HomeMy WebLinkAboutM9 ReportCAMPAIGN TREASURER'S REPORT SUMMARY
(1) —Da M l e lei \7 / II ( 0 V✓) )L OFFICE USE ONLY
Name A S RECE/VED
(2) 'Address
Coil �vl re G%
dress (number �nd street) 2 6 CC / - 3 2022
C, v) -r-L J z I S a Ciity of Sebastian
City, State, Zip Code ( ty Clerk's Off1c,
❑ Check here If address has changed
(3) ID Number:
(4) Check appropriate box(es):
E Oandidate Office Sought: 470 ` ' �1 COG Cl c r
❑ 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 / / To / z, c / _ L Report Type: /
(� Original El 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
$ ioo Uy
Monetary
Expenditures $
Transfers to
Office Account $
Total Monetary $
(8) Other Distributions
(10) TOTAL Monetary Expenditures To Date
$ -- (-,I &t>
(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).Dl6Vl 1' �1 �7/1l le( �LZ 5 (Type name) L
❑ Individual (only for IE Treasurer Deputy Treasurer Candidate Chalrperson (only for PC and PTY)
or electioneering comm.) 59-
X X
Signature 1) Signature
DS-DE 12 (Rev. 111113) SEE REVERSE FOR INSTRUCTIONS
CAMPAIGN TREASURER'S REPORT - ITEMIZED CONTRIBUTIONS COR�cF/CFO
�Q�\eve l ''(eiWtS Ci, Of 3��
(1) Name 1 (2) I.D. Number Cit�Il ebz ,
l Q h"C„..
(3) Cover Period / I / 2 L through 1 / / 2 Z (4) Page I of
(5)
M (6) (9)
Date
Full Name
(6)
(Lest, Suffix, Fiat. Middle)
Sequence
Street Address 8 Contributor Contribution
Number
City, State, Zip Code Type Occupation Type
i
I I �
j
I !�
DS-DE 13 (Rev. 11113)
(10) (11) (12)
In -kind
Description N wwmrd Amount
i
SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES
RF�FII��D
CAMPAIGN TREASURER'S REPORT— ITEMIZED EXPENDITURES
(1) Name (--7 f f i n 0A 5 (2) I.D. Number
, (3) Cover Period _ J /�Zthrough I n
/ 7 / ? (4) Page I of
(5)
(7)
lal
Date
I Full Name
Purpose
(6)
(Last, Suffix, First, Middle)
(add office sought If
Sequence
Street Address 6
contribution to a
Number
City, State, Zip Code
I
candidate)
cit C f SPba..
C
Expenditure
Type Amendment Amount
DS•DE 14 (Rev. 11113) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES