TR 01/18/2002 A
F,,jRID DEPARTMENT OF STATE, DIVIS, ~1 OF ELECTIONS
CAMPAIGN TREASURER'S REPORT SUMMARY
(1) Candidate, Com~i~ee or Party Name <~ (2) I.D. Number
7 ""/"' -;x 33
State Zip Code
(4)
r--} check if Pc has DISBANDED
r"'J Check if CCE has DISBANDED
(5) REPORT IDENTIFIERS
Address (number and street) City
r"'~Chlc~ box if address has changed since last report
Check appropriate box(es):
[] Candidate (office sought): (Z'<~b/r"'/' ~*~" c:/'~*<r~
D Pollical Committee
r"] Committee of Continuous Existence
[~Pa~y Executive Committee
Cover Pedod: From ///
(6) CO~BUTIONS THIS R~RT (7) EXPENDITURES THISRE~RT
'Cash & Chec~ $ , · Ex~nditufes
Loans : $__. , Transfers to
Office Account $__,,
Total Monetary $--' ' ' Total Monetary $__,
In-kind $"' ' "' (8) Other Distributions $__. ,
(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 I certify that I have examined this report and it is
true, correct and complete true, correct and complete
N~me of "]~_'reasurer. Dept~/TreaSUrer:
DS-DE 12 (7/98) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES
Name of: r~ Candidate r'~ Chairmar~ (PC/PTY
· ' Only)
~ ! "', :: ,, ,:. :. · ~ .: , :: ~ ~
(s) (7) (8) (9) (~o)
Dale Full Name
(6) (Last, Suffix, first, Middle) (add office sought if
Sequence Street Address & contribution to a Expenditure
Number City, State, Zip Code candidate) Type Amendment Ainuurn
/ /
/ /
/ /
/ /
/ /
/ /
/ /
DS-DF-- 14 (7/98)
SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES