DS-DE 12 Q2-07 Amended CruzFLORIDA DEPARTMENT OF STATE, DIVISION OF ELECTIONS
CAMPAIGN TREASURER'S REPORT SUMMARY
Candidate, Committee or Party Name I.D. Number
Address (number and street) City State -dip ~de
^ Check box if address has changed since last report ~-~ ~ ~~
-, ; ;~
(4) Check appropriate box(es): ~ ~a
t^°Candidate (office sought): ~ ~ \~ ~ '~-
^ Political Committee Check if PC has DISBANDED ~' ~
~
_
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^ Committee of Continuous Existence ^ Check if CCE has DISBANDED ~
^ Party Executive Committee
(5) REPORT IDENTIFIERS
__-~ _ -
Cover Period: From ~~, / 9 /C1-~ To /~_/ ~d~~- Report Type ~~ ~~"~
^ Original ^°Amendment ^ Special Election Report ^ Independent Expenditure Report
(6) CONTRIBUTIONS THIS REPORT (7) EXPENDITURES THIS REPORT
__
Cash & Checks $_,~_~ Monetary
Expenditures $_,~, ,)`~
,
Loans $ Transfers to
_ Office Account $_, ,
Total Monetary $_, Total Monetary $_, ,
In-kind $_, , ~~ ~}~
(8) Other Distributions $_,
(9) TOTAL Monetary Contributions to Date (10) TOTAL Monetary Expenditures 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.)
1 certify that 1 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
Name of ^ Treasurer ^--~ Deputy Treasurer Name of Candidate ^ Chairman (PC/PTY
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Signature ,.~; Signature
DS-DE 12 (7/98) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES
CAMPAIGN TREASURER'S REPORT -ITEMIZED CONTRIBUTIONS
(1) Name K"`' ' W ~~ (2) I.D. Number
(3) Cover Period ~" / ~ / U~ through ~, / _J c:.:= / ~ (4) Page
of
(5)
Date (~)
Fuil Name (8) (9) (~~) (~~) (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
i ~ ~- t
F{
/ /
/ /
/ /
/ /
I
/
/
/ /
DS-DE 13 (Rev. 08/03) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES
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