Treasurer's Report
FLORIDA DEPARTMENT OF STATE DIVISION OF ELECTIONS
CAMPAIGN TREASURER'S REPORT SUMMARY
a)~o.lJ/?c:JAI L., /-//J Y OFFICE USE ONLY
Name A / ) L"- r# /J ,r
f'27/vu .;;:) - /1 Yc-..
Address (number and street)
go f'd/(7;V fiL::-',4 cd, Fl 33 Y 3S-
City, State, Zip Code I
o CHECK IF ADDRESS HAS CHANGED (3) 10 Number:
~ f1iJ fr/5"p;f:t::P N~/Z 1).:r::> rK..:L.c r
o CHECK IF PC HAS DISBANDED
o CHECK IF CCE HAS DISBANDED
o CHECK IF NO OTHER ELECTIONEERING
COMMUNICATION REPORTS WILL BE FILED
(5) REPORT IDENTIFIERS
From 0/ / CJ / / 1/ To 0/ / 2// 1/ Report Type
(1 )
(2)
(4)
Check appropriate box(es):
~Candidate (office sought):
o Political Committee
o Committee of Continuous Existence
o Party Executive Committee
o Electioneering Communication
~ )
-....
-.4
()
-I
Cover Period:
c....
;r...
z
'"
+-
-0
:x
.r-
eo
-'ltn
-fT1
("')>
fT1CJ
:t:
~
EI
o Original
o Amendment
o Special Election Report
o Independent Expenditure Report
(6) CONTRIBUTIONS THIS REPORT
Cash & Checks $
/0 () " (!JC>
Loans $ ~
/00,,, L) c/
Total Monetary $ -
In-Kind $
(9) TOTAL Monetary Contributions To Date
$ 1.cPt:?, ~
(7) EXPENDITURES THIS REPORT
Monetary
Expenditures
$
-0--
Transfers to Office
Account $
Total
Monetary
"- () .,-
$
(8) Other Distributions
$
(10) TOTAL Monetary Expenditures To Date
$ '""'"'" 0 .-
(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 comple e.
IT""c nan-\C\ (:J<J.IJ PW / W
I D:":;;i;~~ '00" to< Tle'"surer D, ~P"', t,'Y, T 'y,re surer
~ct(OOM';/~/ ~t'
Signature ~
OS-DE 12 (Rev. 08/04)
CAMPAIGN TREASURER'S REPORT - ITEMIZED CONTRIBUTIONS
W~r OW L. t+ AY (2) 1.0. Number
I I
(1) Name
(3) Cover Period DI / 01 / f through 01 / &1 / II (4) Page of /
(5) (7) (8) (9) (10) (11 ) (12)
Date Full Name
(6) (Last, Suffix, First, Middle)
Sequence Street Address & Contributor Contribution In-kind
Number City, State, ZiD Code Type Occupation Type Description Amendment Amount
/ //5// // LVO't5p/?'e'J() i ,lIhf ~h/lc(7iF/( L (}/J -/I /00, c:~
'1.:21/Y4)S'Z#4vi: J !JMC;/J1K,
dO/ 8<7~AI?zf#&~
,K'/339'3?
I I
/ /
, ;
--
/ / ........ r~ --1
........ =~.<
c.... -":c
::Po 0"
:z
'" '.'-ro
.- ~s
-0 ~:z:
(/) --<
I / ::It c:
Oz:
W -rt
-"CD
.c:- -Pl
CO ~>
CJ
:x:
/ /
/ /
OS-DE 13 (Rev. 08/03)
LI
I I
SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES
(1 )
FLORIDA DEPARTMENT OF STATE DIVISION OF ELECTIONS
CAMPAIGN TREASURER'S REPORT SUMMARY
IJ}OOP!?t1W L. /lAY OFFICE USE ONLY
NY27 fil'tV .5 ~ A VE'J
Address (number and street) 3
Bdf.N~K ~EAlH, FL 3~3.5
City, State, Zip Code /
o CHECK IF ADDRESS HAS CHANGED (3) 10 Number:
Check appropriate box(es):
~ Candidate (office sought):
o Political Committee
o Committee of Continuous Existence
o Party Executive Committee
o Electioneering Communication
, .)
--'" r') -;
-A .=i -<
.." -<0
rr1 0"'"
OJ
I r-ro
Me)
-.J :"0-<
~:;~
.." ui--
.r:- .......
.."
~CtJ
f"ll
:~>
, (J
::::
(2)
(4)
o CHECK IF PC HAS DISBANDED
o CHECK IF CCE HAS DISBANDED
o CHECK IF NO OTHER ELECTIONEERING
COMMUNICATION REPORTS WILL BE FILED
(5) REPORT IDENTIFIERS
Cover Period: From.tl.L / 1.'- /.JL To" 2 / P1 / K.- Report Type E 2
o Original 0 Amendment 0 Special Election Report 0 Independent Expenditure Report
(6) CONTRIBUTIONS THIS REPORT
(7)
EXPENDITURES THIS REPORT
Cash & Checks
$
Monetary
Expenditures
$
2- 5-5: So
---
Loans
$
f't'a I EE-
L).. t!!:JO
rc:t:J~-
23~ @E
/
Transfers to Office
Account $
Total
Monetary $
Total Monetary
$
In-Kind
$
(8) Other Distributions
$
(9) TOTAL Monetary Contributions To Date
$ Stt:J<:!,,, ~O /
~
(10) TOTAL Monetary Expenditures To Date
$ ;z5"S". eO ./
(11) CERTIFICATION
It is a first degree misdemeanor for any person to falsify a public record (5S. 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 comp te, correct, and com~l~te. J I
(Type name) ~p~~o) i, #A V (Type name) jUt?OP/<t::>lv l, /1'A Y
o Individual (only for Treasurer 0 Deputy Treasurer &,candidat, 0 Chairperson (only for PC. PTY &
~d"'OO",1!l"mmo'.) X ~g CO 0'. o","i~'ioo)
Signature
OS-DE 12 (Rev. 08/04)
Signature
r
(1) Name
CAMPAIGN TREASURER'S REPORT - ITEMIZED CONTRIBUTIONS
tJ tJ(;Jf)RtJW L # ;!A Y
(2) 1.0. Number
(3) Cover Period l!Jl / 22 /1/ through" 2 / d~ / II (4) Page / of /
(5) (7) (8) (9) (10) (11 ) (12)
Date Full Name
(6) (Last, Suffix, First, Middle)
Sequence Street Address & Contributor Contribution In-kind
Number City, State, Zip Code Tvpe Occupation Tvne Description Amendment Amount
/ /2/f,1/ bJ4"D~1J) l.IIAY ~~Il~ L~A 1/ ft1L7, ~
'I27H'AJS~ Ave; :r '/?do/lltR .'
}3afli1"t?N 8df I="l
0"/
33//:35 ' ,
-
..... :::::;-<
I 1 ~ -<0
l)~
'co
, t'""'1Q
-.J ::0.-<
A'-
.... ........
-0 . .
(f),.-.
I..... .::) :z
.s;:- ~CJ
..
I 1 -- ("Tl
- ell>
- :Tt(j
::::
1 1
/ 1
1 /
1 I
1 I
OS-DE 13 (Rev. 08/03)
SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES
._, CAMPAIGN TREA$URJ:R'S REPORT - ITEMIZED EXPENDITURES
(1) Name wocP1UuA] L. ~ /fA y (2) I.D. Number
(3) Cover Period ~I 122 ILthrOUgh(J2 I~ 1/ (4) Page / of
-
I
(5)
Date
(6)
Sequence
Number
(7) (8) (9) (10) (11)
Full Name Purpose
(Last, Suffix, First, Middle) (add office sought if Expenditure
Street Address & contribution to a
City, State, Zip Code candidate) Type Amendment Amount
I ~II
()o/
Su.P~ .,: eLE~T~ CH<nF.Jr~?:IZSV
2/IIJ S. M;d'T~1/ TI?4:&L cF 1ZF<f~-1' J11~N
wPJ7FL.. 3.39'/5' "t?~.?
b:7Y t'F' 13t>'1/t1n>JI.BF~ LP-f F.lZPI1
(tJlJ ~ 0 BrJI';/TI/I &/1 8l V.P FEE
~,v&:/f~3l/2~
C~rf 4F &vK7l?tI/ 1J~
}.6" E. .BtJf/fl'nJIN &# Hi lIP
~Ji &:/1 F~~'I2.S-
nt6';V
5J7? TE
A7ft-;p~BI
>>I ~;I
0"3
OS-DE 14 (Rev. 08/03)
SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES
c
--" ,.., --<
--" ~-<
-r'1 ~_.< c
rr1
CO
,
-J
,,-n
,-OJ
rT'l C1
:::'0-<
~--
-0 <.r> -
-.r' c:;
--- C) :z
-7.' ~o:;
.-rn
():P'
rrln
::x:
FLORIDA DEPARTMENT OF STATE DIVISION OF ELECTIONS --
.-. ,--) --i
CAMPAIGN TREASURER'S REPORT SUMMARY --" :::::i-<
IAJ 0 t:>.1J 1(0 IAJ L, /lAY :;po ,,""T1
(1 ) OFFICE USE ONLY :::0 .OJ
. , r'1O
NY27 AI IJ 5 & AVE., -1 -:0 _~..
?':i
(2) -0 u~::
:x '-
0-'"
Address (number and street) FL 1-
r -<,
13~'1,A/r~N 8EA~ 33'13S ...- ro
N ---; r'1
cJ::>
City, State, Zip Code / \D i"'ll("')
o CHECK IF ADDRESS HAS CHANGED (3) 10 Number:
(4) Check appropriate box(es): CON)m:t:.S 5IO# l:~ ]):t~ 7l?:L C. T 7f
J;8'Candidate (office sought): .
o Political Committee o CHECK IF PC HAS DISBANDED
o Committee of Continuous Existence o CHECK IF CCE HAS DISBANDED
o Party Executive Committee
o Electioneering Communication o CHECK IF NO OTHER ELECTIONEERING
COMMUNICATION REPORTS WILL BE FILED
(5) REPORT IDENTIFIERS E'I
Cover Period: From 02 / It( / .LL To tJ 3 / tJf / ~ Report Type
o Original o Amendment o Special Election Report o Independent Expenditure Report
(6) CONTRIBUTIONS THIS REPORT (7) EXPENDITURES THIS REPORT
2 1 <itJ , ~~/ Monetary I tJ3&, 3L /
Cash & Checks $ Expenditures $
I {
Loans $ Transfers to Office
02-/ Account $
Total Monetary $ 2/ !./ Cjt!J ~ Total :2<1/
I Monetary $ ( 03B/l .-
In-Kind $ /
(8) Other Distributions
$
(9) TOTAL Monetary Contributions To Date (10) TOTAL Monetary Expenditures To D~
$ s: S70,. ~ ./ $ ~) 72(/.'1
/ /
(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. L. ;-lAY correct, and complete. L~ J/A}I
(Type name) !JOOJJ/?OW (Type name) LV 00 !YROt.J
o Individual (only for DTreasurer 0 Deputy Treasurer o Candidate o Chairperson (only for PC. PTY &
electioneering c mun.) electi2 comm n. organization)
X X /.'
. ',I..
Signature -
OS-DE 12 (Rev. 08/04)
CAMPAIGN TREASURER'S REPORT - ITEMIZED CONTRIBUTIONS
(1) Name bVao.2>^,t'tU l /lAy -
(2) 1.0. Number
(3) Cover Period 02. / I 9 / through CJ 3 / 0 1 / / / (4) Page / of 2
(5) (7) (8) (9) (10) (11 ) (12)
Date Full Name
(6) (Last. Suffix, First, Middle)
Sequence Street Address & In-kind
Number Cit , State. Zi Code T Descrj tion Amendment Amount
2,2 KII1I/ANI"/~VA ~La $~L _
, l(2r JltJ 8 r#/lYE :E l1?rllL'JPlIl. ell t IO't~
CJol E~':1. 331/3S"
6'.JJd/lIll.D FENraN' 11;26; E:..
~/.l~,"- 4I~v'~ t)/E
~~~tAJ7.3~~ "fi
002 ~ FL. 33 '13-6
/ 1<a.5HA if J>~#.l:EL 3C;/e:Joc I/s; ~
t!.Ri'WFclVJ ~ a --
'IllS' CII$q-j/:r d 1- TEA$"/Z- . 0
(/03
J/)oJP~~~ 3<?~7
2-/ Y~/lHE;8P~ c-
~ pt:>WJ. cllE
ftt!)' Lt>a;SoiV' Bl~ ,
Ptt.J?h '/ fJFlJ4II J ~
~3 ~fS-
;;; 20 / / "i1JUl ehe?/W1tif5
, / ' ;UlL q#
~tI. F€f).IfdJ~~
C?tJ ~ ~ rL 33~3S
2 ,'2;2.., "~.rRFF~ V6~
1 tl/lJ19.:r:c7 C alE
c>Ob ftl jJ!>X 773-
FL ~3 Jj2>
:2 ,11 , E"dLZ i.:r:c.. Ptl7~
~~,~ ,rN~, {J/t
?ultTd?5 PAc- rL ~~ !liE
7tJ251114tf$P1 )lA1; C
oog PI?,
'MlltJe; FL.. 32$2.~
OS-DE 13 (Rev. 08/03) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES
CAMPAIGN TREASURER'S REPORT - ITEMIZED CONTRIBUTIONS
~}lJ?t1W L.&ty - -
(1) Name (2) 1.0. Number
(3) Cover Period 0 Z / through () 3 / 0 / /1 (4) Page 2 of :z.
(5) (8) (9) (10) (11 ) (12)
Date
(6)
Sequence In-kind
Number Descri tion Amendment Amount
3 I! Ih {)/E Y$~
-# -
cffi 1f5~
.
3// 11/ m--~ OlE ~po
011
312 11/ ~8' OlE
I I
I I
I I
I /
OS-DE 13 (Rev. 08/03) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES
1J CAMPAIGN TREASURER'S REPORT - ITEMIZED EXPENDITURES
(1) Name '()OPI<,C>w", AlA ~ (2) I.D. Number
, I
(3) Cover Period 02 ,~/K through ~ CJ'/tR (4) Page / of
(5) (7) (8) (9) (10) (11)
Date Full Name Purpose
(6) (Last, Suffix, First, Middle) (add office sought if Expenditure
Sequence Street Address & contribution to a
Number City, State, Zip Code candidate) Type Amendment Amount
'2/22/// C LE1l? ~pp ..r//e- ?Jl.1ltH7/> IY/ 0;/ ~f~~
/301/ H. rEP,- /fA,l}fr ;llJIIp", 1./ 7?
()O! $13,R- 33,/35
~ / / /11 t.tFJR Ld;:'f' Z,/J C r Ptlp.7tr/fL- ~!i.?% '!!:
1301/ '^', 1='1:'"'/),. )/-Nt', /'I},A rt " t/ tt1j:J Y\10)V'
{}O2 J?j FL 33Lj35
3/'1/// }/t:JIYtt: ]JE"Pe;T !J?,ljX}J::5 H>,l? lV)o# t ~ .:u $16
/!>Oosw B~57;
, S;rc//?" ' --..
003 13~ FL 33Y;3~
/ /
/ /
/ /
/ /
/ /
OS-DE 14 (Rev. 08/03) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES
FLORIDA DEPARTMENT OF STATE DIVISION OF ELECTIONS
CAMPAIGN TREASURER'S REPORT SUMMARY
(1 ) aJ Ot:7 P J?ot-J L, //AY OFFICE USE ONLY "
-...... :J_
-
Name ~ tJ -1:f:I. 1/ J .-- ;:::j -:-;-
(2) ~2? S Le, <c
co r;;::;:
A~dress (number and street) FL. ._ J'\) I-CO
<:..v !"'Ie)
8tP f/VlC?# $E/JL!/ 33Lf3.~ "0
;g ~-<
, ;;;.-:
, <.I) ~
City, State, Zip Code a
o CHECK IF ADDRESS HAS CHANGED ':{l -" ....
(3) 10 Number: (J1 :]~
~_J~
(4) Meck appropriate box(es): 6 . <: 1"11(")
Candidate (office sought): ,t?ml1.'::J'SJ:~/';b)Z h57)Z!L<-tT . :t:
o Political Committee o CHECK IF PC HAS DISBANDED
o Committee of Continuous Existence o CHECK IF CCE HAS DISBANDED
o Party Executive Committee
o Electioneering Communication o CHECK IF NO OTHER ELECTIONEERING
COMMUNICATION REPORTS WILL BE FILED
(5) REPORT IDENTIFIERS
Cover Period: From t/ 2 / C>:!5-/ )J To {72. / IR / .LL Report Type E3
-
o Original ~ Amendment o Special Election Report o Independent Expenditure Report
(6) CONTRIBUTIONS THIS REPORT (7) EXPENDITURES THIS REPORT
2, MCJ. OC":> Monetary ~ 9' 27, ys
$ ~- Expend itu res $ <-
Cash & Checks
Loans $ Transfers to Office
O>~ Account $
Total Monetary $ 2) bC'c? --- Total
~5
, Monetary $ / 1/7'~ -
/ - ..
$ .'
In-Kind
(8) Other Distributions
$
(9) TOTAL Monetary Contributions To Date (10) TOTAL Monetary Expenditures To Date
$ -~J /CJ Cfl " t!!!> C> $ Ij 6 8:<, ~.:S
-
'" ,
(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 compjte. /'r ~ ,1,/ correct, and complete. j~/A V
(Type name) a ~Ph>N (Type name) ;JC'OP.2::?~
o Individual (only for DTreasur~r 0 Deputy Treasurer o Candidate o Chairperson (only for PC, PTY &
"''"'''''''' ,mm"".) ~ ~ . electioneeri~:un_ organization)
X /- t"~ _J, ~k /' =</
X 1~~~4
Signature ,...- Signature ~J
OS-DE 12 (Rev. 08/04)
(1) Name ,CAMPAIGN TREASU~'S REPORT - ITEMIZED EXPENDITURES ------
~ 00 p.eC/N L ~ A P (2) I.D. Number
(3) Cover Period CJ2 1 <:::?S/~through ()2 / /$ I---.LL (4) Page I 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
2 //3/1/ !/CJM E p~ ?CJ;r- $C'~.EJ!5 ~;;< $
/..5 cc:r.54.) 2B?# .s;-; 6/9?
c:J CJ I P0F! 3:3r..2b -5:) 41-1>
,.-
;Z /)3/)/ WC)C>P~~ /. ~~ ~ 0 1);Z.P.5 [;"/ R r~
Z;27/,fNS~ AvE ~S24#5 ,PC ..5 ~Y7
OCJ,/ J?,g./ FI 3 3 t3.5--
/ /
/ /
'. J
.- ~:"j-<
""T1
/ / ,...., -<0
to C) -rr
N 'en
w ""'0
"0
;" :;
-0 'n~
- a
U'l D:z:
'1
/ / .. -~co
U'l --r"'!l
\.D C')>
n"ln
::x:
/ /
/ /
OS-DE 14 (Rev. 08/03) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES
FLORIDA DEPARTMENT OF STATE DIVISION OF ELECTIONS
CAMPAIGN TREASURER'S REPORT SUMMARY
(1) LJ 00 j)J(O tJ L,,)! A Y OFFICE USE ONLY ~
Name AI J I 5' r#fl '~ g
(2) '127 IV. w, - Vi:!' , N
Addre. ss (number and street) r / :53 u S- N
13oYdr()~ B/?',4~tf; ,..L 7'3 ;?
City, State, Zip Code U1
o CHECK IF ADDRESS HAS CHANGED (3) 10 Number: ~ r~
(4) Check appropriate box(es): /' 7) ~
~Candidate (office sought): c.OIYlh1..r~.$.roNE7< :rSr/?..r;C r ~
o Political Committee 0 CHECK IF PC HAS DISBANDED
o Committee of Continuous Existence 0 CHECK IF CCE HAS DISBANDED
o Party Executive Committee
o Electioneering Communication 0 CHECK IF NO OTHER ELECTIONEERING
COMMUNICATION REPORTS WILL BE FILED
(5) REPORT IDENTIFIERS
Cover Period: From 02 1051)/ To 02 I /8 I II Report Type E-3
~riginal 0 Amendment 0 Special Election Report - 0 Independent Expenditure Report
(6) CONTRIBUTIONS THIS REPORT (7) EXPENDITURES THIS REPORT
bO . Monetary / L / 1/5
Cash & Checks $ 2 60c:>" - / Expenditures $ / 7 2 7 I - ./
) I
Loans $ Transfers to Office
~ Account $
Total Monetary $ 2, 6c:JOc ~./ Total 1/::5~
Monetary $;; ,/2 ;0 ~ /'
In-Kind $ (
(8) Other Distributions
$
(9) TOTAL Monetary Contributions To Date (10) TOTAL Monetary Expenditures To Date
$ -7/CJCJ. ~ / $ ~682.}/5
I
(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. J / correct, and camp ete. /'/...
(Type name) tJOO])ROW 16 dAy (Type name) ~j)~oJ l.--IiA
o Individual (only for gTreasurer 0 Deputy Treasurer 0 Candidate 0 Chairperson (only for PC, PTY &
~ct'Z7~~ X "'~"" moo.",,,",,,,")
Signature Signature
OS-DE 12 (Rev. 08/04)
bJ CAMPAIGN TRE~~R'S REPORT - ITEMIZED EXPENDITURES
(1) Name t>O.J>~(>tV L I ~ (2) J.D. Number -
(3) Cover Period ()2. 1 ()5; 1/ through 02/ 18/ / / (4) Page / of J
(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
:2 1/3;// H&,;nE ])t!:'-;Pd/ !?>t>-'1-l(pS Fb~ ~/I ~6'~ f7
152'e>..5/,/J tJ~ ST; ::;TG#.5
~cJl i31! r:L. 33~.z6
:2- //111/ 5unvr.S:1'~ ~f! ELErr.rd~..$ LJ?/~ ~Z.~
2. ~b.s. M..r~jJ n{'AZ'L rl/o)./
IA7?BrFL 331/~ C-P
&>t?.2..
2 II$; 1/ J)/.:ST'4- 5.z-9H?, ~t '~f33~~~
271'3 ~ F'EP,)/AJ~ If}~/I
OtJ3 J>E'lR.1tf ~ PL $';-<1'#.:5
23'/#3
I I
I I
I I
I I
I I
OS-DE 14 (Rev. 08/03) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES
CAMPAIGN TREASURER'S REPORT - ITEMIZED CONTRIBUTIONS
LJCJOJJJ<otV !, )/Ay - ...,
(1) Name (2) 1.0. Number
(3) Cover Period 02 I oS-; / I through CJ 2 I ) 8 I J / (4) Page / of I
(5) (7) (8) (9) (10) (11 ) (12)
Date Full Name
(6) (Last, Suffix, First, Middle)
Sequence Street Address & Contribution In-kind
Number Cit , State, Zi Code T T e Descri tion Amendment Amount
2 6 1/ JJ.rIUIfN~. J}sM !/I /lJd a
/ . 1 2JJ1 KArel.. 'IN r. . .......
()O I bJARJlER RbBr4
6A .:3//)98
2 7 // RC",N.4f5.5/1#cE ~5c?t>, ~
/ 1 ?/r?RA-~E 73J. VD 13 {!IF
/SdtJ t;~rEltJ,fII
Sld'rE 2-.~(J
00 2, B.B,/PJ.. 33'126
2. 7 // 7?E/lA~SMd" :5"""?t? /"
1 / EXE~Hr~lI€: tilE
'GO<J~~Y"'LVP 13 .
~(;J..3 5J[e~.3r26
K. t."R l?Efl,IJL$ II Sa>,
'!:~ 9A7"E'/AJIt~ 84VP C/lE
C>&' 'I $UrrG' :t,t::14
$'~'IFL- 33l/~6
2 / /1 5qHhC:YCL.rN~
/ /. PZ$BI{I(s,!}rJGNT . C;lE
(J)CJ~ 7~ IIPlR47H- ~R.
J..A.H1:'9111A ~ 1,
33Y6'2.
2// '/ Stf.llTI/atl tdIISrE JN1+57"f
/ J. y.srE~Lc,
P~8tP(; W1'" "'II-~ dE
(706 791)~A711 ~.
t..AJl7'MA /Pt. ~~
/ /
/ /
OS-DE 13 (Rev. 08/03) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES