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HomeMy WebLinkAboutG1 Report A PAIGN TREASURER'S REPORT SUMMARY (1) 40 ��in 4, i'� OFFICE USE ONLY Name (2) � RECEIVED .sue Address (number and streall ` 91'_ it a 5 OCT — 8 20LI City of Sebastian /q o ; r �, , , t ` City Clerk's Office City, State, Zip Code ❑ Check here if address has changed (3) ID Number: (4) Check appropriate box(es): fp (/ l 6andidate Office Sought: �r<%' -7 j ` i rr n `— t / C—��C r) c 1' ❑ 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 To I / j Report Type: (, ❑ Original ❑ Amendment ❑ Special Election Report (6) Contributions This Report (7) Expenditures This Report Monetary Cash & Checks $ O('D Expenditures $ Loans $ Total Monetary $_ • In -Kind $ 1 1 • (9) TOTAL Monetary Contributions To Date $ `sn. Transfers to Office Account $ Total Monetary $ _ , 0 . rxD (8) Other Distributions $ 1 , (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 1 have examined this re rt and it is true, correct, and complete: r'I (Type name) Z� �j c y �� h (Type name) o ! q V ❑ Individual (only for IE Q'1'reasurer ❑ Deputy Treasurer M'6andidate ❑ Chalrpew (only for PC and PTY) or eleciloneering comm.) Signature Signature DS-DE 12 (Rev. 11113) SEE REVERSE FOR INSTRUCTIONS CAMPAIGN TREASURER'S REPORT — ITEMIZED CONTRIBUT'?TE tC=.,FINED (1) Name (2) I.D. Number nrT - R 71`171 % ) City of Sebastian (3) Cover Period I I / through (4) Page City ClerkbfOffco (5) (7) (6) (9) (10) (11) (12) Date Full Name (6) (Last, Suffix, First, Middle) Sequence Street Address& Contributor Contribution In -kind Number City, State, Zip Code Type Occupation Type Description "awl"M Amount DS-DE 13 (Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES RECEIVED ©CT — 3 20e:1 uty of Sebastian AMPAIGN TASUER'S REPORT— ITEMIZED EXPENDITUREeity ClcffG CfEco (1) Name 1-1 (2) I.D. Number (3) Cover Period -LL? / L /--L through I D /_L/ i (4) Page of (5) (7) (8) (9) (10) (11) Date I Full Name Purpose (6) (Last, Suffix, First, Middle) (add office sought If Expenditure Sequence Street Address & I contribution to a Type Number City, State, Zip Code candidate) Amendment Amount //I I / / OS -DE 14 (Rev. 11113) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES