HomeMy WebLinkAboutG3 ReportCAMPAIqqqGN TREASURER'S REPORT SUMMARY
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(1) C ///���QUfi OFFICE USE ONLY
(2) Name43O C3 fn iLy. '13 VAC., ,`1RFCF/�F
Addre.{ss,i�nymbar and stree
: MO, S `-Il QM , Fk �Jaq S� Ccot 5e5/
City, State, Zip Code 0'."
❑ Check here if address has changed (3) ID Number.
(4) Check appropriate box(es): - I - 1
[9 Candidate Office Sought: � W�2 l� OJY\
❑ Political Committee (PC)
❑ Electioneering Communications Org. (EGO)
❑ Party Executive Committee (PTY)
❑ Independent Expenditure (IE) (also covers an
individual making electioneering communications)
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,
❑ Check here if PC or ECO has disbanded
❑ Check here if PTY has disbanded
❑ Check here if no other IE or EC reports will be filed
(5) Report Identifiers
Cover Period: From 6 / / To /0 / 3 , / f Q Report Type: C 3
Original ❑ Amendment ❑ Special Election Report 1-
(6) Contributions This Report (7) Expenditures This Report
Monetary $
Cash & Checks $_ _ , �00 .00 Expenditures
Loans �_ _ • _ Transfers to
Office Account $
Total Monetary
Total Monetary $ _ _ t� 4,T
In -Kind $ +1-
(8) Other Distributions
$
(9) TOTAL MonetaryContributions To Date (10) TOTAL Monetary Expenditures To Date
$ $Rl�JJ 'o
(11) Certification , 3 -13. -7- y (yam)
It is a first degree misdemeanor for any person to falsify a public record (ss. 839.13, F.S.)
I certify that`I have jexaamined this
report and it is true, correct, and complete: I • �M �1
(Type name) j cl)'+ I t �A 1--h, I Q (h I it (Type name) 1 I (, III aGlf'l"
❑ Individual (only for IE ,_ Treasurerl ❑ Deputy Treasurer Candidate C]Chairpe n (onlyYor PC and PTY)
or electioneering comm.)
Signature Sig a r
DS -DE 12 (Rev. 11113) SEE REVERSE FOR INSTRUCTIONS
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CAMPAIGN TREASURER'S REPORT — ITEMIZED CONTRIBUTIONS `101.1, SFJ
(1) Name (2) I.D. Number
(3) Cover Period JO / / q / /7 through /Q / 3 / (4) Page of
(5) I (T) (6) (9) (10) (11) (12)
Date Full Name
(6) (Last, Suffix, First, Middle)
Sequence Street Address& Contributor Contribution In-kind
Number City. State, Zip Code Tvpe Occupation_ Tvpe Description Amendment Amount
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DS -DE 13 (Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES
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(4) Page
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(7)
(8)
(9)
(10) (11)
Date
(5)
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Type
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DS -DE 14 (Rev. 11113)
SEE REVERSE FOR INSTRUCTIONS
AND CODE VALUES
I CAIIIjIPAIGN TREASURER'S REPORT— ITEMIZED EXPENDITURES
(1) Name Ch({ t (�R//�J t ) ii) (,1 IA +1 (2) I.D. Number
1
(3) Cover Period through --LO LqLLL�_
(4) Page of
(5)
(7) (e)
(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
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0S-DE 14 (Rev. 11113) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES