HomeMy WebLinkAbout19M05 CAMPAIGN TREASURER'S REPORT SUMMARY
(1) ,rle /7� rf / !\ OFFICE USE ONLY
Name Qty c•Miami Gardens
(�) Receive,," I ;th Offic of the laity Cine k
Address(number and street) Date: L �� �i 7
644"" ) Fc_ Time: G! A
City, State, Zip Code •By°
❑ Check here If address has changed (3) ID Number:
(4) Check appropriate box(es):
Hidate Office Sought: ^i►1 l e, 1 ' -
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)
(S)Report Identifiers
Cover Period: From / 1 / ¢ To 1j l l I cl Report Type:
D41-69-inal ❑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 $
(B) 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:
(Type name) P Ih`L 11 "/A�•,rl (Type name)
❑Individual(only for IE gTreasurer ❑Deputy Treasurer ❑Candidate ❑Chairperson(only for PC and PTY)
or electioneering comm.) =
X
Signature - Signature
OS-DE 12(Rev.11113) SEE REVERSE FOR INSTRUCTIONS
CAMPAIGN TREASURER'S REPORT- ITEMIZED CONTRIBUTIONS
(1) Name A 1-t,t /y,,� n-1%rill (2) I.D. Number
(3)Cover Period 51 1 l 0 through / 3 / f (4) Page _� of 1
(5) (7) (6) (9) (10) (11) (12)
Date Full Name
(6) (Last,Suffix,First,Middle)
Sequence Street Address b Contributor Contribution In4und
Number City.-State,Zlp Code Type Occupation Type Descriotion AnWrK ."t ASM
jq
T
DS-DE 13(Rev. 11113) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES
CAMPAIGN TREASURER'S REPORT—ITEMIZED EXPENDITURES
(1)Name i //" % .; (2)I.D.Number
(3)Cover Period / 14 through S / / (4)Page of
(5) (7) (8) (9) (10) (11)
Date Full Name Purpose
(8) (Last,Suffix,First,Middle) (add office sought H
Sequence Street Address 3 contribution to a Expenditure
Number City,State,Zip Code candidate) T Amendment Amount
r� k� Iv i x 6'C.'JVI, C
/\Ln�rG /V
W Ix
N
DS-DE 14(Rev.11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES