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DS-DE 12 F4-09 LibbinFLORIDA DEPARTMENT OF STATE DIVISION OF ELECTIONS CAMPAIGN TREASURER'S REPORT SUMI~A~2~. , :Y~ ~ ~ ~ (-a E ONLY (1) Jerry Libbin Campaign Z ~ ~~ ® ~i~ ~~ 02 Name (2) 1125 North Shore Drive L ~ ~ )~ ~ L Sri ~`j ' S (} ~ t' i (, ¢, Address (number and street) Miami Beach, FL 33141-0000 City, State, Zip Code ^ Check box if address has changed (3) I.D. Number: 00000 (4) Check appropriate box(es): X Candidate (office sought): Commissioner Group 1 Political Committee ^ Check if PC has DISBANDED Committee of Continuous Existence ^ Check if CCE has DISBANDED Party Executive Committee Electioneering Communication ^ Check if no other electioneering communication reports will be filed (5) REPORT IDENTIFIERS Cover Period: From 10/10/2009 To 10/29/2009 Report Type: F3 ^X Original ^ Amendment ^ Special Election Report ^ Independent Expenditure Report (6) CONTRIBUTIONS THIS REPORT (7) EXPENDITURES THIS REPORT ~j Cash & Checks ~7~ ~50. O~ - Monetary Expenditures ~ tel. ~y6. G-9 Transfers to Office Loans $0.00 Account $0.00 Total Monetary ~ ~ ZS~° yn Total Monetary +~ 9 ~ y.~ In-Kind $0.00 (8) Other Distributions $0.00 (9) TOTAL Monetary Contributions to Date (10) TOTAL Monetary Expenditures to Date $/O~LS.fs' 7. zy .~' 7~ ~ y~' . ~ 9 (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 I certify that I have examined this report and it is true, corr d complete true, correct and complete Alan Lis Jerrv Libbin ^ In ' idual (only for ^ Treasurer ^ Deputy Treasurer ctioneering ]{ ^ Candidate ^ Chairman (only for PC, PTY 8 J{ electioneerin comm n anizatio mmun.) g u . org n) X Signature Signatu ua-uc iz trcev. uniua~ Adjutant Software -Campaign ToolBox PA-~ c ~ 6~-7 CAMPAIGN TREASURER'S REPORT -ITEMIZED CONTRIBUTIONS (1) Name Jerry Libbin Campaign (2) I.D. Number (3) Cover Period 10/10/2009 - 10/29/2009 (4) Page 00000 1 of 2 (5) (7) (8) (9) (10) (11) (12) Date Full Name t b C t (6) (Last Suffix First Middle) On rl U Or , , , to-kind Sequence Number Street Address & crty, state, zip code Type Occupation Contribution Type Description mendmen Amount 10/18/2009 Permutter, Michael I Retired CHE $ 250.00 954 RT. 166 Toms River, NJ 08753-6582 000001 10/18/2009 New City, Inc. B Watches CHE $ 200.00 4th Floor 21 S.E. 1stAve. Miami, FL 33131-0000 000002 10/18/2009 Concourse Commercial LC B Real CHE $ 500.00 Ste. 110 Estate 6001 NW 153rd St. Investor Miami Lakes, FL 33014-0000 000003 10/18/2009 Golomb, David 1 CHE $ 50.00 Wayne Ave. 7441 Apt. 10R, FL 33141-0000 000004 10/20/2009 Kruszewski, Frank I CHE $ 25.00 Ste. 2002 1800 Sunset Harbour Dr. Miami Beach, FL 33139-1458 000005 10/23/2009 Howard, Elsie I Retired CHE $ 250.00 Suite 400 1111 Lincoln Rd Miami Beach, FL 33139-0000 000006 10/23/2009 Nusbaum, Ira I Jewelery CHE $ 100.00 4330 N. Michigan Ave. Miami Beach, FL 33140-0000 000007 10/26/2009 Siegel, David I Retired CHE $ 200.00 333 E. Rivo Alto Dr. Miami Beach, FL 33139-0000 000008 DSDE 13 (Rev. 08/03) Adjutant Software -Campaign ToolBox ~'A-GE a ~" ~ CAMPAIGN TREASURER'S REPORT -ITEMIZED CONTRIBUTIONS (1) Name Jerry Libbin Campaign (2) I.D. Number (3} Cover Period 10/10/2009 - 10/29/2009 (4) Page 00000 2 of 2 (5) (7) (8) (9) (10) (11) (12) Date Full Name i (6) (Last, Suffix, First, Middle) Contr butor In-kind Sequence Number Street Address & City, State, Zip Code Type Occupation Contribution Type Description mendmen Amount 10/26/2009 SEIU Florida Healthcare Union CCE C Union CHE $ 500.00 Suite 201 14645 NW 77th Ave. Miami Lakes, FL 33014-0000 000009 10/26/2009 SEIU Florida State Council CCE C Union CHE $ 500.00 Suite 201 14645 NW 77th Avenue Miami Lakes, FL 33014-0000 000010 10/26/2009 Lawrence, Eric I Hotelier CHE $ 150.00 Apt. 601 6917 Collins Ave. Miami Beach, FL 33141-0000 000011 10/28/2009 Government Supervisors C Political CHE $ 500.00 Association of Florida Local 100 Action Suite 405 Com 3600 Red Road 000012 Miramar, FL 33025-0000 10/29/2009 Fromkin, Ava I Registere CHE $ 500.00 #2306 d Nurse 555 NE 34 Street Miami, FL 33137-0000 000013 10/29/2009 Friedman, Gary I Attorney CHE $ 500.00 117 Palm Avenue Miami Beach, FL 33139-0000 000014 10/29/2009 Levy, Lucero I CHE $ 25.00 1855 Clevelander Road Miami Beach, FL 33141-0000 000015 DS-DE 13 (Rev. 08103) Adjutant Software -Campaign ToolBox ~~-~~ 3 ~? CAMPAIGN TREASURER'S REPORT -ITEMIZED EXPENDITURES (1) Name Jerry Libbin Campaign (2) I.D. Number (3) Cover Period 10/10/2009 - 10/29/2009 (4) Page 00000 1 of 2 (5) (7) (8) (9) (10) (11) Date Full Name (Fi) (Last, Suffix, First, Middle) Purpose Sequence Street Address 8 (add office sought ff Expenditure Number City, State, Zip Cade contribution to a candidate) Type mendmen Amount 10/13/2009 50 Blue LLC Mailers/Span. & Eng. MON $ 8,002.75 7525 SW 54th Ct. Miami, FL 33143-0000 000001 10/18/2009 Seniors Are First Meet Voters MON $ 150.00 Suite 117 1940 Park Avenue Miami Beach, FL 33139-0000 000002 10/18/2009 Miami Beach Jewish Community Meet Voters MON $ 350.00 Center 4221 Pine Tree Dr. Miami Beach, FL 33140-0000 000003 10/18/2009 Pay Pal Service Fee MON $ 1.75 2211 N. First Street San Jose, CA 95131-0000 000004 10/19/2009 Fin Sea Foundation Meet voters MON $ 300.00 3282 Gifford Lane Miami, FL 33133-0000 000005 10/25/2009 Domain Registry of America Domain Registered MON $ 95.00 #266 2316 Delaware Avenue Buffalo, NY 14216-2687 000006 10/25/2009 Libbin, Jerry Reimburse for MON $ 41.51 1125 N. Shore Dr. Campaign meeting Miami Beach, FL 33141-0000 000007 10/26/2009 Pay Pal Service Fee MON $ 4.65 2211 N. First Street San Jose, CA 95131-0000 000008 DS-DE 74 (Rev. OS/03) Adjutant Software -Campaign TOOIBox P~~ ~ ~7 CAMPAIGN TREASURER'S REPORT -ITEMIZED EXPENDITURES (1) Name Jerry Libbin Campaign (2) I.D. Number (3) Cover Period 10/10/2009 - 10/29/2009 (4) Page 00000 2 of 2 (5) Date (7) Full Name (8) (9) (1 0) (11) (6) Sequence Number (last, Suffix, First, Middle) Street Address & City, State, Zip Cade Purpose (add office sought ff contribution to a candidate) Expenditure Type mendmen Amount 10/29/2009 City Debate Publishing Company, Inc. Suite 113 Advertising MON $ 1,000.00 000009 6538 Collins Avenue Miami Beach, FL 33141-4694 10/29/2009 Pay Pal 2211 N. First Street San Jose, CA 95131-0000 Service Fee MON $ 1.03 000010 OS-DE 14 (Rev, OB/03) Adjutant Software -Campaign ToolBox CAMPAIGN TREASURER'S REPORT -ITEMIZED DISTRIBUTIONS THIS FORM APPLIES TO POLITICAL COMMITTEES, COMMITTEES OF CONTINUOUS EXISTENCE AND PARTY EXECUTIVE COMMITTEES ONLY. (1) Name Jerry ~ibbin Campaign (2) I.D. Number (3) Cover Period 10/10/2009 -1012912009 (4) Page 00000 0 of 0 (5) Date (7) Full Name (8) (9) (10) (11) (6) Sequence Number (Last, Suffix, First, Middle) Street Address & City, State, Zip Code Purpose (add office sought if contribution to a candidate) Related Expenditures mendmen Amount Nothing to report on t is form DS-DE 14A (Rev. 08/03) Adjutant Software -Campaign ToolBox CAMPAIGN TREASURER'S REPORT -FUND TRANSFERS (1) Name Jerry Libbin Campaign (2) I.D. Number (3) Cover Period 10/10/2009 - 10/29/2009 (4) Page 00000 0 of 0 (5) Date (7) Name of Financial . (8) (9) (10) (11) (6) Sequence Number Instkution Street Address 8 cay, state, Zip Code Transfer Type Nature of Account mendmen Amount Nothing to report on th s for ~J4 (KBV. Otl/()3) Adjutant Software -Campaign ToolBox ~~G~ 7~1