DS-DE 12 G2-11 Berke 10,1tp,2011
FLORIDA DEPARTMENT OF STATE DIVISION OF ELECTIONS
CAMPAIGN TREASURER'S REPORT SUMMARY
(1) 5.. - r ) c . OFFICE USE ONLY
Nam
( `(oY fr/v�e,?L pc
Address (number and street)
/11 a4 jeke r - 3 5
City, State, Zip Code
El CHECK IF ADDRESS HAS CHANGED (3) ID Number:
(4) Check appropriate box(es):
KCandidate (office sought): Atai.4 frit,
Political Committee ❑ CHECK IF PC HAS DISBANDED
❑ Committee of Continuous Existence ❑ CHECK IF CCE HAS DISBANDED
El Party Executive Committee
❑ Electioneering Communication ❑ CHECK IF NO OTHER ELECTIONEERING
COMMUNICATION REPORTS WILL BE FILED
(5) REPORT IDENTIFIERS
Cover Period: From ' / 2 / To / / // Report Type t (
Original El Amendment ❑ Special Election Report ❑ Independent Expenditure Report
(6) CONTRIBUTIONS THIS REPORT (7) EXPENDITURES THIS REPORT
Monetary
Cash & Checks $ .4 / r° Expenditures $
Loans $ Transfers to Office
Account $
Total Monetary $ Total
Monetary $
In -Kind $
(8) Other Distributions
$
(9) TOTAL Monetary Col tributions To Date (10) TOTAL Monetary Expenditures To Date
$ 010 0 et gC(O..
2J/ 0 - Pr V
(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, I certify that I have examined this report and it is true,
correct, and complete. correct, and complete.
(Type name) t// (L L i W rr � t_ /ZK �1-
(Type name) S T � E
❑ Individual (only for cia Treasurer ❑ Deputy Treasurer J Candidate 0 Chairperson (only for PC, PTY &
electioneering commUr j - �,.r -' electioneering commun. organization)
X X
Signature Signature
DS -DE 12 (Rev. 08/04)
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CAMPAIGN TREASURER'S REPORT — ITEMIZED CONTRIBUTIONS
(1) Name (2) I.D. Number
_ (3) Cover Period 5' / 2- / 1( through 1 ° / ? / ( ( (4) Page 1 AR of 1
( ( ( ( ( ( (
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
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CAMPAIGN TREASURER'S REPORT - ITEMIZED CONTRIBUTIONS
(1) Name 6 v it.c (2) I.D. Number
(3) Cover Period 2 / 2- 7/ 1/ through 70 / .7 / / / (4) Page 1 4 of .1
(5) ( ( ( ( 0 ) ( (
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
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C /', / cc�G AIGN EI SU R' PORT — ITEMIZED EXPENDITURES
(1) Name l ! (2) I.D. Number
(3) Cover Period 6 7 / 2i / 1/ through 10 / * / / / (4) Page of . 5 .--
(5) ( ( ( (10) (11)
Date Full Name Purpose
(6) (Last, Suffix, First, Middle) (add office sought if
Sequence Street Address & contribution to a Expenditure
Number City, State, Zip Code candidate) Type Amendment Amount
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DS -DE 14 (Rev. 08/03)
SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES
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CAMP GN TREASURER'S REPORT - ITEMIZED EXPENDITURES
(1) Name , �� ( 2
L �' ( ) I.D. Number
(3) Cover Period 9 / .2'f / ti through 10 / QZ 1 (4) Page gr of
(5) ( ( ( ( (
Date Full Name Purpose
¶nce (Last, Suffix, First, Middle) (add office sought if
Seq
Street Address & contribution to a Expenditure
Number City, State, Zip Code candidate) Type Amendment Amount
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DS -DE 14 (Rev. 08/03)
SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES
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