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FEC FORM 2

RECEIVED
FEC HAIL CE^fTFR

STATEMENT OF CANDIDACY
1, (a) Name of Candidate (In full)

2-815 OECIi^ AH 10: 38

(b) Address (number and street)

llZll,

•Check If address changed

2. FEC Candidate Identification Number

M/Og-

iAn- r^boio 1^^

(c) city. State, and ZIP Code

3. Is This
^New
Statement M (N)

5. Office Sought

4. Party Affiliation

Amended
(A)

OR

6. State & District of Candidate

/y/

,

PYi TfU Cr

DESIGNATION OF PRINCIPAL CAMPAIGN COMMITTEE
7. I hereby designate the following named political committee as my Principal Campaign Committee for the .
electlon(s).
(year of election)
NOTE: This designation should be filed with the appropriate office listed In the Instructions.
(a) Name of Committee (in full)

r^tr/y(b) Address (number and street)

Khz meide /vv/ot
(c) city. State, and ZIP Code

.0
3
DESIGNATION OF OTHER AUTHORIZED COMMITTEES
(Including Joint Fundralsing Representatives)

0

16
8

8. I hereby authorize the following named committee, which Is NOT my principal campaign committee, to receive and expend funds on behalf of my
candidacy.
NOTE: This designation should be filed with the principal campaign committee.
(a) Name of Committee (In full)

(b) Address (number and street)

(c) City, State, and ZIP Code

I certify that I have examined this Statement and to the best of my knowledge and be/ief It is true, correct and complete.
signature of Candidate

Date

Ib-l Id 1
NOTE: Submission of false, erroneous, or Incomplete Information may subject the person signing this Statement to penalties of 52 U.S.C. §30109.

«)0068

FEC FORM 2 (REV. 02/2009)

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Federal Election Commission ENVELOPE REPLACEMENT PAGE FOR INCOMING DOCUMENTS The FEC added this page to the end of this filing to indicate how it was received. Date of Receipt Hand Delivered Postmarked Date of Receipt USPS First Class Mail Postmarked (R/C) USPS Registered/Certified Postmarked USPS Priority Mail Postmarked USPS Priority Mail Express Postmark Illegible No Postmark (\\ /" ShippinoDbte ^Overnight Delivery Service (Specify). Next Business Day Delivery ^ Date of Receipt Received from House Records & Registration Office Date of Receipt Received from Senate Public Records Office Date of Receipt Received from Electronic Filing Office Date of Receipt or Postmarked Other (Specify): PREPARER (3/2015) DATE PREPARED .