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DS-DE 12 Q4-10 Bower j FLORIDA DEPARTMENT OF STATE DIVISION OF ELECTION , S CAMPAIGN TREASURER'S REPORT S(�l l ! c D (1) Ian 11\-=-- L t tr OFFICE USE ONLY Name 1011 JAN I 0 PM 3: ( 1'(' IJ -kie CITY CLERK'S OFF ICE Ad (number � - 32 1 M, 1 City, State, Zip Code ❑ CHECK IF ADDRESS HAS CHANGED (3) ID Number. (4) Check appropriate box(es): [Candidate (office sought): 4d0C— off' \\A t l .&A Ci-k ❑ Political Committee ❑ CHECK IF PC HAS DISBANDED ❑ Committee of Continuous Existence ❑ CHECK IF CCE HAS DISBANDED ❑ Party Executive Committee ❑ Electioneering Communication ❑ CHECK IF NO OTHER ELECTIONEERING COMMUNICATION REPORTS WILL BE FILED (5) REPORT IDENTIFIERS Cover Period: From lc) / 01 / i D To 1 Z / 3' / 1C). Report Type (0i_ ( p A Original ❑ Amendment ❑ Special Election Report ❑ Independent Expenditure Report (6) CONTRIBUTIONS THIS REPORT (7) EXPENDITURES THIS REPORT Monetary Cash & Checks $ 1 l 00 p Expenditures $ Loans . $ Transfers to Office Account $ . Total Monetary $ i� C-b0 Total Monetary $ In -Kind $ (8) Other Distributions 0 $ (9) TOTAL Monetary Contributions To Date (10) TOTAL Monetary nditures To Date $ I Cxo $ (11) CERTIFICATION It is a first degree misdemeanor for any person to falsify a public record (ss. 839.13, F.S.) 1 certify that I h > examined this report and it is true, I certify that 1 have examined this report and it is true, correct, and co • I = . p correct, and con`' • I . (Type ;yam Ak' ` IL -_1 ' - O (T yne name . ` 1 KeZAs e- ❑ 1 • N 1 .. ►� Treasurer [3 Deputy Treasurer 6d candidate • Chairperson (.. tpr PC PTY & steal _ l k t ,.1 4 : ) ., ) X M ` J • ► i `■TV I �, 1—*; I .ii. , ' i . A- l I Signatu - AV Sign - - , Irr , DS -DE 12 (Rev. i . ' ) PolfX / Eri 0 1 I • CAMPAIGN TREASURER'S REPORT - ITEMIZED CONTRIBUTIONS (1) Name t i (2) I.D. Number (3) Cover Period 10 / / 1 through \7, / / (0 (4) Page of 1 ( ( (8) ( ( (11) (12) Date Full Name (6) (Last. Suffix First, Middle) Sequence Street Address & Contributor Contribution In -kind Number City, State, Zip Code Type Occupation Type Description Amendment Amount � 13 / f1� S , SIaI -p(L_. (� a .� . 15cOO oa r 203 Mme, 6a.k fit t\ Su>1, SR- 12! (¶ ! 10 r G -a,� D� I 4iP.rcE Soo l c So3 / 1 ! / ! ! ! ! ! ! DS-DE 13 (Rev. 08103) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES P aLy .?""