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Duck, Samuel David (Maryville City School Board) a CAMPAIGN FINANCIAL DISCLOSURE STATEMENT For State and Local Candidates For Single-Candidate Committees 1. DATE OF REPORT 2.a. NAME OF CANDIDATE OR COMMITTEE I s~N►~E C, D V~4-C 2.b. IF COMMITTEE, NAME OF CANDIDATE 3. ELECTION DATE 2614 110 4.a. CAMPAIGN ADDRESS AND PHONE Street or Rural Route City State Zip Code Phone 3 2 C) ivy A r~ V I Ut T/V 3'78o , s 3 0 0 7 2 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) MAOVIU,E SC-Hoot. iZ-r R 5A,44 vl) C .q 7. CATEGORY OR REPORT (Check one) ❑ ❑ 1:3 1:1 FIRST SECOND THIRD FOURTH PRE- PRE- MID-YEAR YEAR-END QUARTER QUARTER UARTER QUARTER PRIMARY GENERAL SUPPLEMENTAL SUPPLEMENTAL 8.a. BEGINNING DATE OF REPORTING PERIOD 8.b. ENDING DATE OF REPORTING PERIOD 1.0 (4 10 2- 9. (Check one) a. ❑ This campaign is exempt from detailed disclosure because contributions (including in-kind) received total $1,000 or less AND expendi- tures total $1,000 or less for this reporting period. (Complete items 12d., 12e. and 12f.) b. ❑ This campaign is required to file a detailed financial disclosure because contributions (including in-kind) received total more than $1,000 and/or expenditures total more than $1,000 for this reporting period. F. 10. I/we do solemnly swear or affirm that the information contained in this campaign financial disclosure report is true and that this report is an accurate accounting of campaign contributions and expenditures required to be reported by the candidate committee by the Campaign Financial Disclosure Act. Additionally, I/we swear or affirm that no campaign contributions have been expended for the personal financial benefit of the candidate or for any other nonpolitical purpose as defined by the federal internal revenue code. 2-o t 02 9, jj signature of candidate date ~Z signature of political treasurer date e 11. WITNESS SIGNATURE Z2_MZ 1_~\ . 1~1~7~ 2~ signature of witness signature of witness date 12. SUMMARY a. BALANCE ON HAND LAST REPORT $ O $ 0 I O b. TOTAL RECEIPTS THIS PERIOD 1500,()p c. TOTAL DISBURSEMENTS THIS PERIOD $ d. BALANCE ON HAND (12.a. plus 12.b. minus 12.c.) $ 0100 e. TOTAL LOANS OUTSTANDING $ 0 f. TOTAL OBLIGATIONS OUTSTANDING $ O 4) 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 FROM: TO: RECEIPTS 15. CONTRIBUTIONS (other than loans and interest) r1 a. Unitemized Contributions $100 or less from each source this period) b. Itemized Contributions (over $100 from each source this period) $ S . e) 0 c. TOTAL CONTRIBUTIONS (other than loans and interest)(add 15.a. and 15.b.) $ 5 C~ d 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.) $ l~ 0 0 U 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) $ _ Is c o 0 c. TOTAL EXPENDITURES (other than loan repayments)(add 19.a. and 19.b.) $ S U d C) 20. LOAN REPAYMENTS MADE THIS PERIOD $ 21. TOTAL DISBURSEMENTS (add 19.c. and 20.) (must be shown in item 12.c.) $ I S OC1 .0 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) $ V c. TOTAL OBLIGATIONS OUTSTANDING (add 23.a. and 23.b.) (must be shown i item 12.f.) $ SS-1133 (Rev. 4102) Page of ITEMIZED STATEMENT OF CONTRIBUTIONS - CANDIDATE 1. NAME OF CANDIDATE OR COMMIT 2. REPORT COVERING THE PERIOD S A M V L V C FROM: TO: Amount 3. TOTAL ITEMIZED CAMPAIGN CONTRIBUTIONS FROM PRECEDING PAGE (enter $0 if first itemized page) S ( Q , 4. COMPLETE THE APPROPRIATE ITEMS FOR EACH ITEMIZED CONTRIBUTION( contributions totalin more than $100 from an contributor First Name Middle Name 5 A M U& Contribution Received For: .~I Amount of Contribution Last Name/Or nization Name ❑ Primary Election ld General Election U I S ov. oo Address ❑ Runoff (Local Elections Only) City State Zip Code Date of Contribution Aggregate This Election Occupation Employer First Name Middle Name Contribution Received For: Amount of Contribution Last Name/Organization Name ❑ Primary Election ❑ General Election Address ❑ Runoff (Local Elections Only) City State Zip Code Date of Contribution Aggregate This Election Occupation Employer First Name iddle Name Contribution Received For: Amount of Contribution as Name/Organization Name ❑ Primary Election ❑ General Election Address ❑ Runoff (Local Elections Only) City State Zip Code Date of Contribution Aggregate This Election Occupation mP oyer 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.) I S ~1 , ` (If this Is the lest page of contributions, this amount must be shown In item 15b. of summary.) U SS-1131(Rev. 2/06) Page -11- of RDA 1159 ITEMIZED STATEMENT OF EXPENDITURES - CANDIDATE 1. NAME OF CANDIDATE OR COMMITTEE 2. REPORT COVERING THE PERIOD S /A ¢ 1A FROM: TO: moyn 3. TOTAL ITEMIZED CAMPAIGN EXPENDITURES FROM PRECEDING PAGE (enter $0 if first itemized page) SO).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 LastNamelBTusiness `amen MAI I C /30 O Address 1 x R DV ER rt~ S--fN 6 J 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 First Name Middle Name Purpose of Expenditure Amount of Expenditure Last NameBusiness Name Address City State Zip Code First Name Middle Name Purpose of Expenditure Amount of Expenditure Last Name/Business Name Address City State Zip Code 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.) AWL SS-1129 (Rev. 4/02) Page of Ai RDA 1159 i CAMPAIGN FINANCIAL DISCLOSURE STATEMENT For State and Local Candidates For Single-Candidate Committees 1. DATE OF REPORT 12.a. NAME OF CANDIDATE OR COMMITTEE Z p( S tI M l/'t L ( U C 3. ELECTION DATE 2.b. IF COMMITTEE, NAME OF CANDIDATE ' G t 4.a. CAMPAIGN ADDRESS AND PHONE State Zip Code Phone Street or Rural Route City ~L IIt/~'' D r1RR U1CLE (N 3001 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) 141ARYvZUC SCHOOL, o a1 7. CATEGORY OR REPORT (Check one) E3 1:3 1:1 iz MID-YEAR YEAR-END FIRST SEND THIRD FOURTH PRE- ~ QUARTER QUARTER QUARTER _QUARTER PRIMARY GENERAL SUPPLEMENTAL SUPPLEMENTAL 8.b. ENDING DATE OF REPORTING PERIOD 8.a. BEGINNING DATE OF REPORTING PERIOD 2.01 0 20 a 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 revenue code. 0 (y (l C9 ~ Avw+Mr_•~ U °~`r1~ ~~tif/ 'c. ZO I t((1 AFL ~ Ol,rc.~ ,e ~ J ~ ~f ~ ~ signature of political treasurer signature of candidate date date 11. WITNESS SIGNATURE 1~J signature of witness date signature of witness date ~ 1v 11 12 AM n IL ~ Fa. SUMMARY RECEIVED V ..T...,i,,.~........ L„ BALANCE ON HAND LAST REPORT $ s.. I•• 1 O~ , d M CJ $ b. TOTAL RECEIPTS THIS PERIOD 8L 1 E~~OUNfiY••"•' Soo. OD $ c. TOTAL DISBURSEMENTS THIS PERIOD ...................~b.•••••~d Z1 ll 0 `.cd q) PffOTTALL BALANCE ON HAND (12.a. plus 12.b. minus 12.c.) . . TOTAL LOANS OUTSTANDING . . TOBLIGATIONS OUTSTANDING Page 1 of RDA 1159 SS-1109 (Rev. 2106) SUMMARY PAGE - CANDIDATE 13. NAME OF CANDIDATE OR COMMITTEE (In Full) 14. REPORT COVERING THE PERIOD FROM: TO: RECEIPTS 15. CONTRIBUTIONS (other than loans and interest) a. Unitemized Contributions ($100 or less from each source this period) $ Q b. Itemized Contributions (over $100 from each source this period) $ I SOd . o o c. TOTAL CONTRIBUTIONS other than loans and interest add 15.a. and 15.b. o , w 16. LOANS RECEIVED THIS REPORTING PERIOD $ 0 17. INTEREST RECEIVED THIS REPORTING PERIOD $ 18. TOTAL RECEIPTS (add 15.c., 16., and 17.) (must be shown in item 12.b.) $ I~oo 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 c. TOTAL EXPENDITURES (other than loan repayments)(add 19.a. and 19.b.) $ 7 20. LOAN REPAYMENTS MADE THIS PERIOD $ V C 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) $ 0 b. Itemized in-kind contributions (over $100 from each source this period) $ U 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.) $ 0 SS-1133 (Rev. 4102) Page of ITEMIZED STATEMENT OF CONTRIBUTIONS - CANDIDATE 1. NAME OF CANDIDATE OR COMMITTEE 2. REPORT COVERING THE PERIOD s V FROM: T0: Amount 3. TOTAL ITEMIZED CAMPAIGN CONTRIBUTIONS FROM PRECEDING PAGE (enter $0 if first itemized page) S 0 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 ame MUE L Last Name/Organization Name ❑ Primary Election General Election .15 0 LK OO ~n V Address 4 Q~ ~ ❑ Runoff (Local Elections Only) Z l FNS ~r\T v~ City Zip Code Date of Contribution Aggregate This Election R (/I rateO/ ' Occupation S Employer Middle Name Contribution Received For: Amount of Contribution First Name ❑ Primary Election ❑ General Election Last Name/Organization Name Address ❑ Runoff (Local Elections Only) State Zip Code Date of Contribution Aggregate This Election Ciry Occupation Employer iddle Name Contribution Received For: Amount of Contribution First Name as ame rganiza on Name ❑ Primary Election ❑ General Election Address ❑ Runoff (Local Elections Only) State Zip Code Date of Contribution Aggregate This Election City Occupation m Dyer Middle Name Contribution eceive or: Amount o Contribution First Name ❑ Primary Election ❑ General Election Last NamelOrganization Name Address ❑ Runoff (Local Elections Only) State Zip Code Date of Contribution Aggregate This Election City 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.) Page of RDA 1159 SS-1131(Rev. 2106) f ITEMIZED STATEMENT OF EXPENDITURES - CANDIDATE I'll, d 1. NAME OF CANDIDATE OR COMMITTEE 2. REPORT COVERING THE PERIOD FROM: T0: 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 15-00, Address City State Zip Code Middle Name Purpose of Expenditure Amount of Expenditure First Name Last Name/Business Name Address City State Zip Code Middle Name Purpose of Expenditure Amount of Expenditure First Name Last Name/Business Name Address City State Zip Code Middle Name Purpose of Expenditure Amount of Expenditure First Name Last Name/Business Name Address City State Zip Code Middle Name Purpose of Expenditure Amount of Expenditure First Name Last Name/Business Name Address City State Zip Code Middle Name Purpose of Expenditure Amount of Expenditure First Name 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.) Page of RDA 1159 Ash SS-1129 (Rev. 4102) FINANCIAL DISCLOSURE STATEMENT EXEMPTION Pursuant to TCA § 2-10-101(b) a candidate is exempt from filing financial disclosure statements: "If a candidate is seeking an office for which service is part-time, compensation is less than $1,000 a month, and the candidate does not spend more than $1,000 to get elected to office, the candidate does not have to file Campaign Financial Disclosure Reports." CANDIDATE'S INFORMATION: Candidates Name: D Candidate's Position: /~'tiER (/ILCE ~C(-fop Residential Address: ~2~ A S t3 U~ ~I~LV E City: ^ Y Vz C State: T.% Zip: (o I hereby state that I meet the above qualifications for exemption and am therefore exempt from filing financial disclosure statements. J6,~ ~ 6 Date Candidates Signature G ►D.lo ►y Witness's Signature Date 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. +V. m ICr 10 20je , w N ~~I ~V Wd Zl l l Ot 6 .kW •L~ _ r -ur.• r.i._,~ _ _ _ _ _ _ _,n~'a,. .iM MIF`. ur ~1..~,~ ' Imii~R~i~rora®n.ns m~ CAMPAIGN FINANCIAL DISCLOSURE STATEMENT For State and Local Candidates For Single-Candidate Committees 1. DATE OF REPORT 2.a. NAME OF CANDIDATE OR COMMITTEE Zd tq 0710 SAMvc-c 0 uc 2.b. IF COMMITTEE, NAME OF CANDIDATE 3. ELECTION DATE 2W1~ f0 4.a. CAMPAIGN ADDRESS AND PHONE Street or Rural Route City State Zip Code Phone 3 2 `6 O1 T_ UC 'yt1w2 V Z U-6 T 3 o I4 300 ,~2c 4.b. CANDIDATE'S HOME ADDRESS (if different than 4.a.) Street or Rural Route City State Zip Code Phone 5. OFFICE SOUGHT (include district number, if applicable) 6. NAME OF POLITICAL TREASURER (may be candidate) 7. CATS RY OR REPORT (Oheck one) FIRST SECOND THIRD FOURTH PRE PRE MIDYEAR YEAR-END QUARTER QUARTER QUARTER QUARTER PRIMARY GENERAL SUPPLEMENTAL - SUPPLEMENTAL 8.a. BEGINNING DATE OF REPORTING PERIOD 8.b. ENDING DATE OFIREPORTING PERIOD C l ~ 0V c Zo1 ~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. 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, Vwe 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. -1 mi,v 4 Pa,', ~GvZ 2-0c Ye 7c0 001 W (0 signature of candidate date signature of political treasurer date 11. WITNESS SIGNATURE a 94-on Usignature of witness date signature of witness dal 12. SUMMARY 0 a. BALANCE ON HAND LAST REPORT $ b. TOTAL RECEIPTSTHIS PERIOD O c. TOTALDISBURSEMENTS THIS PERIOD $ D d. BALANCE ON HAND (12.a. plus 12.b. minus 12.c.) $ e. . TOTAL LOANS OUTSTANDING $ O 0 f. TOTAL OBLIGATIONS OUTSTANDING $ AGML SS-1109 (Rev. 2/06) Page 1 of RDA 1159 Nacr CAMPAIGN FINANCIAL DISCLOSURE STATEMENT For State and Local Candidates Tor Single-Candidate Committees 1. DATE OF REPORT 2.a. NAME OF CANDIDATE OR COMMITTEE t"C 2.b. IF COMMITTEE, NAME OF CANDIDATE 3. ELECTION DATE 4.a. CAMPAIGN ADDRESS AND PHONE / v ` M I~E C Street or Rural Route City State Zip Code Phone Z 13UA ors~Tv~ n"AaYUTLLe TV 37 L-) $C 3c~c -7 Z 41. 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) S C Ed c~ (30 ~4 !C f) /I : fr V Z c LC' fl M L t ( h e LJ2 b (/t 7. CATEGORY OR REPORT (Check one) ~T SECO11 ND I] ❑ 1111111i 11 ER THIRD FOURTH PRE- ~ MI YEAR YEAR--END QU R QU B.a.BEGINNING DATE OFREPORTINGPERIOD ow PRIMA GENERAL ~EMENTAL SUPPLEMENTAL S.b. ENDING DATE OF REPORTING PER10D J L> i. Y Z , JAn/ G14 15 9.(Check one) a. Cgr 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 and/or expenditures total more than $1,000 for this re (including in-kind) received total more than $1,000 Porting 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 federal internal revenue code. _ t,,,i Jti pa'j z01 o 1 zY _Jr J a~~1signature of candidate data ~ ~ " " ~ ~ 2 Signature at political treasurer date 11. WITNESS SIGNATURE L~ 1~ [ LEI Eej signature of witness date nature of witness da 12. SUMMARY a. BALANCE ON HAND LAST REPORT o b. TOTALRECEIPTSTHIS . 0 PERIOD 44.tz.......................... $ c. TOTAL DISBURSEMENTS THIS PERIOD $ lJ d. BALANCE ON HAND (12.a. plus 121. minus 12.c.) O e. TOTAL LOANS OUTSTANDING f. TOTAL OBLIGATIONS OUTSTANDING O SS-1109 (Rev. 2106) Page 1 of RDA 1159 V- ED v Ip m 131013 ' pUG ~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, 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 of Candidate or Committee: 3. Candidate e-mail address: 3 SfIM ~~L Da ~ ~ p D~C~ ZR c AqQ e t et 4. Campaign Address and Phone: City State Zip Code Phone ~2-g AS6UXy 0AIVE ltlrge~(IJU6 T v 86S 3a'o72' S. Home Address and Phone (if different than item 4 above): City State Zip Code Phone 6. Office Sought (include district number, if applicable) 7. Party Affliation 8. Election Year I'VI RRYvZ(,CC~ 5c (-f 00 L Q©A R D ZG 1 9. Treasurer Name: 10. Treasurer e-mail address: s /VjV& (41 0_21/r K so dW_T e h h N , 11 Cfi 11. Treasurer Address and Phone: City State Zip Code Phone 12. Candidate and Treasurer Signature (both signatures must be witnessed. Treasurer cannot witness candidate's signature): &~~I &,,CA, -,LAx( P 44 Signature of Candidate Signature of Treasurer -190 1. ( 1~ iV Signature of Witness Signature of Witness Regi*Vy of Election Finance SS-1120 (rev 1012010) CAMPAIGN FINANCIAL DISCLOSURE STATEMENT For State and Local Candidates For Single-Candidate Committees 1. DATE OF REPORT 2.a. NAME OF CANDIDATE OR COMMITTEE ~1ZOY~2 SAn~~Ec 01T ii .Z.0 Dt/C~ 2.b. IF COMMITTEE, NAME OF CANDIDATE 3. ELECTION DATE 2 ~~r2 r~ 06 4.a. CAMPAIGN ADDRESS AND PHONE Street or Rural Route City State Zip Code Phone 2 r 95 uR y :TV E MA~YU_jLte TN 3 Oaf 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) 5 c 14 cc i o/{ 0 S ~q "n U EC hip v-t / 7. CATEGORY OR REPORT (Check one) 11 11 11 FIRST SECOND THIRD FOURTH PRE- PRE- MI 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 20 n D! C 2C' 12_ D 3 3 9. (Check one) a. &I 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, 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. ~cf g- Z~ I2 u signature of candidate date signature of political treasurer date 11. WITNESS SIGNATURE r y1.3(12 1, 032_ signature of witness date signature of witness dSte 12. SUMMARY a. BALANCE ON HAND LAST REPORT $ ~J b. TOTALRECEIPTS THIS PERIOD >~SJ c. TOTAL DISBURSEMENTS THIS PERIOD *'11 $ 7 Z d. BALANCE ON HAND (12.a. plus 12.b. minus 12.c.) $ e. TOTAL LOANS OUTSTANDING $ O f. TOTAL OBLIGATIONS OUTSTANDING $ O SS-1109 (Rev. 2106) Page 1 of RDA 1159 SUMMARY PAGE - CANDIDATE 13. NAME OF CANDIDATE OR COMMITTEE (In Full) 14. REPORT COVERING THE PERIOD 4 M GI C- L L)A V I t7 C K FROM: 2o (&vo ( TO: 2d/2o! jI RECEIPTS 15. CONTRIBUTIONS (other than loans and interest) ? 9 a. Unitemized Contributions ($100 or less from each source this period) $ ) y L y b. Itemized Contributions (over $100 from each source this period) $ C c. TOTAL CONTRIBUTIONS (other than loans and interest)(add 15.a. and 15.b.) $ 39. U 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) _ / I % 6 < - 1 l s T N C, $ 3$. Z $ $ $ $ $ $ $ $ Total of Expenditures ($100 or less each payee) $ 3 2 b. Itemized Expenditures (Over $100 each payee this period) $ 0 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) $ U L 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) $ l~ b. Itemized Obligations Outstanding (Over $100 each) $ c. TOTAL OBLIGATIONS OUTSTANDING (add 23.a. and 23.b.) (must be shown i item 121) $ SS-1133 (Rev. 4/02) Page of ITEMIZED STATEMENT OF CONTRIBUTIONS - CANDIDATE 1. NAME OF CANDIDATE OR COMMITTEE < , 2. REPORT COVERING THE PERIOD M U L A V 12 r l FROM: TO: fa l 2c7/2t'>; 3 ount 3. TOTAL ITEMIZED CAMPAIGN CONTRIBUTIONS FROM PRECEDING PAGE (enter $0 if first itemized page) 2 y 4. COMPLETE THE APPROPRIATE ITEMS FOR EACH ITEMIZED CONTRIBUTION contributions totaling more than $100 from an contributor F ) N Middle Name Contribution Received For: Amount of Contribution ~7'mo(L t ; (/L i bast Nametorgani ation Name ❑ Prima Election '/l C i ry [0 General Election Addrms 3-2 8 AS UK M 1 E ❑ Runoff (Local Elections Only) V 1 t t I ` STwe IV ZP Code C Date of Contribution Aggregate This Election Oocyaation S~tF7w~fet= DE vci c 4Iq l::mPlWer (4 TP PS First Name Middle Name Contribution Received For: Amount of Contribution Last Namelorganization Name ❑ Primary Election ❑ General Election Address ❑ Runoff (Local Elections Only) City State Zip Code Date of Contribution Aggregate This Election Occupation Employer FnitNama [ld* Now Contribution Received For. Amount of Contribution Lost n¢a me ❑ Primary Election ❑ General Election Address ❑ Runoff (Local Elections Only,) Crty State Zap Code Date of Contribution Aggregate This Election Occupation Lmpioyer Fast Name Middle Name ntn ubon Received or 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 3. of next page K additional pages of this form are used.) 3 k . Z (f (K this is the last page of contrbutions, this amount must be shown in item 15b. of summary.) V r SS-1131(Rev. 2/06) Page 3 of RDA 1159 ITEMIZED STATEMENT OF IN-KIND CONTRIBUTIONS - CANDIDATE 1. NAME OF CANDIDATE OR COMMITTEE 2. REPORT COVERING THE PERIOD FROM: TO: 3. TOTAL ITEMIZED IN-KIND CONTRIBUTIONS FROM PRECEDING PAGE (enter $0 'd first itemized page) moon 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 Name/Organization Name ❑ Primary Election 13 General Election ❑ Runoff (Local Elections Only) Address Date of In-Kind Contribution Aggregate this Election City Sad zip code Description of h4QW Contribution Occupation r First Name Middle Name In-Kind Contribution Received For. Value of In-Kind Contribution Last Name/Organaatbn Name Primary Election ❑ General Election ❑ Runoff (Local Elections Only) Address Data of In-Kind Canbbution Aggregate ttnis Election city Sale Zip Code Description of MnaCmd Contribution Occupation Employer First Name Middle Name In-Kind Contribution Received For: Value of In-Kind Contribution Last NamelorganzationName ❑ Primary Election ❑ General Election ❑ Runoff (Local Elections Only) Address Dale of In-Kind Contribution Aggregate ft Election Qt Sate ZpCode Description of In-Kind Conliribution Oompation First Name Middle Name In-Kind Contribution Received For. Value of In-Kind Contribution [3 Primary Election ❑ General Election Last Name/Organization Name ❑ Runoff (Local Elections Only) Address Date of In-Kind ContrbrApn Aggregate this Election city Sale ZpCode Description of In-Kind Contribution Occupation Employer FlrstName = N. In-Kind Contribution Received For: Value of In-Kind Contribution LaslNamelorgam¢ationName ❑ Primary Election ❑ General Election ❑ Runoff (Local Elections Only) Address Date of kn Kxnd Conbihution Aggregate this Election City Sale zip code Description or In-Kind Contribution Occupation Tr~p~ 5. TOTAL ITEMIZED IN-KIND CONTRIBUTIONS (Carty forward to item 3. of next page if additional pages of this form are used.) (If this Is the last page of Mond contributions, this amount must be drown in item 22b. of summary.) i SS-1128 (Rev. 2/06) Page of RDA 1159 ITEMIZED STATEMENT OF EXPENDITURES - CANDIDATE 1. NAME OF CANDIDATE OR COMMITTEE 2. REPORT COVERING THE PERIOD FROM:, .qe, TO: Z ►i2 3. TOTAL ITEMIZED CAMPAIGN EXPENDITURES FROM PRECEDING PAGE (enter $0 K first itemized page) noun C Z 4. COMPLETE THE APPROPRIATE ITEMS FOR EACH ITEMIZED EXPENDITURE (expenditures totaling more than $100 to any payee during the period) I First Name Middle Name Purpose of Expenditure Amount of Expenditure Last NamelBusiness Name R S j j S C-,4,r, 7Rs 41 -1 V 3s~ Address IA AA ~ V 1 LL(- 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 Tip 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 NamelBusiness Name Address city state Zip code 5. TOTAL ITEMIZED EXPENDITURES (Carry forward to ilem 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.) A2h SS-1129 (Rev. 4/02) Pape of Y- RDA 1159 ITEMIZED STATEMENT OF LOANS - CANDIDATE 1. NAME OF CANDIDATE OR COMMITTEE 2. REPORT COVERING THE PERIOD FROM: T0: 3. COMPLETE THE APPROPRIATE ITEMS FOR EACH ITEMIZED LOAN (bans 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/Organizabon Name Address Loan Received For: Date of Loan (3 Primary Election 13 General Election GtY State zip Code ❑ Runoff (Local Elections Only) List All Endorsers or Guarantors forAfove Loan (If more space is needed please attach a page) 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 Nana Last Name/Organization Name Last Name0ganization Name Address Address Co Stale Zip Code City Sfate Zip Code Amount Guaranteed Outstanding Amount Guaranteed Outstanding First Name Middle Name First Name Middle Name Last Name/Organizalion Name Last Name/Organizadon Name Address Address city slide- Zip Code Ciy State Zip Code Amount Guaranteed Outstanding Amount Guaranteed Outstanding First Name Middle Name First Name Middle Name Last Name/Organization Name Last Name/Organizatbri Nano Address Address Gh' State Zip Code city, State Zip Code Amount Guaranteed Outstanding Amount Guaranteed Outstanding 4. Totals for d Loans (complef a on last page of Itemttt>ed bans) 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 P nts End of Period (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.) A3h SS-1132 (Rev. 4/02) Page of RDA 1159 ITEMIZED STATEMENT OF OBLIGATIONS - CANDIDATE 1. NAME OF CANDIDATE OR COMMITTEE 2. REPORT COVERING THE PERIOD FROM: TO: 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 Oblii;iaticm First Name WMle Name Last Nama(Business Narne Address Cdy state Lpcwe Description of Obligation First Name Wdle Name Last NamelBusiness 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 Narne/Business Name Address city Slate Zip Code Description of Obigation 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 Frh < s mom, 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 of Candidate or Committee: 3. Candidate e-mail address: ~.o I Zo2(6 SA /q ve D L/3~ p pUClc Sd(~IC,C-AqP Lo 4. Campaign Address and Phone: City State Zip Code Phone 32-8 /i58uAy 0&7-Ve- M"Ta ~L~Ce 7ni 37,~-o`f CS ~2 5. Home Address and Phone (if different than item 4 above): City State Zip Code Phone 6. Office Sought (include district number, if applicable) 7. Party Affliation 8. Election Year SCH(90< 60460 AjAA vILLE z/V- PE1v 0CAl-T Zv 9. Treasurer Name: 10. Treasurer e-mail address: 11. Treasurer Address and Phone: City State Zip Code Phone 3 Z`S /}S ~UP bp 7V'6 4R ~UZLLE TN }7$v `f $d S 3oa 7zE 12. Candidate and Treasurer Signature (both signatures must be witnessed. Treasurer can not witness candidate's signature): ilwa N4 D1404- _-Lta Signature of Candidate Signature of Treasurer &nxd &V-2)7j __A* Signature of Witness Signature of Witness 4D Registry of Election Finance SS-1120 (rev 1012010)