DS-DE 12 Q1-09 M. Gongora (2)pM, u~%9
FLORIDA DEPARTMENT OF STATE DtVIS10N OF ELECTIONS
CAMPAIGN TREASURER'S REPORT SUMMARY
OFFICE USE ONLY
(1) Michel Gc~n~ora
_. _._-. _ c~', N
u
_____- -
Name ~; ° ~
(~) 5838 Collins Av. #3A -~~'~ '~
~ ~ °~
~
..,, --
Address (number and street)
_
Miami Beach, 1:'L 33140 '~
m
_
Gity, State, Ztp Cade
^ CHECK IF ADDRESS HAS CHANGED (3) ID Number: 0000, .c-®~
-
-
Y
i
(4) Check appropriate boxes}: T, ~
/^ Candidate (OfflGe SOUght}: Miami Beach Commission, Group II
^ Political Committee ^ CHECK IF PC HAS DISBANDED
^ Committee of Continuous Existence ^ CHECK 1F CCE HA3 DISBANDED
^ Party Executive Committee
^ Electioneering Communication ^ CHECK 1F NO OTHER ELECTIONEERING
COMMtJNiCATION REPORTS WILL BE F{LED
(5} REPORT IDENTIFIERS
Cover Period: From i ! 1 / 0 9 Ta 3 / 3 i l 0 9 Report Type Ql - 0 9
~ Original ^ Amendment ^ Special Election Report ^ Independent Expenditure Report
(8} CONTRIBUTIONS THIS REPORT (7} EXPENDITURES THIS REPORT
Monetary
Cash & Checks ~ Expenditures $ 0.00
Loans ~ 2 5 , 0 0 0.0 0 Transfers to Office
Account $
Totaf Monetary $
25, 000.00 Total
_ Monetary $ _ o . 0 0
1 n-Kind ~ 0.0 0
(8) Other Distributions
$ _
{8} TOTAL Monetary Contributions Ta Date (10} TOTAL Monetary Expenditures To Date
$ 25,000.00 $ 0.00
(11}CERTIFICATION
it is a first degree misdemeanor for any person to falsify a public record (ss. 838.13, F.S.)
I certify that 1 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.
(Type name) Michael Gongora (Type name) Michael Gongora
^Individual (only for / Treasurer ^ Deputy Treasurer Candidate ^ Chairperson (only for PC, PTY &
'
ctioneering a mun.)
e
le oneering commun. argaNzation)
eI
y
l
A /•
/V
~ /
Sig ature Signature
QS-DE 12 (Rev. 08!04}
~~ ~ ~ ~-
(')) Larne _.._.. ...._. ..._ _ _Ma.c:l~ia~~_ _.Gonc~~_`'__---._____ ._._....._......... __.... (2} f.t7. ~€€e~ber 0OQ00
(3} Cover Period _- 1 __ / o:~ / 09 through 3 _ ! 31~ / os {4) Page ? __ of .__?___
Date FuH Name
(6)
Sequence
Number (Last, Suffix, First, Middle)
Street Address &
Ci State Zi Code
Contributor
T E Occu ation
Contribu#ion
T e
In-kind
Descri tion
Amendment
Amount
3 ~ 7 X09 Michael Gongora I Attorney
at Law Loan 25,000
1
/ /
/ /
/ !
/ /
DS-DE 13 (Rev. 08!03) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES
~~~~~-