HomeMy Public PortalAboutCampaign Treasurer's Report (3)CAMPAIGN TREASURER'S REPORT
(1) no�/L.(!i - (JG:fi2EsS
SUMMARY
,v
OFFICE USE ONLY yy
'5 t �a F
7
Name v!/ Ul7c77 r `
(2) (/�f , e,///t/,.5 4'
Address (number and street)
O a.Jd/Ydo 542'f
,i/
City, State, Zip Code
❑ Check here if address has changed (3)
(4) Check appropriate box(es):
(Candidate Office Sought:
ID Number:
❑ 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 I 0/ I / 7- To /0 I UO I / - Report Type: 6
❑ Original ] Amendment ❑ Special Election Report
(6) Contributions This Report
Cash & Checks $ , , •
(7) Expenditures
Monetary
Expenditures
Transfers
Office Account
Total Monetary
This Report
$ , / , Q. QQ
Loans $ , , (W • CIO
to
$ , , .
Total Monetary $ , , •
$ 0 . DO
In -Kind $ , , •
(8)
Other Distributions
$ , ,
(9) TOTAL Monetary Contributions To Date
$ ,/,(
(10)
TOTAL Monetary Expenditures To Date
$ , / ,/1/0 . 00
(11) Certification
It is a first degree misdemeanor for any person
I certify that I ha a examined this report and it is true, corr
/yii'��1 T
(Type nam )�- ��1 / C/:iy,/
to falsify a public record (ss. 839.13, F.S.)
ct, and complete: o,,/1 zs-
e
(Type name) /1i,
Candidate
X'�
(only for PC and PTY)
■ Individual (only for IE (Treasurer L(LDeputy Treasurer
• Ch ' erson
or electioneering comm.) /
r , L
/z.__
re
Signature
DS -DE 12 (Rev. 11/13)
SEE REVERSE FOR INSTRUCTIONS
CAMPAIQN TREASURER'S REPORT — ITEMIZED EXPENDITURES
(1) Name egl# Ujyl S (2) I.D. Number
(3) Cover Period Oq / 0/ / / 7 through /v / 0 l /7-- (4) Page
of
(5)
Date
(7)
Full Name
(8)
Purpose
(add office sought if
contribution to a
candidate)
(9)
Expenditure
Type
(10)
Amendment
(11)
Amount
(6)
Sequence
Number
(Last, Suffix, First, Middle)
Street Address &
City, State, Zip Code
09 /c23/i7
0fori° Jains
6l0 s. 001145
' 04I ycdo /'% 546-015"
thig o� Dtlavtd0
avour; 661on
Dj 577 5
CA11,1
(ki
1,140.60
Pt /
b9/off/��
�Ey g oa/oddv
bit/ or b
comnasia 2
cyr5
e,g V
D
14/40.a)
OD -
/ /
//
/ /
//
/ /
/ /
DS -DE 14 (Rev. 11/13)
SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES
CAMPAIGN TREASURER'S REPORT — ITEMIZED CONTRIBUTIONS
(1) Name
(aicke
(2) I.D. Number
(3) Cover Period 0 `7 / 0/ I /7- through /0 / 06, / /7 (4) Page 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
/ 06, /7
&duo (JCm&5
52o 3 .Jnil(4s 4.
124.4.40, Fla 32,90s-
3
Carlickii
to
66F
LoA
d11s
goo. 00
DO 1
/ /
/ I
/ /
/ /
/ I
/ I
DS -DE 13 (Rev. 11/13)
SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES