,CAMPAIGN FINANCIAL DISCLOSURE STATEMENT

For State and Local Candidates For Single-Candidate Committees

NAME OF CANDIDATE OR COMMITIEE

rfJm

.:

1. DATE OF REPORT

- 09

2.b. IF COMMITIEE, NAME OF CANDIDATE

//- r 2-0

4.a. CAMPAIGN ADDRESS AND PHONE

Street orRuralRoute. . L. c . .: t. )·ty(.

802··' S-h;rc~{

4.b. CANDIDATE'S HOME ADDRESS (if different than 4.a.)

Street or Rural Route City

State

Zip Code

Phone

6.

NAME OF POLITICAL TREASURER (may be c~nd~ate)

.s II ft/lE /i S' GA N~ c(tttk

5. OFFICE SOUGHT (include district number, if applicable)

to U rLC; L b /5!-v- /Cr $1

7. CATEGORY OR REPORT (Check one) I

o 0 0 0

FIRST SECOND THIRD Fq)URTH

QUARTER QUARTER QUARTER QUARTER

~E- ~- MI~9EAR

PRIMARY GENERAL SUPPLEMENTAL

o

YEAR-END

SUPPLEMENTAL

2009

8.a. BEGINNING DATE OF REPORTING PERIOD I

ENDING DATE OF REPORTING pmlOD

»v e 1M bt2..-v' 2.-1

9. (c:e~o~:iS campaign is exempt from detailed disclolre because contributions (including in-kind) receive~ total $1,000 or less AND expenditures total $1,000 or less for this reporting period. (Complete items 12d., 12e. and 12f.)

b. 0 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. ·Jlwe 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, Ilwe swear or affirm that no campaign contributions have been expended for the personal financial

benefit the cando ate or for any other nonpolitical purpose as defined by the federal intemal revenue code.

C I{/<;; {\

~ ~O( ~~~~~----

11. WITNESS SIGNATURE

signature of witness

date

Signature of witness

date

12. SUMMARY

o

a. BALANCE ON HAND LAST REPORT $ _

b. TOTALRECEIPTSTHIS PERIOD $ _

TOTAL DISBURSEMENTS THIS PERIOD ..

........................................................................... $------

c.

(2

TOTAL LOANS OUTST.

500~

e.

f.

TOTALOBLIGATIONSOUTS~A~fl?~j·:~·~;;,:~·';:{~f············ $

SS-1109 (Rev. 2106)

Page 1 01 __

RDA 1159

SUMMARY PAGE - CANDIDATE

13. NAME OF CANDIDATE OR COMMITTEE (In Full) I 14. REPORT COVERING THE PERIOD
P II/l U-Yr-a..u I FROM: I TO:il - 2 -0(;-
RECEIPTS !
15. CONTRIBUTIONS (other than loans and interest)
a. Unitemized Contributions ($100 or less from each source this period) ................... $ lD~~ ~
b. Itemized Contributions (over $100 from each source this period) ............................ $ '2-'2-50
c. TOTAL CONTRIBUTIONS (other than loans and interest)(add 15.a. and 15.b.) ....................................... $ '2..3 50
, ().
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.) ................................................. $ 7.~50

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)
$
$
$
$
$
$
$
$
$
. if
Total of Expenditures ($100 or less each payee) ........................................................... $
b. Itemized Expenditures (Over $100 each payee this period) ....................................... $ 5t07S'
r "3;oi5
c. TOTAL EXPENDITURES (other than loan repayments)(add 1 s.a. and 1 9.b.) ................................................ $
r~
20. LOAN REPAYMENTS MADETHIS PERIOD .............................................................. .,., ..... .,., ........................ $
21. TOTAL DISBURSEMENTS (add 19.c. and 20.) (must be shown in item 12.c.) ............................................ $ '3 D7 C;
22.IN-KIND CONTRIBUTIONS ,
a. Unitemized in-kind contributions ($100 or less from each source this period) ............. $ -0-
e
b. Itemized in-kind contributions (over $100 from each source this period) ..................... $
fj-
c. TOTAL IN-KIND CONTRIBUTIONS RECEIVED THIS PERIOD (add 22.a. and 22.b.) ................................. $
23. OBLIGATIONS
a, Unitemized Obligations Outstanding ($100 or less each) ............................................ $ £Z
b. Itemized Obligations Outstanding (Over $100 each) ....................................... ., .......... $ 0DO~
-r---.
c. TOTAL OBLIGATIONS OUTSTANDING (add 23.a. and 23.b.) (must be shown i item 12.f.) ......................... $ t:::?'!
SS-1133 (Rev. 4102)

Page __ of __

ITEMIZED STATEMENT OF CONTRIBUTIONS· CANDIDATE

1. NAME OF CANDIDATE OR COMMITIEE ~ MuvrCu...-1 I 2. REPORT COVERING THE PERIOD
I FROM: TO:LJ~ 2-CJ'7
3. TOTAL ITEMIZED CAMPAIGN CONTRIBUTIONS FROM PRECEDING PAGE (entJ $0 if first itemized page) Amounf
4. COMPLETE THE APPROPRIATE ITEMS FOR EACH ITEMIZED CONTRIBUTION (contributions totaling more than $100 from any contributor)
First Name 11m- 2!l. O/IU--- "7; S I Middle Name Contribution Received For: Amount of Contribution
Last Name/Organization Name I o Primary Election o General Election LSD
Address o Runoff (Local Elections Only)
City J State I Zip Code Date of Contribution Aggregate This Election
Occupation
Employer
First Name K (5 MIHJqJ- I Middle Name Contribution Received For: Amount of Contribution
Last Name/Organization Name o Primary Election o General Election -z- "S V
Address o Runoff (Local Elections Only)
City I State I Zip Code Date of Contribution Aggregate This Election
Occupation
.'
Employer
FiistName )V~IAJ~ iiddleName Contribution Received For: Amount of Contribution
o Primary Election o General Election 500
Last Name/Organization Name I
Address o Runoff (Local Elections Only)
City I State I Zip Code Date of Contribution Aggregate This Election
Occupation
Employer
First Name ;ZAG 73..(' UA 41 Middle Name Contribution Received For. Amount of Contribution

Last Name/Organization Name 1 o Primary Election o General Election
So 8
Address o Runoff (Local Elections Only)
City J State I Zip Code Date of Contribution Aggregate This Election
Occupation
Employer
5. TOTAL ITEMIZED CONTRIBUTIONS
(Carry forward to item 3. of next page if additional pages of Ihis form are used.)
(If this is the last page of contributions, this amount must be shown in item 15b. of summary.) SS-1131(Rev.2/06)

Page __ of __

RDA 1159

ITEMIZED STATEMENT o.F EXPENDITURES· CANDIDATE

1. NAME OF CANDIDATE OR COMMITTEE F!Vt,VYI'~ L 2. REPORT COVERING THE PERIOD
J FROM: TO: +'l-~
3. TOTAL ITEMIZED CAMPAIGN EXPENDITURES FROM PRECEDING PAG~nter $0 if firs! itemized page) Amourit I
4. COMPLETE THE APPROPRIATE ITEMS FOR EACH ITEMIZED EXPENDITURE (expenditures lolaling more than $100 10 any payee during the period)
First Name ?) mLejJ~+- Middle Name Purpose of Expenditure Amount of Expenditure
Lasl Name/Business Name I Pr/~H1 '300
Address {O/I (
City Stale Zip Code
FirslName ~4 fVZ'9-r_4b Middle Name Purpose of Expenditure Amount of Expenditure
;5,rn; 7
Lasl Name/Business Name V fO/Z-'3 t 50
Address
City State Zip Code
First Nam~. -rf?t NJh/~ Middle Name Purpose of Expenditure Amount of Expenditure
1'lN-/
Last Name/Business Name v /O/t -:> '6'00
Address
Cily Slate Zip Code
"
Firsl Name 5/VV;~ ~lc-l-r Middle Name Purpose of Expenditure Amount of Expenditure
Last Name/Business Name I toj Z "3 5DO
Address
Cily Siale Zip Code
FirslName 5~ MI:+--;_ Middle Name Purpose of Expenditure Amount of Expenditure
Last Name/Business Name '\ JOj-z-=;, Lj06
Address
City Stale Zip Code
Firsl Name T5U Middle Name Purpose of Expenditure Amount of Expenditure
Last Name/Business Name / Ole; /25
Address Pv1-v~
City Stale Zip Code
5. TOTAL ITEMIZED EXPENDITURES
(Carry forward to item 3. of next page if additional pages of this form are used.)
(If this is the last page of expenditures, this amount must be shown in item 19b. of summary.) SS-1129 (Rev. 4/02)

Page __ of __

RDA 1159

ITEMIZED STATEMENT OF OBLIGATIONS -CANDIDATE

1. NAME OF CANDIDATE OR COMMITTEE prilL V-1r v"Gw-f 2. REPORT COVERING THE PERIOD
FROM: 1m : 1- Z-CP{
3. COMPLETE THE APPROPRIATE ITEMS FOR EACH ITEMIZED ~~~tanding 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)
Flrll7,;.led r;Ffr~ I Middle Name If' eH-I
5eQ ?-
Last NamelBusiness Name
Address
City I State I Zip Code
Description of Obligation
First Name I Middle Name
Last Name/Business Name
Address
City I Stale I Zip Code
Descriplion of Obligation
First Name I Middle Name
.-
Last NamelBusiness Name .-
..
Address
Cily I State I ZipCode
Descripfion of Obligation
First Name I Middle Name
Last Name/Business Name
Address
Cily I State I Zip Code
Description of Obligation
First Name I Middle Name
Last Name/Business Name
Address
Cily I State j Zip Code
Description of Obligation
4. TOTALS tr50D ~
(Total from Outstanding Balance - (End of Period) column must also be shown
in item 23b. on summary page.) - SS-1127 (Rev. 4/02)

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RDA 1159

ITEMIZED STATEMENT OF IN-KIND CONTRIBUTIONS .. CANDIDATE

1. NAME OF CANDIDATE OR COMMITTEE P MU'--y'l~ I 2. REPORT COVERING THE PERIOD
I FROM: TO:
3. TOTAL ITEMIZED IN-KIND CONTRIBUTIONS FROM PRECEDING PAGE (en fer $0 if first itemized page) Amount
4. COMPLETE THE APPROPRIATE ITEMS FOR EACH ITEMIZED IN-KIND CONTRIBUTION (in-kind contributions totaling more than $100 trom any contributor during the period)
First Name f'v'/k I Middle Name In-Kind Contribution Received For: Value of In-Kind Contribution
D Primary Election D General Election
Last Name/Organization Name D Runoff (Local Elections Only)
Address Date of In-Kind Contribution Aggregate this Bection
City I Slate I ZipCode Description of In-Kind Contribution
Occupation Employer
First Name I Middle Name In-Kind Contribution Received For: Value of In-Kind Contribution
D Primary Election D General Election
Last Name/Organization Name D Runoff (Local Elections Only)
Address Date of I n-Kind Contribution Aggregate this Election
City I Slate I ZipCode Description of In-Kind Contribution
Occupation Employer
First Name I Middle Name In-Kind Contribution Received For: Value of In-Kind Contribution
D Primary Election - D General Election
Last Name/Organization Name D Runoff (Local Elections Only)
, --
Address Date of In-Kind Contribution Aggregate this Election
City I Slate I Zip Code Description of In-Kind Contribution
Occupation Employer
First Name I Middle Name In-Kind Contribution Received For: Value of In-Kind Contribution
D Primary Election D General Election
Last Name/Organization Name D Runoff (Local Elections Only)
Address Date of In-Kind Contribution Aggregate this Election
City ISIate -' Zip Code Description of In-Kind Contribution ...
Occupation Employer
First Name I Middle Name In-Kind Contribution Received For: Value of In-Kind Contribution
D Primary Election D General Election
Last Name/Organization Name
D Runoff (Local Elections Only)
Address Date of In-Kind Contribution Aggregate this Election
City I State I ZipCode Description of In-Kind Contribution
uccepanon tmployer
5. TOTAL ITEMIZED IN-KIND CONTRIBUTIONS
(Carry forward to item 3. of next page if additional pages of this fonm are used.)
(If this is the last page of in-kind contributions, this amount must be shown in item 22b. of summary)
·-~i.J..:i, %;;~¢y 88-1128 (Rev. 2/06)

Page of _

RDA 1159

ITEMIZ-ED STATEMENT OF LOANS· CANDIDATE

1. NAME OF CANDIDATE OR COMMITTEE PMu-v-rt 2. REPORT COVERING THE PERIOD
FROM: TO:
It,-,2'" OC;
3. COMPLETE THE APPROPRIATE ITEMS FOR EACH ITEMIZED LOAN (loans t&aling more than $100 from any source during the period)
Complete the Following for the Source of the Loan
First Name {'J. / MdleName Outstanding Loan Balance Loans Loan Outstanding Loan Balance
(Beginning of Period) Received Payments (End of Period)
Last Name/Organization Na,/
Address Loan Received For: Date of loan
0 Primary Election o General Electon
City I Stale I ZipCode
0 Runoff (Local Elections Only)
ListAIl Endorsers or Guarantors for Above Loan (If more space is needed please attach a page)
First Name I Middle Name First Name Middle Name
Lasl Name/Organization Name Last Name/Organization Name
Address Address
City '- State IZiP Code City State I Zip Code
Amount Guaranteed Outstanding Amount Guaranteed Outstanding
First Name I Middle Name First Name ! Middte Name
I
Last Name/Organization Name Last Name/Orqenization Name
Address Address
City I State IZiP Code City State I Zip Code
Amount Guaranteed Outstanding ~mount Guaranteed Outstanding
First Name I Middle Name First Name Middle Name
Last Name/Organization Name Last Name/Organization Name
Address Address
I
City I State I Zip Code City State I Zip Code
Amount Guaranteed Outstanding Amount Guaranteed Outstanding
First Name I Middle Name First Name Middle Name
last Name/Organization Name Lasl Name/Organization Name
Address Address
City I State I Zip Code City State I Zip Code
Amount Guaranteed Outstanding /Amount Guaranteed Outstanding
4. Totals for all Loans (complete on last page 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.) 88-1132 (Rev. 4102)

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RDA 1159