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HomeMy WebLinkAboutG2 Reportn Ao\ CAMPAIGN TREASURER'S REPORT SUMMARY rr (1) W IGAP'14 4f Cit )lrnor. OFFICE USE ONLY Name (Z) rl 4q Addre (num eland street IS ar* C C/ar City, State, Zip Code �k8 4pfrary ❑ Check here if address has changed (3) ID Number: (4) Check appropriate box(es): Cla �Q[�►JC I L— 0 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 Co/ver Period: From IV / / j To [b Report Type; 2� © Original ❑ Amendment ❑ Special Election Report (6) Contributions This Report (7) Expenditures This Report Cash & Checks $_ , � • cm Monetary Expenditures $ j } Loans $_ , _ , _ Transfers to Office Account $ • Total Monetary $_ , % , Z0a• � —� Total Monetary $ In -Kind $_ • _ (8) Other Distributions (9) TOTAL Monetary Contributions To Date $ 00 (10) TOTAL Monetary Expenditures To Date $ (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 littiis true, correct, and complet �� (Type name) I l� f'C. �f (�owv (Type name ( ( �� fR"' 1 �U Individual (only for IE ❑ Treasurer ❑ Deputy Treasurer Candidate ❑ Chairperson (only for PC and PTY) r election eying co m.) X Sign ure atu e DS -DE 12 (Rev. 11113) SEE REVERSE FOR INSTRUCTIONS CAMPAIGN TREASURER'S REPORT— ITEMIZED CONTRIBUTIONS (1) Name !R) awQ9. c�(I f/w (2) I.D. Number (3) Cover Period L / __; / 16hrough / 4</tl'Z (4) Page of I (5) Date (7) Full Name (Last, Suffix, First, Middle) Street Address & City, State, Zip Code (8) Contributor Type Occupation (9) Contribution Type (10) In-kind Description (11) Amendment (12) Amount (6) Sequence Number Pk ']o a H �°sfa M_#_ 0t4,MIX), rt, a dC7 I jNdt.a r) zIdC11 *,,j ,, 6J ks5A ,je*0.63 z96 F _ C 9/_ t� hero �Cil�� s96� 3 F 6 H ti C�� � or'r C °fs �Fo DIS em's of, oe US•UE 13 (Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES /'ok, ,i►, Ak4PAIG T(1R1EA gR�rrE�R�'rS1 �REPORT- ITEMIZED EXPENDITURES (1) Name I r.hA,t "I 1'i lI/W (3) Cover Period (0 / 9 / I6 -through 10 (2) I.D. Number (4) Page �_ ot✓ (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 [0/,T 15 T yr nri I13�0S l L na Ff- 3agSY T slw C .e-SiSa c�iv�s iliUN ,� ���, 03 ID11f V2% WA; Set�CO IVGU Nom" Q�Pev /')ion 33). 23 to 11 ) S CGt?mb'ew g M 0iJ 3 a ". /Vc, Qepoh�l� Clog -3)0,4jW Ca+np� sib /o �l l �' Cumbev�o�-r0 �� �'►�S /rlo� l�� o � OOT 1 �'ez) 60 ofSeb Clark's Shan �Ce DS -DE 14 (Rev. 11113) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES