Shelley 2021-M5 Report TREASURER'SCAMPAIGN
(1) Robert Shelley OFFICE USE ONLY
Dame ITS �/ ❑
(2) 1508 Island Blvd
RA
Address (number and street)
Office tb it Irk
Avenutra, FL 33160 RECEIVED6/0/ 01
City, Mate, Zip Code
❑ Check here if address has changed (3) ID Number: N/A
(4) Check appropriate box(es):
® Candidate Office Sought: City of Aenture - Mayor
❑ 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 05 / 01 / 021 To 05 31 / 2021 Report Type: 2021405
® Original ❑ Amendment ❑ Special Election Report
(6) Contributions This Report (7) Expenditures This Report
Monetary
Cash & Checks $ 00 . 00 Expenditures $ 00 . 0
Loans $ 50 . 00 Transfers to
Office Account $ 00 . 00
Total Monetary $ 50 . 00
Total Monetary $ 0 . 00
In-Find $ 00. 00
(8) Other Distributions
$ 0 00
(9) TOTAL Monetary Contributions To Date (10) TOTAL Monetary Expenditures To Date
$ 50 00 $ 00 00
(11) Certification
It is a first degree misdemeanor for any person to falsify a public record (ss.839.1 , F.S.)
I certify that I have examined this report and it is true, correct, and complete:
(Type name) Di v AIe (Type name) Robert Shelley
❑ Individual(only for I ✓ Treas er ElDeputy Treasurer E] Candidate ElChairperson(only for PC and PTY)
or electioneering com
4
Signature Signature
DS-DE 12 1/13) SEE REVERSE FOR INSTRUCTIONS
CAMPAIGN T T — ITE ICONTRIBUTIONS
(1) Name ROBERT SHELLEY (2) I.D. Number N/A
(3) Cover Feriae! 05 / 01 / 2021 through 05 / 31 / 2021 (4) Page 1 of 1
(5) (7) (8) (9) (10) (11) (12)
Date Full Name
(6) (Last, Suffix, First, Middle)
Sequence Street Address & Contributor Contribution In-kind
Number Cit , State,Zip Code Type Occupation Type Description Amendment Amount
05/20/2021
Robert Shelley
1508 Island Blvd S Candidate LOA 50.00
1 ventura, FL 33160
2
3
4
5
6
7
DS-DE 13(Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES
CAMPAIGN T T - ITEMIZED IT
(1) Name ROBERT SHELLEY (2) I.D.Number /
( ) Cover Period 05 / 01 / 201 through 05 ( 1 ! 2021 (4) Page 1 of 1
(5) (7) (8) (9) (1 0) (1 1)
Date Full Name Purpose
(5) (Last,Suffix, First,Middle) (add office sought if
Sequence Street Address contribution to a Expenditure
Number City,State, Zip Code candidate) Type Amendment Amount
1
! I
2
3
4
5
6
1
7
8
DS-DE 14(Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES