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Garner, Dennis R. CLOSURE STATEMENT EXEMPTION FINANCIAL CIS Pursuant to TCA § 2-10-101(b) a candidate is exempt from filing financial disclosure statements: candidate is seeking an office for which service is di does not pend more If a com is less than $1,000 a month, and the can fil pensation to office, the candidate does not have to e campaign than $1,000 to get elected Financial Disclosure Reports. . G Y 4CANDIDATE'S INFORMATION: - • G~ Y Candidate !s Name'. Candidates Position: : 3' ~ V1/• L-''tit-~0~^-~ ~ Residential Address '7803 State: TN Zip. City: ~ I hereby State that I meet the above qualifications for exemption and am therefore exempt from filing financial disclosure Statements. ~ Z~Dnte Candidates Signature ot,2q-q Date Witness's Signature han a and I realize I will spend more than $1,000 on my campaign, I If my plans c g will immediately make a financial disclosure report. CAMPAIGN FINANCIAL DISCLOSURE STATEMENT For State and Local Candidates For Single-Candidate Committees V 'a. I W a t• Yr 1. DATE O REPORT 2.a. NAME OF CANDIDATE OR COMMITTEE 2.b. IF COMMIT E, NAME OF CANDIDATE 3. ELECTION DATE 4.a. CAMPAIGN ADDRESS AND PHONE State Zip Code Phone Street or Rural Route City 3 17 1/, Lit !,ti/ ~ lle ~i -3 .3 4.b. CANDIDATE'S HOME ADDRESS (if different than 4.a. State Zip Code Phone Street or Rural Route City ZIL/ -71Z 52! .317 N. ZAW&, 5. OFFICE SOUGHT (include district number, if applicable) 6. NAME OF POLITICAL TREASURER (may be candidate) 7. CATEGO Y OR REPO El El RT (Check one) ❑ ❑ ❑ ❑ ❑ FIRST SECOND THIRD FOURTH PRE- PRE- MID-YEAR YEAR-END QUARTER QUARTER QUARTER QUARTER PRIMARY ENDING DATE OF REPORTING PER SUPPLEMENTAL SUPPLEMENTAL 8.a. BEGINNING 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, I/we swear or affirm that no campaign contributions have been expended for the personal financial be efit of the candidate or for any other nonpolitical purpose as defined by the federal internal revenue code. t 7" signature of candidate date signature of political treasurer date 11. WITNESS SIG ~ 2g / ~ xy i signature witness date signature of witness date 12. SUMMARY a. BALANCE ON HAND LAST REPORT $ C, b. TOTAL RECEIPTS THIS PERIOD .......................................i . j,, 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 $ SS-1109 (Rev. 2/06) Page 1 of RDA 1159