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CAMPAIGN TREASURER'S REPORT SUMMARY
(1)/�1ij52 T /�eh OFFICE USE ONLY
(a)
(4)
Na W FCF/VEp
Add re s) (nuin er and �rqa
� v/ alt. i _k 3 _ lb
City, State, Zip Code
❑ Check here if address has changed
Check appropriate box(es):
12tandidate Office Sought:
❑ Political Committee (PC)
❑ Electioneering Communications Org. (ECO)
❑ Party Executive Committee (PTY)
❑ Independent Expenditure (IE) (also covers an
individual making electioneering communications)
Cover Period: From 1p / A, I
,E] Original ❑ Amendment
(6) Contributions This Report
Cash & Checks
Loans
Total Monetary
In -Kind Z
r
t
City of 2 o 202`
City C/e kebastl.::,
C
(3) ID Number:
❑ Check here if PC or ECO has disbanded
❑ Check here if PTY has disbanded
❑ Check here if no other IE or EC reports will be filed
(5) Report Identifiers
�a To // / _% / _z,,;L Report Type:
❑ Special Election Report
(7) Expenditures This Report
/ Monetary
Expenditures $
$ • _ Transfers to
Office Account $
Total Monetary $ _ , TJ 8!
(8) Other Distributions
$
(9) TOTAL Monetary Contributions To Date (10)
$
TOTAL Monetary Expenditures To Date
$ �/ __VJ_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 /eport and It is true, correct, and complete: /
(TYpename) �C.G.U/�k'i/�E'T2f^.5�f/ (Type name) LauIJe-eJ164)6L)r6
❑ Individual (only for IE ,r-�reasurer ❑ Deputy Treasurer OCandidate ❑ Chairperson (only for PC and PTY)
or electioneering comm.)
X
Sig na re
DS-DE 12 (Rev. 11113) -- - - -- -
Signature (/
SEE REVERSE FOR INSTRUCTIONS
AMPAICN TREASURER'S REPORT—
ITEMIZED
EXPENDITURES
C;ty o`fS?�
(1) Pamev
f
(Z) I.D.. Number
eA-
(3)CoverPerlod /P yz/�-Ahrough
(4)Page % of
n4
k, a
(6) -- — --
- — (9) -- - (10)
(11)
Date
Full Flame
Purpose
(6)
(Last, Suffix, First, Middle)
(add office sought if
Sequence
Street Address &
contribution to a
Expenditure
Type
Number
City, State, Zip Code
candidate)
Amendmard
Amount
- -
-
/&0/
ids
7
DS•DE 14 (Rev. 11113) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES