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HomeMy WebLinkAboutG1 ReportCAMPAIGN TREASURER'S REPORT SUMMARY / (1) ( "Jo JAJ,N� l tw+�Gra. �l��y�r OFFICE USE ONLY Name T 'iFc (2) /&:s XkXF., i O 0 CT Address (number and street) C; Jy _&LA"' f SZ4.,� c�e�kS City, State, Zip Code acrid ❑ Check here if address has changed ce (3) ID Number: (4) Check appropriate box(es): L3't.;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 / p ( l Z pi(p To /0 l )-L l 70KO Report Type: C 1 ❑ Original ❑ Amendment ❑ Special Election Report (6) Contributions This Report (7) Expenditures This Report Monetary Cash & Checks $ p Expenditures $ Loans $— — , Transfers to Office Account $ Total Monetary $ () • _ Total Monetary $ . In-Kind $ (8) Other Distributions $ O (9) TOTAL Monetary Contributions To Date (10) TOTAL Monetary Expenditures To Date $ ao $ (o( Do (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: Crype name) M I11 e lI , (Type name) ❑ Individual (only for IE Treasurer ❑ Deputy Treasurer 12rcandidate ❑ Chairperson (only for PC and PTY) or electioneering comm.) X X CIO " Signature Signature CAMPAIGN TR ER'S REPQRT )TEMIZED EXPENDITURES (1) NameL��, rr (2) I.D. Number (3) Cover Period lf) l DI l/0/& through In/0Z/ 107 (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) Amo 't (5) Sequence Number / l F 76 s n� Oh; o DS -DE 14 (Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES CAMPAIGN TREASURER'S REPORT — ITEMIZED CONTRIBUTIONS (1) Name L , A J,�' , (2) I.D. Number (3) Cover Period /V l of / Z p/ through 10 / 07 / 2 r11i0 (4) Page ,— of y (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 tion (11) Amendment (12) Amount (6) Sequence Number R cFi� / of .0 cfe�/r' , 0 e' DS -DE 13 (Rev. 11113) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES