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Jenkins, Patrick FINANCIAL DISCLOSURE STATEMENT EXEMPTION Pursuant to TCA § 2-10-101(b) a candidate is exempt from filing financial disclosure statements due to the following: 1. The service for the office which I seek is part-time and the compensation is less than $1,000 per month, AND 2. 1 do not plan to spend more than $1,000 on my campaign. *Candidates running for Chief Administrative Officer (i.e. Mayor) of the county or city are NEVER exempt from filing and should file the required campaign financial disclosure reports regardless of compensation or spending. V CANDIDATE'S INFORMATION: F~~` coy Candidate's Name:l ~~'~l{~n15 Candidate's Position: 66?M11416610 Residential Address: 6u91~~~~ Stater Zip: ~78~2 City: I hereby state that I meet the above qualifications for t If any of the above therefore exempt from filing financial disclosure statements. change and I no longer qualify as an exemption, I will file the required campaign financial disclosure reports with my local election commission. lie Candidate's Sig at a Date zo I Witness' Sign to a Date 10 I Print Form 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 NLY with their county election commission. F; 118 F' ~_OUtJT COUNT Vii, rCTiON 1. Date: 2. Candidate First and Last Name: 3. Candidate e-mail address: ~/-~l~lC.rf ~~~(,~f~jii(l.s P~'17?fCl~~~~ti(h'IhIS~UMAtt.,c: NL d Phone: City State Zip Code Phone 4. Ca:ai Addre:sa, 3 _F0 wA1s0;Qb i7V 37682 00S ~~f8 0 7OLD wy 7- 5. Home Address and Phone (if different than item 4 above): City State Zip Code Phone AM 6. Office Sought (include district number, if applicable) 7. Party Affiliation 8. Election Year Cry CoMn~; s siotilG'~2 -70&0rjSan0 2018 9. Treasurer Name: 10. Treasurer e-mail address: /0AlnIC 1114 MloKAIC-01,ixJS(2 6MRit- C.OfA 11. Treasurer Address and Phone: City State Zip Code Phone 7$ (a oLtD i4wy 73 ou?,c%5c b -77V 3785 2 gFS 44& 19(o0 12. Candidate and Treasurer Signature (both signatures must be witnessed. Treasurer can not witness candidate's signature): jzz TL on,- f Sign ure f Candidate ig ure of Treasurer Q ignat of Witness ig ature of Witness Registry of Election Finance SS-1120 (rev 12/2013) Jun 07 16 10:13a JENKINS 8654481960 P.1 FINANCIAL DISCLOSURE STATEMENT EXEMPTION Pursuant to TCA 6 2-10-101(b) a candidate is exempt from f iling f inancial disclosure statements: "If c candidate is seeking an office f and the candidate does not spend more compensation is less than $1,000 a month, a than $1,000 to get elected to office, the candidate does not have to fill paign Financial Disclosure Reports." tt,A C., CANDIDATE'S INFORMATION: i c K l t`~ S Candidates Name'. Candidates Position: G WWI SEk. -D s c Residential Address: 1/7 g co t H Lo"_ 73 ~ 7~J~'Z City. ©u~ S 17~ State: TN Zip: I hereby state that I meet the above qualifications for exemption and am therefore exempt from filing financial disclosure statements. Can id lees Signature Date Date Witne Signature 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.