HomeMy WebLinkAbout19M04 CAMPAIGN TREASURER'S REPORT SUMMARY
OFFICE USE ONLY
Name he } City 01 Miami-Gardens
(2) .�� , v `�' Receive;' I;,the O Ice of the City Clerk
Address (number and str t) pate:
Ti
City, State, Zip Code ,
❑ Check here if address has changed (3) ID Number:
(4) Check appropriate box(es):
21-Candidate 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 . /
/ � TO �, `;, / / , , ", Report Type: IYIO
❑ Original ❑ Amendment ❑ Special Election Report
(6) Contributions This Report (7) Expenditures This Report
Monetary
Cash & Checks $ Expenditures $
,
Loans $ Transfers to
Office Account $
Total Monetary $ .
Total Monetary $
In-Kind $
(8) Other Distributions
$ ,
(9) TOTAL Monetary Contributions To Date (10) TOTAL Monetary Expenditures To Date
$ (r"'u $
(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)
i]Individual(only for IE Treasurer ❑Deputy Treasurer FR'A6andidate ❑Chairperson(only for PC and PTY)
or electioneering comm.)
,
X
Signature Signature
DS-DE 12 (Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS
CAMPAIGN TREASURER'S REPORT - ITEMIZED CONTRIBUTIONS
(1) Name :bpo (2) I.D. Number
(3) Cover Period 16A / �u / through (4) Page of -J
(5) (7) (8) (9) (10) (11) (12)
Date Full Name
(6) (Last, Suffix, First, Middle)
Sequence Street Address& Contributor Contribution In-kind
Number City, State,Zip Code Type Occupation Type Description Amendment Amount
DS-DE 13(Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES
_CAMPAIGN TR4SURER'S REPORT- ITEMIZED EXPENDITURES
(1) Name �.�v <S' �. �� k�11``CC (2) I.D. Number
(3) Cover Period _/ �� / _through / / (4) Page of
(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
DS-DE 14(Rev. 11113) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES