HomeMy WebLinkAboutCIT Laura Bentley - 03/11/2018 - Heather CreranMlt'10�'*
ESTABLISHED 1006
CITY OF MILTON CAMPAIGN CONTRIBUTIONS DISCLOSURE FORM
NOTE: This form should be completed by ALL OPPONE
NTS for Rezoning Actions
Name of Subject Rezoning/Case #: 1 �M11JC-� IRA- W
O.C.G.A. § 36-67A-3 2m 11 -0VCY-0Y
(c) When any opponent of a rezoning action has made, within two years immediately preceding the filing oft rezoning action
being opposed, campaign contributions aggregating $250.00 or more to a local government official of the local government / S�
(Mayor or Councilmember) which will consider the application, it shall be the duty of the opponent to file a disclosure with
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the governing authority of the respective local government showing: D
VI it 4A�
(1) The name and official position of the local government official to whom the campaign contribution was made; and
(2) The dollar amount and description of each campaign contribution made by the opponent to the local government t�
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official during the two years immediately preceding the filing of the application for the rezoning action and the date of
each such contribution.
(d) The disclosure required by subsection (c) of this Code section shall be filed at least five calendar days prior to the
first hearing by the local government or any of its agencies on the rezoning application.
OPPONENT'S CERTIFICATION
I hereby certify that I have read the above campaign disclosure information and declare that (select have or have not)
I have within the two years immediately preceding this date made any campaign contribution(s) aggregating $250.00
or more to any local government official involved in the review or consideration of this application. (If this box is
checked, please complete the chart below).
I have not within the two years immediately preceding this date made any campaign contribution(s) aggregating
$250.00 or more to any local government official involved in the review or consideration of this application.
Name of Elected Official/Position
Amount of
Contribution
and/or
Description
of In -Kind
Contribution
Date of Contribution
5 . c'c:
9
NAME OF CONTRIBUTOR:
SIGNATURE OF CONTRIBUTO
DATE: —3 lit