Hall- Treasurer Report- P7- 08-25-17-v^I ^ CAMPAIQN TREASURER'S REPORT SUMMARY
(1) Oftwelued ONLY
Nam
(2) g AUG 252017
ddre s (numbe and tr )
City, State, Zip Code Office of City Clerk
❑ Check here if address has changed (3) ID Number:
(4) Che appropriate box(es): �
504.
Candidate Office Sought: V
❑ 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 I7dfifiers;
Co7r Period: From / �/ G To/ *"Z4 / �� Report Type:
0rriginal ❑ Amendment ❑ Special Election Report
(6) Contributions This Report
(7) Expenditures This Report
Cash & Checks $
Monetary
Expenditures $ ,
Loans $
Transfers to
Office Account $
Total Monetary $ f�
Total Monetary $
In -Kind $�
(8) Other Distributions
$ ,
(9) TOTAL Monetary Contribu,ti.ons 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 thatI have examined thisreport and it is true, correct, and complete:
5
(Type L l� (Type n � v `� 1 l��Z•--
❑ Individual (only for IE ur r ❑ Deputy Treasurer andidate ❑ Chairperso only for PC and PTY)
or electioneering comm.)
Signature Signature
D5 -DE 12 (Rev. 11113) SEE REVERSE FOR INSTRUCTIONS
A A CAMPA113N TREASURER'S REPORT —ITEMIZED EXPENDITURES
(1) Name_ TW
(3) Cover Period j /�/ / through (8 12q
(2) I.D. Number
(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
0123117
.LM l L,cw s�
OrtNNO "rF���-,tel
�7tA + lC &WY FL
F-7 a0j
DS -DE 14 (Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES
CAMPAIGN TREASURER'S REPORT - ITEMIZED CONTRIBUTIONS
(1) NameL��� �" [+ I (tet/ (2) I.D. Number
(3) Cover Period _a / / through / z"[ / _L7 (4) Page 1 of
(5)
Date
(7)
Full Name
(Last, Suffix, First, Middle)
Street Address &
City, State, Zip Code
(8)
Contributor
Type Occupation
(9)
Contribution
Type
(10)
In-kind
Description
(11)
Amendment
(12)
Amount
(6)
Sequence
Number
221 7
dD 1
,FIemw sav A'
MR -S W111(A-*,-
v00C'o.
DS -DE 13 (Rev. 11113) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES