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Cole, Tom CAMPAIGN FINANCIAL DISCLOSURE STATEMENT For State and Local Candidates For Single-Candidate Committees F2.bIF TE OF REPORT 2.a. NAME OF CANDIDATE OR COMMITTEE ~,t- Z'Sl - iFl I Ali /mss Co It- COMM ITTEE, NAME OF CANDIDATE 3. ELECTION DATE m 7 ' 4.a. CAMPAIGN ADDRESS AND PHONE State Zip Code MAY Phone Street or Rural Route City 53q G.-1 ~cN►~.vA- i~~ A~r v%Il c, 771 37801 3(03- Zzli / 4.b. CANDIDATE'S HOME ADDRESS (if different than 4.a State Zip Code Phone Street or Rural Route City 5. OFFICCE~ SOUGHT (include district number, if applicable) 6. NAME OF POLITICAL TREASURER (may be candidate) /f9l7rnAS (..0 r~ C- Omrn i _Z" " JAA 7. CATEGORY OR REPORT (Check one) 0 1:3 El MIDD❑YEAR YEAR-END FIRST SECOND THIRD FOURTH PRE- PRE- QUARTER QUARTER QUARTER QUARTER PRIMARY GENERAL SUPPLEMENTAL SUPPLEMENTAL rEG DATE OF REPORTING PERIOD 8.b. ENDING DATE OF REPORTING PERIOD t _ a y- 2-t- 9. l campaign is exempt from detailed disclosure because contributions (including in-kind) received total $1,000 or less AND expendi- s total $1,000 or less for this reporting period. (Complete items 12d., 12e. and 12f.) campaign is required to file a detailed financial disclosure because contributions (including in-kind) received total more than $1,000 /or expenditures total more than $1,000 for this reporting period. olemnly 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. - signature of candidate date signature of political treasurer date 11. WITNESS SIGNATURE date signature of witness ~ry Odate sig ture of witness ♦ N0 12. SUMMARY ~G J~ coo Q p O O~ Q G C . a. BALANCE ON HAND LAST REPORT $ , a V~ OJ ti" b. TOTAL RECEIPTS THIS PERIOD $ b . 9 ~ z r` wd 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 Page 1 of RDA 1159 SS-1109 (Rev. 2106) SUMMARY PAGE - CANDIDATE F15.CONTRIBUTIO F CANDIDATE OR COMMITTEE (In Full) 14. REPORT COVERING THE PERIOD FROM: TO: S NS (other than loa ns and interest) a. Unitemized Contributions ($100 or less from each source this period) $i b. Itemized Contributions (over $100 from each source this period) $ 379, t0 c. TOTAL CONTRIBUTIONS (other than loans and interest)(add 15.a. and 15.b.) $ 16. LOANS RECEIVED THIS REPORTING PERIOD $ 17. INTEREST RECEIVED THIS REPORTING PERIOD G c 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) $ Total of Expenditures ($100 or less each payee) $_(0 b. Itemized Expenditures (Over $100 each payee this period) $ '96y4 76, ss// ~r 76 c. TOTAL EXPENDITURES (other than loan repayments)(add 19.a. and 19.b.) $ 20. LOAN REPAYMENTS MADE THIS PERIOD $ Q 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) $ qZ ' 00 b. Itemized in-kind contributions (over $100 from each source this period) $ 37 f • F6; 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.) Page of SS-1133 (Rev. 4102) ITEMIZED STATEMENT OF CONTRIBUTIONS - CANDIDATE 2. REPORT COVERING THE PERIOD 1. NAME OF CANDIDATE OR COMMITTEE FROM:-/-%~ T0: -u-/a' Amount 79. 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 Amount of Contribution Middle Name Contribution Received For: First Name C4 1 Ong 1~ (Primary Election El General Election 37T 7~ Last Name/Organization Name ❑ Address -53 [ Runoff (Local Elections Only) / of Contribution Aggregate This Election City M~ V1 jl n state_ Zip 3790 1 Date Occupation mo rn Employer Amount of Contribution Middle Name Contribution Received For: First Name El Primary Election C3 General Election Last Nam,-/Organization Name ❑ Runoff (Local Elections Only) Address Date of Contribution Aggregate This Election State Zip Code City Occupation Employer Amount of Contribution iddleName Contribution Received For: First Name F] Primary Election General Election as -L Nam!/Organizaxion Name F] Runoff (Local Elections Only) Address Date of Contribution Aggregate This Election State Zip Code City Occupation mp oyer mount o ontribubon Middle Name Contribution Received or: First Name ❑ Primary Election ❑ General Election Last Name/Organization Name El Runoff (Local Elections Only) Address Date of Contribution Aggregate This Election State Zip Code 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 ,9114 :1159 0 SS-1131(Rev. 2/06) ITEMIZED STATEMENT OF EXPENDITURES - CANDIDATE 2. REPORT COVERING THE PERIOD [3, NAME OF CANDIDATE OR COMMITTEE FROM: TO: mount 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) Pu ose of Expenditure Amount of Expenditure First Name Middle Name rp Last NamelBusiness Name A~/I, , ~re I ~(/(/T 7~ / s / Prm ~s Address 7/ City St to Pip Code l S' Co 74H 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 NamelBusiness 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.) l~ (It this is the last page of expenditures, this amount must be shown in item 19b. of summary.) Aft SS-1129 (Rev. 4/02) Page of RDA 1159 CAMPAIGN FINANCIAL DISCLOSURE STATEMENT For State and Local Candidates For Single-Candidate Committees 1. DATE OF REPORT 2.a. NAME OF CANDIDATE OR COMMITTEE 51- 7/~- I 1 o m~fi 5 /c-- 2.b. IF COMMITTEE, NAME OF CANDIDATE 3. :EL~ION EDATE ay ~ 4.a. CAMPAIGN ADDRESS AND PHONE Street or Rural Route City State Zip Code Phone Ln~ -7 ~j 37501 363 We 4.b. CANDIDATE'S HOME ADDRESS (if different than 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) C-ay"'WX "'5S ?r Eft 7h© L~ l ~ 7. CATEGORY OR REPORT (Check one) ❑ FIRST SECOND THIRD FOURTH PR - PR - MIDYEAR YEAR-END QUARTER QUARTER QUARTER QUARTER PRIMARY GENERAL SUPPLEMENTAL SUPPLEMENTAL 8.a. BEGINNING DATE OF REPORTING PERIOD 8.b. ENDING DATE OF REPORTING PERIOD 3-1-18 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. 00 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. signature of candidate date signature of political treasurer date 11. WITNESS SIGNATURE ~ ,-7 , signature of witness date signature of date 12. SUMMARY a. BALANCE ON HAND LAST REPORT $ 1,~13,a3 b. TOTAL RECEIPTS THIS PERIOD $ • 3, ~ 3 c. TOTAL DISBU RSEM ENTS TH I S PERIOD $ a L d. BALANCE ON HAND (12.a. plus 12.b. minus 12.c.) $ e. TOTAL LOANS OUTSTANDING $ f. TOTAL OBLIGATIONS OUTSTANDING :f......... REOE;QED................. $ APR - 9 2018 SS-1109 (Rev. 2/06) Page i of RDA 1159 ELEMN 11 vd'~ I * w , SUMMARY PAGE - CANDIDATE 13. NAME OF CANDIDATE OR COMMITTEE (In Full) 14. REPORT COVERING THE PERIOD rn. S FROM: 3-1 18 T0: 3 3 1- ig RECEIPTS 15. CONTRIBUTIONS (other than loans and interest) a. Unitemized Contributions ($100 or less from each source this period) $ vv b. Itemized Contributions (over $100 from each source this period) $ /113..13 c. TOTAL CONTRIBUTIONS (other than loans and interest)(add 15.a. and 15.b.) $ 12.13, 2.'3 16. LOANS RECEIVED THIS REPORTING PERIOD l~ 17. INTEREST RECEIVED THIS REPORTING PERIOD $ • Z3 18. TOTAL RECEIPTS (add 15.c., 16., and 17.) (must be shown in item 12.b.) $ 12-13 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) $ $ 5[~, Qo $ $ $ $ $ Total of Expenditures ($100 or less each payee) $ f d 9 , a 7 b. Itemized Expenditures (Over $100 each payee this period) $ . 9(D c. TOTAL EXPENDITURES (other than loan repayments)(add 19.a. and 19.b.) $ 1 ZI 3. ;13 20. LOAN REPAYMENTS MADE THIS PERIOD $ D 21. TOTAL DISBURSEMENTS (add 19.c. and 20.) (must be shown in item 12.c.) $ i213~ 23 22. IN-KIND CONTRIBUTIONS 00 a. Unitemized in-kind contributions ($100 or less from each source this period) $ f ~ . b. Itemized in-kind contributions (over $100 from each source this period) $ 1113, Z- c. TOTAL IN-KIND CONTRIBUTIONS RECEIVED THIS PERIOD (add 22.a. and 22.b.) $ I Z 1 z3 23. OBLIGATIONS a. Unitemized Obligations Outstanding ($100 or less each) $ 0 b. Itemized Obligations Outstanding (Over $100 each) $ d c. TOTAL OBLIGATIONS OUTSTANDING (add 23.a. and 23.b.) (must be shown i item 12.f.) $ V 4) SS-1133 (Rev. 4102) Page of ' T f ITEMIZED STATEMENT OF CONTRIBUTIONS - CANDIDATE 1. NAME OF CAN ATE OR COMMITTEE 2. REPORT COVERING THE PERIOD FROM: TO: 3 3/ - Amount 3. TOTAL ITEMIZED CAMPAIGN CONTRIBUTIONS FROM PRECEDING PAGE (enter $0 if first itemized page) 12t 3 : 2-3 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 Name Last Name/0Orgeni~ Name r 14 Primary Election ❑ Genera( Election IDDf Address [:1 Runoff (Local Elections Only) t 7[~ ~ `i't G V(~ State Zip Code Date of Contribution Aggregate This Election city Occupation Tr') 3J50 3 / 00 Employer First Name Middle Name Contribution Received For: Amount of Contribution Last Name/Organization Namel Primary Election ❑ General Election 5cW o v~+ L/ ❑ Runoff (Local Elections Only) Address City State Zip Code Date of Contribution Aggregate This Election jvl `l tZ 5;TJ Occupation 3 SW , Employer First Name C iddle Name Contribution Received For: Amount of Contribution as ame r niza ion Name Primary Election ❑ General Election 11~~ Address, ^ / ❑ Runoff (Local Elections Only) 3uo1 D~~~ ht~s rn,: City State Zip Code Date of Contribution Aggregate This Election rv~ Ua alt: rr' 3'403 Occupation 00 mp Oyer Middle Name Contribution Received For: mount o Contribution First Name Last Name/Organization Name [A Primary Election ❑ General Election I t 3~ Z3 Address 5 3j 1 ❑ Runoff (Local Elections Only) city _l State Zip Coe Date of Contribution Aggregate This Election tyvwv Occupation 1[3, 2-3 Employer `J'am be4l 5-0 5. TOTAL ITEMIZED CONTRIBUTIONS 3 (Carry forward to item 3. of next page if additional pages of this form are used.) 2- 13, Z (If this is the last page of contributions, this amount must be shown in item 15b. of summary.) of / RDA 1159 3 SS-1131 (Rev. 2106) Page ITEMIZED STATEMENT OF EXPENDITURES - CANDIDATE [4. NAME OF CAND ATE OR COMMITTEE 2. REPORT COVERING THE PERIOD 7 oyvl, FROM: 3 S TO 3-31-1 TOTAL ITEMIZED CAMPAIGN EXPENDITURES FROM PRECEDING PAGE (enter $0 if first itemized page) mount COMPLETE THE APPROPRIATE ITEMS FOR EACH ITEMIZED EXPENDITURE (expenditures totaling more than $100 to an Z 3 23 any payee during the period) First Name Middle Name Purpose of Expenditure Amount of Expenditure Last Name/Business Name Pr, 31~s.~ 5~t 2-7 Address Sp 0 w^AJt . City State Zip Code 9as~+ I First Name Middle Name Purpose of Expenditure I Amount of Expenditure Last Name/Business Name ! 0w.~- f}c~t!ress s S~, 6v Address 34 City State Tij~p; de /~'1.r~ ~ 7s~y F irst Name Middle Name Purpose of Expenditure Amount of Expenditure Last Name/Business Name OCR Address A 3-01-11:= ~r^ 141,--- City State Zip Code First Name Middle Name Purpose of Expenditure Amount of Expenditure Last Name/Baeesss ame .4 s q Address City State Zip Code ch: l`5 ~-7 First Name Middle Name Purpose of Expenditure Amount of Expenditure Last Name/Business Name Address city State Zip Cade 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.) Amh, I1W SS-1129 (Rev. 4/02) Page of _ RDA 1159 I CAMPAIGN FINANCIAL DISCLOSURE STATEMENT For State and Local Candidates For Single-Candidate Committees 1. DATE OF REPORT 2.a. NAME OF CANDIDATE OR COMMITTEE 1 ?_/f2_ _ '/Is; % ~aW1 A s le- - 2.b. IF COMMITTEE, NAME OF CANDIDATE 3. ELECTION DATE qq~~ /A- CZ 4.a. CAMPAIGN ADDRESS AND PHONE Street or Rural Route City State Zip Code Phone Say 1QJ u,'t! TO 3 ~~0 zr&5 363-Zy8 ~ 4.b. CANDIDATE'S HOME ADDRESS (if different than 4.a.) Street or Rural Route City State Zip Code Phone S~tm-e- as 4 5. OFFICE SOUGHT (include district number, If applicable) 6. NAME OF POLITICAL TREASURER (may be candidate) U mrv-Ji< 6A -mol -5 7. CATEGORY OR REPORT (Check one) ❑ ❑ ❑ ❑ ❑ ❑ ED ]z FIRST SECOND THIRD FOURTH PRE PRE- MID-YEAR YEAR-END QUARTER QUARTER QUARTER QUARTER PRIMARY GENERAL SUPPLEMENTAL SUPPLEMENTAL 8.a. BEGINNING DATE OFREPOR11NG PERIOD 8.b. ENDING DATE OF REPORTING PERIOD 12 --1 Z T 11 1- 15 1 g 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. signature of candidate date signature of political treasurer date 11. .NESS SIGNATURE - 4 1 hl// 13r signature of witness date signature of witness date 12. SUMMARY a. BALANCE ON HAND LAST REPORT $ b. TOTALRECEIPTS THIS PERIOD c. TOTAL DISBURSEMENTS THIS PERIOD d. BALANCE ON HAND (12.a. plus 12.b. minus 12.c.) $ e. TOTAL LOANS OUTSTANDING . f. TOTALOBLIGATIONS OUTSTANDING $ 0 Afflhk SS-1109 (Rev. 2106) Page 1 of RDA 1159 NOW CAMPAIGN FINANCIAL DISCLOSURE STATEMENT For State and Local Candidates For Single-Candidate Committees 1. DATE OF REPORT 2.a. NAME OF CANDIDATE OR COMMITTEE 3. ELECTION DATE 2.b. IF COMMITTEE, NAME OF CANDIDATE 5"- J'~ - /q 4.a. CAMPAIGN ADDRESS AND PHONE State Zip Code Phone Street or Rural Route City A if 1) - TYv 3) 531 _j ii 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) 6, ..A J 7J 7. CATEGORY OR REPORT (Check one) ~I ❑ FIRST SEC1:1 1:1 OND THIRD FOURTH 45RE- PRE- MID YEAR YEAR-END DARTER QUARTER QUARTER DARTER PRIMARY GENERAL SUPPLEMENTAL SUPPLEMENTAL 8.a. BEGINNING DATE OF REPOR I ING PERIOD 8.b. ENDING DATE OF REPORTING PERIOD 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, Itwe 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. y ZZ- l/~Z u`~~J e y zL - / i of didate date signature of political treasurer date 11. N I TURE -aa -22 date signature of witness date gnature of witness 12. SUMMARY a. BALANCE ON HAND LAST REPORT $ b. TOTAL RECEIPTS THIS PERIOD q cl~-I~oC1 c. TOTAL DISBURSEMENTS THIS PERIOD ,l d. BALANCE ON HAND (12.a. plus 12.b. minus 12.c.) $ e. TOTAL LOANS OUTSTANDING 1-1~.................................................................................... $ f. TOTAL OBLIGATIONS OUTSTANDING $ Pag01 of RDA 1159 SS-1109 (Rev. 2106) 0 SUMMARY PAGE - CANDIDATE 13. NAME OF CANDIDATE OR COMMITTEE (In Full) 14. REPORT COVERING THE PERIOD v),A FROM: -l-iy T0: RECEIPTS 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) $ c. TOTAL CONTRIBUTIONS (other than loans and interest)(add 15.a. and 15.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.) $ 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) 419 _ $ $ $ $ Total of Expenditures ($100 or less each payee) $ b. Itemized Expenditures (Over $100 each payee this period) $ I a~ 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.) $ (j a2 io 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.) $ G' 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.) $ A9ft SS-1133 (Rev. 4/02) Page of f ITEMIZED STATEMENT OF LOANS - CANDIDATE 1. NAME OF CANDIDATE OR COMMITTEE 2. REPORT COVERING THE PERIOD FROM: TO: 1 3. COMPLETE THE APPROPRIATE ITEMS FOR EACH ITEMIZED LOAN (loans 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 NamelOrganizalion Name Address Loan Received For: Date of Loan ❑ Primary Election ❑ General Election Gty State Zip Code ❑ Runoff (Local Elections Only) List All Endorsers or Guarantors for Above Loan (if more space is needed please attach a page) First Name Middle Name First Name Middle Name Last Name/Organization Name Last Name/Organization Name Address Address City State Zip Code city State Zip Code Amount Guaranteed Outstanding Amount Guaranteed Outstanding First Name Middle Name First Name Middle Name Last Name/Organization Name Last Name/Organization Name Address Address City State Zip Code City State Zip Code Amount Guaranteed Outstanding Amount Guaranteed Outstanding First Name Middle Name First Name Middle Name Last Name/Organization Name Last Name/Organization Name Address Address City State Zip Code city State Zip Code Amount Guaranteed Outstanding Amount Guaranteed Outstanding First Name Middle Name First Name Middle Name Last Name/Organization Name Last Name/Organization Name Address Address City State Zip Code City State Zip Code Amount Guaranteed Outstanding Amount Guaranteed Outstanding 4, Totals for all Loans (Complete on last page of itemized loans) Outstanding Loan Balance Loans E 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 loan balance should also be shown in item 12.e. on front page.) Aflk SS-1132 (Rev. 4102) 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 Obligation First Name Middle Name Last Name/Business Nam 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 Obligation First Name Middle Name Last Name/Business Name Address city state Zip Code Description of Obligation 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 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 totalin more than $100 from an contributor First Name Middle Nazne Contribution Received For: Amount of Contribution Last Name/OrganizationName ❑ Primary Election ❑ General Election Address ❑ Runoff (Local Elections Only) City 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 L'pCode Date of Contribution Aggregate This Election Occupation Employer First Name iddle Name Contribution Received For: Amount of Contribution as anva Name ❑ Primary Election ❑ General Election Address ❑ Runoff (Local Elections Only) Citye Zip Code Data of Contribution Aggregate This Election OcwpaWn Employer First Name Middle Name Contribubon Received For Amount of Contribution Last Name/Organization Name ❑ Primary Election ❑ General Election Address ❑ Runoff (Local Elections Only) City State L'pCode 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.) (Ir this is the last page of contributions, this amount must be shown in item 15b. of summary.) 0 SS-1131(Rev. 2106) Page of RDA 1159 ITEMIZED STATEMENT OF IN-KIND CONTRIBUTIONS - CANDIDATE 1. NAME OF CANDIDATE OR COMMITTEE 2. REPORT COVERING THE PERIOD FROM: TO: Amount 3. TOTAL ITEMIZED IN-KIND CONTRIBUTIONS FROM PRECEDING PAGE (enter $0 if first itemized page) 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 ❑ Primary Election ❑ General Election Last NamelOrganizalion Name ❑ Runoff (Local Elections Only) Address Date of Inland Contribution Aggregate this Election city state Zip Cade Description of In-Iand Contribution Occupation Employer First Name Middle Name In-Kind Contribution Received For. Value of In-Kind Contribution ❑ Primary Election ❑ General Election Last Name/Organization Name ❑ Runoff (Local Elections Only) Address Date of In-landContibution Aggregate this Election City Slate Zip Code Description of In-Iand Contribution Occupation Employer First Name Middle Name In-Kind Contribution Received For. Value of In-Kind Contribution ❑ Primary Election ❑ General Election Last Name/Organization Name ❑ Runoff (Local Elections Only) Address Date of In-land Contribution Aggregate this Election City State Zip Code Description of In-land Contribution Occupation Employer First Name Middle Name In-Kind Contribution Received For. Value of In-Kind Contribution ❑ Primary Election ❑ General Election Last Name/Organizatan Name ❑ Runoff (Local Elections Only) Address Date of In-Kind ConbiWion Aggregate this Election City stale Zip Code Description of In-Kind Conbbution Occupation Employer First Name Middle Name In-Kind Contribution Received For: Value of In-Kind Contribution F] Primary Election E] General Election Last NamefOrganizatiar Name ❑ Runoff (Local Elections Only) Address Date of In-Kind Contribution Aggregate this Election City State Zip Code Description of In-Kind Contribution Occupation Employer 5. TOTAL ITEMIZED IN-KIND CONTRIBUTIONS (Carry forward to item 3. of next page if additional pages of this form are used.) (If this is the last page of in-kind contributions, this amount must be shown in item 22b. of summary.) SS-1128 (Rev. 2106) Page of RDA 1159 ITEMIZED STATEMENT OF EXPENDITURES - CANDIDATE 1. NAME OF CANDIDATE OR COMMITTEE 2. REPORT COVERING THE PERIOD FROM' - y TO: y- Z4 - I 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 7 /rr c( j) p 1 5 T5. City State Zip Code ck •,--t" 1~'~~:.~ P~rv 55C 7 ~ First Name Middle Name Purpose of Expenditure Amount of Expenditure ~Sf• _ Last Name/Business Name q77, Address City State Zip Code First Name Middle Name Purpose of Expenditure Amount of Expenditure Last Name/Business Name Address W q77, O city State Zip Code c,,,. ICS C~71 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 g 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.) SS-1129 (Rev. 4102) Page of RDA 1169 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: Candidates Name: T ~®f-,nft S Candidates Position: Residential Address: -63 City: State: TN Zip: 317899( I hereby state that I meet the above qualifications for exemption and am therefore exempt from filing financial disclosure statements. CI-7,;z')L;w 3- d3- andidate's Signature Date k, 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. REC:Ei'JED MAR 2 5 hii N 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: Q 1 4. Campaign Address and Phone: City State Zip Code Phone 53 , I I(_~" i 4- ~C_4e f° . 1, 1,+j, 'il T-10 3_78D( ;~&s -41755 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. Parry Affliation 8. Election Year A Vic' ~ y 9. Treasurer Name: 10. Treas rer e-mail address: ~prti~ J 9 16-- C, cj), 4:5 Al e, 11. Treasurer Address and Phone: City State Zip Code Phone 53 l 11-1 v .i/(- 7~~i ~),6c 1 XIS sSG 41995 12. Candidate and Treasurer Signature (both signatures mus a witnessed. Treasurer can not witness candidate's signature): 77~,) Signature of Candidate Sig re Treasurer CI'S Si ure of Witness Q ignature of Witness Registry of Election Finance SS-1120 (rev 1012010) _ _ . - - _ . _ . • y~.rr.. r f ~G'.iYh~. ~ ~YPirGN7W-*~'~RF4~W i dLT'~9~1 1C