HomeMy WebLinkAboutM9 ReportCAMPAIGN TREASURER'S REPORT SUMMARY
/Cc T /p n OFFICE USE ONLY
Nam RECEIVED
e a � Ir _ (2) a .s l d t/"q�
Address (qumber and street) OCT o ��`'
City of Sebastian
r City C!crk':. o"ce
City, State, Zip Code
❑ Check here if address has changed (3) ID Number.
(4) Check appropriate box(es): )) J ❑L
- ndidate Office Sought: S� rJa ; / , n I d y 60 Ll y) L /
❑ 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 ? Q
Cover Period: From / / � To � J / of _J/ Report Type: /
❑ Original ❑ Amendment ❑ Special Election Report
(6) Contributions This Report
Cash & Checks $_ ,
Loans $
Total Monetary $_
In -Kind $ 1 1 •
(9) TOTAL Monetary Contributions To Date
$ I , /50. CEO
(7) Expenditures This Report
Monetary
Expenditures $ ,
Transfers to
Office Account $
Total Monetary $ (2.
(8) Other Distributions
$ ,
(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.)
1 certify that I ha/vve� examined
/�this
/r/�/port/and it is true, correct, and complete:
(Type name) �J6 i A CG % ) r' / n. (Type name)
❑ Individual (only for IE [D'Feasurer ❑ Deputy Treasurer Ia•Lendidale ❑ Chairperson (only for PC and PTY)
X elecOo� . f3oomm.W'/
XSignature Signature
DS-DE 12 (Rev. 11113) SEE REVERSE FOR INSTRUC71ONS
CAMPAIGN TREASURER'S REPORT — ITEMIZED CONTRIBUTIONS
(1) Name
3 Cover Period
()
�� �
U /� G_ l c t
/ I / 1
I�ECEIVED
through /
(2)
7
J
I.D.LD. Number
(4) Page
ol.e - U Wvc.i
city o ebastian
_Ck �G i:ce
(5)
(7)
(S)
(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
Amendmem Amount
DS-DE 13 (Rev. 11/13) SEE REVERSE FOR IASTRUCTIONS AND CODE VALUES
RECEIVED
f?rT - 3 2021
Cf�{VIP/�IGN_zR"SU7R'SREPORT— ITEMIZED YofSebastian
�I y C!crkb OTfcc
1 Name
O
/) ��� c +
)EXPENDITUR
2 1 D. Number
(3) Cover Period
/ 1 through
Q ?
J / J (4) Page of
(s)
(7)
(6) (9) (10) (11)
Date
Full Name
Purpose
(6)
(Last, Suffix, First, Middle)
(add office sought if
Sequence
Street Address &
contribution to a Expenditure
Type
Number
City, State, Zip Code
candidate) Amendment Amount
F-A
DS-DE 14 (Rev. 11113) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES