DS-DE 12 Beach Residents for Quality of Life M12 •
CAMPAIGN TREASURER'S REPORT SUMMARY
(1) Beach Residents for Quality of Life OFFICE USE ONLY
Name
(2) 2618 Centennial Place
Address (number and street)
Tallahassee, FL 32308
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 12 / 01 / 15 To 12 / 31 / 15 Report Type: M12
A Original ❑Amendment ❑ Special Election Report
(6) Contributions This Report (7) Expenditures This Report
Monetary
Cash & Checks $ , , 0 . 00 Expenditures $ , 4 , 250 . 00
Loans $ Transfers to
Office Account $ •
Total Monetary $ , 0 . 00
Total Monetary $ , 4 , 250. 00
In-Kind $ •
(8) Other Distributions
•
$
(9) TOTAL Monetary Contributions To Date (10) TOTAL Monetary Expenditures To Date
$ , 10 , 800 . 00 $ , 4 , 250 00
(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 n..me) Mark r erron (Type name)
❑ Indiv ual(only for IE GI Treasurer ❑ Deputy Treasurer ❑Candidate ❑Chairperson(only for PC and PTY)
or elec .-leering m.
Xa X
Signatu - Signature
DS-DE 12(Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS
CAMPAIGN TREASURER'S REPORT— ITEMIZED CONTRIBUTIONS
Beach Residents for Quality of Life
(1) Name (2) I.D. Number
12 01 15 12 31 15 1 1
(3) Cover Period / / through / / (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
•
CAMPAIGN TREASURER'S REPORT- ITEMIZED EXPENDITURES
(1) Name Miami Beach Advisory Council (2) I.D. Number
(3)Cover Period 12 / 01 / 15 through 12 / 31 / 15 (4) Page of 1
(5) (7) (8) (9) (10) (11)
Date Full Name Purpose
(6) (Last,Suffix, First, Middle) (add office sought if
Sequence Street Address& contribution to a Expenditure
Number City,State,Zip Code candidate) Type Amendment Amount
Elections Mailing
12/ 04/ 15 National Campaign Resource Grp LLC
11380 Prosperity Farms Rd. Ste 221E $4,250.00
Palm Beach Gardens, FL 33410
1
/
/ /
/
DS-DE 14(Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES