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HomeMy WebLinkAboutM9 Report DoellingCAMPAIGN TREASURER'S REPORT SUMMARY /V 6 OFFICE USE ONLY ame FcF/VFO N7iW J Gt/ / l2 �iL (2) auJ OC % dress (numl��nd stre t) 1 L 3 2-9,&—opc�'ty ors 1)fi S 1 / 7v` F , City, State, Zip Code Y C/erkPbas/%- rce ❑ Check here if address has changed (3) ID Number. (4) Check appropriate box(es): andidate 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 fled individual making electioneering communications) (5) Report Identifiers ) Cover. Period: From / / �6 To -9/3o/ ! ReportType: �=1-- Original ❑ Amendment ❑ Special Election Report (6) Contributions This Report (7) Expenditures This Report Cash & Checks $ — Monetary Expenditures $ Loans $_ — l Transfers to Office Account $ Total Monetary $ Total Monetary $ 179 - In -Kind $ ' J (8) Other Distributions (9) TOTAL Monetary Contributions To Date (10) TOTAL Monetary Expenditures ToDate $ � ,GAS . /JO $ �, 0q3. S-6 (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::: f (Tynname) A L LL / A/ 6 (Type name) iL`.—�0'�f nd' ' al (only for IE El Treasurer ❑ Deputy Treasurerandida ❑ Chairperson (only for PC and PTI) or el "on ring comm.) X S ature Si nature DS -DE 12 (Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS /�C.AMPAIGN TREASURER'S REPORT - ITEMIZED CONTRIBUTIONS (1) Name bV ���pC�C (2) I.D. Number (3) Cover Period 9 / /14 through J_ / 0 //6 (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 (tt) Amendment (12) Amount (6) Sequence Number R / / �C T i(f, Ofs FQ ��OO I.% DS(DE 13 (Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES 0 C'. / �o �� C,AMP TREASURER' REPORT - ITEMIZED EXPENDITUR14010110j%- s O� (1) Name / A c LL / (2) I.D. Number 0� 6 e/6+ (3)CoverPeriod 2/// /�-through30/ (4)Pageof (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 (5) Sequence Number ( C_4,A4,forq Sro� '6- Wi , Vie,'^'�'S be)60 d:��MZIQ yfz-5'a 0 J Z wJruv?I- 7 3qq G ��� L4( � 6.00 RjA- , l D 7q6 C�nJ .67 DS -DE 14 (Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES