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HomeMy WebLinkAboutG2 ReportCAMPAIGN TREASURER'S REPORT SUMMARY Name v l A dress (number and street) City, State, Zip Code / ❑ Check here If address has changed OFFICE USE ONLY ocr �: 6 f CrtY of : City C/e kGbasr. Ob,: (3) ID Number: (4) Check appropriate box(es): Candidate Office Sought: Sp t/)e[4, oV1 ir(4� ( coA Gt rl ❑ 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 / $ / 2 Z To L(�_ / -�7 / Report Type: Pbriginal ❑ Amendment ❑ Special Election Report (_ (6) Contributions This Report (7) Expenditures This Report Monetary Cash & Checks $ Expenditures $- Loans �_ - Transfers to Office Account $ Total Monetary $— Total Monetary $ In-Kind-- (6) Other Distributions $ - (9) TOTAL Monetary Contributions To Date (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 thisreportand it is true, correct, and complete: // (Type name))Tamltl •� �7d I t C/V�� (Type name) �nUMr'<vv1 G �l (G % individual (only for IE Treashrer ❑ Deputy Treasurer ( andidate ❑ Chairperso (only for PC a4PTY) �. electioneeri Comm. X X Signatur/ Q Signature DS-DE 12 (Rev. 11113) SEE REVERSE FOR INSTRUCTIONS CAMPAIGN TREASURER'S REPORT — ITEMIZED CONTRIBUTIONS (1) Name�(klM.<f�/1<@l5 (2) I.D.Number rthOfs l 5. (3) Cover Period W/ > / through 0 (4) Page _� of (5) (7) (S) (9) (10) (11) (12) Date Full Name (6) (Last, Suffix. First, Middle) Sequence Street Address & Contributor Contribution In -kind Number City, sta7 Type Occupation Type Description Amerdm M Amount DS-DE 13 (Rev. 11113) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES CAMPAIGN TREASURER'S REPORT— ITEMIZED EXPENDITURES (1) NamE� i (r� �Er-7-- (Z) I.D. Number (3) Cove eriod L� // 7 through/�_/ (4) Page of (5) (7) (8) Date I Full Name Purpose (6) (Lest, Suffix, First, Middle) (add office sought If Sequence Street Address 3 contribution to a Number I City, State, Zip Code candidate) I,' DS-DE 14 (Rev. 11113) jD) (10) (11) Expenditure Type Amendment Amount SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES