Termination Report 05-16-2022CAMPAIGN TREASURER'S REPORT SUMMARY
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OFFICE USE ONLY
Name
FIECE D
vg �ro� 37�..
(Z) .Zin 9..pcecun Ave-
Address (number and street)
Address
MAY 116 2022 !3CC
t a I:L. 33 43S
C' ; State; Zip Code
El Check here if address has changed
(3) ID. Nu CLERK'S OFFICE
(4) Check appropriate box(es)
(Candidate Office Sought:
Political. Committee (PC)
.0 Electioneering .Communications Ord. (ECO) F!Check here if PC or ECO has disbanded
Party Executive Committee (PTY) 0 Check here. if PTY has disbanded
Independent Ex'_penditure (IE) (also covers an 0 Check here if no other IE or EC reports will be filed
individual. making electioneering communications)
(6) Report Identifiers.
Cover Period: From . ,3 1 / . 22. To
.S 1 14. / 2 . Z Report Type.: a r R
do rig'Inal [_1 Amendment :El Special Election Report
(6) Contributions ThisReport
(7)Expenditures This Report
Monetary
Cash & Checks $ , ; 3-y +{ z
Expenditures $ S , . a CFO
Loans $
Transfers to.
Office Account $ ,
Total Monetary 9�9 N 2
Total Monetary $ � , QOD-'30
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.)
certify that I have examined this and it is true, correct, and complete:
report
�r-+."A
(Type name) fx-
(Type name) a r i 4 211
❑ Individual (only for 'IE &feasurer ❑ Deputy Treasurer
Candidate ❑ Chairperson (only for PC and PTY)
or oleciioneering comm.)
X.
Signature I
Signature
DS -DE 12 (Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS
CAMPAIGN TREASURER'S REPORT— ITEMIZED CONTRIBUTIONS
(1) Name VYjo r ; _���a +� _ (2) I.D. Number
1y
(3) Cover Period 3 / / ,22 through / I to 1 22 (4) Page
I of j
-- (5) (7)
Date Full Name
(6) (Last, Suffix, First, Middle)
Sequence Street Address .&
Number Citi, State, Ziu, Code
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(8)
Contributor
T e Occu ation
(9)
Contribution
Tv e
(10)
In-kind
Description
(11) (12)
Amendment Amount
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DS -DE 13 (Rev. 11/13)
SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES
CAMPAIGN TREASURER'S REPORT
(1) Name i -x,,_
(3) Cover Period l 1W /, through
— ITEMIZED EXPENDITURES
(2) I.D. Number
22 (4) Page 1 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
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DS -DE 14 (Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES