M11 2021 Report 12-10-2021CAMPAIGN TREASURER'S REPORT SUMMARY
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(1) ,. �� C�vz OFFICE USE ONLY
Name
(2) \40oz, \I Z6,
Address (number and street)
�
C
City, State, Zip Code I/02 YYI
❑ Check here if address has changed (3) ID Number:
(4) Check appropriate box(es):
andidate Office Sought: Ov-� G, r-,
❑ 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 1( / t / at To 1 t / So / \ ReportType: �k\` z4ak
P<riginal ❑ Amendment ❑ Special Election Report
(6) Contributions This Report
(7) Expenditures This Report
Monetary
Cash & Checks $ `�j , �j bo .
Expenditures $ L. 53
Loans $
Transfers to
Office Account $ ,
Total Monetary $
Total Monetary $6
In -Kind $ ,
(8) Other Distributions
(9) TOTAL Monetary Contributions To Date
(10) TOTAL Monetary Expenditures To Date
(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\ A, %" C�ry'2 (Type name) (Skv-"�L,°`
❑ Individual (only for IE C 'I reasurer ❑ Deputy Treasurer M<andidate ❑ Chairperson (only for PC and PTY)
or electioneering comm.)
X \I X -
Signature Signature
DS -DE 12 (Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS
CAMPAIGN TREASURER'S REPORT — ITEMIZED EXPENDITURES
(1) Name rte; Cruz. (2) I.D. Number
(3) Cover Period \ [ / k / nP\ through ( [ / 1�'Z� / '.;I-\ (4) Page _ - t . of
(5)
Date
(7)
Full Name
(Last, Suffix, First, Middle)
Street Address &
City, State, Zip Code
(S)
Purpose
(add office sought if
contribution to a
candidate)Amendment
(9)
Expenditure
Type
(10)
— (11)
Amount
(6)
Sequence
Number
Nizrz
PuL
d,sseSs�•+^r
gz.5
Able
DS -DE 14 (Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES
CAMPAIGN TREASURER'S REPORT — ITEMIZED CONTRIBUTIONS
(1) Name
(7)
Q u -z
(2)
I.D. Number
(11)
(12)
(3) Cover Period
<< /
/ through
ik a\
(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
Occupation
Type
Descrii:tion
Amendment
Amount
—Type
6� �- '(spa- l—
i l a
v(3 `J
jA
I
DS -DE 13 (Rev. 11113) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES