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Lawhorn, Staci Crisp JT CAMPAIGN FINANCIAL DISCLOSURE STATEMENT For State and Local Candidates For Single-Candidate Committees 1. DATE OF REPORT 2.a. NAME OF CANDIDATE OR COMMITTEE -d3-18 SM is CA LAAWAJ 2.b. IF COMMITTEE, NAME OF CANDIDATE 3. ELECTION DATE 5-1- 4.a. CAMPAIGN ADDRESS AND PHONE Street or Rural Route City State Zip Code Phone N 3 71, 8V 5 - qqs -9 lot- Ced.av tsA- LK. s Z 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) u s' is S CiGtYol 7. CATE RY OR REPORT (Check one) 13 J~ FIRST SECOND THIRD FOURTH PRE- PR - MI -Y R YEAR❑-E ND QUARTER QUARTER QUARTER QUARTER PRIMARY GENERAL SUPPLEMENTAL SUPPLEMENTAL 8.a. BEGINNING DATE OFF REPORTING PERIOD 8.b. ENDING DATE OF REPORTING PERIOD O 9. (Check one) a. 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 c ndidate date signature f political treasurer date 11. WITNESS SIGNATURE s nature of witness date k-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.) $ 1-44.3201 e. TOTAL LOANS OUTSTANDING ~0..........J.................................... $ 3,W. BOO . ..........p RECEIVED w f. TOTAL OBLIGATIONS OUTSTANDING A $ . d' 0) SS-1109 (Rev. 2/06) BLOUNT COUNTY V ELECTION cb page 1 of RDA 1159 O ~Yy Wd Z~ CAMPAIGN FINANCIAL DISCLOSURE STATEMENT For State and Local Candidates For Single-Candidate Committees 1. DATE OF REPORT 2.a. NAME OF CANDIDATE OR COMMITTEE 4-1c)- 8 I S +a6 is - AIIAJ . 2.b. IF COMMITTEE, NAME OF CANDIDATE 3. ELECTION DATE SbG WV - I~ Irwar a ~ 4.a. CAMPAIGN ADDRESS AN PHONE Street or Rural Route 1 ~city state Zip Code Phone ZI,4q e-eBLLW Cues r•l• ~ 1,3 64 ~6-Q 4.b. CANDIDATE'S HOME ADDRESS (if different than 4.a.) Street or Rural Route City State Zip Code Phone F5. OFFICE SOUGHT (include district number, if applicable) 6. NAME OF POLITICAL TREASURER (may be candidate) Cou COWWAis S, no V1 SJ . q S jr C'ar o o% Gri 7. CATEG RY OR REPORT (Check one) 19 IF RSr SECOND THIRD FOURTH PR - PR - 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 64-t A•If 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. Uwe 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. N&O - onmemL- C 9 -Wj&t~ 2!2~ 14-1 signature of ndi te =--4date signature of litical treasurer date 11. WITNES SIGNA RE 4.IP-14 A signature of witness date signature of witness date 12. SUMMARY ' a. BALANCE ON HAND LAST REPORT PI....................,............................. $ J. P b. TOTAL RECEIPTSTHIS PERIOD ....;~i":)..........................$ c. TOTAL DISBURSEMENTS THIS PERIOD $ d. BALANCE ON HAND (12.a. plus 12.b. minus 12.c.) 3cc.®a e. TOTAL LOANS OUTSTANDING f. TOTAL OBLIGATIONS OUTSTANDING $ SS-1109 (Rev. 2106) Page 1 of RDA 1159 1 SUMMARY PAGE - CANDIDATE 13. NAME OF CANDIDATE OR COMMITTEE (In Full) 14. REPORT COVERING THE PERIOD SHia Cr ' FROM: T0: 3 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) $ a b 0 .'0 p c. TOTAL CONTRIBUTIONS (other than loans and interest)(add 15.a. and 15.b.) $ A'Soc..0O 16. LOANS RECEIVED THIS REPORTING PERIOD $ 3 cp. BOG 17. INTEREST RECEIVED THIS REPORTING PERIOD $ $OC3, CD 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) $ $ $ $ $ $ $ e Total of Expenditures ($100 or less each payee) $ 3 p b. Itemized Expenditures (Over $100 each payee this period) $ a Jr 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.) $ 22.IN-KIND CONTRIBUTIONS a. Unitemized in-kind contributions ($100 or less from each source this period) $ 0 P 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.) $Jr~ CP 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 121) $ SS-1133 (Rev. 4102) Page of ITEMIZED STATEMENT OF CONTRIBUTIONS - CANDIDATE 1. NAME OF CANDIDATE OR COMMITTEE 2. REPORT COVERING THE PERIOD Ll \ S FROM: S TO: Z A, I- (A 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 Ngme Middle Name Contribution Received For: Amount of Contribution V-0l V- j. $ moo. CC) Last Na a/Organizat Name Primary Election ❑ General Election ~k Addres MA &V\ ❑ Runoff (Local Elections Only) o e 8 -~j QA. City State-- 11 Zi Code Date of Contribution Aggregate This Election S i I rV P~ ~ O Occupation R.e "reel Employer First ame Middle Name Contribution Received For: Amount of Contribution Last Name/Organization Name IQ Primary Election ❑ General Election e Addre ❑ Runoff (Local Elections Only) City r' Y I State Zip Code Date of Contribution Aggregate This Election W -t Occupal -4 Employer S 1 LX. FirstNa a iddleName Contribution Received For: Amount of Contribution L L ick L4 I'I Last Name/Organization Name Primary Election ❑ General Election 5 C o . 00 GY etAn Address ❑ Runoff (Local Elections Only) City State ZipCode Date of Contribution Aggregate This Election Occupation 3--a 12 Employer First ame Middle Name Contribution Received or: Amount of Contribution Last Name ganization Name Primary Election ❑ General Election I co . OD WL~kw Address City , ❑ Runoff (Local Elections Only) k 'A 1~~ State Zi Code Date of Contribution Aggregate This Election Occupation ^ J' Employer 5. TOTAL ITEMIZED CONTRIBUTIONS n ^ (Carry forward to item 3. of next page if additional pages of this form are used.) to N (If this is the last page of contributions, this amount must be shown in item 15b. of summary.) SS-1131(Rev. 2106) Page of RDA 1159 ITEMIZED STATEMENT OF IN-KIND CONTRIBUTIONS - CANDIDATE 1. NAME OF CANDIDATE Oft COMMITTEE 2. REPORT COVERING THE PERIOD FROM: • T0: moun 3. TOTAL ITEMIZED IN-KIND CONTRIBUTIONS FROM PRECEDING PAGE (enter $0 if first itemized page) liar, 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 Name/Organization 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 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-Kind Contribution Aggregate this Election City State Zip Code Description of In-Kind 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-Kind Contribution Aggregate this Election City State Zip Code Description of In-Kind 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-Kind Contribution Aggregate this Election City State Zip Code Description of In-Kind Contribution Occupation Employer First Name Middle Name In-Kind Contribution Received For: Value of In-Kind Contribution E] Primary Election El General Election Last Name/Organization 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 221b. of summary.) f SS-1128 (Rev. 2106) Page of RDA 1159 CANDIDATE NT OF CONTRIBUTIONS ITEMIZED STATEME 2. REPORT COVERING THE PERIOD To: 3 b FROM: Amount 00.00 1. NAME OF CANDIDATE OR COMMITTE \h enter $0 if first itemized page) Amount of Contribution . TOTAL ITEMIZED CAMPAIGN CONTRIBUTIONS FROM PRECEDING PAGE CONTRIBUTION (contributions totalin more than $100 from an contributor 3 Contribution Received For: 4. COMPLETE THE APPROPRIATE ITEMS FOR EACH ITEMIZED Middle Name ❑ General Election UO 61.0 [,primary Election First Name Laste/organization V\-It' 1V; Name Runoff (Local Elections Only) l~l This Thls Election Address '1 1 Date of Contribution S.ta(le~ ZiQ de City ` Ir Occupation Employer Amount of Contribution ~p~t(ft Contribution Received For: Middle Name First Name ❑ primary Election ❑ General Election Last NamelOrganizationName C3 Runoff Local Elections Only) Address Aggregate This Election state Zip Code Date of Contribution city occupation Employer Amount of Contribution IddleName Contribution Received For: First Name ❑ Primary Election ❑ General Election as ame rganiza on ame ❑ Runoff (Local Elections Only) Address Date of Contribution Aggregate This Election State Zip Code City r Occupation mp oyer Contribution eceived or: Amount o Contribution Middle Name First Name ❑ Primary Election ❑ General Election Last Name/Organization Name ❑ Runoff (Local Elections Only) Address State Zip Code Date of Contribution Aggregate This Election City occupation F Employer 5. TOTAL ITEMIZED CONTRIBUTIONS (Carty 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 151b. of summary.) l SS-1131(Rev. 2106) _ l~'Ifl ITEMIZED STATEMENT OF EXPENDITURES - CANDIDATE 1. NAME OF CANDIDATE OR COMMITTEE 2. REPORT COVERING THE PERIOD Sta Lt CV ► Sp a FROM: _ _ g 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 Last NamelBusiness Name . N ZW S ? a~)Qy '9 4 1 O ,1Iq q . CP YVlf1S 1 Addr s o . WiV ev City State I Zip Code First Name Middle Name Purpose of Expenditure Amount of Expenditure Last Name/ t siness Name ~ ~ 1 Q VIS Addr s J t J City Stale Zip Code TO 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 p (Carry forward to item 3. of next page if additional pages of this form are used.) S d O (It this is the last page of expenditures, this amount must be shown in item 19b. of summary.) SS-1129 (Rev. 4102) Page of RDA 1159 Jg... * r d ITEMIZED STATEMENT OF LOANS - CANDIDATE 1. NAME OF CANDIDATE OR COMMITTEE 2. REPORT COVERING THE PERIOD FROM: TO: 3. COMPLETE THE APPRO RIATE 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 Name/ rganizationName I Socl QC) ..8' A? Y 3~0' ~G Address Loan Received For: Date of Loan 3 ' / C S T 5 Primary Election ❑ General Election City State Zip Code S J 1 1 [I Runoff (Local Elections Only) V 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 i 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 Cade 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 Loan Outstanding Loan Balance (Total loans received should also be shown in item 16. on summary page.) (Beginning of Period Received Pa menu End of Period (Total loan payments should also be shown in item 20. on summary page.) a ~y (Total outstanding loan balance should also be shown in item 12.e. on front page.) -r O TI 3 C,0- 0-1 SS-1132 (Rev. 4/02) Page of RDA 1159 . _ J. . _ ...1~ , _ ors - - - ~-s~r~rti~iritl~r ITEMIZED STATEMENT OF OBLIGATIONS - CANDIDATE 1. NAME OF CANDIDATE OR COMMITTEE I,2. REPORT COVERING THE PERIOD U b- 1 W- Y `QY lr~ FROM: - 8 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 NamelBusiness Name Address City State Zip Code Description of Obligation First Name Middle Name Last Name/Business Name Address I City State Zip Code Description of Obligation Flrst 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.) Alk SS-1127 (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 COUNTY - a Jr- 1 g I w ~LG 6 ELEC i ON 2.b. IF COMMITTEE, NAME OF CANDIDATE 3. ELECTION DATE ~-t- 8 4.a. CAMPAIGN ADDRESS AND PHONE Street or Rural Route City State Zip Code Phone 3VA W SV1t S- -IQ-1 q45 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) uvx-I- CaL ioln~ 1 1(0 ( 1 7. CATEGORY OR RE RT (Check one) , / ❑ ❑ ❑ ❑ ❑ ❑ ❑ OO 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 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. A-~ signature of can idate date signature political treasurer date 11. WITNESS SIGNATURE -&& I -ZS- I2 _ l - 2~- signature of witness 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.) $ _ _ XJ e. TOTAL LOANS OUTSTANDING $ 'pI f. TOTAL OBLIGATIONS OUTSTANDING $ SS-1109 (Rev. 2/06) Page 1 of RDA 1159 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. Candidate First and Last Name: 3. Candidate e-mail address: WL4, cu* 4. Campaign Address and Phone: City State Zip CQck Phone t Lh • i s I e 'r'll~ ~G 5 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 Affiliation 8. Election Year MM~ SS 10 ~ ►S c.a' ~Q a0 ~ $ VA I ci V'- 9. Treasur Name: 10. Tr asurer e-mail address: OLEO 1 11. Treasure ddress and Pho e: City State Zip o e Phone 12. Candidate and Treasurer Signature (both signatures must be witnessed. Treasurer can not witness candidate's signature): ~C~ EO Signature of C ndid to JAN 2 gnature of T easurer 2 ?018 kOIJAIrCo ~oAuf' Signature of Witness Signature of Witness Registry of Election Finance SS-1120 (rev 12/2013)