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HomeMy WebLinkAboutAdams G3 Campaign ReportCAMPAIGN TREASURER'S REPORT SUMMARY (1) Jerome Adams OFFICE USE ONLY Name T'EC4eIV� (2) 901 Roseland Rd. Q Address (number and street) OCT 3 City 2Q�ll Sebastian, FL 32958 o f s City Clerk, bastien City, State, Zip Code F-1Check here if address has changed (3) ID Number: e (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 / 18/ 14 To 10 / 30 / 14 Report Type: G3 ❑✓ Original ❑ Amendment ❑ Special Election Report (6) Contributions This Report (7) Expenditures This Report Monetary Cash & Checks $ 0 , 0 0 00 Expenditures $ 0 0 863. 20 Loans $ 0 , 0 , 60 00 Transfers to Office Account $ 0 0 , 0 .00 Total Monetary $ 0 , 0 60 00 Total Monetary $ 0 0 , 863. 20 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 1 330 00 $ 0 1 , 317 16 (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 Treasurer ❑ Deputy Treasurer 121 Candidate ❑ Chairperson (only for PC and PTY) or electioneering comm.) X4X A40 - _'== Sin ure Sig re DS -DE 12 (Rev. 11113) SEE REVERSE FOR INSTRUCTIONS CAMPAIGN TREASURER'S REPORT — ITEMIZED CONTRIBUTIONS Jerome Adams (1) Name (2) I.D. Number 10 18 14 10 30 14 (3) Cover Period I 1 through 1 1 (4) Page 1 1 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 10 22 14 Jerome Adams 901 Roseland Rd., Sebastian 1 LOA $60 001 ®Cr I 1 City of City Cler , b, of fan s 'Ce DS -DE 13 (Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES CAMPAIGN TREASURER'S REPORT — ITEMIZED EXPENDITURES (1) Name Jerome Adams (3) Cover Period to / is / 14 through 10 / 30 / 14 (2) I.D. Number (4) Page of (5) (7) (8) (9) (1 0) (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 USPS Stamps 10 18 14 Sebastian, FL 32958 CAN $34.00 001 10 20 14 Treasure Coast News Newspaper Ad 1939 S Federal Way Stuart, FL 34994 CAN $325.00 002 Office Depot Postcards 10 20 14 5950 20TH STREET VERO BEACH, FL 32966 CAN $64.20 003 HomeTown News Newspaper Ad 10 21 14 P.O. Box 850 Ft. Pierce, FL 34954 CAN $165.00 004 Vero News Newspaper Ad 10 22 4 4855 North AlA Vero Beach, FL 32963 CAN $275.00 005 � E�V� Q O �T c�t 2 41� fs ea 007 DS -DE 14 (Rev. 11113) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES