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Uityof <br /> _ Louisville <br /> �'V <br /> LOHA D•bINC 187s <br /> City CIerR's Orrice /ti/7 <br /> ,'T ICloin str«t,Coei��iII ,CO 8001I <br /> 303-335-45/5/Fa4 3O3-335-4550 Dare stamp <br /> Email: NicrcdythM@Iouisvilleco.gov <br /> DISCLOSURE BY PUBLIC OFFICtAUEDtR <br /> REPOR i uF t,IF i 5, RONOKARIA AND OTHER BENEFITS <br /> (sec. <br /> rilers shouru arso review provisions of secrion.s,Arne!,mix f t&r,Cory,Pao i.w,st;tut;on <br /> MUNICIPAL FILING <br /> Filing required: .L"auarter 0 L"d Quar rn 3'd Quarter n 4`h Quarter [2I <br /> (Eu.Ap.l1 is) (bee July 15) Roc October 15) (due January 131 <br /> Mame of Orrice Holder: Christopher Leh _ Ward 1 <br /> Address: 414 Walliut Lane Louisville CO 80027 <br /> Check one of the following: I have noting to report (Please sisn and datE below) <br /> eceived the following gilts, Honoraria, or benzfit durins this period. <br /> 1) Name of Person from Who the Gift, Honoraria or Other Benefit vvas Received: <br /> Amount/Value: $ Date Received: <br /> Description: <br /> 2) Name of Person from vvf10 the Gin, Flonoraria or Other Benefit Was Received: <br /> Amount/value: $ Date Received: <br /> Dee cri1,tion: <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_ Flonoraria or OtRer Benefit Was Received: <br /> Amount/value: $ Date Receivzd: <br /> Description: A. <br /> ignawre . .!1.d � /AWL Daae: <br /> 2-0/Ire Of- D� <br />