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DS-DE 12 F3-09 SeguiFLORIDA DEPARTMENT OF STATE DIVISION OF ELECTIONS CAMPAIGN TREASURER'S REPORTS X,! ~ ~ ~:. (1) ~ ~ ~ ~ OFFICE U~{~~ 3~ 2009 ~~~ ~ ° Nam'e` ///^/ ~,//' _ L J ~ Ad ress (numbe and street) ~ ~ ~~ ~ ~ ~ ~ ~c Gm, , ~ City, State, Zip Code ^ CHECK IF ADDRESS HAS CHANGED (3) ID Number: (4) Check appropriate box(es): ~- ^Candidate (office sought): ~ rD>J,{~ ~' ^ Political Committee ^ CHECK IF PC HAS DISBANDED ^ Committee of Continuous Existence ^ CHECK IF CCE HAS DISBANDED ^ Party Executive Committee ^ Electioneering Communication ^ CHECK IF NO OTHER ELECTIONEERING COMMUNICATION REPORTS WILL BE FILED (5) REPORT IDENTIFIERS Cover Period: From ~ / ~ / ~ To ~ / ~ / ~/ Report Type ~- ~' ~ p Original ^ Amendment ^ Special Election Report ^ Independent Expenditure Report (ti) CONTRIBUTIONS THIS REPORT (7) EXPENDITURES THIS REPORT Monetary Cash & Checks $ ~ Expenditures $ ~~ Loans $ ~ Transfers to Office Account $ Total Monetary $ Total Monetary $ £9~ In-Kind $ (8) Other Distributions (9) TOTAL netary Contributions To Date (10) TOT .Monetary Expenditures To Date $ 7--3 ~ $ 6~g' (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 and it is true, I certify that I have examined this report and it is true, correct, and complete. correct, and complete. ~ ~~ (Type name) ~,/r (Ty a name) ~ Individual (only f Tre r ^ Deputy Treasurer Candidate C only for PC, PTY & electioneering c un.) . ion mg mmun. organization) X X Signature Signature DS-DE 12 (Rev. 08/04) ~~ l ~- MPAI TREA URER'S REPORT -ITEMIZED EXPENDITURES (1) Name ~ ~Y (3) Cover Period ~/~/~~ through ~/~/~ (2) I.D. Number (4) Page of (5) Date (~) Full Name (8) Purpose (9) (10) (~~) (s) Sequence Number (Last, Suffix, First, Middle) Street Address & City, State, Zip Code (add office sought if contribution to a candidate) Expenditure Type Amendment Amount ~~ DS-DE 14 (Rev. 08103) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES D~,a ~ ~ 2-