CAMPAIGN FINANCIAL DISCLOSURE STATEMENT For State and Local Candidates For Single-Candidate Committees 2.a.
1.
NAM~
CANDIDA1E ~R COMMITTEE
rA wt
!
M..Uv
Y"
\. 3. ELECTION DATE
4.a. CAMPAIGN ADDRESS AND PHONE Street or Rural Route
~ C)?-
City
5+Oc..~
State
S-t .
\ \.
FV /
4.b. CANDIDATE'S HOME ADDRESS (if different than 4.a.) Street or Rural Route City
A-
N
u'J
hkn': '2. Lf"r;- E
Zip Code
L\ -: TN
State
'"3t?CJ/
Zip Code
Phone
5~ 5.
OFFICE SOUGHT (include district number nif applicable) ~
7.
{/~c:.-~
L kJJ-s~ -.... ~
'5
D
D
0
k~
S "'t-"~
CATEGORY OR REPORT (Check one)
FIRST SECOND THIRD QUARTER QUARTER QUARTER 8.a. BEGINNINGDATEOF REPORTINGPERIOD
NAME OF POLITICAL TREASURER (may be candidate)
6.
o
~J.JJl
~
o
ODD
FOURTH QUARTER
PREPREMID-YEAR PRIMARY GENERAL SUPPLEMENTAL 8.b. ENDINGDATEOF REPORTING PERIOD
r-r«
/0- 0,. -0 ~
...t
YEAR-END SUPPLEMENTAL
J
'2..., -:2.-~€)
9. (Check one)
10.
a.
0
b.
D This campaign
This campaign is exempt from detailed disclosure because contributions {including in-kind) received totai$l,OOO or less AND expenditures total $1,000 or less for this reporting period. (Complete items 12d., 12e. and 12f.) 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.
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 reven e code.
1
~~.
(/~/D'1
t
urer
I
/1-1-b9
dat~
O-j-D9
date
date
I
I
12. SUMMARY a.
BALANCE ON HAND LAST REPORT
,
b.
TOTALRECEIPTSTHIS PERIOD
c.
TOTALDISBURSEMENTSTHIS PERIOD
d.
. !\J;j'}JeJ/. BALANCE ON HAND (12.a. plus 12.b. minu~·'I't.e;i.ti.HH:O:J
$
.
TOTAL LOANS OUTSTANDING
f.
TOTAL OBLIGATIONS OUTSTANDING
SS-1109 (Rev.2106)
$
'1" .............•........•........•...•......••..••..••.....•.•.
e.
$ __
f1'i
r
; ..
:
..eml.-!-~:!.J.l::;
~J!1r.r.1~.
:""""/-1
:J
---::0==-- __
3 67
~
S
7-
t-L1~ ~ .
)
\
$
'gDo
$
~
_
500 ~
$ ---='--
Pagelof __
r;...;;;--_
RDA 1159
:s~
SUMMARY PAGE • CANDIDATE I
13. NAME OF CANDIDATE OR COMMITTEE (In Full)
I
14'. REPORT COVERING THE PERIOD TO: FROM:
I
RECEIPTS 15. CONTRIBUTIONS (other than loans and interest)
~
a. Unitemized Contributions ($100 or less from each source this period) ................... $
1 00
b. Itemized Contributions (over $100 from each source this period) ......................... ~.. $
t2cr.75~
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.) ................................................. $
307S
b
fr
"30,5
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)
$ $ $ $ $
$ $ $
$
-9 Total of Expenditures ($100 or less each payee) ........................................................... $ b. Itemized Expenditures (Over $100 each payee this period) ...;................................... $
tf2,;2 75 ~ C-
c. TOTAL EXPENDITURES (other than loan repayments)(add 19.a. and 19.b.) ................................................ $ 20. LOAN REPAYMENTSMADE 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) ............. $
-e-
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.) ................................. '$
f/'2'2..7'5 ~
z..'Z7 =:;
--e
23. OBLIGATIONS a. Unitemized Obligations Outstanding ($100 or less each) ............................................ $
~
b. Itemized Obligations Outstanding (Over $100 each) ................................................... $
S()O~
-
tYfC>
c. TOTAL OBLIGATIONS OUTSTANDING (add 23.a. and 23.b.) (must be shown i item 12.f.) ......................... $
88-1133 (Rev. 4/02)
'5 DO
r
~
?-
ITEMIZED STATEMENT OF CONTRIBUTIONS - CANDIDATE 1.
NAME OF CANDIDATE
OR COMMITTEE
I .2.
lJ\ Vlf-r~
?kNl
REPORT
COVERING THE PERIOD TO: III - G.-~
I FROM/O -/-0'1
59
Amount
3. iOTAL
ITEMIZED
CAMPAIGN
CONTRIBUTIONS
FROM PRECEDING
PAGE (ent~r
$0 iftirst
itemized page)
4. COMPLETE THE APPROPRIATE ITEMS FOR EACH ITEMIZED CONTRIBUTION (contributions totaling more than $100 from any contributor)
4~
First Name
So f'yN.[
I
Contribution Received For:
Middle Name
rl:
(lfVV 31'" .#
·-d
m
o Primary Election o General o Runoff (Local Elections Only)
Last Name/Organiza~n Name
~U~
"2"2..0""2- tJ~SOr'l
Address City
Iffll '.. '.
N- ~\'V"'f
tF~ :J'* s ,.;;" IV cJ & 5<-
last Name/OrganizationName Address
'JDt
Occupation Employer
~+o
(
o
r::r-{"
Last Name/OrganizationName c.J
~q
City
C
Employer
\~iuL (~l.p
1VN.• I
G
I ZJpCode .
"0 -
of Contribution
Election
(Local Elections Only)
!ff 2 5V
1
e-
Aggregate
This Election
].O()'\
le0 Contribution Received For:
I
M-A-t-Y\.J
o General
Amount
Date of Contribution
.
"3----yGb7
Middle Name
re.·U-J4
Received For:
o Prtmary Election o General Election o Runoff (Local Elections Only)
~+-.
Dale of Contribution
Amount
of Contribution
iff)OO Aggregate
This Election
~lz~o~"3b3
'D~
~1L~J)it:~
16/11IfY~ I
r
#/500
(Carryforwardtoitem 3. of next page if additional pages of this form are used.) (II this is the lastpage of contributions, this amount must be shown in item 15b.of summary.) 2/06)
This Election
II- 0'1
5. TOTAL ITEMIZED CONTRIBUTIONS
1*"- SS-1131(Rev. . ~i;j
~5aV Aggregate
Prtmary Election
o Runoff
W'f\.Q....(/"
PtrrS07lJS
Occupation
of Contribution
~
s:"""'--
'P i-: (L t fJ
(SeL+')
D --
Contribution
o
1
~+v-rf
K
Amount
\}.J f'Y.A.1
j('f'Ndl
Occupation
Address
i
'5'"-'b
D ;-c16r-
f\J fr
First Name
RoArol
riddle Name Name
Received. For:
o Primary Election o Generpl E1ectiori o Runoff (Local Elections Only)
Dvv~
)
%b3
tmployer
Contribution
MiddleName
Date of Contribution
fL-t
I r rv» City
This Election
I 6 -- "2...-z.- 5 \,
YY') -e:..N'
Last NameJBzatlOn
Aggregate
Is~I\7e~7
First Name
Address
I
/
(~li
13 A
fi2S()
DP
'S~N'1h 1J ;c_J~~s in.
{\J /l-;5 l-. "\
City
of Contribution
() Lu 'NAr
.~..t'l~
FlrstName
Election
Date of Contribution
~pCode T12.0,
Occupanan Employer
Amount
Page~ofJ{
ITEMIZED STATEMENT OF CONTRIBUTIONS • CANDIDATE 1. NAME OF CANDIDATE OR COMMITIEE
I
-pQ.(,'\f\..
2. REPORT COVERING THE PERIOD /1> -1-1S'1.. TO: 1\- 'Z-
I FROM:
~~
3. TOTAL ITEMIZED CAMPAIGN CONTRIBUTIONS
FROM PRECEDING PAGE (enter $0 if first itemized page)
4. COMPLETE THE APPROPRIATE ITEMS FOR EACH ITEMIZED CONTRIBUTION
I
A \ e-c
First Name
Address City
Contribution Received For:
G
o IL 'IV\At4-P\.
-S W ~cz,-+,S--t-..r~
~OS
.l.c.. V\.-
I~NIZttt L-"L,5
s
J .~ -le-t D e. IT
Occupation
A
t- J:V\-~
FicstName
Pf)-Ul
'IMiddle Name
:2... 3~\IJ vJ T•.. l~
City
Nfr6h.-
Occupation
o Runoff
(Local Elections Only)
L,~
~
I
ZJ~C2i
'S+o -t: <- Ow
1>P
FirstName
f-.
0 II.J'v
Address
O-z
Received For:
Amount
o Primary
Election
o Runoff
(Local Elections Only)
o General
Election
of Contribution
tisOD Aggregate This Election
c, (!)
J6
I
v
'}
L~v )..-~ S'~
.~.r-.~
~~
Last Name/OrganizationName
<6 6 "l.{\ffor~ ~
Occupation
f11
o Runoff
(Local Elections Only)
~.Middle
Mv~ 01,;
S+,
~I~~WJ
7e-,-tpl ~
tBl/d I
5. TOTAL ITEMIZED CONTRIBUTIONS
2/06)
Contribution
1t tDO
\ol~rr)~ I
r1o
Amount of contribution
o Primary
Election
o Runoff
(Local Elections Only)
General Election
Date of Contribution
\ 'bl
ft~L5 Aggregate
This Election
[L-le{C\
v
I
11]013
(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.
, of
Aggregate This Election
Contribution Received For:
Name
s~0k\~J
Employer
Election
Date of Contribution
1?-01
l\fI.,\.r. r~ '1
o General
Election
?kb~ ,'/\11
Amount
Received For:
o Primary
Occupation
NONv
~6U
D~
~ 1~IZJPCode
Employer
~ "2..-;) (
Contribution
~ (
fV rrvh
City
~5bD Aggregate This Election
Dr '2--z.j D
(D
riddle Name
L+w--rv
Address
Election
Date of Contribution
~CJt
T\.J./
Jf
LastName/UrgamzatJon~f~
First Name
o General
. L
Employer
City
Election
Contribution
h
LastName/°sTti;;~
o Primary
I
~
~.f2e-r
Amount of Contribution
Date o/Contribution
n..f-l
Employer
Address
(contributions 10talinQ more than $100 from any contributor
Middle Name
Last Name/OrganizationName
O~
A,S 0-0
\
Page
-4:- L of
RDA 1159
ITEMIZED STATEMENT O.F EXPENDITURES· 1.
NAME OF CANDIDATE
I
FAJt,...nr~
OR COMMITIEE
CANDIDAT.E·
2. REPORT COVERING
I FROM: I of, /'iJ/rF, I
3. TOTAL ITEMIZED
CAMPAIGN
EXPENDITURES
FROM PRECEDING
First Name
· Last Name/BusinessName City
;J
Address
mIll; .rVbrr ~ 3" ~
-
Address
-:::S-O -~
v
.~
51v"v7.fh .~~
Last Name/BusinessName
City
'Te ~
NA,5h .5 ~
First Name
Address
~
()
tV~~
- City
· City
5. TOTAL
fo/'6fvv ~
-:::;2... ""h
ITEMIZED
C::C::.11?O
(~<'"
dln?\
-Amount of Expenditure
500
lv~
~t
2(')'"":;
'Purpose of Expenditure
')3I9-lA~
Zip Code
l'20
"5
Amount of Expenditure
'-[06 ~
77.I-
. Middle Name
Purpose of Expenditure
/
t\A.-J t-l.-5
IJLV~
0/1
Amount of Expenditure
/25
Pvq-y-~
. State
JI'J Zi1~rL(j 'J
EXPENDITURES
(Carryforward to item 3. of nexl pageif additionalpages of this form are used.) (tf thisis the last pageof expenditures.this-amountmust be shown in item 19b.of summary.) ~
~
Purpose of Expenditure
~bP
SM
Ll-l-
..
) O/z?
I
MIfI....
...
Zip Code
TfII
l
~
ro/-z ~
State
'3506 U-n~AL
N
~"1"'
..
-z, ~ '"3-L:. :,
6")(
Last Name/BusinessName Address
W
~ao
r.. Y\,*~
Zip Code
_~l·'~.O_~
6rvvV~
7')U
First Name
36~
State
,
Amount of Expenditure
I, -::>
::g-/19"crCOO ~
M~ To VvV\.- '\j~ ,
-
/0
Middle Name
Last Name/BusinessName
?~L--s
5~ -:2..
150
Purpose of Expenditure
.. Middle Name
VO B0Y
Address
~/ZJ'
dJ <...
Middle Name
-N/tSl- \-.---
First Name
Zip Code
Amount of Expenditure
fO/Z-""3
- ---
(03
/fh /IA-/h~
PO 80 ~
".
.. City
'2;'!... ~
D /'"(
Purpose of Expenditure
.
.T1v
LastName/BusinessName
'
MiddteName
N'~\vrz /lIv/
I
lls
l?3rJO
H!t1de
o~--
f5(J
120
Rrst NameS
~
State .-rN
· Last NamelBusinessName.
Amount of Expenditure
PI'fNH1
t&qV
~
N~6~r\
· FirstName
..
r I(
Purpose of Expenditure
/In.
C:> ~ 0L Y1-++-Ai ~-uL
Address
- City
~
(expenditures totaling more than $100 to any payee during the period)
MiddteName
D PflvLe ill}
f
$0 if first itemized page)
PAG~nter
.4. COMPLETE THE APPROPRIATE ITEMS FOR EACH ITEMIZED EXPENDITURE
J.
THE PERIOD
TO:1'1_~ I Amount
tI ;22 7.5
!Y'
~.
ITEMIZED STATEMENT OF OBLIGATIONS -CANDIDATE 1. NAME OF CANDIDATE
3. COMPLETE OBLIGATION
OR COMMITIEE
THE APPROPRIATE (obligations
person/vendor
FROM:
ITEMS FOR EACH ITEMIZED
~*tanding (Beginning
totaling more than $100 owed to any
at the end of the reporting
Flrs/~rr;Jjpd
2. REPORT
PM\Ylrr~
(;~~
'3 YLfd
N-I¥Sh~ Description of Obligation First Name
L,
\
I 6 /~ / ~ '\ I TO:
Debt Incurr~ This Period
1 Middle Name
I
Paylnents This Period
( 1-
Z-CPt
Outstanding
Balance
(End of Period)
Jl5CiJ~
1f50()
{)ryUvU-L--
City
THE PERIOD
period)
Last Name/Business Name Address
Balance of Period)
COVERING
S~~ Zip Code
~,,~V
~
'SVvC V'-i'-5
I
Middle Name .
Last Name/Business Name Address City
I
Description of Obligation
First Name
Zip Code
State .,
I
Middle Name
.
..
,
., ."
Last NamelBusiness Name
,
",.
,.
Address City
I
Zip Code
State
Description of Obligation
First Name
(
I Middle Name
Las! Name/Business Name Address City
I
Zip Code
State
Description of Obligation
First Name
.I Middle Name
Last NamelBusiness Name Address City
'1 State
, Zip Code
Description of Obligation
. 4. TOTALS (Total from Outstanding Balance - (End of Pertod) column must also be shown in item 23b. on summary page.)
-
f!£06~
ITEMIZED STATEMENT OF LOANS· CANDIDATE
PMu-v-ti
1. NAME OF CANDIDATE OR COMMITTEE
3. COMPLETE THE APPROPRIATE ITEMS FOR EACH ITEMIZED LOAN Complete
the Following
for !he Source
tv /
First Name
Last Name/Organization
t6
(loans !r\aling more than $100 from any souroeduring
Outstanding Loan Balance (Beginning of Period)
MdleName
Loans Received
TO:
2-""
.07 .
theweriod)
Loan Payments
Loan Received For:
I
State
I
Oulslanding Loan Balance (End of Period)
or Guarantors
1 Middle
First Name
0
Primary Election
0
Runoff (local8ections
Date of Loan
o General Election
Zip Code .
List All Endorsers
. Last Name/Organization
kI(o cr. I It....
Na'i'
City
for Above
Onty)
Loan (If more space
is needed
please
attach
a page)
First Name
Name
I'Middle Name
Last Name/Organization
Name
Name
Address
Address
I
City
State
I
ZipCode
I
First Name
First Name
Middle Name.
Last Name/Organization
City
I
State
I
Middle Name
I
Zip Code
I
Zip Code
~mount Guaranteed Outstanding
Amount Guaranteed Outstanding
Address
FROM:
of the Loan
Address
.,
2. REPORT COVERING THE PERIOD
Name
,
..
Last Name/Organiziltion
Name
Address
..
",
City
1 State
1 Zip
Code
.1
Last Name/Organization
State
Amount Guaranteed Outstanding
Amount Guaranteed Outstanding
First Name
I
City
First Name
Middle Name
I Middle Name
Last Name/Organization
Name
Name
Address
Address
City
I State
I Zip Code
I
'last Name/Organizalion
.\ Zip Code
I State
~mount Guaranteed Outstanding
Amount Guaranteed Outstanding
First Name
City
I
First Name
Middle Name
Last Name/Organization
Name
MidmeName
Name
Address
Address
City
I State
I
Zip Code
City
I State
Amount Guaranteed Outstanding
Amount Guaranteed
4. Totals
Outstanding Loan Balance (Beginning of Period)
for all Loans (complete on last page of itemized loans) (Total loans received should also be shown in item 16..on summary page.) (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.)
88-1132
(Rev. 4/02)
I
Zip Code
Outstanding
Loans Received
Loan Payments
Outstanding Loan Balance (End of Period)
.
Page
-..:J-
of ~
RDA 1159
ITEMIZED STATEMENT OFIN·KIND 1. NAME OF CANDIDATE
CONTRIBUTIONS·
PM,~
OR COMMITTEE
I 2.
,I
REPORT
FROM:
CANDIDATE
COVERI NG THE PERIOD
/0- '1-DC-z TO:
l 3. TOTAL ITEMIZED
IN-KIND CONTRIBUTIONS
FROM PRECEDING
If D;;Z O~
I Amount
PAGE (enter $0 if first itemized
page)
4. COMPLETE THE APPROPRIATE ITEMS FOR EACH ITEMIZED IN-KIND CONTRIBUTION (in-kindcontribulions lotaling mom than $100 fmm any conlribulorduring the period)
I
/V'/Jk-
FllStName
Middle Name
Address
Occupation
. -
I
I
Stale
I
Middle Name
ZipCode
, Value of In-Kind Contribution
Dateof In-KindContJibution
City
I
Stale
I
Middle Name
I
Zip Code,
Aggregatethis Election
Descriptionof In-KindContribution
Employer
Occupation
First Name -,
In-Kind Contribution Received For.
LastName/OrganizationName -, ..' .
."
City Occupation
Value of In-Kind Contribution
Election
o Runoff
(Local Elections Only)
Gerieral Election "
Dateof In-KindContribution
I
I
Stale
I
Middle Name
ZipCode
Aggregatethis Election
Descriptionof In-KindContribution
In-Kind Contribution Received For: Primary Election General Election
o
LastName/OrganizationName
o Runoff (Local
Value of In-Kind Contribution
o
Elections Only)
Daleof In-KindConinbution
Address
I
City
State
Occupation
-0
0,Primary
Employer
FirslName
I
ZipCode
Descriptionof In-KindContribution
Aggregatethis Election
-
Employer
I
FirslName
In-Kind Contribution
MiddleName
Received For:
o Primary Election o General Election o Runoff (Local Elections Only)
LastNamelOrganizationName
Dateof In-KindContribution
Address
I
City
.LF.:=~
Descriptionof In-KindContribution
o Primary Election '0 General Election o Runoff (Local Elections' Only)
,Address
5.
Aggregatethis Election
In-Kind Contribution Received For.
Last NameiOrganizationName
I uccupalJon
Dateof In-KindContribution
Employer
RrstName
Address,
Value of In-Kind Contribution
o Primary Election o General Election o Runoff (Local Elections Only)
tast NameiOrganizationName
City
In-Kind Contribution Received For:
Stale
I
ZipCode
Value of In-Kind Contribution
Aggregate!his Election
DeSCriptionof In-KindContribution
empioyer
TOTAL ITEMIZED IN-KIND CONTRIBUTIONS (CarryfO/wardto item3. of next pageif additionalpaqes.of this form are used.) (If thisis the last pageof in-kindcontributions,this amount must be shown in item 22b. of summary.)
~
~