HomeMy WebLinkAboutTR Report AMPAIGN TREASURER'S REPORT SUMMARY
6�1_ ie TES OFFICE USE N Y
Name
Address (number and street)
City, State, Zip Code
❑ Check here if address has changed
(4) Check appropriate box(es):
10 Candidate Office Sought:
❑ Political Committee (PC)
❑ Electioneering Communications Org. (ECO)
❑ Party Executive Committee (PTY)
❑ Independent Expenditure (IE) (also covers an
individual making electioneering communications)
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(3) ID Number.
❑ 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 filer)
(5) Report Identifiers
Cover Period: From �2_L 1 /0 / 0,2J To j�2_ J / y I Z) Report Type:
2roriginal ❑ Amendment ❑ Special Election Report
(6) Contributions This Report (7) Expenditures This Report
r Monetary
Cash & Checks $ c�— Expenditures $ , , 3,2
Loans $
Total Monetary $
In -Kind $
(9) TOTAL Monetary Contributions To Date
Transfers to
Office Account $
Total Monetary $ I_ , �!) .
(8) Other Distributions
$ 1 1
(10) TOTAL Monetary Expenditures To Date
$ V "3 �
(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) �%'i 7i�i��/jt' < �'�i✓ (Type name) c�iF� [�
❑ Individual (only for IE QTreasarer ❑ Deputy Treasurer It3�Candidate ❑ Chairperson (only for PC and PTY)
or electioneering comm.)
__
Signature Signature
DS-DE 12 (Rev. 11113) SEE REVERSE FOR INSTRUCTIONS
CAMPAIGN TREASURER'S REPORT — ITEMIZED CONTRIBUTIONS
4
(1) Name �—�j'f��, l/ ,JOB s� (2) I.D. Number 0
(3) Cover Period Z)l / IV /.2a through f. l 14'e' (4) Page of
(6) (7) (S) (9) (10) (t1) (12)
Date Full Name
(6) (Last, Suffix, First, Middle)
Sequence Street Address & Contributor Contribution In -kind
Number City, State, Zip Code Type Occupation Type Description Amendment Amount
f
DS-DE 13 (Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES
CAMPAIGN TREASURER'S REPORT— ITEMIZED EXPENDITURES
(1) Name '
(2) I.D. Number
(3) Cover Period// through i'
_//_,h:�
(4) Pageof
(5)
I (7)
(B)
(9) (10)
Date
!I Full Name
Purpose
(B)
(Last, Suffix, First, Middle)
(add office sought if
Sequence
Street Address &
contribution to a
Expenditure
Number
City, State, Zip Code
I
candidate)
Type Amendment
ChB
l I3S�-��
S�i�� �95g
DS•DE 14 (Rev. 11113)
SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES
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/
Amount
34 0