DS-DE 12 F!-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 Zip Code
^ Check box if address has changed since last report ~' o
a
(4) Check appropriate box(es): r
_ ~ }_ ~
^'Candidate (office sought): ~~ ~~ "' ;
to -~
^ Political Committee Check if PC has DISBANDED ..,..
^ Committee of Continuous Existence ^ Check if CCE has DISBANDED ~
;-~
~
^ Party Executive Committee -... ~7
,~,
(5) REPORT IDENTIFIERS
Cover Period: From _~/ ~ / i~ "~"`i"o "'~ /~/~~ Report Type ~~_
^ Original ^' Amendment ^ Special Election Report ^ Independent Expenditure Report
(6) CONTRIBUTIONS THIS REPORT (7) EXPENDITURES THIS REPORT
Cash & Checks $_,y~~,~. _ Monetary _
~t =~
Expenditures $_, --f (U, ~ f
Loans
$
' Transfers to
- Office Account
$-,
Total Monetary $_, ~ Total Monetary $_
In-kind $
, ! , r''~~%.
_ (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
Name of ^ Treasurer Deputy Treasurer Name of ~~
Chairman (PC/PTY
-
---
..
X ~,
,. .,
~' ' ~
-_,
Signature Signature
DS-DE 12 (7/98) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES
(~~ c= ~ ~
CAMPAIGN TREASURE'S REPORT -ITEMIZED EXPENDITURES
(1) Name Simon Cruz
(3) Cover Period_ ~/~/f~to ~//j/0}
(1) Page
(5)
Date (7)
Full Name (8)
Purpose (9) (10) {11)
(6)Sequence
Number (Last, Suffix, First, Middle)
treetAddress & Cit State Zi Code Expenditure
T e Amendment Amount
~"~1 O ~
0 3 Cc~~nC?ou-~~5c1 k~ ~
yb'~ L.a~
~ ~,: ~1G~~ chQLk. ~'oc~ (Qqt~
Total
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_____.___ ._.__-~ ___'
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