HomeMy Public PortalAboutCampaign Treasurer's Report (4)CAMPAIGN TREASURER'S REPORT
(1) — e. , 1 / , //
SUMMARY
OFFICE USE ONLY n _ Cif °CUR;
'
(2) Nam glf 1, SO d,1/3-',‘,'
A fess (number and so - -9t)
City, State, Zip Code
❑ Check here if address has changed (3)
(4) Chec propriate box(es):
Candidate Office Sought:
ID Number:
❑ 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 � / / To / /
/�) � 7 �� 2a / T Report Type: 6'z
❑ Original XAmendment ❑ Special Election Report
(6) Contributions This Report
Cash & Checks $ , , r . Ct)
(7)
Monetary
Expenditures
Transfers
Office Account
Total Monetary
Expenditures This Report
$ , / 1 a''. ‘7
Loans $ ,
to
$ , , .
Total Monetary $ , ` 5t c ()
$ / ?! . Y,
In -Kind $ , •
(8)
Other Distributions
$ , , •
(9) TOTAL Monetary Contributions To Date
$ , ,5"7f...5'L
(10)
TOTAL Monetary Expenditures To Date
$ , ,'7c'Y.
(11) Certification
It is a first degree misdemeanor for any person
I certify that I have examined this report and it is true, correct,
/ /' r
(Type name) h
to falsify a public record (ss. 839.13, F.S.)
and complete: /
(Type name) < i Pee / / ► , 4
■ Individual (only for IE easurer ■ Deputy Treasurer
andidate
x
• Chairperson (only for PC and PTY)
or electioneeri ' - om
// r
M
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7 ,
,6-(/'
i• ' ature
Si ture
DS -DE 12 (Rev. 11/13)
SEE REVERSE FOR INSTRUCTIONS
(1) Name
CAMPAIGN TREASURER'S REPORT - ITEMIZED CONTRIBUTIONS
J,6i e/
(2) I.D. Number
(3) Cover Period g / 1 / /'7 through M. / �� / /7 (4) Page
of
(5)
Date
(7)
Full Name
(Last, Suffix, First, Middle)
Street Address &
City, State, Ziipp Code
Contributor
Type
(8)
Occupation
(9)
Contribution
Type
(10)
In -kind
Description
(11)
Amendment
(12)
Amount
(6)
Sequence
Number
lJt74$ ,, rt✓ ,�/
'/>'
3'
.-/-- cie
e,.... -"V
Aws '/n
i.vrIwJad/ pi. s
a 77 y
DS -DE 13 (Rev. 11/13)
SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES
(1) Name
(riap 2 JGN TRrFA7E»' IREPORT - ITEMIZED EXPENDITURES
e , �/� (2) I.D. Number
(3) Cover Period /0 / 7 / /7 through /d 1, ) // .7 (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)
S
Number Sequence
Number
/0/9//7
/27— /27
1.8; ,2
)/
/G' /l //
,-S <y
j/7 b-hil L
l��4 4 1-:-.L ,�i
#Cd/fa
�jnS
1(2-6)
/Z
ea -P
/) /A7/7
,,- �/0
-- �.(
3fX /i
0
/40// T
�'cQ/ 411'
?d' /.?v 1 S5/
d�
der
S/01 , ed
/ /
/ /
/ /
/ /
DS -DE 14 (Rev. 11/13)
SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES