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DISCLOSURE SUMMARY PAGE DR-2 DISCLOSURE
COMMITTEE NAME (Must be same as on Statement of Organization) (Rev. 07/2004) 1 REPORT
L
For Office Use Only
er r &Apf r \~ or Comm. #
IMPORTANT: Indicate by # type of committee you are repo ing for: Logged In a)(
( 1 )Statewide/Legislative/Judge Standing for Retention Candidate ( 2 )State PAC ( 3 )State Party Scanned
(4 )County Central Committee ( 5 )County Candidate ( 6 )City Candidate ( 7 )School Board or Other
Political Subdivision Candidate ( 8 )County PAC ( 9 )City PAC ( 10 )School Board or Other Political Computer x'1112
Subdivision PAC ( 11 ) Local Ballot Issue Audited
CANDIDATE COMMITTEES ONLY:
Candidate Name Political Party (if applicable)
Late reports are subject to
0C,r.,e I,() . 11A "t b Z. uer , - possible civil and criminal
Office Sought District (if Senate or House) penalties .
wpe-y~Sor
"?la -(a5 _? - ~g 3,F- I-/- l.) -os-
SI NATU E F FILING RESRT TELEPHONE DATE SIGNED
t, r
I AM FILING A . r f NI't 6~ ~RT FOR (1) ELECTION /(2)NON-ELECTION YEAR .
(report date) Indicate by #
**UNPAID BILLS (From Schedule D - Attach Schedule D).. .. . .. ... ... .. . .. . .. . .. ... .. . .. . .. ... .. . .. . .. . .. ... .. . .. . .. ... .. $
*IN KIND CONTRIBUTIONS (From Schedule E - Attach Schedule E) . ... .. ... ... .. . . . ... . .. . . . ... ... .. . .. .. . .. ... .. $
**OUTSTANDING LOANS (From Schedule F -Attach Schedule F) . . ... ... .. ... ... .. . .. ... . . . .. . ... .. . .. .. . .. . .. ... .. $
CANDIDATE COMMITTEES ONLY:
CONSULTANT BREAKDOWN (Schedule G Attached?) YES NO
VALUE OF CAMPAIGN PROPERTY (From Schedule H - Attach Schedule H) $
FOR INSTRUCTIONS, SEE BACK OF FORM SCHEDULE
E IN-KIND
COMMITTEE NAME (Must be sam as on St tement of Organization) (Rev. 06/97)1 CONTRIBUTIONS
71
F-1
71
F-1
F-1
71
F-1
TOTAL (if last
page of this
schedule)
'Disclosure law requires candidates to disclose the relationship of any relative making an in kind contribution to the Page of
committee . Relationship must be shown to the third degree of consanguinity (blood relatives) and affinity (relatives (for Schedule E)
by marriage) . (See Page 2 of forms packet .) If surname of contributor is the same as candidate, but there is no
familial relationship, enter "not applicable" in the relationship column .
FOR 1NSTRUCT7ONS, SEE BACK OF FORM
SCHEDULE
F
, c 4-;Pr 5llo,,oru fso-r
COMTTEE NAME(Must be same as on Statement of Organization) LOANS
(Rev. 071W) RECEIVED
tlk~ .~ l iw,Vie - a REPAID
NOTE : This schedule reports money loaned to the committee which Is deposited In gtis committee account. CHECK THIS BOX IF
TOTAL UNPAID LOANS FROM ICI REPORTING PERIOD $ ;:2 ?d a "O AMENDING FORM
nanY afinueranw o naue VAea~anr _ an Tuae 6COAOT1wn Dig-,-NS s"nT N- Ynwariwv r nam orm"Yupwn Y"nR Twm. RGRnpTINa PFRrnn
(0rly(nei source of loan, such as bank, rrwst be shown if a rhWparty is (Loans forgiven must be reported on Schedule E- In-kind Contributions)
involved. fnclude bans fbm candialete's personal funds.)
DATE NAME AND ADDRESS OF LENDER RELATNDJVSHIP AMOUNT DATE PAID NAME AND ADDRESSOF LENDER RELATIONSHIP AMOUNT
RECEIVED (Include Endorser's Name, If Applicable) TO CANDIDATE OF LOAN (MANDDIYR) (Include Endorser's Name, If Applicable) TO CANDIDATE' REPAID
MMIDD1YR if A icable' If A Ifcable
s s
!a 3 '331 (a a~.
hV%A I6ke, , T"AtI4
'Disclosure low requires candidate committees to dfadose the relationship of any relative
makIng a contribution to the committee. Relationship must be shown to the third degree of
consanguinity(blood relatives) and afanfty (relatives by marriage). If surnarna orwwbubor 15
the same es candidate. but thewe is no famiYal relationship . entsr'not applfoabla'in the
relationship column when it applies. Page of
(for Schedule F)