DS-DE 12 Q3-12 S. Robertsi
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FLORIDA DEPARTMENT OF STATE DIVISION OF ELECTIONS
CAMPAIGN TREASURER'S REPORT SUMMARY
OFFICE USE ONLY
(1) Sherry Roberts
Name
(2) 100 Lincoln Road PH 02
Address(number and street)
Miami Beach,FL 33139
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
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 07/01/2012 To 09/30/2012 Report Type: Q3
❑X Oral ; ❑Amendment ❑ Special Election Report ❑ Independent Expenditure Report
® =
b(6) ONJRIBUTIONS THIS REPORT (7) EXPENDITURES THIS REPORT
Monetary
Cacti&Ghbcks� $250.00 Expenditures $347.63
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$000 Transfers to Office $0.00
Loans o . Account
F--- _
Total Moofh�tary� $250.00 Total Monetary $347.63
In-Kind
$0.00 (8)Other Distributions $0.00
(9) TOTAL Monetary Contributions to Date (10) TOTAL Monetary Expenditures to Date
$3,930.63 $364.63
(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,correct and complete true,correct and complete
Roberta Gould Sherry Roberts
❑ Individual(only for ❑ Treasurer ❑ Deputy Treasurer ❑ Candidate �❑ Chairman(only for PC,PTY&
electioneering —X �{ electioneering commun.organization)
commun.
A X —�-
Signature Signature
This form is based on DS-DE 12(Rev.08104) Adjutant Software,Inc.-Campaign ToolBox
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CAMPAIGN TREASURER'S REPORT - ITEMIZED CONTRIBUTIONS
(1) Name Sherry Roberts (2) I.D. Number 00000
(3) Cover Period 07/01/2012-09/30/2012 (4) Page 1 of 1
(5) (7) _ (8) (9) (10) (11) (12)
Date
Full Name Contributor
(6) (Last,Suffix,First,Middle) In-kind
Sequence Street Address& Contribution
Number city,State,zip code Type Occupation Type Description Amendmeni Amount
07/12/2012 Garcia,jr., Luis R. I Politian CHE $250.00
520 Sw 21 st Rd
Miami, FL 33129-0000
1
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This form is based on DS-DE 13(Rev.08/03) Adjutant Software,Inc.-Campaign ToolBox
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CAMPAIGN TREASURER'S REPORT - FUND TRANSFERS
(1) Name Sherry Roberts (2) I.D. Number 00000
(3) Cover Period 07/01/2012-09/30/2012 (4) Page 0 of 0
(5) (7) (8) (9) (10) (11)
Date
Name of Financial
(6) Institution Transfer Nature of
Sequence Street Address&
Number City,State,Zip Code Type Account Amendmed Amount
Nothing to report on th Is forrr
This form is based on DS-DE 94(Rev.08/03) Adjutant Software,Inc.-Campaign ToolBox
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