DS-DE 87 Q2-13 Islam I
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WAIVER OF REPORT
(Section 106.07(7),F.S.)
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(PLEASE TYPE) 2013 JILL 19 PM 12: 20
OFFICE USE ONLY
MCA MF-T,> F2-AFVa61, LL-A-M tR�tJ -1 (C-OMMIS16TIA
Name Office Sought
Address City State 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
NO A G ` lT IN TNE- AcLou F nd will no Tong Col:):4 t -A'9 5TA�
TYPE OF REPORT (Check Appropriate Box)
QUARTERLY REPORTS PRIMARY ELECTION GENERAL ELECTION
❑ January ❑ 32nd day prior ❑ 46th day prior
❑ April Q 2_ •13 ❑ 18th day prior ❑ 32nd day prior
❑ July ❑ 4th day prior ❑ 18th day prior ❑TERMINATION REPORT
❑ October ❑ 4th day prior ❑SPECIAL ELECTION
NOTIFICATION OF NO ACTIVITY IN CAMPAIGN ACCOUNT FOR THE REPORTING PERIOD OF
0A THROUGH — 3 O – 20 13
X I ZV r Off- 2-61
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.07110)
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CHASE=r June 01,2013 through June 28.2013
0 Bo x 6 6 59754 Chase Bank;N.A.
P Account Number: 000000219580661
P O Bo
San Antonio,TX 78265-9754
CUSTOMER SERVICE INFORMATION
Web site: Chase.com
Service Center: 1-800-242-7338
00047565 DRE 021 141 18013 NNNNNNNNNNN T 1 000000000 61 0000 Deaf and Hard of Hearing: 1-800-242-7383
MOHAMMED RAFIQUL ISLAM Para Espanol: 1-888-622-4273
1004 BIARRITZ DR APT 3 International Calls: 1-713-262-1679
MIAMI BEACH FL 33141-3749
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We're clarifying a transaction and fee description
We're clarifying a transaction and fee description that we use on account statements and online activity.
Starting July 22,2013,if you cash a check and it's returned to us without being paid,we will identify:
The transaction as Cashed Check Returned,and
The related fee as Cashed Check Retumed Fee(not all checking products are charged a lee for this transaction but
for those that are,this fee will still be S12).
This is not a new transaction type or fee,just a clearer description of this type of account activity.Today,we describe
both deposited and cashed items that are retumed to us without being paid as Deposited Item Retumed.After July 22,we
will use this description only for deposited checks that are returned.
All of the terms and conditions of your account remain the same.If you have questions,please call us toll-free at the number
on this statement or visit any Chase branch.
CHECKING SUMMARY Chase BusinessSelect Checking
INSTANCES AMOUNT
Beginning Balance $0.00
Deposits and Additions 1 100.00
Ending Balance 1 $100.00
DEPOSITS AND ADDITIONS
DATE DESCRIPTION AMOUNT
06/03 Deposit 463214355 $100.00
Total Deposits and Additions $100.00
DAILY ENDING BALANCE
DATE AMOUNT
06/03 S100.00
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C HAS O June 01,2013 through June 28,2013
Account Number: 000000219580661
SERVICE CHARGE SUMMARY
TRANSACTIONS FOR SERVICE FEE CALCULATION NUMBER OF TRANSACTIONS
Checks Paid/Debits 0
Deposits/Credits 1
Deposited Items 0
Transaction Total 1
SERVICE FEE CALCULATION AMOUNT
Service Fee $0.00
Service Fee Credit $0.00
Net Service Fee $0.00
Excessive Transaction Fees(Above 200) $0.00
Total Service Fees $0.00
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CHASE=r June 01,2013 through June 28,2013
Account Number: 000000219580661
BA ' i;N:CaNG YOCD.FCHECKEOO.K'
Note:Ensure your checkbook register is up to date with all transactions to date whether they are included on your
statement or not.
1. Write in the Ending Balance shown on this statement: Step 1 Balance: $ ry
m
2. List and total all deposits&additions not shown on this statement:
Date Amount Date Amount Date, Amount
0
o
Step 2 Total: $
3. Add Step 2 Total to Step 1 Balance. Step 3 Total: $
4. List and total all checks,ATM withdrawals,debit card purchases and other withdrawals
not shown on this statement.
Check Number or Date Amount Check Number or Date Amount
Step 4 Total: -$
5. Subtract Step 4 Total from Step 3 Total. This should match your Checkbook Balance: $
IN CASE OF ERRORS OR QUESTIONS ABOUT YOUR ELECTRONIC FUNDS TRANSFERS:Call or write us at the phone number or address on
the front of this statement(non-personal accounts contact Customer Service)if you think your statement or receipt is incorrect or if you
need more information about a transfer listed on the statement or receipt. We must hear from you no later than 60 days after we sent you
the FIRST statement on which the problem or error appeared. Be prepared to give us the following information:
•Your name and account number
•The dollar amount of the suspected error
•A description of the error or transfer you are unsure of,why you believe it is an error,or why you need more information.
We will investigate your complaint and will correct any error promptly. If we lake more than 10 business days(or 20 business days for
new accounts)to do this,we will credit your account for the amount you think is in error so that you will have use of the money during the
time it takes us to complete our investigation.
IN CASE OF ERRORS OR QUESTIONS ABOUT NONELECTRONIC TRANSACTIONS:Contact the bank immediately if your statement is
incorrect or if you need more information about any non-electronic transactions(checks or deposits)on this statement. If any such error
appears,you must notify the bank in writing no later than 30 days after the statement was made available to you. For more complete
details,see the Account Rules and Regulations or other applicable account agreement that governs your account.
WWOR JPMorgan Chase Bank,N.A.Member FDIC
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C BIAS E '. June 01,2013 through June 28,2013
Account Number: 000000219580661
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