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10 30 17; 10: 18AM;myfax555 1212CAMPAIGN FINANCIAL DISCLOSURE REPORTs0. Birth.2/C 2 Rev, 12114SUMMARY PAGE Please Print or Type)jr\') bisection I NameofCandidateorPolitical Committee and ChairpersonOffice
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0 1 hereby certify is a form used to declare a statement as true and accurate.
Individuals or entities who need to certify the accuracy of a statement are required to file 0 1 hereby certify.
To fill out 0 1 hereby certify, the individual must provide their name, date, and signature confirming the accuracy of the statement.
The purpose of 0 1 hereby certify is to ensure that the information provided is truthful and accurate.
The individual must report specific details related to the statement being certified.
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