HomeMy WebLinkAboutG3 Report(1)
(2)
(4)
CAMPAIGN TREASURER'S REPORT SUMMARY
Name
qaG S.
Address (number and street)
biz, r-L '32,t s-
City, State, Zip Code
❑ Check here if address has changed
Check appropriate box(es):
OFFICE USE ONLY
(3) ID Number:
L� &ndidale Office Sought: ¢ to C s TC to Q %V-r CU Nnc t
❑ 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 l0 / 11 1 r20" To 10 / R 5 *0ftp ReportType: (-;—i)_
[;?6riginal ❑ Amendment ❑ Special Election Report
(6) Contributions This Report (7) Expenditures This Report
Monetary
Cash & Checks $_ Ou Expenditures $ I �ReJ
Loans $_ Transfers to
Office Account $
Total Monetary $_ _
Total Monetary $
In -Kind $_ _
(6) Other Distributions
(9) TOTAL Monetary Contributions To Date (10) TOTAL Monetary Expenditures To Date
$ 3 FR:r . -13 $ 1 , Olt . 17-
(11) Certification
It is a first degree misdemeanor for any person to falsify a public record (ss. B39.13, F.S.)
I certify that I have examined this report and it is true, comet(, and complete:
(Type name) r h'!n`v ,� P _t�:)a j d
❑ Individual (only for IE Q'freasurer ❑ Deputy Treasurer
or electioneering comm.
X
Signature
DS-DE 12 (Rev. 11113)
(Type name) Ch��,.�q tin j e(
andidate ❑ Chairperson (only for PC and PTY)
x �/��
Signature
SEE REVERSE FOR INSTRUCTIONS
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t, OfS
C:O-: Ob,
CAMPAIGN TREASURER'S REPORT - ITEMIZED EXPENDITURES
(1) Name
(°tea (o� 17n da
(2) I.D. Number C-3
(3) Cover Period (d / 1090 through
(4) Page ( of I
(5)
(T) (8)
(9) (10) (11)
Date
Full Name Purpose
(6)
(Last, Suffix, First, Middle) (add office sought if
Expenditure
Sequence
Street Address & contribution to a
Tie
Numher
City, State, Zip Code candidate)
Amendment Amount
LU/a1/.1o;#
1_
DS-DE 14 (Rev. 11113)
(13,2 uIFL
S ��Y 1—
' q^1 VWA/ eta-("
SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES