M12 2021 Report 01-10-2022CAMPAIGN TREASURER'S REPORT SUMMARY
(1) 1 CX�Z
Name
(2) 1 E•11� V_�o, �I¢. _ fig.
Address (number and street)
City, State, Zip Code
❑ Check here If address has changed
(4) Check appropriate box(es):
OFFICE USE ONLY
MERV
(3) ID Number:
q,.35r C&
S<: ndidate Office Sought: Q%� C.o r- c+�;.SSt��1� �i r;Gk ',�.
❑ 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 a / a r, To 1'Z 1 31 1 tf.21L ReportType: M \ a 24�\
[}eriginal ❑ Amendment ❑ Special Election Report
(6) Contributions This Report (7) Expenditures This Report
Monetary
Cash 8 Checks $ �{ ,Ifo • afl Expenditures $ 25 , �''
Loans $ Transfers to
Office Account $ ,
Total Monetary $
Total Monetary $
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) an #`' U01 -
[I
yL❑ Individual (only for IE ressurer ❑ Deputy Treasurer
or elecdonea" comm.)
X __X6�C:)
Signature
(Type name) 11 yqe�%b._ CrJ 2
f}candldate Q chairperson (only for PC and PTy)
X — — Lc;;�_
Signature
DS -DE 12 (Rev. 11113) SEE KtVER5F. FOR INSTRUGTILMO
CAMPAIGN TREASURER'S REPORT - ITEMIZED CONTRIBUTIONS
(1) Name Gi cyQ,
14-
Crol.
(2)
I.D. Number
(11)
(12)
(3) Cover Period k Z
/ (
/ ,qk through
\ Q. / S k / all
(4) Page �_ Of t
(5)
(7) ,
(8)
(9)
(10)
(11)
(12)
Date
Full Name
(Last, Suffix, First, Middle)
(8)
Sequence
Street Address $
Contributor
Contribution
In-kind
Number
City, State, Zip Code
Type Occupation
Type
Description
AmendmW
Amount
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Gl. 334»
1 1
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DS43E 13 (Rev.11113) ?i C ee¢vr=r`ac W-%#"...... �.. ...........
CAMPAIGN TREASURER'S REPORT — ITEMIZED EXPENDITURES
(1) Name _P1 t N e k7• C,(.iL
(3) Cover Period 1 I \through
(2) I.D. Number
(4) Page �_ of
(6)
Date
(7)
Full Name
(Last, Suffix, First, Middle)
Street Address &
City, State, Zip Code
(s)
Purpose
(add office sought if
contribution to a
candidate)
(s)
Expenditure
p
Type
(10)
Amendment
(11)
Amount
(6)
Sequence
Number
U�.G
Sk.Psc1&-O—Ws
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DS -DE 14 (Rev. 11/13) SEE REVERSE FOR INSTRUCTIC