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`; City.),- <br /> Louisville <br /> 0,,Tt)1.zaTI@•SINC 1 Ing. <br /> City Clerk's Office C <br /> 749 Main Street, Louisville,CO 80027 <br /> 303-335-4576/Fax 303-335-4550 Date Stamp <br /> Email: MeredythM@louisvilleco.gov <br /> DISCLOSURE BY PUBLIC OFFICEHOLDER <br /> REPORT OF GIFTS, HONORARIA AND OTHER BENEFITS <br /> (Sec.24-6-203,C.R.S.) <br /> Filers should also review provisions of Section 3 rticle XXIX of the Colorado Constitution <br /> MUNI L FILING <br /> Filing required: 15Y Quarter 2nd Quarter 3`d Quarter 4th Quarter Ti <br /> (due April 15) (due July 1 (due October 15) (due January 15) <br /> Name of Office Holder: Ashley Stolzmann Ward 3 <br /> Address: 228 South Jefferson Avenue, Louisville CO 80027 <br /> Check one of the following: _11- <br /> I have nothing to report(Please sign and date below) <br /> I received the following gifts, honoraria, or benefit during this period. <br /> 1) Name of Person from Who the Gift, Honoraria or Other Benefit Was Received: <br /> Amount/Value: $ Date Received: <br /> Description: <br /> 2) Name of Person from Who the Gift, Honoraria or Other Benefit Was Received: <br /> Amount/Value: $ Date Received: <br /> Description: <br /> 3) Name of Person from Who the Gift, Honoraria or Other Benefit Was Received: <br /> Amount/Value: $ Date Received: <br /> Description: <br /> 4) Name of Person from Who the Gift, Honoraria or Other Benefit Was Received: <br /> Amount/Value: $ Date Received: <br /> Description: <br /> —7151 1'7 <br /> Signatuidlig A"ti ; �' Date: <br /> IP <br />