HomeMy WebLinkAbout19M03 1 City of Miami Gardens
�/Sy'm,I}} CAMPAIGN TREASURER'S REPORT SUMMARY Reccwe". h t e Office C. i?8 l:It�N' �ie('C
(1) -psi �-'_ h rTr 0 OFFICE USE ONLY Date: �/ 9'
trn''ame Time:
Address(number and strew)
M Ift-vin f rws . -dT.
CRY.Stas.zip code
❑Cheek here N address has changed (3) 10 Number
(4) Cheek box(es).
�71�n�eomn sought n1/)9M 1 �-�-�Dt-S +
❑PoMinl Cmntslss(PCI
❑ENckanserinp Communtilikes Dry.(ECO) ❑Cheek hue It PC or ECO has dltttterrded
❑Pany Executive Committee(PTY) ❑Cheek hen If PTY hes distwded
❑Independent Expendttue(IE)(also covers an ❑Cheek hen N no other IE or EC reports v M be Med
indi+iduslmgxV oMcboneump commwuutprs)
46►Report Idstttlflers
Cover Period: From ! L! / To r 3 j ! Cj Report Type Q3— C
❑Onpirsl ❑Amendment +--�❑Specwl Ebctgn Report —/"
(6) Cont*,WAofis This Report (7) Expenditures This Report
41 Monetary — —
Cash 3 Checks S , ' OU Expentlnures $ r�
Loess $ Transfers to
Office Account 5
TotalMtlttMary S ,�04 . 8-!
Total Monetary 5 — JL_ 011)_
In-Kind
(8) Other Distributions ---
S
(9) TOTAL Monetary ontnbutions To Date 110) TOTAL Monetary Expend
tures To Date
S - U G ti, 5N W
(11)Certification
It;s a first degree misdemeanor for any person to falsity a public record(ss.839.13,F.S.)
I artfy that I haw,examined tthis reporrt and it is true correct.and canpiele
's.
(Type ) �6 P-�� (Type
tarry a IE ❑rreawm ❑oeplav T— :1 UneeM ❑cr..oe•+a+tow to PC rye Pry)
X X
Spnoun Slprutu
DS-DE 12(Rov.1IM31 SEE REVERSE FOR INSTRUCTIONS
CAMPAIGN TREASURER'S REPORT-ITEMIZED CONTRIBUTIONS
(1) Name c ��--mss (2) I.D.Number
(3)COM PWIod 3 / / /^j 11rprYh 3 / 3 (/ _q (4) Paye
(� Fua'Nmne T— (e) 1191
111) (12f
@I (tst k e Fret YtltlYl
>»aurla sr.e+Aeeressa Cmmeuew � Ca+aouoor, ', In-up
Nlaber .sw.Zp Coe.
opt — k6
9a�(sem X23 �
ov1- !E, (crNis .U
/
I
SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES
CAMPAIGN T
(11 N°'^° REASURER g REPORT—ITEMIZED EXPENDITURES
(31 Cover Period C 121 I.D Number I
through /�/ / / (4)Page I
(5) --tt--of
Data 17j PI PI (tol (ttl
Full Name PtePeee
161 (Last Sufrl:,Firtt Middle) (odd og,ce"Whit If
Sequence Street Addreea& eunufeudon to a Expenditure
Number CIry,Stab,Zip Code eendNlete) Type
Amwwyxe Amount
3 �S Gly
41 1
Q-�2 rt rF I
D64DE 14(Rev.11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES