)
2. DISBURSEMENTS
$4,292.75 $4,292.75
$380.00 $380.00
$4,672.75 $4,672.75
Street Address: P.O. Box 930461
City, State and Zip: Verona, WI 53593
Filing Period Name:
Covers all activity from 01/01/2012 through 06/30/2012
July Continuing 2012
Name of Committee/Corporation:
Friends of Sondy Pope-Roberts
CAMPAIGN FINANCE REPORT
STATE OF WISCONSIN
GAB-2COMMITTEE IDENTIFICATION
1. RECEIPTS
1A. Contributions (Including Loans) from Individuals
1B. Contributions from Committees (Transfers-In)
1C. Other Income and Commercial Loans
TOTAL RECEIPTS (Add totals from 1A, 1B and 1C)
Column A
This Period
Column B
Calendar Year-To-Date
$7,269.01 $7,269.01
$2,450.00 $2,450.00
$13,143.59 $13,143.59
$22,862.60 $22,862.60
SUMMARY OF RECEIPTS AND DISBURSEMENTS
GAB ID: 0103840
OFFICE USE ONLY
CASH SUMMARY
Cash Balance Beginning of Report
Total Receipts
Subtotal
Total Disbursements
CASH BALANCE END OF REPORT
INCURRED OBLIGATIONS
(Balance at the Close of This Period-3A)
LOANS (Balance at the Close of This Period-3B)
$5,731.96
$22,862.60
$28,594.56
$4,672.75
$0.00
$0.00
$23,921.81*
*
I certify that I have examined this report and to the best of my knowledge and belief it is true, correct and complete.
Type or Print Name of Candidate or Treasurer: Signature of Candidate or Treasurer Date:
Daytime Phone:Van Gorden, Reed R
NOTE: The information on this form is required by ss.11.06, 11.20, Wis. Stats. Failure to provide the information may subject you to thepenalties of ss.11.60, 11.61, Wis. Stats.
GAB-2 (Rev. 12/03) This form is prescribed by the Government Accountability Board, P.O. Box 7984, Madison, WI 53707-7984, 608-266-8005.
*Cash Balance as reported by committee
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SCHEDULE 1-A RECEIPTS
Contributions From Individuals
Complete Committee Name: Friends of Sondy Pope-Roberts
02/22/2012 Hasler, Hatheway 3111 Pheasant Branch Rd Apt 206B, Middleton, WI 53562
$100.00 $100.00
02/22/2012 Nachreiner, Dean 12 Sherman Terrace Unit 1, Madison, WI 53704
$25.00 $25.00
02/22/2012 Stanfield, Sandra 10900 Stanfield Rd, Blue Mounds, WI 53517
$50.00 $50.00
02/22/2012 Young, Beverly 1997 County Road PB, Verona, WI 53593
RETIRED $50.00 $50.00
02/05/2012 Miller, Mark 4903 Roigan Ter, Monona, WI 53716
STATE SENATOR State of WI Senate
$100.00 $100.00
02/21/2012 Hift, Helen 6209 Mineral Point Road Tower 1511, Madison, WI 53705
$50.00 $50.00
02/14/2012 Rux, Paul 405 Lake St, Mount Horeb, WI 53572
STRATEGIST Self 400 Lake St, Mount Horeb, WI 53572
$100.00 $100.00
02/22/2012 Upshaw, Mary 2679 Richardson St, Madison, WI 53711
Promega Corp.
2800 Woods Hollow Road, Fitchburg, WI 53711
$50.00 $50.00
02/23/2012 Hayward, Julie 46 Oak Creek Trl, Madison, WI 53717
$50.00 $50.00
02/23/2012 Davis, Fredrick 1521 Golf View Rd, Madison, WI 53704
RETIRED $100.00 $100.00
02/22/2012 Bowles, Dean 1403 Joyce Rd, Madison, WI 53716
RETIRED $100.00 $100.00
02/22/2012 Smith, Rose 218 Du Rose Ter, Madison, WI 53705
RETIRED $25.00 $25.00
02/23/2012 Ansay, Paul 13721 W. Gunsight Dr, Sun City West, AZ 85375
RETIRED $75.00 $75.00
02/22/2012 Stroup, Marylyn 2276 Branson Rd, Oregon, WI 53575
Grassland Media
5944 Seminole Centre Court, Fitchburg, WI 53711
$25.00 $25.00
Monetary
Date Full Name Address Occupation Employer Name
Employer Address
Amount YTD
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02/26/2012 Bicknell, Frances 9 Beach St, Madison, WI 53705
$30.00 $30.00
02/26/2012 Hannemann, Chris 304 Military Ridge Dr, Verona, WI 53593
$50.00 $50.00
02/26/2012 Passman, Donald 3118 Todd Dr, Madison, WI 53713
$50.00 $50.00
02/26/2012 Doyle, Jessica 2001 Hawks Ridge Dr, Verona, WI 53593
$100.00 $100.00
02/26/2012 Farley, Eugene 2299 Spring Rose Rd, Verona, WI 53593
RETIRED $100.00 $100.00
02/27/2012 Myers, Frank 3041 Old Creek Rd, Middleton, WI 53562-1856
RETIRED $35.00 $35.00
02/26/2012 Wallace, Daniel 2286 Branson Rd, Fitchburg, WI 53575-1938
University of Wisconsin
$100.00 $100.00
02/27/2012 Schlesser, Roger 200 Beth Circle, Mount Horeb, WI 53572
RETIRED $100.00 $100.00
02/24/2012 Lundberg, Peter 5927 Schumann Dr, Madison, WI 53711
$50.00 $50.00
02/24/2012 Craney, Terrance 10 Madeline Is, Madison, WI 53719-3241
$100.00 $100.00
02/23/2012 Klein, Susan 2151 Vintage Dr, Fitchburg, WI 53575
$50.00 $50.00
02/25/2012 Ellingson, Susan 1922 Vilas Ave, Madison, WI 53711
$50.00 $50.00
02/23/2012 Benedict, Charles 3639 Bee Ln, Beloit, WI 53511
STATE LEGISLATOR
WI State Assembly
$50.00 $50.00
02/24/2012 Puchalsky, Christine
5847 Tree Line Dr, Madison, WI 53711
$50.00 $50.00
02/25/2012 Silveira, Arlene 5760 Barbara Dr, Fitchburg, WI 53711
MMSD BOARD MEMBER
MMSD 545 West Dayton Street, Madison, WI 53703
$100.00 $100.00
02/25/2012 Helmberger, Rose 1122 Middleton St, Madison, WI 53717
RETIRED $25.00 $25.00
02/25/2012 Pfile, Ken 9019 W. Mineral Point Rd, Mount Horeb, WI 53572
RETIRED $50.00 $50.00
02/24/2012 Behnke, Ken 912 Cedar Court, Verona, WI 53593
REALTOR Self-Employed (part of First Weber Group)
912 Cedar Ct, Verona, WI 53593
$100.00 $100.00
02/25/2012 Nix, Katherine 3605 Niebler Ln, Middleton, WI 53562
RETIRED $50.00 $50.00
Monetary
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02/29/2012 Kniedler, Grant 202 W Hudson St, Mazomanie, WI 53560
$50.00 $50.00
03/01/2012 Bewley, Janet 810 Chapple Ave, Ashland, WI 54806
$25.00 $25.00
02/28/2012 Corrigan, Sharon 6991 Friendship Ln, Middleton, WI 53562
$50.00 $50.00
02/28/2012 Lowndes, Mary Anne
4802 Agate Ln, Madison, WI 53714
$25.00 $25.00
02/28/2012 Lehner, Willi 3480 County F, Blue Mounds, WI 53517
SELF EMPLOYED $50.00 $50.00
02/28/2012 Parisi, Joe 702 McLean Dr, Madison, WI 53718
$50.00 $50.00
02/27/2012 Ashman, Marian 6720 Century Ave, Apt 305, Middleton, WI 53562
RETIRED $100.00 $100.00
02/29/2012 Hesselbein, Dianne
1420 N High Point Rd, Middleton, WI 53562
$25.00 $25.00
02/27/2012 Schumacher, Anthony
2976 Chapel Valley Rd Apt 103, Fitchburg, WI 53711
$30.00 $30.00
02/27/2012 Abraham, Dylan 6237 Charing Cross, Apt A, Middleton, WI 53562
$20.00 $20.00
02/28/2012 Hylbert, Nancy 2809 Hollyhock St, Fitchburg, WI 53711-7630
SELF EMPLOYED Springdale Alpacas
$35.00 $35.00
02/29/2012 Kanter, Dee 450 Jenna Dr, Verona, WI 53593
$50.00 $50.00
02/29/2012 Hauser, Kathy 113 Edward St, Verona, WI 53593
$20.00 $20.00
02/29/2012 Boley, Helen 3110 Waucheeta Trl, Madison, WI 53711
RETIRED $100.00 $100.00
02/29/2012 Kutler, Stanley 4112 Keewatin Trl, Verona, WI 53593
$50.00 $50.00
02/29/2012 Gregg, Marsha 202 N. Franklin Ave, Madison, WI 53705
RETIRED former: Madison Metropolitan School District
$50.00 $50.00
02/29/2012 Dopp, Susan 7101 Friendship Ln, Middleton, WI 53562-1012
$100.00 $100.00
02/29/2012 Deer, Ada 2537 Mutchler Rd, Fitchburg, WI 53711
RETIRED $100.00 $100.00
02/29/2012 Lehmann, Richard 2847 Century Harbor Rd, Middleton, WI 53562
ATTORNEY Boardman Suhr Curry Field
1 South Pinckney Street, Madison, WI 53703
$50.00 $50.00
Monetary
-
03/12/2012 Sieling, Brent 105 Ohio Ave, Madison, WI 53704
$50.00 $50.00
03/13/2012 Schalch, Joanne 3025 Dianne Dr, Middleton, WI 53562
UW Health Clinic
600 Highland Ave, Madison, WI 53792
$50.00 $50.00
03/14/2012 Bruins, Nancy 9391 Union Valley Rd, Black Earth, WI 53515
RETIRED $50.00 $50.00
03/08/2012 Elder, Joseph 1112 Grant St, Madison, WI 53711
$100.00 $100.00
03/08/2012 Palmer, Constance
1533 Comanche Gln, Madison, WI 53704
RETIRED $200.00 $200.00
03/12/2012 Richard, Joanna 1720 Mayflower Dr, Middleton, WI 53562
DEPUTY SECRETARY
WI DWD $50.00 $50.00
03/01/2012 Pease, Francine N7431 Burr Oak Rd, Whitewater, WI 53190
RETIRED $50.00 $50.00
03/01/2012 Lehmann, Richard 2847 Century Harbor Rd, Middleton, WI 53562
ATTORNEY Boardman Suhr Curry Field
1 South Pinckney Street, Madison, WI 53703
$50.00 $100.00
03/01/2012 Clifford, Keith 44 E Mifflin St Ste 800, Madison, WI 53703-2800
$100.00 $100.00
03/05/2012 Lacomb, Charlotte 472 Basswood Ave, Verona, WI 53593
$25.00 $25.00
03/01/2012 Lohr, Elaine 526 Holly Ave, Madison, WI 53711
$50.00 $50.00
03/01/2012 Jenson, Alice 2523 Targhee St, Madison, WI 53711
$35.00 $35.00
03/03/2012 Chapman, Roger 5683 Vineyard Rd, Fitchburg, WI 53575
$100.00 $100.00
03/03/2012 Weisberger Blanchard, June
110 S Henry St Apt 1402, Madison, WI 53703
$75.00 $75.00
03/03/2012 Wottreng, James 440 Glacier Ridge Trl, Verona, WI 53593
$50.00 $50.00
03/02/2012 Hecht, Anne 2524 Targhee St, Fitchburg, WI 53711-5491
RETIRED $50.00 $50.00
03/02/2012 Magnuson, Mark 3007 Park St, Middleton, WI 53562
State of WI $50.00 $50.00
03/02/2012 Skupien, Lawrence
9217 County Rd S, Mount Horeb, WI 53572
$25.00 $25.00
Monetary
-
06/11/2012 Stadler, Judith 5629 Nutone Ct, Fitchburg, WI 53711
RETIRED $100.00 $100.00
06/12/2012 Crook, Kathleen 5631 Timber Ridge Trl, Madison, WI 53711
$100.00 $100.00
06/12/2012 Strube, Peter 908 Vista Ridge Dr, Mount Horeb, WI 53572
$100.00 $100.00
03/24/2012 Haynes, Palmer 9902 Blue Valley Rd, Mount Horeb, WI 53572
RETIRED $25.00 $25.00
03/31/2012 Rouse, Kendall 1934 Rowley Ave, Madison, WI 53726
$35.00 $35.00
03/31/2012 McGuire, Thaddeus
3304 27th St, Kenosha, WI 53144
LEGISLATIVE AID WI State Assembly
$25.00 $25.00
03/21/2012 Yanacheck, Tim 5734 County Road D, Oregon, WI 53575
Bell, Moore and Richter, SC
PO Box 1807, Madison, WI 53701
$25.00 $25.00
06/09/2012 Fuller, Patrick 214 Grove St, Ridgeway, WI 53582
$50.00 $50.00
03/18/2012 Vilmain, Teresa 8381 S Kollath Rd, Verona, WI 53593
Women's Voices - Women Vote
1640 Rhode Island Avenue NW Suite 825, Washington, DC 20036
$100.00 $100.00
03/19/2012 Udell, Randy 2905 Walnut Wood Ct, Fitchburg, WI 53711
$100.00 $100.00
04/09/2012 Kenworthy, Joy 9225 Cascade Ave #2109, West Des Moines, IA 50266
$25.00 $25.00
05/18/2012 Turner, Kim 3306 Gregory St, Madison, WI 53711
EXECUTIVE DIRECTOR
Options in Community Living
2 N 2nd St, Madison, WI 53704
$500.00 $500.00
05/20/2012 Rhodes-Conway, Satya
2642 Hoard St, Madison, WI 53704
$24.01 $24.01
05/24/2012 Palmer, Constance
1533 Comanche Gln, Madison, WI 53704
RETIRED $100.00 $300.00
05/18/2012 Mulliken, Melissa 3306 Gregory St, Madison, WI 53711
CONSULTANT Self 3306 Gregory St, Madison, WI 53711
$500.00 $500.00
04/17/2012 Maurice, Shirley 325 Westridge Pkwy, Verona, WI 53593-8348
$25.00 $25.00
04/28/2012 Gaskill, Sharon 10405 Bell Rd, Black Earth, WI 53515
$30.00 $30.00
05/11/2012 McGuire, Thaddeus
3304 27th St, Kenosha, WI 53144
LEGISLATIVE AID WI State Assembly
$50.00 $75.00
Monetary
-
02/29/2012 Christian, Russell 522 Springdale St Apt 202, Mount Horeb, WI 53572
DENTIST Family Dental Care, LLC
522 Springdale St Apt 101, Mount Horeb, WI 53572
$100.00 $100.00
06/27/2012 Vance, Vaughn 5527 Quarry Hill Dr, Fitchburg, WI 53711
LOBBYIST WEA Trust 45 Nob Hill Rd, Madison, WI 53707
$250.00 $250.00
Sub Total $350.00
Conduit Contribution
06/23/2012 Wille-Schlesser, Cheryl
200 Beth Circle, Mount Horeb, WI 53572
$100.00 $100.00
06/23/2012 Lemanski, Mary 401 Westlawn Ave, Verona, WI 53593
RETIRED $50.00 $50.00
06/24/2012 Young, Beverly 1997 County Road PB, Verona, WI 53593
RETIRED $50.00 $100.00
06/27/2012 Herman, James 870 Jean Circle, Oregon, WI 53575
SELF EMPLOYED $50.00 $50.00
06/25/2012 Sweet, James 120 Paoli St, Verona, WI 53593
RETIRED $50.00 $50.00
06/22/2012 Stroup, Marylyn 2276 Branson Rd, Oregon, WI 53575
Grassland Media
5944 Seminole Centre Court, Fitchburg, WI 53711
$25.00 $50.00
06/14/2012 Schroeer, J.M. 304 Military Ridge Dr, Verona, WI 53593
$100.00 $100.00
06/15/2012 Roe Parker, Friends of
1560 Partridge Hill Dr, Oregon, WI 53575
$25.00 $25.00
06/13/2012 Koechel, Laura 5734 Modernaire St, Fitchburg, WI 53711
$100.00 $100.00
06/13/2012 Bowles, Dean 1403 Joyce Rd, Madison, WI 53716
RETIRED $50.00 $150.00
06/15/2012 Geier, David 815 Garfield St, Apt 1, Madison, WI 53711
$10.00 $10.00
06/19/2012 Baumann, William 579 Harvest Ln, Verona, WI 53593
$20.00 $20.00
06/15/2012 Geier, Tim 5026 Coney Weston Pl, Madison, WI 53711
$20.00 $20.00
06/15/2012 Spaay, Glenn 9227 County Rd S, Mount Horeb, WI 53572
$50.00 $50.00
Sub Total $6,894.01
Monetary
Total UnItemized Contributions $25.00
Total Anonymous Contributions $0.00
Grand Total $7,269.01
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Total $7,269.01
Loan Forgiven (-): $0.00
Non-Monetary (-): $0.00
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SCHEDULE 1-B RECEIPTS Contributions from Committees
(Transfers-In)
Complete Committee Name: Friends of Sondy Pope-Roberts
05/08/2012 WI State Council of Carpenters 115 West Main Street, Madison, WI 53703
$200.00 $200.00
05/08/2012 School Administrators Alliance PAC
4797 Hayes Road, Suite 202, Madison, WI 53704
$250.00 $500.00
06/27/2012 WI PEOPLE Conference 8033 Excelsior Drive, Suite A, Madison, WI 53717
$500.00 $500.00
06/19/2012 Friends of Donna Seidel 807 South 20th Street, Wausau, WI 54403
$500.00 $500.00
05/17/2012 WEAC PAC P.O. Box 8003, Madison, WI 53708-8003 $500.00 $500.00
05/01/2012 School Administrators Alliance PAC
4797 Hayes Road, Suite 202, Madison, WI 53704
$250.00 $250.00
02/14/2012 Intl Operating Engineers 150 6200 Joliet Road, Countryside, IL 60525 $250.00 $250.00
Sub Total $2,450.00
Monetary
Non-Monetary (-): $0.00
Grand Total $2,450.00
Total $2,450.00
Date Full Name Address Amount YTD
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SCHEDULE 1-C RECEIPTSOther Income and Commercial Loans
Complete Committee Name: Friends of Sondy Pope-Roberts
Comment(s): Matured CD
05/10/2012 Unitemized $13,143.59 $0.00
Other Income
Total $13,143.59
Date Full Name Address Amount YTD
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SCHEDULE 2-A DISBURSEMENTS
Gross Expenditures
Complete Committee Name:
05/18/2012 Wells Print and Digital 3121 Waterford Way, Madison, WI 53713
Printing - Brochures
$455.59
04/16/2012 USPS 100 Enterprise Drive, Verona, WI 53593
Mailing Service
$115.00
04/09/2012 Fed Ex Kinkos 7805 Mineral Point Rd, Madison, WI 53717
Office Supplies
$32.97
06/15/2012 Vogeltanz, Jered 431 N Francis Apt 101, Madison, WI 53703
Wages - Campaign Manager
$750.00
06/12/2012 USPS 7613 Elmwood Avenue, Middleton, WI 53562
Postage $225.00
06/08/2012 Costco 2150 Deming Way, Middleton, WI 53562
Parade Expenses - Fees, candy
$104.91
02/18/2012 Amsterdam 917 Williamson St., Madison, WI 53703
Fundraiser - Auction Item
$25.00
02/01/2012 Wells Print and Digital 3121 Waterford Way, Madison, WI 53713
Printing - Brochures
$1,057.82
04/17/2012 Fed Ex 7805 Mineral Point Rd, Madison, WI 53717
Office Supplies
$55.92
02/21/2012 Wells Print and Digital 3121 Waterford Way, Madison, WI 53713
Printing - Brochures
$1,445.54
02/18/2012 Amsterdam 917 Williamson St., Madison, WI 53703
Fundraiser - Auction Item
$25.00
Sub Total $4,292.75
Monetary
Date Full Name Address Vendor Name Vendor Address
Expense Purpose
Amount
Friends of Sondy Pope-Roberts
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Total $4,292.75
Non-Monetary (-): $0.00
Grand Total $4,292.75
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SCHEDULE 2-B DISBURSEMENTS Contributions To Committees
(Transfers-Out)
Complete Committee Name: Friends of Sondy Pope-Roberts
03/01/2012 Jenni Dye, Friends of 2892 Mickelson Pkwy, #209, Fitchburg, WI 53711
$25.00
02/29/2012 Ellis, Matthew 1718 Tarragon Dr, Madison, WI 53716
$20.00
03/09/2012 McCrary, Heather 5401 Williamsburg Way, Apt 315, Fitchburg, WI 53719
$35.00
04/17/2012 Planned Parent Advocates of WI, Inc - MCFL org.
111 King Street, Suite 23, Madison, WI 53703
$100.00
03/13/2012 Silveria, Arlene 5760 Barbara Drive, Fitchburg, WI 53711
$30.00
01/21/2012 Pope-Roberts, Sondy 9262 Moen Rd, Cross Plaines, WI 53528
$50.00
03/09/2012 Democratic Party of Dane Co
P.O. Box 2082, Madison, WI 53701
$100.00
02/29/2012 Storm, Steven 1512 Lynchburg Trl, Madison, WI 53718
$20.00
Comment(s): Petty Cash to Give Anonymous Donations to Colleagues at Fundraisers
Sub Total $380.00
Monetary
Non-Monetary (-): $0.00
Registrant In-Kind Sub Total (-): $0.00
Total $380.00
Grand Total $380.00
Date Full Name Address Vendor Name Vendor Address
Amount
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ADDITIONAL DISCLOSUREIncurred Obligations Excluding Loans
SCHEDULE 3-A
Complete Committee Name:
Incurred Obligation Outstanding Amount:
Grand Total $0.00
Date Full Name Address Amount
$0.00
Friends of Sondy Pope-Roberts
Grand Total $0.00
Date Full Name Amount Paid
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ADDITIONAL DISCLOSURELoans
Individual, Committee or Commercial
SCHEDULE 3-B
Complete Committee Name:
Loans Outstanding Amount:
Friends of Sondy Pope-Roberts
$0.00
Grand Total $0.00
Date Lender Name Address Loan Amount Loan Payment + Forgiven Amount
Outstanding Amount
