HomeMy WebLinkAboutG2 ReportCAMPAIGN TREASURER'S REPORT SUMMARY
OFFICE USE ONLY
Name (/
RFcEIVF�
(Z) 97'? Q.S
OCT
Address (number and/street)
C't C,r� kebasliah
City, State, Zip Code
Cy _
V
❑ Check here If address has changed
(3) ID Number:
(4) Check appropriate box(es):
Z-Candidate Office Sought:
❑ 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)
Report Identifiers
q(5)
Cover Period: From / I LZ To / / Report Type: �„ it
❑ Original ❑ Amendment ❑ Special Election Report
(6) Contributions This Report
(7) Expenditures This Report
Cash & Checks $_ % D• c�
Monetary
Expenditures $
Loans
Total Monetary
In -Kind
R
$_.�,a�o• my
(9) TOTAL Monetary Contributions To Date
Transfers to
Office Account $
Total Monetary $ _ , _ J P3 . Ir_
(8) Other Distributions
$ 1 ,
(10) TOTAL Monetary Expenditures To Date
(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: pp lI.•
name (yP ) V p��U
(Type ) �/.t.Cll"�/L.( � P�P/'��✓./ T ename OVf
❑ Individual (only for IE /LJ Treasurer ❑ Deputy Treasurer RrCandidate ❑ Chairperson (only for PC and PTY)
or electioneering comm.)
X (��1. / /,a, -
Si lur Signature
DS-DE 12 (Rev. 11113) SEE REVERSE FOR INSTRUCTIONS
CAMPAIGN TREASURER'S REPORT - ITEMIZED CONTRIBUTIONS
(1) Name (2) I.D. Number
(3) Cover Period 1� / _�_ /p2fZZ through
(S) (7) (S) (9)
Date Full Name
(6) (Last, Suffix, First, Middle)
Sequence Street Address& Contributor Contribution
Number City, State, Zip Code Type Occupation Type
4o�/'11-6
Ow.� dHor
f41 1e Ide
ass Se,-AE lAzk r r
ve1p 9,kej, 4 -�
37-Te'qo
(4) Page
(10) (11)
In -kind
Description AmwWmem Amount
DS-DE 13 (Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES
101011�
Soo
asp `�
�_70'j, `
CAMPAIGN TRfiASUREj2'S
REPORT — ITEMIZED EXPENDITURES
eb�s/;
(1) Name
u ise
(2) I.D. Number
(3) Cover Period e' /o7�through
i i / /may (4) Page / of
/
(5)
(7)
Date
I Full Name
Purpose
(6)
(Last, Suffix, First, Middle)
(add office sought if
Sequence
Street Address &
I
contribution to a Expenditure
Type
Number
City, State, Zip Code
candidate) Amendment
Amount
�Gztc aeS/
31�fg
/� i L✓
%p/�s�.5e%DJti<n �/ec1.
cSe-(/7�ST boy. rGLy
L�1�
I / /
OS -DE 14 (Rev. 11113)
4, vc "L
Alf trite
L/C� Sn mks
SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES
—1l d , 8'7
aaq-sy