HomeMy WebLinkAboutG3 ReportCAMPAIGN TREASURER'S REPORT SUMMARY
OFFICE USE ONLY
Name
S��das/niu a nber ar-4 street)
City, State, Zip Code
❑ Check here If address has changed (3) ID Number:
(4) Check appropriate box(es): /I
,Ej Candidate Office Sought: C',, 7N- ( c, c/✓ G /
❑ Political Committee (PC)
[} Electioneering Communications Org. (ECO) ❑ Check here it PC or ECO has disbanded
Party Executive Committee (PTY) ❑ Check here if PTY has disbanded
❑ Independent Expenditure (IE) (also covers an ❑ Check here it no other IE or EC reports will be filed
individual making electioneering communications)
(5) Report Identifiers
Cover Period: From /D ! /'j / To / / C�20 Report Type:
❑ Original ❑ Amendment ❑ Special Election Report
(6) Contributions This Report
Cash 8, Checks $_
Loans $_ _
Total Monetary $_ ,
In -Kind $
(9) TOTAL Monet q Con� rlbutions To Date
(7) Expenditures This Report
Monetary :� . ,
Expenditures $
Transfers to
Office Account $
Total Monetary $
(8) Other Distributions
(10) TOTT�onet� Expenditures To Date $
�r
(11) Certification
It is a first degree misdemeanor for any person to falsify a public record (ss. 839.13, F.S.)
I ce y hat I have exa tried this report and is true, correct, and complete:
(T 1r 15a#4 45- . (Type name) v `` •�
❑ Indwitlual (oX�ea rer ly Treasurer ��antlitlale ❑ Chalryerson (only for PC and PTY)
or elecUoneon /.
,72
S4 ,,lure Signature
DS-DE 12 (Rev. 11113)
SEE REVERSE FOR INSTRUCTIONS
n/� CAMPAIGN TREASURER'S REPORT - ITEMIZED CONTRIBUTIONS
(1) Narne A'62z w A,1 a, ✓i o / J d,J (2) I.D. Number
� /� c
(3) Cover Period L— / 17 / ��� through D / / / (4) Page of
(S) (7) (8) (9) (10) (11) (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 No ffim Amc
3.
DS-DE 13 (Rev. 11113)
SEE REVERSE FOR I JSTRUCTIONS AND CODE VALUES
') ,),CAMPAIGN TREA,, ER�rORT— ITEMIZED) EXPENDITURES
1 Name // n_ I(/ f✓ a, t r7 D +� 2 I.D. Number
(3) Cover Period/
through
/v /-/ —�
(d) Page of
(3)
(T)
- (6)
- (9) (10) (11)
Date
I
Full Name
Purpose
(S)
(Lest, Suffix, First, Middle)
(add office sought if
Sequence
I
Street Address &
contribution to a
Expenditure
Type
Nu mbar
City, State, Zip Code
candidate)
Amendment Amount
i/
I//
l
ri
DS•DE 54 (Rev. 11113) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES