HomeMy WebLinkAboutG2 ReportCAMPAIGN TREASURER'S REPORT SUMMARY
0\ LA_' OFFICE USE ONLY
Name4q S 1CAsd\f_4'rkr
Address I_(nnumber and street) city
Of
�ci
City, State, Zip Code °"
❑ Check here if address has changed (3) ID Number:
(4) Check appropriate box(es):
❑ Candidate Office Sought:
❑ 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 To C) 2j ZDReport Type: U z1_
❑ Original ❑ Amendment ❑ Special Election Report
(6) Contributions This Report (7) Expenditures This Report
Monetary
Cash & Checks $_ . _ Expenditures $ , 0 .
Loans $ Q • _ Transfers to
Office Account $ .
Total Monetary $
Total Monetary $
In -Kind $
(8) Other Distributions
$ r ,
(9) TOTAL Monetary Contributions To Date (10) TOTAL Monetary Expenditures To Date
$ , 5,HU14.--I+ $ ,__2,525. -
(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) A �NU ,\-� U� (Type name)
❑ Individual (only for IE ❑ Treasurer ❑ Deputy Treasurer ❑ Candidate ❑ Chairperson (only for PC and PTV')
or electioneering comm.)
x / x >
Signature Signature
DS-DE 12 (Rev. 11113) SEE REVERSE FOR INSTRUCTIONS
RECE/��p
CAMPAIGN TREASURER'S REPORT — ITEMIZED
CONTRIBUTIONS
Of'7
1�
J �1 l E
I.D. Number
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t�`of^c,�a 4
(1) Name
l i
(2)
(3) Cover Period 0I I `ZL7ZOthrough
1p /�
(4) Page C�
Q
of
(5)
I (7) (B)
(9)
(10) (11)
(12)
Date
Full Name
(6)
(Last, Suffix, First, Middle)
Sequence
Street Address & C mtrlbutor
Contribution
In -kind
Number
City, State, Zip Code Type Occupation
Type
Description Amerdm nl
Amount
DS-DE 13 (Rev. 1ill 3) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES
RFC"/���
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Cit
C/h Ccsehas,,a�
j CAMP�41G, N TREASURER'S
lUv� l T
REPORT— ITEMIZED EXPENDITURES
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"Q
(1) Name �J
l ��
(2) I.D. Number
(3) Cover Period /
3 / 2010through
w /
(4) Page 3 of
(T)
- (a)
- (9) - - (10)
(11)
Date
Full Name
Purpose
(Last, Suffix, First, Middle)
(6)
(add office sought If
Expenditure
Sequence
I
Street Address &
contribution to a
Type
Number
City, State, Zip Code
candidate)
Amendment
Amount
DS-DE 14 (Rev. 11113) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES