HomeMy WebLinkAboutTreasurer Report_TR_Basil Dalack_3/12/2018 CAMPAIGN TREASURER'S REPORT SUMMARY
(1) i OFFICE USE ONLY
N me RECEIVED
(2) D� MAR 12
dd ess umb r d stree 2018
VILLAGE CLERKS OFFICE
tor'Kie, ip Code
❑ Check here if address has changed (3) ID Number:
(4) Ch k appropriate box(es):
Candidate Office Sought: F
❑ Political Committee(PC) �-
❑ Electioneering Communications Org. (ECO) ❑ C�ec�ere rC r EC6 h s 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 � / � / � To � / � / ) � Report Type:J �i
Original ❑Amendment ❑ Special Election Report ���--=== ►-��
(6) Contributions This Report (7) Expenditures This Rep rt
Monetary
Cash & Checks $ Expenditures $
Loans $ Transfers to
Office Account $ ,
Total Monetary $
,
Total Monetary $ .
In-Kind $ .
(8) Other Distributi
$ , ,
(9) TOTAL Moneta i tions To Date (10) TOTAL Monet xp nditures To Date
$ $ ,
(11) Certification
It is a first degree misdemeanor for any person to falsify a public record (ss.839.13, F.S.)
I ceilihdhat I /�examined th� p and it is true, correct, le�(Ty n // T_. ;Sp;7,
❑Individual(only for IE Treasurer ❑Deputy Treasurer Candidate ❑Chairperso (only for PC and PTY)
or electioneering comm.)
hz � j r
X X
Xa'('<D
Signature Signature
DS-DE 12(Rev.11113) SEE REVERSE FOR INSTRUCTIONS
CAMPAIGN TREASURER'S REPORT— ITEMIZED CONTRIBUTIONS
(1) Name 2jt :7 (2) I.D. Number
(3) Cover Period / / through 3 / - / 'At (4) Page of
(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 I Type Description I Amendment I Amount
RE EIV D
MA 12 201
I I
I I
� I
DS-DE 13(Rev.11113) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES
P I� TRFURE ET�T - M D EXPENDITURES
(1) Name / (2)I.D. Number
(3)Cover Period Z 7—/ "' / throw h / / /
--�= 9 ' �� (4) Page�—of
(5) (7) (8) (9) (10) (11)
Date Full Name Purpose
(6) (Last,Suffix,First,Middle) (add office sought if
Sequence Street Address& contribution to a Expenditure
Number City,State,Zip Code candidate) Type Amendment Amount
RECEIV ED
R12218
VILLA E CLERKS OFFICE
DS-DE 14(Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES
