DS-DE 12 Q2-06 (1) Simon Cruzr
FLORIDA DEPARTMENT OF STATE, DIVISION OF ELECTIONS
CAMPAIGN TREASURER'S REPORT SUMMARY
(1) ~rrar C1LU.Z
Candidate, Committee or Party Name
Address (number and street) City
^ Check box if address has changed since last report
(4) Check appropriate box(es):
Candidate (office sought): ~~~~
^ Political Committee ^ Check if PC has DISBANDED
^ Committee of Continuous Existence ^ Check if CCE has DISBANDED
^ Party Executive Committee
(5) REPORT IDENTIFIERS
Zip Code
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Cover Period: From ~_/~_/Q~ To _~/~/Q(~ Report Type ~~
^ Original Amendment ^ Special Election Report ^ Independent Expenditure Report
(6) CONTRIBUTIONS THIS REPORT
Cash & Checks
Loans
Total Monetary
In-kind
(2)
I.D. Number
State
(7) EXPENDITURES THIS REPORT
Monetary
Expenditures $_, ,~.
Transfers to
Office Account $
$-,~~' i ~ a I Total Monetary $
(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 (ss. 839.13, F.S.)
I certify that I have examined this report and it is I certify that I have examined this report and it is
true, correct and complete true, correct and complete
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Name of ^ Treasurer ~eputy Treasurer Name of ^ Candidate ^ Chairman (PC/PTY
Only)
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Signature Signature
DS-DE 12 (7/98) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES
P~ , ~.Z
CAMPAIGN TREASURER'S REPORT -ITEMIZED CONTRIBUTIONS
(1) Name ~.~cY~pCl C,~'~;~~ (2) I.D. Number
(3) Cover Period ~ / ( / ~( through ~ / (p / ~~ (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
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DS-DE 13 (Rev. 08/03) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES
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