HomeMy WebLinkAboutM7 ReportCAMPAIGN TREASURER'S REPORT SUMMARY
OFFICE VA.E ONLY
Na/mr yy�� L ECtIVED
(2) 1'ib 1'9'6 r/'lv 57 acFi .
Add s nu�er nd strreet /� C— C 20zi
ASY'tLf ) 3a/J�<� CityCleke6astr,,,.
City, State, Zip Code
❑ Check here If address has changed (3) ID Number:
(4) Check appropriate box(es):
Candidate Office Sought: C ("„_iv:J
Political Committee (PC) V
❑ 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)
(6) Report Identifiers
Cover Period: From 7 / / � To % / \ /I / D� Report Type: _
tl Original ❑ Amendment ❑ Special Election Report
(6) Contributions This Report
Cash & Checks $_
Loans
Total Monetary $_ r
in -Kind $_
(9) TOTAL Monetary Contributions Tq Date
$ ,
(7) Expenditures This Report
Monetary
Expenditures $ ,
Transfers to
Office Account $
Total Monetary $
(6) Other Distributions
(10) TOTAL Monetary Expenditur7T Date
(11) Certification
It is a first degree misdemeanor for any person to falsify a public r c rd (as. 839.13, F. )
I certify that I have examined this report and it is true, correct, and complete:
(Type name Ia rA M A I (Type name) {
❑ Individu only Icr fE ❑Treasurer ❑Deputy Treasurer gcandidate ❑chairperson (onl for and PTY)
Xelecllo g com .)
X
ia7iature Signature
12 (Rev. 11113)
SEE REVERSE FOR INSTRUCTIONS
R
Fc���FO
CAMPAIGN TREASURER'S REPORT
- ITEMIZED CONTRIBUTIONS
41f
0'�Z!!�3.
(2) I.D. Number
(1) Name
'4 ` £`dtio 1 yve9/)
(3) Cover Period '7 / / 0?&0through
(4) Page
of
(5)
(7) (8)
(9) (10) (11)
(12)
Date
Full Name
(6)
(Last, Suffix, First, Middle)
Sequence
Street Address& Contributor
Contribution In -kind
Number
City, State, 71p Code Tyoe Occupation
Type Description Ameromem
Amount
DS-DE 13 (Rev. 11113) SEE REVERSE FOR 14STRUCTIONS AND CODE VALUES
J ; .
�Afl PAIG,� TjiFASURER'S REPORT— ITEMIZED EXPENDITURES
(1) Name r,�G �_ �JP IIv Y (2) I.D. Number
(3) Cover Period �/ (� lthrough/ � / (4) Page of
(8) le) (10) (11)
Date Full Name Purpose
(6) (Last, Suffix, First, Middle) (add office sought if
Sequence Street Address & contribution to a Expenditure
Number City, State, Zip Code candidate) Type Amendment Amount
DS-DE 14 (Rev. 11113)
SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES