M9 Report 10-10-2019CAMPAIGN TREASURER'S REPORT SUMMARY
OFFICE USE ONLY _ -
Name -
(2) 431 kEy L�T7N.z QL D -f ;
Address (number and street)
'36Ynm) n) ZEAtA ti- 3343(.
City, State, Zip Code
❑ Check here if address has changed (3) ID Number:_
(4) Check appropriate box(es):
D/Candidate Office Sought: GYM t4.:r5 S 4J /V dY- ^i J�S'ry-4-c f
❑ 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 OT/ p [ / To 6j l -0 11 Report Type: u'q M
[Original ❑ Amendment ❑ Special Election Report
(6) Contributions This Report
(7) Expenditures This Report
Monetary
Cash & Checks $ 1 , UD n O
Expenditures $ A
Loans $ b 0 o O
Transfers to
Office Account $
Total Monetary $
Total Monetary $ — O
In -Kind $ >
(8) Other Distributions
$ O
(9) TOTAL Monetary Contributions To Date
(10) TOTAL Monetary Expenditures To Date
$ G th t7
$ O
(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) r'FNS05" (Type name) 1)1 PL ►S c i
❑ Individual (only for IE Treasurer ❑ Deputy Treasurer FR Candidate ❑ Chairperson (only for PC and PTY)
or electioneering comm.)
___ ___ z:21�_
X X
Signature Signature
DS -DE 12 (Rev. 11113) SEE REVERSE FOR INSTRUCTIONS
CAMPAIGN TREASURER'S REPORT — ITEMIZED CONTRIBUTIONS
(1) Name n PeN-. etc, A- (2) I.D. Number -&'D ( j M1
(3) Cover Period Bo( / ()I / C 7 through / 50/ l7 (4) Page I of I
(5)
Date
(7)
Full Name
(Last, Suffix, First, Middle)
Street Address &
City, State, Zip Code
(8)
Contributor
Type Occupation
(9)
Contribution
Type
(10)
In-kind
Description
(11)
Amendment
(12)
Amount
(6)
Sequence
Number
d / 9C
�� M"�
�3 15 G'r"-c. P0
33�3k�
N
DS -DE 13 (Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES
CAMPAIGN TREASURER'S REPORT — ITEMIZED EXPENDITURES
(1) Name y PrNSLma
(3) Cover Period Di / D I / 11 through
(2) I.D. Number
(4) Page % of
Z,0ii Mq
(5)
Date
(7)
Full Name
(Last, Suffix, First, Middle)
Street Address &
City, State, Zip Code
(8)
Purpose
(add office sought if
contribution to a
candidate)
(9)
Expenditure
Type
(10)
Amendment
(11)
Amount
(6)
Sequence
Number
N 0 AJi-
DS-DE 14 (Rev. 11113) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES