HomeMy WebLinkAboutGeneral - 20G01 CAMPAIGN TREASURER'S REPORT SUMMARY
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OFFICE USE ONLY
me(2) Na_2 f� J � f/o/,
J7 � •. City ofMiami Gardens Rec,'ver' i.the Office ,.e l:it)f r
Address(numb and street) Date:_C a
Time-
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City, State, Zip Code By-n!`
❑ Check here if address has changed (3) ID Number:
(4) Check appropriate box(es): a
Candidate Office Sought: /l �,� �( %� muk (, Id(..-%L i,
❑ 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 (% / o/ l �(� To0�_ Report Type: '206
Original ❑Amendment ❑ Special Election Report
(6) Contributions This Report (7) Expenditures This Report
r Monetary
Cash & Checks $ , 50 Expenditures $
Loans $ _ _ Transfers to _
Office Account $
Total Monetary $ _ � —� � SC�
Total Monetary $ _ — � , �?1.
In-Kind
(8) Other Distributions
(9) TOTAL Monetary Contributions To Date (10) TOTAL Monetary Expenditures To Date
(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:
(rYPe name) - - (Type name) ]�4 A/ZViI /
❑Individual(only for tE i]Treasurer ❑Deputy Treasurer ❑Candidate ❑Chairperson(only for PC and PTY)
or electioneering comm.)
X x
Signature _----- _-_- -- -- Signature
CATPA(IGN/T ASURER'S REPORT- ITEMIZED EXPENDITURES
(1)Name ` ; /CT,II/ �Y✓ t ,�(�( 1, (2) I.D. Number
(3)Cover Period(9 l Ln 1 -2o through d l9 LSO (4) Page / of I
(5) (7) (8) (9) (10) (11)
Date Full Name Purpose
(6) (Last,Suffix,First,Middle) (add office sought if
Sequence Street Address& contribution to a Expenditure
Number City,State,Zip Code candidate) Type Amendment Amount
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DS-DE 14(Rev.11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES ��
CAMPAIGN TREASURER'S REPORT— ITEMIZED CONTRIBUTIONS
(1) NameC 'i r, UU ��(��j � '� _� (2) I.D. Number
(3) Cover Period V through / �� / (4) Page - of
(5) (�) (8) (9) (10) (11) (12)
Date Full Name
(6) (Last,Suffix,First. Middle)
Sequence Street Address& Contributor Contribution I In-kind
Number City,State,Zip Code Type Occupation Type Description Amendment Amount
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DS-DE 13(Rev.11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES
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