White, Andy {ir{!
. CAMPAIGN FINANCIAL DISCLOSURE STATEMENT
, , fir Jar For State and Local Candidates
For Single-Candidate Committees
1.Date: t"Li/VI 2,a,Candidate or Committee Name: Andy White for City Council
2,b.If Committee,Name of Candidate: Andy White 3.Election Date:
11/08/22
4. Campaign Address: 825 N. Briarcliff Circle
City: Maryville State: TN Zip Code: 37803 Phone: 865-804-1970
5. Candidate Home Address: 113 East Harper Ave.
city, Maryville State: TN Zip Code: 37804 Phone: 865-806-7215
Candidate Email Address: awhite@firewatertic.conl
Maryville CityCouncil
b, Office Sought(include district number1 if applicable) �
7. Name of Political Treasurer(may be candidate): Robyn Blair
Political Treasurer Email Address: robyn.blair@na.denso.corn
B. Category or Report:(check one)
First Quarter Second Qua r QThird Quarter E Fourth Quarter Pre-Primary Pre-General
Mid Year Supplemental Year-End Supplemental
9.Reporting Period: Start Date: ) 1/a End Date: i 2/3 I /,Z 3
10.Detailed Disclosure:(Check one)
I I 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 12.d.,12.e.,and 12.f)El This campaign 1s 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.
11.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 c ntributio have been expended for the personal financial benefit of the candidate or for any other
nonpo ltic purpose defined by the federal internal revenue code.
l/y/3.`1 • 1 l4 iZ
Can date Signature Date ical Treasurer Signature Date
4/4
fitness Signet a Date Witness i nature Date
12.Summary:
a. Balance On Hand Last Report $ kg-Ps.al
b. Total ReceiptsThis Period $
c. Total Disbursements This Period $ _
d. Balance On Hand(12.a.plus 12.b,minus; 40 .-... . $
e. Total Loans Outstanding C�,S $
f. Total Obligations Outstanding ,AN...0.211 i ............... $ i 5 vZ •a
SS-1109(Rev.1/2623) 1
Page of
Blount Co Elections
1
FINANCIAL DISCLOSURE STATEMENT EXEMPTION
Pursuant to TCA 5 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 $1,000 to get elected to office, the candidate does not have to file Campaign
Financial Disclosure Reports."
CANDIDATE'S INFORMATION:
Candidate's Name: Anfif z
Candidates Position: M10oy ll f 6 fy a"z- I
Residential Address: l t 3 6;$f Hc~nef' Ave _
31&00q
City: !1 lti.r►/ y~ ~~e State: TN Zip:
I hereby state that I meet the above qualifications for exemption and am
therefore exempt from filing financial disclosure statements.
Candidate' S na re Date
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.
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: Z. Name of Candidate or Committee: 3. Candidate a-mail address:
0.w~v'fGQ'FirC~tarl~C.CA~-►
4. Campaign AdVress and Phon : City State Zip Code Phone
1~3 ~as~F tirPvr y
►l'tv~~llt IN 371m0 ?7- o
5. Home Address and Phone (if diff erent than item 4 above): Ci State Zip Code Phone
~An,Q
6. Office Sought (include district number, if applicable) 7. Party Affliation 8. Election Year
1/i l it Crr w Re fvblkAn ~o ~y
9. Treas rer Name: 10. Treasurer e-mail address:
WfL
11. T asurer Address and Phone: City State Zip Code Phone
113 f s4 Hc~ r 37 ~Oy
Mir 5663-911-1740
12. Candidate and Treasurer Signature (both signatures must a witnessed. Treasurer cannot witness candidate's signature):
Signature of Can,didate Signature of Trea r r
Azz_ :/;/VU/_ - -
Signature of Witness Signature of Witness
Registry of Election Finance
SS-1120 (rev 10/2010)