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HomeMy WebLinkAboutM6 ReportCAMPAIGN TREASURER'S REPORT SUMMARY (1) °^ "e"., (___1 I f OFFICE USE ONLY Name RF (Z) ► X023 .V j ► a t - $ ✓ CF'VFQ Address (number and street) S��Pt�s-t f W.� R 3ZCi S 9 cit 'tYots 2Q�9 City, State, Zip Code y0/ork's 81/6n �r ❑ Check here if address has changed (3) ID Number: (4) Check appropriate box(es): ETCandidate Office Sought: '5C_R v'�-571 IA -ti ,rt 7rt ,rO v A, c. Q ❑ 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 C_o/ver Period: From / t / t cl To (o / 'c' / 19 Report Type:tq- LJ amu' Original ❑ Amendment ❑ Special Election Report (6) Contributions This Report Cash & Checks $ Loans $ Total Monetary $ In -Kind $ (9) TOTAL Monetary Contributions To Date $ ►oma (7) Expenditures This Report Monetary Expenditures $—" Transfers to Office Account $ Total Monetary $ (8) Other Distributions $ 1 1 - (10) TOTAL Monetary Expenditures To Date $ 1 1 (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: ff�y,!pp�name) �4E''`��—� GIc.0 Y�i—�... i ,(T�ype_rame)�- 01[ndividual (only fprJ F Treasurer ❑ Deputy Treasurer [ Candidate ❑�C 'person (only for PC and PTY) or electioneering c m,) / X X Signature Y Signature y DS -DE 12 (Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS DS -DE 13 (Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES R FCF/�� CAMPAIGN TREASURER'S REPORT — ITEMIZED CONTRIBUTIONS ✓(/� � Lc ' '4"" c C;r J (1) Name VA,—L, C" (2) I.D. Number0��Ofseb�47VI9 "r (3) Cover Period / t / 19 through Qe (4) Page n of t (5) I (7) (8) (9) (10) (11) (12) Date Full Name (6) (Last, Suffix, First, Middle) Sequence Street Address & Contributor Contribution In-kind Number City, State, Zip Code Type Occupation Type Description Amendment Amount DS -DE 13 (Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES R ci�iC°FSFoos b ?®% (1) Name �� -A' (- TREASURER'S REPORT —ITEMIZED EXPENDITURES �"rsps14 (2) I.D. Number �1„ (3) Cover Period / t / 14 through l 3J l t `) (4) Page of i T (5) (7) ($) (9) (10) (11) Date I Full Name (6) (Last, Suffix, First, Middle) Sequence Street Address & Number City, State, Zip Code l I DS -DE 14 (Rev. 11113) Purpose (add office sought if contribution to a Expenditure candidate) Type Amendment Amount SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES