HomeMy WebLinkAboutTreasurer Report_M12_Harrison Vaughn_1/11/2021(4)
CAMPAIGN TREASURER'S REPORT SUMMARY
Name
Address (number and street)
Z y^
City, State, Zip Code
OFFICE USE ONLY
RECEIVED
J') I i : S$
VILLAGE CLERKS OFFICE
❑ Check here if address has changed (3) ID Number:
Check appropriate box(es):
❑Zandidate Office Sought: r( -e q_ ' t ✓� �' `` �--
❑ 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 7--„ To i L / I / -z_ Report Type: Z
E�Original ❑ Amendment ❑ Special Election Report
Contributions This Report (7) Expenditures This Report
Monetary
Cash & Checks $ , Wb • -% Expenditures $ Uy . f�
Loans $ Li < Transfers to
Office Account $ ,
Total Monetary $
Total Monetary $
In -Kind $
(9) TOTAL Monetary Contributions To Date
(8) Other Distributions
$ , ,
(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
I
(TYPe-name) - ,(,. i � �
'Individual (only for IE ❑ Treasurer ❑ Deputy Treasurer
or electioneering comm.)
X�___._ _ _ _..._... .
Signature
and complete:
(Type name . 4 �,( k , , cs " —\,. Y� L, ,
[.•Candidate �,� ❑ Chairperson (only for PC and PTY)
Signature
CAMPAIGN TREASURER'S REPORT —ITEMIZED CONTRIBUTIONS
mil) Name
lSs+. K,a _ (2) I.D. Number
3) Cou Ver Period � L / l / � through (L / 31 / (4) Page __L— of 1_
(5)
Date
(9)
(10)
(11)
(12)
(7)
(8)
(6)
Full Name
Sequence
Number
(Last, Suffix, First, Middle)
Street Address &
Contributor
Contribution
In -kind
Descri tion
Amendment
Amount
Ci ,State. Zip Code
T Occupation ation
T e
&Ir"
"A-
Vj
40—
—r
2
ptA
J J
J J
J J
i
�E 13 (Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES
1) Name 4y 4111iPAI(G> y TREASURER'S REPORT - ITEMIZED EXPENDITURES
, (2) I.D. Number
(3) Cover Period JL/-(—/Ll-' through
td) Rage f
Date
(6)
Sequence
Number
I
Full Name
(last, Suffix, First, Middle)
Street Address &
City, State, ZIP Code
fee,
it 0-vi" ,
0
(8) (9) (10)
Purpose
(add office sought if
contribution to a Expenditure
candidate) Type Amendment
(11)
Amount
/ A % f3
I
i
3
3
i
DS.DE 14 (ReV. 11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES