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DS-DE 12 G4-07 Campaign Treasurer's ReportFLORIDA DEPARTMENT OF STATE DIVISION OF ELECTIONS CAMPAIGN TREASURER'S REPORT SUM (1) MIAMI BEACH CITIZENS ALLIANCE PAC, Ili( OFFICE USE ONLY 20Q1 NOV i 6 Name PM 3~ 18 (2) 4045 SHERIDAN ST (#362) C(TY ~~..~.t`d{'j OFFICE Address (number and street) MIAMI BEACH, FL 33140 City, State, Zip Code ^ CHECK IF ADDRESS HAS CHANGED (3j ID Number: (4) Check appropriate box(es): ^ Candidate (office sought): © Political Committee ^ CHECK IF PC HAS DISBANDED ^ Committee of Continuous Existence ^ CHECK IF CCE HAS DISBANDED ^ Party Executive Committee ^ Electioneering Communication ^ CHECK IF NO OTHER ELECTIONEERING COMMUNICATION REPORTS WILL BE FILED S~ (5) REPORT IDENTIFIERS Cover Period: From 11 / ~ / 2 0 0 ~ To /' 11 / 15 / 2 0 0 ~ Report Type to y0'7 ^ Original ^ Amendment ^ Special Election Report ^ Independent Expenditure Report (6) CONTRIBUTIONS THIS REPORT (7) EXPENDITURES THIS REPORT _ _ _ ~ - ~ Monetary ~ ~"~ ' _ - '' Cash 8~ Checks $ ~'~. Expenditures $ ,~ .%-~ Loans $ ~ ~~ Transfers to Office ,~' , , ~ Account $ Total Monetary $ ~U ~~ Total ~ Monetary $ ~„3~ In-Kind $ (8) Other Distributions (9) TOTAL Moneta Cont ' do s To Date ~ ~ ~ ~~ ~ ~ (10) TOTAL Monetary Expenditure To Date xy ' , $ $ ~3 ~ 9 (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, I certify that I have examined this report and it is true, correct, and complete. correct, and complete. ] I~ (TYPe name) ~~G//~ aJ'r' ~~ RYPe name) J~~G!' N ~l~j~S ^ Individual (only for [/~Treasurer ^ Deputy Treasurer ^ Candidate ai son ( my for PC, PTY & electioneering co n.) a ion g un. organization) X X , Signa a Sig a r DS-DE 12 (Rev. 08!04) " U V V ^` n ~ CAMPAIGN TREASURER'S REPORT -ITEMIZED CONTRIBUTIONS (1) Name MIAMI BEACH CITIZENS ALLIANCE PAC (2) I.D. Number (3) Cover Period » l ~1a l ~10~7 through ~~ / `~/ ~~~ (4) Page 1 of 1 (5) Date (~) Full Name (8) (9) (10) (11) (~2) (fi) Sequence Number (Last, Suffix, First, Middle) Street Address & C' ,State, Zi Code Contributor T Occu tion Contribution T e In-kind Descri tion nmend~nt Amount ~~ ~ Jew ~, 66s ~ ~~ y e ~,~ .~~6~ ,~~~~ ~ ~~~ ~ S~~ ~ /L1i~ ~1ci ,fG i i i i i i i i i i i i DS-0E 13 (Rev. 08/03) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES ~~~-~3 CAMPAIGN TREASURER'S REPORT -ITEMIZED EXPENDITURES (1) Name MIAMI BEACH CITIZENS ALLIANCE PAC, INC (2) I.D. Number (3) Cover Period ~~ / ~~ / ~~~through ~~ l f~ /alder (4) Page 1 of 1 (5) Date (7) Full Name (8) Purpose (9) (10) (11) (s) Sequence Number (Last, Suffix, First, Middle) Street Address 8 City, State, Zip Code (add office sought if contribution to a candidate) Expenditure TYPe Amendment Amount ~/ ~~ ~i~~ ~~ ~Idr~fis,~y f j any ~ ,~,~,~; , ~ 93~ DS-DE 14 (Rev. 08/03) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES (~~ 3 ~ ~