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Form CPF M 102: Campaign Finance Report Municipal Form 7013 JA I I PH 14: 02 O of Campaign and Forltical Flnaace Please print or type all information, except signatures, Fill In dates: Mau$ DW Yer Mau$ Deco Y ea R eport ing P e r iod B o I i ac) t I En t 3 1 - 2 c� I r Type of report: (Check one) 08th day preceding preliminaxy 08th day preceding election 1330 day after election 'Myear -end report 13dissolution Af- i✓`>si %) Full Name of Candidate (if applicable}, SC. to o0 l.- cc f7hT 1 l 1 �L /t 4 Office Sought and District Residentlai Address rj , I..( - TeL No. (optional) Committee Name Name of Committee Treasurer Committee Mailing Address Tel. No, (optional) SUMMARY BALANCE INFORMATION: Line 1: Ending balance from previous report $ CD Line 2: Total receipts this period (J)age 2, line 11) $ Line 3: Subtotal nine 1 plus line 2) $ Line 4: Total expenditures this period (page 3, line la) $ Line S: Ending balance (line 3 minus line a) $ Line 6: Total in -kind eontributiozxs this period (page a> $ Line 7: Total (all) outstanding liabilities (page a) $ Line 8: Name of bank(s) used Alndavit of Committee Treasurers I oft* that 1 have examined this report including attached schedules and it is, to rho best of my knowledge and belief, a true and oompleto stater"d of all campaign futanee activity, including all contribution, Iowa, receipts expenditures, dbburaamaus, hAdnd contributions and liabilities for this reporting period and tapreswrts the campaign flnarwe activity of all persons acting under the authority or on behalf of this omniluoe In accordance with the requirements of M.O.I. c. 55. Signed under the paWda of perjuryt Truaurees signatnsrr (in Ink) Date FOR CANDIDATE FILINGS ONLY (CANDIDATE MUST SIGN BELOW) Att7davtt of Candidate: (dwk 1 box only) O Candidate with Comndtkt and no *cavity Independent or the eomnd tee I certify that I have examined this report Including attael►ed schedules and it is, to the bed of my knowledge and belleg a We and oomplate stateman of all campaign finance activity, of aU persons acting under the authority of on behalf of this coroenittee in acomlance with the requirements of M.O.L. a. 53. 1 have not received any budonu, hicumd nay liabilities nor nude any expenditures on my behalf during this reporting period. anddate ivithoot Committee 0 Cs "Ante with Independent activity tltGtg separate report I certify that I have exsmirted 04 report Including attached schedules and It Is„ to the best of my knowledge and belief; a true and contpl to statement of all campaign finance activity, including contributions, loans, receipts, expenditures, disbursements, bn.kind comributions and liabilities for this reporting period and represents the campaign finatwe acts 'ty of ell g ur►dar suthodty or on behalf o this conunittee in accordance with the requirements of M.O.L e. 33. ofperjttryt 2 Z f Z 20 Date