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CAMPAIGN TREASURER'S REPORT SUMMARY
_
(1) 'ki ICh4.vd 9 I maK OFFICE$&ONLY
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Name
(Z) 17 4 `f Kirt�e�je C �uE ; OCT p8 Zp/5
Ad�res�sl(^numb and street{./ City of
�S �—'JQ SI CftY Cler!<sbOce
City, State, Zip Code
❑ Check here if address has changed (3) ID Number:
(4) Check appropriate box(es):
V Candidate Office Sought: h I Ty Co u N Ct
❑ 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 / O / c I l t } To / O Z 1 )� Report Type:
Original ❑ Amendment ❑ Special Election Report
(6) Contributions This Report
(7) Expenditures This Report
Monetary
Cash & Checks $ 5O . c)d
Expenditures $ 2 7
Loans $_ , _ , _ • _
Transfers to
Office Account $
Total Monetary $_
Total Monetary $ 12/y.
In -Kind $_ , _ ,
(8) Other Distributions
S
(9) TOTAL Monetary Contributions To Date
U U 0
(10) TOTAL Monetary Expenditures To Date
Cl
$
(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(th�is report and it is true, correct, and complete:.
//
(Type name) WjG1//AV4 elf Gi /� (Type name) (cbf �I%�I� 611ime K
❑ Individual (only for IE Treasurer Cl Deputy Treasurer andidate [I Chairperson (only for PC and PTY)
or electioneeringc mm.) r
i
Signature Signa re
Ds -DE 12 (Rev. 11113) SEE REVERSE FOR INSTRUCTIONS
CAMPAIGN TREASURER'S REPORT — ITEMIZED CONTRIBUTIONS
(1) Name (KIC(l4vt 1_rJtll6� (2) I.D. Number
(3) Cover Period /0 / 0 / through (C / D' L / I , (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
to 1 ( 1�>�(l�e
�.�
ml«3c,-7
�
Re4IRe�
11
V t
S r�
17
R
l 1
OCT
Cid or
C/� CZ-
eba8fien
I /
DS -DE 13 (Rev. 11113) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES
C1aMPAl. N RE SURER'S REPORT- ITEMIZED EXPENDITURES
(1) Name �IG�j1lY�I � (�lt90} (2) I.D. Number
(3) Cover Period /O / o ( /( 5 through 10 / 02-- /� (4) Page i of
(5)
Date
(7)
Full Name
(Last, Suffix, First, Middle)
Street Address 8.
City, State, Zip Code
(8)
Purpose
(add office sought if
contribution to a
candidate)
(9)
Expenditure
Type
(10)
Amendment
(11)
Amount
(8)
Sequence
Number
r71ONIC" of d)
33765
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rob
Of's
CityC S
ierks
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sfian
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DS -DE 14 (Rev. 11113) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES