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HomeMy WebLinkAboutG1 Reportf CAMPAIGN TREASURER'S REPORT SUMMARY (1) �)W ZQV\ C', ( I I eiG1, �; OFFICE USE ONLY Nam I/VFW (2) YGZtact Address (number and street) c i/,, of �t� c/o. City, State, Zip Code OfiS ❑ Check here if address has changed (3) ID Number: (4) Check appropriate box(es): /C / candidate Office Sought: � ( 9Uor ❑ 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) (6) Report Identifiers i 7C r Period: From (' / l � 1 To �, 1 � / � Report Type: �7 Original ❑ Amendment ❑ Special Election Report (6) Contributions This Report Cash & Checks $6 r 0 ' U • /6 Loans $� , � , n . ( Total Monetary $� In -Kind $-D— 0 V (9) TOTAL Monetary Contributions To Date $ 3f> o 6 r, , (7) Expenditures This Report Monetary Expenditures $ Transfers to Office Account $ Total Monetary $ (8) Other Distributions $ ('5 - 1 (10) TOTAL Monetary Expenditures To Date $ 6 I (' 0 (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 rep rt a It is true, correct, and complete: .Yrx! (Type name) G�lrM o4 n 71l l"( NHS (Type name)vt-eki 41 // 1Gj`ZL i ❑ Individual (only for IE ❑ Treasurer ❑ Deputy Treasurer ❑ Candidate ❑ Chalrpersorr only for PC and PTY) or electioneering w Signature 'I �', Signature DS-DE 12 (Rev. 11113) SEE REVERSE FOR INSTRUCTIONS RFc CAMPAIGN TREASURER'S REPORT — ITEMIZED CONTRIBUTIONS F/(rFO '� � f t ti C;0�T I ` V (1) Name3 aLAA N au � ( � (2) I.D. Number 461f. f,c 'Gr ' vast, (3) Cover Period / I / Z ( through / / (4) Page I Of � ne (6) (yam (10) (11) (12) Date FglYNar i (6) (Last, Suffix, First, Middle).. Sequence .'Street Address & Contributor Cont lion 1n-kind,:' Number ; ' City. State, Zip Code Type-' Occupation %type /Description Amandmrd Amount i DS-DE 13 (Rev, 11113) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES F� Cnf.° s` CAMPAIGN TREASUR R'S REPORT- ITEMIZED EXPENDITURES �c°she orla (1) Name (2) I.D. Number Pee (3) Cover Period �0 through ! L / / (4) Page of (5) (7) (8) (9) (10) It1) Date Full Name Purpose (5) (Lest, Suffix, FJrsf, Middle) _(add office sought if , Sequence Streel,Address 6 :.', contribution to a Expenditure Number Cl State, Zip C� candidate) TYpa' AmeMmaM .Amount i DS-DE 14 (Rev. 11113) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES