Kelly- Treasurer Report- P6- 08-18-17- vCAMPAIGN TREASURER'S REPORT SUMMARY
r�
(1) C OFFIgEkJLY
Name 11
(2) 1gg 1 U'
Iry 18 2017
Ad r ss ( e and s reet)�'
u�nb
A
Lynn
City, State, Zip Code Office of City Clerk
❑ Check here if address has changed (3) ID Number:
(4) Check appropriate box(es):
ftvlY _C&[X Cj Iq 61smm L'] Seo
Candidate Office Sought: jss i
❑ 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� To F / 11 � / I Report Type:
Nt6riginal ❑ Amendment ❑ Special Election Report
(6) Contributions This Report
(7) Expenditures This Report
Cash & Checks $ ()li
Monetary
Expenditures $ ,
Loans $ r
Transfers to
Office Account $ , � •
Total Monetary $ , , -7)-
Total Monetary $
'
In-Kind $ Uy
(8) Other Distributions
(9) TOTAL Monetary Contributions To Date
(10) TOTAL Monetary Expenditures To Date
$ S, .00
$ So
(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:
1
(Type name) Vek (Type name)
❑ Individual (only for IE ❑ Treasurer Deputy Treasurer Candidate ❑ Chairperson (only for PC and PTY)
or electioneering comm.)
CLVAt) i L jue6
Signature V Signature
DS -DE 12 (Rev.11113) SEE REVERSE FOR INSTRUCTIONS
(1) Name
►]
CAMPAIGN TREASURER'S REPORT - ITEMIZED CONTRIBUTIONS
Co' n Axe- Wel l (2) I.D. Number
(3) Cover Period / � / jI through � / I L / I% (4) Page l
of
(5)
Date
(7)
Full Name
(Last, Suffix, First, Middle)
Street Address &
City, State, Zip Code
(8)
Contributor
Tvpe Occupation
(9)
Contribution
T e
(10)
In-kind
Description
(11)
Amendment
(12)
Amount
(6)
Sequence
Number
l7 l
DMA(t�L-ru, A�
PoihSeWa S
I
c � F,
SkAW�
fir,1 k
Cr
C�6
� y 7
DS -DE 13 (Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES