The URL can be used to link to this page

Headrick, Robert L. 5 t CAMPAIGN FINANCIAL DISCLOSURE STATEMENT For State and Local Judicial Single - Candidate Committees 1. DATE OF REPORT 2.a. NAMEOFCANDIDATE 1/30/18 1 ROBERT L. HEADRICK 2.b. NAME OF CANDIDATE'S COMMITTEE 3. ELECTION DATE The Committee to Reelect Robert L. Headrick 4.a. CAMPAIGN ADDRESS AND PHONE Street or Rural Route City State Zip Code Phone 938 E. Lamar Alex. Pkwy. Maryville TN 37802 865-273-5530 4.b. CANDIDATE'S HOME ADDRESS (if different than 4.a.) Street or Rural Route City State Zip Code Phone 1210 Oak Park Ave. Maryville TN 37803 865-273- 5524 5. JUDICIAL OFFICE SOUGHT (include district number, if applicable) 6. NAME OF POLITICAL TREASURER General Sessions Div. IV Mr. Robert Goddard ❑ ❑ ❑ ❑ 7. CATEGORY OR REPORT (Check on ❑ e) FIRST SECOND THIRD FOURTH PRE- PRE- MID-YEAR YEAR-END QUARTER QUARTER QUARTER QUARTER PRIMARY GENERAL SUPPLEMENTAL SUPPLEMENTAL 8.a. BEGINNING DATE OF REPORTING PERIOD 8.b. ENDING DATEOF REPORTING PERIOD July 1, 2017 January 15, 2018 9. (Check one) a. [ This campaign is exempt from detailed disclosures because contributions (including in-kind) received total $1,000 or less AND expenditures 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. SIGNATURE OF CANDI E 11. SIGNATURE OF POLITICALTREASURER I do solemnly swear or affirm that the information contained in thiscampaign financial looli port is true and accurate. Additionally, I swear or affirm thn contributions have been expended for the personal Signatue of Candida D Ate financial candidate or for any other nonpolitical purpose as defined temal revenue code. 3I/ Signatue of W Hess Dat Signa jlaji#,~j ld&*YL~- turTreasurer Date c' ' ~b Sign ue of Witn ate 12. SUMMARY 14 , 7 3 8.11 a. BALANCE ON HAND LAST REPORT $ -0- b. TOTAL RECEIPTS THIS PERIOD $ c. TOTAL DISBURSEMENTS THIS PERIOD 11raCEIVE0.................................... $ 1,200.00 d. BALANCE ON HAND (12.a. plus 12.b. minus 12.c.) JAN--3-0-2-414 $ 13,5 3 8.11 e. TOTAL LOANS OUTSTANDING ELOUNT COUNTY _0_ .............Et_EeGTtONI...................................................................... $ -o- f. TOTAL OBLIGATIONS OUTSTANDING $ SS-1137 (Rev. 2/06) Page I of RDA 1159 SUMMARY PAGE - CANDIDATE 13. NAME OF CANDIDATE OR COMMITTEE (In Full) 14. REPORT COVERING THE PERIOD FF~Df1 / 17 To: Robert L. Headrick RECEIPTS 15. CONTRIBUTIONS (other than loans and interest) a. Unitemized Contributions ($100 or less from each source this period) $ - -0- b. Itemized Contributions (over $100 from each source this period) $ -0- c. TOTAL CONTRIBUTIONS (other than loans and interest)(add 15.a. and 15.b.) $ 16. LOANS RECEIVED THIS REPORTING PERIOD $ -0- 17. INTEREST RECEIVED THIS REPORTING PERIOD -0- 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) Campaign Contribution $ 300.00 Tickets- fundraising $ 350.00 $ $ $ $ $ $ 650.00 Total of Expenditures ($100 or less each payee) $ 550.00 b. Itemized Expenditures (Over $100 each payee this period) $ 1200.00 c. TOTAL EXPENDITURES (other than loan repayments)(add 19.a. and 19.b.) $ -0- 20. LOAN REPAYMENTS MADE THIS PERIOD 1200.00 21. TOTAL DISBURSEMENTS (add 19.c. and 20.) (must be shown in item 12.c.) $ 22.IN-KIND CONTRIBUTIONS -0- a. Unitemized in-kind contributions ($100 or less from each source this period) $ -0- 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.) $ 0- 23. OBLIGATIONS -0- a. Unitemized Obligations Outstanding ($100 or less each) -0- b. Itemized Obligations Outstanding (Over $100 each) $ -0- c. TOTAL OBLIGATIONS OUTSTANDING (add 23.a. and 23.b.) (must be shown i item 12.f.) $ cC1i'AA (P.v e1ml Page of ITEMIZED STATEMENT OF EXPENDITURES - CANDIDATE N ME OF C DIDA~E OR COMMITTEE 2. REPORT COVERING THE PERIOD tAP. Headrick FROM-7 1 1 TD. 18 Amount 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 Last Name/Business Name Tom Hatcher Charit Golf tickets for fundraising address 125.00 128 Temple Road 4Raryvi11e ' 04 First Name Middle Name Purpose of Expenditure Amount of Expenditure tickets for fundraising t e ~`l~0 emeAdvocacy center 125.00 Ajresj) . Box 5058 Code Maryville L17 802 Fi5l'l5"unt Partenership Middle Name Purpose of Expenditure Amount of Expenditure I att Name/Business Name tickets for fundraising S. Washington St. 125.00 state Zi Code cigaryviIle TN 17804 First Name Middle Name Purpose of Expenditure Amount of Expenditure Ne astlopenesArvocacy Center tickets for fundraising Addrps:0. Box 5058 175.00 City State Zip Code Maryville TN 37802 First Name Middle Name Purpose of Expenditure Amount of Expenditure Last Name/Business Name Address city state Zip Code KJ F H First Name Middle Name Purpose of Expenditure Amount of Expenditure 550.00 Last NamelBusiness 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.) A~k SS-1129 (Rev. 4/02) Page of RDA 1159 CAMPAIGN FINANCIAL DISCLOSURE STATEMENT For State and Local Judicial Single - Candidate Committees 1. DATE OF REPORT 2.a. NAME OF CANDIDATE July 15th, 2015 ROBERT L. HEADRICK 2.b. NAME OF CANDIDATE'S COMMITTEE 3. ELECTION DATE The Committee to Re-Elect Robert L. Headrick 4.a. CAMPAIGN ADDRESS AND PHONE Street or Rural Route City State Zip Code Phone 938 E. Lamar Alexander Pkwy Maryville TN 37802 (865) 273-5530 4.b. CANDIDATE'S HOME ADDRESS (if different than 4.a.) Street or Rural Route City State Zip Code Phone 1210 Oak Park Avenue Maryville TN 37803 (865) 273-5524 5. JUDICIAL OFFICE SOUGHT (include district number, if applicable) 6. NAME OF POLITICAL TREASURER General Sessions Court Division IV Mr. Robert Goddard 7. ❑CATEGORY OR REPORT (Check one) ❑ ❑ ❑ ❑ FIRST SECOND THIRD FOURTH PRE- PRE- MID-YEAR YEAR-END DARTER QUARTER DARTER QUARTER PRIMARY GENERAL SUPPLEMENTAL SUPPLEMENTAL 8.a. BEGINNING DATE OF REPORTING PERIOD 8.b. ENDING DATE OF REPORT ING PERIOD January 16th, 2015 June 30th, 2015 9 (Check one) a. ® This campaign is exempt from detailed disclosures because contributions (including in-kind) received total $1,000 or less AND expenditures 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. SIGNATUREOFCANDIDAT it. SIGNATUREOF POLITICAL TREASURER I do solemnly swear or affirm that the information contained in thiscampaign financial disclosure report is true and accurate. Additionally, I swear or affirm tha o ca aign contributions have been expended for the personal Signature of Cand ate Date financial en fi f the candidate or for any other nonpolitical purpose as defined th ral internal revenue code, 711 ~ Signature f Witness ate Signature of litical Vreasurer Date Signature 1,o, f Witness Dat 12. SUMMARY 19,518.70 a. BALANCE ON HAND LAST REPORT $ b. TOTAL RECEIPTS THIS PERIOD $ -0- 835.00 c. TOTAL DISBURSEMENTS THIS PERIOD $ d. BALANCE ON HAND (12.a. plus 12.b. minus 12.c.) $ 18,683.70 e. TOTAL LOANS OUTSTANDING $ -0- 1.,,... f. TOTAL OBLIGATIONS OUTSTANDING.............,.. . .p, $ RECEIVED .g ~e•• ~O Page I of SS-1117(Rev 2/06) RDA 1159 JUL 2015 t a RLOUNTCOUNTy N v ELECTION ,d2 t68 CAMPAIGN FINANCIAL DISCLOSURE STATEMENT For State and Local Judicial Single - Candidate Committees 1. DATE OF REPORT 2.a. NAMEOF CANDIDATE 1/26/15 1 ROBERT L. HEADRICK 2.b. NAME OF CANDIDATE'S COMMITTEE 3. ELECTION DATE The Committee to ReElect Robert L. Headrick 4.a. CAMPAIGN ADDRESS AND PHONE Street or Rural Route City State Zip Code Phone 938 E. Lamar Alex. Pkwy. Maryville TN 17,902 (865) 273-5530 4.b. CANDIDATE'S HOME ADDRESS (if different than 4.a.) Strut or Rural Route City State Zip Code 1210 Oak Park Avenue Maryville TN 37803 (865) ~~°~'-e5524 5. JUDICIAL OFFICE SOUGHT (include district number, if applicable) 6. NAME OF POLITICAL TREASURER General Sessions Court Div. IV Mr. Robert Goddard 7. CATEGORY OR REPORT (Check one) ❑ ❑ ❑ ❑ ❑ ❑ ❑ FIRST SECOND THIRD FOURTH PRE- PRE- MID-YEAR YEAR-END QUARTER QUARTER QUARTER QUARTER PRIMARY GENERAL SUPPLEMENTAL SUPPLEMENTAL 8.a. BEGINNING DATE OF REPORTING PERIOD 8.b. ENDING DATE OF REPORTING PERIOD October 1, 2014 January 15, 2015 9. (Check one) a.] This campaign is exempt from detailed disclosures because contributions (including in-kind) received total $1,000 or less AND expenditures 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. SIGNATURE OF C IDA 11. SIGNATURE OF POLITICAL TREASURER I do solemnly swear or affirm that the information contained in thiscampaign financial disc is true and accurate. Additionally, I swear or affirm that o campaign co tributions have been expended for the personal Signature of C dida D e financial be efit of th nd ate or for any other nonpolitical purpose as defined by t fede i al revenue code. Signatu of Witness D to Signature of Po icaI Tree urer Date Signature of Witness Dat 12. SUMMARY a. BALANCE ON HAND LAST REPORT $ 19,774.50 b. TOTAL RECEIPTS THIS PERIOD $ c. TOTAL DISBURSEMENTS THIS PERIOD $ 5 _190 d. BALANCE ON HAND (12.a. plus 12.b. minus 12.c.) $ 19.518.70 e. TOTAL LOANS OUTSTANDING $ f. TOTAL OBLIGATIONS OUTSTANDING $ -Q- SS-1137(Rev.2/06) Page I of 1 RDA 1159 CAMPAIGN FINANCIAL DISCLOSURE STATEMENT For State and Local Judicial Single - Candidate Committees 1, DATE OF REPORT 12.a. NAME OF CANDIDATE 10/7/14 ROBERT L. HEADRICK 3. ELECTION DATE 2.b. NAME OF CANDIDATE'S COMMITTEE The Committee to ReElect Robert L. Headrick 8/7/14 4.a. CAMPAIGN ADDRESS AND PHONE State Zip Code Phone Street or Rural Route City P.O. Box 5326 Maryville TN 37802 865 273-5530 4.b. CANDIDATE'S HOME ADDRESS (if different than 4.a.) State Zip Code Phone Street or Rural Route City 1210 Oak Park Avenue Maryville TN 37803 - OF POLITICAL TREASURER AME r7. JUDICIAL OFFICE SOUGHT (include district number, if applicable) nN eneral Sessions Court Div. IV Robert Goddard CATEGORY OR REPORT (Check one) 13 ❑ ❑ ❑ ❑ El ER El FIRST SECOND THIRD FOURTH PRE PRE- MID YEAR YEAR-END ENTAL SUPPLEMENTAL QUARTER QUARTER QUARTER QUARTER 8 bRl ENDING DATE OF GENERAL REPORTING PERIOD 8.a. BEGINNING DATE OF REPORTING PERIOD July 29th,2014 September 30th 2 1 9. (Check one) a. [ This campaign is exempt from detailed disclosures because contributions (including in-kind) received total $1,000 or less AND expenditures 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. SIGNATURE OF CANDIDATE 11. SIGNATURE OF POLITICALTREASURER I do solemnly swear or affirm that the information contained in thiscampaign financial di ure rep is true and accurate. Additionally, 1 swear or affirm th no campaig contributions have been expended for the personal Signatue of ndidate ~O~ financial nefit of a didate or for any other nonpolitical purpose as defined by he f r)ra emal revenue code. lI Nil Signatue of Witness / De SJSigue P ical T surer Date Witness ate 12. SUMMARY 20,942.50 a. BALANCE ON HAND LAST REPORT $ -0- b. TOTAL RECEIPTS THIS PERIOD $ 1,168.00 , c. TOTAL DISBURSEMENTS THIS PERIOD $ d. BALANCE ON HAND (12.a. plus 12.b. minus 12.c.) $19,774.50 e. TOTAL LOANS OUTSTANDING -O- f. TOTAL OBLIGATIONS OUTSTANDING $ SS-1137 (Rev. 2/06) Page 1 of 8 RDA 1159 SUMMARY PAGE - CANDIDATE 13. NAME OF CANDIDATE OR COMMITTEE (In Full) 14. REPORT COVERING THE PERIOD FROM: ? 29 14 TO: 9 30 14 RECEIPTS 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) $ -0- c. TOTAL CONTRIBUTIONS (other than loans and interest)(add 15.a. and 15.b.) $ 16. LOANS RECEIVED THIS REPORTING PERIOD -0- 17. INTEREST RECEIVED THIS REPORTING PERIOD -0- 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) Total of Expenditures ($100 or less each payee) $ b. Itemized Expenditures Over $100 each payee this period) $ 1,168.00 c. TOTAL EXPENDITURES (other than loan repayments)(add 19.a. and 19.b.) $ 1,168.00 20. LOAN REPAYMENTS MADETHIS PERIOD -0- 21. TOTAL DISBURSEMENTS (add 19.c. and 20.) (must be shown in item 12.c.) $ 1,168.00 22AWKIND CONTRIBUTIONS -0- 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.) $ -0- 23. OBLIGATIONS a. Unitemized Obligations Outstanding ($100 or less each) b. Itemized Obligations Outstanding Over $100 each 0 c. TOTAL OBLIGATIONS OUTSTANDING (add 23.a. and 23.b.) (must be shown i item 12.f.) $ -0- Alk Page SS 1133 (Rev. 4102) 2 of 8 ITEMIZED STATEMENT OF CONTRIBUTIONS - CANDIDATE 2. REPORT COVERING THE PERIOD 1. NAME OF CANDIDATE OR COMMITTEE FROM77/29/14 TO' 9/30/14 ROBERT L . HEADRICK Amount -O- 3. TOTAL ITEMIZED CAMPAIGN CONTRIBUTIONS FROM PRECEDING PAGE (enter $0 K first itemized page) 4. COMPLETE THE APPROPRIATE ITEMS FOR EACH ITEMIZED CONTRIBUTION contributions totalin more than $100 from an contributor Amount of Contribution First Name Middle Name Contribution Received For. ❑ Primary Election ❑ General Election Last Name/Organization Name ❑ Runoff (Local Elections Only) Address Date of Contribution Aggregate This Election IV' Code State ~Y Occupation Ern"er Middle Name Contribution Received For: Amount of Contribution First Name ❑ Primary Election ❑ General Election Last NanwJOrganization Name ❑ Runoff (Local Elections Only) Address State Zip Code Date of Contribution Aggregate This Election city Occupation Employer fiddle Name Contribution Received Foi: Amount of Contribution First Name Last naatan me ❑ Primary Election ❑ General Election Address Runoff (Local Elections Only) state Zip Code Date of Contribution Aggregate This Election CAY Occupation ntn uhon or Amount ot-Contribution Fast Name Middle Name Last Nameogarraation Name ❑ Primary Election ❑ General Election ❑ Runoff (Local Elections Only) Address City Date of Contribution Aggregate This Election Stalo ~Cbde Occupation Ernpoyer 5. TOTAL ITEMIZED CONTRIBUTIONS -O- (Carry forward to item 3. of next page I additional pages of tNs form are used.) (K this is the last page d contributions, this amount must be shown in item 15b. of summary.) Page 3 of 8 RDA 1159 SS-1131(Rev. 2106) ITEMIZED STATEMENT OF IN-KIND CONTRIBUTIONS - CANDIDATE 1. NAME OF CANDIDATE OR COMMITTEE 2. REPORT COVERING THE PERIOD FROM: TO: Amount 3. TOTAL ITEMIZED IN-KIND CONTRIBUTIONS FROM PRECEDING PAGE (enter $0 9 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 NameJOrgan¢ation Name ❑ Runoff (Local Elections Only) Address Date of IMCind Contribution Aggregate this Election City State Zip Code Description of InAnd ConbiWion oxupation Fnpbyer First Name Middle Name In-Kind Contribution Received For. Value of In-Kind Contribution ❑ Primary Election ❑ General Election Last Namr/organization Name ❑ Runoff (Local Elections Only) Address Date of In4W Contritwtion Aggregate this Election City State Zip Code Description of In-Kind Cortilwtion Ooeul'>alion Employer Fist 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 dln-IGndContribution Aggregate this Election C4 State Zq Code Description of In-Kind Contribution Paton EmploS- Frst Name Middle Name In-Kind Contribution Received For. Value of In-Kind Contribution ❑ Primary Election ❑ General Election Last NaneOrgan¢afion Name ❑ Runoff (Local Elections Only) Address Date dlMGndContributian Aggregate This Election City Stag Zip Code De,aiption of In-Kind Ca*bution Occupation Er~bf"et First Name Middle Name In-Kind Contribution Received For. Value of In-Kind Contribution ❑ Primary Election ❑ General Election Last NameOganizatk:on Nam ❑ Runoff (Local Elections Only) Address Date of IrNGnd Conbibution Aggregate This Election City State Zip Code Description of In-Kind Contribution 5. TOTAL ITEMIZED IN-KIND CONTRIBUTIONS (Carry forward to item 3. of next page if additional pages of this form are used.) (tf this is the last page of in-kind contributions, this amount must be shown in item 22b. of summary.) SS-1128 (Rev. 2/06) Page of RDA 1159 ITEMIZED STATEMENT OF EXPENDITURES - CANDIDATE 2. REPORT COVERING THE PERIOD 1. NAME OF CANDIDATE OR COMMITTEE FROM: 29 1 T0: 9 30 14 ROBERT L. HEADRICK 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 PeriA)mount of Expenditure Middle Name Purpose of Expenditure First Name Last NamefBusiness Name s and Gir tickets $100 00 Ad ddress 520 S. Washington St. City State Zip Code Maryville TN 37804 Middle Name Purpose of Expenditure Amount of Expenditure First Name Last NamelBusiness Name .00 S1' /Mar vill Booster C tickets $100 sLawrence Avenue ---j city State Zip Code aryville TN 37803 Purpose of Expenditure Amount of Expenditure First Name Middle Name Last NameBusiness Name Advertisement $360.00 he Daily. Times Address 307 E. Har er Avenue city State Zip Code Maryville TN 37802 Middle Name Purpose of Expenditure Amount of Expenditure First Name Last Namausiness Name Advertisement $125.00 Blount County Chamber of Commmerce Address 2 oty State Zip Code Maryville TN ' 37804 Purpose of Expendituim Amount of Expenditure First Name Middle Name i ast Nanebus''ness Nam- .00 IMont omer Ride Intermediate School PTC Advertisement $83 Address 83 Montgomery Slate ZP Code CAY Maryville TN 37803 Pu of Expenditure Amount of Expenditure First Name Middle Name ~e Last Nameklusiness Name 1 QQ , QQ Great Smoky Mountains Heritage Center tickets Address 1123 Cromwell D Stale Zip Code city Townsend TN 37882 5. TOTAL ITEMIZED EXPENDITURES $868 . DO (Carry torward to item 3. of next page 9 additional pages of this form are used.) (H this is the last page of expenditures. this amount must be shown in item 19b. of summary.) Page 5 of RDA 1159 SS-1129 (Rev. 4102) ITEMIZED STATEMENT OF LOANS - CANDIDATE 2. REPORT COVERING THE PERIOD 1. NAME OF CANDIDATE OR COMMITTEE FROM: TO: 3. COMPLETE THE APPROPRIATE ITEMS FOR EACH ITEMIZED LOAN (vans totaling more than $100 from any source during 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 Name/Organization Name Address : Date of Loan Loan Received For ❑ Primary Election ❑ General Election UY 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 I Middle Name First Name Last Name/Organization Name Last Name/Organization Name Address Address State Zip Code city Slit: Zip Code City Amount Guaranteed Outstanding Amount Guaranteed Outstanding Middle Name First Name Middle Name First Name Last Name/Organization Name Last NamelOrganization Name Address Address State Zip Code city State Zip Code City Amount Guaranteed Outstanding Mxmt Guaranteed Outstanding Middle Name First Name Middle Name First Name Last Name/Organization Name Last Name/Organization Name Address Address Slate Zip Code city state Zip Code CAY 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 Zip Code Gry Amount Guaranteed Outstanding unt Guaranteed Outstanding Outstandin Loan Balance Loans Loan Outstanding Loan Balance 4. Totals for all Loans (complete on last page of itemized bans) inn 9 of Peri Received P rtrenls End of Period (Total bans received should also be shown in Rem 16. on summary page.) (Total ban payments should also be shown in item 20. on summary page.) (Total outstanding ban balance should also be shown in item 12.e. on front page.) ® of 8 RDA 1159 SS-1132 (Rev. 4102) Page 6 ITEMIZED STATEMENT OF EXPENDITURES - CANDIDATE 1. NAME OF CANDIDATE QQR COMMITTEE 2. REPORT COVERING THE PERIOD ROBERT L. HEADRICK FROM:7/29/14 To:9/30/14 mount 3. TOTAL ITEMIZED CAMPAIGN EXPENDITURES FROM PRECEDING PAGE (enter $0 if first itemized page) $868.00 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 United Way of Blount County tickets $100.00 Address 1615 E. Broadway Gty State Zip Code Maryville TN 37804 First Name Middle Name Purpose of Expenditure Amount of Expenditure Last Name/Business Name Blount County Republican Women tickets $100.00 Address 3401 Russ Circle Gty State Zip Code Alcoa TN 37701 First Name Middle Name Purpose of Expenditure Amount of Expenditure Last Name/Business Name City of Louisville (Fishing Tournament) tickets $100.00 AddreT.0. Box 215 Gty State Zip Cafe Louisville TN 37777 First Name Middle Name Purpose of Expenditure Amount of Expenditure Las(NamelBusiness Name Address city state Zip Code First Name Middle Name Purpose of Expenditure Amount of Expenditure Last NamelBusiness Name Address City Slate Zip Cafe First Name Middle Name Purpose of Expend'dtlre Amount of Expenditure Last NameMusiness Name Address Gty Slate Zip Code 5. TOTAL ITEMIZED EXPENDITURES (Carry forward to item 3. of next page N additional pages of this form are used.) $1,168.00 (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 8 RDA 1159 ITEMIZED STATEMENT OF OBLIGATIONS - CANDIDATE FCOMPLETEE OFF CANDIDATE OR COMMITTEE 2. REPORT COVERING THE PERIOD L. HEADRICK FROM7/29/14 TO: 9/30/14 HE APPROPRIATE ITEMS FOR EACH ITEMIZED Outstandi ng Balance Debt Incurred Payments Outstanding Balance obligations totaling more than $100 owed to any (Beginning of Period) This Period This Period (End of Period) at the end of the reporting period) First Name Middle Name Last Name/Business Name Address V Zip Code OFirst Name Middle Name Last Name/Business Name Address city De State Lp Code scription of Obligation First Name Middle Name Last Name/Business Name Address Gty Stale Zip Code Description of Obligation First Nam Middle Name Last Name/Business Name Address State Zip Code Description of Obligation First Name Middle Name Last Name/Business Name Address city Stale 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.) _0_ SS-1127 (Rev. 4/02) Page of g RDA 1159 CAMPAIGN FINANCIAL DISCLOSURE STATEMENT For State and Local Judicial Single - Candidate Committees 1. DATE OF REPORT 2.a. NAME OF CANDIDATE July 31st, 2014 Robert L. Headrick =Ug7 2.b. NAME OF CANDIDATE'S COMMITTEE 014 Com mittee to Reflect Ro bert L. Headrick 4.a. CAMPAIGN ADDRESS AND PHONE State Zip Code Phone ?reet or Rural Route City TN 37802 (865)273-5530 P.O. Bog 5326 M~yYi~ 4.b. CANDIDATE'S HOME ADDRESS (if different than 4.a.) State Zip Code Phone Street or Rural Route City T N 37803 (865)273-5524 1210 Oak Park Avenue Maryville 5. JUDICIAL OFFICE SOUGHT (include district number, if applicable) 6. NAME OF POLITICAL TREASURER G eneral Sessions C ourt Div. IV Mr. Robert Goddard 7. CATEGORY OR REPORT (Check on❑e) E] 11 E3 El FIRST El ❑ SECOND THIRD FOURTH P❑l RE- PRE- MID-YEAR YEAR-END EMENTAL SUPPLEMENTAL QUARTER QUARTER QUARTER QUARTER 8 PRIMARY GENERAL ENDING DATE OF REPORTING PERIOD 8, a. BEGINNING DATE OF REPORTING PERIOD Jay 28th, 2014 July 1st, 2014 9. (Check one) (Complete items 12d.! 12e. and 12f.jeived total $1,000 or less AND less for this'reportingsperod because a expend tupestotal $1 000 o from detailed 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. SIGNATURE OF CANDI 11. SIGNATURE OF POLITICAL TREASURER I do solemnly swear or affirm that the information contained in thiscampaign financial disclos ort is true and accurate. Additionally. I swear or 17 31 affirm that campaig contributions have been expended for the personal Signature Can idate D to financia benefi of a candidate or for any other nonpolitical purpose as defined the eral internal revenue code. I1.~1Ilik Signature of Poli ical Treasurer Date Signature of Witness ~ 12 qly` 1-7 Q ~ I RECEIVED ate ignature of Witness . ,I - w ,IUL 3 1 r 12. SUMMARY tiLECT10N.... $ 20,842.50 a. BALANCE ON HAND LAST REPORTI fyf 200.00 see below b. TOTAL RECEIPTS THIS PERIOD $ lOO.OO C, TOTAL DISBURSEMENTS THIS PERIOD $ $ 20,942.50 . d. BALANCE ON HAND (12.a. plus 12.b. minus 12.c.) e. TOTAL LOANS OUTSTANDING f. TOTAL OBLIGATIONS OUTSTANDING Page 1 oi, RDA 1159 SS-1137 (IRev. 2i06) T w o returned campaign contributions from: C9_m missioner Tonya BurchbjAd $100.00 Commissioner Tom Greene $100.00 T000 (Z8LS ON gOr) sc;ET 3ni VTOZ/t0/LO ~f RECQVED\ CAMPAIGN FINANCIAL DISCLOSURE STATEMENT For.atate and Local Judicial Singh - Candidate Committees 1. DAT%0fY p14 2.a. NAMEOFCANDIDATE :.ROBERT L. HEADRICK 2.b. NAME OF CANDIDATE'S COMMITTEE 3. ELECTION DATE The Committee to ReEleCt Judge Robert L. Headric 4.a. CAMPAIGN ADDRESS AND PHONE Street or Rural Route City State Zip Code Phone P.-O. Box 5326 Maryville TN 37802 (865) 273-5530 4.b. CANDIDATE'S HOME ADDRESS (if different than 4.a.) Street or Ruml Route City State Zip Code Phone 1210 Oak Park Avenue Maryville TN 37803 (865) 273--.5524 5. JUDICIAL OFFICE SOUGHT (include district number, if a pllc'abl0) S. NAME OF POLITICAI. TREASURER General Sessions Court Div. lfMr. Robert Goddard TEGQRY OR~REPORT (Check o13 ) ~ 0 SECOND THIRD FOURTH PRE- ~ MID-YEAR YEAR-END gg8RIER QUARTER 9LWM PRIMARY ENERAL SUPPLRAENT UPP AL 8.a. BEGINNING DATE OFR PORTING PERIOD 8.b. ENDING DATEOFREPORTINGPF.RIM April 27th, 2014 June 30th, 201.4 9. (Check one) a. This campaign is exempt from detailed disdosures because contributions (including In-kind) received total $1:,()00 or less AND expenditures total $1,000 or less for this reporting period. (Complete items 12d., 12e. and 12f.) b. [3 This campaign Is required to file a detailed financial disclosure because contributions (including in-kind) received total mci i6 than $1,000 and/or expenditures total more than $1,000 for this reporting period. 10. SIGNATURE OF AT 11. SIGNATURE OF POUTICALTREASURER I do solemnly swearor affirm that the Information contained in thiscampaign / financial disclosure report Is true and accurate. Additionally, I swear or affirm that no cam ig bu dons have been expe nded forthe personal Signalue o n dal a financial. beta of the ca Idate or for any other nonpolificat purpose as defined by the dera al revenue code. h4l `7~E 1 Signatue of Witness Vale Signature PolittcN, E Treasurer Date, Slgnatue of Witness p e rM V 12. SUMMARY a. BALANCE ON HAND LAST REPORT 21s102.50 b. TOTAL RECEIPTS THIS PERIOD . $ .1 00__ 00- - a TOTAL DISBURSEMENTS THIS PERIOD $ 360.00 d. ; QAL.ANQt ,.QN HAND (I2.a.,plus 12.b..Minus 12.c.) $20v842.50 a. TOTAL LOANS OUTSTANDING $ -0- -0- f_ TOTAL OBLIGATIONS OUTSTANDING $ 0 SS.1137 (Rev 2/06) page 1 of 2 RDA 1159 TO /TO 3Jdd AOIi'IQd3H 1 1d3SOd GZSSELZ998 EE:bi bL0Z/i0/L0 13. NAME OF CANDID SUMMARY PAGE - C ATE OR COMMITTEE (In Full) AIVpIpgTE 15. CONTR BUTTONS o 14. REPORT COVERING THE PERIOD ( other than loans a• Unite and interest) /1 TO: 6/30/14 mined Contributions ($100 or less fro FROM: 4/2 m each s b. Itemized Contributions source this (over $100 from each Period) $100.00 C- OTAL CONTRIBUTIONS source this period _ (other than loans and interest)(add 15.a $ -0 6• LOANS RECEIVED THIS REPORTING PERIOD and 15.b.) 17. INTEREST RECEIVED THIS REPORTING PERIOD $ 10 18. TOTAL RECEIPTS _ (add 15.c. 16., and -0- DISBURSEMENTS 17•) (must be shown in item 12.b.) $ 100.00 19• EXPENDITURES (other than loan payments) a• Expenditures ($100 or less each Newspaper Ads payee this period) (must be listed by category - e,y, printing. postage, gasoline) $ 360.00 $ i $ $ $ Total of Expenditures ($100 or less each payee) $ 360.00 b. Itemized Expenditures (Over $100 each payee this period) $ c. TOTAL EXPENDITURES (other than loan repayments)(add 19.a. and 19.b.) . 360.00 20. LOAN REPAYMENTS MADE THIS PERIOD -0_ 21. TOTAL DISBURSEMENTS (add 19.c. and 20.) (must be shown in item 12.c.) $ 360.00 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.) $ 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 121) 2 2 Page of AMk SS•1133 (Rev. 4/12) I` CAMPAIGN FINANCIAL DISCLOSURE STATEMENT For State and Local Judicial Single - Candidate Committees 1. DATE OF REPORT 2.a. NAME OF CANDIDATE 4/29/14 ROBERT L. HEADRICK 2.b. NAME OF CANDIDATE'S COMMITTEE 7EIECTION DATE The Committee to Reelect Judge Robert L. Headr5/6/14 4.a. CAMPAIGN ADDRESS AND PHONE Street or Rural Route City State Zip Code Phone P.O. Box 5326 Maryville TN 37802 (865)273-5530 4.b. CANDIDATE'S HOME ADDRESS (if different than 4.a.) Street or Rural Route City State Zip Code Phone 1210 Oak Park Aven Maryville TN 37803 (865) 273-5524 5. JUDICIAL OFFICE SOUGHT (include district number, if applicable) 6. NAME OF POLITICAL TREASURER General Sessions Court Div. IV Mr. Robert Goddard 7. CATEGORY OR REPORT (Check one) ❑ ❑ ❑ ❑ ❑ ❑ ❑ FIRST SECOND THIRD FOURTH PRE- PRE- MID-YEAR YEAR-END QUARTER QUARTER QUARTER QUARTER PRIMARY GENERAL SUPPLEMENTAL SUPPLEMENTAL 8.a. BEGINNING DATE OF REPORTING PERIOD 8.b. ENDING DATE OF REPORTING PERIOD April 1, 2014 April 26, 2014 9. (Check one) a. ❑ This campaign is exempt from detailed disclosures because contributions (including in-kind) received total $1,000 or less AND expenditures 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 expendit res total more than $1,000 for this reporting period. 10. SIGNATURE OF C DATE 11. SIGNATURE OF POLITICAL TREASURER I do solemnly swear or rm that the information contained in thiscampaign 4 Nj1 financial disclosur report is rue and accurate. Additionally, I swear or ~i affirm that no cam( co tri tions have been expended for the personal Signatur f Can idate ate financial benefit o the di ate or for any other nonpolitical purpose as defined by the fed ral i n revenue code. q ~9 //V y~7R>>y Signature o Witness Date Signature of Political easurer Date Signa of Witne Date 12. SUMMARY a. BALANCE ON HAND LAST REPORT $ 22,502.50 b. TOTAL RECEIPTS THIS PERIOD $ c. TOTAL DISBURSEMENTS THIS PERIOD $ 1.400-00 d. BALANCE ON HAND (12.a. plus 12.b. minus 12.c.) $ 21,102.50 e. TOTAL LOANS OUTSTANDING $ f. TOTAL OBLIGATIONS OUTSTANDING $ -O SS- 113 7 (Rev. 2/06) Page I of 9 RDA 1 159 SUMMARY PAGE - CANDIDATE 1 og OFLCAND AIE KJOMMITTEE (In Full) 14. REPORT COVERING THE PERIOD tl AllK(: FROM: 4/1/14 TO 4/26/14 RECEIPTS 15. CONTRIBUTIONS (other than loans and interest) a. Unitemized Contributions ($100 or less from each source this period) $ -0- b. Itemized Contributions (over $100 from each source this period) $ -0- c. TOTAL CONTRIBUTIONS (other than loans and interest)(add 15.a. and 15.b.) $ 16. LOANS RECEIVED THIS REPORTING PERIOD -n- 17. INTEREST RECEIVED THIS REPORTING PERIOD -0- 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) Campaign contributions $ 1,200.00 tickets $ 200.00 $ $ $ $ $ $ $ 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.) $ 1 4 no O~CI nn 20. LOAN REPAYMENTS MADE THIS PERIOD $__0_ 21. TOTAL DISBURSEMENTS (add 19.c. and 20.) (must be shown in item 12.c.) $ 1,400.00 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.) $ -0- 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 2 of 9 ITEMIZED STATEMENT OF CONTRIBUTIONS - CANDIDATE 1. NAME OF ANDIDATE OR C MMITTE FFROM: PORT CO ENG THE P RIOD ROB RT L. H ADRI K T0: 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) 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 Last ame rganization 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 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 fo item 3. of next page if additional pages of this form are used.) -0- (If this is the last page of contributions, this amount must be shown in item 15b. of summary.) SS-1131 Rev. 2/06) 3 9 ( ) Page of RDA 1159 ITEMIZED STATEMENT OF IN-KIND CONTRIBUTIONS - CANDIDATE 1. NAME OF CANDIDATE OR COMMITTEE 2. REPORT COVERING THE PERIOD ROBERT L. HEADRICK FR~ 1 /14 T0: 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 Name/Organization Name ❑ Runoff (Local Elections Only) Address Dateof 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: 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 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 Name/Organization Name ❑ Runoff (Local Elections Only) Address Date of In-Kind Contribution Aggregate this Electron city state Zip Code Descriptionofln-Kind Contribution Occupation mp 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.) - O SS-1128 (Rev. 2/06) Page 4 of RDA 1159 E:. ITEMIZED STATEMENT OF EXPENDITURES - CANDIDATE 1. NAME OF CANDIDATE OR COMMITTEE 2. REPORT COVERING THE PERIOD ROBERT L. HEADRICK FROM:4 1 1 To: 4/26/14 Amount 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/Business Name Committee to Elect Jeff Headrick campaign $100.00 Address contribution 404 Holyrood Way City State Zip Code Mar ville TN 37803 First Name Middle Name Purpose of Expenditure Amount of Expenditure Last Name/Business Name Committee to Elect Mike Ca for Campaign $100.00 Address 1200 Karina Circle contribution cityaryville s N Z" C017804 Cl First Name Middle Name Purpose of Expenditure Amount of Expenditure Last Name/Business Name Committee to Elect Tonya Burchfiel campaign $100.00 fd"l Morningside Ave contribution City State Zip Code Maryville TN 37804 First Name Middle Name Purpose of Expenditure Amount of Expenditure Last Name/Business Name Committee to Elect Steve Samples campaign $100.00 fIT7 Karina Circle contribution city State Zip Code Maryville TN 37804 First Name Middle Name Purpose of Expenditure Amount of Expenditure Last Name/Business Name Committee to Elect Mike Lewis campaign $100.00 Address 1627 St- Typs Blvd- contribution City State Zip Code Alcoa TN 37701 First Name Middle Name Purpose of Expenditure Amount of Expenditure last Name/Busjnes5e Omml ee to Elect Mark Hasty campaign $100.00 Address 552Black Sulfer Way contribution Maryville Z1A03 5. TOTAL ITEMIZED EXPENDITURES (Carry forward to item 3. of next page if additional pages of this form are used.) $600.00 (If this is the last page of expenditures, this amount must be shown in item 19b. of summary.) 4) SS-1129 (Rev. 4102) Page 5 of 9 RDA 1159 ITEMIZED STATEMENT OF EXPENDITURES - CANDIDATE 1. NAME OF CANDIDATE OR COMMITTEE 2, REPORT COVERING THE PERIOD ROBERT L. HEADRICK FROM:4 1 14 TO: 4/26/14 mount 3. TOTAL ITEMIZED CAMPAIGN EXPENDITURES FROM PRECEDING PAGE (enter $0 if first itemized page) 00 .00 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 st Name/Business Name ommittee to Elect Steve McKenzie campaign $100.00 Address 3831 Morganton Rd contribution Cit State Zi Code Maryville N X37801 First Name Middle Name Purpose of Expenditure Amount of Expenditure Last Name/Business Name Committee to Elect Kenneth Melton campaign $100.00 Address 1499 Q1d Fp-rrv Rd contribution City State Zip Code Louisville TN 37777 First Name Middle Name Purpose of Expenditure Amount of Expenditure Last Name/Business Name ommittee to Elect Rick Carver campaign $100.00 Address 1216 Redwood Ave- contribution City State Zip Code Maryville TN 37803 First Name Middle Name Purpose of Expenditure Amount of Expenditure LVdffi 'fVe&b to Elect Holden Lail campaign $100.00 A ft Alnwick Dr. contribution City State Zip Code riendsville TN 37737 First Name Middle Name Purpose of Expenditure Amount of Expenditure Last Name/Business Name Committee to Elect Tom Greene campaign $100.00 d6V Disco Loop Rd contribution City State Zip Code riendsville TN 137737 First Name Middle Name Purpose of Expenditure Amount of Expenditure La NamelBusiness Name ommittee to Elect Gerald Kirby campaign $100.00 Address 956 Scarlett Oaks Rd contribution Code Cit State Z157801 Maryville ITN 5. TOTAL ITEMIZED EXPENDITURES (Carry forward to item 3. of next page if additional pages of this form are used.) $1,200.00 (If this is the last page of expenditures, this amount must be shown in item 19b. of summary.) 4) SS-1129 (Rev. 4/02) Page 6 of 9 RDA 1159 ITEMIZED STATEMENT OF EXPENDITURES - CANDIDATE 1. NAME OF CANDIDATE OR COMMITTEE 2. REPORT COVERING THE PERIOD ROBERT L. HEADRICK FROM: /1/ 14 TO: 4/26/14 mount 3. TOTAL ITEMIZED CAMPAIGN EXPENDITURES FROM PRECEDING PAGE (enter $0 if first itemized page) It I IWO U0 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 Family Promise of Blount County tickets $150.00 Louisville Rd. City State Zip Code Alcoa TN 37701 First Name Middle Name Purpose of Expenditure Amount of Expenditure L ame/Busine ame coa iwanis tickets $50.00 Address P.O. Bog 54 cAylcoa 1*1bi 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 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.) 1,400.00 (If this is the last page of expenditures, this amount must be shown in item 19b. of summary.) 4) SS-1129 (Rev. 4102) Page 7 of 9 RDA 1159 ITEMIZED STATEMENT OF OBLIGATIONS - CANDIDATE 1. NAME OF CANDIDATE OR COMMITTEE 2. REPORT COVERING THE PERIOD ROBERT L. HEADRICK FROM: 4/1 U, T0: 3. COMPLETE THE APPROPRIATE ITEMS FOR EACH ITEMIZED Outstanding Balance Debt Incurred Payments Outstanding 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 Flrsl 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 4. TOTALS (Total from Outstanding Balance - (End of Period) column must also be shown in item 23b. on summary page.) 0- 4) (Rev. 4/02) Page 9 of 9 RDA 1159 ITEMIZED STATEMENT OF LOANS - CANDIDATE 1, NAME OF CANDIDATE OR COMMITTEE 2. REPORT COVERING THE PERIOD FROM: TO'. ROBERT L. HEADRICK 4/1/14 11.126/14 3. COMPLETE THE APPROPRIATE ITEMS FOR EACH ITEMIZED LOAN (loans totaling more than $100 from any source during the 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 Name/Organization Name Address Loan Received For: Date of Loan ❑ Primary Election ❑ General Election City 1 1 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 Stale 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 Slate 777 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 4. Totalsforall Loans (complete on lastpage ofitemized loans) Outstanding Loan Balance Loans Loan Outstanding Loan Balance (Total loans received should also be shown in item 16, on summary page.) Be innin 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.) - 9) SS-1132 (Rev. 4/02) Page 8 of 9 RDA 1159 CAMPAIGN FINANCIAL DISCLOSURE STATEMENT For State and Local Judicial Single - Candidate Committees 1. DATE OF REPORT 2.a. NAME OF CANDIDATE 4/10/14 ROBERT L. HEADRICK 2.b. NAME OF CANDIDATE'S COMMITTEE 3. ELECTION DATE The Committee to Elect Judge Robert L. Headrick 5/6/14 4.a. CAMPAIGN ADDRESS AND PHONE Street or Rural Route City State Zip Code Phone P.O. Bog 5326 Maryville TN 37802 (865) 273-5530 4.b. CANDIDATE'S HOME ADDRESS (if different than 4.a.) State Zip Code Phone Street or Rural Route City 1210 Oak Park Avenue Maryville TN 37803 (865) 273-5524 5. JUDICIAL OFFICE SOUGHT (include district number, if applicable) 6. NAME OF POLITICAL TREASURER General Sessions Court Div. IV Mr. Robert Goddard 7. CATEGORY OR REPORT (Check one) E] E3 El 1:3 El El E3 FIRST SECOND THIRD FOURTH PRE- PRE- MID-YEAR YEAR-END QUARTER QUARTER QUARTER QUARTER 8 PRIMARY GENERAL ENDING DATE OF REPORTING PERIOD SUPPLEMENTAL SUPPLEMENTAL 8.a. BEGINNING DATE OF REPORTING PERIOD January 16, 2014 March 31, 2014 9. (Check one) a. ❑ This campaign is exempt from detailed disclosures because contributions (including in-kind) received total $1,000 or less AND expenditures 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 expenditure otal more than $1,000 for this reporting period. 10. SIGNATURE OF CAN 11. SIGNATURE OF POLITICALTREASURER I do solemnly swear or affirm that the information contained in thiscampaign financial disclosure report is true and accurate. Additionally, I swear or affirm t *oflitica contributions have been expended for the personal Signatue of C dida Date fnanciandidate or for any other nonpolitical purpose as definenternal revenue code. C~ d jC y j r~1 > Signatue of Witn s D e Signateasurer Date dAaw ~~o / Signatue of Wi tness Date 12. SUMMARY 24 , 282.50 a. BALANCE ON HAND LAST REPORT $ 150.00 b. TOTAL RECEIPTS THIS PERIOD $ 1,930.00 c. TOTAL DISBURSEMENTS THIS PERIOD $ d. BALANCE ON HAND (12.a. plus 12.b. minus 12.c.) $ 22,502.50 e. TOTAL LOANS OUTSTANDING $ -0- -0- f. TOTAL OBLIGATIONS OUTSTANDING $ SS-1137 (Rev. 2/06) Page 1 of 7 RDA 1159 Nm~v SUMMARY PAGE - CANDIDATE 13. NAME OF CANDIDATE OR COMMITTEE (In Full) 14. REPORT COVERING THE PERIOD ROBERT L. HEADRICK FROM:1 16 14 To:3/31 14 RECEIPTS 15. CONTRIBUTIONS (other than loans and interest) 150.00 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.) $ 150.00 16. LOANS RECEIVED THIS REPORTING PERIOD -0- 17. INTEREST RECEIVED THIS REPORTING PERIOD -0- 18. TOTAL RECEIPTS (add 15.c., 16., and 17.) (must be shown in item 121.) 150.00 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) tickets, campaign contributions $ 350.00 $ $ $ $ $ 350.00 Total of Expenditures ($100 or less each payee) $ b. Itemized Expenditures Over $100 each payee this period) $ 1,580.00 $ 1,930.00 c. TOTAL EXPENDITURES (other than loan repayments)(add 19.a. and 19.b.) 20. LOAN REPAYMENTS MADETHIS PERIOD -0- 21. TOTAL DISBURSEMENTS (add 19.c. and 20.) (must be shown in item 12.c.) 1,930.00 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.) $ -0- 23. OBLIGATIONS a. Unitemized Obligations Outstanding ($100 or less each) $ b. Itemized Obligations Outstanding (Over $100 each) $ a TOTAL OBLIGATIONS OUTSTANDING (add 23.a. and 23.b.) (must be shown i item 121) Almhl SS-1133 (Rev. 4/02) Page 2 of 7 ITEMIZED STATEMENT OF CONTRIBUTIONS - CANDIDATE 1. NAME OF CANDIDATE OR COMMITTEE 2. REPORT COVERING THE PERIOD ROBERT L. HEADRICK FRO r0: 3/31/14 Amount 3. TOTAL ITEMIZED CAMPAIGN CONTRIBUTIONS FROM PRECEDING PAGE (enter $0 K first itemized page) 4. COMPLETE THE APPROPRIATE ITEMS FOR EACH ITEMIZED CONTRIBUTION contributions totalin 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 4Ccie Date of Contribution Aggregate This Election Occupation Employer FrstName 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 Last cation ff1e ❑ 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 5. TOTAL ITEMIZED CONTRIBUTIONS (Carry forward to item I of next page d additional pages of this form are used.) (n this is the last page of coritdbutions, this amount must be shown in item 15b. of summary.) SS-1131(Rev. 2/06) Page 3 of 7 RDA 1159 ITEMIZED STATEMENT OF IN-KIND CONTRIBUTIONS - CANDIDATE 1. NAME OF CANDIDATE OR COMMITTEE 2. REPORT COVERING THE PERIOD ROBERT L. HEADRICK FROM/16/14 TO: 3/31/14 mount 3. TOTAL ITEMIZED IN-KIND CONTRIBUTIONS FROM PRECEDING PAGE (enter $0 'ff first itemized page) 4. COMPLETE THE APPROPRIATE ITEMS FOR EACH ITEMIZED IN-KIND CONTRIBUTION (n-kind contributions totaling more Khan $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 NamelOrganization Name ❑ Runoff (Local Elections Only) Address Date of IMGnd Contnbubon Aggregate this Election State Zip Code Description or In4Gnd Contribution Oxupation Employer First Name Middle Name In-Kind Contribution Received For. Value of In-Kind Contribution ❑ Primary Election ❑ General Election Last Namr/Organization Name ❑ Runoff (Local Elections Only) Address Date orln AContritxfion Aggregate this Election City State Zip Code DesaiptiardlMGndCon bjfion 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 Dale din-lard Contribution Aggregate this Election City State Zip Code Description of h4grid Contribution Occupation LmPloYer 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-IGrd Carbibution Aggregate this Election City Stale Zip Code Description of in4Gnd Contrbution Occupation mayor First Name Middle Name In-Kind Contribution Received For. Value of In-Kind Contribution ❑ Primary Election ❑ General Election LastName/Qganization Name ❑ Runoff (Local Elections Only) Address Dale of ln-" Contribution Aggregate this Election C AY State Zip Code Description of In-Kind Contribution 5. TOTAL ITEMIZED IN-KIND CONTRIBUTIONS (Carty forward to item 3. of ne)d page if additional pages of this form are used.) (ft ft is the last page of in-kind contributions. this amount must be stw in item 22b. of summary.) SS-1128 (Rev. 2106) Page Z+ of 7 RDA 1159 ITEMIZED STATEMENT OF EXPENDITURES - CANDIDATE 1. NAME OF CANDIDATE OR COMMITTEE 2. REPORT COVERING THE PERIOD ROBERT L. HEADRICR FROM] / 16/ 1 TO 3/ 31 / 14 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) First Name Middle Name Purpose of Expenditure Amount of Expenditure Last Name/Business Name Boys and Girls Club tickets 200.00 Address 520 S. Washington St State Zip Code Gty Maryville TN 04 First Name Middle Name Purpose of Expenditure Amount of Expenditure Last elBusinessi~me rug &0urt Foundation fundraiser 130.00 Address 950 E. Lamar Alex. Pkw City Stale Zip Code Maryville TN 37804 First Name Middle Name Purpose of Expenditure Amount of Expenditure Last NamelBusiness Name Haven.House tickets 750.00 Address 101 W. Broadway Ave City State T2zJpCode Maryville TN 37801 First Name Middle Name Purpose of Expenditure Amount of Expenditure Last NameMusiness Name Blount Count Republican Par party contribution 500.00 Address city State Zip Code Alcoa TN 37701 First Name Middle Name Purpose of Expenditure Amount of Expenditure Last NamelBusiness Name Address City State ZZp Code First Name Middle Name Purpose of Expenditure Amount of Expenditure Last NamelBusiness Name Address City State Zip Code 5. TOTAL ITEMIZED EXPENDITURES (Cary forward to hem 3. of next page h additional pages of this form are used.) 1,580.00 (H this is the last page of expenditures, this amount must be shown in item 196. of summary.) Page 5 of 7 RDA 1159 SS-1129 (Rev. 4/02) ITEMIZED STATEMENT OF LOANS - CANDIDATE 1. NAME OF CANDIDATE OR COMMITTEE 2. REPORT COVERING THE PERIOD ROBERT L. HEADRICK 1916/14 TO 3/31/14 3. COMPLETE THE APPROPRIATE ITEMS FOR EACH ITEMIZED LOAN (bans totaling more than $100from any source during the pe(od) 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 o.' 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/Organizaton Name Address Address city Stale Zip Code city State Tip 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 Stale 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 C4 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 ciH State Zip Code city State Zip Code Amount Guaranteed Outstanding Amount Guaranteed Outstanding 4. Totals for all Loans (complete on last page of item¢ed loans) Outstanding Loan Balance Loans an Outstanding Loan Balance (Total bans received should also be shown in item 16. on summary page.) (Beginning of Period) Pa is (End of Period (Total ban 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.) AWL SS-1132 (Rev. 4/02) Page 6 of 7_ RDA 1159 ITEMIZED STATEMENT OF OBLIGATIONS - CANDIDATE 2. REPORT COVERING THE PERIOD 1. NAME OF CANDIDATE OR COMMITTEE ROBERT L. HEADRICK FROM:1 / 16 14 TO: 3 31 of BBalance De 3. COMPLETE THE APPROPRIATE ITEMS FOR EACH ITEMIZED Outstanding Balance bt I ncurr ed Payments Outstanding OBLIGATION (obligations totaling more than $100 owed to any (Beginning of Period) This Period This Period ( Period) person/vendor at the end of the reporting period) First Name Middle Name Last NameBusiness Name Address City State Zip Code Descripti on of obligation w e First Name Middle Name Last Nam dBusiness Name Address State Zip Code city Description of Obligation First Name Middle Name Last Name/Business Name Address CRY State Lp ode ;;s ption of obligation First Name Middle Name Last Name/Business Name Address State Zip Code aty Description orObfigation 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 Rem 23b. on summary page.) Page 7 of 7 RDA 1159 Amh SSA127 (Rev. 4102) ' I 'CAMPAIGN FINANCIAL DISCLOSURE STATEMENT For State and Local Judicial Single - Candidate Committees 1. DAT OF REPORT 12.a. NAME OF CANDIDATE 1 ~31 /14 ROBERT L. HEADRICK 2.b. NAME OF CANDIDATE'S COMMITTEE 3. ELECTION DATE The Committee to Elect Judge Robert L. Headri k 5/6/14 4.a. CAMPAIGN ADDRESS AND PHONE Street or Rural Route City State Zip Code Phone P.O. Box 5326 Maryville TN 37802 (865)273-5530 4.b. CANDIDATE'S HOME ADDRESS (if different than 4.a.) Street or Rural Route City date d p e 1210 Oak Park Avenue Maryville N iWi (8650-5524 5. JUDICIAL OFFICE SOUGHT (include district number, if applicable) 6. NAME OF POLITICAL TREASURER General Sessions Court Div. IV Mr. Robert Goddard 7. CATEGORY OR REPORT (Check one) ❑ ❑ ❑ ❑ ❑ ❑ ❑ FIRST SECOND THIRD FOURTH PRE- PRE- MID-YEAR YEAR-END QUARTER QUARTER QUARTER QUARTER PRIMARY GENERAL SUPPLEMENTAL SUPPLEMENTAL 8.a. BEGINNING DATE OF REPORTING PERIOD 8.b. ENDING DATE OF REPORTING PERIOD 7/1/13 1/15/14 9. (Check one) a. ❑ This campaign is exempt from detailed disclosures because contributions (including in-kind) received total $1,000 or less AND expenditures 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. SIGNATURE OF C IDATE / 11. SIGNATURE OF POLITICAL TREASURER I do solemnly swear or affirm that the information contained in thiscampaign financial disc) re r port is true and accurate. Additionally, I swear or affirm that n campai n contributions have been expended for the personal Signature of C didate Date financial be efit o e ndidate or for any other nonpolitical purpose as I defined by t e fe er ernal revenue code. Signature of Witness Date/ Signature of Political Tre urer Date Signature of Witness Date 12. SUMMARY a. BALANCE ON HAND LAST REPORT $ 8,383.85 b. TOTAL RECEIPTS THIS PERIOD $ 1 Q. 67 5 - 00 c. TOTAL DISBURSEMENTS THIS PERIOD $ 3.776-35 d. BALANCE ON HAND (12.a. plus 12.b. minus 12.c.) $24,282.50 e. TOTAL LOANS OUTSTANDING ......................................................................................i;:: r::.'::......... 1 $ -0- [x A u, l f. TOTAL OBLIGATIONS OUTSTANDING $ .x SS- 113 7 (Rev. 2/06) Page 1 of l6 RDA 1159 Wd Zl 0~ ~ SUMMARY PAGE - CANDIDATE 13. NAME OF CANDIDATE OR COMMITTEE (In Full) 14. REPORT COVERING THE PERIOD The Committe to ReElect Judge Headrick FROM: TO1/15/14 :7 11-111 -3 1 RECEIPTS 15. CONTRIBUTIONS (other than loans and interest) a. Unitemized Contributions $100 or less from each source this period) $$8,575.00 b. Itemized Contributions (over $100 from each source this period) $$11,100.00 c. TOTAL CONTRIBUTIONS (other than loans and interest)(add 15.a. and 15.b.) $19,675.00 16. LOANS RECEIVED THIS REPORTING PERIOD -0- 17. INTEREST RECEIVED THIS REPORTING PERIOD -0- 18. TOTAL RECEIPTS (add 15.c., 16., and 17.) (must be shown in item 12.b.) $19,675.00 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) Tickets $ 400.00 Advertisement $ 257.00 Contributions $ 300.00 P.O. Box Renewal and Postage $ 150.00 $ $ $ $ Total of Expenditures $100 or less each payee) $14107.00 b. Itemized Expenditures (Over $100 each payee this period) $2,669.35 c. TOTAL EXPENDITURES (other than loan repayments)(add 19.a. and 19.b.) $3,776,35 20. LOAN REPAYMENTS MADE THIS PERIOD -0- 21. TOTAL DISBURSEMENTS (add 19.c. and 20.) (must be shown in item 12.c.) $ -0- 22.IN-KIND CONTRIBUTIONS a. Unitemized in-kind contributions ($100 or less from each source this period) $ -0- 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.) $ 0- 23. OBLIGATIONS a. Unitemized Obligations Outstanding ($100 or less each) $ -0- b. Itemized Obligations Outstanding (Over $100 each) $ -0- c. TOTAL OBLIGATIONS OUTSTANDING (add 23.a. and 23.b.) (must be shown i item 12.f.) $ _O_ SS-1133 (Rev. 4/02) Page 2 of 16 ITEMIZED STATEMENT OF CONTRIBUTIONS - CANDIDATE 1. NAME OF CANDIDATE OR COMMITTEE 2. REPORT COVERING THE PERIOD The Committee to ReElect Robert L. Headrick FROM7/1/13 TO:.1115/14 Amount 3. TOTAL ITEMIZED CAMPAIGN CONTRIBUTIONS FROM PRECEDING PAGE (enter $0 if first itemized page) -0- 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 LastNamelorganizatlonHame ® Primary Election General Election Garza $1,000.00 Address ❑ Runoff (Local Elections Only) 74 Cherokee Blvd. City state Zip Code Date of Contribution Aggregate This Election K13 0 - 3.C TN 37803 Occupation Attorney 12/19/13 $1,000.00 Employer First Name Middle Name Contribution Received For: Amount of Contribution Bobbie Last Name/Organization Name ~Primary Election ❑ General Election $500.00 Address ❑ Runoff (Local Elections Only) C_It~ State Zip Code Date of Contribution Aggregate This Election Maryville TN 37803 u ation $500.00 Cgveech Pathologist 11/21/13 Employer First Name Iddle Name Contribution Received For: Amount of Contribution Joe ast ame rgan¢a ion ame ]Primary Election ❑ General Election $500 S .00 Cotner Address ❑ Runoff (Local Elections Only) 15 High Street City State Zip Code Date of Contribution Aggregate This Election Maryville TN 37804 Occupation 11/15/13 $500.00 Employer First Name Middle Name Contribution Received or: mount o Contribution Gregory Last Name/Organization Name Primary Election ❑ General Election $500.00 Harrison Address ❑ Runoff (Local Elections Only) Cit State Zip Code Date of Contribution Aggregate This Election Knoxville N 37929 Attorney 11/20/13 $500.00 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.) $2,500.00 3 16 SS-1131(Rev. 2/06) Page of RDA 1159 ITEMIZED STATEMENT OF CONTRIBUTIONS - CANDIDATE 1. NAME OF CANDIDATE OR COMMITTEE 2. REPORT COVERING THE PERIOD The Committee to Reflect Robert L. Headrick FROM/1/13 TO: f/15/14 ~ Amount 3. TOTAL ITEMIZED CAMPAIGN CONTRIBUTIONS FROM PRECEDING PAGE (enter $0 if first itemized page) $ 2 , 500.00 4. COMPLETE THE APPROPRIATE ITEMS FOR EACH ITEMIZED CONTRIBUTION contributions totaling more than $100 from an contributor i First Name Middle Name Contribution Received For: Amount of Contribution Tommy I Last Name/OrganizationName ~Primary Election ❑ General Election $500.00 Hindman Address ❑ Runoff (Local Elections Only) 550 Main St. Code Date of Contribution Aggregate This Election Scam Z137902 Cknoxville TN Occupation 11/20/13 Attorney $500.00 Employer First Name Middle Name Contribution Received For: Amount of Contribution andy Last Name/OrganizationName jp Primary Election ❑ General Election $500.00 Address ❑ Runoff (Local Elections Only) 3617 River Vista WaX Stain Zip Code Date of Contribution Aggregate This Election Louisville TN 37777 Occupation 11/21/13 Business Owner $500.00 Employer First Name iddle Name Contribution Received For: Amount of Contribution John Last Name/Organization Name ® Primary Election ❑ General Election 400.00 Johnson Address ❑ Runoff (Local Elections Only) City Stain Zip Code Date of Contribution Aggregate This Election Townsend ITN 37882 Occupation 11/26/13 $400.00 Retired Employer First Name Middle Name - Contribution Received or: mount of Contribution Last Name/OrganizationName jo Primary Election ❑ General Election $400.00 White & White Attorne s 1148 Phoenix Court ❑ Runoff (Local Elections Only) Date of Contribution Aggregate This Election city Smm ZipCoca 85 S PLY-11111DILL- ITN 137885 Occupation 11/21/13 - $400.00 Employer 5. TOTAL ITEMIZED CONTRIBUTIONS (Carry forward to Item 3. of next page If additional pages of this form are used.) $4,300.00 (If this is the last page of contributions, this amount must be shown In item 15b. of summary.) SS-1131(Rev. 2106) Page 4 of 16 RDA 1159 ITEMIZED STATEMENT OF CONTRIBUTIONS - CANDIDATE 1. NAME OF CANDIDATE OR COMMITTEE 2. REPORT COVERING THE PERIOD The Committee to ReElect Robert L. Headrick FROM7/1/13 TO: 1/15/14 Amount 3. TOTAL ITEMIZED CAMPAIGN CONTRIBUTIONS FROM PRECEDING PAGE (enter $0 if first itemized page) $4,300.00 4. COMPLETE THE APPROPRIATE ITEMS FOR EACH ITEMIZED CONTRIBUTION contributions totaling more than $100 from an contributor {I First Name Middle Name Contribution Received For: Amount of Contribution 1 Joseph Last Name/Organization Name g] Primary Election ❑ General Election $250.00 Mateo Address ❑ Runoff (Local Elections Only) iy2'17 Fence Rail GaI C W a l l a n d I Z'3 86 Date of Contribution Aggregate This Election Occupation Business Owner Employer $250.00 12/2/13 First Name Middle Name Contribution Received For: Amount of Contribution John Last Name/Organization Name ® Primary Election ❑ General Election 250.00 Mitchell Address ❑ Runoff (Local Elections Only) 7112 Pilgrims Parkway Ct a l l a s s e e Ith FY1b 7 8 Date of Contribution Aggregate This Election Occupation Attorney 11121/13 Employer $250.00 First Name iddleName Contribution Received For: Amount of Contribution Doug Last Name/Organization Name Primary Election ❑ General Election $250.00 Overby A Y ?Y3 Runoff (Local Elections Only) 3 Riverview Tower City State Zip Code Date of Contribution Aggregate This Election Knoxville ITN 137902 Occupation $250.00 Attorney 11/11/1.3 Employer Fi Name Middle Name - Contribution Received or: mount o Contribution ope Last Name/OrganizationName ( Primary Election ❑ General Election $250.00 Ingram 'Pr05 Robin Rd ❑ Runoff (Local Elections Only) c%a r y v i l l e lpfft 3 Date of Contribution Aggregate This Election oe ation 11/18/13 $250.00 omemaker Employer 5. TOTAL ITEMIZED CONTRIBUTIONS (Carry forward to item 3. of next page If additional pages of this form are used.) $5,300.00 (If this is the last page of contributions, this amount must be shown In Item 15b. of summary.) SS-1131(Rev. 2106) Page 5 of 16 RDA 1159 ITEMIZED STATEMENT OF CONTRIBUTIONS - CANDIDATE 1. NAME OF CANDIDATE OR COMMITTEE 2. REPORT COVERING THE PERIOD The Committee to Reflect Robert L. Headrick FROM?/l/i3 TO: 1/15/14 Amount 3. TOTAL ITEMIZED CAMPAIGN CONTRIBUTIONS FROM PRECEDING PAGE (enter $0 if first itemized page) $5,300.00 4. COMPLETE THE APPROPRIATE ITEMS FOR EACH ITEMIZED CONTRIBUTION contributions totaling more than $100 from an contributor Middle Name Contribution Received For: Amount of Contribution i First Name Last Namelorganizatlon Name KI Primary Election ❑ General Election $250.00 Breazeale [I Runoff (Local Elections Only) Y'2126 Riveroaks Place Date of Contribution Aggregate This Election Vnogville z3"22 f 11/12/13 $250.00 eon Occ antired Employer First me Middle Name Contribution Received For: Amount of Contribution .~oseph Primary Election ❑ General Election $250.00 Last Name/Organization Name Anderson Addje16 N. Heritage Dr. El Runoff (Local Elections Only) . City- State zip Code Date of Contribution Aggregate This Election ryMaryville TN 37803 Oc`Nua siness Owner 11/21/13 $250.00 Employer First Name iddle Name Contribution Received For: Amount of Contribution Craig Last Name rganiza ion ame Primary Election ❑ General Election $ 2 5 0 . 0 0 Garrett Address ❑ Runoff (Local Elections Only) 607 Smithview Dr. zip Coe Date of Contribution Aggregate This Election Iaryville ~ 7803 cl~ Occupation $250.00 Attorney 11/21/13 mp oyer First Name Middle Name Contribution eceive or: mount of Contribution Fred $250.00 Last N me/OrganizationName IJ Primary Election ❑ General Election awson Address ❑ Runoff (Local Elections Only) 2101 Cochran Rd. c g fDate of Contribution Aggregate This Election ~~Iaryville N ~03 Occupation Banker 11/12/13 $250.00 Employer 5. TOTAL ITEMIZED CONTRIBUTIONS (Carry forward to item 3. of next page n additional pages of this form are used.) $6,300.00 (If this is the last page of contributions, this amount must be shown In Item 15b. of summary.) SS-1131(Rev. 2106) Page 6 of 16 RDA 1159 ITEMIZED STATEMENT OF CONTRIBUTIONS - CANDIDATE 1. NAME OF CANDIDATE OR COMMITTEE 2. REPORT COVERING THE PERIOD The Committee to Reflect Robert L. Headrick FROM7/1/13 15/14 Amount 3. TOTAL ITEMIZED CAMPAIGN CONTRIBUTIONS FROM PRECEDING PAGE (enter $0 if first itemized page) 1$6.300.00 4. COMPLETE THE APPROPRIATE ITEMS FOR EACH ITEMIZED CONTRIBUTION contributions totaling more than $100 from an contributor First Name MlddleName Contribution Received For. Amount of Contribution Brian Last Name/OrganizationName Primary Election ❑ General Election $250.00 Ring Address ❑ Runoff (Local Elections Only) 803 Neff St Ci IN zi1118 04 Date of Contribution Aggregate This Election Maryville 1 % lsiness Owner 11/21/13 Employer $250.00 FirstName Middle Name Contribution Received For: Amount of Contribution Brent Last Name/Organization Name I~Primary Election ❑ General Election $250.00 Watson Ad" O S. Gay St. ❑ Runoff (Local Elections Only) Ci tai zip / 901 Date of Contribution Aggregate This Election ~Knogville N Occupation Attorney 11/21/13 $250.00 Employer First Name iddle Name Contribution Received For: Amount of Contribution Stephen Last Name rgamza ion ame Primary Election ❑ General Election $200.00 Headrick Address ❑ Runoff (Local Elections Only) P.O. Bog 354 Ci Stat N Zip Code Date of Contribution Aggregate This Election Townsend 37882 Occupation 11/21/13 $200.00 nt---;,q Owner mp yer First Name Middle Name Contribution Received or. mount o Contribution Rick Last Name/Organization Name ~Primary Election ❑ General Election $200.00 Walker Address ❑ Runoff (Local Elections Only) P.O. Bog 7209 city N 2IpC,pd 802 Date of Contribution Aggregate This Election Stata Maryville 1- 33 $200.00 Occupation 11/21/13 Business Owner Employer 5. TOTAL ITEMIZED CONTRIBUTIONS $7,200.00 (Carry forward to Item 3. of next page If additional pages of this form are used.) (It this is the last page of contributions, this amount must be shown In Item 151b. of summary.) 7 16 SS-1131(Rev. 2/06) Page of RDA 1159 ITEMIZED STATEMENT OF CONTRIBUTIONS - CANDIDATE 1. NAME OF CANDIDATE OR COMMITTEE E22.REEPORT COVERING THE PERIOD The Committee to Reflect Robert L. Headrick ?/1/TAm* /15/14 nt 3. TOTAL ITEMIZED CAMPAIGN CONTRIBUTIONS FROM PRECEDING PAGE (enter $0 if first itemized page) 7 , 200.00 4. COMPLETE THE APPROPRIATE ITEMS FOR EACH ITEMIZED CONTRIBUTION contributions totaling more than $100 from an contributor Middle Name Contribution Received For: Amount of Contribution First Name Tyler Last NametOrganization Name Primary Election ❑ General Election $200.00 Weiss ❑ Runoff (Local Elections Only) Atld~s~ N. College St. J'IN 3 / 354 Date of Contribution Aggregate This Election ~j'adisonville ~ Occupation Attorney 11/18/13 200.00 Employer Middle Name Contribution Received For: Amount of Contribution First Name Lynne Last Name/OrganizationName ~Primary Election ❑ General Election $200.00 Warner El Runoff (Local Elections Only) Addj14 Oak Park Ave. city1 state Zip Code Date of Contribution Aggregate This Election Maryville ITS 03 Occueationaltor R 11/21/13 $200.00 Employer FirstName iddleName Contribution Received For: Amount of Contribution Richard Last Name/Organization Primary Election E] General Election $200.00 Name Address ❑ Runoff (Local Elections Only) 12719 Tanglew nd Dr. StVN Zip Code Date of Contribution Aggregate This Election city~noaville 37922 Occup 'on 11/21/13 1usiness Owner $200.00 mp yer FirstName Middle Name Contribution Received or: mount o Contribution Alfred Last Name/Organization Name Primary Election ❑ General Election $200.00 Redwine d~e ' ❑ Runoff (Local Elections Only) Ad 1~0$ Hitch Rd . zl Code Date of Contribution Aggregate This Election c"'Maryville 57804 Occupation 11/21/13 $200.00 Employer 5. TOTAL ITEMIZED CONTRIBUTIONS (Carry forward to Item 3. of next page If additional pages of this forth are used.) $8,000.00 (If this is the last page of contributions, this amount must be shown In Item 15b. of summary.) 8 16 SS-1131(Rev. 2106) Page of RDA 1159 ITEMIZED STATEMENT OF CONTRIBUTIONS - CANDIDATE 1. OF CANDIDA 1E OR COMMITTEE 2. REPORT COVERING THE PERIOD NAME The Committee to ReElect Robert L. :HHe:aaddrick:ck] FROM. / 1 / 13 T0: 1 /15/14 Amount $8,000.00 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 Amount of Contribution Middle Name Contribution Received For: First me ichard g] Primary Election ❑ General Election $ 2 0 O.0 O Last Name/Organization Name Wa ❑ Address Runoff (Local Elections Only) Q •~Q~--~-$ Date of Contribution Aggregate This Election State O~Walland TN Zip 37 Code 886 Occupation $ 2 O 0.O 0 Business Owner 11/26/13 Employer Middle Name Contribution Received For: Amount of Contribution First Name Primary Election ❑ General Election $200.00 Address Last NamelOrganization Name El Runoff (Local Elections Only) ry Aggregate This Election 675 Mor ant n uare state N Zrp3Code 7 801 ' Date of Contribution aryville Occupation $200 .00 Attorneys 11/12/13 Empbyer Contribution Received For: Amount of Contribution fiddle Name First Name Margaret General Election )0, Primary Election C] $200.00 ame 1 ❑ Runoff (Local Elections Only) F ters Ridge Dr . Aggregate This Election state Zip Code Date of Contribution gg g le TN 37803 $ 2 0 0 .0 0 11/11/13 Contribution eceive or: mount o Contribution First Na= t Middle Name k met Election E3 General Election $200.00 Last Name/Organization Name ❑ Runoff (Local Elections Only) Address FEmployer 5 stare ZlpCode Date of Contribution Aggregate This Election TN •37803 ar ville tion 10 / 30 / 13 tate Re resentative $200.00 IZED CONTRIBUTIONS $8,800.00 5. TOTAL ITEM (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.) Page 9 of 16 RDA 1159 SS-1131(Rev. 2106) ITEMIZED STATEMENT OF CONTRIBUTIONS - CANDIDATE 1. NAME OF CANDIDATE OR COMMITTEE 2. REPORT COVERING THE PERIOD The Committee to ReElect Robert L. Headrick FROM7/1/13 TO: 1/15/14 Amount 3. TOTAL ITEMIZED CAMPAIGN CONTRIBUTIONS FROM PRECEDING PAGE (enter $0 if first itemized page) $8-800,00 4. COMPLETE THE APPROPRIATE ITEMS FOR EACH ITEMIZED CONTRIBUTION contributions totaling more than $100 from an contributor First Name MlddleName Contribution Received For: Amount of Contribution Ben Last Name/organizationName [ Primary Election ❑ General Election $200.00 Rarnott- Address ❑ Runoff (Local Elections Only) 422 S, Gal St Cit~ State Zip Code Date of Contribution Aggregate This Election Knoxville TN 37902 Occupation Attorney 11/20/13 Employer $200.00 First Name Middle Name Contribution Received For: Amount of Contribution Last Name/OrganizationName [ Primary Election ❑ General Election $200.00 Address ❑ Runoff (Local Elections Only) 611 Smithview Dr. ty State zip Code Date of Contribution Aggregate This Election aryville 37803 Occupation Attorneys 11/22/13 Employer $200.00 First Name iddleName Contribution Received For: Amount of Contribution Donald Last ame rganaawn Name ERPrimary Election ❑GeneralElection $200.00 Address ❑ Runoff (Local Elections Only) P.O. Bog 242 CIt~ State Zip Code Date of Contribution Aggregate This Election Townsend TN 37882 Occupation Bus" 11/21/13 $200.00 mp yei First Name Middle Name Contribution Received or: mount of Contribution .0% vi -z n n Last Name/Organization Name Primary Election ❑ General Election $300.00 Headrick ❑ X4r Hollyrood Way Runoff (Local Elections Only) Cha r y v i l l e S~ FPCI~803 Date of Contribution Aggregate This Election Occupation Realtor 11/21/13 $300.00 Employer 5. TOTAL ITEMIZED CONTRIBUTIONS (Carry forward to item 3. of next page If additional pages of this form are used.) $9,700.00 (If this is the last page of contributions, this amount must be shown In item 15b. of summary.) 10 SS-1131(Rev. 2/06) Page of 16 RDA 1159 i i ITEMIZED STATEMENT OF CONTRIBUTIONS - CANDIDATE 1. NAME OF CANDIDATE OR COMMITTEE 2. REPORT COVERING THE PERIOD Committee to ReElect Judge Robert L. :Re:adri~ck FROM:?/1/13 TO: 1/15/14 3. TOTAL ITEMIZED CAMPAIGN CONTRIBUTIONS FROM PRECEDING PAGE (enter $0 if first itemized page) A$ 9u , 7 00.00 4. COMPLETE THE APPROPRIATE ITEMS FOR EACH ITEMIZED CONTRIBUTION contributions totalin more than $100 from an contributor $ First Name Middle Name Contribution Received For: Amount of Contribution Last Name/Organization Name ® Primary Election ❑ General Election S&K Dry Cleaning $250.00 1429 Kingston Pike ❑ Runoff (Local Elections Only) rh o x v i l l e 1 Z"J" 21 Date of Contribution Aggregate This Election cupabop ~usiness Owner Employer 11/22/13 $250.00 First Name Middle Name Contribution Received For: Amount of Contribution Steve Last NamOOrganization Name L1 Primary Election ❑ General Election $200.00 _q t- i I t- 'Z Address ❑ Runoff (Local Elections Only) City_ state Zip Code Date of Contribution Aggregate a r y v i l l e TN 3 780 2 $ This Election Occupation $ 200.00 Business Owner Employer 11/21/13 First Name Iddle Name Contribution Received For: Amount of Contribution Nicholas ast ame rgamza ron ame [ Primary Election [3 General Election Bunstine $250.00 Address C] Runoff (Local Elections Only) ` 800 S. Gay Street ci ty state Zip Code Date of Contribution Aggregate This Election Knoxvillt, ITN '17Q90 Occupation Attorney 11/20/13 $250.00 Employer First Name Middle Name Contribution Received or: Jerrold mown o Contribution Last Name/Organization Name Primary Election ❑ General Election Becker dre $250.00 Ad 1 j 14 Wheaton Pl. ❑ Runoff (Local Elections Only) citK n o x v i l l a i Zip j" 19 Date of Contribution Aggregate This Election Occupation Attorney 11/21/13 $250.00 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.) M,650.00 SS-1131(Rev. 2106) Pagel 1 of 16 RDA 1159 ITEMIZED STATEMENT OF CONTRIBUTIONS - CANDIDATE 1. NAME OF CANDIDATE OR COMMITTEE t2. EPORT COVERING THE PERIOD Committee to Reflect Judge Robert L. Headrick M:7/1/13 TO: 1/15/14 mount 3. TOTAL ITEMIZED CAMPAIGN CONTRIBUTIONS FROM PRECEDING PAGE (enter $0 if first itemized p$10 , 650.00 4. COMPLETE THE APPROPRIATE ITEMS FOR EACH ITEMIZED CONTRIBUTION contributions totalin more than $100 from an contributor First Name Middle Name Contribution Received For: Amount of Contribution Last Name/Organization Name R] Primary Election General Election $250.00 LeConte Realty, LLC Address ❑ Runoff (Local Elections Only) 604 Crawford Street Ci State ZI Code Date of Contribution Aggregate This Election Maryville TN x/804 ~ealtors 11/21/13 $250.00 Employer First Name Middle Name Contribution Received For: Amount of Contribution William Last Name/Organization Name Primary Election ❑ General Election $200.00 Ad 3038 dress ❑ Runoff (Local Elections Only) m ions Dr. City S Zi Date of Contribution Aggregate This Election Maryville 1tatm °3 boo Occupation 11/21/13 $200.00 Employer First Name lddleName 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 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.) $11,100.00 SS-1131(Rev. 2/06) Page 12 of 16 RDA 1159 ITEMIZED STATEMENT OF IN-KIND CONTRIBUTIONS - CANDIDATE 2. REPORT COVERING THE PERIOD 1. NAME OF CANDIDATE OR COMMITTEE Committee to Reflect Jud a Robert L. Headrick FROM? 1 13 Toounl5 14 -0- 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 Namelorganization Name ❑ Runoff (Local Elections Only) Date of In-Kind Contribution Aggregate this Election Address 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 El Primary Election 1:1 General Election Last Name/Organization Name ❑ Runoff (Local Elections Only) Date of In-Kind Contribution Aggregate this Election Address 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 E] Primary Election ❑ General Election Last NamelOrganiza6on Name ❑ Runoff (Local Elections Only) Date of In-Kind Contribution Aggregate this Election Address 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 NamelOrganizabon 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 FirstName 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 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.) (If this is the last page of in-kind contributions, this amount must be shown in item 22b. of summary.) Page 13 of 16 RDA 1159 SS-1128 (Rev. 2106) ITEMIZED STATEMENT OF EXPENDITURES - CANDIDATE 1. NAME OF CANDIDATE OR COMMITTEE 2. REPORT COVERING THE PERIOD Committee to ReElect Judge Robert L. Headrick FROM T0: 1/15714 mount 3. TOTAL ITEMIZED CAMPAIGN EXPENDITURES FROM PRECEDING PAGE (enter $0 if first itemized page) -0- 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 Bill Haslam Campaign 2014 Contribution $500.00 Address City State Zip Code Nashville TN First Name Middle Name Purpose of Expenditure Amount of Expenditure Last Name/Business Name Blount Count Chamber of Commerce Dues $125.00 Address 201 S. Washington St. Zipcl~ 804 Garyville First Name Middle Name Purpose of Expenditure Amount of Expenditure Last Name/Business Name United States Postal Service Postage for Address Fundraiser $230.00 City State Zip Code Narhville TN 37803 First Name Middle Name Purpose of Expenditure Amount of Expenditure Last Name/Business Name lamar- Copy and Pr-inting Invitations $343.52 Address 329 SandprR St- City State Zip Code Alcoa TN 37701 First Name Middle Name Purpose of Expenditure Amount of Expenditure Last NamelBusiness Name Sul livans Downtown Reception 1,220.83 Y2si W. Broadyway ryville '11b04 First Name Middle Name Purpose of Expenditure Amount of Expenditure Last Name/Business Name Lincoln Day Tickets $250.00 Address CAa r y v i l l e Stafa. Zip Code 5. TOTAL ITEMIZED EXPENDITURES 11Y (Carry forward to item 3. of next page if additional pages of this form are used.) $2,669.35 (If this is the last page of expenditures, this amount must be shown in item 19b. of summary.) 0 SS-1129 (Rev. 4/02) Page 14 of 16 RDA 1159 ITEMIZED STATEMENT OF LOANS - CANDIDATE 1. NAME OF CANDIDATE OR COMMITTEE 2. REPORT COVERING THE PERIOD Committee to ReElect Judge Robert L. Headrick FROM: T0: 7/1/13 11/15/14 3. COMPLETE THE APPROPRIATE ITEMS FOR EACH ITEMIZED LOAN (loans totaling more than $100 from any source during the 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 Name/Organization 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 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 77-t77 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 4. Totals forall 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.) Be innin 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.) -0- _L5 SS-1132 (Rev. 4/02) Page of 6 RDA 1159 ITEMIZED STATEMENT OF OBLIGATIONS - CANDIDATE 1. NAME OF CANDIDATE OR COMMITTEE 2. REPORT COVERING THE PERIOD Committee to Reflect Judge Headrick FROM' 7 1 3 TO; 1/15/14 3. COMPLETE THE APPROPRIATE ITEMS FOR EACH ITEMIZED Outstanding Balance Debt Incurred Payments Outstanding 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 Flrst 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 4. TOTALS (Total from Outstanding Balance - (End of Period) column must also be shown in item 23b. on summary page.) -0- SS-1127 (Rev. 4/02) Page 16 of 16 RDA 1159 I Print Form 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 check with 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 o andidate or Committee: 3. Candidate e-mail address: L3 4. Ca paign Address and Ph ne: City State Zip Code Phone f.z,- A~x /i ~~ii /W 3INY 2~3- szy ng 5. Home Address and Phone (if different than ite 4 a ove): Cit State Zip Code Phone 121,9 OA6 AVk /6-4- / 111~?o4ee z /-ju 3??D9_ 6. Office Sought (include district number, if applicable) 7. Party ffliation 8. Election Year 9. Treasurer Name: 10. Treasurer e-mail address: 54~ 11. Treasurer Address and Phone: City State Zip ode Phone Wr J~4 12. Candidate and Treasurer Sign ure (both signatures must be witnessed. Treasurer can n witness candidate's signature): i Can11 12 PAM gnature of Treasurer jr~e'didate natuof Cb 3'►~ 1Si ~'Yti ~B yU L° gnature of Witness ~,l~l nature of Witness C_k Registry of Election Finance SS-1120 (rev 10/2010) 07/15/2013 MON 14:38 FAX 8652735927 Blount Cc Election 0004/O10 CAMPAIGN FINANCIAL DISCLOSURE STATEMENT For State and Local Judicial Single - Candidate Committees 1. DATE OF REPORT 12.a. NAME OF CANDIDATE 7/15/13 Robert L. Headrick 2.b. NAME OF CANDIDATE'S COMMITTEE 3. ELECTION DATE The Committee to Elect Judge Robert L. Headrick 4.a. CAMPAIGN ADDRESS AND PHONE Street or Rural Route City State Zip Code Phone P.O. Box 5326 Maryville TN 37802 (865) 273-5530 4.b. CANDIDATE'S HOME ADDRESS (if different than 4.a.) Street or Rural Route City State Zip Code Phone 1210 Oak Park Ave. Maryville TN 37803 (865) 273-5524 5. JUDICIAL OFFICE SOUGIiT (include district number, if applicable) 6. NAME qF POLITICAL TREASURER General Sessions Court Judge, Div IV Mr. Robert Goddard 7. CATEGORY OR REPORT (Check one) 1:1 0 FIRS 1 SECOND THIRD FOUR TH PRE- PRE- MID-YEAR YEAR-END QUARTER QUARTER QUARTER QUARTER PRIMARY GENERAL SUPPLEMENTAL. SUPPLEMENTAL 8.a. BEGINNING DATE OF REPORTING PERIOD 8.b. ENDING DATE OF REPORTING PERIOD January 16, 2013 June 30, 2013 g (Checkone) a. ❑ This campaign is exempt from detailed disclosures because contributions (including in-kind) received total $1,000 or less AND expenditures 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 mere than $1,000 for this reporting period. 10. SIGNATURE OF CANDID 11. SIGNATURE OF POLITICALTREASURER I do solemnly swear or affirm that the information contained in thiscampaign 17)1 ~ 3 financial disclosure report is true and accurate. Additionally, I swear or affrm 91-no car pai n contributions have been expended for the personal Signalu Can le Date finan alb ne f th ndida e or for any other nonpolitical purpose as ~f define b f ral nt I evenue code. Sig e of Witnes, Date Signatur of Political Treasurer Date 4~tul Date 12. SUMMARY a. BALANCE ON HAND LAST REPORT $ 9 , OO2.18 b. TOTAL RECEIPTS THIS PERIOD $ c. TOTAL DISBURSEMENTS THIS PERIOD $ 618.33 d. BALANCE ON HAND (12.a. Plus 12.b. minus 12.c.) - $8,383-85 e. TOTAL LOANS OUTSTANDING f. TOTAL OBLIGATIONS OUTSTANDING 0 $ SS-1137 (Rev. 2/06) J ( ~FCF Page I of__ 1 . ✓✓~j F~ 1 MA 1159 L'1 wd Zl ~ti SUMMARY PAGE - CANDIDATE 13 . NAME OF CANDIDATE OR COMMITTEE (In Full) 14. REPORT COVERING THE PERIOD ROBERT L. HEADRICK FROM: TO: 12/31/12 RECEIPTS 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) $ $ 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 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.) $ 23. OBLIGATIONS a. Unitemized Obligations Outstanding ($100 or less each) b. Itemized Obligations Outstanding (Over $100 each) $ Q TOTAL OBLIGATIONS OUTSTANDING (add 23.a. and 23.b.) (must be shown i item 12.f.) $ f 2 7 AOL P't' i oc 4411 Maw em91 Page 0 STATEMENT OF CONTRIBUTIONS -CANDIDATE ITEMIZED 2. REPORT COVERING THE PERIOD 1. NAME OF CANDIDATE OR COMMITTEE FROM:- I 1 11 n T012 3 ROBERT L. HEADRICK Amount 3. TOTAL ITEMIZED CAMPAIGN CONTRIBUTIONS FROM PRECEDING PAGE t nter$0 t irst itemized than a$Ioo ge from an contribute 4. COMPLETE THE APPROPRIATE ITEMS FOR EACH ITEMIZED CONTRIBUTION Amount of Contribution Middle Name Contribution Received For: First Name ❑ Primary Election [I General Election Last NamelOrganizaton Name E-3 Runoff (Local Elections Only) dress Aggregate This Election State Zip Code Date of Contribution City Occupation Employer Amount of Contribution Middle Name Contribution Received For: Flrst Name ❑ Primary Election ❑ General Election Last NamelOrganization Name ❑ Runoff (Local Elections Only) Address Date of Contribution Aggregate This Election Stale Zip Code City Occupation Employer Amount of Contribution iddle Name Contribution Received Foc FrstName Primary Election ❑ General Election s a anizatwn ame Runoff (Local Elections Only) Address Date of Contribution Aggregate This Election State Zip Code city occupation Yef mount To ntn ubon MtddleName ontn ution Received or: First Name ❑ Primary Election ❑ General Election Last NamelOrganizalion Name ❑ Runoff (Local Elections Only) Address Date of Contributi on Aggregate This Election State Zip Code city occupation Employer L(Ifthis TOTALITEMIZED CONTRIBUTIONS (Carty forward to Rem 3. of next page I additional pages of this form are used.) is the last page of contributions, this amount must be shown in item i 5b. of summary.) 3 7 of RDA 1159 SS-1131(Rev. 2/06) Page ITEMIZED STATEMENT OF IN-KIND CONTRIBUTIONS - CANDIDATE !FR REPORT COVERING THE PERIOD 1. NA__K )GK'1' ILAT HI;All ~CKEE OM:7~1~12 TO:12 31 12 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) Middle Name In-Kind Contribulion Received For: Value of In-Kind Contribution First Name ❑ Primary Election 11 General Election Last NameAkganization 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 Dale of In-Kind ContriMon Aggregate this Election ally Stale 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 NamefOrganization Name ❑ Runoff (Local Elections Only) Address Dale of In-Kind Contribution Aggregate this Election City Stale Zip Code Description of In-Kind Contribution Occupation Ye First Name Middle Name In-Kind Contribution Received For. Value of In-Kind Contribution ❑ Primary Election ❑ General Election Last NamefOrganization Name ❑ Runoff (Local Elections Only) Address Date of In4Qnd Contribution Aggregate this Election city Slate Zip Code Description of In-Kind Contribution Occupation Employer First Name Middle Name In-Kind Contribution Received For: Value of In-Kind Contribution E] Primary Election General Election Last NamelOrganization Name ❑ Runoff (Local Elections Only) Address Dale of In-Kind Contribution Aggregate this Election City Stale Zip Code Description of In-Kind Contribilion Occupation 5. TOTAL ITEMIZED IN-KIND CONTRIBUTIONS (Carry forward to item 3. of next page if additional pages of this forth are used.) (K this is the last page of in-kind contributions, this amount must be shown in Item 22b. of summary.) SS4128 (Rev. 2/06) Page of RDA 1159 ITEMIZED STATEMENT OF EXPENDITURES - CANDIDATE 1. NAME OF CANDIDATE OR COMMITTEE =F~ROMI/1/IZ' RT COVERING THE PERIOD Robert L. Headrick T012 31 12 oun 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 $1 oo to any payee during the period) First Name Middle Name Purpose of Expenditure Amount of Expenditure draising Membership Last NamelBusinessName Blount county chamber of Commerce Fun Drive $170.00 AIM S. Washington St. G Zip Code Maryville 37804 First Name Middle Name Purpose of Expenditure Amount of Expenditure Lest Name/Business Name Address City Slate lip Code First Name Middle Name Purpose of Expenditure Amount of Expenditure Last Name/Business Name Address City Slate Zip Code First Name Middle Name Purpose of Expenditure Amount of Expenditure Last Norm/Business Name Address city state Zip Code First Name Middle Name Purpose of Expenditure Amount of Expenditure Lost Nameausiness Name Address City State Zip Code First Name Middle Name Purpose of Expenditure Amount of Expenditure Last NamelBusiness Name Address City State Zip Code 5. TOTAL ITEMIZED EXPENDITURES $170.00 (Carty forward to item J. of next page it additional pages of this form are used.) (if this Is thelast page of expenditures, this amount must be shown in item 19b. of summary.) Page 5 of 7 RDA 1159 SS-1129 (Rev. 4102) ITEMIZED STATEMENT OF LOANS - CANDIDATE 2. REPORT COVERING THE PERIOD T0: 1. NAME OF CANDIDATE OR COMMITTEE FRpi /12 12/31/12 ']~j ROBERT L. HEADRICK PROPRIATE ITEMS FOR EACH ITEMIZED LOAN (loans totaling more than $100 from any source during the period) 3. COMPLETE THE AP LLoan Outstanding Loan Balance Complete the Following for the Source =tl lance Loans End of Period) First Name d) Received Payments Last NamelOrgenization Name Oale of Loan : Address on ❑ Primary Election [I General Electi Gty Stale Zip Code ❑ Runoff (Local Elections Only) First N All Endorsers or Guarantors for Above Loan (If more space is needed please attach a page) Middle Nana List ame Middle Name First Name Last Name/Organization Name Last Name organization Name Address Address Stale Zip Code City State Zip Code city mount 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 Gly State Zip Code Amount Guaranteed Outstanding Amount Guaranteed Outstanding First Name Middle Name first Name Middle Name LA melOrganization Name Last Namelorganization Name FAddun ress Slate State Zip Code t Guaranteed Outstanding t Gua ranteed Outstanding First Name Middle Namame Middle Name Lest Name/Organization Name Last Name/Organization Name Address Address City State Zip Code City State Zip Code mount Guaranteed Outstanding Amount Guaranteed Outstanding Oulslandin Loan Balance Loans Loan Outstanding Loan Balance 4. Totals forall Loans (complete on last page of itemized loans) g End of Period (Total bans received should also be shown in item 16. on summary page.) (Beginning of Period Received Payments (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.) 6 of RDA 1159 SS-1132 (Rev. 4102) Page ITEMIZED STATEMENT OF OBLIGATIONS -CANDIDATE 2. REPORT COVERING THE PERIOD 1. NAME OF CANDIDATE OR COMMITTEE ROBERT L HEADRICK FROM:? /1 / 12 TO: 12 31 1 Outstanding Balance . 3. COMPLETE THE APPROPRIATE ITEMS FOR EACH ITEMIZED Bets In no pea o nce Debt This Period Incurred This Payments Period (End of Period) OBLIGATION (obligations totaling more than $100 owed to any 9n ni 9 personivendor at the end of the reporting period) First Name Middle Name Last Nam musiness Name Address state Zip Code city Description of Obligation First Name Middle Name Last Na usmess Name Address City State Tip Code Description of Obligation First Name Middle Name Last Nam dBusiness Name Address City State Zip Code Descrip6an of Obligation First Name Middle Name Last Nam dBusiness Name Address City State Zip Cade Description of Obligati an Middle Name First Name Last NameMusiness Name Address State Zip Code city Description of Obligation 4. TOTALS (Total from Outstanding Balance - (End of Period) column must also be shown in Item 23b. on summary page.) Page 7 of 7 RDA 1159 JW SS-1127 (Rev. 4102) CAMPAIGN FINANCIAL DISCLOSURE STATEMENT For State and Local Judicial Single - Candidate Committees 1. DATE OF REPORT I2.a. NAMF_QF_CANDIDATE January 31st 2012 2.b. NAME OF CANDIDATE'S COMMITTEE 3. ELECTION DATE The Committee to Elect Judge Robert L. Headrick 4.a. CAMPAIGN ADDRESS AND PHONE Street or Rural Route City TSttate 3T8'02 e Phone P.O. Box 5326 Maryville (865) 273-5530 4.b. CANDIDATE'S HOME ADDRESS (if different than 4.a.) Street or Rural Route City State Zpi Code Phone 1210 Oak Park Ave. Maryville TN 3/803 (865) 273-5524 5. JUDICIAL OFFICE SOUGHT (include district n!Div. ber, if applicable) 6. NAME OF POLITICAL TREASURER General Sessions Court Judge IV Mr. Robert Goddard 7. CATEGORY OR REPORT (Check one) ❑ ❑ ❑ ❑ ❑ FIRST SECOND THIRD FOURTH E] RTH PRE- PRE- MID-YEAR YEAR-END QUARTER QUARTER QUARTER QUARTER PRIMARY GENERAL SUPPLEMENTAL SUPPLEMENTAL 8.a. BEGINNING DATE OF REPORTING PERIOD ff8b. NDINGDATEOFREPORTINGPERIOD Jul 1 2011 anuar y 15, 2012 9. (Check one) a. ® This campaign is exempt from detailed disclosures because contributions (including in-kind) received total $1,000 or less AND expenditures 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. SIGNATURE OF CA DIDA 11. SIGNATURE OF POLITICALTREASURER I do solemnly swear or affirm that the information contained in thiscampaign /hs financial disclosure report is true and accurate. Additionally, I swear or affirm that no campai ibutions have been expended for the personal Signatue of Can Date financial bene of the idate or for any other nonpolitical purpose as defined by the dera i I venue code. Signatue of Witness D e Signature of Polit c l I urer 113111 Date AI 1, ignatue of Witness ate 12. SUMMARY a. BALANCE ON HAND LAST REPORT $ 10,825.75 b. TOTAL RECEIPTS THIS PERIOD $ c. TOTAL DISBURSEMENTS THIS PERIOD $ 745.75 d. BALANCE ON HAND (12.a. plus 12.b. minus 12.c.) $ 10,080.00 e. TOTAL LOANS OUTSTANDING -0 f. TOTAL OBLIGATIONS OUTSTANDING $ -O SS-1137(Rev.2/06) Page 1 of _7 RDA 1159 SUMMARY PAGE - CANDIDATE 13 . NAME OF CANDIDATE OR COMMITTEE (In Full) 14. REPORT COVERING THE PERIOD RUBERT L. HEADRICK FROM?/ 1 / 11 T0. 1 1 RECEIPTS 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) $ 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 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.) $ 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 121) $ ~.eo ro gym" Page 2 of 7 ITEMIZED STATEMENT OF CONTRIBUTIONS - CANDIDATE 1. NAME OF CANDIDATE OR COMMITTEE 2. REPORT COVERING THE PERIOD ROBERT L. HEADRICK 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 totalin more than $100 from an contributor First Name MddleName 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 Arst Name Middle Name Contribution Received For: Amount of Contribution Last Name/Organization Name ❑ Primary Election ❑ General Election Address ❑ Runoff (Local Elections Only) Ctty Slate Zip Code Date of Contribution Aggregate This Election Occupation Employer FirstName iddleName Contribution Received Foy: Amount of Contribution s ame anization 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: Amount o Contribution Last Name/OrganizationName ❑Primary Election ❑ General Election Address ❑ Runoff (Local Elections Only) City Stale Zip Code Date of Contribution Aggregate This Election Occupation Employer 5. TOTAL ITEMIZED CONTRIBUTIONS (Carry forward to item 3. of next paged 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.) 3 7 SS-1131(Rev. 2/06) Page of RDA 1159 ITEMIZED STATEMENT OF IN-KIND CONTRIBUTIONS - CANDIDATE 1. NAMka fff IEATETACllllll~~ Yr JTEE 2. REPORT COVERING THE PERIOD xx FROM: T0: recur 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 Last NameJOrganization Name ❑ Primary Election ❑ General Election ❑ Runoff (Local Elections Only) Address Date of in-Kind ContritwUon 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 ConMbfion 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 El General Election Last Name/Organization Name ❑ Runoff (Local Elections Only) Address Dateorln-Kind Contritultor Aggregate this Election City Stale Zip Code Description of In-Kind Contribution Occupation yer Rrst 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 Stale 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 LastNameoganiration Name ❑ Runoff (Local Elections Only) Address Date of In-Kind Contribution Aggregate this Election City Stale Zip Code Description of In-Kind Contribution uccupation 5. TOTAL ITEMIZED IN-KIND CONTRIBUTIONS (Carry forward to item 3. of rrA 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-1128 (Rev. 2/06) Page of RDA 1159 ITEMIZED STATEMENT OF EXPENDITURES - CANDIDATE MA E OF CANDIDATE OR HEADRICKMMITTEE 2. REPORT COVERING THE PERIOD FROM:7/1/11 TO:1/15 12 Amount 3. TOTAL ITEMIZED CAMPAIGN EXPENDITURES FROM PRECEDING PAGE (enter $0 if first itemized page) -0- 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 Friends of D .0 Qu-Q - rhy campaign contribution 150.00 Address P.0 Box 5316 ryville STtate N L378e02 First Name Middle Name Purpose of Expenditure Amount of Expenditure Last Name/Business Name Address City State Zip Code First Name Middle Name Puipose 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 NamefBusiness 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 NamsAusiness 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.) Of this is the last page of expenditures. this amount must be shown in item 19b. of summary.) 150.00 W SSA129 (Rev. 4/02) Page 5 7 Of RDA 1159 ITEMIZED STATEMENT OF LOANS - CANDIDATE 1. NAME OF CANDIDATE OR COMMITTEE 2. REPORT COVERING THE PERIOD ROBERT L. HEADRICK FROM: TO: 3. COMPLETE THE APPROPRIATE ITEMS FOR EACH ITEMIZED LOAN (loans totaling more than $100 from any source during the 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 Name/Organization Name Address Loan Received For: Date of Loan ❑ Primary Election ❑ General Election city State . Zip Code ❑ RunofT(LocalElecOonsOnly) Llst 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 NamelOrganlzation Name Address Address city Slate Zip Code City State Zip Code Amount Guaranteed Outstanding mount Guaranteed Outstanding First Name Middle Name First Name Middle Name Last NamelOrganization Name Last NamelOrganizationName Address Address city State Zip Code city Stale Zip Code Amount Guaranteed outstanding mount Guaranteed Outstanding First Name Middle Name First Name Middle Name Last Name/Organization Name Last NamelOrganization Name Address Address Gty State 7;p Cade city, Stale Zip Code Amount Guaranteed Outstanding mount Guaranteed Outstanding First Name Middle Name First Name Middle Name Last Name/Organization Name Last NamelOrganization Name Address Address city State Zip Cade city Stale 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 bans received should also be shown in item 16. on summary page.) (Beginning of Period Received Payments End of Period (Total ban paymenls 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. 4/02) Page 6 of 7 RDA 1159 ITEMIZED STATEMENT OF OBLIGATIONS - CANDIDATE [3. . NA:ROBERT F CANDIDATE OR COMMITTEE 2. REPORT COVERING THE PERIOD L. HEADRICK FROM: TO: COMPLETE THE APPROPRIATE ITEMS FOR EACH ITEMIZED Outstanding Balance Debt Incurred Payments Outstanding 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 Nam4usiness 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 Rrst Name Middle Name Last Name/Business Name Address City State Zip Cade Description of Obligation First Name Middle Name Last NarrrAusiness Name Address aty State Zip Code Description of obligation 4.TOTALS (Total from Outstanding Balance - (End of Period) column must also be shown in hem 23b. on summary page.) JW SS-1127 (Rev. 4/02) Page of 7 RDA 1159 CAMPAIGN FINANCIAL DISCLOSURE STATEMENT For State and Local Judicial Single - Candidate Committees 1. DATE OF REPORT 12.a. NAMF.,QF_CANDIDATE 7/20/11 2.b. NAME OF CANDIDATE'S COMMITTEE 3. ELECTION DATE The Committee to Elect Judge Robert L. Headrick 4.a. CAMPAIGN ADDRESS AND PHONE Street or Rural Route City State N Code Phone P.O. Box 5326 Maryville TN 3/802 (865) 273-5530 4.b. CANDIDATE'S HOME ADDRESS (if different than 4.a.) Street or Rural Route City State Zi Code Phone 1210 Oak Park Ave. Maryville TN 3803 (865) 273-5524 5. JUDICIAL OFFICE SOUGHT (include district number, if applicable) 6. NAME OF POLITICAL TREASURER General Sessions Court Judge Div. IV Mr. Robert Goddard 7. CATEGORY OR REPORT (Check one) ❑ ❑ ❑ ❑ ❑ ❑ ❑ FIRST SECOND THIRD FOURTH PRE- PRE- MID-YEAR YEAR-END DARTER QUARTER QUARTER QUARTER PRIMARY GENERAL SUPPLEMENTAL SUPPLEMENTAL 8.a. BEGINNING DATE OF REPORTING PERIOD 8.b. ENDING DATE OF REPORTING P RIOD January 16th, 2011 June 30th, 20'1 9. (Check one) a. This campaign is exempt from detailed disdosures because contributions (including in-kind) received total $1,000 or less AND expenditures 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. SIGNATURE OF CANDIDATE 11. SIGNATURE OF POLITICALTREASURER I do solemnly swear or affirm that the information contained in thiscampaign financial disclosure report is true and accurate. Additionally, I swear or affirm th aign contributions have been expended for the personal Sign7CpWi te a t finan ' I ben fit of a candidate or for any other nonpolitical purpose as define y the fe I i ernal revenue code. Signatue of Witness ate Signature o ~il T asurer Date Signatue of Witness Date 12. SUMMARY a. BALANCE ON HAND LAST REPORT 3..4..5..6.. y g $ 11,405.22 b. TOTAL RECEIPTS THIS PERIOD 1 9 Qom. $ c. TOTAL DISBURSEMENTS THIS PERIOD ~~.....css $ 579.47 d. BALANCE ON HAND (12.a. plus 12.b. minus ....C~.. M $10,825.75 e. TOTAL LOANS OUTSTANDING QF.. y $ f. TOTAL OBLIGATIONS OUTSTANDING $ Offimygkv SS-1137 (Rev. 2/06) Page 1 of RDA 1159 CAMPAIGN FINANCIAL DISCLOSURE STATEMENT For State and Local Judicial Single - Candidate Committees .a. NAME OF CANDIDATE ~u~IyFSt~i, 2016 2 I ROBERT L. HEADRICK 3. ELECTION DATE b. NAME OF CANDIDATE'S COMMITTEE he Committee to Re-Elect Robert L. Headrick 4.a. CAMPAIGN ADDRESS AND PHONE State Zip Code Phone Street or Rural Route City 938 E. Lamar Alexander Parkway Maryville TN 37802 (865)273-5530 4.b. CANDIDATE'S HOME ADDRESS (if different than 4.a.) State Zip Coe Phone Street or Rural Route City 1210 Oak Park Avenue Maryville TN 37803 (865)273-5524 5. JUDICIAL OFFICE SOUGHT (include district number, if applicable) 6. NAME OF POLITICAL TREASURER General Sessions Court Division IV Mr. Robert Goddard 7. CATEGORY OR REPORT (Check one) ❑ ❑ ❑ ❑ ❑ ❑ ❑0 MID YEAR YEAR-END FIRST SECOND THIRD FOURTH ~ QUARTER QUARTER QUARTER QUARTER 8 bRIMARY GENERAL SUPPLEMENTAL SUPPLEMENTAL 8.a. BEGINNING DATE OF REPORTING PERIOD January 16th, 2016 June 30th, 2016 9. (Check one) a. This capaign is exempt from detailed disclosures because expe diture stotal $1,000 or less for this reporting period. (Complete) items 12d.1 12e and 12fc)eived total $1,000 or less AND 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. SIGNATURE OF C (DATE 11. SIGNATURE OF POLITICALTREASURER I do solemnly swear or affirm that the information contained in thiscampaign financi%d ort is true and accurate. Additionally. I swear or t(J affirm t contributions have been expended for the personal Signatue of Ca idate Date financiandidate or for any other nonpolitical purpose as definenternal revenue code. ' P Date Signature of Political Treasurer Date Signatue of Witness Signatue of Witness Dat 12. SUMMARY 17,925.70 a. BALANCE ON HAND LAST REPORT $ -0- b. TOTAL RECEIPTS THIS PERIOD 760.00 $ c. TOTAL DISBURSEMENTS THIS PERIOD 17,165.70 $ rtUALANCE ON HAND (12.a. plus 12.b. minus 12.c.) ANS OUTSTANDI NG $ -0- f. TOTAL OBLIGATIONS OUTSTANDING 1 Page 1 of SS-113 7 (Rev. 2/06) GOB RDA 1159 y