DS-DE 12 G3-11 The Afterparty Pi I/ (o•2 -11
FLORIDA DEPARTMENT OF STATE DIVISION OF ELECTIONS
CAMPAIGN TREASURER'S REPORT SUMMARY
(1) 71 , A -Pker eci r OFFICE USE ONLY
Name _ '11
(2) 00() ,1Jt ILJ/^ I l 7if
Address (number and street)
-3)) i
City, State, Zip Code
❑ CHECK IF ADDRESS HAS CHANGED (3) ID Number:
(4) Check appropriate box(es):
❑ Candidate (office sought):
❑ Political Committee ❑ CHECK IF PC HAS DISBANDED
❑ Committee of Continuous Existence El 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 /0 / Q / i i To /0 / / / / Report Type 1 ---/
a Original ❑ Amendment ❑ Special Election Report ❑ Independent Expenditure Report
(6) CONTRIBUTIONS THIS REPORT (7) EXPENDITURES THIS REPORT
Monetary
Cash & Checks $ / �° J Expenditures $ -C
Loans $ Transfers to Office
Account $
Total Monetary $ / J 0 U Total
Monetary $
In -Kind $
(8) Other Distributions
$
(9) TOTAL Monetary Contributions To Date (10) TOTAL Monetary Expenditures To Date
$ 7,° :0 $ /q/$ od
(1 1) 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 com lete. correct, and co ete.
(Type name) ,kA( 1 (Type name)
a
El
ik /ket( h A.k
Individual (only for Treasurer ❑ Deputy Treasurer El Candidate Chairperson (only for PC, PTY &
electioneeri g j on 1 mu. / fl eectioneering commun. organization)
X A ' X , /
Sig atur Si atu �e
DS -DE 12 (Rev. 08/04) f
CAMPAIGN TREASURER'S REPORT — ITEMIZED CONTRIBUTIONS
Name tt CCU i O 114, (2) I.D. Number
(3) Cover Period / / r / (I through / / Z / ( (4) Page of
(5) (7) (8) (9) (10) (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 _
C S?, ?k
Li/ it C t t-
( 4-.4.444,/k ►W4 � 1
r 5)41.1
/ /
/ /
/ /
/ /
/ /
/ /
/ /
DS-DE 13 (Rev. 08103) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES
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