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HomeMy WebLinkAboutM8 Report 1) (2) CA AIGN TREASURER'S REPORT SUMMARY A, Hi, T )"" OFFICE USE ONLY Name /� /��d /(a <� 7r qca Address (number and street City, State, Zip Code ❑ Check here If address has changed (4) Check appropriate box(es): Candidate Office Sought: ❑ Political Committee (PC) ❑ Electioneering Communications Ong. (ECO) ❑ Party Executive Committee,(PTY) ❑ Independent Expenditure (IE) (also covers an individual making electioneering communications) - zCE!\ ED SEP 10 2021 city of Sebastian City Clerk's Office (3) ID Number: ❑ 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 l a L� l �l To / / Report Type: / � — ❑ Original ❑ Amendment ❑ Special Election Report (6) Contributions This Report (7) Expenditures This Report Monetary Cash & Checks $ Expenditures $ Cnl Loans $_ Total Monetary $ In -Kind $ (9) TOTAL Monetary Contributions To Date $ _ 0 Transfers to Office Account $ Total Monetary $ (8) Other Distributions $ (10) TOTAL Monetary Expenditures To Date $ ,�[. Can (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 re;* and it is true, coned, and complete: (Type name) do �J a� t /1l �r � /n r (Type name) O Individual (only for IE ❑ Treasurer ❑ Deputy Treasurer ❑ Candidate or electioneering comm.) 4,� Signature Signature DS-DE 12 (Rev. 11/13) ❑ Chairperson (only for PC and PTY) �'1�2; SEE REVERSE FOR INSTRUCTIONS AMPAIGN TREASURER'S REPORT — ITEMIZED CONTRIBUTIONS (1) Name /Jo F� `� / 9r� I q (2) I.D. Number RECCwEt3 V s (4) PageSEP i 0 D (3) Cover Period I1 I through / / Cit➢'of Sebastian I (5) (7) (6) (9) (10) (17) (12) Date Full Name (6) (Last, Suffix, First, Middle) Sequence Street Address & Contributor Contribution q Number ) City, State, %Zip Code �1SO) �e1l s�, Type Occupation Type 1�lxt</ion,62je� In -kind Description AmeMm rd Amount DS-DE 13 (Rev. 11113) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES lj4 - -D, oo REC€IVEU SEP 1 © 0Z-1 �AMPAIGNTREA$URER'S REPORT— ITEMIZED EXPENDITURES (1) Name 4j'� /. -% , :- // (2) I.D. Number City of Sebastian ll �/ i (3) Cover Period/ (/ through 7 / (4) Page .nJ I.ICfK u VRICC of c� (5) (6) (9) (16) (11) Date Full Name Purpose (6) (Last, Suffix, First, Middle) (add office sought if Sequence Street Address & I contribution to a Expenditure Type N�,mhor City, State, Zip Code candidate) Amendment Amount DS•DE 14 (Rev. 11113) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES