CFC FORM CCDR REV 1/15 FILER ID: NC2010000017 State of Georgia Campaign Contribution Disclosure Report 1. Report Type 2. Filing is being made on behalf of: Filing Office Use Report of Organization or Person Other than Candidate's Campaign Committee Only E-Filed on Original Report NC2010000017 - 2/5/16 11:37 am Georgia House Republican Trust, Inc. Use Earlier of Post Mark or Hand Delivered Date 3. Identifying and Contact Information (1) Georgia House Republican Trust, Inc. (2) 01/14/2016 Full Name of Candidate or Non-Candidate Campaign Committee Today's Date (3) C/O Bruce Williamson, PO Box 430 Monroe, GA 30655 Mailing Address (4) (478) 474-5633 and / or (478) 361-4617 Contact Phone Number (We will understand the release of this information as permission to call your office if necessary.) (5) If a Candidate or Public Official, is there a campaign committee (one or more persons) to make campaign transactions, keep the financial records of the campaign, or file the reports? N/A (6) If so, is the Committee registered with the State Ethics Commission? N/A (7) Chairperson: Matt Hatchett Treasurer: Hugh B Williamson, III Name of Chairperson and / or Treasurer of Committee 4. Period for which you are Reporting My Non Election Year My Election Year Run-Offs Special Elections (Report Require Only if you are in a Run Off (Report Require Only if you are in a Special Election) Election) January 31, 2016 X January 31, 2016 6 days before Primary 15 days before Run-Off, 2016 Special Primary, June 30, 2016 March 31, 2016 2016 6 days before General Supplemental Reporting June 30, 2016 Run-Off, 2016 June 30, 2016 15 days before Special, 2016 December 31, 2016 September 30, 2016 6 days before Special *Persons leaving office with excess funds until Primary Run-Off, such funds are expended as provided in the Act October 25, 2016 2016 *Unsuccessful candidates with excess funds, or Dec. 31, 2016 who receive contributions to retire debt December 31, 2016 6 days before Special incurred, until such funds are expended, or such unpaid debts are satisfied Run-Off, 2016 The electronic filing of this document constitutes an affirmation that the statement is true, complete, and correct. As per modifications of the Ethics in Government Act, filing a separate notarized affidavit is no longer required. See O.C.G.A. §§ 21-5-34.1(e) and 21-5-50(e). Campaign Contribution Disclosure Report for 2016 January 31st - Election Year - Original Electronically Filed with the Georgia Government Transparency and Campaign Finance Commission on: 2/5/2016 11:37:39AM -- Confirmation #NC2010000017117991 CFC FORM CCDR REV 4/12 FILER ID: NC2010000017 State of Georgia Campaign Contribution Disclosure Report Summary Report CONTRIBUTIONS RECEIVED 1 I Have: In-Kind Cash Amount The following contributions, including Common Source, to report: Estimated Value 2 Total contributions previously reported. $0.00 $500,361.17 3 Total amount of all itemized contributions received in this reporting period which are listed on the "Itemized Contributions" page. $0.00 $315,997.26 3a All loans received this reporting period. $0.00 3b Interest earned on campaign account this reporting period. $0.00 3c Total amount of investments sold this reporting period. $0.00 3d Total amount of cash dividends and interest paid out this reporting period. $0.00 Total amount of all separate contributions of $100.00 or less received in this reporting 4 period and not listed on the "Itemized Contributions" page. "Common Source" contributions must be aggregated on the "Itemized Contributions" $0.00 $600.00 Total contributions reported this reporting period. 5 (Line 3 + 3a + 3b +3c + 3d + 4) $0.00 $316,597.26 Total contributions to date. 6 $0.00 $816,958.43 (Line 2 + 5) EXPENDITURES MADE In-Kind Cash Amount 7 I Have: The following expenditures to report: Estimated Value 8 Total expenditures made and reported prior to this reporting period. $0.00 $126,162.19 9 Total amount of all itemized expenditures made in this reporting period which are listed on the "Itemized Expenditures" page. $0.00 $97,257.47 10 Total amount of all separate expenditures of $100.00 or less each that were made in this reporting period and not listed on the "Itemized Expenditures" page. $0.00 $287.99 11 Total expenditures reported this reporting period. (Line 9 + 10) $0.00 $97,545.46 Total expenditures to date. 12 $0.00 $223,707.65 (Line 8 + 11) INVESTMENTS 13 Amount of investments at the beginning of this reporting period. $0.00 14 Total amount of investments at the close of this reporting period. $0.00 15 Net Balance On Hand. $593,250.78 (Line 6 - 12 + 14) Campaign Contribution Disclosure Report for 2016 January 31st - Election Year - Original Electronically Filed with the Georgia Government Transparency and Campaign Finance Commission on: 2/5/2016 11:37:39AM -- Confirmation #NC2010000017117991 CFC FORM CCDR REV 4/12 State of Georgia Campaign Contribution Disclosure Report Outstanding Indebtedness Primary 2016 Indebtedness Amount 1 Outstanding indebtedness at the beginning of this reporting period. $0.00 2 Loans received this reporting period. $0.00 3 Deferred payments of expenses this reporting period. $0.00 4 Payments made on loans this reporting period. $0.00 5 Credits received on loans/deferred payments this reporting period. $0.00 6 Payments this period on previously deferred expenses. $0.00 Total indebtedness at the close of this reporting period. 7 $0.00 (line 1 + 2 + 3 - 4 - 5 - 6) Campaign Contribution Disclosure Report for 2016 January 31st - Election Year - Original Electronically Filed with the Georgia Government Transparency and Campaign Finance Commission on: 2/5/2016 11:37:39AM -- Confirmation #NC2010000017117991 CFC FORM CCDR REV 4/12 FILER ID: NC2010000017 State of Georgia Campaign Contribution Disclosure Report Itemized Contributions Must list contributions received by a single contributor for which the aggregate total is more than $100.00 Contributor In-Kind Contributions Full Name of Contributor Mailing Address Received Date a. Occupation & Election Cash Estimated Value (Affiliation of Committee if any) Contribution Type b. Employer Cycle Amount Description 21st Century Fox America, Inc. 01/18/2016 2016 $2,500.00 $0.00 Primary 1211 Avenue of the Americas Monetary New York, NY 10036 Aetna 09/18/2015 2016 $2,500.00 $0.00 Primary 151 Farmington Avenue Monetary Hartford, CT 06156 AFLAC 12/17/2015 2016 $5,000.00 $0.00 Primary 1932 Wynnton Rd Monetary Columbus, GA 31999 AGL Resources Georgia PAC 07/22/2015 2016 $5,000.00 $0.00 Primary P.O. Box 4569 Monetary Atlanta, GA 30302 Altria Client Services, Inc 07/30/2015 2016 $30,000.00 $0.00 Primary P.O. Box 85088 Monetary Richmond, VA 23285 American Insurance Association 09/18/2015 2016 $6,000.00 $0.00 Primary 2101 L. Street, NW, Suite 400 Monetary Suite 425 Washington, DC 20037 Apollo Education Group 07/22/2015 2016 $2,500.00 $0.00 Primary 4025 S. Riverpoint Parkway Monetary Phoenix, AZ 85040 Arrow Exterminators 07/15/2015 2016 $250.00 $0.00 Primary 8613 Roswell Rd Monetary Atlanta, GA 30350 Campaign Contribution Disclosure Report for 2016 January 31st - Election Year - Original Electronically Filed with the Georgia Government Transparency and Campaign Finance Commission on: 2/5/2016 11:37:39AM -- Confirmation #NC2010000017117991 Astellas Pharma US, Inc. 01/18/2016 2016 $1,000.00 $0.00 Primary Three Parkway North Monetary Deerfield, IL 60015 AT&T Political Action Committee 12/17/2015 2016 $5,000.00 $0.00 Primary JP Morgan Chase Bank Monetary Syracuse, NY 13209 Barnes & Thornburg LLP 01/21/2016 2016 $2,000.00 $0.00 Primary 11 South Meridian Street Monetary Indianapolis, IN 46204 Blue Cross Blue Shield of Georgia 08/05/2015 2016 $5,000.00 $0.00 Primary P.O. box 68086 Monetary Cincinnatti, OH 45206 Capital Health Management, Inc. 12/17/2015 2016 $2,500.00 $0.00 Primary P.O. Box 7688 Monetary Columbia, MO 65205 CareMark RX Inc. 07/15/2015 2016 $2,000.00 $0.00 Primary P.O. Box 287 Monetary Lincoln, RI 02895 Caterpillar Employee PAC 07/15/2015 2016 $1,000.00 $0.00 Primary 100 NE Adams St. Monetary Peoria, IL 61629 Centene Management Company, LLC 12/17/2015 2016 $5,000.00 $0.00 Primary 7711 Carondelet Avenue Monetary St Louis, MO 63105 Charter Communications 12/17/2015 2016 $5,000.00 $0.00 Primary 12405 Powerscourt Drive Monetary St. Louis, MO 63131 Chuck Efstration for House 12/17/2015 2016 $200.00 $0.00 Primary P.O.Box 1656 Monetary Dacula, GA 30019 Campaign Contribution Disclosure Report for 2016 January 31st - Election Year - Original Electronically Filed with the Georgia Government Transparency and Campaign Finance Commission on: 2/5/2016 11:37:39AM -- Confirmation #NC2010000017117991 Citizens to Elect Ed Setzler 01/14/2016 2016 $200.00 $0.00 Primary 1555 Boxwood Trace Monetary Acworth, GA 30102 Civil Justice PAC of the Georgia Trial 12/30/2015 2016 $4,000.00 $0.00 Primary Lawyer's Association Monetary 101 Marietta Street, NW Suite 3350 Atlanta, GA 30303 Clark, Heath 12/17/2015 a. State 2016 $200.00 $0.00 Primary 113 Maryjay Monetary Representative Warner Robins, GA 31108 b. State of Georgia Comcast Corporatation 12/17/2015 2016 $5,000.00 $0.00 Primary One Comcast Center Monetary 1701 JFK Boulevard Philadelphia, PA 19103 Comcast Corporatation 07/22/2015 2016 $1,000.00 $0.00 Primary One Comcast Center Monetary 1701 JFK Boulevard Philadelphia, PA 19103 Comcast Corporation 01/18/2016 2016 $5,000.00 $0.00 Primary One Comcast Center Monetary 1701 JFK Boulevard Philadelphia, PA 19103 Committee to Elect Allen Peake 12/17/2015 2016 $200.00 $0.00 Primary 103 Colony Ct.