Loading...
HomeMy WebLinkAboutTR ReportCAMPAIGN TREASURER'S REPORT SUMMARY 1 �2t �-{ !�J l OFFICE USE ONLY Name (2) / 0 �e 7JI VY Address (number and street) rL 37'-f sr city 2416 o f City, State, Zip Code cit' Ci SebaSti arl ❑ Check here if address has changed (3) ID Number: (4) Check appropriate box(es): Candidate W)1*fjL"P rL/ IvG' t- E Office Sought: CfC L C ❑ 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 /0/ 3J I To Report Type: •� [Original ❑ Amendment ❑ Special Election Report (6) Contributions This Report (7) Expenditures This Report Monetary Expenditures L Cash &Checks $ $ Loans $ Transfers to Office Account $ Total Monetary $ Total Monetary $ In-Kind $ (8) Other Distributions (9) TOTAL Monetary Contributions To Date (10) TOTAL Monetary Expenditures To Date $ �_�, %fin. $ (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 heNe examined this report and it is true, correct, and complete: t�g6/L` (Type name 14rz4., iT e name [I Individual (only for IE easurer ❑ Deputy Treasurer ❑ Candidate ❑ Chairperson (only for PC and PTY) or electioneering corn X X Signature •`" Signature DS -DE 12 (Rev.11113) SE's REVERSE FOR INSTRUCTIONS y r CAMPAIGN TREASURER'S REPORT — ITEMIZED CONTRIBUTIONS (1) Name 6/Wl//044-1 (2) I.D. Number (3) Cover Period �through I 3o 1 /1v (4) Page _� of (5) Date (7) Full Name (Last, Suffix, First, Middle) Street Address 8 City, State, Zip Code (8) Contributor Type Occupation (9) Contribution Type (10) In-kind Description (11) Amendment (12) Amount (6) Sequence Number F� F evi � 916 , s aS1id Once I I 1 I DS -DE 13 (Rev. 11113) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES ,, CAMPAIGN TREASURER'S REPORT — ITEMIZED EXPENDITURES n (1) Name `07-Z fl�o-s^ (2) I.D. Number (3) Cover Period /* / 3 J / f Xthrough _tel_ 3v/ i �r (4) Page j of - I (8) 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 (8) Sequence Number 30 /�Aoo" �w e! .' ,//, *-t. f 1<0>'3 Vf `4/7 RF Q1 04b. 16 �s S1id O* DS -DE 14 (Rev. 11113) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES