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Declaration of Intention to Accept Campaign Contributions: Rick Mohrig
SEC DECLARATION OF INTENTION TO ACCEPT Form Dol Rev 4/06 CAMPAIGN CONTRIBUTIONS - Year of Election: d` -W 7 Date of this Filing: ,,��]] Candidate (Full Name): irC� 7 /'gyp / el Campaign Committee Chairperson (Full Name): ((��� AA f -v h hfI �i e'^2S2 /'l d v i!� Candidate Address: 1 3 ge 1 ie'�-e" Chairperson Address: ' � feY✓� Di^, orf` 10A/ 64: 3000 /O��j(��le oii Telephone Number(s): a) 66 7b Telephone Number(s): 11 (%%p 46,3— ©G Give Name of Office Sought: (include district, post, or judicial circuit) ❑ State ❑ County Municipal Treasurer (Full Name): Treasurer Address: pQ tine / ' e-rese Ag� n \-J p� A � / 0-�— ��Ile't�-Y��JJ✓A• T a �if / Name of Incumbent: Al `[ hdlo J Q W OS !' I &Art 6 Party Affiliation (Optional): ❑ Democrat ❑ Republican ❑ Other or None For Office Use SIGNA OF CAND :"go�� ♦J a I w Cr"CLMK