HomeMy WebLinkAboutElections 021021 - Recall Exploratory Committee Campaing Treasurer Report Summary (50) 2021 M1 AmendmentCAMPAIGN TREASURER'S REPORT SUMMARY
(1) �"&IZARAMX N� • .
OFFICE USE ONLY
Name �p
(2) }J 6Eaafi
Z
•
02-10-21 P03:48 RC`
Address (rnumMaid id dreet)
City, State, Zip Code
❑ Check here if address has changed
(3) ID Number:
(4) Check appropriate box(es):
❑ Candidate Office Sought
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)
(6) Report Identifiers
Cover Period: From I i I „� To
_ I 31 1 .1 / Report Type:
❑ Original F1 Amendment ❑ Special Election Report
(6) Contributions This Report
(7) Expenditures This Report
Monetary
Cash & Checks $ , 0 .
Expenditures $
Loans $ 3 0
Transfers to
Office Account $ , D .
Total Monetary $ � -
Total Monetary $ Q -
In -Kind $ 0 -
(8) Other Distributions
$ 0.
(9) TOTAL Monetary Contributign9To Date
(10) TOTAL Monetary Expenditu o Pate
// ,
$ i ti
$
ij I I
(11) Certification
It Is a first degree misdemeanor for any person to falsify a public record (as. 839.13, F.&)
I certify that I have examined this reportwd`ft is tnm. correct, and complete:
(Type �) A0 rTA �-. ul�i ..rl1L-
(Type name) �� / () (JE � i OEP S (F/ A)
❑ Indlvldwl (only br E CIrTn owAw a DWW Tm emw
❑ Candid J4,Chakpm. (only for PC and PT1)
or COMM.)
X �?� k.��
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x
,
Signature
Signature
DS-M 12 (Rev. 11113) SEE REVERSE FOR INSTRUCTIONS
02-10-21 P03:48 RCVD
CAMPAIGN TREASURER'S REPORT --- ITEMIZED CONTRIBUTIONS
(1) Name RecAll C QlU !� A�$,�.Mt r E (2) I.D. Number
(3) Cover Period [ 1 �/ 1 through / IL 1 -2,1 (4) Page Of
(5)
Date
(7)
Full Name
(Lest, Suffix, First, Middle)
Street address &
Citv, State, Zip Code
(8)
Contributor
Type Occupation
(9)
Contribution
T
(10)
ln4dnd
Description
(11)
AmendmeM
(72)
Amount
(6)
Sequence
Number
I !
D"E 13 (Rev.11113) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES
02- )-21 P03:48 RCVD
CAMPAIGN TREASURER'SKEPOR ITEMIZED EXPENDITURES
(1) Name Z f {2} I.D. Number
(3) Cover Period "L1_ _ 1/JI through / I (4) Page ,,. , Of-
(5)
Date
(n
Full Name
(Last, Suffix, First, Middle)
Street Address &
City, Stabs, Zip Code
(8)
Purpose
(add office sought If
contribution to a
candidate)
(9)
Expenditure
Type
(10)
Amendment
(17)
Amount
(6)
Sequence
Number
0.5-0E 14 (Rev. 08/03)
SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES