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HomeMy WebLinkAboutQualifying Packet RR - 08-12-2016 03 D D -11 - 71 Jj DO 3:1 m 33 -5-- 2 fri z c c m m H H -, D -. 0 0 ii› --- m 0 > o -- - c-) —. o A C, Z a © -i --, et I _ E ITS m gs ft '__/ i• VO...,. H EA EFI EA N I -.7.--) - '.. 4„ 0 › —1 — 'i .',.... ER . - Le LJJ c, ...... Loop 0 ,....c, • MmOmCf) 00- OS 4111 R X 33 cn (A 1r r 1 4, -*//firf' CITY OF CAPE CANAVERAL, FLORIDA QUALIFYING PACKET FOR PERSONS WHO ANNOUNCED CANDIDACY PRIOR TO QUALIFYING PERIOD I, CY1 la,-<,� � , previously announced my candidacy for City Council and do hereby acknowledge receipt of additional materials as follows: • Form DS-DE 25 (rev. 05/11), Candidate Oath — Non-Partisan Office and Affidavit of Nickname • City Oath of Candidate • CE Form 1, (Jan 1, 2016) Statement of Financial Interests and Instructions • Election Laws of the State of Florida as of _a4 20/6)/4- • Candidate and Campaign Treasurer Handbook as of Janury.2-13 Zoic 42.4- • Form DS-DE 87 (rev. 6/15), Waiver of Report • 2016 General Election Canvassing Board Dates I understand to have my name appear on the November 8, 2016 Municipal Election Ballot, I must complete qualifying paperwork and pay qualifying fees during the qualifying period which begins on August 12, 2016 at noon and ends August 26, 2016 at noon. G20 Qom- i--,- Signature Date iiii AUG 12 2016 i.e.gbie 2,70 Enter Date&Time Received and Initials of Clerk's Office Staff Member DECIEDVEF CANDIDATE OATH - NONPARTISAN OFFICE AUG 1 2 2016 I (Not for use by Judicial orIP ./O School Board Candidates) OFFICE USE ONLY OATH OF CANDIDATE (Section 99.021, Florida Statutes) SR 0 R fl e.1.5 (PLEASE PRINT NAME AS YOU WISH IT TO APPEAR ON THE BALLOT*-- NAME MAY NOT BE CHANGED AFTER THE END OF QUALIFYING) am a candidate for the nonpartisan office of C-1 TV% CAD V.Nsit L, (blr�Q_ Ci41JAv 41411\ (office) (district#) ; I am a qualified elector of Q••4 County, Florida; (circuit#) (group or seat#) I am qualified under the Constitution and the Laws of Florida to hold the office to which I desire to be nominated or elected; I have qualified for no other public office in the state, the term of which office or any part thereof runs concurrent with the office I seek; and I have resigned from any office from which I am required to resign pursuant to Section 99.012, Florida Statutes; and I will support the Constitution of the United States and the Constitution of the State of Florida. 0 CS4NIC"g174-3".-PC)Q-C-44- 3.2A) .-713 4 -512(i at, Signature of Candidate Telephone Number Email Address 3018 e g1-.) P. D. Sod, 308 C4%ge. CAoP% - L c-\- 3>-q>o -0'3o8 Address City State ZIP Code Candidate's Florida Voter Registration Number(located on your voter information card): toO4153 ��3 * Please print name phonetically on the line below as you wish it to be pronounced on the audio ballot for persons with disabilities (see instructions on page 2 of this form): 0C— Km STATE OF FLORIDA COUNTY OF //-- -.1-444-2._ —..Gt/.¢2i� Sworn to (or affirmed) and subscribed before me this Mel day of 4/C•UST , 20 /6 . / Pr HSA,,, MIA GOFORTH J Personally Known: V or I �', c Notary Public-State of Florida •. = My Comm.Expires May 16,2017' ure of otary lic .�. ,: Commission # EE 866939 Produced Identification: _ P;,,`,t`;''`' Bonded Through National Notary Assn. Pint,Type.or Stamp Commissioned Name of Notary Public Type of Identification Produced: DS-DE 25(Rev.5/11) Rule 1S-2.0001,F.A.C. INSTRUCTIONS: INSERTING PHONETIC SPELLING OF CANDIDATE'S NAME FOR AUDIO BALLOT Use the PRONUNCIATION KEY below to provide pronunciations for ambiguous first names and surnames. Capitalize STRESSED syllables, use lower case for unstressed syllables. Use dashes (-) to separate syllables. You should also add any notes such as rhyming examples, silent letters, etc. Samples: PRONUNCIATION KEY Stressed Vowel Sounds NAME ON BALLOT PRONOUNCED AS EE (FEET)feet (FIT)fit Mishaud mee-SHO('d'is silent) E (BED)bed A (KAT)cat(KAD)cad Jahn HAHN(rhyme:fawn) AH (FAH-thur)father Beauprez boo-PRAI(rhyme:hooray) (PAHR)par AH (HAHT)hot(TAH- Maniscalco man-uh-SKAL-ko dee)toddy UH (FUHJ)fudge Tangipahoa TAN-ji-pah-HO-uh (FLUHD)flood Monte Mahn-TAI UH (CHUHRCH)church AW (FAWN)fawn Tanya TAWN-yuh(not TAN) U (FUL)full 00 (FOOD)food OU (FOUND)found O (FO)foe El (FEIT)fight Al (FAIT)fate Cl (FOIL)foil YOO (FYOOR-ee-uhs) furious Unstressed Vowel Sounds uh (SO-fuh)sofa(FING- guhr)finger Certain Vowel Sounds with R AHR (PAHR)par ER (PER)pair IR (PIR)peer OR (POR)pour OCR (POOR)poor UHR (PURR)purr Consonant Sounds B (BED)bed TS (ITS)its(PITS-feeld)Pittsfield D (DET)debt TH (THEI) Thigh _- F (FED)fed TH (THEI) Thy G (GET)get ZH (A-zhuhr)azure(VI-zhuhn)vision H (HED)head Z (GOODZ)goods(HUH-buhz-tuhn)Hubbardston HW (HWICH) which J (JUNG)jug K (KAD)cad L (LAIM)/ame M (MAT)mat N (NET)net NG (SING-uhr)singer P (PET)pet R (RED)red S (SET)set T (TEN)ten ✓ (VET) vet (YET)yet W (WICH) witch CH (CHUCRCH)church SH (SHEEP)sheep NOTE: This page should not be submitted to the filing officer. Page 2,DS-DE 25(Rev.5/11) Rule 1S-2.0001,F.A.C. 4pCE q�'b CFI / %OFF- OATH OF CANDIDATE I, C.C>14. cQ , do solemnly swear or affirm that I am qualified under the City of Cape Canaveral Charter and Ordinances to hold the Office of Council Member, to which I desire to be elected and I will support the City of Cape Canaveral Charter and Ordinances. Qictv.J-cg4S4L Signature of Candidate State of Florida County of Brevard City of Cape Canaveral Sworn to (or affirmed) and subscribed before me this /i71%-- day of August, 2016 by �� �, /s , who is personally known or produced Identification. MIA GOFORTH �OSP, ` •' r. . Notary Public-State of Florida / ' •: '•1`: •_My Comm.Expires May 16,2017 ` %,%,%+1-4,',:T.FCommission # EE 866939 Signature of N . ary Public iThroughNotary Bonded National Assn. Print,type or stamp Commissioned Name of Notary Public FORM 1 STATEMENT OF 2015 Please print or type your name,mailing FINANCIAL INTERESTS FOR OFFICE USE ONLY: address,agency name,and position below: LAST NAME--FIRST NAME--MIDDLE NAME: �/aNtQE.Ls� RacV4 MAILING ADDRESS: -3 B 13E_v St. - CITY:C fp e ZIP: COUNTY: RECEOVE[1 - CA-N P. ' - 3 -P-v-c3o 8 g,z Q._•i we AUG 12 2016 NAME OF AGENCY: G i 7'y o- C4 -P E. C P-N A V C�.�t�►t� F-L NAME OF OFFICE OR POSITION HELD OR SOUGHT 0-G2— 2 �O arit G 11-9 CC>O N C i L Kl You are not limited to the space on the lines on this form.Attach additional sheets,if necessary. CHECK ONLY IF JA CANDIDATE OR ❑ NEW EMPLOYEE OR APPOINTEE **** BOTH PARTS OF THIS SECTION MUST BE COMPLETED *'`'`'t DISCLOSURE PERIOD: THIS STATEMENT REFLECTS YOUR FINANCIAL INTERESTS FOR THE PRECEDING TAX YEAR, WHETHER BASED ON A CALENDAR YEAR OR ON A FISCAL YEAR. PLEASE STATE BELOW WHETHER THIS STATEMENT IS FOR THE PRECEDING TAX YEAR ENDING EITHER(must check one): DECEMBER 31, 2015 OR ❑ SPECIFY TAX YEAR IF OTHER THAN THE CALENDAR YEAR: MANNER OF CALCULATING REPORTABLE INTERESTS: FILERS HAVE THE OPTION OF USING REPORTING THRESHOLDS THAT ARE ABSOLUTE DOLLAR VALUES,WHICH REQUIRES FEWER CALCULATIONS, OR USING COMPARATIVE THRESHOLDS,WHICH ARE USUALLY BASED ON PERCENTAGE VALUES (see instructions for further details). CHECK THE ONE YOU ARE USING(must check one): COMPARATIVE(PERCENTAGE)THRESHOLDS OR ❑ DOLLAR VALUE THRESHOLDS PART A--PRIMARY SOURCES OF INCOME [Major sources of income to the reporting person-See instructions] (If you have nothing to report,write"none"or"n/a") NAME OF SOURCE SOURCE'S DESCRIPTION OF THE SOURCE'S OF INCOME ADDRESS PRINCIPAL BUSINESS ACTIVITY OV ICL ©P If E.g 4Vt ©•i' 1; �% 41,.4.,o-0-4 p pl-5JlZtrSv7��A ct' Pos r., PrQ i�8-� r++ `r 1-31e)i y Ria C 3 O a iP f 7 ..ft>t�1.'Oy fh�aer �'s b �`.r 11-3c•-+ 50,411\144,_ Rtcc(, � TNt��Fr _s�►J4r,c3S % gjc'3 ffi2.1 P asz (�L Sty-M/c t�c�cx- 6 r'rp pL4 P SHVv�L+yS sIOl b *1)is4-9 35 i 9V., W IikFc ir3L04%I 0' P057`0 CO S Cc, c til u z.-� Ll�t c1.36 .t 1150►� wl-. w`t�K>le�P. 1z��r►1�+<t ami _Z+�,L lv 1 C.0 14 t51-1--Ct�R,va L.rAp:w cLut2,t),;14 kJ, tt2W CD�� vl�..»s `FA1 � S ,tee— pMr-i-: P�t.� taw` tvr upj '.. ~` C.�G wT.•t-L i.i:c t� ,/-43 Y-�`S PART B— SECONDARY SOURCES OF INCOME [Major customers,clients,and other sources of income to businesses owned by the reporting person-See instructions] (If you have nothing to report,write"none"or"n/a") NAME OF NAME OF MAJOR SOURCES ADDRESS PRINCIPAL BUSINESS BUSINESS ENTITY OF BUSINESS'INCOME OF SOURCE ACTIVITY OF SOURCE PART C--REAL PROPERTY [Land,buildings owned by the reporting person-See instructions] (If you have nothing to report,write"none"or"n/a") FILING INSTRUCTIONS for when and where to file this form are located at the bottom of page 2. eC.S t D Cyv>Ce \- - Q_� D n INSTRUCTIONS on who must file 47 )1:300( ,� S �, -1 2- this form and how to fill it out begin on page 3. CE FORM 1-Effective:January 1,2016 (Continued on reverse side) PAGE 1 Incorporated by reference in Rule 34-8.202(1),F.A.C. //2// /4/4 VIC ph PART D—INTANGIBLE PERSONAL PROPERTY[Stocks,bonds,certificates .-deposit,etc.-See instructions] (If you have nothing to report,write"none or"n/a") TYPE OF INTANGIBLE BUSINESS ENTITY TO WHICH THE PROPERTY RELATES PTS azr C S A v' S.+►.a�• s �- }- wh ],`>d 4.(1 Fv -.201 ,Ai-411- S Len ft-r2 Po c re Fc fzr�p+L r K A t�ry -G C. v w^ �1; C-P,-re-CV-.L5 S�v-�r..1."4-- �'f� �►Y� �.^n 6 R c� J I L(, C. - v T ea .-+J C U »cRn."4_ PART E—LIABILITIES [Major debts-See instructions] (If you have nothing to report,write"none"or"n/a") NAME OF CREDITOR ADDRESS OF CREDITOR PART F—INTERESTS IN SPECIFIED BUSINESSES [Ownership or positions in certain types of businesses-See instructions] (If you have nothing to report,write"none"or"n/a") BUSINESS ENTITY# 1 BUSINESS ENTITY#2 NAME OF BUSINESS ENTITY ADDRESS OF BUSINESS ENTITY PRINCIPAL BUSINESS ACTIVITY POSITION HELD WITH ENTITY I OWN MORE THAN A 5% INTEREST IN THE BUSINESS NATURE OF MY OWNERSHIP INTEREST PART G—TRAINING For elected municipal officers required to complete annual ethics training pursuant to section 112.3142, F.S. I CERTIFY THAT I HAVE COMPLETED THE REQUIRED TRAINING. IF ANY OF PARTS A THROUGH G ARE CONTINUED ON A SEPARATE SHEET, PLEASE CHECK HERE ❑ SIGNATURE OF FILER: CPA or ATTORNEY SIGNATURE ONLY If a certified public accountant licensed under Chapter 473, or attorney Signature: in good standing with the Florida Bar prepared this form for you, he or she must complete the following statement: O' I. , prepared the CE 1G � �J�/� Form 1 in accordance with Section 112.3145, Florida Statutes, and the instructions to the form. Upon my reasonable knowledge and belief,the disclosure herein is true and correct. Date Signed: J 1 CPA/Attorney Signature: Date Signed: FILING INSTRUCTIONS: WHAT TO FILE: WHERE TO FILE: WHEN TO FILE: After completing all parts of this form, including If you were mailed the form by the Commission Initially,each local officer/employee,state officer signing and datinca it, send back only the first on Ethics or a County Supervisor of Elections for and specified state employee must file within sheet(pages 1 and 2)for filing. your annual disclosure filing, return the form to 30 days of the date of his or her appointment that location. or of the beginning of employment. Appointees If you have nothing to report in a particular Local officers/employees file with the who must be confirmed by the Senate must file section, you must write "none" or "n/a" in that Supervisor of Elections of the county in which they prior to confirmation, even if that is less than section(s). permanently reside. (If you do not permanently 30 days from the date of their appointment. reside in Florida, file with the Supervisor of the Candidates must file at the same time they file NOTE: county where your agency has its headquarters.) their qualifying papers. MULTIPLE FILING UNNECESSARY: Thereafter,file by July 1 following each calendar State officers or specified state employees year in which theyhold their positions. A candidate who previously filed Form 1 because file with the Commission on Ethics, P.O. Drawer y of another public position must file a copy of 15709, Tallahassee, FL 32317-5709; physical Finally, file a final disclosure form (Form 1F) his or her Form 1 when qualifying. A candidate address: 325 John Knox Road, Building E, Suite within 60 days of leaving office or employment. who files a Form 1 with a qualifying officer is 200,Tallahassee, FL 32303. Filing a CE Form 1F(Final Statement of Financial not required to file with the Commission or Interests)does nQf relieve the filer of filing a CE Supervisor of Elections. Candidates file this form together with their Form 1 if the filer was in his or her position on qualifying papers. December 31,2015. Facsimiles will not be accepted. To determine what category your position falls under,see page 3 of instructions. CE FORM 1-Effective:January 1,2016. PAGE 2 Incorporated by reference in Rule 34-8.202(1),F.A.C. Mia Goforth From: Mia Goforth Sent: Wednesday, August 17, 2016 2:51 PM To: Mia Goforth Cc: Daniel LeFever Subject: Reminder- Campaign Treasurer Report Code P6 Due - 8-19-16 Good afternoon Candidates, Please remember that another Report is due this Friday the 19th by COB. If you need additional forms, please let us know. Thank you! Mia `.,1'- i'•4 Mia Goforth, CMC �� City Clerk �. m.goforth�a,cityofcapecanaveral.org J ---- 321-868-1220 Ext 220 321-868-1248 fax 105 Polk Avenue. P.O.Box 326 '411=Pr Cape Canaveral,FL 32920 www citvofcapecanaveraLorg `Mit . Launch your connection... 0 x 1 Mia Goforth From: Mia Goforth Sent: Friday, August 19, 2016 5:09 PM To: Rocky Randels Cc: Daniel LeFever Subject: Campaign Treasurer Report - P6 Due 8-19-16 Importance: High Tracking: Recipient Delivery Rocky Randels Daniel LeFever Delivered:8/19/2016 5:09 PM Rocky, I hope everything is ok with you, I tried calling you twice today and left one voicemail message. Please contact me at your earliest convenience regarding the Campaign Treasurer Report - P6 Due that was due today, 8-19-16 by close of business. State statute dictates that the Qualifying/Filing Officer(me) must impose a fine of$50.00 per day for each late day, not to exceed 25 percent of the total receipts or expenditures, whichever is greater for the period covered by the late report. All fines must be paid from the candidate's personal funds—not campaign funds. (Section 106.07(2) and(8), F.S.). Thank you. Mia t •- iT Mia Goforth, CMC City Clerk m.goforth@cityofcapecanaveral.org `—', - 321-868-1220 Ext 220 321-868-1248 fax 105 Polk Avenue. P.O.Box 326 : --ate Cape Canaveral,FL 32920 �- www cityofcapecanaveraLorg \ I Launch your connection... ID C 0 1 CAMPAIGN TREASURER'S REPORT SUMMARY (1) 0 C' -taNeR t�� �s FRSE( OYL Name 3 D 8 Fprst C '�c rL St.Y4 D LS I� (2) P" a ' ` " AUG 22 2016 Address (number and street) City, State, Zip Code 2:0 'D3o r" '+ _ 33000_ E Check here if address has changed (3) ID Number: �. (4) Check appropriate box(es): IS Candidate Office Sought: C-0-Va-.. C-44'1•141h1'Q.L.00L L z" Cou .ci G n`-- ❑ Political Committee(PC) ❑ Electioneering Communications Org. (ECO) ❑ Check here if PC or ECO has disbanded ❑ Party Executive Committee (PTY) ❑ Check here if PTY has disbanded ❑ Independent Expenditure(IE) (also covers an ❑ Check here if no other IE or EC reports will be filed individual making electioneering communications) (5) Report Identifiers Cover Period: From 0-$ / 01/4) / ltp To OS / / i ko Report Type: PJ \P Original ❑ Amendment ❑ Special Election Report (6) Contributions This Report (7) Expenditures This Report Monetary Cash & Checks $ Expenditures $ 00 d 00 Loans $ 3 D p p Transfers to Office Account $ 0 era Total Monetary $_,3_ O ID 01 — Total - Total Monetary $ — 3 In-Kind $ Q (8) Other Distributions $ (9) TOTAL Monetary Contributions To Date (10) TOTAL Monetary Expenditures To Date $'* 3 D o • ®® $ �`._ _ .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: n�, (Type name) ROC.�+ 11,N IcQ\._5 (Type name)�O ( V' IR 0- J Q X.S ❑ Individual(only for IE Treasurer ❑ Deputy Treasurer Candidate E Chairperson(only for PC and PTY) or electioneering comm.) X Caq;X-V,Nei _ X ciSs Cd4‘4 QMjQ•9A-'. Signature Signature DS-DE 12(Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS r Instructions for Campaign Treasurer's Report Summary (1) Name: full name of the candidate, political committee, party executive committee, electioneering communications organization, or individual making an independent expenditure or electioneering communication. (2) Address: the full address or post office box, city, state, and zip code. Check the box if the address has changed since the last report filed. (3) ID Number: identification number assigned by the filing officer. (4) Check the appropriate box(es). (5) Report Identifiers Cover Period: the dates this report covers (i.e., From 1/1/15 To 1/31/55). Important: use the appropriate cover period dates as published by the filing officer. Report Type: refer to the filing officer's calendar of reporting dates for the correct codes to be used for each reporting period. If report is for a special election add "S" in front of the report code(i.e., SG3). Check one of the appropriate boxes: ❑Original: first report filed for this reporting period. ❑Amendment: must summarize only contributions/fund transfers and expenditures/distributions being reported as additions or deletions. Read instructions for sequence numbers and amendment types on the back of Forms DS-DE 13A and 14A. Special Election Report: Important: once a special election report is filed, the entity is required to file all remaining reports due for the special election. (6) Contributions This Report: Cash and Checks: total amount for this reporting period. Loans: total amount for this reporting period. Total Monetary: sum of Cash and Checks and Loans. In-Kind: the fair market value of the in-kind contribution at the time it is given for this reporting period. (7) Expenditures This Report: Monetary Expenditures: total amount of monetary expenditures for this reporting period. Transfers to Office Account: total amount transferred to an office account by elected candidates only. Total Monetary: sum of Monetary Expenditures and Transfers to Office Account. (8) Other Distributions: the total amount of goods and services contributed to a candidate or other committee by a PC, ECO, or PTY. (9) TOTAL Monetary Contributions To Date: the amount of total monetary contributions to date. Candidates keep cumulative totals from the time the campaign depository is opened through the termination report. (10) TOTAL Monetary Expenditures To Date: the amount of total monetary expenditures to date. Candidates keep cumulative totals from the time the campaign depository is opened through the termination report. (11) Type or print the required officer's name and have them sign the report: Candidate report: treasurer and candidate must sign. PC report: treasurer and chairperson must sign. PTY report: treasurer and chairperson must sign. ECO report: organization's treasurer must sign. IE or EC report: individual must sign (this applies when an individual acts alone to make these expenditures) AMENDMENT REPORTS: An amendment report summary should summarize only contributions, expenditures, distributions, & fund transfers being reported as additions or deletions. Read the instructions for the sequence number & amendment type fields on the back of forms DS-DE 13, 14, 14A and 94. J' i�,(1(v A C ND1fla 4Fa PL- Cocoa.- CAMPAIGN QCAMPAIGN TREASURER'S REPORT - ITEMIZED EXPENDITURES C., -c (1) Name IZ O G X N.‘ S rp Q—)LS (2) I.D. Number (3) Cover Period O$ / 010 / i to through 0 / ( . / b (4) Page of (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 �8/02/D b l r�� O 1~ UiQE CSA 14 PNVIRS� ,��F�eag P. 4- e�-�L3zb �. a �ArN t4R-ii1 0 F $� CAA 1.1 3 9, 0� r � 32-41- / / / / { DS-DE 14(Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES INSTRUCTIONS FOR CAMPAIGN TREASURER'S REPORT - ITEMIZED EXPENDITURES (1) Candidate's full name or name of the political committee (PC), electioneering communications organization (ECO), or party executive committee(PTY). (2) Identification number assigned by the filing officer. (3) Cover period dates (01/01/15 through 01/31/15). (See filing officer's reporting dates calendar for appropriate cover periods.) (4) Page numbers (e.g., 1 of 3). (5) Date of expenditure(Month/Day/Year). (6) Sequence Number - Each detail line shall have a sequence number assigned to it. Sequence numbers are to be assigned within each reporting period and for each type of detail line. Thus the report type, detail line type, and sequence number will combine to uniquely identify a specific contribution, expenditure, distribution or fund transfer. This method of unique identification is required for responding to requests from the filing officer and for reporting requirements. For example, a M1 report having 40 expenditures would use sequence numbers 1 through 40. The next report (M2), comprised of 30 expenditures would use sequence numbers 1 through 30. Expenditures on amended M1 reports would begin with sequence number 41 and on amended M2 reports would begin with sequence number 31. See Amendment Type instructions below. (7) Full name and address of entity receiving payment(including city, state and zip code). (8) Purpose of expenditure (if expenditure is a contribution to a candidate, also type the office sought by the candidate). PLEASE NOTE: This column does not apply to candidate expenditures, as candidates cannot contribute to other candidates from campaign funds. However, PCs (supporting candidates) and party executive committees contributing to candidates must report office sought(Section 106.07, F.S.). (9) Enter Expenditure Type using one of the following codes: Code Description CAN Candidate Expense DIS Disposition of Funds DFC Disposition of Funds to Future Campaign (effective 11/1/13) DPP Disposition of Funds to Political Party(effective 11/1/13) DPV Disposition of Funds to Petition Verification (effective 11/1/13) ECC Electioneering Communication IEC Independent Expenditure Regarding a Candidate IEI Independent Expenditure Regarding an Issue MON Monetary(Not to a Candidate) PCW Petty Cash Withdrawn PCS Petty Cash Spent PPD Pre-paid Distribution REF Refund (Negative Amount Only) RMB Reimbursements TOA Transfer to Office Account(Disposition of Funds) (10) Amendment Type (required on amended reports) - To add a new (previously unreported) expenditure for the reporting period being amended, enter"ADD" in amendment type on a line with ALL of the required data. The sequence number for expenditures with amendment type "ADD" will start at one plus the number of expenditures in the original report. For example, amending an original M1 reports that had 75 expenditures, means the sequence number of the first expenditure having amendment type "ADD" will be 76; the second "ADD" expenditure would have sequence number 39. PC" CAMPAIGN TREASURER'S REPORT - ITEMIZED CONTRIBUTIONS f zZ e_ory DAsre-. G-oR c P$ C p e�Fa a1- Co we.c 4 (� (1) Name T�0 s NI (2) I.D. Number (3) Cover Period flv / Q b / through 0 S / s 2__ Ito (4) Page of if (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 08 RA,C-N4 CA-‘401 a - 3 oe FCom, 8I. data Lop 3vay. oo CANham►+w` -ro ly20 .? 5411.1U' DS-DE 13(Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES INSTRUCTIONS FOR CAMPAIGN TREASURER'S REPORT — ITEMIZED CONTRIBUTIONS (1) Candidate's full name or name of the political committee (PC), electioneering communications organizations (ECO)or party executive committee(PTY). (2) The identification number assigned by the filing officer. (3) Cover period dates(e.g., 1/1/15 through 1/31/15). (See filing officer's reporting dates calendar for appropriate year and cover periods.) (4) Page numbers(e.g., 1 of 3 ). (5) Date contribution was RECEIVED(Month/Day/Year). (6) Sequence Number—Each detail line shall have a sequence number assigned to it. Sequence numbers are to be assigned within each reporting period and for each type of detail line. Thus the report type, detail line type, and sequence number will combine to uniquely identify a specific contribution, expenditure, distribution or fund transfer. This method of unique identification is required for responding to requests from the filing officer and for reporting amendments. For example, a M1 report having 75 contributions would use sequence numbers 1 through 75. The next report(M2), comprised of 40 contributions would use sequence numbers 1 through 40. Contributions on amended M1 reports would begin with sequence number 76 and on amended M2 reports would begin with sequence number 41. See the Amendment Type instructions below. (7) Type full name and address of contributor(including city, state and zip code). (8) Enter the type of contributor using one of the following codes: Occupation of contributor for contributions over$100 only. (If a business, please indicate nature of business.) Individual B Business (also includes corporations, organizations, groups, etc.) E Electioneering Communications Organizations F Political Committee (federal or state) P Political Parties (includes federal, state and county executive committees) O Other (e.g., candidate surplus funds to party, etc.) S Candidate to Self (9) Enter Contribution Type using one of the following codes: NOTE: Cash includes cash and cashier's checks. Code Description CAS Cash or Cashier's Check CHE Check COF Carryover Funds from Previous Campaign INK In-Kind INT Interest LOA Loan MO Money Order MUC Multiple Uniform Contributions RCT Other Receipts REF Refund (Negative Amount Only) LISPS MAIL & E-MAIL., August 22, 2016 Rocky Randels 308 East Central Boulevard PO Box 308 Cape Canaveral, FL 32920-0308 INITASWEN "14M As you know, the Campaign period 08/06/2016 was due 08/19/2016. Your P6 Campaign attached) 6 past the deadline. I Section 106.07(8)(b), Florida Statutes. provides for a fine of $50.00 per day for the first 3 days lai and, thereafter, $500.00 per day for each late day, not to exceed 25 percent of the total receipts expenditures,greater, check for « 100.00 made payable to the City of Cape Canaveral by mail or via hand delivery to City Clerk's Office at 105 Polk Avenue. If you have any questions regarding this letter, please do not hesitate to contact me at 321-6- 1220 x220 or via e-mail at ��i, 0� /oi°t�� y ciu.y ��Ga rl� s� �a era . Sincerely, Mia Goforth, CMC City Clerk/Elections Qualifying Officer Encls. cc: David L. Greene, City Manager Anthony Garganese, City Attorney Daniel LeFever, Deputy City Clerk 105 Polk Avenue • Post Office Box 326 Cape Canaveral, FL 32920-0326 Telephone (321) 868-1220 Fax: (321) 868-1248 www.cityofcapecanaveral.org • email: info@cityofcapecanaveral.org CAMPAIGN TREASURER'S REPORT SUMMARY 11 L9 NameC4'C%A�\_ D %goi �� AUG Address (number and street) City, State, Zip Code F Check here if address has changed (3) ID Number: (4) Check appropriate box(es): OCandidate Office Sought; C'. El Political Committee (PC) ❑ Electioneering Communications Org. (ECO) F1 Check here if PC or ECO has disbanded ❑ 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 0-S I ()-b-- I To L) 13 / 1 -2- / % 10 Report Type: 1p— )10- $ Original n Amendment E] Special Election Report (6) Contributions This Report (7) Expenditures This Report Cash & Checks $ Monetary Expenditures $ ...* 3 Loans $3 D V. 00- Transfers to Office Account $ Total Monetary $ 0 t) _3L�) Total Monetary $ IDS In -Kind $ (8) Other Distributions $ (9) TOTAL Monetary Contributions To Date (10) TOTAL Monetary Expenditures To Date -0 $ ea (111) 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: lik "Y -(Type name) P'0<:'y"4 �'? % N & q.�_5 —(Type name) 0 G [I Individual (only for IE Treasurer 17 Deputy Treasurer Candidate M Chairperson (only for PC and PTY) XC or electioneering comm.) Signature Signature DS -DE 12 (Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS 'A Instructions for Campaign Treasurer's Report Summary (1) Name: full name of the candidate, political committee, party executive committee, electioneering communications organization, or individual making an independent expenditure or electioneering communication. (2) Address: the full address or post office box, city, state, and zip code. Check the box if the address has changed since the last report filed. (3) ID Number: identification number assigned by the filing officer. (4) Check thea ro riate box es (5) Report Identifiers Cover Period: the dates this report covers (i.e., From 1/1/15 To 1/31/55). Important: use the appropriate cover period dates as published by the filing officer. Report Type: refer to the filing officer's calendar of reporting dates for the correct codes to be used for each reporting period. If report is for a special election add "S" in front of the report code (i.e., SG3). Check one of the appropriate boxes: Original: first report filed for this reporting period. Amendment: must summarize only contributions/fund transfers and expenditures/distributions being reported as additions or deletions. Read instructions for sequence numbers and amendment types on the back of Forms IDS -DE 13A and 14A. Special Election Report: Important: once a special election report is filed, the entity is required to file all remaining reports due for the special election. (6) Contributions This Report: Cash and Checks: total amount for this reporting period. Loans: total amount for this reporting period. Total Monetary: sum of Cash and Checks and Loans. In -Kind: the fair market value of the in-kind contribution at the time it is given for this reporting period. (7) Expenditures This Report: Monetary Expenditures: total amount of monetary expenditures for this reporting period. Transfers to Office Account: total amount transferred to an office account by elected candidates only. Total Monetary: sum of Monetary Expenditures and Transfers to Office Account. (8) Other Distributions: the total amount of goods and services contributed to a candidate or other committee by a PC, ECO, or PTY. (9) TOTAL Monetary Contributions To Date: the amount of total monetary contributions to date. Candidates keep cumulative totals from the time the campaign depository is opened through the termination report. (10) TOTAL Monetary Expenditures To Date: the amount of total monetary expenditures to date. Candidates keep cumulative totals from the time the campaign depository is opened through the termination report. (11) Type or print the required officer's name and have them sign the report: Candidate report: treasurer and candidate must sign. PC report: treasurer and chairperson must sign. PTY report: treasurer and chairperson must sign. ECO report: organization's treasurer must sign. IE or EC report: individual must sign (this applies when an individual acts alone to make these expenditures) AMENDMENT REPORTS: An amendment report summary should summarize only contributions, expenditures, distributions, & fund transfers being reported as additions or deletions. Read the instructions for the sequence number & amendment type fields on the back of forms DS -DE 13, 14, 14A and 94. 4 CAMPAIGN TREASR'S REPORT— ITEMIZED EXPENDITURES (1) Name �Z*or.�Y.. VK A= (2) I.D. Number (3) Cover Period 013 / 0 b j_ik_ through _Q'6l I10_ (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 Amount (6) Sequence Number Ole/ clltlr� or_ UNVC CWAW44�"*. QV C44 -39. OD L DS -DE 4(gey. 11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES INSTRUCTIONS FOR CAMPAIGN TREASURER'S REPORT ~ ITEMIZED EXPENDITURES (1) Candidate's full name orname ofthe political committee (PC)^ electioneering communications organization (ECO), nrparty executive committee (PTY). (2) Identification number assigned bythe filing officer. (3) Cover period dates (01/01i15 through 01 /31/15). (Bee filing officer's reporting dotes calendar for appropriate cover periods.) (4) Page numbers (e.g..Ynf3). (5) Date ofexpenditure (Mondh/Ooy/Year). ' ' (G) Sequence Number - Each detail line shall have a sequence number assigned to it. Sequence numbers are tobe assigned within each reporting period and for each type of detail line. Thus the report type, detail line type, and sequence number will combine to uniquely identify a specific oonbibudon, axpsndUure, distribution or fund transfer. This method of unique identification is required for responding to requests from the filing officer and for reporting requirements. For example, a M1 report having 40 expenditures would use sequence numbers 1 through 40. The next report (IW2), comprised of 30 expenditures would use sequence numbers 1 through 30. Expenditures on amended M1 reports would begin with sequence number 41 and onamended yW2reports would begin with sequence number 31. See Amendment Type instructions below. (7) Full name and address ofentity receiving payment (including city, state and zip code). (8) Purpose of expenditure (if expenditure is a contribution to a candidate, also type the office sought by the candidate). PLEASE NOTE: This column does not apply to candidate expenditunea, as candidates cannot contribute to other candidates from campaign funds. However, PCs (supporting candidates) and party executive committees contributing to candidates must repo office sought (Section 108.07. F.S.). (R) Enter Expenditure Type using one ofthe following codes: Code Description CAN Candidate Expense bis Disposition of Funds DPP Disposition of Funds to Political Party (effective 11/1 /13) DPV Disposition of Funds to Petition Verificatiop ECC Electioneering Communication IEC Independent Expenditure Regarding a Candidate IEI Independent Expenditure Regarding an Issue MON Monetary (Not to a Candidate) PCW Petty Cash Withdrawn PCS _Pt!ty Cash PPD __Ere.:p id DistribuLion REF Refund (Negative Amount Only) RMB Reimbursements TOA Transfer to Office Acc isposition of Funds) (10) Amendment Type (required on amended reports) - To add a new (previously unreported) expenditure for the reporting period being amended, enter "ADD" in amendment type on a line with ALL of the required data. The sequence number for expenditures with amendment typo "ADD" will start at one plum the number of expenditures inthe original report. For example, amending unoriginal M1 reports that had 75expenditures, means the sequence number of the first expenditure having amendment type "ADD" will be 76; the second "ADD" expenditure would have sequence number 38. CAMPAIGN TREASURER'S REPORT — ITEMIZED CONTRIBUTIONS e_"VVVj0*1*_ (1) Name (2) I.D. Number (3) Cover Period 08 / 0 (0 / _1_10 through 0 9 / t 2— / (4) Page 1 of I (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 Amendment (12) Amount (6) Sequence Number 3 0a X-. C, OP%- L -O* W-4 0A r—t. - df*+Q -ros QAf L 0 A 39vo. vo 1110o" DS -DE 13 (Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES <1) Candidate's full name or name of the political committee (PC), electioneering communications organizations (ECO)orparty executive committee (PTY. (2) The identification number assigned by the filing officer. (3) Cover period dates (e.g,Y/11/`K5 through 1/31/15). (See filing officer's reporting dates calendar for appropriate year and cover periods.) (4) Page numbers (a1g._1_ of _3_). (5) Date contribution was RECBVED(MonUh/0oy/Year). (G) Sequence Number — Each detail line shall have a sequence number assigned to it. Sequence numbers are to be assigned within each reporting period and for each type of detail line. Thus the report type, detail line type, and sequence number will combine to uniquely identify a specific contribution, expenditure, distribution orfund transfer. This method of unique identification is required for responding to requests from the filing officer and for reporting amendments. For example, e K41 report having 7Scontributions would use sequence numbers 1 through 75. The next report (M2), comprised of 40 contributions would use sequence numbers 1 through 40. Contributions on amended M1 reports would begin with sequence number 76 and on amended M2 reports would begin with sequence number 41. See the Amendment Type instructions below. (7) Type full name and address of contributor (including city, state and zip code). (8) Enter the type of contributor using one ofthe following codes: Occupation ofcontributor for contributions over $100 only. (if abusiness, please indicate nature of business.) I Individual CAS B Business Check INK F Political Committee (federal or state) P Political Parties (includes federal, state and county executive 0 Other (e.g., candidate surplus funds to party, etc.) S Candidate to Self REF (9) Enter Contribution Type using one ofthe following codes: Code Description CAS Cash or Cashier's Check CHE Check INK In -Kind INT Interest LOA Loan Mo Money Order MILIC Multiple Uniform Contributions RCT Other Receipts REF Refund (Negative Amount Only) _ U • • • • • s ; ._ _ REC_Epp T No. DATE jv5 /-‘ 62 603 FROM ✓�i�i�yv O �J $ `000 �� � Lam,•- L G ✓�--_____-- . ®0 FORFOR RENT !"�e DOLLARS ACCT. ()CASH PAID j /, ®CHECK FROM a TO ()MONEY ORDER DUE ()CREDIT CARD I BY A-11 T-416161 WAIVER OF REPORT AUG 2 6 2016 I (Section 106.07(7), F.S.) (PLEASE TYPE) •": f G.4-41 CAMPAIGN TREASURER'S((�� REPORT SUMMARY (I) R0 � P! [�LTLc& - = Name -305 �c.�-s'1" C .e.".c.w1— rs\.4 E — (2) P. a . S3e-y. '3t1f/ Address (number and street) SEP 0 9 2016 tfze-PE 'GL 319Z0 City, State, Zip Code --«� -- -1 Check here if address has changed (3) ID Number: (4) Check appropriate box(es): Candidate Office Sought: - - 04.1 .AL G}• Co ❑ 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 09 / b / lb To 09 / p Z / Report Type: G - Original ❑ Amendment ❑ Special Election Report (6) Contributions This Report (7) Expenditures This Report Monetary Cash & Checks $ , , • Expenditures $ , 7 ` o3 Loans $ • Transfers to 4111111 Office Account $ Total Monetary �, Total Monetary $ +-) « Ds In-Kind • (8) Other Distributions (9) TOTAL Monetary Contributions To Date (10) TOTAL Monetary Expenditures To Date $ '"""1"17 31 Do 0 . 00 $ , 664 U3 (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) „oc c ��►1_4( Q.4� (Type name) c2",42L\41 R-f-1( ❑ Individual(only for IE ,treasurer ❑ Deputy Treasurer ❑Candidate ❑Chairperson(only for PC and PTY) or electioneering comm.) ((II (� a--9%46— x Q,0 Signature Signature DS-DE 12(Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS Instructions for Campaign Treasurer's Report Summary (1) Name: full name of the candidate, political committee, party executive committee, electioneering communications organization, or individual making an independent expenditure or electioneering communication. (2) Address: the full address or post office box, city, state, and zip code. Check the box if the address has changed since the last report filed. (3) ID Number: identification number assigned by the filing officer. (4) Check the appropriate box(es). (5) Report Identifiers Cover Period: the dates this report covers (i.e., From 1/1/15 To 1/31/55). Important: use the appropriate cover period dates as published by the filing officer. Report Type: refer to the filing officer's calendar of reporting dates for the correct codes to be used for each reporting period. If report is for a special election add "S" in front of the report code (i.e., SG3). Check one of the appropriate boxes: Original: first report filed for this reporting period. Amendment: must summarize only contributions/fund transfers and expenditures/distributions being reported as additions or deletions. Read instructions for sequence numbers and amendment types on the back of Forms DS-DE 13A and 14A. Special Election Report: Important: once a special election report is filed, the entity is required to file all remaining reports due for the special election. (6) Contributions This Report: Cash and Checks: total amount for this reporting period. Loans: total amount for this reporting period. Total Monetary: sum of Cash and Checks and Loans. In-Kind: the fair market value of the in-kind contribution at the time it is given for this reporting period. (7) Expenditures This Report: Monetary Expenditures: total amount of monetary expenditures for this reporting period. Transfers to Office Account: total amount transferred to an office account by elected candidates only. Total Monetary: sum of Monetary Expenditures and Transfers to Office Account. (8) Other Distributions: the total amount of goods and services contributed to a candidate or other committee by a PC, ECO, or PTY. (9) TOTAL Monetary Contributions To Date: the amount of total monetary contributions to date. Candidates keep cumulative totals from the time the campaign depository is opened through the termination report. (10) TOTAL Monetary Expenditures To Date: the amount of total monetary expenditures to date. Candidates keep cumulative totals from the time the campaign depository is opened through the termination report. (11) Type or print the required officer's name and have them sign the report: Candidate report: treasurer and candidate must sign. PC report: treasurer and chairperson must sign. PTY report: treasurer and chairperson must sign. ECO report: organization's treasurer must sign. IE or EC report: individual must sign (this applies when an individual acts alone to make these expenditures) AMENDMENT REPORTS: An amendment report summary should summarize only contributions, expenditures, distributions, & fund transfers being reported as additions or deletions. Read the instructions for the sequence number & amendment type fields on the back of forms DS-DE 13, 14, 14A and 94. W•42,100=A- CEA CAMPAIGN TREASURER'S REPORT - ITEMIZED CONTRIBUTIONS (1) Name E 0C. (Q412cad (2) I.D. Number (3) Cover Period 0$ / 242 I $ b through .o9 / `r Z/ ) 10 (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 INSTRUCTIONS FOR CAMPAIGN TREASURER'S REPORT - ITEMIZED CONTRIBUTIONS (1) Candidate's full name or name of the political committee (PC), electioneering communications organizations (ECO)or party executive committee(PTY). (2) The identification number assigned by the filing officer. (3) Cover period dates(e.g., 1/1/15 through 1/31/15). (See filing officer's reporting dates calendar for appropriate year and cover periods.) (4) Page numbers(e.g., 1 of 3 ). (5) Date contribution was RECEIVED(Month/Day/Year). (6) Sequence Number—Each detail line shall have a sequence number assigned to it. Sequence numbers are to be assigned within each reporting period and for each type of detail line. Thus the report type, detail line type, and sequence number will combine to uniquely identify a specific contribution, expenditure, distribution or fund transfer. This method of unique identification is required for responding to requests from the filing officer and for reporting amendments. For example, a M1 report having 75 contributions would use sequence numbers 1 through 75. The next report(M2), comprised of 40 contributions would use sequence numbers 1 through 40. Contributions on amended M1 reports would begin with sequence number 76 and on amended M2 reports would begin with sequence number 41. See the Amendment Type instructions below. (7) Type full name and address of contributor(including city, state and zip code). (8) Enter the type of contributor using one of the following codes: Occupation of contributor for contributions over$100 only. (If a business, please indicate nature of business.) Individual B Business (also includes corporations, organizations, groups, etc.) E Electioneering Communications Organizations F Political Committee (federal or state) P Political Parties (includes federal, state and county executive committees) O Other (e.g., candidate surplus funds to party, etc.) S Candidate to Self (9) Enter Contribution Type using one of the following codes: NOTE: Cash includes cash and cashier's checks. Code Description CAS Cash or Cashier's Check CHE Check COF Carryover Funds from Previous Campaign INK In-Kind INT Interest LOA Loan MO Money Order MUC Multiple Uniform Contributions RCT Other Receipts REF Refund (Negative Amount Only) ') tet-- Q 2.o1(p 6H CAMPAIGN T EAS RER'S REPORT- ITEMIZED EXPENDITURES (1) Name 07 CAMPAIGN KAN� ILLS (2) I.D. Number (3) Cover Period O 8 / a.�7 i 1 b through O9 / 0 2J 1 Q (4) Page I of , (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 SPAcQ_-rnRA.;PJ o8Mil)b E,,,,beatDe- my61%% 6. N il- G...i P.W.'Say._ ,o z rif4c1 c12- cyl.0 _ VI. v3 3'z9a0 l 1 Th / / / r. r DS-DE 14(Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES INSTRUCTIONS FOR CAMPAIGN TREASURER'S REPORT - ITEMIZED EXPENDITURES (1) Candidate's full name or name of the political committee (PC), electioneering communications organization (ECO), or party executive committee(PTY). (2) Identification number assigned by the filing officer. (3) Cover period dates (01/01/15 through 01/31/15). (See filing officer's reporting dates calendar for appropriate cover periods.) (4) Page numbers(e.g., 1 of 3). (5) Date of expenditure(Month/Day/Year). (6) Sequence Number - Each detail line shall have a sequence number'assigned to it. Sequence numbers are to be assigned within each reporting period and for each type of detail line. Thus the report type, detail line type, and sequence number will combine to uniquely identify a specific contribution, expenditure, distribution or fund transfer. This method of unique identification is required for responding to requests from the filing officer and for reporting requirements. For example, a M1 report having 40 expenditures would use sequence numbers 1 through 40. The next report (M2), comprised of 30 expenditures would use sequence numbers 1 through 30. Expenditures on amended M1 reports would begin with sequence number 41 and on amended M2 reports would begin with sequence number 31. See Amendment Type instructions below. (7) Full name and address of entity receiving payment(including city, state and zip code). (8) Purpose of expenditure (if expenditure is a contribution to a candidate, also type the office sought by the candidate). PLEASE NOTE: This column does not apply to candidate expenditures, as candidates cannot contribute to other candidates from campaign funds. However, PCs (supporting candidates) and party executive committees contributing to candidates must report office sought(Section 106.07, F.S.). (9) Enter Expenditure Type using one of the following codes: Code Description CAN Candidate Expense DIS Disposition of Funds DFC Disposition of Funds to Future Campaign(effective 11/1/13) DPP Disposition of Funds to Political Party(effective 11/1/13) DPV Disposition of Funds to Petition Verification(effective 11/1/13) ECC Electioneering Communication IEC Independent Expenditure Regarding a Candidate IEI Independent Expenditure Regarding an Issue MON Monetary(Not to a Candidate) PCW Petty Cash Withdrawn PCS Petty Cash Spent PPD Pre-paid Distribution REF Refund (Negative Amount Only) RMB Reimbursements TOA Transfer to Office Account(Disposition of Funds) (10) Amendment Type (required on amended reports) - To add a new (previously unreported) expenditure for the reporting period being amended, enter"ADD" in amendment type on a line with ALL of the required data. The sequence number for expenditures with amendment type "ADD" will start at one plus the number of expenditures in the original report. For example, amending an original M1 reports that had 75 expenditures, means the sequence number of the first expenditure having amendment type "ADD" will be 76; the second "ADD" expenditure would have sequence number 39. 7-6 ENTE WAIVER OF REPORT SEP 2 0 2016 (Section 106.07(7), F.S.) I (PLEASE TYPE) X/O FFICE USE ONLY C6,0 Rocyl 1�F1N ( lT� C�Jw.nG�IL Name Office Sought F-L 3 fl F„4431' C Tit, _ Pv . P Sepe 3V5 e-ft AIN)citAt - FL 32•9 Address City State Zip Code Candidate ❑ Political Committee ❑ Party Executive Committee NOTE: This form does not apply to an electioneering communications organization(ECO). An ECO must file a report(not a waiver)that no reportable contributions or expenditures were made during the reporting period (s. 106.0703(6), F.S.). Check here if address has changed since last report. Check here if PC has DISBANDED and will no longer file reports. TYPE OF REPORT (Check Appropriate Box and Complete Applicable Line beneath Box) ❑ MONTHLY REPORT ❑ PRIMARY ELECTION GENERAL ELECTION 17 OTHER REPORT TYPE Indicate report# Indicate report# Indicate report# Indicate report type and# M P G_ \1.2 as applicable: ❑ TERMINATION REPORT I I SPECIAL ELECTION NOTIFICATION OF NO ACTIVITY IN CAMPAIGN ACCOUNT FOR THE REPORTING PERIOD OF Oq - a 3-Jb THROUGH o9 - " IQ X ©c cQ �� sem- i.oi12 9 nature Date X Q o ci �a-� dIL�4 - 3-O Ste- 'ignature Date REQUIRED SIGNATURES FOR: Candidates: Candidate and Campaign Treasurer or Deputy Treasurer(s. 106.07(5), F.S.) Political Committees: Chairman and Campaign Treasurer or Deputy Treasurer(s. 106.07(5), F.S.) Party Executive Committees: Treasurer and Chairman(s. 106.29(2), F.S.) Except as noted above for an ECO, in any reporting period when there has been no activity in the account(no funds expended or r2.r,g14244 the filing of the required report is waives'However,the filing o usfbe notified in wrirrig on the prescribed reporting date that no report is being filed. Aoric►.Q Z O s,Z -Zi t DS-DE 87(Rev.06/15) ()Nuns 11 F e� +�-G,1-a4+, G�C3�f`�` w A[J4.P tV aOtir t Q 4-) s �0�+`�v�C� -b7s W co i� dY ` %`ns:A c o Qii B 1'�'414 a wt' c a- z Z d v�� 4t56%;e t4-1 e 4n Kai .ti c ft,&E+oz* N Pan as �? CAMPAIGN TREASURER'S REPOR ; Y----- --- �. 1 � !�JLr0 (1) Rvc.,k?A SR PI-141i as FFICE USE ONLY Name 3o9C.ep � 124-4&) OCT 5 2016 ' �1 (2) P. a Berx -308 Address (number and street) FINANCE ( M-pe GP-t4 aA v L- FL_ -3.1A 2-.7 City, State, Zip Code [ Check here if address has changed (3) ID Number: (4) Check appropriate box(es): [Candidate Office Sought: L-01 2e, C t i R VV-e-.44-1.. C ti'Ty UZ L ❑ 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 Qq / / To 05 / 3 p I tib Report Type: 6 -3 ❑ Original ❑ Amendment ❑ Special Election Report (6) Contributions This Report (7) Expenditures This Report Monetary Cash & Checks $ , , • Expenditures $ b. lrs Loans $ , Transfers to Office Account $ k--"*--% Total Monetary $ , • Total Monetary $ � -. gab. GS In-Kind $ , , • (8) Other Distributions $ , }e5 (9) TOTAL Monetary Contributions To Date (10) TOTAL Monetary Expenditures To Date $ , 3 ,4;49-D , o 0 $ ��� 941 919 (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 anditis true, correct, and complete:(' (Type name) 1�p C.V. 1 ^ 44./J AQ. (Type name) �1 Ocd\4 ❑ Individual(only for IE ,'Treasurer ❑ Deputy Treasurer Net andidate ❑Chairperson(only for PC and PTY) or electioneering comm.) ( (l- (� (J X(17 CA G7dX Signature Signature DS-DE 12 (Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS Instructions for Campaign Treasurer's Report Summary (1) Name: full name of the candidate, political committee, party executive committee, electioneering communications organization, or individual making an independent expenditure or electioneering communication. (2) Address: the full address or post office box, city, state, and zip code. Check the box if the address has changed since the last report filed. (3) ID Number: identification number assigned by the filing officer. (4) Check the appropriate box(es). (5) Report Identifiers Cover Period: the dates this report covers(i.e., From 1/1/15 To 1/31/55). Important: use the appropriate cover period dates as published by the filing officer. Report Type: refer to the filing officer's calendar of reporting dates for the correct codes to be used for each reporting period. If report is for a special election add "S" in front of the report code(i.e., SG3). Check one of the appropriate boxes: • Original: first report filed for this reporting period. Amendment: must summarize only contributions/fund transfers and expenditures/distributions being reported as additions or deletions. Read instructions for sequence numbers and amendment types on the back of Forms DS-DE 13A and 14A. Special Election Report: Important: once a special election report is filed, the entity is required to file all remaining reports due for the special election. (6) Contributions This Report: Cash and Checks: total amount for this reporting period. Loans: total amount for this reporting period. Total Monetary: sum of Cash and Checks and Loans. In-Kind: the fair market value of the in-kind contribution at the time it is given for this reporting period. (7) Expenditures This Report: Monetary Expenditures:total amount of monetary expenditures for this reporting period. Transfers to Office Account: total amount transferred to an office account by elected candidates only. Total Monetary: sum of Monetary Expenditures and Transfers to Office Account. (8) Other Distributions: the total amount of goods and services contributed to a candidate or other committee by a PC, ECO, or PTY. (9) TOTAL Monetary Contributions To Date: the amount of total monetary contributions to date. Candidates keep cumulative totals from the time the campaign depository is opened through the termination report. (10) TOTAL Monetary Expenditures To Date: the amount of total monetary expenditures to date. Candidates keep cumulative totals from the time the campaign depository is opened through the termination report. (11) Type or print the required officer's name and have them sign the report: Candidate report: treasurer and candidate must sign. PC report: treasurer and chairperson must sign. PTY report: treasurer and chairperson must sign. ECO report: organization's treasurer must sign. IE or EC report: individual must sign (this applies when an individual acts alone to make these expenditures) AMENDMENT REPORTS: An amendment report summary should summarize only contributions, expenditures, distributions, &fund transfers being reported as additions or deletions. Read the instructions for the sequence number& amendment type fields on the back of forms DS-DE 13, 14, 14A and 94. CAMPAIGN TREASURER'S REPORT- ITEMIZED EXPENDITURES ( 1 (7124-AwnNiP' L (1) Name C:3,cjC., -61 is. J a-Q-A-S (2) I.D. Number 4-1#4 LO. •t%L (3) Cover Period 09 / 1'7 / /ti, through ®tet I 50 / I (4) Page of 9 G _ 3 (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 09/2C' Ii, 1 Tia F Coievoat OR. ,0X Ziti o'L-A > I)^D� c-I- P f4-R.0•� �A 'NJ 805. O a LI 0I 3'103 s,r:-NS 4-A ry o C c c-pQ 11.1 cis„}- Oct/WV `b G41.1 RJ GAZ.S -L i2(,4•A441-- "D 61- % 1 O 5 Po VK_ it *Q 3)..);*3.0 1r R 1 nD 'c �" C 4Z.00 -- --1* � '� 0 2 x.14-p1 i- .1%02-tr-0,,V` (ssaat� s VP+C42_ / / ---------) / / ------ / / / / / / 1.--(r7) / / 7 DS-DE 14(Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES INSTRUCTIONS FOR CAMPAIGN TREASURER'S REPORT - ITEMIZED EXPENDITURES (1) Candidate's full name or name of the political committee (PC), electioneering communications organization (ECO), or party executive committee(PTY). (2) Identification number assigned by the filing officer. (3) Cover period dates (01/01/15 through 01/31/15). (See filing officer's reporting dates calendar for appropriate cover periods.) (4) Page numbers (e.g., 1 of 3). (5) Date of expenditure (Month/Day/Year). (6) Sequence Number - Each detail line shall have a sequence number assigned to it. Sequence numbers are to be assigned within each reporting period and for each type of detail line. Thus the report type, detail line type, and sequence number will combine to uniquely identify a specific contribution, expenditure, distribution or fund transfer. This method of unique identification is required for responding to requests from the filing officer and for reporting requirements. For example, a M1 report having 40 expenditures would use sequence numbers 1 through 40. The next report (M2), comprised of 30 expenditures would use sequence numbers 1 through 30. Expenditures on amended M1 reports would begin with sequence number 41 and on amended M2 reports would begin with sequence number 31. See Amendment Type instructions below. (7) Full name and address of entity receiving payment(including city, state and zip code). (8) Purpose of expenditure (if expenditure is a contribution to a candidate, also type the office sought by the candidate). PLEASE NOTE: This column does not apply to candidate expenditures, as candidates cannot contribute to other candidates from campaign funds. However, PCs (supporting candidates) and party executive committees contributing to candidates must report office sought(Section 106.07, F.S.). (9) Enter Expenditure Type using one of the following codes: Code Description CAN Candidate Expense DIS Disposition of Funds DFC Disposition of Funds to Future Campaign(effective 11/1/13) DPP Disposition of Funds to Political Party(effective 11/1/13) DPV Disposition of Funds to Petition Verification (effective 11/1/13) ECC Electioneering Communication IEC Independent Expenditure Regarding a Candidate IEI Independent Expenditure Regarding an Issue MON Monetary(Not to a Candidate) PCW Petty Cash Withdrawn PCS Petty Cash Spent PPD Pre-paid Distribution REF Refund (Negative Amount Only) RMB Reimbursements TOA Transfer to Office Account(Disposition of Funds) (10) Amendment Type (required on amended reports) - To add a new (previously unreported) expenditure for the reporting period being amended, enter"ADD" in amendment type on a line with ALL of the required data. The sequence number for expenditures with amendment type "ADD" will start at one plus the number of expenditures in the original report. For example, amending an original M1 reports that had 75 expenditures, means the sequence number of the first expenditure having amendment type "ADD" will be 76; the second "ADD" expenditure would have sequence number 39. CAMPAIGN TREASURER'S REPORT - ITEMIZED CONTRIBUTIONS C- pe....- c{I N &vice CX-,1 t'' CA/we*C � (1) Name �o (2) I.D. Number (3) Cover Period d 5 I 0/ IA, through 0 3 Q I ` le (4) Page of d 6-3 (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 Am mens Amount / / / / / / DS-DE 13(Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES INSTRUCTIONS FOR CAMPAIGN TREASURER'S REPORT - ITEMIZED CONTRIBUTIONS (1) Candidate's full name or name of the political committee (PC), electioneering communications organizations (ECO)or party executive committee(PTY). (2) The identification number assigned by the filing officer. (3) Cover period dates(e.g., 1/1/15 through 1/31/15). (See filing officer's reporting dates calendar for appropriate year and cover periods.) (4) Page numbers(e.g., 1 of 3 ). (5) Date contribution was RECEIVED(Month/Day/Year). (6) Sequence Number—Each detail line shall have a sequence number assigned to it. Sequence numbers are to be assigned within each reporting period and for each type of detail line. Thus the report type, detail line type, and sequence number will combine to uniquely identify a specific contribution, expenditure, distribution or fund transfer. This method of unique identification is required for responding to requests from the filing officer and for reporting amendments. For example, a M1 report having 75 contributions would use sequence numbers 1 through 75. The next report(M2), comprised of 40 contributions would use sequence numbers 1 through 40. Contributions on amended M1 reports would begin with sequence number 76 and on amended M2 reports would begin with sequence number 41. See the Amendment Type instructions below. (7) Type full name and address of contributor(including city, state and zip code). (8) Enter the type of contributor using one of the following codes: Occupation of contributor for contributions over$100 only. (If a business, please indicate nature of business.) Individual B Business (also includes corporations, organizations, groups, etc.) E Electioneering Communications Organizations F Political Committee (federal or state) P Political Parties (includes federal, state and county executive committees) O Other (e.g., candidate surplus funds to party, etc.) S Candidate to Self (9) Enter Contribution Type using one of the following codes: NOTE: Cash includes cash and cashier's checks. Code Description CAS Cash or Cashier's Check CHE Check COF Carryover Funds from Previous Campaign INK In-Kind INT Interest LOA Loan MO Money Order MUC Multiple Uniform Contributions RCT Other Receipts REF Refund (Negative Amount Only) CAMPAIGN TREASURER'SU/ REPORT SUMMARY (1) c o � a. Name . , Cu..r,'t-(�4j (?a�.V� n U (2) p.0. 3 08 Address (number and street) I OCT 14 2016 C. f�V E L Of I-3 RV�� �L ���� �� I City, State, Zip Code eCa Z:fOP� Check here if address has changed (3) ID Number: (4) Check appropriate box(es): ;NdCandidate Office Sought: ( )'I Ltd N Com!L — c-A' CANT-Ii POW-40— �L ❑ 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 / I To 10 / 07/ st to Report Type: &—e4 LA Original ❑ Amendment ❑ Special Election Report (6) Contributions This Report (7) Expenditures This Report Monetary Cash & Checks $ , , Expenditures $ _ ,�2- I -1) Loans $ , Transfers to Office Account $ Total Monetary $ , , • Total Monetary $ — =s LI> •0'3 In-Kind $ , • (8) Other Distributions $ te7 (9) TOTAL Monetary Contributions To Date (10) TOTAL Monetary Expenditures Topp Date $ 3 w tD Qv �' , y , 9 3'10 cg (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) R0014 C211 g (Type name) cZfl C\`/,1 C{A 1.2 ❑ Individual(only for IE ,( reasurer ❑ Deputy Treasurer E Candidate ❑Chairperson(only for PC and PTY) or electioneering comm.) X r X G —c Signature Signature DS-DE 12(Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS Instructions for Campaign Treasurer's Report Summary (1) Name: full name of the candidate, political committee, party executive committee, electioneering communications organization, or individual making an independent expenditure or electioneering communication. (2) Address: the full address or post office box, city, state, and zip code. Check the box if the address has changed since the last report filed. (3) ID Number: identification number assigned by the filing officer. (4) Check the appropriate box(es). (5) Report Identifiers Cover Period: the dates this report covers (i.e., From 1/1/15 To 1/31/55). Important: use the appropriate cover period dates as published by the filing officer. Report Type: refer to the filing officer's calendar of reporting dates for the correct codes to be used for each reporting period. If report is for a special election add "S" in front of the report code (i.e., SG3). Check one of the appropriate boxes: Original: first report filed for this reporting period. Amendment: must summarize only contributions/fund transfers and expenditures/distributions being reported as additions or deletions. Read instructions for sequence numbers and amendment types on the back of Forms DS-DE 13A and 14A. Special Election Report: Important: once a special election report is filed, the entity is required to file all remaining reports due for the special election. (6) Contributions This Report: Cash and Checks: total amount for this reporting period. Loans: total amount for this reporting period. Total Monetary: sum of Cash and Checks and Loans. In-Kind: the fair market value of the in-kind contribution at the time it is given for this reporting period. (7) Expenditures This Report: Monetary Expenditures: total amount of monetary expenditures for this reporting period. Transfers to Office Account: total amount transferred to an office account by elected candidates only. Total Monetary: sum of Monetary Expenditures and Transfers to Office Account. (8) Other Distributions: the total amount of goods and services contributed to a candidate or other committee by a PC, ECO, or PTY. (9) TOTAL Monetary Contributions To Date: the amount of total monetary contributions to date. Candidates keep cumulative totals from the time the campaign depository is opened through the termination report. (10) TOTAL Monetary Expenditures To Date: the amount of total monetary expenditures to date. Candidates keep cumulative totals from the time the campaign depository is opened through the termination report. (11) Type or print the required officer's name and have them sign the report: Candidate report: treasurer and candidate must sign. PC report: treasurer and chairperson must sign. PTY report: treasurer and chairperson must sign. L ECO report: organization's treasurer must sign. L IE or EC report: individual must sign (this applies when an individual acts alone to make these expenditures) AMENDMENT REPORTS: An amendment report summary should summarize only contributions, expenditures, distributions, & fund transfers being reported as additions or deletions. Read the instructions for the sequence number & amendment type fields on the back of forms DS-DE 13, 14, 14A and 94. CAMPAIGN TREASURER'S REPORT — ITEMIZED CONTRIBUTIONS 6r—L4 (1) Name G-N) Or-1O[ (2) I.D. Number 44413*-- (3) Cover Period 100 / Q ) / V through ` ® / 01 / 4r,C (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 INSTRUCTIONS FOR CAMPAIGN TREASURER'S REPORT - ITEMIZED CONTRIBUTIONS (1) Candidate's full name or name of the political committee (PC), electioneering communications organizations (ECO)or party executive committee(PTY). (2) The identification number assigned by the filing officer. (3) Cover period dates(e.g., 1/1/15 through 1/31/15). (See filing officer's reporting dates calendar for appropriate year and cover periods.) (4) Page numbers(e.g., 1 of 3 ). (5) Date contribution was RECEIVED(Month/Day/Year). (6) Sequence Number—Each detail line shall have a sequence number assigned to it. Sequence numbers are to be assigned within each reporting period and for each type of detail line. Thus the report type, detail line type, and sequence number will combine to uniquely identify a specific contribution, expenditure, distribution or fund transfer. This method of unique identification is required for responding to requests from the filing officer and for reporting amendments. For example, a M1 report having 75 contributions would use sequence numbers 1 through 75. The next report(M2), comprised of 40 contributions would use sequence numbers 1 through 40. Contributions on amended M1 reports would begin with sequence number 76 and on amended M2 reports would begin with sequence number 41. See the Amendment Type instructions below. (7) Type full name and address of contributor(including city, state and zip code). (8) Enter the type of contributor using one of the following codes: Occupation of contributor for contributions over$100 only. (If a business, please indicate nature of business.) Individual B Business (also includes corporations, organizations, groups, etc.) E Electioneering Communications Organizations F Political Committee (federal or state) P Political Parties (includes federal, state and county executive committees) O Other (e.g., candidate surplus funds to party, etc.) S Candidate to Self (9) Enter Contribution Type using one of the following codes: NOTE: Cash includes cash and cashier's checks. Code Description CAS Cash or Cashier's Check CHE Check COF Carryover Funds from Previous Campaign INK In-Kind INT Interest LOA Loan MO Money Order MUC Multiple Uniform Contributions RCT Other Receipts REF Refund (Negative Amount Only) Li t,t CAMflotIGN TREASU R' REPORT — ITEMIZED EXPENDITURES (1) Name d L y g A-10 Q/J (2) I.D. Number (3) Cover Period 1 7 / 0) / 1(j through 19 / 01/ )b (4) Page u 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 10/0y)b 3vvve,„.4...e.. °Ire v.\,acicis aize,hf3/40-p Cew.,-4y �p.L�. ' GA o �Z• o 0 I tet / / -----"! / / -,,,„..,_ ,, / / , ., / / / / / / / / _...... ,/ --- /\ , v ,� 4v DS-DE 14(Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES INSTRUCTIONS FOR CAMPAIGN TREASURER'S REPORT - ITEMIZED EXPENDITURES (1) Candidate's full name or name of the political committee (PC), electioneering communications organization (ECO), or party executive committee (PTY). (2) Identification number assigned by the filing officer. (3) Cover period dates (01/01/15 through 01/31/15). (See filing officer's reporting dates calendar for appropriate cover periods.) (4) Page numbers (e.g., 1 of 3). (5) Date of expenditure(Month/Day/Year). (6) Sequence Number - Each detail line shall have a sequence number assigned to it. Sequence numbers are to be assigned within each reporting period and for each type of detail line. Thus the report type, detail line type, and sequence number will combine to uniquely identify a specific contribution, expenditure, distribution or fund transfer. This method of unique identification is required for responding to requests from the filing officer and for reporting requirements. For example, a M1 report having 40 expenditures would use sequence numbers 1 through 40. The next report (M2), comprised of 30 expenditures would use sequence numbers 1 through 30. Expenditures on amended M1 reports would begin with sequence number 41 and on amended M2 reports would begin with sequence number 31. See Amendment Type instructions below. (7) Full name and address of entity receiving payment(including city, state and zip code). (8) Purpose of expenditure (if expenditure is a contribution to a candidate, also type the office sought by the candidate). PLEASE NOTE: This column does not apply to candidate expenditures, as candidates cannot contribute to other candidates from campaign funds. However, PCs (supporting candidates) and party executive committees contributing to candidates must report office sought(Section 106.07, F.S.). (9) Enter Expenditure Type using one of the following codes: Code Description CAN Candidate Expense DIS Disposition of Funds DFC Disposition of Funds to Future Campaign (effective 11/1/13) DPP Disposition of Funds to Political Party(effective 11/1/13) DPV Disposition of Funds to Petition Verification (effective 11/1/13) ECC Electioneering Communication IEC Independent Expenditure Regarding a Candidate IEI Independent Expenditure Regarding an Issue MON Monetary(Not to a Candidate) PCW Petty Cash Withdrawn PCS Petty Cash Spent PPD Pre-paid Distribution REF Refund (Negative Amount Only) RMB Reimbursements TOA Transfer to Office Account(Disposition of Funds) (10) Amendment Type (required on amended reports) - To add a new (previously unreported) expenditure for the reporting period being amended, enter"ADD" in amendment type on a line with ALL of the required data. The sequence number for expenditures with amendment type "ADD" will start at one plus the number of expenditures in the original report. For example, amending an original M1 reports that had 75 expenditures, means the sequence number of the first expenditure having amendment type "ADD" will be 76; the second "ADD" expenditure would have sequence number 39. G-5 CAMPAIGN TREASURER'S REPORT SUMMARY (1) B G Name 3 8 'S- L 'E31..►� Q (2) O . 3 09 Address (number an street) OCT 2X 2016 C., f3 -c rimey J City, State, Zip Code ❑ Check here if address has changed (3) ID Number: (4) Check appropriate box(es): 5' Candidate Office Sought: (ZiZrP 1— ❑ 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 ,'a 1C)8 / 110 To , C) / y t4 / Report Type: ❑ Original ❑ Amendment ❑ Special Election Report (6) Contributions This Report (7) Expenditures This Report Monetary Cash & Checks $ Expenditures $ Loans $ , Transfers to �— Office Account $ Total Monetary $ , Total Monetary $ o-_—= _�� L4 11.0 g0q In -Kind $ , (8) Other Distributions $ , (9) TOTAL Monetary Contributions To Date (10) TOTAL Monetary Expenditures To Date $ =-3j Do0-0 $ (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: P C' 1 1 0 )I� MS (Type name) (Type name) t`�C. �j e/ ❑ Individual (only for IE 1&ktreaJer ❑ Deputy Treasurerj�andidate ElChairperson (only for PC and PTY) A or electioneering comm.).) n � © C X /�+ X Signature Signature DS -DE 12 (Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS Pm— Instructions for Campaign Treasurer's Report Summary (1) Name: full name of the candidate, political committee, party executive committee, electioneering communications organization, or individual making an independent expenditure or electioneering communication. (2) Address: the full address or post office box, city, state, and zip code. the box if the address has changed since the last report filed. Check p 9 (3) ID Number: identification number assigned by the filing officer. (4) Check the appropriate box(es). (5) Report Identifiers Cover Period: the dates this report covers (i.e., From 1/1/15 To 1/31/55). Important: use the appropriate cover period dates as published by the filing officer. Report Type: refer to the filing officer's calendar of reporting dates for the correct codes to be used for each reporting period. If report is for a special election add"S" in front of the report code (i.e., SG3). Check one of the appropriate boxes: Original: first report filed for this reporting period. Amendment: must summarize only contributions/fund transfers and expenditures/distributions being reported as additions or deletions. Read instructions for sequence numbers and amendment types on the back of Forms DS-DE 13A and 14A. Special Election Report: Important: once a special election report is filed, the entity is required to file all remaining reports due for the special election. (6) Contributions This Report: Cash and Checks: total amount for this reporting period. Loans: total amount for this reporting period. Total Monetary: sum of Cash and Checks and Loans. In-Kind: the fair market value of the in-kind contribution at the time it is given for this reporting period. (7) Expenditures This Report: Monetary Expenditures: total amount of monetary expenditures for this reporting period. Transfers to Office Account: total amount transferred to an office account by elected candidates only. Total Monetary: sum of Monetary Expenditures and Transfers to Office Account. (8) Other Distributions: the total amount of goods and services contributed to a candidate or other committee by a PC, ECO, or PTY. (9) TOTAL Monetary Contributions To Date: the amount of total monetary contributions to date. Candidates keep cumulative totals from the time the campaign depository is opened through the termination report. (10) TOTAL Monetary Expenditures To Date: the amount of total monetary expenditures to date. Candidates keep cumulative totals from the time the campaign depository is opened through the termination report. (11) Type or print the required officer's name and have them sign the report: Candidate report: treasurer and candidate must sign. PC report: treasurer and chairperson must sign. PTY report: treasurer and chairperson must sign. ECO report: organization's treasurer must sign. IE or EC report: individual must sign(this applies when an individual acts alone to make these expenditures) AMENDMENT REPORTS: An amendment report summary should summarize only contributions, expenditures, distributions, &fund transfers being reported as additions or deletions. Read the instructions for the sequence number& amendment type fields on the back of forms DS-DE 13, 14, 14A and 94. CAMPAIGN TREASURER'S REPORT — ITEMIZED CONTRIBUTIONS C—�y C�uNGyL (1) Name Q °a..., Q .` (2) I.D. Number �cov fiVer...PA- (3) Cover Period 1 0 /0e) / 16 through 1 Q / 14 I ti;„ (4) Page ‘ of f (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 / / / / / o r/ --------------- / / / / / / / / ,___ DS-DE 13(Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES INSTRUCTIONS FOR CAMPAIGN TREASURER'S REPORT - ITEMIZED CONTRIBUTIONS (1) Candidate's full name or name of the political committee (PC), electioneering communications organizations (ECO)or party executive committee (PTY). (2) The identification number assigned by the filing officer. (3) Cover period dates(e.g., 1/1/15 through 1/31/15). (See filing officer's reporting dates calendar for appropriate year and cover periods.) (4) Page numbers (e.g., 1 of 3 ). (5) Date contribution was RECEIVED(Month/Day/Year). (6) Sequence Number—Each detail line shall have a sequence number assigned to it. Sequence numbers are to be assigned within each reporting period and for each type of detail line. Thus the report type, detail line type, and sequence number will combine to uniquely identify a specific contribution, expenditure, distribution or fund transfer. This method of unique identification is required for responding to requests from the filing officer and for reporting amendments. For example, a M1 report having 75 contributions would use sequence numbers 1 through 75. The next report(M2), comprised of 40 contributions would use sequence numbers 1 through 40. Contributions on amended M1 reports would begin with sequence number 76 and on amended M2 reports would begin with sequence number 41. See the Amendment Type instructions below. (7) Type full name and address of contributor(including city, state and zip code). (8) Enter the type of contributor using one of the following codes: Occupation of contributor for contributions over$100 only. (If a business, please indicate nature of business.) Individual B Business (also includes corporations, organizations, groups, etc.) E Electioneering Communications Organizations F Political Committee (federal or state) P Political Parties (includes federal, state and county executive committees) O Other (e.g., candidate surplus funds to party, etc.) S Candidate to Self (9) Enter Contribution Type using one of the following codes: NOTE: Cash includes cash and cashier's checks. Code Description CAS Cash or Cashier's Check CHE Check COF Carryover Funds from Previous Campaign INK In-Kind INT Interest LOA Loan MO Money Order MUC Multiple Uniform Contributions RCT Other Receipts REF Refund (Negative Amount Only) 6 -5 LOQ C14-4 R,rppp'- CAMPAIGN TREASURER' REPORT — ITEMIZED EXTENDITURES (1) Name �O G�.u1 Q R NG'�+ V� (2) I.D. Number L-O 'INC.;1-- (3) Cover Period it) / 00 / 10 through b'Q / / 1 1p (4) Page of (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 .10 / to/)10 1.04"0 MV.A" � PRv��wc� Rot,.-1.8 Toutr"4". C.-6;11%) Cao �a Qa ocA v...q a /1z/tb Bros Go � a 'Wevti let s yo�.r-. c ���� e r / / / / / / / V DS-DE 14(Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES INSTRUCTIONS FOR CAMPAIGN TREASURER'S REPORT - ITEMIZED EXPENDITURES (1) Candidate's full name or name of the political committee (PC), electioneering communications organization (ECO), or party executive committee(PTY). (2) Identification number assigned by the filing officer. (3) Cover period dates (01/01/15 through 01/31/15). (See filing officer's reporting dates calendar for appropriate cover periods.) (4) Page numbers (e.g., 1 of 3). (5) Date of expenditure(Month/Day/Year). (6) Sequence Number - Each detail line shall have a sequence number assigned to it. Sequence numbers are to be assigned within each reporting_period and for each type of detail line. Thus the report type, detail line type, and sequence number will combine to uniquely identify a contribution, expenditure, distribution or fund transfer. This method of unique identification is required for responding to requests from the filing officer and for reporting requirements. For example, a M1 report having 40 expenditures would use sequence numbers 1 through 40. The next report (M2), comprised of 30 expenditures would use sequence numbers 1 through 30. Expenditures on amended M1 reports would begin with sequence number 41 and on amended M2 reports would begin with sequence number 31. See Amendment Type instructions below. (7) Full name and address of entity receiving payment(including city, state and zip code). (8) Purpose of expenditure (if expenditure is a contribution to a candidate, also type the office sought by the candidate). PLEASE NOTE: This column does not apply to candidate expenditures, as candidates cannot contribute to other candidates from campaign funds. However, PCs (supporting candidates) and party executive committees contributing to candidates must report office sought(Section 106.07, F.S.). (9) Enter Expenditure Typ-using one of the following codes: Code Description CAN/ Candidate Expense DIS Disposition of Funds DFC Disposition of Funds to Future Campaign (effective 11/1/13) DPP Disposition of Funds to Political Party(effective 11/1/13) DPV Disposition of Funds to Petition Verification (effective 11/1/13) ECC Electioneering Communication IEC Independent Expenditure Regarding a Candidate IEI Independent Expenditure Regarding an Issue MON Monetary(Not to a Candidate) PCW Petty Cash Withdrawn PCS Petty Cash Spent PPD Pre-paid Distribution REF Refund (Negative Amount Only) RMB Reimbursements TOA Transfer to Office Account(Disposition of Funds) (10) Amendment Type (required on amended reports) - To add a new (previously unreported) expenditure for the reporting period being amended, enter"ADD" in amendment type on a line with ALL of the required data. The sequence number for expenditures with amendment type "ADD" will start at one plus the number of expenditures in the original report. For example, amending an original M1 reports that had 75 expenditures, means the sequence number of the first expenditure having amendment type "ADD" will be 76; the second "ADD" expenditure would have sequence number 39. 6-13 cave GR-t3 C vy v, (.`awe e, CAMPAIGN TREASURER'S REPORT SUMMARY (1) 7 E Th Name stsk ❑ q� 11� q�V i (2) p'' 'eV*, 3 3 OCT 2 8 2016 Address (number and street) L 3}1 Q C IVO Ci'Vt9-12-4-1- cL- 3?R L City, State, Zip Code ® -E'-'' / L- U 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 0 / lc / b To ro / / 00 Report Type: 6-to `Original ❑ Amendment ❑ Special Election Report (6) Contributions This Report (7) Expenditures This Report Monetary Cash & Checks $ — 671. Expenditures $ a e *Qi Loans $ Transfers to Office Account $ ' 0 , „---", Total Monetary $ 0 Total Monetary - Iq g In-Kind $ c: (8) Other Distributions $ , � (9) TOTAL Monetary Contributions To Date (10) TOTAL Monetary Expenditures To Date $ �__ 3 0 . 430 $ , , 5l.$ O'er (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 is true, correct, and complete: (Type name) �QC. M 1�`� t.)4144 . (Type name) bL�� ❑ Individual(only for IE XTreasurer ❑ Deputy Treasurer $.Candidate ❑Chairperson(only for PC and PTY) or electioneering comm.) X Ov` X C—. ••s CO c Signature Signature DS-DE 12(Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS Instructions for Campaign Treasurer's Report Summary (1) Name: full name of the candidate, political committee, party executive committee, electioneering communications organization, or individual making an independent expenditure or electioneering communication. (2) Address: the full address or post office box, city, state, and zip code. Check the box if the address has changed since the last report filed. (3) ID Number: identification number assigned by the filing officer. (4) Check the appropriate box(es). (5) Report Identifiers Cover Period: the dates this report covers (i.e., From 1/1/15 To 1/31/55). Important: use the appropriate cover period dates as published by the filing officer. Report Type: refer to the filing officer's calendar of reporting dates for the correct codes to be used for each reporting period. If report is for a special election add "S" in front of the report code (i.e., SG3). Check one of the appropriate boxes: ❑Original: first report filed for this reporting period. 0 Amendment: must summarize only contributions/fund transfers and expenditures/distributions being reported as additions or deletions. Read instructions for sequence numbers and amendment types on the back of Forms DS-DE 13A and 14A. Special Election Report: Important: once a special election report is filed, the entity is required to file all remaining reports due for the special election. (6) Contributions This Report: Cash and Checks: total amount for this reporting period. Loans: total amount for this reporting period. Total Monetary: sum of Cash and Checks and Loans. In-Kind: the fair market value of the in-kind contribution at the time it is given for this reporting period. (7) Expenditures This Report: Monetary Expenditures: total amount of monetary expenditures for this reporting period. Transfers to Office Account: total amount transferred to an office account by elected candidates only. Total Monetary: sum of Monetary Expenditures and Transfers to Office Account. (8) Other Distributions: the total amount of goods and services contributed to a candidate or other committee by a PC, ECO, or PTY. (9) TOTAL Monetary Contributions To Date: the amount of total monetary contributions to date. Candidates keep cumulative totals from the time the campaign depository is opened through the termination report. (10) TOTAL Monetary Expenditures To Date: the amount of total monetary expenditures to date. Candidates keep cumulative totals from the time the campaign depository is opened through the termination report. (11) Type or print the required officer's name and have them sign the report: Candidate report: treasurer and candidate must sign. PC report: treasurer and chairperson must sign. PTY report: treasurer and chairperson must sign. ECO report: organization's treasurer must sign. IE or EC report: individual must sign (this applies when an individual acts alone to make these expenditures) AMENDMENT REPORTS: An amendment report summary should summarize only contributions, expenditures, distributions, & fund transfers being reported as additions or deletions. Read the instructions for the sequence number & amendment type fields on the back of forms DS-DE 13, 14, 14A and 94. CAMPAIGN TREASURER'S REPORT — ITEMIZED CONTRIBUTIONS ( e- cot 0 p Q- `'4e� L. (1) Name caG.V. y R � S (2) I.D. Number C,044.UGm (3) Cover Period 10 / 15 / p 10 through %IQ / Z) / Vio (4) Page 1 of 1 (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 oils- / I L. °s ViNO9 Roc1A't MIX 4 I %.A-Sf-O 308 E Glirr +est tis.kia 1 r- 10-‘4a CosRoewt " " P 11V� FdE` 1,48I -F-1._ 3zg .S 445 N3 s A4(m s ?-1/ c., r viN v.S V43-. to / 15. rib Ras it IS � -1I q, voti .- Cane 4. °h tAcL 1441174 I O.ocox k"--c` .f s 0 . 1 CA $ 'a^ -ry roQ re rL Pltactv.A ` sows vy+ Ivo cosr yes / / / / / / 0 / / 2 / / DS-DE 1 (Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES INSTRUCTIONS FOR CAMPAIGN TREASURER'S REPORT - ITEMIZED CONTRIBUTIONS (1) Candidate's full name or name of the political committee (PC), electioneering communications organizations (ECO)or party executive committee (PTY). (2) The identification number assigned by the filing officer. (3) Cover period dates (e.g., 1/1/15 through 1/31/15). (See filing officer's reporting dates calendar for appropriate year and cover periods.) (4) Page numbers (e.g., 1 of 3 ). (5) Date contribution was RECEIVED (Month/Day/Year). (6) Sequence Number— Each detail line shall have a sequence number assigned to it. Sequence numbers are to be assigned within each reporting period and for each type of detail line. Thus the report type, detail line type, and sequence number will combine to uniquely identify a specific contribution, expenditure, distribution or fund transfer. This method of unique identification is required for responding to requests from the filing officer and for reporting amendments. For example, a M1 report having 75 contributions would use sequence numbers 1 through 75. The next report(M2), comprised of 40 contributions would use sequence numbers 1 through 40. Contributions on amended M1 reports would begin with sequence number 76 and on amended M2 reports would begin with sequence number 41. See the Amendment Type instructions below. (7) Type full name and address of contributor(including city, state and zip code). (8) Enter the type of contributor using one of the following codes: Occupation of contributor for contributions over$100 only. (If a business, please indicate nature of business.) I Individual B Business (also includes corporations, organizations, groups, etc.) E Electioneering Communications Organizations _ F Political Committee (federal or state) P Political Parties (includes federal, state and county executive committees) O Other (e.g., candidate surplus funds to party, etc.) S Candidate to Self (9) Enter Contribution Type using one of the following codes: NOTE: Cash includes cash and cashier's checks. Code Description CAS Cash or Cashier's Check CHE Check COF Carryover Funds from Previous Campaign INK In-Kind INT Interest LOA Loan MO Money Order MUC Multiple Uniform Contributions RCT Other Receipts REF Refund (Negative Amount Only) 6—to Com- K CAMPAIG TREA URER'S REPORT - ITEMIZED EXPENDITURES c - (1) Name �OUV -r7& 1 (2)115771=e7' (3) Cover Period j 0 / 15 I 00 through I)D / Z) / b (4) Page of 9 (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 10 /ay'l Vb A-Lies Q FAv�t'v�q 'Prrrn`�`e444 Q y fl Mwvt.-1\ rioh9 CP,A.Z.,,Ld0ftici CAr� a 2o�kt.�e2 tom- 37A5� � ISA-‘a3ISA-‘a3)tv ca. , ISA-‘a3 1 / (r/"/ / / DS-DE 14(Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES INSTRUCTIONS FOR CAMPAIGN TREASURER'S REPORT - ITEMIZED EXPENDITURES (1) Candidate's full name or name of the political committee (PC), electioneering communications organization (ECO), or party executive committee(PTY). (2) Identification number assigned by the filing officer. (3) Cover period dates (01/01/15 through 01/31/15). (See filing officer's reporting dates calendar for appropriate cover periods.) (4) Page numbers(e.g., 1 of 3). (5) Date of expenditure(Month/Day/Year). (6) Sequence Number - Each detail line shall have a sequence number assigned to it. Sequence numbers are to be assigned within each reporting period and for each type of detail line. Thus the report type, detail line type, and sequence number will combine to uniquely identify a specific contribution, expenditure, distribution or fund transfer. This method of unique identification is required for responding to requests from the filing officer and for reporting requirements. For example, a M1 report having 40 expenditures would use sequence numbers 1 through 40. The next report (M2), comprised of 30 expenditures would use sequence numbers 1 through 30. Expenditures on amended M1 reports would begin with sequence number 41 and on amended M2 reports would begin with sequence number 31. See Amendment Type instructions below. (7) Full name and address of entity receiving payment(including city, state and zip code). (8) Purpose of expenditure (if expenditure is a contribution to a candidate, also type the office sought by the candidate). PLEASE NOTE: This column does not apply to candidate expenditures, as candidates cannot contribute to other candidates from campaign funds. However, PCs (supporting candidates) and party executive committees contributing to candidates must report office sought(Section 106.07, F.S.). (9) Enter Expenditure Type using one of the following codes: Code Description CAN Candidate Expense DIS Disposition of Funds DFC Disposition of Funds to Future Campaign(effective 11/1/13) DPP Disposition of Funds to Political Party(effective 11/1/13) DPV Disposition of Funds to Petition Verification(effective 11/1/13) ECC Electioneering Communication IEC Independent Expenditure Regarding a Candidate IEI Independent Expenditure Regarding an Issue MON Monetary(Not to a Candidate) PCW Petty Cash Withdrawn PCS Petty Cash Spent PPD Pre-paid Distribution REF Refund (Negative Amount Only) RMB Reimbursements TOA Transfer to Office Account(Disposition of Funds) (10) Amendment Type (required on amended reports) - To add a new (previously unreported) expenditure for the reporting period being amended, enter"ADD" in amendment type on a line with ALL of the required data. The sequence number for expenditures with amendment type "ADD" will start at one plus the number of expenditures in the original report. For example, amending an original M1 reports that had 75 expenditures, means the sequence number of the first expenditure having amendment type "ADD" will be 76; the second "ADD" expenditure would have sequence number 39. , 6-11 Q f i6Po."T. I CA►pe c.4414 pav►ra� NOV 0 4 2016 ` c'yvs cxivo.`I b CAMPAIGN TREASUR RERA - v (1) R 0 W'A'S A.-S i cco 0/// L____ v '.;. :':. t1'� r: Namevts,A ( t - - C Address (number and street) � � OCT 282016 City, State, Zip Code C-c, .----- ❑ Check here if address has changed (3) ID Number: (4) Check appropriate box(es): '� w aS n ,� 0 p cm(t -4"./1- G-6 14,1, 1 yi Candidate Office Sought: C� c;7_.4-�C�. -Q,i.1� (•.� 1 �''?'`� CW`w<' ❑Political Committee(PC) ❑Electioneering Communicatio s Org. (ECO) 0 Check here if PC or ECO has disbanded 0 Party Executive Committe PTY) 0 Check here if PTY has disbanded ❑ Independent Expenditur IE)(also covers an 0 Check here if no other IE or EC reports will be filed individual making election ring communications) (5) Report Identifiers Cover Period: Fro / `5 / b To }'0 / �,1 I � �,j Report Type: 6--(p J oAmendment 0 Special Election Report — (6) Contributions This Report (7) Expenditures This Report Monetary Cash & Checks $ C7 Expenditures $ _ , a ' .o Loans $ ",— 0 .-r- Transfers to Office Account $ Total Monetary $ — 0 Total Monetary —$. ,s i .q In-Kind $ , (8) Other Distributions $ , Z (9) TOTAL Monetary Contributions To Date (10) TOTAL Monetary Expenditures To Date $ - 3J ccio r 40c7 $ , , 51,c), 05 (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: t7�.� (Type name) RO 'g14-C' 'gY1J Cy (Type name) ^ v1 Ii ..IXA4S14,\6 ,.� 0 Individual(only for IE Treasurer 0 Deputy Treasurer Candidate 0 Chairperson(only for PC and PTY) or electioneering comm.) C)41 ic— or;t4).,ode.e._ X CZ41:4 C"-\2"-el C:::: :7**AsPI;244-QA___ s Signature ` Signature DS-DE 12(Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS 6-1 CPQ Guv.c,)• L CAMPAIGN TREASURER'S REPORT SUMMARY (1) 14 cC 1 pa tiA.iS ; Y.= Name 308 EPE.'s- LcrAw-raL �wQ 1 i �f (2) P. 4. % 3O B 1 Address (number and street) • NOV 0 4 2016 L E t, rl ervQJZI _ "�—�-. 124 z V � �P A City, State, Zip Code ❑ Check here if address has changed (3) ID Number: (4) Check appropriate box(es): Candidate Office Sought: C_.AVQ. C.Prn1 p�VQ \-- C.,)`�' LO LAN-%0 1L. ICI 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 )'O / / pv To 1 ➢ / 0 3 / 1 Report Type: tj- --'7 Original ❑ Amendment ❑ Special Election Report (6) Contributions This Report (7) Expenditures This Report Monetary Cash & Checks $ -`' --` Expenditures $ , 306; cl Loans $ Transfers to Office Account $ Total Monetary $ ' C' 4= Total Monetary $ 305-, C3 b In-Kind $ — ,...., CD (8) Other Distributions (9) TOTAL Monetary Contributions To Date (10) TOTAL Monetary Expenditures To Date $ Si Ot2a . l3 o ( $ -;�� 8 y� (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: RoLK1 � oc \Ri s► (Type name) I R A-0 tJ . 5 (Type name) ❑ Individual(only for IE treasurer ❑ Deputy Treasurer andidate 0 Chairperson(only for PC and PTY) or electioneering comm.) XQ� e ,� X Cie Cd Signature Signature DS-DE 12(Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS CAMPAIGN TREASURER'S REPORT — ITEMIZED CONTRIBUTIONS CA-v-.42._ C"-t4 Pliv-aftoa. CA (1) Name Roc L\ gi4-NS.�S (2) I.D. Number Co :L.._ (3) Cover Period ID / 2Z / >12 through 1 1 / -p 3 / 1 b (4) Page i 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 V ARS Was VOL. P1 P GvnCi 001 wn' Rl2.- i o / 22 / l b Rbvz,J_,a..��s eP sre,1%41 jt r M42.— C taw fivQ Com,+ off, 1 `-AoRt. 0N, o 1 Lo -Co. ve%q s e N.s s. �s ► cA�prec,�oST� Kc R. P 1 0ecgr.,n C41.4&ie .$) ------7 , (77 ----------, / /9 / / ( / / DS-DE 13(Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES C 1.3 14-4i/C430.. CAMPAIGN TREASURER'S REPORT — ITEMIZED EXPENDITURES 1G G.>>� (1) Name bC. A (2) I.D. Number CIO LAN.CA L (3) Cover Period y t7 / 7,Z / )10 through II / 03 / Vip (4) Page 0 of ! (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 , /22/1 b 41►ascrc, Pg.v." -,r r.9 ?Rh%+A"9 Ok 0 irn .na) {Zv,:)_ Ct../ �oc�JGLoQ i'rL 37.95'5- '9 r4 "3"M .%0 6,9 b Ve N-v4e_ /1) //) r„, DS-DE 14(Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES rsz) C-4 fisc,- C. CAMPAIGN TREASURER'S REPORT SUMMARY (1) �OcA+J� snF � �-,T Name 3O psi- C�+fi - R�1.vk L; (2) • 0 Rcrw 30Q FEB 0 3 2017 { Address (number and street) t.�a (I, C.-po Cit — p —'3111 City, State, Zip Code C«, ric Check here if address has changed (3) ID Number: (4) Check appropriate box(es): 1 PA Candidate Office Sought: ( 044;'S CAZ-i� � CSa C AL- ❑ 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 ,) / 0 9 / ) b To 0 / 0 3 / 1'-7 Report Type: `i Original ❑ Amendment ❑ Special Election Report (6) Contributions This Report (7) Expenditures This Report Monetary Cash & Checks $ Expenditures $ —; t 3 16 c.Q I Loans $ 0, Transfers to Office Account $ Total Monetary $ �T Total Monetary $ In-Kind $ (8) Other Distributions $ , (9) TOTAL Monetary Contributions To Date (10) TOTAL Monetary Expenditures To Date $ oo0. 1-6 $ — ODD . (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 haveavexamined this report and it is` true, correct, and complete: Q (Type name) l�Q(j_ ,� C R N el S (Type name) R0 i RA 14 04).i ❑ Individual(only for IE treasurer ❑ Deputy Treasurer NeCandidate ❑Chairperson(only for PC and PTY) or electioneering comm.) n (� X O Ca X ( 0C-341 c3Ol CXh Signature Signature DS-DE 12(Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS Instructions for Campaign Treasurer's Report Summary (1) Name: full name of the candidate, political committee, party executive committee, electioneering communications organization, or individual making an independent expenditure or electioneering communication. (2) Address: the full address or post office box, city, state, and zip code. Check the box if the address has changed since the last report filed. (3) ID Number: identification number assigned by the filing officer. (4) Check the appropriate box(es). (5) Report Identifiers Cover Period: the dates this report covers (i.e., From 1/1/15 To 1/31/55). Important: use the appropriate cover period dates as published by the filing officer. Report Type: refer to the filing officer's calendar of reporting dates for the correct codes to be used for each reporting period. If report is for a special election add "S" in front of the report code (i.e., SG3). Check one of the appropriate boxes: Original: first report filed for this reporting period. Amendment: must summarize only contributions/fund transfers and expenditures/distributions being reported as additions or deletions. Read instructions for sequence numbers and amendment types on the back of Forms DS-DE 13A and 14A. Special Election Report: Important: once a special election report is filed, the entity is required to file all remaining reports due for the special election. (6) Contributions This Report: Cash and Checks: total amount for this reporting period. Loans: total amount for this reporting period. Total Monetary: sum of Cash and Checks and Loans. In-Kind: the fair market value of the in-kind contribution at the time it is given for this reporting period. (7) Expenditures This Report: Monetary Expenditures: total amount of monetary expenditures for this reporting period. Transfers to Office Account: total amount transferred to an office account by elected candidates only. Total Monetary: sum of Monetary Expenditures and Transfers to Office Account. (8) Other Distributions: the total amount of goods and services contributed to a candidate or other committee by a PC, ECO, or PTY. (9) TOTAL Monetary Contributions To Date: the amount of total monetary contributions to date. Candidates keep cumulative totals from the time the campaign depository is opened through the termination report. (10) TOTAL Monetary Expenditures To Date: the amount of total monetary expenditures to date. Candidates keep cumulative totals from the time the campaign depository is opened through the termination report. (11) Type or print the required officer's name and have them sign the report: ❑Candidate report: treasurer and candidate must sign. ❑ PC report: treasurer and chairperson must sign. ❑ PTY report: treasurer and chairperson must sign. ❑ ECO report: organization's treasurer must sign. ❑ IE or EC report: individual must sign (this applies when an individual acts alone to make these expenditures) AMENDMENT REPORTS: An amendment report summary should summarize only contributions, expenditures, distributions, &fund transfers being reported as additions or deletions. Read the instructions for the sequence number & amendment type fields on the back of forms DS-DE 13, 14, 14A and 94. 1"QAt ,s•i fivTi�a .a) mgr CAMPAIGN TREAS�V RER'S REPORT - ITEMIZED EXPENDITURES� °� (1) Name RaCl.0 �L` IR4 +34V2 (2) I.D. Number 1 't (3) Cover Period /O/Qkithrough /Q_/ 3- ) 11_-.7 (4) Page I of (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 r I l /o$/ lb &o ,ywQ, 1� TSN 444— (131 v Car,w 841/0 y o1.4 cwan Cats 4 '.....'"IP 2A:0,b$ i (4 ikVe. Cw..-a.,r-so.rrL f 0 6v,nco Star c.r4tcc. fa Ga-46;to i1 /7,S/ ib p0'i L c1ate., 4 4.4Ln 4 o pos r1or1� 4,VE � l' Ems")• 1gO.t Q E vac voA Dfkj i=o1 -; F RAwteat, LA,",ct-2, gSiS o ( S ca, rrI tY QN‘ ' ►1 ci C-d v iA <7.-o 14 c-.. PK* C par%fitlaSs:2) C71/31/1/ 3 vy$ E p-S.-1 c -- po tz-z1 off/ 6w0. ©R��ctv�.;w%- D15. 7648.31 3 ce��Co"�MJ44ak '-SQ 1-o ,Y,.y .PivI9a / / Fg1D1 , tp ,%1� 11 I. / / /1100 / / / / DS-DE 14(Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES INSTRUCTIONS FOR CAMPAIGN TREASURER'S REPORT - ITEMIZED EXPENDITURES (1) Candidate's full name or name of the political committee (PC), electioneering communications organization (ECO), or party executive committee (PTY). (2) Identification number assigned by the filing officer. (3) Cover period dates (01/01/15 through 01/31/15). (See filing officer's reporting dates calendar for appropriate cover periods.) (4) Page numbers(e.g., 1 of 3). (5) Date of expenditure (Month/Day/Year). (6) Sequence Number - Each detail line shall have a sequence number assigned to it. Sequence numbers are to be assigned within each reporting period and for each type of detail line. Thus the report type, detail line type, and sequence number will combine to uniquely identify a specific contribution, expenditure, distribution or fund transfer. This method of unique identification is required for responding to requests from the filing officer and for reporting requirements. For example, a M1 report having 40 expenditures would use sequence numbers 1 through 40. The next report (M2), comprised of 30 expenditures would use sequence numbers 1 through 30. Expenditures on amended M1 reports would begin with sequence number 41 and on amended M2 reports would begin with sequence number 31. See Amendment Type instructions below. (7) Full name and address of entity receiving payment(including city, state and zip code). (8) Purpose of expenditure (if expenditure is a contribution to a candidate, also type the office sought by the candidate). PLEASE NOTE: This column does not apply to candidate expenditures, as candidates cannot contribute to other candidates from campaign funds. However, PCs (supporting candidates) and party executive committees contributing to candidates must report office sought(Section 106.07, F.S.). (9) Enter Expenditure Type using one of the following codes: Code Description CAN Candidate Expense DIS Disposition of Funds DFC Disposition of Funds to Future Campaign (effective 11/1/13) DPP Disposition of Funds to Political Party(effective 11/1/13) DPV Disposition of Funds to Petition Verification (effective 11/1/13) ECC Electioneering Communication IEC Independent Expenditure Regarding a Candidate IEI Independent Expenditure Regarding an Issue MON Monetary(Not to a Candidate) PCW Petty Cash Withdrawn PCS Petty Cash Spent PPD Pre-paid Distribution REF Refund (Negative Amount Only) RMB Reimbursements TOA Transfer to Office Account(Disposition of Funds) (10) Amendment Type (required on amended reports) - To add a new (previously unreported) expenditure for the reporting period being amended, enter"ADD" in amendment type on a line with ALL of the required data. The sequence number for expenditures with amendment type "ADD" will start at one plus the number of expenditures in the original report. For example, amending an original M1 reports that had 75 expenditures, means the sequence number of the first expenditure having amendment type "ADD" will be 76; the second "ADD" expenditure would have sequence number 39. %,i.a 3J'ON (-RJ CAMPAIGN TREASURER'S REPORT — ITEMIZED CONTRIBUTIONS (ZiLesoPJi D _ e (..) �-y C wit% L(1) Name c_N.Lti c.ArN (�r� (2) I.D. Number r� (3) Cover Period )1 / 04 / Ii, through 0 1 / GS / 1 (4) Page i 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 \-113\-V-Arai—e,42.e— lAQe, e . Mc, CQ& U / 08 / lb eesscb t' � � a?� P�cX wp to me Cct.+ j� rRwc�• N (IS I- 1'af N(, ? 4 ►h) tdie.5 CA N,&viQ '36s%S rJ -ro ewc%) cow AL*. we s.. / / 'Po i1»g ;;'..¢. eim cs! eft,. Q c,.C.- 4 p i:ACQ,0 w'Itiies irazi,e94.4 %.4.b °-k rt.,-e&/ Ct.A ye r wap oil & 1ij / / / / /717.' )r- / / / / / / / LD8'DE 13(Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES INSTRUCTIONS FOR CAMPAIGN TREASURER'S REPORT - ITEMIZED CONTRIBUTIONS (1) Candidate's full name or name of the political committee(PC), electioneering communications organizations (ECO)or party executive committee (PTY). (2) The identification number assigned by the filing officer. (3) Cover period dates(e.g., 1/1/15 through 1/31/15). (See filing officer's reporting dates calendar for appropriate year and cover periods.) (4) Page numbers(e.g., 1 of 3 ). (5) Date contribution was RECEIVED(Month/Day/Year). (6) Sequence Number—Each detail line shall have a sequence number assigned to it. Sequence numbers are to be assigned within each reporting period and for each type of detail line. Thus the report type, detail line type, and sequence number will combine to uniquely identify a specific contribution, expenditure, distribution or fund transfer. This method of unique identification is required for responding to requests from the filing officer and for reporting amendments. For example, a M1 report having 75 contributions would use sequence numbers 1 through 75. The next report(M2), comprised of 40 contributions would use sequence numbers 1 through 40. Contributions on amended M1 reports would begin with sequence number 76 and on amended M2 reports would begin with sequence number 41. See the Amendment Type instructions below. (7) Type full name and address of contributor(including city, state and zip code). (8) Enter the type of contributor using one of the following codes: Occupation of contributor for contributions over$100 only. (If a business, please indicate nature of business.) Individual B Business (also includes corporations, organizations, groups, etc.) E Electioneering Communications Organizations F Political Committee (federal or state) P Political Parties (includes federal, state and county executive committees) O Other (e.g., candidate surplus funds to party, etc.) S Candidate to Self (9) Enter Contribution Type using one of the following codes: NOTE: Cash includes cash and cashier's checks. Code Description CAS Cash or Cashier's Check CHE Check COF Carryover Funds from Previous Campaign INK In-Kind INT Interest LOA Loan MO Money Order MUC Multiple Uniform Contributions RCT Other Receipts REF Refund (Negative Amount Only)