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HomeMy WebLinkAbout19M11 CAMPAIGN TREASURER'S REPORT SUMMARY (1) r­�- 'r ecd L . k-k;UX-je Rec'�'*I.,.q the ;,.e City e i NameDate: t o (2) 2O7 ,-y Ti . Address(number and street) By. kkk4a� 9"",V5.- _,6. _3.3.�� ...................... City, State, Zip Code r] Check here if address has changed (3) ID Number: 4X21— g-g :2141 (4) Check appropriate box(es): [(Candidate Office Sought: _�kLal c CLL_ ❑Political Committee(PC) ❑ Electioneering Communications Org. (ECO) ❑ Check here if PC or ECO has disbanded F] Party Executive Committee (PTY) ❑ Check here if PTY has disbanded n Independent Expenditure(IE)(also covers an El Check here if no other IE or EC reports will be filed individual making electioneering communications) (6) Report Identifiers Cover Period: From To I I Report Type: Original ❑Amendment ❑Special Election Report (6) Contributions This Report (7) Expenditures This Report Monetary Cash &Checks V0 Expenditures $ Loans Transfers to Office Account $ Total Monetary Total Monetary $ In-Kind (8) Other Distributions (9) TOTAL Monetary Contributions To Date (10) TOTAL Monetary Expenditures To Date $ (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: (Ty (Type name) [] Individual(only for IE IgTreasurer [I Deputy Treasurer Candidate ❑Chairperson(only for PC and PTY) or election eerina comm.),_ X __ ���iY /.......... X Signature Signature IDS-DE 12(Rev.I 1113) SEE REVERSE FOR INSTRUCTIONS t;AWAIUN I KtA,UKtK'S KWIUKI — I I EMV-hU G{INTMOUTIONS (1) Name NAYAgjiL M L eje (2) I.D. Number 91-21x"521 LI (3) Cover Period � 1 � / through / � /_a (4) page _� of (5) (7) (8) (9) (10) (11) (12) Date Full Name (6) (Last,Suffbc,First,Middle) Sequence Street Address& Contributor Contribution In-kind Number city,State Mp Code Type Occupation T Amc Amount ll 7, 11 9.4 F� PAT JoN �3 Fd � 00,do L 3 4A 'i 1 f 1 ! 1 1 7 DS-DE 13(Rev.'11113) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES