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20M05
CAMPAIGN TREASURER'S REPORT SUMMARY (1) � � ,s L L �— OFFICE USE ONLY Name City of Mia:rni �ard(;rls (2) U-) r Rec�;vec i•,the Office of the Ci y Clerk - ---.___ _. : 141 Address (number and street) -Time:DateQ City, State, Zip Code ❑ Check here if address has changed (3) ID Number. �5.- 32l q (4) Check appropriate box(es). [Candidate Office Sought 1_ s 06 u t4 L Se.41 ❑ Political Committee(PC) ❑ Electioneering Communications Org. (ECO) Lj Check here if PC or ECO has disbanded [W; Party Executive Committee (PTY) FI Check here if PTY has disbanded ❑ Independent Expenditure(IE)(also covers an L_]Check here if no other IE or EC reports will be f-.,-,d individual making electioneering communications) (5) Report Identifiers Cover Period: From Q l 0 1 t Q 0 To 1 I 0.,;20 [Report Type of jVADs ❑ Original ❑Amendment ❑ Special Election Report (6) Contributions This Report (7) Expenditures This Report Monetary Cash & Checks Expenditures l� ! Loans $ CLr% Transfers to Office Account $ 1 l Total Monetary Total Monetary $ 0 In-Kind $ On (8) Other Distributions (9) TOTAL Monetary Contributions I o Date (10) TOTAL Monetary Expenditures To Date $ Q� (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) 'q el, riD UCY (Type name) W41114- _��I UgR 0 IndhAdual(only for IE Treasurer ❑Doputy Treasurer Canaidate 0 Chairperson(only for PC and PTY) or eiectioneering comm.) Signature Signature DS-DE 12(Rev.11113) SEE REVERSE FOR INSTRUCTIONS C PAIGN TREASURER'S REPORT- ITEMIZED EXPENDITUR S _ (1) Name f�ltl� - (2) I.D. Number (3)Cover Period o-57 ©L/)WO20hrough( I ? _! (4) Page of (5) - (7) (S) (9) (10) (11, Date Full Name Purpose (�) (Last,Suffix,First,Middle) (add office sought if Street Address& contribution to a Expenditure ! Sequence � Number City,State,Zip Code candidate) I Type IAmondment Amount i 0 c � OF N`� ,�r(� C q��P� h1� toA rroy g 3 1 F�� i DS-DE 14(Rev.11113) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES