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CAMPAIGN FINANCIAL REPORT <br /> (All of the information in this report is public information) <br /> Name of candidate,committee or corporation Office sought or ballot question I District GG'�rP c <br /> Type of •t Candidate report Period of time covered by report: <br /> report Campaign committee report <br /> Association or corporation report ,1 / <br /> from to <br /> Final report %jr�E'�,c•" <br /> CONTRIBUTIONS RECEIVED <br /> Give the total for all contributions received during the period of time covered by this report, Contributions should be listed by type <br /> (money or in-kind)rather than contributor. See note on contribution limits on the back of this form.Use a separate sheet to itemize all <br /> contributions from a single source that exceeded$100 during the calendar year.This itemization must include narne,address,employer <br /> 0 or occupation if self-employed,amount and date for these contributions. <br /> a <br /> CASH $ / G'Gi TOTAL CASH-ON-HAND $ $ GHQ <br /> IN-KIND + $ <br /> TOTAL AMOUNT RECEIVED - <br /> $ <br /> DISBURSEMENTS <br /> Include the amount,date and purpose for all disbursements made during the period of time covered by report. <br /> Attach additional sheets if necessary. <br /> Date Purpose Amount <br /> �d �` JJ erg:a4 2`1, l <br /> TOTAL <br /> CORPORATE PROJECT EXPENDITURES <br /> Corporations must list any media project or corporate message project for which contribution(s) or expenditure(s) total <br /> more than$200. Submit a separate report for each project, Attach additional sheets if necessary. <br /> Project title or description <br /> Date Purpose Name and Address Expenditure or <br /> of Recipient Contribution <br /> Amount <br /> v <br /> E _. <br /> z TOTAL <br /> I certify that this is a full and true statement. <br /> Signature Date <br /> Printed Name ..::> 21.e- r`G'C,lle',.. Telephone i''? 312 VYfl' Email (if available) <br /> b Address a biz/41/' � � C7� rra ire f 'r/1i J_. .. �� C efrrr�.rl��J/�l✓i/ <br />