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HomeMy WebLinkAbout2017 - M8- Campaign Treasurer Report – DS-DE 12, DS-DE 13, DS-DE 13A, DS-DE 14, DS-DE 14A & DS-DE 94 - Michelle J GomezCAMPAIGN TREASURER'S REPORT SUMMARY OFFICE USEQNLY `94 Name Adds (number and street) 0-4M W 3 >v City, State, Zip Code :K;o y,+ ❑ Check here if address has changed (3) ID Number: b (4) Check appropriate box(es): Candidate Office Sought: ��(SS 1 yl l"h ��✓��-��CC��dT�LG� 2 ❑ 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 8 / l ��/ - To / .7 �k- Report Type: awl Mtn (Original ❑ Amendment ❑ Special Election Report (6) Contributions This Report (7) Expenditures This Report Monetary Cash & Checks $ Q c7- Expenditures $ ®. 00 Loans $ Q • 00 Transfers to Office Account $ -- Total Monetary $ • 01D Total Monetary $ , In -Kind $ dy (8) Other Distributions $ 0. -a_} (9) TOTAL Monetary Contributions To Date (10) TOTAL Monetary Expenditures To Date $ $ (02 (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), (Type ame) N1dWk7J6,o1xe_ -,X - ❑ Individual (only for IE ❑ Treasurer ❑ Deputy Treasurer Candidate ❑ Chairperson (only for PC and PTY) or electioneering comm.) n� X X _ Signature Signatur DS-DE 12 (Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS r I CAMPAIGN TREASURER'S REPORT - ITEMIZED CONTRIBUTIONS (1) Name �(���-��,r�`'i?eL� (2) I.D. Number (3) Cover Period g / / (:Po/through ?3 (4) Page Of _/ (5) Date (7) Full Name (Last, Suffix, First, Middle) Street Address & City, State, Zip Code (8) Contributor Occupation (9) Contribution Type (10) In -kind Description (11) Amendment (12) Amount (6) Sequence Number -Type f DS-DE 13 (Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES �tMPAIGN TREASURER'S REPORT - ITEMIZED EXPENDITURES (1) Name ©/n� (2) I.D. Number (3) Cover Period 8 / I /oio/'through 3 / 3 / / (4) Page of (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) A /ndment (11) Amount (6) Sequence Number I� i f I DS-DE 14 (Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES