HomeMy WebLinkAboutRun-Off 20R4 aim. - - —
CAMPAIGN TREASURER'S REPORT SUMMARY
(1) - i e(c 1 -3 \\ a I ` WICIlAt OFFICE USE ONLY
Name
(2) � 1 f' 1 I
7 Tel
City of 7* LI i Gardens
•l1 I Recve�' i; the Office of;.i-ie city Cleric
. •dress (number aid street) Date: 1 + ' Zs.
/
Time: 1 ' l '
r . '��((o
Ci , State, Zip Code
❑ Check here if address has changed (3) ID Number:
(4) Check appropriate box(es): )
C didate Office Sought: �V Ur)C( I
❑Political Committee (PC)
❑ Electioneering Communications Org. (ECO) ❑ Check here if PC or ECO has disbanded
0 Party Executive Committee (PTY) 0 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 (02 / 7f) ' 1Fl f�
I _____VOIC) To / UUr✓C.� Report Type:`�XJ� /
'Original 0 Amendment 0 Special Election Report
(6) Contributions This Report (7) Expenditures This Report
,�/� Monetary
Cash & Checks $ , 2.*• W Expenditures $
Loans $ , •• Transfers to
Office Account $
Total Monetary $ i-3S. - --
_2Y
Total Monetary $
In-Kind $ ,
(8) Other Distributions
$ .
(9) TOTAL Monetary Contributions To Pate (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 ave examined this r �plrt,all is true, L ct, and complete: ) 1
Ir i� I j ( . f " r-c12'J
(Type name) ( L (Type n e) r (erg Gil,
❑Individual on for IE i'Treasurer
or clec6on n. omm.) Deputy T - andi•- e 0 Chairperson(only for PC and i?T'Y)
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DS-DE Ray.11/13)
SEE REVERSE FOR INSTRUCTIONS
7-CAMPAIGN TREASURER'S REPORT—ITEMIZED CONTRIBUTIONS
(1) Name '• k(C(D ()`T '' ! , (2) I.D. Number
(3) Cover Period L( / , / �L-� through I[) / 02 / 2 C' (4) Page 2 of -2—
(5) (7) (8) (9) (10) (11) (12)
Date Full Name
(6) (Last,Suffix,First, Middle)
Sequence Street Address& Contributor Contribution In-kind
Number City, State,Zip Code Type Occupation Type Description Amendment Amount
09 Zvl LCJ do ' HeLK
72 /044/4„ 4/6,ov
fit,(!ars,
l •
_33rd
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(1,v ri r S C+11,10 ��C�c._
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G F FtPt (5°1641
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blehte
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DS-0E 13(Rev.11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES