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TR FLORIDA DEPARTMENT OF STATE DIVISION OR~~calg'NTON BEACH '-' CAMPAIGN TREASURER'S REPORT SUMMMtVRK'S OFFICE; ~~ (1) .]05't.wt /u~dfc' WI:J9N y~ ....'(: 2i Name , 743 MMafee B1' p/,o ~ Address (number and street) :JC {3v:j11 k;n f3dt F1 '53, '35 City, State, Zip Code D CHECK IF ADDRESS HAS CHANGED (3) 10 Number: -<0 0'" ICD ,." 0 ;;0-< ~-z.. Ui....... o 0% _ -nee .. ~ f"T1 N ("')> ;1"0-635." C y :x: (2) (4) Check appropriate box(es): J j ~Candidate (office sought): /Vt c.ytJ/; D Political Committee D Committee of Continuous Existence D Party Executive Committee D Electioneering Communication pOY/1fo~ ;7~4d1 D CHECK IF PC HAS DISBANDED D CHECK IF CCE HAS DISBANDED Original D CHECK IF NO OTHER ELECTIONEERING COMMUNICATION REPORTS WILL. BE fiLED (5) REPORT IDENTIFIERS From 2 / ~ / ~ To L / 70 / ~ Report Type 112 D Amendment D Special Election Report D Independent Expenditure Report Cover Period: (6) CONTRIBUTIONS THIS REPORT (7) EXPENDITURES THIS REPORT Cash & Checks $ Monetary Expenditures $ 7<1 -- Loans $ Transfers to Office Accou nt $ Total Monetary $ Total Monetary $ In-Kind $ (8) Other Distributions $ (9) TOTAL Monetary Contributions To Date $ '6')5 (10) TOTAL Monetary Expenditures T7e $ g'35 (, (11) CERTIFICATION It is a first degree misdemeanor for any person to falsify a public record (55.839.13, 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) Jidlo Yt:sk. (Tpename) Jo~hVtt; fvJs....H-r D Individual (only for Treasurer D Deputy Treasurer Candidate D Chairperson (only for PC, PTY & ;(';~::t ~ X "";o~""g~m"".o",,";_") Si9~ / Sig OS-DE 12 (Rev. 08/04) ~ CAMP,AIGN TREASURER'S REPORT - ITEMIZED EXPENDITURES (1)Name jo~h~ I0df~1k ' (2)I.D.Number ~O.- 6 3<;,t~({;<;;- (3) Cover Period L~ /0 through L 76 I to (4) Page ! of / (5) (7) (8) (9) (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 ~/?o/ /0 4u-1t:t( 11 fif" d (I' ()'5-5 [ rOO a 1'1 - po OK [JI < 7lf-- Ot'~ .AI!t:?111~~/ tA 50]<' b I / / / / / / / I / / / / / OS-DE 14 (Rev. 08/03) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES