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SUMMARY PAGE
liNA*{E OFCOM]T{TTTEE
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tr.itr*n.Na MFI
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n January 10 hling fl 7th day preceding primary n 7th day preceding referendum U Initial Contribution or Disbursement
(PACs ONL|)
D April 10 hling fl 30 days follorving primary [ 45 days follorving relerendum
n Amendment to
l-l .Iulr' l0 filins [7th day preceding elecrion D Deficit T,vpe of Report:
I Independent Expenditure
fI45 days follorving election
E Primf,r) E Elecrion
not held in November
,.:ii,::
s., FF,RI{:}Tir'€OVtRtr..n .:
lt
/0/drla9 thru
tl
/a/ao/"?
ii'
I hereby certifu and state, under penalties of false statenent, that all of the information set lorlh on this ltemized Campaign Finance
Disclosure Statement for the period covered is true, accurate and complete.
- -
ASURER (SlGNATURE)
**-'?
PRINT NAME OF SIGNER
TOTALS
NnMFjnI' anM]l{{.f1f.Fli INGDIIF DA:|E:::
l1 Balance on hand January 1 of current year for Ongoing and Parti' Comrnittees OR
Balancc on hand from daY Committee q'as formed for all other comnittees
xt.
1 2. Balance on hand a1 the beginning of Reporting Period
7, a Y/, Da
16a. Total Small Food and Beverage Receipts at l-air (Section Ll) To*-n Committees ONLY ?S\ 'a
l6b. Total Proceeds from Small Purchases at Tag Sales, Auctions or Other Sales (Section L2)
b' 6.
Municipal and Town
15c Tolal P h ase I Advertisins in a Prosram Book (Section L3) Commitlees ONLY X L. t '1,s1
ac
3 ,lt 34, g ti ao
/' ,r'
18. Subtotals (add totals ir line 12 + line 17 in Column A: and in line I I + 17 in Column B) t3, ,a/.
19. Erpenses Paid by Committee (Section P)
q4 ?z 47 g3 g "f | ,8f
20. Balance on hand at close ofReporting Period (Subtract line 19 from iine I 8 in both Columns) -{ 9 a t,?r tgc.l ,w
21. In-Kind Donations not Considered Contributions Received (Section L4) d &
22. In-Kind Contributions Received (Section M) & F,
t_x
& K,
q
23. Refundable Deposit to Telephone Company (Section N)
-q lnr,-.^n
Amount of
Clontribution
Kesldetrtlal Stleet Address lrp Looe olo\ er
'
+ C),***,,f 'y'r,u. 1-a^ 0 /" Vt9 l' ,oo't
Is contributor a lobbyist. spouse, D Yes Ifcontrrbution(is in excess of$400 to a candidate commrttee ior a chiefexecutive officer ola
or dependent child ofa lobbyist? fl No municipality does contributor or business he/she is associated rvith have a contract \\'ith said
municipality valued at more than $5.000? DYes INo
ls thrs corrtrrburron associated witb a -F
y.. Is contributor a principal ofa state contractor or prospective state contractor? I Yes 5-D, N
fundraising event listcd in Section Ll? E t'lo f1'es, indrcate u,hroh branch or branches !No
IJ.y-es,listEvent# I b. /A * C I of govemment the contract is with: fl Executive I Legislative
Method of contribution: Date Received t Aggregate contflbut !ons
frCastr Personal n Check I CreditDebit Card D Pa1'roll Deduction I Money Order tofrz/a1 / 4 4, ca
Lxt Nme
(t oto.
Fvs1.-1
Xc sr= rr'.('
\1I
' .S <)+- <wpl"r<J
PrircipalOccupation e, t I Amount of
Contribution
Residential Strdet Address
'-l'- ,l)--.) ttate hp Code Name of Emplol'er
J q4,*
Method of contribution:
n
Cash lB
Personal Check n Credit/Debit Card n Pavroll Deduction I Money Order 7e/arfaq
I-art Naine Ft'"t i{I
(-l^* Ior,t 'F,rtnLor-- 'ryi::"'ff:, Amount of
Contribution
{csjdential Sqeet.{ddress / )Iate 11p Code
^"7T:'#"'*
tt l-hne, Lo^" S-*L ll""k /f A 64q2, o€ 1Dn,L,
spouse. fl
Is contributor a loUbyist, Yes Ifcontrittutron is in excess of$400 to a chiefexecutive ollic'er ofa
a candidate committee foi
ordependentchildofalobbl,ist? n No municipality does contributor or business he/she is associated r.vith have a contract with said
municipaliw valued at more than $5.000? D Yes I No
a ts Yet I Yes
J*Z d'
Is this connibution associated rvith ls contributor a principalofa state contractor or prospective state contractor?
fundrarsins event listed in Section Ll? fl No IfJ,es,indicate u,hich branch or branches nuo
fles. lisiEvent # /D'l& 'A 7 ofgovenrment the contract is with: I Executive n Legislative
Date Recerved Aggregate confibutroDs
N{ethod of contribution:
fl
Casn ft
Personal Check fl CredilDebit Card [1 Payroll Deduction I Money Order .ro
7
/rS/ot
/
/V51 n
o'"'
'nT ,.llo - j',, /,4.,n,
N{I Pnncioal Occunarion
'
'---L-/-a^sO. (f, iu,{ l f-
f,hrqlrcef.
Amount of
Contribution
(eirOeDtlal )trcct AOffesS I Itate ltp Code arne 01 LmDl()\'er v
-
SUBTOTAL Section B-This Page
"i {a
7.Ssn '
Name of Committe e
\ame ol freasurer
Amount of Contribution
Address ls this contrrbution associated *'ith a il Yes fyes, ltsl
fi.urdraisrngeventlisted in SectionLl? [ No Event#
Zip Code Date Received A.glregate Cootn
'rty
Name ofTreaswer
Name of Comitlee
.,lme of Treaswer
ame of Comrnittee
a I Amount of Contribution
ddress ls this contribution associated with Yes If yes, lisl
fundrarsing event listcd in Section Ll? fl No Event #
lty State Zip Code Date Received Aggregate
a I Amount of Contribufion
Address Is this contrbution associated *ith Yes If yes,bst
fimdrarsing event listed in Section L 1? fl No Event #
_rn Zip Code Date Recelved
Is contributor a lobbyist, Yes If contribution-Kin excess of $400 to a candidate committey'lor a chief executive officer of 6
ordependentchildofalobbyist? [ No municipality does contributor or business he/she is associated with have a contract rvith said
municipalitv valued at more than $5,000? [ Yes E llo
Is this contribulion associated u,ith a
fundraising event listed in Section Ll ?
D Yes ls contributor a principal ofa state contractor or prospective state contractor? fl Yes /oD, ae
E No If,es, indicate u'hich branch or branches ENo
fyes. list Event # of govemment the contract is with: n
Executive D l-egislative
Date Received -A ggregatg contnbutrons
]r4ethod of contribution:
ICash Personaldl Check I CrediLDebit Card n Payroll Deduction n N{oney Order ro/as/d?
MI Principal Occupation Amount of
'"tY^ ?^ L, *-l- O{a
-o
Kesroenrral Jtrej!+otress / / ti81u",.,..=An ,Ate ,rP LOOe Name of F-nrnlo\ d
Contribution
tr Casn $ Personal Check I CrediilDebit Card D Payroll Deduction I Money Order to /os /eQ 4 o t.t-c
srYme
(
I
u'"?ol# MI Principal Occupation Amount of
r"rna dnn Contribution
;; /rffil;)"tr",.1'
Kesrdentral Sr*et Addresv
p,l
spouse, fl
Is contributor a lobbyist, Yes
'ilo* ,/o
If contribution
,Ale
\7-
^ is in excess of $400 to
:lp
adrl')
LOOe Nme ot .bmployer
tr casl l( fersonal Check I CreditiDebit Card n Payroll Deduction I Money Order /a/aq/u,z
LTltNme i First l!{I Itucipal O;glpatiop . / Amount oi
[ ,.-an/rr ;flf,^es itate hp Code
Ke-J: n.-d
ame 01 l,mploJ'er
Contribution
I Casn S fersonal Check fl CrediVDebit Card I Payroll Deduction D Money Order t a /rz /a? d 4f. oo
vage / of /3
I. MONETARY RECEIPTS
Section B. Additional Page
NT A N'E AD FII -ING r)ITF, f}ATE
la *t?-2oa/
'AIA'I']:mE
S* 1{, e.; {: - l\'(at o -
'}.. Itemized Contributions from Individuals
Fint 1r l
l-astNm
('"-l^
i
{ J".;
#a
MI Principal Occupcion Amount of
Contribution
1a,-) itate pip Code Nme of Employer
ij'o;"n'o*ss" qy' ,lte-,-b v
I
(rl6e'/t?
Is contributor a lobbyist, spouse, E Yes If contribution ii in excess of M00 to a candidate committee for a chief executive ofhcer of a
or dependent child of a lobbyist? []No municipality does contributor or business he/she is associated with have a conkact with said
municipality valued at more than $5,0O0? fl Yes n No
Is this contribution associated with a X v"t Is contributor a principal ofa state contractor or prospective state confactor? fl Yes Ji-A , tr
li.rndraisingevent listed in Section Ll? DNo fyes, indicate which branch or branches DNo
If yes.listEventf - / A -D ?
/C olgovemment the conkact is with: fl Executive fl Legislative
Date Received Aggegate conhbutroos
Method of contribution: , ,
lQCastr I personal Check n Credit/Debit Card D Payroll Deduction D Money Order /o /tt /aq / 3V. eo
t^P*l[^. "'*;). * r*//
MI Amount of
Contribufion
{esldmhal Stret Addess ,r?-iln,- ;tat€ ap LO{e Nme ol bmDlovtr
!1* t6qtt (J 4.rt(
r
h.
1rp
a
D.
Is contributor lobbyist, spousg I Yes
^il*r,., ,i
Ifcontribution is in excess of
ilate
3/* o6vo/
aip Code
ordependentchildofalobbyist? [ No municipality does contributor or business he/she is associated with have a contract with said
municipaliry valued at. more than $5,000? Yes No n fl
a E Y*
Is this contribution associated with
Ll? E No
fi.rndraising event lisied in Section
Is contribdor a principal ofa state contractor or prosp€ctive state contractor?
I/yes, indicate *fiich branch or branches
D
n
Yes
No f aa,m
Ifyes,lixEvent# I O - tO - o? of govemment the con{ract is with: E
Executive D Legislative
Method of contribution: Dare Rreired Aggregate mlntrutros
fl Casn { fersonal Check D CrediyOpbit Card [J Payroll Deduction I Money Order zal,-? /ol ,?45,*
st Nme FiBt ji l MI h'*i'"tftTTTf. Amount of
l)r-et"l^^" V ancy 13u i^,, ^J
,'zj,
f
^ Contribution
;;;-F:;"-:;,." ?J
Is contribuior a lobbyis! spouse, U Yes
c*i
If contribr,rtion is in excess of
Jtate
(-r
,lp L{Jde
0[,,/2f'
Name oI bmployer
/a
/r'.,, ^ U,^
-L-\
s-,-...,,-- :";fr 66(R,.i
Iscontributoralobbyist,spouse, fl Yes If coritribution is in excess of M00 to a candidate committee for a chief executive officer of a
ordependentchildofalobbyist? D No municipality does contribtrtor or business he/she is associated with have a contract with said
municipality valued at more than $5,000? [ Yes I No
Is this contribution associated with a E Yes Is contributor a principal ofa state contractor or prospective state contractod tr Yes
f'undraising event listed in Section L l? fl No fyen, indicate which branch or branches u No
/ t-t-' r-u
/yes, lisiEvent # /D - il -o f ofgovemmenttiecontractiswith: IExecutive ILegislative
Method of conrribution: f)ateReceivsl r / Aggregate mntnbuIons
tr Casn ,{
Personal Chcck D Credit/Debit Card I Payroll Deduction fl Money Order ta/r /a I J6::*
SUBTOTAL Section B-This Paee ({t e
v^g" 3
I. MONETARY RECEIPTS
Section B. Additional Page
NT A T'E r)N ;II IN'}I\IM NATF
1a -s?-Rat?
'r}I\fI\,{I'T'|FF
*T/a4e on-i -j*- (\x, D f-
B. Itemized Contributions from Individuals
Last Nme Fint MI Principal Qcupation /\ Amount of
(4, l,-,n- s hn Contribution
--/
'fil^l{,n ttate Zip Code \me 9r bmproytr J
.xT""1T;1"?-
Is contributor a lobbyist,
1,. RJ
spouse, D Yes ".CJ ,l a elq2 I1;(on, -
If contributi/on is in excess of M00 to a candidate committee for
lL4q.Aioc
a chief executive officer of a
r>1
ordependentchildofalobbyist? U No municipality does contributor or business he/she is associated with have a contract with said
municipality valued at more than $5,(F0? il Yes fl No
Is this contribution associated with a E Yes Is contributor a principal ofa state contractor or prospective state contractor? tr Yes
ftrrdraising event listed in Section Ll? EI, lto fyes, indicate which branch or branches n No ,11'z 'w
fyes, list Event #_ of govemment the contract is with: fl Executive E Legislative
Method of contribution: Date Raeived ; , Aggegate contributioN
E Casn {fersonal Check fl Credit/oebit card fl Payroll Deduction D Money Order /a /gh1
L2r{me I
t-r-toc (1 q.na
i"A
.\acan
ltvtl
I
' Occuarim
Prircioal t
,<-if.."^-loourl
I Amount of
Contribution
ofEmployo
(esrdenuat sEet Aoorss
Is contributolalobbyist, spouse, fl Yes If contribution is in excess of $400 to a candidate committee for a chief executive officer of a
ordependentchildofalobbyist? E No municipality does contributor or business helshe is associated with have a contract with said
municioalitv valued al more than $5,000? EYes ENo
Is this contribution associated wth a E y"t Is contributor a principalofa state contractor or prosp€ctive slate conkactor? Yes g /oa,fi
fundnising event listed in Section Ll? E No fyes, indicate *thich branch or branches No tr
fyes, lisi Event # / b -lL -O I of govemment the contract is with: I Executive D Legislative
Date Recived Aggregate mtrrbutrotrs
Method of conbibution: /
D C*n flr"rsonal Check I Credit/Oebit Card [1 Payroll Deduction D Money Order / a/r z/a?
L9Lf.\rame Fi'"t I I\.{ Principal Occupation Amount of
(==Ou.rn 7{oon ra{-, I f) n.,n42 f Contribution
LNdmtnl ,
Sfteet Address -PD- itate lrp Looe Name ol bmDloYer -
cr *
I
Lgy Nmef
l-l-'u* Ao <
oH.,
R. ltemized Contritrutions from Individuals
neJ4
MI *"'ffii} e.n^-kr./ Amount of
Contribution
NameofEmployer
':U-.bn
livn r
(e\Idesrtal Streel Addr6sl tl lsl?re :lp Lde /
4)o lr),-'L'te,, lluo h-r aL(/r
Is contributor a lobbyist, spouse, D Yes Ifcontributioh is in excess of$400 1o a candrdate committee for a chiefexecutrve ofhcer ofa
ordependentchildofalobbyist? [1 No municipality does contributor or business hey'she is associated with have a contract with said
municipality valued at more than $5,@0? D Yes fl No
a
ls this contribution associated wth .E Vo Iscontributoraprincipal ofastatecontractororprospectivestatecontractor? [ Yes
Ll]
fmdraising evcnt listed in Section
Ifyes.lrslBvent# j r: - / L' 6 4
[ No I/yes, indicate which branch or
of govemment the contract
branches
is with: U Executive fl Legislative
D No tzrtr
Method of contribution: l)ate R4eivql Aggregate conmDuuo{ls
D casfr ft
Peisonal Check fl CrediVDebit Card fJ Payroll Deduction I Money Order to /tr / ot J / {,to
Nme '
Eist-- I I MI
/"J Amount of
Last I Primipal Scgpation
:aE. k.u n *1"
-iry-
t\t, r,l tv o I Contribufion
",'';; "2::";: */"- 2.-
n
(nLllonJ, lP
lr'- I6f32 N, G,; L q( IYo. ,7*.,n
lstate u@9 Nme otJ]mDlovq
Is contributor a lobbyist, spouse, I ^ Yes If contributionis in excess of $40O to a candidate committee for a chief executive ofltcer of a
ordependentchildofalobbyist? fl No municipality does contributor or business he/she is associated v.ith have a contract with said
municipality valued at more than $5,000? ENo Eyes
Is this contribution associated with a I Yes Is contributor a principal ofa state contractor or prosp€ctive state contractor? fI Yes 3 o-a,a*
fi.mdraising event listed in Section Ll? E$ N" I/yes, indicate **rich branch or branches U No
fyes, list Event # of government the contract is wit}l:
U Executive E Legislative
Method of contribution: Dare Raeiv{ l Aggregate mtnbutiom
D C*n Et-p"rsonal Check fl Crediyoebit Card I Payroll Deduction I Money Order /o lz/a4
L6t Nme t'trtt /' - I MI Principal Ompatioo I / Amount of
q, /C e^ n laue<:(
J
tl Casft
ft Personal Check D CreOitneUit Card I Payroll Deduction f] Money Order rc/r/oQ 5-?5-, *
L6(Nme Finf .t MI Amount of
-a7u,," I
I M,.ln""t
Principal 9ggqpglm
Yes
l1",il*,"J;r )
If conkibution is in excess of M00 to
lY f')fr' rq
a candidate committee for a chief executive offtcer of a
ordependentchildofalobbyist? E Wo municipality does contributor or business he/she is associated with lrave a contract with said
municipalityvaluededmorethan$5,000? E yes I No
ls this contribution associated with a u Yes Is contributor a principal ofa state contractor or prospective state contractod n Yes l5z,e
fundraising event listed in Section L1? -9, No Ifyes, ndicate which branch or branches n No
If yes,list Event #_ ofgovernmentthecontractiswith: flExecutive DLegislative
Method of contribution: Date Rtreivf Aggregate contrrbutons
/
tr Casfr fr Personal Check I Credit/Debit Card E Payroll Deduction I Money Order /D /t3 /D g
Nme MI Occup4ion i
rt
U- il,-lnu.
I
"f'Lr.Lo./ Principal
k Isc -tT ,crcrn
Amount of
Contribution
2,,t:r
- q,o UY
C
Iscontributoralobbyist,spouse, Yes tf contributidn is in cxcess of M00 to a candidate committee for a chief executive officer of a
ordependentchildolalobbyist? fl No mrmicipality does conkibutor or business he/she is associated with have a contract with said
municipality valued at more than $5,000? IYes INo
ls this contribution associated rvith a EI Yes Is contributor a principal ofa state contractor or prospective state contractor? I Yes
fundraising event listed in Section L!? n DNo
/ya', list Event #
No fyes, indicate which branch or branches
of government the contract is with: D Executive fl Legistative 5a,*
Ilate Received Aggrcgate mntrbuhons
Method of contribution:
M
h,
Curi, I Persona] Check il CreditDebit Card D Payroll Deduction fl Money Order ,,o /ta /t i /s-2,"n
SUBTOTAI, Section B-This :Pase '7 {o.r
Yage f d /3
I. MONETARY RECEIPTS
Section B. Additional Page
L'E AD NTI RTC NI IE N A TE
'AIA'I.I-EE
X-a;ffi?J ?J u
Is coirtributor a lobbyist, spouse, Yes
- \s a c i-tt.-
l5rare
l(f 66Ys3
lf con'tribution is in excess of 5400 to a candidate committee fora chief executive officer of a
or dependent child of a lobbyist? n No municipality does contributor or business he,/she is associated with have a contract with said
municipality valued at more than $5,000? fl Yes fl No
Is this contribution associated with a .E vo Is contributor a principal ofa state contractor or prospective state contractor? n Yes /a d"t
fiindraising event listed in Section Ll? ENo fyes, indicate which branch or branches DNo
fyes, list Event # 1A-/_Q_*a 7_ of govemment the contract is with: I Executive D Legislative
Date Recqved Aggegate confibutlons
Method of contribution:
Qcastr I Penonal Check E Credit/Debit Card fl Palroll Deduction I Money Order to /rt /o?
Lasl Nme ' I h rrst MI Prircipal Opcqpaion ,1 Amount of
P,' /t ) , /l,o^ 5-lf 'ar^ , /"r./ Contribution
{esrdmtial "tlq./,u^
StIffit Address itate 4p L@e Name oI bmproyer
xp code
Principal Occupation
Name ofEmployer
Amount of
Contribution
Is contributor a lobbyist, spouse, fl Yes Ifcontribudon is in excess of$400 to a candidate committee for a chiefexecutive officer ofa
or dependent child ofa lobbyist? ENo municipality does contributor or business he/she is associated with have a contract with said
municipality valued at more than $5,000? U yes El No
Is this confibution associated with a Eo yo Is contributor a principal ofa state contractor or prospective state contractor? fl Yes
fundraising event listed in Section Ll? E No fya, indicate which branch or branches fl No
fyes, listEvent# ia- lL-oai of govemment the contract is with: Executive fl Legislative I
Method of contribution Date Rrceiyed / 5-o.ro
:
^ti'/.{4r,,,. '+!
A
'II
l"(a^, u - /D " -2)- o? e o7'
B. Itemized Contributions from.Individuals
Nt Namh Fisf 1 - MI PnpopalQccupation / ; . /
Mn'l"--.#
Kesloenltd Street Address l
l),"".#
'h*I
t
jtate
/n^,J"..",* 'fl",. I A,.V
\mc ol
Amount of
Contribution
IZIP Lode hmDldtver
Is conhibutor a lobbyist, Jporise, fl Yes Ifconkibrttion is in excess of$400 to a candidate comfitttee for a chiefexecutive officer ofa
or dependent child ofa lobbyist? D No municipality does contributor or business he,/she is associated with have a contract with said
municipality valued at more than $5,000? !Yes INo
Is this contribution associated with
firndraising event listed in Section L I ?
a .& Vo
E No
Is contributor a principal ofa state contractor or prospecfive state contractor?
I/yes, indicate **rich branch or branches
D
I
Yes
No
5-a,r'
Ifyes,liiEtent# /D " t L " o of govemment the contract is with: I
Executive LJ Legislative
" DateRmeived Aggregate mlrrDuuons
Method of contribution: L
NC*n D Personal Check fl Credit/Debit Card D Payroll Huction E Money Order ta/a/og /Q b,ca
L6tNme frb MI Princioal Ckruration Amount of
lrl- Plnnu,
';;"i1":.,
Stret Addrcs
Resi'Cmhal
( ,n *r,n8-t
''"fu^," itate ,rp Loce
0*.-*''n
\ame Fmproytr
or
h". "- Contribution
J^ iT:,A,
Is contributor a lobbyis! spotse, fl
o n
Yes
on,i..
Ifcontribution is in exccss of$400 to
r7- D6tb/ l.* i4-."r..",^ -A-Llo T;< /]\
a candidate committee fora chiefexecutive officer ofa
ordependentchildofalobbyist? [ No municipality does contributor or business hey'sbe is associated with have a contract with said
municipality valued at more than $5,000? E Yes fl No
Isthiscontributionassociatedwitha -( Vo Is contributor a principal ofa state conFactor or prospective state conFactor? D Yes
/tz.o
fundraising event listed in Section Ll? [ No fyes, indicate which branch or branches ENo
fyes, listEvent# I SJL ^ O? of govemment the contract is with: I Executive il Legislative
Method of contribution: Date Received Aggegate cootfibutoN
tl Casn ,{ Penonal Check E CreAitfOeUit Card I Payroll Deduction fl Money Order
Ay'd.^
'T4T"1",* j-. '^:tt
.rry
,n l*
Princjpa{
')/^o
Oaupa[m-
" / l- ,-. ,
Amount of
Contribution
-eslofluil Jue Aoq6s I uode {me 9t
;a;;
arp EmpldDrq
,.,. 1kl
lstate
]l-.rc--lv 1nr.ln,*. kl- o L+to M: /- ^, (! H o,, V. ,, ,n
ls contributor a lobbyist" U spoue, Yes If contribution is in excess of $400 to
a candidate committee for a chief executive officer of a
ordependentchildofalobbyist? El No muicipality does contributor or brsiness helshe is associated with have a contract \ .ith said
rnunicifality valued d morethan$5,000? M y* D No
Is this contribution associated with a E Yes Is contributor a principal ofa state contmctor or prospective state contractofl n Yes
fundraisingeventlistedinSectionLl?'B No fyes, indicate which branch or branches E No
I/yes, list Event # ofgovernmentthecontractiswith: DExecutive DLegislative ",iloo.n-
Method of contribution: Date Rrceived Aggregate contrr butrons
[J Cash E Penonal Check E Credit/Debit Card D Payroll Deduction tl Money Order /,t f rzJ oq
Last,Nm€
Mo o.< '")16;r,, l* Amount of
Contribution
tilJ
Ras'ideitial Stret Adrh eis
lJ.^-rl,nr,. ?J
litjr-
'
lu^1,,
/ itate
1r
4,rp
b
Code
btl}'
Nme of Employer t I
Iscontributoralobbyist,spous6, fl Yes If contributidn is in excess of M00 toa candidate committee for a chief executive officer of a
ordependentchildofalobbyist? fl No municipality does contributor or business hc/she is associated with have a confact with said
municipality valued at more than $5,000? D Yes No fl
a
Is this contribution associated with [l E Yes
Ll?
fundraising event listed in Section fl
Yes
No
Is contributor a principal ofa state contractor or prospective state contractor?
fyes, indicate which braoch or branches DNo 5a.r
{fye-r, listEvent # i D -)b " D? of govemment the contract is with:
D Executive Legislative n
Me^thod of contribution: Date Receiyed
flCuth [l Personal Check I Cre.dit/Debit Card I Payroll Deduction I Money Order tolrLl,? J9o'n
SUBTOTAL Section B-This P ase lD {o.F
I'age of LJ-
L MONETARY RECEIPTS
Section B. Additional Page
JN INGI-}ITF-NATF
n
Is contributor a lobby'ist, spouse, Yes If contribufion is in excess of M00 to a candidate committee for a chief executive ofhcer of a
or dependent child of a lobbyist? n No municipality does contributor or business he/she is associated with have a contract with said
mwricipality valued at more than $5,0O0? El Ves fl No
Is this contribution associated with a
fi.urdraising event listed in Section L1 ?
Fvo
DNo
Is contributor a principal ofa state contractor or prospective state contractor?
fyes, indicate u*rich branch or branches
Yes fl
ENo
fi'to
ffyes,listEvent # /b - ll' b? olgovemment the contract is with: Executive ! Legislati"e fl
Date Rseivcd Aggegate cof,tnbutons
Method of contribution:
Qcash I Penonal Check fl Credit/DebitCard I Payroll Deduction il Money Order lo /rt /a f /5-o, aa
First MI PrincipalOccpp4lim ; / Amount of
a4'r , :f;.
J
fi C^n E Personal Check fl Credit/Debit Cad fl Payroll Deduction E Money Order tD// z /? J,?s "o*
'^'Br"Yt^rlo, l'*'sl,,lo
MI PrinciB{Occupatim ,
( 'o
^^ u
.l
nih, -2o *lus,.n#
t Amount of
Contribution
WrB-J!Wl"*
D
Wolr,,/L
ls contributor a lobbyist, spouse, Yes -If contribution
rate
ET
lo
t6z6
Code Name of
n.-1,'
Emolovs
.-+ -T] J
is in excess of $400 to a candidate committed for a chidf executl?e offrcer of a
I
u
or dependent child ofa lobbyist? fl No municipatity does contributor or business he,/she is associated with have a contract with said
municipality valued d more than $5,00o? No [f Yes il
Is this contribution associated with a S Yes Is contributor a principal of a state contractor or prospectiv€ state conlmctor? [ Yes
fundraising event listed in Section Ll? INo fyes, lndicate which branch or branches E No 5'D,',;"
fyes,tistEvent* l6 "lL - OQ of govemment the conlract is with: D Executive fJ Legislative
Method of coniribution: Date Reeived, ; Aggregate conlrrtluuoro
E c*n { Personal Check E CrediVoebit Card B Payroll Deduction D Money Order to /B/o9 l4o,w
F[st_- I MI Amount of
tP- la cc,:,.
LdtNane I
l--and Contribution
lesidenhal Street Address .&L,tJ^ itate 1ip Code ,b::J::'":??J,
4 z ()^l< /tru- :r- a4vtu
ls contributor a lobbyist, spouse, I Yes If contribution is in excess of M00 to a candidate committ& for a chief executive officer of a
or dependent child ofa lobbyist? dNo municipality does contributor or business he/she is associated with have a contract with said
municipality valued at more than $5,000? fl Yes E No
ls this contribution associated wath a K Ym Is contributor a principal ofa state contractor or prospective state conlractofl fl Yes
fundraising event I isted in Section L I ? tr No fyes, indicate which branch or branches ENo Joa,fr
If yes. list Event# f1! ;1!l! | of govemment the confact is with: I Executive il kgistative
Dale Rrceived Aggregate mnlnbuooN
Method of contribution:
tl casn { Personal Check I Credit/Debit Card fl Payroll Deduction fl Money Order toliz/dt 7 oo,a'
SUBTOTAL Section B-TEU lggg 4 {ud
s>
Page 0 ot /3
I. MONETARY RECEIPTS
Section B. Additional Pase
N A M IJ OF rIT INGillF,DATF
9V. 44.l, -!)-
'r)N/{\I]TTFF
lYoo
'" ,/a - X 7 -1oc?
B. Itemized Contributions from Individuals
Lpry)me FBt-,=- / MI o"o'SflZ
fc,oQ-
tesider{tia!}rcet Addre_ss
fr "(
ttY--<') Nme ot h,mployer
?- n^, l,r./ Amount of
Confribufion
ll
'//*b.t/
itate Zip Code
Is contributor a lobbyidt, spouse, tr Yes a candidate committee for a chief executive ofltcer of a
If contributioh is in sxcess of $400 to
or dependent child ofa lobbyist? & No municipality does contributor or business he/she is associated with have a contract with said
mudcipality valued ai more than $5,000? F yo D No
Is this contribution associated with a FYo Is contributor a principal ofa state contractor or prospective state contractor? fl Yes
fundraising event listed in Section Ll? []No {/yes, indicate which branch orbranches El No /o-e, t-x
.I/ya, lisiEvent * t_X t L -o?_ of govemment the contract is with: E Executive E Legislative
Lrarc Kecerveo , AggreSare conmDunoN
Method of contribution:
tr Casfr fi Personal Check D CreaitfOeOit Card E Payroll Huction El Money Order ta/r a /a? | 2s1p
Lroj.Nqas
'K" h *"- i
'^4/, I; Ls€
MI Priqcippl Occlpation,
(rA,a( iJ^ /s1{',"",
\me tmolovs oI
. Amount of
Contribution
),T':X::"<J
rtare :rp
"7"1, L
"
aA qto C /n ol /"-b,
.s contributor a lobbyis! spouse, I Yes Ifcontribution is in excess of$400 to a candidate committedfor a chiefexecutive qfftcer of a
rr dependent child ofa lobbyist? []No municipality does contributor or business he/she is associated with have a contract with said
municipality valued at more than $5,000? [ Yes E No
Is this contribution associated with a Evo Is contributor a principal ofa state contractor or prospective state contractor? D Yes
fi.mdraising event listed in Section Ll? []No ftss, indicaJe which branch or branches INo 5:o,r+
fyes, listEvent# l8- /(*a? of govemment the contract is with:
Executive E kgislative I
Method of contribution: DareReceivfl I Aggregale coofibuhoDs
fl Cash ( Personal Check fl Credit/Debit Card El Payroll Deduction I Money Order /o/a/o? / %:*
Lgtrlsl.flme MI Principal pqgpatlopr / / Amount of
X vss, "t1 ^iln SalJ- - a-+^'?layed Contribution
StreetA0{lr6s alp uooe Nme olEmploytr
Kesroennar
- )i 'No^q"'/o"A itate
, Dn C.*,."*l '1o11"- 1) nA ))c
Is confibutor a lobbyist, spousc, E Yes If contrlbution is in excess of MOO to a candidate committee for a chief executive officer of a
or dependent child of a lobbyist? INo municipality does contributor or business he/she is associated with have a contract with said
municipality valued at more than $5,00O? B yes E No
Is this contribution associated with a ff Yes Is contributor a principal ofa state contractor or prospective state contractor? D Yes
fundraising event listed in Section L1? fl No ENo
/ d*'*
fyes, indicate which branch or branches
fyes, listEvent # E;lL:!!_ ofgovemmenttlrecontractiswith. IExecutive flLegislative
Method of cqnqibution: Date R4eived / Aggregate contnbutroN
E Cash ftPersonal Check E Credit/Debit Card E Payrolt Deduction D Money Order t o/2 /of / la,oo
"W: l"^ x-/n,; Fint
r, l -
MI *"totY?T- Amount of
l,l1 tD u^ ^ 1",.1 Contribution
dentgrytreet Af dress
.?v 'k"ti ar- L)..
Resr
:;;^y;"::YL^,t A"
Is contributor
a lobbyist, spouse, I Yes
2-1, ttate
:7-
lrp LJXe
ob,{t 8
Name ot bmployer
Cr
lip Code
n Lz/r o p,"F:?"! 't\n 3*-..^
If contribution is in excess of MOO to a candidate committee for a chief executive officer of a
or dependent child ofa lobbyist? INo municipality does contributor or business he/she is associated with have a contract with said
municipality valued at more than $5,000? D yes U No
Is this contribution associated with a I Yes Is contributor a principal ofa state contractor or prospectiye state contmctor? D Yes
fi.mdraising event listed in Section L1?
,fyes, list Event #
.El N" I/yes, indicate which branch or branches
of government the contract is with: I
Executive f1 Legisiative
ENo
4 ro''o
Method of contribution: Date Reeived r / Aglfegate cotrmbutrotr
D C*fr fr Personal Check D Credit/DpbitCard n Payroll Deduction I Money Order /o/'o /"q
Lasl Nase o*''fln*don, MI hincinal Omatim Amount of
**4r'.-'. l''{a,t or Contribution
z5Tr:'i'T:*, /, ttal
Iscontributoralobbyist,sfouse, I Yes
J/""Jn
If contridution is in excess of $400 to
brl 6L 1iltr
lNme
a candidate committee for a chief executive officer of a
ordependentchildofalobbyist? fl No municipality does contributor or business he/she is associated with have a contract *,ith said
municipatity valued at more than $5,000? fl Yes I No
Is this contribution associated with a $, v"s Is contributor a principal ofa state contractor or prospective state contractor? n Yes
flrndraising event lisieil in Section L1? []No u l\o
fyes. lisiEvent# Ib-tL-o ?
fyes, indicate which branch or branches
of government the contract is with: fl Executive I Legislative Jz,n
Date R6eived Aggregate cotrtrrbuhons
Method of contnbution:
{Castr I Persona] Check n Credit/Debit Card I Payroll Deductron D Moncy Ordcr
to /tt/rq t qj:''
SUBTOTAL Section B-This Page (nn.o"
Page of lJ
I. MONETARY RECEIPTS
Section B. Additional Pase
?II TNr} NI TF NATF
n Cash Q Personal Check f] Credit{Debit Card I Payroll Deduction I Money Order ta/?/a? 4e*.t'
First ,)- PrircipalOccupatqtl, I , /
tfft Name
/jA" r /;
J
a-^.o n
|
A
MI
'K.*r.d. Amount of
Contribntion
(eslomud }tre€t AddreSS t 'ivfrJ / itate f,p Lme Name ofEmployer
qq C1"". l,t, ^/<d L / A le.,^ /)tt f't 3r
ht,709
Is contributor a lobtyist, spouse, tr Yes If contribution is in €xcess of $400 to a candidate committee for a chief executive offictr of a
or dependent child ofa lobbyist? tr No municipality does contributor or business he/she is associated wilh have a contract with said
municipality valued at more than $5,000? E Yes D No
ls this contribution associated with a e Yes ofa state contractor or prospective state contractor?
Is contributor a principal fl Yes
firndraising event listed in Section Ll? tr No {yer, indicate which branch or branches fl No
fyes, list Event #
/ 6 -/4 -b? of govemment the contract is with: I Executive E Legislative -i--4.*
Method of contribution: Date RtreiYed,.
t1 Cast ft Personal Check E Credit/Debit Card E Payroll Deduction fl Money Order /o/ts/o1' 216,64
-$t^aqe I
Vn l^^{tnn
rt5l/)
' /,/" ,c k
I MI Princinal
' Ocuoation /
'3 " +,.;J
t Amount of
Contribution
^r^
iesloeuDa Jtreet Aooress
sa
--, a -\tm mi I
Ir ^/
(jL-
J '2--1, itate
n7--
rp Lme
6/'ilr
),lame of Emplot'u
.s contributor a lobbyis! spouse, U Yes Ifcontributlon is in excess of $400 toa candidate committee for a chiefexecutive officer ofa
rr dependent child ofa lobbyist? trl No municipality does contributor or business hey'she is asscciated with have a contract with said
municipality valued at more than $5,000? E yes E No
ls this contribution associated wilh a E[vo Is contributor a principal ofa state contractor or prospective state contractor? fl Yes
fundraising event listed in Section Ll? INo I/yer" indicate which branch or branches INo /aa'm
{/yes, listEvent# IO -/4-c'i ofgovernmenttlrecontractiswith: EExecutive ILegislative
Date Rffived / Aggregarp mrrDuDom
Method of contribution:
D Cash p Penonal Check fl CrediyOeUit Card D Payroll Huction fl lr{oney Order to/, /u ? Ll rt,.*o
astN?me
/ rs/ MI Amount of
/t/m hnD k durQ, Contribution
Kesrdfl tral str€t Addx6s t'U"^-ln *
;tate ap usre Nme oI tmDroyer I
IVQ tJ. A,- aa+tf, n.L "# ,/r*tt
Is contributor a lobbyist, spouse, E Yes a chief executive offr&r of a
If contribiltion is in excess of $400 to a candidate committed for
or dependent child of a lobbyist? fl No municipalrty does contributor or business he/she is associated with have a contract with said
municipality valued at more than $5,00O? E yes E No
Is this contribution associated with a {v". Is contributor a principal ofa state contractor or prospective state contractor? E Yes
fundraisrns event listed in Section Ll?
I/yes. lisT Event /O * -il -a?
ENo ,I/yes, indicate which branch or branches
of govemment the contract is with: D Executive E Legislative
ENo Jn.^
Date Raeived ; rggregare auuouuorN
Method of contribution:
fiC^tt E Personal Check E Credit/Debit Card E Palroll Deduction I Money Order td/a/t'7 oV c-rit*
Frst / J MI Princip{Oaupagipn t / Amount of
nff\,1JretJAddless /,//,r*
), J> /+ - €q D lor.ol Contribution
{esrdenftar I ,o ttate Llp Loce Nme oi.tfiployer /
:r
A
-sLCt", G./-
vl^, o r- /n -Jt-A tc7
B, Itemized Contritrutions from Individuals
Last Name/ Fnt 1, , MI Pmcipal Occupation t/ Amount of
[r) ) h^,^ cr^n vl5a4y ee n
f N un;q Contribution
<es'0(iluil Jtreet Aooress
t /-t .l
b? (;"-,,.", +r. ---I <-rr
''.A^to" ,L
;iate
(:T' lip Code
A le10 I
Nme ot
E:-.
EmDlover
k^ //r,*/
spouse, fl
Is cnntributor a lobbyist, Yes If contribution is in excess of $400 to
a candidate committee for a chief executive'ofhcer of a
ordependentcbildofalobbyist? D No municipality does contributor or business he,/she is associated with have a contract with said
municipality valued at more than $5,000? No fl Yes n
Is this contribution associated with a fi Yes Is contributor a principal of a state contractor or prospective state contractor? [ Yes
fundraising event listel in Section
fyes, list Event #
Ll? n No fyes, indicate which branch or branches
of govemment the contract is with: I Executive I Legislative
fl No
/ D4 .''
Method of contribution: Date Raeived. AggIegate contrrbuhoN
D Casn ,Q Personal Check I Credit/Debit Card fJ Payroll Deduction D Money Order )o /tz /o7 JAo't-d
Last Name First MI Principal Ocirpation Amount of
Contribution
<esrdennal SlI€t Ad&ess lity Itate 1ip Code Narne 01 bmptoytr
Is contributor a lobbyist, spouse, D yes If conaibution is in excess of$40O to a candidate committee for a chief executive officer of a
ordependentchildofalobbyist? E No municipality does contributor or business he/she is associated with have a contract with said
municipali{ valued at more than $5,000? fl Yes U No
Is this contribution associated with a I Yes ofa state conFactor or prosp€ctive state contractor?
ls contributor a principal I Yes
fi.mdraisingeventlistedinSectionll? fl No I/yes, indicate which branch or branches DNo
fyes, list Event # of govemment the contract is with: E Executive E Legislative
Method of contribution: Dale Rssved Aggregate mln-tlutros
fl
Casn n
Personal Check n CrediyDebit Card fl Palroll Deduction I Money Onder
LiltNme First MI Principal Occupatioa Amount of
Contribution
<6rdflial Str€t Address lity itate :rp Code
s contributoralobbyis! spouse, I Yes excess of$4O0 to a candidate committee for a chiefexecutive officer ofa
Ifcontribution is in
>rdependentchiidofalobbyist? [ No municipality does contributor or business hdshe is associated with have a contract v.ith said
municipality valued at more than $5,000? E Yes No fl
Is this contribution associated with a E Yes ls contributor a principai of a state contractor or prospective state contractor? n Yes
fundraising event listed in Section Ll? fl No I/yes, indicate utrich branch or branches D No
/yes. list Event # of govemment the confact is with. n
Executive D kgislatit
DateRffiived
"
Aggregate mnttrbilUoos
Method of contribution:
D Castr fl Personal Check fl CreditDebit Card I Payroll Deduction fl Money Order
NtNme Fist MI hincipal Occupatim Amount of
Contribution
lesidflhal Stret Addrss 'tty itate ilp Code Nme of Fnployu
ls contributor a lobbyisl spouse, E Yes If contribution is in excess of M00 to a candidate committee for a chief executive officer of a
ordependentchildofalobbyist? E Uo mruricipality does contributor or business he/she is associated with bave a contract with said
municipality valued d more than $5,00O? [Yes []No
ls this contribution associated with a fl Yes Is contributor a principal ofa state contractor or prospective state contractor? n Yes
hrndraising event listed in Section Ll? INo df}es, indicate which branch or branches fI No
{fyes, list Event # of govemment the contract is with:
D Executive D Legislative
Method of contribution: Date Rrceived Aggregate conkrbutrons
fl Cash E Personal Check C Credit/Debit Card E Payroll Deduction ! Money Order
I -ast Nme First M] Principai Ocmpation Amount of
Contrihution
Residentral Sa€t Address \ry itate 4rp Code \me ol bmptoyfl
Is contributor a lobbyist, spouse, I Yes If contribution is in excess of M00 to a candidate committee for a chief executive officer of a
or dependent child of a lobbyist? fl No municipality does contributor or business he/she is associated with have a contract u,ith said
mrinicipality valued at more than $5,000? [ Yes D No
Is this contribution associated with a I Yes Is contributor a prirrcipal ofa state contractor or prospective state contractod D Yes
fundraising event listed in Section Ll? fl No fyes, indicatc which branch or branches u No
/yes, list Event # of govemment the contract is with: fl
Executive Legislative n
Date Reccived Aggregate sntnbuhons
Method of contribution:
! Cash D Personal Check fl Credit{Debit Card I Payroll Deduction D Money Order
lntL.n -
$ J"v, B4
J-,rnteiest f.aiit
Amomt Amoml Total
Date Received Date Received -
Amount Received
Description
s e.
Nme Date of Trmaction Amount Received
Desinprron
X
Name Date ol lrmactron Amount Received
Description
4
S
&
6
IV. EXPENDITIIRES Page 13 of 17
FL 33rbt
I Code
to f ,, f ,7 Echect*
kq.rc 41,^-L,L atC E Debit Card
l-\rmose ot ExDendrMe
,r,r'cod.r/
- / A _ V pl
'H::7,;. //\o, 1,, Tlu.rs Event #
Tl
"rH
pe of Expendi tur e (f app lirahle). Cmdida2€(s) Nme 0flice Sought U Supported
(if upplictule) D Opposed
I Coordinated with reimbursement sought
n Coordinated rvithout reimbursemenl sought
D Independent
fl Organization (s ee Instructions)
tla trB nc !n trn J,33A.oB
Nme Method olPayment Amount
73
n
tO
peodrl
:1p LOOc
4-T-
tate alp Lode
)ula,'^
{odress
Sl
!q:1
l)-J:q
I
cr
Jtate Lrp I ooe
b /' Lllf
r" f $f,r &cttecu* I i4
E Debit Card
o
Yurpose ol bxpendlhfe
'i':T:.-)", Lvent # J /
(b-vcode)
FN n ? A
^1"-u")-
C-J*u.', ic/r/,/oQ
Type of Expendit\tre (if qpplicable) -. Cmdidate(s) Nme Office Sought fl Supported
(if applXable)
fl Coordinated rvith reimbwsement sought [1 Opposed
I Coordinated rvithout reimbursement sought
D Indcpendent
I Organization (see Instructions)
[-"] a l-1 p l-l r- T-I n Tl s f,td,c c
me or ravee te or ra]Dem tvremoo ot raymenl Amount
' l,/,,; vr'\ t
^'
c- M^*. -c
eu a b'fo ( n
^, on.o-- lci-"
n Debit Card
f'JJ
rrpctrdtuc^ *" #
lT,J". 4- {:-J,n*u.r
rurpos€ 01 Event / ,
(bycode)
Fil n p to//d/oq
T_vpe of Expendihtre (d applicoble). Candidate(s) Nmie Office Soug)rt D Supported
! Coordinated rvith reimbursement sought
(if upplitable) I Opposed
I Coordinateti rvithout reimbursement sought
I lndependent
fl Organization (s e e Instructions)
l.q. !B flc Dr Un
s 14t1rc
Name
'-
ofParee i )ate ofPavment Method of Payment Amounl
V-',. {Ju^ Lot
;";;Tfil lhu, lw?",,l, "h- 5At9
4:T-
,lp Lode
S+^ (V,r'ri
'AI/T/ITTtrF
4o'. f(aot a r /4 --?2" .t eaJ
P, Expenses Paid by'Committee
-TTi.,^o- Ll" )ate ofPayment Method of Payrnent Amount
I-t ar,,s tt
"
)tleet Address tc/r e fcl S tate arp Code Kcn""ux //{ 3
;;- 1".i," J [,.,L u' Au. 3nuehte\
)escriotion,
c.-r- abfa I
r ,\ I
n Debit Card
Event # I I
3,,j,;A * s ol.- /*^,*, f i' dt..'s*
Purpose ot bxpendllue
(bycode)
f tg.lQ
(
7a/tr/az
Type of ExpendiluTe (iftpplicable)
Cadidate(s) Nme OfEce Sought LJ Supported
!
.
ll | {
)ueetAddrFSs I J / 99- i itate Zip Code
641/7
icfrof,:? ,frcn""u*
E
*'r 81, ^oLrtl't 3-l- )/-rb t :t Debit Card
rumose ol bxDendltue o"'H-i'J,'o, Event 4 / i
nv',"a"t f fyi pB r*,,a/,,/u?' k)t, eJ /0/14/a7
Cmdidate(s) Nme Olfice Sought Ll Supported
fype of Lxpenditure (if applicable) .
n Coordinated with reimbursement sought (ifappticable) I opposed
n Coordinated rvithout reimbursement sought
D lndependent
n Organization (see Instructions)
!a UB flc nD nE
s I a'/. aa
Type of Expenditvre (if applic able). Cadidate(s) Nme Oftrce Sought L-J Supported
I Coordinated with reimbursement sought (if applicable) I opposed
fl Coordinated without reimbursement sought
n Independent
I Organization (see Instructions) J
trA DB f]C trD trI
Nare ofPayee tate oI raweot Method 01 Payment Amount
SS City [l Check #_
n Debit Card
DescnptroD Event #
(by code)
4
SUBTOTAL Scction P- this Pagc 3 6,qa
42
Page J of J
IV. EXPENDITURES I'age 17 of 17
NAMEIOF'COMI4{'I'TFE
-*, .J. ,^ l\a-, II INGN{IFI}A'lF-
/a * a7-aaa 7
S-''\+a {4, u
.{ "-
T. Itemizatiiln of Reimbursemenfs to Committee Workers and Consultants
L.ast Nme of Worker/Clonsultmt o""bk*l. MI Date of Pp;me4t
Method of Payment Amount
M. lYo^.,." 7t /o, /o 7
Pavec
iccor.;da4
''/",n
I furpose ot Expendliue
{cn"ct* l/33
4.-o.r.t rLo .bvcode) p, N OR I Debit Card
'"J
/1o,, #
State 1-io Code
"'/h t,,nrn a"7* a6Vol
r*"'
De scnDtion
4I r',n'f<A
tl +. l'/' $- A^J*,,s":
Tvpe of Expendilrr e (if applitable). Cmdidate(s) Nme Office Sought f-l Suooorted
I Coordinated rvith reimbursement sought (iJ applkahlz) fl C)noosed
D Coordinated u.ithout reimbursement sought
I Independent
D Organization (see Instructions)
l-la l-1 n l-lc nD DE ,L/4 -t'<
Last Nme of Worker/Consultalt First I NI1 Date of Pa\ment , A mou nt
Method olPal'ment
Llu",l,"' K". ro /o s /o"i
Jcrr"ru* f / 3-t-
iecondarj Clyee rurpose bt Expendlture
w*4"1fl VL
er:" Ul,of"r^ L cl"[
5treet Adffess cl}-:--r i State
n Debit Card
Zip Code
1,,. I
Last Nme ol I\ orler Consultant I l- irst t N{I Date of PalDettt I N4ethod ofPal,ment Amount
il^^ f/.,, ot fil /oq
iecondm']ar ee r \rpose ofExpenditwe
ncheck# /13 J
SJ=* [.
w*d")67f (c { fl Debit card
Sfteet Address
.A-L,,
CitL t JIAIE Zip Code
Dcscnption I
p 1,"." 5 ,n i^uln
I
C
"ll
Type ol Expenditwe (if app lica
Coordinated '"vith reimbursement sought
ble). landidate(s) Name
'if applicable)
OfEce Sought I Supported
l-l Onnosed
I Coordinated u.ithout reimbursement sought
I
I
lndependent
orgrnrzrlion lsee Instructionst
l-ln trs trc tro fl e *31tr, r'
$. UBTCITAL S glf i.o-n.l:I!E,te* { iq,li
, :;;";-: ;:t,,t'.,:=;;:... a... t'a:: , :::lt:::::::..: ;: : :1.',
{t f,'?A
1::.
Al-^.1,r
7a f ufo? Elcheck
fl
#
Debil caid
I l'12
Jtre€t.\ddrels I ltrpose oi bxpendltwe
(bvcode) dtrFlCtr
boa l\,*- lJorr,, A* Zip Code Description
Citv State
?D" n(v I.
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lype of Expendlture (if applicable) .
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