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HomeMy WebLinkAboutG3 Report _7P )AIGN TREASURER'S REPORT SUMMARY (1) �('a .,r ' �c ti OFFICE USE Q�ILY (2) (4) Name 6S0 4, 1-r'.�� _�tYNac.e Addres (number and st/�rJ�//pj t) 4 /\ - �S �I'IQ City, State, Zip Code ❑ Check here if address has changed (3) ID Number: C "yof �g�bn%' ty C/erksbaSrGn Check appropriate box(es): % 0Candidate Office Sought: ❑ 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 l �/ Report Type: .� Original ❑ Amendment ❑ Special Election Report (6) Contributions This Report (7) Expenditures This Report Monetary Cash &Checks $_ 1�)C). LAC) Expenditures $ _ _ , (?. al_ Loans $_ _ , JOLT • 00 Transfers to Office Account $ Total Monetary $ 1 ,'3O61. t)0 In -Kind $ (9) TOTAL Monetary Contributions To Date $ i S'7 S . oo Total Monetary $ C • C +.� (8) Other Distributions (10) TOTAL Monetary Expenditures To Date $ on (11) Certification It is a first degree misdemeanor for any person to falsify a public record (ss. 839.13, F.S.) I certify that I have Lexamined dtthis rr port/and It is true, correct, and complete: (Type name) .% I n !� / /� l n ✓ T /0" (Type name) ❑ Individual (only for IE ©measurer ❑ Deputy Treasurer Qfandidale ❑ Chairperson (only for PC and PTY) or electioneering comm.) Signature Signature DS-DE 12 (Rev. 11113) SEE REVERSE FOR INSTRUCTIONS AMPAIGN TREASURER'S REPORT - ITEMIZED CONTRIBUTIONS �J ' 1 Name O �'J o � n �� � Y' 1� 2 O I.D. Number �ii`V��`�✓ .5,,:� amity �" (3) Cover Period /[� / / through / / i (4) Page C% S,P�ias of (5) (7) (6) (9) (10) (11) (12) Date Full Name (6) (Last, Suffix, First, Middle) Sequence Street Address 6 Contributor Contribution In -kind Number Citv, State, Zj Code Tvpe Occupation Tvpe Description Amendmem Amount 101.27 9gYrr}, 7;/"- iJl 3300 �q�J1� fl ¢Dr ter C s % 60, 00 �'SO ge_I11 2) fr{1, { LOA JX1.00 3J0 DS-DE 13 (Rev. 11113) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES CAMPA G TREASURER'S REPORT— ITEMIZED EXPENDITURES (1) Name ✓ ( r - /� L _ (2) I.D. Number (3) Cover Period O through// (4) Page of (5) (T) (6) Ig) (10) 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 OS -DE 14 (Rev. 11113) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES `o Cili ` J Cit C,o S0'b'3 e� 0;1�o Amount