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Electronic Filing System

SEI Report for Cliff Bentz, 2016

1. BUSINESS OFFICE OR DIRECTORSHIP; BUSINESS NAME:

Business Name Address Line City State ZIP Description of Business Title of Office Held by Whom Client(s)
Business Name Address Line City State ZIP Description of Business Held by Whom Client(s)

2. SOURCES OF INCOME:

Name of Source Business Address Description of Source

3. REAL PROPERTY:

Description Address Line City State ZIP

4. HONORARIA:

Date Organization Name Nature of Event Amount

5. SHARED BUSINESS WITH LOBBYIST:

Name of Lobbyist Name of Business Type of Business

6. INCOME OF $1,000 OR MORE:

Income Source Address Line City State ZIP Description

7. DEBT OF $1,000 OR MORE:

Name of Creditor Date of Loan Interest Rate of Loan

8. BUSINESS INVESTMENT OF $1,000 OR MORE:

Business Name Address Line City State ZIP Description of Business

9. SERVICE FEE OF $1,000 OR MORE:

Name
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