HomeMy WebLinkAboutM9 ReportCAMPAIGN TREASURER'S REPORT SUMMARY
(1) aL(� ��G� (Idd 1 (��(� OFFICE USE ONLY
Name
Address (num er and street) 7 p� £ CT ` j 20'
77A L J Cityof13Ll
City, State, Zip Code City clerks "shay
❑ Check here if address has changed (3) ID Number:
(4) Ch
eck appropriate box(es):
he
El 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)
(5) Report Identifiers
(Co er Period: From / / L To t I U / ( Report Type: Al
Original ❑ Amendment ❑ Special Election Report
(6) Contributions This Report
Cash & Checks $
Loans $ o U
Total Monetary $C) r_�\
In -Kind $ O V V a
(7) Expenditures This Report
Monetary
Expenditures $ U V
Transfers to
Office Account $ G O
Total Monetary $ 6 . 0
(8) Other Distributions
`$ 1 ) -'tom"-
(9) TOTAL Monetary Contributions To Date (10) TOTAL Monetary Expenditures To Date
$ — — (00 $
(11) Certification
It is a first degree misdemeanor for any person to falsify a public record (ss. 839.13, F.S.)
I certify that 1 have examined this report
fand it is gtrnue, correct, and complete:
�� y /
(Type name)Pk l/iik((✓ V \ (Ill` ( (l W_C\ ' (Type name) ._I!�i.��.l"e1/l C�r (11
(]'Individual (only r IE 0I Treasurer ❑ Deputy Treasurer ❑ Candidate ❑ Chairperson (only for PC and PTY)
or elecllon"n
X � X
Signature I v Signat a
DS-DE 12 (Rev. 11113) SEE REVERSE FOR INSTRUCTIONS
R
�CF/CFO
CAMPAIGN TREASURER'S REPORT
- ITEMIZED CONTRIBUTIONS
001
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�,�a�,
SeF,
(1) Name
(2) I.D.DNumber
c,
co
(3) Cover Period
I /
through
(4) Page
of
(5)
(7)
(8)
(9) (10) (11)
(12)
Date
Full Name"
(6)
(Lest, Suffix; First, Middle)
Sequence
Street Address&
Contributor
Contribution In -kind
Number
City, State, ZiD Code
TYDe Occupation
Type Description Amendment Amount
I
DS-DE 13 (Rev, 11113) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES
CAMPAIGN TREASURER'S REPORT— ITEMIZED EXPENDITURES
(1) Name T_)n,l AA (Ci 1 t-7r I (2) I.D. Number
(3) Cover Period I through .1 (4) Page of
(s)
(T) -
Date
Full Name
(6)
(Last, -Suffix, First, Middle)
Sequence
- ' Street Address &
Number
City, State, Zip Code
(a) (9) (10) (11)
Purpose
(add office sought If
'contribution to a
candidate),.-
-Expenditure
Type Amendment Amount
i
OS -DE 14 (Rev. 11113) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES