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Third Quarter - 2009 OFFICE USE ONLY OFFICE ACCOUNT REPORT (Section 106.141, F.S.) (PLEASE TYPE) Name - [/lid "i. oR- Address ().,n S &./ :t? 'ytl (/S Name of Ba?k WII-Mto (/;';9- Address Office to Which Elected City !J (j~1)T&,tI ~f..k4. State -- j- L Zip Code 3:;j-.J-C City State Zip Code ?:f'f,j{, 1 [/1J il/ L"(),.v C;2 f" >'> ,ilf/ 12- ~7;;d/ ;/'..4'-' ;: ~ This report contains /1<1___. -- C-/ pages of Deposits and Disbursements, upon which I have written my initials covering the period of .- J" u'-V / {j ,)oe 9 through j'f" /Jt/.j6~ ,feY J ,) CJCJe:; Balance on hand at beginning of reporting period $ s--'I6 ' ) I' ,/ Deposits during reporting period $ -()-- Disbursements during reporting period $ - I!) --- Balance on hand at end of reporting period $ )46. /'7 ,J 1,'Jil2t2 V 7:1 Y AtJl- is complete, 'true and correct. x ...~ lected Official , certify that this report o >.D en rT'J ." W o ,., nq ::::;-< -'>:;ib ,~);~11 ".01 :~:q) A.:~ '.'" > i...l..... =c c~ - ~::l: -r;:Q ~ Gl8~ ::c OS-DE 48 (Rev. 08/03)