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HomeMy WebLinkAboutG3 ReportCAMPAIGN TREASURER'S REPORT SUMMARY (1) (-P�.'` ` ��\l�� C OFFICE USEONLYE/VED Name (2) (c�v3 L) s i k�� /.. S- SfP?� ?0?4 Address (number and stre City of C State,114- Zip JC Z- z9 �S City Clefk sbOf�ce ❑ Check here If address has changed (3) ID Number: (4) Check appropriate box(es): © Candidate Office Sought t" td ❑ 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 1 / _1 / z* To I / ZS / ?,t Report Type: OQ 3 [jaOriginal ❑ Amendment ❑ Special Election Report (6) Contributions This Report (7) Expenditures This Report Monetary Cash & Checks $ Expenditures $ Loans $_ _ • _ Transfers to Office Account $ Total Monetary $ In -Kind $ 1 1 - (9) TOTAL Monetary Contributions To Date $ C''- Total Monetary $ (8) Other Distributions $ (10) TOTAL Monetary Expenditures To Date $ 1 1 r ) . _ (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: (Type name) -Dvk Wtu^ Ck• t 1,'" s (Type name) "C-- C, ( l r ❑ Individual (only for E " asurer ❑ Deputy Treasurer 2 Candidate _ - - -,❑ Chairperson (only for PC and PTV) or electioneering com(n.) X J X / Signature Q Signature `' Y DS-DE 12 (Rev. 11113) SEE REVERSE FOR INSTRUCTIONS 11,60Fi� CAMPAIGN TREASURER'S REPORT — ITEMIZED CONTRIBUTIONS '960 F� ,r'ry 1� 1p? (1) Name - . c� ��< (2) I.D. Number CLnf S, SsaS�'d (3) Cover Period / _I / 74- through 2 / 7-/ z k (4) Page ( of I. 195 0. (5) Date (6) Sequence Number 1 (7) (8) (9) (10) 1 (11) 1.12) Full Name (Last, Suffix, First, Middle) Street Address & Contributor City, State, Zip Code Type Occupation Contribution In -kind Type Description amendment DS•DE 13 (Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VAJES Amount SFp ? cF�VFp 0 CAMPAIGN TREASURER'S REPORT - ITEMIZED EXPENDITURES... t� �f zp14 (1) Name 74 t Ltl (2) I.D. Number 't'.4 4b_ 3 Cover Period ( ) C / - l 2 + through g / 2 `' / �� l ( (4) Page of f 9 Q t�drj f� _ e (5) (7) (8) --- (9) --. - o (11) Date Full Name Purpose (5) (Last, Suffix, First, Middle) (add office sought If Sequence Street Address & contribution to a Expenditure Number City, State, Zip Code candidate) Type Amend Amount DS-DE 14 (Rev. 11113) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES