HomeMy WebLinkAboutRun-Off 20R3 CAMPAIGN TREASURER'S REPORT SUMMARY
OFFICE USE ONLY
Nam? � � / C` City of ivliumi vardcrlS
(2) �2 ?(1 /V (r(f.: gy l�CCS Rec;,'v� ' i;; th Office oT aye City Clr
Address (number/ynd street) Date:^ L
f "r/Gtitg1, c7nl mL - �Z �3�5.6 lime:_L�1!
City, State, Zip Code By
❑ 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 0 l OS l To 0 / //P / �' Report Type: v
❑Original ❑Amendment ❑ Special Election Report
(6) Contributions This Report (7) Expenditures This Report
Monetary
Cash & Checks $-— • Sly• Expenditures $
Loans $ Transfers to
Office Account $ ,
Total Monetary $ 0. jQ U• 0<)
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 falsity a public record(ss. 839.13, F.S.)
I certify that I have examined this report and it is true, correct, and complete:
I's(Type name) �,� �. /4�,I�Cr� (Type name) ,Oc l 914 r I's
❑Individual(only for IE reasurer ❑Deputy Treasurer candidate ❑ hairperson( ly for PC and PTY)
or electioneering comm.)
i
Signature Signature
DS-DE 12(Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS
CAMPAIGN TREASURER'S REPORT— ITEMIZED CONTRIBUTIONS
(1) Name 1 \0 j rj-f�'LJ �q T l,s (2) I.D. Number
(3) Cover Period V9 / / _;;2, 0 through _ /�� / (4) Page of
(5) (7) (8) (9) (10) (11) (12)
Date Full Name
(6) (Last,Suffix,First, Middle)
Sequence Street Address& Contributor Contribution In-kind
G� Number City,State,Zip Code Type Occupation Type Description nmendmern Amount
! l [f /;-O T/- /ree
rq,)-eT ,.h,
r �s 9 P14*1i XIvd oma,av
�} o
2,0Ari 0 61
Fe A4 I y T 12 �na
330 6
if
015 mq`^_
UKIbIA
97 o/N 0-JPy ol.) /
33l
i
DS-DE 13(Rev.11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES
CAMPAIGN TREASURER'S REPORT— ITEMIZED EXPENDITURES
(1) Name G C/�Py Nq r%i (2) I.D. Number
(3) Cover Period / w/ 1y through / / y (4) Page / _ of /
Isl . (7)
Date Full Name I Purpose
-
---
- (Last, Suffix, First,Middle) (add office sought if
Street Address & contribution to a Expenditure
Sequence Type Amendment Amount
Number City, State,Zip Code candidate)
Am
�2 0 07j N. u!3�f�� 1 i��v (.L� �y►'l�' 3/x,6 6
l M t a,,�; Gam' 3�of
01 /.Sze (`/`�L�(� ,V 67. SJ�'f
A)JA) t 3� 5�r�� r,9l qy C3-1611
5
i
DS-DE 14(Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES