?$* * *,*.+,,-. -7 - - - - :' -. + Date of this statemen1

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e l e c t e d city or County OBicer 7 Candidate for Cit.i;

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Each public officer holding office in Georgia, add each person who qualifies as a c&diGie for election as 2

lic officer for one of the offices listed below, and all others on the following lis' .' '" '" "' Every constitutional officer; ;&:-&i , :ir Every elected state official; The executive head of every state uepamnenr or agency, wnetner elected or app Each member of the General Assembly;, ' - ' b 4 - - 5- t The executive director of each state authdrity, board or commission and the members there; Every elected county official, every elected county or area school superintendent, and every elected member of a county

., -,. -- - " AT&- + 1 area board of education; and - ' -- 2'2% ; 1 -Q - -;;: (G) Every elected municipal officer. ' 1. . 7 -

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w a E ~ TO FILE AFINANCIAL DIF;CLQSURE s <>%PA Public Officer: A Financial Disclosure Statement is filed .. wUw.L ye& thai y,u,,t

lfficer holds office (except the year of election). The info e that from the pieceding calendar year. , / . , . 1 . - - . : &+q. .: b , - > 4 ,- ..b<~,,* 4 ,

* .-, <-. f the public officer chooses not to run for re-election or for another public office no ~ i n g c i a l ~isclds&e Statement need be 111ca m

the year qualifying to succeed him takes plac to hold the office in a year in which the uublic jficer holds office for less than 15 days. A

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Candidate for Public Ofice: A Financial Disclosure Statement covering the period of preceding calendar year' shall be filec ..-. later than the fifteenth day following the date of qualifying as a candidate. Candidates for state wide office file not later than seven :* days after qualifying for office. Only one Financial Disclosure Statement is required per calendar year,

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Special requirements for State Wide Candidates: Candidates for a public office elected state wide must fde their Financid - Disclosure Statements not later than seven days after qualifying or filing a notice of candidacy. State wide candidates must disclose more information than other candidates for public office and the additional disclosure sections required of state wid$- '

candidates must be completed in the year of election filing, ., . , - - ;@$&ii : :L+ :-" :-3 3 , > " V '-3 *> - L L-- *-<*-

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iL?" ."' ' . . WHERE TO FILE A FINANCIAL DISCLOSURE STATEMENT: Every public officer who is an elected county official and every candidate for Financial Disclosure Statement with the election sbPerinte1ndent of the county

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Every public officer who is an elected municipal officer and every candidate for electiorl a a municipal public O~IILGK,WIII L I I ~ a Financial Disclosure Statement with the municipal clerk or, if there is no clerk, with the chief executive officer of the munici~alit of election.

I re ewea: & monetary fa or honorarium. Monetary fee(s) or honoraria as shown belov

Identify Fee or Honorarium And Amount Accepted

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jointly or as tenants in common between the person and spouse.

Identify h e name, address and principal activity of any business entity and the office held by and the duties of the candidate for pub: office or uublic officer within a business entity as. of December 3 1 of the covered year in which a direct ownershiv interest: (A) Is

: value or thls tract i Between $10,000 .l

The Value of this kact ir Z n Between $10,000 and $100,000

I More than wnn

SECTION V SPOUSE'S DIRECT OWNERSHIP INTERESTS IN REAL PROPERTY

Identify each tract of real property in which the filer's spouse has a direct ownership interest as of December 31 of the covered year when that interest has a fair market value in excess of $10,000.00. (You may attach additional sl~eets of paper if necessary.) Check one box to show the applicable valuation range for each tract. (You may attach additional sheets ofpaper if necessary.)

>Iy spouse had: ~. K - , \ \ ~ i ~ : ~ h i p i111<r:,:s $ \ i ~ l i .I t.iir~ii>rLc~ \A:.:: I:] cx .cs ,~ t'5:C. r ;

J I I ~ I : I i l l r I 1 I r I . Y i S I ' , '

IDENTIFY: 1. County where property is located. 2 . State where property is located. 3. General description of property ( ~ i v e street address or location, size of tract, and nature or use of property)

Property $1 The Value of this tract is M t faL 3 Between $10.000 and $100,000

c Between $100,000.01 and $200,000 7=.1b .A-&A+ W 4 a . c - C M o r e than $200,000 1 1 - n m ~ o 'n A .. 4

Propertj F2 The Value of this tract 1s 2 Between S1O.OOO and $100.000 6 Behveen $100,000.01 and $200,000 c More than $200.000

Property *3 The Value of this tract is 3 Behveen $10,000 and $100.000 o Behveen $100,000.01 and $200.000 J More than $200.000

Property $4 The Value ofthis tract is n Behveen $10,000 and $100,000 c Behveen $100.000.01 and $200,000 7 More than $200.000

Property $5 The Value of this tract is o Behveen $10.000 and $100,000 G Bemeen $100,000.01 and $200,000 o More than $200.000

SECTION VI ERZPLOYMENT AND FAMILY ME,MBEKS

Filer's Occupation Q , 0.- . \A& C r . . T Ch P ' b s r a w , . - - ., Filer.8 Employer 'C-OUI rr- ,n. & C.C- ---\

Employer's Address \uo cod -+. Cr-uq c- P-<TcJ> Employer's Principal Activity C L k -4

Filer's Spouse's Name f,o-W -6 tU Spouse's Occupation ?& O.G & ,U, Spouse's Employer C-QU~ Q& ap- a=+-6' Address of Spouse's Employer Principal Activity of Spouse's Employer 5 -

\Tames of Filer's Dependent Children &J&e er\ , CCo;u . (, o SECTION VII

INVESTMENT INTERESTS

List the name of any business or subsidiary thereof or investment (do not list individual stocks and bonds that are held by mutual funds), in which the filer (either individually or with any other legal or natural person or entity) owns a direct ownership interest that:

1. Is more than 5 percent of the total interests in such business or investment. or 2. Has a net fair market value of more than $10.000.00.

Business or lnvestment Entlr). '11 Name Cocr , P A C .

Business or Investment Entity *2 &me

Business or Investment Entity #3 Name

Business or Investment Entity $4 h a m e

SECTION VIII KNOWN BUSINESS OR INVESTMENT INTERESTS OF SPOUSE AKD DEPEXDENT CHILDREN

Identify any business or investment known to the filer in which the Filer's spouse or dependent children have a direct ownership interest (either individually or with any other legal or natural person or entity) if any one of the following is true (do not list individual stocks and bonds that are held by mutual funds):

1, the subject interest is more than 5 percent of the total interest in the business or investment, 2. the subject interest has a n a fair market value exceeding 510,000.00. or 3. the subject interest is one in an entity for which the Filer's spouse or a dependent child serves as an ofiicer, director, equitable

partner. or trustee.

Business or lnvestment Entity # I Name C r , r UO-

Business or lnvestment Entity i 2 Name

Business or Investment Entity *3

Business or In\ estment Entity d4

SECTION IX .4NhT1AL PAYMENTS RECEIVED BY THE PUBLIC OFFICER OR BUSINESS ENTITY

FROM THE STATE OF GEORGIA

(This section to be completed by Public Officers only) Identify all annual payments in excess of $20,000.00 received by the public officer- or by any business entity in which the public officer has an oxvnership interest of more than 10 percent of the business or has an ownership interest having a net fair market value of more than $?0;000.00 - from the State, any agency, department, commission or authority created by the State and authorized and exempted from disclosure under O.C.G.A. 5 45-10-25. (You may attach additional sheets of paper if necessary.)

I received: o h o annual payments in excess of $20,000.00 from any State entity. r d n n u a l payments in excess of $20,000.00 from the below named State entiry(ies).

IDESTIFY: I. Kame and address of State entity making the payments. 2. .4mount of annual payment. 3. The general nature of the consideration rendered for the payment(s)

State entlt?. source $1 Ccd.dmhua C r n a a a L . n - + Pr-, &>. 6 3L50Z

h uk. t L4.02 A n n ~ 4 - >-

State entity source li2

VERIFlC-\TION BY OATH O R AFFIR&lATIOT State of Georgia

COL'nty Of-

I i, the undersigned. being duly sworn (affirm), depose and say that the information in this statement is complete, true, and correct. ) Sworn to and subscribed before F e on

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h7.% ('d4.L *Sotari Public

/ l i ly Commission expires 7-10 c'

C 3+%1-. .. - -, of Candidate or ~u l ) i : c Officer

PENALTIES: Any person who lnowingly fails to cornpll with or uha knaningly r.iolatcs any ofthe provisions ofrhe Ethics in Gaiemment Act shall be guilty o fa misdemeanor.