HomeMy WebLinkAboutM8 ReportCAMPAIGN TREASURER'S REPORT SUMMARY
OFFIC"�EONLY
1 f Name
,CCE1,,Fo
(2)
Address (number and street) Q City Of
C •l i i 7 I I" 7% �`L 1 �� C1tyCle ksboff c
City, State, Zip Code
❑ Check here If address has changed (3) ID Number:
(4) Check appropriate box(es): `^
0 Candidate Office Sought: V 1QS� ��
❑ 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 / / (Z_ To / j / ( r_ Report Type: �A,
Original ❑ Amendment ❑ Special Election Report
(6) Contributions This Report
Cash & Checks $
Loans $_"�_
Total Monetary $_
In -Kind $
(9) TOTAL Monetary Contributions To Date
$ 100 po
(7) Expenditures This Report
Monetary D
Expenditures $
Transfers to
Office Account $
Total Monetary $
(8) Other Distributions
$ ,
(10) TOTAL Monetary Expenditures To Date
$ , �2 \ C'o
(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) "�� °� l� 1 ``ta MCI (Type name)
❑ Individual (only for IE )�7reasurer t ❑ Deputy Treasurer
or J electioneering co
X
Signature
DS-DE 12 (Rev. 11113)
candidate
❑ Chairperson (oW for PC and PTY)
X
Signature
SEE REVERSE FOR INSTRUCTIONS
CAMPAIGN TREASURER'S REPORT — ITEMIZED CONTRIBUTIONS R�cFi
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(1) Name `/L�f �' b� C / I I'I IM S (2) I.D. Number
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(3) Cover Period / I through ! �( ! ZZ (4) Page I of
(5) (7) (S) (0) (10) (11) (12)
Date Full Name
(6) (Lest, Suffix, First, Middle)
Sequence Street Address & Contributor Conbibudon In -kind
Number City, State, Zip Code Type Occupation Type Description Amersd^•M Amount
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DS-DE 13 (Rev, 11113) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES
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CAMPAIGN TREASURER'S REPORT- ITEMIZED EXPENDITURES e (s N1,
(1) Name (2) I.D. Number r
e
(3) Cover Period G' /-/ �� z through / >1 / L (z (4) Page of
(5) 1�1 t�i �tii 11ei (11)
Date Full Name Purpose
(6) (Lost, Suffix, First, Middle) (add office sought If
Sequence Street Address 6 contribution to a Expenditure
Number City, State, 23p Code candidate) Type Amendment Amount
C, � V4 Setoc14f Q ca l ' CAN
I)eloas+,avl CC t���c e�����4r�ay. N ('Z��
DS-DE 14 (Rev. 11113) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES
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INSTRUCTIONS FOR CAMPAIGN TREASURER'S REPORT - ITEMIZED EXPENDITURES
(1) Candidate's full name or name of the political committee (PC), electioneering communications organization (ECO),
or- party executive committee (PTY).
(2) Identification number assigned by the filing officer.
(3) Cover period dates (01101115 through 01131115). (See filing officer's reporting dates calendar for appropriate cover
periods.)
(4) Page numbers (e.g., J. of A).
(5) Date of expenditure (Month/DayNear).
(6) Sequence Number - Each detail line shall have a sequence number assigned to It. Sequence numbers are to be
assigned within each reporting period and for each type of detail One. Thus the report type, detail One type, and
sequence number will combine to uniquely identify a specific contribution, expenditure, distribution or fiord transfer.
This method of unique identification Is required for responding to requests from the filing officer and for reporting
requirements.
For example, a M1 report having 40 expenditures would use sequence numbers 1 through 40. The next report
(M2), comprised of 30 expenditures would use sequence numbers 1 through 30. Expenditures on amended M1
reports would begin with sequence number 41 and on amended M2 reports would begin with sequence number 31.
See Amendment Type instructions below.
(7) Full name and address of entity receiving payment (including city, state and zip code).
(8) Purpose of expenditure (if expenditure is a contribution to a candidate, also type the office sought by the candidate).
PLEASE NOTE: This column does not apply to candidate expenditures, as candidates cannot contribute to other
candidates from campaign funds. However, PCs (supporting candidates) and party executive committees
contributing to candidates must report office sought (Section 106.07, F.S.).
(9) Enter Expenditure Type using one of the following codes:
Code Description
CAN Candidate Expense
DIS Disposition of Funds
DFC Disposition of Funds to Future Campalpn (effective 1111113)
DPP Disposition of Funds to Political Party (effective 1111113)
DPV Disposition of Funds to Petition Verification (effective 1111/13)
ECC Electioneering Communication
EC Independent Expenditure Re aA ng 9 a Candidate
El Independent Expenditure Re arcfsn an Issue
MON Monetary jNot to a Candidate)
PCW Petty Cash Withdrawn_
PCS Petty Cash Spent
PPD Pre -paid Distribution
REF Refund (Negative Amount Only)
RMB Reimbursements
TOA Transfer to Office Account (Disposition of Funds)
(10) Amendment Type (required on amended reports) - To add a new (previously unreported) expenditure for the
reporting period being amended, enter "ADD" In amendment type on a line with ALL of the required data.
The sequence number for expenditures with amendment type "ADD" will start at one plus the number of
expenditures In the original report. For example, amending an original M1 reports that had 75 expenditures, means
the sequence number of the first expenditure having amendment type "ADD" will be 76; the second "ADD"
expenditure would have sequence number 39.
To correct a previously submitted expenditure use the following drop/add procedure. Enter "DEL" in amendment
type on a tine with the sequence number of the expenditure to be corrected. In combination vAth the report number
being amended, this sequence number will identify the expenditure to be dropped from your active records. On the
next tine enter "ADD" In amendment type and ALL of the required date with the necessary corrections thus replacing
the dropped data. Assign the sequence number as described above.
(11 j Amount of expenditure.