Loading...
HomeMy WebLinkAbout20M04 CAMPAIGN TREASURER'S REPORT SUMMARY j - — L (1) ry-) L L S 1--1 CD C) S Y __ OFFICE USE ONLY i Name City of fV�iUn�i �Grdc, (2) 1 4ti I N (,(1 7 C 0 C2.�' Rec,;ve,' ir,tF e Office ofthe 0f� 7I. Address (number and street) Date: S IL__J_ A �_' 0 L--7v15��L3 3 G'j L Time �"�7�1 City, State, Zip Code ❑ Check here if address has changed (3) ID Number. (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) (5) Report Identifiers Cover Period: From v j l / / 9 To 0(/ / 3 C) / ? v Report Type: Z fJ M ❑ Original ❑Amendment ❑ Special Election Report (6) Contributions This Report (7) Expenditures This Report Monetary Cash & Checks $ Expenditures $ Loans $ Transfers to Office Account $ G Total Monetary $ f Total Monetary $ - ��- In-Kind $ ' (8) Other Distributions $ (9) TOTAL Monetary Contributions To Date (10) TOTAL Monetary Expenditures To Date $ l�� °-00- $ t2 (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)(Y) Y L t-S 14 D 0 (Type name) W Y L L S H L� u Treasurer Candidate ❑Chairperson(only for PC and PTY) ❑Individual(only for IE reasurer ❑Dep Deputy or electioneering comm.) X X C- �natu Signature SEE REVERSE FOR INSTRUCTIONS DS-DE 12(Rev.11113) CAMPAIGN TREASURER'S REPORT — ITEMIZED EXPENDITURES (1)Name ��` (2) I.D. Number - - - --- J� w �4_-. --.. (3)Covw Period l7� !� (� L"Othrough O l / (4) Paye of - ----- �) (6) fgl (10) (11) DateFull Name Purpose (6) (Last,Suffix,First,Middle) (add ufficu Sought if contribution to a Expenditure Street Address b SpWlmq City,State,Zip Code candidate) Type Amondmont Amount Number -- — i i I r SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES