DS-DE 12 Q1-09 Redfern~^
FLORIDA DEPA TMENT OF STATE DIVISION OF ELECTIONS ~ ' "
CAMPAIG TREASURER'S REPORT SUMMA
(1) ~~/ OFFICE USE ONLY
Add (rtium and~treet) 0/1 ~.3J1 ~
City, State, Zip Code
^ CHECK fF ADDRESS HAS CH NGED (3) ID Number:
(4) kappropriatebox(es): L~ /3 /:~rn~,~~
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Candidate (office sought): i
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Political Committee ^ CHECK IF PC HAS DISBANDED
^ Committee of Continuous Exi ence ^ CHECK IF CCE HAS DISBANDED
^ Party Executive Committee
^ Electioneering CommuniCati ^ CHECK IF NO OTHER ELECTIONEERING
COMMUNICATION REPORTS WILL BE FILED
Cover Period: From Q~ l Q (5) REPORT IDENTIF2IERS 1111
l Og To ~ /:/~ 1 v 9 Report Type ~ Q Za~
rigina! ^ Amendment Speaal Election Report ^ Independent Expenditure Report
(6) CONTRIBUTIONS THIS REPO T (~) EXPENDITURES THIS REPORT
D fl Monetary
Cash & Checks $ Expenditures $
Loans $ Transfers to Office
Account $
Total Monetary $ Total
Monetary $
In-Kind ~
(8) Other Distributions .
(9) TOTAL Monetary Con on To Date (10) TOTAL Monetary Expenditures To Date
(11) CERTIFICATION
b is a first ree misdem nor for an person to falsify a public record (ss. 839.13, F.S.)
I certify that I have examined this re and it is true, 1 certify that I have examined this report and it is true,
correct, and complete.
Type name ~ ~~~
~" correct, and co~mpjlete. ~ ~ ,_. ~
( ~~~I~I
^{ndividual (Dory for Treasurer Deputy Treasurer Candidat ^ Chairperson (Dory for PC, PTY &
electioneering com n.) electioneering commun. organization)
X X
Signature Signa e
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CAMPAIGN TREASURER'S REPORT -ITEMIZED CONTRIBUTIONS
(1) Name ~~lG~~ ~~~~~~"~
(2) f.D. Number
(3) Cover Period ~ / 0' / ~ 7 through 07 / ~ 1 / Q~
4
p
(
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age of
(5)
Date Full(Name (8) (9) (10) (~~) (f2)
(s) (Last, Suffix, First, Middle)
Sequence Street Address &
Number Ci ,State Zi Code
Contributor
T e Occu ati
Contribution
In-kind
) _ ^ ,+~ ['t' ~~
. / Af~7G,1 d~ [T o T e Descri tion Amendment
Amount
iqZ ~ 12
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76
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DS-DE 13 (Rev. 08/03) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES
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