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P os I IJ1 A-f1, 4i.
, FLORIDA DEPARTMENT OF STATE, D; :IN OF ELEC,
CAMPAIGN TREASURER'S R' )RT SUM~'
(')~~~ \{~..v~
Candidate, Committee ?\P~rty N~
(3) 1000 ~~~~~
Address (number and street) City
o Check bOx if address has changed since last report
(4) Check appropriate box(es): '
~Candjdate (office sought): ~~~ r; ~
o Political Committee 0 Check i : has DISBANDE
o Committee 01 Continuous Existence D Check if E has DISBAND
o Party E)(ecutive Committee
(2)
~. ~ .I.D.Nu'
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Stc_
(5) REPORT IDENTI. ,5
Cover Period: From Ct'1 I~ ~ To.J!2....J 00 .1lloS Rc;
~nal 'EJ Amendment 0 Special Election Repe
D Independ '.
(6) CONTRIBUTIONS THIS REPORT
~ ~eo,~
(7) EYJOITURES Tt
Monek
Exper: es
Transl ~
Office,. Junt
Cash & Checks
$ t
$-
b~
Loans
$_.
$-
Total Monetary
$_.
Total I, ~tary
$-
In-kind
$_.
(8) 01' )istributions $_
'-
(9) TOTAL Monetary Contributions to Date (10) TO l. Monetary Ex~
$ <, o-erl.) .~ $ b ~ 5'0
(11) CERTIFICATi
It is . first degree misdemeanor for any person to fa I"~ '/ a public reco
ave examined this report and it is
pie
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x
DS.OE. 12 (7/98)
Z0'd PSC6~69 S0~
SEE REVERSE FOR INSTRUCTIONS /,' ') CODE VALUE'S
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~ CAMPAIGN TREASURER'S REPORT - '
(1) Name ^'~ \}~1;~
(3) Cover Period ~..Q!I2sL through ...lE-' oa: I dc:o~
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CAMPAIGN TREASURER'S REPORT -1~ 'lZED CONT
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(3) Cover Period _~,1...J~/.?Q23.lhroUgh ~I Oli 1....2!x>7> (4) Page_
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Dati Full N.me
Contributor
(6) (Last, Suffix, FIrst, Middle)
SequencI Street Addr... l
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