HomeMy WebLinkAboutStatement of Personal Expenditures 2-2-2024FmEsToNE Towx CLERK Space Below for Office Use Only
9950 Park Avenue
Firestone, CO 80520
TownClerk@FirestoneCO.gov
Ph: (303) 531-6264 f IRESTONE
Fax: (720) 7134106 C tt L� f A D O
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STATEMENT OF PERSONAL EXPENDITURES Y A CANDIDATE
[t-a5-t08(l) & 145-109, C.R.S.]
For use by a candidate who has not received any contributions (does not have a candidate committee) but has made
expenditures of personal funds.
Name of Candidate: ,
Address of Candidate: `r
City; r State: Zip Code:
Office: District No.: NOT APPLICABLE
Elec./Yr.:
Reporting_ Period: Beginning Date �° ' * Ending Date `
Total amount of Non -Itemized Expenditures ($19.99 or less):
Expenditures exceeding $19.99 shall be itemized and listed below.
Date Expended
Amount
Name of Reci i nt
Address
City
State
zip
Comment ! Purpose
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Date Expended
Amount
lame of Recipient
Address
$ �'
_'
City
State
Zip
Comment Purpose
Date Expended
Amount
Name of Recipient
Address
$
City
State
Zip
Comment ! Purpose
I certify to the best of my knowledge this Statement of Expenditures is true and correct.
Date
Firestone Town Clerk Rev. 12/2023