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M11 Report 12-10-2021
CAMPAIGN TREASURER'S REPORT SUMMARY (1) r'lar i i OFFIJW19SF[QNLY Namel (2) 3l a Cte-cLn Ave- I�pt 3'10 � Address (number and street) 1 L_& Bo vv+o, o c I- 33`{35 City, State, Zip Code ❑ Check here if address has changed (3) ID. Number: (4) Check appropriate box(es): Candidate Office Sought: Co m W ; 55 t a Kow- ❑ 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 f I l Z/ To // l 30 l z 1 ReportType: Original ❑ Amendment ❑ Special Election Report (6) Contributions This Report (7) Expenditures This Report Monetary Cash &Checks $ L '6-015. oa Expenditures $ 7� Loans $ NL > Transfers to Office Account $ Total Monetary , , Total Monetary $ In -Kind $y� (8) Other Distributions (9) TOTAL Monetary Contributions To Date (10) TOTAL Monetary Expenditures To Date $ , _ , �0©. oo $ X13 '53 (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`^ `' R. r""' name n (Type ) ❑ Individual (only for IE Treasurer ❑ Deputy Treasurer PIC-andidate ❑ Chairperson (only for PC and PTY) or electioneerin comm.) X Signature Signature Ds -DE 12 (Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS CAMPAIGN TREASURER'S REPORT — ITEMIZED CONTRIBUTIONS (1) Name nary + H0tTILQ.r _ _ (2) I.D. Number (3) Cover Period 11 / l I 21 through 1 1 13 D l Zr (4) Page 1 of r (5) (7) (8) (9) (10) (11) (12) Date Full Name (6) (Last, Suffix, First, Middle) Sequence Street Address & Contributor Contribution In-kind Number City, State, Zip Code Type e Occu ationT e - Description Amendment Amount z PeavY, Beac'V'. lD NCG`� 1 (J✓ CAA f�bO,00 Zu5�tN FlerOL '53,4091 or;C(0_ b\re✓ i c 0k) 0. 2100 fqCsA(�O RI u0PC3 FL334�9 : z - 343 Le / DS -DE 13 (Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES CAMPAIGN TREASURER'S REPORT — ITEMIZED EXPENDITURES (1) Name Mar -,f H L keo-A (2) I.D. Number (3) Cover Period-// / I / Z through f! / 3a / Z I (4) page 1 of 1 — (5) (7) (8) ( 9) (10) (11) Date Full Name Purpose (6) (Last, Suffix, First, Middle) (add office sought if. Sequence Street Address &, contribution to a Expenditure Number City, State, Zip Code candidate) Type Amendment Amount 9 ZI C,4,A 1 X06 & Dceoar' Ave. I't (�t�� �ZJr• oa 1 i'x�y n�ori 3C,J'_, t=t- 33 H 3 6- C,iy tri �O�pAo� 1b a��� �Cn� 1 j j Q ZI ef_t' Iq .s3 100 G OGec n /� ye- 3pyr%v� 13e.��i I'L 33L136- Ll �� Z► (000 S. �n�✓ac9� u�Qy '�25D Ob z OH�Q¢ s fi=x pQ"szs CocXL SAC -L- 33NkD PAJ C DS -DE 14 (Rev.11113) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES