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DS-DE 12 S. Roberts Q1-13 FLORIDA DEPARTMENT OF STATE DIVISION OF ELECTIONS CAMPAIGN TREASURER'S REPORT SIJI&WRY,'! (1) Sherry Roberts 2013 QrN!"UsE/;°rl`5: 53 Name (2) 100 Lincoln Road 407 Lincoln Rd Suite 2 E C I T Y `L'' ';"° 0._': I i is 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 Group III Political Committee ❑ Check if PC has DISBANDED Committee of Continuous Existence Party Executive Committee ❑ Check if CCE has DISBANDED Electioneering Communication ❑ Check if no other electioneering communication reports will be filed (5) REPORT IDENTIFIERS Cover Period: From 01/01/2013 To 03/31/2013 Report Type: Q1 ❑X Original ❑ Amendment ❑ Special Election Report ❑ Independent Expenditure Report (6) CONTRIBUTIONS THIS REPORT (7) EXPENDITURES THIS REPORT Monetary Cash 8 Checks $8,025.00 Expenditures $40.10 Transfers to Office Loans $10,000.00 Account $0.00 Total Monetary $18,025.00 Total Monetary $40.10 In-Kind $0.00 (8)Other Distributions $0.00 (9) TOTAL Monetary Contributions to Date (10) TOTAL Monetary Expenditures to Date $21,955.63 $404.73 (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 f' Roberta Gould Sherry Roberts Individual(only for Chairman(only for PC,PTY& ❑ electioneering Treasurer ❑ Deputy Treasurer Lx] ❑ 9 }( �( electioneering organization) commun.) Sigrl1{4re Signature This forth is based on DS-DE 12(Rev.08104) Adjutant Software,Inc.-Campaign ToolBox 9 CAMPAIGN TREASURER'S REPORT - ITEMIZED CONTRIBUTIONS (1) Name Sherry Roberts (2) I.D. Number 00000 (3) Cover Period 01/01/2013-03/31/2013 (4) Page 1 of 6 (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 Amendment Amount 03/13/2013 Manning, Josephine 1 CHE $25.00 1460 Ocean Dr#408 Miami Beach, FL 33139-0000 1 03/13/2013 Losson, Jane Pierce I CHE $ 100.00 1810 Jefferson Ave Miami Beach, FL 33139-0000 2 03/13/2013 Oramas, Joseph I CHE $ 100.00 100 Lincoln Road #510 Miami Beach, FL 33139-0000 3 03/25/2013 Coppola, Gladys I Insuranc CHE $ 100.00 1717 N Bayshore Dr#2151 a Sales Miami, FL 33132-0000 4 03/27/2013 Sims, Michael I Student CHE $ 100.00 8201 cattail dr Nirvat, CO 80503-0000 5 03/27/2013 Sims,Vicki I Student CHE $ 100.00 8201 cattail dr Nirvat, CO 80503-0000 6 03/27/2013 Gould, Roberta I Real CHE $500.00 6585 Allison Rd Estate Miami Beach, FL 33141-0000 Sales 7 03/27/2013 Margolis, Gwen I State CHE $200.00 2 Grove Isle Dr#209 Senator Coconut Grove, FL 33133-0000 8 This form is based on DS-DE 13(Rev.08103) Adjutant Software,Inc.-Campaign ToolBox CAMPAIGN TREASURER'S REPORT - ITEMIZED CONTRIBUTIONS (1) Name Sherry Roberts (2) I.D. Number 00000 (3)Cover Period 01/01/2013-03/31/2013 (4) Page 2 of 6 (6) (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 Amendment Amount 03/27/2013 Lipman, Martin I Retired CHE $ 100.00 31701 Daniel Dr Willowick, OH 44095-0000 9 03/27/2013 Stolar, Suzanne I Retired CHE $500.00 1500 Ocean Dr#803 Miami Beach, FL 33139-0000 10 03/27/2013 Stolar, Henry I Retired CHE $500.00 1500 Ocean Dr#803 Miami Beach, FL 33139-0000 11 03/27/2013 Sims, Jacob I Student CHE $ 100.00 8201 cattail dr Nirvat, CO 80503-0000 12 03/27/2013 Langer, Ira I CHE $ 100.00 2206 Charleston Weston, FL 33326-0000 13 03/28/2013 Shullman, Sandra I Retired CHE $500.00 268 Croswell Rd Croswell, OH 43214-0000 14 03/28/2013 Nemitz, David I Retired CHE $ 100.00 268 Croswell Rd Colombus, OH 43214-0000 15 03/28/2013 Roses, Gloria Romero I Consulta CHE $250.00 13431 Old Sheridian St nt Sw Ranches, FL 33330-0000 16 This ions is based on DS DE 13(Rev.08!03) Adjutant Software,Inc.-Campai ToolBox/4 CAMPAIGN TREASURER'S REPORT - ITEMIZED CONTRIBUTIONS (1) Name Sherry Roberts (2) I.D. Number 00000 (3)Cover Period 01/01/2013-03/31/2013 (4) Page 3 of 6 (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,Tip Code Type Occupation Type Description Amendment Amount 03/28/2013 Sims, Marilyn R. I Retired CHE $ 100.00 456 Muirfield Dr Cleveland, OH 44143-0000 17 03/28/2013 Malakoff, Joy I Retired CHE $250.00 6415 Pinetree Dr Miami Beach, FL 33141-0000 18 03/28/2013 Mangos Tropical Cafe B Restaura CHE $500.00 900 Ocean Dr nt Miami Beach, FL 33139-0000 19 03/28/2013 Del Vecchio, Marian I Retired CHE $ 100.00 301 Ocean Dr#604 Miami Beach, FL 33139-0000 20 03/28/2013 Del vecchio, Frank I Retired CHE $ 100.00 301 Ocean Dr#604 Miami Beach, FL 33139-0000 21 03/28/2013 Burstein, Harvey I Foundati CHE $200.00 1775 Washington Ave on Miami Beach, FL 33139-0000 Director 22 03/28/2013 Zemo, Dona M. I tourism CHE $ 100.00 3101 Indian Creek Dr#104 promotio Miami Beach, FL 33140-0000 ns 23 03/2812013 Tropical Tours B Tour CHE $ 100.00 3101 Indian Creek Dr Company Miami Beach, FL 33139-0000 24 This form is based on DS-DE 13(Rev.08/03) Adjutant Software,Inc.-Campaign ToolBox P�-Sk q 4' ' CAMPAIGN TREASURER'S REPORT - ITEMIZED CONTRIBUTIONS (1) Name Sherry Roberts (2) I.D. Number 00000 (3)Cover Period 01/01/2013-03/31/2013 (4) Page 4 of 6 (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 Amendment Amount 03/28/2013 Grant, Barbara I Insuranc CHE $300.00 100 Lincoln Rd#910 a Sales Miami Beach, FL 33139-0000 25 03/28/2013 Minnie's Management Services B Retail CHE $ 100.00 11 Island Ave#602 Miami Beach, FL 33139-0000 26 03/28/2013 Miss Naomi International LLC B Museum CHE $ 100.00 300 S Pointe Dr#3801 Miami Beach, FL 33139-0000 27 03/28/2013 Garcia, Jorge Luis I Travel CHE $ 100.00 520 Sw 21 Rd Consulta Miami, FL 33129-0000 nt 28 03/28/2013 Garcia,jr., Luis R. I Politian CHE $250.00 520 Sw 21 st Rd Miami, FL 33129-0000 29 03/28/2013 Showcase Websites Inc B Web CHE $500.00 1130 Stillwater Dr Designer Miami Beach, FL 33141-0000 s 30 03/28/2013 Golden, Sidney I Retired CHE $200.00 5415 Collins ave Miami Beach, FL 33140-0000 31 03/28/2013 Browwning, Mary-Leggett I Retired CHE $ 100.00 5255 Collins Ave#8g Miami Beach, FL 33140-0000 32 This form is based on DS-DE 13(Rev.08/03) Adjutant Software,Inc.-Campaign ToolBox � � ft? OJ <6V CAMPAIGN TREASURER'S REPORT - ITEMIZED CONTRIBUTIONS (1) Name Sherry Roberts (2) I.D. Number 00000 (3)Cover Period 01101/2013-03/3112013 (4) Page 5 of 6 (5) (7) (8) (9) (10) (11) (12) Date Full Name Contributor (6) (Last,Suffix,First,Middle) In-kind Sequence Street Address 8 Contribution Number City,State,Zip Code Type Occupation Type Description Amendment Amount 03/28/2013 Wihi, Lloyd 1 Engineer CHE $250.00 100 Lincoln Rd Miami Beach, FL 33139-0000 33 03/28/2013 Entin, Richard I Attorney CHE $ 100.00 110 Se 6 Street Ft. Lauderdale, FL 33301-0000 34 03/28/2013 Remington, Laura I Retired CHE $ 100.00 3945 Lower Waterford Rd Waterford, VT 05819-0000 35 03/28/2013 Cano, Laura I CHE $ 100.00 2038 Sw 19 Terr Miramar, FL 33027-0000 36 03/28/2013 Esposito,Tanya I CHE $ 100.00 1829 Sw 11 Ct Ft Lauderdale, FL 33312-0000 37 03/28/2013 Ross, Neil I Mortgage CHE $250.00 100 lincoln rd ph 5 Broker Miami Beach, FL 33139-0000 38 03/29/2013 Roberts, Sherry I Candidat LOA $ 100 Lincoln Rd PH2 a 10000.00 Miami Beach, FL 33139-0000 39 03/29/2013 Raney, Michael I Exec CHE $ 100.00 395 E Broad Street Director Columbus, OH 43215-0000 Ohio Psych 40 Assoc This form is based on DS-DE 13(Rev.08/03) Adjutant Software,Inc.-Campaign ToolBox v� CAMPAIGN TREASURER'S REPORT - ITEMIZED CONTRIBUTIONS (1) Name Sherry Roberts (2) I.D. Number 00000 (3)Cover Period 01/01/2013-03/31/2013 (4) Page 6 of 6 (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,Tip Code Type Occupation Type Description Amendment Amount 03/29/2013 Kaplan, Gloria I Retired CHE $ 100.00 1709 E Beaubien Phoenix,AZ 85024-0000 41 03/29/2013 Rivera, Sol I Housewif CHE $ 100.00 13960 Lake Placid Ct#c28 e Miami Lakes, FL 33014-0000 42 03/30/2013 Randolf, Douglas I Retired CHE $50.00 9368 Ivory Isle Rd Boyton Beach, FL 33473-0000 43 03/30/2013 DeMaille, Leon I President CHE $300.00 Q Bridge 129 Church St#511 co new haven, CT 06510-0000 44 This form is based on DS-DE 13(Rev.08/03) Adjutant Software,Inc.-Campaign ToolBox 4 -�4q 0 v- I CAMPAIGN TREASURER'S REPORT - ITEMIZED EXPENDITURES (1)Name Sherry Roberts (2) I.D. Number 00000 (3)Cover Period 01/01/2013-03/31/2013 (4) Page 1 of 1 (5) (7) (8) (9) (10) (11) Date Full Name (6) (Last,Suffix,First,Middle) Purpose Sequence Street Address& (add office sought if Expenditure Number City,State,Zip Code contribution to a candidate) Type Amendment Amount 03/13/2013 Paypal Paypal charge MON $3.20 2216 N. First Street San Jose, CA 95131-0000 1 03/13/2013 Paypal Paypal charge MON $3.20 2216 N. First Street San Jose, CA 95131-0000 2 03/13/2013 Paypal Paypal charge MON $3.20 2216 N. First Street San Jose, CA 95131-0000 3 03/16/2013 Paypal Paypal charge MON $3.20 2216 N. First Street San Jose, CA 95131-0000 4 03/24/2013 Paypal Paypal charge MON $ 14.80 2216 N First St San Jose, CA 95131-0000 5 03/27/2013 Paypal Bank Charges MON $ 1.75 2211 N. First Street, CA 95131-0000 6 03/28/2013 Paypal Paypal fee MON $7.55 2211 N. First Street, CA 95131-0000 7 03/28/2013 Kaplan, Gloria business expense MON $3.20 1709 E Beaubien. Phoenix,AZ 85024-0000 8 This form is based on DS-DIE 14(Rev.08/03) Adjutant Software,Inc.-Campaign ToolBox P'—f g-� � v/ CAMPAIGN LOANS REPORT ITEMIZED Page of (PLEASE TYPE) FULL NAME AND ADDRESS OF LENDER: FULL NAME AND ADDRESS OF LENDER: kt-V\ As -e rk OCCUPATION: OCCUPATION: AMOUNT OF LOAN: /Ui o o d AMOUNT OF LOAN: DATE RECEIVED: 3 /a 9 //-) DATE RECEIVED: FULL NAME AND ADDRESS OF LENDER: FULL NAME AND ADDRESS OF LENDER: OCCUPATION: OCCUPATION: AMOUNT OF LOAN: AMOUNT OF LOAN: DATE RECEIVED: DATE RECEIVED: FULL NAME AND ADDRESS OF LENDER: FULL NAME AND ADDRESS OF LENDER: OCCUPATION: OCCUPATION: AMOUNT OF LOAN: AMOUNT OF LOAN: DATE RECEIVED: DATE RECEIVED: DS-DE 73A(Rev.08/03)