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Rushing, Susan H. CAMPAIGN FINANCIAL DISCLOSURE STATEMENT For State and Local Candidates For Single-Candidate Committees 1. DATEOF REPORT 12.a. NAME OF CANDIDATE O COMMI EE ECTION DATE 2.b. IF COMMITTEE, NAME OF CANDIDATE -7 al Route City Lj'rGNADDREOclude DDRESS AND PHONE Stat Zip Code Phone 'S HOME ADDRESS (if different than 4.a.) State Zip Code Phone al Route City % UGHT (include district number, if applicable) 6. NAF POLITICALTREASURER (may be candidate) OR REPORT (Check one) ❑ ❑ FIRST SEND THIR0 El D FOURTH PR - P~_ MI FEAR YEAR-END SUPPLEM QUARTER QUARTER QUARTER QUARTER P8 RIM ENDING DATE OF REPORTING PERIODENTAL SUPPLEMENTAL 8.a. BEGINNING DA OF REPORTING PERIOD _ - / ~ 7- 9. (Check one) o less forth setailedi disclosure period. (Complete contributions (in uding in-kind) received total $1,000 or less AND expendi-items 12d., 12e. 12f.) a ❑ nes total campaign is exempt tu 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 Discl ure Act. Additionally, I/we swear or affirm that no campaign contributions have been expended for the personal financial benefit of the id a or f r any other nonpolitical purpose as defined by the fed al i ternaI rev nue code. date signature of political treasurer Xte signature of candidate 11. WIT Ssignature of witness date signature of witness date 12. SUMMARY a. BALANCE ON HAND LAST REPORT $ b. TOTAL RECEIPTS THIS PERIOD $ c. TOTAL DISBURSEMENTS THIS PERIOD $2 d. BALANCE ON HAND (12.a. plus 12.b. minus 12.c.) e. TOTAL LOANS OUTSTANDING ..........4r`. ~'•t. I $ f. TOTAL OBLIGATIONS OUTSTANDING Page 1 of RDA 1159 SS-1109 (Rev. 2106) ITEMIZED STATEMENT OF CONTRIBUTIONS - CANDIDATE 1. NA OF CANDIDATE 70MMj;TEE '2. REPORT COVERING THE PERIOD rx tiav~ S F M: _ T0: _ G~- Amo t 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) HaFkarna Namef / Contribution Received For: Amount of Contribution l~ Last el0 i on Name ❑ Primary Election General Election J Address ~~y ❑ Runoff (Local Elections Only) - If City Zr 1 Date of Contribution Aggregate This Election Occupation Employer Amount of Contribution FirstNa a Mid e ameJ Contribution Received For: Last Name/Organization Nape ❑ Primary Election Ltd General Election Adfy/ 'Y ❑ Runoff (Local Elections Only) C;ry Sta \I Zj Code Date of Contribution// ` Aggregate This Election IV -4 occupy Employer First Na a iddle Name, Contribution Received For: Amount of Contribution s ame an atr ame ❑ Primary Election (EGeneral Election Address ❑ Runoff (Local Elections Only) fY0 K ~c,c~pa;'~ City State Zip Code Date of Contribution Aggregate This Election Mo"( ,Mlle TN '31 E;03 Occupation ' Employer tom-' " First Name 7 Middle Name Contribution Receive For: Amount of Contribution Last Name/Organization Name ❑ Primary Election ❑ Genera( Election Address ❑ Runoff (Local Elections Only) City State Zip Code Date of Contribution Aggregate This Election Occupation Employer 5. TOTAL ITEMIZED CONTRIBUTIONS ODD (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.) SS-113l (Rev. 2106) Page of RDA 1159 ITEMIZED STATEMENT OF EXPENDITURES - CANDIDATE 1. NAMPF CANDIDATE OR C MITTE 2. REPORT COVERING THE PERIOD vit FROM: 10: ~aDr- 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) Middle Name Purpose of Expenditure Amount of Expenditure First Name L-Gv, L 1 NameBusi ess Name &4- A City State Zig Wde CIA/ Q Middle Name Purpose of Expenditure Amount of Expenditure First N e Last Name/Business Name -17 (Lai AddresrQ,c, ~Z City f State Zip Code Middle Name Purpose of Expenditure Amount of Expenditure Flt ame` I / 1 , Last NameBusiness Name 6LS Addr O ~ city Q Q / Qsi Zip Code Middle Name Purpose of Expenditure Amount of Expenditure Flt2me 77 Last Name/Business Nlime Addresso CHY~ [ state Zip Code First Name MiddleName Purpose of Expenditure Amount of Expenditure , eaS Name s 7674z- j~; S3 AdITsq Y y ,k Slate a-4 Zip t7~1@~ ga g' k Z Q J Middle Name Purpose of Expenditure Amount of Expenditure First Name ~mLNameQusijess Name 1 A esY~/ City O,f ^ ( / , Sta Zip n,;~ 5. TOTAL ITEMIZED EXPENDITURES (Carry forward to Item 3. of next page H 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.) SSA129 (Rev. 4102) Page-j- of 3 RDA 1159 ITEMIZED STATEMENT OF EXPENDITURES - CANDIDATE 2. REPORT COVERING THE PERIOD 1. NAME OF CANDIDATE OR COM TEE FROM TO: miunt~ 3. TOTAL ITEMIZED CAMPAIGN EXPENDITURES F R6 PRECEDING PAGE (enter $0 if first itemized page) c( / 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 nO Amount of Expenditure Last Na usiness Name r a Address city I, I Sta e Zip Code W Middle Name Purpose of Expenditure rn Amount Expenditure Firs ~~((""__((rrGG// Last Na eBusiness a Address Q City State Zip Code A160 0, First Name Middle Name Purpos 61 e of Expenditure Amount of Expenditure 16 I LazlNa usi~ Nam /1" Address Gf+ 77 City State Zip Code First Name Middle Name Purpose of of Expenditure Amount of Ezpenditur Last NameBusi s Name Address r~ 9 City Slate Zip Code / Lp~o C~ First Name Middle Name Purpose of Exxpend~iture' ~ Amount of Expenditure LastN sinessName I ~vI lrl~"`' .i b v' Address City State Zip _C / O`/ 3 First Name Middle Name Purpose of Expenditure l Amount of Expenditure Last e i s§ Name I (C ~ O c12 C~hl/ ✓nw G City Stat Zip Code 5. TOTAL ITEMIZED EXPENDITURES (Carry forward to item 3. of next page if additional pages of this form are used.) oZ Of this Is the last page of expenditures, this amount must be shown in item 19b. of summary.) -7 3 41, (P Q Page of~ 3t RDA 1159 AMk SS-1129 (Rev. 4102) . ITEMIZED STATEMENT OF EXPENDITURES - CANDIDATE L NAME OF CANDIDATE OR CO EE FFR REPORT OVERINGT0:THE PE D 5 n 3. TOTAL ITEMIZED CAMPAIGN EXPENDITUR S FROM PRECEDING PAGE (enter $0 'd first itemized page) 9 4. COMPLETE THE APPROPRIATE ITEMS FOR EACH ITEMIZED EXPENDITURE (expenditures totaling more than $100 to any Payee during the pe110d) P =ofiture Amount of Expenditure Fast Name Middle Name Y J J~ Last ess Larne i r Address City So Zi°CS'-~3 Middle Name Purpose of Expend' Amount of Expenditure First Name Last uskressName 0~f Addr ass 1 3 Fo S CiH stale DP Cede r t 5 Fust Name Mdse Name Purpose of Expenditure Amount of Expenditure Last N Name , Y/V sae 1 vl~ CRY State ZipCnde Ll T-) 15 -79,7- Fast Name Diddle Name Purpose of Expenditure Amount of Expenditure City State Zip CW6 Rrst Name Viddla Name Purpose of Expendilue Amount of Expenditure Last NamelBusiness Name Address C Stale [ApQxle Fast Name muddle Name Purpose of Expenditure Amount of Expenditure Last Name/Business Name Address CRY State Zip Code 5. TOTAL ITEMIZED EXPENDITURES (Cary forward to item 3. of next page if addmonal pages of m form are used.) ~C7 p~ ' 3 of #ds is the last page of expenditures, this amount must be shown in Kan 19b. of summary.) SS4129 (Rev. 4102) Page of _ RDA 1159 SUMMARY PAGE - CANDIDATE 13. ME OF CANDIDAT OR C MITTEE (in Full) 14. REPORT COVERING THE PERIOD J _L,4 FR _ TO:-7 _/v RECEIPTS f 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) $ 3 c. TOTAL CONTRIBUTIONS (other than loans and interest)(add 15.a. and 15.b.) $ C~ 16. LOANS RECEIVED THIS REPORTING PERIOD $ C7 17. INTEREST RECEIVED THIS REPORTING PERIOD _ 6.2~1 18. TOTAL RECEIPTS (add 15.c., 16., and 17.) (must be shown in item 12.b.) DISBURSEMENTS 19. EXPENDITURES (other than loan payments) a. Ex nditures ($100 or less each payee this period) (must be listed by category - e.g., printing, postage, gasoline) S $33i!~ eaf/ -412 LI V $ Total of Expenditures ($100 or less each payee) $ b. Itemized Expenditures (Over $100 each payee this period) $ c. TOTAL EXPENDITURES other than loan re a ments add 19.a. and 19.b. $ 3 ad~ " 3 20. LOAN REPAYMENTS MADE THIS PERIOD 21. TOTAL DISBURSEMENTS (add 19.c. and 20.) (must be shown in item 12.c.) $ 3zu-34/ 22.IN-KIND CONTRIBUTIONS a. Unitemized in-kind contributions ($100 or less from each source this period) $ _ b 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 t-Q a. Unitemized Obligations Outstanding ($100 or less each) $ b. Itemized Obligations Outstanding (Over $100 each) $ Y c. TOTAL OBLIGATIONS OUTSTANDING (add 23.a. and 23.b.) (must be shown i item 12.f.) , SS-1133 (Rev. 4/02) Page of f.~ T Appointment of Political Treasurer For State and Local Candidates and Single-Candidate Committees INSTRUCTIONS The Appointment of Political Treasurer statement must be used to appoint a political treasurer as required by the Campaign Financial Disclosure Act (T.C.A. § 2-10-105) for state and local candidates and single- candidate political campaign committees. A state candidate may not receive or expend funds for an election until a political treasurer has been appointed for that election. A local candidate pursuant to T.C.A 2-10-101, maybe exempt from completing this form, please check with county election commission for more information. A candidate may appoint himself or herself as political treasurer. A new form must be filed if the treasurer is changed. Candidates for state public office must file their original Appointment of Political Treasurer statement ONLY with the Registry of Election Finance, 404 James Robertson Parkway, Suite 104, Nashville, TN 37243-1360. Candidates for local public office must file their original Appointment of Political Treasurer statement ONLY with their county election commission. 1. Date: 2. Name of Candidate or Committee: 3. Candidate e-mail address: / Y c j, Yl YCc~ C~ [ C 4. Campaign Address and Phone: City State Zip Code Phone J V _5 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 ✓ ~ C>j ~zj Ss' t5 9. Treasurer Name: 10. Treasurer e-mail address: 11. Treasurer Address and Phone: City State Zip Code Phone ?(Q- -7 t ~l U 12. Candidate andare,~surer Signature (both signatures must be witnessed. Treasurer can not witness candidate's signature): ~z4 LL A ig. Signature of Candid a Signature of Treasurer Signatur of Witness Signature of Witness Registry of Election Finance SS-1120 (rev 10/2010) ~6" 0 Wd Zl i ~ p~ 6 CAMPAIGN FINANCIAL DISCLOSURE STATEMENT For State and Local Judicial Single - Candidate Committees 1. DATE OF REPORT I2.a. NAMEOFCANDIDATE 2.b. AME OF CAND TE'S COMMITTEE 3. ELECTION TE 4.a. AMPAIGN ADDRESS AND PHONE Stet or Rural Route City State Zip Code Phone 410 ( rJ l c- G~ L 3 4.b. CANDIDATE'S HOME ADDRESS (if different than 4.a.) C~ ty t to Zip Code Phon b~ Street or Rural Route Ci 5. JUDICIAL OFFICE SOUGHT (ipclude district number, if applicable) NAME OF POLITICAL, TREASURER 7 ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ 7. CATEGORY OR REPORT (Check one) FIRST SECOND THIRD FOURTH PRE- PRE- MID YEAR YEAR-END QUARTER QUARTER QUARTER UARTER PRIMARY GENERAL SUPPLEMENTAL SUPPLEMENTAL 8.a. BEGINNING DATE OF REPORTING PERIOD 8.b. ENDING DATE OF REPORTING PERIOD 9. (Check one a. This campaign is exempt from detailed disclosures because contributions (including in-kind) received total $1,000 or less AND expenditures total $1,000 or less for this reporting period. (Complete items 12d., 12e. and 12f.) b. ❑ This campaign is required to file a detailed financial disclosure because contributions (including in-kind) received total more than $1,000 and/or expenditures total more than $1,000 for this reporting period. 10. SIGNATURE OF CANDIDATE 11. SIGNATURE OF POLITICALTREASURER I do solemnly swear or affirm that the information contained in thiscampaign financial disclosure report is true and accurate. Additionally, I swear or ~'7 affirm that no campaign contributions have been expended for the personal Sign ue f Candidate Date financial benefit of the caAdidate or for any other nonpolitical purpose as defined by the"fe er~Y me re nue code. nat of Witness Date Signat of Political Treasur Date Signatue of Witness Date 12. SUMMARY a. BALANCE ON HAND LAST REPORT $ D b. TOTAL RECEIPTS THIS PERIOD $ c. TOTAL DISBURSEMENTS THIS PERIOD $ d. BALANCE ON HAND (12.a. plus 12.b. minus 12.c.) $ e. TOTAL LOANS OUTSTANDING f. TOTAL OBLIGATIONS OUTSTANDING $ CJ lJC~ - SS-1137 (Rev. 2/06) Page 1 of IMI RDA 1159 IMF ITEMIZED STATEMENT OF CONTRIBUTIONS - CANDIDATE 1. NAME OF CANDIDATE OR COMMITTEE 2. REPORT COVERING THE PERIOD 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 NametOrganization 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 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 iddteName Contribution Received FoF: Amount of Contribution Last an 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 For Amount of Contribution Last Name/Organization Name ❑ Primary Election ❑ General Election Address ❑ Runoff (Local Elections Only) City State zip Code Date of Contribution Aggregate This Election Occupation Employer 5. TOTAL ITEMIZED CONTRIBUTIONS (Carry forward to item 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.) 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 FROM: TO: Amount 3. TOTAL ITEMIZED CAMPAIGN EXPENDITURES FROM PRECEDING PAGE (enter $0 if first itemized page) 4. COMPLETE THE APPROPRIATE ITEMS FOR EACH ITEMIZED EXPENDITURE (expenditures totaling more than $100 to any payee during the period) First Name Middle Name Purpose of Expenditure Amount of Expenditure Last Name/Business Name Address city State Zip Code First Name Middle Name Purpose of Expenditure Amount of Expenditure Last Name/Business Name Address Gty 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 NwrAusiness Name Address City State Zip Code First Name Middle Name Purpose of Expenditure Amount of Expenditure Last NameiBusiness Name Address City State Zip Code First Name Middle Name Purpose of Expenditure Amount of Expenditure Last NameAusiness Name Address City State Zip Code 5. TOTAL ITEMIZED EXPENDITURES (Carty forward to item 3, of next page if additional pages of this form are used.) (If this is the last page of expenditures, this gaunt must be shown in item 19b. of summary.) SS-1129 (Rev. 4/02) Page of RDA 1159 r 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 Zap 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 CUgadon First Name Middle Name Last Name/Business Name Address city State Zip Code Description of Obfigabon 4. TOTALS (Total from Outstanding Balance - (End of Period) column must also be shown in item 23b. on summary page.) Adhk SS-1127 (Rev. 4102) Page of RDA 1159 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: 4. Campaign Address and Phone: City State Zip Code Phone Q 1 s S. Home Address and Phone (if di erent than item 4 above): City State Zip Code Phone 6.Office Sought (include district number, if applicable) 7&E . Party Affliction lection Year e►1 Sts s ar-s ► ~ 9. Treasurer Name: 10. Treasurer a-m address: ( 11. Treasurer Address and Phone: City State Zip C Phone 12. Candidate and Treasurer Signature (bothsignatures must be wit/~ nessed. easurerca not witness candidate's signature): Signature of Candidat Signature of Tre urer Signature of Witness Signature of Witness Registry of Election Finance tr„ SS-1120 (rev 10/2010)