DS-DE 12 Q2 4/1 - 6/30/3· FLORIDA DEPARTMENT OF STATE, DIVISION Of ELECTIONS
CAMPAIGN TREASURER'S REPORT SUMMARY
Candidate, Committee or Party Name
(3) W. z4'"4
Address (number and street) City
[] Check box if address has changed since last report
(2)
I.D. Number
Zip Code
(4)
Check appropriate box(es):
[~Candidate (office sought):
[] Political Committee
[] Committee df Continuous Existence
~ Check if PC has DISBANDED
[] Check if CCE has DISBANDED
Party Executive Committee
Cover Period:
Original
L
(5) REPORT IDENTIFIERS
[] Amendment [] Special Election Report
(6) CONTRIBUTIONS THIS REPORT
.h & Checks $ , 0
Loans $ 0
Total Monetary $ 0
,n-Kind $ C)
(9) TOTAL Monetary Contributions to Date
$ I00
Report Type: ~) ~
] Independent Expenditure Report
(7) EXPENDITURES THIS REPORT
Monetary
Expenditures
Transfers to Office
Account
Total Monetary $ 0
(8) Other DistfibulJons
(10) TOTAL Monetary Expenditures to Date
(11) CERTIFICATION
It is a flint degree misdemeanor for any p~mon to false7 a public record (ss. 839.13,
I ce~fy that I have examined this report and it is
~'ue, correct and complete
I cer'd~ tha~ I have examined this report and i~s tr~.
correct and complete ~ ~-~
Signature SignatUre
)S-DE 12 (7/98)
SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES
CAMPAIGN TREASURER'S REPORT-ITEMITED CONTRIBUTIONS
,,~) Cover Period '4 / I / O~ttirough (~) /20 / C~ I
(s) ('/} (8) (o) (to) (11)
Date Full Name
(6) (Last, Suffix. First, Middle) Contributor
Sequence Street Address &
,C(x~lbutJon In-kind
Numbe¢ City, State, ZIp Code Type Occupatlo~ Type De$cri~tionAmendment Amoun~
/ /
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/ /
/ /
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CAMPAIGN TREASURER'S REPORT- ITEMIZED EXPENDITURES
(1) Name ~0.J~ 1. ~0fl~.. (2) I.D. Number
(, ,over Period A- / I__~/ O~ro.gh LO / ~X~/O3 (41"age t of I
(5) {7) (8) (9) (10) (1 t)
Date Full Name '~' Purpose
(6) (Last, Suffix, First, Middle) (add offic~ sought if
,.~-~quence Street Address & contribution to · Expenditure
Number City, State, Zip Code candidate.) Type ~ Amount
/ /
/ /
/ /
/ /
/ /
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CAMPAIGN TREASURER'S REPORT- FUND TRANSFERS
" ,me J RC0J~ I. ~ (2) l.D. Number
~) Cover Period 4 / J / 0.~through ~7 /~O/ ~ (4)Page [ of J
(7) ~ (8) (9) (4 o) (4 ~)
(5)
Date Name of Financial
(6) (nslilulion
Sequence Street Add _re~_$ & Transfer Nature of
Number City, State, ;Zip Code Type AcaT~um Amendment Amoum
/ / -
/ /
/ /
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