Martin, Dennis "D.L."
CAMPAIGN FINANCIAL DISCLOSURE STATEMENT
For State and Local Candidates
For Single-Candidate Committees
1. DATE OF REPORT 2.a. NAME OF CANDIDATE OR COMMITTEE
22 April 2018 Committee to Elect Dennis "D.L." Martin Blount County Mayor
2.b. IF COMMITTEE, NAME OF CANDIDATE 3. ELECTION DATE
Dennis "D.L." Martin 01 May 2018
4.a. CAMPAIGN ADDRESS AND PHONE
Street or Rural Route City State Zip Code Phone
147 Smokey Dr Townsend TN 37882 865-696-7189
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)
County Mayor Steven L. Mobley
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
01 April 2018 21 April 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 campaign contributions and expenditures required to be reported by the candidate committee by the Campaign Financial
Dis_Jos ct. Additionally, I/we swear or affirm that no campaign contributions have been expended for the personal financial benefit of the
candi t r ter nonpolitical purpose as defined by the federal ' ernal revenue code.
signature o candidate date signature of p itical trea rer date
11. WITNESS SIGNATURE
_W
signature Nwitness date signatur of witness date
12. SUMMARY
a. BALANCEON HAND LAST REPORT 50.00
b. TOTALRECEIPTSTHIS PERIOD $ 0.00
c. TOTALDISBURSEMENTSTHISPERIOD 0.00
~..3...... `s 6... $ 50.00
d. BALANCE ON HAND (12.a. plus 12.b. minus 12.c.) N........3
e. TOTAL LOANS OUTSTANDING ,r....................................... $ 0.00
n nn
2 4 201 f
f. TOTALOBLIGATIONS OUTSTANDING . $
K3.
ff - 'E<.E~TIJ y~
Page 1 of RDA 1159
SS-1109 (Rev. 2/06) `yf ~l,,,_„„_,,,,,,/„~►►
SUMMARY PAGE - CANDIDATE
13. NAME OF CANDIDATE OR COMMITTEE (In Full) 14. REPORT COVERING THE PERIOD
Committee to Elect Dennis "D.L." Martin Blount County Mayor FROM: 01 APR 2018 T0: 21 APR 2018
RECEIPTS
15. CONTRIBUTIONS (other than loans and interest)
a. Unitemized Contributions ($100 or less from each source this period) $ 0.00
b. Itemized Contributions (over $100 from each source this period) $ 0.00
c. TOTAL CONTRIBUTIONS (other than loans and interest)(add 15.a. and 15.b.) $ 0.00
16. LOANS RECEIVED THIS REPORTING PERIOD $ 0..00
17. INTEREST RECEIVED THIS REPORTING PERIOD $ 0.00
18. TOTAL RECEIPTS (add 15.c., 16., and 17.) (must be shown in item 12.b.) $ 0.00
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)
Total of Expenditures ($100 or less each payee) $ 0.00
b. Itemized Expenditures (Over $100 each payee this period) $ 0.00
c. TOTAL EXPENDITURES (other than loan repayments)(add 19.a. and 19.b.) $ 0.00
20. LOAN REPAYMENTS MADE THIS PERIOD $ 0.00
21. TOTAL DISBURSEMENTS (add 19.c. and 20.) (must be shown in item 12.c.) $ 0.00
22.IN-KIND CONTRIBUTIONS
a. Unitemized in-kind contributions ($100 or less from each source this period) $ 0.00
b. Itemized in-kind contributions (over $100 from each source this period) $ 0.00
c. TOTAL IN-KIND CONTRIBUTIONS RECEIVED THIS PERIOD (add 22.a. and 22.b.) $ 0.00
23. OBLIGATIONS
a. Unitemized Obligations Outstanding ($100 or less each) $ 0.00
b. Itemized Obligations Outstanding Over $100 each . $ 0.00
c. TOTAL OBLIGATIONS OUTSTANDING (add 23.a. and 23.b.) (must be shown i item 12.f.) $ 0.00
rr; Pagea of
SS-1133 (Rev. 4/02)
L,
CAMPAIGN FINANCIAL DISCLOSURE STATEMENT
For State and Local Candidates
Tor Single-Candidate Committees
1. DATE OF REPORT 2.a. NAME OF CANDIDATE OR COMMITTEE
RUC ~.cmm l ~u- i~~ a~ . L n) ~ • I,J i 3'•
2.b. IF COMMITTEE, NAME OF CANDIDATE 3. ELECTION DATE
,e> > >7; av 5
4.a. CAMPAIGN ADDRESS AND PHONE
Street or Rural Route city state Zip Code Phone
11-7 .5m " - b 7 3 ?&5-- _ 71 la
41. CANDIDATE'S HOME ADDRESS (d 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)
Cap r' : E,d L.
7. CATEGORY ORREPORT (Check on b)
09 FIRST SECOND T~ FO❑URTH P❑RE• PRE- MID-YEAR ❑
YEAR YEAR-END
QUARTER MARY GENERAL SUPPLEMENTAL SUPPLEMENTAL
8.a. BEGINNING DATE OF REPORTING PERIOD S.b. ENDING DATE OF REPORTING PERIOD
3-) 3-3) - l Sf
9. (Check one)
a. V Thls 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 d* 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
FinanC% Disclosure Acl. Additionally, Uwe swear or affirm that no campaign contributions have been expended for the personal financial
be t of candidate or for any other nonpolitical purpose as defined by the federal internal revenue code.
signature of candidate cat signature of poi " I treasur date
11. WITNESS SIGNATURE
signaturess date signature of wiltrifte' date
12. SUMMARY
a. BALANCE ON HAND LAST REPORT $
b. TOTALRECEIPTS THIS PERIOD RECEYVEJ5 $
c. TOTAL DISBURSEMENTS THIS PERIOD $
APR•r• 71
d. BALANCE ON HAND (12.a. plus 12.b. minus 12.c.) ....R,(.W NT.pn $
e. TOTAL LOANS OUTSTANDING $ D • dig
f. TOTAL OBLIGATIONS OUTSTANDING $
SS-1109 (Rev. 2106) Page 1 of RDA 1159
SUMMARY PAGE - CANDIDATE
13. NAME OF CANDIDATE OR COMMITTEE (In Full) 14. REPORT COVERING THE PERIOD
n/~ p FROM: --1-~ ~ T0: 3 ~ 3) r5f
IGE1GG ~QW6 L. IfJ.eTi~ aU,d'T CAA H
I t-
RECEIPTS
15. CONTRIBUTIONS (other than loans and interest)
a. Unitemized Contributions ($100 or less from each source this period) $ d- 00
G)
b. Itemized Contributions (over $100 from each source this period) $
c. TOTAL CONTRIBUTIONS (other than loans and interest)(add 15.a. and 15.b.) $ j~. 0/)
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.) $ 56• co
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)
$
$
i
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
21. TOTAL DISBURSEMENTS (add 19.c. and 20.) (must be shown in item 12.c.) $ C;
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) $ 1 a9 a. 93
c. TOTAL IN-KIND CONTRIBUTIONS RECEIVED THIS PERIOD (add 22.a. and 22.b.) $ i25a-$3
23. OBLIGATIONS
a. Unitemized Obligations Outstanding ($100 or less each) A,
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.) $
SS-1133 (Rev. 4102) Page 9- of
r
ITEMIZED STATEMENT OF CONTRIBUTIONS - CANDIDATE
1. NAME OF CANDIDATE OR COMMITTEE 11 7 2. REPORT COVERING THE PERIOD
C~ - -44z. /C d FROM: - 1 To: ,31-1
Amount
3. TOTAL ITEMIZED CAMPAIGN CONTRIBUTIONS FROM PRECEDING PAGE (enter $0 9 first itemized page) U
4. COMPLETE THE APPROPRIATE ITEMS FOR EACH ITEMIZED CONTRIBUTION contributions totaling more than $100 from an contribu
Fiet Name Middle Name Contrbution Received For. Amount of Contrb lion
j ~
Last NamerOmarstribm Name ® Primary Election ❑ General Election
Address ❑ Runoff (local Eledm Only)
C4 Staff ZpCode Dale of Contbution Aggregate This Election
.3 7 SO
L
O=Wwn 7 8 C 1C~
=cue, ~ ~ 3- ~1- 5
Enpbyer
,3 T~ eA) TY) bpi
Fast Name Wid*Name Contribution Received For. Amount of Contbudon
Last NabwName ❑ Primary Election ❑ General Election
Addren ❑ Runoff (Local Elections Only)
city Stet: Zip Code Date of Contrbution Aggregate This Election
EmOo~w
FiroNum Nana Contribution Received For. Amount of Contribution
Ind N&msKXpnmm Nam ❑ Primary See" ❑ General Election
Address ❑ Runoff (Local Elections Ong)
(ply Srata zip code Date of Contnbution Aggregate This Election
Occupation
Rust N a me Muddle Name or of Contribution
Last NamelOryaNa6ort Norm ❑ Primary Election ❑ General Election
Address ❑ Runoff (Local Elections Only)
City 6twe Zip Code Date of Contrbution Aggregate This Election
Oomotion
Employ-
5. TOTAL ITEMIZED CONTRIBUTIONS -
(Carry sward to Item 3. of nerd papa r od&6orrat papas or ft form are used.)
(ti ft is ft last page d oonbbrr OM rhis anaud must be ahorm in item 75b. of aiarmery.)
SS-1131(Rev. 2/06) Page of RDA 1159
ITEMIZED STATEMENT OF IN-KIND CONTRIBUTIONS - CANDIDATE
1. NAME OF CANDIDATE OR COMMITTEE 2. REPORT COVERING THE PERIOD
Tv r f L/~ CtJ~ Ay f? FROM: ' TO: 3 -
n
3. TOTAL ITEMIZED IN-KIND CONTRIBUTIONS FROM PRECEDING PAGE (enter $0 ii first itemized page)
4. COMPLETE THE APPROPRIATE ITEMS FOR EACH ITEMIZED IN4QND CONTRIBUTION (m-" contrbukams to,*v more than $100 from any aonotKAor durkp the period)
First Name MkMNe Name In-Kki Contribution Received For. Value of In4QA Contribution
' Primary Election ❑ General Election
Last NsmelOrgantz ti Narm ❑ Runoff (Local Elections Only) ,-4
Date cfkrlGd Cw&bubm Aggregate ft FJeedon 2
Aftm w S 3-1-1
q,1 i Lv Desa"mofkwjwca*wbn
~ _ Employer ;'r✓17G~'/c=AJI~
Fait Name Middle Name kWYW Contibution Received For. Value of WOW Contribution
} 1 12 Primary Becbon ❑ General E w*m
L"NsmdV%wiz6m Name ' ❑ Runoff (Local Faction Only) IG „Z • -5cl
tetlt EWc6m 71
L lkmakmlcamaconkbrAion Aggrega
safe Dawp6mcfh4QWC *butiar
Rm tk1) r~ T c 2 5 L ~ 5 J Fire Name Mid& Name "nd C *Wdon Received For. Value of In4W Contribution
i., is J Primary Election ❑ General Election
IastNamelOrganaatimName
/ ! Ly Gi
T l ❑ Runoff (Local Elections 0*) pp
Addmss Date of h4W rYan AB9mgak ft won 71
3 .6-18"
IW Code Desa0 mofh4&WC**Wion
C4 L~
~md Mi4dis Name In4Qwl CorktKidon Receivod For. Value of In r.W Conlrbution
FkatNrme t) , Primary Election ❑ General Election Cf
Last NweDgwimk011 Norm ❑ Runoff (Local Elections Only) D t
L4,1E 1-d Date of In-Kad Ca*b Aon Aggregate Ns Electron
Address
d ,e R;~) -s -i '
- Zip Code Desaip6amorh"Cw*bAfon
z
OOM98bon Employer C_ m P r~) ti , G.~3 S
6T)P_ E
FWName ~iddeNartre In-Kind Contribution Recetved For. Value of kt4W Contribution
❑ Primary Election ❑ General Election
Lief NamenrgarAZaYOn Name
❑ Runoff (Local Factions Only)
Address Date of b4W Cw*hbon Aggregate ft Election
C• Y `fate Zip Code Dma0mof h4W Ca&bA on
5. TOTAL ITEMIZED IN-KIND CONTRIBUTIONS
' 12 ~
(Cony brwwd lo km 3. of m A page N additional pages cfewe form are wed.) Q
(if ft Is to Iasi page of h4*4 ow* but". M amount met be ft m In Nam 22b. of wrmury.)
SS-1128 (Rev. 2/06) Page of RDA 1159
ITEMIZED STATEMENT OF EXPENDITURES - CANDIDATE
1. NAME OF CANDIDATE OR COMMITTEE 2. REPORT COVERING THE PERIOD
"
FROM: -1-1 X T0: -31
Cc %
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 ow 5100 to any payee during the period)
First Name Middle Name Purpose of Expenditure Amount of Expenditure
Last Narresusiness Name
Address
cky state zip Code
First Name Middle Name Purpose of Expenditure Amount of Expenditure
W Na r*Su*.= Name
Address
Gy Stale Zip Code
First Name Middle Name Purpose of Expenditure Amount of Expenditure
Last Na a/Busirms Name
Address
py State Zip Code
Fret Name Middle Name Purpose of Expenditure Amount of Expenditure
Last Nww%siness Name
Address
ck Stab Zip Coda
First Name Middle Name Purpose of Expenditure Amount of Expenditure
last NamalBusinesa Name
Address
CRY State zip code
First Name Middle Name Purpose of Expenditure Amount if Expenditure
Last NameJBusiness Name
Address
City Slate Zip Code
5. TOTAL ITEMIZED EXPENDITURES / q
(Carry forward to item 3. a( next page it additional pages of ft form are used.)
IK" Is the lat page of axw4lk s, ft amount must be shown In Item 19b. of u nnary.)
® SS-1129 (Rev. 4102) Page Of RDA 1159
ITEMIZED STATEMENT OF LOANS - CANDIDATE
1. NAME OF CANDIDATE OR COMMITTEE 2. REPORT COVERING THE PERIOD
►Y),grco FROM: TO:
-31-
Z T-n T n~ti~ L.
3. COMPLETE THE APPROPRIATE ITEMS FOR EACH ITEMIZED LOAN co" btalmc more man si from dry souroe during me period)
Complete the Folb*irtg for the Source of the Loan
First Name Viddle Name Outstanding Loan Balance Loan Loan Outstanding Loan Balance
(Beginning of Period) Received Payments (End of Period)
Last NamalOrganizatm Name
Address Loan Received For. Oate ollean
❑ Pr4nary Election ❑ General Election
y IStale hp Code
❑ RunoU(local Electioru Only)
Ust U Endorsers or Guarantors forAbove Loan (K more space is heeded please sttach a page)
Fast Name 1Rddle Name Fast Name Middle Name
Last Nw*0gw&Wfiw Name Last Nameogwastion Name
Address Address
qb' State Znp Code Gty Slate zo Code
Amound Guaronleed Oufslandin9 Guarmised
Middle Name First Name Middle Name
First Name
Last Name/Oryar xbw Name Last NarnelOrymization Name
Address Address
Qty Stab Zip Code City Stator ZO Code
Amount Gw anfeed Outstar&q Gwrmleed Outstmdng
First Nam piddle Nmwt Rirst Name Mwis Name
Usl NarneOrganizsboa Name Last Narne0gantzation Name
Address Addmu
lab Zip Code qty la e Code
Amount Cxumnlaed Outstanding Mwg Guacanleed Outstanding
First Name Ltiddle Name First Name Middle Name
Last NmvlO%&*atiom Name last Name"ani slim Name
Address ;Gu"Wed0utstanding
My State zp Cade Stale Amount Guaradeed Outstanding 4. Totals for AR Lofmm (COmplebe on W page of Memized Inns) Outstanding Lam Balance Loom Loan Outstanding Loa, Balance
(Total loan rocatvad should also be shown in llem 1& on summary page.) (Beginning of Received (End of Period)
(Total ben payments should also be :lawn in item 20. on summary page.) /r\
(Total outstanding ban balance should also be shown in ilan 12.e. on font page.)
® SS-1132 (Rev. 4102) Page -l of 7 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 Outstandi Bal Debt Incurred Payments Outstanding Balance
OBLIGATION (obligations totaling more than $100 owed to any (Beginning of Period) This Period This Period (End of Period)
persoNvendor at the end of the reporting period)
Flat Name Biddle Name
Last NwroSuslnm Name
Address
City Stale 7p Code
Fire Name fiddle Name
Addreu
City Stale 4 Code
Description of m4awn
FW Name iidAe Name
Last Nam&Susineu Name
A&%u
City State Zip Code
Description of Obfi*on
Flat Name fiddle Name
Last Nwr&Susiness Name
Address
City Stale TV Code
Description of O*abm
Flan Name twiddle Name
Lost NaTaAMiness Name
Address
City SWW Zip Code
Description of Obksf*n
4. TOTALS
(Total from Oubwr&V Balance - (End of Period) wk mn must also be ahorrm
In item 23b. on summary page.) ( ` )
® SS-1127 (Rev. 4102) Page 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, 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
their county election commission.
1. Date: 2. Candidate First and Last Name: 3. Candidate e-mail address:
-1 z 1 L 9, -b 'eW NIS ~'~.1~ ~''~C i'Cr~i✓" I701 1. ~KCO- C
4. Campaign Address and Phone: City State Zip Code Phone
TW 56 (a q 6 - kl!~
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. Party Affiliation 8. Election Year
My- e,.; >~h~ zap
CD
9. Treasurer Name: 10. Treasurer e-mail address:
d,~
_b y """5 11. Treasurer Address and Phone: City State Zip Code Phone
(~7 ~,,e -~le ,,j "e"7 7~v
12. Candidate and asurer Signature (both signatures must be witnessed. Treasurer can not witness candidate's signature):
Signature of Candidate Signature of Treasurer
~a
ti q~c 9
Signature f Witness a G,y 0 1O y Signature of Witness
211
d Registry of Election Finance O[ 6 g L 9
SS-1120 (rev 1212013)
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:
U~ M
5 o~ 4-,`4 A/,,Ae~ &4-
4. Campaign Address and Phone: City State Zip Code Phone
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. Party Affiliation S. Election Year
9. Treasurer Name: 10. Treasurer e-mail address:
11. Treasurer Address and Phone: City State Zip Coe one
.31S LC4" 2) /z l 37~v1 ad9-yad-83v
12. Candidate and asurer Signature (bot res mu be witnessed. Treasurer can not witness candidate's signature):
pt0E1V1tD
Signature of Candidate MAP ~ 8 2018 Signatu a of Treas er
Sign ure of Witness Sig re of Witness
Registry of Election Finance
SS-1120 (rev 1212013)