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Latham, Allen CAMPAIGN FINANCIAL DISCLOSURE STATEMENT For State and Local Candidates For Single-Candidate Committees 1. DATE,OF,R R 2.a. NAME OF CANDIDATE O COMMITTEE `4� ICR/ I t') a a al en l_a_th a-m 2.b. IF COMMITTEE,NAME OF CANDIDATE 3.ELECTION DATE 53) Th7 4.a.CAMPAIGN ADDRESS AND PHONE V�jStreet or Rural Route City State Zip Code Phone 4.b.CANDIDATE'S HOME.64ADQ Le.if different than A4CR vi o(Q 1rh 3 S S.(ALI 9-1N 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) ,.ASS C S O✓ C PfD P" tls, IL(--r► e1Q-l ivc bixfaS 7. CATEGORY OR REPORT(Check one) FIRST SECOND THIRD FOURTH PR - 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 0I )-0 )7 41alt1trb-? 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. /.01 _)„.._ koLgL....e signature o a didate date signature of polit'-asurer date 11. WITNESS SIGNATURE VOIV(} 4A-ALO ClOP it)(Cr signat of witness date signature witness date 12. SUMMARY r(r ,j a. BALANCE ON HAND LAST REPORT 4�� r}.' � ) .T $ 1 J Y J Y b. TOTAL RECEIPTS THIS PERIOD A� �2'., $ 100 0 1\.S5 1 c. TOTAL DISBURSEMENTS THIS PERIOD $ I I d. BALANCE ON HAND(12.a.plus 12.b.minus 12.c.) $ '(I Q)S 5-1 e. TOTAL LOANS OUTSTANDING $ L)o t' 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 T�.E PERIOD FROM: 4 J 1103 TO: 4 RECEIPTS i 15. CONTRIBUTIONS (other than loans and interest)a. Unitemized Contributions ($100 or less from each source this period) $ '1 V b ' op b. Itemized Contributions (over$100 from each source this period) $ c.TOTAL CONTRIBUTIONS (other than loans and interest)(add 15.a. and 15.b.) $ I Ob ' 0 b 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 DO UD 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) M"ici 7Afl - ►l s Mild S $ a.55 L--) d&A-1-sieko, $ Total of Expenditures ($100 or less each payee) $ b. Itemized Expenditures (Over$100 each payee this period) $ 1 O 4G • IS c. TOTAL EXPENDITURES (other than loan repayments)(add 19.a. and 19.b.) $ It 0 Z' 20. LOAN REPAYMENTS MADE THIS PERIOD $ 21. TOTAL DISBURSEMENTS (add 19.c. and 20.) (must be shown in item 12.c.) $ 1 I b ` 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.) $ g 23.OBLIGATIONS a. Unitemized Obligations Outstanding ($100 or less each) $ b. Itemized Obligations Outstanding (Over$100 each) or $ c. TOTAL OBLIGATIONS OUTSTANDING (add 23.a. and 23.b.)(must be shown i item 12.f.) $ SS-1133(Rev.4/02) Page of ITEMIZED STATEMENT OF EXPENDITURES - CANDIDATE 1. liAgE OF CANDIDATE OR COMMITTEE 2. REPORT COVERING THE PERIOD ,( f FROM14'jI a. TO: 4's��.a-- I A unt 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 I Middle Name Purpose of Expenditure Amount of Expenditure Last N sin s hINner, 151541- -,q 3a-- Addres Sw d -eve City wyt tt S is Zip Code First Name Middle Name Purpose of Expenditure Amount of Expenditure Last Name Ejlisj ess Name n C e _ _ /��/1 /�,(�-; (� Address/ (j/� �,\„�}�� (J`1...,� ('i{/� �O ��� � l.� irtirCity 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 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.) 7� J (If this is the last page of expenditures,this amount must be shown in item 19b.of summary.) r Page of RDA 1159 •.,4' SS-1129(Rev.4/02)