DS-DE 12 F4-07 Amended CruzFLORIDA DEPARTMENT OF STATE, DIVISION OF ELECTIONS
CAMPAIGN TREASURER'S REPORT SUMMARY
Candidate, Committee or Party Name I.D. Number
P
-=-~1-~ '~ ~l ~' '11,1 ~~~~~i ~ ~' l ~ ~ ~ ~ ( ,
(3) `ti ~`x~-~'~ '~~% .~~!+ ~
'--~'~
.
Address (number and street) City State ~ C~e
^ Check box if address has changed since last report ~~ ''~ r~
`~'
~
r
-
~ ,
(4) Check appropriate box(es): ~--, --
^
~~ ~ ~~ W
^-'Candidate (office sought): µ'S
,.
~
Check if PC has DISBANDED ~
^ Political Committee '-=;, ~,,~
^ Committee of Continuous Existence ^ Check if CCE has DISBANDED ;=, ~
^ Party Executive Committee
(5) REPORT IDENTIFIERS
Cover Period: From ~/~/~.-~"" To _~/~__! ~ ~~~ Report Type ~ =~-
^ Original ^'Amendment ^ Special Election Report ^ Independent Expenditure Report
(6) CONTRIBUTIONS THIS REPORT (7) EXPENDITURES THIS REPORT
~
Cash & Checks $_,..,
-~-~~' Monetary , _, ;~~~~~j
-~~ ~~~
Expenditures $_, iz;~ ,
Loans $_, Transfers to
Office Account $ ,
Total Monetary $-, Total Monetary $_,
In-kind $-~ (8) Other Distributions $_,
(9) TOTAL Monetary Contributions to Date (10) TOTAL Mon7et~yary~ 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
;-
i , _._ _._ _ _ nl
~- _ .----._.
A
Sign(~ture '~
-` ; Signature ~ - -
DS-DE 12 (7/98) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES
~~~~ ~ ~ ~