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HomeMy WebLinkAboutG1 ReportCAMPAIGN TREASURER'S REPORT SUMMARY {{6& �� /o rf OFFICE USE ONLY Name (2) _i(c-;- Address (number and street) rSAW<'r/01V A-- 0,9 ?4 City, State, Zip Codeci y°r so is r_1Check here if address has changed (3) I D Number: Irks O CO (4) Check appropriate box(es): Candidate Office Sought:d?s7o�s�s ❑ 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 / n / / / $'_ To /o / 0,7- / fS— ReportType: 6; / [Original ❑ Amendment ❑ Special Election Report (6) Contributions This Report (7) Expenditures This Report Monetary Cash & Checks $ Expenditures $ — — Loans $ — , _— — Transfers to Office Account $ — Total Monetary $ — — Total Monetary $ In-Kind $ �_ — • _� (8) Other Distributions $ (9) TOTAL Monetary Contributions To Date (10) TOTAL Monetary Expeer(]Tdit9ures To Date $ l • $ (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: 4�& j/1~ Ait (Type name) t4Jli!/J (Type name) !A.4+ ❑ Individual (only for 1E,_--1n7r-dAsurer ❑ Deputy Treasurer ecandidate ❑ reon (only for PC and PTY) or electioneering Wrnn`1*1 X X Signature Signature DS -DE 12 (Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS CAMPAIGN TREASURER'S REPORT— ITEMIZED CONTRIBUTIONS (1) Name 'bwwxi. �!l�• I (2) I.D. Number (3) Cover Period 10 / O / / /,through /W / O L / / �_ (4) Page / of / (5) Date (7) Full Name (Last, Suffix, First, Middle) Street Address& City, State, Zip Code (8) Contributor Type Occupation (g) Contribution Type (10) In-kind Description (11) Amendment (12) Amount (6) Sequence Number / / RETE Oct 0 s Clty cit, C Sebe VED 015 ti an doe DS -DE 13 (Rev. 11113) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES AIG4I TREASURER'S REPORT— ITEMIZED EXPENDITURES (1) Name b,CAP (2) I.D. Number (3) Cover Period through w / 01/ /f (4) Page % of (5) Date (T) 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 FCEIVE c ;r City 0 9 709 aebastlg rk's ofnc DS -DE 14 (Rev. 11113) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES