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HomeMy WebLinkAboutG1 ReportMI CAMPAIGN TREASURER'S REPORT SUMMARY _ (1) 'ki ICh4.vd 9 I maK OFFICE$&ONLY �`�CF/Vgp 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 `�oS i CA r) rob Of's CityC S ierks �Fp ��%S sfian fP DS -DE 14 (Rev. 11113) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES