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DS-DE 12 F2-07FLORIDA DEPARTMENT OF STATE DIVISION OF ELECTIONS CAMPAIGN TREASURER'S REPORT SUMMARY OFFICE USE ONLY (1) _ ~~Sc, ~sr~~;7cn Name '' _ Address (number and street) i'~~ U~', '~ruc~n , '~ 1 3313 ~ City, State, Zip Code ^ CHECK IF ADDRESS HAS CHANGED (3) ID Number: ~ ,,,, a (4) Check appropriate box(es): © 7t7 Candidate (office sought): C~,M; ss, v~~r GYc~c,~~-- c-n ~ ~"~ ^ Political Committee ^ CHECK IF PC HAS DISBANDED r^~ .- ^Committee of Continuous Existence ^ CHECK IF CCE HAS DISBANDED ~ N ^ Party Executive Committee `" _" '~ ~ o ^ Electioneering Communication ^ CHECK IF NO OTHER ELECTIONEERI ~ ILEG. COMMUNICATION REPORTS WILL B (5) REPORT IDENTIFIERS Cover Period: From o1 / ~~ / O~ To q / Z y / O ~. Report Type '~Z -o ~ [~ Original ^ Amendment ^ Special Election Report ^ Independent Expenditure Report (6) CONTRIBUTIONS THIS REPORT (7) EXPENDITURES THIS REPORT Monetary Cash 8~ Checks $ \ i (~OV Expenditures $ ~ ~ yp , ~ Loans $ Transfers to Office Account $ Total Monetary $ ' ; GC:'U Total Monetary $ ~ ~ ~(;~ ~~{- ~ In-Kind $ (8) Other Distributions (9) TOTAL Monetary Contributions To Date (10) TOTAL Monetary Expenditures To Date $ V~, ~9 t,r~y $ ZZ~Z40, gZ (11) CERTIFICATION It is a first degree misdemeanor for any person to falsify a public record (ss. 839.13, F.S.) 1 certify that I have examined this report and it is true, I cert'dy that I have examined thi report and it is true, correct, and comple t e. correct, and complete. r ~ (TYPe name) 1=...~~r c, ~lc~ /~/; (TYpe ) ~,/S,q )~lJ / Z ^Individual (onry for Treasurer ^ Deputy Treasurer Candidat ^ Chairperson (oniy for PC, PTY & ~ electioneering commun.) . electi?iq Bering commun. organization) / X X ~.~q-ti l/ /, Signature Signature DS-DE 12 (Rev. 08J04) ~~,C3 CAMPAIGN TREASURER'S REPORT -ITEMIZED CONTRIBUTIONS (1) Name ~1sA ~t ~~:~ U (2) I.D. Number (3) Cover Period a / 1~ / ~~ through ~ / Z~ / C ~ (4) Page 1 of I (5) Date (7) Full Name (8) (9) (10) (11} (12) (6) Sequence Number (Last, Suffix, First, Middle) Street Address & Ci ,State, Zi Code Contributor T Occu tion Contribution T In-kind Descri tion nrr,endmenc Amount O / /S / o '7 /y~ ~'I/~PA~ 0 / l6 / vcf e ~~ ~ ~ Oc'Z , / '~~r~ h f2<s ~ ~ "`~~ °'} C ~ ,DSO . rt) ~ l ~~' /~ ~~va ~~ Ss~ 3 3 3/ S cc,~ I o7 ~.e Q l~ l ~ /) ~ d ~~ U~k•Circ~~~+f t~o/ ~i,oF'~ Arm l / l ~s~ ~,; ~1 C'~P~.~ / / / / / / DS-DE 13 (Rev. 08/03) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES Z6C 3 CAMPAIGN TREASURER'S REPORT -ITEMIZED EXPENDITURES (1) Name ~ ISo~ ~~~ ;~~Z~ (2) I.D. Number (3) Cover Period a1 / ~S / ~~ through Q / Z`1 / O~ (4) Page ~ of (5) Date (7) Full Name (81 Purpose (9) (~0) (11) (s) Sequence Number (Last, Suffix, First, Middle) Street Address S City, State, Zip Code (add office sought if contribution to a candidate) Expenditure TYPe amendment Amount a t~ ~~~~,~ o~, ~~t ~. , ~- ~-~~ ~~~ «~i ~~ ~~q ~1 (V~; a U^ ~ 1 . q ~ v~ ./~ C ~ 1 QQ ~'` ~ ~ Z Sid , oc~ 13S ~1~Yj \ ,, (iiY~iC ~~Gak ~Ca~/1 U t~ G iii J5, ~ ~ L DS-0E 14 (Rev. 08/03) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES S ~r~