HomeMy Public PortalAboutCampaign Treasurer's ReportCAMPAIGN TREASURER'S REPORT SUMMARY
(1) -J/ire 4 / 1/
OFFICE USE ONLY
Name 7 /N/•�
(2) /g4/ (l.'7e0/1
iORi_c.;'.;°y
A ss (number and str et)
/MI ds G� Sol fa
r €y?
City, State, Zip Code
❑ Check here if address has changed (3) ID Number:
(4) Check appropriate box(es): � l _
Rtrandidate Office Sought: ( ciainv-rj;erl1'2 �'S/�/ rfo S
❑ 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 J / / / h To 57 / g a / /' Report Type:
41 f
❑ Original Amendment
■
Special Election Report
(6) Contributions This Report
Cash & Checks $ 7,4) . CO
(7) Expenditures This Report
Monetary
Expenditures $ , /a,2 . ,ii'
Loans $ , •
Transfers to
Office Account $ .
Total Monetary $ , /40- Q
Total Monetary $ 6; . if
In -Kind $ , •
(8) Other Distributions
$ ,
(9) TOTAL Monetary Contributions To Date
$ , , /00. eD
(10) TOTAL Monetary Expenditures To ate
$ , , 62 . JY
(11) Certification
It is a first degree misdemeanor for any person
I certify that I have amined this report and it is true, correct,
(Type name)/ �/ 4
to falsify a public record (ss. 839A3, F.S.)
and complete:
(Type na 7 -4;
■ Individual (o . IE • Treasyyy{{{er 0 Deputy Treasurer
or election-- g . m.) �
0)114
J
andidate • Chairperson (only for PC and
X J Sac -c=am R
PTY)
ign• ure
Signature
DS -DE 12 (Rev. 11/13)
SEE REVERSE FOR INSTRUCTIONS
PAIGN TR7pygSU 'S REPORT - ITEMIZED EXPENDITURES
(1) Name ` i fee/ /� (2) I.D. Number
(3) Cover Period 9 / / / /b through % / tie
(4) Page / of
(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
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7 i 6 o/eewy„
,e% di g faoles'
exe cries
,5 p4.i,
slip S
Pa a,it
0/
1/
/1
1/
/1
/1
/1
1/
DS -DE 14 (Rev. 11/13)
SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES
CAMPAIGN TREASURER'S REPORT — ITEMIZED CONTRIBUTIONS
(1) Name
�6 / 1/,,
(3) Cover Period / / / /6
through
(2) I.D. Number
/ ' /4
(4) Page / of /
(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
V /a2/ /4
.lf6ree///,'
/id7 04' 'ordd°f
DIVA? do NON-
NO
$/D4,da
0 I
/ /
/ r
/ /
DS -DE 13 (Rev. 11113)
SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES