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DS-DE 12 Q1-12 Roberts FLORIDA DEPARTMENT OF STATE DIVISION OF ELECTIONS CAMPAIGN TREASURER'S REPORT SUMMARY 0)" Sherry Roberts OFFICE USE ONLY° Name -4 (2) `4 A� (2) 100 Lincoln Road PH2 Address (number and street) Cl r y� D �,�t f�i�'•j ll. OrF!I;,c- Miami Beach, FL 33139 City, State, Zip Code ❑ CHECK IF ADDRESS HAS CHANGED (3) ID Number: (4) Check appropriate box(es): ® Candidate (office sought): Group IV ❑ 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 03 / 21 / 2012 To 03 / 31 / 2012 Report Type Q1_12 Original ❑ Amendment ❑ Special Election Report ❑ Independent Expenditure Report (6) CONTRIBUTIONS THIS REPORT (7) EXPENDITURES THIS REPORT Monetary Cash & Checks $ 0.00 Expenditures $ 0.00 Loans $ 1, 000.00 Transfers to Office Account $ 0 .00 Total Monetary $ 0.00 Total Monetary $ 0.00 In-Kind $ 0.00 (8) Other Distributions $ 0.00 (9) TOTAL Monetary Contributions To Date (10) TOTAL Monetary Expenditures To Date $ 1,000.00 $ 0.00 (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 I have examined this report and it is true, correct, and complete. correct, and complete. (Type name) Roberta S. Gould (Type name) Sherry Roberts ❑Individual(only for QTreasurer ❑Deputy Treasurer ✓❑Candid a Chairperson(only for PC,PTY& electioneering commun.) ele ioneering ommun.organization) X (7 X o Signature Signature CAMPAIGN TREASURER'S REPORT— ITEMIZED CONTRIBUTIONS 1(1) Name Sherry Roberts (2) I.D. Number (3) Cover Period 03 21 2012 through 03 / 31 / 2012 4 Page 1 of 1 (5) (7) (8) (9) (10) (11) (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 Roberts, Sherry Licensed LOA $1000.00 03 / 28 /2012 100 Lincoln Road Real Penthouse Two Estate Miami Beach, FL Broker 33139 DS-DE 13(Rev.081103) SE VERSE FOR INSTRUCTIONS AND CODE VALUES C 1