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CAMPAIGN FINANCIAL REPORT
(All of the information in this report is public information) }../ "" fl },,/·-,,, ' ? Name of candidate, committee or corporation � A J ,-., J I/ 4 < e;>,<� j
Office sought or ballot question C (Ltv C.4 u, ,A-I c I'-District Cv t. tt,/lf #IA /./-r?1t/lz:1
Type of
report
__ ___,:.'X_· ___ Candidate report _______ Campaign committee report _______ Association or corporation report ______ Final report
CONTRIBUTIONS RECEIVED
Period of time covered by report:
from%; hv to ¼z 6,J
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.
CASH $ <Y t I, ,Ju TOTAL CASH-ON-HAND $ f.Jf. 0)
IN-KIND +_./ a{J $--="'-->_0�, __ _ /1 f'AN/J 1}/A -�,ltv(,>,v; /f��"'UL--
TOTAL AMOUNT RECEIVED =
$ ___ _
DISBURSEMENTS
Include the amount, date and purpose for all disbursements made during the period of time covered by report. Attach additional sheets if necessary,
TOTAL
CORPORATE PROJECT EXPENDITURES
Corporations must list any media project or corporate message project fo� 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
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TOTAL
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Printed Name l,4/t.//, '( /3c<[i?..lll<.. t?
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Signature Date . e, ... .!-Telephone 76'}-'J)J ·I, ft,/ Email (if available) //11 'fi11lf(�ttl\ l0
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DONATION REPORT #1
CONTRIBUTOR ADDRESS EMPLOYER AMOUNT COMMENTS
Ramona Anderson 4132 Stinson CH 55421 Jaffra Cosmetics $ 100.00
Clara Schmidt 691 47th Av NE CH 55421 Retired $ 100.00
Veronica Johnson 351 Jolly Ln CH 55421 Retired $ 100.00
Judy Moneta 4030 6th St NE, CH 55421 Retired $ 100.00
Kay Jacobs 4101 Monroe St NE CH 55421 Candidate $ 500.00 LOAN
Deb Loerke 700 Shallow Cove Rd Lake Zurich IL 60047 Teacher $ 100.00