HomeMy WebLinkAboutDocumentation_Miscellaneous_Tab 09_03/15/2016 CAMPAIGN LOANS OFFICE USE ONLY
REPORT
(Section 106.075, F.S.)
(PLEASE TYPE)
This report applies to all candidates ELECTED to office who had loans
exceeding $500 in value, which were accepted and used for campaign
purposes within the 12 months preceding the election. All such loans
must be reported to the filing officer within 10 days after the candidate's
election to office.
Full Name of Newly Elected Official
Office
Mailing Address
City State Zip Code
I CERTIFY THAT I HAVE EXAMINED THIS REPORT
AND IT IS TRUE, CORRECT AND COMPLETE.
Type or Print Name of Newly Elected Official
X
Signature
DS-DE 73 (Rev. 08/03)