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Fsc.>Ltyty <br /> Louisville 0\�� <br /> ech.vnnuI •SirsUE. iBra — tylr111 <br /> City Cieries Orrice <br /> icy Main Sher,EeeL ille,CO 13DDzi <br /> JU3-33s-zis /Fo=. 171i-Sdb-4SSD Email: pate tamp <br /> Merea rtn110i goei3Villeco.g0V <br /> DISCLOSURE BY PUBLIC OFFICEHOLDER <br /> REPUR 1 UF GIF i 5, HONORARIA AND 0 i HER BENEFITS <br /> (3ec.zw-'o-z03,C.R.3.) <br /> Filers should also review provisions of 3ecrion 3,,vrricre#WA of me rororauo C ..st 7..r:o.. <br /> ' MUNICIPAL FILING <br /> Filing required: ft Quarter znd Quarrern i`d Quarte, n 4t Quarter n <br /> Isue April 15) (6e.ael,15) lace Octo6er 15) (doe Janoa�yy 15) <br /> Dame of Drrice Flolaler: Jeff Lipton Ward <br /> Address: 692 !a,riar isk LOui t, Lvuisvillu CO 80027 <br /> Check one of the following: I have nothing (0 report (Please sign an nate below) <br /> I received the following gifts_ honoraria, or henefit during this period. <br /> 1) Name of Per3on from Who the Gift, Honoraria or Other Benefit Was Received: <br /> Amount/Value: 5 Date Received: <br /> Description: <br /> 2) Name of Person from vvho the Gift_ honoraria or Other Benefit Was Received: <br /> ►mount/value: $ Date Received: <br /> Description: <br /> 3) Name of Person from Who the Gift, Honoraria or Other Benefit Was Received: <br /> Amount/Valu: 5 Date Received: <br /> Description: <br /> 4) Name of Person from Who the Gift_ honoraria or Other Benefit was Received: <br /> Amount/Value: $ Date Receive0: <br /> Description: <br /> .signature/7 (// Date: � ,,,e <br />