HomeMy WebLinkAbout03: M04-18 Report........
CAMPAIGN TREASURER'S REPORT SUMMARY
(1) UGN'\l Ce_., Bta(DBIIW'ED
(2)
33o5(p
0 Check here if address has changed (3) ID Number: -----------------
(4) C~eck appropriate box(es): 1 0cam~idate otrK:esought \ ... \1Ami~\1J\5~~W\Cll&wwba l ~S
0 Political Committee (PC)
D Electioneering Communications Org. (ECO) D Check here if PC or ECO has disbanded
D Party Executive Committee (PTY) D Check here if PTY has disbanded
D Independent Expenditure (IE) (also covers an D Check here if no other IE or EC reports will be filed
individual making electioneering communications)
(5) Report Identifiers
Cover Period: From D.:l I QL I ~ To J2.i I j (b I l_g_ Report Type: MD4--I B
D Original 0Amendment D Special Election Report
(6) Contributions This Report
Cash & Checks $_ J _I b51.• 00
Loans $ I I --------
Total Monetary $ I ~ts2 • 1)0 ---- --
(7) Expenditures This Report
Monetary
Expenditures
Transfers to
$
Office Account $
Total Monetary $ __ ~133 ·75
In-Kind $ I I -----
(8) Other Distributions
$ __ ,_1 __ 1 __ _
(9) TOTAL Monetary Contributions To Date (10) TOTAL Monetary Expenditures To Date
$ -I ___11 ~ • ...oQ_ $ _1_1 133 .15
(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 cbmplete:
(Type name) S\\\v-\ ~. cJ Cll'f-(Ty enam~k) M~C...-e..> e.oQ~
0 Individual (only for IE
or electioneering comm.)
X
Signature
DS-DE 12 (Rev. 11/13)
reasurer D Deputy Treasurer PTY)
. ...... ,. .
CAMPAIGN TREASURER'S REPORT -ITEMIZED CONTRIBUTIONS
(1) NamedCU\LC:e.,.. C.O~\~ (2) I.D.Number ____ _
(3) Cover Period D£1 I _QL_ I J.!b_ through 0 ~ I l1_ I ~ (4) Page _I_ of ~
(5) (7) (8) (9) (10) (11) (12)
Date Full Name
(6) (Last, Suffix, First, Middle)
' Sequence StreetAddress_& Contributor Contribution In-kind
~ Number City, State, Zip Code Type Occupation Type Description Amendment Amount
6~, 1eq ~~B V \ V l.e...n~ ~'tM Q_,\\t.-1 tOD~ ~w '1 St-)5V, o0 ~ .. ~o.a.J ~~ I "b2>2l~
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OS-DE 13 Rev.11/13 ~q SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES
' . .
CAMPAIGN TREASURER'S REPORT -ITEMIZED CONTRIBUTIONS
(2) 1.0. Number ____ _
(3) Cover Period o4 I Ql_ 1 l <6 through ~ 1 ~ 1 lt_ (4) Page 1:L_ of -4._
(5) (7) (8) (9) (10) (11) (12)
Date Full Name
(6) (Last, Suffix, First, Middle)
-_Beauence ___8.treetAddress_&__ Coottibutoc Gootributioo_ lod<iod ... -
Number City, State, Zip Code Type Occupation Type Desaiption Amendment Amount
o4 ~l<b d 8 eJ r\o.n \\cu-r\ s
~ \a~6o\~~ ~s ~\0 too s .:c. !AJ"'\7 ~ \4-1
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oq 1/K!J 1 t9J ~ C:,\.az.e ' ~ c rt \~t{vJ I C.AS fib'oo
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I I
OS-DE 13 (Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES
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. ... . --,. .
CAMPAIGN TREASURER'S REPORT -ITEMIZED EXPENDITURES
(1) Name :r=&N)\ ~ C..O Q\L-\ ~ 5 (2) 1.0. Number _____ _
(3) Cover Period .Q..:L J2.L; ~through :Jd:_t _2Lt __i_S_ (4) Page J of _ _._I __
~ m ~ (9) (10) (11)
Date Full Name Purpose
(S) (Last, Suffix, First, Middle) (add office sought if
Street Address & contribution to a Expenditure ~~=-1=-~-S~~~~J~~~~~~e=r====~~~-.~~.~~~~,.~,~,,"~·P~~~uu~r====1===amoo~,==t==~~--~~==~~mm ... i Amoun~1~---~
I I
I I
I I
I I
I I
I I
I I
OS-DE 14 (Rev. 11/13) SEE REVERSE"FOR INSTRUCTIONS AND CODE VALUES