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DS-DE 12 Rosen Gonzalez 2015-M05 CAMPAIGN TREASURER'S REPORT SUMMARY (1) Kristen Rosen Gonzalez OFFICE`l1SE ONLY Name 2015 JUN ! 0 PM 2= 23 (2) 4618 Alton Road Address (number and street) CITY c'_i_I'ti4 J OFFICE Miami Beach, FL 33140 City, State, Zip Code 1 ❑ Check here if address has changed (3) ID Number: 1 V (4) Check appropriate box(es): ® Candidate Office Sought: ❑ 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 5 / 1 / 15 To 5 31 15 Report Type: 70 L(-t1a 'fffOriginal ❑Amendment ❑ Special Election Report (6) Contributions This Report (7) Expenditures This Report Monetary 7804 58 Cash & Checks $ , -) . 00 . Expenditures $ , Loans $ 25 200 00 Transfers to Office Account $ • Total Monetary $ , • Total Monetary $ 7804 58 In-Kind $ 0 (8) Other Distributions $ , (9) TOTAL Monetary Contributions To Date (10) TOTAL Monetary Expenditures To Date $ 3n1576 0 0 $ ,7804. 58 (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) (Type name) ❑Individual(o ly f r IE Treasurer ❑Deputy Treasurer 'Candidate ❑Chairperson(only for PC and PTY) or electionee co m.) X X Signature Signature DS-DE 12(Rev. 11/13JU,,x,11 A, 1 0 2015 ., SEE REVERSE FOR INSTRUCTIONS 0-e. '+� aP 7?-K,...,:;,.:,::x,,w:"/_ ...'}: ::(a^k...' > •7i g':f :�!° tM. ..c�:. -,.,'s.!;`.a7 r.... `"- "l ,r(. . . �{... yS_,.., °.. eL' ,jlT•i� ? <. 1 FM: ':'.!SSIE' - '.:Ie� .7' •i".�,.y..�«!. 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',tit: _' '� ,4 w . l ,rr ' ;x %.1::' }c : . cR . F-:" 1` n„ � yy W» xi^ S F:; ..;;', ". ndltu�To D - ()cord(ss. 830, • ' rtffy tJ nd comp led • ll .. .. (Type.name)., , . �= e �j Individual(. lY Treasurer C Treestxr r #dat C]Chairpesori,( � • .!� ..- _ Rw i"'a jet•, T � ,,,,,t; . 3 ' ' - 7 f.''',:-; . t�' ,�43ry� :d.,- ,' '+ ' t k. i.Fi :'.7:-.'.:--,,,-•-•--','.--4.4 «w.. I, ".•%'',''',, k�P ' r +L`. .. ti...,..: . . • a an'( r'L` m., .w ,._, ::'s �+; ,”tt - o;`,K''sfi Hs,e`O:YYµ,F .,iA =". . ,:z._ Zc,c 7 1 CAMPAIGN TREASURER'S REPORT— ITEMIZED CONTRIBUTIONS Kristen Rosen Gonzalez (1) Name (2) I.D. Number 5 1 2015 5 31 2015 1 4 (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 Chezzi, Giulio 05 01 2015 1791 NE Miami Gardens / / Dr. 1 Apt E402 I Jeweler CHE 250 Miami, FL 33179 Baby Dot Com, Inc. 05 03 ' 2015 515 NE 109th Street / / Miami, FL 33161 2 B CHE 15 Simin Curtis 05 03 2015 5 VonLent Place / / Pittsburgh, PA 15232 3 I Executive CHE 500 Greg Curtis 05 04 2015 5 VonLent Place / / Pittsburgh , PA 15232 4 I Finance CHE 500 Hernan Pisano 05 07 2015 265 3rd St. #2 / / Jersey City, NJ 07302 5 I Tech CHE 100 Mile Tellez 05 09 2015 223 S. Grove Avenue / / Oak Park, IL 60302 6 I Real Estate CHE 100 Rajan Chopra 05 11 2015 6101 Aqua Avenue / / #301 7 Miami Beach, FL I Finance /'l,it 200 DS-DE 13(Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES Fc,za___ 3 e,r 7 CAMPAIGN TREASURER'S REPORT— ITEMIZED CONTRIBUTIONS Kristen Rosen Gonzalez (1) Name 1 (2) I.D. Number 05/01/2015 05/31/2015 2 4 (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 Todd Sandova 05 12 2015 112050 SW 63rd Avenue --_-'•, / / Pinecrest, FL 33256 8 I Retail CHE 100 Zulie Delgado 05 13 2015 1865 Brickell Ave. / / #402 9 Miami, FL 33129 I Insurance CHE 50 Thomas Musca 05 20 2015 6365 Collins Ave. #908 / / Miami Beach, FL 33141 10 I Professor CHE 100 Bar Brothers 05 15 2015 Purdy Lounge / / 1811 Purdy Avenue 11 MB, FL 33139 B Bar CHE 500 Aimee Kamat 05 15 2015 558 Hibiscus Lane / / Miami, FL 33137 12 I Doctor CHE 200 Claudia Jagid 05 15 2015 550 Bay Point Road / / Miami, FL 33137 13 I Management CHE 50 Marty Zaiac 05 17 2015 4308 Alton Road #750 / / Miami Beach, FL 33140 14 I Doctor CHE 250 DS-DE 13(Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES Fee--(-1 of 7 CAMPAIGN TREASURER'S REPORT- ITEMIZED CONTRIBUTIONS Kristen Rosen Gonzalez (1) Name (2) I.D. Number 05 01 2015 05 31 2015 3 4 (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 Dan Rivlin 05 19 2015 4308 Alton Road / / Ste. 510 15 Miami Beach, FL 33140 I Doctor CHE 500 Ricardo 011oqui 05 20 2015 1665 S. Miami Avenue / / Miami, FL 33129 16 I Telecom CHE 500 Tom Yazdgerdi 05 20 2015 Department of State / / Washington, DC 20520 17 I Diplomat CHE 500 RR Management 05 20 2015 17100 Collins Avenue / / Ste. 225 18 Sunny Isles, FL 33160 BUS Real Estate CHE 500 2241 Partners LLC 05 21 2015 5496 N Bay Road / / Miami Beach, FL 19 BUS Real Estate CHE 500 Kristen Rosen Gonzalez 05 15 2015 4618 Alton Road / / Miami Beach, FL 33140 20 LOA Real Estate CHE 200 Kristen Rosen Gonzalez 05 20 2015 4618 Alton Road / / Miami Beach, FL 33140 21 LOA Real Estate CHE 25000 DS-DE 13(Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES Pc--.4e_6-6,r 7 CAMPAIGN TREASURER'S REPORT— ITEMIZED CONTRIBUTIONS Kristen Rosen Gonzalez (1) Name (2) I.D. Number 5 1 2015 5 31 2015 4 4 (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 Simring, Richard 5 30 2015 5400 LaGorce Drive / / MB, FL 33140 25 I Legal CHE 100 Courey, Trudy 5 30 2015 6470 Allison Island / / Rd. Miami Beach, FL 33141 I Marketing CHE 100 / / / / DS-DE 13(Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES 60c7 CAMPAIGN TREASURER'S REPORT- ITEMIZED EXPENDITURES (1)Name Kristen Rosen Gonzalez (2)I.D. Number 05 01 015 5 31 015 1 1 (3)Cover Period /01 / /� (4)Page of (5) (7) (8) (9) (10) (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 DIAZ CONSULTING GROUP, INC. Consulting Services 05 /15 /2015 P.O. BOX 454351 MIAMI, FL 33245 MON 5000 1 Triumph Fundraising Consulting 05 15 2015 Miami Beach, FL 33140 MON 2000 2 DIAZ CONSULTING GROUP, INC. Consulting 05 15 2015 P.O. BOX 454351 MIAMI, FL 33245 MON 742.84 3 Merchant Card Fees 05 15 2015 Paypal Inc PO Box 45950 Omaha NW 8145-0950 MON 61.74 / DS-DE 14(Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES g . 7