IUNSAS GOVERNMENTAL ETHICS COM.MISSlON li" CrEWED

RECEIPTS AND EXPENDITURES REPORT OF A CANDIDATE FOR STATE OFFICE

1\5 Govern>jN::!I"'~1""'h f~," r_[ 'cs t-January 10, 2017 - , \.-.OfTIml

FILE WITH SECRETARY OF STATE SEE REVE'RSE SIDE FOR INSTRUCTIONS

A. Name ofCandida{c: _Slwt:. l-1uC.~g-.r_··-+-,--_ --'-_.'--

Addross: _._1.P. (CJ. ~.,\ ~\\cC ..b

City and Zip Co~-_\l1l.1L:J ~-e..",,1-e< /<5.," /.."I !.'f2 County: &~lcK Office ~ought: ,~~Y~\'~~"1 ',-I,e.,. ,_.__ District: .. ,~~__

B. Check only If appropriate: __.Amended filing ___ Tennina\ion Report

C. S~lmmary (covering (he pcriod from Octoher 28,2016 through DeccmbeJ' 31, 2016)

1. Cnsh 011 hand !.It beginning ofperiod " , ", . JJ J,1l2..i_~7 2. Tot~l Contribwtlol13 ul1d Other Receipl~ (Use S~nccfule A) , ", "." . _~;J.~i) .

3. Cash available (11is period (Add Lines 1 and 2) , .. He ~ J?-- •3'1 ~ ,-.­

4. Total Expenditures and Other Disbillsements (Use Schedule C) .. ".5r;J..7Q.:!~~.. 5. Cash on hand at close of period (~ubu'aet Line 4 from 3) " " .. J~4'Y ,.S~'

6_ In-Kind Contribulions (Utie Schedule B) ....,.... _,,~ 7. Other Transactions (Usc Bchedllie D) ... "........ ~

D. t'l declare that this report, including any accompanying schedulos and :>tt\tcment~, has been exam1ned by me and to the best of my knowledge and bcliefis t1.'ue, con-cct andcumplete. rUndel':;land that \.he intcnt1nnfll failure to file this document or intcnthmally filing a fuls.f;l document is a class A Inisdemeanor. H

Date jty\(L~4!£-=H21~:,~~dr--L-.o.' Signaturo OfCMdidate or ~(lsur~r

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GEe Form Rev, 2016

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Rece Ived Time Jan. 13. 2017 10: 18AM No, 1489

SCHEDULE A CONTRIBUTIONS AND OTHER RECEIPTS

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AmounlorOCC\1 pntion of Check CAsh, Check,NlIme lIud Alh.ll·c~s Jlldlvt<funl Gtvlllg More Appl'OprhHe Box

LOIlIl or OtherPnte of ContriJmto \' Thnn $150 .;r'lII'ICJ,en.sll Ch«k LORt! ltecelptIIlher

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Received Time Jan. 13, 2017 10: 18AM No. 1489

SCHEDULE A CONTIUDUTIONS AND OTHER RECEIPTS

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Dote:

Oecuplltion of Nnme and Address lndlvidusl Glvln~ More

of Contl'ibHtor Thon S150

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SnbtotRI This Page ~/~

Complete if last page of Schodulo A

Tolal Itemized Receipts for Period JJ ?DO Totol Unllomized Conlrlbutions ($50 or Jess)

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Sale of PuJilic~1 Mlllcrilll~ (Unitemlzt:<!) .,--Totftl COHtl'llmtlons When Contributor Not KJ10\\11 /'"

TOTAL RgCEIPTS TIIlS PERlO}) (to line 2 or Summuy) JtaW

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Received Time Jan. 13. 2017 10: 18A~ No, 1489

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SCHEDULEC EXl'ENDITURES AND OTHER DISRUHSEMENTS

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Putt' Naillll and Addresll Purpose of Expenditure

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Subtotal Tills Pugll

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Received Time Jan. 13. 2017 10: 18AM No. 1489

-.---- ............... - -0 .....

SCHRDULEC EXP.F.NI>lTURES AND OTHER DISBURSEMENTS

Hlle.~ (Name ofCanJiuate)

Date Name and AtJuresl) Purpose ofExpcuditu1'6

or Disburllcment Amount

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Subtotal Tills Page

Complete lfI1\st Pil~C of Schedule C

TOLal TLcmli'.ed F.xptmdilures Thl:- {'Ol'ioll LJ 'i<f) l/ s:.. Total Unitemized Expenditures of$50 or less 4~&;/:D TOTAL EXPENDITURES & OTHER DlSBURSR~NTS. TillS PElUO:V (to line 2 of Summary) 5:>..,o.7~

Page ~2.....; ot.'2.... _

Recei vedT ime Jan. 13. 20 17 10: 18 AM No. 1489