Kelly- Treasurer Report- P7- 08-25-17 -vCAMPAIGN TREASURER'S REPORT SUMMARY
(1) Si 'p i �%l �`�I O1RBW9M 1E ONLY
Name M\� S�-
(2) 1�q.�-, AUG z 5 2017
Add e s (n rnber an street
,o FL 3DD2�
k�va
Office of City Clerk
City, State, Zip Code
❑ Check here if address has changed (3) ID Number:
(4) Check appropriate box(es):
Candidate Office Sought:I��'1
❑ 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 / / Report Type:
�—
Original ❑ Amendment ❑ Special Election Report
(6) Contributions This Report
(7) Expenditures This Report
Cash & Checks $ ,) . 0)
Monetary 1
Expenditures $ 1
Loans $ ,
Transfers to
Office Account $
Total Monetary $ , • �0
Total Monetary $ ,aW . –71
In-Kind $
(8) Other Distributions
$ ' Q—
(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.)
I certify that I have examined this report and it is true, correct, and complete:
(Type name) ,6 `f Ar (Type name) GkA—CA(b M iN
❑ Individual (only for IEj 4KTreasurer ❑ Deputy Treasurer Candidate ❑ Chairperson (' my for PC and PTY)
or electioneering co .)
X
Signature Signature
DS -DE 12 (Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS
CAMPAIGN TREASURER'S REPORT — ITEMIZED CONTRIBUTIONS
(1) Name C,Q VAI (2) I.D. Number
(3) Cover Period / 1� / through / �� / (4) Page of I
(5)
Date
(7)
Full Name
(Last, Suffix, First, Middle)
Street Address &
City, State, Zip Code
(8)
Contributor
Type Occu g2n
(9)
Contribution
Type
(10)
In-kind
Description
(11)
Amendment
(12)
Amount
(6)
Sequence
Number
13 .-7
All' a �g/
c0i
/�i /n
va� I
i wl, fL
e-) Q(),
MCA
DS -DE 13 (Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES
C,C�►I)(ITgK► jR,EASURER'S REPORT — ITEMIZED EXPENDITURES
(1) Name YY��c�.ii((�� 0,1 �7 (2) I.D. Number
(3) Cover Period 9/ ';I- / 11 through / / / (4) Page 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
n
�lA� �Y1C� �n�
�04
CAVI
DS -DE 14 (Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES