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G1 Report
AMPAIGN TREASURER'S REPORT SUMMARY (1) lGYAA OFFICE USE ONLY � Name � CtIjvzo - (2) 1-7�;_�,�. ©cr F�ddress (number and stirV. ` 8i 0"'-j `��.`�s�, ✓v _ t �Gi C„YLtf Sebastian City, State, Zip Code _ Offn ❑ Check here if address has changed (4) Check appropriate box(es): [�'Candldate Office Sought: CdA_ -/ ❑ Political Committee (PC) I ❑ Electioneering Communications Org. (ECO) ❑ Party Executive Committee (PTY) ❑ Independent Expenditure (IE) (also covers an Individual making electioneering communications) (3) ID Number: l (-It i LA CL' ❑ 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 t / 01 / Z(,Z I To I v / z) l Z dry j ReportType: i L Original El Amendment ❑ Special Election Report (6) Contributions This Report Cash & Checks $ Loans $ Total Monetary $_ In -Kind / $_ _ (9) TOTAL Monetary Contributions To Date $ I I , 3t:10 . 00 (7) Expenditures This Report Monetary Expenditures $ Transfers to Office Account $ Total Monetary (8) 45ther Distributions $ (10) TOTAL Monetary Expenditures To Date $ c' C (11) Certification It is a first degree misdemeanor for any person to falsify a public record (as. 839.13, F.S.) I certify that I have examined this report an it is trul, correct, and complete: �] }��, n (Type name) /., 7f-`� v I V I I !� o'� (Type name) �i �� ❑ Individual (only for IE [` Treasurer Deputy T_Ve surer %.Candid�to (�,\ Che rperaon (only for PC and P1Y) or electioneering comm.) f /�; l.�' ignature ( S DS-DE 12 (Rev. 11113) \\VERSE FOR INSTRUCr10N5 � CAMPAIGN T ASURER'S REPORT - ITEMIZED CONTRIBUTIONS �. !'T eCFO c°us (1) Name l ' ,(1 �1: 1 l (2) I.D. Number :: V ary (3) Cover Period i l0 1l (through L�z, (4) Page of 1_ (5) (7) (6) (g) 00) (11) (12) Date Full Name (6) (Last, Suffix, First Middle) Sequence Street Address& Contributor Contribution In -kind Number CIN, State- Z1D Corte Tvoe Occupation TVDe Descriodon Amw4mefft Amount i I / G i l I l I DS-DE 13 (Rev. 11113) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES �rR�cF1 tFO �r . /�,m MP�IGN�EASURER'S REPORT — ITEMIZED EXPENDITURES O (1) Name ( '' „(i (2) I.D. Number "e (3) Cover Period J01 / Zy4throughQLt/ r�l / 7_OL( (4)Page / of (S) Sequence Number OS -DE 14 (Rev. 11113) (7) Full Name (Last, Suffix, First, Middle) Street Address d City, State, 23p Code (8) Purpose (add office sought If contribution to a candidate) (9) (ill) (11) Expenditure TYps Amendment Amount SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES