HomeMy WebLinkAboutG3 Report(1)
(2)
(4)
CAMPAIGN TREASURER'S REPORT SUMMARY
/1SIC`j 1T%�/9/0 OFFICE U^�ONLY
Name
/gt/�5r7 Sf
Add re<s,S �(n,um(�er and htreet)
Jd%' 1A,,
City, State, Zip Code
❑ Check here if address has changed
(3) ID Number:
Clt C L Sebas,,rc
Check appropriate box(es).
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)
(5) Report Identifiers
Cover Period: From f 0 I pit ! ` n- To ! ReportType:
0 Original ❑ Amendment ❑ Special Election Report
(6) Contributions This Report (7) Expenditures This Report
Monetary —
Cash 6 Checks $ Expenditures $
Loans $ _ 1 1 • _
Total Monetary $!
In -Kind $_ —
(9) TOTAL Monetary Contributions To Date
tr��,-
$ ry� on>
Transfers to
Office Account $
Total Monetary $
(8) Other Distributions
(10) TOTAL Monetary Expenditures Date
$
(11) Certification
It is a first degree misdemeanor for any person to falsify a public record (ss. 839.13, F.S.)
1 certify that I/Ihave examined
dtthis report and It is true, correct, and complete:
/ t %
(Type name) U �ae__ / �'�/u�•w) (Type name) (__,/)risk&
Indivi al my for IE Treasurer ❑ Deputy Treasurer 'I t Candidate ❑ Chairperson (only for PC and PTY))
or are
neari
X
Si ature Signature
DS-dk 12 (Rev. 11113) SEE REVERSE FOR INSTRUCTIONS
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01
cJtycekscCa�
PAIL T ASURER'SREPORT- ITEMIZEDEXPENDITURES
A5/�
(1) Name �
(2) I-D. Number
(3) Cover Period
I (J /� through
/
I! l b�l (4) Page t' of
(5)
(7)
(8) (e) (10)
(11)
Date
I
Full Name
Purpose
(8)
$
(Last, Suffix, First, Middle)
Street Address &
(add office sought if
contribution to a Expenditure
aqua ce
Number City, State, Zip Cale candidate) Type Amendment Amount
1
�L
1 /
I /
f > /
i
DS-DE 14 (Rev. 11113)
SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES
CAMPAIGN TREASURER'S REPORT
— ITEMIZED
CONTRIBUTIONS
Ekr� Fp
Name
� S��G/✓�?�1
IA
C%"arc°fs�tiY 'tr°
(1)
VYJPlOS
(a)
I.D. Number
(3) Cover Period /0 / /c through _� /
t6 / c
(4) Pepe
of e
(5)
I (7) (6)
(9)
(10) (11)
(12)
Date
Full Name
(6)
(Last, Suffix, First, Middle)
Sequence
Street Address & Contributor
I
Contribution
In -kind
Number
City, State, Zip Code Type Occupation
Type
Description AMMO M Amount
I 1
I
/ / I
DS-DE 13 (Rev. 11113) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES