HomeMy Public PortalAboutCampaign Treasurer's Report (4)Jun. 10. 2015 4:51PM AMSCOT FINANCIAL
No. 4212 P. 2
AM IGN TREASURER'S REPORT SUMMARY
(1) a ° o ii rq
OFFICE USE ONLY
Name
(2) 5u/.. &M -4- d-.1/7
A ess (num� 'er and street)
t, ill e ( 2,:z1-_2-2- ,
City, State, Zip Code
•
Check here if address has changed (3) ID Number:
(4)
Che appropriate box(es); ` CJ1'' 'c 2_.
Candidate Office Sought: ei/v1.2„//a_4;:a L rt1„Jr.. S/dfy s'
■
■
❑
■
individual
Political Committee (PC)
Electioneering Communications Org. (ECO)
Party Executive Committee (PTY)
Independent Expenditure (IE) (also covers an
making electioneering communications)
■ Check here if PC or ECO has disbanded
0 Check here if PTY has disbanded
1 Check hero if no other IE or EC reports will bo filed
(5) Report Identifiers
Cover Period: From �,., 1 P/ 1 /5 To di. / 3) 1 /5• Report Type: 2!1/,x` /15
■
Original 0 Amendment ❑ Special Election Report
(6) Contributions This Report
r1
Cash & Checks $ ,S , IgV . D 0
(7) Expenditures This Report
Monetary
Expenditures $ , , t2 .
Loans $ ,
Transfers to
Office Account $ , 0 . 0 C)
L.---,
Total Monetary $ ,, '0 D
Total Monetary $ , 0 • QC)
In -Kind $ , , •
(8) Other Distributions / f�y 0
$ , V - CJ
(9) TOTAL Monetat Contributions TDate
(10) TOTAL Monetary Expe itures Toate
(11) Certification
it Is a first degree misdemeanor for any person
1 certify that 1 (Type hav examined this report and it is true, correct,
(T a name) 4 a)
to falsify a public record (ss. 839.13, F.S.)
and complete: ]
(Type name) / / -�' _
9 Individual
or electioneering
gl.C anit
(only for IE [� Treasurer 9 Deputy Treasurer
con)m,) /
--g-eetV
aidate ❑ Chairperson (only for PC and PTY)
r
x
Signature
Signature
DS -DE 12 (Rev. 11!13)
SEE REVERSE FOR INSTRUCTIONS
Jun. 10. 2015 4:51PM ASCOT, FINANCIAL No. 4212 P. 3
CAMPAIGN TREA$l1RER'S REPORT — ITEMIZED CONTRIBUTIONS
(1) Name
izeM
(2). I,D. Number
(3) Cover Period °/ d / / lS through 6 5 / 1 (4) Page
of %
(5)
Date
(7)
Full Name
(Last, Suffix, First, Middle)
Street Address &
ity, State, Zip Code
Contributor
Type
(8)
Occupation
(9)
ContribUGah
Type
(1 0)
In -kind
Description
(1 1)
Amendment
(12)
Amount
(B)
Sequence
Number
/
/
Ib5 2''r9'i.4/j
/i)7 / yC ado/b/4/3
c,,,,-ch,e),404"
ei‘
ecg5 al>
e4045 507/A.
37 SiMi4,9h01/1t
pr/grr6a, <. 267
e,. #6----
4 re)r-.4.
/
!
J i 6pc)_
•vb1,2 f Citocold V,
Okiagco W 324o3
eliC
s'
1
1
f rrlo 4' g4"
IIlu►9;ng
ill /1/. Cy prcl'f 44x411
61$5441,001 F4'
31747
C145
3( ,4U.oz
1
1
44/70,7414. 1Pal.
3109 3lr•r►14 kL,sh
Lc4 a(c r 9-„ ice-.
37&a .
g C-(
t c-13
1
l..
S r" Yin ‘r,j
110 3 co.dson . r
bitc.rcL4 ft,
3 airD4
p _
F- � 1
ia,0.40
1
1
�'rj,,►c,l' 30tr-�
teo r brtiAS;44',,
K,,,i96 mini 4., It...,
a44-7 Lill
k e T
1
0 1+ o .° o
DS -DE 13 (Rev. 11113)
SEE REVERSE FOR INSTRUCTIONS AND CODs; VALUES