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CANDIDATE' OFFICEHOLDERCAiIPAIGN FINANCE REPORT

FORil CrOl{COVER SHEET PG 2

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17 CONTRIBUTIONTOTALS

EXPENDITURETOTALS

CONTRIBUNONBAI.ANCE

()TJTSTAhIDINGLOAN TOTALS

1. TOTAL POLTTTCAL CONTRTBUTTONS OF f50 OR LESS (OTHER THANPLEDGES. LOANS. OR GUARANTEES OF LOANS). UNLESS ITEIIIZED $ D

2. TOTALPTOL|TICALCOIITRIBUTK)IIS(OTHER THAN PI-€DGES, LOAI{S, OR GUARATITEES OF LOAttls) $ o

3. TOTAL POUTICAL EXPENDITURES OF '1OO

OR LESS,UNLESS ITET'IZED $ D

1. TOTALPOUTICALEXPEI{DITURES $ o5. TOTAL POLITICAL CONTRIBUTIONS IIAINTAINED AS OF THE LAST DAY

OF REPORTING PERIOD $ o6. TOTALPRINCIPALAilOUNTOFALLOUTSTANDIHG LOANSASOFTHE

LAST DAY OF THE REFORTII{G PERIOD $ b

tA AFFIDAVIT

I srcar, or affirm, urder pemtty of periury thd lhe ac@rrperryirE repdt bbue ard correct and irdudes dl hionndim required to be repubd by me

urderTile 15, Election Code.

Siignature of Candidde or OficehoHer

AFFIX NOTARY STAilP 'SEALABOVE

Strorn to and subscribed before me" by lhe said thisthe $

day of , 2OlC-, to oertify \fr'hich, witress my hand and sed of ofroe-

Andtod /agDtnat, ,Hr"a a,. berno* 7)ulatttn; ranredoficor*

Forms provifed byT** Ethics Comrnbsion nrrw.€dfli:8.#.t(.rrs RflA€d02mm15