HomeMy WebLinkAbout02: M04-17 ReportCAMPAIGN TREASURER'S REPORT SUMMARY
(1) t^c^ux:L\
Name(2) iszfo AliOt^i^rl
Address (number and street) ,
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City, State, Zip Code
Q Check here if address has changed
OFFICE US
(3) ID Number:
E ONLYCity 0^ Miami I -s
Receiver'Li' the Ohict. oi .' le City Cletk
patft- Ult^laoi 1
Time:- ^AQor/A,
6y; Aj^-
(4) Check appropriate box(es):
IB^andidate Office Sought: ^ -000 G) CouLnCi]
□ Political Committee (PC)
□ Electioneering Communications Org. (ECO) □ Check here if PC or ECO has disbanded
□ Party Executive Committee (PTY) □ Check here if PTY has disbanded
n Independent Expenditure (IE) (also covers an Q Check here if no other IE or EC reports will be filedindividual making electioneering communications)
(5) Report IdentifiersCover Period: From g*/ / g/ / n To 0^ I "2:0 / i"7 Report Type: "7
^^riginai □ Amendment □ Special Election Report
(6) Contributions This Report
. _£)■ 00 Monetary
Cash & Checks $Expenditures
Loans $Transfers to
Office Account
Total Monetary $. 0 (70
Total Monetary
In-Kind $Jim
(7) Expenditures This Report
$. O dd
■Jl
(8) Other Distributions
$D. (22
(9) TOTAL Monetary Contributions To Date
$ , . ce:^(10) TOTAL Monetary Expenditures To Date
$ ,
(11) CertificationIt is a first degree misdemeanor for any person to falsify a public record (ss. 839.13, F.S.)
I certify that I have examined this report and it is true, correct, and complete:
(Type name)
□ Individual (only for IE 0 Ti
(Type name)
I Treasurer □ Deputy Treasurer r Candidate
or electioneering comrn^
Signature
□ Chairperson (oniy for PC and PTY)
X
Signature
DS-0E12(Rev. 11/13)SEE REVERSE FOR INSTRUCTIONS
(1) Name
CAMPAIGN TREASURER'S REPORT - ITEMIZED CONTRIBUTIONS
(2) I.D. Number
(3) Cover Period 0^ / Ol I I'l through ^ / H (4) Page —of
(5)
Date
(6)
Sequence
Number
/ /
/ I
(7)
Full Name
(Last, Suffix, First, Middle)
Street Address &
City, State, Zip Code
0
(8)
Contributor
Type Occupation
(9)
Contribution
Type
(10)
In-kind
Description
(11)
Amendment
(12)
Amount
/ I
I I
I L
I /
/ /
DS-DE 13 (Rev. 11/13)SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES
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