DS-DE 12 F3-07 Amended CruzFLORIDA DEPARTMENT OF STATE, DIVISION OF ELECTIONS
CAMPAIGN TREASURER'S REPORT SUMMARY
Candidate, Committee or Party Name I.D. Number = co '
Address (number and street) City State dip Cede
~~ ~
^ Check box if address has changed since last report ~, w ;'
(4) Check appropriate box(es):
~; ~
;
^"Candidate (office sought): ~~ y t~
^ Political Committee Check if PC has DISBANDED
^ Committee of Continuous Existence ^ Check if CCE has DISBANDED
^ Party Executive Committee
(5) REPORT IDENTIFIERS
Cover Period: From ~ '~ /, ~4~~' /~ To ,r~ / % Re ort T e `~~
^ Original ^`Amendment ^ Special Election Report ^ Independent Expenditure Report
(6) CONTRIBUTIONS THIS REPORT (7) EXPENDITURES THIS REPORT
Cash & Checks $_, ~/ ``~ , ^i`~` -
,~ , Expend ures $_,~~-:~, ~~`~~'
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
_. ~-
(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 ~~Candidate ^ Chairman (PC/PTY
~~
~~
f.,"
nIY)
~
Sign ure Signature
DS-DE 12 (7/98) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES
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