HomeMy WebLinkAboutBolton - 2019M12 ReportCAMPAIGN TREASURER'S REPORT SUMMARY
OFFICE USE ONLY
Name
.,I A 0 PH ! : c! 6
(2) A
Addess (number and street)�`
�,.F
City, State, Zip Code
❑ Check here if address has changed
(3) ID Number: _
(4) Check appropriate box(es):
j�Candidate Office Sought:
❑ 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 To
L / _�\ Report Type: �� Z
❑ Original ❑ Amendment ❑ Special Election Report
(6) Contributions This Report
(7) Expenditures This Report
Cash & Checks $
Monetary
Expenditures $,.:S 1,
Loans $ C)
Transfers to
$ ' � �+
Office Account $
Total Monetary � 1 4�]
Total Monetary $ �,e
13
In -Kind $ >� '�
(8) Other Distributions _
$ , —,
(9) TOTAL Monet Contributions To Date
$
(10) TOTAL Monetary Expenditures To Date
$ r
p
,
(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 nam �_A T — �
(Type name) 'v\CM I �, i� �' t1✓,
❑ Individual (only for IE ❑ Treasurer Deputy Treasurer
Candidate ❑ Chairperson (only for PC and PTY)
or electioneering comm.)
x
X
Signature
Signature
DS-DE 12 (Rev. 11113) 1, titt KtVtK,t PUK IN,) I KUL, I IUNJ
CAMPAIGN TREASURER'S REPORT — ITEMIZED CONTRIBUTIONS
(1) Name M 6�, %ZIA —0 + `"— ci (2) I.D. Number
(3) Cover Period Lj through / j / (4) Page of
(5)
Date
(7)
Full Name
(Last, Suffix, First, Middle)
Street Address &
, State, ZipCode
(a)
Contributor
Type_ Occu ation
(9)
Contribution
Type
(10)
In -kind
Description
(11)
Amendment
(12)
Amount
(6)
Sequence
Number
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CAMPAIGN TREASURER'S REPORT - ITEMIZED CONTRIBUTIONS
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(5)
Date
(7)
Full Name
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(8)
(9)
(10)
(11)
(12)
(6)
Sequence
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Contribution
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Description
Amendment
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CAMPAIGN TREASURER'S REPORT - ITEMIZED CONTRIBUTIONS
(1) Name na 6N, b t P�v� , �/) (2) I.D. Number
(3) Cover Period 12 i ( / through / / (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
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DS-DE 13 (Rev. 11113) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES
CAMPAIGN TREASURER'S REPORT - ITEMIZED CONTRIBUTIONS
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(3) Cover Period (-), / / (� through I / 31
(2) I.D. Number
/ (4) Page of
(5)
Date
(7)
Full Name
(Last, Suffix, First, Middle)
(8)
(9)
(10)
(11)
(12)
(6)
Sequence
Number
Street Address &
City, State, Zip Code
Contributor
Type Occupation
Contribution
Type
In -kind
Description
Amendment
Amount
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05-DE 13 (Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES
CAMPAIGN TREASURER'S REPORT - ITEMIZED CONTRIBUTIONS
(1) Name 00(1M 6 1 (2) I.D. Number
(3) Cover Period I' / / Cl through l / / 1 C, (4) Page 15 of IL
(5)
Date
(7)
Full Name
(Last, Suffix, First, Middle)
Street Address &
, State, Zip Code
(8)
Contributor
Type Occu ation
(9)
Contribution
Type
(10)
In -kind
Description
(11)
Amendment
(12)
Amount
(6)
Sequence
Number
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DS-DE 13 (Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES
CAMPAIGN TREASURER'S REPORT — ITEMIZED CONTRIBUTIONS
(1) Name (Aa.(M �, (2) I.D. Number
(3) Cover Period 'Z / 0, / through (4) Page �'-i of jp
(5)
Date
(7)
Full Name
(Last, Suffix, First, Middle)
Street Address &
City, State, Zip Code
(a)
Contributor
Type Occupation
(9)
Contribution
Type
(10)
In -kind
Description
(11)
Amendment
(12)
Amount
(6)
Sequence
Number
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05-DE 13 (Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES
CAMPAIG TREASURER'S REPORT — ITEMIZED EXPENDITURES
(1) Name � (,�.( U� �, ``1 (2) I.D. Number
(3) Cover Period through k2 / _ (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)
Amendment
(11)
Amount
(6)
Sequence
Number
Z 31
Pr-fNeA3+ i C f n
DS-DE 14 (Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES