HomeMy WebLinkAboutM6 ReportCAMPAIGN TREASURER'S REPORT SUMMARY
(1) iYYlm i C \ (���1 OFFICE USE ONLY
Name 1 t - k�_:CEIV�
(2) 7 Z Z 1)
dr ss (n, mber and str (� �U� u
�y'} I. 3 Z 5 5 Cq Y of eb
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City, State, Zip Code y Clerk,, astlan
"race
❑ Check here If address has changed (3) ID Number:
(4) Check appropriate box(es):
dCandidate 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)
(5) Report Identifiers
Cover Period: From ZI To / /71 Report Type:_
❑ Original ❑ Amendment ❑ Special Election Report
(6) XReportort (7) Expenditures This Report
Monetary
Cash- Expenditures $
LoanTransfers to
Office Account $TotaTotal Monetary $In-Ki— —_
(8) Other Distributions
$ .
(9) TOTAL Monetary Contributions To Date (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 � �a/ (T Pe a) ;� 1'Y11V1 �l lam- T � `,y('�'-_e>_
❑ Individual (only for IE ❑ Treasurer Df piny Treasurer ❑ idal ❑ aalmerson (only for PG`9fid P1Y)
or eleclionnee/wing comm.)
X / _ y/ X
Signature /r✓ ! / Signa re
DS-DE 12 (Rev. 11113) SEE r 9VERSE FOR INSTRUCTIONS
CAMPAIGN TREASURER'S REPORT — ITEMIZED CONTRIBUTIONS RE CFi
(1) Name (2) I.D. Number%�,r✓�� `'''��a ��O
(3) Cover Period I / ZL through (4) Page of y Cc o
e
(5) (7) (S) (9) (10) (11) (12)
Date Full Name
(6) (Last, Suffix, First, Middle)
Sequence Street Address & Cc ntributor Contribution In -kind
Number City, State, Zip Code Type Occupation Type Description AmeWE ffl Amount
V
r 1
jf
0
DS-DE 13 (Rev. 11113) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES
CAMPAIGN TREARRER'S REPORT— ITEMIZED EXPENDITURES
(1) Name 4, ^A...,/ /I ( tPCC- (2) I.D. Number
131 Cover Period / I /-7f throu h / 4011 1// 141 Pa e % of / 116
9 9
(5) (1) (8) (gl (1g) /Am,ut
Date Full Name Purpose
(5) I(Last, Suffix, First, Middle) (add office sought If
SequenceStreet Address & contribution to a Expenditure
Number City, State, 7Jp Code candidate) Type Amendme
//I
I/I
OS -DE 14 (Rev. 11113)
SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES
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