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HomeMy WebLinkAboutG1 ReportCAMPAIGN TREASURER'S REPORT SUMMARY /� (1) AI ace. Cos/ OFFICE USE ONLY Name RECEIVED (z) _,S70 l �a� fn., e _ OCT 0 5 2015 ' Address (number and stree 2 �C�ST,1 City of Sebastian �S��cam:1 City Clerk's Office City, State, Zip Code ❑ Check here if address has changed (3) ID Number: (4) Check appropriate box(es): 1 &Candidate Office Sought: ❑ 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 j 0 / D l 070To ! 6012 1 '?0 /_ Report Type: Original ❑ Amendment ❑ Special Election Report (6) Contributions This Report (7) Expenditures This Report Cash & Checks $ " , - d . Monetary Expenditures $ t Loans $ 00 Transfers to — Office Account $ 06 — — Q Total Monetary $ - O , -- , _ Total Monetary $ — — �� 7 I k In -Kind $ 6 0 0 — (8) Other Distributions G O $ (9) TOTAL Monetary Contributions To Date (10) TOTAL Monetary Expenditures To Date $ — `_ 00 $ (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: i (Type name) / % v.Ctte--+ s(T e n 1 YP name) f / h rl�V_ e.c. T_ ❑ Individual (only For IE Treasurer gcandidate ❑ Chairperson (oNy for PC and PTY) or electioneering m.) X X Signature Signature DS -DE 12 (Rev. 11113) SEE REVERSE FOR INSTRUCTIONS CAMPAIGN TREASURER'S REPORT — ITEMIZED CONTRIBUTIONS (1) Name Rn�ce� () _ �o✓ (2) I.D. Number (3) Cover Period Q ! O ( 1p20IJ through (4) Page Of (5) Date (7) Full Name (Last, Suffix, First, Middle) Street Address& City, State, Zip Code (S) Contributor Type Occupation (9) Contribution Type (10) In-kind Descr tion (11) Amendment (12) Amount (6) Sequence Number G RECE OCT 0 City of S IVED 5 1015 Bbastian DS -DE 13 (Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES /� C MPAIGN TREASURER'S REPORT– ITEMIZED EXPENDITURES (1) Name A n A cps Cz, (3) Cover Period / l 01 l20iS through 12 1Oo?1:�O /S} (2) I.D. Number (4) Page—of (5) Date (7) Full Name (Last, Suffix, First, Middle) Street Address & City, State, Zip Code (6) Purpose (add office sought if contribution to a candidate) (9) Expenditure Type (10) Amendment (11) Amount (6) Sequence Number 0/0/1 m r� W- ��kW"'�'e. X530 u,s,Nwy U..;}� 5e-�s�;�. , F� 3a�i7�C /—s(.:� Mery NIA�9�16 to/Or �G` T ` REC OCT City of Sebastian City Cle IVED 5 2015 k's Office DS -DE 14 (Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES