TR Amended 02/28/2002 FLORIDA DEPARTMENT OF STATE, DIVISION OF ELECTIONS
CAMPAIGN TREASURER'S REPORT SUMMARY
(1) (2)
Address (number and street) City State Zip Code
~Ch~k ~x if address has chang~ since la~ re~d
(4) Check appropriate box(es):
E~;~idate (office sought):
D Political Committee
r"'] Committee of Continuous Existence
liParty Executive Committee
J"J Check if PC has DISBANDED
r""'} Check if CCE has DISBANDED
(5) REPORT IDENTIFIERS
,~I~o
"} Special Election Repod
Report Type "T"/?,, ?~
F'q lndependent Expenditure Report
CONTRIBUTIONS THIS REPORT
Cash & Checks $._,__,
(7) EXPENDITURES THIS REPORT
Monetary
Expenditures $ ....
Loans $ , Transfers to
..... Office Account $ ....
Total Monetary
Total Monetary $__, __
In-kind $__,.____, __
(8) Other Distributions $__, __
- $ , ;~ ~ $ ,Z ~e , ~. ~ o
(11 ) CERTIFICATION
It is a first degree misdemeanor for any per~n to falsi~ a public record (~. 839.13, F.S.)
I certify that I have examined this report and it is
true, correct and complete ~
~Slure - ~'
I certify that I have examined this report and it is
true, corred and complete
Name of Car,:~date CR ' an (PC/PTY
Signatj ~