DS-DE 12 G2-11 Levey ` s
FLORIDA DEPARTMENT OF STATE DIVISION OF ELECTIONS
CAMPAIGN TREASURER'S REPORT SUMMARY
( LAURA RIVERO LEVEY OFFICE USE ONLY
E CFJ r)
Name ._:
( 4777 PINE TREE DR. 2011 OCT 14 PM 5100
Address (number and street)
MIAMI BEACH, FL 33140 CITY CLERK'S OFT ICE-
City, State, Zip Code
n CHECK IF ADDRESS HAS CHANGED (3) ID Number:
(4) Check appropriate box(es):
n Candidate (office sought): _ /4 &yof or 14,i•
a viA ( Q,GZ. C&)
U Political Committee I CHECK IF PC HAS DISBANDED
n 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 09 / 24 / 2011 To 10 / 07 / 2011 Report Type G2-11
Original n Amendment ❑ Special Election Report Independent Expenditure Report
p p n p P p t
(6) CONTRIBUTIONS THIS REPORT (7) EXPENDITURES THIS REPORT
Monetary
Cash & Checks $ 1,000.00 Expenditures $ 2,050.00
Loans 3 Transfers to Office
Account $
Total Monetary $ t, 000 . 0 0 Total
Monetary $ 2,050.00
In -Kind $
(8) Other Distributions
(9) TOTAL Monetary Contributions To Date (10) TOTAL Monetary Expenditures To Date
$ 8,500.00 $ 3,410.00
(11) CERTIFICATION
It is a first degree misdemeanor for any person to falsify a public record (ss. 839.13, F.S.)
certify that I have examined this report and it is true, I certify that I have examined this report and it is true,
correct, and complete. correct, and complete.
(Type name) Lam.- 2.1:,/e4e- 1 (Type name) LGu/ /,
Individual (only for Lj Treasurer U Deputy Treasurer 0 Candidate J Chairperson (o ly for PC, PTY &
elections ing co un.) elect] eering corm organization)
Signature Signature
DS -DE 12 (Rev. 08/04) OCT 14 2 e
sut.inn
9•401
CAMPAIGN TREASURER'S REPORT — ITEMIZED CONTRIBUTIONS
(1) Name LAURA RIVERO LEVEY (2) I.D. Number
09 24 2011 10 07 2011
(3) Cover Period / / through / / (4) Page 1 of
( ( (8) (9) (10) ( (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
CATHERINE M. B CHE 500
09 / 27 /2011 RODRIGUEZ, P.A.
1688 MERIDIAN AVE,
SUITE 900
0 0 q MIAMI BEACH, 33139
ALL MEDICARE HOME B CHE 500
09 / 27 011 AIS, INC.
3400 SW 26 TERRACE
o 0 S FT LAUDERDALE,
33312
LEWIS J. LEVEY I I-0 A 5000
10 / 07 2/011 4777 PINE TREE DR.
MIAMI BEACH 33140
Oo h
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DS -DE 13 (Rev. 08/03) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES
X-c-cf. A 3
CAMPAIGN TREASURER'S REPORT - ITEMIZED EXPENDITURES
(1) Name LAURA RI VERO LEVEY (2) I.D. Number
(3) Cover Period 09 24 2011 through 10 / 07 2011 (4) Page 1 of 1
(5) ( ( ( ( (
Date Full Name Purpose
(6) (Last, Suffix, First, Middle) (add office sought if
Sequence Street Address & contribution to a Expenditure
Number City, State, Zip Code candidate) Type Amendment Amount
SOCIAL CAPITAL MANAGEMENT ADVERTISING MON
09 �26 /11 $l, 000.00
/
SENIO CARE FIRST MON $50.00
09 /26 /11
o o5
SOCIAL CAPITAL MANAGEMENT ADVERTISING MON
$1,000.00
10 /Ol /11
c oG
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1 /
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DS -DE 14 (Rev. 08/03)
SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES //I
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