HomeMy WebLinkAboutGeneral - 20G04 CAMPAIGN TREASURER'S REPORT SUMMARY
0)qullks �IY) OFFICE USE ONLY
Namqj City of Miami,Gardens
(2) ��T �,( 1� Rec 'ver: ' ,the Of jc�e or'the City Clerk
Date:
AcLdress (number and s reet)
EL
)� Time: .,r.�
CiN, State, Zip Code
❑ Check here if address has changed (3) ID Number:
(4) Check appropriate box(es): 1
Candidate 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)
(5) Report Identifiers
Cover Period: From / IL
/ To / / Report Type:
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��Tol!late (10) TOTAL Moneta 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 have examined this report and it is true, correct, and complete:
(Type name f l5W, "S�-f ro i9ki ru (TyU-ff"kqk Q I
.sar, &IM'-5 _
❑ Individual nl fo IE as or 1h Deputy Treasurer Candidate Ij C rp rson(only for Pk and PTY)
or lectione i g comm.)
Signatu SignaVe
DS-DE 12 (Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS
C4PAI T 6ASU ER'S REPORT - ITEMIZED EXPENDITURES
(1) Name I (2) I.D. Number
(3) Cover Period �� / / through (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
DS-DE 14 (Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES
CAMPAIGN TREASURER'S REPORT— ITEMIZED CONTRIBUTIONS
(1) Name (2) I.D. Number
(3) Cover Period 9Ci through / `�/ (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
33o NO) 9PIJ'� ���� /�D, o c�
DS-DE 13(Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES