DS-DE 12 North Beach Neighbors Alliance 2015-M11 CAMPAIGN TREASURER'S REPORT SUMMARY
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(1) b t // • _ A it Zee,[ ' n,4i.r OFFICE USE ONLY
Name 7.!015 DEC y.. PH 2: 14J
(2) X33 o dC;J l/ L -.`' OFF I
1
Address (number and street) I,�'
On f 3 W/ 7
City, Zip Code
❑ Check here if address has changed (3) ID Number:
(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 i I / / /I To /1 / 30 / J( Report Type: 00/r nii)
Original ❑Amendment ❑ Special Election Report
(6) Contributions This Report (7) Expenditures This Report
Monetary
Cash & Checks $ 0 , • 0 Expenditures $ Q , - , •
Loans $ Transfers to
Office Account $ (' ,
Total Monetary $ 0 , , •
Total Monetary $ O ,
In-Kind $ 0 , •
(8) Other Distributions
$ ,
(9) TOTAL Monetary Contributions To Date (10) TOTAL Monetary Expenditures To Date
, , 00 , , .
(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(only for IE cdTreasurer ❑Deputy Treasurer ❑Candidate Chairperson(only for PC and PTY)
or electioneering comm.)
X X
Signature Signature
DS-DE 12(Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS
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CAMPAIGN TREASURER'S REPORT— ITEMIZED CONTRIBUTIONS
(1) Name &n -S1 ( /v4/29i4'aec, (2) I.D. Number
(3) Cover Period if / / / fs- through I ( / 3i / / I (4) Page 1 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
/ /
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/ /
/ /
/ /
/ /
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DS-DE 13(Rev.11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES
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CAMPAIGN T. AS RER'S REPORT- ITEMIZED EXPENDITURES
(1) Name OA-0e f ovie-5' r/ p /- (2) I.D. Number
(3)Cover Period 1/ / t / fr.-through /( / 30 / /T (4) Page ,1 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
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1. I /� --/
/ /
/ /
/ /
/ /
/ /
•
/ /
/ /
DS-DE 14(Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES
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