HomeMy WebLinkAboutG3 ReportCAMPAIGN TREASURER'S REPORT SUMMARY
(1) A,4 1/�-v[ dk
1CGII (;j OFFICE USE ONLY
Name
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Addre (nu bar and str
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City, State, Zip Code C ofNaZO
s
❑ Check here if address has changed (3) ID Number: ice
(4) Check appropriate box(es): a
/
Xpandidate Office Sought: C I Ty C aJNG( L
❑ 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/ / /0/ Lf— To / 0 /29 / / Report Type: C
❑ Original ❑ Amendment ❑ Special Election Report
(6) Contributions This Report
(7) Expenditures This Report
�
Cash & Checks $_ , _ ,—p
Monetary
Expenditures
Loans $_ _ , _ • _
Transfers to
Office Account $ ,
Total Monetary $_ , _ , _ .
Total Monetary $ q3721
In-Kind
(8) Other Distributions
(9) TOTAL Monetary Contributions To Date
(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 it is true, correct, and complete:
(Type name) i'\I cSi V4` � . Gc V/'Kn- (Type name) T I ChAd 4, t/ t
Individual (only for IE ❑ Treasurer ❑ Deputy Treasurer Wandidate ❑ Chairperson (only for PC and PTY)
or egn
ectioneering comm.)
X
re Signature
DS -DE 12 (Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS
CAMPAIGN TREASURER'S REPORT — ITEMIZED CONTRIBUTIONS
(1) Name <R(C�P41 �(��ot— �/ cy (2) I.D. Number
(3) Cover Period 10 / *1 through ! v / F ( / � j� (4) Page 4
of
(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
(11)
Amendment
(12)
Amount
(6)
Sequence
Number
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DS -DE 13 (Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES
CAMPAIGN T E URER'S REPORT—ITEMIZED EXPENDITURES
(1)Name eR ichAy-i /�,<//f12uY
i
(3) Cover Period �/—/W/ / 5 through /`� /7/ LI—N
(2) I.D. Number
(4)Page �of 1
(5)
Date
(7)
Full Name
(Last, Suffix, First, Middle)
Street Address &
City, State, Zip Code
(0)
Purpose
(add office sought if
contribution to a
candidate)
(9)
Expenditure
Type
(10)
Amendment
(11)
Amount
(S)
Sequence
Number
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ase ��°ti war
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DS -DE 14 (Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES