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HomeMy WebLinkAboutM5 Report(1) (2) (4) -yI CAMPAIGN TREASURER'S REPORT SUMMARY OFFICE USE NLY Name 70780-A�,' Address (number and street) S& C /4 _< -1;' ti Ft- 3 z City, State, Zip Code ❑ Check here If address has changed Check appropriate box(es): (3 Candidate Office Sought: C'qy ( ct v Ij 1 (3) ID Number. 68 /ected S L ` J(,rAJ lCFI CFO ofgob e�ks Orman ❑ Political Committee (PC) ❑ 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 `) / y / I To 5 / 3 1 / _q f ReportType: /n.5 E) Original ❑ Amendment ❑ Special Election Report (6) Contributions This Report Cash & Checks $ Loans $ 1610 • ere Total Monetary $ In -Kind $ - (9) TOTAL Monetary Contributions To Date $ 1 , iz, C, . rl G (7) Expenditures This Report Monetary Expenditures $ Transfers to Office Account $ Total Monetary $ I I— (B) Other Distributions $ I , (1) . c) (') (10) TOTAL Monetary Expenditures To Date $ , (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) ` i�C r i -S l_•.. c n • : ,a (Type nahiel �� E ly Rr l-NALtf✓W 0 IndNldual (only for fE O Treasurer ❑ Deputy Treasurer ZCendfoete Q chairperson (only for PC and PTY) or electioneering oomm.) Signature �yG �— DS-DE 12 (Rev. 11113) SEE REVERSE FOR INSTRUCTIONS 1� CAMPAIGN TREASURER'S REPORT - ITEMIZED CONTRIBUTIONS _�Ilf j©c�iL�O (1) Name ChrISfcP° 120 (2) I.D. Number n%�^ sC) (3) Cover Period / I 'Z through �5 / / -Z I (4) Page z of (5) (7) (6) (9) (10) (11) (1,!) Date Full Name (6) (Last, Suffix, First, Middle) Sequence Street Address & Contributor Contribution In -kind Number State, ZiD Code Tvoe Occupation TVDe Description Amendment Amount I LI^ter-- City, L n r r r r r r r r r DS•DE 13 (Rev. 11113) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES