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r <br /> A;AND WATES.REPQR-T <br /> (to k fled t `' can didat. 'hid rind a:`cavi ai n etir mi tee <br /> # p g . } <br /> 'l: uati in dame an Address o Candidate �: �f�c Sought(Include title bf dfripe as . <br /> We II as parch; city, t6wn and/or cion: <br /> Ve <br /> 05 L_Ov- T f <br /> 3 rate of <br /> rirrlal`y <br /> ..:9. . <br /> .....:... . <br /> This repod Covers fro n <br /> tr <br /> through <br /> 4.Tom.of Rego <br /> . ith da riot to h day after. en ral <br /> Y p p <br /> r <br /> stn day i ivr. pr n ary 4nnual(future:election): <br /> V'` 0th day pnikto rima a upp. nal(past etecf n <br /> ) <br /> oth day print tp primary <br /> h day 0or tp:general.. .Amendment- .:Amendment to prior report <br /> 5.FINAL REPORT if: <br /> ___. ithdrawn File atter the election AND.all bans and debts:.paid <br /> AND no surplus funds remaining. <br /> �t�nv�pc� d <br /> ::Name and Address i.Finandai institution 7.Fdtf Name atW of Treasurer <br /> YOU are rqu r„ by lam to use one or more <br /> bans, swinos.and loan associations=or money <br /> market mutual fun :as. the deoaitdryy of all <br /> oarrtpaign fi�+nds_ <br /> 64 <br /> Aw <br /> .Name cif person Prep eft Report <br /> Daytime�e T'lophonle "� r , <br /> ---------------- <br /> t l M HER� eknrY that the informat�t�n oflnta�ned �n this reFv� ani the atteehed �. AOR f�RINClPAL CAmpAiGN COMMITTEE&ONLY <br /> soedutes is#rue and�orre�t.the.best of Our knowj6dc e,in Mi ation artd belief,and that na a. carne tnd`address pf principal campa' n: <br /> } <br /> Ig <br /> n: <br /> have n made nor contributions received that have not leen reported herein,s;nd committ" cornmittee s chairperson;and.subsidisry <br /> Ah no inf�r�atien re fired to be reporteeci by the l~.vulsiana ampa_n Finenoeaisclosu a A�et has. committees,.if`ani+f use addit€onat sheets if ne�essar r}. <br /> been deiiberatei :omitted; <br /> 'hisd9y Of <br /> .. <br /> i <br /> F'r- <br /> - i <br /> iae dfrdidathairpersn leytrre Telephone. <br /> J <br /> Tb t signed b Chairperson only if report by - <br /> r of at Carripa n comm e) x <br /> EXHIBIT <br /> nature Of.TreasiuM�` f)2g r�Te L hot e <br /> Form 102 nev,111 <br />