DS-DE 12 North Beach Neighbors Alliance 2015-M12 CAMPAIGN TREASURER'S REPORT SUMMARY
�Y rr
► OFFI ONLY r
Name ZC�� ,.i =CE� °�USE f �` : 2 9
(2) 2) e •, ,'
Address(number and street) � ' `` U F i E_
City, State, 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 / / J ( To a / / ici° Report Type:
0 Original ❑Amendment ❑ Special Election Report
(6) Contributions This Report (7) Expenditures This Report
Monetary
Cash &Checks $ , , . r) Expenditures $ , • C
Loans $ Transfers to
Office Account $ (C , •
•
Total Monetary $
Total Monetary $ C , •
In-Kind $ , •
(8) Other Distributions
$ 7 ,
(9) TOTAL Monetary Contributions To Date (10) TOTAL Monetary Expenditures To ate
$ , , . o o $ - , , ' .
(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 reasurer ❑Deputy Treasurer ❑Candidate (only for PC and PTY)
or electioneering comm.)
%Chairperson
r .
X �� a/'.5��� X 09 �...�._,
Signature Signature
DS-DE 12(Rev.11/13) SEE REVERSE FOR INSTRUCTIONS
CAMPAIGN TREASURER'S REPORT- ITEM!. ED EXPENDITURES
(1) Name Aia. 12;Ilk:�A �# aL ,: 1\4. %1 ■ (2) I.D. Number y
(3)Cover Period a / � / cthrough (� / _// (4) Page of
(5) (7) (8) (9) (10) (11)
Date Full Name Purpose
(s) (Last,Suffix,First,Middle) (add office sought if
Sequence
Street Address& contribution to a Expenditure
Number City,State,Zip Code candidate) Type Amendment Amount
NON &
/ /
/
/ /
/ /
/ /
/
/ /
DS-DE 14(Rev.11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES
CAMPAIGN TREASURER'S REPORT— ITEMIZED CONTRIBUTIONS
(1) Name item C if .;� )(2) I.D. Number
(3) Cover Period I of / / through a / �/ / (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
/ /
DS-DE 13(Rev.11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES