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HomeMy WebLinkAboutM6 Report AMPAIGN TREASURER'S REPORT SUMMARY OFFICE USE ONLY Name (Z) )l Address (number and street) / City! ~ 620EJ City, State, Zip Coda cleOf:_ ❑ Check here if address has changed (3) ID Number: (4) Check appropriate box(es): B �l 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) (6) Report Identifiers Cover Period: From / n/ / 2 To p G 1 �) 1 Report Type:_ ❑ Original ❑ Amendment ❑ Special Election Report (6) Contributions This Report Cash & Checks $_ Z D� Loans $ L7 1 Total Monetary $ In -Kind $ 1 1 • (9) TOTAL Monetary Contributions To Date (7) Expenditures This Report Monetary Expenditures $ Transfers to Office Account $ '620 Total Monetary $ i . (8) Other Distributions $ 1 e)C> (10) TOTAL Monetary Expenditures To Date $ -ra (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: i (Type name) f�tlJ%✓S� ,� S. � �, ❑ Individual (only for IE I] Treasurer f Deputy Treasurer or electioneering comm.) x Signature DS-DE 12 (Rev. 11113) (Ty a name)r�7/.`�i, %ii% O%. JOirs Candidate ❑ Chairperson (only for PC and PTY) Signature SEE REVERSE FOR INSTRUCTIONS AMPAIGN TREASURER'S REPORT — ITEMIZED CONTRIBUTIONS (1) Name ��j,; �, �� (2) I.D. Number (3) Cover Perlod Qt.1 / LI / _�j— through Ub / S= l :z j (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 Tvpe Occupation Type Description Amendmem Amount �r i21 l✓s�yslbs v DS-DE 13 (Rev. 11113) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES CAMPAIGN TREASURER'S REPORT— ITEMIZED EXPENDITURES (1) Name € ,>,%: c� ✓1n. ,ff� (2) I.D. Number (3) Cover Period 1W l P( /_ V through 12Z, l ;3 l (4) Page / of (5) I (7) (g) - - (2) -(10) (11) Date Full Name Purpose (g) (Last, Suffix, First, Middle) (add office sought if Sequence Street Address & contribution to a Expenditure Number City, State, Zip Code candidate) Type Amendment Amount I DS-DE 14 (Rev. 11113) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES