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CAMPAIGN FINANCIAL REPORT

To of -------------------------------(Municipality)

(City Recorder l'Ioum Clerk)

For Full name of candidate

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Name of office

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(District

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1. Total contributions of donors who gave more than $50.00 (Form "11» total from other side of this sheet)

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4. Balance at the end of the repcrting period

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Date __

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(Candidate) NOTE: Utah election code 10-3-208 states that all municipalities

shall adopt

all ordinance establi8hing campaign finance disclosure requirements for can5-6-C Carr Printing

Co=pany, Bountiful, Utah

Complete Election Supply Service Since 1902

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didates .running fur city or town office. You should check: with your

Street Address

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1. Total contributions of donors who gave more than $50.00 (Form ':A." total from other side of this sheet)

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2. Aggregate total of contributions of $50.00 or less

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3. Total campaign expenses (Form "B" total from other side of this sheet)

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4. Balance at the end of the reporting period

$ 58&'"

Date

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Signed'~

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(Candidate) NOTE: Utah election code 10-3-208 states that all municipalities shall adopt

an ordinance establishing campaign finance disclosure requirements for can5·6·C Carr Printing Company, Bountiful, Utah

Complete Election Supply Service Since 1902

didates running

for city or town office. You should check with your city which pertain to your

recorder or town clerk for the disclosure requirements

municipality.

!TEMIZED CONTRIBUTION Date Received

REPORT (Form '14"/ Mailing Address & Zip Code

Name of Contributor

Amount of Contribution

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(if additional space is needed, use blank paper and list information like the above format and then attach to report)

ITEMIZED EXPENDITURE REPORT (Form "8") Date of Expenditure

Person or Organization To Whom Expenditurewas made

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(If additional space is needed, use blank paper and list informauon like the above format and file with this report)

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CAMPAIGN FINANCIAL REPORT To

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lTEIVilZl:.-:;OEXPEN\)iTUR~ Date oi Expenditure

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Parson or Orcanization To Whom Expenofiure was made

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R[;'PQFrr (Form uf3'~l Amount

;'113i1ing Address

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& Zip Code

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CAMPAIGN FINANCIAL REPORT To of (City Recorder I Town Clerk)

(Municipality)

For

Full name of candidate

Street Address

U

_)_O_~_V_D_I)I_~_I-;-/-'q_h_1 ;/_I/;_e__ _G_/~r u

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G~~~~~~_6_~~u~f~~~~~~~~~~~_,U~M03t (District

Name of office

_

1. Total contributions of donors who gave more than $50.00 (Form 'W' total from other side of this sheet)

$ __ IL.l

2. Aggregate total of contributions of $50.00 or less

$

3. Total campaign expenses , (Form "B" total from other side of this sheet)

$

4. Balance at the end of the reporting period

$

Date

ocIo6er.0(00/7-

Signed

_1_o__0__ 7/

_

;: /36 . Ljr; )

_1i::=-....1_~~.

(Candidate)

NOTE: Utah election code 10-3-208 states t.hat all municipalities

~_ shall adopt

an ordinance establishing campaign finance disclosure requirements for can5·6-C

Carr Printing Company, Bountiful, Utah Complete Election Supply Service Since 1902

didates running

for city or town office. You should check with your city

recorder or town clerk for the disclosure requ.irernerrts which pertain to your

municipality,

~'TEMIZEDCONTfUaU110N REPORT (Form ''A ") Date Received

Name of Contributor

(if additional space is needed, use blank paper and fist information

like t.k~ above tormet and men attach to report)

iTF.;.Mf~EOEXPENDITURE R~?ORT (Form "8") Date of

Expenditure

Amount of Contribution

Mailing Address & Zip Code

see

t1 ff/:lie J7le/l

Person or Organization

ToWhom Expenditurewas made

[if wfiitional

t ._ t:

Amount :)i

[\;1ailing Address &_ Zip Code

spa ce is neeaea, use iJfank paper ana list information like the above format and file wttn this report}

Expenditure

Form A - Itemized Contribution Report - Hanz Johansson Date Recieved First Name Last Name 09/24/2017 Timothy Dora 09/26/2017 Nathan Brockbank 10103/2017 Sara Goldkind 09/26/2017 Nathan Brockbank

Street Address 1340 Lasso Dr

City

State

Hideout

2265 E Murray Holladay Rd 10747 N Hideout Trl

Holladay Hideout Holladay

Utah Utah

2265 E Murray Holladay Rd

Utah Utah

Postal Code Amount of Contribution 84036 $100.00 84117 $500.00 84036 $100.00 84117 $1,000.00 Total

$1,700.00

· ,

Form B - Itemized Expenditure Report - Hanz Johansson Date of Expenditure

09/20/2017 09/22/2017 09/22/2017 09/22/2017 09/22/2017 09/25/2017 09/27/2017 09/28/2017 10/02/2017 10/02/2017 10104/2017 10/10/2017 10/17/2017 10/23/2017 10/23/2017 10/25/2017 10/25/2017 10/29/2017 10/29/2017

Person or Organization

GO DADDY Vista Print Vista Print VistaPrint Square Inc Square Inc Square Inc VistaPrint KAMAS FOODTOWN USPS PO 49421604 Square Inc Square Inc Square Inc Wal-Mart Super 840 USPS PO 49353601 KAMAS FOODTOWN KAMAS FOODTOWN Chris M Baier VistaPrint

to Whom Expenditure

was made Mailing Address

& Zip Code

14455 N Hayden Rd, Scottsdale, AZ 85260 95 Hayden Av, Lexington, MA 02421 95 Hayden Av, Lexington, MA 02421 95 Hayden Av, Lexington, MA 02421 1455 Market Street, San Francisco, CA 94103 1455 Market Street, San Francisco, CA 94103 1455 Market Street, San Francisco, CA 94103 95 Hayden Av, Lexington, MA 02421 146 W 200 S, KAMAS UT 84036 55 W 100 N, KAMAS UT 84036 1455 Market Street, San Francisco, CA 94103 1455 Market Street, San Francisco, CA 94103 1455 Market Street, San Francisco, CA 94103 1274 S US 189, HEBER CITY UT 84032 125 E 100 N, HEBER CITY UT 84032 146 W 200 S, KAMAS UT 84036 146 W 200 S, KAMAS UT 84036 10497 N Forevermore Ct, Hideout UT 84036 95 Hayden Av, Lexington, MA 02421 Total

Amount of Expenditure

$12.17 $3.00 $11.25 $263.69 $0.33 $3.20 $14.80 $137.99 $7.45 $34.00 $0.88 $1.75 $29.30 $59.44 $55.57 $21.03 $27.65 $380.00 $72.99 $1,136.49

CAMPAIGN FINANCIAL REPORT To

of

(City Recorder I Town Clerk)

(Municipality)

For .L!tJ~U~

.

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