HomeMy WebLinkAboutTR ReportCAMPAIGN TREASURER'S REPORT SUMMARY
Name
(2)
Address (number and street)
SEP-AS i I LXKI . �77L
City, State, Zip Code
❑ Check here if address has changed
(4) Check appropriate box(es):
OFFICE USE ONLY
=f V D
C'`y Of �obashan
City Clerk c Off'-
(3) ID Number:
Candidate Office Sought: P i-Ty (_'f_)( WIC1L
Political Committee (PC)
❑ Electioneering Communications Org. (ECO)
❑ Party Executive Committee (PTY)
❑ Independent Expenditure (IE) (also covers an
individual making electioneering communications)
❑ 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 filed
(5) Report Identifiers
Cover Period: From / (\ / C) To ( Z ReportType:
ROriginal ❑ Amendment ❑ Special Election Report
(6) Contributions This Report
Cash & Checks $
Loans $
Total Monetary $
In -Kind $
(9) TOTAL Monetary Contributions To Date
$ 11 (POG . OG
(7) Expenditures This Report
Monetary
Expenditures $
Transfers to
Office Account $
Total Monetary $
(8) Other Distributions
$ 1 ,
(10) TOTAL Monetary Expenditures To Dade
$ i -00 CCU
(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) Iv �N L .\ V L I1_�) 1
❑ Individual (only for IF I'Tfeasurer ❑ Deputy Treasurer
or electioneering comm.)
X �H � 4 _/
Signature rj
DS-DE 12 (Rev. 11/13)
(Type name)
UACandidate ❑ Chairperson (only for PC and PTY)
X
Signature
SEE REVERSE FOR INSTRUCTIONS
CAMPAIGN TREASURER'S REPORT — ITEMIZED CONTRIBUTIONS
1.
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(1) Name
o-i N �� �){. {-�
(2)
I.D. Number
`aSti
(3) Cover Period C) / 1 / through /
5 /
(4) Page
of
(5)
(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
Amendment Amount
DS-DE 13 (Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES
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CAMPAIGN TREASURER'S REPORT— ITEMIZED EXPENDITURESC4t�OfSF,y<'?
(1) Name
(2) I.D. Number
(3) Cover Period/
1 / �0 through
(4) Page
) of
(5)
(7)
(a) (9)
(10) (11)
Date
Full Name
Purpose
(6) (Last, Suffix, First, Middle)
(add office sought if
Sequence
Street Address &
contribution to a Expenditure
Number
City, State, Zip Code
candidate) Type
Amendment Amount
C) /I`7/DO L.)UDP- atJell d�
I`)O 1>7—M(A(Lb—r
9 /30/a0 I oa o us i-i ('4wo'y 1
a SP-b'Aem AID) FL- 3�'
Mfl)21 t ) E I lkd 1-2us?
10 (oao us
SE bPk:-, [AVL F:anSB
11 23 2D 1A�QTE
/ 7 700
5EC�STIflN,FL 9;0158
DS-DE 14 (Rev. 11113)
SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES
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