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HomeMy WebLinkAboutM9 ReportCAMPAIGN TREASURER'S REPORT SUMMARY OFFICE USE ONLY (2) Namlq� yy�ea� 54 R�CEIVE� Addres (nymber nla treet) q Cat ZZ2 d L 307 ! City r" Se6asti City, State, Zip Code Check here if address has changed (4) Check appropriate box(es): Candidate Office Sought: ❑ Political Committee (PC) ❑ Electioneering Communications Org. (ECO) ❑ Party Executive Committee. (PTY) ❑ Independent Expenditure (IE) (also covers an individual making electioneering communications) erk S Ola� (3) ID Number. ❑ 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 C)q To (� / -� C) / Report Type: i ti 1 Original ❑ Amendment �- ❑ Special Election Report (6) Contributions This Report Cash & Checks Loans $ r Total Monetary $ o r In -Kind $ (J r (9) TOTAL Monetary Contributions To Date $ ola d0 (7) Expenditures This Report Monetary _. Expenditures $ , (� Transfers to Office Account $ Total Monetary $ _ , _ , L�2 (8) Other Distributions $ , (10) TOTAL Monetary Expenditures To Date $ G t PP (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: �( p1 (Type name) U 1 & (Z— •�ki a 1Mw / (Type name) CA!1.rIe5 �11Ajel kl!(.'1 [ Individual (only for IE ttTreasurer l] Deputy Treasurer 1ACandldate ❑ Chairperson (only for PC and PTY) or electioneering comm.) 94 na re �( Signature DS:DE 12 (Rev. 11113) SEE REVERSE FOR INSTRUCTIONS CAMPAIGN TREASURER'S REPORT - ITEMIZED CONTRIBUTIONS �S�v �Pr ��' (1) Name (2) I.D. Number (3) Cover Period C�-'� / 0� / 3,� through b� / 3D / 19-3 (4) Pape of (5) (7) {S) (9) (10) (11) (12) Dale Full Name (6) (Lest, Suffix, First, Middle) Sequence Street Address & Contributor Contribution In -kind Number City, State, Zip Code Type Occupation Type Description Moend"M Amount DS-DE 13 (Rev. 11113) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES 11 11i', FO Q/ V `7 c�csebas AMPAIGN TRE� URER S REPORT— ITEMIZED EXPENDITURES 1 Name (� ' � mv, 2 I.D. Number 0 (3) Cover Period 1 / / a� through! 3 / (4) Page ( of (5) Date Full Name Purpose (S) I (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