Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
Morton, Mike
CAMPAIGN FINANCIAL DISCLOSURE STATEMENT For State and Local Candidates For Single-Candidate Committees 1. DATE OF REPORT 2.a. NAME OF ,C(A~JNDIDATE OR COM ITTEE 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 0- B(OrlTz A-Loot -T;'7 S27o 1 4.b. CANDIDATE'S HOME ADDRESS (if different than 4.a.) Street or Rural Route Cit State Zip Code Phone T r 3?PD 5. OFFICIO SOUGHT (inclu a district number, if applica e) 6. NAME OF POLITICAL TREASURER (may e candidate) /'S v er d•. ~Cw~ 7. CATEG9RY OR REPORT (Check on g) V ❑ ❑ ❑ ❑ ❑ ❑ ❑ 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 ~z -Z¢-1x 3-31 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 federal internal rev code. 10 -1z s6 nature of c didate date si~na of political treasurer date 11. WIT SIGNATURE signature o witness date sign ure of witness date 12. SUMMARY hM/ a. BALANCE ON HAND LAST REPORT $ Lr1~J b. TOTAL RECEIPTS THIS PERIOD Z16~-+• YI~ c. TOTAL DISBURSEMENTSTHIS PERIOD $ / IL+ d. BALANCE ON HAND (12.a. plus 12.b. minus 12.c.) $ ~.J e. TOTAL LOANS OUTSTANDING $ /O~ f. TOTAL OBLIGATIONS OUTSTANDING $ SS-1109 (Rev. 2/06) Page 1 of RDA 1159 SUMMARY PAGE - CANDIDATE 13. NAME OF CANDIDATE OR COMMITTEE (in Full) 14. REPORT COVERING THE PERIOD 114i?~e_ FROM:2- -IL T0. 3-3f-1L RECEIPTS 15. CONTRIBUTIONS (other than loans and interest) 00 a. Unitemized Contributions $100 or less from each source this period) b. Itemized Contributions (over $100 from each source this period) $ 2~1~ ' 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 $ z .'3 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) i . 00 SI/,n .S~dn flt~ $ 3s'-O° P sNE 1S $ ~3 ° $ $ $ $ $ $ Total of Expenditures ($100 or less each payee) $ 1Z. 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 O 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) $ O b. Itemized in-kind contributions (over $100 from each source this period) $ D c. TOTAL IN-KIND CONTRIBUTIONS RECEIVED THIS PERIOD (add 22.a. and 22.b.) $ 10 23. OBLIGATIONS a. Unitemized Obligafions Outstanding ($100 or less each) $ Q b. Itemized Obligations Outstanding (Over $100 each) $ 0 a c. TOTAL OBLIGATIONS OUTSTANDING (add 23.a. and 23.b.) (must be shown i item 121) $ SS-1133 (Rev. 4/02) Page 7._ of ITEMIZED STATEMENT OF CONTRIBUTIONS - CANDIDATE 1. NAME OF CANDIDATE OR COM 1 E 2. REPORT COVERING THE PERIOD /;1 i FROM: 2 _7_ - TO: 3 --31 _ j Z • Amount 3. TOTAL ITEMIZED CAMPAIGN CONTRIBUTIONS FROM PRECEDING PAGE (enter $0ff first itemized page) Q 4. COMPLETE THE APPROPRIATE ITEMS FOR EACH ITEMIZED CONTRIBUTION contributions totalin more than $100 from an contributor First Name MlddleName Contribution Received For: Amount of Contribution ~~n Last Name// anizalion Name T Primary Election ❑ General Election too 42- Soo Address -p`~ ~~g ❑ Runoff (Local Elections Only) City f r S Zip Code Date of Contribution Aggregate This Election LOKls~ll~t, Occupation /°~1 Employer :3 W First Name . Middle Name Contribution Received For: Amount of Contribution A G Last Name/0 anizatio Name Primary Election ❑ General Election 73 49 r o~ Address ff ❑ Runoff (Local Elections Only) Z,~ 31524 Ar, LiA1-,- City IF I Staff Zip Code Date of Contribution Aggregate This Election (h Occupation 73 F1n oyer atv 8 ^ Z1 - 17, '77341. a v~+rr1 RrstName ddleName Contribution Received For: Amount of Contribution as ame rgan¢a ion 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 to item 3. of next page if additional pages of this form are used.) rJ,t✓~ Z. J (If this is the last page of contributions, this amount must be shown In item 15b. of summary.) Lr~ rv SS-1131(Rev. 2106) Page 3 of Z RDA 1159 ITEMIZED STATEMENT OF EXPENDITURES - CANDIDATE 1. NAME OF CANDIDATE OR COMMITTEE 2. REPORT COVERING THE PERIOD Ai 4L FROM: 2_u_/L T0: 3-3j-/Z mown ~ 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 iness Nam 41 Address ,30~, E. / J Qty St Zip Code ImIt r ti .317 ?.o First Name Middle Name Purpose of Expenditure Amount of Expenditure Last NamelBusiness_Name ,/Vl 5~`! Q p 4t S ! ~ 1 Address 122- ~Ot.l l 2Z Gcu.+QtiC~~I 1, S~1 q-0 city State Zip Code A ~ s r r,, s v~ First Name Middle Name Purpose of Expenditure Amount of Expenditure Lest Nameffi s N me Ca k tI/l Address .~3a rfa~t crs ~rosSc w i/Y r~ city state Zip Code ILt~ jco~f First Name Middle Name Purpose of Expenditure Amount of Expenditure Last Name/Business Name Address City State Zip Code First Name = a Purpose of Expenditure Amount of Expenditure Last Name/Business Name Address city State Zip Coda First Name Middle Name Purpose of Expenditure Amount of Expenditure Last Name/Business Name Address City State Zip Code 5. TOTAL ITEMIZED EXPENDITURES (Carry forward to item 3. of next page if additional pages of this form are used.) (if this is the last page of expenditures, this amount must be shown in item 19b. of summary.) r~ 0 SS-1129 (Rev. 4/02) Page --4-- of 1 RDA 1159 an ITEMIZED STATEMENT OF LOANS - CANDIDATE 1. NAME OF CANDIDATE OR COMMITTEE 2. REPORT COVERING THE PERIOD FROM: T0: e Or N 7-2, -1Z 31- lZ 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. Dale of Loan ❑ Primary Election ❑ General Election city rIeTp 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 Name0ganization Name Address Address city State Zip Code city State Zip Code Amount Guaranteed Outstanding Amount Guaranteed Outstanding First Name Middle Name First Name Middle Name Last Name/Organization Name Last Name/Organization Name Address Address city State Zip Code city State Zip Code Amount Guaranteed Outstanding Amount Guaranteed Outstanding First Name Middle Name First Name Middle Name Last Name/Organization Name Last Name/Organization Name Address Address City State Zip Code City State Zip Code Amount Guaranteed Outstanding Amount Guaranteed Outstanding 4. Totals for all Loans (complete on last page of itemized bans) Outstanding Loan Balance Loans Loan Obtstanding Loan Balance (Total loans received should also be shown in item 16. on summary page.) (Beginning of Period Received Payments End of Period (Total loan payments should also be shown in Item 20, on summary page.) (Total outstanding loan balance should also be shown in item 12.e. on front page.) AM% SS-1132 (Rev. 4102) Page S, of _ a RDA 1159 ITEMIZED STATEMENT OF OBLIGATIONS - CANDIDATE FCOMPLETE NDIDATE COMMI EE 2. REPORT COVERING THE PERIOD r oh FROM:2- Z- TO: -3 - z- 3 HE APPROPRIATE ITEMS FOR EACH ITEMIZED Outstanding Balance Debt Incurred Payments Outstanding Balance obligations totaling more than $100 owe d 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 city State Zip Code DescnpUon of Obligation Will 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 Stale Zip Code Description of Obligation First Name Middle Name Last Name/Business Name Address City State Zip Code Description of Obligatlon 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 O in item 23b. on summary page.) SS-1127 (Rev. 4102) Page of RDA 1159 ITEMIZED STATEMENT OF IN-KIND CONTRIBUTIONS - CANDIDATE 1. NAME OF CANDIDATE OR COMMI 2. REPORT COVERING THE PERIOD e Qr FROM2-2l-lZ T0: 3_31-f7_ Amount 3. TOTAL ITEMIZED IN-KIND CONTRIBUTIONS FROM PRECEDING PAGE (enter $0 if first itemized page) 0 4. COMPLETE THE APPROPRIATE ITEMS FOR EACH ITEMIZED IN-KIND CONTRIBUTION (in-kind contributions totaling more than $100 from any oontributorduring 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 /V/V Date oflnAndContribution 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 Contnbution Occupation Employer First Name Middle Name In-Kind Contribution Received For: Value of In-Kind Contribution Primary Election ❑ General Election Last Name/Organizabon Name ❑ Runoff (Local Elections Only) Address Dateof In-kind CDriftution Aggregate this Election City Stabs 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 ofln-kindConhibution Aggregate this Election City State Zip Code Description of InAnd Contribution Occupation Employer First Name Middle Name In-Kind Contribution Received For: Value of In-Kind Contribution Last Name E] Primary Election ❑ General Election !Organization Name ❑ Runoff (Local Elections Only) Address Date ofln-Kind Contribution Aggregate this Election City State Zip Code Description of In-Kind Contribution Occupation yer 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.) QD SS-1128 (Rev. 2106) Page °I of 17 RDA 1159 sEp ti~ 101 Appointment of Political Treasurer ,v i UNY0 o sy ~En\00 For State and Local Candidates and Single-Candidate Committees ti WV V~d 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: q_?jz_R MI'Kt Morton MMOr+'ohP L1a"th oirzy 4. Campaign Address and Phone: City State Zip Code Phone -T. o. -geX r18o2 l LaA T V 317201 a23 - X67 5. Home Address and Phone (if different than item 4 above): City State Zip Code Phone 33:3st A do ~ t e-- Ad Vt lie, ~ 37g® 3" - 30 6. Office Sought (include district number, if applicable) 7. Parry Affliation 8. Election Year f}sSGSS®r o ~ticPzrl~ 'I >rPu abV' tah Zoiz 9. Treasurer Name: 10. Treasurer e-mail address: 'Ka~~c, LgmLzrt rated I, ~~~.L7f e ~wtjVLt -9-6c (tty . L 11. Treasurer Address and Phone: City State Zip Code Phone ° er ` I R r~ . A Vt t't 31?03 &r -two 12. Candidate and Treasurer Signat a (both signatures must be Witnessed. Treasurer can not witness candidate's signature): Signature of C ndidate gnature of Treasurer Signature of Witness 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. DATE OF REPORT 2.a. NAME OF CANDIZ+""' COMMITTEE 1-30-1z 116 2.b. IF COMMITTEE, NAME OF CANDIDATE 3. ELECTION DATE ~4 X01 L 4.a. CAMPAIGN ADDRESS AND PHONE Phone Street or Rural Route City State Zip Code T. D. a0 0YA a 0 37701 4.b. CANDIDATE'S HOME ADDRESS (if different than 4.a.) Phone Street or Rural Route City State Zip Code 3 3' 1- v t e `Z~ 27 P0 5. OFFICE SOUGHT (in ude district number, if applicabl 6. NAME OF POLITICAL TREASURER (may be candidate) sgsor ~a r w. 7. CATEGORY OR REPORT (Che one) 0 1:1 E] 1:1 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 OFREPORTING PERIOD Zoe ~I~dn K41 1 - ZO,= 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. D This campaign is required to file a detailed financial disclosure because contributions (including in-kind) received total more than $1,000 and/or expenditures total more than $1,000 for this reporting period. 10. 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 accounting of campaign contributions and expenditures required to be reported by the candidate committee by the Campaign Financial Disclosure Act. Additionally, I/we swear or affirm that no campaign contributions have been expended for the personal financial benefit of the candidate or for any other nonpolitical purpose as defined by the federal internal revenue code. a~, S_30_ ~-~C I • 3o gnature of ndidate date sign at of politica treasurer date 11. WI, SS SIGNATURE , ~ ~ II signatuiAe of witness date si ature of witness date 12. SUMMARY VI 10. a. BALANCE ON HAND LAST REPORT $ - 00 b. TOTALRECEIPTST}{ISPERIOD F9.fl..S..1O-4 $ c. TOTALDISBURSEMENTS THIS PERIOD $ ~-f--- Q~ d. BALANCE ON HAND (12.a. plus 12.b. minus 12.c.) $ Z. e. TOTAL LOANS OUTSTANDING $ - f. TOTAL OBLIGATIONS OUTSTANDING $ SS-1109 (Rev. 2106) Page 1 of 4 RDA 1159 SUMMARY PAGE - CANDIDATE 13. NAME OF CANDIDATE OR COMMITTEE (In Full) 14. REPORT COVERING THE PERIOD M A K~ C C n FROM: TO: 1-15- i2 RECEIPTS 15. CONTRIBUTIONS (other than loans and interest) a. Unitemized Contributions ($100 or less from each source this eriod $ cc b. Itemized Contributions (over $100 from each source this period) $ 7_7 ,O 00 c. TOTAL CONTRIBUTIONS (other than loans and interest)(add 15.a. and 15.b.) S O a 16. LOANS RECEIVED THIS REPORTING PERIOD 17. INTEREST RECEIVED THIS REPORTING PERIOD 0 Cc 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) TIDAa $ `73 cc L ~o CC ~ r CRS Cc -p j , Tai rL r~S - 1~a5 ~ $ $ 7+~Z• Total of Expenditures ($100 or less each payee) $ b. Itemized Expenditures (Over $100 each payee this period) $ 43 c. TOTAL EXPENDITURES (other than loan repayments)(add 19.a. and 19.b.) ~pZ 20. LOAN REPAYMENTS MADE THIS PERIOD O ~z?'S• 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) $ d b. Itemized in-kind contributions (over $100 from each source this period) $ 0 c. TOTAL IN-KIND CONTRIBUTIONS RECEIVED THIS PERIOD (add 22.a. and 22.b.) $ 23. OBLIGATIONS a. Unitemized Obligations Outstanding ($100 or less each) $ 0 b. Itemized Obligations Outstanding (Over $100 each) $ d c. TOTAL OBLIGATIONS OUTSTANDING (add 23.a. and 23.b.) (must be shown i item 12.f.) $ O Page Z of I 0 SS-1133 (Rev. 4102) ITEMIZED STATEMENT OF CONTRIBUTIONS - CANDIDATE 2. REPORT COVERING THE PERIOD 1. NAME OF CANDIDATE OR COMMITTEE FROM: T0: -i6-iF- /44 i K~ oV- Amount O 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 MlddleName Contribution Received For: First Name J / s Ke- LY1 Primary Election ❑ General Election Last Name/ r anizationName i;Z r J ❑ Runoff (Local Elections Only Address 3 a'`~ - City Aggregate This Election Sra~ Zip Code Date of Contribution a~ Occupation r o rP ✓ 0~~ Employer ~ou w C_o ~i h V t Contribution Received For: Amount of Contribution First Name Middle Name tY LastNamelOr ani atio Name Primary Election 1:1 General Election El Runoff (Local Elections Only) Address - SH2rWcc r~V Aggregate This Election 41 City state Zip Code Date of Contribution A ~ f~l Occupation 10 - - 10~ ~ - ~Irp r S Employer , r ~c.uw pct., (giv Contribution Received For: Amount of Contribution First Name fiddle Name ast amel rgamzati ame Primary Election ❑ General Election S~© o Address ❑ Runoff (Local Elections Only 2ve,fott Aggregate This Election City State Zip Code Date of Contribution 'Iyyz Occupation 1~-Il j 11 -Employer Contribution Received For: Amount of Contribution First Name Middle Name Last NamelOr LrJ Primary Election 13 General Election gan 1✓~~ IAation Name 4cter LL44~~ Address ❑ Runoff (Local Elections Only) OR City S ZipC3e,, Date of Contribution Aggregate This Election 411-0 TIN /J Occupation 1Q or Ke 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.) Page 3 of RDA 1159 SS-1131(Rev. 2/06) ITEMIZED STATEMENT OF CONTRIBUTIONS - CANDIDATE 1. NAME OF CANDIDATE OR COMMITTEE 2. REPORT COVERING THE PERIOD r o N FROM: q-1 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 totalin more than $100 from an contributor Middle Name Contribution Received For: Amount of Contribution FirstName { Last Name/OrganizationName Primary Election ❑ General Election 0L e- Address ❑ Runoff (Local Elections Only) City Sta zipC~~~Z Date of Contribution Aggregate This Election ow Occupation I j_ j5 „ 1 I1 D C1i a r 1, Employer ~z1f Middle Name Contribution Received For: Amount of Contribution First Name rr L, Last NamelOrganizati n Name Primary Election ❑ General Election Address y ❑ Runoff (Local Elections Only) 3S hT ~~r ~dx~ City - Sta zip Code Date of Contribution Aggregate This Election A A' Occupation -ReR J-~.U- 11-1s-1i. 1 Employer sz 1f FirstName iddleName Contribution Received For: Amount of Contribution ast ame rganizabon ame Primary Election ❑ General Election .5od Address ❑ Runoff (Local Elections Only) r + City State Zip Code Date of Contribution Aggregate This Election AALo Occupation ~r 1 mp oyer First Name Middle Name ontribution Received For: Amount of Contribution Last Name/Organization Name ❑ 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 2„il~ (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.) F Page of RDA 1159 SS-1131(Rev. 2106) ITEMIZED STATEMENT OF IN-KIND CONTRIBUTIONS - CANDIDATE 1. NAME OF CANDIDATE OR COMMITT E EFROWI.t.1i ORT COVERING THE PERIOD TO: - - Z /V~ K~ a o moun a 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 Contribution Received For: Value of In-Kind Contribution First Name ❑ Primary Election 11 General Election LastNamelOrganizationName ❑ Runoff (Local Elections Only) Date of In-Kind Contribution Aggregate this Election Address city state Zip Code Description of In-Kind Contribution Occupation Employer Middle Name In-Kind Contribution Received For: Value of In-Kind Contribution First Name Primary Election ❑ General Election Last Name/Organization Name ❑ Runoff (Local Elections Only) Date of lr-KindContribution 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 Name/Organization Name ❑ Runoff (Local Elections Only) Address Date of In-Kind Contribution Aggregate this Election City Stale ZpCode Description of I -Kind Contribution -Occupation m yer First Name Middle Name In-Kind Contribution Received For: Value of In-Kind Contribution Primary Election ❑ General Election Last NamelOrganizafion 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 [I 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 Contdbution Occupation mp yer 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.) RDA 1159 SS-1128 (Rev. 2108) Page of ITEMIZED STATEMENT OF EXPENDITURES - CANDIDATE 1. NAME OF CANDIDATE OR OMMITTEE 2. REPORT COVERING THE PERIOD MIKe- 10r*n FROM: FMOUI jY.12 3. TOTAL ITEMIZED CAMPAIGN EXPENDITURES FROM PRECEDING PAGE (enter $0 if first itemized page) Q 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/Bu ' ess Name I Address U rn e 1 , 0 E, er jq-vt. ' City St at Zip Code 3'1744- First Name Middle Name Purpose of Expenditure Amount of Expenditure Last Name/Business Name ~Lko~ r M. ~ 3 Address !ZZ l~e y~y~ P rJ u City A/ II Slate Zip Code First Name Middle Name Purpose of Expenditure Amount of Expenditure Last Name/Business Name , d -lf LAr,VRr h~gK aw Address + ~?d c ~Ir ~~il {.~d 321 City State Zip Code A-L OIR 37101 First Name Middle Name Purpose of Expenditure Amount of Expenditure Last Name/Bu 'rTq Name few 03 Address 3 ~'-h-u ~Kfi.rtN~ City State Zip Code '5' 37201 First Name Middle Name Purpose of Expenditure Amount of Expenditure Last Name/Busin s Name ~ (J 3~ Address City State Zip Code ko 3?40. First Name Middle Name Purpose of Expenditure Amount of Expenditure Last Name/Business Name Ike 15 c-_ Address ~t Ibr ft t 1l ~tts City State r Zip Code / l~ ADX LI: 4- 5. TOTAL ITEMIZED EXPENDITURES (Carry forward to item 3. of next page if additional pages of this form are used.) r1/]rJG'. (If this is the last page of expenditures, this amount must be shown in item 19b. of summary.) !!~~11 La SS-1129 (Rev. 4/02) Page of p RDA 1159 ITEMIZED STATEMENT OF EXPENDITURES - CANDIDATE 1. NAME OF CANDIDATE OR COM E IVY ( MITT 2. REPORT COVERING THE PERIOD G,+, FROM: rj - -11 TO: _ 3. TOTAL ITEMIZED CAMPAIGN EXPENDITURES FROM PRECEDING PAGE (enter $0 if first itemized page) -S~ moun 4. COMPLETE THE APPROPRIATE ITEMS FOR EACH ITEMIZED EXPENDITURE (expenditures totaling more thaw $100 to an First Name y payee during the period) Middle Name Purpose of Expenditure Last Name/Business N me Amount of Expenditure ~4dVr.;r Address W30 SFr I ~Q~1 . city - d ®Y►q State ZIP Code First Name Middle Name Purpose of Expenditure Last Name/ -sin ss Name Amount of Expenditure " Address o Leo r~ t9 city 1,e t/~ /c•tS~. State Zip Code ~A(e 3'135 First Name Middle Name Purpose of Expenditure Last Nam Business Name Amount of Expenditure I I twlS r l H - Address vl City State Zip Code -10 377,02 First Name Middle Name Purpose of Expenditure Last Name/Business Name Amount of Expenditure W Address I 16 7- ro s ili 2?r2 Yw2 q , Csly State Zip Code ui"~ I ~ tS f~ Icoq 372d / First Name Middle Name Purpose of Expenditure Amount of Expenditure Last Name/Business Name Oh 11+~r ~1 L`~~(~Vl Address 1ZZ co o City _ State Zip Code hvl ~(z 373s First Name Middle Name Purpose of Expenditure Amount of Expenditure Last Name/Business Name Address Qty State Zip Code 5. TOTAL ITEMIZED EXPENDITURES (Carry forward to item 3. of next page if additional pages of this form are used.) S13 (If this is the last page ofexpenditures, this amount must be shown in item 19b. of summary.) 7t / , SS-1129 (Rev. 4102) 'I Page of RDA 1159 ITEMIZED STATEMENT OF LOANS - CANDIDATE 1. NAME OF CANDIDATE OR COMMITTEE 2. REPORT COVERING THE PERIOD ,4a+" 7-i-ii Tai-1c=1z 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 E3 Primary Election ❑ General Election city state Zip Code ❑ Runoff (Local Elections Only) List All Endorsers or Guarantors forAbove 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 7mddle, 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 %mount 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 for all Loans (complete on last page of itemized bans) Outstanding Loan Balance Loans Loan Outstanding Loan Balance (Total loans received should also be shown in item 16. on summary page.) (Beginning of Period Received Payments End of Period (Total loan payments should also be shown in item 20. on summary page.) o (Total outstanding ban balance should also be shown in item 12.e. on front page.) `/J) SS-1132 (Rev. 4102) Page of RDA 1159 ITEMIZED STATEMENT OF OBLIGATIONS - CANDIDATE 1. NAME OF CAN IDATE OR COMNITTEE 2, REPORT COVERING THE PERIOD Mike- grro„ FROM: 1-1- TO: 1- S-12 3. COMPLETE THE APPROPRIATE ITEMS FOR EACH ITEMIZED Outstanding Balance Debt Incurred Payments Outstanding Balance OBLIGATION (obligations totaling more than $100 owed to any (Beginning of Period) This Period This Period (End of Period) person/vendor at the end of the reporting period) First Name Middle Name Last Name/Business Name Address City State Zip Code ascription of Obligation First Name Middle Name Last Name/Business Name Address City State Zip Code Description of Obligation First Name Middle Name Last Name/Business Name Address city Slate Zip Code Description of Obligation First Name Middle Name Last Name/Business Name Address City State Zip Code Description of Obligation First Name Middle Name Last Name/Business Name Address City State Zip Code Description of Obligation 4. TOTALS (Total from Outstanding Balance - (End of Period) column must also be shown G in item 23b. on summary page.) SS-1127 (Rev. 4/02) Page of RDA 1159 CAMPAIGN FINANCIAL DISCLOSURE STATEMENT For State and Local Candidates For Single-Candidate Committees 1. DATE OF REPORT 12.a. NAME OF CANDIDATE OR COMMITTEE Zi-~$- tZ M1 e o loh 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 BO Alco4 3rJ 0 4.b. CANDIDATE'S HOME ADDRESS (if different than 4.a.) Street or Rural Route City State Zip Code Phone UGHT (in ude district number, if applic le) 6. NAME OF POLITICAL TREASURER (may be candidate) 4CATEGORYOR ~aHe err v e 3 ro+.~ REPORT (Che one) ❑ ❑ ❑ 5~ ❑ ❑ ❑ 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 `Z- zs- 9. 12 (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. D~ This campaign is required to file a detailed financial disclosure because contributions (including in-kind) received total more than $1,000 and/or expenditures total more than $1,000 for this reporting period. 10. 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, 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 federal internal revenue code. x -a8-1z I-ature of ca 7idate date ~sig ture of po itical treasurer da 11. WIT SIGNATURE signat re of witness dat PM 1 2 s' nature of witness date 61 12. SUMMARY D\'Isp CE cp a. BALANCE ON HAND LAST REPORT ° 10~~ _........u? $ 2 ' 0 b. TOTAL RECEIPTS THIS PERIOD $ !12TO P s„ 6 V ti~ Zo c. TOTAL DISBURSEMENTS THIS PERIOD . ....,.,a $ ~ Z L Wd ®C d. BALANCE ON HAND (12.a. plus 12.b. minus 12.c.) 7-,163, C e. TOTAL LOANS OUTSTANDING $ O f. TOTAL OBLIGATIONS OUTSTANDING $ SS-1109 (Rev. 2/06) Page 1 of 17 RDA 1159 SUMMARY PAGE - CANDIDATE 13. NAME OF CANDIDATE OR COMMITTEE (In Full) 14. REPORT COVERING THE PERIOD FROM: 1KC Q vA -/~-/Z T0: 2-LS'1Z 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) $ 100 0 c. TOTAL CONTRIBUTIONS (other than loans and interest)(add 15.a. and 15.b.) $ ~~'Z 16. LOANS RECEIVED THIS REPORTING PERIOD 17. INTEREST RECEIVED THIS REPORTING PERIOD $ O ~ 0 18. TOTAL RECEIPTS (add 15.c., 16., and 17.) (must be shown in item 12.b.) $ ri 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) $ 81. $ $ $ $ $ W. z 8 Total of Expenditures ($100 or less each payee) $ Z b. Itemized Expenditures (Over $100 each payee this period) $ 3 Sq " ZC 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.) --T- 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) $ 9ZZ c. TOTAL IN-KIND CONTRIBUTIONS RECEIVED THIS PERIOD (add 22.a. and 22.b.) $ 23. OBLIGATIONS a. Unitemized Obligations Outstanding ($100 or less each) $ b. Itemized Obligations Outstanding Over $100 each $ c. TOTAL OBLIGATIONS OUTSTANDING (add 23.a. and 23.b.) (must be shown i item 12.f.) $ Cl 9D SS-1133 (Rev. 4/02) Page Z of ITEMIZED STATEMENT OF CONTRIBUTIONS - CANDIDATE 1. NAME OF CANDIDATE OR OMMITTEE 2. REPORT COVERING THE PERIOD I~~- r fn FROM: fZ TO: Z-ZS-IL mount O 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 T Contribution Received For: Amount of Contribution W~. l.~ ' 511p mary Election ❑ General Election Last Name/Organizalion Name L~7 ri Address d ❑ Runoff (Local Elections Only) City state Zip Code Date of Contribution Aggregate This Election -3 1-3 Occupation Employer First Name / Middle Name Contribution Received For: Amount of Contribution L( ~ Last Name/Organizatio ame LNPrimary Election ❑ General Election arr-e 2.~ o Address 1 - ❑ Runoff (Local Elections Only) 01 5m ~/rf rw city Smffi Zip Code Date of Contribution Aggregate This Election 3~1 63 r -tie Occupation Employer First Name le Name Contribution Received For: Amount of Contribution -36 W s am rganiza n Name, I.. K-ary Election ❑ General Election Address ❑ Runoff (Local Elections Only) to wi- City State Zip Code Date of Contribution Aggregate This Election ~rt ubo 3`It'Z Occupation ~~15~ X12 SS N~✓K~r /r~/I mp oyer JL First Name Middle Name nt i ubon eceive or: mount o Contribution Last Name/Organization Name R (Primary Election ❑ General Election y ~(lrCd Address 1o n ❑ Runoff (Local Elections Only) City State Zip Cade Date of Contribution Aggregate This Election PtACo a C Occupation 2©e 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.) p SS-1131(Rev. 2106) Page 3 of s RDA 1159 ITEMIZED STATEMENT OF CONTRIBUTIONS - CANDIDATE 1. NAME OF CANDIDATE OR OMMITTE 2. REPORT COVERING THE PERIOD i G O r 0 h FROM: - -I Z TO: Z -~S- 17 Amount 3. TOTAL ITEMIZED CAMPAIGN CONTRIBUTIONS FROM PRECEDING PAGE (enter $0 if first itemized page) QD 4. COMPLETE THE APPROPRIATE ITEMS FOR EACH ITEMIZED CONTRIBUTION contributions totaling more than $100 from an contributor First Name z , Middle Name L Contribution Received For. Amount of Contribution Last Name/Organization Name r ❑ Primary Election ❑ General Election Address ~6,3 ❑ Runoff (Local Elections Only) City Sta Zip Code Date of Contribution Aggregate This Election r 3,171) Occupation rJ►1S1to QO( ~.r 1-31-1z ZOO Employer i First Name Middle Name Contribution Received For: Amount of Contribution ALL Last Name/Org nization Name Primary Election ❑ General Election Or p h 1•/ Address ❑ Runoff (Local Elections Only) City stag.,,-- Zip Code Date of Contribution Aggregate This Election vN 3'7 Po Occupation t 4400 Employer ~b Cr1lWtew First Name { iddle Name Contribution Received For: Amount of Contribution ~6t thk~~ L Last Name/Organization amemary Election ❑ General Election ut11 p Address ❑ Runoff (Local Elections Only) D /C N! , City /14 Ista Zip Code Date of Contribution Aggregate This Election /L h0 Nl 'C. 37 / Occupation ~~-14-1z Soo mp oyer S First Name Middle Name ntn utton eceive or: mount 0 ont6bution Last Name/Organization Name Yt' Primary Election ❑ General Election Address ❑ Runoff (Local Elections Only) City sta N Zip Code Date of Contribution Aggregate This Election t A6 Occupation -12 ;Z Employer S 5. TOTAL ITEMIZED CONTRIBUTIONS (Carry forward to item 3. of next page if additional pages of this form are used.) 310o (If this is the last page of contributions, this amount must be shown in item 15b. of summary.) SS-1131(Rev. 2/06) Page of RDA 1159 ITEMIZED STATEMENT OF IN-KIND CONTRIBUTIONS - CANDIDATE 1. NAME OF CANDIDATE OR COMMITTEE , 2. REPORT COVERING THE PERIOD I ke, &P Oh FROM: 17- TO: -zS-1 3. TOTAL ITEMIZED IN-KIND CONTRIBUTIONS FROM PRECEDING PAG:E(:n:te r$0 if first itemized page) moun 4. COMPLETE THE APPROPRIATE ITEMS FOR EACH ITEMIZED IN-KIND CONTRIBUTION (in-kind contributions totaling more than $100 from any contributor during the©iod) First Name Middle Name In-Kind ontribution Received For: Value of In-Kind Contribution Last Nam Organization Name Primary Election ❑ General Election I~ ❑ Runoff (Local Elections Only) Address Data of In-Kind Contribution .0 > Aggregate this Election State Zip Code Description of In-ICnd Contribution Occupation Employed First Name Middle Name In-Kind Contribution Received For: Value of In-Kind Contribution Last Name/Organaation Name ❑ Primary Election ❑ General Election ❑ Runoff (Local Elections Only) Address Date of In-Kind Contribution Aggregate this Election city state _Zip ode P Description of In-Kind Contribution Occupation Employer First Name Middle Name In-Kind Contribution Received For: Value of In-Kind Contribution Last Name/OrganizationName Primary Election [3 General Election ❑ Runoff (Local Elections Only) Address Date of IMGnd Contribution Aggregate this Election City State Zip Code Description of lo-Kind Contribution Patron m Ya First Name Middle Name In-Kind Contribution Received For: Value of In-Kind Contribution Last Name/Organization Name E] Primary Election ❑ General Election ❑ Runoff (Local Elections Only) Address Date of In-Kind Contribution Aggregate this Election City State Zip Code ontribution Occupation JE-pkryer First Name Middle Name Contribution Received For: Value of In-Kind Contribution Last NameiOrganizatbnName ❑Primary Election General Election Address ❑ Runoff (Local Elections Only) Date of IndOnd ConInWtion Aggregate this Election City State Zip Code DrucriptionoTln-Kind Contribution on 5. TOTAL ITEMIZED IN-KIND CONTRIBUTIONS (Carty forward to item 3. of next paged 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. 2106) Page of RDA 1159 ITEMIZED STATEMENT OF EXPENDITURES - CANDIDATE 2. REPORT COVERING THE PERIOD 1. NAME OF CANDIDATE OR COMMITT E f FROM: 1 1~- 10: 2 ZS = /Z 1 11 pr 061% moun 3. TOTAL ITEMIZED CAMPAIGN EXPENDITURES FROM PRECEDING PAGE (enter $0 if first itemized page) than $100 to any payee during the perod) 4. COMPLETE THE APPROPRIATE ITEMS FOR EACH ITEMIZED EXPENDITURE (expenditures totaling more Amount of Expenditure Middle Name Purpose of Expenditure First Name Z~fis~~~ 1 Last NamelBusi s Name Address Qr j~ e ~ / 1 Scat Zip Code City ~ O 3 O AY V I t Amount of Expenditure Middle Name Purpose of Expenditure First Name / 'ylc,,~ Last Name/Business Name ~ w _ T1J Tr-1 Address <4-11:+ "TYt rn " tau ~ ~tale Zip Cade city / ry 371 7 of Ex endihue Amount of Expenditure Middle Name Purpose p First Name ~ p 01'% , N I 4 ap s t1I Last Name/Business I r/ 2 q-. 1 tr , I iI bwv- ~~rv~ 1 Address ?5 a d d "P.O. -80X f State Zip Code city , ,3Xc Z v L l t Amount of Expenditure First Name Middle Name Purpose of Expenditure Last Name/Business Narre r' V e ~~~f 1 r WtCS L ~1 L Address 30q _[~Lt Stale Zip Cade CCCJJJ~~~ city Ala N 3~~ Amount of Expenditure First Name Middle Name Purpose of Expenditure Last ~Np Biginess Name t It M 1✓V Address / ay-", -Roil if city Stat Zip Code /44 4YW V- '391 "70 Middle Name Purpose of Expenditure Amount of Expenditure First Name 17 IALOr Last N ini!~s Name, a .-1-~~ + t r r 'S T Address City Zip Code 1 ll Y - SrV 3r7 oz 5. TOTAL ITE ZED EXPENDITURES C{ ~2 (Carry forward to item 3. of next page ff additional pages of this form are used.) L (If this is the last page of expenditures, this amount must be shown in item 19b. of summary.) / AGN, - ) SS-1129 (Rev. 4102) r P 01 ,,59 b ITEMIZED STATEMENT OF LOANS - CANDIDATE 1. NAME OF CANDIDATE OR COMMITTEE 2. REPORT COVERING THE PERIOD r FROM: -TT- ZS-lZ 41 & l -1(, -1z- 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 Z I A: Address Loan Received For: Date of Loan ❑ Primary Election ❑ General Election city state I Zip Code ❑ Runoff (Local Elections Only) List All Endorsers or Guarantors forAbove 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 State Zip Code Amount Guaranteed Outstanding Amount Guaranteed Outstanding First Name Middle Name First Name Middle Name Last Name/Organization Name Last Name/Organization Name Address Address City State Zip Code City State Zip Code Amount Guaranteed Outstanding Amount Guaranteed Outstanding First Name Middle Name First Name Middle Name Last Name/Organization Name Last Name/Organization Name Address Address City State Zip Code City state Zip Code Amount Guaranteed Outstanding Amount Guaranteed Outstanding 4. Totals for all Loans (complete on last page of ftembmd bans) Outstanding Loan Balance Loans Loan Outstanding Loan Balance (Total loans received should also be shown in item 16. on summary page.) (Beginning of Period Received Payments End of Period (Total loan payments should also be shown in item 20. on summary page.) (Total outstanding ban balance should also be shown in item 12.e. on front page.) ID SS-1132 (Rev. 4102) Page tl of 7 RDA 1159 ITEMIZED STATEMENT OF OBLIGATIONS - CANDIDATE 1. NAME OF CANDIDATE OR COMMITTEE ' 2. REPORT COVERING THE PERIOD 1 K_ /A A 0 FROM: 1-k--12- TO: Z-2S - 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) personivendor at the end of the reporting period) First Name Middle Name Last Name/Business Name Address city state Zip code DescHption of Obligation First Name Middle Name Last a usiness Name Address city State Zip Code Description of Obligation First Name Middle Name Last Name/Business Name Address city state Zip Code Description of Obligation First Name Middle Name Last Name/Business Name Address City State Zip Code Description of Obligation First Name Middle Name Last Name/Business Name Address City State Zip Code Description of Obligation 4. TOTALS (Total from Outstanding Balance - (End of Period) column must also be shown in item 23b. on summary page.) SS-1127 (Rev. 4102) Page of RDA 1159