DS-DE 12 F2-07FLORIDA DEPARTMENT OF STATE DIVISION OF ELECTIONS
CAMPAIGN TREASURER'S REPORT SUMMA
(1) J .`a~~L~ ~~~~ ~~
/ OFFICE USE ONLY ~~
Name. 2001 OCT - S PM I ~ 58
(2) ~C/ ~= ~ ~ /,~i` Lim ~~' ~ CITY CL~r~i~,'S Ot-f= {CE
Address (number and street)
/~~ ~~ ~ rl; ~ 3i.-~
City, State, Zip Code
^ CHECK IF ADDRESS HAS CHANGED (3) ID Number:
(4) Che k appropriate box(es):
C ~-
/
andidate (office sought):
[ ;/_
^ Political Committee ^ CHECK IF PC HAS DISBANDED
^ Committee of Continuous Existence ^ CHECK IF CCE HAS DISBANDED
^ Party Executive Committee
^i Electioneering Communication ^ CHECK IF NO OTHER ELECTIONEERING
COMMUNICATION REPORTS WILL BE FILED
(5) REPORT IDENTIFIERS
Cover Period: From ~ l lam- l ~ To ~~ / ~~~' / ~?7 Report Type J~
^ Original ^ Amendment ^ Special Election Report ^ Independent Expenditure Report
(6) CONTRIBUTIONS THIS REPORT (7) EXPENDITURES THIS REPORT
Monetary
Cash & Checks $ ~5~~ '`'~? Expenditures $ ~ - ~ ~
Loans $ (~% Transfers to Office
Account $
~ ~~CI
Total Monetary $ r~ ~~
Total
Monetary $ ~ ~ ~7
In-Kind $ ~~
Ci
(8) Other Distributions
$ ~3 12.E ~~
(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 (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. correct, and complete.
(Type name) (Type name)
~Indw~dual ioniy for
~reasurer ^ Deputy Treasurer Candidate ^ Chairperson (only for FC, PTY &
~
electioneering common.} electioneering common. organization)
x
Signature Signature
bS-DE 12 (Rev. 08/04) ~ ~~ ~ ~ ~ ~ ~""'"~ ~.'~ T
S ~~ ~_'y !.I'
CAMPAIGN TREASURER'S REPORT -ITEMIZED CONTRIBUTIONS
(1) Name ~ (~~(~ n~L~, ~~7_
(3) Cover Period ~ / ~ / ~ through ~~''/ ~(~'~
(2) I.D. Number
(4) Page of
(5)
Date (7)
Full Name (8) (9) (10) (11) (12)
(6)
Sequence
Number (Last, Suffix, First, Middle)
Street Address &
Cit ,State, Zi Code
Contributor
T e Occu ation
Contribution
T e
In-kind
Descri tion
Amendment
Amount
~ l i ~ . ~~v Jai- ~
~~~ w ,~,~ ~r ~ -
~~ ~~ ~n~~~ .~~,~,
3~~-/~O ~~~~~if~
~. U,l~n~, ~~~-
/ /
/ /
/ /
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DS-DE 13 (Rev. 08/03) SEE REVERSE FOR INSTRUCTIONS A~D~C~~ ~Ll}~S ~ y~~ v~
CAMPAIGN TREASURER'S REPORT -ITEMIZED EXPENDITURES
(1) Name /_~~~~ ~ ~'~-CZ (2) LD. Number
(3) Cover Period ~ /~,,L/ /? 7through l~ /~/ ~ ~? (4) Page of
(5)
Date h)
Full Name (8)
Purpose (9) (10) (11)
(6)
Sequence
Number (Last, Suffix, First, Middle)
Street Address &
City, State, Zip Code (add office sought if
contribution to a
candidate)
Expenditure
TYPe
mendment
mount
~~ ~ ~~~ /~~G ~ ~t~~ (i~/2'
~-, ~ ~ ~ ~6/ G . ~? 0/~' ~ .3 , G'1c~
DS-DE 14 (Rev. 08/03)
SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES
~~~ 3~~