HomeMy Public PortalAboutCampaign Treasurer's Report (5)CAMPAIGN TREASURER'S REPORT SUMMARY
(1) Jim Gray
OFFICE USE ONLY
Name
(2) 9798 Blandford Rd
E lRi CT i' CL
__f
(number street)
Address and
Orlando, FL 32827
4 Y8' _ p :°_:
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jni
City, State, Zip Code
❑ Check here if address has changed (3) ID Number:
(4) Check appropriate box(es):
I Candidate Office Sought: Orlando City Council - District #1
❑ 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 04 / 01 / 2017 To 04 / 30 / 2017 Report Type: M4
✓
Original ❑ Amendment
■ Special Election Report
(6) Contributions This Report
Cash & Checks $ ,
(7) Expenditures This Report
Monetary
Expenditures $ , , 158.64
Transfers to
Office Account $ .
Loans $ , 10 , 000 . 00
Total Monetary $ , 10 , 000. 00
Total Monetary $ , , 158. 64
In -Kind $ •
(8) Other Distributions
$
(9) TOTAL Monetary Contributions To Date
$ , 10 , 000 . 00
(10) TOTAL Monetary Expenditures To Date
$ , 158 . 64
(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) Melissa Gray
to falsify a public record (ss. 839.13, F.S.)
and complete:
(Type name) JiIll Gray
❑ Individual (only for IE 0 Treasurer 0 Deputy Treasurer
or electioneering comm.)
0 Candidate 0 Chairperson (only for PC and PTY)
SignatuuVe
Signat e
DS -DE 12 (Rev. 11/13)
SEE REVERSE FOR INSTRUCTIONS
CAMPAIGN TREASURER'S REPORT — ITEMIZED CONTRIBUTIONS
Jim Gray
(1) Name (2) I.D. Number
04 01 2017 04
30
(3) Cover Period / / through / / 2017 (4) Page 1 of
1
(5)
Date
(7)
Full Name
(Last, Suffix, First, Middle)
Street Address &
City, State, Zip Code
Contributor
Type
(6)
Occupation
(9)
Contribution
Type
(10)
In -kind
Description
(t1)
Amendment
(12)
Amount
(6)
Sequence
Number
04
/
04
/
2017
D
Jim Gray
9798 Blandtord Rd
Orlando, FL 32827
S
Investor
LOA
$10,000.00
1
/
1
/
/
/
/
/
/
/
/
/
/
DS -DE 13 (Rev. 11/13)
SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES
CAMPAIGN TREASURER'S REPORT - ITEMIZED EXPENDITURES
(1) Name Jim Gray
(3) Cover Period 04
/ 01
/ 2017 through 04
/ 30 / 2017
(2) I.D. Number
(4) Page 1 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
P
Type
(10)
Amendment
(11)
Amount
(6)
Sequence
Number
04
/11
//201'1
Harland Clarke
15955 La Canters Parkway
San Antonio, TX 78256
Purchase of Checks
& Deposit Slips
MON
$158.64
1
/
/
/
/
/
/
/
/
/
/
/
/
/
/
DS -DE 14 (Rev. 11/13)
SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES