M10 Report 11-12-2019CAMPAIGN TREASURER'S REPORT SUMMARY
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OFFICE USE ONLY
Name
Address (number and street)
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o� ay cis 'r1. -- ri
City, State, Zip Code
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❑ Check here if address has changed
(3) ID Number:'=
(4) Check appropriate box(es):
Na _n>'
Candidate Office Sought: dhannL,5Sj_Df -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 j 1 i To
Jo 1 31 Report Type:
Original ❑ Amendment ❑ Special Election Report
(6) Contributions This Report
(7) Expenditures This Report
Moneta ry
Cash & Checks $
Expenditures $ 0 a 1p
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
$ Vzs; •ate
$ 2 , LD .va
(11) Certification
It is a first degree misdemeanor for any person to falsify a public record (ss. 639.13, F.S.)
I certify that I have examined this report and it is true, correct, and complete:
(Type name) ��r—nt l� {-C� (,� r"';, q.�'
(Type name)�"�[
❑ Individual (only for IE ❑ Treasurer 1211&puty Treasurer
or electioneering comm.)
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Candidate Chairperson (only for PC and PTY)
r� k:
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X
Signature
Signature
DS -DE 12 (Rev. 11113) SEE REVERSE FOR INSTRUCTIONS
CAMPAIGN TREASURER'S REPORT - ITEMIZED EXPENDITURES
(1) Name ae--r a r fir: (2) I.D. Number
(3) Cover Periods I % I f through 1 c3 )1 (4) Page of
(5)
Date
(6)
Sequence
Number
(7) (8) (9) (10) (11J
Full Name Purpose
(Last, Suffix, First, Middle) (add office sought if
Street Address & contribution to a Expenditure
City, State, Zip Code candidate) Type Amendment Amount
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% It>b4 T fir --'jC i L'Ar.� ►�e�*�
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DS -DE 14 (Rev. 11113)
SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES