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HomeMy WebLinkAboutG1 Report�D� CAMPAIGN TREASURER'S REPORT SUMMARY (1) �-�V A( S, (���\m� OFFtC USE ONLY NameECEIVt;U � 0 C T t 4 Address (number a d stre� �- p Jt" l� \ l h/1 C — 'RC 1 Citt)' of Seba . City, State, Zip Code Y Cle; i.; ❑ Check here If address has changed (3) ID Number. (4) Check appropriate box(es): Candidate Office Sought: i ��L) (1Gi' ❑ Political Committee (PC) ❑ Electioneering Communications Org. (ECO) ❑ Check here It 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 &I Cover Period: From l 07Ct�) To /(l-) / C,4 / V• `d Report Type: "P4J� 01Original ❑ Amendment ❑ Special Election Report (6) Contributions This Report (7) Expenditures This Report Cash & Checks $_ Loans $ Total Monetary $ In -Kind $ (9) TOTAL Monetary Contributions To Date $ aas . 6)e� Monetary l Expenditures $ Transfers to Office Account $ Total Monetary $ (8) Other Distributions $ (10) TOTAL Monetary Expenditures To -Date $ 7/ (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: j ` � / pp / (Type name) ,� C( S r U(h'� W��(;�i (Type name) P knj'I - - �3rA�1 -1'V9i% ❑ Indmdual (only for IE Treasurer ❑ Deputy Treasurer lCandldate ❑ Chairperson (only for PC and PTY) or election g comm x X Cu9a� Sign ure Signature 12 (Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS CAMPAIGN TREASURER'S REPORT - ITEMIZED CONTRIBUTIONS REce1 I1ED (1) Name on"", �&SU W1 (2) I.D. Number pith,,: (3) Cover Period t U I 01 /QQthrough kC" f C21�D (4) Page Of (5) I (7) (8) (9) (10) (t1) (12) Date + Full Name (6) (Last Suffix, First, Middle) Sequence Street Address & C mtributor Contribution In -kind Number City, State, Zip Code Type Occupation Type Description Amendmem Amount I I I DS-DE 13 (Rev, 11113) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES RF�E/VRD iU qry ? A�PAILi, TR A URER'S REPORT— ITEMIZED EXPENDITURES ��/1f ITf»,r/r �f C'r�C,�Sebastian C-fce (1) Name h^� 11(l� (2) I.D. Number (3) Cover Period �U /�< through jC7 / 7 / a�� (4) Page Of p / (sl (7) CS) (9) (10) (11) Date Full Name Purpose (S) (Last, Suffix, First, Middle) Street Address 3 (add office sought If contribution to a Expenditure Numbers City, State, Zip Code candidate) Type Amendment Amount I DS•DE 14 (Rev. 11113) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES