County Clerk Salt Lake County Clerk
Election Division
Financial Disclosure Report

Name of Candidate of Officeholder Political Party
Crockett, Mark REPUBLICAN
Address City State Zip Code

Office Sought Phone Number Fax # Email Address

Org Type: Personal Campaign Committee
Report: 2011 Summary Report


Column A
Total this Period
Column B

Contributions Received
1 Total Contributions Received
(See Schedule A)
$25,000.00 $25,000.00 * - YTD totals may reflect activity from past years.
Expenditures Made
2 Total Expenditures Made
(See Schedule B)
$1,931.93 $1,931.93 * - YTD totals may reflect activity from past years.
Balance Summary
3 Balance at Beginning of Reporting Period $0.00 Refer to Line 7 on last report
4 Total Contributions Received
(From Line 1 Column A)

5 Subtotal
(Add Lines 3 and 4)

6 Total Expenditures Made
(From Line 2 Column A)

7 Balance at Close of Reporting Period $23,068.07

Schedule A
Itemized Contributions Received

Date Received Contributor
Address Occupation Employer Type Amount In-Kind?
12/05/2011 Mark Crockett
Management ViciCapital Individual $25,000.00

Total Contributions $25,000.00

Schedule B
Itemized Expenditures Made

Date Expended Recipient Name Purpose Amount In-Kind?
12/07/2011 Wells Fargo Service Fee $8.00
12/12/2011 Salt Lake Mailing Mailer $1,873.93
12/27/2011 Midvale Mining Cafe Leadership Meeting $50.00

Total Expenditures $1,931.93