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HomeMy WebLinkAbout20M05 1� J,� CAMPAIGN TREASURER'S REPORT SUMMARY CO ) I/144 ,4 644 I'i� OFFICE USE ONLY Name _ I City of Miami Gardcns (2) ,�20I7 n !V 3iie plye Recbive:: iil t e Office of the City Clerk ;)71ress(nu era d street) 7Date: G 3 , O, up //dA4t �fl�cJ Cdime: By: ��C , Sta ip Code ❑ Check here if address has changed (3) ID Number: (4) Check appropriate box(es): �� r, 'Candidate Office Sought: �� ❑ Political Committee(PC) ❑ Electioneering Communications Org. (ECO) El Check here if PC or ECO has disbanded 0 Party Executive Committee(PTY) El 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 05 / 0) / cult/ To 05 / 31 / vat) Report Type: o5 ❑ Original ❑Amendment 0 Special Election Report (6) Contributions This Report (7) Expenditures This Report ,tel Monetary Cash & Checks $0 uv qq � , Expenditures $ 9dlt�: a , . Loans $ , Transfers to Office Account $ . Total Monetary MAO , 6) , • Total Monetary $ AV,iii) . In-Kind $ , , . (8) Other Distributions $ l0 , . (9) TOTAL Monetary Contributions To Date (10) TOTAL Monetary Expenditures To Date $ qo 0 , 6b , • $ r?2,49 , • (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) (Type name) Individual(only for IE ❑Treasurer ❑Deputy Treasurer ❑Candidate ❑Chairperson(only for PC and PTY) or electioneering comm.) tat i • X / l l,<< ` maX Signature Signature DS-DE 12(Rev.11/13) SEE REVERSE FOR INSTRUCTIONS CAMPAIGN TREASURER'S REPORT- ITEMIZED CONTRIBUTIONS (1) Name 44 Aaj-11 r,�/(I (2) I.D. Number (3) Cover Period CO / U 1 / ‘,10-i; through 3 I SI / /,,WJ (4) Page t of l (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 ������``,,�/�. 1, ,.gyp 1 in44'0 edo wit �kl6ldl4/ ulV l� �' I�� A i'r'G0:oD ii;41,44;intik ipto:00 M iux, curat Ft. 3'3oS ra / / • / / / / / / DS-DE 13(Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES CAMPAIGN TREASURER'S REPORT— ITEMIZED EXPENDITURES (1) Name �lf /- �ibi) i, 2 (2) I.D. Number (3) Cover Period 0 5 / 6 l / £(,through ti'e / 3/ / ciU 2 (4) Page / of (5) (7) (8) (9) (10) (11) Date Full Name Purpose (6) (Last, Suffix, First, Middle) (add office sought if Sequence Street Address& contribution to a Expenditure Number City, State,Zip Code candidate) Type Amendment Amount d 5/moi/ 111° �� fir' /71NtJv 4 Frdu,1�h1m9� ► Nd,� 11326:6 4�l944 Yf i3Pss & — / / / / / / / / / / / / / / DS-DE 14(Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES