HomeMy WebLinkAboutG2 Report(1)
(2)
(4)
CAMPAIGN TREASURER'S REPORT SUMMARY
�tq Wl(�vl 1 �1lCLt �Af+ S OFFICE US,EONLY
Name, .Al
Address (number and street)
e >'ite'iI+.i<, iL 32'�/ST
City, State, Zip Code
❑ Check here If address has changed
Check appropriate box(es).
0 Candidate Office Sought:
(3) ID Number.
Z�
C/t �OfSeh:=,
❑ 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)
Cover Period: From /':�) / �? /
Q-Original ❑ Amendment
(6) Contributions This Report
Cash & Checks $ ---
Loans $
(5) Report Identifiers
To
❑ Special Election Report
Total Monetary $_
In -Kind $
(9) TOTAL Monetary Contributions Tate
$ It��
7— % Report Type: b . Z
(7) Expenditures This Report
Monetary
Expenditures $ .
Transfers to
Office Account $
Total Monetary $
(8) Other Distributions
$ , ,
(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:
�1 1 IVY_
(Type name) \-6Li1,(.I,t T"1 C3 tf (Type name)
❑ Individual (only for IE t&Treaeurer D Deputy Treasurer E)-Candidale ❑ Chalrperson (only for PC and PTY)
or electioneering comm.)
Signature Signature
DS-DE 12 (Rev. 11/13) I' SEE R VERSE FOR INSTRUCTIONS
"FC4/v
CAMPAIGN TREASURER'S REPORT - ITEMIZED
CONTRIBUTIONS
1(�
�ku(�`" s
(2)
I.D. Number
(1) Name
e
cO�k• basr
,�
(3) Cover Period 10 1 _ through (c !
L- 1 / _
(4) Page
of
(5)
(7) (6)
(9)
(10) (11)
(12)
Date
Full Name
(6)
(Lest, Suffix, First, Middle)
Sequence
Street Address& Contributor
Contribution
In -kind
A
Number
City, State, Zip Code Type Occupation
Type
Description Ameid�m
Amoun(-1/
DS-DE 13 (Rev. 11113)
SEE REVERSE FOR 14STRUCTIONS AND CODE VALUES
J
rs.
PAIG�111R'S REPORT— ITEMIZED EXPENDITURES
(1) Name ( v' 1I 5
I N
(2) I.D. Number
(3) Cover Period / b / Z-"through
I / " ( / '
(4) Page of
(5) (T)
(6)
- 19) - - - (10)
(11)
Date Full Name
I
Purpose
(Last, Suffix, First, Middle)
(6)
(add office sought if
Sequence Street Address 3
I
contribution to a
Expenditure
Type
Number City, State, 2Ip Code
candidate)
Amendment
Amount
F1
DS-DE 14 (Rev. 11113) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES