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Burch-M1CAMPAIGN TREASURER'S REPORT SUMMARY (1) Alice Burch Campaign OFFICE USE ONLY Name (2) 1235 NE 96 Street Address (number and street) 02-11-19 0 9: 2 9 R C v U Miami Shores, FL 33138 City, State, Zip Code ❑ Check here if address has changed (3) ID Number: (4) Check appropriate box(es): Miami Shores Village Council 0 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 1 /1 /2 19 To 1/31/4019 / Re ort T e: M 1 Cover Period: From 9 P Yp ❑ Original ❑ Amendment ❑ Special Election Report (6) Contributions This Report (7) Expenditures This Report Monetary Cash &Checks $ 200.00 Expenditures $ 0 , Loans $ 0 Transfers to Office Account $ 0 $ 200 Total Monetary .00 Total Monetary $ 0 , In -Kind $ 0 (8) Other Distributions $ 0 (9) TOTAL Monetary Contributions To Date (10) TOTAL Monetary Expenditures To Date $ 200.00 $ 0 , (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 name) Robert Williamson (Type name) Alice Burch ❑ Individual (o41EE, asurer ❑ Deputy Treasurer El Candidate ❑ Chairperson (only for PC and PTY) or electioneerin X Sig Signatur e DS -DE 12 (Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS CAMPAIGN TREASURER'S REPORT — ITEMIZED CONTRIBUTIONS Alice Burch Campaign (1) Name 1/1/2019 1/31/2019 (3) Cover Period / _ / through / (2) I.D. Number 1 1 / (4) Page of (5) Date (7) Full Name (Last, Suffix, First, Middle) Street Address & City, State, Zip Code (8) Contributor Type Occupation (9) Contribution Type (10) In -kind Description (11) Amendment (12) Amount (6) Sequence Number 1/11/2019 Robin D Heckler 555 NE 15 Street Miami, FL 33132 I Business CAS 100.00 1 1/16/2019 Alice Burch 1440 NE 110 St. Miami Shores, FL 33138 S Business CAS 100.00 2 DS -DE 13 (Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES CAMPAIGN TREASURER'S REPORT - ITEMIZED EXPENDITURES (1) Name Alice Burch campaign (2) I.D. Number 1/1/2019 1/31/2019 1 (3) Cover Period / / through / / (4) Page of (5) Date (7) Full Name (Last, Suffix, First, Middle) Street Address & City, State, Zip Code (8) Purpose (add office sought if contribution to a candidate) (9) Expenditure Type (10) Amendment (11) Amount (s) Sequence Number $0 DS -DE 14 (Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES