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HomeMy WebLinkAbout19M11 CAMPAIGN TREASURER'S REPORT SUMMARY (1) -Ll}rr'+ ;;�D,nc ('v; .,-,;:,.-,1 s OFFICE USE ONLY Name - Oity of Miami Gardcns 2 Reci,eve--' i,' he Office o"~he City Clerk �' " �I f t - - Date: Address(number and street) Time:— 4- City, State, Zip Code ❑ Check here if address has changed (3) ID Number: (4) Check appropriate box(es): ff6andidate Office Sought: ❑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 ❑ Independent Expenditure(IE)(also covers an ❑Check here if no other IE or EC reports will be filed individual making electioneering communications) (5) Report Identifiers Cover Period: From I To it / ig Report Type: [3 Original ❑Amendment ❑Special Election Report (6) Contributions This Report (7) Expenditures This Report Monetary Cash & Checks $ G t > G Expenditures $ Loans $ _ Transfers to Office Account $ Total Monetary $ Total Monetary $ In-Kind $ !yv (8) Other Distributions $ r, (9) TOTAL Monetary Contributions To Date (10) TOTAL Monetary Expenditures To Date $ rsr (11) Certification It 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) (Type name) N , i, A rt e,A Q Individual(only for IE ❑Treasurer ❑Deputy Treasurer EiCand+dale ❑Chairperson(only for PC and PTY) or electioneering comm) 14 X Signature Signature DS-DE 12(Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS CAMPAIGN TREASURER'S REPORT — ITEMIZED CONTRIBUTIONS (1) Name /h,c ytiv e_ lvf-'Vefs 4 jk— (2) I.D. Number (3) Cover Period ( ! / 1q- through 1! / 561 / t 'f (4) Page / of (5) (7) (8) (9) (10) (11) (12) _ Date Full Name (6) (Last,Suffix,First,Middle) I Sequence Street Address& ContributorI Contribution In-kind Number City,State,Zi Code— T e Occu ation Tyke Description Amendment ' Amount Ch,.rdsen � T I 5 0.1 I n r rtc5 I I i I 51,v+'Flet- Y ' I I DS-DE 13(Rev. 11113) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES CAMPAIGN TREASURER'S REPORT— ITEMIZED EXPENDITURES (1) Name _t k",,rt I ..,_ -_ —' � (2)I.D. Number (3)Cover Period i l 1 14 through 1( / ! i 4c (4)Page�_of (5) (7) (8) (8) (10) (11) Date Full Name Purpose --i (Last,Suffix,First,Middle) (add office sought if Sequence Street Address& contribution to a Expenditure Number City,State,Zip Code candidate) Type Amendmont Amount fla /4 (2w,c �'� ,k i') W k' d V I I DS-DE 14(Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES