G4-RojasCAMPAIGN TREASURER'S REPORT SUMMARY
(1) Miryam S. Rojas OFFICE USE ONLY
Name
(2) 534 NE 95 ST
Address (number and street)
04-05-19 1 6 16 :<
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 03 / 23 / 19 To 04 / 04 / 19 Report Type: G4
✓❑ Original ❑ Amendment ❑ Special Election Report
(6) Contributions This Report
(7) Expenditures This Report
Monetary
Cash & Checks $ 100. 00
Expenditures $ 120. 00
Loans $ -
Transfers to
Office Account $ 0 . 00
Total Monetary $ 100. 00
Total Monetary $
In -Kind $ � 0. 00
(8) Other Distributions
$ 0 00
(9) TOTAL Monetary Contributions To Date
(10) TOTAL Monetary Expenditures To Date
$ 6 865 00
$ 4 948 27
(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) Anthony J. Shaleesh (Type name) Miryam S. Rojas
❑ Individual (only for IE lj Treasurer ❑ Deputy Treasurer El Candidate ❑ Chairperson (only for PC and PTY)
or electioneering co W m.)
X X
Signature SignAe7q
DS -DE 12 (Rev. 11/13) .01 � SOE- hEVERSE FOR INSTRUCTIONS
CAMPAIGN TREASURER'S REPORT — ITEMIZED CONTRIBUTIONS
Miryam S. Rojas
(1) Name (2) I.D. Number
03 23 19 04 04 19 1 1
(3) Cover Period / / through (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
03 25 19
Steve Dobie
290 NE 101 ST
Miami Shores, FL 33138
I
:Software Dev
CAS
$50.00
1
04 04 19
Penn Davis
384 NE 94 ST
Miami Shores, FL
33138
I
CEO
CAS
$50.00
2
DS -DE 13 (Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES
CAMPAIGN TREASURER'S REPORT - ITEMIZED EXPENDITURES
(1) Name Miryam S. Rojas
(2) I.D. Number
(3) Cover Period 03 / 23 / 19 through o4 / 04 / 19 (4) Page 1 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
(6)
Sequence
Number
03 25 19
MS Chamber of Commerce
9620 NE 2nd Ave #201
Miami Shores, FL 33138
Event Dinner Ticket
CAN
$120.00
-
1
DS -DE 14 (Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES