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DS-DE 12 F3-07 Campaign Treasurer's Report MHB
FLORIDA DEPARTMENT OF STATE DIVISION OF ELECTIONS CAMPAIGN TREASURER'S REPORT SUMMARY t~. FiC~~ l~~ ~I~Y Name 2Q01 QCT ! 9 AM ! I ~ 02 A d ess (number and street) ~ ~ ~ ~ ~ ~- ~' ~ ~ ~ ~ ~~r~ f=1 C ~,~ ~~c~i ~hc-~ !-~, -3313 City, State, Zip Code ^ CHECK IF ADDRESS HAS CHANGED (3) ID Number: (4) Check appropriate box(es): ~ ' ~~ y '~ '~ C ~ ~ ~ ~ ~ ~ ~I ` ~ C?~ Candidate (office sought): __ `L p~`t . - C {J ~Mt ( G ^ Political Committee ~ ^ CHECK IF PC HAS DISBANDED ^ Committee of Continuous Existence ^ CHECK IF CCE HA5 DISBANDED ^ Party Executive Committee ^ Electioneering Communication ^ CHECK IF NO OTHER ELECTIONEERING COMMUNICATION REPORTS WILL BE FILED (5) REPORT IDENTIFIERS Cover Period: From ~?~ / Z / ~ To ILL !~~ ! (U Report Type `- ~ -- c; Original ^ Amendment ^ Special Electio n Report ^ Independent Expenditure Report (6) CONTRIBUTIONS THIS REPORT (7) EXPENDITURES THIS REPORT Cash & Checks $ ~, , ~d ~ , DD Monetary Expenditures $ ~-~' ~r y- Loans $ ~--~~-{~ Transfers to Office Account $ Total Monetary $ ~ ~ ~j~5 ; p Gj Total Monetary $ ~ ~ (~ 1l~ ~ ?~ ~ In-Kind $ ~ -~ (8) Other Distributions (9) TOTAL Monetary Contributions To Date (10) TOTAL Monetary Expenditures To Date $ 5~1 ~ 1 ~ ~ $ 15T X33 : ~~., (11) CERTIFICATION It is a first degree misdemeanor for any person to falsify a public record (ss. 839.43, 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 c~tnplete. correct, and co~p ete. -, ~ F f ~ aye ~v R _ (TYPe name) ~'~! ~' (~ ~T 1~-~~. `"~,., \ ~Y--~~..~ , (TYPe name) ``v ~ \ _ ` ~; ~ _ C. ^Individ I for ~Tre'asurer ^ Deputy Treasurer Candidate ` ^ Chairperson (only for PC, PTV 8 electioneen urf!) election ri common anization) ~ :t X ~'= 11 /~ Signature `:'~' ~. Signatur ~ DS-0E 12 (Rev. 08/111) (~ j 5 •j ..~` ~ ~ G J~ J CAi1~AiGN TREASURER'S REPORT -ITEMIZED CONTRIBUTIONS .~ ~! (7) Name ` ~` ~ (2) I.D. Number , (3) Cover Period ~ / Z~ / ~ ~ / 1 ~- / ~ (4) Page l of (5) ('T) (8) (9) (~~) ~») t12) pa(e FuN Name (6) (Last, SutPor, Fast, M6ddle) " Sequence Numtrer Street Address ~ Code Ca~iribu6~r T lion Goranbution T It-~-k etd A"fordni~ Amourrt S ~-~G ~ ~R r,~~F.~i~le, Fl .~ -_ 1~ ~ ~Z ~c1 ~ ~ s~ l~~%l~-5~~3;~~f %~~2 CSC /tad -- 1a ~ dZ~v~l ~~r~iN~ ~o~~z ~ ~ /33 /v1~~~S ~ ~ ~ N b~ _, 33~ I v i o~ iC =~ E 5 ! la ~ : nti r~~~ ~ ' ~ C:~ G ~~ ~/ ~~ "~1 ~AM~~-~..f~i~ f ~, 3 ~._ ~ OS-DE 73 (Rev. 081b3) SEE REVERSE FOR Nd.4TRUCTlONS AND CODE VALUES /-,y, a,~ 5 CA~AIGN TREASURER'S REPORT -ITEMIZED CONTRIBUTIONS l ~- (1) Name ~~ ~~ ~ ~. ~', ~ Y=~~~- (2} I.D. Number (3) Cover Period ~ ~ ~ ~ ,~ _1= ~ ~ 1 _"! (4} Page ~ of (5) pie (n Fuq Name (g) (g) (t0} (11) (12) (6) Sequence Number (last. Sul6oc, Fast. Mme) Street Address b ~ . Stafe Code Contra T Ca~rfiuCwn T In-katd ^"~"'~ Amount --~ ,t I / C'I pp~~ 1t~v~~, lei ~~hSi() , ~`~~- ~jb,OU 0 q 1 ~1~ n;~ i~>>c.~ ~ ~L. 33i3 ~i~ ~~ ~ I o ~~ ~~~,~ ~~ ; I~. ~~~ 3~ i ~ I ~ I c~ ~tn ~c ~JI'aLi~ 13 ~ C I C~~S ~ : nv ~ ~ :ce:~.: ~~+~~~~~ f ~~ ~ ~ 1 ~ I I V~ [^ ~\ I a , I,,t~ Ip~ I .1 S-~„~;~Y ~y' ~f~. o K~ ~~ t ~_ .~I i~ e ~E ~0 ;GCS ~ ,cr~.~{ ~~ ~~ ~t~, n- M~AC~~ , ~i. ~~~ ~t %;~Y ~ ~ nti~r~w U~~ ~~: - i ~ ~,~ ~-~ ".u~ P~~,~a.,~~ .L ~~ CNE. ~ ~od ~~i A1a1 ~.~ ~ ~- (_.. ~~ I n I ~~ , o ~t~ G 5-~= ~ ~ cKC 5~a -- 33~ 3 OS-0E 13 (Rev 08/Q3) S~ REVERSE FOR INSTRUCTIONS AND CODE VALUES ~~ 3~~ (1) Name CAMPAIGN TREASURER'S REPORT -ITEMIZED CONTRIBUT~7NS ,~ ~I~~ ~ - ~~.~'" (2) I.D. Number ~ } 2 (3) Cover Period C~~ / Z~ 1 ~~ thrau~- (~ / ~ Z / ~ (4) Page ~J of _ (5) paw (n FuN Name (g) (9j (10) (11) X12) (6) Sequence Number (Last. Sulfa. Fast. 11~ddte) Street Address 3 State Cale CarirbuDor' T tion Cartrbutia~ T In-kind ^~"~"'~ Amount ~~ "~' CSC: I ~I I~ t~~~~% ~-~~~ ~c~ ;~~ ~_ ~ ~ ~ ~~ 1,~5 1~ve~,M~-~ ~ ~~ ~a ; 51~ ~W 15_F, 5. ~ ~v~,_ ~ ~ ~ ~~ , o~ ~~S~S C~~ ~~ ~ ~ ~~ ~ i~ 'l c.~-~ ~. 5«~; ~ . • ~~~~~ L~~s t ~~ .3~`~ E~ ~~~~ 1~ ~ ~ ~ 01 ~ ~E~+ , ~ `~lo~ ti~ i~Q ~ ~>' ~`~ C ~~ c~~cb `~ , J~Jr~ / G~ ~ ~~ ~p~ ~~~isy~Ql.~~lc ~ ~~j ~ ~ ~-'~ r~ ~! N\ SAM ~ ~~S ~ ~ ~..- 330 o ~ o~ , o~ Gz ; r~ ~~~x, ~ ~ C ~ ~'~~-~ i 3l~t~~ ~ ~,~ ~~ t~~ TS-~... ~~~~~ g~~ ~~ ~~ 3 i i ~ ~ DS-DE 13 (ttev t)8It)3) SEE REVERSE FOR INSTtttICTIONS AWD CODE VALUES p,~ vas 5 CAM IG REASURER'S REPORT -ITEMIZED EXPENDITURES (1) Name °iV~t~\""~ ~ ~.~V.:'~_ (2) I.D. Number (3) Cover Period ~/~/~ through _~D /~ 2- /~ (4) Page ~_ of (5) Date (T) Full Name (8) Purpose (8) (10) (~~) Is) Sequence Number (Last, Suffix, First, N6ddle) Street Address b City, State. Trp Code (add office sought if co~ibution to a candidate) Expenditure YPe Amendment Amount ~i'Mt~!-~ ~~f~'-A 1 E~-~1 ~ 33 ~ ~ ~~ DS-0E 14 (Rev. 08/03) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES ~~ ~ 6~ ~~