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Bickers, Tom 02/02/2018 FRI 17:52 FAX X003/003 , CAMPAIGN FINANCIAL DISCLOSURE STATEMENT For State and Local Candidates For Single-Candidate Commltteee 1, DATE OF REPOT 2.a. NAME OF CANDIDATE OR COMMITTEF Z'i- pv%, 5tcaav 2.b. IF COMMITTEE, NAME OF CANDIDATE 3. ELECTION DATE 4.a. CAMPAIGN ADDRESS AND PHONE Street or Rural Route City , State Zip Code Phone to' *2,Q, ~aLj'5(,A~_ 910my wivi 4,b, CANDIDATE'S HOME ADDRESS (if different than 4.s) Street or Rural Rouutte~ City State Zip Code Phone II'L ~ 60 - b. OFFJCE SOUGHT (Include district number, If applicable) 6. ryAME OF POLITICAL TREASURER (may be candidate) L~2 tn) ";o,I- ( _k.d A 7. CATEGORY OR REPORT (Check one) FIRST SEO D TF RD FOURTH IP - PRE- MIDYEAR YEd END QUARTER CAI&,RIER QUARTER QUARTER PRIMARY LEM 8.s. BEGINNING DATE OF REPORTING PERIOD 8.b. ENDING DATE OF REPORTING PERIOD 9. (Check one) a. ❑ This campaign Is exempt from detailed disclosure because contrlbutlons (including in-kind) received total $1x000 or lose AND expendl- turee total $1,000 or lose for this reporting period. (Complete items 12d., 12e. and 12f.) b. ❑ This campaign Is required to file a detailed flnenclal disclosure because contributions (Including In-kind) received total more then $1,000 and/or expenditures total more then $1,000 for this reporting period. 10. i/we dD solemnly swear or affirm that the Information contained In this campaign financial disclosure report Is true and that this report Is on accurate eccountlng of campaign contributions end expenditures required to be reported by the candidate committee by the Campaign Finanolel Disclosure Act. Additionally, I/we swear or affirm that no campaI n ntributlons have been expended for the personal flnanclal beneti candidate or for any other nonpolitical purpose as defined by the deml Intern 1 anus code. signature of candidate to signature of political treasurer d to 11. WITNESS SIGNATURE signature of wit ess date signature of wttneea date 12. SUMMARY a. BALANCE ON HAND LAST REPORT .....l;~G f~ b. TOTAL RECEPTSTHIS PERIOD .................E c. TOTAL DISBURSEMENTSTHIS PERIOD S QJJj~J7~!......... $ ' d. BALANCE ON HAND (12.a. plus 12.b. minus 12.c.) ......~~.T►ON . ......................................E e. TOTAL LOANS OUTSTANDING f, TOTAL OBLIGATIONS OUTSTANDING ~i SS-1109 (Rev, 2108) Page 1 of RDA 1159 r CAMPAIGN FINANCIAL DISCLOSuitew ' %MENT For State and Local Candidates For Single-Candidate Committees 1. DATE OF REPO TT 12.a. NAME OF C IDATE OR OMMITTEE J„ r ~°`D~ s i ex.,^ / 3. ELECTION DATE 2.b. IF COMMITTEE, NAM OF CANDIDATE - 4.a. CAMPAIGN ADDRESS AND PHONE State Zip Code Phone 1 7ep~s S Street or Rural Route City 4.b. CANDI ATE'S HOME ADDRESS (if diff erent tcay 4.a.) State Zip Code Phone V Street or Rural Route S X&l§- )IN U`3L 5. OFFICE SOUGHT (include district number, if applicable) 6. NAME OF POLITICAL TREASURER (may be candidate) 1/14 IVA 71 7. CATEGORY OR REPORT (C he k one) ❑ 1:1 ❑ PLEMENTAL FIRST SECOND THIRD FOU❑RTH PRE- PRE- YEAR ND R?_L~NTA1-SUP MEQUARTER QUARTER QUARTER QUARTER PRIM AERNDING DATE OF REPORTING SUP S.a. BEGINNING DATE OFREPOR~NGPERIOD r(Check one) period. (Complete nemstions (including in- ij d) received total $1,000 or less AND expendi-12d., 12e. 12f. `lures total $1,000 or les for TThis campaign is exemptt from h detailed . ❑ This campaign is required t ll than d$1,000 for etailed financial disci ur because contributions (including in-kind) received total more than $1,000 and/or expenditures total o 10. I/we do solemnly swear or affirm that the information containd this g of campaign contributions and expenditureslequi d opbe rep rted by thelcandida eocommittee by the Campaign is an accurate accounting of as defined by the contributions hav 1 internal reveeue code. for the personal financial )k'5~3 ditionally, I/we swear or /afflrose that no campaign Financial Disclosure Act. benefit of the candidate or or any other nonpolitical pure r z 1 date tD signature of political treasurer date signature of candidate i 11. WITNESS SIGNATURE ~ signature of witness signature of witness date da e 12. SUMMARY 711 a. BALANCE ON HAND LAST REPORT $ e1~ . 0 b. TOTALRECEIPTSTHIS PERIOD $ c. TOTAL DISBURSEMENTSTHISPERIDD d. BALANCE ON HAND (12.a. plus 12.b. minus 12.c . v e. TOTAL LOANS OUTSTANDING RECEIVED f. TOTAL OBLIGATIONS OUTSTANDING ........................................JUL. 9 2016 BLOUNT COUNTY 1 of RDA 1159 Page SS-1109 (Rev. 2106) ELECTION l CAMPAIGN FINANCIAL DISCLOSURE STATEMENT For State and Local Candidates For Single-Candidate Committees 1. DATEOFREPORT' 12.a. NAMEOFCANpIDATEORCOMMITTEE s pa 2.b. IF COMMITTEE, NAME OF CANDIDATE 3. ELECTION DATE 4.a. CAMPAIGN ADDRESS AND PHONE Street or Rural Route City State Zip Code Phone 41elft, 1111f WL 4.b. CANDIDATE'S HOME ADDRESS (if different than 4.a.) Street or Rural Route ity State Zip Code P o e .5w tic slfi&i #5014t- ?w - fm 00, 5. OFFICE SOUGHT (include district number, if applicable) 6. NAME OF POLITICAL TREASURER (may be candidate) vi S 6 Z R e, /h& & 14IVPA- 7. CATEGORY OR REPORT (Check one) FIRST SECOND THIRD FOURTH PREl ID E- PRE- YEAR❑-END QUARTER QUARTER QUARTER QUARTER PRIMARY GENERAL SUPPLEMENTAL SUPPLEMENTAL 8.a. BEGINNING DATE OF REPORTING PERIOD 8.b. ENDING DATE OF REPORTING PERIOD 6 _ o.-. 9. (Check one) a. This campaign is exempt from detailed disclosure because contributions (including in-kind) received total $1,000 or less AND expendi- tures total $1,000 or less for this reporting period. (Complete items 12d., 12e. and 12f.) b. ❑ This campaign is required to file a detailed financial disclosure because contributions (including in-kind) received total more than $1,000 and/or expenditures total more than $1,000 for this reporting period. 10. I/we do solemnly swear or affirm that the information contained in this campaign financial disclosure report is true and that this report is an accurate accounting of campaign contributions and expenditures required to be reported by the candidate committee by the Campaign Financial Disclosure Act. Additionally, I/we swear or affirm that no campaign contributions have been expended for the personal financial bene the candidate or for any other nonpolitical purpose as defined by the federal internal revenue code. 441 /_5 signature of candidate d signature of political treasurer date 11. WITNESS SIGNATURE 1 si a ure of witness date signature of witness date 12. SUMMARY g ~o a. BALANCE ON HAND LAST REPORT $ b. TOTAL RECEIPTS THIS PERIOD $ - - c. TOTAL DISBURSEMENTS THIS PERIOD $ 9 d. BALANCE ON HAND (12.a. plus 12.b. minus 12.c.) $ ~0• • r~ $ e. TOTAL LOANS OUTSTANDING . Z RECEIVED f. TOTAL OBLIGATIONS OUTSTANDING 9....................................... $ ~ SS-1109 (Rev. 2106) BLOUNTCV RDA 1159 ELECTIPage 1 of CAMPAIGN FINANCIAL DISCLOSURE STATEMENT For State and Local Candidates For Single-Candidate Committees 1. DATE OF REPORT ~ 12.a. NAI ~SOFnA\ IDaE OiR COMMI 2.b. IF COMMITTEE, NAME OF CANDIDATE 3. E~LEfTIO TE 4.a. CAMPAIGN ADDRESS AND PHONE LL Street oral ~outeL City - U~ ~ State Zip Code Phone Z " Vi`Ahk s . ~wK_/1J ( I 4.b. CANDIDATE'S HOME ADDRESS (if different than 4.a.) St et or Rur I Route ity tate Zip Code one qtf~ 12Ldfel r ac 1~s0) r P, - 5. OFFICE SOUGHT include district number, if applicable) 6. NAME OF POLITICAL TREASURER (may be candidate) 7. CATEGORY OR REPORT (Check one) ❑ ❑ ❑ ❑ ❑ ❑ ❑ FIRST SECOND THIRD UR 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 9. (Check one) a. This campaign is exempt from detailed disclosure because contributions (including in-kind) received total $1,000 or less AND expendi- tures total $1,000 or less for this reporting period. (Complete items 12d., 12e. and 12f.) b. ❑ This campaign is required to file a detailed financial disclosure because contributions (including in-kind) received total more than $1,000 and/or expenditures total more than $1,000 for this reporting period. 10. I/we do solemnly swear or affirm that the information contained in this campaign financial disclosure report is true and that this report is an accurate accounting of campaign contributions and expenditures required to be reported by the candidate committee by the Campaign Financial Disclosure Act. Additionally, I/we swear or affirm that no campaign contributions have been expended for the personal financial benefit f the candidate or for any other nonpolittiic~al purpose as defin y the fed I internal revenue de. 0_~) Y W na re of ca didate da signature of political treasurer ate 11. JESSSIGNATURE _zk. 14K -*~'4 QA=:---> 2 sign u of witness date signature of witness d e 12. SUMMARY a. BALANCE ON HAND LAST REPORT $ OR • O 12..x 1~ 11 AM b. TOTAL RECEIPTS THIS PERIOD $ tb.. . RF c. TOTAL DISBURSEMENTS THIS PERIOD .CO........tfgN............F......... 9 e ~ cn LO ~ J d. BALANCE ON HAND (12.a. plus 12.b. minus 1 . ......S, $ p~ 04;r Cb e. TOTAL LOANS OUTSTANDING ~1a $ O Q f. TOTAL OBLIGATIONS OUTSTANDING $ SS-1109 (Rev. 2106) Page 1 of T RDA 1159 CAMPAIGN FINANCIAL DISCLOSURE STATEMENT For State and Local Candidates For Single-Candidate Committees 1. DATE OF REPORT 12.a. NAM OF CANDIDATE OR COMMITTEE 3o t f?_f 3. ELECTION DATE 2.b. IF COMMITTEE, NAME OF CANDIDATE / r / 4.a. CAMPAIGN ADDRESS AND PHONE State Zip Code Phone Street or Rural Route City S 1AJ 4.b. CANDIDATE'S HOME ADDRESS if different than 4.a.) State Zip Code Phone Street or Rural Route City 5. OF ICE SOUGHT (i clude distript number if applicable) 6. NAME OF PO ITICAL TREAS~IRER (may be candidate) 7. CATEGORY OR RE ~ T (Checkone 1:1 ❑ DEAR YEAR-END ❑ FIRST SECOND THIRD FOURTH PRE- RE- MI QUARTER QUARTER QUARTER UARTER S bIMAERNDING DATE OF REPORTING PERIODEM~ SUPPLEME fi.a. BEGINNING DATE OF REPORTING PERIOD ~c-~ 9. (Check one) a. n is exempt from detailed disclosure because contributions (including in-kind) received total $1,000 or less AND expendi- This campaig 0 tures total $1,000 or less for this reporting period. (Complete items 12d., 12e. and 12f.) b. ❑ This campaign is required to file a detailed financial disclosure because contributions (including in-kind) received total more than $1,000 and/or expenditures total more than $1,000 for this reporting period. Faaccuratee lemnly swear or affirm that the information contained in this campaign financial disclosure report is true and that this report is an ccounting of campaign contributi ons and expenditures required to be reported by the candidate committee by the Campaign Disclosure Act. Additionally, I/we swear or affirm that no campaign contributions have been expended for the personal financial the candidate or for any other nonpolitical purpose as defined by the fede al internal revenue ode. 6/1 /0 dot si nature of political treasurer date signature of candid to 11. WITNESS SIGNATURE h) o o 6 0 / signature of witness d to signature of witness to [12. SUMMARY COX a. BALANCE ON HAND LAST REPORT $ ...fff""" JUUU r b. TO TALRECEIPTSTHIS PERIOD $ G c. TOTAL DISBURSEMENTS THIS PERIOD $ d. BALANCE ON HAND (12.a. plus 12.b. minus 12.c.) e. TOTAL LOANS OUTSTANDING $ f. TOTAL OBLIGATIONS OUTSTANDING $ SS-1109 (Rev. 2106) Page 1 of J_ RDA 1159 10--~ CAMPAIGN FINANCIAL DISCLOSURE STATEMENT For State and Local Candidates For Single-Candidate Committees 1. DATE OF REPORT 12.a. NAME OF CANDIDAT R COMMITTEE -rd iv 12( 2.b. IF COMMITTE , NAME OF CANDIDATE 3. ELECTION DATE 4.a. CAMPAIGN ADDRESS AND PHONE Street or Rural Route City State Zip Code Phone L© trd 1GL G)l 4.b. CANDIDATE'S HOME ADDRESS (if different than 4.a.) Street or Rural Route City State Zip Code Phone 5. OFFICE SOUGHT (include district number, if applicable) 6. NAME OF POLITICAL TREASURER (may be candidate) ~r.kd14 0e~S 1:1 1:1 7. CATEGORY OR REPORT (Check one FO FIRST SEND I URTH PRE- MI EAR YEAR❑-END QUARTER QUARTER QUARTER QUARTER PRIMARY GENERAL SUPPLEMENTAL SUPPLEMENTAL B.a. BEGINNING DATE OF REPORTING PERIOD B.b. ENDING DATE OF REPORTING PERIOD I 7 -30 9. (Check one) a. XThis campaign is exempt from detailed disclosure because contributions (including in-kind) received total $1,000 or less AND expendi- tures total $1,000 or less for this reporting period. (Complete items 12d., 12e. and 12f.) b. ❑ This campaign is required to file a detailed financial disclosure because contributions (including in-kind) received total more than $1,000 and/or expenditures total more than $1,000 for this reporting period. 10. I/we do solemnly swear or affirm that the information contained in this campaign financial disclosure report is true and that this report is an accurate accounting of campaign contributions and expenditures required to be reported by the candidate committee by the Campaign Financial Disclosure Act. Additionally, Itwe swear or affirm that no campaign contributions have been expended for the personal financial benefit of the candidate or for any other nonpolitical purpose as defined by th federal internal revenue code. RA= )14 signature of candidate date signature of political treasurer date 11. WITNESS SIGNATURE , J /U lq'I signature of witness date signature of witness ate 12. SUMMARY ~Jc Y~ 96 a. BALANCE ON HAND LAST REPORT $ V b. TOTAL RECEIPTSTHIS PERIOD $ O ~a - c. TOTAL DISBURSEMENTS THIS PERIOD $ enl) d. BALANCE ON HAND (12.a. plus 12.b. minus 12.c.) $ e. TOTAL LOANS OUTSTANDING $ 1 f. TOTAL OBLIGATIONS OUTSTANDING $ SS-1109 (Rev. 2106) Page 1 of RDA 1159 ~:PrintForm ,~_r 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, maybe 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 of Candidate or Committee: 3. Candidate e-mail address: 4. Campaign Address and Phone: City State Zip Code Phone % j C* e N,4 So I-IV ~ty~ C, I 5. Home Address and Phone (if different than item 4 above): City State Zip Code Phone , j/fV4. Ab Aa'e, 6. Office Sought (include district number, if applicable) 7. Party Affliation 8. Election Year G4alv16le. 0111dn- R*Ali (Ltftj 24 9. Treasurer Name: 10. Treasurer e-mail address: Owe ~i L J~v~t. S f ~c ~ rvSc~ 11. Treasurer Address and Phone: City State Zip Code Phone JN A) A*g-f-- 12. Candidate and Treasurer Signature (both signatures must be witnessed. Treasurer can not witness candidate's signature): 23 Q~ iO Signature of Candidate Signature of Treasurer cL n ° c D M ti IA~ lAi&AJ11FAQ) C, o a I aLX14~ &AQ) Signature of Witness ~9 S ~d Signature of Witness Registry of Election Finance SS-1120 (rev 10/2010) CAMPAIGN FINANCIAL DISCLOSURE STATEMENT For State and Local Candidates For Single-Candidate Committees 1.~ DA=E0F REPORT 12.a. N-ro iv\NDIpQT~RC~4MITTEE 2.b. IF COMMITTEE, NAME OF CANDIDATE T jQ~t, S 3. ELECTION DATE 4.a. CAMPAIGN ADDRESS AND PHONE Street or Rural Route City St at Zip Code Phone 212 Lov,sv, (~Ih►►`~. fai~sl~ Ile ~ 3! b'65-~d1' 4.b. CANDIDATE'S HOME ADDRESS (if different than 4.a.) Street or Rural Route City State Zip Code Phone 5. OFFICE SOUGHT (include district number, if applicable) 6. NAME OF POLITICAL TREASURER (may be candidate) 10 ftd2 - Loci s~ If-e- L-Z"I$ M6b 7. CATEGORY OR REPORT (Check one) FIRST SECOND THIRD FOURTH PRE- P❑RE-, Y AR 10 f~ ~Dff, QUARTER QUARTER QUARTER QUARTER PRIMARY GENERAL SUPPLEMENTAL 8.a. BEGINNING DATE OF REPORTING PERIOD 8.b. ENDING DATE OF REPORTING PERIOD 9. (Check one) a. This campaign is exem pt from detailed disclosure because contributions (including in-kind) received total $1,00 Xtures 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 tand/or expenditures total more than $1,000 for this reporting period. 10. I/we do solemnly swear or affirm that the information contained in this campaign financial disclosure report is true and that this report is an accurate accounting of campaign contributions and expenditures required to be reported by the candidate committee by the Campaign Financial Disclosure Act. Additionally, I/we swear or affirm that no campaign contributions have been expended for the personal financial benefit of the candidate or for any other nonpolitical purpose as defined by I internal revenue cod . 7~A4G, signature of candidate date signature of political treasurer dat A ' 11. WITNE S I NATURE signature of witness date signature of witness date 12. SUMMARY a. BALANCE ON HAND LAST REPORT $ (ICU b. TOTAL RECEIPTS THIS PERIOD c. TOTAL DISBURSEMENTS THIS PERIOD $ d. BALANCE ON HAND (12.a. plus 12.b. minus 12.c.) $ --O -r e. TOTAL LOANS OUTSTANDING $ f. TOTAL OBLIGATIONS OUTSTANDING $ 0 SS-1109 (Rev. 2/06) Page 1 of J_ RDA 1159 CAMPAIGN FINANCIAL DISCLOSURE STAT MENT For State and Local Candidates For Single-Candidate Committees 1. DATE OF REPORT 2.8. OF CANDIDATE OR COMMITTEE 2.b. IF COMMITTEE, NAME OF CANDIDATE 1_3 ELECTION DATE 4.a. CAMPAIGN ADDRESS AND PHONE Street or Rural Route city state Zip Code Phone ';u 2 LdVJV'lle #)A 'j it. TAI - ?777 ~6r"41 4.b. CANDIDATE'S HOME ADDRESS (d different than 4.a.) Street or Rural Route City State Zip Code Phone 5. OFFICE SOUGHT (Indude district number, if appGcabie) 6. NAME OF POLITICAL TREASURER (may be candidate) f1 A-,oR- tiiSv', III LSivn✓~ 7. CATEGORY OR REPORT (Check one) FIRST SECOND T~ FOURTH ~ ~ MID-YEAR Y`A D QUARTER QUARTER QUARTER MARY GENERAL SUPPLEMENTAL SUPPLEMENTAL 8.a. BEGINNING DATE OF REPORTING PERIOD 8.b. ENDING DATE OF REPORTING PERIOD 9. (Check one a. This campaign is exempt from detailed disclosure because contributions (inducting it ind) received total $1,000 or less AND exponcti- tures total $1,000 or less for this reporting period. (Complete items 12d., 12e. and 12f.) b. ❑ This campaign is required to file a detailed financial disclosure because contributions (including in-kind) received total more than $1,000 and/or expenditures total more than $1,000 for this reporting period. 10. Vwe do solemnly swear or affirm that the Information contained in this campaign financial disclosure report is true and that this report is an accurate accounting of campaign contributions and expenditures required to be reported by the candidate committee by the Campaign Financial Disclosure Act. Additionally, ilwe swear or affirm that no campaign contributions have been expended for the personal financial benefit f the candidate or for any other nonpolitical purpose as defined by the federal Internal revenue code. signature of candidate dal signature of political treasurer date 11. WITNESS SIGNATURE signature of witness date sl nature of witness date 12. SUMMARY y0 a. BALANCE ON HAND LAST REPORT $ d b. TOTALRECEIPTSTHISPERIOD c. TOTAL DISBURSEMENTS THIS PERIOD .GD d. BALANCE ON HAND (12.a. plus 12.b. minus 12.c.) $ e. TOTAL LOANS OUTSTANDING $ f. TOTALOBL.IGATIONSOUTSTANDING $ SS-1109 (Rev. 2106) Pape 1 of / RDA 1159 CAMPAIGN FINANCIAL DISCLOSURE STATEMENT For State and Local Candidates Tor Single-Candidate Committees 1. TE OF REPORT 2.a. NAME OF CANDIDATE OR COMMITTEE - IL-13 I6 H. &C'k 2.b. IF COMMITTEE, NAME OF CANDIDATE 3. ELECTION DATE N-2-/6 4.a. CAMPAIGN ADDRESS AND PHONE Street or Rural Route city State Zip Code Phone 2(2 Lo:.fA n e JIAW 54, Ld-w Ife- TV 37177 1- f 4.b. CANDIDATE'S HOME ADDRESS ('d different than 4.a.) Street or Rural Route City State Zip Code Phone 5. OFFICE SOUGHT (include district number, if applicable) 6. NAME OF POLITICAL TREASURER (may be candidate) M Ayx - Lot4v; I Int. LrNaa Weal 7. CATEGORY OR REPORT (Check one) I FIRIRST SECOND T~ FOU❑RTH P❑Rl= PRE- Mf0-YEAR YEAR-END Ql1ARTER QUARTER QUARTER QUARTER MARY GENERAL SUPPLEMENTAL SUPPLEMENTAL 8.a. BEGINNING DATE OF REPORTING PERIOD 8.b. ENDING DATE OF REPORTING PERIOD I- I- 13 G-~e-13 9.(Check one) a.~This campaign is exempt from detailed disclosure because contributions (including in-kind) received total $1.000 or less AND expendi- tures total $1,000 or less for this reporting period. (Complete items 12d., 12e. and 12f.) b. ❑ This campaign is required to file a detailed financial disclosure bemuse contributions (including in-kind) received total more than $1,000 and/or expenditures total more than $1,000 for this reporting period. 10. Uwe do solemnly swear or affirm that the Information contained in this campaign financial disclosure report is true and that this report is an accurate accounting of campaign contributions and expenditures required to be reported by the candidate committee by the Campaign Financial Disclosure Act. Additionally, Uwe swear or affirm that no campaign contributions have been expended for the personal financial benefit of the candidate or for any other nonpolitical purpose as defined 7;nature -13 signature of candidate date of political treasurer d 4 to 11. WITNESS SIGNATURE 1 signature of witness date signature of witness ate 12. SUMMARY ~p a. BALANCE ON HAND LAST REPORT 5 St9 ,qv- b. TOTAL RECEIPTS THIS PERIOD $ c. TOTAL DISBURSEMENTS THIS PERIOD $ 55). D d. BALANCE ON HAND (12.a. plus 12.b. minus 12.c.) ~Sty....... S -a- e. TOTAL LOANS OUTSTANDING ............................................:s:.............................................................................. 5 f. TOTALOBLIGATIONS OUTSTANDING ......................................:............................................................................3 SS-1109 (Rev. 2/06) Page 1 of RDA 1169 b~ RECEI VEp CAMPAIGN FINANCIAL DISCLOSURE STATEMENT For State and Local Candidates Tor Single-Candidate Committees 1. DATE OF REPORT 2.a. NAME OF CANDIDATE ORCOMM(TTEE I Z) - t7 I 6 /v\~ i3i C 1615 2.b. IF COMMITTEE, NAME OF CANDIDATE 3. ELECTION DATE 4.a. CAMPAIGN ADDRESS AND PHONE Street or Rural a City t State Zip Code Phone Z Lo ~cJ Qe tb1alti ~I. b-.,~,IlL 4.b. CANDIDATE'S HOME ADDRESS (rf different than 4.a.) Street or Rural Route city state Zip Code Phone 5. OFFICE SOUGHT (include district number, If applicable) . NAME OF POLITICAL TREASURER (may be candidate) LQv:~~~i W~~ 7. Z rA- w~SS 7. CATEGORY OR REPORT (Check one)❑ ❑ ❑ ❑ ❑ FIRST SECOND THIRD PRE. PRE- MID-YEAR YEAR-END (xyuz GENERAL SUPPLEMENTAL SUPPLEMENTAL 8.a. BEGINNING DATE OF REPORTING PERIOD 81. ENDING DATE OF REPORTING PERIOD - - I `v 9. (Check one) a. This campaign is exempt from detailed demure because contributions (including in-kind) received total $1,000 or less AND expendi- tures total $1,000 or less for this reporting period. (Complete items 12d., 12e. and 12f.) b. ❑ This campaign Is required to file a detailed financial disclosure because contributions (including in-kind) received total more than $1,000 and/or expenditures total more than $1,000 for this reporting period. 10. Uwe do solemnly swear or affirm that the information contained in this campaign financial disclosure report is true and that this report is an accurate accounting of campaign contributions and expenditures required to be reported by the candidate committee by the Campaign Financial Disclosure Act. Additionally, Uwe swear or affirm that no campaign contributions have been expended for the personal financial benefit of the candidate or for any other nonpolitical purpose as defined by the Cede Internal revenue a~da. ~L i - 2 ~~3 c / t 13 signature of candidate date signature of political treasurer d Ate 11. WITNESS SIGNATURE 0 G1~+cC,1\ 1 '2 az-~, signature of witness date signature of witness d e 12. SUMMARY a. BALANCE ON HAND LAST REPORT $ ko b. TOTALRECEIPTS THIS PERIOD $ 3b~, 5 c. TOTAL DISBURSEMENTS THIS PERIOD fq\0%I.."VI (I.,- R.......~~. $ 2 S~ ~ 1 if d. BALANCE ON HAND (12.a. plus 12.b. minus 12.a) S e. TOTAL LOANS OUTSTANDING S v f. TOTAL OBLIGATIONS OUTSTANDING S SS-1109 (Rev. 2106) Pape 1 of RDA 1159 T CAMPAIGN FINANCIAL DISCLOSURE STATEMENT For State and Local Candidates For Single-Candidate Committees 1. DATE OF REPORT 2.a. NAM OF CANDIDATE OR COMMITTEE e /V\ 2.b. IF COMMITTEE, NAME OF CANDIDATE 3. ELECTION DATE 4.a. CAMPAIGN ADDRESS AND PHONE Street or Rural Route M M City F Zip Code Phone lie, lie L-e 4.b. CANDIDATE'S HOME ADDRESS (if different than 4.a.) Street or Rural Route City State Zip Code Phone 5. OFFICE SOUGHT (include district number, if applicable) 6. NAME OF POLITICAL TREASURER (may be candidate) tee"S~'y ht M AMQ_ 1-1vjw4- 41e~_b 7. CATEGORY OR REPORT (Check one) El El 1:1 0 FIRST SECOND THIRD FOURTH PR - P❑RE- MID-YEAR YXRN D DA RTER QUARTER QUARTER DARTER PRIMARY GENERAL SUPPLEMENTAL SUPPLEMENTAL 8.a. BEGINNING DATE OF REPORTING PERIOD 8.b. ENDING DATE OF REPORTING PERIOD /_J/ /-/S'-t2_ 9. (Check one) a. This campaign is exempt from detailed disclosure because contributions (including in-kind) received total $1,000 or less AND expendi- tures total $1,000 or less for this reporting period. (Complete items 12d., 12e. and 12f.) b. ❑ This campaign is required to file a detailed financial disclosure because contributions (including in-kind) received total more than $1,000 and/or expenditures total more than $1,000 for this reporting period. 10. I/we do solemnly swear or affirm that the information contained in this campaign financial disclosure report is true and that this report is an accurate accounting of campaign contributions and expenditures required to be reported by the candidate committee by the Campaign Financial Disclosure Act. Additionally, I/we swear or affirm that no campaign contributions have been expended for the personal financial benefit of the candidate or for any other nonpolitical purpose as defined by the fede fel internal revenue de. signature of candidate date signature of political treasurer to 11. WITNESS SIGNATURE signal rre of witness date si iature of witness date 12. SUMMARY a. BALANCE ON HAND LAST REPORT $ G Y Z b. TOTAL RECEIPTS THIS PERIOD c. TOTAL DISBURSEMENTS THIS PERIOD $ _0 d. BALANCE ON HAND (12.a. plus 12.b. minus 12.c.) $ e. TOTAL LOANS OUTSTANDING $ - d f. TOTAL OBLIGATIONS OUTSTANDING $ r AIML SS-1109 (Rev. 2106) Page 1 of RDA 1159 'qVV y CAMPAIGN FINANCIAL DISCLOSURE STATEMENT For State and Local Candidates For Single-Candidate Committees r 1. REPORT 2.a. NAME OF CANDIDATE OR COMMITTEE 3 - l ( IoM B;C,K&,es 2.b. IF COMMITTEE, NAME OF CANDIDATE 3. ELECTION DATE t - G2 - /0 4.a. CAMPAIGN ADDRESS AND PHONE Street or Rural Route City State Zip Code Phone a 0 MAW TC Le-As v:)l(- TN 37771 of-9t g 4.b. CANDIDATE'S HOME ADDRESS (if different than 4.a.) Street or Rural Route City State Zip Code Phone 5. OFFICE SOUGHT (include district number, if applicable) 6. NAME OF POLITICAL TREASURER (may be candidate) ~OV4V'Se- 0A04 7. CATEGORY OR REPORT (Check one) FIRST SECOND THIRD FOURTH PRE- PRE J_Y YEAR❑-END QUARTER QUARTER QUARTER UARTER PRIMARY GENERAL SUPPLEMENTAL SUPPLEMENTAL 8.a. BEGINNING DATE OF REPORTING PERIOD 8.b. ENDING DATE OF REPORTING PERIOD 1-16-0 9. (Check one) a. This campaign is exempt from detailed disclosure because contributions (including in-kind) received total $1,000 or less AND expendi- tures total $1,000 or less for this reporting period. (Complete Items 12d., 12e. and 12f.) b. ❑ This campaign is required to file a detailed financial disclosure because contributions (including in-kind) received total more than $1,000 and/or expenditures total more than $1,000 for this reporting period. 10. I/we do solemnly swear or affirm that the information contained in this campaign financial disclosure report is true and that this report is an accurate accounting of campaign contributions and expenditures required to be reported by the candidate committee by the Campaign Financial Disclosure Act. Additionally, I/we swear or affirm that no campaign contributions have been expended for the personal financial benefit of the candidate or for any other nonpolitical purpose as defined by the fe ral internal revenue co of candidate date signature of political treasurer date signature 11. WITNESS SIGNATURE / signature of witness .7 date 'll signature of witness date 3 12. SUMMARY ^~P~ O S 5~j / T a. BALANCE ON HAND LAST REPORT o sG...~............... $ rn $ 0 - b. TOTALRECEIPTSTHIS PERIOD o co b V_ Z41 c. TOTALDISBURSEMENTS THIS PERIOD s s w ..a $ c d. BALANCE ON HAND (12.a. plus 12.b. minus 12.c. £ Z..(... N1d $ S e. TOTAL LOANS OUTSTANDING $ f. TOTAL OBLIGATIONS OUTSTANDING $ SS-1109 (Rev. 2106) Page 1 of RDA 1159