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Burch-G4CAMPAIGN TREASURER'S REPORT SUMMARY (1) Alice Burch Campaign OFFICE USE ONLY Name (2) 1235 NE 96 Street 0 4 -04 -1 9 16 :31 RC VD Address (number and street) Miami Shores, FL 33138 City, State, Zip Code ❑ Check here if address has changed (3) ID Number: (4) Check appropriate box(es): Candidate Office Sought: Miami Shores Village Council ❑ 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 3/23/2019 / To 4/4/2819 / Report Type: G4 [D Original ❑ Amendment ❑ Special Election Report (6) Contributions This Report (7) Expenditures This Report Monetary Cash & Checks $ 450.00 Expenditures $ 406.87 , Loans $ 0 Transfers to Office Account $ 0 , Total Monetary $ 450.00 Total Monetary $ 406.87 In -Kind $ 0 (8) Other Distributions $ 0 , (9) TOTAL Monetary Contributions To Date (10) TOTAL Monetary Expenditures To Date $ 12,340.16 $ 11, 072, 74 , (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 (only for IE 21 Treasurer ❑ Deputy Treasurer Q Candidate ❑ Chairperson (only for PC and PTY) or electioneering co m.) X 2�4 Signature DS -DE 12 (Rev. 11/13) 1 SEE REVERSE FOR INSTRUCTIONS CAMPAIGN TREASURER'S REPORT — ITEMIZED CONTRIBUTIONS Alice Burch Campaign (1) Name (3) Cover Period (2) I.D. Number 3/23/2019 4/4/2019 1 1 through / / (4) Page of (5) (7) (8) (9) (10) (11) (12) Date Full Name (Last, Suffix, First, Middle) (6) Sequence Street Address & Contributor Contribution In -kind Number City, State, Zip Code Type Occupation Type Description Amendment Amount 3/25/2019 Larrie S Blasberg I Retired CHE 100.00 1155 NE 103 St Miami Shores, FK 33138 1 3/25/2019 David A Puyanic I Real estate CHE 100.00 9259 N Bayshore Dr / Miami Shores FL 33138 2 3/26/2019 CHE 50.00 Miami Shores FAP B 4051 NW 66 Ave ' Virginia Gardens FL 3 33166 I Caterer CHE 100.00 3/26/2019 Jackie Butler / 1461 NE 102 St Miami Shores, FL 33138 — 4 3/28/2019 Robert Ader I Lawyer CHE A!:.*c- 100.00 100 SE 2 Street Ste 3550 5 Miami, FL 33131 us -Ut is (Kev. ivi3) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES CAMPAIGN TREASURER'S REPORT- ITEMIZED EXPENDITURES (1) Name Alice Burch Campaign 3/23/2019 (3) Cover Period / 4/4/2019 through (2) I.D. Number 1 (4) Page of (5) (7) (8) (9) (10) (11) Date Full Name (Last, Suffix, First, Middle) Street Address & City, State, Zip Code Purpose (add office sought if contribution to a candidate) Expenditure Type Amendment Amount (6) Sequence Number 3/29/ 019 TD Bank Bank Fees CAN 2.00 9005 Biscayne Blvd Miami Shores, FL 33138 1 3/29/2019 TD Bank Bank fees CAN 10.00 9005 Biscayne Blvd Miami Shores, FL 33138 2 4/1/2019 Minuteman Press Printing CAN 104.93 921 NB 79 Street Miami, FL 33138 3 4/1/2019 Sarahlu Confections Campaign food CAN 51.36 175 NE 96 Street Miami Shores, FL 33138 4 4/1/2019 Facebook Advertising CAN 25.00 1 Hacker Way Menlo Park, CA 94026 5 4/2/2019 Minuteman Press Printing CAN 188.58 921 NE 79 Street Miami, FL 331384/1/2019 6 - 4/4/2019 Miami Shores Village Filing CAN 25.00 10050 NE 2 Avenue Miami Shores, FL 33138 7 DS-DE 14 (Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES