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Hill-Treasurers Report- P6- 8-16-17 -vCAMPAIGN TREASURER'S REPORT SUMMARY (1) James K Hill ONOWW ONLY Name (2) 372 7th Street �...' 1 6 2017 Address (number and street) Atlantic Beach FL 32233 Office of City Clerk City, State, Zip Code ❑ Check here if address has changed (3) ID Number: N/A (4) Check appropriate box(es): Atlantic Beach FL Commissioner Seat 4 . 0 Candidate Office sought: ❑ 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 08 / 05 / 17 To 08 / 11 / 17 Report Type: 2017-P6 0 Original ❑ Amendment ❑ Special Election Report (6) Contributions This Report (7) Expenditures This Report Monetary Cash &Checks $ 1 200 00 Expenditures $ 0 0 0 00 Loans $ 0 0 0 00 Transfers to Office Account $ 0 0 0 00 Total Monetary $ 200 00 Total Monetary $ 0 0 0 00 0 0 0 00 In-Kind $ (8) Other Distributions $ 000 000 000 00 (9) TOTAL Monetary Contributions To Date (10) TOTAL Monetary Expenditures To Date $ 1 710. 00 $ 554 12 (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: Delia Hill James K Hill (Type name) (Type name) ❑ Individual (only for IE ❑ Treasurer ® Deputy Treasurer ® Candidate rperson (only for PC and PTY) or electioneering comm.) X X Signatu nature DS -DE 12 (Rev. 11113) SEE REVERSE FOR INSTRUCTIONS CAMPAIGN TREASURER'S REPORT — ITEMIZED CONTRIBUTIONS (1) Name James K. Hill (2) I.D. Number (3) Cover Period 08 105 1 17 --through 08 / 11 17 (4) Page 1 of 1 (5) Date (7) Full Name (Last, Suffix, First, Middle) Street Address & City, State, Zip Code (8) Contributor Type Occupation (9) Contribution I Type (10) In-kind Description (11) Amendment (12) Amount (6) Sequence Number 08, 11 117 Don Ford, DB a Don C Ford Insp Service, 338 6th Atl Bch 32233 B ction St, C H E N $200.00 2017-P6 - 1 DS -DE 13 (Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES