DS-DE 12 F2-07 Amended CruzFLORIDA DEPARTMENT OF STATE, DIVISION OF ELECTIONS
CAMPAIGN TREASURER'S REPORT SUMMARY
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Candidate, Committee or Party Name I.D. Number
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Address (number and street) City State Zip Code
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Check box if address has changed since last report
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(4) Check appropriate box(es): ,_w ~ -~
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^~- 'Candidate (office sought): ~~~.. ~ ~ ~''' ~. ~"~
^ Political Committee Check if PC has DISBANDED <~^ -D :,~
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^ Committee of Continuous Existence ^ Check if CCE has DISBANDED ~~
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^ Party Executive Committee ~ -- '~
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(5) REPORT IDENTIFIERS
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Cover Period: From =L/ /~_/ ~'~-~ To _ ~'~'` / ,_ r ~%/ ~~-{-- Report Type l ^ ~--
^ 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 $-,
($) Other Distributions $-,
(9) TOTAL Moneta 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.}
I certify that I have examined this report and it is
true, correct and complete I certify that I have examined this report and it is
true, correct and complete
Name of ^ Treasurer ^°Deputy Treasurer Name of ^`Candidate ^ Chairman (PC/PTY
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C ,,. , OnIY)
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Signature Signature
DS-DE 12 (7198} SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES
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