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19M02
CAMPAIGN TREASURER'S REPORT SUMMARY OFFICE USE ONLY Name ' _` �`�✓�-t t� CCityc.+J�I�mi Gan, rS (2) 1�+ V�+ 'S _S ) �I=—O — FEc 'vf',i:,t e O^: e c': .;�2 Cit. ":iel`k Date: ��%1 Address (number rid street) ! Time: City, State. Zip Code Check here if address has changed (3) ID Number - (4) Check propriaie box(es) CRI c " t Cf�} rj©u ri Ct andidate Office Scughl f ❑Political Committee IPC) ❑Elecboneerinc Communications Org !ECG? ❑ Check here if PC or ECO has disbanded ❑Party Executive Committee (PTY) L Check here if PTY has disbanded _r__J Independent Expenddure (IEI kalso covers an ❑ Check here if no other IE or EC reports will be filed indroduai -raking electioneering communications) (5) Report Identifiers Cover Period From ! / 1 To f 2 ! / Report Type �o� �l Original Arnenament ❑ SRecial Election Report (6) Contributions This Report (7) Expenditures This Report Monetary Cash & Checks S - -- L� w Expenitures $ — -- ----- — Loans $ _ _ Transfers to Office Account S "otal Monetary S _ 00 Total Monetary S In-Kind S (8) Other Distributions (9) TOTAL Monetary Contributions To Date (14) TOTAL Moneta penditures To Date S - (11) Certification It is a first degree misdemeanor for any person to falsity a public record (ss 839 13, F S.) certify that i have exammea this e00ri and it is true correct aria complete (Type nacre) �F�'�`^'. �'' — -�t vU Jyae ,amel ���l�r' T _ _�' �`'��'✓u -- L C ICY for PC and PTY) in4wduai(ony iE Q Trwasunr TreasaAt+ 1/C�u�d�� -- Cruwpwson I- a+ewctaneenng cornu _ -— _ x Signature Sig nat ur e DS12(Rev 11113) SEE REVERSE FOR INSTRUCTIONS e CAMPAIGN TREASURER'S REPORT — ITEMIZED CONTRIBUTIONS (1) Name (2) I.D. Number (3) Cover Period / I through (4) Page 1 Of Date Full Name ! f 6 (Last. Suffix, First. Middte) Sequence ,, Street Address & Contnbutor Cortnbubon ! In-kind Numbe- 4 City State Zip Code Tie i Occupation e _ DescniAmount uvL. I i ! f � I ( t 1 t , 08-DE 13(Rev.1U1ll) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES