Lagner - DSDE 12, 14 - Treasurers Report - G-TR - Amendment - 2-15-23 CAMPAIGN TREASURER'S REPORT SUMMARY
(1) Jennifer D. Lagner OFFICE USE ONLY
Name RECEIVED 4
(2) 278 Seminole Road ,
Address(number and street) FEB 1 5 1013
Atlantic Beach, FL 32233
City, State, Zip Code
❑Check here if address has changed (3) ID Number: N/A
(4) Check appropriate box(es):
❑Candidate Office Sought: Atlantic Beach Commission Seat 4
❑Political Committee(PC)
❑Electioneering Communications Org.(ECO) 0 Check here if PC or ECO has disbanded
❑Party Executive Committee(PTY) 0 Check here if PTY has disbanded
❑Independent Expenditure(IE)(also covers an 0 Check here if no other IE or EC reports will be filed
individual making electioneering communications)
(5) Report Identifiers
Cover Period: From 11 / 04 / 22 To / / Report Type: G-TR
0 Original 0 Amendment 0 Special Election Report
(6) Contributions This Report (7) Expenditures This Report
Monetary
Cash&Checks $ 00 Expenditures $ , 6 2_94 .-1 I
Loans $ • 02 Transfers to
Office Account $ , , .
Total Monetary $ -b b
Total Monetary $ , C II l� , 21-4-1"1 I
In-Kind $ /, 00
(8) Other Distributions
$ .
(9) TOTAL Monetary Contr ions To Date (10) TOTAL Mone ry Expenditures To Date
$ , ICS . b0 $ , l0 ,19(1. . CU
(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)Jennifer D. Lagner (Type name)Jennifer D. Lagner
❑Individual .n, for IE El Treasurer 0 Deputy Treasurer 0 Candidat, 0 Chairperson(only for PC and PTY)
or electi. =rin•comm.)/
X 4* Al X '_1
Signatu - 7 Signat e
DS-DE 12 - v.11/13) EE REVERSE FOR INSTRUCTIONS
CAMPAIGN TREASURER'S REPORT—ITEMIZED EXPENDITURES N/A
(1)Name Jennifer D. Lagner (2)I.D. Number
(3)Cover Period 11 104 12022 through / / (4)Page 1 of 1
(5) (7) (8) (9) (10) (11) --- —
Date Full Name Purpose
(s) (Last,Suffix,First,Middle) (add office sought if
Sequence Street Address& contribution to a Expenditure
Number City,State,Zip Code candidate) Type Amendment Amount
11/21/22 WIX original
website fee MON missing $6.00
5 7095 Hollywood Blvd seq #
Los Angeles, CA
12/07/22 Connecting Thru Music original
1917 Beach Ave donation 501c3 DIS missing $908.76
6 AB, FL 32233 seq#
12 /7 /22 Beaches Veteran Memorial original
P.O. Box 330515 donation 501c3 DIS missing $908.77
7 Atlantic Beach, FL 32233 seq #
11/07/
1 07 22 Jennifer Lagner $3,000.00
/ 278 Seminole Road Loan Reimburse RMB DEL
2 Atlantic Beach, FL 32233
11/ 7/ 22 Jennifer Lagner Loan Reimburse DIS ADD
278 Seminole Road $3,000.00
8 Atlantic Beach, FL 32233
1
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DS-DE 14(Rev.11113) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES