DS-DE 12 Q4-10 Bower j
FLORIDA DEPARTMENT OF STATE DIVISION OF ELECTION , S
CAMPAIGN TREASURER'S REPORT S(�l l ! c D
(1) Ian 11\-=-- L t tr OFFICE USE ONLY
Name
1011 JAN I 0 PM 3:
( 1'(' IJ -kie CITY CLERK'S OFF ICE
Ad (number � - 32 1
M, 1
City, State, Zip Code
❑ CHECK IF ADDRESS HAS CHANGED (3) ID Number.
(4) Check appropriate box(es):
[Candidate (office sought): 4d0C— off' \\A t l .&A Ci-k
❑ 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 lc) / 01 / i D To 1 Z / 3' / 1C). Report Type (0i_ ( p
A Original ❑ Amendment ❑ Special Election Report ❑ Independent Expenditure Report
(6) CONTRIBUTIONS THIS REPORT (7) EXPENDITURES THIS REPORT
Monetary
Cash & Checks $ 1 l 00 p Expenditures $
Loans . $ Transfers to Office
Account $ .
Total Monetary $ i� C-b0 Total
Monetary $
In -Kind $
(8) Other Distributions 0
$
(9) TOTAL Monetary Contributions To Date (10) TOTAL Monetary nditures To Date
$ I Cxo $
(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 h > examined this report and it is true, I certify that 1 have examined this report and it is true,
correct, and co • I = . p correct, and con`' • I .
(Type ;yam Ak' ` IL -_1 ' - O (T yne name . ` 1 KeZAs e-
❑ 1 • N 1 .. ►� Treasurer [3 Deputy Treasurer 6d candidate • Chairperson (.. tpr PC PTY &
steal _ l k t ,.1 4 : ) ., )
X M ` J • ► i `■TV I �, 1—*; I .ii. , ' i . A- l I
Signatu - AV Sign - -
, Irr ,
DS -DE 12 (Rev. i . ' )
PolfX / Eri 0 1
I
•
CAMPAIGN TREASURER'S REPORT - ITEMIZED CONTRIBUTIONS
(1) Name t i (2) I.D. Number
(3) Cover Period 10 / / 1 through \7, / / (0 (4) Page of 1
( ( (8) ( ( (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
� 13 / f1� S , SIaI -p(L_. (� a .� .
15cOO
oa r 203
Mme, 6a.k fit t\
Su>1, SR-
12! (¶ ! 10 r G -a,� D� I 4iP.rcE Soo l c
So3
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DS-DE 13 (Rev. 08103) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES
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