DS-DE 12 F2-07FLORIDA DEPARTMENT OF STATE DIVISION OF ELECTIONS
CAMPAIGN TREASURER'S REPORT SUMMARY
(1) ~~ - -, ~ - ., ~ ~_~ OFFICE USE ONLY
Name
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A d ess (numbs and street)_ :- ~ ~ r
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City, State, Zip Code
^ CHECK IF ADDRESS HAS CHANGED (3) ID Number: ~~ -cs ~""'
(4) Check appropriate box(es): , ~, ~:
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Candidate (office sought): ~lJ Lr >
^ Political Committee ^ CHECK IF PC HAS DISBANDED --r
^ Committee of Continuous Existence ^ CHECK IF CCE HAS DISBANDED
^ Party Executive Committee
^ Electioneering Communication ^ CHECK IF NO OTHER ELECTIONEERING
COMMUNICATION REPORTS WILL BE FILED
(5) REPORT IDENTIFIERS
Cover Period: From C.'~ ! ~- / ~,,. To ~~t~' / ~ / Re ort T e
~`7 ~ ~ ~~ ~ P YP ~L-y
Original ^ Amendment ^ Special Election Report ^ Independent Expenditure Report
(6) CONTRIBUTIONS THIS REPORT (7) EXPENDITURES THIS REPORT
Monetary -
_
Cash & Checks $ ~~~ ~,~~ °`` Expenditures $
Loans $ ~ ~ Transfers to Office
Account $
Total Monetary $ ~~,~~Cj --~ Total
Monetary $
In-Kind $
(8) Other Distributions
ns To Date
u
i
o
(9) TOTAL Monetary Contri
b
t (10) TOTAL Monetary Ex enditures To Date
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(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 co lets.
~ correct, and comple
~ \ } °. ~' ~:_` r
(TYpe name) ~~~ ~ ~, (Type name
^ I i i I niy for Treasurer ^ Deputy Treasurer Candidat ^ Ch irperso only fo PC, PTY
electi n mmun { ele a 'ng comm .organization)
X / X
Sign Signat
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