HomeMy Public PortalAboutCampaign Treasurer's Report (5)CAMPAIGN TREASURER'S REPORT SUMMARY
(1) -tQn~L6 nri i f
OFFICE USE ONLY
(2) \N(.0 F, 4{(i('.r(?Sk- c4,
_ = o) ,=
Address (number and street)
(9r l c.- 9 -A `:2-
City, State, Zip Code
❑ Check here If address has changed (3) ID Number: 9 - 3 5 4d81,7
(4) Check appropriate box(es): ,
jCandidate Office Sought: �, rY1 L S
1 �'
Political Committee (PC)
❑ Electioneering Communications Org. (ECO) ❑ Check here if PC or ECO has disbanded
❑ Party Executive Committee (PTY) • Check here if PTY has disbanded
❑ Independent Expenditure (IE) (also covers an ['Check here if no other IE or EC reports will be filed
individual making electioneering communications)
(5) Report Identifiers
Cover Period: From D 5 / 0 / //...),Q15 To n 5 / s/ / Report Type: 1\-'( J
•
Original ❑ Amendment ❑ Special Election Report
(6) Contributions This Report
Cash & Checks $ 6/)6.0()
(7) Expenditures This Report
Monetary
Expenditures $ , ,'C\ o . 3o
Loans $ , D • 011
Transfers to
Office Account $ , , 0'00
Total Monetary $ '_"._.,f,6'66
Total Monetary $ , , 101O. D
�jj
In -Kind $ , ,`�!Q • /) 1
(8) Other Distributions
$ , 0. CO
(9) TOTAL Monetary Contributions To Date
$ , a5o. bo
(10) TOTAL Monetary Expenditures
$ , , lqo
To Date
-a\0
(11) Certification
It Is a first degree misdemeanor for any person
ve examined this report and it is true, correct,
I certify that I hJOt-..
(Type name) /°4*-- ��
to falsify a public record (ss. 839.13, F.S.)
and complete:
(Type name)
■ Individual (only for IE Treasurer 0 Deputy Treasurer
or electioneerin com .)
X Lk CC:
• Cand' at II Chairperson (only for PC and P )
"a
X ✓e
Signature
Signatu e
DS -DE 12 (Rev. 11/13)
SE
SE FOR INSTRUCTIONS
CAMPAIGN TREASURER'S REPORT - ITEMIZED CONTRIBUTIONS
(1) Name Antonio Ortiz
(3) Cover Period 05/01/2015 - 05/31/2015
(2) I.D. Number 47-3524881
(4) Page 1 of 1
(5)
Date
(7)
Full Name
(Last, Suffix, First, Middle)
Street Address &
City, State, Zip Code
Contributor
Type
(8)
Occupation
(9)
Contribution
Type
(10)
In -kind
Description
(11)
Amendment
(12)
Amount
(6)
Sequence
Number
05/05/2015
Carr, John M.
2214 E Concord St
Orlandio, FL 32803-0000
I
web
designer
CHE
$ 250.00
1
05/05/2015
Carr, Alexander
10075 Waterfront Dr
Woodbury, MN 55129-0000
I
Web
Designer
and
Graphics
INK
Create
web page
$ 450.00
2
This form is based on DS -DE 13 (Rev. 11/13)
Adjutant Workshop, Ina - Campaign ToolBox
CAMPAIGN TREASURER'S REPORT - ITEMIZED EXPENDITURES
(1) Name Antonio Ortiz
(3) Cover Period 05/01/2015 - 05/31/2015
(2) I.D. Number
(4) Page
47-3524881
1 of 1
(5)
Date
(7)
Full Name
(Last, Suffix, First, Middle)
Street Address &
City, State, Zip Code
(8)
Purpose
(add office sought if
contribution to a candidate)
(9)
Expenditure
Type
(10)
Amendment
(11)
Amount
(6)
Sequence
Number
05/11/2015
USPS
Hwy 17-92
Orlando, FL 00000-0000
stamps
PPD
$ 50.30
1
05/11/2015
McGehee, Stephen
2055 Bond Road
DeLand, FL 32720-0000
Campaign Toolbox
software
IEC
$ 140.00
2
This form is based on DS -DE 14 (Rev. 11(13)
Ad utant Workshop, Inc. - Campaign ToolBox
CAMPAIGN TREASURER'S REPORT - ITEMIZED DISTRIBUTIONS
(1) Name Antonio Ortiz
(3) Cover Period 05/01/2015 - 05/31/2015
(2) I.D. Number
(4) Page
47-3524881
0 of 0
(5)
Date
(7)
Full Name
(Last, Suffix, First, Middle)
Street Address &
City, State, Zip Code
(8)
Purpose
(add office sought if
contribution to a candidate)
(9)
Related
Expenditures
(10)
Amendment
(11)
Amount
(6)
Sequence
Number
Nothing to report on this
form
This form is based on DS -DE 14A (Rev. 08/03) [Note about Committees has been removed]
Adjutant Software, Inc. - Campaign ToolBox