DS-DE 87 Preserve MB i
WAIVER OF REPORT
(Section 106.07(7), F.S.)
(PLEASE TYPE) RFCFIVFPj
2012 OCT 12 PM 4: 57
CI T Y CLEf�-Nlt'S 0 F I IC'
OFFICE USE ONLY
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Name Office Sought
-J5!-3
Address City St to Zip Code
❑ Candidate ❑ Committee of Continuous Electioneering Communication Organization
Existence
❑ Political Committee ❑ Party Executive Committee
❑ Check box if address has changed since last report. ❑ Check here if PC, CCE, or ECO has DISBANDED
and will no longer file reports.
TYPE OF REPORT (Check Appropriate Box)
QUARTERLY REPORTS PRIMARY ELECTION GENERAL ELECTION
❑ January ❑ 32nd day prior ❑ 46th day prior
❑ April ❑ 18th day prior ❑ 32nd day prior
lal July ❑ 4th day prior ❑ 18th day prior ❑TERMINATION REPORT
❑ October ❑ 4th day prior ❑SPECIAL ELECTION
NOTIFICATION OF NO ACTIVITY IN CAMPAIGN ACCOUNT FOR THE REP RTI G PERIOD OF
1// THROUGH
X �-
Signature Date
SIGNATURES REQUIRED FOR: Candidates
Candidate, Campaign Treasurer or Deputy Treasurer(s. 106.07(5), F.S.)
Political Committees
Chairman, Campaign Treasurer or Deputy Treasurer(s. 106.07(5), F.S.)
Committees of Continuous Existence and Electioneering Communication Organizations
Treasurer (s. 106.04(4)(c), F.S.)
Party Executive Committees
Treasurer or Chairman(s. 106.29(2), F.S.)
In any reporting period when there has been no activity in the account(no funds expended or received)the filing of the
required report is waived. However,the filing officer must be notified in writing on the prescribed reporting date that no report
is being filed.
DS-DE 87(Rev.07/10)
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