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HomeMy WebLinkAboutM9 ReportCAMP IGN TRE RER'S REPORT SUMMARY (1) pkyykA tJI OFF,JCECSE ONLY 1 �t EIV (2) Na G. Vu P 15.4 r OCT t ^ ED Add _b andstreet t/` 1 City of 1��9 City Cle�!bC�ae City, State, Zip Code ❑ Check here if address has changed (3) ID Number: (4) Check appropriate box(es): L(� 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 / I / To / so/ Report Type: ❑ Original ❑ Amendment ❑ Special Election Report (6) Contributions This Report (7) Expenditures This Report Cash & Checks Monetary Expenditures $ , Loans $ _ • _ Transfers to Office Account $ Total Monetary $_ _ , Total Monetary $ In -Kind (8) Other Distributions $ 1 , (9) TOTAL Monetary Contributions To Date (10) TOTAL Monetary Exp di ures o/Date $ t. l�. 0�. $ W (11) Certification It is a first degree misdemeanor for any person to falsify a public record (ss. 839.13, F.S.) I certify thatfty'm examined this repo d it is true, correct, and complete m (Type nae (0,- r P00— "S (Type n me)00,e X paiii ❑ Indivi I (only for IE reasurer ❑ Deputy Treasurer ndidat: ❑ Chairperson (only for PC and PTY) or elec' ne ring comm.) Signature Signature DS -DE 12 (Rev. 11113) SEE REVERSE FOR INSTRUCTIONS R AMPAIGN TREASURER'S REPORT — ITEMIZED CONTRIBUTIONS () �� U 1 Name � S (2) I.D. Number of fl�(3) Cover Period / / through /�/ 1 `^ (4) Page of (5) (T) (8) (9) (10) (11) (12) Date _ Full Name (6) (Last, Suffix, First, Middle) Sequence Street Address & Contributor Number City, State, Zip Code Type Occupation �CIY` Contribution In-kind Type Description Amendment Amount C ►�- DS-DE 13 (Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES 0 c fse� ?®19 AMIN EP �%RE PORT — ITEMIZED EXPENDITURES ost (1) Name .� (\� (2) I.D. Number o (3) Cover Period q/C1 through/ l / I (4) Page of 1 (5) (7) (S) (g) (10) (11) Date Full Name Purpose (6) I (Last, Suffix, First, Middle) (add office sought if Sequence Street Address & contribution to a Expenditure Number City, State, Zip Code candidate) Type A ndment Amount I DS -DE 14 (Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES