HomeMy WebLinkAbout08: M06-17 Report(1)
(2)
CAMPAIGN TREASURER'S REPORT SUMMARY
Name
city 0{Mii,9S!K&y.?P ONLY
Received ii/the Office of l^e City Olerx
Date:Time: ^£2il^^3—,
By. ^
(4)
/() rJ'^ sT^rLfiT Jho I
Address (number and street) /
(- Cv S ^ ^
City. State, Zip Code
Q Check here if address has changed
Check appropriate tx)x(es): ^
QjC^didate Office Sought Cy^ /bitAoj / ^^
□ Political Committee (PC)
(3) ID Numt)er:
□ Electioneering Communications Org. (EGO)
Q Party Executive Committee (PTY)
□ Independent Expenditure (IE) (also covers an
individual making electioneering communications)
Q Check here if PC or ECO has disbanded
□ Check here if PTY has disbanded
r~l Check here if no other IE or EC reports will be filed
Cover
□ Original Q Amendment
(5) Report IdentifiersPeriod: From Ci I f I ^ J'To 3Z' . *~j Report Type: ^ bL
' ' □ Special Election Report
(6) Contributions This Report
Cash & Checks 5 .
Loans $
Total Monetary
In-Kind
, a. fs:\>
(7) Expenditures This Report
Monetary
Expenditures $
Transfers to
Office Account $
Total Monetary $
(8) Other Distributions^
$
(9) TOTAL Monetary Contributions To Date
$ . S ■
(10) TOTAL Monetary Expenditures To Date
$ , , ^ <70
(11) CertificationIt is a first degree misdemeanor for any person to falsify a public record (ss. 839.13, F.S.)
certify that I have examined this report and it is true, correct, and complete:
(Typename) ^
□ IndwKlual (only Ux IE □ Treasurer QlB^puty Treasurer
Signatu
(Type^me) ,J (j (-f-o
j^XJandidl^andidate O Chairperson (only for PC
Signal!^
and PTY)
DS-OE 12 (Rev.SEE REVERSE FOR INSTRUCTIONS
CAMPAIGN TREASURER'S REPORT - ITEMIZED CONTRIBUTIONS
(1) Name ^2) I.D. Number
(3) Cover Period jo / f_ / 7 >^through (4) Page [_ of (_
(5)
Date
(6)
Sequence
Number
Oi>^l
(7)
Full Name
(Last Suffix, First, Middle)
Street Address &
City, State, Zip Code
€ o (1-
fnvz-o Z.O
/la I ^ ^ !
(8)
Contributor
Type
<(io/Yv
f
Occupation
£^<0 M
(9)
Contribution
I^ee
(10)
In-kind
Description
(11)
Amendment
(12)
Amount
^0,
/ /
/ /
DS-DE 13 (Rev. 11/13)SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES