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1 Modified For Lee County Only (092001) SEE REVERSE SDE FOR NSTRUCTONS ON COMPLETNG TEMS 1 THROUGH 11 /K$ GhGL Candidate, Committee or Political Party o & 9 Wrncub c,wccg Address (Number and Street) (2) Daytime TeleThone Number Zip Code (4) @eck appropriate box or boxes below indicating reporting status: indidate (office sought and district or seat #) ~13 O$ &rnt &Q&A hrsrlfcr 3 Continuous Existence CHECK F PC HAS DSBANDED 0 CHECK F CCE HAS DSBANDED 0 CHECK F NO OTHER ELECTONEERNG ingperiodcovered: From 10 f 13 od TO!! / 62 / ed, ReportTypeCode: GY @ Original Report Amended Report Special Election Report ohdependent Expenditure Report (6) CONTRBUTON FOR THS REPORTNG PEROD Cash and Checks Loans by Candidate $ $ l0;olu * 00 TOTAL blonetary for F;t,;iiting Psriod $ lb,d f 0. 0 0 nkind s ($ 1 For thls reporting period only. DO NOT add inkind with monetary AND only list the amount for this reporting period. * a/, 310 Combtne amount in (9) from last report on thls line. (9) TOTAL Monetary s TO DATE: certify tm. * ; 2xamined thls report and &is true, correct and complete (7) EXPENDTURES FOR THS REPORTNG PEROD vonetary Expenditures $!Sp0!. 30 Transfers to Office Account $ TOTAL Monetary Expenditures for Reporting Period (8) Otrie;" Distributicjns (DOES NOT APPLY TO CANDDATES) ($ 'd For this reporting period only. DO NOT add to expenditures AND only list the amount for this reportinq period. (see instructions) (10) TOTAL Monetary Expenditures TO DATE: * (SEE N!XQUCTONS FOR SGNATURE REQUREMENTS) certify that have examined this report and &is true, correct and complete 6 Treasurer Deputy Treasurer ndividual (only for Electloneering (Communication Organization or ndependent Expenditure) @ Candidate 0 Chairman (only for PC, PTY and Electloneering Communication Or~anlratlon) THS FORM MUST (SEL MSTRUCTONS FOR SXGNATURE REQUREMENTS) WJ 72 (Q8fC.4) Modified for Lcw Ceuntf t3j05 GNED AS REQURED

w CAMPAGN TREASURER S REPORT (TEMZED CONTRBUTONS) (1) m/ke i3/ k?l (3) Reporting Period Covered: /b / /v / 06 TO // / 02 / 0 6 1 8YY902 6aTtime Telephone Number (4) Page 1 of < (itemized contributions) SEE REVERSE SDE FOR NSTRUCTONS ON COMPLETNG TEMS 1 THROUGH 12 (7) (8) (9) (10) (11) Sequence Number Contributor., Type nklnd Description use ADD or DEL see instructions r B L. w4 z C M 1 092001)

CAM PAG N TREASU RER'S RE PORT (TEMZED CONTRBUTONS) (3) Reporting Period Covered: /o / /r/ / 6 TO /&a (4) Page of.e' (itemized contributions) SEE REVERSE SDE FOR NSTRUCTONS ON COMPLETNG TEMS 1 THROUGH 12 1 (5)&(6) (7) (8) (9) (10) Full of ConMbutor (Last, Suffix, First, Middle) Contributor Sequence Number CityStateZip Code Type / Occupation raklnd. '.. Type Description cw use see nstructions (12) AMOUNT ecrc '.

CAMPAGN TREASURER S REPORT (TEMZED CONTRBUTONS) (1) /37/Kis i3/ & 1 BW902 2 dajkime Telephone Number (3) Reporting Period Covered: /b / /v / 06 TO / 02 / 0 6 5 SEE REVERSE SDE FOR N5 (7) TRUCTONS 0 (8) (4) Page 3 of (itemized contributions) COMPLE (9) Full of Contributor (last, Suffix, First, Middle) CityStateZip Code Contributor Trpe Occupation... Type nkhd AMOUNT /$ 77/ b J f & 15 f d b T a *. ma i DSDE 5 (02 4 57) M

1 CAMPAGN TREASURER'S REPORT (TEMZED CONTRBUTONS) (1) /WKE a/ kl (3) Reporting Period Covered: /b / /v / TO // / 02 / 0 & REVERSE SDE FOR N! (7) rruct (a )NS 0 daftime Telephone Number (4) Page 4 of 5 (itemized contributions) (9) (10) (11) Sequence Number Full of Contributor (Last, Suffix, First, Middle) CityStateZip Code rercsp L( T,*J3e&Urwd ecacck Type 1 Contributor. nmind use chd, Pp 3L d '29) P

1 CAMPAGN TREASURER'S REPORT (TEMZED CONTRBUTONSj (3) Reporting Period Covered: /b / /v / 06 TO // / 02 / 06 a (7) Contributor (4) Page 5 of (itemized contributions) SEE REVERSE SDE FOR NSTRUCTONS ON COMPLETNG TEMS 1 THROUGH 12 Full of Contributor (Last, Suffix, First, Middle) CityStateZip Code iype nkind Description use see nstructions AMOUNT / 3G B * 37 DSBE 13 (02

4 (1) m$ke /3fe (2) 5 ) W F FOL2 (3) Reporting Period Covered: /o / lq / 06 TO /( / 02 / oc Dadme Telephone Number (4) Page of * (itemized expenditures) SEE REVERSE SDE FOR NSTRUCTONS ON COMPLETNG TEMS THRO JGH 11 (8) PURPOSE OF EXPENDnURE (including bank service fees) NOTE: A candidate cannot Entity Receiving Payment: contribute to another candidate Full from campaign funds. we (la& Suffii Fist, Middle) (Pcls, PTY's, CCE'S add office sought f contribution to a Expenditure S M Number CityStateZlp Code candidate) Type instructions AM0lJNr (9) (11) 4, s00.00

CAMPAGN TREASURER'S REPORT (TEMZED EXPENDTURES) (1) /?htl. &/a Day6me Telephone Number (3) Reporting Period Covered: /o / f/ 06 TO // / o z / ob (4) Page 6 of 2 (itemized expenditures) SEE REVERSE SDE FOR NSTRUCTONS ON COMP (5) a (1 (6) (8) PURPOSE OF EXPENDrrURE (induding bank senrice fees) NOTE: A candidate cannot Entity Receiving Payment: DATE and contribute to another candtdate Full from campaign funds. (Last, SuffbG First, Mfddle) (E'S, P"s, CCE'S add OtA Stteet Address sought tf contribution to a Number citysbt0~0 code candidate) ETNG TEMS THROUGH 11 (9) Expenditure Tvpe us8 see instruceions T DSDE 14 (02/97) Modified for Lee County 0 2 ly (092001)

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