Kelly - DSDE 12, 13 - Treasurers Report - 2022-G3 - 11-04-22CAMPAIGN TREASURER'S REPORT SUMMARY
CO CON aca. L14Q OFFICE USE ONLY
Name
2) 0- - >; IUGA Dr RECEIVED 4
t "
Add ess (number and street NOV J 4 ion
6-V It ,kt-c GAaCh 33:3
City, State, Zip Code
Check here if address has changed 3) ID Number:
4) Check appropriate box(es):
Q
andidate Office Sought: 1t1U1i rki L atn I (-5 1 d i er -ic•- g
Political Committee (PC)
Electioneering Communications Org. (ECO)El 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 r U / ,)\.) / , To 1— / > / Report Type: .
El Original Amendment Special Election Report
6) Contributions This Report 7) Expenditures This Report
Monetary
Cash & Checks $ SO • 03 Expenditures $ J ,
Loans 0 , Transfers to
Office Account $ J
Total Monetary
e,
c 6 • OJ
n,
Total Monetary $
In-Kind N ,
8) Other Distributions
1 ,
9) TOTAL Monetary Contributions To Date 10) TOTAL Monetary Expenditures To Date
3 , 00 . er) 3 , 13‘--H . (i
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
rtrt
and it is true, correct, and complete:/
j,A (!t4II1ITypename) C a IN 1 1) Type name) CVI A(Q
Individual(only for IE ligreasurer 0 Deputy Treasurer p;Candidate Chairperson(only for PC and PTY)
or electioneering comm.)
X CL ` x C,L
Signature Signature
DS-DE 12(Rev. 11/13)SEE REVERSE FOR INSTRUCTIONS
CAMPAIGN TREASURER'S REPORT - ITEMIZED CONTRIBUTIONS
1) Name qn Q e_eV ily 2) I.D. Number
3) Cover Period Ib / al / as through \\ / 1J / 2 (4) Page 1 of 1
5) 7) 8) 9) 10) 11) 12)
Date Full Name
6) Last, Suffix, First, Middle)
Sequence Street Address& Contributor Contribution In-kind
Number City, State,Zip Code Type Occupation Type Description Amendment. Amount
sink G16N
C O 1 ff- --3-aa3')
DS-DE 13(Rev.11113) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES