HomeMy WebLinkAbout19M11 CAMPAIGN TREASURER'S REPORT SUMMARY
OFFICE USE ONLY
Name City 01 Miami Gardens
Receiver i;,t e Of'ice o--'he City Clerk
(2) �i�� �Lr� 3 ✓� Date: I /a�_ _2
A dress (numb rand street) 2 2 ;ime: a ^'►
j a U 3��5 By. —
City, State, Zip Code
❑ Check here if address has changed (3) ID Number:
(4) k appropriate box(es): r
Che7ndidate 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)
(6) Report Identifiers
Cover Period: From / p l 4,0/9 To l JD / 2,1)fi Report Type:
❑ Original ❑Amendment ❑ Special Election Report
(6) Contributions This Report (7) Expenditures This Report
Monetary
Cash & Checks $ 0 , Expenditures $
Loans $ V Transfers to
Office Account $
Total Monetary $ (� , ,
Total Monetary $
In-Kind $ 0
(8) Other Distributions
$ __D_ , -
(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) `.i��, a�� (Type name)
❑Individual(only for IE ❑Treasurer ❑Deputy Treasurer ❑Candidate ❑Chairperson(only for PC and PTY)
or electioneering comm.)
X X
Signature Signature
DS-DE 12(Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS