DS-DE 12 TR 11 The Afterparty FLORIDA DEPARTMENT OF STATE DIVISION'OF ELECTIONS
CAMPAIGN TREASURER'S REPORT SUMMARY
(1) ({ - (-OFPtE W E ONLY
Name
(2) OZ ti& 36 S _71* 2012 JAN 30 PM 4,- 36
Address (number and street) C1T`` CLEn K'S CI=F ICE
3�-
City, State, Zip Code
❑ CHECK IF ADDRESS HAS CHANGED (3) ID Number: ^;
(4) Check appropriate box(es):
❑ Candidate (office sought): r- =Y;
❑ Political Committee ❑ CHECK IF PC HAS DISBANDED
❑ Committee of Continuous Existence ❑ CHECK IF CCE HAS DISBANDED T9
Ul
❑ Party Executive Committee = ' -j
[ yElectioneering Communication HECK IF NO OTHER ELECTIONEERING Ln
PCOMMUNICATION REPORTS WILL BE FILED
(5) REPORT IDENTIFIERS
Cover Period: From r o l Ztr l j To / 3 a Report Type —�
®triginal ❑ Amendment ❑ Special Election Report ❑ Independent Expenditure Report
(6) CONTRIBUTIONS THIS REPORT (7) EXPENDITURES THIS REPORT
Monetary
Cash & Checks $ C7 Expenditures $ �6 ,
Loans $ Transfers to Office
Account $
Total Monetary $ Total
Monetary $ 16 1 1.!q�-
In-Kind $
(8) Other Distributions
(9) TOTAL Monetary Contributions To Date (10) TOTAL Monetary Expenditures To Date
$ 2D / D37 $
(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) PAIAO Alht-Jn/J�7 (Type name)
❑Individual(only for foTreasur r [:]Deputy Treasurer ❑Candidate Chairperson(only for PC,PTY&
electioneering commun. ne ring commun.organization)
X a� X a164977'
Signature Signature
DS-DE 12(Rev. 08/04)
CAMPAIGN TREASURER'S REPORT— ITEMIZED CONTRIBUTIONS
(1) Name ��'" 1 (2) I.D. Number
(3) Cover Period r'.J / �� / Gj through / 3 0/ r2-- (4) Page -2-- 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
s
DS-DE 13(Rev.08103) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES
i
CAMPAIGN TREJLSURER'S REPORT — ITEMIZED EXPENDITURES
(1) Name (2) I.D. Number
(3)Cover Periods through / / / a" (4) Page of 3
(5) (7) (8) (9) (10) (11)
Date Full Name Purpose
(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
i I QC r-(✓ 33 I n1 o
DS-DE 14(Rev.08103)
SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES