HomeMy WebLinkAboutG3 Reportn //CAMPAIGN //�I t EASURER'S REPORT SUMMARY
a
(1) f/VYt�I_rVa— L5 OFFICE USE 9`t
LY
Name �� ,cF/SFO
MOP
Addre um erandstreet) _Q,/� Q [ �() Oityof ®J�
S V 1 t� I ✓ V Crty C'ersebasban
City, State, Zip Code Once
❑ Check here if address has changed
(4) Check appropriate box(es):
MX'andidate Office Sought:
❑ Political Committee (PC)
❑ Electioneering Communications Org. (ECO)
❑ Party Executive Committee (PTY)
❑ Independent Expenditure (IE) (also covers an
individual making electioneering communications)
(3) ID Number:
G—� Cal/l C i
❑ 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 j (} / { 11A / To j 0 / / Report Type:
❑ Original ❑ Amendment ❑ Special Election Report
(6) Contributions This Report
Cash & Checks
Loans
Total Monetary
I
In -Kind $_ 1_ , O .
(9) TOTAL Monetary Con //}r}r�cI�YYYdo s�T��7o�\ Date
$ V V
(7) Expenditures This Report
Monetary
Expenditures
Transfers to
Office Account $
Total Monetary $ L!
(8) Other Distributions
$ ,
(10) TOTAL Monetary Expqnplitures To Date
$
(11) Certification
It is a first degree misdemeanor for any person to falsify a public record (ss. 839.13, F .)
I certify that I he amined this report aA
it is true, correct, and complete:
(Type name) �r l� KO t �-S (Type name) O�Q (k r U r13
❑ Individual for IE reasu ❑ Deputy Treasurer ndidate ❑ Chalrperson (onl for PC and PTY)
Or election rin mmJ ��
X X�� so
Signature Signature
DS -DE 12 (Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS
R
RcF/VF
CA AIGN T'REEASURER'S ORT—ITEMIZED CONTRIBUTIONS
(1) Name
UL
(2) I.D. Number
fir• _s/,a
(3) Cover Period ' 0 / A /
through
O / /
(4) Page
of
(5)
Date
(6)
Sequence
Number
(7) (6) (g) (10) (11) (12)
Full Name
(Last, Suffix, First, Middle)
Street Address & Contributor Contribution In-kind
City, State, Zip Code Type Occupation Type Description Amendment Amount
DS -DE 13 (Rev. 11113) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES
:S
TREIV ITEMIZED EXPENDITURES
(1) Name CPp", O- (2) I.D. Number ccticz6;`�_J'_
(3)
J�
Cover Period W/ iq/19 through J U ` / "/ (4) Page of
(5) I (7) (8) (g) (10) (11)
Date Full Name Purpose
(8) —I (Last, Suffix, First, Middle) (add office sought if
Sequence
Street Address & contribution to a Expenditure
Number City, State, Zip Code candidate) Type Amendment Amount
DS -DE 14 (Rev. 11113) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES