DS-DE 12 Jorczak 2015-M06 sty (k loZpis
CAMPAIGN TREASURER'S REPORT SUMMARY
(1)
JJIA �YG Z�c OFFICE USE ONLY
(2) Name 3 ine,d,-.7 40i 312
Address (number and street)
Mahar )?44/t/ f- L 33/p
City, State, Zip Code
❑ Check here if address has changed (3) ID Number:
(4) Check appropriate box(es): ��
Candidate Office Sought: J721/(4/11 Yh if'
f"®ll
❑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 2J15--
Cover Period: From O6 I 0/ I /5 To 106 / ld l /c Report Type: inO6
'Original ❑Amendment ❑Special Election Report
(6) Contributions This Report (7) Expenditures This Report
Monetary
Cash &Checks $ , 2t' T Do Expenditures $ , , �� .
Loans $ - Transfers to
Office Account $ ,
Total Monetary $ 7 , 26s • 00
Total Monetary $ 260 .
In-Kind $
(8) Other Distributions
(9) TOTAL Monetary Contributions To Date (10) TOTAL Monetary Expenditures To Date
$ , '5 3- 0 0 0
(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:
4/ A (Type name) ;S CC-7:-/-C Zak
(Type name � �Q"7'�ZGt T� ( YP )
❑Individual(only for IE M-Treasurer ❑Deputy Treasurer A-Candidate ❑Chairperson(only for PC and PTY)
or electioneering comm.)
X X 4 •
? ?/(3(tk-
Signat Signature
DS-DE 12(Rev. 11!13) SEE REVERSE FOR INSTRUCTIONS
0 C-
11 Z
CAMPAIGN TREASURER'S REPORT-ITEMIZED CONTRIBUTIONS
le J17 ( a L
(1) Name � (2) I.D. Number
(3)Cover Period __ / 0/ / /5 through 0( / 70 / /C (4) Page - of 2
(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
/5 oifellb, aid
270 Ad., Ad 5"1/2"76141'CO' :15
FL filicd
I
/ 113O /s E1 911 w' t/ X51" 2793 15-a'
2 -gem r,} 11 f1 ---
320?3
�0
15 Petdain LPtth
1035 1,./,401- �o e4 e 3313?
/6 , go / 1r CluA
m 4ve I & lr 0-4
if 1ThB, fL Y313?
ôt 3o is (7' dp,)"1.
ge& -7- 6)1
It J3/G‘ 2,0
1 3b i
fOrgr° LOU;1
O
5-24$ Ally 201 (5°'- ��h 46 t (1, 12°
m,--44,"c/ t_--/ /
DS-DE 13(Rev. 11113) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES
CAMIcN TFR�ASURR'S REPORT- ITEMIZED EXPENDITURES
(1) Name U�r9 C./ ''G 644 (2)I.D.Number
(3) Cover Period 1, 0/ / `5 through Oi/ � / 75 (4)Page 2- of 2
(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
ii S
/l / 3-2 - w 3` Jr)- 54200
, ,
—1— C Lg 2oo
1 in,-744-).; 5 tv k �1/u WO.p -6
/ /
/ / .
/ /
/ /
/ /
/ /
/ /
DS-DE 14(Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES
--F _C2— 3 0x3