DS-DE 12 Q4-12 S. Roberts FLORIDA DEPARTMENT OF STATE DIVISION OF ELECTIONS
CAMPAIGN TREASURER'S REPORT SUMMAW-= _
(1) Sherry Roberts 20MARE'TLIA 11 11: 57
Name CITY CLLR";r"'S OF'r- IC'r_
(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 �,V
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 10/01/2012 To 12/31/2012 Report Type: Q4-17.
❑X Original ❑Amendment ❑ Special Election Report ❑ Independent Expenditure Report
(6) CONTRIBUTIONS THIS REPORT (7) EXPENDITURES THIS REPORT
Monetary
Cash&Checks $0.00 Expenditures $0.00
Transfers to Office
Loans $0.00 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
$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 Chairman(only for PC,PTY&
❑
electioneering Treasurer Deputy Treasurer Candidate
g 3{ �{ electioneering commun.organization)
commun.)
X X ® �
Signature Signature
This form is based on DS-0E 12(Rev.08/04) Adjutant Software,Inc.-Campaign ToolBox
CAMPAIGN TREASURER'S REPORT - ITEMIZED CONTRIBUTIONS
(1) Name Sherry Roberts (2) I.D. Number 00000
(3)Cover Period 10/01/2012-12/31/2012 (4) Page 0 of 0
(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,zp,code Type Occupation Type Description Amendmeni Amount
Nothing to report on this orm
Th is form is based on DS DE 13(Rev.08/03) Adjut SoftwaWV olBox
CAMPAIGN TREASURER'S REPORT - FUND TRANSFERS
(1) Name Sherry Roberts (2) I.D. Number 00000
(3) Cover Period 10/01/2012- 12/31/2012 (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 Amendmeni Amount
Nothing to report on th s for
IB
This form is based on DS-DE 94(Rev.08/03) Adjutant Software,Inc.-Campaign Tc*
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