HomeMy Public PortalAboutCampaign Treasurer's Report (5)CAMPAIGN TREASURER'S REPORT
(1) t. /ke / ? 74
SUMMARY
€ .
OFFICE USE ONLY
OiCT2 '_i p P,
k 537537
2 s(n 1ber and r et) 1 ..—
City, State, Zip Code
❑ Check here if address has changed (3)
(4) Chec appropriate 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 /v / 7 I /7 To /6 10`'4, I /7 Report Type: �?
Original Amendment ❑ Special Election Report
(6) Contributions This Report
Cash & Checks $ , 32 • G'L)
(7)
Monetary
Expenditures
Transfers
Office Account
Total Monetary
Expenditures This Report
$ , , V/t) . YJ
Loans $ -
to
$ , , .
Total Monetary $ , , :6SQ - ?d
$ 9/t , ii 7
In -Kind $ ,
(8)
Other Distributions
$ , ,
Date
(9) TOTAL Monetary Contributions To pate
$ , 7 , -I " . J'Sr"
(10)
TOTAL Monetary Expenditures To Date
$ , 5 ,1)(V,"? .
5 (g.2 . J
(11) Certification
It is a first degree misdemeanor for any person
I certify that I have examined this report and it is true, correct,
(Type name) e /'%Y/a / i L�
/
to falsify a public record (ss. 839.13, F.S.)
and complete:
(Type e) - i/.' e l 4/,'
■ Individua (only or IE ■ Treasurer ■ Deputy Treasurer
I'andidate
X
• Chairperson (only for PC and PTY)
or ele tioneerin comm.) I
-Y��! '`�G / �"
'.2 r -flit/% /�. i
d
Sig ture
Sinure
DS -DE 12 (Rev. 11/13)
SEE REVERSE FOR INSTRUCTIONS
CAMPAIGN TREASURER'S REPORT — ITEMIZED CONTRIBUTIONS
(1) Name
(3) Cover Period /e1 / I / /7 through /17
(2) I.D. Number
/ 2/' / / 7 (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
✓4
0/
Vii 4,
.-? 3W
/D . /6 1�
4 0 L' d��ti
/400
?3/ LA.k�'ietuc✓
MA.- �
�
U
DS-DE 13 (Rev. 11113)
SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES
AIGN TREASURRRE ;S REPORT — ITEMIZED EXPENDITURES
(1) Name (2) I.D. Number
(3) Cover Period /0 / ? / /7 through /I9 /.G` / /' (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
/1 /U/17
7, /t/
/17/i7 9
cr�r Vet iv >l/kie
A/ #. PL.-
�,r
.r.
X76/
/O//�/// D
,
.-Sbee / 4h
/. D , .cS/f9 J�
/nid, rz- . � S
Pied
6;
IG9x,16'/;i
e
es
/ /
/ /
/ /
/ /
/ /
DS -DE 14 (Rev. 11/13)
SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES