Mezrahi 2020 M5 Report & AmendmentCAMP GN TREASURER'S REPORT SUMMARy
F
OFFICE ONLY
Nam
_ G
Addres (number and street)
City, State, Zip Code
El Check here if address has change () i® Number:
() Check appropriate box(es): —
Candidate Office Sought: p
® Political Committee (PC)
® Electioneering Communications Org. (EGO) 0 Check here if PC or ECC has disbanded
0 Warty Executive Committee (PTY) 0 Check here if PTY has disbanded
® independent Expenditure (lE) (also covers an Check here if no otter lE or EC reports will be filed
individual making electioneering communications)
() Report Identifiers
Cover Period: From f f To f f Deport Type:
�(Original El Amendment ❑ Special Election Deport
(6) Contributions This rt () Expenditures This Report
00 Monetary
Cash & Checks x Expenditures $ p
Loans x Transfers to
Office Account Total Monetary x
Total Monetary
p ,
In -Kind x
) Other Distributions
p p °
() TOTAL ore Contributions To Date (1) TOTAL M` neExpendituresTo ate
(11) Certification
It is a first degree misdemeanor for any person to falsify a public record (ss° 839.13, F°S.)
i cerffy that i have 'ilned this rep and it is true, conect, andcomplete:
(Type nalrr (Type name)
0 Wividu i (®n for usurer 0 De" Treasurer Carndidatfe Chairperson (only for PC and Fai1'j
or election An MM
Sign Signatur
DS -1jR,,. 111 ) V SEE REVERSE FOR INSTRUCTIONS
a
Name I.D.0 r
Date
(7)
FuI( Marne
(Last, Suffix, First, Middle)
(8)
(9)
(10)
(11)
(12)
(6)
Sequence
Number
Street Address &
City, State, Zip Code
Contributor
Type Occupation
Contribution
Tvpe
In -kind
Description
,amendment
Amount
4
r�
APO z
e r
r r
f(Rev. REVERSESEE FOR INSTRUCTIONS AND CODE;i;
CAM
i� t roia F� .�' 1 T REPORT ITEMIZED
() Cover Period 1 f through
% {
Page of
Date Full Hams Purpose
() (Last, Suffix, First,Middle) (add office sought i
Sequence Street Address & contribution to s Expenditure
Number City, State, Zip Cade candidate) Type Amendment Amount
1�
DS-D 14 (Rev- 1111 ) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES
CAMPAIGN TREASURER'S REPORT SUMMARY
_j
Name
(2) c,21150 e 2 0 4
Address (number and street)
City, State, Zip Cody'
El Check here if address has changed (3) ID Number-
(4) Check appropriate box(es)-.
I'candidateOffice Sought: Cjr-/
0 Political Committee (PC) I
EJ Electioneering Communications Org. (ECO) D Check here if PC or ECO has disbanded
M Party Executive Committee (PTY) El Check here if PTY has disbanded
[I Independent Expenditure (JE) (also covers an Check here if no other IE or EC reports will be flied
individual making electioneering communications)
(5) Report Identifiers
Cover Period: From 051 % TO -,'I? Report Type: V
El 0 , riginal R;Zendment El Special Election Report
(6) Contributions This Report (7) Expenditures This Report
Monetary
Cash & Checks $ Expenditures $
Loans $ Transfers to
Total Monetary $ Office Account $
Total Monetary $
In -Kind $
(8) Other Distributions
$ — I I
(9) TOTAL Monetary Contributions To Date (10) - TOTALi-Monetary Exp ndPres To Date
,
$ $
0 1) Certification
It is a first degree misdemeanor for any person to falsify a public record (ss. 839.13,
I certify that I have examined this report and it is true, correct, and complete:
(Type name) 61�1,11 L 41 Z 44 //1 W,,� 44-1717 (Type n e)
El Individual (only fo 2treasurer 0 Deputy Treasurer and�idate Chairparson (only for P(;,ar4 PTY)
or electioneering cov.� 11_� — I I
X � 0"o
n�a_t u ree A
-fqWj ri Icy
D
WV I jW1140