Blankenship, Robert Stephen
AMPAIGN FINANCIAL DISCLOSURE STATEMENT
For State and Local Candidates
For Single-Candidate Committees
1. DATEOFREPORT 2.a. NAME OF CANDIDATE ORCOMMlTTEE
4-fl-12) Igo r as Kcr~Sh i
2.b. IF COMMITTEE, NAME OF CANDIDATE 3. ELECTION DATE
4.a. CAMPAIGN ADDRESS AND PHONE State Zip Code Phone
Street or Rural Route ~Y
O. IIIS M t TjJ 31802 645-2S I-%10
4.b. CANDIDATE'S HOME ADDRESS (if different than 4..) State Zip Code Phone
Street or Rural Route City
rj Ar t TfJ 3780 M-4 l -OND
5. OFFICE SOUGHT (include disbid number, If &p P&") 6. NAME OF POLITICAL TREASURER (may be candidate)
eic fyK. ko-vl e& Vh
7. CATEGORY OR W-PORT(Check /
FFT SECOND THFU FOURTH 'pgR~. PRE- M(-Y JAR YEAR-END
AL SURP-LaEffAL
8.a. BEGINNING DATEOF REPORTING PERIOD 8.b. ENDING DATE OF RfPOF7f1NG PERIOD
120l r 20
9. (Check dne)
a. ❑ This campaign is exempt from detailed disclosure because contributions (including in*M) 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 fie a detailed financial disclosure because contributions (including in4dnd) 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 commtttee by the Campaign
Financial Disclosure Act Additionally. Uwe swear or affirm that no campaign contributions have been expended for the personal financial
fit of the ca or for any other nonpolitical purpose as defined by the federal emal nue code.
_,Z
signa of political treasurer date
L~ na
ture of t
11. ESS SIGNATURE
I"L1
si nature Of witness date signature of witness date
12. SUMMARY
019-7- 4L
a. BALANCE ON HAND LAST REPORT _ $
b. TOTAL RECEIPTS THIS PERIOD S ( . DO
c. TOTAL. DISBURSEMENTSTHIS PERIOD ...................................................................................5
d. BALANCE ON HAND (12.a. plus 12b. minus 12.c.) 3 01. 7-
e. TOTAL LOANS OUTSTANDING $
S
f. TOTALOBLIGATIONS OUTSTANDING
SS-1109 (Rev. 2106) APP 2 3 2 pap 1 of RDA 1159
_J
SUMMARY PAGE - CANDIDATE
lay 14. REPORT COVERING THE PERIOD
. NAME OF CAN ~j1t, pATE OR COMMITTEE (In Full) FRS: w I T0:
CI
FREEPTS
. CONTRIBUTIONS (other than bans and interest)
a. Unitemized Contributions ($100 or less from each source this period) $
ALA-
b. Itemized Contributions (over $100 from each source this period) $
c. TOTAL CONTRIBUTIONS (other than loans and interest)(add 15.a. and 15.b.) $ AD-Q--0
16. LOANS RECEIVED THIS REPORTING PERIOD $
17. INTEREST RECEIVED THIS REPORTING PERIOD -
(;0,00
18. TOTAL RECEIPTS (add 15.c., 16., and 17.) (must be shown in item 121.)
DISBURSEMENTS
19. EXPENDITURES (other than loan payments)
a. Expenditures ($100 or less each payee this period) (must be listed by catego - e.g., printrng, postage, gasoline)
$
$
$
S
$
s
$
s _
Total of Expenditures ($100 or less each payee) S
'
,
b. Itemized Expenditures (Over $100 each payee this period) $ MI J
c. TOTAL EXPENDITURES (other than loan rePaymants)(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) $
b. Itemized in-kind contributions (over $100 from each source this period) $ ' 4
251, BFI
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 5100 each) $
c, TOTAL OBLIGATIONS OUTSTANDING (add 23.a. and 23.b.) (must be shown i Rem 121)
2- of
AIML
SZ-1133 (Rev. 4&12) P"e
ITEMIZED STATEMENT OF CONTRIBUTIONS - CANDIDATE
1. NAME OF CANDIDATE OR COMMITTEE 2. REPORT COVERING THE PERIOD
O ! S. sltUj&jsh;e FROM: TO: • ,
3. TOTAL ITEMIZED CAMPAIGN CONTRIBUTIONS FROM PRECEDING PAGE (P.nter $0 d fist keff zed paQe~
4. COMPLETE THE APPROPRIATE ITEMS FOR EACH ITEMIZED CONTRIBUTION cantrbufions mom flan $100 from any con WKFbor
RM Narm wide CarbbAon Rea prod For. Amount of Con bbu don
( ,,wy Election ❑ General Election
Last Name~OrYantraia+
lac r
Aedrm S e ❑ Runoff (Local Bestions Only)
1 ri ~p O Date d Co * bution Aggregate Thus Election
-q^,a 100.00
r
EnOW
St
HrstNwd bfddVeNeme COnwkan Rewived For. Amount of Cadrtwtlon
l." WrnsAkv ru a5w Name ❑ ftwy Bedon ❑ General Election
Address ❑ Runoff (Local Elections OrM
CRY fare J Zpcode Dde of Contribution Aggregate This Becdon
ooapdfon
brow
FnttNome Name ContrbUtial Raceived For. Amount of Contribution
❑ Prirnfry Efeelon ❑ GKOW Election
Addma ❑ Ruuoff am al Elec6au Ofm
ally 6~e Lpcode Be* d CQr&bAon Aggregate T* Election
OW*Bfon
FkslNome WMellame
Lades Now ❑ Ptinety EWft ❑ General Election
Aftm ❑ Runoff (local Elections only)
MY tie Lpcode Date of Co*bjfwn Aggregate TMs Election
Ooct"bw
Eepbyor
5. TOTAL ITEMIZED. CONTRIBUTIONS 100 r Uo
(Ceey brvwd b rem S.of neA"f ed"aiat peas a(" fwM are wad.)
(f fro is to Md pope of cenebdoM frs ena ntgad be darn n ibm 15b. of sumeryd
SS-1131(Rev. 2006) Page of RDA 1159
ITEMIZED STATEMENT OF IN-KIND CONTRIBUTIONS - CANDIDATE
1. NAME OF CANDIDATE OR COMMITTEE 2. REPORT COVERING THE PERIOD
1- FROM: TO:
3. TOTAL ITEMIZED INXIND CONTRIBUTIONS FROM PRECEDING PAGE (enter $0 if first itemized page)
4. COMPLETE THE APPROPRIATE ITEMS FOR EACH ITEMIZED INaaND CONTRIBUTION WW ow*butams WWV more ton $100 from sny contrbubr durhg the WOO
kn-IGnd Contribution Received For. Value of In-KM Contribution
F~ Name A_ ~r '"id°'° "'m° s •
'"`XP*Nry Eisa n 0 GeneraEection 51.4
I
ICS ❑ Runoff (Local ElaGim OnW
Amldreet t>dedirwaw mrbmAnm AppepaletitElecim
1115, 1
CiH ( l)w"wmdh4GWComlmbA m
Uoapaimm J Employer N paper 90odS d' Sm ac k$
Firtl Nana Q ~e Qi Middle Noma Ca> r ubon Received For. Value of M4*W ConEdtxfion
ud Nm J 1~ Election E3 General Eledw
" e- P 1~ a Runoff (Lou Elections Ordy) Zo~ • ob
Add Ddedb►10ndConrbubon ' o Appepat MSecli mm
q2 Wilt..k IA
'
CMy eey O DeeodpBm@flrW MC r*b"
T- shtr}-S
is
ey" ZM wt value of haald contribution
Fed Name MkWWName h4rjrld Cdrtrbbution Received For. PtYnety Elution ❑ General Election
NarnsAorgarizo t,tc u,n Na>k ❑ Runoff (Local Sodom Only)
Addrm Dsbdh4 dCw*bAon ApprepaletitBecfon
City slats LpCoda Dssor bmo(t>♦W0mrbAon
ow*swn WOW
Fro Name Middia Nara W(W ConbtKdion Received For. Value of rNCrld Contrbution
O Pway Election ❑ General Election
❑ Runoff (Lord each= only)
Ad*m Ddedhow App+epstetitBaclbn
C*y yd,, LpC*do petaipfondh40nd0omMbuton
Crampo5m EffoW
Fret Nero Mddia lime lo•Idrd CoMrbrrtion Received For Value of 14GW Cor►trb Aw
E3 Primary Eledion ❑ General Election
LaatNamdOryamtratamName Runofff gmal Elections Only)
OMedbKndCanYbulion A4709wtitEeeBon
Address
I8hk Lp Cods Desaipton dYm Ibmd Carmerbuiam
tmp"w
5. TOTAL ITEMIZED "ND CONTRIBUTIONS ~ ~ ~ .
(Carybrwadbbm3.dma1 pope Iad&"W popes deft bmm are wed.)
pf tilt k to W pope d b4 d cmrbutao. tmb uncut mudbe dam in Morn 22b. d rA mary.) RDA 1159
SS-1128 (Rev. 201) Pape of
ITEMIZED STATEMENT OF EXPENDITURES - CANDIDATE
1. NAME OF CANDIDATE OR COMMITTEE 2. REPORT COVERING THE PERIOD
Ro6erl S. 1 _ s6 FROM: -1 TO: -11
K~ moon
3. TOTAL ITEMIZED CAMPAIGN EXPENDITURES FROM PRECEDING PAGE (snW $0 If first itemized pap)
4. COMPLETE THE APPROPRIATE ITEMS FOR EACH ITEM= EVSWURE wwend m batuq acre Bun $100 to any payee dump sa period)
Fo* Name ldddte Name Purpose of E)Vwdkge Amount of Expendkire
Les,
VlWnk- NX0affiamen Norm CouNft b &tAI,~I hL, {lON' H00. 00
f.l
Address
First Narno M'iddte Name Purpose d ExpW^n Amount d Expendkum
Last NeaafikWrrws Name
Address
M stab Zip Code
wd& Name Purpose of Experxfihae Amount of EVWKt n
First Nsma
LastNvns%Ainess Name
Address
Cipr Sae Zip Code
Fssl Nana ltidde Name P" ow of Ewdbffi Amount of EgwdWe
Last W nugusiness Name
Address
pv Sae Zip Cede
FNst Name 16ddle Nrro Pixpose of Experxlihrre Amount of Expenftre
Last NowSusiness Name
Address
qy sate ztpc°de
Ftru Name tiddte Name Purpose o(Eqw4kn Amour of Expenftn
Last NamBlBwiass Name
Address
a state Lp Cede
5. TOTAL ITEMIZED EXPENDITURES q00,
forward b ibm 3 dnerd tope Maddtional papas dYris lam w wed.)
ill this k the dst papa des<pxdNues. tlds anwrad muu la sham in Item t9b. d srmrry.)
pop of I le 1~i RDA 1159
® s8-1129 (Elev. 4102) '*1"-
CAMPAIGN FINANCIAL DISCLOSURE STATEMENT
For State and Local Candidates
'For Single-Candidate Committees
1. DATE OF REPORT 2.a. NAMEOFCANDtDATEORCOMMITTEE
+ 10 -15 er S . ~Icw~Cet'sh
2.b. IF COMMITTEE, NAME OF CANDIDATE 3. EL CTION DATE
S -I-tB
4.a. CAMPAIGN ADDRESS AND PHONE
Street or Rural Route city state Zip Code Phone
P•o•~aX if 13 v le, N 2 15+4 (6 ID .
4.b. CANDIDATE'S HOME ADDRESS (if different than 41a.)
Street or Rural Route city state Zip Code Phone
5 R lg le. Tr`s 3 0 8atS - 8240
5. OFFICE SOUGHT (include district number, tf ap ) 6. AANAME OF POLITICAL TREASURER (may be candidate)
o CiYcw'~' Cacrr~ 1 L~ `ri r ~ It0 tJ SM I~t
7. CATEGORY OWREPOKI C one 0
SECOND THFU FOURTH PRE- PRS- ❑ ❑
MI YEAR YEAR-END
8.e. BEGIN MDATEOFREPORTMPERJOD Et
8.6. ENDINGDATEOFRE
FREPORTINGPERiOp
JaNuar Zot Marc4 2ola
S. (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. A This campaign Is required to fife a detailed financial disclosure because contributions (including in-ktnd) received total more than $1,004
and/or expenditures total more than $1000 for this reporting period.
10. Vile do solemnly swear or affirm that the information contained in this campaign financial disclosure report is true and that this r
accurate accounting of campaign contributions and expenddures r sport is an
Financial Disclosure Act. ertuired to be reported by the candidate committee by ttte Campaign
benefit the candidate orb other swear or affirm that no campaign cordn'budons have been expended for the personal financial
ny pofrtirat) purpose as defined by the interrml revenue code.
n
signature of candidate -
ureof poHtiq! treasurer date
11. INt SSSIGNATURE
1/117
signature of witness date signature of witness Ate
12. SUMMARY
a. BALANCE ON HAND LAST REPORT .......................IrV $ + 3 S
b. TOTALRECEIPTSTHIS A®
Pei,oD .................s
c. TOTALDISBURSEAIENTS THIS PERM [p(wr 1 ~18 a 0 S . 5~j
ter ~
d. BALANCE ON HAND (12.a. plus 12.b. minus 12.c......................................................... III®~ ~97 2,
e. TOTALLOANS OUTSTANDING
F~
f. TOTALOBLIGATIONSOUTSTANDING I b................... $
SS-1104 (Rev. 2106) 1, -"r•/~
pays 1 of..,~ I20A 1159
SUMMARY PAGE - CANDIDATE
13. NAME OF CANDIDATE OR COMMITTEE (In Full) 14. REPORT COVERING THE PERIOD
tl W,GtJ FROM:t T0: -51
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) $ _140 • 00
7 do
c. TOTAL CONTRIBUTIONS (other than bans and interest)(add i5.a. and 15.b.) $
16. LOANS RECEIVED THIS REPORTING PERIOD $
17. INTEREST RECEIVED THIS REPORTING PERIOD
16. TOTAL RECEIPTS (add 15.c., 16., and 17.) (must be shown in item 121. $ 40 ' 00
DISBURSEMENTS
19. EXPENDITURES (other than ban payments)
a. Expenditures ($100 or less each payee this period) (must be fisted by categoy-e.g., printing, postage, gasoline)
$
S
$
$
$
$
$
$
$
Total of Expenditures ($100 or less each payee) $
b. Itemized Expenditures (Over $100 each payee this period) $105-7. Sb
$ 10"T59
c. TOTAL EXPENDITURES (other than ban repayments)(add 19.a. and 19.1b.)
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) $
b. Itemized in-kind contributions (over $100 from each source this period) $ ~Z~ 1 J
52-0 '
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 23.1b) (must be shown i item 121) $ AMh
SS-1133 (Rev. 402) Pegs Z of J-
ITEMIZED STATEMENT OF CONTRIBUTIONS - CANDIDATE
1. NAME OF CANDIDATE OR COMMITTEE 2. REPORT COVERING THE PERIOD
u' Ay, Vj r4 Shi FROM: TO:3 3
19 3. TOTAL ITEMIZED CAMPAIGN CONTRIBUTIONS FROM PRECEDING PAGE (wW $0 d first itemized page) nt
a. COMPLETE THE APPROPR ATE ITEMS FOR EACH mizED COtJiR1 mmm oonh~ufiota W*v moos um $100 hm cv&bubr
F.at►taune aiddlet~une Corb ulimRaoeivedFor: Amount of ContbiSon
etmmft Primary Beotim ❑ General Election loo .00
Ads ![`Runoff (Local Samna only)
.~-7 Date of ~ Aggregate This Eledion
i v~11t,J
0=4)auw
i -0 ► "o-k rw,-nce, Coa f all n~~t - 100.00
Lmmm
a i~lc ScL,otlS
FiruNarne, KedbNarne Contrikrdw Received For Amount of CoMri jsm
=(,Dry- RPrmaty s ection ❑ General Bach n
o Pr e r ' s ~So .00
[ Runoff (Local Eiections 00A
1 Orr Circ.1e.
UY zp
a v~ ale ( co 0 ( Date of Cant bition Aggregate This Election
cr 2 i5~18
250.00
O~rCO " arc r~rS
FrctName Name Ca>tribAm Received For AmwN of Contritxrtion
bi R .
c Xp"" " ❑ wo
(401K1 rJ Tr v Stec 25d .0 O
A"- ❑ Rurgff (I ocel Doom Only)
Cky
~rJ 7q 23 Date e of Cw*bAon Aggregate This E>acii«,
rcntc~ z -ig - 2,60-00
~~Q~cc1Sc.~(2, rJc
HrstName
G~J t J 8 Ocnt o ub~n
tsst Nama►orpW&9 or, No= w W A Primary Election ❑ Genera! Eiection
❑ Runoff amat mow only)
1 0 fie
ar C S1me r Z,p Q mie or Conguftn /Aggregate TNs Election
cV
E Li-ifcCl
S. TOTAL ITEMIZED. CON7 muTi0NS
(Carry torwerd b tlu„ s. of naR papa if sdddortal ps ~ of thk wm,ra u»ea
(1(Irs iclsetastpapeormnr<butions, tftsaewrs,trnuslba d,oWninitsm Ise, of:umwy.) -2
SS-1131(Rev. 2106) Page y ot~_ RDA 1169
ITEMIZED STATEMENT OF CONTRIBUTIONS - CANDIDATE
i
1. NAME OF CANDIDATE OR COMMITTEE 27REPORT COVERING THE PERIOD
g . ~(p FROM, T0: ~Jbl
AnWA-t
3. TOTAL ITEMIZED CAMPAIGN CONTRIBUTIONS FROM PRECEDING PAGE (WW $0 d first heafted page)
L 0
4. COMPLETE THE APPROPRIATE ITEMS FOR EACH MIZED CONTRIBUTION corN tiwts Wft more than $100 from Con~
FkUName 1&i *k-v a Cott bAw Recehbd For. A.,.t of CortLfbution
w ' Iii t2 .
Lost HarneO
Vanrr rion Name Primary t aWw E7 General Election
Tho MAS 100 -00
Aftm 3 0 0 " Oaks ar • ❑ Runoff Amal Elections 0*)
City kow l OL Tf.1 ~3 0 Dete of Corb~ Aggregate This Election
Pat►re. 3-8. 8 Ioo . Da
j R~.~ir{d
Frst ► ' C.onhihution Received For. Animt of C ntrbAon
G
Noft $P*=y Section ❑ General Bectm
ascl 200.00
Aft
7 fiD 0 0 R%wff (Local El ftm OnM
I j (S
Cly ~ `e. ?r X37 0 Date of eantnbertion Aggregate Tlrs Election
N~f i,,lclu
I-11 -lb 200.00
s►t-l
oAd-,d 1-3 FMNxne
CorttribuWri Received For Mount of Contribution
Lasl We S ❑ Primary Elector ❑ General 8odion
Address ❑ Runoff (Local Efeclierts Only)
C4 orate Lv txde Date of CanlnbAm Aggregate This Election
0= "bon
EnVtW
FMftNime lbddeName t 0
~fA° 0" N+me E7 Pri wy Election ❑ Genera! Election
Address ❑ Rumff Mcal Sections 0*
City stm Zq Code Date of Co *bAon
Aggregate This Election
OCwpatson
EmpioYer
S. TOTAL MMMD. CMIOUT)ONS
tCionYfawardniem3.ot+kxtprpeiEsd66omtpspesor/+kbnnaroweda -NO. 6V
(Nthist;iti~tastpageofaat{+bubons lr Wouvitrini eAow,i,ttemlWafgwmwy.)
0 SS-1131(ftft 2106) Page 4 of RDA 1169
ITEMIZED STATEMENT OF IN-KIND CONTRIBUTIONS - CANDIDATE
1. NAME OF CANDIDATE OR COMMITTEE 2. REPORT COVERING THE PERIOD
&6114 PIG1J Sh i FROM: TO: 31 7F
3. TOTAL ITEMIZED IN-KIND CONTRIBUTIONS FROM PRECEDING PAGE (enter $0 if first itemized page) Amount
4. COMPLETE THE APPROPRIATE REMS FOR EACH REIAM IN-KIND CONTR18UTION (-AW wnabWm fobkkq more Mkan $100 hm sny conabumrdw4 ft period)
fist Namen Md*Name CwWWWn Received For Value of In4W Contribution
V Primary Ew" 0 Get*w sod=
Last Naw*7ntzabmNwrw 17J+ • ? S
&t t [3 Runoff (Local Elections Only)
Address d , • D&dhhGdCw*bubon AggkeQ left Election O;Ag CIO&
74 Desaipiandio-lcrdCadkbcdak
sin
First Name M"eNeme AWM Contribution RmWd For. Value of hrlw Conbibulkm
Primary Election [3 General Election
V w lc ❑ Runoff (Local Elections (>ly)
Address 4q8 a Sul 14 Dsledh ,d 2 , ^ 15
• da
zna ilk, 9aa Desori --fh4wcmubur-
> CcAr t-~9n~~s ~ Z x ~S
R ISlame n bCC T e h4QW Cw* bAon Received For: Value of kn OrW Contribution
rc.0 CkPdnwry Election 0 General Election
Ust NamerOkyanizati°"'tune G Q•0 0
0 Runoff (Local Election Only) ai -1
Aa~ess ~l S (Z~ D t DdedhaCadCaskbkAion AggregateMisEleciorn
city ZP DesaiptiardharndConkiwSan
✓I~~Sa
ua+ u ~s(r,31v
RW Nwe Middle Name In (Gnd C**bulion Received For. Value of IWW Contrbwtion
tasf NemetOrQaatization Name ❑ Primary Election ❑ General Election
❑ Rwa (foal Elections Only)
Address t)alsofkWj dCa *bjbon AggkegateM!Dacbon
~y smra rpooda wsa;~,dh-x.,dcokw+a~on
Ocovation
FMNwe WldeName In4&d C rtion Received For. Vatve of h-Kmd Cw*btrtion
Primary Election ❑ General Election
fast Namepcgantration Name
❑ Rurwff (Local Eiedom Only)
Ad&m 0atedh*WCw0bubm ApgregateM>tst3ec6on
Y SWe Zip Code Descri 6mc(h4GrWCawbAon
Wwpow
5. TOTAL ITEMIZED IN-KIND CONTRIBUTIONS
(CaaybawwdbMemIcfneaWfad&jwWpag o(ftsfamareused.) G~ T
(tfftIsI,erasrpagedh4dr4oantW",M ssmou+tmustbedmninKam224.ofw wy.) J (f
SS-1128 (Rev. 2108) Page-5 of RDA 1159
ITEMIZED STATEMENT OF EXPENDITURES - CANDIDATE
1. NAME OF CANDIDATE OR COMMITTEE 2. REPORT COVERING THE PERIOD
2-n C S
L, sk; FROM: TO: 3 M
mown
3. TOTAL ITEMIZED CAMPAIGN EXPENDITURES FROM PRECEDING PAGE (enter $0 If first itemized page)
4. COMPLETE THE APPROPRIATE (TENS FOR EACH ITEkSM E)PENDITIRE (apendism u*Q more orm 5700 Lo any payee Aorinp we period)
First Hams 6Wdte flame Purpose of Experoftn Amount of Expendbxe
W Nauffiusinm Name 9&4d r(main i jWwq-
v» CQ``pa;~t~ lOs7'
Adchm
4 ,Lo K Or.
siyNS
`4L
First Name Lr6ddie Name Ptxpose of Expenditure Amount of ExpereMn
Lai NamelBusiness Name
Address
City State Zip Code
Fhst Name VAd& Name Purpose o(Expertditum Amount of Expend+ture
Last► -wfi trakwa Now
Address
city State tip code
Fast Name W* Nam Papose of ExperdW Amount of E*enftre
LastNamaBuskou Name
Address
City State Zip Code
Fkst Name Iridd twl Purpose of Exper4kn Amount of Eger ftm
Last Na wBusiness Name
Address
QA' Stme Zip Code
First Name triddieName Purpose ofEttpW$ftrce Amount of Epenftn
Last Nw Business Name
Address
My State T4 Code
5. TOTAL ITEMIZED EXPENDITURES Q
(Cartyfawardbitem3.a(re~dpaperad?r6onelpa~esatlrts~xmrsused.J j OS7 5U
( fft is U fast pa0s a aes.INs anqu~t must be don to Mem 19b_ dwrdnary.)
SS-1129 (Rev. 4/02) Para - at RDA 1159
ITEMIZED STATEMENT OF LOANS - CANDIDATE
1. NAME OF CANDIDATE OR COMMITTEE 2. REPORT COVERING THE PERIOD
FROM: TO:
Qo6g,/- S, ~jlan~r>,~hi !v 18 3 31
3. COMPLETE THE APPROPRIATE ITEMS FOR EACH ITEMIZED LOAN Roans t t*v mm om Stoo from any sarrw durhp fre period)
Complele the FokwiV Ior the Souse of the Loan
First Name ttiddle Name Dam ding tam Rabnce Loans tm Qulstwwq Loan a orm
(Be wkQ of PVJA Recetved Payments (End of Period]
tali NamelOrga GG; Name
Addtess Loan Receired For - 0
Date of t m
State ❑ PrimaryEbebon E3 Gerard E Wn
City
Z4
❑ Rug Mca(EWGms0nW
List A! Endorsers or Guataftm forAhove tAatr (if ffm space is treaded pim attach a page)
First Name iAd& Name Felt Name Kddte Name
LastNaaalOryeniza Name Last NemelOrgan¢stionName
Address Address
04 SW zip co* Cdy State Zip CDde
AmowrtGuaranfwows<andmg Amow4 Gwranbed 0utsia AM
First Name Midde Name First Name toddle Name
LastNamWftw 2z5wNwm NwrA rpamzafimName
Address Address
C+N Stab lip code Ci(y State Zip Code
MquntGuarenbad0utstandrq Guxanked0utstandr+Q
First Nara hiddte tdame Fhx Name Wddte Name
Led NametOryantz*m Name W Nwo0p rizabw Name
Address Address
ckv Shlb zip Cfly cafe Cade
AmamtGAmrleed 0ulsb *V GuaraNeedOutstandrq
Fart Name hiddb Name Fret Name Wddle Name
Las! NamefOrgartiution Idarrre thmelDrganae6onNeme
Address Address
cky zip
State ( City Stale Zip Code
Amount Guaranteed Outsmndkg Guarantied Outatandrg
4.ToWsforalI oar komokdeonbd pap ofimdmdbans)
m 6alarrce
(Total bans reo&W ahourd Aso be Von h lbml& on vAvnxy pWI 0 a a Batanoa ft~ eitrad pamords Low 0utsWEW orLnPftedrbom
(total loan payn>et* stand also be shown h bben2l on summary po9t)
t~orr~nrdrq banbataroeshgrW also besfrown hitim 12.e.on fradpape.)
SS 1132 (Rev. 4102)
Page _ i(
RDA 1159
ITEMIZED STATEMENT OF OBLIGATIONS - CANDIDATE
1. NAME OF CANDIDATE OR COMMITTEE
r cS C~J of $ 2 REPORT COVERING THE PERIOD
3. COMPLETE THEAPpRppRtATE ITEMS FOR EACH I7E ZED FROM: J I !r TO: Balance rred 3
OBLIGATION (obligagons totat'utg more than $100 owed to any Outstanding P Debi Iperiod Payments Outstanding Balance
PersmWndor at the end of ifte reporting Period) Beginning of Period) This Period This Period (End of Period}
Rat Name
►iddle Name
last ~ Nam
Whi--k r , 105-7 - 5b 0 X0
Of ` t~ 37861
s.
Flat Name
LWdfeName
Aditu
QY
~aoonaot~aso„
Flat Name
Afdae Name
Last NsndBawM Name
Address
CKY srate zip owe
~s~+lpGm of Obigation
Flat Name
fiddle Name
Last Nam
Address
CRY
St* Z1pCode
~SCripGoa dObiparpe
Rat Name
Wddfe Nve
Lut ttamef Ak*u Name
Address
Qb
Stafe TpCode
Desapfon ofObigaSOn
4. TOTALS
POW
hem on pW) of Petiodi ooMmtn must also be shoMm
AM6
SS-1127 (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
1-a -18 , ~abv-~~ S . Tar t e sh i
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
j?. 0 - &0 7 r /i TiQ 3-786 -L 5-25 T~
4.b. CANDIDATE'S HOME ADDRESS (if different than .a.)
Street or Rural Route City State Zip Code Phone
915 RAd Nor id. Ma ; alt Tt3 378o 5-(010 - Z o
5. OFFICE SOUGHT (include district number, if applica le) 6. NAME OF POLITICAL TREASURER (may be candidate)
oLojf QgLtt,h Ci rr-L-4+ Cou.-f C ex K, ri 1 ` e,1 Is SFt
7. CATEGORY O REPORT (Check one)
❑ ❑ ❑ ❑ ❑ ❑ ❑ Q-*,
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
T'UIV 14 0 v 15, 20l
9. (Check on
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 $1,000 for this reporting period.
10. Itwe do solemnly swear or affirm that the information contained in this campaign financial disclosure report is true and that this report is an
accurate accounting of campaign contributions and expenditures required to be reported by the candidate committee by the Campaign
Financial Disclosure Act. Additionally, I/we swear or affirm that no campaign contributions have been expended for the personal financial
benefit the candidate or for any other nonpolitical purpose as defined by the federal internal revenue code.
signature of candidate dal ' signature of political treasurer date
11. WITNESS SIGNATURE
J2°► Imo is of Z9 ~
sig at re witness date signature of witness date
12. SUMMARY
a. BALANCE ON HAND LAST REPORT R1:-GE$Vt_-................................... $
~'12OfD.~O
b. TOTAL RECEIPTSTHIS PERIOD ......................................AN3.Q..2n
vli- 7 $
00
LOtliJlf C0;, 5.~
00
c. TOTAL DISBURSEMENTSTHIS PERIOD ............................Et•,.J:.x....................... $
d. BALANCE ON HAND 12.a. plus 12.b. minus 12.c. $ vI •(nJ
e. TOTAL LOANS OUTSTANDING $
f. TOTAL OBLIGATIONS OUTSTANDING $
SS-1109 (Rev. 2/06) Pagel of_ 1 _ RDA 1159
SUMMARY PAGE - CANDIDATE
13. NAME OF CANDIDATE OR COMMITTEE (In Full) 14. REPORT COVERING THE PERIOD
O tJr T 1Ar1 ~.c1.i5~ t FROM:1 „ 1.1'7 T0:11-1s-18
RECEIPTS
15_ CONTRIBUTIONS (other than loans and interest)
a. Unitemized Contributions ($100 or less from each source this period) $ Jo
b. Itemized Contributions (over $100 from each source this period) $ Z•~ Z-~d • 00
c. TOTAL CONTRIBUTIONS (other than loans and interest)(add 15.a. and 15.b.) Z•t Z~
16. LOANS RECEIVED THIS REPORTING PERIOD
17. INTEREST RECEIVED THIS REPORTING PERIOD $ t[/ _
18. TOTAL RECEIPTS (add 15.c., 16., and 17.) (must be shown in item 12.b.) $ ---ZtTTTZ~----•O~
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) $ 25
b. Itemized Expenditures (Over $100 each payee this period) $ PAS w)
c. TOTAL EXPENDITURES (other than loan repayments)(add 19.a. and 19.b.) $ • W
20. LOAN REPAYMENTS MADE THIS PERIOD $
21. TOTAL DISBURSEMENTS (add 19.c. and 20.) (must be shown in item 12.c.) $ Q
V 5. oO
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 i item 121.) $
S5-1133 (Rev. 4/02) Page Z of
ITEMIZED STATEMENT OF CONTRIBUTIONS - CANDIDATE
1. NAME OF CANDIDATE OR COMMITTEE 2. REPORT COVERING THE PERIOD
Obt t~' S . ~1 Ker.3 ~l! FROM: TO: I • I S - I
Amount
3. TOTAL ITEMIZED CAMPAIGN CONTRIBUTIONS FROM PRECEDING PAGE (enter 80 if first itemized page) AEr
4. COMPLETE THE APPROPRIATE ITEMS FOR EACH ITEMIZED CONTRIBUTION contributions totaling more than S 100 from a conifibutor
FestName die Name Contribution Received For: Amount of Contribution
rom t. rA.
Last Name/OrganizallnName (lPNmary Election ❑ General Election Soo .00
B laN Ke,•t Sh i
Address qS45 N. ❑ Runoff (Local Elections Only)
wi lad noel ~.ct
City State Zip Code Date of Contribution Aggregate This Election
Ma 5v it R 37OL
Occupation 12 - 34 ^7 4 o oo .0o
cr~,~ C r 1
Employer
A\ I31011111:~441hi
FFstName Middle Name Contribution Received For: Amount of Contribution
-Last Name/Organiza' me e5mmary Election ❑ General Election
0~1 N tSob.oO
Address ❑Runoff (Local Elections Only)
32t? WOW brawls Ci r+
city Stale ~03 Date of Contribution Aggregate This Election
M 4tt4 7S
Occupation i Sob•0c)
mployer
vt~.
FirstName dleName Contribution Received For: Amount of Contribution
Charles ~i
Last m an a on Name 21'/rimary Election ❑ General Election
~ ~••l'h $2a0 •ao
Address Runoff (Local Elections Only)
cl
City Stato Zip Code Date of Contribution Aggregate This Election
J: -rO 57801
Occup
Sp~ ation 1-
ur Gtp. OU
Employer
k~44 ~'IYO r (414
First Name Middle Nafne Contribution Received mount o Contribution
Last Name/OrganizationName ❑ Primary Election ❑ General Election
Address ❑ Runoff (Local Elections Only)
City state Tip Code Date of Contribution Aggregate This Election
Occupation
Employer
5. TOTAL ITEMIZED CONTRIBUTIONS
(Carry forward to item 3. of next paged additional pages of this farm are used.) 2 I t XJ . 0~
(ti this is the last page of contributions, this amount must be shown in item 15b. of summary.)
SS-1131(Rev. 2/06) Page 3 of _ RDA 1159
ITEMIZED STATEMENT OF IN-KIND CONTRIBUTIONS - CANDIDATE
1. NAME OF CANDIDATE OR COMMITTEE 2. REPORT COVERING THE PERIOD
S • INarst Kcn! ShIJ2 FROM: -I . TO: 1$.- a
mount
3. TOTAL ITEMIZED IN-KIND CONTRIBUTIONS FROM PRECEDING PAGE (enter SO if first itemized page)
4. COMPLETE THE APPROPRIATE ITEMS FOR EACH ITEMIZED IN-KIND CONTRIBUTION (In-kind contributions totaling more than 1100 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) 49
Address Date of In-Kind Contribution Aggregate this Election
City state Zip Cade 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 ln4U Corffibudon Aggregate this Election
City State Zip Code Description of let-tornd Contribution
Occupation Employer
First Name Middle Name In-Kind Contribution Received Fa: 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 Tup Code Description of In-Kind Contribution
ccupation m
Fast Name Middle Name in Kind Contribution Received For: Value of fit Kind Contribution
❑ Primary Election ❑ General Election
Last Name/0rganization Name
❑ Runoff (Local Elections Only)
Address Date of In-Kind Contribution Aggregate this Election
City State Zip Code Description of In-Kind ConMxftn
Occupation Employer
First Name mime Name In-Kind Contribution Received Fop: Value of In-Kind Contribution
Last Name/OrgarkationName ❑ Primary Election ❑ General Election
❑ Runoff (Local Elections Only)
Address Date of In-Kind Contribution
Aggregate this Election
City State Zip Code DescrtptionofIn-Kind Contribution
cups n m er
5. TOTAL ITEMIZED IN-KIND CONTRIBUTIONS
(Car yforward to item 3. of next page it additional pages of this tam are used.)
(if this is the last page of in-kind contributions, this amount must be shown in item 22b. of summary.)
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
~D . Gtr11 FROM: T0: _ 5 -1,9
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 7mame Purpose of Expenditure Arrattnt of Expenditure
Last Name/Business Name
-1112 s osier ~or jmdL 4100.00
Address 97-0 rc Sic~c.1S ~pro~
City State Zip Code
Y ' T
First Name Middle Name Purpose of Expenditure Amount of Expenditure
Last NameBusiness Name
6S1 F ` 7 p
Address R,GlVt0.tr1{ t, F d
V 5' 00
City Lilo rc Dr. r var Si9Ns
Stale Zip Code
l Tc~ 3 X801
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 Tip Code
5. TOTAL ITEMIZED EXPENDITURES
(Carry forward to item 3. of next page if additional pages of this form are used.) 88 V O
(If this is the last page of expenditures, this amount must be shown in item 19b. of summary.) (f
t SS-1129 (Rev. 4102) Page of RDA 1159
i
ITEMIZED STATEMENT OF LOANS - CANDIDATE
1. NAME OF CANDIDATE OR ,CpO,1M,MITTEE 2. REPORT COVERING THE PERIOD
R1Sb~~T S fJX AYA2~ FROM: T0: _15-1b
3. COMPLETE THE APPROPRIATE 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/Organization Name e 0
Address Loan Received For. Date of Loan
[3 Primary Election ❑ General Election
City State Zip Code
❑ Runoff (Local Elections Only)
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
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 Code City State Zip Code
Amount Guaranteed Outstanding Amount Guaranteed Outstanding
4. Totals forall Loans (complete on lastpage 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 Payments End of Period
(Total loan payments should also be shown in item 20. on summary page.)
(Total outstanding loan balance should also be shown in item 12.e. on front page.)
"Y° j SS-1132 (Rev. 4/02) Page of . RDA 1159
ITEMIZED STATEMENT OF OBLIGATIONS - CANDIDATE
1. NAME OF CANDIDATE OR COMMITTEE 2. REPORT COVERING THE PERIOD
FROM:I - I - I TO: I IS-18
3. COMPLETE THE APPROPRIATE ITEMS FOR EAC 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 Name/Bu
rip siness Name S ~ Q r 14 5 ~ OO $10-57.5's
Address 42 l r-fat DY
city state Zip Code
M V t LC T~ 3? S o
Description of ligahon
h.t (First Name Middle 'Name
Last Name/Business Name
Address
city state Zip Code
Description of Obligation
First Name Middle Name
Last Name/Business Name
Address
City State Zip Code
Description of Obligation
First Name Middle Name
Last Name/Business Name
Address
City State Zip Code
Description of Obligation
First Name Middle Name
Last Name/Business Name
Address
city state Zip Code
Description of Obligation
4. TOTALS
(Total from Outstanding Balance - (End of Period) column must also be shown 10'57 ,
in item 23b. on summary page.)
d `~Jj SS-1127 (Rev. 4/02) Page-? of -7 RDA 1159
Appointment of Political Treasuh t
For State and Local Candidates and Single-Candidate Committees
INSTRUCTIONS
The Appointment of Political Treasurer statement must be used to appoint a political treasurer as required by
the Campaign Financial Disclosure Act (T.C.A. § 2-10-105) for state and local candidates and single- candidate
political campaign committees. A state candidate may not receive or expend funds for an election until a
political treasurer has been appointed for that election. A local candidate pursuant to T.C.A 2-10-101, may be
exempt from completing this form, please check with county election commission for more information. A
candidate may appoint himself or herself as political treasurer. A new form must be filed if the treasurer is changed.
Candidates for state public office must file their original Appointment of Political Treasurer statement ONLY with
the Registry of Election Finance, 404 James Robertson Parkway, Suite 104, Nashville, TN 37243-1360.
Candidates for local public office must file their original Appointment of Political Treasurer statement ONLY with
their county election commission. n ~~~~Q\
1. Date: 2. Candidate First and Last Name: 3. Candidate e-mail address:
7 J$e t. I«NKe-►"L,hI blc;~s~~;r~,o:cd -CCIV1
4. Ca paig Address and Phone: City tate Zip Code Phone
P, C, ix I I Ma( lc 3../~C2_ &Q-;S 1 - yu1 C
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 arty Affiliation 8. Election Year
~I~~(~~ C~t~U` C►r~ C'c;cirf Lie ► K 2r UJ~i(C, ti c
9. Treasurer Name: 10. Treasurer e-mail address:
t l N~ Sit ~'h ct ~f.ISr';~k~, 1434 )Jot,4 , CL
11. Tr asurer Address and Phone: City State Zip Code Phone
12. Candidate and Treasurer gnatur (both signatures must Lk- witnessed. Treasurer can not witness candidate's signature):
1,7
F~EC27 7
Signature of Candidate Signature of Treasurer
,FC .
Aat& -
Signature of Witness Signature of Witness
y~{ Registry of Election Finance
1. SS-1120 (rev 12/2013)