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HomeMy WebLinkAboutG3 ReportppCAMPAIGN TREASURER'S REPORT SUMMARY OFFICE USE ONLY (2) M-r� ' Address (number and street) rt- City, State, Zip Code ❑ Check here if address has changed (4) Check appropriate box(es): ❑ Ci andidate Office Sought: ❑ Political Committee (PC) ❑ Electioneering Communications Org. (ECO) ❑ Party Executive Committee (PTY) ❑ Independent Expenditure (IE) (also covers an individual making electioneering communications) C h Cep seb e�®fn (3) ID Number: ❑ Check here if PC or ECO has disbanded ❑ Check here if PTY has disbanded ❑ Check here if no other IE or EC reports will be filed (5) Report Identifiers Cover Period: From / t c` / t of To I / / Ci Report Type: 6-3 ❑ Original ❑ Amendment ❑ Special Election Report (6) Contributions This Report (7) Expenditures This Report Monetary Cash & Checks $ — Expenditures $ Loans $_ , _ , 6 e . - Transfers to Office Account $ — – Total Monetary Total Monetary $ }ZS In -Kind $_ , _ (8) Other Distributions (9) TOTAL Monetary Contributions To Date (10) TOTAL Monetary Expenditures To Date $ 30C�• $ (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 andit is true, correct, and complete: (Type name) �)vku,tkt4t &,((LaLLs (Type name) 'L )"I v (bA (�Ci-t- ❑ Individual (only for IE El' reasurer ❑ Deputy Treasurer ©'Candidate ❑_ 'r arson (only for PC and PTY) or electioneering X \. X Signature Signature V DS -DE 12 (Rev. 11113) SEE REVERSE FOR INSTRUCTIONS RF CAMPAIGN TREASURER'S REPORT— ITEMIZED CONTRIBUTIONS Ut1t�t2 �w l -nth i Jc/0�e6d 769 (1) (1) Name (2) I.D. Number cd4 e (3) Cover Period 10/ ( Q through 1 0 / 3 �_ / tr( (4) Page of t (6) I (7) (8) (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 374 sfi r / DS -DE 13 (Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES Amount 5� r / / I DS -DE 14 (Rev. 11113) Ao J SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES R c%r REPORT- ITEMIZED EXPENDITURES�'r�c�fSab,���? (1) Name �r�+UCAMPAPNTREASURER'S (2) I.D. Number (3) Cover Period IC./ (°t/ through is / 3l / l h (4) Page lof t (6) (y) (6) (g) (10) (11) Date I Full Name Purpose (6) (Last, Suffix, First, Middle) (add office sought if Sequence Street Address & contribution to a Expenditure Number City, State, Zip Code candidate) Type Amendment Amount / / I DS -DE 14 (Rev. 11113) Ao J SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES