Name of Elected Official
BROWARD COUNTY CODE OF ETHICS DISCLOSURE FORM
CAMPAIGN FUNDRAISING FOR OTHER CANDIDATES
Name of the candidate for whom you are soliciting campaign contributions:
Location and date of any and all associated campaign events:
Name(s) and contribution amounts) of any individual(s) who provided contributions to you, either directly or indirectly, for delivery to the candidate:
 
Contributor NameContribution Amount
none$0.00
Total Amount Being Declared: $0.00
AUTHORIZATION SIGNATURE
Elected Official Signature
Date
If this form amends an earlier-filed form, please state date of earlier form: