HomeMy WebLinkAboutTR Report AMPAIGN TREASURER'S REPORT SUMMARY
nL OFFICE USE ONLY
N/e<L7 /`?, ra t4
Address number and street))
J)( t ST in r, "
City, State, Zip Code
❑ Check here if address has changed
(3) ID Number:
iVED
MN p ,
C'ty of Sebastiaq
City Clerks Offs,,.
(4) Check appropriate box(es): % 4 L+
t i
[,)-Grandidate Office Sought: JC 10 � /
❑ 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 0 / %/ a To Report Type:_
Dibriginal ❑ Amendment ❑ Special Election Report
(6) Contributions This Report
Cash & Checks $_
Loans $
Total Monetary $_ + _ O eni
In -Kind $ 1 1 •
(9) TOTAL Monetary Contributions To Date
$ ,/,5?S.D'D
(7) Expenditures This Report
Monetary
Expenditures $
Transfers to
Office Account $
Total Monetary $�.
(8) Other Distributions
$ ,
(10) TOTAL Monetary Expenditures To Date
$ —1 + 575. a i�
(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 examined this re on and it is true, correct, and complete:
(Type name) �G' Y� V (c i n r 1 i C% r (Type ame) �n 9 f-
r,
0 Individual (only for IE QXreasurer ❑ Deputy Treasurer 9-6aandidate ❑ Chairperson (only for PC and FTY)
or eleclioneerinn comm.)
Signature Signature a
DS-DE 12 (Rev. 11f13) SEE REVERSE FOR INSTRUCTIONS
RCCFI(,CO
TREASURER'S REPORT - ITEMIZED CONTRIBUTIONS
CAMPAIGN
/
(1) Name
(2) LD.Number
Cover Period through /
JS/<a (4) Page
c/
: L `w4
of
(3)
(5)
(7) (6)
(9) (10) (11)
(12)
Date
Full Name
(6)
(Last, Suffix, First, Middle)
Sequence
Street Address& Contributor
Contribution In -kind
Number
City. State, Zio Code Type Occupation
Tvpe Description Amendment
Amount
/ 1
I /
I
/
i
DS-DE 13 (Rev. 11113) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES
f
//��AMPAIGNj EASU ER'S REPORT— ITEMIZED EXPENDITURES °'�11bas/4�
} 2 I.D. Number 00 Name /J
J
(3) Cover Period �� // / through /�/ xc l (4) Page of
(5) I (7) - (8) - - (9) (10) (11)
Date Pull Name Purpose
(5) I (Last, Suffix, First, Middle) (add office sought If
Sequence Street Address & contribution to a Expenditure
Number City, Slate, Zip Code candidate) Tine Amendment Amount
/0Bt/ D 1YA Wok /J VV
953O 0S N„,y
s�Ls�,gn,i!5L 3a9g
DS•DE 14 (Rev. 11113)
SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES