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HomeMy WebLinkAbout22G01 CAMPAIGN TREASURER'S REPORT SUMMARY (11 \- -•S .- C..— k W \!---S Name OFFICE USE ONLY ' .!! . City L. Mla.i11i G,11, •5 (2) \�l�l� .�lJ�, -- Z 11V.-5L- REC::ve • i" t C:'i;E ci'4a City Clerk Address (number and street) Date:-�.1_QU1 .e3 \i\I. Time: • • \' �='a t'-c� �c FL. 3 3 l 6 By:_ - �: City, State, Zip Code ❑ Check here if address has changed (3) ID Number: (4) Check appropriate box(es): Q Candidate Office Sought: \..___C ,.\\C \\ , 1/4..., ❑ Political Committee (PC) �� _ ❑ Electioneering Communications Org. (ECO) ❑ Check here if PC or ECO has disbanded 0 Party Executive Committee (PTY) 0 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 ` , / t' / a` To i----t / 1-7-. Report Type: '. Original - r, '_ ❑Amendment ❑ Special Election Report (6) Contributions This Report (7) Expenditures This Report Monetary Cash & Checks $ , , 1 404 . C ; Expenditures $ Loans $ _ ' 00 Transfers to Office Account $ ' Total Monetary $ \ 0 Ot --- Total Monetary $ In-Kind $ ^•^_ — (8) Other Distributions $ , (9) TOTAL Monetary Contributions To Date (10) TOTAL Monetary Expenditures To Date (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) �\8411/4- = � i (Type name) �1 �; ,-•••• ._- NriS 1,1/4.S ❑Individual(only for IE l�Treasurer 0 Deputy Treasurer or electioneering comm.) ©Candidate 0 Chairperson(only for PC and PTY) I t. I III _XT....„.<4.,c.,_ c_. , Wu...4.N / X ( , Signature— `�' � ` �U�'1 e Signature DS-DE 12(Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS CAMPAIGN TREASURER'S REPORT- ITEMIZED EXPENDITURES (1) Name ` :!- `. \ V-/T (2) I.D. Number (3) Cover Period / (')\ / at,4- rough rk / ! `� / 4.>').T. (4) Page %; of (5) (7) (8) (9) (10) (11) Date 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 • b.,5 A tax-1=0-14-e-tr- 5 :et) r`V J / / / / / / / / / / DS-DE 14(Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES CAMPAIGN TREASURER'S REPORT— ITEMIZED CONTRIBUTIONS (1) Name (2) I.D. Number (3) Cover Period ,-' / 0 1 / through D L / L '1 tat )-3. (4) Page of (5) (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 Amount l 3, 'Tl t 0,m A:.,tcVvis- C�Ci`1 \-‘, c01 — � Ft_ b , ck PL. -h-3 / / DS-DE 13(Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES