HomeMy WebLinkAboutRun-Off 20R2 CAMPAIGN TREASURER'S REPORT SUMMARY
OFFICE USE ONLY
Name ;.,. .
(2) , a3-0 Al LAI / '1y City Clea
Address(number and street) caic 9
x°11�ar►�i C'r, �+N , "Z 3305 By:
City, State, Zip Code
❑ Check here if address has changed (3) ID Number:
(4) Check ppropriate box(es): y�/f
Candidate Office Sought: / ' t c)
❑ 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 / / ' 2 / -2 �' To O 9 / / t 1 n Report Type: 9 7
❑ Original ❑ Amendment ❑ Special Election Report
(6) Contributions This Report (7) Expenditures This Report
Monetary
Cash & Checks $ ---Z2 , �10. Expenditures $ ,
Loans $ Transfers to
Office Account $ .
Total Monetary $ 07 �� 0-0
Total Monetary $
In-Kind $ ,
(8) Other Distributions
(9) TOTAL Monetary Contributions To Date (10) TOTAL Monet ry Expenditures To Date
$ 3a -. $ 99
(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) Sot b/Zj L. f 6 /� (Ty name) A,,1 f
❑ Individual(only for IE Treasurer ❑Deputy Treasurer Candidat Chai n(only for PC and PTY)
or electioneering comm.)
X X
Signature Signature
DS-DE 12(Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS
CAMPAIGN TREASURER'S REPORT - ITEMIZED CONTRIBUTIONS
(1) Name //,v (2) I.D. Number
(3) Cover Period / / .1 0 through O j/ / ;2 (4) Page / of
(5) (7) (8) (9) (10) (11) (12)
Date Full Name
(6) (Last, Suffix, First, Middle)
Sequence Street Address 8 Contributor Contribution In-kind
Number City, State,Zip Code Type Occupation Type Description Amendment Amount
U31 � V fi e liar
M A r1015e-71" �t a l i
/s0��r74AWO4 7 0000
SSSS N. W 'z 00. 0(7
a &M 1,3?/V Z_
/ .2o ��GM �r,ice,
yoo
a �3 3i1,
DS-DE 13(Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES