DS-DE 12 Q2-12 Reform MB.com :fl0���-
FLORIDA DEPARTMENT OF STATE DIVISION OF ELECTIONS
CAMPAIGN TREASURER'S REPORT SUMMARY
(1) OFFICE USE ONLY
Name
(2) 7i Cozz1,r,� iryyrJ,SyiJ o'�J
Address (number and street)
Am (
City, State, Zip Cod
❑ CHECK IF ADDRESS HAS CHANGED (3) ID Number:
(4) Check appropriate box(es):
❑ Candidate(office sought):
P"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 ___L / j2,,- To _L / / Report Type
Original ❑Amendment ❑ Special Election Report ❑ Independent Expenditure Report
(6) CONTRIBUTIONS THIS REPORT (7) EXPENDITURES THIS REPORT
Monetary
Cash & Checks $ } (� [ 7 Expenditures $ /Q 8
Loans $ - O cC Transfers to Office
Account $ 0 • Q d
Total Monetary $ p Total
Monetary $ STS OCR ��
In-Kind $ 66
(8) Other Distributions D
$
(9) TOTAL Monetary Contributions To Date (10) TOTAL Monetary Expenditures To Date
$ L/ / , g7e e ? $ ref 0
(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) fN r (Type name)
[:]Ind' id al only)fo rea surer ❑Deputy Treasurer ❑Candidate Chairperson(only for PC,PTY&
electio a ng m .) commun.organization)
X va.
Signature nat e
DS-DE 12(Rev.08104) � /
CAMPAIGN TREASURER'S REPORT- ITEMIZED EXPENDITURES
(1) Name �% �Dle/11 ,((�5 Cpl (2)I.D. Number
(3)Cover Period /�_/��through & 30 / 1,,)— (4) Page of
(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
C#-AP r6"N
339y Go 3k0 A�c,�dy' p D
s
PRO
P�
DS-DE 14(Rev.08103)
SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES