HomeMy WebLinkAboutG3 ReportCAMPAIGN TREASURER'S REPORT SUMMARY
(1) QAIIMQ 2) C_,01/ OFFICE JUONLY
Name j
'cCB
(z) 50( pckw ���. 0
30
Address (number and street) COClity 2015
~t SCtYSClek�C,
State, p Code�11
❑ Check here if address has changed (3) ID Number:
(4) Check appropriate box(es):
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
Cover Period: From 10/ /_7 l A 01 To 10 / c2 / l a��IS Report Type: G3
(Original ❑ Amendment ❑ Special Election Report
(6) Contributions This Report
(7) Expenditures This Report
O0
Cash & Checks $ ' , _ , ���. _
Monetary �7
Expenditures $ --
/-, Oo
Loans $ — — V • �–
Transfers to
Office Account $
Total Monetary $00 _ J Od
Total Monetary $ �� Y
In -Kind $=
(8) Other Distributions
$
(9) TOTAL Monetary Contributions To Date
(10) TOTAL Monetary Expenditures To Date
$ — J G O
$ �- O-1 .
(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:
(Type name) qy`cic E:c �) , C oy (Type name) � Jv
❑ Individual (only for IE Treasurer ❑ puty/reasurer Candidate ❑ Chairperson (only for PC an PTY)
or electioneering m.)
X X
Signature Signature
DS -DE 12 (Rev. 11113) SEE REVERSE FOR INSTRUCTIONS
CAMPAIGN TREASURER'S REPORT — ITEMIZED CONTRIBUTIONS
1 Name p(� 2
O vtol'Cc_c- �� � o�/ (2) I.D. Number
(3) Cover Period 0/ /,_:�?O/sthrough/ / (4) Page of
(5)
(7)
(6)
(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 Occupation
Type
Description
Amendment
Amount
10/ 19
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/
P.O. Qax 780A5:
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rty
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ksOra
DS -DE 13 (Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES
CAMPAIGN TREASURER'S REPORT — ITEMIZED EXPENDITURES
(1) Name- 6 njxee- Coy/
(3) Cover Period )() 117 l ,20/S through
(2) I.D. Number
(4) Page I of
(5)
(7)
(8)
(g)
(10)
(11)
Date
Full Name
Purpose
(Last, Suffix, First, Middle)
Street Address &
(add office sought if
contribution to a
Expenditure
(6)
SequenceCity,
Number
State, Zip Code
candidate)
Type
Amendment
Amount
10 a l 15
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City
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DS -DE 14 (Rev. 11113) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES