Campaign Contributions Report Name of Director Candidate(Required) First Last Voting District(Required) Period of time covered by report (date from and date to)(Required) Contributions Received1. Name, Address, Occupation and Employer of ContributorCash or Other (please describe) Amount or ValueDate of Contribution Acceptance MM slash DD slash YYYY 2. Name, Address, Occupation and Employer of ContributorCash or Other (please describe) Amount or ValueDate of Contribution Acceptance MM slash DD slash YYYY 3. Name, Address, Occupation and Employer of ContributorCash or Other (please describe) Amount or ValueDate of Contribution Acceptance MM slash DD slash YYYY If necessary, upload additional contribution documentsMax. file size: 50 MB.Total Amount of Contributions Received(Required)Optional StatementI have chosen NOT to accept campaign contributions Check if true By signing, I certify that this report is true, complete and accurate.(Required) Reset signature Signature locked. Reset to sign again Date(Required) MM slash DD slash YYYY Phone(Required)Address(Required) Street Address Address Line 2 City ZIP / Postal Code Email Δ
