DEBT SETTLEMENT PLAN (Only Committees that are terminating are eligible to file this form.) (See reverse side for instructions)

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FOR OCF USE ONLY GOVERNMENT OF DISTRICT OF COLUMBIA OFFICE OF CAMPAIGN FINANCE WASHINGTON, D.C. 20009 ID# NAME OF DEBT SETTLEMENT PLAN (Only Committees that are terminating are eligible to file this form.) (See reverse side for instructions) PAGE CITY, STATE AND ZIP CODE DAYTIME PHONE PART I - COMMITTEE SUMMARY INFORMATION 1. CASH ON HAND AS 6. TOTAL AMOUNT OF DEBTS BY THE 2. TOTAL ASSETS TO BE 7. TOTAL NUMBER OF 3. TOTAL (ADD 1 & 8. NUMBER OF CREDITORS IN PART OF THIS 4. CUMULATIVE 9. TOTAL AMOUNT OF DEBTS TO THE CREDITORS IN PART II THIS 5. CUMULATIVE 10. TOTAL AMOUNT TO BE PAID CREDITORS IN PART II OF 11. WHEN DOES THE COMMITTEE EXPECT TO FILE A TERMINATION REPORT? 12. IF THIS IS AN AUTHORIZED COMMITTEE, DOES THE CANDIDATE HAVE OTHER AUTHORIZED COMMITTEES? ο YES ο NO IF YES, LIST BELOW. 13. DOES THE COMMITTEE HAVE SUFFICIENT FUNDS TO PAY THE TOTAL AMOUNT INDICATED IN THIS PLAN? ο YES ο NO IF NO, WHAT STEPS WILL BE TAKEN TO OBTAIN THE FUNDS? 14. HAS THE COMMITTEE FILED PREVIOUS DEBT SETTLEMENT PLANS? ο YES ο NO 15. AFTER DISPOSING OF ALL THE COMMITTEE DEBTS AND OBLIGATIONS, WILL THERE BE ANY RESIDUAL FUNDS? ο YES ο NO IF YES, SPECIFY HOW THE FUND WILL BE DISBURSED IN ACCORDANCE WITH 3 DCMR 3015 I certify, to the best of my knowledge, that the information contained in this Debt Settlement Plan is true, correct and complete. SIGNATURE OF TREASURER OF COMMITTEE DATE

NAME OF DEBT SETTLEMENT PLAN PART II (See reverse side for instructions) OCF ID FULL NAME AND MAILING ADDRESS OF CREDITOR SUMMARY INFORMATION ( TO BE COMPLETED BY COMMITTEE FOR EACH CREDITOR IN PLAN) OWED OFFERED INCORPORATED UNINCORPORATED CANDIDATE COMMERCIAL VENDOR COMMERCIAL VENDOR COMMITTEE/ PROGRAM/ FUND/ EMPLOYEE OTHER A. TERMS OF THE INITIAL EXTENSION OF CREDIT AND NATURE OF THE DEBT B. EFFORTS MADE BY THE COMMITTEE TO PAY THE DEBT C. STEPS TAKEN BY THE CREDITOR TO COLLECT THE DEBT CREDITOR SECTION (TO BE COMPLETED BY CREDITOR) D. WAS THE EFFORT MADE BY THE CREDITOR TO COLLECT THE DEBT SIMILAR TO OTHER DEBT COLLECTION EFFORTS AGAINST NONPOLITICAL DEBTORS? YES NO IF NO, PLEASE EXPLAIN. E. ARE THE TERMS OF THE DEBT SETTLEMENT COMPARABLE TO OTHER SETTLEMENTS MADE BY THE CREDITOR WITH OTHER NONPOLITICAL DEBTORS? YES NO IF NO, PLEASE EXPLAIN. As a representative of the creditor, I hereby accept the settlement offer made to me by the committee and; upon payment; agree to consider the debt satisfied. A copy of the signed agreement, if any, is attached. SIGNATURE OF CREDITOR OR REPRESENTATIVE DATE

NAME OF DEBT SETTLEMENT PLAN PART III (See reverse side for instructions) OCF ID LIST REMAINING DEBTS A. FULL NAME, MAILING ADDRESS AND ZIP CODE OF CREDITOR B. FULL NAME, MAILING ADDRESS AND ZIP CODE OF CREDITOR C. FULL NAME, MAILING ADDRESS AND ZIP CODE D. FULL NAME, MAILING ADDRESS AND ZIP CODE E. FULL NAME, MAILING ADDRESS AND ZIP CODE DOES THE COMMITTEE HAVE SUFFICIENT FUNDS TO PAY THE REMAINING AMOUNTS TO BE PAID OR OFFERED? YES NO IF NO, WHAT STEPS WILL BE TAKEN TO OBTAIN THE FUNDS?

INSTRUCTIONS FOR PREPARING THE DEBT SETTLEMENT PLAN Political committees that settle their debts for less than the full value are required to file a debt settlement plan for review by the Director of OCF. Only terminating committees are eligible to file debt settlement plans. A terminating committee is one that is winding down its political activities in preparation of filing a terminating report and would be able to terminate except that it has outstanding debts and obligations. A political committee will be considered to be winding down its political activities if it has ceased to make or accept contributions and expenditures, other than contributions accepted for debt retirement purposes and expenditures representing payments for debts or obligations previously incurred or payments for the cost associated with the termination of political activity. Every terminating committee that settles a debt for less than full value shall file at least one debt settlement plan for the Director to review, prior to filing its termination report. The plan should be filed after the creditors have agreed to the settlement. Payments should not be made upon completion of the Director s review. Debts and obligations subject to debt settlement include amounts owed to commercial vendors, debts arising from advances by committee staff and other individuals, salary owed to committee employees and debts arising from loans from political committees or individuals, including candidates, to the extent permitted under 3016 (45 DCR 3161, 3180: May 22, 1998). Debts that are disputed and bank loans are not subject to the debt settlement process. Committees that file or have filed a debt settlement plan should continue to report each outstanding debt or obligation included in a debt settlement plan on its Report of Receipts and Expenditures until the Director has informed the Committee that review of the plan has been completed. TREASURER S RESPONSIBILITIES A copy of this Plan must be preserved by the treasurer of the political committee for a period of not less than three years from the date of filing. The treasurer of the political committee is personally responsible for the information submitted in the plan and for responding to any request of the Director for information regarding the plan. WHERE TO FILE Office of Campaign Finance Frank D. Reeves Municipal Bldg. 2000 14th Street, N.W., Suite 433 Washington, D.C. 20009 GENERAL INFORMATION Complete the committee s full name, address and daytime phone number. Sequentially number the pages in this plan, after including all pages in parts II and III. Upon completion of the entire plan, the treasurer should sign and date the plan. LINE BY LINE INSTRUCTIONS FOR PART I LINE 1 Enter the committee s cash on hand at the time of filing. LINE 2 Calculate the value of any of the committee s assets that can be liquidated. Enter the total amount on line 2. LINE 3 Add Lines 1 and 2. LINE 4 Enter the cumulative receipts to date. LINE 5 Enter the cumulative disbursements to date. LINE 6 Enter the total amount of debts and obligations owed by the committee, including loans. LINE 7 Enter the total number of creditors owed by the committee. LINE 8 Enter the number of creditors that are in Part II of this plan. LINE 9 Total the debts owed to the creditors in Part II of this plan, and enter the amount on this line. LINE 10 Add the amounts to be paid to the creditors in Part II of this plan, and enter the amount on this line. LINE 11 Only committees that are terminating are eligible to file a debt settlement plan. Indicate the date you expect the committee to file a termination report. LINE 12 List any other political committee(s) the candidate has authorized to support his/her candidacy for election to office. LINE 13 If Line 3 above is less than Line 10, please explain how the committee expects to obtain the additional funds. LINE 14 If the committee has filed any debt settlement plans prior to this one, check yes. LINE 15 Should the committee have any residual funds after it has paid or settled all debts and obligations, state how they will be spent in accordance 3015 of the Regulations of the BOEE (45 DCR 3161, 3178: May 22, 1998).

INSTRUCTIONS FOR PART II 1. THE FOLLOWING SHOULD BE COMPLETED BY THE COMMITTEE. For each creditor in the plan with whom the committee is settling a debt, a separate PART II sheet should be completed. Enter the committee s full name and OCF identification number in the appropriate boxes. Enter the creditor s name and address as reported on the debt schedules filed with the committee s reports of receipts and expenditures (OCF Form 16). DATE INCURRED Enter the date the committee incurred the debt. If it is a debt that accumulated over a period of time, enter the time frame in which the debt was incurred. Enter the amount owed to the creditor. If this amount is different from what the committee has disclosed on its reports, include an explanation. AMOUNT OFFERED IN THE SETTLEMENT Enter the amount the creditor is being offered to settle the debt. TYPE OF CREDITOR Check the appropriate box. A. TERMS OF THE INITIAL EXTENSION OF CREDIT/NATURE OF THE DEBT Describe the initial terms of the debt and give a brief description of the nature of the debt. Terms include any time requirements for payment such as payment due monthly, as well as any extensions on the original terms and any penalties for failure to comply. B. EFFORTS MADE BY THE COMMITTEE TO PAY THE DEBT Briefly describe the committee s efforts to pay the debt in full. C. STEPS TAKEN BY THE CREDITOR TO COLLECT THE DEBT Briefly describe what steps the creditor took to collect the debt. Examples include: oral and written requests for payment, withholding delivery of additional goods or services until overdue debts are satisfied, late charges or penalties, referral to commercial debt collection service and/or litigation. 2. THE FOLLOWING SHOULD BE COMPLETED BY THE CREDITOR. D. WAS THE EFFORT MADE BY THE CREDITOR TO COLLECT THE DEBT SIMILAR TO OTHER DEBT COLLECTION EFFORTS AGAINST NONPOLITICAL DEBTORS? If no, please explain why the committee was treated differently. E. ARE THE TERMS OF THE DEBT SETTLEMENT COMPARABLE TO OTHER SETTLEMENTS MADE BY THE CREDITOR WITH NONPOLITICAL DEBTORS? If no, please describe how the terms are different from those offered to nonpolitical debtors. 3. THE COMMITTEE SHOULD HAVE THE CREDITOR SIGN AND DATE THE APPROPRIATE SECTION, OR ATTACH A COPY OF THE SIGNED AGREEMENT. If the committee is released from the debt pursuant to a bankruptcy discharge, attach a copy of the bankruptcy court order and a list of all debts from which the committee is released. Do not include a separate Part II for any such debt.

INSTRUCTIONS FOR PART III Complete the committee s full name and OCF identification number. LIST REMAINING DEBTS List any debts and obligations that the committee owes that are not included in this plan. Complete the appropriate information for each remaining creditor. Identify the type of creditor for each as one of the following: incorporated commercial vendor; unincorporated c o m m e r c i a l v e n d o r ; c a n d i d a t e ; employee/committee/program/fund; or other. TO PAY OR OFFER This should represent the amount that the committee expects to offer the creditor to settle the debt. DOES THE COMMITTEE HAVE SUFFICIENT FUNDS TO PAY THE REMAINING AMOUNTS TO BE PAID OR OFFERED? If the committee does not have sufficient funds to cover the total amount to be offered or paid to its remaining creditors, briefly explain how the funds will be obtained.