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HomeMy WebLinkAbout20M04 t CAMPAIGN TREASURER'S REPORT SUMMARY y (1) CAty �f5 araNLY, Name Recc we i.; t E Officy�oi:he City 4,1 (7) 3�� Date: ! Time: Ad8ress (number and s reef) By; -- City, State, Zip Code ❑ Check here If address has changed (3) ID Numbers (4) Check appropriate box(es) Candidate Office Sought: 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) I (b) Report Identifiers Cover Period: From Q ! ! l �v To ©4 I 3cj / ;2,0 Report Type: a�ojy C) c� ❑Original ❑Amendment ❑ Special Election Report (6) Contributions This Report (7) Expenditures This Report Monetary Cash & Checks $ _ . _0 dy Expenditures $ Loans _ Fransfers to — Office Account $ Tota! Monetary Total Monetary $ Q In-Kind $ (8) Other Distributions (9) TOTAL Monetary ontributions 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 (Type name)94e4j!i: . I U(r(s ale (Type name} kirkaAlt,6z 6, ( �t Lte 4 ❑Individual(only for IE reasurer ❑Deputy Treasurer andidate ❑Chairperson(only for PC and PTI) or electio ring comm.) Signature Signature DS-DE 12(Rev.11!13) SEE REVERSE FOR INSTRUCTIONS CAMPAIGN TREASURER'S REPORT- ITEMIZED CONTRIBUTIONS I�I (1) Name _�t,ari' �� Cyr /�\1 (2) I.D. Number (3) Cover Period ©� / a � / G through ) _ (4) Page of f (5` (T) (8) (10) (11) (12) Date Full Name i (6) (Last,Suffix, First Middle) Sequence Street Address& Contributor Contribution In-kind Number Ci , State,Zi Code T Occu anon T e Description Amsnamem Amount CD i l � E I J I 1 I i I DS-DE 13(Rev.11113) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES