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HomeMy WebLinkAboutG2 Report(1) Jo Name ��/CAAMPJAIGN TREASURER'S REPORT SUMMARY /'(_ I' i r r (a r OFFICE USE ONLY (2) Address (number and street City, State, Zip Code ❑ Check here if address has changed (3)ID Number: (4) CC—heck appropriate box(es): I , / F],&didate Office Sought: 2 �a.t 11 4 n L t �t/ Qld 0 L Y) e– I ❑ 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 /0 lJ� l To /Q l / /q Report Type:6 j ❑ Original ❑ Amendment ❑ Special Election Report (6) Contributions This Report (7) Expenditures This Report Monetary ���� Cash &Checks $_ _ .� Expenditures $ _ , /1 7' % Loans $ 1 1 - Total Monetary $ 550• Qv In -Kind $ - (9) TOTAL Monetary Contributions To Date '3,/SD. 00 Transfers to Office Account $ Total Monetary $ 1 5� '/ (8) Other Distributions $ , (10) TOTAL Monetary Expenditures To Date $ ,_/,S/S.? / (11) Certification It is a first degree misdemeanor for any person to falsify a public record (ss. 639.13, F.S.) I certify that I have examined tthiss repo//rte and it is true, correct, and complete: //(� /j //// (Type name) /� Gt / < c' ! y f -//, (Type_ ame) /go (j / < < 9 (r' I, , ❑ Individual (only for IE Treasurer ❑ Deputy Treasurer Ofandidate ❑ Chairperson (only for PC and PTI) or electioneedng comm.) Signature I Signature DS -DE 12 (Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS CAMPAIGN TREASURER'S REPORT - ITEMIZED CONTRIBUTIONS (1) Name / (2) I.D. Number (3) Cover Period L / S / L through /0 / 4 / � (4) Page (5) (7) (6) (9) Date Full Name (6) (Last, Suffix, First, Middle) Sequence Street Address & Contributor Contribution Number City State Zip Code Type I Occupation T /01 /I /o/ /l /0//( /I ype I/9 �evelJa/d L 'Sm�/r9dew,��s Ye-ro Kr'7& 31963 /94&t,5on/�oS !1l spow��jre� We�y �-- �64�lrQN, J / �v J// 9 �a�9�1 l��aer f /a-25 33r` '_ S % V�>, &aaI Ft C klc_ LI{� cfrr C8E M� (10) (11) In-kind Description Amendment DS -DE 13 (Rev. 11113) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES R�cFi pCT , �Fo e eb o '� c asci of (12) 1 Amount �D. (qt) 75-',08 lro"6o /,00,50 ugqSi�,�s1 //0/rs h Sf J / 37 c7 Se-ka3/1"4R / f' /4 S� V✓q/� ,-r-i ref 5 f1wY l /0/IS/I� l jonl Y7s, co GA rJ 7/, 7F GA � r (g �A W9e 4/7 DS -DE 14 (Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES ' ®l l<' �� AM,,�P I�9 N TREPSURER'S C" REPORT –ITEMIZED EXPENDITURES�'�yof Sm, (1) Name / (� I n / L / n n (2) I.D. Number n. </1. (3) Cover Period /o/ S / / through (4) Page of (5) (7) (8) (9) (10) (11) Date Full Name Purpose (6) (Last, Suffix, First, Middle) (add office sought If Sequence Street Address & contribution to a Expenditure Number City, State, Zip Code candidate) Type Amendment Amount ugqSi�,�s1 //0/rs h Sf J / 37 c7 Se-ka3/1"4R / f' /4 S� V✓q/� ,-r-i ref 5 f1wY l /0/IS/I� l jonl Y7s, co GA rJ 7/, 7F GA � r (g �A W9e 4/7 DS -DE 14 (Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES