HomeMy WebLinkAboutM7 Report- ll , s - _�/ j )1 6 _,-2-- J)_4
CAMPAGN TREASURER'S REPORT SUMMARY
OFFICE USE ONLY
Nam
(2)L �liei
Add (umber and street) r' AUG i
�� Jli'V cryo ? ?017
City, State, Zip Code rill crtj C/e kebaslia
❑ Check here if address has changed (3) ID Number:
(4) Check appropriate box(es):
Candidate 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)
!? Report Identifiers
Cover Period: From 2 / I �/ -4 To —1 / / j ( l –[1 Report Type:
❑ Original ❑ Amendment F1Special Election Report
(6) Contributions This Report (7) Expenditures This Report
Monetary
Cash & Checks
$ r _
_ • _ Expenditures
$
Loans
$
• Transfers to
_ _
Office Account
$
Total Monetary
$_
Total Monetary
$
In -Kind
$_
(9) TOTAL 0onetary Contributions To Date
$ [_al , — , — - —
(10)
iSnll
(8) Other Distributions
$ 1 1
(10) TOTAL,Monetary Expenditures To Date
$ C,
(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) (Typ name)
i
❑ Individual (only for IE Tre/�aq/rer ❑ Deputy Treasurer Candidate ❑ C.'%hai/r�jpe%rso�n,(o-,nly for PC and PTY)
or electi a ing comm
01
Signature Signature
DS -DE 12 (Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS
CAMIP TR ASU��ORT— ITEMIZEDEXPENDITURES
(1) Name II !A (2) I.D. Number
(3) Cover Period �/ through —1—/ -SLA (4) Page
(5) (7) (8) (g)
Date Full Name Purpose
(S) (Last, Suffix, First, Middle) (add office sought if
Sequence Street Address & contribution to a
Number City, State, Zip Code candidate)
of I
(10)
DS -DE 14 (Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES
nount
CAIGN TRE URER'S REPORT - ITEMIZED CONTRIBUTIONS
AA�
(1) Name rpm io, { (2) I.D. Number
(3) Cover Period / T�_/ 41 through /�j /_a (4) Page of
(5) (7) (8) (9) (10) (11)
Date _ Full Name
(6) (Last, Suffix, First, Middle)
Sequence Street Address &. Contributor Contribution
Number City, State, Zip Code Type Occupation Type
`7, (S-1 QwC9/c
fArv-t T
� o
a
6er
DS-DE 13 (Rev. 11113)
(12) I
In-kind
Description Amendment Amount
SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES