HomeMy Public PortalAboutCampaign Treasurer's Report (21)CAMPAIGN TREASURER'S REPORT
(1) ;bee/ 4/,
SUMMARY
OFFICE USE ONLY
(2) ,. S3-/�r-8f
A ess (number and street)
City, State, Zi Code
❑ Check here if address has changed (3)
(4) Chec appropriate box(es):
(1
Candidate Office Sought: ?Th M, 6 , ener
ID Number:
i S C'.A t
❑ 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 9 / / / /7 To P / , / / /7 Report Type: 4,,iy
Original Amendment ❑ Special Election Report
(6) Contributions This Report
Cash & Checks $ , , 57-C OD
(7) Expenditures
Monetary
Expenditures
Transfers
Office Account
Total Monetary
This Report
$ , , VU . / 5 -
Loans $ , , •
to
$ .
Total Monetary $ , , 5-%5'. 0 6)
$ Yd* /S. -
In -Kind $ , , •
(8)
Other Distributions
$ .
(9) TOTAL Monetary Contributions To Date
$, , 1 5JI
(10)
TOTAL Monetary Expenditures To Date
$ , 2 , S/� o . 92,
(11) Certification
It is a first degree misdemeanor for any person
I certify that I examined this report and it is true, correct,
J
(Type name) VnCt.6. / e " t i
to falsify a public record (ss. 839.13, F.S.)
and complete:
j t
(Type name) ie E'e 1 lli II
■ Individual (only for fE reasurer ■ Deputy Treasurer
l ndidate
■ Chairperson (only for PC and PTY)
or electioneeri omm.)
Sifn ure
Signature
DS-DE'12 (Rev. 11/13)
SEE REVERSE FOR INSTRUCTIONS
CAMPAIGN TREASURER'S REPORT — ITEMIZED CONTRIBUTIONS
(1) Name t.// I re,e- / /,
(3) Cover Period 2 / / / / 7 through
(2) I.D. Number
/ 3/ / /7 (4) Page
of aZ
(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
(2) I.D. Number
(3) Cover Period Si / / / // through / 3/ / /7 (4) Page 2 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
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DS -DE 13 (Rev. 11/13)
SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES
PAIGN T/ �1HEq"�� RER' REPORT — ITEMIZED EXPENDITURES
/
(1) Name i r"'(?(� , Nit (2) I.D. Number
(3) Cover Period Si / / / /7 through rS / 3/ / /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)
Sequence
Number
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DS -DE 14 (Rev. 11113)
SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES