TR Report CAMPAIGN TREASURER'S REPORT SUMMARY
(1) 11-€.ti V.,,, lihr-Fet`) v41 OFFICE USE ONLY
Name FILED
(2) 36a 1 5r. ,Q).b a
0dress (number and street) 2024
�' ,0010 B - , a51/35 CITY CLERK'S OFFICE
City,State, Zip Code �
❑ Check here if address has changed (3) ID Number:
(4) Che k appropriate box(es):
SIOf/ ( - I'
Candidate Office Sought: �(j:/t4ttil t ,(� ��T�_
0 Political Committee (PC)
LI Electioneering Communications Org. (ECO) LI Check here if PC or ECO has disbanded
LI 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 10 / 01 / To �; / .0 / r--
.LI Report Type: / /\
[ 1'OriginaI ❑Amendment LI Special Election Report
(6) Contributions This Report (7) Expenditures This Report
Monetary
Cash & Checks $ , , • Expenditures $ , , 'C ') . 00
Loans $ , , • Transfers to
Office Account $ , , .
Total Monetary $ , •
Total Monetary $ , , 100 . OC)
In-Kind $ •
(8) Other Distributions
$ , ,
(9) TOTAL Monetary Contributions To Date (10) TOTAL Monetary Expenditures To Date
$ , , • $ , , iPO .0 °
(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) f-,YiV� ./��frgtr (Type name) f��v `ba -A5 C
IDIndividual(only for IE j Areasur (r1
er Deputy Treasurer ❑Candidate 0 Chairperson(only for PC and PTY)
or electioneering comm.) ,4
try •
,4
Signature Signature X
DS-DE 12 (Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS
pAMPAIG�-T,REASURER'S REPORT - ITEMIZED EXPENDITURES
(1) Name v1 Q/ �\ >f�v�Vl� (2) I.D. Number
(3) Cover Period Jo / 01 / aci through J J / RO / 42(/ (4) Page 1 of
(5) (7) (8) (9) (10) (11)
Date Full Name Purpose
(6) (Last, Suffix, First, Middle) (add office sought if
Sequence Street Address& contribution to a Expenditure
Number City,State,Zip Code candidate) Type Amendment Amount
/a/aq � 11)P-A/icy (p_ ss
1);(A-rif— /oO oc)
/ /
/ /
/ /
/ /
/ /
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/
DS-DE 14(Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES