DS-DE 12 Jorczak TR CAMPAIGN TREASURER'S REPORT SUMMARY s�.
(1) \j(-)S� k Jarc-cas OFFICE_U,SE ONLY
Name 2M FEB - PA 114
. 1
Address (number and street)
,7 r/k i Ittac.k. (1 - -137
City, State, Zip Code
❑ Check here if address has changed (3) ID Number:
(4) Check appropriate box(es): ��
12/Candidate Office Sought: C 71 67 Orir'17-5.510/1 rou p V
❑ 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 3 / 19 I IS" To i1 I O / JS Report Type: 1
5-Original ❑Amendment ❑Special Election Report
(6) Contributions This Report (7) Expenditures This Report
Monetary
Cash &Checks $ , _„.. 11.1,4r:fKer Expenditures $ , , _ II 0
Loans $ , , • Transfers to
Office Account $ , , •
Total Monetary $ , ,'Y .:41,--cl
Total Monetary $ i 40 0
In-Kind $ , , •
(8) Other Distributions
$ ,
-- -
(9) TOTAL Monetary Contributions To Date (10) TOTAL Monetary Expenditures To Date
$ , , __ . G $ , 5-4 6 . ue1_
(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 a , it is true,correct,and complete: /
T e name) �,,1! / ' (Type name) ° /I
( YP ) / / (TYp ) i e , -----
❑Individual(only fo [( Treasure- ❑Deputy Treasurer [Candidate / ❑Chairpe "on(o ly for PC and PTY)
or electioneering comm.)
X X �, / � ' ) .
Signature / Signatu /1
DS-DE 12(Rev.11/13) SEE REVERSE FOR INSTRUCTIONS
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CAMPAIGN TREASURER'S REPORT- ITEMIZED EXPENDITURES
(1)Name �J e2S �- i 1 o s 1-z-L( (2) I.D. Number
(3)Cover Period 09 / I l 6 through I? /JO / 1 S (4)Page / of J
(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
11 l(j 1 0 FOI 4.e Gc\ f o vh )) th&uc\ 36'i-
14a6 Ore.xd �b4\ y 5oO
e2./-vt-fro If\ _5
IM‘.r, 5e;�h, -(1 333311
6ti4k 4)/Nw“C �
1/ 1/ 11S /9 i1J /II ion 'a fn U r\ 5_‘,60
.„2 r.„„r,, ,-,,,i...
F� 33131 glen V -lee
1 l
l 1
1 /
1 l
/ 1
1 1
DS-DE 14(Rev.11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES
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