McNelly, Don
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CAMPAIGN FINANCIAL DISCLOSURE STATEMENT
For State and Local Candidates
For Single-Candidate Committees
1. DATE OF REPORT 12.a. NAME OF CANDIDATE OR COMMITTEE
U ~W c
2.b. I COMMITTEE, NM AE OF CANDIDATE 3. ELECTION DATE
4.a. CAMPAIGN ADDRESS AND PHONE
Street or Rural Route City State Zip Code Phone
0 &-?44 04 AP~VU& 7)v v ~~Eq?L2d Z
4.b. CANDIDATE' HOME ADDRESS (if different than 4.a.)
Street or Rural Route City State Zip Code Phone
5. OFFICE SOUGHT (include district number, if applicable) 11 6. NAME OF POLITICAL TREASURER (may be candidate)
s Noy 13,~glreA--,
7. CAT ORY OR REPORT (Check one)
FIRST SEND THIRD FOURTH PRE- MIDD❑YEAR YEAR❑-END
QUARTER QUARTER QUARTER QUARTER PRIMARY ENERAL SUPPLEMENTAL SUPPLEMENTAL
8.a. BEGINNING DATE OF PORTING PERIOD 8.b. ENDING DATE OF REPORTING PERIOD
2G1
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 o the candidate or for any other nonp ' ical purpose as defined by the federal internal revenue code.
signature of candidate date l signature o p liti reasurer date
11. WITNESS SIGNATURE
signature of witness date J signature of Witness date
12. SUMMARY
a. BALANCE ON HAND LAST REPORT $ J
b. TOTAL RECEIPTS THIS PERIOD $ \
c. TOTAL DISBURSEMENTS THIS PERIOD a
$,3Q,9a
d. BALANCE ON HAND (12.a. plus 12.b. minus 12.c.) l~
e. TOTAL LOANS OUTSTANDING $
f. TOTAL OBLIGATIONS OUTSTANDING o a
SS-1109 (Rev. 2/06) Page 1 of RDA 1111
ITEMIZED STATEMENT OF LOANS - CANDIDATE
1. NAME OF CANDIDATE OR COMMITTEE 2. REPORT COVERING THE PERIOD
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 L Vdle Name Outstanding Loan Balance Loans Loan Outstanding Loan Balance
C V, (Beginning of Period) Received Payments (End of Period)
Last Name/Organization Name "32.6)0 -
Addres ^ Loan Received For: ate of Loan
1 E3 Primary Election neralElection Nmat!'~1 64*0 E kA `ll
City State (~(\S~ f✓b« ~lrlrl
❑ Runoff (Local Elections Only)
List All Endorsers or Guarantors for Above Loan (If more space is needed please attach a page) `C
First Name Middle Name First Name Middle Name
Last Name/Organization Name Last Name/Organization Name
Address Address
City --TSt Zip Code City State Zip Code
Amount Guaranteed Outstanding Amount Guaranteed Outstanding ~7 First Name Middle Name First Name Middle Name
Last Name/Organization Name Last NamelOrganization Name
Address Address
city State Zip Code City State Zip Code
Amount Guaranteed Outstanding Amount Guaranteed Outstanding
First Name Middle Name First Name Middle Name
Last Name/Organization Name Last Name/Organization Name
Address Address
City State Zip Code City State Zip Code
Amount Guaranteed Outstanding Amount Guaranteed Outstanding
First Name Middle Name First Name Middle Name
Last Name/Organization Name Last Name/Organizat on Name
Address Address
Gty State Zip Code City Slate Zip Code
Amount Guaranteed Outstanding mount Guaranteed Outstanding
4. Totals for all Loans (complete on last page of itemized loans) Outstanding Loan Balance Loans Loan Outstanding Loan Balance
(Total loans received should also be shown in item 16. on summary page.) (Beginning of Period Received Pa menu 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.)
Agm
SS-1132 (Rev. 4/02) Page of RDA 1159
5
CAMPAIGN FINANCIAL DISCLOSURE STATEMENT
For State and Local Candidates
For Single-Candidate Committees
1. DATE OF REPORT 12.a. NAME OF CANDIDATE OR COMMITTEE
7 a~-ly 1 Nl~ ell
2_b. IF COMMITTEE, NAME OF CANDIDATE 3. ELECTION DATE
4.a. CAMPAIGN ADDRESS AND PHONE City State Zip Code Phone
Street or Rural Route
P-0-'Roy' S I LI ? /yl'tr a~ 7-A) 1(& 5_- ~ 77-'?
4.b. CANDIDATE'S HOME ADDRESS (if different than 4.a.) State Zip Code Phone
Street or Rural Route City 5_ OFFICE SOUGHT (include district number, if applicable) 6. NAME OF POLITICAL TREASURER (may be candidate)
~(AvaTC'wrt Sc < C / N der
7. CATEGORY OR REPORT (Check one)
IR
FIRST SECOND THIRD FOURTH PRE. PRE- MI YEAR YEAR-END
QUARTER DARTER PRIMARY GENERAL SUP EMENT& 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. 5a 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. Itwe do solemnly swear or affirm that the information contained in this campaign financial disclosure report is true and that this report is an
accurate accourding of campaign contributions and expenditures required to be reported by the candidate committee by the Campaign
Financial Disclosure Act.'iAdditionally, Uwe swear or affirm that no campaign contnbutions have been expended for the personal financial
benefit of the candidate or for any other nonpolitical purpose as defined by the federal internal revenue code.
/12 7-as-~~{ ~ -
signature of candidate date afire political treasurer date
11. WITNESS SIGNATURE I
signature of witness vl ignature of witness date
1ti {~tA
12. SUMMARY py
P
a. BALANCE ONHAND LAST REPORT ..................................RECEIVED r $
eb LP
b. TOTALRECEIPTSTHISPERIOD .F 9i .
l -3o~,pg
1f1
C. TOTALDISBURSEMIENTSTHISPERIOD .d.....~ .......co -
d. BALANCE ON HAND (12.a. plus 12.b. minus 12.c. 1... 2 $
e. TOTAL LOANS OUTSTANDING $
f. TOTALOBLIGATIONSOUTSTANDING $
SS-1109 (Rev. 20) Page 1 of RDA 1159
SUMMARY PAGE - CANDIDATE
14. REPORT COVERING THE PERIOD
13. NAME OF CANDIDATE OR COMMITTEE (In Full) FROM: TO: .~c)
RECEIPTS i
15. CONTRIBUTIONS (other than loans and interest) a ~O ~y
a. Unitemized Contributions ($100 or less from each source this period) $
.
b. Itemized Contributions (over $100 from each source this period) $ 1,500
c. TOTAL CONTRIBUTIONS (other than loans and interest)(add 15.a. and 15.b.) X
c~c
16. LOANS RECEIVED THIS REPORTING PERIOD
17. INTEREST RECEIVED THIS REPORTING PERIOD
Z O
18. TOTAL RECEIPTS (add 15.c., 16., and 17.) (must be shown in item 12.b.) 1
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) $
U .O
$
c. TOTAL EXPENDITURES (other than loan repayments)(add 19.a. and 19.b.)
$
20. LOAN REPAYMENTS MADE THIS PERIOD
vV-dg
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. Unitem¢ed Obligations Outstanding ($100 or less each)
b. Itemized Obligations Outstanding (Over $100 each) $
c. TOTAL OBLIGATIONS OUTSTANDING (add 23.a. and 23.b.) (must be shown i item 12.f.)
Page of
SS-1133 (Rev. 4102)
r. ~
ITEMIZED STATEMENT OF CONTRIBUTIONS - CANDIDATE
1. NAME OF CANDIDATE OR COMMITTEE 2. REPORT COVERING THE PERIOD
G
AJ e, (A FROM: TO:
Amount
3. TOTAL ITEMIZED CAMPAIGN CONTRIBUTIONS FROM PRECEDING PAGE (enter $0 If first itemized page)
4. COMPLETE THE APPROPRIATE ITEMS FOR EACH ITEMIZED CONTRIBUTION contributions totaling more than $100 from an contributor
First Name Middle Name Contribution Received For. Amount of Contribution
Last Name/Organization Name 5 Primary Election ❑ General Election
z) ,.5- do. 6
Address _ ❑ Runoff (Local Elections Only)
City state Zip Code Date of Contribution Aggregate This Election
C O
37 yr
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 Name/Organization Name ❑ Primary Election ❑ General Election
Address ❑ Runoff (Local Elections Only)
City 111,1, Zip Code Date of Contribution Aggregate This Election
Occupation
Employer
First Name Middle Name Contribution Received or. mount ntn ution
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 C
(Carty forward to item 3. of next page ti additional pages of this form are used.) 0c)
(If this is the last page of contributions, this amount must be shown in item 15b. of summary.)
3
SS-1131(Rev. 2/06) Page of RDA 1159
ITEMIZED STATEMENT OF EXPENDITURES - CANDIDATE
1. NAME OF CANDIDATE OR COMMITTEE 2. REPORT COVERING THE PERIOD
N C N2 l FROM: TO:
morn
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
1• /
Last NamelBusinessName
,~2, v ~y
AlYP/5 M clot" `t/y S
Address o s, ~,q<~° `taw S rA' Ta«W Re CcQd
City State Zip Code
7 -fey
13
~~s~,~l~- rN
First Name Middle Name Purpose of Expenditure Amount of Expenditure
Last Name/Business Name
~ bc 4*45 ~s6.sa
Address 36 ? E
city state Zip Code
*r me riv
First Name Middle Name -3 ?8Q3 Purpose of Expenditure Amount of Expenditure
Last Name/Business Name
Address olGG~ ( O t~ • SL3
city state Zip Code
jM 47 V ul 1. . ~-N 3 7 to
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 3 D 8 O V
(If this is the last page of expenditures, this amount must be shown in item 19b. of summary.) v
SS-1129 (Rev. 4/02) Page -y- of RDA 1159
FINANCIAL DISCLOSURE STATEMENT EXEMPTION
Pursuant to TCA 5 2-10-101(b) a candidate is exempt from filing financial
disclosure statements:
"If a candidate is seeking an office for which service is part-time,
compensation is less than $1,000 a month, and the candidate does not spend more
than $1,000 to get elected to office, the candidate does not have to file Campaign
Financial Disclosure Reports."
~6Zu14 j
CANDIDATE'S INFORMATION:
Candidate's Name: C7 tj__ M L ~e
Candidate's Position: CX,( 1 w Ad (VLW bel_ fp((' T_
Residential Address. a( (t l N iM hk rte- R _-0
City: _ffi. I/ulo~, State: TN Zip: 3_7 I hereby state that I meet the above qualifications for exemption and am
therefore exempt from filing financial disclosure statements.
c"
G-
Candidate's Sign re [)ate
Witness's Signature ate
If my plans change and I realize I will spend more than $1,000 on my campaign, I
will immediately make a financial disclosure report.
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 (r.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 2-10-10 1, 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 theiroriginal Appointment of Political Treasurer statement ONLY with
their county election commission.
1. Date: 2. Name of Candidate or Committee:
/ 3. Candidate e-mail address:
9 w (1{ j'0 I A nl,
4. Campaign Address and Phone: City State Zip Code Phone CiJ
rOfrice o h, v.~ (e ?-iy 3 7 66U 7 dress and Phone (if different than Item 4 above): Ci
ty State Zip Code Phone
NJ 00Uk)1-( .Sc~c,u( bo.'rz~( Di sneic-1- 5
ught (include district number, if applicable) 7. Party Affliation 8. Election Year
Ci >vQ ff e~ e v6(~c * a/• (2U
9. Treasurer Name: 10. Treasurer a-mail address:
oZ t` ~cJ N " ef-' e- 370)
140
11.1 reasurerAddressandPhone: (e& 4 ed-
Q(
City State Zip Code Phone
12. Candidate and Treasurer Signature (both signatures must be witnessed. Treasurercan not witness candidate's signature):
ignature of Candida ~FC`F4 ignature reasurer
-441 Fo
l
Signature of Witness Sig ature of Witness
Registry of Election Finance
SS-1120 (rev 10!2010)