HomeMy WebLinkAbout14: M12-17 ReportI
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CAMPAIGN TREASURER'S REPORT SUMMARY
(1) ~<Z.-(ftt Go f2..-lGr .fto l) A-fl--o
Name r---
(2) fl l N vJ I 8'.$ ~ J . 1 #-f o I I~~~ 1 0 2018
Address (number and street)
1\1 { ttM I ~ t'bt Q ~1 F (__ 3 3 Lb l
City, State, Zip Code 7
BY~ .............. J}{ ... .
D Check here if address has changed (3) ID Number: ------------------
(4) Ch~ appropriate box(es): ~Candidate Office Sought: tY\ I ft<'l\ ( Gk-~~) ( { f'i
D Political Committee (PC)
D Electioneering Communications Org. (ECO)
D Party Executive Committee (PlY)
D Independent Expenditure (IE) (also covers an
individual making electioneering communications)
D Check here if PC or ECO has disbanded
D Check here if PTY has disbanded
D Check here if no other IE or EC reports will be filed
(5) Report Identifiers l_;f:-To /;A t3 _(__ I _!J Report Type: {vJ-I 2. -I
D Special Election Report
Cover Period: From _l3-1 _{ _ I
D Original 0Amendment
(6) Contributions This Report
Cash & Checks
Loans
Total Monetary
In-Kind
$_' d-,_)oJ . ~
·-------$ ' I
(9) TOTAL Monetary Contributi ns To Date
$ _._)_2...~. >o
(7) Expenditures This Report
Monetary
Expenditures $
Transfers to
Office Account $
Total Monetary $
(8) Other
$ --·--·--
(10) TOTAL Monetary Expenditures To Date
$ . .f#!_.oo
(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 complete:
Tt: (Type name) £ {<_ ~0 0 ~ -q 4-/;'.!) Pr fLO
0 Individual (only for IE 0 Treasurer (i'Deputy Treasurer 0 Chairperson (only for PC and PTY)
or electioneering comm.)
X
SEE REVERSE FOR INSTRUCTIONS
' 4 •
EASURER'S REPORT -ITEMIZED ONTRIBUTIONS
(2) 1.0. Number ____ _
(3) Cover Period { 2--,_1_ I 4 through ( 2-I _?,.t I ~ (4) Page -J-of _L
(5) (7) (8) (9) (10) (11) (12)
Date Full Name
(6) (Last, Suffix, First, Middle)
Sequence Street Address & Contributor Contribution In-kind
Number City. State, Zip Code Type Occupation Type Description Amendment Amount
/1 I 1}-I f'/ /?M ~of<-J-(Y\N~ ~ . lf: ~ 1 ( o Co ('J""-;-( ODO-oo ()i:HtYl ;nt-. ~-PL~t~~/ F-l I
0 0, ,.... -,, ~ {( I f 7 I I 7 (0~ r6v_,fc ~~ .. rl~~ I I l{f(->I tJ t_ 2 9 ~ ( (}00. (]\ ~ #=-fO I o
ooJ_ Av~~~fl-33 (
18-o
1?--1 ~t it' ~~ ltfc.~
{'J II\) 0 ~'-(O( /hiJ r p?(~< ~ )oo. oo /~0 f\Jw 'l' '9 c~ -It: :z.o 2.-
D 0:1 trltA.MI f:"L 3~/ bf:;
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OS-DE 13 (Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES