M12 Report 01-07-2020CAMPAIGN TREASURER'S REPORT SUMMARY
(1) 965,10 M�F1�4�5�
OFFICE USE ONLY
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Address (number and street)
City, State, Zip Code
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❑ Check here if address has changed
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(3) ID Number:
(4) Chec appropriate box(es): (� p n z:3 M.
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Candidate Office Sought:
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❑ 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
Period: From I'L 1 I 1 I q To
1 3► 1 9 ReportType:
rCo�ver
I- 6nginal ❑ Amendment ❑ Special Election Report
(6) Contributions This Report
(7) Expenditures This Report
Cash & Checks $ O a
Monetary
Expenditures $
Loans $ , , _
Transfers to
Office Account $ ,
Total Monetary $ , _3 , D _0
Total Monetary $ ,
In -Kind $
(8) Other Distributions
(9) TOTAL Monetary Contributions To Date
(10) TOTAL Monetary Expenditures To Date
$ 3 O 0
$ 2 .17 �!
(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) �5H 1 �K1� .3�1
10
(Type name) r—✓'il i M�Y1�li �1
❑ Individual (only for IE 53Treasurer ❑ Deputy Treasurer
®'Candidate ❑ Chairperson (only for PC and PTY)
or electioneering comm.)
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X
Signature
Signature
DS -DE 12 (Rev. 11113) SEE REVERSE FOR 1N—STft'GTIONS
p CAMPAIGN TREASURER'S REPORT - ITEMIZED EXPENDITURES
(1) Name _99SNI M'4H&fl f'%j (2) I.D. Number
(3) Cover Period j� 1 1 1 J1 through 12- 1 1) 1 /2 (4) Page of
(5)
(7)
(8)
(9)
(10)
(11)
pate
Full Name
(Last, Suffix, First, Middle)
Street Address &
Purpose
(add office sought if
contribution to a
Expenditure
(6)
Sequence
Number
City, State, Zip Code
candidate)
Type
Amendment
Amount
12-19 I q
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DS -DE 14 (Rev. 11113) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES
CAMPAIGN TREASURER'S REPORT — ITEMIZED CONTRIBUTIONS
(1) Name �SHfc- N414-wo-;5k (2) I.D. Number
(3) Cover Period 12 1 f / l I through 1 Z 1 31 1 __L� (4) Page of
(5)
(7)
(8)
(9)
(10)
(11)
(12)
Date
Full Name
(Last, Suffix, First, Middle)
(6)
Sequence
Street Address $
Contributor
Contribution
In-kind
Number
City, State, Zip Code
Type Occupation
Type
Description
Amendment
Amount
1 �7s'G`�7'�
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DS -DE 13 (Rev. 11113) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES