HomeMy Public PortalAboutCampaign Treasurer's Report (19)CAMPAIGN TREASURER'S REPORT SUMMARY
(1) . ,JI brae) PA:
OFFICE USE ONLY
(2) 17e0 :Box SS) 5 -35 -
Address (number and street)
City, State, Zip Code
❑ Check here if address has changed (3) ID Number:
(4) Check appropriate box(es):
Candidate Office Sought:
❑ Political Committee (PC)
❑ Electioneering Communications Org. (ECO)
❑ Party Executive Committee (PTY)
• Independent Expenditure (IE) (also covers an
individual making electioneering communications)
❑ Check here if PC or ECO has disbanded
❑ Check here if PTY has disbanded
• Check here if no other IE or EC reports will be filed
(5) Report Identifiers
Cover Period: From 6 / ) / /7 To & / 34 / /7 Report Type: M 42
Original
■
Amendment
IN
Special Election Report
(6) Contributions This Report
Cash & Checks $ , / , o&,2. 27
(7) Expenditures This Report
Monetary
Expenditures $ , 7g2 . &it
Loans $ ,
Transfers to
Office Account $ ,
Total Monetary $ ' 1 'Oh ,2 • 37
Total Monetary $ , 727. (pZ
In -Kind $ ,
(8) Other Distributions
$ ,
(9) TOTAL Monetary Contributions To Date
$ , 3 ,592x. 5"f
(10) TOTAL Monetary Expenditures To Date
$ , / ,7s .gs
It is a first degree misdemeanor
I certify that I have examined this report and
(Type name) —") 1Dh� ' �
for
it is
�Ir
(11) Certification
any person
true, correct,
to falsify a public record (ss. 839.13, F.S.)
and complete: /��7
(Type name) Z�'�CL 2. ^
1:1 Individual (o CCC reasurer ■ Deputy Treasurer
or election ing,sp .)
andidate
■ Chairperson (only for PC and PTY)
9 n ure
Signat�
DS -D
2 (Rev. 11/13)
SEE REVERSE FOR INSTRUCTIONS
CAMPAIGN TREASURER'S REPORT - ITEMIZED CONTRIBUTIONS
(1) Name
(2) I.D. Number
(3) Cover Period 6 / / / /7 through 6 / a3 / /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. 11/13)
SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES
CAMPAIGN TREASURER'S REPORT — ITEMIZED CONTRIBUTIONS
(1) Name
bra.al
(2) I.D. Number
(3) Cover Period 4) / / / /7 through (p / .30 / /7 (4) Page of 2J
(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
l /.2 l /7
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DS -DE 13 (Rev. 11/13)
SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES
_CAMP N TR ASURER'S REPORT — ITEMIZED EXPENDITURES
(1) Name ,� i' b 1, fl -1 i
(2) I.D. Number
(3) Cover Period (p / / / /7 through 6 /7 (4) Page
of 1
(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
6 // /17
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1
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DS -DE 14 (Rev. 11/13)
SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES