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DS-DE 12 Cynamon 2015 - M05 CAMPAIGN TREASURER'S REPORT SUMMARY (1) Jeff Cynamon for Miami Beach Commission OiF-16 •6 Sio.IVL.Y Name 2615 ,113,' -9 PH 1: i 7 (2) 300 Seventy-First Street, Suite 300 Address (number and street) CITY OFF ICE Miami Beach, Florida 33141 City, State, Zip Code ❑ Check here if address has changed (3) ID Number: (4) Check appropriate box(es): D Candidate Office Sought: Miami Beach Commission Group 6 ❑ Political Committee (PC) ❑ Electioneering Communications Org. (ECO) ❑ Check here if PC or ECO has disbanded ❑ Party Executive Committee (PTY) ❑ Check here if PTY has disbanded ❑ Independent Expenditure (IE) (also covers an ❑ Check here if no other IE or EC reports will be filed individual making electioneering communications) (5) Report Identifiers Cover Period: From 05 / 01 / 2015 To 05 / 31 / 2015 Report Type: 2015-M05 12 Original ❑ Amendment ❑ Special Election Report (6) Contributions This Report (7) Expenditures This Report Monetary Cash & Checks $ , 2,350 . 00 Expenditures $ , , 877 . 26 Loans $ , , 0 . 00 Transfers to Office Account $ , , 0 . 00 Total Monetary $ , 2 ,350 . 00 Total Monetary $ , , 877 . 26 In-Kind $ , 0 . 00 (8) Other Distributions $ , 0 . 00 (9) TOTAL Monetary Contributions To Date (10) TOTAL Monetary Expenditures To Date $ 6 , 300 . 00 $ , , 923 . 69 (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, correct, and complete: (Type name)Jeff Cynamon (Type name)Jeff Cynamon ❑Individual(only for IE D Treasurer ❑Deputy Treasurer o - ndidate ❑Chairperson(only for PC and P or electioneering comm.) X X Sig•ature Sign ure DS-DE 12(R- . 11/13) SEE REVERSE FOR INSTRUCTIONS PC1&. OCS CAMPAIGN TREASURER'S REPORT— ITEMIZED CONTRIBUTIONS Jeff Cynamon for Miami Beach Commission (1) Name (2) I.D. Number 05 01 2015 05 31 2015 1 1 (3) Cover Period / / through / / (4) Page of (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 Jason Alderman, P.A. 05 15 2015 9999 N.E. 2nd Avenue / / Suite 211 001 Miami Shores, FL 33138 g Law Firm Check 1000.00 Vicente Roger, M.D., 05 15 2015 P.A. / / 1069 Kane Concourse 002 Bay Harbor Island, FL g Pediatrician Check 1000.00 33154 Annette Canon 05 15 2015 103 - 7th Terrace / / Miami Beach, FL 33139 003 I Attorney Check 50.00 Legacy Acquisitions 1, 05 15 2015 LLC / / 18701 S.E. Federal 004 Highway, B Marina Check 100.00 Jupiter, FL 33469 Chepenik and Trushin, 05 15 2015 LLP, / / 12550 Biscayne Blvd., 005 Suite 904 B Law Firm Check 200.00 Miami, FL 33181 / / / / DS-DE 13(Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES cu e. 2 0 5 CAMPAIGN TREASURER'S REPORT- ITEMIZED EXPENDITURES (1) Name Jeff Cynamon for Miami Beach Commission (2) I.D. Number (3) Cover Period 05 / 01 / 2015 through 05 / 31 / 2015 (4) Page 1 of 1 (5) (7) (8) (9) (1 0) (11) 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 Miami Beach Chamber of Commerce Gala 05 if 01/2015 1920 Meridian Avenue Miami Beach, Florida 33139 Mon 325.00 001 Discovercard Letterhead and 05 13 2015 / / for Union Printering, Inc. envelopes 2321 Pembroke Road Hollywood, FL 33020 Mon 552.26 002 552.26 / / / / / / / / / / / DS-DE 14(Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES y m(2,3 i 5 CAMPAIGN TREASURER'S REPORT - ITEMIZED DISTRIBUTIONS Jeff Cynamon for Miami Beach Commission (1) Name (2) I.D. Number (3) Cover Period 05 / 01 /2015 through 05 31 /2015 (4) Page 1 of (5) (7) (8) (9) (10) (11) (12) Date Full Name Purpose (6) (Last,Suffix, First,Middle) (add office sought if Sequence Street Address& contribution to a Related Distribution Number City,State,Zip Code candidate) Expenditures Amendment Amount Type Nothing to Report on this Form. / I I I I / / I I DS-DE 14A(Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES 1 Ctge -1 5 CAMPAIGN TREASURER'S REPORT— FUND TRANSFERS (1) Name Jeff Cynamon for Miami Beach Commission (2) I.D. Number (3) Cover Period 05 X01 ?015 through 05 X31 ?i015 (4) Page 1 of 1 (5) (7) (8) (9) (10) (11) Date Name of Financial (6) Institution Sequence Street Address& Transfer Nature of Number City,State,Zip Code Type Account Amendment Amount Nothing to Report on this Form. / l 1 1 I I l 7 DS-DE 13A(Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES Yne