Kelly- Treasurer Report- P1-6-30-17CAMPAIGN TREASURER'S REPORT SUMMARY
(1) cm U_ VUAI 0191tR!&Iyll1111 ONLY
Name1 �"
(z) \I-A'A ,QfP J` JUN 3 0 2011
Address (numb and treet
_3aa�
Ii iL e
office of City clads
City, State, Zip Code
❑ Check here if address has changed (3) ID Number:
(4) Check appropriate box(es): �' n /` n
4
;Candidate Office Sought: JAI 4,11C &A Ch �-I�( (hrD%' 1V1 y
❑ 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 HE or EC reports will be filed
individual making electioneering communications)
(5) Report Identifiers
Cover Period: From / / �� To / -)3 / 1__L Report Type:
Original ❑ Amendment ❑ Special Election Report
(6) Contributions This Report
(7) Expenditures This Report
Cash &Checks $
Monetary
Expenditures $ , 2 .
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 pate
$
$1
It 1) Certification
It is a first degree misdemeanor for any person to falsify a public record (ss. 839.13, F.S.)
I certify that II have examined this report and it is true, correct, and complete:
1 p / 1y�'1
L Kll'
(Type name)V/1(\(`Aca Yw� name) Arj (e
���(TTTType
❑ Individual (only far IE ❑ Treasurer Deputy Treasurer pl Candidate ❑ Chairperson (only br PC and PTY)
or electioneenngt(co�m�m.))/�� r`
r 1� Q �/�/�
X CCW!k X 1��1UAL:\
Signature Signature
DS -DE 12 (Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS
CAMPAIGN TREASURER'S REPORT — ITEMIZED CONTRIBUTIONS
(1) Name CONVAU e4 (2) I.D. Number f
(3) Cover Period � / I / 1 / through � / / )-? (4) Page 1 of
(5)
Date
(T)
Full Name
(Last, Suffix, First, Middle)
Street Address 8
Citv, Stale, Zip
(6)
Contributor
T e Occupation
(9)
Contribution
Type
(10)
In-kind
Description
(11)
Amendment
(12)
Amount
(6)
Sequence
Number
lV I .� ,
,C\od-e
t�C�n ri R�4+ r{�
1
10 ��
Lina klo l�
(4QI�n1
54C� 5
C6
a%
0 ,1� ,A�
- ane
�n'a1-31/33
(�ti1)
W%
DS43E 13 (Rev. 11113) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES
A PAIG T'Izr URER'S REPORT - ITEMIZED EXPENDITURES
(1) Name ��C//�,,, .LSI. rimy %� )2) I.D. Number
(3) Cover Period IL / l / n through "' /'21 / 17 (4) Page of I
(5)
Date
(T)
Full Name
(Last, Suffix, First, Middle)
Street Address 8
City, State, Zip Code
(8)
Purpose
(add office sought if
contribution to a
candidate)
(8)
Expenditure
T e
YP
(1g)
Amendment
(11)
Amount
(8)
Sequence
Number
a
CSI o
36
CPN
OIni
KA ern
OZ
DS -DE 14 (Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES