Q1-07 Amended
FLORIDA DEPARTMENT OF STATE DIVISION OF ELECTIONSR E C
CAMPAIGN TREASURER"S REPORT SUMMARY ~ E I V;:: T"\
(1 ) -< /'/lj;J /1 (bId Z--. OFFICElB~s P/1 ...,
Name CITy 4: 15
(2) hIL, ~O h? /" . CLERK'S
L{--r I 1:' OFFICE
Address (number and street)
j'1J '4 - ;Ct, ::t;! 1;(1:-
City, State, Zip Code
o CHECK IF ADDRESS HAS CHANGED (3) 10 Number:
(4) Check appropriate box(es): (' (lllJ//J /i--I",JIC;//a- ~rt7~ =// I
o Candidate (office sought):
o Political Committee o CHECK IF PC HAS ISBANDED
o Committee of Continuous Existence o CHECK IF CCE HAS DISBANDED
o Party Executive Committee
o Electioneering Communication o CHECK IF NO OTHER ELECTIONEERING
COMMUNICATION REPORTS WILL BE FILED
(5) REPORT IDENTIFIERS
Cover Period: From ~ / ~ / J!l2 To ~ / ~ / ~ ReportType 0/ 1- 07,
o Original ~Amendment 0 Special Election Report 0 Independent Expenditure Report
(6) CONTRIBUTIONS THIS REPORT (7) EXPENDITURES THIS REPORT
~ Yf/lt200 Monetary 0
Cash & Checks $ Expenditures $
.
Loans $ i{ SI (J /11-0 . Transfers to Office
Account $ 0
Total Monetary $ 33. 900 Total
Monetary $ to
In-Kind $ ~Icf y~ 7S
(8) Other Distributions
$
(9) TOTAL Monetary Contributions To Date (10) TOTAL Monetary Expenditures To Date
$ $
(11) CERTIFICATION
It is a first degree misdemeanor for any person to falsify a public record (55. 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. correct, and complete.
(Type name) -' (Type name)
D Individual (only for [3Treasurer D Deputy Treasurer [d'"6ndidate D Chairperson (only for PC, PTY &
electioneering commun.) electioneering commun. organization)
X ~ .~'t~ X __~__~~
Signature Signat'Ure
OS-DE 12 (Rev. 08/04)
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CAMPAIGN TREASURER'S REPORT - ITEMIZED CONTRIBUTIONS
(1) Name
L' I W r? /f- (; I"(J{'?-
(2) 1.0. Number
(3) Cover Period --L / ~ / ~ through ~ / ~ / J:ZL, (4) Page ~ of L-
(5) (7) (8) (9) (10) (11 ) (12)
Date Full Name
(6) (Last, Suffix, First, Middle)
Sequence Street Address & Contributor Contribution In-kind
Number Citv, State, Zip Code Tvpe Occupation Tvpe Description Amendment Amount
'7, (I 107 .J' fer ;vt.f'\.
Erffl1 el' --r::: Al.l U-? O~.
lfd'l, (l ~ tl tv" I/Il.,m qtJif~
LI, { 107 Ii. 1"1? 1l-z..t?,;1I, tL.. r
(!.Art;!.rlr4 fl1 (.).
(, 0, ((~ ;za /.,;. d.'IJIf7, ;:C, tJtwftft-. ce::o 'obir" ;;? () tt,[, v
'r ut. .
-:t 1:/ 'J I n7 L / rv t:'1 (;/'tA"Z- - prr;;-r 1100
INK f l S" ~.'-1'11
'If I e 'I::JI'l-, '.aJ ):;j -r:- brt1eJr vr~.t
/J7/J- FI.--'V/;:l9 .
.-$ I? { 107 A (t4 I? /f- (#rfl.f7-- (ivlC Ne('f4~q.( .
t(f'1 e - ~~"tJ~ .-c . AD ~vfJ '0
t4I7D
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OS-DE 13 (Rev. 08/03)
SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES
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