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Farmer, Gary CAMPAIGN FINANCIAL DISCLOSURE STATEMENT For State and Local Candidates For Single-Candidate Committees 1. DATE OF,REPORT 2.a. NAME OF CANDIDATE OR COMMITTEE e e 3 col C~ 2.b. IF OMMITTEE, NAME OF C NDIDATE 3. ELECTION DATE C`i- 2 ZD 4.a. CAMPAIGN ADDRESS AND PHONE Street or Rural Route city State Zip Code Phone 17 i~ ~ Gtr ► V 4.b. CANDIDATE'S HOME DDRESS (if different than 4. State Zip Code Phone Street or Rural Route city 5. OFFICE SOUGHT (include district number, if applicable) 6. NAME OF POLITICAL TREASURER (may be candidate) Cot, 7. CAT E^ RY OR REPO T (Check onej El 1:1 ❑ FIRST SEND THIRMir, D FOURTH PRE- PRE- MIDYEAR YEAR❑-END EMENTAL QUARTER QUARTER QUARTER __QUARTER 777==77 8.a. BEGINN NG DATE , F REPORTING PERIOD Z Z 9.(Chec one) ause contributions (including in-kind) received total $1,000 or less AND expendi- a. ❑ This campaign is exempt from detailed disclosure bec tures total $1,000 or less for this reporting period. (Complete items 12d., 12e. and 12f.) b. This campaign is required to file a detailed financial disclosure because contributions (including in-kind) received total more than $1,000 and/or expenditures total more than $1,000 for this reporting period. 10. I/we do solemnly swear or affirm that the information contained in this campaign financial disclosure report is true and that this report is an accurate accounting of campaign contributions and expenditures required to be reported by the candidate committee by the Campaign Financial Disclosure Act. Additionally, I/we swear or affirm that no campaign contributions have been expended for the personal financial benefit of the candidate or for any other nonpolitical purpose as defined by the federal internal revenue code. litical treasurer ate dat s signature of candidate 11. WITNESS SIGNATURE IN 1 C'4n_~_ , U ate LI)ignature of witness date signature of witness 12. SUMMARY ~ ~ a. BALANCE ON HAND LAST REPORT $ b. TOTAL RECEIPTSTHIS PERIOD Z_ Z , G. Z TOTAL DISBURSEMENTS THIS PERIOD $ d. BALANCE ON HAND (12.a. plus 12.b. minus 12.c.) $ e. TOTAL LOANS OUTSTANDING $ f. TOTAL OBLIGATIONS OUTSTANDING $ SS-1109 (Rev. 2/06) Page 1 of RDA 1159 SUMMARY PAGE - CANDIDATE 13. NAME OF CANDIDATE OR COMMITTEE (In Full) 14. REPORT COVERING THE PERIOD C~ C"_r I FROM:? .;Z TO: t C~ 1 ' RECEIPT 15. CONTRIBUTIONS (other than loans and interest) a. Unitemized Contributions ($100 or less from each source this period) $ b. Itemized Contributions (over $100 from each source this period) $ c. TOTAL CONTRIBUTIONS (other than loans and interest)(add 15.a. and 15.b.) $ 16. LOANS RECEIVED THIS REPORTING PERIOD $ 17. INTEREST RECEIVED THIS REPORTING PERIOD $ 18. TOTAL RECEIPTS (add 15.c., 16., and 17.) (must be shown in item 12.b.) $ DISBURSEMENTS 19. EXPENDITURES (other than loan payments) a. Expenditures ($100 or less each payee this period) (must be listed by category - e.g., printing, postage, gasoline) 0 5 ~~t 7 $ v0 cc, $ Q t~ rY~ L~ 5a s $ 1 B , Dc9 $ $ $ $ Total of Expenditures ($100 or less each payee) $ 3 r b. Itemized Expenditures (Over $100 each payee this period) $ S c. TOTAL EXPENDITURES (other than loan repayments)(add 19.a. and 19.b.) $ 2-Z1 z ~V 20. LOAN REPAYMENTS MADE THIS PERIOD $ 21. TOTAL DISBURSEMENTS (add 19.c. and 20.) (must be shown in item 12.c.) $ L-LI Z 22.IN-KIND CONTRIBUTIONS a. Unitemized in-kind contributions ($100 or less from each source this period) $ b. Itemized in-kind contributions (over $100 from each source this period) $ y c. TOTAL IN-KIND CONTRIBUTIONS RECEIVED THIS PERIOD (add 22.a. and 221.) $ 23.013LIGATIONS a. Unitemized Obligations Outstanding ($100 or less each) $ b. Itemized Obligations Outstanding (Over $100 each) $ c. TOTAL OBLIGATIONS OUTSTANDING (add 23.a. and 23.b.) (must be shown i item 12.f.) $ ` 45 SS-1133 (Rev. 4/02) Page Z of ITEMIZED STATEMENT OF CONTRIBUTIONS - CANDIDATE 1. NA OF CANDIDATE OR COMMITTEE 2. REPORT COVERING THE P RIOD FROM: TO: Amount 3. TOTAL ITEMIZED CAMPAIGN CONTRIBUTIONS FROM PRECEDING PAGE (enter $0 if first itemized page) 4. COMPLETE THE APPROPRIATE ITEMS FOR EACH ITEMIZED CONTRIBUTION contributions totaling more than $100 from an contributor First Name Middle Name Contribution Received For Amount of Contribution Last Name/Organization Name ❑ Primary Election ❑ General Election Address ❑ Runoff (Local Elections Only) City State Zip Code Date of Contribution Aggregate This Election Occupation Employer First Name Middle Name Contribution Received For: Amount of Contribution Last NamelOrganization Name ❑ Primary Election ❑ General Election Address ❑ Runoff (Local Elections Only) City state Zip Code Date of Contribution Aggregate This Election Occupation Employer First Name iddle Name Contribution Received For: Amount of Contribution as ame rganiza on Name ❑ Primary Election ❑ General Election Address ❑ Runoff (Local Elections Only) City State Zip Code Date of Contribution Aggregate This Election Occupation Employer First Name Middle Name Contribution Received or: mount of Contribution Last Name/Organization Name ❑ Primary Election ❑ General Election Address ❑ Runoff (Local Elections Only) City State Zip Code Date of Contribution Aggregate This Election Occupation Employer 5. TOTAL ITEMIZED CONTRIBUTIONS (Carry forward to item 3. of next page if additional pages of this form are used.) (If this is the last page of contributions, this amount must be shown in item 15b. of summary.) 0 SS-1131(Rev. 2/06) Page _,3 of RDA 1159 ITEMIZED STATEMENT OF IN-KIND CONTRIBUTIONS - CANDIDAT 1. NAME OF CANDIDATE OR OMMITTEE E f << 2. REPORT COVERING THE P RIOD FROM.. u TO: moun~,~ 3. TOTAL ITEMIZE IN-KIND CONTRIBUTIONS FROM PRECEDING PAGE (enter $0 if first itemized page) /C 4. COMPLETE THE APPROPRIATE ITEMS FOR EACH ITEMIZED IN-KIND CONTRIBUTION (in-kind contributions totaling more than $100 from any contributor duringgtthe period) First Name Middle Name In-Kind Contribution Received For: Value of In-Kind Contribution Last Name/Organization Name ❑ Primary Election ❑ General Election Address ❑ Runoff (Local Elections Only) Date of In-Kind Contribution City Aggregate this Election State Zip Code Desaiption of In-Kind Contribution Occupation Employer First Name Middle Name In-Kind Contribution Received For Value of In-Kind Contribution Last Name/Organization Name ❑ Primary Election ❑ General Election Address ❑ Runoff (Local Elections Only) Date of In-Kind Contribution City Aggregate this Election State Zip Code Description of In-Kind Contribution Occupation Employer First Name Middle Name In-Kind Contribution Received For: Value of In-Kind Contribution Last NamelOrganizatronNcrme ❑ Primary Election ❑ General Election Address ❑ Runoff (Local Elections Only) Date of Inaand Contribution Cg), Aggregate this Election State Zip Code Description of in-rind Contribution cupaUon m Dyer First Name Middle Name In-Kind Contribution Received For: Value of In-Kind Contribution Last Name/Organization Name ❑ Primary Election ❑ General Election ❑ Runoff (Local Elections Only) Address Date of In-Krid Contribution Aggregate this Election city State Zip Code Description of In-Kind Contribution Occupation Employer First Name Middle Name In-Kind Contribution Received For: Value of In-Kind Contribution Last Name/Organ¢ationName E] Primary Election [1] General Election E] Runoff (Local Elections Only) Address Date of IrAnd Contribution Aggregate this Election State Zip Code Description of IMGnd Contribution aupa ion m oyer 5. TOTAL ITEMIZED IN-KIND CONTRIBUTIONS (Carry forward to item 3. of next page if additional pages of this form are used.) (If this is the last page of in-kind contributions, this amount must be shown in item 22b. of summary.) SS-1126 (Rev. 2106) Page of RDA 1159 ITEMIZED STATEMENT OF EXPENDITURES - CANDIDATE 1. NAME OF CANDIDATE OR COMMITTEE 2. REPO T COVERING THE PERIOD. FROM:? 2, T0: Y/ 3/9 Z6~ /4 f2, I mAMOLOt 3. TOTAL ITEMIZED CAMPAIGN EXPENDITURES FROM PRECEDING PAGE (enter $0 if first itemized page) 4. COMPLETE THE APPROPRIATE ITEMS FOR EACH ITEMIZED EXPENDITURE (expenditures totaling more than $100 to any payee during the period) First Name Middle Name Purpose of Expenditure Amount of Expenditure Last Name/Bu6iggssNam 1-4 . (J Q -t ~t (/,mar/{~ Address ~ 0 E_ , e o A ~j City V L~ Zip Code First Name Middle Name Purpose of Expenditure Amount of Expenditure Last NamV~j s ess Name Gk 1~Y\~ V- ~t 5k Address Pry, City Stale Zip Code M 7 First Name Middle Name Purpose of Expenditure Amount of Expenditure Last Name/Business Name Address City State Zip Code First Name Middle Name Purpose of Expenditure Amount of Expenditure Last NameBusiness Name Address City State Zip Code First Name Middle Name Purpose of Expenditure Amount of Expenditure Last Name/Business Name Address City State Zip Code First Name Middle Name Purpose of Expenditure Amount of Expenditure Last Name/Business Name Address City State Zip Code 5. TOTAL ITEMIZED EXPENDITURES (Carry forward to item 3. of next page if additional pages of this form are used.) (If this is the last page of expenditures, this amount must be shown in item 19b. of summary.) SS-1129 (Rev. 4/02) Page of -2- RDA 1159 ITEMIZED STATEMENT OF LOANS - CANDIDATE 1. NAME OF CANDIDATE OR COMMITTEE 2. REPORT COVERING THE PERIOD FRO T0: 3. COMPLETE E APPROPRIATE ITEMS FOR EACH ITEMIZED LOAN (loans totaling more than $100 from any source during he period) Complete the Following for the Source of the Loan First Name Middle Name Outstanding Loan Balance Loans Loan Outstanding Loan Balance (Beginning of Period) Received Payments (End of Period) Last NamelOrganization Name Address Loan Received For: Date of Loan ❑ Primary Election ❑ General Election City State Zip Code ❑ Runoff (Local Elections Only) List All Endorsers or Guarantors for Above Loan (If more space is needed please attach a page) First Name Middle Name First Name Middle Name Last Name/Organization Name Last Name/Organization Name Address Address city Slate Zip Code city State Zip Code Amount Guaranteed Outstanding Amount Guaranteed Outstanding First Name Middle Name First Name Middle Name Last Name/Organization Name Last Name/Organization Name Address Address city State Zip Code City State Zip Code Amount Guaranteed Outstanding Amount Guaranteed Outstanding First Name Middle Name First Name Middle Name Last Name/Organization Name Last Name/Organization Name Address Address city State Zip Code city State Zip Code Amount Guaranteed Outstanding Amount Guaranteed Outstanding First Name Middle Name First Name Middle Name Last Name/Organization Name Last Name/Organization Name Address Address City State Zip Code Gty State Zip Code Amount Guaranteed Outstanding Amount Guaranteed Outstanding 4. Totals for all Loans (complete on last page of itemized loans) Outstanding Loan Balance Loans Loan Outstanding Loan Balance (Total loans received should also be shown in item 16. on summary page.) -(Beginning of Period Received Payments End of Period (Total loan payments should also be shown in item 20. on summary page.) (Total outstanding loan balance should also be shown in item 12.e. on front page.) Amb, SS-1132 (Rev. 4102) Page (1_ of RDA 1159 ITEMIZED STATEMENT OF OBLIGATIONS - CANDIDATE 1. NAME OF CANDIDATE 9R COMMITTEE 2. REPORT COVERING THE PERIOD Ck j ) FROM: Z,~ T0: 01 3. COMPLETE TH APPROPRIATE ITEMS FOR EACH ITEMIZED Outstanding Balance Debt Incurred ayments Outst ding Balance OBLIGATION (obligations totaling more than $100 owed to any (Beginning of Period) This Period This Period (End of Period) person/vendor at the end of the reporting period) First Name Middle Name Last Name/Business Name Address City State Zip Code Description of Obligation First Name Middle Name Last Name Business Name Address City State Zip Code Description of Obligation First Name Middle Name Last Name/Business Name Address City State Zip Code Description of Obligation First Name Middle Name Last Name/Business Name Address City State Zip Code Description of Obligation First Name 7 Middle Name Last Name/Business Name Address City State Zip Code Description of Obligation 4. TOTALS (Total from Outstanding Balance - (End of Period) column must also be shown in item 23b. on summary page.) Afflk SS-1127 (Rev. 4/02) Page-2--of RDA 1159 CAMPAIGN FINANCIAL DISCLOSURE STATEMENT For State and Local Candidates For Single-Candidate Committees 1. YDAE QF REPORT 12.a. NAME OF CANDIDATE R COMMITTEE 2.b. IF C MITTEE, N ME OF CANDIDATE 3. ELECTION DATE q Lt 4.a. CAMPAIGN ADDRESS AND PHONE Street or oral Route City ` State Zip Cod Phone 4.b. CANDIDATE'S HOME/ADDRESS (if different than 4.a. Street or Rural Route City State Zip Code Phone 5. OFFICE SOUGHT (include district number, if applicable) 6. NAME OF POLITICAL TREASURER (may be candidate) 7. CATEGO Gil REPO Check one) ❑ ❑ ❑ ❑ Er ❑ ❑ FIRST SECOND THIRD FOURTH PRE- PRE- MID-YEAR YEAR-END QUARTER QUARTER QUARTER QUARTER PRIMARY GENERAL SUPPLEMENTAL SUPPLEMENTAL 8.a. BEGINNIN DATE OF REPORTING PERIOD 8.b. EN ING DATE O REPORTING PERIOD 7/ zCl z' al 9. (Ch k on ) a. ❑ This campaign is exempt from detailed disclosure because contributions (including in-kind) received total $1,000 or less AND expendi- tures total $1,000 or less for this reporting period. (Complete items 12d., 12e. and 12f.) b. d This campaign is required to file a detailed financial disclosure because contributions (including in-kind) received total more than $1,000 and/or expenditures total more than $1,000 for this reporting period. 10. Uwe do solemnly swear or affirm that the information contained in this campaign financial disclosure report is true and that this report is an accurate accounting of campaign contributions and expenditures required to be reported by the candidate committee by the Campaign Financial Disclosure Act. Additionally, I/we swear or affirm that no campaign contributions have been expended for the personal financial benefit of the candidate o lor_any other nonpolitical pur se as defined by the federal internal revenue code. signature ndidate dat signat litical tre asurer to ' di 11. WITNESS SIGNATURE si ture of tness date ` signature of witness dat 12. SUMMARY ~ 8 9 a. BALANCE ON HAND LAST REPORT u Ip.... $ b b. TOTAL RECEIPTS THIS PERIOD 1 S6 zq 0 D r&~G,a $ c. TOTAL DISBURSEMENTS THIS PERIOD .....p...........p~~............. $ d. BALANCE ON HAND (12.a. plus 12.b. minus 12.c.) ~d e. TOTAL LOANS OUTSTANDING i'..E..y..{..9'..................................................... $ f. TOTAL OBLIGATIONS OUTSTANDING $ SS-1109 (Rev. 2/06) Page 1 of RDA 1159 ,law SUMMARY PAGE - CANDIDATE 13. NAME OF CA,`NDIDATE OR COMMITTEE (In Full) 147 PORT COVEC?OC~ -j RECEIP15. CONTRIBUTIONS (other than loans and interest) a. Unitemized Contributions ($100 or less from each source this period) $ so - b. Itemized Contributions (over $100 from each source this period) $ SS5 Q c. TOTAL CONTRIBUTIONS (other than loans and interest)(add 15.a. and 15.b.) 16. LOANS RECEIVED THIS REPORTING PERIOD $ 17. INTEREST RECEIVED THIS REPORTING PERIOD 18. TOTAL RECEIPTS (add 15.c., 16., and 17.) (must be shown in item 12.b.) $ 3 y~ DISBURSEMENTS 19. EXPENDITURES (other than loan payments) a. Expenditures ($100 or less each payee this period) (must be listed by category - e.g., printing, postage, gasoline) Total of Expenditures ($100 or less each payee) $ b. Itemized Expenditures (Over $100 each payee this period) $ c. TOTAL EXPENDITURES (other than loan repayments)(add 19.a. and 19.b.) $ 20. LOAN REPAYMENTS MADE THIS PERIOD $ d 21. TOTAL DISBURSEMENTS (add 19.c. and 20.) (must be shown in item 12.c.) 22.IN-KIND CONTRIBUTIONS a. Unitemized in-kind contributions ($100 or less from each source this period) $ b. Itemized in-kind contributions (over $100 from each source this period) $ c. TOTAL IN-KIND CONTRIBUTIONS RECEIVED THIS PERIOD (add 22.a. and 22.b.) $ l/ 23. OBLIGATIONS a. Unitemized Obligations Outstanding ($100 or less each) $ b. Itemized Obligations Outstanding (Over $100 each) $ c. TOTAL OBLIGATIONS OUTSTANDING (add 23.a. and 23.b.) (must be shown i item 12.f.) $ SS-1133 (Rev. 4102) Page of ITEMIZED STATEMENT OF CONTRIBUTIONS - CANDIDATE 1. NAME OF CANDIDATE OR COMMITTEE 2. REPORT COVERING THE PERIOD, • FROM: / TO: "7 q cl, t- ~xin Amoun 3. TOTAL ITEMIZED CAMPAIGN CONTRIBUTIONS FROM PRECEDING PAGE (enter $0 if first itemized page) 4. COMPLETE THE APPROPRIATE ITEMS FOR EACH ITEMIZED CONTRIBUTION (contributions totaling more than $100 from an contributor First Name Middle Name Contribution Received For: Amount of Contribution Last Nam anizationName ❑ Primary Election d General Election a~d~0 Address ❑ Runoff (Local Elections Only) ~c City E~ State ZipC e o Date of Contribution Aggregate This Election V ~ / Occupation 77/ /J Employer First Name Middle Name Contribution Received For Amount of Contribution LastName/Or anizationN e ` 1 ❑Primary Election L~J General Election 0 L.-izi V1 I Ace, vt r 2. 006) Address P` 0 ❑ Runoff (Local Elections Only) c City t I Zip Code Date of Contribution Aggregate This Election (i-T Occupation Employer V First Namq ( iddle Name Contribution Received For: Amount of Contribution W 0/v e7 1 ❑ Primary Election ❑ General Election as am rga mza on Name , Address ,j - ❑ Runoff (Local Elections Only) Ciry State Zip Code Date of Contribution Aggregate This Election Occupation Employer First Name Middle Name Contribution Received or: mount o Contribution Last Name/O anization Name ❑ Primary Election U /General Election r~ Address ❑ Runoff (Local Elections Only) Ciry l State zpCode Date of Contribution Aggregate This Election j n "*k of / Occupalio P44 CL J Employer 5. TOTAL ITEMIZED CONTRIBUTIONS (Carry forward to Rem 3. of next page if additional pages of this form are used.) (If this is the last page of contributions, this amount must be shown in item 15b. of summary.) SS-1131(Rev. 2/06) Page of RDA 1159 ITEMIZED STATEMENT OF IN-KIND CONTRIBUTIONS - CANDIDATE 1. NAME OF CANDIDATE OR COMMITTEE 2. REPORT COVERING THE PERIOD L> f r FROM: TO: 7 WICI moun 3. TOTAL ITEMIZED IN-KIND CONTRIBUTIONS FROM PRECEDING PAGE (enter $0 if first itemized page) 4. COMPLETE THE APPROPRIATE ITEMS FOR EACH ITEMIZED IN-KIND CONTRIBUTION (in-kind contributions totaling more than $100 from any contributor during the period) First Name Middle Name In-Kind Contribution Received For: Value of In-Kind Contribution ❑ Primary Election ❑ General Election Last NamelOrganlzationName ❑ Runoff (Local Elections Only) Date of In-Kind Contribution Aggregate this Election Address City State Zip Code Descripton of In-IGnd Contribution Occupation Employer First Name Middle Name In-Kind Contribution Received For: Value of In-Kind Contribution Primary Election ❑ General Election Last NamelOrganizaGon Name ❑ Runoff (Local Elections Only) Date of In-land Contribution Aggregate this Election Address city State Zip Code Description of InXind Contribution Occupation Employer First Name Middle Name In-Kind Contribution Received For. Value of In-Kind Contribution ❑ Primary Election ❑ General Election Last NamelOrganization Name ❑ Runoff (Local Elections Only) Date of InAnd Contribution Aggregate this Electlon Address City State Zip Code Desorption of In-Knd Contribution -Occupation Employer Middle Name In-Kind Contribution Received For: Value of In-Kind Contribution First Name ❑ Primary Election ❑ General Election Last Name/Organization Name ❑ Runoff (Loral Elections Only) Date of In-Kind Contribution Aggregate this Election Address State lap Code Description of In-Kind Contribution city Occupation Employer First Name Middle Name In-Kind Contribution Received For: Value of In-Kind Contribution ❑ Primary Election ❑ General Election Last Name/OrganizationName ❑ Runoff (Local Elections Only) Date of In-Kind Contribution Aggregate this Election Address City State Zip Code Description of In-Kind Contribution ccupa ion mp oyer 5. TOTAL ITEMIZED IN-KIND CONTRIBUTIONS (Carry forward to item 3. of next page if additional pages of this form are used.) (t(~ (If this is the last page of in-kind contributions, this amount must be shown in item 22b. of summary.) Page of RDA 1159 SS-1128 (Rev. 2106) ITEMIZED STATEMENT OF CONTRIBUTIONS - CANDIDATE 2. REPOR COVERING THE P RIOD 1. NAME OF CANDIDATE OR QQMMITTEE FROM: -7 TO: 7 2 TOTAL ED CAMPAIGN CANTRIBUTIONS FROM PRECEDING PAGE (enter $O H fast itemized page) t3OTAtL RIATE ITEI,IS. FOR EACH fTEMIZED COP MBUTION ox* butions ioLIM more than 5100 from a. oontrbAor I ETE THE APPROP I~ddk Kew Colfto on For. Amount of Conbibution Fkst flame ❑ Primary Election General Elo ti test Na ❑ Runoff (Local Elections OnM Date of Contnbution Aggregate This Election CeY ~ Stara Zp Code Com"bo" EmploY~ µ~Te Contribution Received For. Amount of Cont iWtion FirxtName [3 Primary Election 1:3 General Election Lsst tlamelOcgactlm5o~+ ❑ Runoff (Local Erections OnM Mdrcss Date of Contrbution Aggregate This Election Y Stale LP Code OowPation t NO" Cowbi6on Received For. Amount of Contribution Fislltarne ❑ Primary Election ❑ General Election Runoff (Local Eledons OnM Address Date of Contnbu6on Aggregate This Election CkY t~ LP Code 0="tion o Fird Wme Ixddle Name ❑ Primary Election ❑ General Election LsstNamdOrpantr~t'an Na zip code ❑ Runoff (Local Eledions OnM Address Date of Contributan Aggregate This Election Cky , Stale zip Code oou~paban Ems 5. TOTAL ITEMIZED. CONTRIBUTIONS of bm, usea t J (ri*W ltsl 0(neA t~ be dawn kfMM 15b.dwwrary.) (tr rk is ne pepe a owa+bttributions. tds w4v C page ✓ of ~ RDA 1159 SS-1131(Rev.2/06) ITEMIZED STATEMENT OF EXPENDITURES - CANDIDATE 1. NAME OF CANDIDATE OR COMMITTEE 2. REPORT C VERING THE PERIOD FROM: TO: 7 2 3. TOTAL ITEMIZED CAMPAIGN EXPENDITURES FROM PRECEDING PAGE (enter $0 if first itemized page) mou 4. COMPLETE THE APPROPRIATE ITEMS FOR EACH ITEMIZED EXPENDITURE (expenditures totaling more than $100 to any payee during the period) First Name Middle Name Purpose of Expenditure Amount of Expenditure Last Name/Business Name Address 3,07 at^ i city ti Stale Zio Code f L/ J First Name Middle Name Purpose of Expenditure Amount of Expenditure Last NameBusin s Name L r f A~' ri1a Address 0 ! C,/ 1 A I City State Zip Code 4 N 3 777 First Name Middle Name Purpose of Expenditure Amount of Expenditure Last Name/Business Name Address city State Zip Code First Name Middle Name Purpose of Expenditure Amount of Expenditure Last Name/Business Name Address City State Zip Code First Name Middle Name Purpose of Expenditure Amount of Expenditure Last Namausiness Name Address City State Zip Code First Name Middle Name Purpose of Expenditure Amount of Expenditure Last Name/Business Name Address City State Zip Code 5. TOTAL ITEMIZED EXPENDITURES l (Carry forward to item 3. of next page if additional pages of this form are used.) / (If this is the last page of expenditures, this amount must be shown in item 19b. of summary.) t SS-1129 (Rev. 4/02) Page of RDA 1159 ITEMIZED STATEMENT OF LOANS - CANDIDATE 1. NAME OF CANDIDATE OR COMMITTEE 2. REPORT COVERING THE PERIOD FROM• Q~ 0& ! y 7 3. COMPLETE T E APPROPRIATE ITEMS FOR EACH ITEMIZED LOAN (loans totaling more than $100 from any source ring a period) Middle Name Outstanding Loan Balance Loans Loan Outstanding Loan Balance 7Name/Organnizzation thee Following for the Source of the Loan (Beginning of Period) Received Payments (End of Period) Name Address Loan Received For: Date of Loan ❑ Primary Election ❑ General Election city State Zip Code ❑ Runoff (Local Elections Only) List All Endorsers or Guarantors for Above Loan (If more space is needed please attach a page) Middle Name First Name Middle Name First Name Last Name/Organization Name Last NamelOrganization Name Address Address city State Zip Code City State Zip Code Amount Guaranteed Outstanding Amount Guaranteed Outstanding Middle Name First Name Middle Name First Name Last Name/Organization Name Last Name/Organization Name Address Address State Zip Code City State :1, p Code C ty mount Guaranteed Outstanding Amount Guaranteed Outstanding First Name Middle Name First Name Middle Name Last Name/Organization Name Last NamelOrganizagon Name Address Address City State Zip Code State Zip Code city mount Guaranteed Outstanding Amount Guaranteed Outstanding Middle Name Middle Name First Name First Name Last NamelOrganization Name Last Name/Organization Name Address Address State Zip Code State Zip Code city city mount Guaranteed Outstanding Amount Guaranteed Outstanding 4. Totals for all Loan Outstanding Loan Balance e of itemized loans) Outstanding Loan Balance Loans pa ments End of Period Loans (complete on last 11 (total loans received should also be shown in Item m 16. on summary page.) (Beginning of Period Received (Total loan payments should also be shown in item 20. on summary page.) (Total outstanding loan balance should also be shown in item 12.e. on front page.) page of RDA 1159 Afflbk SS-1132 (Rev. 4102) ITEMIZED STATEMENT OF OBLIGATIONS - CANDIDATE 1. NAME F CANT I ATW COMMITTEE 2. REPORT 0 ERING THE PERIOD FROM: IV TO: Z 4'11 Cl 3. COMPLETE THE PPROPRIATE ITEMS FOR EACH ITEMIZED Outstanding Balance Debt Incurred Payments utstand' g Bal nce OBLIGATION (obligations totaling more than $100 owed to any (Beginning of Period) This Period This Period (End of Period) personivendor at the end of the reporting period) First Name Middle Name Last Name/Business Name Address City State Zip Code Description of Obligation First Name Middle Name Last Name Business Name Address City state Zip Code Description of Obligation First Name 7 Middle Name Last Name/Business Name Address City State Zip Code Description of Obligation First Name Middle Name Last Name/Business Name Address City State Zip Code Description of Obligation First Name Middle Name Last Name/Business Name Address city State Zip Code Description of Obligation 4. TOTALS (Total from Outstanding Balance - (End of Period) column must also be shown in item 23b. on summary page.) SS-1127 (Rev. 4102) Page c~ of RDA 1159 CAMPAIGN FINANCIAL DISCLOSURE STATEMENT For State and Local Candidates For Single-Candidate Committees 1. DATE OF REPORT 2.a. NAME OF CANDIDATE OR COMMITTEE a I Gar far 3. ELECTION DATE K 2.b. IF C MI EE, NAME OF CANDIDATE 4.a. CAMPAIGN ADDRESS AND PHONE State Zip Code Phone Street or Rural Route City Mal' ( 7? ifferent than 4.a.) Phone 4.b. CANDIDATE'S HOME A RESS (if d Street or Rural Route City State Zip Code 5. OFFICE SOUGHT (include district number, if applicable) 6. NAME OF POLITICAL TREASURER (may be candidate) 7. CAT GORY OR REPORT (Check one 0 E3 ❑ ❑ ❑ FIRST SECOND THIRD FOURTH PRE- PRE- MID-YEAR YEAR-END QUARTER QUARTER QUARTER QUARTER PRIMARY GENERAL SUPPLEMENTAL SUPPLEMENTAL 8.a. BEGIN ING DATE OF REPORTING PERIOD 8.b. ENDING DATE OF REPORTING PERIOD 0 a 9. (Chic one) a. ❑ This campaign is exempt from detailed disclosure because contributions (including in-kind) received total $1,000 or less AND expendi- tures total $1,000 or less for this reporting period. (Complete items 12d., 12e. and 12f.) b. ❑ This campaign is required to file a detailed financial disclosure because contributions (including in-kind) received total more than $1,000 and/or expenditures total more than $1,000 for this reporting period. 10. I/we do solemnly swear or affirm that the information contained in this campaign financial disclosure report is true and that this report is an accurate accounting of campaign contributions and expenditures required to be reported by the candidate committee by the Campaign Financial Disclosure Act. Additionally, I/we swear or affirm that no campaign contributions have been expended for the personal financial benefit of the candidate or for any other nonpolitical purpose a)s defined by the federal internal revenue code. 7Nt C,o/ I signature of candidate to signature of political treasurer date 11. WITNESS SIGNATURE 41i![~a -7LqL) q signature of witness d to U signature of witness 12. SUMMARY a. BALANCE ON HAND LAST REPORT $ _5~4 O b. TOTAL RECEIPTS THIS PERIOD $ ~ O 2:~7(9, c. TOTAL DISBURSEMENTSTHIS PERIOD d. BALANCE ON HAND (12.a. plus 12.b. minus 12.c.) O $ e. TOTAL LOANS OUTSTANDING $ Q f. TOTAL OBLIGATIONS OUTSTANDING Page 1 of ~ RDA 1159 SS-1109 (Rev. 2/06) SUMMARY PAGE - CANDIDATE 14. REPORT COVERING T E PERIOD 13. NA E OF CANDIDATE OR COMMITTEE (In Full) FROM: 2 TO* / kr r RECEIPT . 15. CONTRIBUTIONS (other than loans and interest) a. Unitemized Contributions ($100 or less from each source this period) $ b. Itemized Contributions (over $100 from each source this period) $ c. TOTAL CONTRIBUTIONS (other than loans and interest)(add 15.a. and 15.b.) $ 16. LOANS RECEIVED THIS REPORTING PERIOD $ 17. INTEREST RECEIVED THIS REPORTING PERIOD Q 18rEEXPENDITURES TOTAL RECEIPTS (add 15.c., 16., and 17.) (must be shown in item 12.b.) EMENTS (other than loan payments) a. Expenditures ($100 or less each payee this period) (must be listed by category - e.g., printing, postage, gasoline) $ . $ Total of Expenditures ($100 or less each payee) ~ 0 b. Itemized Expenditures (Over $100 each payee this period) $ c. TOTAL EXPENDITURES (other than loan repayments)(add 19.a. and 19.b.) $ $ 20. LOAN REPAYMENTS MADE THIS PERIOD 21. TOTAL DISBURSEMENTS (add 19.c. and 20.) (must be shown in item 12.c . 22. IN-KIND CONTRIBUTIONS a. Unitemized in-kind contributions ($100 or less from each source this period) $ b. Itemized in-kind contributions (over $100 from each source this period) $ d c. TOTAL IN-KIND CONTRIBUTIONS RECEIVED THIS PERIOD (add 22.a. and 22.b.) $ 23. OBLIGATIONS a. Unitemized Obligations outstanding ($100 or less each) $ b. Itemized Obligations outstanding (Over $100 each) $ c. TOTAL OBLIGATIONS OUTSTANDING (add 23.a. and 23.b.) (must be shown i item 12.f.) $ Page ~ of Aah, SS-1133 (Rev. 4102) ITEMIZED STATEMENT OF CONTRIBUTIONS - CANDIDATE 1. NAME OF CANDIDATE OR COMMITTEE 2. REPORT COV RING THE PERIOD A r r FROM:'i 7#q TO: Amount 3. TOTAL ITEMIZED CAMPAIGN CONTRIBUTIONS FROM PRECEDING PAGE (enter $0 if first itemized page) 4. COMPLETE THE APPROPRIATE ITEMS FOR EACH ITEMIZED CONTRIBUTION (contributions totaling more than $100 from an contributor First Name Middle Name Contribution Received For: Amount of Contribution Last Name/OrganizationName ❑ Primary Election ❑ General Election Address ❑ Runoff (Local Elections Only) State Zip Code Date of Contribution Aggregate This Election City Occupation Employer First Name Middle Name Contribution Received For: Amount of Contribution Last Name/Organization Name ❑ Primary Election ❑ General Election Address ❑ Runoff (Local Elections Only) City State Zip Code Date of Contribution Aggregate This Election Occupation Employer First Name iddle Name Contribution Received For: Amount of Contribution as Name/Organization Name ❑ Primary Election ❑ General Election Address ❑ Runoff (Local Elections Only) City state Zip Code Date of Contribution Aggregate This Election Occupation Employer Middle Name Contribution Received or: mount o Contribution First Name Last Name/Organization Name ❑ Primary Election ❑ General Election El Runoff (Local Elections Only) Address city Date of Contribution Aggregate This Election State Zip Code Occupation Employer 5. TOTAL ITEMIZED CONTRIBUTIONS D (Carry forward to item 3. of next page if additional pages of this form are used.) (If this is the last page of contributions, this amount must be shown In hem 15b. of summary.) Page-3- of Z RDA 1159 SS-1131(Rev. 2106) a ITEMIZED STATEMENT OF IN-KIND CONTRIBUTIONS - CANDIDATE 1. NAME OF CANDIDATE OR COMMITTEE 2. REPORT COVERING THE PERIO /1^Q FROM: Yk /of T0: 4 11 d I I mo t 3. TOTAL.ITEMIZED IN-KIND CONTRIBUTIONS FROM PRECEDING PAGE (enter $0 if first itemized page) 4. COMPLETE THE APPROPRIATE ITEMS FOR EACH ITEMIZED IN-KIND CONTRIBUTION (in-kind contributions totaling more than $100 from any contributor during the period) First Name Middle Name In-Kind Contribution Received For: Value of In-Kind Contribution ❑ Primary Election ❑ General Election Last Name/Organization Name ❑ Runoff (Local Elections Only) Address Date of In-Kind Contritwtlon Aggregate this Election City State Zip Code Description of In-Kind Contribution Occupation Employer First Name Middle Name In-Kind Contribution Received For: Value of In-Kind Contribution ❑ Primary Election ❑ General Election Last Name/Organization Name ❑ Runoff (Local Elections Only) Address Date of In-Kind Contribution Aggregate this Election City State Zip Code Description of In-Kind Contribution Occupation Employer First Name Middle Name In-Kind Contribution Received For. Value of In-Kind Contribution ❑ Primary Election ❑ General Election Last NamelOrganization Name ❑ Runoff (Local Elections Only) Address Date of In-Kind Contribution Aggregate this Election City State Zip Code Description of In-Kind Contribution Occupation Employer First Name Middle Name In-Kind Contribution Received For: Value of In-Kind Contribution ❑ Primary Election ❑ General Election Last Name/Organization Name ❑ Runoff (Local Elections Only) Address Date of In-Kind Contribution Aggregate this Election City State Zip Code Description of In-Kind Contribution Occupation Employer First Name Middle Name In-Kind Contribution Received For: I lue of In-Kind Contribution Last Name/Organization Name ❑ Primary Election ❑ General Election ❑ Runoff (Local Elections Only) Address Dam of In-Kind Contribution Aggregate this Election City State Zip Code Description of IrAnd Contribution Occupation Employer 5. TOTAL ITEMIZED IN-KIND CONTRIBUTIONS (Carry forward to item 3. of next page if additional pages of this form are used.) D (If this is the last page of In-kind contributions, this amount must be shown in item 22b. of summary.) SS-1128 (Rev. 2106) Page of RDA 1159 ITEMIZED STATEMENT OF EXPENDITURES - CANDIDATE 1. NAME OF CANDIDATE OR COMMITTEE 2. REPO T COVERING THE ERIO I .7 FROM• T0: CL!2 mo t 3. TOTAL ITEMIZED CAMPAIGN EXPENDITURES FROM PRECEDING PAGE (enter $0 if first itemized page) n 4. COMPLETE THE APPROPRIATE ITEMS FOR EACH ITEMIZED EXPENDITURE (expenditures totaling more than $100 to any payee during the period) First Name Middle Name Purpose of Expenditure Amount of Expenditure Last Name/Business Name n V r~; A Address Cj City Stat Zip Code a( v~~ First Name Middle Name Purpose of Expenditure Amount of Expenditure Last Name/Business Name Address City State Zip Code First Name Middle Name Purpose of Expenditure Amount of Expenditure Last NamelBusiness Name Address City State Zip Code First Name Middle Name Purpose of Expenditure Amount of Expenditure Last Name/Business Name Address City State Zip Code First Name Middle Name Purpose of Expenditure Amount of Expenditure Last Name/Business Name Address City State Zip Code First Name Middle Name Purpose of Expenditure Amount of Expenditure Last NameBusiness Name Address City State Zip Code 5. TOTAL ITEMIZED EXPENDITURES (Carry forward to Item 3. of next page if additional pages of this form are used.) 2 (If this is the last page of expenditures, this amount must be shown in item 19b. of summary.) 7 RD AIN SS 1129 (Rev. 4102) Page : of ` A 1159 ITEMIZED STATEMENT OF LOANS - CANDIDATE 2. REPORT COVERING THE PERIOD 1. NAME OF CANDIDATE OR COMMITTEE FR M: TO' C:i 27 3. COMPLET HE APPROPRIATE ITEMS FOR EACH ITEMIZED LOAN (loans totaling more than E100 from any sour a Burin the period) Complete the Following for the Source of the Loan Loan Outstanding Loan Balance First Name Middle Name Outstanding Loan Balance Loans End of Period (Beginning of Period) Received Payments ( ) Last NamelOrganization Name Loan Received For: Date of Loan Address ❑ Primary Election ❑ General Election City State Zip Code ❑ Runoff (Local Elections Only) ::::::I List All Endorsers or Guarantors for Above Loan (If more space is needed pb:ase attach a page) First Name Middle Name First Name Middle Name Last NamelOrganization Name Last Name/Organization Name Address Address State City Zip Code State Zip Code GtY Amount Guaranteed Outstanding Amount Guaranteed Outstanding First Name Middle Name First Name Middle Name Last NamelOrganization Name Last Name/Organization Name Address Address city State Zip Code city State Zip Code Amount Guaranteed Outstanding Amount Guaranteed Outstanding First Name Middle Name First Name Middle Name Last NamelOrganization Name Last NamefOrganization Name Address Address State Zip Code City State Zip Code City mount Guaranteed Outstanding Amount Guaranteed Outstanding Middle Name First Name Middle Name First Name Last Name/Organization Name Last Name/Organization Name Address Address Stale Zip Code Gty State Zip Code city mount Guaranteed Outstanding Amount Guaranteed Outstanding 4. Totals for all Loans (complete on last page of Itemized loans) Outstanding Loan Balance Loans Loan Outstanding Loan Balance (Begin nin of Period Received Pa menu End of Period (Total loans received should also be shown in item 16. on summary page.) (Total loan payments should also be shown in item 20. on summary page.) (Total outstanding loan balance should also be shown in item 12.e. on front page.) SS-1132 (Rev. 4102) Page ( of RDA 1159 i i ITEMIZED STATEMENT OF OBLIGATIONS - CANDIDATE 1. NAM OF CANDIDAT OR COMMITTEE 2. REPORT COV RING THE PER D a"r FROM: T0: d 3. COMPLETE TAE APPROPRIATE ITEMS FOR EACH ITEMIZED Outstanding Balance Debt In d ayments Ou standing Balance urre OBLIGATION (obligations totaling more than $100 owed to any (Beginning of Period) This Period This Period (End of Period) person/vendor at the end of the reporting period) First Name Middle Name Last Name/Business Name Address City State Zip Code Description of Ob igation First Name Middle Name Lasl Name Business Name Address City State Zip Code Description of Obligation First Name Middle Name Last Name/Business Name Address City State Zip Code Description of Obligation First Name Middle Name Last Name/Business Name Address LLI I city State Zip Code Description of Obligation First Name Middle Name Last Name/Business Name Address city State Zip Code Description of Obligation 4. TOTALS (Total from Outstanding Balance - (End of Period) column must also be shown In Item 23b. on summary page.) SS-1127 (Rev. 4/02) Page of RDA 1159 CAMPAIGN FINANCIAL DISCLOSURE STATEMENT For State and Local Candidates For Single-Candidate Committees 1. DATE OF REPORT 12.a. NAME OF CANDIDATE OR COMMITTEE c. 2_` G Ket 2.b. IF OMMITTEE, NAME OF CANDIDATE 3. ELECTION DATE 4.a. CAMPAIGN ADDRESS AND PHONE Street or R ral Route Cit State Zip Code Phone ;reel 3?5~69 4.b. CANDIDATE'S HOME-ADDRESS (if different than 4.a Street or Rural Route City State Zip Code Phone 5. OFFICE SOUGHT (include district number, if applicable) 6. NAME OF POLITICAL TREASURER (may be candidate) Cou~.n`~ C~ i Pi 5'f 7. CAT ORY OR REPORT (Check one) FIRST SECOND THIRD FOURTH PRE- PRE- MID-YEAR YEAR❑-END QUARTER QUARTER QUARTER QUARTER PRIMARY GENERAL SUPPLEMENTAL SUPPLEMENTAL 8.a. BEGINN NG DATE OF REPORTING PERIOD 8.b. END NG DATE OF REPORTING PERIOD ( `f 01 0 2~ 9. (Check one) a. ❑ This campaign is exempt from detailed disclosure because contributions (including in-kind) received total $1,000 or less AND expendi- tures total $1,000 or less for this reporting period. (Complete items 12d., 12e. and 12f.) b. This campaign is required to file a detailed financial disclosure because contributions (including in-kind) received total more than $1,000 and/or expenditures total more than $1,000 for this reporting period. 10. I/we do solemnly swear or affirm that the information contained in this campaign financial disclosure report is true and that this report is an accurate accounting of campaign contributions and expenditures required to be reported by the candidate committee by the Campaign Financial Disclosure Act. Additionally, I/we swear or affirm that no campaign contributions have been expended for the personal financial benefit of t didate or for any other nonpolitical pu ose as defined by the federal internal revenue code. l d sig ature of candidate ate ature of political treasurer dat 11. ITNESS SIGNATURE signet re o witn s date sig ature of 'tn ss date 12. SUMMARY a. BALANCE ON HAND LAST REPORT $ b. TOTAL RECEIPTS THIS PERIOD $ c. TOTAL DISBURSEMENTS THIS PERIOD $ z Y d. BALANCE ON HAND (12.a. plus 12.b. minus 12.c.) $ e. TOTAL LOANS OUTSTANDING $ D f. TOTAL OBLIGATIONS OUTSTANDING $ V SS-1109 (Rev. 2106) Page 1 of~ RDA 1159 SUMMARY PAGE - CANDIDATE 14. REPORT COVITHEPERIOD 13. NAME OF CANDIDATE OR COMMITTEE (In Full) FROM:pt~ g~ RECEIPT 15. CONTRIBUTIONS (other than loans and interest) a. Unitemized Contributions ($100 or less from each source this period) $ b. Itemized Contributions (over $100 from each source this period) $ c. TOTAL CONTRIBUTIONS (other than loans and interest)(add 15.a. and 15.b.) ....................................16. LOANS RECEIVED THIS REPORTING PERIOD $ 17. INTEREST RECEIVED THIS REPORTING PERIOD 18. TOTAL RECEIPTS (add 15.c., 16., and 17.) (must be shown in item 12.b.) r19. BURSEMENTS EXPENDITURES (other than loan payments) . Expenditures ($100 or less each payee this period) (must be listed by category - e.g., printing, postage, gasoline) $ $ $ Total of Expenditures ($100 or less each payee) $ d $ b. Itemized Expenditures (Over $100 each payee this period) $ L 27 C. TOTAL EXPENDITURES (other than loan repayments)(add 19.a. and 19.b.) 20. LOAN REPAYMENTS MADE THIS PERIOD $ 21. TOTAL DISBURSEMENTS (add 19.c. and 20.) (must be shown in item 12.c.) 2 22.IN-KIND CONTRIBUTIONS a. Unitemized in-kind contributions ($100 or less from each source this period) $ b. Itemized in-kind contributions (over $100 from each source this period) $ C. TOTAL IN-KIND CONTRIBUTIONS RECEIVED THIS PERIOD (add 22.a. and 22.b.) $ r 23.OBLIGATIONS a. Unitemized Obligations Outstanding ($100 or less each) $ b. Itemized Obligations Outstanding (Over $100 each) $ C. TOTAL OBLIGATIONS OUTSTANDING (add 23.a. and 23.b.) (must be shown i item 12.f.) $ Page ~ of SS-1133 (Rev. 4102) ITEMIZED STATEMENT OF CONTRIBUTIONS - CANDIDATE 1. NAME OF CANDIDATE OR COMMITTEE 2. REPORT OVERING THE PE IOD 0.^ FROM:p lD TO: t9 Amount 3. TOTAL ITEMIZED CAMPAIGN CONTRIBUTIONS FROM PRECEDING PAGE (enter $0 if first itemized page) 4. COMPLETE THE APPROPRIATE ITEMS FOR EACH ITEMIZED CONTRIBUTION contributions totaling more than $100 from an contributor First Name Middle Name Contribution Received For: Amount of Contribution Last Name/Organization Name ❑ Primary Election ❑ General Election Address ❑ Runoff (Local Elections Only) City State Zip Code Date of Contribution Aggregate This Election Occupation Employer First Name Middle Name Contribution Received For: Amount of Contribution Last Name/organization Name ❑ Primary Election ❑ General Election Address ❑ Runoff (Local Elections Only) City State Zip Code Date of Contribution Aggregate This Election Occupation Employer First Name iddle Name Contribution Received For: Amount of Contribution as ame rganiza on ame ❑ Primary Election ❑ General Election Address ❑ Runoff (Local Elections Only) City State Zip Code Date of Contribution Aggregate This Election Occupation Employer First Name Middle Name Contribution Received or: mount o Contribution Last Name/Organization Name ❑ Primary Election ❑ General Election Address ❑ Runoff (Local Elections Only) city State Zip Code Date of Contribution Aggregate This Election Occupation Employer 5. TOTAL ITEMIZED CONTRIBUTIONS (Carry forward to item 3. of next page if additional pages of this form are used.) (If this is the last page of contributions, this amount must be shown in item 15b. of summary.) SS-1131(Rev. 2/06) Page-3--- of - RDA 1159 ITEMIZED STATEMENT OF IN-KIND CONTRIBUTIONS - CANDIDATE 1. NAME OF CANDIDATE OR COMMITTEE 2. REPORT CO RING THE P RIO a r r- FROM0419 1, 14 TO:p moun 3. TOTAL ITEMIZED IN-KIND CONTRIBUTIONS FROM PRECEDING PAGE (enter $0 if first itemized page) 4. COMPLETE THE APPROPRIATE ITEMS FOR EACH ITEMIZED IN-KIND CONTRIBUTION (in-kind contributions totaling more than $100 from any contributor during the period) First Name Middle Nama In-Kind Contribution Received For: Value of In-Kind Contribution ❑ Primary Election ❑ General Election Last Name/Organization Name ❑ Runoff (Local Elections Only) Address Date of In-Kind Contribution Aggregate this Election City State Zip Code Description of In-Kind Contribution occupation Employer First Name Middle Name In-Kind Contribution Received For: Value of In-Kind Contribution ❑ Primary Election ❑ General Election Last NamelOrganization Name ❑ Runoff (Local Elections Only) Address Date of InXind Contribution Aggregate this Election city State Zip Code Description of In-Kind Contribution Occupation Employer First Name Middle Name In-Kind Contribution Received For: Value of In-Kind Contribution ❑ Primary Election ❑ General Election Last Name/Organization Name ❑ Runoff (Local Elections Only Address Date of InMnd Contribution Aggregate this Election City State Zip Code Description of In-Kind Contribution -Occupation oyer First Name Middle Name In-Kind Contribution Received For: Value of In-Kind Contribution ❑ Primary Election ❑ General Election Last Name/Organization Name ❑ Runoff (Local Elections Only) Address Date of In-Kind Contribution Aggregate this Election City State Zip Code Description of InXind Contribution Occupation Employer First Name Middle Name In-Kind Contribution Received For: Value of In-Kind Contribution ❑ Primary Election ❑ General Election Last NamelOrganization Name ❑ Runoff (Local Elections Only) Address Date of InMnd Contribution Aggregate this Election City State Zip Code Description of In-Kind Contribution Occupation 5. TOTAL ITEMIZED IN-KIND CONTRIBUTIONS (Carty forward to item 3. of next page if additional pages of this form a7us-ed.) (it this Is the last page o1 in-kind contributions, its amount must be shb. of summary. ) Page of ~~RC1159 SS-1128 (Rev. 2106) ITEMIZED STATEMENT OF EXPENDITURES - CANDIDATE 1. NAME OF CANDIDATE OR COMMITTEE 2. REPORT 0 ERING THE PE IOD 0.r FROM: T0: W mount 3. TOTAL ITEMIZED CAMPAIGN EXPENDITURES FROM PRECEDING PAGE (enter $0 if first itemized page) 4. COMPLETE THE APPROPRIATE ITEMS FOR EACH ITEMIZED EXPENDITURE (expenditures totaling more than $100 to any payee during the period) Middle Name Purpose of Expenditure Amount of Expenditure First Name G Last NamelBusiness Name S 3 • Address City I' 1 State Zip Code L= I M "a 1), 1 Middle Name Purpose of Expenditure Amount of Expenditure First Name r G Pot r ~ Last Namel usinessName p 288 Address 3 D G . &a~ 14 City • State Zip Code tr Middle Name Purpose of Expenditure Amount of Expenditure 4"'n Last NamelBusiness Name Address city State Zip Code Middle Name Purpose of Expenditure Amount of Expenditure First Name Last NamelBusiness Name Address City Stale Zip Code First Name Middle Name Purpose of Expenditure Amount of Expenditure Last Name/Business Name Address city State Zip Code First Name Middle Name Purpose of Expenditure Amount of Expenditure Last Name/Business Name Address City State Zip Code 5. TOTAL ITEMIZED EXPENDITURES X27 (Carry forward to item 3. of next page if additional pages of this form are used.) (If this is the last page of expenditures, this amount must be shown in item 19b. of summary.) SS-1129 (Rev. 4102) Page of RDA 1159 ITEMIZED STATEMENT OF LOANS - CANDIDATE 2. REPORT COVERING THE PERIOD 1. NLOFCANDIDATE OR COMMITTEE FROMT0: Q 3. CPROPRIATE ITEMS FOR EACH ITEMIZED LOAN (loans totaling more than 8to0 from any sourced) omplete the Following for the Source of the Loan Loan Outstanding Loan Balance C ::::a Middle Name Outstanding (Beginning of Loan Period) Balance Loans End of Period) Address Received Payments elOrganization Name Loan Received For: Date of Loan [I Primary Election ❑ General Election Gty State Zip Code [3 Runoff (Local Elections Only) List All Endorsers or Guarantors for Above Loan (If more space is needed please attach a page) First Name Middle Name First Name Middle Name Last NamelOrganizabon Name Last Name/Organization Name Address Address State Zip Code City State Zip Code Gty mount Guaranteed Outstanding Amount Guaranteed Outstanding First Name Middle Name First Name Middle Name Last NamelOrganization Name Last Name/Organization Name Address Address State Zip Code State Zip Code City City mount Guaranteed Outstanding Amount Guaranteed Outstanding Middle Name Middle Name First Name First Name Last Name/Organization Name Last Name/Organization Name Address Address State Zip Code State Zip Code city city mount Guaranteed outstanding Amount Guaranteed Outslending First Middle Name Middle Name First Name Name Last NamelOrganization Name Last Name/Organization Name Address Address State Zip Code State Zip Code city Gty mount Guaranteed Outstanding Amount Guaranteed Outstanding Outstanding Loan Balance Outstanding Loan Balance Loans Loan Received Pa menis End of Period age.) Be innin of Period 4. Totals for all Loans (complete on last page of itemized page.) (Total loans received should also be shown in Item 16. on summary (Total loan payments should also be shown in item 20. on summary page.) 59 (Total outstanding loan balance should also be shown in item 12.e. on front page.) page RDA 11 of ''1 SS-1132 (Rev. 4102) -1L- ITEMIZED STATEMENT OF OBLIGATIONS - CANDIDATE 1. NAME OF CANDIDAT OR COMMITTEE 2. REPORT COVERING THE PERIOD a f FROM:D / T0=(Endof 3. COMPLETE E APPROPRIA ITEMS FOR EACH ITEMIZED Outstanding Balance Debt Incu ed r PaymentOBLIGATION (obligations totaling more than $100 owed to any (Beginning of Period) This Period This Perioperson/vendor at the end of the reporting period) First Name Middle Name Last Name/Business Name Address City T ate Zip Code scnpbon of Ob igation First Name Middle Name astName/Business Name Address City State Zip Code Description of Obligation First Name Middle Name Last Name/Business Name Address city State Zip Code Description of Obligation First Name Middle Name Last NamelBusiness Name Address city State Zip Code Description of Obligation First Name Middle Name Last NamelBusiness Name Address City State Zip Code Description of Obligation 4.TOTALS /I (total from Outstanding Balance - (End of Period) column must also be shown U in Item 23b. on summary page.) SS-1127 (Rev. 4102) Page of RDA 1159 14 CAMPAIGN FINANCIAL DISCLOSURE STATEMENT For State and Local Candidates For Single-Candidate Committees 1. DATE OF REPORT 12.a. NAME OF CANDIDATE R C MM. E 2.b. IF COMMITTEE, NAME OF CANDIDATE 3. ELECTION DATE 4.a. CAMPAIGN ADDRESS AND PHONE Street or Rural Route City State Zip Code Phone , Ole- ~2✓ 7,; 7 _3?xa-v v1 9e, 4.b. CANDIDATE'S HOME ADDRESS (if different than 4.a. Street or Rural Route City State Zip Code Phone 5. FICE SOUGHT incl a district n mb if pplicable) 6. N OF POLITICAL TREASURER (may be candidate) 2 u 2 er~c 642100,4 i S 7. CATEGOLLY ' OR REPORT (Check one)❑ ❑ ❑ ❑ ❑ ❑ FIRST SECOND THIRD FOURTH PRE- PRE- MID-YEAR YEAR-END QUARTER QUARTER QUARTER UARTER PRIMARY GENERAL SUPPLEMENTAL SUPPLEMENTAL 8.a. BEGINNING DATE OF REPORTING PERIOD 8.b. ENDING DATE OF REPORTING PERIOD 1-14-207 0V - 9. (Check one) a. ❑ This campaign is exempt from detailed disclosure because contributions (including in-kind) received total $1,000 or less AND expendi- tures total $1,000 or less for this reporting period. (Complete items 12d., 12e. and 12f.) b. 1jaO his campaign is required to file a detailed financial disclosure because contributions (including in-kind) received total more than $1,000 and/or expenditures total more than $1,000 for this reporting period. 10. I/we do solemnly swear or affirm that the information contained in this campaign financial disclosure report is true and that this report is an accurate accounting of campaign contributions and expenditures required to be reported by the candidate committee by the Campaign Financial Disclosure Act. Additionally, I/we swear or affirm that no campaign contributions have been expended for the personal financial be t of the candidatje or for ny other nonpolitical purpose as defined by the federal internal revenue code. - W_~'50" signature of candidate signatur5 of political treasurer political treasurer mate 11. WITNESS SIGNATURE 6nature Kness date signature of witness date 12. SUMMARY a.. BALANCE ON HAND LAST REPORT $ I'~ 4 b. TOTAL RECEIPTS THIS PERIOD 3CQ d °3 c. TOTAL DISBURSEMENTS THIS PERIOD $ d. BALANCE ON HAND 12.a. plus 12.b. minus 12.c. $ e. TOTAL LOANS OUTSTANDING $ f. TOTAL OBLIGATIONS OUTSTANDING $ SSA109 (Rev. 2/06) Page 1 of RDA 1159 SUMMARY PAGE - CANDIDATE 14. REPORT COVERING THE PERIOD 13. NAME OF CANDIDAT OR GpMMITTEE (In Full) FROM: /_/6 TO: Diy1 l~ CR e✓ RECEIPTS 15. CONTRIBUTIONS (other than loans and interest) O a. Unitemized Contributions ($100 or less from each source this period) $ b. Itemized Contributions (over $100 from each source this period) $ d c. TOTAL CONTRIBUTIONS (other than loans and interest)(add 15.a. and 15.b.) $ Q 16. LOANS RECEIVED THIS REPORTING PERIOD 17. INTEREST RECEIVED THIS REPORTING PERIOD 18. TOTAL RECEIPTS (add 15.c., 16., and 17.) (must be shown in item 12.b.) DISBURSEMENTS 19. EXPENDITURES (other than loan payments) a. Expenditures ($100 or less each payee this period) (must be listed by category - e.g., printing, postage, gasoline) $ $ $ . 03 s~ Total of Expenditures ($100 or less each payee) $ 3 h O Q 3 ' ' $ b. Itemized Expenditures (Over $100 each payee this period) c. TOTAL EXPENDITURES (other than loan repayments)(add 19.a. and 19.b.) $ 0 3 20. LOAN REPAYMENTS MADE THIS PERIOD . 21. TOTAL DISBURSEMENTS (add 19.c. and 20.) (must be shown in item 12.c.) $ 22AN-KIND CONTRIBUTIONS a. Unitemized in-kind contributions ($100 or less from each source this period) $ D b. Itemized in-kind contributions (over $100 from each source this period) $ - - O c. TOTAL IN-KIND CONTRIBUTIONS RECEIVED THIS PERIOD (add 22.a. and 22.b.) $ 23.OBLIGATIONS a. Unitemized Obligations Outstanding ($100 or less each) b. Itemized obligations Outstanding (Over $100 each) $ c. TOTAL OBLIGATIONS OUTSTANDING (add 23.a. and 23.b.) (must be shown i item 12.f.) Page of 0 SS-1133 (Rev. 4102) ITEMIZED STATEMENT OF EXPENDITURES - CANDIDATE 1. NAME OF CANDIDATE OR COMMITTEE 2. REPORT COVERING THE PERIOD DIN / G et" FROM:/-/# T0: muunr 3. TOTAL ITEMIZED CAMPAIGN EXPENDITURES FROM PRECEDING PAGE (enter $0 if first itemized page) 4. COMPLETE THE APPROPRIATE ITEMS FOR EACH ITEMIZED EXPENDITURE (expenditures totaling more than $100 to any payee during the period) First Name Middle Name Purpose of Expenditure Amount of Expenditure Last Nausinesspame a Jd Oa Address it(p~Er /t Yet 4 a , ,~gmR~7 It City Slate Zip Code Ing 4~z v, //e rA( 7 A Middle Name Purpose of Expenditure Amount of Expenditure Rust Name l/3= /`i 2 Last NamelBusiness Name r,qg L I 5d Address city State Zip Code TM 3 First Name Middle Name Purpose of Expenditure t r Amount of Expenditure Last NamelBusiness 1 r 5 / e uP rn~Q 13 r"' ~ erS ~ er ~~erKs Ib Address r✓ p ner Y fit4 I(" Stale Zip Code ?hag e Guy / Middle Name Purpose of Expenditure Amount of Expenditure First Name Last Name/Business Name ~ u R )QUAIA 1A "4~11f '1~au 41 DA-! t7C Address ( n 6015, 1 CRY V; je State 3 Cqde 421-1 First Name Middle Name Purpose of Expenditure Amount of Expenditure Last Name/Business Name 5f0CI Vo14 a~~o ~o y8?~ Address Cod City First Name Middle Name Purpose of Expenditure Amount of Expenditure eve_ Last NamelBusinessName /i ~eo -71 Address D , aty 64r1, l e S L 5. TOTAL ITEMkED EXPENDITURES (Carry forward to item 3. of next page it additional pages of this form are used.) (If this is the last page of expenditures, this amount must be shown in item 19b. of summary.) - AWL M1129 (Rev. 4/02) Page of RDA 1159 CAMPAIGN FINANCIAL DISCLOSURE STATEMENT For State and Local Candidates For Single-Candidate Committees 1. TE OF REPORT 2.a. NAME OF CANDIDATE OR COWA(TTEE 2.b. IF COMMITTEE, NKME OF CANDIDATE 3. ELECTION DATE 1 z0 4.a. CAMPAIGN ADDRESS AND PHONE Street or Rural Route City State Zip Codl Phone 4.b. CANDIDATE'S HO ,1E ADDRESS (if different than 4. . Street or Rural Route City State Zip Code Phone 5. OFFICE SOUGHT (include district number, 9 applicable) 6. NAME OF POLITICAL TREASURER (may be candidate) A c ~ISe 7. CATXQ3PRY0R-R-tP6RT(Ch9dc one) 10 1:1 ED FIRST SECOND T ~ FO~ ill ~ MID AR YEARR-TAD GENERAL SUPPLEMENTAL B.a.BEGINNING TEOFR>~ORTMNGPERIOD 8b. ENDW? DATE OFRE'ORTINGPERIOD 1 9. (Check one) I a. ❑ This campaign is exempt from detailed disclosure because contributions (kv*Wkv in-kind) received total $1.000 or less AND expendi- tures total $1.000 or less for this reporting period. (Complete items 12d., 12e. and 12f.) b. dThls campaign is required to file a detailed financial disclosure because contributions (Including W*4dnd) received total more than $1.000 andlor expenditures total more than $1.000 for thisveporfing period. 10. l/we do soleur * swear or affirm that the kftmetion contained in this campaign financial disclosure report Is true and that this report is an accurate acootxKkp of carrvaign contributions and expenditures required to be reported by the candidate caturdtiee by the Campaign Financial Disclosure Act. Additionally. Vwe swear or affirm that no campaign contribution have been expended for the personal financial benefit of the candidate or for any other nonpolitical purpose as defined by the federal inte`rnnal revenue code. ~3b 1~/c signature of ca idate dat signature of political treasurer e 11. tMTNESS SIGNATURE G a 31 ~y ~(/1 C I> / 3 I signature of witless date signature of witness date 12. SUMMARY a. BALANCE ON HAND LAST REPORT S b. TOTALRECEIPTSTHISPERIOD . D> D~ c. TOTALDISBURSEMENTSTHISPERLOD ......5 1. 7.2 d• BALANCE ON HAND (12.a. plus 12.b. minus 12.c.) ~ 3 64, 7 e. TOTAL LOANS OUTSTANDING U C TOTALOBLIGATIONS OUTSTANDING SS-1109 (Rev. 20) Pape 1 or RDA 1169 SUMMARY PAGE - CANDIDATE 13. NAME OF CANDIDATE OR COMMITTEE (In Full) 14. REPO 'COVERING THE PERIOD FROM:(q 'ZO TO: Z(~/ RECEIPTS 15. CONTRIBUTIONS (other than bans and interest) C a. Unltemized Contributions ($100 or less from each source this period) $ l 0 b. Itemized Contributions (over $100 from each source this period) . c. TOTAL CONTRIBUTIONS (other than bans and interest)(add 15.a. and 15.b.) Z3© 16. LOANS RECEIVED THIS REPORTING PERIOD 17. INTEREST RECEIVED THIS REPORTING PERIOD ....................................................................................5 U 18. TOTAL RECEIPTS (add 15 c., 16., and 17.) (must be shown in item 12.b.) S . 2-300 DISBURSEMENTS 19. EXPENDITURES (other than ban payments) . a. Expenditures ($100 or less each payee this period) (must be 64ted by category - e.g., printing, postage, gasoline) r2t,~o. Par -7:t $J00'(90 $ s s 5 s s • 5 5 Total of Expenditures ($100 or less each payee) S I V L~ G' b. Itemized Expenditures (Over $100 each payee this period) $ , Z -431 c. TOTAL EXPENDITURES (other than ban rePalmsnts)(add 19.a, and 19.b.) C~! 7 5 , 20. LOAN REPAYMENTS MADE THIS PERIOD . 21. TOTAL DISBURSEMENTS (add 19.0. and 20.) (must be shown in item 12.c.) 22.[N-KIND CONTRIBUTIONS a. Unitemized in-kind contributions ($100 or less from each source this period) $ b. Itemized in-kind contributions (over $100 from each source this period) $ c. TOTAL IN4QND CONTRIBUTIONS RECEIVED THIS PERIOD (add 22.a. and 22.b.) . O 23.013LIGATIONS a. Unitemized Obligations Outstanding ($100 or less each) b. Itemized Obligations Outstanding (Over $100 each) 5 a TOTAL OBLIGATIONS OUTSTANDING (add 23.a. and 23.b.) (must be shown i item 12.f.) .........................5 d SS-1133 (Rev. 4AM Pap Z- of ITEMIZED STATEMENT OF CONTRIOUTIONS CANDIDATE I. NAME~OF CANOlDA7E OR ~OMMITTF.E 2. REPORT COVER RUNE to & FROti+ , TO: o 3. TOTAL ITEIAIZED CAMPAIGN.CW RWTIONS FROM RRECEOWG. PAGE (erdwU K&M itemized PW) 4: COMPME TWA-PPfWPWEff%M FaR EAM ITFidi2Etl CON TWBtITM moos fta $100 from ROW Cftftfte, riNras 1idd~ihia~ Ck ~°°hF'~bu6on KOCRVW rbr aftaa,t of ca*bu6a, t,a Nam )5 e r~ 0 r n El Genoto Mcson A"Im E: jqi ❑w,notr nocat eer~o,~s onyl 3 o p Ck u r v ►i l 0v0i wk al cmbbuft Aooro Ple TW Ems, o S I,e rr ` r~~i z a FM NM ataaieNm Oon6bu6on Reoaared For Anqurt a Con4~ tad Nmi ` Pl y Bubm ❑ Gw'"Eklon A ' I ► o Ebc6m OrM 3 ° a Cb 11 l Al!, 1~ 0 wbotcmmkAaon Apgt bTHa RP!Flm DID r l D3 DJ Cpl U . B~ i ~ l 1 r I a~naa~n. nom, - Conaibu6on RsceiMee For• Amount of ow&U,aipn low ol,~ k9, r Iia~~Y Ebdion ❑ tasnerai EteeGon ` ❑ R+not► tLocel EbcBooa ooly► 5 cly mckr4 V sw zp'ooe~ . Mk aw*bj6an AeDfepak Ph Section go q r i CO p.fIG CiA O brmw `Z©l y U, KI C49 Ll- CA ',5~. e on f . . 3 Gar p 1\ C , ~ c • , O i:ax►ar "Aw e,a" or,M ~00 civ, AA 4L Deb of Canbk,6on AQ J* e mom 5. TOTAL nEMRMCONIRBUTIONS ~anrtawwar~a.ea~co•o•r.aaKo,w~orr,~~.n„~ei pffiskh.apepwct=rkftu./,k«no tmwaMewsinmm"LorswW w W1131(Rew 2106) Fopo3-a RitA 1159 ITEMIZED STATEMENT OF CONTRIBUTIONS - CANDIDATE L NAM OF CANDlDJ1TE OR CM 2 REPORT COVERING THE PERIOD n A FR TO: / 3. TOTAL f TEMIZED 14MIRIBUTIM FROM PRECEDWG PAGE (order SO K frs *Whed page) 12 e: OWLETS Tt FOR EACH ffai ZED OONiRi ! IIm 1100 Ian Rd"mw c Ifda.wioe OohlOt t" Moat of Co *bAon lsa~ UfP&myBwft ❑ OeneblEbCSai Aeem ~ D RuwA rat 6ec6ona only :350 civ nv Dale of Coa6budon Aggr"ab This EbcHon ooa pMioo I i C, - of k- 0 ` c t'v, 1 FMN*m J-t'h liddeNrse Owd t" ROcWW For Anw a of CwabAan l,u . Wiw aPrknay eec6on (lentil Eledion A+~ l ~ ~ ~ r , w~ ❑Runolf (Local Eted~na a+hA ~~V apl f LPtibee Deis of OmIplk" ApOtepala TNa g sm r RdNmw Name Ow*bu6on Rooaived For Mwurt a Ow*busm 13NMYBedm Q Ganewl Ebc6on A+ldrsa ❑ Ruwtf (load Elm -sm r 1 Only) Spb LP Cede . 0* of ommk Bap Appropale THs Beckon owvdm Firftltsae lasl~nllan+e ❑P&MYmodw 13 Qe"Beo6on Alas ❑ RuwK (Local Bertiom Onilr} qy ' 12.0 zoods Dale of Ombbuft Approgdo TNe gm, lion Ocaapsfon . EmOw 5. T+ W ITEMIZ CWTR&1 t10N3 (Orgiawndb>tem3.aeadppei<Wdliawtpapatarfib~mwwad,) ~ (eNs Y M lalMOadao~buaar. Ns amoadawalbe M~ow►In1Nm 15b.a(wnnry,► ) W113.10Rew 2MM Paine a ~ RDA 111Ii ITEMIZED STATEMENT OF IN-KIND CONTRIBUTIONS - CANDIDATE 1. NAME OF CANDIDATE-OR COMMITTE 2. REPORT,COVERING THE PERIOD t FROM;(/ TO: Aniount 3. TOTAL ITEMIZED INANO 9UM18UTIONS FROM PRECEDIING PAGE (enter $0 if first ilemlzed page) Q 4. Comm THE APPROPRKTE f iEMS FOR EACH fTBAm w4aw CONTmurm wa+d tankbu60ns.ro &V more rim 1104 from spry CW* btAordukp to periodl 49 Nana Kd* HW4 kl4W CarlbbAm Rsoeived For Value of IrAW Contribution Pmlary F_ioo ❑ ew&sl Election LastNamaDryaria6 Name ❑ Runot( (lxal Elections Only] Address Dab akr W Canton Apgropsb V* 9edm ciq stale 2ipfbde. Deeaipfmo(k,,"Ca16bi" FkuName fxddfeName klaarld Confflbt" Received For. Value of IndQnd Caniritwtion 0 Primary Election . ❑ omww Election dame ❑ Runoff (Local Elections only) Adders Daleak►+aadcolrribu6a, ApgiepaleHs9eCkn Cfey I&* TV Co* Duatp6onatNa dekxwlbu6a~ t~pt~yec FM Name I A* Nm b*W Cdntrix 6m Received For Vatire of kl-Iftl Ca *blrtioa ❑ Prinwy Bection .0 Ganeral Eiac w lsstNamalOryarcza6onlbiae Runoff (Local Electiom Only) Addrst ale«tn~aletxnkfbufon Apprepaleris t3ecfan as sae zpooda D.salp6onak,*ndc«,kiH;cal Ficu Nm IiA& tww Mffw cftw6on Reoeired Foe Value of m-&A cwmx Yrn PrimOry Election' ❑ Ganaral Elaafion last NemeNrysr~ZSion Name ❑ Rma (local Elections 0rry) Adders DeB«h4rjrW w*b6m Apprepalet,isElec6on City stab 2pC4ds DesaipfagafkaKr~dCarkbuion Eft0oVw FrNName L45&mm %4W Cmlbbutan Received For. VaW of h4W C *butioe Primary Election ❑ General Election ❑ Runoff (Local Elediora Only) Adders D*o(h4WOwlkbibon Ap¢+eg*ft 3ee6on Cdr shb zip oode DesaiAm4f MC cw&bu6on 5. TOTAL IT AM IN-WND CONTRIBUTIONS D tanyk,n~aa>~la.«ne~apaarw~6awpa~ae~af«,Ir.rer~ed.~ . (I(Na><6k4Apepeof k►~dndeeniburonc, Ns amount muubs shosmintlaa226.«wnansrya SS-1128 (Rev. 2106) Pape of RDA 1159 ITEMIZED STATEMENT OF EXPENDITURES - CANDIDATE 1. NAME OF CANDIDATE OR COM EE 2. REPORT COVERT NG THE PERIOD S ! C FROM' (9/ TO 3. TOTAL ITEMIZED CAMPA N EXPENDITURES FROM PRECEDING PAGE (enter $O If ftW kWgZW page) 4.. COMPLETE THE APPROPRIATE ITEMS FOR EACH ITEIAIZED OPBM 111RE (expdd0ores btarmp more than $100 b aey t Aft the period) tint Name ( Vaddle Name Purpose of Egwo t n Amount of Evenftm Lag Namelf3Wkwu Name 7 5 5 ixn1 ` y n y to 7z cW4 CA(' v I s Dees 1. First Name Kdde Name Purpose of Elc V41tUre Amount of Expec►diWa LmdN&Td0:bM Name Address cttr 51a1e z+p Dods R* Names bides Nine Purpose of ExpWWdure Arraur>l of EitpeisdiYure Last N+melBwins Neae Address r Name W& Name Purpose of Emerliftwe ARMW of 8"nftn cast NemelBrrcYasss Name ab teals apt)ode tint Name VMS* Name Purpose of Exp&-4% a MOM of Ezpenftn cast NamefBu:hess Name Addms teals ap podo lira Name 16ddie Name Purpose of Ercperom Amount of ExpWdl ue fast NamelBuskbu name AOOreu ab Stab TV lode 5. TOTAL REMIZ® EXPENDITURES (~YbnnrdbNomi.aeexlpa~peradd6onftpapesdHctonname:sees ~ ~ /c 7z prftkristadplodf wdUm.rikwmWffud0edmainIlanl9h.ofwmyrya 88-1129 (Rev. 4002) Pape of RGA 1159 ITEMIZED STATEMENT OF LOANS - CANDIDATE 1. NAME OF CANDIDATE OR COMMITTEE 2- REPORT COVERING THE PERIOD A L s l FR0M1. I T O~ 3. COMPLETE THE APPROPRIATE ITEMS FOR EACH ITEMIZED LOAN om s wtaifn nafe wm itoo fiam any mme auinp/r,e/ Coff0ebe the Fob*ft for tie som ark Loaf, t9rd Name 7;eName outsfandn0loan aiatafxe lmns Loan Outstand'eg Loan "awe M +D cf pe" Received Pe f -ft (End of PwiA NamedDfpanaa6on Nxro , Address Lon Received For. Dale or lwn ❑ PfimwyB0060 ❑ Gefferala3ac6on CRY lbala zo code ❑ 1"9=aaa]aciofssom WAI Endorsers or&xra Mots faAbwe Loan Of mote space is needed please attach a pogo) Fist Name Lid* Name Fill Name Wddle Name uANameKkp&*AswR me LaslNameAfgaf anµdme AM M cw Stale Lp code ei0r State Zip code AmouflOufrafMeedouhfandn0 Gwnnwedp+a Fist Wm Lid* Nmk Ford Name Itiddfe Name ~e Name Name0ganaaion Name Address Addim ok Sblr T,pooda Cray Stabfs Zfpcowe MafeflGuara+bedOulslandig O Fifd Name Lime Name Peg Name 7le Name Lasl WmeOpaffara6m Name WfndorgafftrsianName Address UM Zip Odds stme '174 AntoffnlGlrarnleedOulslandaf0 p„x FW Name LWdle Name FW Name wddFe Name last Namelofpadraion . Aftm Aft= C~ SMe zap code tAty sU1Et Zap Oode Arfnfadtavaranbed oubtandinp GuaracMeedoutstandf>Q 4. Total: bra!! Loans (m~ on f of IEarbed bale) O"Mands'aLonBattnoa Lm of,tswaaf>o Lon a3slanoe (Wd bms fefbiwd ehak *o be don In aem~ti sff mwy pap.) P40ow (ioGt ban payffaffls should solo be m h Wn 20, on su mwy paps.) (T -tsWftbnbaw"damalsoteem"iun12.e.o *wpaw ® SS-1132 (Rev. 4102) Page of RDA 1159 ITEMIZED STATEMENT OF OBLIGATIONS - CANDIDATE 1. NAME OF CANDIDATE OR COMMITTEE - . 2. REPORT CO ING THE PERIOD 0 C J2 FROM: A4 TO: L'I I OOMR.ETE THE APPROPRIATE ITEMS FOR EACH I ZED Outstanding Balance Debt bwdffW' Payments Outstanding Balance OBt.IGATION (obligaUons toWing more than $100 owed to any Beginning of Period) This Period This Period (End of Period) PU=Vvendor at the end of the reporUng period) FkdM me twiddleNanw test Nw"sAiress Name Address ab Stale rVCode FlRI Name LW* Nwm Lao NaTomakwa N am Addmu CW zip CA Dm"m ofOb%A m FW Nm IRd* Nww last K"&swiness Nine Address Ck State zp code OescdpfandobiQa6on tlrel Name UNW Namo Lag Nam bjsken Name Address ~ Stale zp tbde Desaip6oaaobipe6oa Flnt Name piddle Nina LadNW&Susrwss Name Ache" civ stale bpco Oesafp6onoloaipafen 4. TOTALS (Total from W tar*v Batwm - (End of PwbM cokmn nW atlso be tdtown 61 in lbm 2 on atatarwry page.) (J SS-1127 (Rev. 4A92) Page of RDA 1159 Appointment of Political Treasurer For State and Local Candidates and Single-Candidate Committees INSTRUCTIONS The Appointment of Political Treasurer statement must be used to appoint a political treasurer as required by the Campaign Financial Disclosure Act (T.C.A. § 2-10-105) for state and local candidates and single- candidate political campaign committees. A state candidate may not receive or expend funds for an election until a political treasurer has been appointed for that election. A local candidate pursuant to T.C.A 2-10-101, may be exempt from completing this form, please checkwith county election commission for more information. A candidate may appoint himself or herself as political treasurer. A new form must be filed if the treasurer is changed. Candidates for state public office must file their original Appointment of Political Treasurer statement ONLY with the Registry of Election Finance, 404 James Robertson Parkway, Suite 104, Nashville, TN 37243-1360. Candidates for local public office must file their original Appointment of Political Treasurer statement ONLY with their county election commission. 1. Date: 2. Name of Candidate or Committee: 3. Candidate e-mail address: iq ►n C-02- 4. Campaign Address and Phone: City State Zip Code Ph ne ~.f N L u e J' X7803~'Z99 5. Home Address and hone (if different than item 4 above): Ci State Zip Code Phone 6.Office Sought (include district number, if applicable) 7. Party Affliation 8. Election Year Z1/ 9 (&d coltG4to1; p; s`f e 9. Treasu r Name: 10. Treasurer a-mail address: G F4 11. Treasurer ddress and Phone: City State Zip Code Phone 12. Candidate and Treasurer Signature (both signatures must be witnessed. Treasurercan not witness candidate's signature): Signature of Candidate Signature of Treasurer Signature of Witness Signature of Witness 3 1U1( Registry of Election Finance SSA120 (rev 10=10) Jut9TY 6 8 L9 FINANCIAL DISCLOSURE STATEMENT EXEMPTION Pursuant to TCA 5 2-10-101(b) a candidate is exempt from filing financial disclosure statements: "If a candidate is seeking an office for which service is part-time, compensation is less than $1,000 a month, and the candidate does not spend more than $1,000 to get elected to office, the candidate does not have to file Campaign Financial Disclosure Reports." CANDIDATE'S INFORMATION: Q Candidate's Name: G &I-A, Candidate's Position: COQ co ~l Residential Address: r n e ~D City: ar v~ State:(S) Zip: ~ I hereby state that I meet the above qualifications for exemption and am therefore exempt from filing financial disclosure statements. 2 9' Candidates Signature Date Witness's Signature Date iI If my plans change and I realize I will spend more than $1,000 on my caJ~Ltz will immediately make a financial disclosure report.