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Q3 - 2009 (1) F ~~YN et.. Name (2) '~01 " I E. '.l.-o fr /Ie. Address (number and street) J5o'IN72;vJ PxlA Fi- City/State, Zip Code FLORIDA DEPARTMENT OF STATE DIVISION OF ELECTIONS CAMPAIGN TREASURER'S REPORT SUMMARY {!.. -;J Eft f\.1 t?J rtf'7i 576 OFFICE USE ONLY > '3 37:3 <:: o 1.0 g "-i - N D CHECK IF ADDRESS HAS CHANGED (4) Check appropriate box(es): ~ Candidate (office sought): D Political Committee D Committee of Continuous Existence D Party Executive Committee D Electioneering Communication (3) ID Number: :Jf v>. '" t""Jo ~f MA~ D CH CK IF PC HAS DISBANDED D CHECK IF CCE HAS DISBANDED D CHECK IF NO OTHER ELECTIONEERING COMMUNICATION REPORTS WILL BE FILED (5) REPORT IDENTIFIERS Cover Period: From L I L ?tx;1 To ~ I ~ I 'Jt:x;1 Report Type tp~T6eL;1 ~Original D Amendment D Special Election Report D Independent Expenditure Report (6) CONTRIBUTIONS THIS REPORT Cash & Checks $ 0 Loans $ 0 Total Monetary $ 0 In-Kind $ 0 (7) EXPENDITURES THIS REPORT Monetary Expenditures $ o Transfers to Office Account $ Total Monetary o $ o (8) other Distributions $ o (9) TOTAL Monetary Contrib~ons T07e $ <g<;v, (10) TOTAL Monetary Expenditures To Date $ 7Y2 I' .c:,.~ ~ (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) Dlndividual (only for ~Treasurer D Deputy Treasurer electioneer" 9 commun.) F (Type name) ~ Candidate D Chairperson (only for PC, PlY & electioneering commun. rganization) x x OS-DE 12 (Rev. 08/04) CAMPAIGN TR ASURER'S REPORT -IT~MIZED EXPENDITURES (1) Name 6,\ c... . / C (2) I.D. Number (3) Cover Period 1 / l~throughL~~'1 (4) Page I of / (5) Date (6) Sequence Number (7) Full Name (Last, Suffix, First, Middle) Street Address & City, State, Zip Code (8) (9) (10) (11) Purpose (add office sought If contribution to a candidate) Expend iture Type Amendment Amount ,/ I / OS-DE 14 (Rev. 08/03) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES CAMPAIGN TREASURER'S REPORT -ITEMIZED CONTRIBUTIONS (1) Name Fto/J1#L f(- J C,A 1\/ 131tP7/ <7 e- (2) I,D. Number (3) Cover Period through 0 I (4) Page f of I (5) (7) (8) (9) (10) (11) (12) Date Full Name (6) (Last, Suffix, First, Middle) Sequence Street Address & Contributor Contribution In-kind Number Cit , State, Zi Code T e Occu ation T e Descri tion Amendment Amou nt OS-DE 13 (Rev, 08/03) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES