DS-DE 12 2015-M05 Samuelian CAMPAIGN TREASURER'S REPORT SUMMARY: _Y
r +
(1) Mark Samuelian 2 FiEE V$ Q LY3: 54
Name
(2) 10 Venetian Way#1502 CITY 1.,, W I __
1 I 1�
Address(number and street)
Miami Beach, FL 33139
City, State, Zip Code
❑ Check here if address has changed (3) ID Number:
(4) Check appropriate box(es):
A Candidate Office Sought: Miami Beach Commisioner, Group VI
❑ 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-M o5
®Original ❑Amendment ❑Special Election Report
(6) Contributions This Report (7) Expenditures This Report
Monetary
Cash & Checks $ , 10, 035 . 00 Expenditures $ , 5,950 . 82
Loans $ , 251 000 . 00 Transfers to
Office Account $ •
Total Monetary $ , 35 , 035 . 00
Total Monetary $ , 5, 950 . 82
In-Kind $ , , 275 . 00
(8) Other Distributions
$ , , .
(9) TOTAL Monetary Contributions To Date (10) TOTAL Monetary Expenditures To Date
$ , 161 ,607 . 00 $ , 17 , 786 . 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) Laura Dominguez (Type name) Mark Samuelian
❑Individual(only for IE l'Treasurer ❑Deputy Treasurer '[ Candidate ❑Chairperson(only for PC and PTY)
or electioneering comm.)
X 6/
X ��
Signature Signature
DS-DE 12(Rev.11113) SEE REVERSE FOR INSTRUCTIONS
Poky I ar
CAMPAIGN TREASURER'S REPORT— ITEMIZED CONTRIBUTIONS
Mark Samuelian
(1) Name (2) I.D. Number
05 01 2015 05 31 2015 1 7
(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
McHugh, Harry
05 01 2015 578 Whitford Hills Rd
Exton, PA 19341
I Retired CHE $200.00
1
Hasan, Sohail
05 01 /2015 246 E 46 St #6H
New York, NY 10017
I Retired CHE $250.00
2
Jacobson, Marc
05 01 2015 115 1st Rivo Alto Ter
Miami Beach, FL 33139
I Retired CHE $25.00
3
Beruvides, Maricarmen
05 04 /2015 4802 SW 127th Court
Miami, FL 33175
I Retired CHE $300.00
4
+ 1
Fundora, Jessi
05 06 /2015 4451 NW 171 Terrace
Miami, FL 33055
I Sales Rep CHE $25.00
5
05 11 2015 Kareguesian, Jack
/ 1408 Brickell Bay Dr
Miami, FL 33131
I Retired CHE $250.00
6
Jacob, Allan
05 11 2015
536 W 47th Street
Miami Beach, FL 33140
I Educator CHE $500.00
7
DS-DE 13(Rev.11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES
45e apf
IZ
CAMPAIGN TREASURER'S REPORT—ITEMIZED CONTRIBUTIONS
Mark Samuelian
(1) Name (2) I.D. Number
05 01 2015 05 31 2015 2 7
(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
05 11 2015 Quade, Debra
1691 Michigan Av #210
/ / Miami Beach, FL 33139
I Realtor CHE $100.00
8
Breslin, Ray
05 11 2015 2395 Lake Pancoast Dr
/ /
#4
Miami Beach, FL 33139 I Property Mgr CHE $25.00
9
Roos, Hector
05 11 2015 1925 Brickell Av #1604
/ / Miami, FL 33131
I CEO/Media CAS $25.00
10
Lawrence, Dee
05 / 12 /2015 16850 N Bay Rd #1409
Sunny Isles Beach, FL
33160 I Retired CHE $50.00
11
Lapciuc, Tiffany
05 15 2015 4900 Pine Tree Drive
/ /
Miami Beach, FL 33140
I Homemaker INK food/bev $150.00
12
05 15 2015 Barello, Joseph
/ / 4112 Enfield Ridge Dr
Cary, NC 27519
I Bus Manager CHE $100.00
13
Lapciuc, Tiffany
05 15 2015
4900 Pine Tree Drive
/ /
Miami Beach, FL 33140
I Homemaker CHE $250.00
14
DS-DE 13(Rev.11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES
PCk6 3 OC 2,
CAMPAIGN TREASURER'S REPORT—ITEMIZED CONTRIBUTIONS
Mark Samuelian
(1) Name (2) I.D. Number
05 01 2015 05 31 2015 3 7
(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
Potash, Jill
05 15 2015 1541 Brickell Av #1802
/ Miami, FL 33131
I Sales Rep CHE $200.00
15
Supron, Wendy
05 / 19 /2015 121 Ballantine Road
Bernardsville, NJ
07924 I Retired CHE $1,000.00
16
Bohmiller, Paul
05 19 2015 205 Jordan Road
/ Franklin, MA 02038
I Software Eng CHE $50.00
17
Riedel, Ralph
05 22 2015 12 Euclid Drive
Athens, OH 45701
I Professor CHE $500.00
18
CRE, LLC
05 23 /2015 136 W Belmont Dr
#11-124
Calhoun, GA 30701 B Real Estate CHE $1,000.00
19
05 26 2015 Browne, Lynda
/ 37 Green Acre Lane
Westport, CT 06880
I Fin Services CAE $1,000.00
20
05 27 2015 Losson, Jane
1810 Jefferson Avenue
Miami Beach, FL 33139
I Retired CHE $100.00
21
DS-DE 13(Rev.11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES
Pt Icy. 4oiZ.
CAMPAIGN TREASURER'S REPORT—ITEMIZED CONTRIBUTIONS
Mark Samuelian
(1) Name (2) I.D. Number
05 01 2015 05 31 2015 04 07
(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
Schmidt, Steven
05 27 2015 1000 Michigan Av
/ / Miami Beach, FL 33139
I Hair Stylist CHE $50.00
22
Samuelian, Linda
05 / 28 2015 232 Cambridge St #9
Boston, MA 02114
I Paralegal CHE $400.00
23
Hagopian, Jason
05 28 2015 6444 Allison Road
/ Miami Beach, FL 33140
I Architect CHE $100.00
24
Walker, Waverly
05 28 2015 1300 Lincoln Rd #1001
Miami Beach, FL 33139
I Bus Consult. CHE $25.00
25
Garcia, Anthony
05 / 28 2015 255 West 33rd Street
Miami Beach, FL 33140
I Fin Services CHE $500.00
26
Romanello, Madeleine
05 28 2015
890 NE 72 Terrace
Miami, FL 33138
I Realtor CHE $100.00
27
Zundel, Jurg
05 28 2015
4180 Poinciana Avenue
Coconut Grove, FL
33133 I Attorney CHE $50.00
28
DS-DE 13(Rev.11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES
OC
CAMPAIGN TREASURER'S REPORT— ITEMIZED CONTRIBUTIONS
Mark Samuelian
(1) Name (2) I.D. Number
05 01 2015 05 31 2015 5 7
(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
Khagan, Mojdeh
05 28 2015 5151 Collins Avenue
Miami Beach, FL 33141
I Attorney CHE $500.00
29
Mouzon, Wanda
05 28 2015 744 10th Street #111
/ Miami Beach, FL 33139
I Designer CHE $25.00
30
Lorenzo, Cristina
05 , 28 /2015 4326 Alton Road
Miami Beach, FL 33140
I Travel Agent CHE $25.00
31
Edmee Prats Court
05 28 2015 Reporting
1442 NW 13 Terrace
Miami, FL 33125 B Court Report CHE $100.00
32
Karaguesian, Jack
05 / 28 2015 1408 Brickell Bay Dr
Miami, FL 33131
I Retired CHE $500.00
33
05 28 2015 Tandy, Aaron
4825 Lakeview Drive
Miami Beach, FL 33140
I Attorney CHE $150.00
34
Elder Law Partners
05 28 2015
3655 LeJeune Road, 323
Coral Gables, FL 33134
B Law Practice CHE $150.00
35
DS-DE 13(Rev.11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES
CAMPAIGN TREASURER'S REPORT—ITEMIZED CONTRIBUTIONS
Mark Samuelian
(1) Name (2) I.D. Number
05 01 2015 05 31 2015 6 7
(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
Listed, LLC
05 28 2015 900 Meridian Av #212
1 Miami Beach, FL 33139
B Realtor CHE $100.00
36
Saltzman, Nicolle
05 29 2015 3900 Island Boulevard
/ /
Aventura, FL 33160
I Camp. Asst. INK food/bev $100.00
37
Donnelly, James
05 29 2015 915 Jefferson Avenue
/ 1 Miami Beach, FL 33139
I Historian CHE $10.00
38
Adkins, Rod
05 30 2015 5959 Collins Av #1603
/ /
Miami Beach, FL 33140
I Private Inv CHE $500.00
39
Welty, Carl
05 30 2015 4825 Adams Road
/ /
Dunwoody, GA 30338
I Engineer CHE $250.00
40
My Agent, Inc
05 30 2015
17 Kazimer Drive
/ /
Billerica, MA 01821
B Concierge CHE $300.00
41 services
Miflin, Marsha
05 30 2015
34 Anderson Road
1
Greenwich, CT 06830
I Homemaker CHE $250.00
42
DS-DE 13(Rev.11113) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES
a 1/—
CAMPAIGN TREASURER'S REPORT—ITEMIZED CONTRIBUTIONS
1 Mark Samuelian
(1) Name (2) I.D. Number
05 01 2015 05 31 2015 7 7
(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
Samuelian, Mark
05 31 2015 10 Venetian Way #1502
/ / Miami Beach, FL 33139
I Priv Invest INK Canvass Asst $25.00
43
Samuelian, Mark
05 31 /2015 10 Venetian Way #1502
/
Miami Beach, FL 33139
I Priv Invest LOA $25,000.00
44
/ /
/ /
/ /
/ /
/ /
DS-DE 13(Rev.11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES
r;PA 5 t (/). It
CAMPAIGN TREASURER'S REPORT- ITEMIZED EXPENDITURES
(1)Name Mark Samuelian (2)I.D. Number
(3)Cover Period 05 / 01 / 2015 through 05 / 31 / 2015 (4) Page 01 of 03
(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
MDW Communications Media and PR
05i/ 04/2015 601 NW 82 Av #432
Plantation, FL 33324 MON $2,798.57
1
05//05 /015 MDW Communications Media and PR
601 NW 82 Av #432
Plantation, FL 33324 MON $1,000.00
2
Anedot Credit card
05/06 /015 5555 Hilton Avenue #106 processing fee
Baton Rouge, LA 70808 MON $1.27
3
Anedot Credit card
0511 2 015 5555 Hilton Avenue #106 processing fee
/
Baton Rouge, LA 70808 MON $10.05
4
Office Depot office supplies
05/15 /015 13575 South Dixie Highway
Miami, FL 33156
MON $272.89
5
Anedot credit card
05/15 2 015 5555 Hilton Avenue #106 processing fee
Baton Rouge, FL 70808 MON $12.30
6
Messer Caparello PA legal assistance
05/18 /015 2618 Centenniel Place
Tallahassee, FL 32308 MON $210.00
7
Saltzman, Nicolle campaign assistance
05/19 015 3900 Island Boulevard
Aventura, FL 33160
MON $500.00
8
DS-DE 14(Rev.11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES
PAC5C. 9 Ck IZ
CAMPAIGN TREASURER'S REPORT- ITEMIZED EXPENDITURES
(1)Name Mark Samuelian (2)I.D. Number
(3)Cover Period 05 /01 /2015 through 05 / 31 /2015 (4)Page 2 of 03
(5) (7) (8) (9) (1 0) (1 1)
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
Anedot credit card
05/19 /2015 5555 Hilton Avenue #106 processing fee
Baton Rouge, LA 70808 MON $41.55
9
05/22 /015 Anedot credit card
5555 Hilton Avenue #106 processing fee
Baton Rouge, LA 70808 MON $19.80
10
Anedot credit card
05/123 /2015 5555 Hilton Avenue #106 processing fee
Baton Rouge, LA 70808 MON $39.30
11
Publix food/bev & supplies
0526 2 015 2270 SW 27 Avenue for campaign events
/
Miami, FL 33145 MON $127.17
12
BankUnited bank wire
05/26 /015 1695 Alton Road processing fee
Miami Beach, FL 33139
MON 15.00
13
Anedot credit card
05/27 2 015 5555 Hilton Avenue #106 processing fee
Baton Rouge, LA 70808 MON $2.25
14
Sheets, Alysha data work
05/127 /015 603 Call Street #714
Tallahassee, FL 32301
MON $260.00
15
Saltzman, Nicolle campaign assistance
05/27 015 3900 Island Boulevard
Aventura, FL 33160 MON $500.00
16
DS-DE 14(Rev.11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES
(" ct o)e. 6 oC 12
CAMPAIGN TREASURER'S REPORT-ITEMIZED EXPENDITURES
(1) Name Mark Samuelian (2)I.D. Number
(3)Cover Period 05 / 01 /2015 through 05 / 31 / 2015 (4) Page 3 of 3
(5) (7) (8) (9) (10) (71)
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
Publix food/bey for
0)/28 )&015 1920 West Avenue campaign event
Miami Beach, FL 33139 MON $49.62
17
05/28 /015 Anedot Credit card
5555 Hilton Avenue #106 processing fee
Baton Rouge, LA 70808 MON $58.26
18
Anedot Credit card
05/29 //015 5555 Hilton Avenue #106 processing fee
Baton Rouge, LA 70808 MON $0.69
19
Anedot Credit card
05 . 30 2015 5555 Hilton Avenue #106 processing fee
Baton Rouge, LA 70808 MON $32.10
20
/
/
/ /
/ /
DS-DE 14(Rev.11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES
?ay, 0-F 17_
CAMPAIGN LOANS REPORT ITEMIZED
Page 01 of 01
(PLEASE TYPE)
FULL NAME AND ADDRESS OF LENDER: FULL NAME AND ADDRESS OF LENDER:
Mark Samuelian
10 Venetian Way#1502
Miami Beach, FL 33139
OCCUPATION: Private Fin. Investor OCCUPATION:
AMOUNT OF LOAN: $25,000.00 AMOUNT OF LOAN:
DATE RECEIVED: 5/31/2015 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)
ale IZei2