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