HomeMy WebLinkAbout05: M07-17 Report/1
(1)
(2)
CAMPAIGN TREASURER'S REPORT SUMMARY
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OFFICE US
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E ONLY
City oJ Mif)nni Gar(dci is
Received Ili the Office of ihe City Cie wmc/C xj
Ad(3ress (number and street) _
V^iqynl 33o55>
City, State, Zip Code
Q Check here if address has changed
(4) Check appropriate box(es):
Date;_.e3^in
Time: _ .
By
(3) ID Number:
E^andidate Office Sought: ^ Q/)00 Q C-i 1
□ Political Committee (PC)
□ Electioneering Communications Org. (EGO) □ Check here If PC or ECO has disbanded
□ Party Executive Committee (PTY) □ 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 IdentifiersCover Period: From ^ / £L ' iX To 0*1 / 3) / f7 Report Type: ir\Ol-i 7
□ Original □ Amendment □ Special Election Report
(6) Contributions This Report
Cash & Checks $
Loans $
(7) Expenditures This Report
• \005- 00
Total Monetary $
In-Kind $
Monetary
Expenditures $, 2.4 .97
Transfers to
Office Account $
Total Monetary $34.17
(8) Other Distributions ,$ . ,w. n
(9) TOTAL Monetary Contributions To Date
$ ,, .1005. QO
(10) TOTAL Monetary Expenditures To.Date$ , .6>15 . /4
(11) Certification
It is a first degree misdemeanor for any person to falsify a public record (ss. 839.13, F.S.)
1 certify that I have examined this report and if is true, correct, and complete:
(Type name)
□ Ipd^dual fonly
ofelectidneerino^bmm.)
(Ty|3^ name)
Treasurer □ Deputy Treasurer □ Chairperson (only for PC and PTY)idate
Signature Signature
DS-DE 12 (Rev. 11/13)SEE REVERSE FOR INSTRUCTIONS
(1) Name
CAMPAIGN TREASURER'S REPORT - ITEMIZED CONTRIBUTIONS
(2) i.D. Number
(3) Cover Period 0*^ / 0 I I [T through / -3 I / (4) Page —)— of _l_
(5)
Date
(6)
Sequence
Number
/ t
(7)
Full Name
(Last, Suffix, First, Middle)
Street Address &
City. State. Zip Code
I •"
(8)
Contributor
Type Occupation
(9)
Contribution
Type
(10)
In-kind
Description
(11)
Amendment
(12)
Amount
/ L
/ I
DS-DE 13 (Rev. 11/13)SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES
CAMF^AIGN TREA^RER'S Ij^pPORT - ITEMIZED EXPENDITURES
(2) I.D. Number
^ CAMPAIGN TREASURER'S RE
(1) Name S^y^ckyZK H^CJOouOC^^A
(3) Cover Period ^ I / 1 "/ through ^ /3 I / /^ (4) Page of
(5)
Date
(6)
Sequence
Number
(7)
Full Name
(Last, Suffix, First, Middle)
Street Address &
City, State, Zip Code
(8)
Purpose
(add office sought If
contribution to a
candidate)
(9)
Expenditure
Type
(10)
Amendment
(11)
Amount
*7 /27/n
OO )
Oia'^ondOi^ .
901
LJ_
LJ^
LJ^
LJ^
1_L
J_L
DS-DE 14 (Rev. 11/13)SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES