HomeMy WebLinkAboutdwillis_cocc_campaign_treasurers_reports_202109CAMPAIGN.TREASURER'S REPORT SUMMARY
(1) Donald Andrew Willis
Name
(2) 8984 Puerto Del Rio Drive, #301
Address (number and street)
Cape Canaveral; FL 32920
City, State, Zip Code
RECEIVED
SEPT 02 2021
By: CCO DL
❑ Check hereif address has changed (3) ID Number:
(4) Check appropriate box(es):
X- Candidate Office Sought:. Cape Canaveral City Council
❑ Political Committee (PC)
❑ Electioneering Communications Org. (ECO) ❑ Check here if PC or ECO has disbanded
❑ Party Executive Committee (PTY) ❑ Check here if PTY has disbanded
❑ Independent Expenditure (IE) (also covers an ❑ Check here if no otherIE or EC reports will be filed
individual making electioneering communications)
(5) Report Identifiers
Cover Period: From 08 / 01 / 21 To 08 /.27 / 21 Report :Type: G 1
X- Original ❑ Amendment ❑ Special Election Report
(6) Contributions This Report
Cash & Checks $ __, __, 500.00
Loans $ __, 1,000.00
Total Monetary $ __, 1, 500.00
In-Kind $ __, __, __. __
(7) Expenditures This Report
Monetary
Expenditures $ __, __, 39.00
Transfers to
Office Account $ __, __, __. __
Total Monetary $ __, __, 39.00
(8) Other Distributions
$ __, __, __. __
(9) TOTAL Monetary Contributions To Date
$ __, 1, 500.00
(10) TOTAL Monetary Expenditures To Date
$ __, __, 39.00
(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:
(Type; name) Jay E. Petty
■ Individual (only for IE X-Treasurer • Deputy Treasurer
or electioneering comm.)
X Jay E. Petty
Signature
(Type name) Donald Andrew Willis
X- Candidate ■ Chairperson (only for PC and PTY).
X- Donald Andrew Willis
Signature
DS-DE 12 (Rev. 11/13)
SEE REVERSE FOR INSTRUCTIONS
CAMPAIGN TREASURER'S REPORT — ITEMIZED CONTRIBUTIONS
(1) Name Donald Andrew Willis (2) I.D. Number
(3) Cover Period 08/ 01 /21 through 08 / 27 / 21 (4) Page 1 of 1
(5)
Date
08/ 12 / 21
(6)
Sequence Number
1
(7)
Full Name
(Last, Suffix, First, Middle)
Street Address &
City, State, Zip Code
Willis, Donald, Andrew
8984 Puerto Del Rio
Dr.
# 301
Cape Canaveral, FL
(8)
Contributor
Type
S
(8)
Occupation
Retired
(9)
Contribution
Type
LOA
(10).
In -kind
Description
(11) ..
Amendment
(12)
Amount
$100.00
(5)
Date
08/ 20 /21
(6)
Sequence Number
2
(7)
Full Name
(Last, Suffix, First, Middle)
City, State, Zip Code
Willis, Donald, Andrew
8984 Puerto Del Rio
Dr.
#301
Cape Canaveral, FL
(8)
Contributor
Type
S
(8)
Occupation
Retired
(9)
Contribution
Type
LOA
(10)
In-Kind Description
(11)
Amendment
(12)
Amount
$900.00
(5)
Date
08/ 18/ 21
(6)
Sequence Number
(7)
Full Name
(Last, Suffix, First, Middle)
Street Address &
City, State, Zip Code
Lane, Garrett
8934 Puerto Del
Rio Dr.
Unit 401
Cape Canaveral, FL 32920
(8)
Contributor
Type
I
(8)
Occupation
Retired
(9)
Contribution
Type
CHE
(10)
In-Kind Description
(11)
Amendment
(12)
Amount
$500.00
/ /
/ /
/ /
/ /
DS-DE 13 (Rev. 11/13)
SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES
CAMPAIGN TREASURER'S REPORT — ITEMIZED EXPENDITURES
(1) Name Donald Andrew Willis (2) I.D. Number
(3) Cover Period 08/ 01/ 21 through 08/ 27/ 21
(5)
Date
08/ 12/ 21
(6)
Sequence
1
Number
(7)
Full Name
(Last, Suffix, First, Middle)
Street Address 8,
City, State, Zip Code
City of Cape Canaveral
City Clerk
100 Polk Avenue
Cape Canaveral, FL 32920
(8)
Purpose
(add office sought if
contribution to a
candidate)
Filing Fee
(9)
Expenditure
Type
CAS
(10)
Amendment
Amount
$39.00
/ /
/ /
/ /
/ /
/ /
DS=DE 14 (Rev. 11/13)
'SEE REVERSE FOR INSTRUCTIONS'ANDCODE VALUES
CAMPAIGN TREASURER'S REPORT SUMMARY
(1) Donald Andrew Willis
Name O
(2) 8984 Puerto Del Rio Drive, #301
Address (number and street)
Cape Canaveral, FL 32920
City, State, Zip Code
OFFICE USE ONLY
RECEIVED
SEP 16 2021
By: CCO DL
❑ Check here if address has changed (3) ID Number:
(4) Check appropriate box(es):
X- Candidate Office Sought: Cape Canaveral City Council
❑ Political Committee (PC)
❑ Electioneering Communications Org. (ECO) ❑ Check here if PC or ECO has disbanded
❑ Party Executive Committee (PTY) ❑ Check here if PTY has disbanded
❑ Independent Expenditure (IE) (also covers an ❑ Check here if no other IE or EC reports will be filed
individual making electioneering communications)
(5) Report Identifiers
Cover Period: From 08 / 28 / 21 To 09 / 10 / 21 Report Type: 2021 G2
✓ Original ❑ Amendment ❑ Special Election Report
(6) Contributions This Report
Cash & Checks $ __, 3,000.. 00
Loans $ __, __, __. __
Total Monetary $ __, 3, 00.00
In-Kind $ __, __, __. __
(7) Expenditures This Report
Monetary
Expenditures $ __, 1,587.39
Transfers to
Office Account $ __, __, __. __
Total Monetary $ __, 1587.39
(8) Other Distributions
$ __, __, __. __
(9) TOTAL Monetary Contributions To Date
$ __, 4 500.00
(10) TOTAL Monetary Expenditures To Date
$ __, 1,626.39
(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) Jay Petty
■ Individual (only for IE X- Treasurer 0 Deputy Treasurer
or electioneering comm.)
X- Jay Petty
Signature
(Type name) Don Willis
X- Candidate ■ Chairperson (only for PC and PTY)
X- Don Willis
Signature
DS-DE 12 (Rev. 11/13)
SEE REVERSE FOR INSTRUCTIONS
CAMPAIGN TREASURER'S REPORT - ITEMIZED CONTRIBUTIONS
(1) Name Donald Andrew Willis (2) I.D. Number
(3) Cover Period 08 /28 /21 through 09 /10 /21 (4) Page 1 of 2
(5)
Date
09/ 08/ 21
(6)
Sequence Number
1
(7)
Full Name
(Last, Suffix, First, Middle)
Street Address &
City, State, Zip Code
Willis, Lovella
220 Webster Road
Graham, NC 27253
(8)
Contributor
Type
I
(8)
Occupation
Retired
(9)
Contribution
Type
CHE
(10)
In -kind
Description
(11)
Amendment
(12)
Amount
$500.00
(5)
Date
08 / 30 / 21
(6)
Sequence Number
2
(7)
Full Name
(Last, Suffix, First, Middle)
Street Address &
City, State, Zip Code
Central Florida Police
Benevolent Association
810 Fentress Court,
Suite 150
Daytona Beach, FL
32117
(8)
Contributor
Type
B
(8)
Organization
(9)
Contribution
Type
CHE
(10)
In-Kind Description
(11)
Amendment
(12)
Amount
$250.00
(5)
Date
09 / 06 21
(6)
Sequence Number
3
(7)
Full Name
(Last, Suffix, First, Middle)
Street Address &
City, State, Zip Code
Kendle, Margaret
8964 Puerto Del Rio
Drive, #501
Cape Canaveral, FL
32920
(8)
Contributor
Type
I
(8)
Occupation
Retired
(9)
Contribution
Type
CHE
(10)
In-Kind Description
(11)
Amendment
(12)
Amount
$100.00
(5)
Date
09 / 07 / 21
(6)
Sequence Number
4
(7)
Full Name
(Last, Suffix, First, Middle)
Street Address &
City, State, Zip Code
Petty, Jay
8984 Puerto Del Rio
Drive, #401
Cape Canaveral, FL
32920
(8)
Contributor
Type
I
(8)
Occupation
Retired
(9)
Contribution
Type
CHE
(10)
Amendment
(11)
Amount
$1000.00
(5)
Date
09 / 08 / 21
(6)
Sequence Number
5
(7)
Full Name
(Last, Suffix, First, Middle)
Street Address &
City, State, Zip Code
Perkins, Ken
8914 Puerto Del Rio
Drive, #404
Cape Canaveral, FL
32920
(8)
Contributor
Type
I
(8)
Occuaption
Retired
(9)
Contribution
Type
CHE
(10)
In-Kind Description
(11)
Amendment
(12)
Amount
$200.00
(5)
Date
09 / 08 / 21
(6)
Sequence Number
6
(7)
Full Name
(Last, Suffix, First, Middle)
Street Address &
City, State, Zip Code
Finkelstein, Ira
8903 Laguna Ln
Unit 302
Cape Canaveral, FL
32920
(8)
Contributor
Type
I
(8)
Occupation
Retired
(9)
Contribution
Type
CHE
(10)
In-Kind Description
(11)
Amendment
(12)
Amount
$200.00
(5)
Date
09 / 08 / 21
(6)
Sequence Number
7
(7)
Full Name
(Last, Suffix, First, Middlle)
Street Address &
City, State, Zip Code
Marchionni, Rick
8633 Villanova Dr
Cape Canaveral, FL
32920
(8)
Contributor
Type
I
(8)
Occupation
Retired
(9)
Contribution
Type
CHE
(10)
In-Kind Description
(11)
Amendment
(12)
Amount
$200.00
DS-DE 13 (Rev. 11/13)
SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES
CAMPAIGN TREASURER'S REPORT — ITEMIZED CONTRIBUTIONS
(1) Name Donald Andrew Willis (2) I.D. Number
(3) Cover Period 08/ 28 / 21 through 9 / 10 / 21 (4) Page 2 of 2
(5)
Date
09/ 08/ 21
(6)
Sequence Number
8
(7)
Full Name
(Last, Suffix, First, Middle)
Street Address &
City, State, Zip Code
Blaha, Phillip
408 Harrison Ave
Unit 10
Cape Canaveral, FL
32920
(8)
Contributor
Type
I
(8)
Occupation
(9)
Contribution
Type
CAS
(10)
In -kind
Description
(11)
Amendment
(12)
Amount
$100.00
(5)
Date
09 / 09 / 21
(6)
Sequence Number
9
(7)
Full Name
(Last, Suffix, First, Middle)
Street Address &
City, State, Zip Code
Andrews, Jill
8964 Puerto Del Rio
Drive, #502
Cape Canaveral, FL
32920
(8)
Contributor
Type
I
(8)
Occupation
(9)
Contribution
Type
CHE
(10)
In-Kind Description
(11)
Amendment
(12)
Amount
$100.00
(5)
Date
09 / 09 / 21
(6)
Sequence Number
10
(7)
Full Name
(Last, Suffix, First, Middle)
Street Address &
City, State, Zip Code
Matta, Rosa
200 International
Drive #708
Cape Canaveral, FL
32920
(8)
Contributor
Type
I
(8)
Occupation
(9)
Contribution
Type
CAS
(10)
In-Kind Description
(11)
Amendment
(12)
Amount
$100.00
(5)
Date
09 / 09 / 21
(6)
Sequence Number
11
(7)
Full Name
(Last, Suffix, First, Middle)
Street Address &
City, State, Zip Code
McDowell, Melissa
4116 JacksonSt.
Cape Canaveral, FL
32920
(8)
Contributor
Type
I
(8)
Occupation
(9)
Contribution
Type
CAS
(10)
In-Kind Description
(11)
Amendment
(12)
Amount
$100.00
/ /
/ /
/ /
DS-DE 13 (Rev. 11/13)
SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES
CAMPAIGN TREASURER'S REPORT - ITEMIZED EXPENDITURES
(1) Name Donald Andrew Willis (2) I.D. Number
(3) Cover Period 08 / 28 / 21 through 09 / 10 / 21
(4) Page 1 of 1
(5)
Date
09/ 10/ 21
(6)
Sequence Number
1
(7)
Full Name
(Last, Suffix, First, Middle)
Street Address &
City, State, Zip Code
Willis, Donald Andrew
8984 Puerto Del Rio Dr.
#301
Cape Canaveral, FL 32920
(8)
Purpose
(add office sought if
contribution to a
candidate)
Campaign Signs
(9)
Expenditure
Type
RMB
(10)
Amendment
(11)
Amount
$1587.39
/ /
/ /
/ /
/ /
/ /
/ /
/ /
DS-DE 14 (Rev. 11/13)
SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES
WAIVER OF REPORT
(Section 106.07(7), F.S.)
(PLEASE TYPE)
RECEIVED
SEP 30 2021
By: KS 11:OO AM
OFFICE USE ONLY
Don Willis Cape Canaveral City Council
Name Office Sought
8984 Puerto Del Rio Dr. #301
Cape Canaveral FL 32920
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 ❑ OTHER REPORT TYPE
Indicate report # Indicate report # Indicate report # Indicate report type and # as applicable:
M P G 2021 G3
❑ TERMINATION REPORT ❑ SPECIAL ELECTION
NOTIFICATION OF NO ACTIVITY IN CAMPAIGN ACCOUNT FOR THE REPORTING PERIOD OF
09/11/21 THROUGH 09/24/21
X Jay Petty
Signature
October 1, 2021
Date
X Don Willis
Signature
October 1, 2021
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
received) the filing of the required report is waived. However, the filing officer must be notified in writing on the prescribed
reporting date that no report is being filed.
DS-DE 87 (Rev. 06/15)
CAMPAIGN TREASURER'S REPORT SUMMARY
(1) Donald Andrew Willis
Name
(2) 8984 Puerto Del Rio Drive, #301
Address (number and street)
Cape Canaveral, FL 32920
City, State, Zip Code
OFFICE USE ONLY
RECEIVED
OCT 08 2021
By: AY 8:30 AM
❑ Check here if address has changed (3) ID Number:
(4) Check appropriate box(es):
X- Candidate Office Sought: Cape Canaveral City Council
❑ Political Committee (PC)
❑ Electioneering Communications Org. (ECO) ❑ Check here if PC or ECO has disbanded
❑ Party Executive Committee (PTY) ❑ Check here if PTY has disbanded
❑ Independent Expenditure (IE) (also covers an ❑ Check here if no other IE or EC reports will be filed
individual making electioneering communications)
(5) Report Identifiers
Cover Period: From 09 / 25 / 21 To 10 / 01 / 21 Report Type: 2021 G4
X- Original ❑ Amendment ❑ Special Election Report
(6) Contributions This Report
Cash & Checks $ __, 2,120.00
Loans $ __, __, __. __
Total Monetary $ __, 2120.00
In-Kind $ __, __, __. __
(7) Expenditures This Report
Monetary
Expenditures $ __, __, 425.00
Transfers to
Office Account $ __, __, __. __
Total Monetary $ __, 425.00
(8) Other Distributions
$ __, __, __.__
(9) TOTAL Monetary Contributions To Date
$ __, 6, 620 . 00
(10) TOTAL Monetary Expenditures To Date
$ __, 2, 051 . 39
(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) Jay Petty
• Individual (only for IE X- Treasurer ■ Deputy Treasurer
or electioneering comm
X- Jay Petty
Signature
(Type name) Don Willis
X- Candidate ■ Chairperson (only for PC and PTY)
X- Don Willis
Signature
DS-DE 12 (Rev. 11/13)
SEE REVERSE FOR INSTRUCTIONS
CAMPAIGN TREASURER'S REPORT — ITEMIZED CONTRIBUTIONS
(1) Name Donald Andrew Willis (2) I.D. Number
(3) Cover Period 09/ 25 /21 through 10/ 01/ 21
(4) Page 1 of 1
(5)
Date
09/ 27/ 21
(6)
Sequence Number
1
(7)
Full Name
(Last, Suffix, First, Middle)
Street Address &
City, State, Zip Code
Wave Developments LLC
280 W. Central BLVD
Cape Canaveral, FL
32920
(8)
Contributor
Type
B
(8)
Occupation
Corporation
(9)
Contribution
Type
CHE
(10)
In -kind
Description
(11)
Amendment
(12)
Amount
$1000.00
(5)
Date
09 / 27 / 21
(6)
Sequence Number
2
(7)
Full Name
(Last, Suffix, First, Middle)
Street Address &
City, State, Zip Code
Danny P. Ringdahl
ENT., Inc.
750 N. Atlantic Ave
Apt. 1209
Cocoa Beach, FL 32931
(8)
Contributor
Type
B
(8)
Occupation
Corporation
(9)
Contribution
Type
CHE
(10)
In-Kind Description
(11)
Amendment
(12)
Amount
$100.00
(5)
Date
09 / 28 / 21
(6)
Sequence Number
3
(7)
Full Name
(Last, Suffix, First, Middle)
Street Address &
City, State, Zip Code
Parisi, Rick
1020 Pelican Ln
Rockledge, FL 32955
(8)
Contributor
Type
I
(8)
Occupation
Retired
(9)
Contribution
Type
CAS
(10)
In-Kind Description
(11)
Amendment
(12)
Amount
$20.00
(5)
Date
09 / 30 / 21
(6)
Sequence Number
4
(7)
Full Name
(Last, Suffix, First, Middle)
Street Address &
City, State, Zip Code
Realtors Political
Advocacy Committee
7025 Augusta National
Drive
Orlando, FL 32822
(8)
Contributor
Type
B
(8)
Occupation
Organization
(9)
Contribution
Type
CHE
(10)
In-Kind Description
(11)
Amendment
(12)
Amount
$1000.00
/ /
/ /
/ /
DS-DE 13 (Rev. 11/13)
SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES
CAMPAIGN TREASURER'S REPORT - ITEMIZED EXPENDITURES
(1) Name Donald Andrew Willis (2) I.D. Number
(3) Cover Period 09 / 25 / 21 through 10 / 01 / 21
(4) Page 1 of 1
(5)
Date
09/29/21
(6)
Sequence Number
1
(7)
Full Name
(Last, Suffix, First, Middle)
Street Address &
City, State, Zip Code
Explorer Multimedia
PO Box 320773
Cocoa Beach, FL 32932
(8)
Purpose
(add office sought if
contribution to a
candidate)
Campaign Ad
(9)
Expenditure
Type
DIS
(10)
Amendment
(11)
Amount
$425.00
/ /
/ /
/ /
/ /
/ /
/ /
/ /
DS-DE 14 (Rev. 11/13)
SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES
CAMPAIGN TREASURER'S REPORT SUMMARY
(1) Donald Andrew Willis
Name
(2) 8984 Puerto Del Rio Drive, #301
Address (number and street)
Cape Canaveral, FL 32920
City, State, Zip Code
RECEVIED
OCT 14 2021
By: CCO DL
OFFICE USE ONLY
❑ Check here if address has changed (3) ID Number:
(4) Check appropriate box(es):
X- Candidate Office Sought: Cape Canaveral City Council
❑ Political Committee (PC)
❑ Electioneering Communications Org. (ECO) ❑ Check here if PC or ECO has disbanded
❑ Party Executive Committee (PTY) ❑ Check here if PTY has disbanded
❑ Independent Expenditure (IE) (also covers an ❑ Check here if no other IE or EC reports will be filed
individual making electioneering communications)
(5) Report Identifiers
Cover Period: From 10 / 02 / 21 To 10 / 0 8 / 21 Report Type: 2021 G5
X- Original ❑ Amendment ❑ Special Election Report
(6) Contributions This Report
Cash & Checks $ __, __, 100.00
Loans $ __, __, __. __
Total Monetary $ __, __, 100.00
In-Kind $ __, __, __. __
(7) Expenditures This Report
Monetary
Expenditures $ __, __, 120 . 00
Transfers to
Office Account $ __, __, __. __
Total Monetary $ __, __, 120. 00
(8) Other Distributions
$ __, __, __. __
(9) TOTAL Monetary Contributions To Date
$ __ , 6, 720 .00
(10) TOTAL Monetary Expenditures To Date
$ __, 2, 171 .39
(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) Jay Petty
• Individual (only for IE X- Treasurer ■ Deputy Treasurer
or electioneering comm.)
X Jay Petty
Signature
(Type name) Don Willis
X- Candidate ■ Chairperson (only for PC and PTY)
X - Don Willis
Signature
DS-DE 12 (Rev. 11/13)
SEE REVERSE FOR INSTRUCTIONS
CAMPAIGN TREASURER'S REPORT — ITEMIZED CONTRIBUTIONS
(1) Name Donald Andrew Willis (2) I.D. Number
(3) Cover Period 10 / 02 / 21 through 10 / 08 / 21
(4) Page 1 of 1
(5)
Date
10/ 08/ 21
(6)
Sequence Number
1
(7)
Full Name
(Last, Suffix, First, Middle)
Street Address &
City, State, Zip Code
Beardall, Pauline
8904 Puerto Del Rio Dr
#301
Cape Canaveral, FL
32920
(8)
Contributor
Type
I
(8)
Occupation
Retired
(9)
Contribution
Type
CHE
(10)
In -kind
Description
(11)
Amendment
(12)
Amount
$100.00
/ /
/ /
/ /
/ /
/ /
/ /
DS-DE 13 (Rev. 11/13)
SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES
CAMPAIGN TREASURER'S REPORT - ITEMIZED EXPENDITURES
(1) Name Donald Andrew Willis (2) I.D. Number
(3) Cover Period 10 / 02 / 21 through 10 / 08 / 21 (4) Page 1 of 1
(5)
Date
10/ 06/ 21
(6)
Sequence Number
1
(7)
Full Name
(Last, Suffix, First, Middle)
Street Address &
City, State, Zip Code
Pioneer Printing and Graphics
6500 N. Atlantic Ave.
Cape Canaveral, FL 32920
(8)
Purpose
(add office sought if
contribution to a
candidate)
Campaign Signs
(9)
Expenditure
Type
DIS
(10)
Amendment
(11)
Amount
$120.00
/ /
/ /
/ /
/ /
/ /
/ /
/ /
DS-DE 14 (Rev. 11/13)
SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES
CAMPAIGN TREASURER'S REPORT SUMMARY
(1) Donald Andrew Willis
Name
(2) 8984 Puerto Del Rio Drive, #301
Address (number and street)
Cape Canaveral, FL 32920
City, State, Zip Code
RECEIVED
OCT 21 2021
By: KS 11:27 AM
OFFICE USE ONLY
❑ Check here if address has changed (3) ID Number:
(4) Check appropriate box(es):
X- Candidate Office Sought: Cape Canaveral City Council
❑ Political Committee (PC)
❑ Electioneering Communications Org. (ECO) ❑ Check here if PC or ECO has disbanded
❑ Party Executive Committee (PTY) ❑ Check here if PTY has disbanded
❑ Independent Expenditure (IE) (also covers an ❑ Check here if no other IE or EC reports will be filed
individual making electioneering communications)
(5) Report Identifiers
Cover Period: From 10 / 09 / 21 To 10 / 15 / 21 Report Type: 2021 G6
X- Original ❑ Amendment ❑ Special Election Report
(6) Contributions This Report
Cash & Checks $ __, __, __.00
Loans $ __, __, __. __
Total Monetary $ __, __, __. 00
In-Kind $ __, __, __. __
(7) Expenditures This Report
Monetary
Expenditures $ __, 2,908.79
Transfers to
Office Account $ __, __, __. __
Total Monetary $ __, 2, 908.79
(8) Other Distributions
$ __, __, __. __
(9) TOTAL Monetary Contributions To Date
$ __, 6,720.00
(10) TOTAL Monetary Expenditures To Date
$ __, 5, 080.18
(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) Jay Petty
■ Individual (only for IE X- Treasurer • Deputy Treasurer
or electioneering comm.)
X- Jay Petty
Signature
(Type name) Don Willis
X- Candidate ■ Chairperson (only for PC and PTY)
X Don Willis
Signature
DS-DE 12 (Rev. 11/13)
SEE REVERSE FOR INSTRUCTIONS
CAMPAIGN TREASURER'S REPORT — ITEMIZED CONTRIBUTIONS
(1) Name Donald Andrew Willis (2) I.D. Number
(3) Cover Period 10 /09 / 21 through 10 / 15 / 21
(4) Page 1 of 1
(5)
Date
(6)
Sequence Number
(7)
Full Name
(Last, Suffix, First, Middle)
Street Address &
City, State, Zip Code
Contributor
Type
(8)
Occupation
(9)
Contribution
Type
(10)
In -kind
Description
(11)
Amendment
(12)
Amount
/ /
/ /
/ /
/ /
/ /
/ /
/ /
DS-DE 13 (Rev. 11/13)
SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES
CAMPAIGN TREASURER'S REPORT - ITEMIZED EXPENDITURES
(1) Name Donald Andrew Willis (2) I.D. Number
(3) Cover Period 10 / 09 / 21 through 10 / 15 / 21
(4) Page 1 of 1
(5)
Date
10/12/21
(6)
Sequence Number
1
(7)
Full Name
(Last, Suffix, First, Middle)
Street Address &
City, State, Zip Code
Willis, Don
8984 Puerto Del Rio Dr
#301
Cape Canaveral, FL 32920
(8)
Purpose
(add office sought if
contribution to a
candidate)
Campaign Signs
(9)
Expenditure
Type
RMB
(10)
Amendment
(11)
Amount
$340.59
(5)
Date
10 / 12/ 21
(6)
Sequence
2
(7)
Full Name
(Last, Suffix, First, Middle)
Street Address &
City, State, Zip Code
Willis, Don
8984 Puerto Del Rio Dr.
#301
Cape Canaveral, FL 32920
(8)
Purpose
(add office sought if
contribution to a
candidate)
Social Media
Strategy
(9)
Expenditure
Type
RMB
(10)
Amendment
(11)
Amount
$200.00
(5)
Date
10 / 13/ 21
(6)
Sequence Number
3
(7)
Full Name
(Last, Suffix, First, Middle)
Street Address &
City, State, Zip Code
Pioneer Printing and Graphics
6500 N. Atlantic Ave.
Cape Canaveral, FL 32920
(8)
Purpose
(add office sought if
contribution to a
candidate)
Campaign Postcards
(9)
Expenditure
Type
DIS
(10)
Amendment
(11)
Amount
$882.00
(5)
Date
10/ 14 /21
(6)
Sequence Number
4
(7)
Full Name
(Last, Suffix, First, Middle)
Street Address &
City, State, Zip Code
Willis, Don
8984 Puerto Del Rio Dr.
#301
Cape Canaveral, FL 32920
(8)
Purpose
(add office sought if
contribution to a
candidate)
USPS Mailing
(9)
Expenditure
Type
RMB
(10)
Amendment
(11)
Amount
$1396.20
(5)
Date
10/ 14 /21
(6)
Sequence Number
5
(7)
Full Name
(Last, Suffix, First, Middle)
Street Address &
City, State, Zip Code
Pioneer Printing and Graphics
6500 N.,Atlantic Ave.
Cape Canaveral, FL 32920
(8)
Purpose
(add office sought if
contribution to a
candidate)
Campaign Signage
(9)
Expenditure
Type
DIS
(10)
Amendment
(11)
Amount
$90.00
/ /
/ /
/ /
DS-DE 14 (Rev. 11/13)
SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES
CAMPAIGN TREASURER'S REPORT SUMMARY
(1) Donald Andrew Willis
Name
(2) 8984 Puerto Del Rio Drive, #301
Address (number and street)
Cape Canaveral, FL 32920
City, State, Zip Code
RECEIVED
OCT 28 2021
By: KS 2:09 PM
OFFICE USE ONLY
❑ Check here if address has changed (3) ID Number:
(4) Check appropriate box(es):
X- Candidate Office Sought: Cape Canaveral City Council
❑ Political Committee (PC)
❑ Electioneering Communications Org. (ECO) ❑ Check here if PC or ECO has disbanded
❑ Party Executive Committee (PTY) ❑ Check here if PTY has disbanded
❑ Independent Expenditure (IE) (also covers an ❑ Check here if no other IE or EC reports will be filed
individual making electioneering communications)
(5) Report Identifiers
Cover Period: From 10 / 16 / 21 To 10 / 28 / 21 Report Type: 2021 G7
X- Original ❑ Amendment • Special Election Report
(6) Contributions This Report
Cash & Checks $ __, __, 450.00
Loans $ __, __, __. __
Total Monetary $ __, __, 450.00
In-Kind $ __, __, __. __
(7) Expenditures This Report
Monetary
Expenditures $ __,1,567.08
Transfers to
Office Account $ __, __, __. __
Total Monetary $ __, 1 567.08
(8) Other Distributions
$ __, __, __. __
(9) TOTAL Monetary Contributions To Date
$ __, 7, 170 .00
(10) TOTAL Monetary Expenditures To Date
$ __ , 6, 647. 26
(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) Jay Petty
• Individual (only for IE X-Treasurer ■ Deputy Treasurer
or electioneering comm.)
X Jay Petty
Signature
(Type name) Don Willis
X- Candidate • Chairperson (only for PC and PTY)
X Don Willis
Signature
DS-DE 12 (Rev. 11/13)
SEE REVERSE FOR INSTRUCTIONS
CAMPAIGN TREASURER'S REPORT — ITEMIZED CONTRIBUTIONS
(1) Name Donald Andrew Willis (2) I.D. Number
(3) Cover Period 10 / 16 / 21 through 10 / 28 / 21
(4) Page 1 of 1
(5)
Date
10/ 16 / 21
(6)
Sequence Number
1
(7)
Full Name
(Last, Suffix, First, Middle)
Street Address &
City, State, Zip Code
Nadeau, Linda
8904 Puerto Del Rio Dr
Unit 201
Cape Canaveral, FL
32920
(8)
Contributor
Type
I
(8)
Occupation
Retired
(9)
Contribution
Type
CHE
(10)
In -kind
Description
(11)
Amendment
(12)
Amount
$200.00
(5)
Date
10 / 16 / 21
(6)
Sequence Number
2
(7)
Full Name
(Last, Suffix, First, Middle)
Street Address &
City, State, Zip Code
Matta, Rosa
200 International Dr.
#708
Cape Canaveral FL
32920
(8)
Contributor
Type
I
(8)
Occupation
Realtor
(9)
Contribution
Type
CHE
(10)
In-Kind Description
(11)
Amendment
(12)
Amount
$100.00
(5)
Date
10 / 16 / 21
(6)
Sequence Number
3
(7)
Full Name
(Last, Suffix, First, Middle)
Street Address &
City, State, Zip Code
Lane, Garrett
8934 Puerto Del Rio Dr
#401
Cape Canaveral, FL
32920
(8)
Contributor
Type
I
(8)
Occupation
Retired
(9)
Contribution
Type
CHE
(10)
In-Kind Description
(11)
Amendment
(12)
Amount
$100.00
(5)
Date
10 / 27 / 21
(6)
Sequence Number
4
(7)
Full Name
(Last, Suffix, First, Middle)
Street Address &
City, State, Zip Code
Nancy Mackey
8954 Puerto Del Rio Dr
#502
Cape Canaveral, FL
32920
(8)
Contributor
Type
I
(8)
Occupation
Psycologist
(9)
Contribution
Type
CHE
(10)
Amendment
(11)
Amount
$50.00
/ /
/ /
/ /
DS-DE 13 (Rev. 11/13)
SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES
CAMPAIGN TREASURER'S REPORT - ITEMIZED EXPENDITURES
(1) Name Donald Andrew Willis (2) I.D. Number
(3) Cover Period 10 / 16 / 21 through 10 / 28 / 21
(4) Page 1 of 1
(5)
Date
10/ 20/ 21
(6)
Sequence Number
1
(7)
Full Name
(Last, Suffix, First, Middle)
Street Address &
City, State, Zip Code
Zarella's Italian and Wood Fired
Pizza
8801 Astronaut Blvd #103,
Cape Canaveal, FL 32920
(8)
Purpose
(add office sought if
contribution to a
candidate)
Candidate Meet and
Greet Event
(9)
Expenditure
Type
DIS
(10)
Amendment
(11)
Amount
$154.08
(5)
Date
10 / 20/ 21
(6)
Sequence Number
2
(7)
Full Name
(Last, Suffix, First, Middle)
Street Address &
City, State, Zip Code
Pioneer Printing and Graphics
6500 N. Atlantic Ave.
Cape Canaveral, FL 32920
(8)
Purpose
(add office sought if
contribution to a
candidate)
Campaign Signs
(9)
Expenditure
Type
DIS
(10)
Amendment
(11)
Amount
$560.00
(5)
Date
10/ 22/ 21
(6)
Sequence Number
3
(7)
Full Name
(Last, Suffix, First, Middle)
Street Address &
City, State, Zip Code
Willis, Don
8984 Puerto Del Rio Dr.
#301
Cape Canaveral, FL 32920
(8)
Purpose
(add office sought if
contribution to a
candidate)
Postage
(9)
Expenditure
Type
RMB
(10)
Amendment
(11)
Amount
$464.00
(5)
Date
10/ 2 2/ 21
(6)
Sequence Number
4
(7)
Full Name
(Last, Suffix, First, Middle)
Street Address &
City, State, Zip Code
Willis, Don
8984 Puerto Del Rio Dr.
#301
Cape Canaveral, FL 32920
(8)
Purpose
(add office sought if
contribution to a
candidate)
Campaign Literature
(9)
Expenditure
Type
RMB
(10)
Amendment
(11)
Amount
$389.00
/ /
/ /
/ /
/ /
DS-DE 14 (Rev. 11/13)
SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES
CAMPAIGN TREASURER'S REPORT SUMMARY
(1) Donald Andrew Willis
Name
(2) 8984 Puerto Del Rio Drive, #301
Address (number and street)
Cape Canaveral, FL 32920
City, State, Zip Code
RECEIVED
DEC 14 2021
By: CCO DL
OFFICE USE ONLY
❑ Check here if address has changed (3) ID Number:
(4) Check appropriate box(es):
X- Candidate Office Sought: Cape Canaveral City Council
❑ Political Committee (PC)
❑ Electioneering Communications Org. (ECO) ❑ Check here if PC or ECO has disbanded
❑ Party Executive Committee (PTY) ❑ Check here if PTY has disbanded
❑ Independent Expenditure (IE) (also covers an ❑ Check here if no other IE or EC reports will be filed
individual making electioneering communications)
(5) Report Identifiers
Cover Period: From 08 / 28 / 21 To 09 / 10 / 21 Report Type: 2021 G2
❑ Original X- Amendment ❑ Special Election Report
(6) Contributions This Report
Cash & Checks $ __, __, __. __
Loans $ __, __, __. __
Total Monetary $ __, __, __. __
In-Kind $ __, __, __. __
(7) Expenditures This Report
Monetary
Expenditures $ __, __, 16.59
Transfers to
Office Account $ __, __, __. __
Total Monetary $ __, __,16.59
(8) Other Distributions
$ __, __, __. __
(9) TOTAL Monetary Contributions To Date
$ __, __, __. __
(10) TOTAL Monetary Expenditures To Date
$ __, 1,642.98
(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) Jay Petty
• Individual (only for IE X- Treasurer • Deputy Treasurer
or electioneering comm.)
X Jay Petty
Signature
(Type name) Don Willis
X- Candidate 0 Chairperson (only for PC and PTY)
X Don Willis
Signature
DS-DE 12 (Rev. 11/13)
SEE REVERSE FOR INSTRUCTIONS
CAMPAIGN TREASURER'S REPORT - ITEMIZED EXPENDITURES
(1) Name Donald Andrew Willis (2) I.D. Number
(3) Cover Period 08 / 28 / 21 through 09 / 10 / 21
(4) Page 1 of 1
(5)
Date
09/ 01/ 21
(6)
Sequence Number
2
(7)
Full Name
(Last, Suffix, First, Middle)
Street Address &
City, State, Zip Code
Main Street Checks
C/O Sunrise Bank
5404 N. Atlantic Ave.
Cocoa Beach, FL 32931
(8)
Purpose
(add office sought if
contribution to a
candidate)
Campaign
branded checks
(9)
Expenditure
Type
DIS
(10)
Amendment
ADD
(11)
Amount
$16.59
/ /
/ /
/ /
/ /
/ /
/ /
/ /
DS-DE 14 (Rev. 11/13)
SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES
CAMPAIGN TREASURER'S REPORT SUMMARY
(1) Donald Andrew Willis
Name
(2) 8984 Puerto DeI Rio Drive, #301
Address (number and street)
Cape Canaveral, FL 32920
City, State, Zip Code
RECEIVED
DEC 14 2021
CCO DL
OFFICE USE ONLY
Check here if address has changed (3) ID Number:
(4) Check appropriate box(es):
X- Candidate Office Sought: Cape Canaveral City Council .
❑ Political Committee (PC)
❑ Electioneering Communications Org. (ECO) ❑ Check here if PC or ECO has disbanded
❑ Party Executive Committee (PTY) ❑ Check here if PTY has disbanded
❑ Independent Expenditure (IE) (also covers an ❑ Check here if no other IE or EC reports will be filed
individual making electioneering communications)
(5) Report Identifiers
Cover Period: From 10 / 29 / 21 To 12 / 13 / 21 Report Type: 2021 TR
X- Original ❑ Amendment ❑ Special Election Report
(6) Contributions This Report
Cash & Checks $ __, __, __. __
Loans $ __, __, __. __
Total Monetary $ __, __, __. __
In-Kind $ __, __, __. __
(7) Expenditures This Report
Monetary
Expenditures $ __, __, 506.15
Transfers to
Office Account $ __, __, __. __
Total Monetary $ __, __, 506.15
(8) Other Distributions
$ __, __, __. __
(9) TOTAL Monetary Contributions To Date
$ __, 7,170 .00
( (10) TOTAL Monetary Expenditures To Date
$ __, 7,170 .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 1 have examined this report and it is true, correct, and complete:
(Type name) Jay Petty
• Individual (only for IE X-Treasurer • Deputy Treasurer
or electioneering comm.)
X Jay Petty
Signature
(Type name) Don Willis
X- Candidate • Chairperson (only for PC and PTY)
X Don Willis
Signature
DS-DE 12 (Rev. 11/13)
SEE REVERSE FOR INSTRUCTIONS
CAMPAIGN TREASURER'S REPORT - ITEMIZED EXPENDITURES
(1) Name Donald Andrew Willis (2) I.D. Number
(3) Cover Period 10 / 29 / 21 through 12 / 13 / 21
(4) Page 1 of 1
(5)
Date
11/ 01/ 21
(6)
Sequence Number
1
(7)
Full Name
(Last, Suffix, First, Middle)
Street Address &
City, State, Zip Code
Zarella's Italian and Wood Fired Pizza
8801 Astronaut Blvd #103
Cape Canaveral, FL 32920
(8)
Purpose
(add office sought if
contribution to a
candidate)
Campaign Worker Driver
(9)
Expenditure
Type
DIS
(10)
Amendment
(11)
Amount
$453.74
(5)
Date
12 / 13/ 21
(6)
Sequence Number
2
(7)
Full Name
(Last, Suffix, First, Middle)
Street Address &
City, State, Zip Code
VFW Post 10131 Auxiliary Christmas Fund
105 Long Point Rd,
Cape Canaveral, FL 32920
(8)
Purpose
(add office sought if
contribution to a
candidate)
Close out
Contribution
(9)
Expenditure
Type
DIS
(10)
Amendment
(11)
Amount
$52.41
/ /
/ /
/ /
/ /
/ /
/ /
DS-DE 14 (Rev. 11/13)
SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES