HomeMy WebLinkAboutM9 ReportCAMPAIGN TREASURER'S REPORT SUMMARY
Name
(2) ( b Z-3 V <' Ikux/ t
Address (number and street)
`jam ('v<5' i lrti aJ -fit_ �iZ-Gi. S
City, State, Zip Code
❑ Check here If address has changed
(4) Check appropriate box(es):
OFFICE USE ONLY
KECEI VED
(3) ID Number:
®Candidate Office Sought: lj��ik�iu�' e�_ r'l C nu"'
❑ Political Committee (PC)
❑ Electioneering Communications Org. (ECO)
❑ Party Executive Committee (PTY)
❑ Independent Expenditure (IE) (also covers an
individual making electioneering communications)
Cih01Sebasti :,
l C.erk'c
❑ Check here if PC or ECO has disbanded
❑ Check here if PTY has disbanded
❑ Check here if no other IE or EC reports will be filed
(5) Report Identifiers
Cover Period: From / t l Z'i To q I l 2 z Report Type:
0 Original ❑ Amendment ❑ Special Election Report
(6) Contributions This Report (7) Expenditures This Report
Monetary
Cash & Checks $_ r _ • _ Expenditures $
Loans $_ •
Total Monetary $_ _
In -Kind $—/ I _ •
(9) TOTAL Monetary Contributions To Date
$ , he
Transfers to
Office Account $
Total Monetary $
(8) Other Distributions
$
(10) TOTAL Monetary Expenditures To Date
$ 1
(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) V )0,Lx-A,,-Ch C^' (_ �_ Ivy...- f lA— (Type name) C )Lk vV4 ti C'-'i
❑ Individual (only for IE m Treasurer ❑ Deputy Treasurer M,Candidale 0 Chairperson (only for PC and PTY)
or electioneering comm.) —
/r—��(�'tTr�IV'
X X
Signature Signature
DS-DE 12 (Rev. 11113) SEE REVERSE FOR INSTRUCTIONS
RFCEI1rE0
CAMPAIGN TREASURER'S REPORT — ITEMIZED CONTRIBUTIONS
C'C
(1) Name
(2) I.D. Number
�rtYot seba
.'erk's Office
(3) Cover Period 1 / / 21. through "t l
�� 1 Z-L (4) Page _ k
of _�
(5)
(7) (S)
(9) (10) (11)
(12)
Date
Full Name
(6)
(Lest, Suffix, First, Middle)
Sequence
Street Address 8 Contributor
Contribution In -kind
Number
City, State, Zip Code Tyne Occupation
Type Description AmWK�MeM
Amount
DS-DE 13 (Rev. 11113) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES
TREASURER'S REPORT— ITEMIZED EXPENDITURES
(1) Name
�CAMPAIGN
I
(2) I.D. Number
(3) Cover Period Ct / f_1 27 through
(4) Page 1 of
I51
(7)
Pill
Ib) (10) (11)
Date
Full Name
Purpose
(S)
(Last, Suffix, First, Middle)
(add office sought If
Sequence
Street Address 8
contribution to a
Ex enditure
Number
City, State, Zip Code
candidate)
Amendment Amount
IAA
DS-DE 14 (Rev. 11113) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES