HomeMy WebLinkAboutG2 ReportCAMPAIGN TREASURER'S REPORT SUMMARY
OFFICE USE ONLY�
Name
d
�ress nwnn ber a( stre/et)
u51/G7w 'Ilk
rOrr., �>..
City, Stale, Zip Code �- o._(
❑ Check here If address has changed (3) ID Number.
(4) Check appropriate box(es): /J
Candidate Office Sought: C,' ( p V kl C_
❑ Political Committee (PC) r
❑ Electioneering Communications Ong. (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 /(j l 3 / 020 To 149 / 16 Report Type:
59'Driginal ❑ Amendment ❑ Special Election Report
(6) Contributions This Report
Cash &:Checks $
Loans $� r
Total Monetary $
In -Kind $
(g) OCTAL Monet Cont�tionsDate
(7) Expenditures This Report
Monetary
Expenditures $ 3
Transfers to
Office Account $j
Total Monetary $ 4e ,
(8) Other Distributions
$
(10) TOTAL ""eta xpenditures To Date
(11) Certification
It is a first degree misdemeanor for any person to falsify a public record (as. 839.13. F.S.)
I ce .It that I have exa ned this report and it is true, correct, and complete:
(T :rkalaely®/ S///!v / I (Type name) % /30 (✓7 (V
❑ Intl idual (only for IE Treasurer a ly Treasurer Candidate ❑ Chairperson (only for PC and PTY)
ar ale clioneadnp com_) •�
L
X21
C
Sigp due Signature
DS-DE!'12 (Rev. 11113) SEE REVERSE FOR INSTRUCTIONS
12 CAMPAIGN TREA ER��aEPORT- ITEMIZED EXPENDITURES
(1) Name I rr_ !✓ 1✓ (T� 9 i / C'A" (2) I.O. Number
(3) Cover Period ✓� ! _/ - through �/ /J /_ 2f (4) Page of /t
(5)
Gate
(7)
Full Name
(Last, Suffix, First, Middle)
Street Address d
City, State, Zip Code
(S)
Purpose
(add office sought It
contribution to a
candidate)
(9)
Expenditure
Type
(10)
Amendment
(11) ---
Amount
(5)
Sequence
Number
O 13 a
.Sea Go ti / aiv �
�'a,✓ Y�i ,L
3
i�
i
DS-DE ',d {Rev. 11113) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES