HomeMy WebLinkAboutJeffrey Thom CAMPAIGN FINANCIAL REPORT
(All of the information reportn this is public information)
Name of candidate,committee or corporation ---1‘ \\s
cif 110-0,..,
Office sought or ballot question MVO r 0c SL k District
Type of /C Candidate report Period of time covered by report:
report Campaign committee report
Association or corporation report
Final report from %/ elO it to / ,.25°,-/e
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 in-kind)rather than contributor. See note on contribution limits on the back 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.
a
cc CASH $ TOTAL CASH-ON-HAND $
IN-KIND + $
TOTAL AMOUNT RECEIVED = $ 0
DISBURSEMENTS
Include the amount,date and purpose for all disbursements made during the period of time covered by report.
Attach additional sheets if necessary.
Date Purpose Amount
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0
TOTAL Sii SID
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 Expenditure or
of Recipient Contribution
Amount
co TOTAL
z -
I certify that this is a full and true statement.
Signature Date
r
Printed Name ,e--cce y Telephone ,/1" 3`c{cl"0244/ Email (if availablerrk ,:) {y0-16/0co .w"^
Address2Yin Re J w'.i D . Sha kph-/ Imo. tJ Cs-1-71
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