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Campaign Treasurer's Report M8
CAMPAIGN TREASURER'S REPORT SUMMARY (1) TSln v( 5:ike e v c1.01- - • lEbelEsg*E1-, Name [1.2) (2) Z l SF_ Lcvi PGt vLT2 cl SEP - 4 2015 Address (number and street) � Cc c'v-c ,- Zq,ZLA-a- 61 , / State, Zip Code /. ❑ Check here if address has changed (3) ID Number: (4) Check appropriate box(es): []Candidate Office Sought: C i ¢y 6.-o V t? C r El Political Committee(PC) El Electioneering Communications Org. (ECO) El Check here if PC or ECO has disbanded El Party Executive Committee(PTY) ❑ Check here if PTY has disbanded ❑ Independent Expenditure(IE)(also covers an 0 Check here if no other IE or EC reports will be filed individual making electioneering communications) (5) Report Identifiers Cover Period: From 6 I L l j r To 6 / 31 / j S Report Type: Alt8 Original El Amendment ❑ Special Election Report (6) Contributions This Report (7) Expenditures This Report Monetary Cash & Checks $W ,CO OC) •40O Expenditures $06.) , D U , 3 . O Loans $) 00 , 7/ • 00 Transfers to Office Account $ QD ,OO ,©O . O 0 Total Monetary $00 ,OU , t/ .00 Total Monetary $ )O , Z ,31 . U O In-Kind $C0 , d0 1.00 • CO (8) Other Distributions $ O ) , C0 , oC . Oa (9) TOTAL Monetary Contributions To Date (10) TOTAL Monetary Expenditures To Date $ 00 ,o , 06 $o() , OCA , 3? . a0 (11) Certification It is a first degree misdemeanor for any person to falsify a public record (ss.839.13, F.S.) 1 certify that I have examined this report and it is true,correct, and complete: (Type name) - O S\Q 0.�ulr p t'-VI c (kr (Type name) 1-6 c›Vi u (A v' p r-e celQ ❑Individual(only for IE V(Treasurer 0 Deputy Treasurer KCandidate 0 Chairperson(on y for PC and PTY) or electio eering comm.) X X \ mfr. L. glirft Signat Sign- DS-DE 12( -v.11/13) SEE REVERSE FOR INSTRUCTIONS CAMPAIGN TREASURER'S REPORT- ITEMIZED EXPENDITURES (1) Name Joshua Surprenant (2)I.D. Number (3)Cover Period 8 / 24 / 15 through 8 / 31 / 15 (4) Page 1 of 1 (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 Surprenant, Joshua A Check to City Hall 8 /25 /( 15 218 E Long Point RD for running for Cape Canaveral, FL City Council CAN $39.00 32920 001 / / / / / / / / / / / / / / DS-DE 14(Rev.11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES CAMPAIGN TREASURER'S REPORT— ITEMIZED CONTRIBUTIONS Joshua Surprenant (1) Name (2) I.D. Number 8 24 15 8 31 15 1 1 (3) Cover Period / / through / / (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 Type Description Amendment Amount Surprenant, Joshua A 8 24 15 218 E Long Point RD / / Cape Canaveral, FL 001 32920 I Designer LOA Money to run $91.00 Surprenant, Brenda, A 828 15 218 E Long Point RD / / Cape Canaveral, FL 2 32920 I Designer INK Logo design $100.00 / / / / / / / / / / DS-DE 13(Rev.11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES