Loading...
HomeMy WebLinkAboutM9 ReportCAMPAIGN TREASURER'S REPORT SUMMARY (1) L w.../ 0. rJ (' wAhP�iti� IAao-� OFFICE USE ONLY lw,,2 Name (�) Dl_ RECEIVED (2) /& � 4X2411 Address (number and stre,Bt) OCT 10 2016 > a,i s / j L53 6 City of Sebastian City, State, Zip Code I City Clerk's Offico ❑ Check here if address has changed (3) ID Number: (4) Check appropriate box(es): D-16andidate Office Sought: �, ,.� r �, ) Cho �,/ L1 'l&A/ �Knn ❑ 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 / 1 / Lct(., To Z)q_ / 3D l Z01� ReportType: l,tq_ Lolfo riginal ❑ Amendment ❑ Special Election Report (6) Contributions This Report (7) Expenditures This Report Monetary Cash & Checks $__ , (� ao Expenditures $ Loans $_ _ , /l)o . 00 Transfers to Office Account $ Total Monetary $_ _ , L . oa Total Monetary $ �a In -Kind $_ oa (8) Other Distributions (9) TOTAL Monetary Contributions To Date (10) TOTAL Monetary Expenditures To Date $ $ �— . 00 (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) �%% t ���� AJ,.p,c4 (Type name) / ❑ Individual (only for IE reasurer ` ❑ Deputy Treasurer IaCandidate ) ❑ Chairperson (only for PC and PTY) or electioneering comm.) X X Signature Signature 1 CAMPAIGN TREASURER'S REPORT— JTEMIZED EXPENDITURES (1) Name �re.� ��� 2 r , f to r (2) I.D. Number (3) Cover Period Oq / 01 / zo,(o through 09 / 30 /10116 (4) Page '— of ,— (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 (S) Sequence Number �► G�� IT tel+-�4b/,A~ ►�zS rl �. �A Vfl�� fn o,J 41.00 RFc 0/c, sii Off° 6 n DS -DE 14 (Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES CAMPAIGN TREASURER'S REPORT — ITEMIZED CONTRIBUTIONS (1) Name /j- fJe'R1'C (.r.7aafl, /t'1«4A 1 (2) I.D. Number (3) Cover Period j l gkj& through 09 / �SV / 0/ (4) Page 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 Description (11) Amendment (12) Amount (6) Sequence Number Dot ! D / DI&F `. ", ;j . / R 143 Luta 'D7 J: LOA RFc l l Cl � eS b©1O e p caa FO DS -DE 13 (Rev. 08/03) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES CONTRIBUTIONS RETURNED (Section 106.07(4)(b), F.S.) (PLEASE TYPE) RECEIVED OCT 10 2016 City of Sebastian City Clerk's Office OFFICE USE ONLY This report applies only to contributions received by any candidate, committee, or organization but returned to the contributor before being Jeposited in the campaign account. D C ndid ate Full Name: .s.._i LJ Committee or Organization Full Address: S,rts-iinJ FL ZLIa Y Full Name and Address of Contributor: A �la,n N,1✓e-✓ / le�sl7 �o�lrau� /i�fa-Minn Amount of Contribution: II$ o{JD.yD Date Received: 5/z3/lb Date Returned: !o h !/& Full Name and Address of Contributor: Amount of Contribution: $ Date Received: Date Returned: X Full Name and Address of Contributor: Amount of Contribution: $ Date Received: Date Returned: Full Name and Address of Contributor: Amount of Contribution: $ Date Received: Date Returned: I CERTIFY THAT I HAVE EXAMINED THIS REPORT AND IT IS TRUE, CORRECT AND COMPLETE. W, Ne -pi �✓ DS -DE 2 (Rev. 07/10) or Print Name of Candidate, Treasurer or Chairman LA). V ) _ n