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CAMPAIGN TREASURER'S REPORT SUMMARY
(1) l)a0A i (/) OFFICE USE ONLY
Name ( RFCEIVEp
Address (number and street)
S P IF L ) Z 6% S �) City Of kebasLor,
City, State, Zip Code
❑ Check here if address has changed
(3) ID Number:
(4) Check appropriate box(es): 1 / I / r
lb -Candidate Office Sought: 9c ba-`4-i e �1 / i i4 C. 6uo Gf I
❑ 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 L I % Z I To J / Z ' Report Type: L �
Original ❑ Amendment ❑ Special Election Report
(6) Contributions This Report
Cash & Checks $
Loans $
Total Monetary $_
In -Kind $ - -
(9) TOTAL Monetary Contributions To Date
$ (cc
(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:
i
(Type name) �C+' L, i-(11 � I ;, �Lt S ) I i V� 1 (
7 (TYPe name _DCt (, r C
I] IndWidual (orgy for lE EVTressurer ❑ Deputy Treasurer P )Candidate ❑ Chairperson (only Ior PC and PTY)
or eleclloneedng comm.) I 1
Signature 9G L—j Signature
DS-DE 12 (Rev. 11113) SEE REVERSE FOR INSTRUCTIONS
RF�FiI�FD
CAMPAIGN TREASURER'S REPORT - ITEMIZED CONTRIBUTIONSci
Y ��
Cif;. t ti
(1) Name -e 1 �7 f � 1 (�1 ��1 5 (2) I.D. Number � r l ( e
(3) Cover Period 1 U / Lam! 7 Z through 1 / ` (4) Page I of
(5) (7) (8) (9) (10) (11) (12)
Date Full Name
(6) (Lest, Suffix, First, Middle)
Sequence Street Address 8 C mtributor Contribution In -kind
Number Citv, State pp fnrie Tvne Occupation T DescriDflon ABM Amount
! ! 7 l7
DS-DE 13 (Rev.11M3) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES
CAMPAIGM TR�j SUIPER'S REPORT —ITEMIZED EXPENDITURES
(1) Name. IJi (AAi P 6-\ l ; I a IlI r q Wk.0 (2) I.D. Number
(3) Cover Period hrough 1 ( / / 22 (4) Page of
(a) (T) ro) (9) 1 (t0)
Date Full Name
(a) (Last, Suffix, First, Middle)
Sequence _ street Address 6
I ✓
0S43E 14 (Rev. 11113)
G/
Purpose
(add office sought if
contribution to a
ndidate)
Type
SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES
R�C''I,Fo
f;;;.
C}; Of t ;
Amount