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c.itygf <br /> Louisville ;, 3 <br /> Cchr,,, 1...0•D1P3l;L' 1618 !i, <br /> city ElerR's Olilce in in <br /> 145 IClain street,rouisvine,co SDuz i <br /> .30,5-is -715/Fa;iOj-jj5-455D Date stamp <br /> Email: M.reaytn191@loni,v:Ilec....gov <br /> DISCLOSURE BY PUBLIC OFFICEHOEDER <br /> REPORT UF GIFT5, RuIQuRARIA AND OTHER BENEFITS <br /> ( ec.zw-13-03z,i..R. .) <br /> Filers should also review provisions of secrion.s,,vrricre AAAA of rnL rest...U.cv,,,t;rwr;v„ <br /> MUNICIPAL FILING <br /> Filing required: 1'`Quarter I I z"d auartern I'd Quarter 17 4`"Quarter I r <br /> i'aue April 151 (Ea.Jul,i. ) Mere Octv5er 15) (due January 11 <br /> Name of Office Rainer: Jett Leon Ward 2 <br /> Addrss: 692 1 alum isK C;Out t, Louisville CO 80027 <br /> Check one of the following: E] have nothing to report (Please si5n and date below) <br /> I received the following gifts, honoraria, or benefit dorina this period. <br /> 1; Name of Person from Who the Gift, Honoraria or Other Benefit vvas ReceiveG: <br /> Amount/Value: $ Date Receiveu: <br /> Description: <br /> 2) Name of Person from Who the Gift_ Ronoraria or Other Benefit Wa3 Received: <br /> Amount/value: $ Date Received: <br /> Description: <br /> 3) flame or Person from Who the Gift, Honoraria or Other Benefit Was Received: <br /> Amount/Value: 5 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 /> uescription: <br /> Signature Date: 74 4-5' <br /> r <br />