HomeMy WebLinkAbout08: M10-17 Report<1)
(2)
CAMPAIGN TREASURER'S REPORT SUMMARY
Savxk^ & RcfowjeC/OFFICE USE ONLY
rlcO <f! SK
Address (number (
t'
RECEIVED
BY:.Vy
NOV 0 8 REC'D
Mio,..
O Check here If address has changed (3) ID Number;
(4) Check appropriate box(es): ^ ^ ^ \
n Candidate Office Sought: 1 ^
□ Political Committee (PC)
□ Electioneering Communications Org. (EGG) □ Check here if PC or ECO has disbanded
□ Party Executive Committee (PTY) □ Check here if PTY has disbanded
Q 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 identifiersCover Period: From _|^ / To (Q / 3^ ' fll Report Type:
□ Original D Amendment D Special Election Report
(6) Contributions This Report
Cash & Checks $ .
Loans $ .
Total Monetary $ •
$In-Kind
(525 jXI
(7) Expenditures This Report
Monetary
Expenditures $
T ransfers to
Office Account $
Total Monetary $
•_e M
(8) Other Distributions
$
(9) TOTAL Monetary Contributions To Date$ . . [MV oO (10) TOTAL Monetary Expendi^res To Date
J
(11) Certification
It is a first degree misdemeanor for any person to falsify a public record (ss. 839.13, F.S.)
I certify that IJjave examined this report and it is true, correct, and complete^
(Type name)(Type name)
□treasurer □ Deputy Treasurer Cf Candidate ^,,Q-GUaiiperson (only for PC and PTY)□ Irjiiyduat (only for IEor/^ctibneeriwi £
Signature Signature
DS-DE 12 (Rev. 11/13)SEE REVERSE FOR INSTRUCTIONS
(1) Name
CAMPAIGN TREASURER'S REPORT - ITEMIZED CONTRIBUTIONS
(2) '-D- Number
(3) Cover Period iQ_ I QL ' IL i2_ ' ^ ' J2 H) Pafle _J_ of _L
(5)
Date
(6)
Sequence
Number
(7)
Full Name
(Last, Suffix, First, Middle)
Street Address &
City, State. Zip Ccxfe
(8)
Contributor
Type Occupation
(9)
Contribution
Type
(10)
In-kind
Description
(11)
Amendment
(12)
Amount
/ I
I I
/ /
/ L
I L
DS-DE13(Rev. 11/13)SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES
(1) Name.
^, CAMPAIGN TREASURER'S REf
>orA vt\ |]\^ cDo L-cg M
, CAMFfAIGN TREASURER'S REPORT - ITEMIZED EXPENDITURES
(2) I.D. Number
(3) Cover Period ] 0 / 0( /(. j through /Q (4) Page
(5)
Date
(6)
Sequence
Number
j of l_
(7)
Full Name
(Last, Suffix, First, Middie)
Street Address &
City, State, Zip Code
(8)
Purpose
(add office sought if
contribution to a
candidate)
(9)
Expenditure
Type
(10)
Amendment
(11)
Amount
AA
AA
AA.
AA
AA
DS-DE 14 (Rev. 11/13)SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES