Amended F3 Guerra FLORIDA DEPARTMENT OF STATE, DIVISION OF ELECTIONS
CAMPAIGN TREASURER'S REPORT SUMMARY
(1) -i- t4 (2)
C'andidat~, c~)mmittee o~ Party Name i- ' - I I.D. Number
Address ~umbe~' ~nd street) - ' -City ....... State ' -- Zip'C"'od¢
[] Check box if address has changed since last report
(4) Ch, ap o.r,ata ox(es): '- °
[~ Candidate (office sought): · ~L /
[] Political Committee [] Check if PC has DISBANDED
[] Committee of Continuous Existence [] Check if CCE has DISBANDED~
[] Party Executive Committee
(5) REPORT IDENTIFIERSmc~
[] Original ~ Amendment [] Special Election Report [] Independent Expenditure Report
(6) CONTRIBUTIONS THIS REPORT (7) EXPENDITURES THIS REPORT
Monetary
Loans $~ , , . _ Office Account $ , , ·
Total Monetary $__,~ , ~__ .00 Total Monetary
/_~/d~ Other ~) _.~ _(~
In-kind $__ , __ , . ~ (8) Distributions $~ , , ·
(9) TOTALs Monetary,~_ClN~t_ributions~.~?~_ .0~t° Date (10) TOTALs Mon/_~.~,_.~ '~i Exit. ndjturest/~/_~ .~/__/~ate
(11) CERTIFICATION
It is a first degree misdemeanor for any person to falsify a public record (ss. 839.13, F.S.)
I certify that I have examined this report and it is true, I certify that I have examined this report and it is true,
correct and complete co_~a~ ~~
Na~e%; ~Tr'~a--sur;r ~ DePuty ~r'a~rer Nam; o~ C~didata [] Chairman (PC*--
Sior! !tut ,(~ ~ )~/?# Signature ~ -
DS-DE 12 (9~1)
SEE REVERSE FORII
CAMPAIGN TREASURER'S REPORT - ITEMIZED CONTRIBUTIONS
[$] Cover Period lC) / I 1 ' 0__0_~'hrough l 0, ~/03 (4)P,,ge 1 of I
(5) (7) (8) (9) (10) (11) (12)
Date Full N8me
ffi) (L;it, Suffix, Fire, Mkldle) Contributor
S~equenGe Street Address & Contribution In-kind
Number City, Stilte, Zip Code TypeOccupation Type De~crlption Amendment Amount
-- 51oo. ~0
~uq ctucrr~__.
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CAMPAIGN TREASI.~ER'S REPORT - ITEMIZED EXPENDITURES
cover Period lt~) ,{1 h~% through ]0 '~)--'~ (4)".." / o, f
(s) (7) (0) (o) (lO) (11)
Dete Full Name Purpose
(6) (Last, Suffix, First, Middle) (add offloe ~ought ff
Sequence Street Address & contribution to a Expenditure
Number City, State, Zip Code candidate) Type ~ Amount
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