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CAMPAIGN TREASURER'S REPORT SUMMARY
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OFFICE USE ONLY
jNam City of Miami Gardens
(2) cz U Rec6Ive�; in the
O Zp of the City Cleth
press (numb nd str et) Date:_
Time:
By:
City, State, Zip Code
❑ Check here if address has changed (3) ID Number:
(4) Check appropriate box(es):
Candidate Office Sought: _�1eal 0I
❑ 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:o� '
❑ 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
�) �
$ c�' V,,ccam�" $
(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 comple k
(T e e) J 1 (Type name) I'l S , !YYl /V os
ndividua for49 Tr c rer ❑ Dep ty Treasurer [ C didate ElC irper on my fo PC and PTY)
r electione in c )
X X
Ign re Signature
DS-DE 12(Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS
CAMPAIGN TREASURER'S REPORT - ITEMIZED WNTRIBUTIONS
(1) Name, .�1 �—/��S (2) I.D. Number
(3) Cover Period t / / through / _�=?L / ,270 (4) Page of
(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
o/ sw /a �r
3oa 7
DS-DE 13(Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES