HomeMy WebLinkAboutGilliams G1 Campaign ReportCAMPAIGN TREASURER'S REPORT SUMMARY
P#4411ef_ sal A//1 ", s
1
OFFICE USE ONLY
2 Nprpe (P � 3 US -- % � ' -� RFC E/veQ
A ess (number and street
L—-s�� ter,✓
OCT o $ z41
City, State, Zip Code
�
City of's
C• eb
ElCheck here if address has changed
(3) ID Numberw'"Of�C�
(4) Check appropriate box(es):
C3 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 V I I /y To
/p /7 I / f Report Type.
0 Original ❑ Amendment ❑ Special Election Report
(6) Contributions This Report
(7) Expenditures This Report
Cash &Checks $
Monetary
Expenditures $ ,
Loans $ ,��
Transfers to -
Office Account $
Total Monetary $ -
Total Monetary $
In-Kind
z—
(8) Other Distributions
$ , , -
(9) TOTAL Monetary Cont ri utions To Date
(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:
d
(Type name %ie'uf
(Type name) k�4m'-f-' v r r4uc j
❑ individual OVreasurer ❑ Deputy Treasurer
J' Candidate ❑ Chairperson (only for PC and PTY)
or electioneerNg comm.
X
X
Signature
Signature
DS -DE 12 (Rev. 11113) v SEE REVERSE FOR INSTRUCTIONS
CAMPAIGN TREASURER'S REPORT - ITEMIZED CONTRIBUTIONS
O Name
1 yi�
(2) I.D. Number
(3) Cover Period /0/ / I /`f through _�b/ Y/ / Y (4) Page of
(6)
Date
(7)
Full Name
(Last, Suffix, First, Middle)
Street Address &
City, State, Zip Code
(8)
Contributor
Type Occupation
(9)
Contribution
Type
(10)
In-kind
Description
(11)
Amendment
(12)
Amount
(6)
Sequence
Number
I I
I I
I I
OCT
City Of Seba
City Clerk's
014
fian
ice
1 I
DS -DE 13 (Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES
(1) Name
�AMPAIGN TREASURER'S REPORT — ITEMIZED EXPENDITURES
(2) I.D. Number
(3) Cover Period %0 / ( / IY through /o/_-/ /�/ (4) Page of
(5)
Date
(7)
Full Name
(Last, Suffix, First, Middle)
Street Address &
City, State, Zip Code
(8)
Purpose
(add office sought if
contribution to a
candidate)
(9)
Expenditure
Type
(10)
Amendment
(11)
Amount
(6)
Sequence
Number
Ocr
C/
a
�o 14
; l
�fY C/erk's
aStian
�fflce
1/
1
DS -DE 14 (Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES