Upload
lytuyen
View
219
Download
1
Embed Size (px)
Citation preview
IUNSAS GOVERNMENTAL ETHICS COM.MISSlON li" CrEWED
RECEIPTS AND EXPENDITURES REPORT OF A CANDIDATE FOR STATE OFFICE
1\5 Govern>jN::!I"'~1""'h f~," r_[ 'cs t-January 10, 2017 - , \.-.OfTIml
FILE WITH SECRETARY OF STATE SEE REVE'RSE SIDE FOR INSTRUCTIONS
A. Name ofCandida{c: _Slwt:. l-1uC.~g-.r_··-+-,--_ --'-_.'--
Addross: _._1.P. (CJ. ~.,\ ~\\cC ..b
City and Zip Co~-_\l1l.1L:J ~-e..",,1-e< /<5.," /.."I !.'f2 County: &~lcK Office ~ought: ,~~Y~\'~~"1 ',-I,e.,. ,_.__ District: .. ,~~__
B. Check only If appropriate: __.Amended filing ___ Tennina\ion Report
C. S~lmmary (covering (he pcriod from Octoher 28,2016 through DeccmbeJ' 31, 2016)
1. Cnsh 011 hand !.It beginning ofperiod " , ", . JJ J,1l2..i_~7 2. Tot~l Contribwtlol13 ul1d Other Receipl~ (Use S~nccfule A) , ", "." . _~;J.~i) .
3. Cash available (11is period (Add Lines 1 and 2) , .. He ~ J?-- •3'1 ~ ,-.
4. Total Expenditures and Other Disbillsements (Use Schedule C) .. ".5r;J..7Q.:!~~.. 5. Cash on hand at close of period (~ubu'aet Line 4 from 3) " " .. J~4'Y ,.S~'
6_ In-Kind Contribulions (Utie Schedule B) ....,.... _,,~ 7. Other Transactions (Usc Bchedllie D) ... "........ ~
D. t'l declare that this report, including any accompanying schedulos and :>tt\tcment~, has been exam1ned by me and to the best of my knowledge and bcliefis t1.'ue, con-cct andcumplete. rUndel':;land that \.he intcnt1nnfll failure to file this document or intcnthmally filing a fuls.f;l document is a class A Inisdemeanor. H
Date jty\(L~4!£-=H21~:,~~dr--L-.o.' Signaturo OfCMdidate or ~(lsur~r
~~
GEe Form Rev, 2016
. slon
Rece Ived Time Jan. 13. 2017 10: 18AM No, 1489
SCHEDULE A CONTRIBUTIONS AND OTHER RECEIPTS
Sk.u~_ J;b:...>o::.::e~=[-"-1-d:_· ~ (Namo or Cllndidllte)
AmounlorOCC\1 pntion of Check CAsh, Check,NlIme lIud Alh.ll·c~s Jlldlvt<funl Gtvlllg More Appl'OprhHe Box
LOIlIl or OtherPnte of ContriJmto \' Thnn $150 .;r'lII'ICJ,en.sll Ch«k LORt! ltecelptIIlher
LJ: Ch.\~~ (.?~Nn( Pk 0 0/ /'1,0 lA-1 .Ocu....\~ ~f\c ~:5D) }···7 W\Ch.:·k ~ lsi)JD~
~ () ~t" jY\f1..,..X Q.:Jv·rAe.-.J/..PO.5 S '5,c;; ," k r-:e. ~~IJ- 3> () Is .H,1' .L.l<:'~ IJ(pO~1I
V ~oVrt:-:. \('\e &. "t\ PQf-~~+~~ I
~OILP~8.1 o...~--l)j) - 3 ff'G ('fv...V'~ -H t....e 1-« L,l/Sl>ti
t-<.s ~ Bu-t \~.s /k!OL d U0(X)·2.-/':\.. .3 w g--j~ it: 2..0 I PAc j/1J.. I TOpt~. K~ t.".(,(,D~ ..
roe. ~.er'O'>.').... 0..,; C~~~ YCJ~c.~bv o.(.&~ ()0¥O-"", r,l t'<'.e..., e.1i.~.-t.<6 3>5. ,.s w fJ~'1V- / :l:5/)J~-I CV««..kc:l c\..-I-<.. ~7"/IOp.{,I{<:.. K:s. bIA.~ I~
i...'l-l
'1,.;),00Subtotal Thh Poge
Received Time Jan. 13, 2017 10: 18AM No. 1489
SCHEDULE A CONTIUDUTIONS AND OTHER RECEIPTS
~----=-=------=-:-7""'"""":5=-. .. L'h1_·.::--(~_-_·b~e,,---H...:J..'_~...;. ~_ (Name of Cllndioate)
Dote:
Oecuplltion of Nnme and Address lndlvidusl Glvln~ More
of Contl'ibHtor Thon S150
~
~ ~ ~
~ ~
Check Appropl'hlte Hox
en,h Choo. Lcnu \'. rl/lll~' Olilor
~ ~
~,
Amollnt of CU~hl Check,
Loan or Othor H.ccolpl
SnbtotRI This Page ~/~
Complete if last page of Schodulo A
Tolal Itemized Receipts for Period JJ ?DO Totol Unllomized Conlrlbutions ($50 or Jess)
.-. r- ...-/'
Sale of PuJilic~1 Mlllcrilll~ (Unitemlzt:<!) .,--Totftl COHtl'llmtlons When Contributor Not KJ10\\11 /'"
TOTAL RgCEIPTS TIIlS PERlO}) (to line 2 or Summuy) JtaW
Page. ~.. o(~
Received Time Jan. 13. 2017 10: 18A~ No, 1489
.. --------.-.., ..... -- ----- -.- ...... ---- ............. -0 -,
SCHEDULEC EXl'ENDITURES AND OTHER DISRUHSEMENTS
. .,.S~.u~ l-\ tAe..he..vH- . (Nome of Candidate)
Putt' Naillll and Addresll Purpose of Expenditure
or Dishul'sement Amoun{
)b~L9
\\-3
J) ~
H'~
'(Y\'~l"~.. Cn:..e~ ~.:t 1\'\· lcS !
Sc.o* ~ ("Co 0. TS<,. ~ 5'~)/; W 9ifi-. trl
l OoJu{q....{ (2-JK.~
~'t\..)h~-("~ O;<:'.f\..rM r tLc:., ~,.>.=.t"'.\r'. '\. )-\-\t\~ ~t\<.~""5<\O;' Cj.v-r··~
if Cl \ lLf) c~ .'\'~r· \-<~. (.,""1 ( "I'")
r..\,-\ (c:. S1-. Cc,f",\kI &\d5 k~<..K.c. 1</,>. (..-~
N~" +.l Bv Il~n ~-,,~\ Jl. I ~ 'T~"',~·'S "':J Wtu-..;~ Ks. ~'JJ-I":)..
Po\ \~ ~
d~·iID('.
do(,,~A \~~,
Wtb hD-S-1 j'~' lM· \d.~..,..:>) I. jJ
,bit. c...h. tt,) ,) ~ (<. ,
3[X)bO
)::00.>
CJ~
\\CW
DoYOu
))-g VClII~ S",~d<~ Z J2> e.¥' Crl,; "'""'" Uc.1 \~ CAr'I,>t.-¥,
1 Lt~u...~('
&")/1.1,k~
BI e.,*\~ v.->~kh
~plk,)
t~1c. "'~ lSO,ol -
) \~ ~ 'T~{d- SW~ N ' . c\J..-L ~ iAh't.h. i \c. K-s. [, ");,).0 ~
pn ('\-e-('" JO~,1l
J \ ~g 5:J R..ef~l) ,.'(:<......:;u,o s <...u 'QL.1 ~4
':T"J f'~!<J.1.... 1<~ . rC. (.~
(" lfiv CX-( d00Cv+iO'f' 00
5£j)
1?- '$
}~-\S
)~. 'Z".}
l~-i>
i;Jc:, I h-&- y.-:\;
53~ ~Mu~A;~
Lu«(-\-,,~ {c.., k~· L,') ~ t.r
LXb10('". l i ~ l' rl~(~. ~ ~ fV\ C!.L.e.....
tc..~ ~ 4..., K ~". 1./)~3.
Sl-e,vle H\4~·6LV-t-f.p ,~ .tV l~i"r~-..v'\"
)~\) i.' 't <-u\ ~,t\ k ..... l/J/I.f'1
5kv~ H~·b-l(T"' LPICJI ~ B·'('C.h
li ,I If'',Ve...\ \t.<.1 -C~.n.+a-v 1.(..) / :
"
Subtotal Tills Pugll
"TO-0\1... \.:
.'
d~"~OI-"'" (~~\:~.,.~(t;{ ~~~~
bC4 - O~<:..- 20 /L
re..~('('\.-~:>~~ ~ ~~-/,,,~1 ~s.. lOp.-' """'.,
:l. 00 \ - wr:. g .. ' " .... .' .
~.' '.:'. ,",:" ..
~V'YI.,
'l.J~tN
95>:5&
q0D IJ-)
'LJ r;o <-j I ~.~
Pago~of~
Received Time Jan. 13. 2017 10: 18AM No. 1489
-.---- ............... - -0 .....
SCHRDULEC EXP.F.NI>lTURES AND OTHER DISBURSEMENTS
Hlle.~ (Name ofCanJiuate)
Date Name and AtJuresl) Purpose ofExpcuditu1'6
or Disburllcment Amount
~
~ ~ ~
i'--
~ ~ ~
~
Subtotal Tills Page
Complete lfI1\st Pil~C of Schedule C
TOLal TLcmli'.ed F.xptmdilures Thl:- {'Ol'ioll LJ 'i<f) l/ s:.. Total Unitemized Expenditures of$50 or less 4~&;/:D TOTAL EXPENDITURES & OTHER DlSBURSR~NTS. TillS PElUO:V (to line 2 of Summary) 5:>..,o.7~
Page ~2.....; ot.'2.... _
Recei vedT ime Jan. 13. 20 17 10: 18 AM No. 1489