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CAMPAIGN FINANCIAL REPORT
(All of the information in this report is public information)
Name of candidate, committee or corporation
office sought or ballot question
Type of
report
Candidate report
Le ZV, ev�..
Campaign committee report
Association or corporation report
Final report
District
Period of time covered by report.
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CONTRIBUTIONS RECEIVED
Give the total for all contributions received during the period of time covered by this report. Contributions should be listed by type
{money or in4ind) rather than contributor. See note on contribution limits on the hack of this form. Use a separate sheet to itemize all
contributions from a single source that exceeded $100 during the calendar year. This itemization must include name, address, employer
or occupation if self employed, amount and date for these contributions.
CASH _
lWKIND
TOTAk AMOUNT RECEIVED
$ -- t75
+ .—
$
TOTAL CASH -ON -HAND $
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DISBURSEMENTS
Include the amount, date and purpose for all disbursements made during the period of time covered by report.
Attach additional sheets if necessary.
Purpose
Amount
Date
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TOTAL
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CORPORATE PROJECT EXPENDITURES
Corporations must list any media project or corporate message project for which contribution(s) or expenditure(s) total
more than $200. Submit a separate report for each project. Attach additional sheets if necessary.
Project title or description
Date
Purpose
Name and Address
of Recipient
Expenditure or
Contribution
Amount
TOTAL
I certify that this is a full and true statement.
Signature
t• F
Printed Name Telephones ��� �`. Email (if available)
Address
Date