HomeMy WebLinkAbout02: M08-17 ReportCAMPAIGN TREASURER'S REPORT SUMMARY
C) IF A o c \:s
Name
(2)
Address (number and street)
>r<\
Citv,„State^Zip,Code
OFFICE USE ONLY
received
Wl 3 2QU-
BY:
Q Check here if address has changed
(4) Check appropriate box(es):
0 Candidate Office Sought:
□ Political Committee (PC)
(3) ID Number
□ Electioneering Communications Org. (ECO)
□ Party Executive Committee (PTY)D Independent Expenditure (IE) (also covers an
individual making electioneering communications)
n Check here If PC or ECO has disbanded
n Check here if PTY has disbanded
□ Check here if no other IE or EC reports will be filed
(5) Report Identifiers
Cover Period: From ^ /\S ^ ^ ^ Report Type:
□ Original □ Amendment □ Special Election Report
(6) Contributions This Report
Cash & Checks $
Loans $
Total Monetary $
In-Kind $ (cA) I
(9) TOTAL Monetary Contributions To Date
$ lOQQ , , . 00
(7) Expenditures This Report
Monetary
Expenditures ,■CV?
Transfers to
Office Account $
Total Monetary $3^•SlL
(8) Other Distributions
$
(10) TOTAL Monetary Expenditures To Date
$ - . • <n7
(11) CertificationIt 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)'V-/-V <;
□ Individual (only for IE □ Treasurer Q^puty Treasureror el^otioneering cqmrn.)
OL
Signature
(Typename)ip^^rvcLv«;.
□ C □ Chandidateairperson (only for PC and PTY)
Signature / ^£r2L
DS-DE 12 (Rev. 11/13)7 SEE REVERSE FOR INSTRUCTIONS
CAMPAIGN TREASUr^R'S REPORT - ITEMIZED EXPENDITURESNatneV S (2) I.D. Number(2)1
(3) Cover Period ^ / i T) / \-^ through / \«~\ (4) Rage of
(5)
Date
(6)
Sequence.
Number
Zv^nWT
/ /
/ /
AJ.
LA.
LjL
LJ.
LA.
LA.
m
Full Name
(Last, Sufflx, First, Middle)
Street Address &
^Cily, I
c \WCN /viss
<>r«^
(8)
Purpose
(add office sought if
contribution to a
iidat<
(9)
Expenditure
(10)
rdmern —Amount"
(11)
P V? 0
DS-DE 14 (Rev. 11/13)SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES
CAMPAIGN TREASURER'S REPORT - ITEMIZED CONTRIBUTIONS
(1) Name V AA c\ (2) I.D. Number
(3) Cover Period \ q through ^(4) Page of
(5)
Date
(6)
JSequence^
Number
/ /
/ /
/ /
/ /
/ /
/ /
(7)
Full Name
(Last, Suffix, First, Middle)
StreetAddress &
City, State, Zip Code
DS-DE 13 (Rev. 11/13)
(8)
-Contributor
Type Occupation
(9)
-Contribution-
Type
(10)
-lOTkind-
Description
(11)(12)
Amendment Amount
SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES