HomeMy WebLinkAbout2018 - M1 Amendment - Campaign Treasurer Report – DS-DE 12, DS-DE 13, DS-DE 13A, DS-DE 14, DS-DE 14A & DS-DE 94 - Michelle J GomezCAMPAIGN TREASURER'S REPORT SUMMARY
(1) Michelle J Gomez
His HAR 23 PH IfIff USE ONLY
Name
(2) 4910 Woodlands Blvd
]RECEIVED
Address (number and street)
C Il Y OF TAMARAC
Tamarac, F1 33319
('ITY CL,;,,:.RK
City, State, Zip Code
I
El Check here if address has changed
(3) ID Number:
(4) Check appropriate box(es):
E Candidate Office Sought: Commissioner for Tamarac District 2
R Political Committee (PC)
R Electioneering Communications Org. (ECO)
Ej Check here if PC or ECO has disbanded
R Party Executive Committee (PTY)
El Check here if PTY has disbanded
R Independent Expenditure (IE) (also covers an
El Check here if no other IE or EC reports will be filed
individual making electioneering communications)
(6) Report Identifiers
Cover Period: From 01 01 /2018
To 01 31 /2018 Report Type: 2018M01
El Original Q Amendment Ej
Special Election Report
(6) Contributions This Report
(7) Expenditures This Report
Monetary
Cash & Checks $ 2 , 328. 00
Expenditures $ 1 169 .06
Loans $ 1, 159. 06
Transfers to
Office Account $ 0 00
Total Monetary $ 3, 487. 06
Total Monetary $ 1 169 06
In -Kind $ 783. 00
(8) Other Distributions
$ I 1 0 . 00
(9) TOTAL Monetary Contributions To Date
(10) TOTAL Monetary Expenditures To Date
$ 11 1 459 83
1
$ 1 814 .36
(111) 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) Thomas Toffoli
(Type name) Michelle J Gomez
El Individual (only for IE 112/freasurer El Deputy Treasurer
121 Candidate [I Chairperson (only for PC and PTY)
or electio 7
07
X 7�)*
—
L_ Signature/ " 4/ V
I Signaturd
Ub-Uh 12 (Rev. 11113) SEE REVERSE FOR INSTRUCTIONS
CAMPAIGN TREASURER'S REPORT — ITEMIZED CONTRIBUTIONS
Michelle J Gomez
(1) Name (2) I.D. Number
31
(3) Cover Period i / 01 01 2018 Ol 2018 through 1 i (4) Page
1 6
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
Ronald Cacciatore
01 29 2018
2675 Palmer Place
/0
Weston, Florida 33332
1
I
Appraiser
CHE
$500.00
Joslyn Ward
01 29
8150 W McNab Rd
l2018
`
Tamarac, F1 33321
2
I
CAS
13.00
Mark E Allsworth PA
01 ' 29 J2018
1177 SE 3rd Ave
Ft Lauderdale, F1
33316
B
Attorney
Che
250.00
3
Karen M Long
01 29 2018
4607 Bayberry Lane
Tamarac, F1 33319
4
I
Che
50.00
Herbert Daley
01 29 2018
6085 Sabal Palm Blvd
j
Apt 301
Tamarac, F1 33319
I
Che
50,00
5
Joel Davidson
of 29 2018
4608 Norfolk Island
Pine Drive
Tamarac, F1 33319
I
Che
50.00
6
Ol 29 2018
Harriet Slatzman
/
7650 W McNab Rd
Apt 301
Tamarac, FL 33321
1
Che
20.00
7
us-Ut 13 (Rev. 11ji3) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES
CAMPAIGN TREASURER'S REPORT — ITEMIZED CONTRIBUTIONS
Michelle J Gomez
(1) Name
(2)
I.D. Number
(3) Cover Period 01 / 01 201$
/
01 31 2018
through i
2
6
/
(4) Page
of
(5) (7)
Date
(8) (9)
(10) 0 1)
(12)
Full Name
(6) (Last, Suffix, First, Middle)
Sequence Street Address &
Contributor Contribution
In -kind
Number Cit , State, Zip Code
T e Occu ation Type
Description Amendment Amount
O1 29 2018 Santa Burke
334 Peachtree Drive
East Norwich, NY 11732
8 I
Che
50.00
Ina Ellen Wendler
O1 29 6351 N. University
J201$
J
Drive, Unit 104
9 Tamarac, FL 33321 I
Che
25.00
West Boca Hearing
01
j 29 /2018 Center
9178 Glades Road
10 Boca Raton, FL 33434 B
Hearing Aid Che
100.00
O1 / Joseph Grossman
29 f2018 1699 Grantham Drive
Wellington , FL 33414
11 =
Che
75.00
01 Suzaanne McCall
29 2018
/ 7650 W McNab Rd
Apt 216
12 Tamarac, FL 33321 =
Che
20.00
01 29 2018 Big Dog Construction
6308 NW 65 Terr
Parkland, FL 33067
13 B
Contractor Che
100.00
O1 29 2018 Doumar, Allsworth,
Laystrom, Voigt,
Adair, Dishowitz
14 1177 SE 3 Ave B
Law Firm Che
Ft Lauderdale, FL
250.00
33316
DS-DE 13 (Rev. 11/13) SEE
REVERSE FOR INSTRUCTIONS AND
CODE VALUES
CAMPAIGN TREASURER'S REPORT — ITEMIZED CONTRIBUTIONS
Michelle J Gomez
(1) Name (2) I.D. Number
(3) Cover Period
01 01 2018 through 01 31 2018 3 6
/ / (4) Page of
(5)
(7)
(8)
(9)
(10)
(11)
(12)
Date
Full Name
(Last, Suffix, First, Middle)
(6)
Sequence
Street Address &
Contributor
Contribution
In -kind
Number
City, State, Zip Code
Type _Occupation
Type
Description
Amendment
Amount
01 29 2p1s
Law Offices of Richard
Entin
1720 Harrison St
Suite 8D
Hollywood, FL 33020
B
Law Firm
Che 100.00
15
�uaicn joinman
01 / 29 /2p18 2006 Granada Drive
Coconut Creek, FL
16 33066
M. E. De La Rosa
01 / 29 /2018 6211 SW 3rd Street
Margate, FL 33068
17
Marcia E. Oban
01 t 29 f2018 P. 0. Box 26054
Tamarac, FL 33321
18
Alan Wise
01 29 2018
5208 Buttonwood Ct
Tamarac, FL 33319
19
01 29 2018 S Pannaman
/ ` 7301 NW 75 Ct
Tamarac, FL 33321
20
I I I Che I 1 120.00
I I I Che I I 125.00
I I I Che I I I75.00
I (Interior Desk Che
I
Che
100.00
25.00
01 29 2018 Pamela T. Le Mielle
7845 NW 78 Ave
Tamarac, FL 33321
21 I Che 75.00
DS-DE 13 (Rev.11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES
CAMPAIGN TREASURER'S REPORT — ITEMIZED CONTRIBUTIONS
c
0
(1) Name Michelle S Gomez
(2) I.D. Number
0
1 01 2018 01 31 2018
(3) Cover Period / I through ! i (4) Page 4 of 6
-- -- — -- •�� xM KCVtKbI: I•UK INSTRUCTIONS AND CODE VALUES
CAMPAIGN TREASURER'S REPORT — ITEMIZED CONTRIBUTIONS
(1) Name Michelle J Gomez
(2) I.D. Number
0
1 01 2018 01 31 2018 5 6
{3) Cover Period 1 / through / ! (4) Page of
(5)
(7)
(8)
(9)
(10)
(12) —
Date
Full Name
(Last, Suffix, First, Middle)
(S)
Sequence
Street Address &
Contributor
Contribution
In -kind
Number
City, State, Zip Code
Type- Occupation
Type
Description
Amendment
Amount
Saul Chapnick
01 z9 zo18 100 Golden Isles Dr
/ / Apt 415
29 Hallandale, F1 33009
I
Cas
20.00
Roxanne Leitner
01 29 2018
6351 N University
Drive
Apt 314
Tamarac, F1 33321
I
Cas
20.00
30
Esther Tiburcio
01 29
4915 Woodlands
/2018
J
Bouelvard
Tamarac, FL 33319
I
Cas
31
20.00
Patricia Randall
01 29 2018
11860 NW 42 St
Sunrise, F1 33321
32
I
Cas
50.00
01 24 2018
Carol J. Gomez
r `
63-61 99 St
Rego Park, NY 11374
33
I
Mother
In Kind
Metro Diner
783.00
(Kickoff Party food
and service)
01 01 2018
Michelle J. Gomez
4910 Woodlands Blvd.
Tamarac, FL 33319
of Expense 1 S
(Photographs)
Candidate
LOA
265.00
34
Ol 10 2018
Michelle J. Gomez
4910
Woodlands Blvd.
Tamarac, FL 33319
Expense 2 (Cell S
Candidate
LOA
15.00
35 of
phone)
Ua-UG "IS (K@Y. I1113) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES
CAMPAIGN TREASURER'S REPORT - ITEMIZED CONTRIBUTIONS
Michelle J Gomez
(1) Name (2) I.D. Number
01 01 2018 01 31 2018
(3) Cover Period / I through (4) Page
6 of 6
(5)
Date
(7) (8)
Full Name
(Last, Suffix, First, Middle)
Street Address & Contributor
Ci , State, Zip Code T e Occu ation
Michelle J. Gomez
4910 Woodlands Blvd.
Tamarac, FL 33319
of Expense 3 (Pens) g Candidate
(9)
Contribution
Type
Loa
(10)
In -kind
Description
(11}
Amendment
(12)
Amount
(6)
Sequence
Number
1 12 2ols
/ !
508.06
36
1 ! 14 /2418
Michelle J. Gomez
4910 Woodlands Blvd.
Tamarac, FL 33319
of Expense 4 (Clings) g
Candidate
Loan
371.00
37
! J
DS-DE 13 (Rev.11/13)
SEE
REVERSE
FOR INSTRUCTIONS
AND
CODE VALUES
CAMPAIGN TREASURER'S REPORT — ITEMIZED EXPENDITURES
(1) Name Michelle J Gomez (2) I.D. Number
(3) Cover Period 01 / 01 / 2016 through °1 / al 1 2018 (4) Page 1 of 1
(5)
(7)
(8)
(9)
(10)
(11)
Date
Full Name
(Last, Suffix, First, Middle)
Street Address &
Purpose
(add office sought if
contribution to a
Expenditure
(6)
Sequence
Number
City, State, Zip Code
candidate)
Type
Amendment
Amount
01 1 018
Skye Dazzle Photography
7650 Westwood Drive
Apt 507
Photographs
Headshots
Tamarac, FL 33321
MON
265.00
1
01 10 018
Metro PCS
5718 North University Drive
Phone
Tamarac, FL 33321
MON
15.00
2
01 12 018
4 Imprint
101 Commerce St
Pens
P O BOX 320
Oshkosh, WI 54901
MON
508.06
3
01 14 2018
Type Styles Inc
9381 W Sample Road
clings
Ste 200
Coral Springs, FL 33065
MON
371.00
4
TD Bank
Bank Paper
01 31 201E
1800 North Pine Island Road
Statement Fee
Plantation, FL 33322
MON
10.00
5
DS-DE 14 (Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES