M10 2021 Waiver of Report 11-10-2021WAIVER OF REPORT
(Section 106.07(7), F.S.)
(PLEASE TYPE)
f!
ir
Name
Addhss
10"Candidate ❑ Political Committee
Office Sought
City State
❑ Party Executive Committee
Zip Code
NOTE This form does not apply to an electioneering communications organization (ECO). An ECO must file a report (not a
waiver) that no reportable contributions or expenditures were made during the reporting period (s. 106.0703(6), F.S ).
❑ Check here if address has changed since last report. ❑ Check here if PC has DISBANDED and will no longer file
reports.
TYPE OF REPORT (Check Appropriate Box and Complete Applicable Line beneath Box)
�MONTHt_Y REPORT ❑ PRIMARY ELECTION ❑ GENERAL ELECTION ❑ OTHER REPORT TYPE
Indicate report # Indicate report # Indicate report # Indicate report type and #
M 10 P G as applicable:
❑ TERMINATION REPORT ❑ SPECIAL ELECTION
NOTIFICATION OF NO ACTIVITY IN CAMPAIGN ACCOUNT FOR THE REPORTING PERIOD OF
Ci�'OLf 45 tom) THROUGH 0 C YJ -if 3 b r I
A4AIZ
Signature Date
X `f ti Cfl-j [JI WJA--
Signature
Date
REQUIRED SIGNATURES FOR: Candidates:
Candidate and Campaign Treasurer or Deputy Treasurer (s 106 07(5), F S )
Political Committees:
Chairman and Campaign Treasurer or Deputy Treasurer (s. 106.07(5), F S.)
Party Executive Committees:
Treasurer and Chairman (s. 106.29(2), F.S.)
Except as noted above for an ECO, in any reporting period when there has been no activity in the account (no funds expended or
received) the filing of the required report is waived. However, the filing officer, must be notified in writing on the prescribed
reporting date that no report is being filed.
DS -DE 87 (Rev. 06115)