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HomeMy WebLinkAboutG1 Report DoellingTREASURER'S REPORT SUMMARY =MPAIIGN (1) ��QC�'Ge, OFFICE USE ONLY Name // S 1�A46yze F (Z) Cq r/ -r Address (number and str et) City, State, Zip Code ❑ Check here if address has changed (3) ID Number: (4) Chec 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 filed individual making electioneering communications) (5) Report Identifiers Cover Period: From (r / / / /L/' To /e, / % Report Type: ❑ Original ❑ Amendment ❑ Special Election Report (6) Contributions This Report (7) Expenditures This Report Monetary Cash & Checks $ (2. Ot> Expenditures $ bo Loans Transfers to Office Account $ (7 . 00 Total Monetary Total Monetary $ p 17 In -Kind $ (8) Other Distributi-ris $ (9) TOTAL Monetary Contributions To Date (10) TOTAL Monetary Expenditures To Date $�,5/ DU $ �T (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 comple / �- (Type name) ,� L (�/O'�' �- J ^J (Type name II» i hdi ' ual (only for IE reas rer ❑Deputy Treasurer—PfCantli to El Ch (only for PC and PTY) 'ore coon Bring comm.) ` Ignature DS -DE 12 (Rev. 11/13) _� SEE REVERSE FOR iNSTkUCTIONS CAMPAIGN TREASURER'S REPORT — ITEMIZED CONTRIBUTIONS (1) Name '� L� D0 F-u-� (2) I.D. Number (q�over Period 1 O / -1 / /Z through / / ( //4 (4) Page [ f —L (5) to (7) Full Name (Last, Suffix, First, Middle) Street Address & Ci State, Zi Code (8) Contributor Type Occupation (9) Contribution Type (10) In-kind Descri t' n 1) Amendment (12) Amount (6) Sequen Number DS-DE13 Rev. 11113) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES CAM AI TR URER'$ PORT - ITEMIZED EXPENDITURES (1) Name LW t— �%yL— �� / C- (3) Cover Period �0 through /,o/ 7 (2) I.D. Number (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 (6) Sequence Number k4AZ44P(, I -CA f a r9rL1C I y� DS -DE 14 (Rev. 11113) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES