HomeMy WebLinkAboutGeneral - 20G05 CAM PAI N TREASURER'S REPORT SUMMARY
(1) OFFICE USE ONLY
Nae
(2) I ' ��' CU.r+ City of Miami Gardens
on Rec&�ve,- n the Office of the City Cler:
A d ess (number a d str t) f Date: Qm
CL4Y Fk- 631 t//o
Time: '
City, State, Zip Code By.
❑ Check here if address has changed (3) ID Number:
(4) Ch�Pk appropriate box(es):
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
Cove Period: From / / (7) To / / � Report Type:cqy 6
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
(11) Certification
It is a first degree misdemeanor for any person to falsify a public record (ss. 839.13, F.S.)
I certify that1 have examined this repo and it is true, correct, and complete:
(Type name) off (Type ame)� / S
❑ Individual my f r reasur De Treasurer Candid ❑C rpe on o r PC and PTY)
or electione r' g c mm.) 1
w
X� X - -
Signatur'A ignat e
DS-DE 12 (Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS
CAMPAIGN TREASURER'S REPORT — ITEMIZED CONTRIBUTIONS
�� ' (2) I.D. Number
(1) Name -
(3) Cover Period / I0 1 V through 0'/ 102Y / a?0 (4) Page of
(5) (7) (8) (9) (10)
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
I
1
I
-1
DS-DE 13 (Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES
��MPAT' TI�ASU R'S REPORT— ITEMIZED EXPENDITURES
(1) Namei �5 (2) I.D. Number
(3) Cover Period o /4 through /O (4) Page of
(5) (7) (8) (9) (10) (11)
Date Full Name Purpose
(6) (Last,Suffix,First,Middle) (add office sought if Expenditure
Sequence Street Address& contribution to a Type Number City, State,Zip Code candidate) YP Amendment Amount
�i
C �
DS-DE 14(Rev.11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES