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DS-DE 12 F1-09 FLORIDA DEPARTMENT OF STATE DIVISION OF ELECTIONS CAMPAIGN TREASURER'S REPORT SUNA~"~f ~ '',° ~= ~') (1) Laura Rivero Levey 20~1~~!"~rY4 $ Name (2) 4777 Pinetree Drive ~~ ~ ,~ l.,i`~`r'~`.a ~~ f• ~~~- Address (number and street) C7 Miami Beach, Fl 33140 -a City, State, Zip Code ~` r- ^CHECK IF ADDRESS HAS CHANGED (3) ID Number: ~`~" (4) Check appropriate box(es): U~; ~ Candidate (office sought): Mayor of Miami Beach ~-; ^ Political Committee ^ CHECK IF PC HAS DISBANDED ^ Committee of Continuous Existence ^ CHECK IF CCE HAS DISBANDED' ^ Party Executive Committee N a a .,o .. `~ w ~', -~ ~r ~ `~ ^ Electioneering Communication ^ CHECK IF NO OTHER ELECTIONEERING COMMUNICATION REPORTS WILL BE FILED (5) REPORT IDENTIFIERS Cover Period: From 7 / of / 09 To 9 / 11 / 09 Report Type F1-o9 © Original ^ Amendment ^ Special Election Report ^ Independent Expenditure Report (6) CONTRIBUTIONS THIS REPORT (7) EXPENDITURES THIS REPORT Monetary Cash & Checks $ 0 Expenditures $ p Loans $ 2 8 0 0.0 0 Transfers to Office Account $ 0 Total Monetary $ 2 8 0 0.0 0 Total Monetary $ 0 In-Kind $ (8) Other Distributions $ 0 (9) TOTAL Monetary Contributions To Date (10) TOTAL Monetary Expenditures To Date $ 2800.00 $ 0 (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 this report and it is true, I certify that 1 have examined this report and it is true, correct, and complete. correct, and complete. (Type name) (Type name) ^Individual (only for QTreasurer ^ Deputy Treasurer ^/ Candidate ^ Chairperson (only for PC, PTY 8 electioneering mmun.) ( ~ electioneering commun. organization) Signature Signature (1) Name CAMPAIGN TREASURER'S REPORT -ITEMIZED CONTRIBUTIONS Laura Rivero Levey (3) Cover Period ~ / 1 / 09 through (2) I.D. Number 9 / 11 / 09 (4) Page of (5) Date (7) Full Name (8) (9) (10) (11) (12) (6) Sequence Number (Last, Suffix, First, Middle) Street Address & Ci ,State Zi Code Contributor T e Occu ation Contribution T In-kind Descri lion Amendment Amount 9 ~ 11 /0 9 Laura Rivero Levey ~Y Q f~ ~e '~ ~'~'~ P i Housewif e chk 1400 1 ^ ^ , ~ ~,31~t(~ 9 11 09 . 2 Laura Rivero Levey i(Yl~~~ ~Z~ ~~~~ Housewif cash 1400 / / / / I / / / / t DS-DE 13 (Rev. 08/031 SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES O,r~ 02- /~