HomeMy WebLinkAboutG3 ReportCAMPAIGN TREASURER'S REPORT SUMMARY
Name
(2) ( C2'Z-::� t] S - l ttt
Address (number and street
giq STtW-a\\
City, State, Zip Code
❑ Check here If address has changed
(4) Check appropriate box(es):�
® Candidate Office Sought:
OFFICE 0SIk bNLY�D
C1
1
Cri.� afseb_
(3) ID Number.
❑ 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 7
Cover Period: From / z t l XL- To it / / % ReportType:
[f,Ariglnal ❑ Amendment ❑ Special Election Report
(6) Contributions This Report
Cash & Checks $
Loans $
Total Monetary $_
In -Kind $
(9) TOTAL Monetary Contributions To Date
$ 1 , ( `,`'
(7) Expenditures This Report
Monetary
Expenditures $
Transfers to �—
Office Account $
Total Monetary $
(8) Other Distributions
$ , -
(10) TOTAL Monetary Expenditures o Date
$ , i..l
(11) Certification
It is a first degree misdemeanor for any person to falsify a public record (as. 839.13, F.S.)
I certify that I have examined this report
and itIstrue, correct, and complete: /�
(Type name) �i,�,,,i-<, li C�`�L'-c"-f (Type name)
1,��(r"" � GtL.C�(e.-4,
❑ individual (only for IE [Q Treasurer 0 Deputy Treasurer 0 Candidate ❑ Chairperson (only for PC and PTN')
or electioneering comm.)
9 X X
Signature Signature
DS-DE 12 (Rev.11/13) SEE REVERSE FOR INSTRUCTIONS
f i1;, I Fli
CAMPAIGN TREASURER'S REPORT — ITEMIZED CONTRIBUTIONS
�
,. i ( t I � J. Cc �� S
(1) Name (2) I.D. Number " `>
(3)CoverPeriod {O /?Z / Z?--#wwgh )( / 3 12� (4) Page of
(5)
Date
(a)
Sequence
Number
(7) (a) (9) (10) (11) (12)
Full Name
(Lest, Suffix, First Middle)
Street Address 6 C mtributor Contribution In -kind /Mwnt
Cily. State- Zio Code Ttne Cocupation Tvoe Descrioaon
DS-DE 13 (Rev.11113) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES
CAMPAIGN TARE SURER'S REPORT— ITEMIZED EXPENDITURES
(1) Name (���"`t 1 1 F ���� —� 3 (2) I.D. Number
(3) Cover Period through 11 / i / Z (4) Page t of
(5) ITI (9) (9) (1e) (11)
Date Full Name Purpose
(S) (Last, Suffix, First, Middle) (add office sought If
Sequence Street Address d contribution to a Expendiwfe �.
Number City, State, Zip Code candidate) TYPO Amendment Amount
O"E 14 (Rev. 11113)
SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES