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DS-DE 12 FLORIDA DEPARTMENT OF STATE DIVISION OF ELECTIONS CAMPAIGN TREASURER'S REPORT SUMMARY Saul Gross Campaign OFFICE USE ONLY (1 ) Name c-) 0 (2) 1125 Washington Avenue -i U'1 ;tJ Address (number and street) _.-' (/) (~....) rr1 rn Miami Beach, FL 33139-0000 r"" -0 () City, State, Zip Code (..,.:) r{11 0' C) 0 Check box if address has changed ..t"" ~ ~ (3) 00000 - :t,...""!:il I.D, Number: .r'" ~- "-i'/ ~....- (4) Check appropriate box(es): CD - rn ........~. - - .. :-"l X City Commissioner -r, 'i,-#, Candidate (office sought): w - "", -J Ul Political Committee o Check if PC has DISBANDED rr1 ~ - Committee of Continuous Existence o Check if CCE has DISBANDED Party Executive Committee - o Check if no other electioneering communication reports will be filed _ Electioneering Communication (5) REPORT IDENTIFIERS Cover Period: From 07/01/2005 To 09/23/2005 Report Type: FI [R] Original o Amendment o Special Election Report o Independent Expenditure Report (6) CONTRIBUTIONS THIS REPORT (7) EXPENDITURES THIS REPORT $1,150,00 Monetary $7,970.00 Cash & Checks Expenditures Transfers to Office Loans $0.00 Account $0,00 Total Monetary $1,150.00 Total Monetary $7,970,00 In-Kind $0.00 (8) Other Distributions $0.00 (9) TOTAL Monetary Contributions to Date (10) TOTAL Monetary Expenditures to Date $20.400.00 $12.172.34 (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 I certify that I have examined this report and it is true, correct and complete true, correct and complete Saul Gross Saul Gross o Indlllldual (only for [X] Treasurer o Deputy Treasurer [X] Candidate o Chairman (only for PC, PTY & electioneering ruJ(, ~"_OOI cOlTV11Un.) S~ ~ X S X Signature Signature OS-OE 12 (Rev. 08104) Adjutant Software - Campaign ToolBox FtL5! ot- 3 CAMPAIGN TREASURER"S REPORT - ITEMIZED CONTRIBUTIONS (1) Name Saul Gross Campaign (3) Cover Period 07/01/2005 - 09/23/2005 (2) I.D, Number (4) Page 00000 1 of 1 (5) (7) (8) (9) (10) (11 ) (12) Date Full Name Contributor (6) (Last, Suffix, First, Middle) In-kind Sequence Street Address & Contribution Number City, State, Zip Code Type Occupation Type Description Amendmen Amount 07/15/2005 Donnelly, James F. I Activist CHE $ 50.00 915 Jefferson Avenue 3C Miami Beach, FL 33139-0000 000001 07/20/2005 Dunn, John G, I Real CHE $ 100.00 5925 NE 6th Court Estate Miami, FL 33137-0000 Broker 000002 07/26/2005 Star Island Entertainment LLC B Entertain CHE $ 500.00 1235 Washington Avenue ment Miami Beach, FL 33139-0000 000003 07/26/2005 136 Collins Avnue, LLC B Night CHE $ 500.00 136 Collins Avenue Club Miami Beach, FL 33139-0000 000004 OS-DE 13 (Rev. 08/03) Adjutant Software - Campaign ToolBox r(J.~ '2 %- 3 CAMPAIGN TREASURER'S REPORT - ITEMIZED EXPENDITURES (5) (7) (8) (9) (10) (11 ) Date Full Name (6) (Last, Suffix, First, Middle) Purpose Sequence Street Address & (add office sought if Expenditure Amendmen Number City, State, Zip Code contribution to a candidate) Type Amount 07/11/2005 The Donner Group Voter Database MaN $ 1,500.00 7525 SW 54th Court Miami, FL 33143-0000 000001 07/11/2005 The Donner Group General Consultant MaN $ 1,000.00 7525 SW 54th Court Miami, FL 33143-0000 000002 08/19/2005 The Donner Group Poll MaN $ 3,450.00 7525 SW 54th Court Miami, FL 33143-0000 000003 09/06/2005 City of Miami Beach Qualifying Fee - MaN $ 1,020.00 1700 Convention Center Drive Commission Miamii Beach, FL 33139-0000 000004 09/13/2005 The Donner Group General Consultant MaN $ 1,000.00 7525 SW 54th Court Miami, FL 33143-0000 000005 (2) 1.0. Number (4) Page 00000 1 of 1 (1) Name Saul Gross Campaign (3) Cover Period 07/01/2005 - 09/23/2005 OS-DE 14 (Rev. 08/03) Adjutant Software. Campaign ToolBox pa ~ :? t 3