HomeMy WebLinkAboutG3 ReportCAMPAIGN TREASURER'S REPORT SUMMARY
OFFICE y�,€ ONLY
Name
(2) 7 Zz g iz s`�
Address number and sire ++
S�t c ✓l 3 Z`/ S
City, State, Zip Code
❑ Check here if address has changed
(4) Check appropriate box(es): /
(`Candidate Office Sought:
❑ Political Committee (PC)
❑ Electioneering Communications Org. (ECO)
❑ Party Executive Committee (PTY)
❑ Independent Expenditure (IE) (also covers an
Individual making electioneering communications)
D
OCT292-
O'trof
Crty CIc, kebastlan
Offce
(3) ID Number:
r;�OU✓JGy /
❑ 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 ! j ! � To 6/� ! Z g !� / Report Type:
1�10riginal ❑ Amendment ❑ Special Election Report
(6) Contributions This Report
Cash & Checks
Loans
Total Monetary
In -Kind ' $— —
(9) TOTAL Monetary Contributions To Date
$ , / - ZA0
(7) Expenditures This Report
Monetary
Expenditures $
Transfers to
Office Account $
Total Monetary " ,
(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 (as. 839.13, F.S.)
I certify that I have examined this report and it is true, correct, and complete:
(Type name) 4) i f 7,1)i l' /1���1i1N— ( e name) I(hitil w� t;i�Y�7
❑ Individual (only for IE Treasuy ❑ Deputy Treasurer (date ❑(Chelrpenson (only for PC G )
or electioneering Comm.)
X ��c� X
Signature J Signal
DS-DE 12 (Rev. 11113) 1 SEE REVERSE FOR INSTRUCTIONS
CAMPAIGN TREASURER'S REPORT - ITEMIZED CONTRIBUTIONS
clt,
c
(2) I.D. Number
(1) Name city ��� kebasra�l
e
(3) Cover Period 0 l _� 1 _Z�Z/through l L / f (4) Page of
(5) (7) (8) (9) (10) (11) (12)
Date Full Name
(6) (Leal, Suffix, First, Middle)
Sequence Street Address & Contributor Contribution In -kind
Number Citv. State. 712 Cnde Tvox Occubation Tvoe DescTiCdon Amount
/
DS-DE 13 (Rev.11113) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES
3`'PAGN T SURER'S REPORT— ITEMIZED EXPENDITURES
(1) Name / //i2 q/ G (2) I.D. Number
(3) Cover Period C> / 1 / / 2601 tthrrough �{_/_��/ 'r:-7 / (4) Page
(s)
(T)
(a)
Date
I
Full Name
Purpose
(a)
(Last, Suffix, First, Middle)
(add office sought If
Sequence
Street Address &
contribution to a
Number
City, Slate, 23p Code
candidate)
RFGFf��D
Cr1-1 o
C,plCe kSbC���e
of
(9) (10) (11)
Expenditure
Type Amendment
Amount
DS-DE 14 (Rev. 11113) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES