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Hasty, Gaye CAMPAIGN FINANCIAL DISCLOSURE STATEMENT For State and Local Candidates For Single-Candidate Committees OMMITTEE 1. DATEOFREPORT I2.a. NAME OF CANDIDATE ACXS~_LA - IF COMMITTEE, NAME OF CANDIDATE 3. ELECTION DATE 4.a. CAMPAIGN ADDRESS AND PHONE Street or Rural Route City State Zip Code Phone 5~~ Q~ ~Lk.S~,,~~ • r ~ ` i le ~~V ~1 3 ~i ' ~-1k17 4.b. CANDIDATE'S HOME ADDRESS (if different than 4. . 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) C 7. CATEGORY OR REPORT (Check one) I FIRST SECOND THIRD FOURTH PRE- PRE- 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 L4 - C) 19 CL4 -a 1- Q0 ( S-' 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..KThis 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 candid to or for any other nonpolitical purpose as defined by the federal internal revenue code. i fiha~Asm'x OLA- - signatur f candidate date s gnature of political treas er date 11. WIT SS SIGNATUR j signature of win date signature of witness date 12. SUMMARY a. BALANCE ON HAND LAST REPORT $ _ b. TOTAL RECEIPTSTHIS PERIOD c. TOTAL DISBURSEMENTS THIS PERIOD d. BALANCE ON HAND 12.a. plus 12.b. minus 12.c. $ e. TOTAL LOANS OUTSTANDING $ EcenrEC f. TOTAL OBLIGATIONS OUTSTANDING ............................A.2.............................................................................. $ SS-1109 (Rev. 2/06) ~ - ■ Page 1 of_ RDA 1159 SUMMARY PAGE - CANDIDATE 13. NAME OF CANDIDA E OR COMMITTEE (In Full) 14. REPORT COVERING THE PERIOD C FROM _ T0: RECEIPTS 15. CONTRIBUTIONS (other than loans and interest) ¢ a. Unitemized Contributions ($100 or less from each source this period) $ y 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) Total of Expenditures ($100 or less each payee) $ b. Itemized Expenditures (Over $100 each payee this period) $ c. TOTAL EXPENDITURES (other than loan repayments)(add 19.a. and 19.b.) $ 4 00 00 20. LOAN REPAYMENTS MADE THIS PERIOD 21. TOTAL DISBURSEMENTS (add 19.c. and 20.) (must be shown in item 12.c.) $ ~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.) $ 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.) $ SS-1133 (Rev. 4/02) Page of ITEMIZED STATEMENT OF EXPENDITURES - CANDIDATE 1. NAME OF CANDIDATE OR COM ITTEE 2. REPORT COVERING THE PERIOD L FROM:© _ T0: _ 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 NamelBusine s Name c© 'i\} r'% b LL r, C k'1 1A0 0C) Address O (0r^ vls City Slate ZipC;de First Name ` -Middle Name ! Purpose of Expenditure Amount of Expenditure Last Name/Business Name Address City Slate 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 Stale 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.) 0 v SS-1129 (Rev. 4/02) Page of~ RDA 1159 ti CAMPAIGN FINANCIAL DISCLOSURE STATEMENT For State and Local Candidates For Single-Candidate Committees 1. DATE OF REPORT 12.a. NAME OF CANDIDATE R COMITTEE . CC (L -0 C 2.b. IF COMMITTEE, NAME OF CANDIDATE 3. ELECTION DATE 4. ,C) 1 r `O 4.a. CAMPAIGN ADDRESS AND PHONE Street or Rural Route City State Zip Code Phone 4.b. CANDIDATE'S HOME ADDRESS (if different than 4.a)- 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) 7. CATEGORY OR REPORT (Check o e) X ❑ ❑ ❑ ❑ ❑ ❑ ❑ FIRST SECOND THIRD FOURTH PRE- 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 C) \ i <2~ 0 ~ 3! 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. signatur of candidate date ignature of political treasu er date 11. WITNESSSIGNATUR signature of witness date signature of witnes date 12. SUMMARY L lo~ a. BALANCE ON HAND LAST REPORT $ b. TOTAL RECEIPTS THIS PERIOD $ c. TOTAL DISBURSEMENTS THIS PERIOD $ d. BALANCE ON HAND 12.a. plus 12.b. minus 12.c. ~61 WMON e. TOTAL LOANS OUTSTANDING APA..1.. $ f. TOTAL OBLIGATIONS OUTSTANDING ........................~`~V1VnP................................................................ $ SS-1109 (Rev. 2/06) Page 1 of RDA 1159 SUMMARY PAGE - CANDIDATE ' 13. N ME OF CANDIDAT OR CQMMITTEE (In Full) 14. REPORT COVERING THE PERIOD c I FROM T0:03 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) Total of Expenditures ($100 or less each payee) $ b. Itemized Expenditures (Over $100 each payee this period) c. TOTAL EXPENDITURES (other than loan repayments)(add 19.a. and 19.b.) $ 20. LOAN REPAYMENTS MADE THIS PERIOD $ 00 21. TOTAL DISBURSEMENTS (add 19.c. and 20.) (must be shown in item 12.c.) $ _/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.) 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.) $ SS-1133 (Rev. 4/02) Page of y ITEMIZED STATEMENT OF EXPENDITURES - CANDIDATE 1. NA AE OF CANDIDATE 0 COMMI EE 2. REPORT COVERING THE PERIOD FROMr TO: 03] moun~ 3. TOTAL ITEMIZED CAMPAIGN EXPENDITURES FROM PRECEDING PAGE (enter $0 K first itemized page) 4. COMPLETE THE APPROPRIATE ITEMS FOR EACH ITEMIZED EXPENDITURE (expenditures being more than $100 to any payee during the period) First Narne Middle Name Purpose of Expenditure Amount of Expertdihxm Address ; L i✓; l h n e t/ } , City Stale 4 code J First Name Middle Name Purpose of Expenditure Amount of Expenditure Last NamelBusiness Now Address Gh' State Zip Code Fast Name h9ddle Name Purpose of Expenditure Amount of Expendture Last NarnelBus'mess Name Address CRY State Zip Code Fast Name Middle Name Purpose of Expenditure Amount of Expenddure Last NamelBusiness Name Address City State 4 Code First Name Middle Name Purpose of Expenditure Amount of Experidrhure Last NamelBusiness Name Address city state Zip Code First Name Middle Name Purpose of Expenditure Amount of Expenditure Last Name/Business Name Address City 7ff-], Zq Code 5. TOTAL ITEMIZED EXPENDITURES (Carty forward to ilem 3. of next page 9 additional pages of this form are used.) T f~~ (If tds Is the last page of ezperddrrres, tds amount must be shown in ilem 19b. of wrrawy.) SS-1129 (Rev. 4102) 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 01/22/18 GAYE HASTY 2.b. IF COMMITTEE, NAME OF CANDIDATE 3. ELECTION DATE 05/01/2018 4.a. CAMPAIGN ADDRESS AND PHONE Street or Rural Route City State Zip Code Phone 3552 BLACK SULFUR WAY MARYVILLE TN 37803 865-982-1817 4.b. CANDIDATE'S HOME ADDRESS (if different than 4.a.) 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) BLOUNT COUNTY CLERK STEPHANIE THOMPSON 7. CATEGORY OR REPORT (Check one)❑ ❑ ❑ ❑ ❑ FIRST SECOND THIRD FOURTH PRE- 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 07/01/2017 01/15/2018 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. ;a18. 4 1 AILI I I signat of candidate date ^ ignature of pco al treasur dat 11. WITNESS SIGNATURE 1-~a-lg signat e f witness date sign ffreotne date 12. SUMMARY 1,789.82 a. BALANCE ON HAND LAST REPORT $ b. TOTAL RECEIPTS THIS PERIOD $ 4,060.00 c. TOTAL DISBURSEMENTS THIS PERIOD $ 1,916.16 d. BALANCE ON HAND (12.a. plus 12.b. minus 12.c.) . 11.JZ. $ 3,933.66 24 0 0 e. TOTAL LOANS OUTSTANDING ao ~VED.......... $ 0 f. TOTAL OBLIGATIONS OUTSTANDING ..........i.`.~ $ rr%f - BL0 ELkTIOt4 SS-1109 (Rev. 2/06) A. Page 1 of j~k_ RDA 1159 SUMMARY PAGE - CANDIDATE 13. NAME OF CANDIDATE OR COMMITTEE (In Full) 14. REPORT COVERING THE PERIOD - 1 GAYE HASTY, BLOUNT COUNTY CLERK FROM: 07/01/17 TO: 01/15/18 RECEIPTS 15. CONTRIBUTIONS (other than loans and interest) a. Unitemized Contributions $100 or less from each source this period) $ 2,175.00 b. Itemized Contributions over $100 from each source this period) $ 1,885.00 c. TOTAL CONTRIBUTIONS (other than loans and interest)(add 15.a. and 15.b.) $ 4,060.00 16. LOANS RECEIVED THIS REPORTING PERIOD $ 0 17. INTEREST RECEIVED THIS REPORTING PERIOD 0 18. TOTAL RECEIPTS (add 15.c., 16., and 17.) (must be shown in item 12.b.) $ 4,060.00 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) Printing & Postage $ 137.59 Paper products - campaign kick-off $ 75.93 Misc. Reception supplies (Target & Amazon $119.28 Food supplies for Reception (Kroger Target, Costco) $174.55 Christmas Parade supplies (Target Walmart) $189.27 Hometown Christmas supplies (Michaels) $ 42.23 Blount County Jaycee's parade entry fee $ 25.00 Donation-Employee Eclipse Party $ 41.00 Donation-Good Neighbors $ 50.00 Donation - United Way Basket Auction $ 46.20 Table Sponsor- United Way luncheon $ 75.00 Best of Blount - Lone Survivor $ 79.00 The Daily Times -State Champs Football Ad $ 62.50 Blount Chamber Foundation - MLK Luncheon $ 35.00 The Daily Times-Athena Awards $ 60.00 Total of Expenditures $100 or less each payee) $ 1,212.55 b. Itemized Expenditures (Over $100 each payee this period) $ 703.61 c. TOTAL EXPENDITURES other than loan re a meets (add 19.a. and 19.b. $ 1,916.16 20. LOAN REPAYMENTS MADE THIS PERIOD 0 21. TOTAL DISBURSEMENTS (add 19.c. and 20.) (must be shown in item 12.c.) 1,916.16 22AWKIND CONTRIBUTIONS a. Unitemized in-kind contributions ($100 or less from each source this period) $ 0 b. Itemized in-kind contributions over $100 from each source this period) $ 0 c. TOTAL IN-KIND CONTRIBUTIONS RECEIVED THIS PERIOD (add 22.a. and 22.b.) $ 0 23. OBLIGATIONS a. Unitemized Obligations Outstanding ($100 or less each) $ 0 b. Itemized Obligations Outstanding Over $100 each $ 0 c. TOTAL OBLIGATIONS OUTSTANDING (add 23.a. and 23.b.) (must be shown i item 12.f.) $ 0 SS-1133 (Rev. 4102) Page _a_ of ITEMIZED STATEMENT OF EXPENDITURES - CANDIDATE 1. NAME OF CANDIDATE OR COMMITTEE 2. REPORT COVERING THE PERIOD FROM: TO: 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 1 Last Name/Business Name \ Office fit' a6e t5, o,- f),5 Address 1 a rerida City State Zip Code First Name Middle Name Purpose of Expenditure Amount of Expenditure Last Name/Business Nam r 3 I i C,0Y", ktOff 00 Address ?c _ r V- per City State Zip Code K e L e r E-; 0 r, ► TO o First Name Middle Name Purpose of Expenditure Amount of Expenditure Last N m /Business N me er; ctc e Pn er BI tic ; bban ov Address ( O~ 6r) -a & LC)uYlbq Rlir City State Zip Code -~)L,;,jS.enc~ Tv 3-1~ ~ First Name Middle Name Purpose of Expenditure Amount of Expenditure Last Name/Business Nam l I.Z~C4vlP rA~J~~CQh GO it' ~~rE'GIS~ Address 00 City State Zip Code ((ff 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 Ury 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.) SS-1129 (Rev. 4102) Page 3- 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 totaling more than $100 from an contributor First Name Middle Name Contribution Received For: Amount of Contribution Last Name/Organization Name Primary Election ❑ General Election r( L r. Address LA -4 "~10 C 11~0 CL\ -C- V11 61 ❑ Runoff (Local Elections Only) ~l ~0 ~ City State Code Date of Contribution Aggregate This Election ~ 1► ~ ~ IT VQ Zip3^l U 3 Occupation Q C.. \ r e L` Employer First Name Middle Name Contribution Received For: Amount of Contribution M Last Name/Organization Name rCJ Primary Election ❑ General Election NN-'\ LVV-N Address ❑ Runoff (Local Elections Only) City State zipcode Date of Contribution Aggregate This Election Occupation Employer First Name fiddle Name Contribution Received For: Amount of Contribution st ame rgamza ion antUee ET-P~dmary Election General Election 7Q ~ t l Address []Runoff (Local Elections Only) ~C 00 LA f\ C city state Zip Code Date of Contribution Aggregate This Election ti 3`13 Occupation r l C_' " Q. A Employer First Name 1 Middle Name Contribution Received or: mount o Contribution Last Na a/Organization Name Primary Election El General Election Address ❑ Runoff (Local Elections Only) U au Lan CA- Z Code _ Date of Contribution Aggregate This Election Ili State city Occupation Employer 5. TOTAL ITEMIZED CONTRIBUTIONS O (Carryforward 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.) 14AJ SS-1131(Rev. 2/06) Page of RDA 1159 , I,_.. ITEMIZED STATEMENT OF CONTRIBUTIONS - CANDIDATE 1. NAME OF CANDIDATE OR COMMITTEE 2. REPORT COVERING THE PERIOD FROM: TO: Amount pe 3. TOTAL ITEMIZED CAMPAIGN CONTRIBUTIONS FROM PRECEDING PAGE (enter $0 if first itemized page) 5 4. COMPLETE THE APPROPRIATE ITEMS FOR EACH ITEMIZED CONTRIBUTION contributions totalin more than $100 from an contributor First Nam Middle Name Contribution Received For: Amount of Contribution T, m~. Last Name/Organization Name rimary Election ❑ General Election Address ~ C ❑ Runoff (Local Elections Only) ~ p JC ~C r city k . State , Zip Code Date of Contribution Aggregate This Election Le V`110 I C " Occupation f• ,Looe Employer ` ~ ~ k' 1 i r 2 First Name Middle Naamme_ Contribution Received For: Amount of Contribution t Last Name/Organization Name ,OPrimary Election ❑ General Election Address ❑ Runoff (Local Elections Only) I O C) City State Zip Code Date of Contribution Aggregate This Election Occupation ec f k F r~ Employer G 1-14 5- First Name iddle Name Contribution Received For: Amount of Contribution ~C, Ll C st ame rganization Name O'Primary Election ❑ General Election Address, ❑ Runoff (Local Elections Only) _ U3 !70~ C6,_3 i (o ' State Zip Code Date of Contribution Aggregate This Election city Occupation Employer First Na Middle Name Contribution Received or: mount o Contribution 1;a Last Organization Name'Q 1 Primary Election 1:1 General Election amel Addre LA V4 S ~i a ❑ Runoff (Local Elections Only) C C CD City + State ZipCode l C_ Date of Contribution Aggregate This Election Occupation 1 l Employer A 1 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.) SS-1131(Rev. 2106) Page 5- of RDA 1159 ITEMIZED STATEMENT OF CONTRIBUTIONS - CANDIDATE 2. REPORT COVERING THE PERIOD 1. NAME OF CANDIDATE OR COMMITTEE FROM: T0: Amount' ~ ~pp 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 , U F \v efPrimary Election ❑ General Election Last NamelorganizationName Ski. r I~ov El Runoff (Local Elections Only) Address ` State, `J Zip Code Date of Contribution Aggregate This Election City \ e w Occupation AR nl?Ak S !e Employer Contribution Received For: Amount of Contribution First Name Middle Name L\' Primary Election El General Election 00 Last Name/Organization ganization Name k/"lC Address ❑ Runoff (Local Elections Only) f A re ate This Election City State zipCodeDate of Contribution gg g Occupation ~r,t t'C9 Employer Contribution Received For: Amount of Contribution First Name Middle Name [3 Primary Election E] General Election FName[Organnizz-aalionn ame ❑ Runoff (Local Elections Only) State Zip Code Date of Contribution Aggregate Ths Electon Employer Contribution ecelved or: mount o contribution First Name Middle Name E3 Primary Election ❑ General Election Last Name/Organization Name El Runoff (Local Elections Only) Address Date of Contribution Aggregate This Election City State Zip Code 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.) ~b Page of RDA 1159 ~,J SS-1131(Rev. 2106) CAMPAIGN FINANCIAL DISCLOSURE STATEMENT For State and Local Candidates Tor Single-Candidate Committees 1. DATE OF REPORT 2.a. NAME OF CANDIDATE OR COMMITTEE 2.b. IF COMMITTEE, NAME OF CANDIDATE 3. ELECTION 'DATE 4.a. CAMPAIGN ADDRESS AND PHONE Street or Rural Route City State Zip Code Phone I~ulr Vf~cLy \e 03 Q6 a-k90 4.b. CANDIDATE'S HOME ADDRESS (if different than 4.a.) 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) +n - Du►n Cy er t" \nay e, . h 7. CATEGORY OR (Cheft one) FIRST SECOND TM FOURTH PRE- ~ MI YEAR YEAR❑ F -END QUARTER QUARTER QUARTER - QUARTER MARY GENERAL SUPPLEMENTAL SUPPLEMENTAL 8.a. BEGINNING DATE OF REPORTING PERIOD 8.b. ENDING DATE OF REPORTING PERIOD 0 LA -C l a 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 'tie 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 Vwe swear or affirm that no campaign contributions have been expended for the personal financial be bn_~t CAOLA A_, -L- Of j4A &*td-;- '4 Q!~~ nefit of the candidate or for any other nonpolitical purpose as defined by the federal internal revenue code. signal of candidate date natur , ig e of political treasu r date 11. WITNESS SIGNATURE signatu witness date signal of witness date 12. SUMMARY a. BALANCE ON HANG LUST REPORT b. TOTAL RECEIPTS T HIS PERIOD ` Q U c. TOTAL DISBURSEMENTS THIS PERIOD r~ Olo $ d. BALANCE ON HAND (12.a. plus 12.15. minus 12.c.) 3- r q a. TOTAL LOANS OUTSTANDING $ f. TOTAL OBLIGATIONS OUTSTANDING $ SS-1109 (Rev. 2/06) Pape 1 of RDA 1159 i i SUMMARY PAGE - CANDIDATE 13. NAME OF CANDIDATE OR COMMITTEE (In Full) 14. REPORT COVERING THE PERIOD FROM: RECEIPTS - 6-0 15. CONTRIBUTIONS (other than loans and interest) -1 a. Unitemized Contributions ($100 or less from each source this period) $ ol2t-ls +0d b. Itemized Contributions (over $100 from each source this period) $15300-on -1 SA c. TOTAL CONTRIBUTIONS (other than bans 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.) $ C~;IS e0 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) Rcof ess►o ynCJ ?~nu*os $ :3 0 - 0~ V o yer I i s•1 $ 5 0, 00 'k~eG•e yN SL&-12 Q 1; es $ 13 37 $ 1a1 ?r + r\~'1 ng~ $ 1 d ► 3 $ $ Total of Expenditures ($100 or less each payee) $ L4 3 i b. Itemized Expenditures (Over $100 each payee this period) $ C1 ~ 3 - -'d 60 c. TOTAL EXPENDITURES (other than ban 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.) $ l• 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.) $ 23.013LIGATIONS 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 ) item 12.f.) $ SS•1133 (Rev. 4102) Page of i ~x °r tC ITEMIZED STATEMENT OF CONTRIBUTIONS - CANDIDATE 1. NAME OF CANDIDATE COMMITTEE 2. REPORT COVERING THE PERIOD FROM: _ Amount 3. TOTAL ITEMIZED CAMPAIGN CONTRIBUTIONS FROM PRECEDING PAGE (enter $0 it first itemized page) -e- 4. COMPLETE THE APPROPRIATE ITEMS FOR EACH ITEMIZED CONTRIBUTION corllrrbutions totaling more than $100 from an contributor Fiat Narna,e• Mddle Name ConMbt" Received For. Amount of Contribution p 1 V1G~ Last Name0vark0on ❑ Primary Eleaat O'Generaf Eledion Address ❑ Runoff (Local Elections Only) A Do. C)o c" r , ` ► Q T7JP ; Dale of Contribution Aggregate This Election ooapatan e ' re Empbyer 941A a 00 - Firs(Nyw Nam Contribution Received For. Amount of Contrtution Berman Last Name/Oryardatim Name ❑ Primary Election Literreral Election r Address , ❑ Runoff (Local Elections Or*A CKY `I 1 e ~ i~pt; Date of Con(nTxrlion Aggregate This Election Occupation ` r 000100 First Name Name Contribution Received For. Amount of Wilrbution ❑ Primary Election metal Election Q Address PC) ❑ Runoff (Local Elections Only) 1 . a* Zip Coda Date of Contribution Aggregate This Election LMV"W - L e FhUbm Liddle Hama Q Contrbution Received pr. 0 wee. Name ❑ Primary Election General Election Vh Q f Address ❑ Runoff (Local Elections ow s e e-dow ~tC?C~ rLA/ 1 Sf % t We or Contribution Aggregate This Election Occupation Employer 5. TOTAL ITEMIZED CONTRIBUTIONS (Carty forward lo Nam 3. of ned page K addir W pages of Kds brm are used.) Oct (K Oft is the lest papa of oonhb Aons, this amount must be shown in Nam 15b. of surtmary.) 0 SS-1131(Rev. 2/06) Page of L RDA 1159 ITEMIZED STATEMENT OF CONTRIBUTIONS - CANDIDATE 1. NAME OF CANDIDATE R COMMITTEE 2. REPORT COVERING THE PERIOD FROM: 1 TO: Amount 3. TOTAL ITEMIZED CAMPAIGN CONTRIBUTIONS FROM PRECEDING PAGE (enter $0 if first itemized page) 2L Lk 00, oc) 4. COMPLETE THE APPROPRIATE ITEMS FOR EACH ITEMIZED CONTRIBUTION contributions totaling more than $100 from an contributor First Name Middle Name Contribution Received For: Amount of Contribution r' a L t Last Name/Organization Name El Primary Election 4ETGeneral Election i ron Address ❑ Runoff (Local Elections Only) AS00d F ~ City ^ i ( State Zip Code Date of Contribution Aggregate This Election Occupation ` ` Employer r First Name Middle N me Contribution Received For: Amount of Contribution Last Name/Organizaaf me ❑ Primary Election x~ General Election L-A Y)r\ 1r, )z ,r + Address ❑ Runoff (Local Elections Only) rJ0 k Lx o O Pl\ City le State I ?n Zip Code ~j Date of Contribution Aggregate This Election Occu tion ` T i mP yer Fi ame iddle Name Contribution Received For: Amount of Contribution s ame rganiza; ame ❑ Primary Election E't eneral Election Address V S ` V ❑ Runoff (Local Elections Only) ~(5D City ^ \ State ZipCode Date of Contribution Aggregate This Election Occupation Employer Fart Name ` Middle Name Contribution Received or: mount o Contribution -e ka z Li n Last Name/Organization Name ' ❑ Primary Election .l" General Election 'r 11,~ Add ss ❑ Runoff (Local Elections Only) q{' co S 11 Ca r City,~^ a State Zip Code I Date of Contribution Aggregate This Election r ` n Occu 'on %I ~.j Employer nL(~~U 5. TOTAL ITEMIZED CONTRIBUTIONS (Carry forward to item 3. of next page if additional pages of this form are used.) 0-0 (If this is the last page of contributions, this amount must be shown in item 15b. of summary.) SS 1131(Rev. 2/06) Page ~T of RDA 1159 ITEMIZED STATEMENT OF CONTRIBUTIONS - CANDIDATE 1. NAME OF CANDIDATE OR C MMITTE 2. REPORT COVERING THE PERIOD FROM TO: L-* ,3 I" tv Amount oa 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 First Name-T-1 Middle Name Contribution Received For: Amount of Contribution I % Last Name)0 anizationName _ CL4 i So iv, ❑Primary Election ~neralElection rnq Address, OG,- -R(1 El Runoff (Local Elections Only) ~ 1 n0- 1 city Le O, ' Stale Zip Code Date of Contribution Aggregate This Election Occupation Employer Fi s o ~W- + I Middle Name Contribution Received For: Amount of Contribution t L- Last Na /Organization Name` ❑ Primary Election ;Er General Election Addre"? O ~ ❑ Runoff (Local Elections Only) ~ OKI (113 Ciry r i I e State L~ Date of Contribution Aggregate This Election Occupation Employer F rst Na e i iddle Name Contribution Received For: Amount of Contribution X'k' k k VY\ IM Last e rgan¢a on ame ❑ Primary Election Q-Se'neral Election Adl,bj -A w ❑Runoff (Local Elections Only) L1 ~0 Ciry ` 1 n State ZipC_ooddei Date of Contribution Aggregate This Election Occupation \`,C D Employer Middle Name Contribution Received or: mount of Contribution rary-f-'L Last Name/Organization Namel 11 Primary 216eneral Election v a , V Address l ❑ Runoff (Local Elections Only) aV J lo1 V- City Stat K) Zip Code cl Date of Contribution Aggregate This Election T -3- Occupation Employer 5. TOTAL ITEMIZED CONTRIBUTIONS (Carry forward to item 3. of next page if additional pages of this form are used.) 0 (If this is the last page of contributions, this amount must be shown in item 15b. of summary.) ate, SS-1131(Rev. 2106) Page ..7 of RDA 1159 r i ITEMIZED STATEMENT OF CONTRIBUTIONS - CANDIDATE 1. NAME OF CANDIDATE R COMM TTEE 2. REPORT COVERING THE PERIOD FROM T0: _ ount 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 First Name \ Middle Name Contribution Received For: Amount of Contribution Last Name/Organization Name ❑ Primary Election OGeneral Election d Address ❑ Runoff (Local Elections Only) O~ 1 fj U V-, V\ LA A S00 City ; Stater 3 ipCoe Date of Contribution Aggregate This Election kca> Occupali n 1V 'ke-~ 1 r~ Employer Fi tN m e Middle Name Contribution Received For: Amount of Contribution vL Last Name/Organization Name ❑ Primary Election General Election L c- o r-& Do Address ❑ Runoff (Local Elections Only) Ciry . State zip Code Date of Contribution Aggregate This Election r uM2 Elm -yl 0 tion t-j -\A r cR mployer First Name fiddle Name Contribution Received For: Amount of Contribution st ame ganizahon ame E] Primary Election ❑ General Election Address ❑ Runoff (Local Elections Only) City State Zip Code Date of Contribution Aggregate This Election Occupation Employer First Name Middle Name Contribution ecerve or: mount o Contribution Last Name/Drganization Name ❑ Primary Election ❑ General Election Address ❑ Runoff (Local Elections Only) City State Zip Code Date of Contribution Aggregate This Election Occupation Employer 5. TOTAL ITEMIZED CONTRIBUTIONS 1~0 00 (Carryforward 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.) ' SS-1131(Rev. 2/06) Page of RDA 1159 ITEMIZED STATEMENT OF IN-KIND CONTRIBUTIONS - CANDIDATE 1. NAME OF CANDIDATE R COMMITTEE 2. REPORT COVERING THE PERIOD FROM TO: 00- 3. TOTAL ITEMIZED IN-KIND CONTRIBUTIONS FROM PRECEDING PAGE (enter $0 if first itemized page) Amount X4 ' 4. COMPLETE THE APPROPRIATE ITEMS FOR EACH ITEMIZED IN-KIND CONTRIBUTION (rvadnd cw&buU= tofal6p more than $700 from any axrtrbulor durirp the period) Fro Name Middle Name In-ft! Contribution Received For Value of In-ICnd CaiUibution lest NamerOrgarYzatiorrNams ❑ Primary Election 11 General Election ❑ Runoff (Local Elections ONy) Address Dais of h4 W Canbbram Aggregate V* EW" C'h' stage zpCode Dexslp ofh4 dCorMrb" Frat Name Middle Name h4W Contribution Received For. Value of In W CwMbution Nartre ❑ Primary Election ❑ General Election ❑ Runoff (Local Elections Ong) Address Dale of MGM Cmtrbut*n Aggregate ft BeWm City stale zip code DesaomofhiQrWiCor*bAon oompod- Enpbyer Frsl Name Midas Name h4W Contribution Received For. Value of In-Kind Conhib~ition Nam ❑ Primary Election ❑ General Election Lag Nw*ogwa2fim ❑ Runoff (Local Elections Only) Address tareort 4WCw*busoo Aggrepale tNs Bec6m Co Srava $ Des oWndhKedC *Wbm Fins Name DrGddle Name Vt-KM Contriwtion Received For. Value of In-Kiind Contribution Lest Name+Orgarrution Name ❑ Primary Election ❑ General Election ❑ Runoff (Local Elections Only) Address Datedh rxWCor*bubon AggregatethisEbcNm city state zrpCO& Dmo"mdharrtdCokbAon 0-pabon Espicw FYstName WddleNarm In-Iand Contribution ReceNed For: Value of tri-W Contriwtion ❑ Primary Election ❑ General Election ❑ Runoff (Local Elections ONy) Ad*m talsdtn Kr,dcor~trlD,bm Aggregate this Election CRY Stage Zip Code DesoriptimdhiCndCorWbu6m 5. TOTAL ITEMIZED IN-KIND CONTRIBUTIONS (Carry beard b Nam 3. of need page Iaftional pages of Nrs form are used) (if M b fire last page of h kind embbub".16 SMOA must be shown in Nom 22b. of summary.) SS-1128 (Rev. 2106) Pape of RDA 1159 ITEMIZED STATEMENT OF EXPENDITURES - CANDIDATE TOT 1. NAME OF CANDIDATE OR COMMITTEE 2. REPORT COVERING THE PERIOD FROM. TO- 3. AL ITEMIZED CAMPAIGN EXPENDITURES FROM PRECEDING PAGE (enter $O If first itemized page) mwun + 1 4. COMPLETE THE APPROPRIATE ITEMS FOR EACH ITEMIZED EXPENDITURE (expenditures totaling more than $100 b any PeYeo during the pexiod) First Name ATiddle Name Purpose of Expenditure Amount of Expendkm Last Nartre&9usiness Name Address OZ ~Otr1G~ OFl~ C AY State Zip Code 0 171'k04- First Name Mioate Na,nme ~ ® l Purpose of Expeflddore Amount of Expenditure Name Address A S ' m -e RC9 C. a r rf\acJr,~.~ s fit" State IlpCode ma i I le 3-I 2f0 lac-00 Frst Name Mddfe Name Purpose of Expenditure Amount of Expenditure Last NamelBwlnesa Name Address c73ax 1 '~oolr`~nob bugs CNy slate zip code Feat Name Middle Name Purpose of Expen lkure Amount of Expenditure Last NamdBus6ass Name 'PQ k t' 47-1 C-a L-` ACXW r) S'i o\ V) ddress qk V-rl Q~l Stale Tq code r, Ca ►-t✓l s DVS SLIqSG Ste! First Name Mdse Nacre ~ Plapose of Expenddure Amount of Experiddure Last Name/Business Name s 1 Address C~l (a ah e- 5 na 11 swa zip L r h S Code LA, 2 cl (a First Name LSddle Name Purpose of Expenditure Amount of Expenditure Last NamalBusmau Name Address C4 Slate zo Code 5. TOTAL ITEMIZED EXPENDITURES (Coryforward b (lam 3. of next papa if additional papas of ft form amused.) (If Ws Is the lost pope of axpandilums, ft amount must be shown In Nom 19b. of o rcay.) Alh SS-1129 (Rev. 4ro2) Pape -It(- of D RDA 1159 ITEMIZED STATEMENT OF LOANS - CANDIDATE 1. NAME OF CANDIDATE OR COMMITTEE 2. REPORT COVERING THE PERIOD FROM: T0: 3. COMPLETE THE A OPRIATE ITEMS FOR EACH MIZED LOAN (vans soWrg morethan S100 from any sowm during the period) Complete the FdbwkV for the Source of the Loan First Nam Middle Name Outstanding Loan Balance Loans Loan Outstanding Loan Balance 1 (ftwg of Pew) Received Payments (End of Period) Last Name/Oryanization Name Address Loan Received For. We of Um Gb Stak ❑ Primary Election ❑ General ElecSah Zp Code ❑ wa,ar (focal Ebcsahs only) ListM Endorsers orGuaranom borAbove Loan (K more space is needed please attach a page) c First Name Middle Name Fret Name Middle Name Last NamelOganizatm Name Usl NamelOrganizalion Name Address Address C4 State Zip Cade Cdy State rV Code t Amourt Guaranteed O A&WWug Affoint Guaranteed Ot*Uf dirg l First Name Addle Name Fist Name Middle Name Last m Name Lost NawAkga wjm Name Address Address City Stab T* Code City State Zip Code An w o Guaranteed Oulsbndng Guaranteed Oulswdag Fret Name Middle Name First Name Middle Name Last Nam 0ganiuton Name Last Namr,0gan stion Name Address Address fate zip Mount Guaranteed Outstanding Oufsta~ First Name Addle Name First Name piddle Name LW Narae/Onganizaton Nm Last Narft$Q aniution Name Address Address Qb' State Zip Code Ck State Zip Code Mount Guaranteed OutsfanWirg t Gwrenbed Oulstandaq 4. Totals ford Loam (oompme on fast page of k ntmed bans) answding Loan Balance Loan Loan Of landing Loan Balance (Tow bam recOved ahoWd also be sham to Llem 1G on summary paged (Begiankv or Pwiod) RemWed qperi4 (W ben payments stock also be shown in item 20. on sumhary page.) (Total oulswdirp ban balance should also be shown in Nem 12a. on font ) P~ ® SS-1132 (Rev. 4/02) Page CA of 10 RDA 1159 ITEMIZED STATEMENT OF OBLIGATIONS - CANDIDATE 1 • NA E OF CANDIDATE OR CO MITTEE ' 2• REPORT COVERING THE PERIOD 3. COMPLETE T PPROPRIATE ITEMS FO FROM: TO: OBLIGATION CH ITEMIZED Outstanding Balance Debt Incurred Pa (obligations totaling more than $100 owed to any (Beginning of Period) This peril Yams Outstanding Balance PersonMendor at the end of ft reporting pew This Period (End of Period) Flrst Name 6iddle Nine Lest Name/Business Name Address qly state Zip Code Flrst Name Afddb Mama t Address City Slade Zp Code o(06Fpa6on Fksl Name 6idrJe Name ~ NamatBuskaess Name Address Slate Zap Code Oescriv6am orl)Wiya6e„ Flral Nana Wd* Warne Last NamelBuska Nye A*hu City Slate Zp Code Desaip6on orCbkpaGon Flral Nam W* Name Last Nane!&akress Na- Addaou City Stale Lp Code 6ora or Obipa6on 4. TOTALS Rota) from Oubarm*p Balance - (End of Period) column must also be shown in Nem 23b. on summary page.) SS-1121 (Rev. 4102) Page ^ or -Lb RDA 1159 e 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 ONLY with 3 their county election commission. I 1. Date: 2. Name of Candidate or Committee: 3. Candidate e-mail address: e, Co ` V 4. Campaign Address and Phone: Ci State Zip ode Phone 3SS~ 2:~\o~ckSLkl~4 v., ~ar^ I I e 3~~SO3 ~~5 q -ISSI~ 5. Home Address and Phone (if different than item 4 above): City State Zip Code Phone 6. Office Sought (include district number, if applicable) 7. Party Affliation 8. Election Year Co u V\ C l e t- k '~e U C- cx n 910 ~ (o 9. Treasurer Name: 10. Treasurer e-mail address: 7VNOh&_ 5 ' e'\o1m on5 c m, 11. Treasure Address and Phone: City State Zip Code Phon % 1 3^7k03 C G5 9 -a 3 35$a u -~u r l c~ MdiWy 12. Candidate and Treasurer Signature (both signatures t be witnessed. Treasurer can not witness candidate's signature): 1/ -1 1. cal lF~ Y~ Signa a of Candidate Signature of Treasu er I 4~Lgnat`ure\6_rWitness Sign ure of i ness Registry of Election Finance SS-1120 (rev 10/2010) ,ham