DS-DE 12 Miami Beach for All 2016-M12 CAMPAIGN TREASURER'S REPORT SUMMARY •
(1) Miami Beach For All , OFFICE„USE.ONLY
Name
(2) 2618 Centennial Place i.;i T`t !;I_L l,;; ; ;l;
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):
El Candidate Office Sought:
El Political Committee(PC)
51 Electioneering Communications Org. (ECO) El Check here if PC or ECO has disbanded
El Party Executive Committee(PTY) El Check here if PTY has disbanded
El 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 / 16 To 12 / 31 / 16 Report Type: M12
0 Original El Amendment El Special Election Report
(6) Contributions This Report (7) Expenditures This Report
Monetary
Cash & Checks $ , , 0 . 00 Expenditures $ , , 3 . 00
Loans $ Transfers to
Office Account $
Total Monetary $ 0.00
Total Monetary $ 3 . 00
In-Kind $
(8) Other Distributions
$ ,
(9) TOTAL Monetary Contributions To Date (10) TOTAL Monetary Expenditures To Date
$ , 100 • 00 $ 3 . 00
(11) Certification
It is a first degree misdemeanor for any person to falsify a public record (ss. 839.13, F.S.)
certify that I have examined this report and it is true, correct, and complete:
(Type nam:) Mark I'`erron (Type name)
❑
lndividu. (only for IE D Treasurer ❑Deputy Treasurer ❑Candidate ❑Chairperson(only for PC and PTY)
or election,ering c mm.)
X X
Signature Signature
DS-DE 12(Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS
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CAMPAIGN TREASURER'S REPORT — ITEMIZED CONTRIBUTIONS
Miami Beach For All
(1) Name (2) I.D. Number
12 01 16 12 31 16 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.11113) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES
CAMPAIGN TREASURER'S REPORT - ITEMIZED EXPENDITURES
(1) Name Miami Beach Advisory Council (2) I.D. Number
12 01 16 12 31 16 1 1
(3)Cover Period / / through / / (4) Page of
(5) (7) (8) (9) (1 0) (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
Hancock Bank Dormant Account Fee
12/27 / 16 P.G. Box 4019
Gulfport, MS 39502-4019
MON $3.00
1
/
/ /
DS-DE 14(Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES
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