HomeMy WebLinkAboutM8 ReportCAi AIGN TREASURER'S REPORT SUMMARY
(1) 1 Y n
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OFFICE USE ONLY
RF�Fi�Eo
(2)
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Address (r)umber street)
L9 ?D�s
e- -4�h �zOf
cC
8
C/erks
City, State, Zip Code
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❑ Check here if address has changed
(3) ID Number:
(4) Check appropriate box(es):
[lt andidate Office Sought: Si`,
ei j
❑ 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 / /
To/ 3 (/ Report Type: ,
❑ Original ❑ Amendment ❑
Special Election Report
(6) Contributions This Report
(7) Expenditures This Report
Monetary
Cash & Checks $ Q O
Expenditures $ / ( 0
Loans $_ _ • _
Transfers to
Office Account $ .
Total Monetary $_ , ,
_
Total Monetary $
In -Kind $_
(8) Other Distributions
(9) TOTAL Monetary Contributions To Date
(10) TOTAL Monetary Expenditures To Date
$ LDc, . (�; 1
$
(11) Certification
It is a first degree misdemeanor for any person
to falsify a public record (ss. 839.13, F.S.)
I certify that I have examined this report and it is true, correct, and complete: n
(Type name); �% 1 /
(Type name)
❑ Individual (only for IE Wreasurer ❑ Deputy Treasurer
or electioneering comm.)
®tiandidate ❑ Chairperson (only for PC and PTY)
Signature
Signature
DS -DE 12 (Rev. 11113) SEE REVERSE FOR INSTRUCTIONS
CAMPAIGN TREASURER'S REPORT — ITEMIZED CONTRIBUTIONS
i
(1) Name
(2) I.D. Number
(3) Cover Period / / through /' / /' (4) Page of
(5)
Date
(7)
Full Name
(Last, Suffix, First, Middle)
Street Address &
City, State, Zip Code
(6)
Contributor
Type Occupation
(9)
Contribution
Type
(10)
In-kind
Description
(11)
Amendment
(12)
Amount
(6)
Sequence
Number
hY
/arks Ori n
e
DS -DE 13 (Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES
CAM PAIGN/T-REAS RER'S REPORT— ITEMIZED EXPENDITURES
(1)Name ✓ ��„
{ 7
(3) Cover Period _/�// -through_ / Jll
(2) I.D. Number
(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
(8)
Sequence
Number
RFC
ci�F'° py
�o
F
s0
DS -DE 14 (Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES