HomeMy WebLinkAbout19M12 CAMPAIGN TREASURER'S REPORT SUMMARY
(1) R/bre- �efoMe. N,Like(wrk JK OFFICE USE ONLY
City o,"IVliomi Garc is
Name Recve- is the T.ce of'ye City Clerk
(2) r g�)c IfY k,,- K4, e4- Date-:'---—1J La ces
Address(number and street) Time:. 1"
Mrt-Mt, &,JjeAS Fi- By'
City, State, Zip Code
❑ Check here if address has changed (3) ID Number:
(4) Check appropriate box(es):
[t-Grandidate Office Sought: m"rte' 6A0"Jenj L1I,FY �d�'"Cr l seve
❑Political Committee(PC)
❑Electioneering Communications Org. (ECO) ❑ 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 Identifiers
Cover Period: From / / (¢— To Report Type:
E�6riginal ❑Amendment ❑Special Election Report
(6) Contributions This Report (7) Expenditures This Report
Monetary
Cash &Checks S Expenditures $ -
Loans S a ma Transfers to
Office Account $
Total Monetary S _
Total Monetary $
In-Kind $
(8) Other Distributions
$
(9) TOTAL Monetary Contributions To Date (10) TOTAL Monetary Expenditures To Date
S �9,9 O0
(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:
(Type name) (Type name) Ntkr6cj
❑Individual;only for IE [3rreasurer ❑Deputy Treasurer ❑Candidate ❑Chairperson(only for PC and PTY)
or electioneering comm.)
XX
Signature Signature
DS-DE 12(Rev.11H3) SEE REVERSE FOR INSTRUCTIONS
CAMPAIGN TREASURER'S REPORT- ITEMIZED CONTRIBUTIONS
(1) Name TKerva (2) I.D. Number
(3) Cover Period I} / / le` through P (4) Page of
(S) (7) (8) (9) (10) (11) (12)
Date Full Name
(o) (Last,Suffix,Frst, Middle)
Sequence Street Address& Contributor Contribution In-kind
Number City,State.Zip Code Tym Occu ation T e Description Amendment Amount
i
I �
DS-DE 13(Rev. 11113) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES
CAMPAIGN TREASURER'S REPORT— ITEMIZED EXPENDITURES
(1) Name- I s — (2) I.D. Number
(3) Cover Period �' / / l¢ through 1 / �� / (4) Page c of
(5) (7) (8) (9) (10) (11)
Date Full Name Purpose
(6) (Last,Suffix. First, Middle) (add office sought if
Sequence Street Address& i contribution to a Expenditure
Number City, State,Zip Code candidate) Type Amendment Amount
a io I} 011. (
�1, e
1 jo
WOW p
i
DS-0E 14(Rev.11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES