HomeMy Public PortalAboutCampaign Treasurer's Report (13)CAMPAIGN TREASURER'S REPORT
(1) w.//Aree•1 t A
SUMMARY
OFFICE USE ONLY
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City, State,'2ip Code
❑ Check here if address has changed (3)
(4) Check appropriate box(es):
[Candidate Office Sought: d.+hiJi/' .SS; (7/Jer -'
ID Number:
)/Sir/c/
❑ 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 / / /7 To I / 2y / /7 Report Type: Z
❑ Original Amendment ❑ Special Election Report
(6) Contributions This Report
Cash & Checks $ , 75[( 00
(7) Expenditures
Monetary
Expenditures
Transfers
Office Account
Total Monetary
This Report
$ , . , Lb -
Loans $
to
$ , ,
Total Monetary $ , 795: 00
$ , . ,415 --
In -Kind $ , , 2/7. Sr
(8)
Other Distributions
$ •
(9) TOTAL Monetary Contributions To Date
$ , / , 5$T P S)
(10)
TOTAL Monetary Expenditures To Date
$ , , 62 . g3
(11) Certification
It is a first degree misdemeanor for any person
I certify that 1 have amined thisthrreport and it is true, correct,
(Type name) Q� ,/ . �Gi
to falsify a public record (ss. 839.13, F.S.)
and complete: �%
(Type n e) Jr�2 tree P J /� J 1;
D Individual (o reasurer ■ Deputy Treasurer
Candidate
x
• Chairperson (only for PC and PTY)
or electionee' c .)
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DS -DE 12 (Rev. 11/13)
SEE REVERSE FOR INSTRUCTIONS
CAMPAIGN TREASURER'S REPORT - ITEMIZED CONTRIBUTIONS
(1) Name hi.6ree/ J5. A�
(3) Cover Period oC / / / /7 through
(2) I.D. Number
A� / 72 / /7 (4) Page / of .2
(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
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DS -DE 13 (Rev. 11113)
SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES
(1) Name
CAMPAIGN TREASURER'S REPORT — ITEMIZED CONTRIBUTIONS
jb e/ ilt"
(2) I.D. Number
(3) Cover Period p2 / / / /7 through v; / v(g / /7 (4) Page I of L
(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
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DS -DE 13 (Rev. 11/13)
SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES
C A N I F A I G N T R , S U R f l ' $ R E P O R T - I T E M I Z E D E X P E N D I T U R E S
( 1
) N a m e , 2 Q 7 C 7 / / / ��o ( 2 ) I . D . N u m b e r
( 3 ) C o v e r P e r i o d A / / / / 7 t h r o u g h a / : w / 7 ( 4 ) P a g e / o f
/
( 5 )
D a t e
( 7 )
F u l l N a m e
( L a s t , S u f f i x , F i r s t , M i d d l e )
S t r e e t A d d r e s s &
C i t y , S t a t e , Z i p C o d e
( S )
P u r p o s e
( a d d o f f i c e s o u g h t i f
c o n t r i b u t i o n t o a
c a n d i d a t e )
( 9 )
E x p e n d i t u r e
T Y P e
( 1 0 )
A m e n d m e n t
( 1 1 )
A m o u n t
( 6 )
S e q u e n c e
N u m b e r
7 / / t / r 7
$ /
p i e s
. 1 0 4 6 '
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D S - D E 1 4 ( R e v . 1 1 / 1 3 )
S E E R E V E R S E F O R I N S T R U C T I O N S A N D C O D E V A L U E S