HomeMy WebLinkAbout2015 - TR- 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
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OFFICE USE ONLY
Name
&
(2) �qto LA-)Oc 16L'xd-s,
2015 FEB -2 PH 4:31
Address (number and street)
RECOVED
1TY 01: TAt=
City, State, Zip Code
r I OARAC
F-1 Check here if address has changed
(3) ID Number: k,,l t-VIK
(4) Check appropriate box(es):
[ja Candidate Office Sought: Lrvt k-ji 5sicinie t'
F-1 Political Committee (PC)
F1 Electioneering Communications Org. (ECO) ❑ Check here if PC or EGO has disbanded
F1 Party Executive Committee (PTY) F] Check here if PTY has disbanded
F1 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 I I To
- -
Type:rt / ol / 15Repo
] Original El Amendment ❑ Special Election Report
(6) Contributions This Report
(7) Expenditures This Report
Monetary
Cash & Checks $
Expenditures $
Loans
Transfers to
Office Account $ 3, 9,9 q 6
Total Monetary $
Total Monetary $
I n-Kind $
(8) Other Distributions
$
(9) TOTAL Monetary Contributions To Date
(10) TOTAL Monetary Expenditures To Date
$
$
(111) 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) 6et)b)e tz AE� 7-(Type
name) 6 /- j 60 �
Ej Individual (only for IE R-l'i-reasurer El Deputy Treasurer
V6andidate El Chairperson (only for PC and PTY)
or electioneering comm.)
X
X
Signature
Signatu6 11/111'—
DS-DE 12 (Rev. 11 /13) SEE REVERSE FOR INSTRUCTIONS
(1) Name rt--1 I e- L,, eAk < Ge-It 1-1 C' $,- (2) I.D. Number
(3) Cover Period through t (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
DS-DE 13 (Rev. 111.1141
13, SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES
CAMPAIGN TREASURER'S REPORT — ITEMIZED EXPENDITURES
(1) Name (Y) ( e kE 11� Vic. F-I'e Z (2) I.D. Number
(3) Cover Period _I C / I / I L( through C,,/C// / � (4) Page of
(5)
(7)
(8)
(9)
(10)
(11)
Date
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
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DS-DE 14 (Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES
CAMPAIGN TREASURER'S REPORT — ITEMIZED EXPENDITURES
(1) Name t-1 I C_ke 11 e .� 6' u"—A e L (2) I.D. Number
(3) Cover Period `0 through ! ! (4) Page of
(5)
(7)
(8)
(9)
(10)
(11)
Date
Full Name
(Last, Suffix, First, Middle)
Street Address &
City, State, Zip Code
Purpose
(add office sought if
contribution to a
candidate)
Expenditure
Type
Amendment
Amount
(6)
Sequence
Number
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DS-DE 14 (Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES
(1)
(3)
CAMPAIGN TREASURER'S REPORT - ITEMIZED DISTRIBUTIONS
Name (2) I.D.Number
Cover Period l I 14 - through I I (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)
Related
Expenditures
(10)
Amendment
(11)
Amount
(12)
Distribution
Type
(6)
Sequence
Number
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DS-DE 14A (Rev. 11 /13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES
CAMPAIGN TREASURER'S REPORT - FUND TRANSFERS
(1) Name V--I- \1 -e C ,, ' " (2) I.D. Number
(3) Cover Period 10 through (4) Page Of
(5)
Date
(7)
Name of Financial
Institution
Street Address &
City, State, Zip Code
(8)
Transfer
Type
(9)
Nature of
Account
(10)
Amendment
Amount
(6)
Sequence
Number
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DS-DE 94 (Rev. 08/03) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES