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HomeMy WebLinkAboutAdams M9 Campaign ReportCAMPAIGN TREASURER'S REPORT SUMMARY (1) Jerome Adams OFFICE USE ONLY Name 901 Roseland Rd.- (2) �d Address (number and street) oc% Sebastian, FL 32958 City 2014 Of S City, State, Zip Code it' CI ebas ; ❑ Check here if address has changed (3) ID Number: Hca (4) Check appropriate box(es): ❑✓ Candidate Office Sought: Councilmember ❑ 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 09 / 01 / 2014 To 09 / 30 / 2014 Report Type: M9 0 Original ❑ Amendment ❑ Special Election Report (6) Contributions This Report (7) Expenditures This Report Monetary Cash & Checks $ 0 , 0 100. 00 Expenditures $ 0 0 12. 75 Loans $ 0 0 0 . 00 Transfers to Office Account $ 0 0 0. 00 Total Monetary $ 0 , 0 100. 00 Total Monetary $ 0 0 12 - 75 In-Kind $ 0 , 0 0 . 00 (8) Other Distributions $ 0 0 0 00 (9) TOTAL Monetary Contributions To Date (10) TOTAL Monetary Expenditures To Date $ 0 0 170 . 00 $ 0 0 73 . 75 (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: (Type name) Jerome Adams (Type name) Jerome Adams ❑ Individual (only for IE El Treasurer ❑ Deputy Treasurer El Candidate ❑ Chairperson (only for PC and PTY) or electioneering comm.) X X Sig a ure Si n ture DS -DE 12 (Rev. 11113) SEE REVERSE FOR INSTRUCTIONS CAMPAIGN TREASURER'S REPORT — ITEMIZED CONTRIBUTIONS (1) Name Jerome Adams _ (2) I.D. Number 09 01 2014 09 30 2014 1 1 (3) Cover Period 1 1 through 1 1 (4) Page of _ (5) Date (7) Full Name (Last, Suffix, First, Middle) Street Address & City, State, Zip Code (8) Contributor Type Occupation (9) Contribution TVDe (10) In-kind Description (11) Amendment (12) Amount (6) Sequence Number 09 08 14 Russell & Leslie Herrmann 586 Redwood Ct., Sebastian, FL 32958 I Retired CHE $100 001 40 Eb 1 I 1 I 1 I DS -DE 13 (Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES CAMPAIGN TREASURER'S REPORT — ITEMIZED EXPENDITURES (1) Name Jerome Adams (2) I.D. Number (3) Cover Period 09 01 1 2014 through 09 / 30 1 2014 (4) Page 1 of 1 (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 (1 0) Amendment (11) Amount (6) Sequence Number 09 27 14 Walmart 2001 US Highway 1 Sebastian, FL 32958 Copy paper and mailing labels CAN $8.47 001 09 27 14 Dollar General 9200 Sebastian Blvd., Sebastian, FL 32958 Envelopes CAN $4.28 e arks �i,;,v DS -DE 14 (Rev. 11113) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES