First Quarter 2009
OFFICE USE ONLY
OFFICE ACCOUNT REPORT
(Section 106.141, F.S.)
(PLEASE TYPE)
Name Office to Which Elected
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Address State Zip Code
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Name of Bank
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Add ress
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City
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State
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Zip Code
This report contains
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pages of Deposits a8d ?l:
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Disbursements, upon which I have written my initials covering the period~f ~~
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through
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Balance on hand at beginning of reporting period
Deposits during reporting period
$ l'f' . I?
$ '-
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,
$ /-;i6 ~/1
Disbursements during reporting period
Balance on hand at end of reporting period
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is complete(true and correct.
, certify that this report
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OS-DE 48 (Rev. 08/03)
OFFICE ACCOUNT
DISBURSEMENT OR DEPOSIT INFORMATION
(PLEASE TYPE)
AMOUNT
DATE NAME AND ADDRESS PURPOSE
Disbursement Deposit
. ~OV~
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rl- 3 3"3 d'1
ELECTED OF~ INITIALS TOTAL TOTAL
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OS-DE 48A (Rev. 08/03)