HomeMy WebLinkAbout19M04 CAMPAIGN TREASURER'S REPORT SUMMARY
�nv a.Ot'(1-.7 _ OFFICE USE ONLY
Name
(2) _it 1 rJW
Address(number and street)
m14"'If FL 33rbc __
CRY State.Zip Cade
❑Check here if address has changed (3) ID Number
(4) .-
Cheyk appropriate box(es).
.L.LWC/andidate Office Sought (/�iA r I �' rn 1 t �1 '�G"s ( tO�n...,(�, S 3
❑Political Committee(PC)
❑Electioneering Communicabons Org.(ECO) ❑Check here If PC or ECO has disbanded
❑Party Executive Committee(PTY) ❑Cheek hen It PTY has disbanded
❑Independent Expenditure(IE)(also covers an ❑Cheek hers If no other IE or EC reports will be filed
indmoual making electioneering communications;
(6)Report Identifiers
Cover Period From / r / To i t7 / J Report Type
Original Amendment ❑Swial Election Report �1--
(6) Contributions This Report (7) Expenditures This Report
Monetary �t
Cash 8 Checks $ a y3 �U Expenditures S �3 v O 5
Loans S Transfers
�� �� Office Account $
Total Monetary S _ n
Total Monetary S o�3�_ OS
In-Kind ---
(8) Other Distributions
S
(9) TOTAL Monetary buttons To Date (10) TOTAL Monetary Expenditures To Date
$ . S�`'3 �o s _ 6'�
If 11 Certification
It rs a first degree misdemeanor for any person to falsity a public record(ss.839.73.F.S.)
I certify that I have examined this report and rt is true correct.and complete
TMe.ame) �i/ri"1`IN-r✓ E(T441_019,–W lType amei 51�M+n.R'^/
(arty ktr IE ❑Traattrs Tmaaurer ae O Ch-W—(My la PC end PTY)
X X_ %V
Signature Signature
D5-0E 12(Rev.71117) SEE REVERSE FOR INSTRUCTIONS
City 01 Mia.mi Gardens
Recc_,:ve;: );, t e Of it,of;;ie City clerk
Date: 1 ,901
Time: t
By; 1
CAMPAIGN TREASURER'S REPORT-MaGIM CONTRBUTXM
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-1M�71 SEE REVERSE FOR MSTRtWnDW MO CODE VALAF3
CAMPAIGN TLR yrs REPORT—� ITEMIZED EXPENDITURES
(1)Name 5��{,+ M^' / So_ (2)I.D.Number
(3)Cover Period ) ( /�thb�h `/� (4)Page
�_of
(5) (7) (e)
Date (9)
(Last,Suffix Fant Middle) latltl�C'1- (te) (11)
(6) contri6 sougd aK
Sequence Street Address b uLon t Eapenditu.
Number City,Stam,ZIP Code Candidate) Type
Am_tlmeis Amount
12S, u 13 Ar" 1�1.z ?0.C11
"o( M ?310
OS-DE 14(Rev.11113) SEE REVERSE FOR INS
TTyI)OT)ONS AND CODE VALUES