HomeMy WebLinkAbout2017 - M5 2nd 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
OFFICE USE ONLb
Name
(2) 4910 Woodlands Boulevard
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Address (number and street)
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Tamarac, Florida 33319
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City, State, Zip Code
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❑ Check here if address has changed
(3) ID Number: Q
(4) Check appropriate box(es):
❑✓ Candidate Office sought: Commissioner for Tamarac District 2
❑ 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 5 / 1 / 2017 To
5 / 30 / 2017 Report Type: 2017M5
❑ Original ❑✓ Amendment -- 2nd ❑ Special
Election Report
(6) Contributions This Report
(7) Expenditures This Report
Monetary
Cash & Checks $ 1 , 000 .00
Expenditures $ 10.00
Loans $ 0 .00
Transfers to
Office Account $ 0.00
Total Monetary $ 1,000 •00
Total Monetary $ 10.00
In -Kind $ 0 • 00
(8) Other Distributions
$ I 1 0 .00
(9) TOTAL Monetary Contributions To Date
(10) TOTAL Monetary Expenditures To Date
$ 3,472 .77
$ , 514 .62
(11) Certification
It is a first degree misdemeanor for any person
to falsify a public record (ss. 839.13, F.S.)
I certify that 1 have examined this report and it is true, correct, and complete:
(Type name) Thomas Toffoli
(Type name) Michelle J. Gomez
❑ Individual (only for IE 0 reasurer [1Deputy Treasurer
� Candidate El Chairperson (only for PC and PTY)
or election ing c m.
X
X
Signature
Signature
DS-DE 12 (Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS
CAMPAIGN TREASURER'S REPORT — ITEMIZED CONTRIBUTIONS
(1) Name (! �jQ I I� ��.✓%)��� (2) I.D. Number
(3) Cover Period through S� 1 3 % ! 1 (4) Page [ of
(6)
Date
(7)
Full Name
(Last, Suffix, First, Middle)
Street Address &
City, State, Zip Code
(8)
Contributor
_Type Occupation
(9)
Contribution
Type
(10)
In -kind
Description
(11)
Amendment
(12)
Amount
(6)
Sequence
Number
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DS-DE 13 (Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES
CAMPAIGN TREASURER'S REPORT- ITEMIZED EXPENDITURES
(I)Name- (2) I.D. Number
(3) Cover Period 5 / I _/ 00 through Jr /_3) _/c2)11 (4) Page __ __l___ . _ of I
(5)
Date
(7)
Full Name
(Last, Suffix, First, Middle)
Street Address &
City, State, Zip Code
(8)
Purpose
(add office sought if
contribution to a
candidate)
(9)
Expenditure
Type
(10)
Amendment
(11)
Amount
(6)
Sequence
Number
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DS-DE 14 (Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES