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HomeMy WebLinkAboutG2 ReportCAMPAIGN TREASURER'S REPORT SUMMARY (1) ,` OFFICE USE ONLY rr Name I RECEIVED (2) 7 ZZ g )cE45 .r S4 Address (number and st t) OCT 2 2 ?0?1 SN17Z+-,, ` V) 3 7S S� City of Sebastian City, State, Zip Code rin' 000W, Office ❑ Check here If address has changed (3) ID Number. (4) Check appropriate box(es): // /f aCandidale Office Sought: �y vi4 ! Oust-i ❑ 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 HE or EC reports will be filed Individual making electioneering communications) (6) Report Identifiers Cover Period: From /() / Z / Z 1 To IP / /S / Z./ Report Type: _/�7 '2 i7POriginal ❑ Amendment ❑ Special Election Report (6) Contributions This Report (7) Expenditures This Report Monetary Cash & Checks $ Expenditures $ Loans $_ Transfers to Office Account $ Total Monetary $ y_ Total Monetary $ In -Kind $ (9) TOTAL Monetary Contributions To Date $ I, -ago . 00 (8) Other Distributions (10) TOTAL Monetary Expenditures To Date $_,1,25'/.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 thisreport and It is true, correct, and complete: (Type name) LO('(/T Th reek, k'1 1 1 I/L'^ (Type name) ❑IndW4"l(oNylwlE reseurw I ❑De(]uly Treasurer O CnelrparsonERSE(Wy(or PC am M) welsaor/aarrhn, mmt I ) X h,�(�S(A� X _ Signal.,alur Sig lure DS-DE 12 (Rev. 11113) SEE REVFOR INSTRUCTIONS �CAMPAIGN TREASURER'S REPORT - ITEMIZED CONTRIBUTIONRECEIVED (1) Name (/// ADS (2) I.D. Number (1CT 2 2 2021 r J City of SehastMll (3) Cover Period IP / Z / 2J through /O / �5 / Z/ (4) Page C/'/ (S) p) (S) (9) (10) (11) (12) Date Full Name (S) (Last Sulfa. Flat, Middle) Sequence Street Address& Contributor Contdbuticn IrNdnd Number City. Stab, ZW Code Tvoe Occupation Tvile Descriptlon Amount / 1 I 1 / / I / I l / DS-DE 13 (Rev. 11113) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES RECEIVED OCT 2 ? 2021 City of Sebastian C! MPAIGNiTStEASURER'S REPORT —ITEMIZED EXPENDITURETitj C!c::;'c Cfflco (1) Name (3) I.D. Number s r� {3)Cover Period _L0_/ 2- /_2 through 10 / /S/-ZL (<)Poge ol_�_ (5) (7) (8) Date Full Name Purpose (S) (Lost, Suffix, First, Middle) (add office sought If Sequence Street Address & contribution to e Number City, State, DP Code candidate) (9) 110) (11) Expenditure DS.DE 14 (Rev. 11113) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES