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Cityty <br /> LV Iui5 V 1llt <br /> L.VJ.O/WV 1JV•51.114 lata �� <br /> icy EIerk's ijffice � 1*Y <br /> Hwy IGlain zcreet,rouisvilie,io a00cr / <br /> .517)y-a3-4st5/Fax 60.*-�sD-z550 Dace Scamp <br /> Email: Rlereaytn141@Ioeir—:Ik..e.go; <br /> DISCCUSUKE BY PUBLIC OFFICEHOLDER <br /> REPORT OF GIFTS, HONORARIA AND DIRER BENEFI S <br /> (Sec.24-6-203,C.R.S.) <br /> Filers should also review provisions of Secrion a,Article nnln of rile Cotorarlo Consrirurion <br /> iviD19ICIPAL FILING <br /> Filing required: r Quarter 2"a Quarter[ uua,.er a zth Qaurter [ <br /> ('ane April 151 (Due July 15) (aue Octeae.15) iMac 10..eory 15) <br /> Name of Office folder: Bob Muckle Ward Mayor <br /> Address: 1101 Lincoln Avenue Louisville CO 80027 <br /> I Check one of the following: I have nothing to report(Please sign and date below) <br /> I received thr following gifts, honoraria, or benefit during this perion. <br /> 1) Name of Person from Who the Gift, Honoraria or Other Benefit Was Received: <br /> Amount/Value: 5 Date Received: <br /> Description: <br /> 2) Name of Person from Who the Gift, Honoraria or Other Benefit vvas Receiver!: <br /> Amount/Value: $ Date receive l: <br /> Description: <br /> 3) Dame of Person rrom vvllo 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 vvas Received: <br /> Amount/Value: 5 Date Received: <br /> Description: <br /> 1 <br /> Signature Date: qii, to <br />