Laserfiche WebLink
City , <br /> Louisville �/ <br /> 4VLCJ tClClll�•a1S4 Cr. 18lS J 3 �y' <br /> City Clerk's Office a PJM <br /> 7.+�Main SlreeL, rouisville,CQ 3(104/ ''r <br /> 50D-555- 5/5/Fax Drls-DDD-7D50 rate tamp <br /> Email: IOleresyt11101 @lou is.illeeo.ea. <br /> D1sCEOsORE BY PUBLIC OFFICEHOLDER <br /> REPORT OF GIF r s, RUMORMRIM AND U I HER BENEFITS <br /> (Sec.24-6-zv3,;•.R.3.} <br /> s should also review provisions of 3eciion 3,Article Turn of the CororaiTo <br /> MUNICIPAL FILING <br /> Finns required: 1'`QuaRer ` I c°O uuaRern 3`d QuaRer n 4th Quarter vi <br /> (uue April 1j) (aye July 15) (Om Octel]cr 15) (due January 1D) <br /> Name of Office Holder: Ward 1 <br /> Address: 1488 Wilson Place ouisville CO 80127 <br /> Chuck one of the following: I have nothing to report (Please sign ann nate below) <br /> I received the following gifts, honoraria. or 15enerit aurins this period. <br /> .t) Name or Person from Who the Gift, Honoraria or Other Benefit Was Received: <br /> Amort/Value: 5 Date Received: <br /> Description: <br /> 2) Name of Person from Who the Gift. Honoraria or Other Benerit was Received: <br /> Amount value Date Received <br /> $ � Gd <br /> uescription: <br /> 3) Name of Person from Nilo the Gift, Honoraria or Other Benefit Was Received: <br /> Amount/Value S Date Received <br /> Description: <br /> 4) Name of Person from Whu the Gift, Honoraria or OLher Benefit vvas Receiver!: <br /> Amount/Value. $ Dare Receives: <br /> Description: - <br /> Signature Date: <br /> —dif+ ,���� <br />