HomeMy WebLinkAbout2014 - G4- 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
—,r�
(1) '(+ I i `lAe-1�e �S, Govl a lz
OFFICE USE ONLY
Name
(2) ` A 10 t ,;t(,JC VJJ h� Lj
'
20111 OCT -8 PH 3: 25
Address (number and street)
F� "- i
RECENED
►�a0a
CITY OF TAMARAC
City, State, Zip Code
y Cl Epk
❑ Check here if address has changed
(3) ID Number:
(4) Check appropriate box(es):
LVJ Candidate Office Sought: � i%^ vii I z -i ok-e r fi i a L"a ryc
❑ 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 C)Q / / - To
10 / V 3 / Iq Report Type: �O/c(
[j�'Original ❑ Amendment ❑ Special Election Report
(6) Contributions This Report
(7) Expenditures This Report
Monetary
Cash & Checks $ 5,00. 00
Expenditures $
Loans $ ,
Transfers to
Office Account $
Total Monetary $ , �a0 • 0�
Total Monetary $
In -Kind $ go • )q
(8) Other Distributions
$ , , q, `783, 7(
(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 that I have examined
ined this report and it is true, correct, and complete:
(Type name) � � �� e crfnrjUL4
(Type name) /k, v e
f
❑ Individual (only for IE [+Treasurer ❑Deputy Treasurer
or electioneering comm.)
Candidate El Chairperson (only for PC and PTY)
, _
x1
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Signature
Signature
DS-DE 12 (Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS
CAMPAIGN TREASURER'S REPORT — ITEMIZED CONTRIBUTIONS
(1) Name (",I 1"e e- -�) , 6/v"e Z
(2) I.D. Number
(3) Cover Period 0/ ZJl / Iq through /j) / t) / / Ll (4) Page ;� of
(5)
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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A �� l 1
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DS-DE 13 (Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES
CAMPAIGN TREASURER'S REPORT — ITEMIZED EXPENDITURES
(1) Name K-1-A i4lto t(e- --�S Gc,r-,c e- (2) I.D. Number
(3) Cover Period _ 09 / 0( / Iq through (C / C S/ Iq (4) Page 5 of S
(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
(`iPe
i v-56N _
C,,M Sp r-il�V, FL 330 71,
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S- LCAkiss
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ns
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1,044, 3
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/�`J'(j
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1 evD ev,5-
il�
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e7
DS-DE 14 (Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES
CAMPAIGN TREASURER'S REPORT - ITEMIZED DISTRIBUTIONS
(1) Name (VI icLICAke '� %!2(ez (2) I.D. Number
(3) Cover Period Oq / of l l L4 _ through I D / U / /q (4) Page of -s—
(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)
Related
Expenditures
(10)
Amendment
(11)
Amount
(12)
Distribution
Type
(6)
Sequence
Number
09/OS/ 14
ggIcr wocd14,,dsAil•
�q'-4 AFL 3 SS k 9
4, c:ipeise
(�q
T me
vrlvjijy
44gIc vcvtIa tjs;
a >�ta'raC Fc
a
p I/
`i l l ft l �T
L��VL kl&) 7 C
iu "4 fae, FL 33 3� I
09 I:?3 14
iL-O Ael le "e z
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l2eie-,-uvse64e,, •
/c / :3/ iq
i-((J-(le &v,1eZ
Lj410 Wc)0cV c ty
l i t ►cra✓�c� F2
DS-DE 14A (Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES
CAMPAIGN TREASURER'S REPORT - FUND TRANSFERS
(1) Name—Y (2) I.D. Number
(3) Cover Period C)q /b_/ I Ll through lU l 0 4 (4) Page > of a
(5)
Date
(7)
Name of Financial
Institution
Street Address &
City, State, Zip Code
(8)
Transfer
Type
(9)
Nature of
Account
(1 0)
Amendment
(� )
Amount
(6)
Sequence
Number
i
1
DS-DE 94 (Rev. 08/03) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES