HomeMy WebLinkAboutPrange, Tena - Candidate Statement of Non-Receipt and Non-ExpenditureSpace Below For Office Use Only
STATEMENT OF PERSONAL EXPENDITURES BY A CANDIDATE
[1-45-108(1) & 1-45-109, 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: _________________________________________________________________
City: __________________________ State: ______________________ Zip Code: _______________
Office: _______________________________ District No.:__________________ 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 Recipient Address
$
City State Zip Comment / Purpose
Date Expended Amount Name of Recipient Address
$
City State Zip Comment / Purpose
**Detailed spreadsheet may be attached if needing more space to list expenditures.
I certify to the best of my knowledge this Statement of Expenditures is true and correct.
Candidate Signature:_________________________________ Date: ____________
City of Englewood City Clerkâs Office 1000 Englewood Parkway Englewood, CO 80110
Ph: (303) 762-2430
Email: cityclerk@englewoodco.gov