F3 Amended FLORIDA DEPARTMENT OF I OF ELECTIONS
STATE,
CAMPAIGN TREASURER'S REPORT SUMMARY-
Can;:i~late, Com~'tee' or Party Name
Address (number and street) City
N Check box if address has changed since last report
(4) Check appropriate box(es):
~andidate (office sought): H lJ~Yl/V~
r"'J Political committee
N Committee of Continuous Existence
N Party Executive Committee
(2)
I.D. Number
State Zip Code
E3Check if PC has DISBANDED
D Check if CCE has DISBANDED
(5) REPORT IDENTIFIERS
Report Type --o ,~
ITt
Independent Ex~di~..~e Report
Cover Period: Fro~ IO / [3 / O/ To 11 !l~l I OI
D original [~Amendment D Special Election Report D
(6) CONTRIBUTIONS THIS REPORT
Monetary
Cash &Checks $._, ~ ,"1~,l}. ~ Expenditures $__, '7/-f II .3 l
Transfers to
Loans $ Office Account $__, ,
Total Monetary $__, ~ , ~'~ O. ~ Total Monetary $__, T ,~ | ~ · ~ l
(7) EXPENDITURES THIS REPORT
In-kind $__, ,
(8) Other Distributions $__,
- $ ,1 Io . eo $ ,m3 . O~
(11 ) CERTIFICATION
It is a first degree misdemeanor for any person to falsify a public record (ss. 839.13, F.S.)
I ce~ify that I have examined this repo~ and it is I ce~ify that I have examined this re~d and it is
' ~ ~ ~ t 'Chairman (PC/PTY
DS-DE 12 (7/98) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES