HomeMy Public PortalAboutCampaign Treasurer's Report (6)CAMPAIGN TREASURER'S REPORT
(1) Jim Gray
SUMMARY
i5
OFFICE USE ONLY
-
)i l R- '_ ' AWL'
Name
(2) 9798 Blandford Rd
Address (number and street)
Orlando, FL 32827
City, State, Zip Code
❑ Check here if address has changed
(4) Check appropriate box(es):
(3)
Council
ID Number:
- District #1
✓ Candidate Office Sought: Orlando City
• Political Committee (PC)
❑ Check
here if PC or ECO has disbanded
here if PTY has disbanded
here if no other IE or EC reports will be filed
❑ Electioneering Communications Org. (ECO)
❑ Party Executive Committee (PTY) ■ Check
❑ Independent Expenditure (IE) (also covers an ■ Check
individual making electioneering communications)
(5) Report Identifiers
Cover Period: From 05 / 01 / 2017 To 05 / 31 I 2017 Report Type: M5
Election Report
❑ Original ✓ Amendment ■ Special
(6) Contributions This Report
Cash & Checks $ , 1, 000 .00
(7) Expenditures
Monetary
Expenditures
Transfers
Office Account
Total Monetary
This Report
$ , 375 .00
Loans $
to
$ ,
Total Monetary $ 1, 000 .00
$ , , 375.00
In -Kind $ ,
(8)
$
Other Distributions
.
(9) TOTAL Monetary Contributions To Date
$ , 11 , 000 .00
(10) TOTAL
Monetary Expenditures To Date
$ 533.64
(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) Jim Gray
❑ Individual (only for IE IDTreasurer 0 Deputy Treasurer
or electioneering comm.)
X
13 Candidat • Chairperson (only for PC and PTV)
X /,1�
Signature
Signature
DS -DE 12 (Rev. 11/13)
SEE REVERSE FOR INSTRUCTIONS
CAMPAIGN TREASURER'S REPORT — ITEMIZED CONTRIBUTIONS
(1) Name
Jim Gray
05 01 2017 05
(3) Cover Period / / through
(2) I.D. Number
31 / 2017
1
(4) Page of
1
(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
(tt)
Amendment
(12)
Amount
(6)
Sequence
Number
05
/
04
2017
/
Maurice Chao
2549 Rose Spring Dr
Orlando, FL 32825
I
Doctor
CHE
$500.00
1
05
/
04
2017
/
E T S Inc
13960 Lake Mary Jane
Rd
Orlando, FL 32832
B
Logistics Cc
CHE
$500.00
2
05
/
04
2017
/
Sonya Labosco
10741 Tyson Rd
Orlando, FL 32832
I
Retired
CAS
$500.00
3
05
/
05
2017
/
Sonya Labosco
10741 Tyson Rd
Orlando, FL 32832
I
Retired
REF
($500.00)
4
/
/
/
/
DS -DE 13 (Rev. 11/13)
SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES
CAMPAIGN TREASURER'S REPORT - ITEMIZED EXPENDITURES
(1) Name Jim Gray (2) I.D. Number
(3) Cover Period 05
/ 01 / 2017 through 05 31 / 2017 (4) Page 1 of
1
(5)
Date
(n)
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
(9)
Sequence
Number
os/ 22%2017
( /
WebDesign499, LLC
1033 Goldenrod Rd
Wellington, FL 33414
Web Design
MON
$375.00
1
/ /
/ /
/ /
/ /
/ /
/ /
/ /
DS -DE 14 (Rev. 11/13)
SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES