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M9 Report 10-09-2019CAMPAIGN TREASURER'S REPORT SUMMARY �d bj 21 `- Y (1) orp go IL114 OFFICE USE ONLY Name _ Address (number and street) = CD x; _ City, State, Zip Code ❑ Check here if address has changed (3) ID Number: (4) Check appropriate box(es): Sii'"�� []Candidate Office Sought: !�►°1n1 S�,�G�11✓G t� %•� ❑ 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 G l Q I H Report Type: ? Original ❑ Amendment ❑ Special Election Report (6) Contributions This Report (7) Expenditures This Report Monetary Cash & Checks $ % (jdlj- (1 0 Expenditures $ , Loans $ , , Transfers to Office Account $ , Total Monetary $ , &;0 O0 Total Monetary $ , In-Kind $ (8) Other Distributions (9) TOTAL Monetary Contributions To Date (10) TOTAL Monetary Expenditures To Date $ ,_�, IDG'. �O $ .00 (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: LI/� /� (Type name) . ��� C^�� Z: A/V (Type name) /iCSi�gw"® L.) Z. lzl y ❑ Individual (only for IE XTreasurer ❑ Deputy Treasurer Candidate ❑ Chairperson (only for PC and PTY) .) or eleZ:: X��'�Z�(. Signature Signature DS -DE 12 (Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS CAMPAIGN TREASURER'S REPORT — ITEMIZED CONTRIBUTIONS (1) Name )J0'0PR0z'j l /'4 (2) I.D. Number (3) Cover Period D � / 0/ / 1,9 through 0 / / 30/ l ,�' (4) Page i of (5) Date (7) (8) Full Name (Last, Suffix, First, Middle) Street Address & Contributor City, State, Zip Code Type Occupation (9) Contribution Type (10) In-kind Description (11) Amendment (12) Amount (6) Sequence Number D , 2 3 , l y # 4-9;r4,9p.;C1V6 XAe SBRzwgaaa t z�Y R 3? 'r- eel) sreA6 l�%l � Ii SE�sicREs; "�L ►°D '�p , i l �'�E= / DS -DE 13 (Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES