HomeMy WebLinkAboutG1 ReportCAMPAIGN TREASURER'S REPORT SUMMARY
(1) OFFICE USEON�ifVFD
(2) l (t,�3 LJ s Fk-�3/ - I 14 - , AUG 2 3 2024
Address (number and street) City of Sebas an
Git'6tA �Iqf j i::L 3Z4' g � City Clerks Office
City, State, Zip Code
❑ Check here if address has changed (3) ID Number.
(4) Check appropriate box(es): �'
® Candidate Office Sought: �� �1'4^-)C ` `� ► ����c `�
❑ 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 7 / / 2 To / Z f / Z V Report Type:
j$ Original ❑ Amendment ❑ Special Election Report
(6) Contributions This Report
Cash & Checks $ — — —
Loans $ ICE'
Total Monetary $
In -Kind $
(9) TOTAL Monetary Contributions To Date
$ Ioo --
(7) Expenditures This Report
Monetary
Expenditures $ I .
Transfers to
Office Account $
Total Monetary $
(8) Other Distributions
(10) TOTAL Monetary Expenditures To Date
$ W ,
(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 it is true, correct, and complete:
DR yAar � hI"i vk� S (Type name
(Type name )
❑ Individual (only for IE RI Treasurer ❑ Deputy Treasurer 0 Candidate ❑ Chalrperean (only for PC and PTY)
or eiectloneedng comm.) ,.. , E
Signature Signature
DS-DE 12 (Rev. I IM)
SEE REVERSE FOR INSTRUC1nONS
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CAMPAIGN TREASURER'S
REPORT
- ITEMIZED
CONTRIBUTIONsr;t�
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(1) Name
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(2]
I.D. Number
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(3) Cover Period / 1 1
through /
Z3 / 11-
(4) Page
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(5)
(7)
(8)
(9)
(10)
(11) (12)
Date
Full Name
(6)
(Last, Suffix, First, Middle)
Sequence Street Address &
Contributor
Contribution
in -kind
Number
City. Stale. Zj Code
Type Occupation
Type
Description
Anwnd�r Amount
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D"E 13 (Rev.11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES
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1 tCAMPAIGN T13EASURERIS REPORT- ITEMIZED EXPENDITURES r tP~ksbdStidh
(1) Name 1 .i4.ot-VA (% (tea L4 L�""S (2) I.D. Number off.
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(3) Cover Period -7 through —L/ Z?7 /-2—± (4) Page I of I
(5) (7) (8) (9) (10) (11)
Date Full Name Purpose
(8) (Last, Suffix, First, Middle) (add office sought If
Sequence Street Address & contribution to a Expenditure
Number City, State, Zip Code candidate) TYPO Amendment Amount
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DSDE 14 (Rev.11113) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES k'a i