HomeMy WebLinkAboutTR Report\ CAMPAIGN TREASURER'S REPORT SUMMARY
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City, State, Zip Code I Clerk s Oryice
❑ Check here if address has changed (3) ID Number:
(4) Check appropriate box(es): (
��Fcandidate Office Sought: I�� / ���G�`
LJ 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 2 / / Z- Report Type:
❑ Original ❑ Amendment ❑ Special Election Report
(6) Contributions This Report (7) Expenditures This Report
Monetary
Cash & Checks $ -- - Expenditures $
Loans
Total Monetary
In -Kind
(9) TOTAL Monetary Contributions To Date
$ Oa Cs
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 (ss. 839.13, F.S.)
I certify that I have examined this report and it is true, correct, and complete:
(Type name)D41,M t'e l/� 6 r I I i (a. I/Vt � (Type name) .14M w\ l b
�dividual (only for IE EY'treasurer 1 ❑ Deputy Treasurer --Candidate ❑Chairperson (only for PC and PTY)
or electioneering co .)
X X
Signature a/ Signature
DS-DE 12 (Rev. 11113) SEE REVERSE FOR INSTRUCTIONS
��CAMPAIGN TREASURER'S REPORT - ITEMIZED CONTRIBUTIONS
LPA
(1) Name \/"t•2 fn ��\\a S (2) I.D. Number
(3) Cover Period I / 2,1 through 2 / / ZZ (4) Page
(5) (T) / (S) 110) (11) (12).
Da Full Name �
(Last, Suffix, First, �#rddle)
Set
quencs Street Add & Co_ MA u� ntribution In -kind
Number Citv. State, Zip Code TvDe Occupa , Type Description menem
DS-DE 13 (Rev. 11113) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES
CAMPAIGN TREASURER'S REPORT- ITEMIZED EXPENDITURES
(1) Name S-WAte,V\ L W i ftv-t-C. (2) I.D. Number
(3) Cover Period '6 1 Z( through Z/ 1 / ZZ (4) Page 1 of
(S) I (T) (8) (g) (10)
Date Full Name Purpose
(6) (Last, Suffix, First, Middle) (add office sought If
Street Address & contribution to a Expenditure
Sequence
Number City, State, Lp Code candidate) Type Amendment Amount
I
DS-DE 14 (Rev. 11113)
SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES