HomeMy WebLinkAboutM9 ReportCAMPAIGN TREASURER'S REPORT SUMMARY
(1) bowl ,, �/�oLlyl OFFICE USE ONLY
Name kEc�/VES
(2) /&2-
Address (number and street) CBCT a 9 ?015
Jzw** riAl Aq- city of
City, State, Zip Code City c/e k?S o nC n
❑ Check here if address has changed (3) ID Number:
(4) Check appropriate box(es):
M Candidate Office Sought: e�? 7-/ e.'c r /
❑ 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 Q l Ol / i,- To 9 / a l /,r Report Type: /1/-
59 Original ❑ Amendment ❑ Special Election Report
(6) Contributions This Report
(7) Expenditures This Report
y
Cash & Checks $ `� , = , p%G' . B�
Monetary
Expenditures $
Loans $ r — —
Transfers to
Office Account $ — _ —
Total Monetary $
Total Monetary $
r
In -Kind $
—
(8) Other Distributions
$
(9) TOTAL Monetary Contributions To Date
(10) TOTAL Monetary Expenditures To Date
$ - , 9i�^ m�
$ - �t�Q -
(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:
AW04H-V (;//4'S4._( f'Gl. LG4•ef
(Type name) (Type name) T"- r614'e!
❑ Individual (only for IE _ urer ElDeputy Treasurer an
Cdidate airper n (only for PC and PTY)
or electioneering comm)
X X
Signature Signature
DS -DE 12 (Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS
CAMPAIGN TREASURER'S REPORT - ITEMIZED CONTRIBUTIONS
(1) Name byPlli�iLo4��`$u f (2) I.D. Number
(3) Cover Period I / 0 / / r through 0 / _3v / rJ�_ (4) Page =L of 3
(5)
(7)
(8)
(9)
(10)
(11)
(12)
Date
Full Name
(Last, Suffix, First, Middle)
(6)
Sequence
Street Address &
Contributor
Contribution
In-kind
Number
City. State, Zip Code
Type I Occupation
Type
Amendment
Amount
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DS -DE 13 (Rev. 11113) SEE REVERSE FOR INSTRUOiJOtdt jD�SQ VALUES
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City lof USebastian
City Clerk's Office
CAMPAIGN TREASURER'S REPORT - ITEMIZED CONTRIBUTIONS
(1) Name � yttr—G $ (2) 1. D. Nurnber
(3) Cover Period 01_ / e I / 1.r through �_L / _3 / /j— (4) Page 2" of 3
(5)
Date
(7)
Full Name
(Last, Suffix, First, Middle)
(6)
(9)
(10)
(11)7Amnt
(6)
Sequence
Street Address &
Contributor
Contribution
In-kind
Number
City, State, Zi Code
Type Occupation
Type
Description
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U5 -13E 13 (Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUiEW
OCT o s 2015
City of Sebastian
City Clerk's Office
CAMPAIGN TREASURER'S REPORT — ITEMIZED CONTRIBUTIONS
(1) Name (2) I.D. Number
(3) Cover Period l of / /f through / Pa / / j (4) Page of z/
(5)
Date
(7)
Full Name
(Last, Suffix, First, Middle)
(8)
(9)
(10)
(11)
(12)
(6)
Sequence
Street Address 8
Contributor
Contribution
In-kind
Number
City, State, Code
Tyoe Occu ation
Type
—Description
Amendment
Amount
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A CAMPAW T}3EASURER'S REPORT— ITEMIZED EXPENDITURES
(1)Name peuf
(3) Cover Period / o / / / 3 through i9
(2) I.D. Number
(4) Page f 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
(6)
Sequence
Number
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DS -DE 14 (Rev. 11113) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES