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Bain, Sophia Diane FINANCIAL DISCLOSURE STATEMENT EXEMPTION Pursuant to TCA § 2-10-101(b) a candidate is exempt from filing financial disclosure statements due to the following: 1. The service for the office which I seek is part-time and the compensation is less than $1,000 per month, AND 2. 1 do not plan to spend more than $1,000 on my campaign. *Candidates running for Chief Administrative Officer (i.e. Mayor) of the county or city are NEVER exempt from filing and should file the required campaign financial disclosure reports regardless of compensation or spending. CANDIDATE'S INFORMATION: Candidate's Name: Candidate's Position: Residential Address: Stater Zip: IQ1~ City: I hereby state that I meet the above qualifications for exemption and am therefore exempt from filing financial disclosure statements. If any of the above change and I no longer qualify as an exemption, I will file the required campaign financial disclosure reports with my local election commission. .APR ~ 291a Air Candi ate's Signature Dat q,CQ(~ Witness's Signature Date Appointment of Political Treasurer ~rJ`~b~oe 5 to and Local Candidates and Single-Candidate Committees For 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 rsuant political treasurer has been appointed for that election. A local candidattepu scion foor more -10-10 , ma Abe exempt from completing this form, please check with county election comformation. candidate may appoint himself or herself as political treasurer. A new form must be filed if the treasurer is changed. 37243tement ONLY with Candidates for state public office must file their original Appointment of Political Treasurer the Registry of Election Finance, 404 James Robertson Parkway, Suite 104, Nashville, Candidates for local public office must file their original Appointment of Political Treasurer statement ONLY with their county election commission. 3. Candidate e-mail address: 1. Date: 2. Candidate First and Last. Name: ' ~ Q Q f N ~ ~C~OUCJ ~ M ff r ~ ~ r ` u LO nla, V1 e, 0- St ate Zip Co de Pon 51 SzSS'~3 4. Ca paig Address and Phone: City H _ f C~' I l e l ti :3~1~~~ I C~ r~" y4l Zi Code Phone State p 5. Home Address and hone (if erent than item 4 above): ity 8. Election Year 6. Office Sought (include district number, if applicable) 7. Party Affiliation ; ~ ~ D Ito ~~n f to ( &a D16- r;Cf3 ~b~ ^q t 9. Treasurer Name: 10. Treasurer e-mail address: i a- bi CA, I ~ 1300..1 l1~ ~ ~ Cl. h~ ~ ~ Ck l ~ ® C ~I ©u r ~ ~ 11. Treasurer Address and Phone: City State Zip Code Phone t d ~5 ar r X7$0 {gb.~J W natures must b witnessed. Treasurer can not witness candidate's signature): 12. Candidate and 7r asurer Si ature (both slg Signature of Treasurer Signature of Candidate Signature of Witness Signature of Witness Registry of Election Finance SS-1120 (rev 12/2013)