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. FLORIDA DEPARTMENT OF STATE, DIVISION OF ELEC1l0NS
CAMPAIGN TREASURER'S REPORT SUMMARY
, (1) DAVID DERMER
Candidate, Committee or Party Name
(2)
1.0. Number
17T n>>TT\A 111la.O
State Zip Code
. (3) 4195 NORTH BAY ROAD MIAMI BEACH
Address (number and street) City
o Check box if address has chanQed since last report
(4) Check appropriate box(es):
~ Candidate (office sought):
o Political Committee
o Committee of Continuous Existence
o Party, Executive Committee
MAYOR OF MIAMI BEACH
o Check if PC has DISBANDED
o Check. if CCE has DISBANDED
( ) "EPORT IDENllFIERS
Cover Period: From 09/27/03 To . 10/1 O/Oi
o Original. 0 Amendment 0 Special Election Report
(6) CONTRIBUTIONS THIS REPORT
Cash & Checks $. 1.';00 00
Loans $ ..,0.,
Total Monetary $ 1,500.00
in-Kind S -0-.
(9) TOTAL Monetary Contributions to Date
$
1'5,050.00
Report Type: F7
o Independent Expenditure Report
(7) EXPENDITURES THIS REPORT
Monetary
Expenditures $ 150.00'
Transfers to Office
Account $
. . Total Monetary
$
150.00
(8) Other Distributions $ .
(10) TOTAL Monetary Expenditures to Date
$ 2,402.27
(11) CERTIFICATION
It is a first degree misdemeanor for any person to falsify a public record (55. 839.13, F.S.)
I certify that I have examined this report and It is
true, correct and complete
YAFFA DERMER
D Deputy Treasurer
I?"
I certify that I have examined this report and it is true,
ct and mplete
D Chairman (pCIPTv only)
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SEE REVERSE fOR INSTRUCTIONS AND CODE VALUES
CAMPAIGN TREASURER'S REPORT -ITEMIZED CONTRIBUTIONS
(1) Name
DAVID DERMER
(2) 1.0. Number
(3) Cover Period
09/ 27 /03 through-1.Q./ 10/ 03
(4) Page
1
of 1
(5) {7} (8) (9) (10) (11) (12)
Date Full Name
(6) (Last, Suffix, First, Middle) Contributor
Sequence Street Address & Contributlon ln~ind
Number City, State, Zip Code Ty~ Occupallon Type Description Amendment Amount
.
Burkett Properties, rnc.
J.O / OS/03 801 Alton Road fI2 B Propert' CRE 500
1 Miami Beach, FL 33139 Manageml nt
1O/0S/03 Linda Gibb
5S20 N. Bay Road ~nvestor CRE 500
L Miami Beach, FL 33140 j I -
10/08/03 Charles W Burkett, IV Managem nt
801 Alton Road #2 CRE 500
.}, Miami Beach, FL 33139 I
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CAMPAIGN TREASURER'S REPORT -ITEMIZED EXPENDITURES
(1) Name
DAVID DERMER
(2) 1.0. Number
(3) Cover Period 09/ 27 103 through 101 10 103
(4) Page
1
of
1
(5) (7) (a) (Il) {10} (11)
Date Full Name Purpose
(6) (Last, Suffix. FirCt, Middle) (add office sought If Expenditure
Sequence Street Address & contribution to .
Number City, State, Zip Code candidate) Type AIr...odment Amount
.
. .
'lei 03/ 03 FORUM PUBLISHING GROUP, IN
Post Office Box 8547
i 1 Chicato, IL 60680-8547 AD MON 150
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