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=` CANDIDATE'S REPORT <br /> • to be filed by a candidate or his principal'campaign committee) <br /> ................................................................... <br /> I.Qualifying Name and Address of Candidate 2. Office Sought(Include title of office as; OFFICE USE ONLY <br /> well as parish, city, town and/or election <br /> ie district.) <br /> �VVIN A^64k%A <br /> 3. Date of <br /> Primary_ <br /> This report covers from. through 3; <br /> ---- ---------- ....... ----- ------ <br /> 4.Type of Report-,. <br /> .1 80th day prior to primary: 40th day after general <br /> 90th day prior to primary —Annual(future election.) <br /> day-prior to primary Supplemental(past election) <br /> I Oth day prior to primary <br /> �"" �Cith day-prior to general Amendment to prier report <br /> 5.FINAL REPORT if <br /> Missing numbered pqes were. <br /> With-drawn Filed after the election AND all loans and debts paid <br /> AND by surplus funds rernaining. <br /> blank and had no intormation <br /> unopposed an them+ <br /> 6.Name and Address of Financial Institution 7, 170 Name and Addiress of Treasurer <br /> (You are required by law to use one or more. <br /> banks, savings andloan associations,or money <br /> market mutual fund as the depository of all 17.(,% <br /> S:., <br /> campaign funds,.) <br /> A <br /> L <br /> �A <br /> .......... <br /> 9. Name of Person,Prepaning Report <br /> Daytime.Telephone (0 <br /> ............................................................ .............. <br /> CS <br /> 10. WE HEREBY CERTIFY that the information contained in, this report and the attached 8, FOR PRINCIPAL CAMPAIGN OMMITTEEONLY <br /> schedules is true and correct to the best of our knowledge!,. infdrmation and belief, and that no a. Name and address of principal campaign <br /> expenditures have been made nor contributions receivedthat have:not been reported herein,,and committee,committee's chairperson,and subsidiary- <br /> that no 1 n form a tj on re q u i red to be reported by t h e Lou isjan a Campaign Finance D i sd oS u re Act h a s committees,if any(use additional sheets if necessary). <br /> been delliberately omitted. <br /> T -1 <br /> his day ofZz) �' <br /> - _ <br /> CD <br /> < <br /> 3!" <br /> A/ <br /> Signature of CandildatelChairperson DaytimeTelephone <br /> a <br /> To be signed•by C (J <br /> if <br /> hairperson only- report by <br /> ' i <br /> pnncipal campaign committee) <br /> EXHIBI1' <br /> � 2 <br /> Signature of Treasurer Day timeTelephone <br /> Form 1:02,Rev.11/14 <br />