You are on page 1of 30

SEEC FORM 20 .,.

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'

Itemized Campaign Finance Disclosure Statement -'


CONNECTICLTT STATE ELECTIONS ENTORCEMENT COMMISSION ,=- , ..",..
Rev. l/08
Pase 1 of 17

SUMMARY PAGE
l.NAME OFCOMMITTEE

A Nuro.E<-.1 nnil-)e: E{e,.r


2 TREAsTT*np NAM*. U U
&. /'Yla'.: ar 20c:*,
litle MI Lst Sultrx

ft1rs "
L,,.c{ *- t* [rt-^
3. TRLAST]RN,R ADDRf,,SS
Street Ad&ex Ciql State Zip Code

/o'y'(o'rrsr J)zrb.-t li-


6. DISTRICTNUMBER
C*^rl r N
4. trLECTION/R*FER*IDT'M DATE S. OFFICE SOU cFlT (Connlete ontv tf Catlatfue Commtuee)
(mn/dd/rrrry)

i tIoz f tooq Itta eor


'1.cAitnmAfnr NLlfE (Connilete onlv if Candidore or E$loratom Committee)
title lFirst turr.f
l) r. l-D"n I r-I Y l-- 5r.
q TVPD flI'D['DnD'r /rrhrl: (lno Rnw\

I January l0 filme tr 7th day preceding primary tr 7th day preceding referendum tr Initial Contribution or Disbursement
(PAC| ONLY)

tr April l0 hling U 30 days following primary [ 45 days followingreferendum


I Amendment to

tr July l0 iiling tl 7th day preceding election tr Deficit Type ofReport:

Foctober
l0 tiling il l2th day preceding election E Termination
(Stste Centd Cmminees On$)
E lndependent Expenditure
trPrimary ElElection 845 days following election
not held in November

9. PnRIf)n.f|VF.RT'.I)
Beginning Date Ending Date

thru
lr>
{ov{aoaq
10. (]ERTIFICATION

I hereby certi! and state, under penalties of false statement, that all of the information set forth on this Itemized Campaign Finance
Disclosure Statement for the period covered is true, accurate and complete.

/)
*fV+A,_
/ Vc"-^ t^,
TREASURER OR DEPUTY TREAS{'RER (SIGNATURE)
I

LtNOn
PRINT NAME OF SIGNER
L.l-z-rSc-o ta(usb"ct
DATE (mm/ddflyy)

PENALTY FOR FALSE STATEMENT IS PUNISHABLE BY FINE NOT TO EXCEED


$1.OOO. OR IMPRISONMENT FOR NOT MORE THAN ONE YEAR, OR BOTH.

iflfi! 0[T 5 irn 9:51


SEEC FORM 20
Itemized Campaign Finance Disclosure Statement
CONNECTTCUT STATE ELECTIONS ENT'ORCEMENT COMMISSION
Rev. 1/08 Page2 oflT
SUMMARY PAGE
TOTALS
NAME OF COMMITTEE FN,ING DI}F. DATF,

A h)rr, , fu.;'n i nc -- 6 lt ,, Jk lXlrrurrf .)dts;Q to l9/oq


(J ) UULUIVIN A UULLJMN H
This Period Assresate
t1. Balance on hand January 1 of current year for Ongoing and Party Committees OR
Balance on hand fiom day Committee was formed for all other committees *a.u*
12. Balance on hand at the besinnhe of Reoortins Period
{ o .cro
13. Contributions received from Individuals (Sections A and B)
s 7, f,J3.oo s 7, J.]3.on
14. Receiots from Other Committees (Sections Cl and C2)
t 5Z).o* qiZoo
15. Other Monetary Receipts (Sections D-K) t/5*o."o * l SZ.l "<:,-,

l6a. Total Small Food and Beverage Receipts at Fair (Section LI) Town Committees ONLY

16b. Total Proceeds from Small Purchases at Tag Sales, Auctions or Other Sales (Section L2) I =s-s- .Oo t' 3ff 'ch
Municipal and Town
l6c. Total Prrrchases of Advertisins in a Propram Book lSection L3\ Committees ONLY

17. Total Monetarv Receiots (add totals for lines l3-l6c)


s J,?)E-.c-ro S l, 1)X.ao
18. Subtotals (add totals in line 12 + line 17 in Column A; and in line l1 + 17 in Column B)
sl.*l?&.ro fi-], J) K.co
19. Expenses Paid by Committee (Section P) { {, qrz.o? H v, gYa.o3
20. Balance on haad at close ofReporting Period (Subtractline 19 from line l8 in bothColumns)
$D,r?f.?r * ar.7gi gl
21. In-Kind Donations not Considered Contributions Received (Section L+)

22. In-Kind Contributions Received (Section M) *9l ..ro tr *ql.6e


23. Refundable Deposit to Telephone Company (Section N)

24. Receipts ofOrganization Expenditures (Section O)

25. Beginning Loan Balance

?-52 * T.."r" Received /seciion T)\

25b. * Interest and Penalties on Loan


_**

25c. - Pavments on Loan

+
25d. Total Outstandine Loan Amount

26. Campaign Expenses Paid by Candidate (Section Q) ffo.o., h c), cc;


27. Expenses Incrmed on Committee Credit Card (Section R) fr I r()c: .rq $' { r sto.:?

28. Expenses lncurred by Committee Dunng this Period bul Not Paid (Section S) H o -c,--
28a. Total Outstanding Expenses lncuned by Committee still Unpaid (Section S) {o"or-,
MONETARY RRCEIPTS (Sections .A-K) Page 3 of 17

VAME NF (-rrMMITTFF F'II-INGDIlF DATF,


A [,-]e-,":']4rrc]nn]r\(; * Qtie.s €a,r ]"ylaucrr J(}O,9 tnlg lnl
A. Total CoftlributiodSfrom Small Contributots-Received this Period ONLY
lSee instnntions for definition of Small Contribnor) Subtotal Section I s 4L7. c:c
B. Itemized Contributions from Individuals
Lmt Nme MI Princioal Occumtion Amount of
Xtt oJuk." € a{^c.Q"- Vi\lLJl{ \-,, *: J-.. - Contribution
(esldstial Sft€fl Address tlale lrp Loag tffi'ru:"lit ^,,
Lln l\h^"',,ir
tstontriLrutor a lobbyist,
t€
spouse,
A
E Yes
i. -bl fr47 /'tL.d tb
excess of$400 to a candidate comlnittee ior a chielexecutive officer ofa
IfcontributiQf is in
,,: l*l-,a , xe", ilcp , *r'l $Afa.CI.

rrdependentchildofalobbyist? F No municipality does contributor or business he/she is associated with have a contract with said
municipality valued at more than $5,000? E Yes B No
Isthiscontribulionassociatedwitha I Yes Is contributor a principal ofa state contractor or prospectivg state contractofl E Yes
fundraising event listed in Section Ll? F No I/yes, indicate rvhich branch or brancbes ENo
f-1,es, list Event # of govemment the contract is with: E Executive E Legislative
Date igceived Aggregale conmDunons
Method of contribution
SV.ai co
:

I Cash p Persona] Check fl Credit/Debit Card D Payroll Deduction E Money Order ia lat(a1
LalLNme First MT fuipcipal Occupation Amount ot
lL, ^,<r" J^ I n}.o 9'rn'.nl lhanc stl-
\ume or Dmproyq
Contribution
Sh€l Address
tesidential A itate aip Code
btoc,...c
t tlr:a #rl rue 1rl +"e n ,,,e- '4r" o il-+. n C; (z,{v+ S od-p'y' o'fr.)a(l Ih r'rJ',CrS
ls contributor a lobbyist, spouse, E Yes If contribution is in excess of $400 to a candidate committee for a chief executive officer of a
municipality does conftibulor or business he/she is associated with have a contract with said
or dependent child ofa lobbyist?
FNo municipality valued at more than $5,000? Yes Etr N" fl
Is this contribulion associated with a ! Yes Is contributor a principal of a state contractor or prospective state contractor? E Yes
fundraising event listed in Section Ll? E T,Io fyes, indicate which branch or branches fl No
fyes, list Event # ofgovernmentthecontractiswith: flExecutive flLegislative
Date Re€ived Aggregaie eontnbutrotrs
Method of contribution:
tr
Castr $.personal Check I CreditDebit Card I Payroll Deduction fl Money Order 4 igalae Sloe. ao
LmtNme MI Prhcipal Occupation Amount of
N) or{'l".
ELst
l*tnr' td_ 6 n{.-LifE ",c u- cr.a'n Dcr,'-lo r- Contribution
<esrdmlral Shffil Address r , rlate llp LOOe Nane ot EmDlorg
Tt,L *(ir,'.',n trg?"or
l{-f,-,n** rr'l "ft- tlcl ll br b: 'bo rT dGY'q s.,'tF (
Is contributor a lobbyist, spouse, E Yes excess of $400 to a candidate committee for a. chief executive.offtcer
If contnbutiot is in
"t."&{i{)
ordependentchildofalobbyist? "p. No municipality does contributor or business he/she is associated wrth have a contract with said
municipality valued at more than $5,000? D Yes E[ No
Is this contribution associated with a I Yes Is contributor a principal of a state contractor or prospective state contractor? D Yes
fundraising event listed in Section Ll? 7l-tro .It,es, indicate which branch or branches FNo
Ifyes,list Event #_ ofgovernmentthecontractiswith: EExecutive lLegislative
Date Received Aggregate cortnbutlons
Method of contribution:
D Cash $.nersonal Check D CrediilOeblt Card fl Payroll Deduction I Money Order taltlaT hlS0. "o
' L^/ ar^
Lglj4ple
'"lLgr-* MI Priqqipal Occupation
(rr', ttl) rrr., f ,'t'n4v;,r-lar
Amount of
Contribution
{esidential Stret Address
rf.
1ip Code me ol bmDlovtrv
S'IF/R lh'e| w I.," n
sai?. n.:
1t, A+n:n.lt..- 4,,.* fl.--u.-, 'IilE
aY-rJ 6
* fln'.;-tf
ls contributor a lobbyist. spouse, [-l Yes Ilcontributio$ is in excess of $400 to a candidate committee for a chiEf execuiive ofhcer of_a f4i n+in5
ordependenrchildofalobbyist? F uo municipality iloes contributor or business he/she is associated with have a contract with said u,e.,h)l ,8)
municipality valued at more than $5,000? E Yes fl No
Is this contrrbution associated with a fl Yes Is contributor a principal ofa state contractor or prospective slate contmctor? n Yes
fundraisingeventlistedinSectionLl? p' No f/e,r, indicate which branch or branches F No
Ifyes. list Event #_ ofgovernmentthe contract iswith; I Executive D Legislative
Aggregate c@tnbutrons
Method of contribution:
I Cash fl rersonal Check E Credit'/Debit Card fl Payroll Deduction n Money Order I tzc{ af t t5r:,c;c &f
, i t'o.o
SUBTOTAL Section B-This Pagt l$"1' rSt
t's,
TOTAL of additional Section B Pages L,a.u

TOTAL OF AI.I. CONTRIBUTIONS FROM INDMDIIALS (Sections A &B) (Enter totol on !!!! lj of tlot *ry l!84 l'7 .zzs.<
t- IPTS
{AME OF COMMITTEE
{ lrker:BqCnqni -frsle.i
.d l-otal Contffbution$lfrom Small eb
€s; ffi /& lq/&
, tSee instnrtiomfor defnition of Small Collributor) Subtotal Section I $ LFL3. c,C
tribu iduals
LrorNme MI Drinci1ynl
Ourupation Amount ol
Hnrn[ tt\ln tt n't
(eltdsrllal \tr&t Addrss
R:,J^onQ llJl4'v 7ta4s u C'ontributio
lp
34 ( i"ri*ft t ld
:tate Code \ilne L\l tlnDlovg - I
S+ I)r rt'tu fJ-
(-r. cGrrt I Sz:1fi.'fh i.., + Ko,-c[, ahu n Stco.,'G.1
lsconflbutoralobbylst,spouse, fl Yes If contributif,n is in
excess of $400 to a candidate committee ior a chief executiu- oti""i oii-ffilJ '-'
chrkl ola lobbyist? said '' "-l -
.t'j
cr dependent
ts *u municipal ity does contributor or business he/she is associaterj with have a conlmct with
municipality valued at more than $5,000? fl Yes I No
Is this contritrution associated with a I Yes Is contributor a pnncipal ofa state conbaotor or prospective state contractoll E ytx
tundraisirrg cvent listed in Section Ll?
ftes. lisl Event #
EN" fyes, indicate rvhioh branch or brznches & wo
of govemment the contract is lvilh: El Executive l:grslarrve F
Method of contribution : Date Recei\ ed
D Casn
Nue
p Personal Check E CreaiyOebit Card I
n"tarce^ue-
payroll Deduuion f1 Money Order
'lhi I aq a-#;T",'
*;1st MI ftirci;nl
14ic rl, Qccupation
J'ILIr-14\F u
Amount of
(lontributior
a }tl€l Adffess
+a t) )late 1p Code Ndne ofE )]iqr
Saca..,
&
I
kri"rr" Lrtll,c-A 8qSts d)tr,-b.{ ^/>--- tY-u (8 / ilt rcr.; , Kr,*r'1u (!run
Is contributor a l6byist, spouse, D yes
or dependent child ofa lobbyisr?
If coniributicbis in excess of $400 to a candidate comminee for.a chief execulrve olircer cf f,
AuqS 6il ,*)
F *o munioipaliry does contributor or business he/she is associated with have a contract with said
municipality valued at more than $5,000? EYes DNo
Is this conribution associated with af] Yes is contributor a principal oia slate oontractor or prospeciive state c.ontrautor'l I yes
in SectionLl?
F *o
fundraisingeventlisted
fl,es, indicate \afiich branch or branches FLNo
fyes, iisl Evenl # of govemment the contract is with: I Executive Legrslariven
Method of contribution: Dale RGived Ag8regale coninbulrdrs
fl Cash
Nine
p fersonal Check fl CrejiyDebit Card
Fi.!i
E payroll Deduction E Money Order
MI
?l,rlaq $Joc.a..
Prurcioal C)ccumtion
Lecn-i
(€somnd Strtrt Address
l[<>
"l) lo,ci A,ritsu, ,.;, G,
Amount of
Contribufior
itate hp Code lt tmDlo\ s
r4f; {rn€-Tf; L)r. hnr.h, ft: eGqlJr it*/a $loc.n
ls contributor a lobbyist, spaus€, E Yes Ifcontributiol is in excess of$400 to a candidate committee ior a chiefexeculive ofrcer ofa
or dependent child ofa lobbl..ist? 7F tco municipality does contributor or business he/she is associated with have a contraci rvith said
municipality valued at more than $5,000? DYes [] No
Is this contribution associated with a I yes Is contributor a principal ofa state contractor or prosp€ctive state qlntractor? f| yes
l'undraising event listed in Section Ll? El. No fyes, indicate whioh branch or branches E No
Itcs, list Event # of govemment the contract is with: fl Executive Legislativefl
Method of contribution: Date Rsceived Aggregate cootritrutions

9 I r i-la?
D Cash lF-Personal Check El Credir/DeUit Canl il payroil Deducrion
,sL{!me First
D Money Onler h loo,ao
Ftiocioal Ckcumtior
| ,*-np a
\Esroqtrrut5uel AoorsS
J-. r'r, t l-c?- ]t', #ei;{;; r^
^F
U;.k n*
Amount of
C'ontributior

\ b tfartrrrd Ar:e
scontributoralobbyist,spouse. D yes
\-h- itate
r:--
i'
lip Code
a.-q tK
Nane ol Employq
( i J^, F
',
Ifcontributiofr is in excess of$400 to a candidate commiftee 1bf a chiefexeculive officefofa
I). "-1, * S E?r. a.,

rrdependentchildofatobbyist? Fl No mulicipality does contributor or business he/she is associated witi have a contract wilh said
municipaiity valued at more than $5"000? DYes D No
Is this contribution assooiated with a fl yes is contributor a principal ofa state contractor or prospective state contractor? fl yes
fundraising event listed in Section L l? F_ No Ites^ rndlcate whicb branch or branches !; No
fyes. hst Event # ofgovernment the contract is with: fl Executive D Leeislative
Methtd ofcontnbution: Aggregate 6ntnbutions
I
D Cash Fpersonal Check CreditrOebit Card fl payroll Deduction D Money Order
E ltolaE $ fc" cr,
SUBTOTAL Section B-This Pagr SSf ( 0r)

TOTAL of additional Section B Pages


6,
' u,2t 6 "06
TOTAL OF ALL CONTRIBUTIONS FROM INDMDUALS {settions A & B} {Enter totd on Line 13 of Sumnwry Pase) L23 .dc
EIPTS Page J of I

Amount of
Contribulio
*'iac.6o
spouse, I
ls contributor a lobbyist. Yes If contributidnis in excess of $400 to a canilidate commifiee a;il et*rtt""
ordependentchildofalobbyist? F ruo municipality does contributor or business helshe is associated with"hief
have "fi,"*.1"
a conlracl with said
municipality valued at more than $5,000? IYes DNo
Is this conribution associated with a I Yes Is conkibutor a principal of a state contractor or proslJective stale contraclofl E yes
lundraising event iisted in Secrion L1 ?
bNo fyes, indicate which branch or branches Ekl-to
fyes. list Event # ofgoverrunentthecontractiswith: t]Executive ELrgrslarrve
Method ol conlribution : Aggregate contnbutions
D Cash [fopersonal Check E CrediVnebir Card I payroll Deilucrion D Money Order

.4.munt of
Contributio;
ks-a ,
spouse, fl
Is oontributor a lobbyist, yes If contribution is in exccss of 9400 to a candidate
"a
fbr a chiefexocut
dependentchildofalobbyrst? F No municipalily does contnbutor or business helshe is associated with have a conl
municipaliry* valued at more than $5.000? EYes ENo
fl
ls this contribution assooiated with a yes Is contributor a principal ofa slate contractor or prospective state contractor? fl yes
fundraisingevenrlistedinsectionLl? No branches
F {f1es, indicatewhich branch or 'El No
fyes,Iist Event # of govemment the contract is with: fl Executive I
Legislative
Methorl of contribution: Aggregate coDtnbuti(Ds
tr Cash
fl Personal Check I CrexiitOeU;t Card I payroll Deductron D -* S2.
Money Order
oa
Amount of
Contribufior
$ 3c"co
ls contributor a lobbyist, spouse, D yes lfcontribution is in excess of$400 to a candidate committee for a chiefexecutive officer ofa
dependenrchildofalobby.isr?
14" No municipaliry* does contributor cr business he/she is associated with have a contract with said
municigality valued at more than $5,000? !Yes B
No
Is this contribution associated u'ith a E yes Is contributor a principal ofa state contractor or prospective state contractor? f] yes
t'undraising event listed in Section Ll? No .f,yes,indicatewhichbranchorbranches
.It'es, list Event # F -El no
of govemment the contract is with: il Executive ! Legislative
Method of contribution:
E Cash p Personal Check fl Credil,Debir Card fl payroll Deducrion D Money Onler

ktlN* Amount of
VO Contributior
*ri-"oc
ls contributo{dlobbyist, spouse, D yes If contributionis in excess of $400 to a candidate committee fbr a chief execulive ol}i{ier oia
or dependent child of a lobbyist? E- No municipality does contributoror business helshe is associated with have a contract with said
municipality valued at more than $5,000? DYcs ENo
Is this contibulion associated with a D Yes Is conlribiltor a principal ofa state contractor or prospectivs state contractot? fl yes
f'undmising event listed in Section Ll? F-No fyes, indicate whioh branch or branches E No
Iftes, list Event # olgovernment the contract is with: I Executive I
Legislarivc
Method ol contrrbutkrn: Aggregale contributiors
I Cash fu"rronal Cher.k fl CrediLiDebir Card [J payroll Deduction fl Money Order
f ;ei ao
SUBTOTAL Section B-This Page 4 ao \lcu
TOTAL of additional Section B Pages :SJ.Ga
TOTAL OF ALL CONTRIBUTIONS FROM INDTWDUALS {Sections A &B} (Enter total on Line 13 aLi
ARY I tions A- Jofl
NAME qF COMMITTEE
A tile Lu'beun n'r ny fr:t € LJ -{Ar- N\ar i rrr Jrnq lr) q
A. Total Contribitions froriiS-
?
(Sez instrailions for dtrtil:ition of Smal t Contributod Subtotal Section .4 $ Ve3"oo
temized from
leqt Name Fis( t\{l Prpgipal Occupalion Amount ol
-laSSe-lfi lJt>i rlcl ( 'on*r^< ('fu.,,-- Conlributio
ute ot L.lnDlovs ^
9'{ii?;*fi5ts?"+ 'An<orrr) rtate Zip Code

Is contrrb\tor a lobbyist. spouse,


r,
-,' H*Va t Sp/F"Ii],rn"' C^" I dl5zo.odO
U Yes Ifcontribution is in excess ofM00 to a oandidaie corunittee for a chlefexe,cutive o{ficer ofa
or dependent child ofa lobbyist? ET No municipality does contributor or business he/she rs associated with have a contract with said
munioipality valued at more than $5,000? -E[ NoD Yes
Is this contribution associated with a I yes
ls cnntributor a principal ofa state contraotor or prospective state oontractoll D yes
i-undraising event listed rn Section Ll? ,E[ No I/yes. indicate which branch or branches ,EI' Iio
.f1as. list Event # with:
of govemment the contract is fl Executive E Legislative
Method olcontribution: Aggregate contributions
D Cash ,.8 Personal Check fl CredirlDebir Card ! payroll Deduction D Money Order
slt tla4 *&io. ..r,
'Jd
ldtNme Fr*t- Prmcipl L)cuparim Amount of
r-i n
(esidmtial Str€t Addr6s
6rian Y? l--o ,^v1<c ct ee {- Contributior
xp Lo(k
5
ttate le OI DmDt0Vg
aLTl-'i-:7,"., A.,ro De,-6* V dr-" t8 I S4 iP
,
^
JEv-in Aa,r',,n L"u. J.&:. Oz
s contributor a
lobbyist, spouse. f| Yes Ifcontributid is in excess of $400 {o a candidate committee tbr a chiefexecutrve offlcer ofa
)r dependent child of a lobbr-ist?
$No municipality does contributor or business he/she is associated with have a contract with said
municipaliry- valued at more than $5,0O0? UYes DNo
Is this contribution associated with a ft Yes Is oontributor a principal ofa state contractor or prospective state contraclor? [ yes
fundraising event iisted in Section Ll? V- No Ifyes"indiaate *trichbranchorbranches Ef No
{,1'es, list Evenr # of govemment the contract is with: D Executive u Legislative
Method oi contribution: Dale I tmived Aggregate contributiqs
I Cash !-Personal Check D CreilitDeUit Card U payroll Deduction E Money Orcler 8 'bv I .q t Joa . o<:
ft{-r. /^ 'Tt MI Priucipal Ocoupation Amount of
lfi+-l hr. t#,sor: n,r;-$ ie- Contributior
{esrdentlal 5ret Addr6s
{4i-fl;'^.
ls contributor a lobbyist,-lpouse,
{ot. l?nyes
E
3tr* 1J.,,,..
;tale
Lt'
.rp Liode Nme ol hmDlovs
ouw4 #.*"i?'. r ol{t .;Ponhaoi
lf contritrution is in excess of $400 ro a candidate commiti'ee for a chieliex""*iuJ omierXru
$toe.q-
.ao

ordependentchildofalobbyisr? p- Irfo municipalir)- does contributor or business he/she is associated with have a contracl with said
municipality valued at more than $5,000? fl Yes []
No
Is this contributian associated with a ft Yes Is conlributor a principal of a state contractor or prospective state contractor? [] yes
i-undrarsing event listed in Section Ll? F No fyes, indicate which branch or branches E ruo
I/yes, list Event # with:
of govemment the contract is il Executive ! Legislative
Melhod of contribution: Dale Received
D Cash peersonal Check F creairroeUit Crard D payroll Derluction D Monery order
Y lzr:( c:i * too. c)d
l-X{Nme o'hor^., MI Princioal Ocomtim
Vn ftrra n<- G rrde cql zrrd
Drr i'?: O (lontributior
rdmtlal Stret Addrss r$t itate ,rp L6e Emploir_ -lZ u'r.r d'F
' lt\ct/,, t
g
l-p {'f )€-tJ rnc..r,- fi= !3{,eof
o&,Yd3 6srrrt,-r )r An.r i S> J rttt,*f - * f7.oe
6E
s spouse, I
contnbutora ldbbyist, Yes If conlribution is in excess of $400 to a candidate committee $r a lhlJf nmio
)rdependenrchildofalobbyist? 8 No municipality does contribulor or business he/she is associated witi have "*J"ti* "if,
a contract wilh said
municipality valred at more than $5,000? I Yes fl No
Is this conribution associated with a I yes ls contributor a principal
ofa state contractor or prospective state contractor? D yes
l-undraising event listed in Secrion Ll? lp-t'to fyas, indicate which branch or branches \[hNn
Ifes. list Event # olgovernment the contract is with: I
Executive D Legislative
Method of contribution: Date Rzueived Aggregale ailtnbutlDls
D Cash F"Personal Check fl Cre<titrDebit Card E Payroli Derluclion fl Money Order E laa{cE flso r>

SUBTOTAL Section B-This Page y5a. c!C


TOTAL of additional Scction B Pages 5,4 ta (k)
TOTAL OF ALL CONTRIBLTTIONS FROM INDTVIDUALS (Sections A & B) (Enter total on Line 13 o! Summary Page) 7,2'z 3.oO
I. EIPTS (Secfions A-K) Pase J of l
NAME OF COMM]TTEE
"lj /uz.r.r -*\e<inn int- 6l<,t "h,r |4au nr -L*t-, a
A. 'l'otat Contr{Dutions fi$rn Small Cottri
(See inshnions for definition of Small ('ontrihnnrt Subtotal Section 4 $t83.os
ndi
Fjr,rl,
W) Pr
-}{,-{l
ingipqf Ocguparior
Amount ol
TV'",j i-= .).rS'rr ^ l-. -o h Contributio
lsrderlt,al Stret Addr-ess

ir++f4.",+horn"Q ?Adr
ls contributor a lobbyist. spouse.
\.i-,*
{ate
1;:
irp Clode

h,u t,{
Nane ofEtn
h a_
lqyq
t)b ,c,
OC
D Yes Ifcontributi{fis in excess of $400 to a candidate corunittec for a chief exei:urive officer oi'a
or dependent child ofa lobbyist?
F No municipality does contributor or business he/she is asscciated
municipaliry- valued at more than $5,000? I Yes fl
wth
No
have a contract with said

Is this contribution associaled with a il yes


Is contributor a principal ofa state contractor or prosp€ctive state contractoll fl- yes
tundraisingeventlistedinSectionLI? E No fyes, indicate which branch or branches S r'Jo
f;'es. list Event # ofgovernment the contract is with: D Executive E Legislative
Method of contriburion: Date Rqcei ved Aggregate confributions
fICash F.personal Check I
4s\Nme
CredlrtOebitC:ard []
'[h,u*-ru*
payroll Deducrion fl Monev Order
MI
ilBloe S-sz aa
ryiffipal Oocupatio - Amount of
FJu-a'e,ll fiJ" G ne ,fi Contributiol
lip Code
iffqi.T;lknrb T\r
iobblst, spouse,
h.L:-,
trale
.Y*
otrt{lY
ane 01 bmplo).tr
AJ &A Ssz-e a
ls contltutor a fl yes IfcontributirNr is in excess of MCo to a canriidate co**iitee t*
u chiere"ecutive otliccr nti
rr dependenl child of a lobbyist? t-P_No munrcipalitytoes contributor or business he/she is associated with have a contract with said
municipalify valued at more than $5,000? No fl Yes D
Is thjs contribution associated with ft a yes is contributor a principal ofa state contractor or prosp€ctive state contractoil E yes
fundraising event listed jn Section L I ?
A No fres, indicate which branch or branches E Nu
fyes.list Event # of govemment the contract is *'ith: fl Executive Legrslatrve fl z -
Method of contribution. Date Received Aggregate contnbutims
p
D castr Personal Check I credit/Debit card E payroll Deducrion fl Money onler
fla.ziae $6:.oo
ffi;crlcr ''kt'l F Pnnuipal O'ccupation

ts-f +) r€
n
d
Amount of
Confributior

i.ifl,';:Xfuspouse,
Lr,r;{- K
yes
iilac,a*o,..t 6l laV6a
ttate Ip L.Ode Nme ot
r.l
tmployq
a S sa.a
6c)
Is contributor a lobbyist, fl Ifcontribution is in excess of$40o to a candidate committei for a chiefexecutive officer ola
ordependentchildofalobbyisr? E No municipaliry* does contributor or business he/she rs associated with have a contract with said
municigality valued at more than $5.000? fl Yes D
No
a
Is this contribution assoclated with fl yes Is contributor a principal ofa state conlractor or prospective state contractor? E yes
l-undraising event listed in Section Ll?
$ No If1es,indicale which branch orbranches Eh.No
.I/.yes, list Event # of govemment the contract is with: fl Executive I Legislarive
Method of contribution: Date Reeiral Aggregale conlnbuttoDs
D castr pe-.sonal check D creairrnerit card tl payroll Deduction I Money order
Ylez lot { L&.o.'
sl.*lme rst- MI Prilciru.l Occumtion Amount of
Ynf ,2ts }l^a {a. fl{*f,;1r t\h'natt r- Contributior
' ttate lrp L-ode l4me ot Emplo] qJ..--
3il"ffi,'ru'i
lscontributora lobbyist,
Aue
spouse, I yes
L"b * .'r--
:Y,,q IK
tn
r-G..., llr t l lAo ..' l^l ( $ t?. oc
If
oontribufroh is in excess of $400 to a candidate committee lbr a chief executive oliicei ofa
or dependent child of a tobbyist? p.. No municipality does oontributor or business heishe is associated with have a contmct with said
municipality valued at more than $5,000? No[f Yes D
Is this conribution associated wilh a D yes ls contributor a principal ofa state contractor or prospective stale contractor? yes [
fundraising event listed in Section Ll? *u fyas, indicate which branch or bmnches ..p_No
I/yes. list Event # F ofgovernment the contract is with: ! Executive Legislarive n
Method of oontnbution: AeCregate @nlributions
U Casfr p Personal Cher:k I Credit/Debir Car<l E payroll Deduction I Money order
azl'3li5l *Jlo. oc,
SUBT0TAL Section B-This Page fiaoo" o3
TOTAL of additional Section B Pages G,,b.)..- oG

TOTAL OF ALL CONTRIBLITIONS FROM INDMDUALS (Sections A & B) (Enter total on Line 13 of Summarv Pa*e) 3 .da
ONETARY Jofl

s Vb' &O

Arnount o{
Conlribulio

s conlribulor a iobbr ist. spouse, fl yes If conlribution is in excess of $400 ro a oandidare committee io.
{ loo.co
dependent child of a lobbvisr? 'p.. wo
aitGfI"eut,Gi?fr"offi
municipalit} does contributor or business he/she is associated with have a sontmot with sairl
municipality valued at more than $5,000? IYes I No
Is fhis contributitrn associated rvith a I yes
Is contributor a piincipal ofa state contractor or prospective state contractor? yes
lundmising event listed in Section Ll? [
V_Wo If yes, indicate whicb branch or branches ,F*-No
fyes. list Event # of govemment the conttact is with: E Executive Legrslatrve
E
Method of contribution :

D casn ts Personal check E crerlit,t)ebit card fl payroil Deduction fl Money order

AmoDnt of
Clontributio
Sacqi *
spouse, ufl y",
ls contributor a lobbyist, Ifcontributi*}rsinexcessof$4001oacandidate"o'n-'lttffi
0rdependentchildofalobbyisr? F No municipality does contributor or business he/she is associated with have a conlract rvith sairi
municipality vaiued at more than $5.0O0? DYes ENo
ls this ctntribution associated wilh a I yes Is contritrutor a principal ola state contractor or prospective stale I yes
contrtujtor?
fundraising event listed in Section Ll? ptUo fyes, indicate l'hich branch or branohes No \O.
fyes" list Event # ofgovernment the contract is with: E Execulive I Legislative A
Method of eontribution:
D custt !-fersonal Check D crsditDenitcard fl payroll Deductron D Money order

Amount of
(lontribrtinr

lib -o
spouse, I yes
Is contributor a lobbyist, If oontributiorlls in excess of $400 to u .undiaur" io'nrffi
dependentchildofatobbl.ist? E. lto municipality does contributor or business he/she is associated with have a contract with said
municipality valued at more ihan $5,000? lYes RNo
Is this contribution associated with a "Jf. yes
Is contribulor a principal ofa state contmctor or prospective state contmctor? D yes
f'undraising event listed in Section Ll? E No fyas, indicate which branch or branches Eh No
f1'es. list Elenr # <11- with:
of govemment the contract is fl Executive E Legislatrve

E cash )El Personal check E creaitoeuit card fl payroll Deducrion D Money order

Amount of
Contributior
i.
S 3co. o.r
lscontribGlralobblisr.spouse. - t; Ilcontribution is in excess oT$400 to a candidateffi
ordep€ndentchildofalobbyrst? B No municipality does contributor or business he/she is associated with have a contract with said
municipality valued at more than $5.000? Yes 'F-lto
fl
Is this conrribution associated with a $. yes ls contributor a principal ofa state contractor or prospective state contractor? fl yes
f'undraising event listed in Section Ll? b Nn f-yes, indicate which branch or branches '{t No
fyrs. lisr Evenr# A of govemment the contracl is with: fl Executive D Legrslatrve -
"
Method of contnbution:
B cash I Personal Check fl credit/Debit card fJ payroll Deduction n Money order
#r:c. oo
SUBTOTAL Section B-This 75?"o1

TOTAL of additional Section B Pages cld


TOTAL OF ALL CONTRIBUTIONS FROM INDIVIDUALS (sections A B) (Enter total on Line 13 of Summary
& LLl"oc
L MONETARY RECEIPTS (Sections A:K)
NAME OF COMMITTEE
]ILINGDUEDATE
""--, "t
-K?<^,,-rn
/-
A.
ftka: in e 4{p
'fotal Contribntions frod]Small Con
a Cor- fYlau n{ tanq ta /a/ aq
(See instructions for ilefnition of SmallCgntributor) Subtotal Section d $ +t* 3.as
B. Itemized Contributions from Individuals
L6tNme , Fsst- MI
L,,Ja*so n 1t
)a rlCl fr,' f:- Prhcioal Ocruoation
(lf{;, Wtdaft\tr*
Anount of
Contribution

;:{;
esrdentlal Steet Address
ry- itate p Code
ii] +i,,* i rt: , I ilve J)e rh"t tlr",Vol )..frii,"; P.r.ut,,-* S t:"a.rr.-r
Is contributor a lobbyisi, spouse, I Yes Ifcontributiorlis in excess of$400 to a candidate cornmitlee lor a chidfexecutiveqolhcer;ia
or dependent child of a lobbyist?
BNo municipality does contributor or business he/she is associated with have a contract with said
municipality valued at more than 55,000? No lYes E
Is this contribution associated wilh a RYes
fundraising event lisred in Secrion Ll? 'E Is oontributor a principal ofa state contractor or prospective slate contractor? [ yes
f'lo fyes, indicate which branch or branches RNo
If)tes,list Evenr # r"a- ofgovernmentthecontractiswith: flExecutive ELegislarive
Method of contnbution: Date Received Aggregate contn buhoD s
E Cash S.lersonal Check E
-T\}ff
CreditiDebit Card fl payroll Deducrion [1 Money Order
I lt /o9 t lr.i. -,,.
ksrdmlal "
[<-tf ;
Srfr€t Address
n r n'{-h
.{q. 1
; r-
itate
MI

.rp Looe
PriDcipal OccupatioD
'!+{}( JSP t t\ t k,-\.
Nme of Employd
Amount of
Contribution

?i Eetl<drgtr-j Df- J} r^b'r 0Lvrf llc.-- $3de,,rr


ls contributor a lobbyist, spouse, I Yes If contributioh is in
exsess of $400 to a candidate committei ior a cttier e"ecutiue omce. oG
or dependent child of a lobbyist? municipality does contributor or business he/she is associated with have a conlract with said
FrNo
municipality valued at more than $5,000? UNo DYes
Is this contribution associated with a p-v"' Is contributor a principal
ofa state contractor or prospective state contractor? fl yes
fundraising event listed"in Section Ll? fl No I/yes, indicate which branch or branches .EA No
fyes, list Event # of govemment the contract is with: I Executive E Legislative
Method of contribution: Date Received Aggregate contnbutior s
E Cash \Fpersonal Check
LrstNme A
E Credit/Debit Card
Fint
fl payroll Deduction U Money Order
MI
9 l& laq S ]oc. oa
Pri4cipal Occuparion Amount of
*Ol.e v -H n -o{yw n t{-z I I *ca er
#;-sffiti,..rk-])n. I\-rb.,
"- itale lp Lode
cfA
1\me oI tmotovtr
Contribufion
Stsa or
Is contributor a lobDyist, spouse, I Yes
/t--'l.
I 6e.tlr x f ;J,{ of Dr'-fz'r
If contributioh is in excess of 9400 to a candidate committd,e for a chief exe"utiu.ffi"". of u
or dependent child ofa lobbyist?
F- No municipalily does contributor or business he/she is associated with have a contract with said
municipaliry valued at more than $5,000? ENo EYes
ls this conlribution associared wirh a Elc-yes Is contributor a principal ofa state contractor or prosp€ctive state contractor? D yes
lundraising event listed.ir Section Ll? E Ilo fyes, indicate which branch or branches E wo
fles, list Event # .L of govemment the contract is with: E Executive E Legislative r
Method of contribution: Date Receired , Aggregate eonttbutiotrs
E Cash pJersonal Check E Credit/Oebit Card I payroll Deduction fl Money Order q /aa1o.j t l-zo-o<)
-6t Nme
Llrr i-r le
'1 7l', z r,bp\l-L Sl-.
.eslomlit:l sareet Address
fi lftarzt rlale
b
1ip Code
Prircilpl ftcupation
I-Nttt-n* t)
Nme ol EmDlovtr / I
Amount of
Contribution

A-o^^: r ir bt^rf'tg q,, l4 ( Ikt,t u ..\',:rv'r ho',


^n.-
$-l ja."'o
s contributor a lobbyist, spouse, il Yes If contributionis in excess of $400 to a candidate committee for a chGf ex6cutive ofTicer of a
rr dependent child of a lobbyisr? 'FNo municipality does contributor or business he/she is associated with have a contract with said
municipality valued at more than 95,000? EYes E No
Ts this contriburion associated wirh a 'ft=Yes Is contributor a principal ofa state contractor or prospective state conlractor? yes E
t'undraising evenr lisled in Section Ll? | no f7es, indicate which branch or branches E
Ifyes.listEvent# r 5o
A ofgovernment the contract is with:U Executive E Legislative
Method of contnbution: Date Received Aglyegate conlributions
I Cash $Personal Check I Credit/Debit Card E Payroll Deriuction D Money Order 1l n{aq S t sl"oa

SUBTOTAL Section B-This Page {'i il}. cia


TOTAL of additional Section B Pages tI &io.oc
TOTAL OFALL CONTRIBUTIONS FROM INDwIDUALS (sectionsA &B\ (Enter total on Line 13 of Summarv Pase) *].>lz r
-l

Y RECEI 3ofl

otal Contributibns fro


instructionsfar defrnition of Small Contri (. .do
Amount ot
Contribulio
tt 52.c,.:
Is t:ontribufor
rronfrbuloraa lobbyist. spouse. f] yes
iobbyist. spouse. tf contributiof is in excess of $400 to u.undidut"-"oilmilil8 achief executive
dependenr chjld of a lobbyist? p_No muntcipality does contributor or business he/she is associated with havo a conlmcl
municipality valued at more than $5,000? I
Yes l..to fI
Is thrs coniribution assocrared wilh a \a-V"s Is contributor a principal ofa state contraotor or prospective state conlractoll
fundrarsing er cnt ltsted in Secr ion L I
. i N" D Yes
If yes.listEtent# 9- fTeg indicate which branch or bmnches
ofgovernment the contract is with: D Executive D L_egislative *JNo
AggreEate
n Cash F:Personal crheck fl credir/Debir card D pa1roil Deduction I Money order

Amount of
Cortributioi

ff r:?".,a
spouse, l--l
Is contributor a lobbyist, yes ll
ccnlfibulion is in excess of $400 to a candidate committe€ tbr a ch ve ollicer ola
depenJenrchitdolatobb)ist? )3 No municipality does contributor or business he/she is associated with have a oontract with said
municipalify valued at more than $5,000? fl Yes E No
Is tfiis conrrihulion associared with a EI_yes is contributor a principal ofa slate contrastor or prospective stale contractor?
tLrn.iraisrng event lisleJ in Seution Ll? h [
yes
Evenr d
Nu fles, indjcate which tfanch or branches rel, tgo
IJ les.lisl -!-- of govemmentlhe contract is witl: fl Executive fJ Legrslarive
Method of contri bution: Date Rrceir ed.,
U Castr
Ffersonal Check il CrerlitlOeUit Card fl payroll Deducrion fl Money Orrier lal i (or
Amount of
flontributior

$ t St."o
Ifcontributiohisinexcessof$4@toacandidatecom.in.*ioffi
municipaliq does conlrtbutor or busrness he/she is assocrated with have a contracl with sard
)ttvt )
municipality valued at more rhan $5,000?
Is this contribution associated with a
LIt
g Is contributor a principal ofa state contractor or prospective state contractor?
[
yes
i'un.lraising event listed in Section tr fles, indicate which branch or branches 'Gtr No
f1es. Iisr Event,v -? rvilh:
ofgovemment the conlraot is fl Executive fl Legrslative
Method of contribution: Aggregafe
U Cash pf'ersonal Check E CreAilDebit Card [J payroil Deduction D Mongy Order

Amount of
{-'tntributior

s contributor a lobbyXt, spouse, n yes


,'chcr{ h V'olo tt:t"u.
Ilcontribulipn is in excess of $400 toa candidate 1- u chieiexecurive officei ofl
,r dep€ndenr child of a lobbyist? ,F* *o municipality does contributor or business he/she is"orn-itt""
associated with have a contract with said ,
municipality valued at msre than $5,000? nYes INo
Is this contriburron associateJ wilh a \e_-yes Is contributor a principal
ofa stale contractor or prospective slate contractor? D yes
l'undraising cvenl listetj in Se(llon Ll') fi-No fyes, indicate which branclr or branches
fyes list Evenr # -4- E nn
ofgovernmentthecontractiswith: IExecutive ILesislative'
Method of contnbution.
[J casn EPersonal check fl credit/Debit card fl payroll Deduction fl Money o'der

SUBTOTAL Section B-This

TOTAL of additional Section B Pages

TOTAL OF ALL CONTRIBUTIONS FROM INDIWDUALS {sccrions A & B} (Enter total on Line !-j
LL).ad
ARY PTS fSections A-K 3ofl
NAME OF COMMITTEE
Nlr, \'B€<\ nflin c * {-rtlo , t .&rr llYhu ar--,%o(E (ot ?/o
A. Total Contributidns from Slnall Contribrltors-Received thi$ PeiiodTNllf
(See inst 'uctions.for delinition of Small Contributor) Subtotal Section,4 $ CZ.oa
B. ized Contritrufions I
t Nase oli MI Prirpip*.Qccupation Amount of
frtSt-* t.''0 { ko l-,re &
^
Contributio

#t jz.o .l
rtate rlp L.ooe Lrr tsmproytr
il;'pru,?+'B+. f,irbq (4, /1,iV(k x-l a-
Is contrrbritor a lobbyist. spouse,
or dependent r:hild ofa lobbyist?
r Yes
No
Ifcontribution is in excess of$400 to a candidate commitlee for a chiefexecutive officer ofa
municipality does contributor or business he/she is associated with have a contract with said
Y municipality valued a! more than $5,000? IYes
DNo
ls thrs Lontnhulion associated with a VJes Is contributor a principalofa state contraslor or prosprctive state contractoil I Yes
lundrarsurg erent lisred in Section Ll? fi No Ifes, indicate which branch or branches F* No
fyes. listEvent# A__ of govemment the contract is with: fl
Executive D lrgislailve
Method of contriburion: Atsgregale contributions
I Casn tspersonal Check n Credit/Debit Card I
Firr'
Payroll Deduclion D Money Order
l,c{ t /og t t\-o. u^
Latr1$rse
V.p
Lesidmtial
o<-
Str€t Address
Lrrtnk
ttale
?
,rp Code
Principal Occupation
fi nn-l<--n rJtrf
"*"-{}"fr (€
Amuntof
Contribulior

42-,t "?) .h., Arsp bp.b,, AuVtx ?opo Co*sh,rt.- S tlZ.ca


Is contributor iobbyist,
a $ouse, D Yes If contributiol is inexcessof $400loacandidatecommittee t-orachief Ixecutive6flcerof a
or dependent child of a lobbyist? p.. No municipality does contributor or business he/she is associated with have a contract with said
municipality valued at more than $5.0O0? IYes ENo
Is this rontributron associared *ilh a E yes Is contributor a principal ofa state contractor or prospective state contractor? yes fl
lwdraising erent liste{l4Seetron Ll? 'D No fl,es, indicate which branch or branches No $.
I/yes, list Event# .zL- olgovemment the contract is with: fl
Executive Legislatrve I
Method of contribution: A8grsgate sontnbutiqls
I Cash ptersonal Check [] CrerlitDebit Carcl fl Payroll Deduction D Money Onier toft/<:g * l:?.,>",
-tll{me I
, Y x-l-on L.*tk*
-q(
MI

Lo&
Principal Occupatior
ari,a, 6nt .<\Dn ,/'e 1-r,t'rt
Amoilnt of
Contributior

rh ; r i,cxe t' Sckt*, { 1:?"


itaie rrp
.t f n{J^a-[qh tt a-fr rr . I)t rk>'.t Ct. ot*+tY s["iff;']l, s+-.
c
Is contributor a lobbyiSf,spouse, n Yes Iicontributiotr is in excess of$4ff) to
a candidate committee for a chiefexecutive officer ofa
or dependent child ofa lobbyist?
F No municipality does contributor or business he/she is associated with have a contract with said
municipalis valued at more than $5,000? Yes flNo U
ls thrs contribulion asstrialed with a tstVes Is contributor a principal ofa state contractor or prosp€ctive state contractor? fl Yes
lundraisrngevcnt lrsteri rn Scction Ll? fi No fyes, indicate which branch or branches E No
fles. lisr Evenr r 3 of govemment the contraot is with: fl
Executive Legrslatrve fl
Method of contribution: Date Reeived
U Cash \p*ersonal Check U CreaitOeU;t Card E Payrotl Deduction D tof tlog
Money Order ti*''r";****"""
Llil-fme
(of<co /_)
>f .
'Y)',nc
't+r
z{t* L
ll
Tit?Hi') ; Tz /-. /w^n."p (-.ontributior
Amount of

Li ocrl tx V.c il o:, J-; :. l-#l(^o|Lfr sffa"


;tale N&e bmDlors
rp Llode ot U

Itr I .Sh.,. h'tcort< T>r: I-h r h,t Oc't

s contributor a lobblilt, spouse, [] Yes If contributioh is in excess of M00 to a candidate corfrminec lbr a chief executiv*iffrcer df u Q.U f
rr dependent child of a lobbyist? 'B *o municipaliS does conffibutor or business he/shc is aisociated with have a conlracl wilh sard ' \f \-
municipality valued at more than $5,000? Yes [] hNo
Is rhis conrributron associated with r -BLYes Is contributor a principal ofa state contractor or prospective state contractor'1 D Yes
tundraising erenl Iisted g,section L.l? b no fyes, indicate whioh branch or branches No I
I/ycs. list Event # ./- ofgovernment the contract is with: fl
Executive Legislative fl
Method olcontribution: Dare RrcciYed Aggregate mtnbutrons
[] Cash Fpersonal Cher;k fl CredittDebit Card E Payroll Deduclion fl Money Order 1 brlaq S tga. cx
SUBTOTAL Section B-This Page ! r;m, q)
TOTAL of additional Section B Pages n o qxl
TOTAL OF ALL CONTRIBUTIONS FROM INDMD{.IALS (sections A &B\ (Enter totut on Line 13 of Summarv Pase) 7 .co
Y RECEI Sofl

5 . ()(J

Amount o{
Contritrulio

lsconlributoral6bbyist-spouse.
h"r'rL"r^ L.Q* ,St:2."u
E yes It contnbutiofr is in ercess ol$400 to a ca;didute;;*mm
dependentchildofalobbyist? Nu municipality itoes contributor or business helshe is associated with have a conlract with sai{l
F
municipaliry* valued at more than $5,000? E yes D No
Is this conrrrburion associaled wlth a \B.yes Is oontributor a principal ofa state contraotor or prospective state {lontracloL)
lundraising cvent listed in Seclion Ll' tf fl yes
Nu I/yas, indrcate which branch or branches .E Nu
f;'es. lrsr Eventil 3- ofgovernment the contract is wilh: fl Executive E Legrslative
Method olcontribution:
D Cash p:*'ersonal Check fl Credlr,rf-lebir Card ! payroll Detluction fl Money Order

Amount of
Contribufior
State

&. ftt:2"q,
isconffibutoralobbyist,spouse, D yes If contributiorf is in excess of $400 1o a candidate co*rmiftee i-or
a chie-f executrve ofticei irf a
dependenr child ofa lobbyisr? No
F municipality does contributor or business he/she is associated with have a contract with saiti
municipalitl vaiued at more than $5.000? fl
Yes ENo
Is rhis conu ibutron associared with a E- y*t is contributor a principal ofa state contractor or prospective stale cdlntractor? E yes
Iundraisirgevenr lrsredrAsection Llo fi No fler, indicate which Lrranch orbranches )EI" nfo
fyes, list Event# J- ofgovernmentthe contract iswith: fl Executive I Leeislative
Method of contribution:
I cash p Personal check E creliyneuit caril I payroll Deiluction fl Money o*ier

Amount of
(lontrihutkrr

lJ),4
is contributor a lobbyist, spouse, f] yes Itcontribution is in
excess of$400 to a candidate committee for a cttiEt-""""utlue oirt.o oru
or dependent child ola lobbyist? 'p" No municipality does contributor or business he/she is associated wift have a contracl with said
municipality valued at more than $5,000? fl Yes I No
Is rhrs conrribution assmiared wirh a )6p-Ve: Is contributor a principal ofa state contractor or prospective stale D yes
contractor?-\f,L
l'undrarsing event listed in Section Ll o 'f|
listEvent# a
No .Ifles, indicate whicb branch orbranches No
fl Lesislatrre / -
lfyes. of government the contract is with: fl Executive
Merthod of contribution:
E Castr Fpe.sonal Check E CreairOeUir Card I payroll Deduction D Money Order

Amount of
C-ontributior
t t sa,aa
lscontributoralobbyful,spouse, I yes is in excess of M00 to a candidate committee 1br a chief
dependenr child of a lobb; ist? F municipality does oontributor or business he/she is associated with have a contract with said
^o munlcrpalrty valued at more than $5,000? DYes ENo
Is this contribution associated with a ls contributor a principal ofa state contractor or prospective state confactor? I yes
l-undraising event Iisted in Section Ll ?
f-les, indicate which branch or branches \fL Nu
fyeg list Event # of government the contract is with: I Executive D Legislative /'
Melhod of contributron. Aggregale snlibuti0[s
Vasn fl Personar cher'k EcreditrDebitcard Epayrolr Deducrion DMoneyorder
s'tsrl"oo
SUBTOTAL Section B-This Page

TOTAL of additional Section B Pages

TOTAL OFALL CONTRIBUTIONS FROM INDIWDUALS (Sections A & B) (Enter total on Line 13
I. MONETARY RECEIPTS {Sections.4.-K) PaseJoflT
$AMTOFCOMMIITEE FILING DTJE DATE
{l Ner-n: rlas}nnlne.- ffi) Q t ) *{ti- Wnrt of JocsQ la lQl c>q
A. l'{lt*l crntribtutions from fmall contritfutors*Received this perioelONtf
, .(See infiracii,ins for definition of Sma!! Contrib*ar) Subtotal Seetion ,{ s *r;4.e:a
B. Itemized Contributions from Individueln
LwtNme Kt MI *irppal Oeumtior Amount of
fV nn c. i l/ r:r fVnrl*./; n-e *le <a <:ka f {--ontribution
aesrogllll.& )rq:rlAddfess ,_ !p Lwe
c; tse \ffiolEmDIofd \
.-l \Pinr{lc- Ra. S*, F'tttt r f t\{..4Y4 CL; .,C J},.b", tr;j'.oo
Is confibutor a lobbyist, spouse, E Yes If contlibutionis in excess of M00 to a candidate commifiee for a chief executiv" ot$"t,rf u
ordependentchildofatobbyisr? p. No municipality does contributor or business he/she is associaterl wilh have a contract with said
municipality valued al more than $i.000? Yes No fl fl
Is t.his contribution associated wirh a I Yes Iscontributoraprincipalofastatecontractororproslxctivestateconfactor? il Yes
fundnising event iisted in Section Ll? p.tto /yes, indicate which branch or branches Sh. trio
f-res, list Event # of govemment the contract is with: D Executive E Legislarive t
Method of contribution: Date Re*ived Aggr atecoltlrbutions
I Cash
E6Penonal Check E CreAit,OeUrr Carrl - Paymll Deducrion I Money Or.der o sl rr /ot S zi" on
"1X*qa+fo fl-;#.- MI Itire14rl Occupalion
J X "t-{-; ql.
Amount of
Clontribution
.TT6ry
,*?"aa+. Sr. D-rrb.t (T
)tale ,rp Code
0te\.1i3
^*U T?tr/Su n .l},,,,,r, .I
$ga:c.
ts contflbutor a lobbyist, spouse, I Yes
..p if contributidn is in excess of M00 to a cardidate committee lor "no
a chre-f execulive o{Ticer of a ^'t
cr dependent child of a lobbl'ist? No mrmicipality does contributor or business he/she is associated with have a contract with said
municipality valued at more than $5,000? [1 Yes El No
ls this conIibutron associarcd with a EAYes ls contributor a principal ofa slatg contractor or prospeclive state contrastor? fl Yes
lundrarsingevent lrstc,l tn Sgdtion l,l? tl tlo fyes. indicate which branch or branches E[wo
fyrs. Iisi Erent # ;9-- ofgovernment the contract is with: IExecutive ! Legislative /
Method of contribulion: Aggregaig srtributrous
[] Castt Fpersonal Check E Credit,OeUit Card E Payroll Deducrisn E Money Order
O'1 f zr:,log S.f;7, o.
L* Name Ml Principal occup+ioD I Amount of
(t a s>eJf, Dar:id ( a Aha r'.|*-otf Contribution
re$ffiH >trHAffiss ''l..^<n itate llp LNS Nme of EffDloyer
ft3o.oc
i-{tr'"#'' il.rco
3,r$
ls contribu{dra lobbyist, spouse, F
n'r\ u .'-7-- oaVoi J-/- /F ^ ^
I t>; . ^ Cne )
Yes Ifcontribution is in
exsess ofS4OO to a candidate committee for a chieli:xecutive officer ola
or dependent child cfa lobbyisfl rp No municipality does contributor or busioess he/she is associated with have a contract witi said
municipaliry- valued at more than $5,000? I Yes E-No
Isthiscontributionassociatedwitha f] Yes Is conlributor a principal of a state contractor or prcsp€ctive state oonFactor? - f] Yes
hndraising event listed in Section Ll? I/yes, indicate which branch or branches *$"tlu
Fno (
fyes, list Event # of govemment the contract is with: I Executive LegislatrveI
Methcd of contribution: Dale Rccsived
D Castt Fcyersonal Check D CreditlOeUitCud I Payroll Deriuction fl Money ortler n.r./ tz lO'l ff'F'#.;o
LctNme
Ynkotrz '{\.^. u z Prircipal Ocapation
I\lr rrS€
Amount of
Contribution

I o)h', d)0nc>( t rit I hnvw &., /Y't(\t/-


ibte
.--r-:-
vl.
1ip Code

a1^\.t*2
Nme ol L,mployer
s ti.o:
"
Is contributofl a-lobbyi st, spouse.
or dependent child ofa lotrbyist?
U Yes If contlibutionis in excess of $400 to a candidate commillee lor a chiefexecutive ofilcer of a

)F* No municipality does contributor or business he/she is associated with have a contract rvilh said
municipaliry* valued at more than $5,000? fl Yes D No
Is this contribution associated with a I Yes Is contributor a principal ofa stat€ contractor or prosp€ctive state oontractor? fl Yes
iirndraising event listed in Section Ll? p.No fl,€s, indicate which branch or branches RNo
ryJes, list Event # of govemment the contract is with: I Executive I Legrslative
Melhod of contributirin: Date Reaived ASStegal9 co!trrbutrons
fl Cash $Personal Check [J Credit/Debit Card fl Payroll Deduction I Money Order os-/e zlo? fl {i, cr,
SUBTOTAL Sectior B-This Page {3lo,o
TOTAL of additional Section B Pages FA,:?o,o:

TOTAL OF ALL CONTRJBUTIONS FROM INDMDUALS (Sections A &B) (Enter total on Line 13 of Summary Page) *7.zzz.ct
I. MONETARY RECRIPTS fSeelinns A-K) Page 3 of l7
NA[48 OF COMNJI]'TEE- ;II"IN{i DIIF DATF
A N<z.r \6as:li
A'
:y.rl<i l(3 t ?lo9
Totrl Contribut(ans from S*rall Contribiltoitffi
(See instracryrys Jor defixitiott of Small Contrib*or) Subtotal Section . $*(,,3" or\
B. Itemizcd Contributions from Individuals
Lst Naft
C; ,, r'1, ,, '(\or-,,f ir.s- Prircipal Oaupalion .Amount of
Contribution

x-"rh.,-Pi;i; At-e T)urh--


ttate
l\--
Zip Code NaEe o1 ti.lnployq
I {o, ao
"
Is contritlutor a lobbyist, spbuse,
or dependent child ol'a lobbyist?
I Yes
No
Il contributior(F
\!l o&"qlk
in excess of$400 to a candidate committee tbr a chiefexecutive ot'llcer ofa
muntcipality does contributor or business he/she is associated with have a contract rvith said
.F&
municipality valued al more than $5,000? DYes
f]No
Is this contribution associated wiih a I Yes contractor? il yes
ls contributor a principal of a state contactor or prospective state
fundmising event listed in Section Ll? p'Uo branches
I/yes, indicate rvhich branch or lotto
fyes, lst Event # ofgovernmentthecontractiswith: D Executive E Legislative'
Melhod oi contribution: AFgregate contnbutlons
ICastr Fpersonal Che,ck fl Credir,OeUit Card [J Payrctl Deducrion E Money Order nY leo lct t Ufi . a,,
LstNue
-Tan A<,r t"Q16r-g- MI Pringjgrl Oqcupation Amount of
'4o+" .il
lesrdenhal Shet Address -tJi ;tale 1ip Code
-n
Nme ol tmployer
Contribution

I )(-ts} re Lr r.
D
lpouse,
\ rY nnra, r r fli-t. 6f^4w xln Saf.oc
Is contributoralobbyisq fl Yes Ifcolrtnbution is in excess of $400 toa candidate committee fo'r a chief execulive ofTicer ofa
or dependent child of a iobuj4ist? No municipality does contrrbutor or business he/she is associated rvith have a contract with said
F municipalit) valued al more *ran $5.000? fl Yes E No
Is this contribution associaled with a fl Yes ls contributor a principal of a state contractor or prospective state contractor? . D Yes
iundraising event listed in Section Ll? FNo branches
I/yes, indicate which branch or E No
ftds, list Event # ofgovernmentthecontracliswith: DExeculive flLeerstative
Method of contributron Date Reaive.l A&grcBarc c4$Erouuo

aYl Klar a:
:

pasn E Personal Check fl Credit/Debit Card I Payroll Deducrion I Money Order B "66
-qslNme 4 MI Principal Ocapaliou Amount of
Ailnza t* 5 r Rurl a td- Contribution
'Sdlnfol'. L Q.n. ttu fti.\,1r
)tare
C;^ nuqyf
1lp cQde Nm€ ot b,mployer
h:o,uo
Is contribulor a lobbyist. spouse. ,I Yes If conltibution is in excess of $400 10 a candidate committee for a c-hiefexecutive olTicer ofa
or depcndenr child of a lobb; isr? No municipaliE does contributor or busioess he/she is associated with have a contract with said
)* municipaliry* valued at more than S5,0O0t I Yes fl ]go
Isthiscontributionassociatedwitha I Yes Is contributor a principal of a state contractor or prosp€ctive state contractof/ fl yes
fundraising event listed in Section Ll? pNo .fyes, indicate which branch or branches $! No
fyrs. iist Event # olgovemment the contract is with: U Executive Legislative I
Method of contribution: 3-Kecerrerl Aggregalg cootfl butlons

)ECash E Personal Check I CreditDebit Card n Palroll Deduction U Money Order b8 /azlaq #Jo.oo
*3T. q MI Principal Ocruparion Amount of
Bf-, reo Contribution
{gsldmlral Suefi Addr$s -b.r,., rtare ,rp Lwe Nm€ ol bnploler
$sa, qr
I t"9 Var k- H"o e ryaqt K
s contritlutor a lobbyist, spouse, n Yes If contributi{n is in exoess of M00 to a candidate committee for a chief executive ofticer of a
rr dependenr child of a lobb,risr?
F *o municipality does contributor or business he/she is associated
municipaliry* valued at more than $5,000? DYes DNo
witi have a contract with said

ls this cortribution associaled w-ith a I Yes ofa state contractor or prospeclive state contraotor?
Is contributor a principal fl Yes
fundraising event listed in Section Ll? No branches
F fles, indisale which branch or E l.lu
f1.es, list Event # of govemment the contract is wiihr fl
Executive D l-egislative
Metirod of contnbution: Date Rewi\:ed AgStegate cotrtnbutrons
pCasn Personal Check
fl D Credit,Debit Card ! Payroll Deduction [J Money Order AY laz lnq fi Lo, oa
*13J-.4d
SUBTOTAL Section B-This Pagr
b
TOTAL of additional Section B Pages A,6li'or
TOTAL OF ALL CONTRIBUTIONS FROM INDMDUALS {Sections A &B) (Enter total on Line 13 of Summnrv Pa*e) s ?,.2:i, "
r NTt-lNtr.,TARY RT],CEIPTS (SECtiONS A-K) Page 4 o1l1

F{r.INGDIIE DATE
{AMF NF CNMMITTEE
.' l.-lre*l t4pc-i n n i nq,=
u
6i";C"r flwu*r J-c:r:1 TiV4Tan
L) r-r ionrrihnfions from Otber Committees
mofTrmuq
{me of Comnittee
'-T\n , t 9.flr= I rn.-{;e R-{tJ..
contribution assoc. ated wlth a EY€ s fJes, hst

Pn B"'n [ {-K -} K
s this
lndraising event listed il r Section L ?FN r Event #- fr j-a .co
r Contributions

sti )'art
1ip Code

gL }cr4rl 'l ql ';loq


!+",".fsrd 'lme of Treasuq
NmeofComittre

Amount of Contribution
\ddress Is this oontrlbutlon asso( LI )s .ljrJss' lrst
fundraising event listed i Section L ?tr o Event#
Received Aggregat e Contributiols
State 1ip Code
lity
lDate
Nme ofTrefffl
NmeofComitt*
Amount of Contribution
Addrss ls thrs contnbutlon asso( LI 95 ,'JJi'e$' lrsl
fundraising event listed rn Section L ?tr Io Event #
Rmeived Aggrege te Contributions
City.-
,tate Zip Code

lDate
Naffi ofTreasftr
Name of Comittee

Amount of Contribution
Addr6s ls this contribul fl Yes l/yes, list
fundraising eve nt listed in Section L ? E No Event# _
r-::::7::;ffi*__-
lity State lip Codt

.lmofTrroru
NmofComittee

Amount of Contribution
Ad&ess ls th$ contrlbuuon ass E Yes fYes' list
fu ndraising event liste, in Section L ? D No Event#
itate Zip Code Date Reerved
:ity lAgCreCarc
I

NmofTrmus
Nme of Cqmittee

Amount of Conlribution
\ddress Is this contribution associated with a fl Yes fyes, list
fundraising eventlisted in Section Ll? f] No Event#-

itat€ Zip Code Date RMlved l^ggrcBarc


lity I
I
tttl
^- c----r.,- T\i-+*:k,t+i^na frnm nther Cnmmittegs
e2. l(ellnbufsements' ravmctrrs' w' ""' { Nme of Treasuer
{me olCominee

DateE;A;;A Amount of Receipt


Address

lity
itate Zip Code
fl Reimbursement for shared expense tr Surnlys .

fr Paymentforgootlsandservices Distribution
Nme of Treasuq
iffidffeoffittre
)ate Re*iYed Amount of ReceiPl
Address

lity itate p
il Reimbwsement for shared expense tr.Surnlys
fr Payment tbr goods and sen*ices Distribution

#
SUBTOTAL Section C-This Page Sso.co
TOTAL of additional Section C Pages { S?' .a
Ti 14 of Summarv Pase) $ S'O. 6d
TrlTAL f)[' AIL {]OMI\1lrl-llrl' ut 1\l nI'U rrulrD ^r\u rwLD" '" '""'-' '"-- "'- -''--
t. MONETARY RECEIPTS (Sections A-K) Pqgc i nf 1

VAME oF coMMIr-rEE il fu h s -r I 'F tscu. r'in.tyr() o


qJ U
erk.i .{}-r.n"- ffi4u1of" J{?C? lru.nvcpueoars r:9 lr:4 I s,r:r>e
D. Loans Received this Period
*meoflada **)r.,1 Source of l-oan: Is there a Cosigner Amount Received
or Guarantor of
;tf,eet Address -rty itafe Zrp Code I ganl D Candidate this loan?
D Yes (if i.es !is/
.Jme of Cosigner/Gtrililrt0r name and address oJ
n Individual I other Cosigner/(;uarantor)
Committee fl No
iheet Ad&ess t'ity Stat€ Zip Code Dal€ ol K€cerpl

{me of Lendq Source of Loan: Is there a Cosigner Amount Rmeived


or Guarantor of
ilreet Address irty Jtate Zip Code I eank D Candidate this loan?
fl Yes frfyo'li"r
Nme of Cosignu/Guumtor nme and address of
n Individual I other Cosigrcn(iuarantor)
C^-*:*-, ENo
Street Address state lZip code Date of Reeipl

Total Section D $

E. Receipts from Entities other than Individuals or Other Committees (Referendum Commifiees ONLY
Nane ofEDtit!

Jteet Address
i'{g}<s*i )ate Received Amount Received

-trt)' rtale aip Code Aggregate Llotrtnbutlons

Nme of Entity

Steet Address )ale Re€ived Amount Received

lity itate Zrp Code Aggregate Contnbutlons

PUUry

Street Address
Amount Rmeived

Zip Code

Total Section E $

F. Amount Transferred from Affiliated Business Treasury (Business Entitv Committees ONLY)
)ateofReceipt O-"rnt :_)/l7 Date of Receipt Amount Total Transfers
(
Is this transaction associated with a I yes lfyes,lisl Is this transaction associated with a fl yes lfyes,list
ftu'rdraising event listed in Section LI? E No Event # _ fundraisirg event listed in Section Ll? El No Event # _ $

G. Amount Transferred from Affiliated Labor lJnion or Other Orsanization Treasurv (otoanizotion CommitTees ONLYI
Date of Receipt Date of Receipt Total Transfen

Amount
-"V Amount
$

H^ Personal Frrnrls of fhe Candidafe Received fhis Period (Cnndidnte Conmirpes (INLY)
'l otal
Method of payment. Method of payment: Amount Received
Date of Receipt Date of Receipt
fl Cash I Cash
!. D Personal Check
S rS?. Oo fl
Personal Check
I
Amounl
T*-^ P.r,"d ni; s< r Credit/Debit Card Amount CreditDebit Card
* /5?.&
L MONETARY RECEIPTS (Sections A-K) Page 6 of 17

NAME OF COMMITTFF- TILING DIJE DATE

\ Nzrrl Bec)n'1: r\<l * f:ir.r,, *fo- fYVt t./1,/-Ar-!rtq t alQ ln?


J l.Hnonymous Contribu tions $oecifv dollar amount of the bitls received)
)ate Resived Amout Date R@lved Total
Amount Received

$i bills _ $5 bills _ $1 bills $5 bills


_ _
coins $l 0 bill _ coins $10 bill
$

J. Interest from Denosits in Authorized Accounts


Date Recived \rnourt Date Re@ived
- Total
Amount Received
Nme of lnstihrtion Nme ol

Sheet Ad&ess Street Address

lity Itale Zip Code Ciry-- State Zip Code


$

K. Miscellaneous Monetarv Receipts not Considered Contributions


Nme Date of Tresaction
Amount Received

Strfrt Ad&ess City State Z1p eodc

tl-ar&-r-
Dewiption

s
Nue Dale of Trmsaction
Amount Received

Street Addrms City State Zrp Code

,1,*4*/la_
Dewiption

$
Nme Dale of Tmsaction
Amount Received

Street Address City Stale Zip Code


i^*J-)u-
Dewiption

Total Section K r illn


Summary of Other Monetary Receipts (Sections D-IQ
Total Loans Received this Period (Section D)
-4L-r^,a "
Total Receipts from Entities other than Individuals or Other Committees (Section E) +
-nI t^{a-
Total Amount Transferred from Affiliated Business Treasury (Section F) +
--'ll-t v\-u
Total Amount Transferred from Afriliated Labor Union or Other Organiz*tion Treasury (Section G) + .--ilJ'-\A--{
Total Amount of Personal Funds of the Candidate Received this Period (Section II) + $ I n], c..
Total Amount of Anonymous Contributions (Section I) + r-il ;.ti_-s._
Total Amount of Interest from Deposits in Authorized Accounts (Scction J) + ---.r,( _,lr-v<--e-_
Total Miscellaneous Monetary Receipts not Considered Contributions (Section K) +
a*Ar!/.rz
Total of Other Monctary Receipts (Add Sections D-Iq
(Enter total on Line 15 of Sammnry Page)
-l rSr: " oo
II. FUNDR{ISING EVENT ACTWITY pnse j otr1
{AME OT COMMITTEE TTI,ING DIIE DATF,

t L).pi*r -J4eq'inn;np * ffifulJ {}rr: fTlartnT &acss I t'nla/aq


U {J
L1. Fundraiser nvedt Information
L@aliol: StreetAddress rly State Zip Code
Description
lfafe
Subpdrt I :'(Ail Committees)
L3 &;2alx++,'
d)
;! D*,-/'* oe v{x.

Was this trndraising event hosted at a personal residence?


X" es (Ifyes, go lo Section L4 In-kind Donations not Considered Contritrutions
and complete required information for purchases made by host(s) for food,
beverage and invitations.)
No
Did this fundraiser include items donated by a business entity of up to fl Yes (.I/yes, go to Section I;t In-kind Donations not Considered Contribufions
$100 or items donated by an individual ofup to $50? and complete required inlormation.)
XNn
DYes (f.r""
with purchases from an individual ofup to $50? Donated Items.)
ti*^
Subparl 2: (Town Committees and Municipal Candidale Committees ONLY)
Were there pruchases of adverlising space in a program book associated I
Yes (fyes, go to Section L3 Purchases of Advertising Space in a program Book
with this fundraiser? and complete required infomation.)
trNo
Subpart 3: (Town Committees ONLI)
Did your committee sell food or beverage aI a fair or similar mass tr Yes (fyeq
gathering held ra,'ithin the state? _>
enter Total Receipts from small purchases here.)

tr No

#4
Fundraisins Event (Ja -ocation: :ity State Zip Code
Date of Fudr-aisr Lettq Description

iairlnq a %r{*,',l ?otl* L1 L(,^r,.).n'lln Ouoh.,


S+ Q_l OaV{ 3
Subparti: fi)lt Committeesl J
d
Was this firndraising event hosted at a personal residence? SYes (fyes, go to Section L4 In-kind Donations not Considered Contributions
and complete required information for purchases made by hos(s) lor 1bod,
beverage and invitations.)
No
Did this fundraiser include items donated by a business entity of up 1o ! Yes (.I/yes, go to Section L,t In-kind Donations not Considered Contributions
$100 or items donated by an individual ofup to $50? and complete required inlormation. )
Xl N^
Was this frmdraiser a tag sale, auction, or other sale of donated items E Yes (fyes, go to Section L2 Proceeds from Tag Sale, Auction, or Other Sale of
with purchases from an individual ofup to $50? Donated ltems.)
E
Subpart 2: (Town Committen and Municipal Candidate Committees ONLY)
Were there purchases ofadvertising space in a program book associated tr Yes (.I/yes, go to Section L3 Purchases ofAdvertising Space in a Program Book
with this fi.rndraiser? and complete required information..)
tr No
Subpart 3: (Town Committees ONLY)
Did your oommittee sell food or beverage at a fair or similar mass E Yes (ffes, enter Total Receipts from small purchases hg3!
gathering held within the state?
f] No

SUBTOTAL Section Lr (Town Committees Ol{Il) Total Receipts-This Pagr

TOTAL of additional Section Lr Pages ++

TOTAL OF ALL RECEIPTS FROM SECTION Ll (Enter total on Line l6a of Summary page,
TI. FUNDRAISING EVENT ACTWITY Pase 8 of 17
NAME OF COMMTTEE

:-6 uti nn\ nr *


FII-INGDIIEDATE
Ne Fbls .t Gr l't1au ctr 2nnffi
LY Proceeds frim Tag Saleo Ariction, or Other Sale of Donated Items
Nme
Nme of
(rndiviauisoxtn
Puchmr
-f,i.
A"rrr<s Lx_ r\Y
F6r,r\ast
I t{cv, ald
I MI Meflod ofpayment:
ElCasfr E Personal Check E CredivDebir Card
Aggregate
Amount of
ttate Zip Code Jate Reqerved Event # Purchas
L A-trttrnhi, tl S+. 'J)* rL'u
_

Pwhmed
Items
(i f](-LI lY f:Yl-z,z/r'tA , *f .oo
/ -I-sh ir{-
Nme of Puchaer Ldt Nue MT Method of oalment: Aggregate
(tndividuatsINLY
l{ Of $+-, D o,.., &J* X-C*t,' E Personal Check E Credit/Debit Card Amount of

i>G;;ti,.=
KeSrdelrhAlJ;treet Addr$s la& Zip Code Evmt# Purchasts
lLtt br.b.* ( {. 6u.rt F "iivTX\
Itm }trcnNd
r,,q , & /c.c.
2- -Tshi d-s
'lme o{Puchrer Last Nms MI Method of payment:
In(lividuatsoNLY)
Ff4i:U" {C: Ro'*h let nt .r IZlCash El PersonalCheck E Credit/Debitcard
Aggregate
Amount of
(esrdmbat Strd ArtrirR( #
^ ln;+,R Jtate 4ip Code Jate Re@ved Eletrt Purchases
lQ T): v o ,r Au"t fu"J r,rL,1,1+- c'T G6\ ba 0t t'+zloq / i.
P/O.dt
-:l -Tsh;,^ fs
o"msru"h*"d

N me of Purch6fr I-AQI Nme M] Method of payment: Aggregat€


(In.tiiduatruNLn
(esldetrtral Slff t Address
ll, I S')t I LA,t, r'zr.(e-
tlale lip Code
)Q C*h [f
/de Ke@lvm
Personal Check E CrediL/Debil Card Amount of
Event # Purchases
{fL5"La:,-Aa.k Dr. br.A., L, Cte', t{ tt a{ lzziaq I hSlcu
*lI*
t
of Puchmer Lrntt;Nme
fi,n; r#
'lme MI Method of payment:
'rndividads0NLY1 fl?rsS tt,,,,s ot. ts Casn E
Personal Check E CredillDebit Card
Aggregate
Amount of
K9:IgeAal street Addr{ss G s- 'IaI€ Zip Code Date Reeived .vent# Purchases
5 {a.l/.r"t {1rtn {efr
Itm Purch&*d I
Jbr l->.-. ( r, fi*{ tr itYl3Zlnq I s-f.crc

Nme of
i --Sb1ir+
Pwchrer Lgsl Nme
U

MI
)NLy) qr+d
Method of payment: Aggregate
endividuars
n i Sa, lJ;.'a hte Zip Code
\E! Cash E
Date Rffiived
Personal Check El
Evffit#
CreditrDebit Card Amount of
Purchases
l;Sffi"Tffir," A.",e Kl^" t.l"^^ (s. ht^9 tV nx lzz l<vt I Fj-".tu
ItffiPuehased
I T5hrr,l-
,li}ft of Purchaer Lasllame
tndividuatsziiy ( lh* ilfr.fella D.t,.,. Method of payment:
ECastr E Personal Check tl Credit/Debit Card
Aggregate
Amount of
(esrdmtal stf €t Address Zip Code Date Received Purchases
s Ltzlal
Event #
l?-S.''rre#\ D"
trm nrcnffid
h-q-.b* cft rt.,{ tV I Sricn
4'-i 5r"lrls
t1 f_:_

\lme of Purchmr I-mt Nggre


.a

First z Method of payment:


TndivituatsoNLn
.NJ.,
{-SfAZCC: ?,^l n -Ecash D Personal Check E Credit/Debit Card
Aggregate
Amount of
rtate JaIe Keq:lveo u*".l
T)"h* Pu rchases
Zip Codc I
5.;+ . r'+rr, w^ A*' ft" 0(*4 tY cx{ l2zlaT hto.a
ItemsPuchased *?-:h
&= ; f+s
'ime of Puchroer L6t Nme
Irdietutuats oLrLY) -7 o l-O V 'T'r]:ttiq",." Method of navment:
&rCasir'
"D
PersonalCheck E Credit/DebitCard
Aggregate
Amount of
(egoennal wd Adtress " itate lip Codg Dale Recsrved Evert#, . Purchases
b-t.b
.

{a T-Iand+.ct A't q cT-. CfuW o{lazlcn $s*. o.,


Item Pucha*d *l-sh;nr J
{
SUBTOTAL Section L2-This Page $ ?cl.oa
TOTAL of additional Section L2 Pages $x&s.oo
'I'OTAL OF ALL SMALL PURCIIASES FROM TAG SALES, AUCTIONS OR OTEER SALES OF DONATED ITT,MS
{Enler lntnl on Line l6h of ,9umman Ptsp)
S3SS- ur
II. FLINDRAISING EVENT ACTIVIry Page 8 of I7
\IAME OF COMMITTFF
hJp,r)'y'v")nn|/\e *E>tt o ,Drr'lhattrtrlaag | rc/qt
L2. eeds T Sale, Auc or Other Sale of Donated Items
Nure FitSr*
;;;:.:;;":;:';ff',)E)lq*,.p l"'*B^n
{me ol Purchrcr Last I MI Method of payment:
3Zl Cash fl
Personal Check il Credit/Debit Card
Aggregate
Amount of
rtate lip Code Datc Reaived Purrhasm

"4 k:^e=of^,trl'
Items Purchaied U
bn rb.- 1)i.,Qt? ot hzla9 I S: cr'
i -T-shi rf U

\me of Purchur lls\N;dne I Er&it MI Method ofpayment: Aggregate


(tn{tividuatroNl-y) P-)',n; l^l}n;S'.o E[ Cash D Personal Check E Credit/Debit Card Amount of
<srdmhai slreel AcktJess rn tate lip Code CIc t{J Date Received Elent # Purchases
5 k" c-', A ^d.i 11 . )c U /yrrlrf C.; ll -tlQcr a pl.azft* I
$s"cc
IremsPurchas,fii
t r Sa,rF
ime .,f Purchrser Lasr-Ilmc I l'i+€q MI Method of payment: Aggregate
rnttividuat<oNr.t1 (
hn^Ao | 4\r ).nr-L B.Cash [f Personal Check n Credil,/Debit Card Amount of

5 q
(eslddlllal:ket Affiesg

l4z ll'o,Y;c, .
I

i ,t)-,a.lr'
itale
(7 1ip Code
Ar,<-FtV "t\Yiiztm Event t
I
Purchases

S f"o.t
itmrsrt*hed I
I 1 sh,'rF
NmeofPuchas LANme MI Method of payment.
Qndividuats())Ln ( lnlg(
tesrdtrlial Slr€et .\ddrN v
e ir.r.+ itate 1lp Uo{e
IZlCash Personal
)ale Reelved
E
-
Check
event #
fl CreditDebit Card
Aggregate
Amount of
Purchases
7 lYrr*n# ;n
Items Pucha*d
5- + borb ') (-:. 06qtg av lezlat I tf $.ca
I Sh) 11-
NaDe oiPuchaser Lst Nme MI Melhod of payment: Aggregate
(tndividuots o,\Lr') \/tl fC ?trA^.A EtCash E PersonalCheck D CreditDebitCard
Evmt #
Amount of
Purchases

er55;*ibark-D, brrb--U
tale

{ r.
lip Code
/v-.tL rw ""X#'"t*t"n h/o..,u
*l--
i
Items Purchased
Sh:
L6t Nme
rts
Nane of
(I n
Puchrcr
diidu ils oNLn:V rT o. . 4<
''h rlo MI Method of payment:
F Cash []
Personal Check El Credit/Debit Card
Aggregate
Amount of
Resrdsrtlai Stleet Ad&ess ^ lip Code Datc Reeiaed Evetrl # Purchascs
I {L' {ts ', A.t -Lp(-rac
IteruPurchased
hlrb..U CT: a,q lg avl:.zlnq / is f oct
t -rtsr', ; rl
Purchmr -tas{{dne Firft Method of payment:
'lane of Aggregate
t,ii,,i,i
"t'
inin T1p n r4-o lrAq fc\ vs,*ash Personal fl Check EI Credit/DebirCard Amount of

r'; Rffived Purchases

iK ()uard
lesidmti.a+€tr€t Address
r;,na-tprr IXr-b.r
::ity 'mte Zip Code
0u9 ty avlzalol I
Date lF-vert #
I $ icn
tmPutlased U
i T-!Ll r,f
\me of Puchm Latllame
(lntliviluuLtONLfi
\. { B-r* Metiod olpalment
\El Cash D Personal Checl' E CredrL/Debil L'ard
Aggregale
Amount of

lbq ; 'L
r{{ Rewived Purchases
I
legidmtial Stre )taa€ Zip Co,ie )ate I Elent n

Itffis Puchasd
A,€
"l\ "-1", 0u9tY nrlzz laq I * to, (n
cx

rJme of
3- Shl /{<
-T-
Puchrcr lj{Nane Method of oar nt: ,4ggregaae
Indivi{tuatr()NLn-R, ,} l-O f- l"fa"n<s b Castr fl
me
Personal ('heck E Crcdrt/Debit Card Amount ol
)ale Recellecl lF-vst Purcbases
fi
Kesldstral's'g€t ttate Zip Code
II
#

lr;ftik
AddJess

IY Au+ rJr., C{. O{"vo t cy lzzlcn Siaut


Itflns Purchased
| '-T-Sr^l r$-
SUBTOTAL Section Lz-This Page * tJ*. a 4
TOTAL of additional Section L2 Pages
3oo, -dJ
TOTAL OF ALL SMALL PTIRCIIASES FROM TAG SAI,ES, AT]CTIONS OR OTHER SALES OF DONATIED ITEMS 355:
fFnlm lolol nn Linp I6h nf ,lummnrv Papel
II. FUNDRAISING EVENT ACTIVITY Pagc I of l7
{AME OF COMM]TTEE
-ilesi (€ q r fWua sf zooq
- &sfrom The {b
lUar".-i ; q
r ^nL2.^Pr"oceeds Sale. Auction,'or Other Sale of Donated Items
Nme o1-Puchmer --Lc{Nanre MI Method oi pay,ment: Aggregate
(tndi.vittutLsour.n (1nnA;
Ksrdelrtral Street Address
/1 I
'ia
Bruno itate Zip Code
# EfCash Personal
Llate Re€rved
fl Check
Event #
E CrediLDebil Clard Amount of
Purchases

5ta Sr,,; - ba r kT,V J\o rL',, (.; orvf P *v lnzlng F C.,-,


Item Purchased
( -T--<1.';r*
MI
'trme oiPurchryr Last ry4ne , Method of payment: Aggrcgtte
'tndividuats t)NI-Y) I* i*C--k
litu
Vkt'-n El Cash D Personal
Date Received
Check
Event #
E Credit/Debil Card Amount of
Purchases
;tate Zip Code

Jaa f triit'-,r. kJ)r


it*.
il rh,, CT TY.LLI N oY l+z {a? I
I f ico
I t_ Shirt
,laE of Puchrwr l-aslAme
)
MI Method of payment: Aggregate
IadiidqakI)NI.Y) Gt" /^', 7 f , 41 ;.fu-A \E Castr ll Personal Check D Cre.liuDebtl Clard Amunt of
{esrddltial Str*t Address lq. tWe )ate Receired Elat #

2i^t L-n,t{e I {*."p


A
J) r-b /,7
4ip Code
hi^i K nyla3loq I hi o^
Iteiu I'ucha*d
'l-5]l;r+ "
,ime of Puchmr Latf N{ne F irst MI Method of payment. Aggregatc
t,ii,,i,i,ii,ii.n ( FnfZp lur-ru L,nrcer: \El Cash EI Personal Check I Credir/Debit Card Amount of
.ddress

5e-'U ,, l[eU.rlP,,t Df: TJ,


/ I
fri-il
rtate
(11.
Zip Code
I F "Hi"li"le Evmt
I
I Purchases

die
il;;ffiffir----: ";.,
-
l- -t-sr"lr+
Nane of Puchuer Ltstd\ame
(tnditiduats2NLY)
'
l4p"{ ', n i
"Jia.rr.*^ MI Method of payment:
'\BlCash D Personal Check D Credit/Debit Card
Aggregatc
Amount of
Residmtial Street Address^ ;tat€ lio Code Fvent # Purchases

5k"clz'r^'AA 'P-)
i-PLJ rilnrf (o I ltr "qtx arlz4aq gicrho
ItemPucheH
j- -T-Sa;r+
-
Nme of Pucher '|Rl-l: n
l#LNme t\{l I Method t.rt'payment: Aggregale
$ndiidusls ONLYT A^, o,s'^ I E,Castr E Personal Check n CrediLDebitCard Amount of
Purcbases
Kesrdstral 5tree1 Address itate Zip Code )ale Recei!ed evmt #

5 Acc.', n,r l{ r0.


bi
,o rt /vilorbc "l ,-:-
,r tuu[Ik n{l)zlm I $ p"oo

,iane of puchrer Lat(Nme Melhod of payment: Aggregate


Indili,taalroNLn ( Vn Uq {
ltv
%r;=hn< rtate Zio Code
Ylfash
lDate Rmired
I
Personal Check
F-venl #
fl CredirrDebitCard Amouut of
Purchases
of
.

iXffif;'i'ry" rtt'T)r. \ tirnr"* t/ ['r


m - Ar^J*z f ltz/c>? Q i,a
J I '-l Sh:r't-
{rryofPurchm Ll51Nane Method ofpayment: Aggregate
nii,ni,iiiin C, rr kv,r'l< 'fr ,rol\ +a SCash fl Personal Check E Credi/Debit Card Amount of
Itr Date Reqived # Purchascs
(T ht,4t ? Zip Cade tsvenl

ttrmsPuchaed
Residrnual Sued AddJess IAIE -

Id lllr<s{_ Arre J) rh,, P,P 12? loq' t W 7o.au


.f, - '-fS Lt; r{-s
T I

',iii,ii,"i,"iff.,t!t,tn<l^
{me Puuha*r
ol Nrune Lcst I Firsl Method 0f payment: Aggregate

Rsidotial )l\ret Address


I I plI ll;a^r^ )tat€ Zip Code
'\g3
Cash D personal
Ja[e Kecel\'d
Cbeck E CrediyDebit Card Amount of
Pu rcbases
(J _,
kr \" ;.U-A*- lv rJa-, (r-t-:" ^t. r>"{ t t( lJslaq I fr S.c,<r

i -f
^Y
lisnsPurchard . 4
Sh, rl- J

-
SIIBTOTAL Section L2-This Page *ff. CId

TOTAL of additional Section L2 Pages s30d, e (}


TOTAL OF ALL SMAI,I, PURCILA.SES FROM TAG SAI.ES' AI]CNONS OR OTHER SALES OF DONATED ITEMS
(Enter total on Line 16b ol Summan Paeel
f36s. 0*
It. FUNDRAISING EVENT ACTIVITY 8of17

or Other Sale of Donated Items


Aggregate
Cash fl Personal Check E Credit/Debit Card Amount of
Purchases

*:la'
-r,
Aggregatc
Cash D Personal Check tl Credi/Debjt Card Amount of
Furchases

E f=.e
-T:
Method of payment: Aggregate
Gl Cash CI Personal Cheok El CredivDebit Chrd Amunt of
Pnrchas€s

tfi
+t. i 4c)
of Puchaw Lsl Nme Aggregate
,duubuNLYl D
fi--k) n.f Cash fl Personal Clheck Credit/Debit Card Amount of
Purchases
$ r.oc
-T_: S A:
Method of payment: Aggregate
Cash I Personal Check E Credit/Debit Card Amount of
. Purchases
f l,:.oo
9- -I= srn:
puchrcr LslNue
Nme of Method ofpayment: Aggregate
Cash D Personal Check f} CredirDebit Card ,Amount of
Purchascs
Vt o.o,
p
Method ofpayment: Aggregale
[] Cash fl
Personal Check E CrediriDebil Card Anrount of
Purcha*s

fflo.o.
Method of payment: Aggregate
EL.Cash fl Personal Check [f C--redit/Debit Card Amount of
Purchases
b lo.oo
9-
Aggregate
fl Cash EL Personal Check E CrediLT)cbit Card Amount of
Purchases
srj-.e
'T- Sh; r
St'BTOTAL Section L2-This Page * ?o.*
TOTAL of additional Scction L2 Pages
1Li^.aa
TOTAL OF ALL SMALI, PURCIIASES FROM TAG SALES, AUCTIONS OR OTHER SAT,ES OF T}ONATND ITEMS
5 "oo
II. FUNDRAISING EVENT ACTIUry Sofl?

L2. roceeds from Sale Auc or Other Sale of Donated Items


Nme of Puchas rd ofpayment: Aggregate
(Iadividutls 0NLY) Cash E Personal Check EI Credil,rDebil Card Amount of
. Purchases
$;.*,
l- Method of payment: Aggregatc
\ltr Cash D personal Check [] Credir/Debit Card Amount of
Purchases
ts-.co
i-
Method of payment: Aggregate
&l Cash fl Personal Check [] CrediLDebit tlard Amount of
Purchas€s
Sfoo
-r
Aggregate
:wry Ge,*[€) n Cash D Personal Check E] CrediVDebit Card Amount 0f
Purchasts
S tS.ao

Method of payment: Aggregate


El Cash Lf Personal Check E Clredit )ebit Llard Amount of
Purebascs
{i.co
i
Method ofpayment: Aggregate
E Personal Cher;k [] CreditiDebit Card Amount of
Purchases
S sloo
t T-Sl..t
Method ofpayment: Aggregale
E
El-Cash Personal Check F CrediUDebit Card Anrount of
Purchases
{fo"
Aggregate
Cash D Personal Check F Credit/Debit Card Amount of
Purchases
fr I o"oo
-r
Aggregat€
Clash E Personal Check E Credit/Debir Card Amount of
Purcheses

$ {o.oa
SI-IBTOTAL Section L2-This Pege s ctd

TOTAL of additional Section L2 Pages


*J{ta, aa

TOTAL OF ALI- SMALI, PURCTLdSES FROM TAG SALES, AUCTIONS OR OTHER SALES OF DONATED ITEMS s:r4l a
TI. FUNDRAISING E!-ENT ACTIVITY Sofl7
.IAME OF COMMITTEE

.L'rou F5, c;on in(r


-ffi le tt 2r l4A,nttnr )eae I tofel,
Lz. Froceeds from'Tas SaIe. Auctiori. or Other Sale of Donated Items
Nme of Puchm ljsl \ilne I l-rrsJ MI Method tif payment: Aggregatc
(IndividuulsotYL{) [lJ-lon, I k;Z El Cash fl
Personal Cheok E CreditDebit Card Amount of
Re Address I ^ aip C'ode Da{e Rrceived Event # Purchases
ai lzz ln i
FeT

a"'j irrJ"..rnA Dr. Yuv Cie-t.l iflr*. a[v2Y / tJo. aa


L+ T <lt"trk
ItsnsPlrchased . -€

ime of furchaw I ul Nane I


Firsl MI Method of payment: Aggregate
Inlividuali o.\l.V) I n Clash E
Pcrsonal Cheok fl Credil,/Debh Card Amount of
(srdsltral Stteet Addrcss rr)_ ilale Zip Code Date Received Event # Purchases

Itsns Purchased

{ue uf Purchmer Llsl Nme First MI Method of payment: Aggregate


tlndiiduals ONLY) n
fl Cash ll
Personal Check ClreditrDebit tlard Amunt of
I Street Addrcss 'rty ttate lip Code Date Reeived Event # Purchass

[1ems Prrchawd

ime of Purchasm Ldt Nilne Firsl MJ Method ofpayment: Aggregate


'lndividusls
oNLY) E Cash D
personal Check fl Clredil,/Debit Card Amount of
(€Std$raal iltr€t A{rdms rly itate Zip Code i)ate Reerved Event # Purchascs

t@sPuchffid

Nme of Purchawr L6t Nane First MI Method ofpayment: Aggregrte


(IndividaflLt ONLV fl Cash E
Personal Clheck E flredit/Debil Card ntmount of
Rsidmtral Strsct Addrcss rfy ilate lip Code Dale Re@ived F,vs)t # Purchases

Items Purchared

.Jane of Purchroer -t-trt Nms Fis{ MI Method of payment: Aggregale


'Indiidutls {)NI"I) D Cash El Personal Check I Credil/Debit Card Amount of
Resrdmha.l Street Address :lty ilate lip Code Dale Received I Evmt # Purchases

Items Puchased

'lme of Puchcer Last Nane l {s1 Method of payment: Aggregate


'Indiiduds ONL!) F
Cl Cash il
Personal Check Credi/Debit Card Arnount of
lesidatial Street Address lit] itate Zip Code Date Recived lEvent # Purchases

Items Pufchasd

,lme of Purcharr L6t Nffie First Method of payment: Aggregate


Indivitluils QNLY) E L-ash I
Personal Check t] Credit/Debit Card Amount of
Residmiial Stret Address li.r- Itate Zip Cod€ DaJe Re€ived lErent 4 Purchases

Itms Plrrcha€rl

{me of Purcharer Last Nane First Method of payment: Aggregate


'Individutls 0NLf) E Cash D Personal Check E tlreditrDebit Card Amount of
Ke$dsbal Str€i Address iity itate Zip Code )ate Recerved I E\ ent # Purchases

iiems Purehased

SLiBTOTAL Section l-2-This Pege #ao"


TOTAL of additional Section L2 Pages I a:s, &
TOTAL OF ALL SI,[.{LL PT]RCTLASSS FROM TAG SALES, AUCTIONS OR OTHER SALES OF DONATED ITEMS d-: s'
lF.ntet tntol nn Line l6h of Sumntaw Pape) oa
IT. FUNDRAISING EVENT ACTryITY Page l0 of 17

{^Nm nu.nN^nrrEE ,ft f\}er r k4P r:i n,n n cr ,-_ trfl IN1lDITF I)ATF

&lptt -fi,r,^ lYlcrUr)r *J'oo4 " ;' I c1? /er?


La. In-Kind Donations Not Considered Contributions
Nme of Donor Donation p Individual Fair Market
An'lo
Addr:q
Duqrm*la tlib'_
glven by: tl Business Entiq Value of Donation
5reet ,J State Zip Code Aggregate value for ihis evmt
l'-\ =-d*'tc, !.+l &r^r-{-.$
bq ? I
",
,,rAs *l-, S{*. JJt,-L., Lr 0e tJ tE \-j <;? d ( -[ tr]1l-J
Y
SF-ttcs-
L)eknDlron ol donahorr I EveDt# - f.lr-t1*.
-h,"rAr:,'I-,rlv' .{ 1r} t.c o fit* Sa.rio
Name
Cerl r /r:e
Donation
"9A Fair Market
*rr ; {*
^rfDonor CI f2$Jndividual
T),-rc <ri il{, given by: I Business Entity Value of Donation

'?;'{Lz', State Zip Code Aosrepate value lbr this evmt


fc) e*
zaiLnd.'q* S-*tf * (-r 6av [r { i-r? c\o **,,+= T)rnct{.'f
5"Pii.c4-
DeilllpliDn of doration -. t o'""1
J)ann.t ** cS {p"<-o- fn[.r YTffTAT.
('ryl t1r:n l- A
Name ofDonor tl Donation Elndividual Fair Market
given by: fl Business Entify Value ofDonafior
Sireet Address City State Zip Code Aggregate value fu this event

Desaiption of donation Dat€ Recerved Evelt #

Nme of Donor Donation il Individual Fair Market


given by: E Business Entir)- Value of Donatior
Street Address :iry State Zrp eode Aggregate value for this flml

Dercriptior ofdonatior Dale Ke@lveo Evot #

Nme of Doror Donation fl Individual Fair Market


given by: E Business Entrry Value of Donatior

Steet Ad&ess :irr State Zip Code Aggregate value for this ev%t

Dewription ofdonation Date Received Evflt #

Nme of Donor Donation IIndividual Fair Market


given by: fl Business Entity' Velue of l)nnatior

Street Address lity State Ltp L:ode Aggregate value for this evflt

Degiption of I)ate Recsveal F,vent #

Name ofDouor Donation fllndividual Fair Market


given by: I Business Entity Value of Donatior

Street Address lity State Zip Code Aggregate value ior this evfll

Dewription ofdonation )ate R€cerved Evmt #

Nmre of Douor Donation D Individual Fair Market


given by: D Business Entitv Value of Donation

Streel Address City State Zrp Code Aggregate value for this evert

Description of donation Date Received Evetrt #

SUBTOTAL Section Ll-This Page

TOTAL of additional Section Ln Pages

TO'IAL OF ALL IN-KIND DONATIONS NOT CONSIDERED CONTEEIITI:ONS (Enter total on Ane 21 d
III. NONMONETARY RECEIPTS Page 1l oflT
NAME OF COMMITTEE IILING DI'E DATE
FJ lr) a"rtTi,lz,crlnrr i'rte, --- G"t.o, ln fT'ldtt sr A{}oci I lo l"i r",a
J t) ld In-rina Conjributions
**"ftL Fair Market
n i la T).a cca**n
Type ofContributor:
[l Intlividual Value of this
'r'-q*"'fi rq t Committee Contribution
i', z r. ht#.'{+
Is contributor a lobbyist, spouse, I Yes
J\r.rb t tr
)tale lp L.ooe
Ae.rii X ] O|het l.lpplicable onlJ to Refetendum Committees)
frs-r?..n
If cor*ribution is in excess of M00 to a candidate committee ior a chief executive officer of a
or dep€ndenr child of a lobbyist? p.No municipality does contributor or business he/she is associated with have a contract wilh said

ls this contribution associated uith


fundraisingevenl listed in Sectron Ll? '[
Yes
No
-'ff,r#';:;'sf,T.
municipality valued at more than $5,000?
a p
Yes fl flNo
Ag8tregar9

TFa?
9onnDuilons

rhvlcx fyes, lisi Event # , A oo


'T,)I IL'a,o, K^rrtl , q/"ri;vr Type ofContributor:
[[ Individual
-trair Market
Value of this
'T).r
itreet Address -r|t Jtate Zrp Code ll Lommrttee Contribution
r l-p l) - ,i \rr]r -t 4"- f!^ tt i{ I Other (Applicable unly to Referenttum Committex)
Is'contributor a lobbyist, spouse, ! Yes If cqltributionis in excess of $400 to a candidate committee for a chief executive officer of a
Q a$e*
ordependentchildofalobbyist? fl No municipalit) does contributor or business he/she is associated with have a contract with said
municipality valued at more than $5,000? EYes INo
ls this contribulion assocrated with a 'EL Yes DescriDtion of In-Kind Cotrtributiotr

lofrlcq Iundraising event lrsred m Section Ll? 6 No ,uzqid, -(Lr {+*d -&'.* h3.K). &
#
f.1'es. Iist hvcnt ..1J1 irr P4-a',1 0a,^l--.-
Nme Type of Coitributor: lair Market
f] Individual Valne of this
Street Address - rr)' itate arp Code fl Committee Contribution
Z Olhet Upp6cable on\' to Refercndum Commiltees)
Is contributor a lobbyist, spouse, I Yes If{rontribution is in excess of $400 to a candidate committee for a chiefexecutive officer of a
ordependentchildofalobbyist? E No municipality, does contributor or business he/she is associated with have a contract with said
mwicipality valued at more than $5,000? D Yes No fl
Dewriptiou of lu-Kild Contributior \ggregate
)ate Re@ived ls this contribution associated with a I Yes
ftmdraising event listed in Section L1? [ No
fl'es, list Evenr #
Nmc Type ofContributor: liarr ,v|arKet
I Individual Value of this
(-'ontribution
Street Address :rt]' Jtate Zrp Code E Committee
I Olher (.lpplicable ofrlj to Referendum Committees)
Is contributor a lobbyist, spouse, n Yes If contribution
is in excess of M00 to a candidate committee for a chief executive officer of a
ordependentchildofalobbyist? U No municipality does contributor or business he/she is associated with have a contract with said
municipality valued at more than $5,000? ENo EYes
)ate Re€ived Is this contribution associated with a Derription of In-Kjnd Contributior A ggregate coDtributions
I Yes
t'undraising event listed in Section Ll? D No
Ifies, list Event #
Nme Type ofContributor: ralr vtarKer
I Individual Value of this
Street Address li'y* Zlp Code fl Committee Contribution
'tate
I C4her (,tpplicable only to Referendam Commiltea)
Is contributor a lobbyist, spouse, I Yes Ifoontribution is in exoess of$400 to a candidate committee fbr a chiefexecutive oflcer ofa
ordependentchildofalobbyist? [ No municipality does contributor or business he/she is associated with have a contract rvilh said
municipalily valued at more than $5,000? D Yes No tl
Date Received Description of In-Kiud ContributioD {ggregat€ contnbutroDs
Is this conlribution associated with a [] Yes
lundraising evenl listed in Section Ll ? INo
Ifyes.list Event # _
SUBTOTAL Section M-This Pase {,S9r. co
TOTAL of additional Section M Paees f k;r no
TOTAL OF ALL IN-KIND CONTRIBUTIANS (Enter total on Line 22 of Summarv Pape) I f9?.ar
(NOTE: This section refers only lo ailvances of deposits hy individuuls from
N. Refundable Deposit to Telephone Company personal funds to benelit lhe committee, not dcposits made bt the committee
Lmt Nme of Individual First M Dare Deposir Made Amount of
I
Deposit
Residential Streel Address CF itate I Zip Code

Nme of telephole company


bc.cc
Street Add{ess -:rt)' Srate Ztp Code

Total Section N (Enter total on Line 23 of Summan Pape)


IV. EXPENDITURES
\AMI Page 13 of

ffi
OF COMMITTEE
*l AJu,or ? LIQ u\.t L){ .,lc :J ri to
p E'*
-uJvv mittee

ilprfi
_-_r _:revg
lluye i ! ^
Frr

Yq 2 { i::,i,J; 1 '\c
Date of Paymeut
Method of Pavment Amount
9l ,sfq
Stre€t,n

a-ftqnCi.s St q- t O ?3 b'/ao 'O3


Stafe Zip Code

(ttl code)
&"b., e-V{tr
Elchcck
5 oeurr c-a__--
frDrv
Igrc ol Lxpendit urc 0f qpptkobt4.
EveDt #

('oordrnated with rermbursemenl


L-.J
soughl (if applicable)
)ongh
tr Supporria
LJ CoortlinatcJ witiout reimbursemcnt
soughl
D Opposed
Ll Independent
fl Organization (see Instructions)
tr.r tre trc trn Dn s

ifi,li* " lol;sVt n )ats 01 Po-trKnl Mern0d of payment .4mount


sreel ll4trss
-t kancis
rurpose ol Experditue
oycoae)
I
"" S< F.
"
l+\U
d)t,,h^n
*s
)tale

O;u tx
arp Lode 1(azrc1 pcnecr # OqS
Ll Debit Card
r?aV: L
AD XU')r1er (aw .frtlq"n I.'J ,^.,. I
Evert #
0t tbt:
t1 pe of Erpendiru ^re (if apptict
LJ Coordinated with reimbur 'sement sough (if applicahle)
sought f]supportE
Ll Coordinateii rvithout rern bursemenl sor ght D opposed
fl lndependenr
E Organization (see Inaru :tions)
ne trn 0c Un trs $
NgpFe

i;.? Gq .q u u+ - Payrent Jate ot V{ethod ofPayment


12

LN ffi.i= f,*- i!. l laziq State Zip Code


Bcrrecr #@L
Amount

* 3Jo.u*
{}dz.i
w\unpnon
G. Ot Vl& U Debit t'ard
3 '1A ozt'r des)<rr o{ Ca. r)a'i('n /,'Lr*--l IrYent #

Tlpe ot Expendirure ftI apptkt Soughf


LJ Coordinated with rermbur semenl soughl (if applieoble) u supp,r.rea
U Coordinated wrthout reim bursement sou ghl I Opposed
fl hdepndent
I Organization {see Instrutlions)
tr.1 trr flc Un Dn $

S:;3,T ?asiy^asl+, Dale ofPalment


qbvlar
Method t)f Payment
' -)o
:s?J{;?;q
rurpos ot Exptrditure
si Dntb.r-
5tate

cr.
,rp L-ode

aa"vl*
pchecr * O?-l
I neurt car.t
SSor
-
'ry*oficer (&' Ai>nl
Iype oi
?ffit*n,.,1; ,. p r:l I ..-,- -..' - I tl- i
Evelt #

Expendttute (if applica


OfficSlSought
LJ Coordinated with reimbur rement sought (if appticable) E Supported
LI Coordinared without relml )urs€ment sou U Opposed
tht
I lndependerrt
I Organization (see Instru< tions)

ofParre
Ar trn; tlc trn ln s

\t- #- f
Nanrg:
of Palment

-}tni^:sl-i
Date Method of Paynrent Amount
State Zrp ('ode {oliq oOS'' Sa5?.cp
IOrl$u "-BruaA,,,a,
rur!,ose ol L.xpstdrture
Wtn;+. flt^:,* NJLI loc-rrq Echeck
Ll Dehrt Card
tot''"'& tu €-ff P"""c!-a-5,8/\
'lrr-L< tr
t-
r r\ a ,K.' Ir+ .{p ?ca nct L'-veDf S

Ilpe of Frpndit we tif lppticohte):


Soughl
LJ ('oordlnaterj with rermbursement sought (if aFp$cable) El Supported
LJ ('oorrfinated u ilhoul rcimbursen)enl ICrpposeri
soughl
LJ Independent
I Organization (see Instructions)
tra Ds Dc trn Dr
SUBTOTAL Secrion p-This page
J,tf)l G
,z

TOTAL of additional Section p papes J,, f49.V 7


Tn**t-i q q, ?ffe. o?
% IV. EXPENDITTIRES %
page of
\AME OF COMMITTE; ,
13

4 Nl€rrl Era\i t-{<li^Foocj lFrLrNG Dr.rE pATE


I talq'ffi
M llt I {.;.r9"
55i2-txpffiditue
rurpose ot
i*
1t1

flo.-rs{*rn F;';,. I )o9J


ues( ,npnon
P. Exr rcnsgs Paid by Committee

zrp L.Ne
Date of Paymeirt

'llaz@
Msthod of Pal ment

E Check #
fl* (\ tul ;-l-r
DebrrCaad el .
*
Amount

1, z:re zl
'*Y"' A --Sra rul q fv^tf'ma nu\.
T_r pe ol Expcn<jitute (iJ appticohtc,
)ougi
LJ ('oordlnaled with reimbursement soughl (if applitahle)
t
E Supported
Ll ('oordrnaleJ withoul reimburscmcnt soughl fl opposed
U Independent
fl Organization (see Instructions)

NUJ€
tra trn Uc Dn trt - $
ol € Pa)

-Pa. Pt- O; lt,


fate ol l'a)-ntilt

ffi
ol payment
l lzdo?
Me1n0o Amount
,1r)- atp Lode
lStde fl Check *
t't.{ t ,oY
rupose ol Ex?srdihue { )Cartc.e lC,i ot" V l-J LJ Debit Card
\I-ClLr.'t-^d*l
*0.) Fl\j
ktfier vr;dsd t-r rlr lrs t$.:Sill'(15
4Wrrpuoll
tot
D-€-
I ) pe of Expendirure (
I

5ought
;TB
Ll C0ordinated wilh relmbu15ement sought (if applicable) nsupportJa
I Cnortiinated wirhr )ut reimbursement sou ght fl oppose<i
I Indepenrient
fJ Organization /ser 'Instruclioas)

Nanmf Pave
tr,r
-_-
trs Dc trn ln I
s

##s+ !-.n.,,. jr- L )ate ot Palment Vethod of Payment Amount

M
t*-?r.,'a I Fr, rn P
loc v nt
0--"$ *.,1".u|, c.r-e"-..{- fj^ {t
lState

lcr.
lZrp Code l lza(a1
rtdQ ccck{ait
fl Check #
gR"bil,?'%;
ab
t3?, c L
g - _.-r-..*..-,' tv gyp',.uutzt. Otii€
Ll Coordinated with reimbuxemenl soughl (if tppEcsble)
SouBhl
fl Suppotrea
LJ Cooldinated wrthout reimbursemenl
sought
D Opposed
Ll Indeprndenr
I Organization (see Instructions)
trA Dr Uc fln Dr $

Ji;fr+- f,,
LfoY fltn ;n {l-
f /v. n.P .)
*Lzf 5tate ,rp Code
Jale 01

]o[
raFrcnt

1f ot'
Method of Payment

D Check #
Amounl

4t,.T{
rurpow ot Expmditurs Ansort io Cr Ot,4 oi trpeurtqgnr^ I
tot*oo
FA)
Tlpe of Expenclture c
17 r{-
'fdlbr *F,'- G,r r.,l, t',uWJiIf1 SouBht
Event #

r_8
E Coordinated with 'eimbursement soughl (if applicable) D Supporred
n Coordinared wirh( ut reimbursement sou ht flopposecl
I Independent
D Organization fs'ee Inslructions)
DB trC trT, ln
Nmg of Par're

Jns1.r ?o '-','*a l<


--tr1 'A*+'yPn=+ L1\' Zip Code
late of Pawent
t61r (og
Method olPayrnent

D
Amount

tg'rl.l t
-gaq
rurpose 01 Expendih(e
0,t Oranor ef. 6eq)-) Clheck #

€?ibJf^19^."d
(b)-6de).FNlD
l.-r :^.{*-Q cF ( - r r\ tol t ICQ <rckkl bve0t #
L ll4SS{ S *z,r Dq,rk,
I
.fA
llpe of Expnditure /rJ sot&ht
U Coordinated wrth r elmbursement sought (if upplicable) fl Supported
D Coor,linated witho :t reimbursemenl soup hr flopposed
il Indepentlent
D Organization (see lnstructions)
trl Ds Dc Do t E

SIIBTOTAL Section p-This page


L. z9
fOTAL of additional Section p pases Z: g. d)
G--

-I-crtqL .t q,g g,z o?


ry. EXPENDITURES Page 15 of 17

IAME OF COMMITTRF, ]II,INGDIIE DATE


A ilsr-r) -i1p*,', {t rt"r A? -
rJ
J- ti+ r r -#i'r lThu.ra .a./}r:f} I I f: /Q I rtq='
.J
R. Exnen9es Incurred on Committee Credit Card
Name of lssuing Institutipn Type of Credit Card:
L* E trs€- tl.n"r K 'fr Viru I Master Card fl Discover ! American Express
sh<>p,? ) n9 Ct,r'l*r
Era^;r ('&,^bt'(z- -
1/v rhYu . .t tl tg u
EI orher
Nme of Veudof Date of Trmsaction Amount
b)
Street
i.l. + Lr q (r cr,- Ou*{ e-r-
Addresl t Cit! State Zip Code
Q l^r7"2 b 3-ct
5)x'bastron Pc+ffu Urzi^ct ro
li-
(*1. ot"{11
ofExpoditure Eveut# o a
Purpose r Ynphon <=t-b
rbr cude)
Foc o { FrvD O l.'\,r? I <,5e<-'l-c'r t oli lcq -ft,r.{r.ti s-e..l
\ne ot'\'endor n
Vrc vY:- i r t y-vr- Li.rn fi ln'tt <
l laslrn St,:-3i O
Steet Address 0
State Zip Code

55 t z Pl; {. k)" i,c llr,,o{-, -.' Tixx' 1"ta9 z Event #


Pupose ofExpenditure
(brcode) p|' -5 iG hJ I'arnrl:l< n l^'rr')r-r {. lc,.rr \ f aCc l
Nac.pt
'Vant-u Vqrdor

C;.1 .r. 9lze(ar $q r "cr


sreerAcfdh I _it Crtrr State Zip Code

J? ::' t4^t".{#,+ f )-"', ..*


?} )e$nprion \)
C:ta L41'1
.
Evilt#
Pupose of EXgflditure aag-4<;t Pa,k 2 (5
(bycode) FN) DA ifu,.o<v- (lr,rrrJs, G l,:ltlcci .c,n.{.',i !€J
Ijgs\ofVmdor Date of Tmsactio[ Amount

Steel
l4i * L.{-
Ad&€rB I 1
S.rPer r?1er- kef" State lip Code
g
lao{ot \ zcl, t"z
Vot-l l"!L"lr', \1. [*".',n l^ P"i ht^Ut'>,
Purpose of Expmditrue Descriprion CC<-?{_a', I pQ,fky e"""t#.)-6
rbrcode)
Fo.lD / mgDP 9.t9frlies f+r- tc:l tlaq -h,^r4roiLr
NgnegfVmdor Date of Trilsaction

c LL S* C*r rvtc-- , .t
Amount

Sheet
f4 r
Add{ejls 1l )tale rrp Code
1a | ,lctt ta q8
'4,"1<
Qo( r?L;r. 5F- nAi c:
)e$npbon
Oa Vor
Pupose of Expaditure Cockh,lfl<rrl1 euentS<8
ftycode) pAJD/L 4r> [b= ;ca- G r ral,ioq?;,ffi*,'."t
Date of Trmsaction

ffi , {o.- lR P n.}a ts


Amount

Street Addrels State Zip Code


ta(1(<t'V' { g +"3r
to + D..n&"..o fu.+ Rl h* Dercription
r,*-u (; 0LLl-11
ru""t#afu6
Purpose ofExpaditure
" 0^ lc{r(OiCe<_{c{art
Ov"o0") FN Dpl }-en+^ t cf q laS5es -H-r S*in{ra , !;a,
Nme of Vendor Date ofTransactior Amounl

Street Ad&ess City State 4ip Code

Purpose of Expotrditue
)esnptran EYilt #
(by code)

Nme of Vmdo1 Date of Tr@saetion Amount

Street Address City State lip Code

Purpose ofExpendihue
)e$nptrou EYent #

(by code)

SUBTOTAL Section R-This Page B I, v )0,4


TOTAL of additional Section RPages *-*
TOTAI, OF' AI,I, RXPRNSRS INCI]RRED ON COMMITTEE CREDTT CAFjD (Enter total on Line 27 of SummArv PaSE)
( t, ,-l I o.;1'
TV. EXPENDITURES PagelT oflT
NAME OF COMMITTEE ]ILINGDIIE DATE
I\iv lr 'l\eEi^Y1i n g - -e>i* t r lr Md unr J-uu-i lc>( 9laq
- T. lt*-Ytation of Reinlbursements to lCommittee Workers and Consultants
-ag{.Jme of Worker,'Con su ltanl Fr;t__ ut Dale ofPayment
Amount
Method of Payment
Yar, z e bhai rc. I l'tle>q
#9s,tg
o"*0"'FNDR ftcr,ect* O? I
5iq rr l<s El Debit Card
City tat9 Zip Code

&r:
Description
lwctey-e I ilrl.., $ s rb..r Augt<<
$
-l]r., iJ.LJj G{5
Type of Expenditu rc (if appticable):
f* (orj4h',I ea n*q + labe I <
Nme Ofi€
Cmdidate($ Soughl I Supported
E Coordinated with reimbursement sought (lf tpplicable) l-'iOnmsed
f] Coordinated without reimbursement sought
El Independent
fl Organization (see Instruclians)
l-l r l-1 n f-l r- l-'l n l-'l n s
-l&Nme of Worker/Consultmt First Ml Date ofPayment
Amount
Method of Payment
Flr<t-<t
I
K i luttv> L. 4laicn 67r.?f
'ry#;fu
irudn Paveq

g,? F!.:F,iHFl: t t S! Ce rv' rrr I r: I ar' - t +r t ot-u" FiJ DR Ecr'""t*OfJ


E Debit card
Zip Code

tD?ln-*l 5* bx rr, u C; 0c,V,t I


"i;:W"
Abs.)iu* \lodrer* * c\ roltop s+o^L {-o s""d- r:rut* i nvr-ta€^^fffti*t
Type of Expenditure (if appticabtS: Candidate(s) Nme Offiw Soughl I Supported
E Coordinated with reimbursement souuht (if applicuble)
EOpposed
n Coordinated without reimbursement s"ought
E Independent
E Organization (see Insiructions)
l-'1 a l-'l n Tl r. f'l rr T-l E' s
Last Nme of Worker/Consultot First MI Date ofPayment
Amouut
Method of Payment
F&le-u l]lr,,,* * gfrsloq tl ts,e
Secondary Payee I
Etcheck# (JgY
?*or"ti urn Q.roCIhi sg
ot
"'0")
4-src F/ il D"bir c-d
'fi-iiinq.s r.{tv >IAIC Zip Code

Deuiption iJ
Go.)+ flrb " I
L-J 6utf lff
"p4rclnns< oS sD [a *n {i sm I
Type of Expenditure (if applicable) :
"-a Cildidate(s) Nme Office Sought fl Supported
D Coordinated wilh reimbursement sought (if applicable)
D Opposed
E Coordinaled without reimbursement sought
fl Independent
F Organization (see Instructions)
l-l r l-'l p l--l r- l-'l n l-l n s
Last Nme of Worker/Consuitmt Firsl \4I Dale of PalmeDl Amounl
Method of Payment

;*oodary Palee \rpose ofExpendih{e


by code) E Check #-
E Debit card
itreet Addrgss ciry State Zip Code

l)esnption

Type of Expenditure (if applicable) : Cmdidate(s) Nme Office Sought fl Supported


I Coordinated with reirnbursement sought (i.f applicable)
I Opposed
I Coordinated without reimbursement sought
fl Independent
I Organizatron (see Inslructions)
n^ nR Tl(- f'ln f'll'' $

SUBTOTAL Section T-This Pase n93t.ry


TOTAL of additional Section T Pages

TOTAL OF ALL REIMBI]RSEMENTS TO COMMITTEE WORKERS AND CONSIJLTANTS tizq t

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