DS-DE 12 G2-11 Amended Levey FLORIDA DEPARTMENT OF STATE DIVISION OF ELECTIONS
CAMPAIGN TREASURER'S REPORT SUMMARY _
(1) (a,(J p. LO(/Qy OFFICE USE ONLY
2011 NOV -8 PM 2: 1 1
(
Name 777 - PI 1; a I")rt'✓e_
Address (number and street) CITY Ci[;['S OFFICE
,a��G, �( 33► yo
City, State, Zip Code
❑ CHECK IF ADDRESS HAS CHANGED (3) ID Number:
(4) Check appropriate box(es): / ,/ ,-
LCandidate (office sought) /( Q $ a //LL -u4 1a e 4
111 Political Committee CHECK 1 PC HAS ISBA DED
❑ 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 Penod From op o / o I / // To /0 / 7 / ?Oil Report Type — /
El Original Q Amendment ❑ Special Election Report ❑ Independent Expenditure Report
(6) CONTRIBUTIONS THIS REPORT (7). EXPENDITURES THIS REPORT
Monetary
Cash & Checks $ 1 6 0 0 . 0 6 Expenditures $ 1) 0 • 00
Loans $ C 0 00 - 06 Tr��'nsfers to Office
/ Account
b $
Total Monetary $ r 0 00 . (l0
Total
Monetary $ / 0 SO • 0
In -Kind $
(8) Other Distributions
(9) TOTAL Monetary Contributions To Date (1C) TOTAL Monetary Expenditures To Date
$ ? 00 $ � /0 00
(11) CERTIFICATION
It is a first degree misdemeanor for any person tc 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
(T name) La () Lave y (Type name) LOX) 1 L9-t/12 y
❑Individual (only for ❑Treasurer 0Deputy Treasurer E "Candidate ❑ Chairperson (only for PC, PTY &
electioneering mmun.) %ionor9anization)
Signature g ignature
DS -DE 12 (Rev. 08/04)
•
/ CAMPAIONTR ASURER'S REPOR — ITEMIZED EXPENDITURES
(1) Name L [k c� � ... ' • � Q ✓�,t( (2) I.D. Number
(3) Cover Period Oy / l o � 11 through ib / 7 ad 1 I (4) Page of
(5) ( 1 (8) ( (10) (11)
Date Full Name 1Purpose
(6) (Last, Suffix, First, Middle) (add Office sought if
Sequence Street Address & contribution to a Expenditure
Number City, State, Zip Code candidate) Type Amendment Amount
7 / ; V /0t/ 66 a• c C - e-!-�
�� v� �`C�V '� ,c' I�000°r
02-3 Gu- ( rtv w�
/
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DS -DE 14 (Rev. 08/03)
SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES