HomeMy WebLinkAbout5th day prior AMPAIGN TREASURER'S REPORT SUMMARY
OFFICE USE PNLY
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Address (number and street
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City, State, Zip Code -
❑ Check here if address has changed (3)
(4) Check appropriate box(es):
LJCandidate Office Sought /'.ry ���/e✓(',/
❑ Political Committee (PC)
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City of r' 2Q7,/f
Ctb C)e ks ON'an
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ID Number.
❑ Electioneering Communications Org. (ECO) ❑ Check here N 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 communim ions)
(5) Report Identifiers
OCov rPeriod: From l a2 1To 09 / /0 f �C7 ReportType
riginal ❑ Amendment ❑ Special Election Report
(6) Contributions This Report (7) Expenditures This Report
Monetary
Cash & Checks $_ _ , r�� • 0� Expenditures $
Loans $ I Transfers to
Office Account $
Total Monetary $ _
Total Monetary $ _ _ 1 4!2?- ..6--1
in -Kind $_ 22 • 41
(9) TOTAL Monetary Contributions To Date
$—,—,?-,?Ly-•/L
(8) Other Distributions
$ —
(10) TOTAL Monetary Expenditures To Date
$—•_1.--Z-?l•21).
(11) Certification
It is a first degree misdemeanor for any person to falsity a public record (es. 839.13, F.S.)
I certify that I have examined this report and it is true, correct, and complete:
(TTpename) %�i i/]E�i%.�' 6� �.,.�J (7TY aname) AxAeR,� A ,7 nGs
❑ XdiWEuWjemy fm lE Tnesu. ❑puty su DeTrearer Caminate ❑Chabpareon(edyf-pCerd Pn7
N6lectitvaedno mmm.) X X
Signature Signature
DS•DE 12 (Rev. 11113) SEE REVERSE FOR INSTRUCTIONS
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CAMPAIGN TREASURER'S REPORT - ITEMIZED CONTRIBUTIONSJ
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(1) Name %a9KG7, Off. 115
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(2) I.D. Number
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(3) Cover Period 9S- I ;ff l �?D through o9
/ L / a.� (4) page
of
Date
I (T)
Full Name
(S)
(9)
(70)
(11)
(12)
(6)
(Last Sulfi; First Middle)
I
I
I
Sequence
Street Address 8
Cm:wor
Conbbul
In -kind
Number
CIN. State. Zia Code
Twe
Ocauostion Twe
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Amewnem
Amount
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DS-DE 13 (Ra, 1tr13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES
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CAMPAIGN TREASURER'S REPORT —ITEMIZED EXPENDITURES
(1) Name
(2) I.D. Number
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(3) Cover Period _0—ri t'�/ thtough _O / 2�
(4) Page of
(5)
(7)
(e)
(g) (te)
(11)
Date
Full Name
Purpose
(5)
Sequence
(Last Suffix. First, Middle)
Street Acidness S
(add office sought if
contribution to a Expenditure
Number
City. State, 21p Code
candidate)
TYPO xmaMmem Amount
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DS•DE 14 (Rev. 11113) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES