HomeMy WebLinkAboutAdams G2 Campaign ReportCAMPAIGN TREASURER'S REPORT SUMMARY
(1) Jerome Adams
OFFICE USE t.Y
Name
C�c�V�O
(2) 901 Roseland Rd.
Address (number and street)
Oily
Sebastian, FL 32958
of
C� "�'b
Clerk s O ti�17
City, State, Zip Codee
❑ Check here if address has changed
(3) ID Number:
(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 10 ! 4 1 14 To
10 1 17 1 14 Report Type: G2
✓❑ Original ❑ Amendment ❑ Special Election Report
(6) Contributions This Report
(7) Expenditures This Report
Monetary
Cash & Checks $ 0 , 0 , 600. 00
Expenditures $ 0 0 380. 21
Loans $ 0 0 0 00
Transfers to
Office Account $ 0 0 , 0 .00
Total Monetary $ 0 0 , 600. 00
Total Monetary $ 0 , 0 , 380. 21
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 1 , 270 00
$ 0 0 453 96
(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 [D Treasurer ❑ Deputy Treasurer
El Candidate ❑ Chairperson (only for PC and PTY)
or electioneering comm.)
X '4X
SigWure
Sig ture
DS -DE 12 (Rev. 11113)
SEE REVERSE FOR INSTRUCTIONS
CAMPAIGN TREASURER'S REPORT — ITEMIZED CONTRIBUTIONS
Jerome Adams
(1) Name (2) I.D. Number
10 4 14 10 17 14
(3) Cover Period / / through / / (4) Page
1 1
Of
(5)
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
10 9 14
1 1
Carolyn S Anderson
262 Fig St.
Sebastian, FL 32958
I
Retired
CHE
$100
001
10 1 17 1 14
Waste Management
2700 NW 48th St.,
Pompano Beach, FL
33073
B
Waste Mgmt
CHE
$500
002
J 1
c;�yy
C;
s p
eb
Ice
I I
DS -DE 13 (Rev. 11113) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES
CAMPAIGN TREASURER'S REPORT— ITEMIZED EXPENDITURE, �2
2
Jerome Adams
7
(1) Name (2} I.D.DNumber City °�SA�, _
10 4 14 10 17 14 1 erk O&a�
(3) Cover Period I 1 through I ! (4) Page of ce
(5)
(7)
(8)
(9)
(10)
(11)
Date
Full Name
(Last, Suffix, First, Middle)
Purpose
(add office sought if
(6)
Sequence
Street Address &
contribution to a
Expenditure
Number
City, State, Zip Code
candidate)
Type
Amendment
Amount
Walmart
Copy paper and
10 4 14
2001 US Highway 1
printer ink
Sebastian, FL 32958
CAN
$40.60
001
10 6 14
USPS
Stamps
Orange Ave. Station
Ft. Pierce, FL 34950
CAN
$49.00
002
USPS
Stamps
10 11 14
Sebastian, FL 32958
CAN
$49.00
003
Walmart
Mailing Labels
10 11 14
2001 US Highway 1
Sebastian, FL 32958
CAN
$4.76
004
Custom Ink
Shirts
10 11 14
2910 District Ave.,
Fairfax, VA 22031
CAN
$76.35
005
Impeccable Signs
Signs
10 13 14
832 Doctor Ave,
Sebastian, FL 32958
CAN
$80.25
006
Impeccable Signs
Signs
10 17 14
832 Doctor Ave,
Sebastian, FL 32958
CAN
$80.25
007
DS -DE 14 (Rev. 11113) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES