HomeMy WebLinkAboutG1 Report AmendedCAMPAIGN TREASURER'S REPORT SUMMARY
(1) C YlCkA �Q0 f11, I Q(,+1 OFFICE USE ON Y
Name �tr�C�/VF
(2) X38 Gc�3lvcl. ®cT2
Address(number and str t) / Cr/tCOf b &I
0,
t�o am
y oaks
City, State, Zip Code O<
❑ Check here if address has changed (3) ID Number:
(4) Check appropriate box(es): II /
®,Candidate Office Sought: E1e-t^^ cls a� CI I1` Y
❑ Political Committee (PC) I
❑ 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 �� ! L / To 1 0 ! Report Type:
EIH( �
Original Amendment ❑ Special Election Report
(6) Contributions This Report
Cash & Checks $_ _ , -0— - go -
Loans S_ _ , • 4�r
Total Monetary • -e
In-Kind •-45�_
(7) Expenditures This Report
Monetary
ExpendituresS _ , 33 . 33. -"r
Transfers to
Office Account $
Total Monetary $
(8) Other Distributions
$
(9) TOTAL MonetaW Contributions To Date (10) TOTAL Monetary Expenditures To Date
r
(11) Certification
It is a first degree misdemeanor for any person to falsify a public r cord (ss. 839.13, F.S.)
I certify that I have examined this report and it is true, correct, and complete: n
(Type name) �c�-iYr Ct (A is t) � (TYPe name) �' � 11416 � . IV I Q U �1
❑ Individual (only for IE gTreasurer ❑ Deputy Treasurer Candidate ❑ Chairperson (only for PC and PTY)
or elec6o eedng comm)
Signature Sig at e
DS -DE 12 (Rev. 11113) SEE REVERSE FOR INSTRUCTIONS
DS -DE 13 (Rev. 11113) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES
CAMPAIGN TREASURER'S REPORT- ITEMIZED CONTRIBUTIONS
1z
(1) Name
II �
(� t"�'L �!)�L� LtT (2)
I.D. Number
(3) Cover Period 01 through 411(-?
�j—
(4) Page
of V
(5)
(7) (6) (9)
(10)
(11) (12)
Date
Full Name
(6)
(Last, Suffix, First, Middle)
Sequence
Street Address & Contributor Contribution
In-kind
Number
City, State, Zip Code Type Occupation Type
Description
Amendment Amount
orSe ��If
j
DS -DE 13 (Rev. 11113) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES
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CAMP/#IGN TRJEASURER'TREPORT— ITEMIZED EXPENDITURES Sc
1 Name �Q t^(l
O � t:�/l Q /1 G I• (2) I.D.DNumber '••�.,
(3) Cover Period �/,�/ / thnou9h __Y 6 J-0 j/ j (4) Page of
(5) I (T) (g) (s) (1l1) (11)
Date Full Name Purpose
(S) (Last, Suffix, First, Middle) (add office sought If
Sequence Street Address & contribution to a Expenditure
Number City, State, Zip Code candidate) Type Amendment Amount
JQ it / / I 4 GCd d� e CCA-V\ paju
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DS -DE 14 (Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES