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HomeMy WebLinkAboutkljackson_treasurers_reports_202309CAMPAIGN TREASURER'S REPORT SUMMARY (1) Kay Jackson Name (2) PO Box 1029 SEP 0 8 2023 Address (number and street) Cape Canaveral, FL 32920 City, State, Zip Code OFFICE USE ONLY RECEIVED SEP 08 2023 By: CCO DL ❑ Check here if address has changed (3) ID Number: (4) Check appropriate box(es): ✓ Candidate Office Sought: City Council Member ❑ 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 / 01 / 2023 To 09 / 01 / 2023 Report Type: 2023 G1 ✓ Original ❑ Amendment ❑ Special Election Report (6) Contributions This Report Cash & Checks $ , , 100 . 00 Loans $ , ,. Total Monetary $ , , . In-Kind $ , , . (7) Expenditures This Report Monetary Expenditures $ , , 0 . 00 Transfers to Office Account $ , , . Total Monetary $ , • (8) Other Distributions $ 0 . 00 (9) TOTAL Monetary Contributions To Date $ , , 100 . 00 (10) TOTAL Monetary Expenditures To Date $ , , 0. 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) Kay Jackson ■ Individual (only for IE 0 Treasurer ■ Deputy Treasurer or electioneering comm.) X Kay Jackson Signature (Type name) Kay Lyn Jackson O Candidate • Chairperson (only for PC and PTY) X Kay Jackson Signature DS-DE 12 (Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS CAMPAIGN TREASURER'S REPORT - ITEMIZED CONTRIBUTIONS Kay Lyn Jackson (1) Name (2) I.D. Number (3) Cover Period 08/01/2023 through 09/01/2023 (4) Page 1 of 1 (5) Date 08 / 17 / 2023 (6) Sequence Number 01 (7) Full Name (Last, Suffix, First, Middle) Street Address & City, State, Zip Code Kay Jackson PO 1029 Cape Canaveral, FL 32920 (8) Contributor Type a (8) Occupation Self (9) Contribution Type CHE (10) In -kind Description N (11) Amendment (12) Amount $100.00 / / / / / / / / / / / / DS-DE 13 (Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES CAMPAIGN TREASURER'S REPORT SUMMARY (1) Kay Jackson Name (2) PO Box 1029 Address (number and street) Cape Canaveral, FL 32920 City, State, Zip Code OFFICE USE ONLY RECEIVED SEP 21 2023 MG CCO ❑ Check here if address has changed (3) ID umber: (4) Check appropriate box(es): ✓ Candidate Office Sought: 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 9 / 2 / 2023 To 9 / 15 / 2023 Report Type: G2 X Original ❑ Amendment ❑ Special Election Report (6) Contributions This Report Cash & Checks $ , , 0.00 Loans $ , , . Total Monetary $ , , . In-Kind $ , , . (7) Expenditures This Report Monetary Expenditures $ , 0 . 00 Transfers to Office Account $ . Total Monetary $ • (8) Other Distributions $ , • (9) TOTAL Monetary Contributions To Date $ , 0 .00 (10) TOTAL Monetary Expenditures To Date $ , , 0 . 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) Kay Jackson • Individual (only for IE X Treasurer ■ Deputy Treasurer or electioneering comm.) X Kay Jackson Signature (Type name) Kay Jackson X Candidate O Chairperson (only for PC and PTY) X Kay Jackson Signature DS-DE 12 (Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS CAMPAIGN TREASURER'S REPORT SUMMARY Kay Jackson (1) Name (2) PO Box 1029 Address (number and street) Cape Canaveral, FL 32920 City, State, Zip Code OFFICE USE ONLY RECEIVED OCT 06 2023 12:17 By: Anna Young ❑ Check here if address has changed (3) ID Number: (4) Check appropriate box(es): ✓ Candidate Office Sought: 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 9 / 16 / 2023 To 9 / 29 /2023 Report Type: G3 ❑ Original ❑ Amendment ❑ Special Election Report (6) Contributions This Report Cash & Checks $ , , 100 .00 Loans $ , , . Total Monetary $ , , . In-Kind $ , , . (7) Expenditures This Report Monetary Expenditures $ , , 35 . 16 Transfers to Office Account $ Total Monetary $ • (8) Other Distributions $ , , , . (9) TOTAL Monetary Contributions To Date $ , , 100 .00 (10) TOTAL Monetary Expenditures To Date $ , , 35 . 16 (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) Kay Jackson ■ Individual (only for IE 0 Treasurer ■ Deputy Treasurer or electioneering comm.) X Kay Jackson Signature (Type name) Kay Jackson X Candidate ■ Chairperson (only for PC and PTY) X Kay Jackson Signature DS-DE 12 (Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS CAMPAIGN TREASURER'S REPORT - ITEMIZED EXPENDITURES (1) Name Kay Jackson (2) I.D. Number G3 (3) Cover Period 09 / 16 / 2023 through 09 29 2023 (4) Page 1 of 1 (5) Date 09 / 27 / 2023 (6) Sequence Number (7) Full Name (Last, Suffix, First, Middle) Street Address & City, State, Zip Code GoDaddy (8) Purpose (add office sought if contribution to a candidate) Website & Domain for Campaign (9) Expenditure Type ECC (10) Amendment ADD (11) Amount $35.16 / / / / / / / / / / / / / / DS-DE 14 (Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES CAMPAIGN TREASURER'S REPORT — ITEMIZED CONTRIBUTIONS (1) Name Kay Jackson (2) I.D. Number G3 (3) Cover Period 09 /16 /2023 through 09/29 /2023 (4) Page 1 of 1 (5) Date 9 / 18 / 2023 (6) Sequence Number (7) Full Name (Last, Suffix, First, Middle) Street Address & City, State, Zip Code Joan Schmeck PO Box 627 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 Mia Goforth From: kay4council@att.net Sent: Friday, October 13, 2023 7:09 PM To: Mia Goforth Subject: RE: Campaign Treasurer's Report "2023 G5" due NEXT FRIDAY, October 20, 2023. (Report 2023 G4 is due TODAY) Attachments: TransactionRecordShipmentG4Report.pdf Warning-This email originated outside the City of Cape Canaveral mail system. Please review the sender's address. Report any suspicious mail by using the Phishalert button in Outlook. If that is not possible forward the suspicious mail to phishalert@cityofcapecanaveral.org Hi Mia, I have Fedexed it today. Attached is my transaction receipt. It is on the way. Kay From: Mia Goforth <M.Goforth@cityofcapecanaveral.org> Sent: Friday, October 13, 2023 4:08 PM To: Kay Jackson <kay4council@att.net> Cc: Daniel LeFever<D.LeFever@cityofcapecanaveral.org> Subject: FW: Campaign Treasurer's Report"2023 G5" due NEXT FRIDAY, October 20, 2023. (Report 2023 G4 is due TODAY) Hi Kay, This is a follow-up email to a voicemail that I just left you at 4:02 pm to turn in a Campaign Treasurer Report or a Waiver of Report DSDE 87 form before 5pm today. Thank you! Mia Mia Goforth, CMC City Clerk + Records Custodian + ADA Coordinator City of Cape Canaveral (321) 868-1220 x207 100 Polk Avenue— P.O. Box 326 Cape Canaveral, Florida 32920 CELEBRATING 60 YEARS 1963 2023 From: Daniel LeFever<D.LeFever@cityofcapecanaveral.org> Sent: Friday, October 13, 2023 8:46 AM Cc: Mia Goforth <M.Goforth@cityofcapecanaveral.org> Subject: Campaign Treasurer's Report"2023 G5" due NEXT FRIDAY, October 20, 2023. (Report 2023 G4 is due TODAY) NOTE: If you have not already done so, please submit/mail report 2023 G4 by close of business today. Good morning candidates, Please be advised that Campaign Treasurer's Report, Code 2023 G5, is due at the City Clerk's Office, NEXT FRIDAY, October 20, 2023, by close of business. This report covers activity 10/07/2023-10/13/2023. Attached are report forms, if needed. AS A REMINDER: You can submit an Amended report if, for any reason, you feel you need to correct and/or revise an already-submitted report, due to incorrect or missing: - reporting dates - report codes/numbers - contribution/transfer/expenditure/disbursement forms - et cetera As always, a report mailed via USPS to City Hall, postmarked on or before its due date, will be acceptable. Thank you and have a wonderful weekend. Daniel LeFever Deputy City Clerk City of Cape Canaveral (321) 868-1220 x206 100 Polk Avenue— P.O. Box 326 Cape Canaveral, Florida 32920 CELEBRATING 60YEARS 1963 2023 Florida has a very broad public records law. As a result, any written communication created or received by the City of Cape Canaveral officials and employees will be made available to the public and/or media upon request, unless otherwise exempt. Under Florida Law, email addresses are public records. If you do not want your email address released in response to a public-records request, do not send electronic email to this entity. Instead, contact our office by phone or in writing. Florida has a very broad public records law. As a result, any written communication created or received by the City of Cape Canaveral officials and employees will be made available to the public and/or media upon request, unless otherwise exempt. Under Florida Law, email addresses are public records. If you do not want your email address released in response to a public-records request, do not send electronic email to this entity. Instead, contact our office by phone or in writing. Florida has a very broad public records law. As a result, any written communication created or received by the City of Cape Canaveral officials and employees will be made available to the public and/or media upon request, unless otherwise exempt. Under Florida Law, email addresses are public records. If you do not want your email address 2 released in response to a public-records request, do not send electronic email to this entity. Instead, contact our office by phone or in writing. 3 Transaction Record Fedex. TRACKING NO.: SHIP DATE: ESTIMATED SHIPPING CHARGES: 773742219287 Oct 13, 2023 19.23 USD From address To address Kay Jackson Mia Goforth PO Box 1029 City of Cape Canaveral 32920 FL Cape Canaveral 100 Polk Avenue US 32920 FL Cape Canaveral Phone: 3212977559 US kay4council@att.net Phone: 321-868-1220 M.Goforth@cityofcapecanaveral.org Package information Pieces Weight Dimensions (LxWxH) Declared value Package options 1 x 0.02 lb n/a Package type: Service: Pickup/drop off type: FedEx Envelope FedEx Express Saver Drop off package at a FedEx location Billing information Bill transportation cost to: ******562 P.O. No.: Bill duties, taxes and fees to: Invoice No.: Your reference: Department No.: Please note:This transaction record is neither a statement nor an invoice,and does not confirm shipment tendered to FedEx or payment.FedEx will not be responsible for any claim in excess of $100 per package,whether the result of loss,damage,delay,non-delivery,misdelivery,or misinformation,unless you declare a higher value, pay an additional charge,document your actual loss and file a timely claim.Limitations found in the current FedEx Service Guide apply.Your right to recover from FedEx for any loss,including intrinsic value of the package,loss of sales,income interest,profit,attorney's fees,costs,and other forms of damage whether direct,incidental, consequential,or special is limited to the greater of $100 or the authorized declared value.Recovery cannot exceed actual documented loss.Maximum for items of extraordinary value is $1000,e.g., jewelry, precious metals,negotiable instruments and other items listed in our Service Guide.Written claims must be filed within strict time limits; Consult the applicable FedEx Service Guide for details.The estimated shipping charge may be different than the actual charges for your shipment.Differences may occur based on actual weight,dimensions,and other factors.Consult the applicable FedEx Service Guide or the FedEx Rate Sheets for details on how shipping charges are calculated. 1 ORIGIN ID:COIA (321)297-7559 SHIP DATE:130CT23 KAY JACKSON ACTWGT:0.02 LB PO BOX 1029 CAD:259094231/INET4535 11 a AK • CAPE CANAVERAL,FL 32920 BILL SENDER • UNITED STATES US 4 L • ® 1 r TO MIA GOFORTH — , •aay}a60 ; 0c d e .7•a- CITY OF CAPE CANAVERAL ,r 100 POLK AVENUE q; e3 anew diay uea r 6/1 Ili II am M04 wealO Ue]S CAPE CANAVERAL FL 32920 i mj (321)868-1220 REF: ca ,..1. I ■ INV: 004 +A PQ; DEFT: III IIIIIIIIIINTIIIIN III 1111 g. - o 1 . 11E3 Express?fit Ripir g ... ..r go' V 4'' E I , .._ in 4p,„ ii. I IZ E al EV 00 WED - 18 OCT 5 : 00P I o of 17737 4221 9287 EXPRESS SAVER 32920 rrt 4ZCOCOG C7 ,-vs MCO iiim r C.1) C, C GO C-) cn W —I EIv ci c N 1 c I i 1 I PZ/60 AM=_5EP-L0I.rad •sd l 5ui ped io,6ui6e aecipau '7'Xapa 01 op Ldlaq PaaN'A1 inoA 6upped fiq uopeupsap sS! IN/Clam ase .ped inoA lab sn 's uaucdlgsessaaldx3 x3paJ Joi Apo st IMO - uu1oe ped Sita OF Strouu!uv.:.,,Ic.nun.a,n>r fsUt94 F-111 It..1-‘41.1..w ., - ..1 ' - e. - - CAMPAIGN TREASURER'S REPORT SUMMARY (1) Kay Jackson Name (2) PO Box 1029 Address (number and street) Cape Canaveral, FL 32920 City, State, Zip Code OFFICE USE ONLY RECEIVED OCT 17 2023 REC'D BY FEDEX 10/14/23 By: CCO DL ❑ Check here if address has changed (3) ID Number: (4) Check appropriate box(es): 1 Candidate Office Sought: 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 9 / 30 / 2023 To 10 / 06 / 2023 Report Type: G4 ❑ Original ❑ Amendment ❑ Special Election Report (6) Contributions This Report Cash & Checks $ , , 200.00 Loans $ , , . Total Monetary $ , , . In-Kind $ , , . (7) Expenditures This Report Monetary Expenditures $ , , 0.00 Transfers to Office Account $ , , • Total Monetary $ , , 0.00 (8) Other Distributions $ , , . (9) TOTAL Monetary Contributions To Date $ , , 200.00 (10) TOTAL Monetary Expenditures To Date $ , , 0 . 00 (11) Certification It is a first degree misdemeanor for any person to falsify a public record (ss. 839.13, F.S.) certify that I have examined this report and it is true, correct, and complete: (Type name) Kay Jackson • Individual (only for IE GI Treasurer • Deputy Treasurer or electioneering comm.) X Kay Jackson Signature (Type name) Kay Jackson 0 Candidate ■ Chairperson (only for PC and PTY) X Kay Jackson Signature DS-DE 12 (Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS CAMPAIGN TREASURER'S REPORT — ITEMIZED CONTRIBUTIONS Kay Jackson (1) Name (2) I.D. Number (3) Cover Period 9/30 / 2023 through 10/ 06 /2023 (4) Page 1 of 1 (5) Date 10 / 3 / 2023 (6) Sequence Number (7) Full Name (Last, Suffix, First, Middle) Street Address & City, State, Zip Code Sarah K. and William D Hodge 390 Sanders Ln Merritt Island, FL 32953 (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 SUN SPACE AND SEA CITY OF CAPE CANAVERAL P.O. Box 326 • 100 Polk Avenue • Cape Canaveral, FL 32920-0326 (321) 868-1220 if www.cityofcapecanaveral.org October 18, 2023 Kay Lyn Jackson P.O. Box 1029 18600 Ridgewood Avenue Cape Canaveral, FL 32920 VIA CERTIFIED MAIL (7022 3330 0000 1287 2817), STANDARD MAIL and EMAIL Re: 2023 Campaign Treasurer's Report 2023 G4, Due October 13, 2023 Dear Ms. Jackson, On Tuesday, October 17, 2023, the City Clerk's Office received, via Federal Express, your Campaign Treasurer's Report, 2023 G4, covering activity from September 30, 2023 to October 6, 2023. The due date for this report was close of business on Friday, October 13, 2023. The receipt and tracking information related to your Federal Express shipment (Attached) indicate the shipping label was created at 6:05 p.m. on Friday, October 13, 2023, and physically received by Federal Express at 10:14 a.m. on Saturday, October 14, 2023. Per this information, the report is deemed to have been submitted one day late. Per Section 106.07(8)(b), Florida Statutes, a fine of $50.00 per day for the first 3 days late and, thereafter, $500.00 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, must be paid to the filing officer (me) within 20 days after receipt of the Notice of Payment Due. In accordance with Florida Statute, you are hereby assessed a fine of $50.00 This fine must be paid using your personal funds within 20 days of the receipt of this notice. You will need to submit a personal check made payable to the City of Cape Canaveral by mail or via hand -delivery to the City Clerk's Office at 100 Polk Avenue. If you have any questions regarding this letter or the fine, please do not hesitate to contact my office at 321-868-1220 x207/x206 or via e-mail at m.goforth@cityofcapecanaveral.orq. Mia Goforth, CMC City Clerk Cc: Todd Morley, City Manager John DeLeo, Administrative/Financial Services Director Anthony Garganese, City Attorney Transaction Record TRACKING NO.: 773742219287 SHIP DATE: Oct 13, 2023 ESTIMATED SHIPPING CHARGES: 19.23 USD From address Kay Jackson PO Box 1029 32920 FL Cape Canaveral US Phone: 3212977559 kay4council@att.net To address Mia Goforth City of Cape Canaveral 100 Polk Avenue 32920 FL Cape Canaveral US Phone: 321-868-1220 M.Goforth@cityofcapecanaveral.org Package information Pieces Weight Dimensions (LxWxH) Declared value Package options 1 x 0.02 lb Package type: Fed Ex Envelope Service: n/a Pickup / drop off type: Fed Ex Express Saver Drop off package at a Fed Ex location Billing information Bill transportation cost to: Bill duties, taxes and fees to: Your reference: ******562 P.O. No.: Invoice No.: Department No.: Please note: This transaction record is neither a statement nor an invoice, and does not confirm shipment tendered to FedEx or payment. FedEx will not be responsible for any claim in excess of $100 per package, whether the result of loss, damage, delay, non -delivery, misdelivery, or misinformation, unless you declare a higher value, pay an additional charge, document your actual loss and file a timely claim. Limitations found in the current FedEx Service Guide apply. Your right to recover from FedEx for any loss, including intrinsic value of the package, loss of sales, income interest, profit, attorneys fees, costs, and other forms of damage whether direct, incidental, consequential, or special is limited to the greater of $100 or the authorized declared value. Recovery cannot exceed actual documented loss. Maximum for items of extraordinary value is $1000, e.g., jewelry, precious metals, negotiable instruments and other items listed in our Service Guide. Written claims must be filed within strict time limits; Consult the applicable FedEx Service Guide for details. The estimated shipping charge may be different than the actual charges for your shipment. Differences may occur based on actual weight, dimensions, and other factors. Consult the applicable FedEx Service Guide or the FedEx Rate Sheets for details on how shipping charges are calculated. FedEx° Tracking DELIVERED Tuesday 10/17/23 at 3:44 PM Signed for by: AYOUNG I Obtain proof of delivery How was your delivery? DELIVERY STATUS Delivered Q TRACKING ID 773742219287 , * FROM Cape Canaveral, FL US Label Created 10/13/23 6:05 PM WE HAVE YOUR PACKAGE COCOA, FL 10/14/23 12:24 PM ON THE WAY COCOA, FL 10/17/23 8:12 AM OUT FOR DELIVERY COCOA, FL 10/17/23 8:57 AM DELIVERED Cape Canaveral, FL US Delivered 10/17/23 at 3:44 PM .1. View travel history Want updates on this shipment? Enter your email and we will do the rest! YOUR EMAIL MORE OPTIONS Manage Delivery Shipment facts 773742219287 DELIVERED TO Receptionist/Front Desk SHIP DATE 10/14/23 STANDARD TRANSIT 0' 10/18/23 before 5:00 PM ACTUAL DELIVERY 10/17/23 at 3:44 PM I Services SERVICE FedEx Express Saver TERMS Shipper SPECIAL HANDLING SECTION Deliver Weekday Package details WEIGHT 0.5Ibs/0.23 kgs TOTAL PIECES 1 TOTAL SHIPMENT WEIGHT 0.5 Ibs/0.23 kgs PACKAGING FedEx Envelope Travel history Ascending Local Scan Time Friday, 10/13/23 • 6:05 PM Shipment information sent to FedEx Saturday, 10/14/23 • 10:14AM Shipment arriving early MERRITT ISLAND, FL • 10:14AM Picked up Tendered at FedEx Office MERRITT ISLAND, FL • 12:24 PM Picked up COCOA, FL • 3:09 PM Left FedEx origin facility COCOA, FL Back to top At local FedExfacility COCOA, FL • 8:56 AM At local FedExfacility COCOA, FL • 8:57 AM At local FedExfacility Your package is expected to arrive on the scheduled delivery date COCOA, FL Tuesday, 10/17/23 • 8:12 AM At local FedExfacility COCOA, FL • 8:13 AM Shipment arriving early COCOA, FL • 8:57 AM On FedEx vehicle for delivery COCOA, FL Q 3:44 PM Delivered Cape Canaveral, FL OUR COMPANY About FedEx Our Portfolio Investor Relations Careers FedEx Blog Corporate Responsibility Newsroom Contact Us MORE FROM FEDEX FedEx Compatible FedEx Developer Portal FedEx Logistics ShopRunner LANGUAGE ® United States FOLLOW FEDEX B f Y C6J in P © FedEx 1995-2023 Site Map I Terms of Use I Privacy & Security Back to top 7022 3330 0000 1287 2817 U.S. Postal Service'"' CERTIFIED MAIL° RECEIPT Domestic Mail Only For delivery information, visit our website at www.usps.com r. OFFICICAL USE Certified Mail Fee Extra Services & Fees (check box, add fee ❑ Return Receipt (hardcopy) $ ❑ Return Receipt (electronic) $ ❑ Certified Mail Restricted Delivery $ ❑ Adult Signature Required $ ❑ Adult Signature Restricted Delivery $ Postage $ Total Postage and Fees Sent To KAY LYN JACKSON Street and Apt. No., or PO Box No. PO BOX 1029 City, State, ZIP+4 CC FL 32920 PS Form 3800, April 2015 PSN 7530-02-000-9047 See Reverse for Instruction • Postmark Here CAPE CANAVERAL OCT 18 2023 USPS-FL 32920 SENDER: COMPLETE THIS SECTION ■ Complete items 1, 2, and 3. • Print your name and address on the reverse so that we can return the card to you. • Attach this card to the back of the mailpiece, or on the front if space permits. 1. Article Addressed to: KAY LYN JACKSON P.O. BPX 1029 CAPE CANAVERAL, FL 32920 IIIIIIIIIlIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII 9590 9402 6916 1104 1967 07 COMPLETE THIS SECTION ON DELIVERY A. Signature X Kay Jackson B. Recevied by (Printed Name) Kay Jackson D. Is delivery address different from item 1? Yes If YES, enter delivery address below: No KJ ■ Agent ■ Addressee C.• Date of Delivery 10-19-23 2. Article Number (Transfer from service label) 7022 3330 0000 1287 2817 PS Form 3811, July 2020 PSN 7530-02-000-9053 3. Service Type ❑ Priority Mail Express® ❑ Adult Signature 0 Registered Mail"' ❑ Adult Signature Restricted Delivery ❑ Registered Mail Restricted ❑ Certified Mail® Delivery D Certified Mail Restricted Delivery ❑ Signature Confirmation " D Collect on Delivery ❑ Signature Confirmation ❑ Collect on Delivery Restricted Delivery Restricted Delivery ❑ Insured Mail ❑ Insured Mail Restricted Delivery (over $500) Domestic Return Receipt USPS TRACKING # IIIIIIIIIIIIIIIIIIII ORLANDO 328 9590 9402 6916 1104 1967 07 United States Postal Service First -Class Mail Postage & Fees Paid USPS Permit No. G-10 • Sender: Please print your name, address, and ZIP+4® in this box• CITY OF CAPE CANAVERAL. City Clerk's Office P. O. Box 326 Cape Canaveral, FL 32920-0326 IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII Mia Goforth From: kay4council@att.net Sent: Thursday, October 19, 2023 11:25 AM To: Mia Goforth Cc: Todd Morley;John DeLeo; Anthony Garganese; Daniel LeFever Subject: RE: LATE FILING OF REPORT: Campaign Treasurer's Report - 2023 G4 - Due 10/13/2023 - NO FINE APPLICABLE Warning-This email originated outside the City of Cape Canaveral mail system. Please review the sender's address. Report any suspicious mail by using the Phishalert button in Outlook. If that is not possible forward the suspicious mail to phishalert@cityofcapecanaveral.org Mia and All, Thank you very much. I think the problem came in because I dropped it later and more than likely the last pick up had occurred. I am getting it ready today for this week's report. I appreciate all of your work on this. I am sorry I was a problem. My work appointments had me out of the area until later in the day, and I did not want to print that on my client's printer.Thank you all so much! Best regards, Kay Jackson From: Mia Goforth <M.Goforth@cityofcapecanaveral.org> Sent:Thursday, October 19, 2023 11:18 AM To: kay4council@att.net Cc:Todd Morley<T.Morley@cityofcapecanaveral.org>;John DeLeo <J.DeLeo@cityofcapecanaveral.org>;Anthony Garganese<agarganese@orlandolaw.net>; Daniel LeFever<D.LeFever@cityofcapecanaveral.org> Subject: RE: LATE FILING OF REPORT: Campaign Treasurer's Report-2023 G4- Due 10/13/2023- NO FINE APPLICABLE Importance: High Good morning Kay, I consulted with our City Attorney Anthony Garganese this morning. You will be pleased to know that we both came to the conclusion that the Transaction Report can be the "receipt from an established courier company" which in this case bears the date on or before the date on which this Campaign Treasurer's Report— 2023 G4 was due, 10/13/2023. Therefore, no fine is applicable and you owe no fee. My apologies if this issue caused any stress. I work hard to do the very best to get it right, but sometimes the language of the laws don't always match up perfectly with the actions required or being performed. That's when we need guidance from Anthony. We learn something new every year when it comes to Elections! I also want to remind you that all reports can be amended, so don't forget that you can turn them in early if its convenient to do so. If you have any questions or need further assistance, please don't hesitate to come by, call or email me. i Thank you and have a great day! Mia Mia Goforth, CMC City Clerk + Records Custodian + ADA Coordinator City of Cape Canaveral (321) 868-1220 x207 100 Polk Avenue— P.O. Box 326 Cape Canaveral, Florida 32920 CELEBRATING 60 YEARS 1963 2023 From: Mia Goforth Sent: Wednesday, October 18, 2023 3:42 PM To: kay4council@att.net Cc:Todd Morley<T.Morley@cityofcapecanaveral.org>;John DeLeo <J.DeLeo@cityofcapecanaveral.org>;Anthony Garganese <agarganese@orlandolaw.net>; Daniel LeFever<D.LeFever@cityofcapecanaveral.org> Subject: RE: LATE FILING OF REPORT: Campaign Treasurer's Report- 2023 G4- Due 10/13/2023 - Response Importance: High Good afternoon Kay, The language in 106.07 Reports; certification and filing is confusing, but the laws have not changed recently or to my knowledge regarding this section. Unfortunately, I don't believe that I can accept the Transaction Report you emailed (see attached) last Friday as proof of a Receipt going by the language highlighted at the bottom of the FedEx Report itself, see below. It appears to me that the Transaction Report acts as a reservation rather than a receipt for the actual "shipment tendered": Please note:This transaction record is neither a statement nor an invoice,and does not confirm shipment tendered to FedEx or payment. FedE) for any claim in excess of $100 per package,whether the result of loss,damage,delay, non-delivery, misdelivery,or misinformation, unless you pay an additional charge,document your actual loss and file a timely claim.Limitations found in the current FedEx Service Guide apply.Your rig for any loss.including intrinsic value of the package, loss of sales, income interest, profit,attorney's fees,costs,and other forms of damage whe consequential,or special is limited to the greater of$100 or the authorized declared value. Recovery cannot exceed actual documented loss. M extraordinary value is $1000,e.g.,jewelry,precious metals,negotiable instruments and other items listed in our Service Guide.Written claims rr time limits; Consult the applicable FedEx Service Guide for details.The estimated shipping charge may be different than the actual charges for may occur based on actual weight,dimensions,and other factors. Consult the applicable FedEx Service Guide or the FedEx Rate Sheets for de charges are calculated. F.S. 106.07(2)(a)1. - All reports required of a candidate by this section shall be filed with the officer before whom the candidate is required by law to qualify. All candidates who file with the Department of State shall file their reports pursuant to s. 106.0705. Except as provided in s. 106.0705, reports shall be filed not later than 5 p.m. of the day designated; however, any report postmarked by the United States Postal Service no later than midnight of the day designated is deemed to have been filed in a timely manner. Any report received by the filing officer within 5 days after the designated due date that was delivered by the United States Postal Service 2 is deemed timely filed unless it has a postmark that indicates that the report was mailed after the designated due date. A certificate of mailing obtained from and dated by the United States Postal Service at the time of mailing, or a receipt from an established courier company, which bears a date on or before the date on which the report is due, suffices as proof of mailing in a timely manner. In light of all this, if you could produce a "receipt ... which bears a date on or before the date on which the report is due, suffices as proof of mailing in a timely manner" from FedEx, then we can withdraw the applicable fine. If you have questions, please do call me at your convenience. Thank you! Mia Mia Goforth, CMC City Clerk + Records Custodian + ADA Coordinator City of Cape Canaveral (321) 868-1220 x207 100 Polk Avenue— P.O. Box 326 Cape Canaveral, Florida 32920 CELEBRATING 60 YEARS 1963 2023 From: kay4council@att.net<kay4council@att.net> Sent: Wednesday, October 18, 2023 1:48 PM To: Daniel LeFever<D.LeFever@cityofcapecanaveral.org> Cc: Mia Goforth <M.Goforth@cityofcapecanaveral.org>;Todd Morley<T.Morley@cityofcapecanaveral.org>;John DeLeo <J.DeLeo@cityofcapecanaveral.org>;Anthony Garganese<agarganese@orlandolaw.net> Subject: RE: LATE FILING OF REPORT: Campaign Treasurer's Report- 2023 G4- Due 10/13/2023- Mailed 10/14/2023- Received 10/17/2023 Warning-This email originated outside the City of Cape Canaveral mail system. Please review the sender's address. Report any suspicious mail by using the Phishalert button in Outlook. If that is not possible forward the suspicious mail to phishalert@citvofcapecanaveral.orq Hi Daniel, I see your letter now. I did the transaction receipt earlier online with my Fedex account. I am not sure what time I printed it. I dropped it off that night. Nowhere in the Deadline for filing under 106.07(2)(a)1 F.S. does it mention a time it must be mailed and it does say however, "or a receipt from an established courier company, which bears a date on or before the date on which the report is due, suffices as proof of mailing in a timely manner."Has this statute changed? I want to check. Because I need to know what suffices as proof if I am not in the area to get this out. Obviously, trying to provide this on that date is not going to work with the courier FedEx, and the city looking at a time which is not in the statute as I know it. I would like to make sure I am following those guidelines. Thank you for your help with this! Kay Jackson 3 From: Daniel LeFever<D.LeFever@cityofcapecanaveral.org> Sent: Wednesday, October 18, 2023 9:47 AM To: kay4council@att.net Cc: Mia Goforth <M.Goforth@cityofcapecanaveral.org>;Todd Morley<T.Morley@cityofcapecanaveral.org>;John DeLeo <J.DeLeo@cityofcapecanaveral.org>;Anthony Garganese<agarganese@orlandolaw.net> Subject: LATE FILING OF REPORT: Campaign Treasurer's Report- 2023 G4- Due 10/13/2023- Mailed 10/14/2023- Received 10/17/2023 Importance: High Good morning Ms. Jackson, Please see the attached Letter regarding your late filing of Report 2023 G4 and subsequent fine. Also attached is a copy of the submitted report, for your records. Daniel LeFever Deputy City Clerk City of Cape Canaveral (321) 868-1220 x206 100 Polk Avenue— P.O. Box 326 Cape Canaveral, Florida 32920 CELEBRATING 60YEARS 1963 2023 Florida has a very broad public records law. As a result, any written communication created or received by the City of Cape Canaveral officials and employees will be made available to the public and/or media upon request, unless otherwise exempt. Under Florida Law, email addresses are public records. If you do not want your email address released in response to a public-records request, do not send electronic email to this entity. Instead, contact our office by phone or in writing. Florida has a very broad public records law. As a result, any written communication created or received by the City of Cape Canaveral officials and employees will be made available to the public and/or media upon request, unless otherwise exempt. Under Florida Law, email addresses are public records. If you do not want your email address released in response to a public-records request, do not send electronic email to this entity. Instead, contact our office by phone or in writing. Florida has a very broad public records law. As a result, any written communication created or received by the City of Cape Canaveral officials and employees will be made available to the public and/or media upon request, unless otherwise exempt. Under Florida Law, email addresses are public records. If you do not want your email address released in response to a public-records request, do not send electronic email to this entity. Instead, contact our office by phone or in writing. Florida has a very broad public records law. As a result, any written communication created or received by the City of Cape Canaveral officials and employees will be made available to the public and/or media upon request, unless otherwise exempt. Under Florida Law, email addresses are public records. If you do not want your email address released in response to a public-records request, do not send electronic email to this entity. Instead, contact our office by phone or in writing. 4 CAMPAIGN TREASURER'S REPORT SUMMARY (1) Kay Jackson Name (2) PO Box 1029 Address (number and street) Cape Canaveral, FL 32920 City, State, Zip Code OFFICE USE ONLY RECEIVED OCT 20 2023 MG 9:28 AM ❑ Check here if address has changed (3) ID Number: (4) Check appropriate box(es): ❑✓ Candidate Office Sought: 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 / 07 2023 To 10 / 13 / 2023 Report Type: G5 X Original ❑ Amendment ❑ Special Election Report (6) Contributions This Report (7) Expenditures This Report Monetary Cash & Checks $ , , 1000. 00 Expenditures $ , , 738 . 60 Loans $ , , 100. 00 Transfers to Office Account $ , , Total Monetary $ • Total Monetary $ , . In-Kind $ , , • (8) Other Distributions $ , • (9) TOTAL Monetary Contributions To Date (10) TOTAL Monetary Expenditures To Date $ , , 1100 . 00 $ , , 738 . 60 (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) Kay Jackson (Type name) Kay Jackson ❑ Individual (only for IE X Treasurer ❑ Deputy Treasurer X Candidate ❑Chairperson (only for PC and PTY) or electioneering comm.) X Kay Jackson X Kay Jackson Signature Signature DS-DE 12(Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS CAMPAIGN TREASURER'S REPORT — ITEMIZED CONTRIBUTIONS Kay Jackson (1) Name (2) I.D. Number G5 (3) Cover Period 10 / 07 / 2023 through 10 / 13 / 2023 (4) Page 1 of 1 (5) Date 10 / 11 / 2023 (6) Sequence Number (7) Full Name (Last, Suffix, First, Middle) Street Address & City, State, Zip Code Wave Developments, LLC 109 Long Point Rd Cape Canaveral, FL 32920 (8) Contributor Type B Occupation Development (9) Contribution Type CHE (10) In-Kind Description (11) Amedment (12) Amount 1000.00 (5) Date 10 / 11 / 2023 (6) Sequence Number (7) Full Name (Last, Suffix, First, Middle Street Address & City, State,Zip Code Kay Jackson PO Box 1029 Cape Canaveral, FL 32920 (8) Contributor Type S Occuption Property Mgm (9) Contribution Type LOA (10) In-Kind Description (11) Amendment (12) 100.00 / / / / / / / / / / DS-DE 13 (Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES CAMPAIGN TREASURER'S REPORT - ITEMIZED EXPENDITURES (1) Name Kay Jackson (2) I.D. Number G5 (3) Cover Period 10 / 07 / 2023 through 10 / 13 / 2023 (4) Page 1 of 1 (5) Date 10 / 04 / 2023 Full Name (6) Sequence Number (7) Full Name (Last, Suffix, First, Middle) Street Address & City,State,Zip Code All Service Graphics, Inc. 1020 West Eau Gallie Blvd, Suite 1 Melbourne, FL. 32935 321-259-8957 www.asgprinting.com (8) Purpose (add office sought if contribution to a candidate) Campaign Mailers (9) Expenditure Type ECC (10) Amendment (11) Amount $461.49 10 13 2023 FedEx 3640 Hacks Cross Road Memphis, TN 38125-7305 Fedex Campaign Report G4 LOA $19.23 $19.23 10 / 13 / 2023 GoDaddy Operating Company, LLC. 2155 E. GoDaddy Way Tempe, AZ 85284 USA GoDaddy Website Hosting LOA $191.88 10 /13 / 2023 United States Postal Service 8700 Astronaut Blvd Cape Canaveral, FL 32920 Stamps for Mailers LOA $66.00 / / / / / / / / DS-DE 14 (Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES CAMPAIGN TREASURER'S REPORT SUMMARY (1) Kay Jackson Name (2) PO Box 1029 Address (number and street) Cape Canaveral, FL 32920 City, State, Zip Code OFFICE USE ONLY RECEIVED OCT 27 2023 By: CCO DL ❑ Check here if address has changed (3) ID Number: (4) Check appropriate. box(es): ✓ Candidate Office Sought: 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 / 14 / 2023 To 10 / 20 /2023 Report Type: G6 X Original ❑ Amendment ❑ Special Election Report (6) Contributions This Report Cash & Checks $ , , 1000. 00 Loans $ , , 50.93 Total Monetary $ , , . In-Kind $ , , . (7) Expenditures This Report Monetary Expenditures $ , , 157 . 94 Transfers to Office Account $ , , . Total Monetary $ , , . (8) Other Distributions $ , , . (9) TOTAL Monetary Contributions To Date $ , , 2550 . 93 (10) TOTAL Monetary Expenditures To Date $ , , 931.70. (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) Kay Jackson • Individual (only for IE X Treasurer or electioneering comm.) • Deputy Treasurer X Kay Jackson Signature (Type name) Kay Jackson X Candidate • Chairperson (only for PC and PTY) X Kay Jackson Signature DS-DE 12 (Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS CAMPAIGN TREASURER'S REPORT - ITEMIZED CONTRIBUTIONS Kay Jackson (1) Name (2) I.D. Number G6 (3) Cover Period 10/ 14 / 2023 through 10/ 20 / 2023) (4) Page 1 of 1 (5) Date (7) Full Name (Last, Suffix, First, Middle) Street Address & City, State, Zip Code (8) Contributor Type (8) Occupation (9) Contribution Type (10) In -kind Description (11) Amendment (12) Amount (6) Sequence Number 10 / 17 /2023 Realtor's Political Adovacy Committee 1025 Augusta National Drive Orlando, FL 32822 F Real Estate CHE $1000.00 10 / 20 /2023 Kay Jackson PO Box 1029 Cape Canaveral, FL 32920 S Self Emp LOA $31.57 10 / 20 2023 Kay Jackson PO Box 1029 Cape Canaveral, FL 32920 S Self Emp LOA $19.36 / / / / / / / / DS-DE 13 (Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES CAMPAIGN TREASURER'S REPORT - ITEMIZED EXPENDITURES (1) Name Kay Jackson (2) I.D. Number G6 (3) Cover Period -10 / 14 / 2023 through 10 / 20 / 2023 (4) Page 1 of 1 (5) Date (6) Sequence Number (7) Full Name (Last, Suffix, First, Middle) Street Address & City, State, Zip Code (8) Purpose (add office sought if contribution to a candidate) (9) Expenditure Type (10) Amendment (11) Amount 10/20 / 2023 Dollartree 755 North Courtenay Merritt Island, FL 32953 Campaign Event Supplies ECC $31.57 © 10 / 20 / 2023 BJ's 415 East Merritt Avenue Merritt Island, FL 32953 Campaign Event Supplies ECC $107.01 10/ 20 / 2023 Dollartree 3015 N. Atlantic Cocoa Beach, FL 32931 Campaign Event Supplies ECC $19.36 / / / / / / / / / / DS-DE 14 (Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES CAMPAIGN TREASURER'S REPORT (1) Kay Jackson Name (2) PO Box 1029 NOV 0 3 2023 Address (number and street) Cape Canaveral, FL 32920 City, State, Zip Code OFFICE USE ONLY RECEVIED NOV 03 2023 By: CCO DL ❑ Check here if address has changed (3) ID Number: (4) Check appropriate box(es): ✓ Candidate Office Sought: 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 / 21 2023 To 11 / 02 /2023 Report Type: G7 ✓ Original ❑ Amendment ❑ Special Election Report (6) Contributions This Report Cash & Checks $ , , 500. 00 Loans $ , , 107.58 Total Monetary $ , , . In-Kind $ , , . (7) Expenditures This Report Monetary Expenditures $ , 617 . 88 Transfers to Office Account $ , , . Total Monetary $ . , . (8) Other Distributions $ , , . (9) TOTAL Monetary Contributions To Date $ , , 3050 . 93 (10) TOTAL Monetary Expenditures To Date $ , , 1588 . 58 (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) Kay Jackson ■ Individual (only for IE X Treasurer • Deputy Treasurer or electioneering comm.) X Kay Jackson Signature (Type name) Kay Jackson X Candidate • Chairperson (only for PC and PTY) X Kay Jackson Signature DS-DE 12 (Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS CAMPAIGN TREASURER'S REPORT - ITEMIZED EXPENDITURES (1) Name Kay Jackson (2) I.D. Number G7 (3) Cover Period 10 /21 /2023 through 11 / 02 / 2023 (4) Page 1 of 1 (5) Date (6) Sequence Number (7) Full Name (Last, Suffix, First, Middle) Street Address & City, State, Zip Code (8) Purpose (add office sought if contribution to a candidate) (9) Expenditure Type (10) Amendment (11) Amount 10 /21 /2023 VFW 105 Long Point Road Cape Canaveral, FL 32920 Campaign Event ECC $200.00 10 / 24 / 2023 City of Cape Canaveral 100 Polk Ave Cape Canaveral, FL 32920 Campaign Event- Fridayfest Booth ECC $42.80 GoSigns Campaign Event 10 / 24 / 2023 8105 Canaveral Blvd Cape Canaveral, FL 32920 Campaign Event Supplies ECC $267.50 11/ 02/ 2023 Office Depot 550 East Merritt Island Cswy Merritt Island, FL 32953 Campaign Event Supplies ECC $49.21 11/ 02/ 2023 BJs 415 East Merritt Avenue Merritt Island, FL 32953 Campaign Event Supplies ECC $39.98 11 / 02 / 2023 Office Depot 550 East Merritt Island Cswy Merritt Island, FL 32953 Campaign Event Supplies ECC $18.39 / / / / DS-DE 14 (Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES CAMPAIGN TREASURER'S REPORT — ITEMIZED CONTRIBUTIONS (1) Name Kay Jackson (2) I.D. Number G7 (3) Cover Period 10/ 21/ 2023 through 11/ 02 / 2023 (4) Page 1 of 1 (5) Date (6) Sequence Number (7) Full Name (Last, Suffix, First, Middle) Street Address & City, State, Zip Code (8) Contributor Type (8) Occupation (9) Contribution Type (10) In -kind Description (11) Amendment (12) Amount 10 / 17 /2023 Katrina Freeman 504 Fillmore Unit A5 Cape Canaveral, FL 32920 F Retired CHE $500.00 / / / / / / / / / / / / DS-DE 13 (Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES CAMPAIGN TREASURER'S REPORT SUMMARY (1) Kay Jackson Name (2) PO Box 1029 Address (number and street) Cape Canaveral, FL 32920 City, State, Zip Code OFFICE USE ONLY RECEVIED FEB 05 2024 By: CCO DL I I Check here if address has changed (3) ID Number: (4) Check appropriate box(es): X Candidate Office Sought: 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 0 Check here if no other IE or EC reports will be filed individual making electioneering communications) (5) Report Identifiers Cover Period: From 8 / 1 /2023 To 9 / 1 /2023 Report Type: G1 EI Original X Amendment 0 Special Election Report (6) Contributions This Report Cash & Checks $ , , 100 . 00 Loans $ , , . Total Monetary $ , , . In-Kind $ , , . (7) Expenditures This Report Monetary Expenditures $ , , 39.00 Transfers to Office Account $ , , . Total Monetary $ , , . (8) Other Distributions $ , , . . (9) TOTAL Monetary Contributions To Date (10) TOTAL Monetary Expenditures To Date $ , ,100 .00 $ , , 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) Kay Jackson (Type name) Kay Jackson Individual (only for IE X Treasurer 0 Deputy Treasurer X Candidate El Chairperson (only for PC and PTY) or electioneering comm.) X Kay Jackson X Kay Jackson Signature Signature DS-DE 12 (Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS C I T T - IT I IT (1) Name Kay Jackson (2) I.D. Number G1 (3) Cover Period oe / 01 / 2023 through 09 01 ,2023 (4) Page 1 of 1 (5) (7) (8) (9) (10) (11) Date Full Name Purpose (Last, Suffix, First, Middle) (add office sought if (6) Street Address& contribution to a Expenditure Sequence Number City, State,Zip Code candidate) Type Amendment Amount City of Cape Canaveral Filing Fee to Run 8 /17 12023 100 Polk Avenue for Office Cape Canaveral, FL 32920 CAN ADD $39.00 / / / / / / / / / / / / / / DS-DE 14(Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES CAMPAIGN TREASURER'S REPORT - ITEMIZED CONTRIBUTIONS (1) Name Kay Lyn Jackson (2) I.D. Number G1 (3) Cover Period 08 /01 /2023 through 09/ 01 / 2023 (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 Kay Jackson 08 / 17 / 2023 PO 1029 Cape Canaveral, FL 32920 S Self S N $100.00 / / / / / / / / / / / / DS-DE 13 (Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES CAMPAIGN TREASURER'S REPORT SUMMARY (1) Kay Jackson Name (2) PO Box 1029 Address (number and street) Cape Canaveral, FL 32920 City, State, Zip Code OFFICE USE ONLY RECEVIED FEB 05 2024 By: CCO DL Check here if address has changed (3) ID Number: (4) Check appropriate box(es): ❑✓ Candidate Office Sought: 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 9 / 2 / 2023 To 9 / 15 / 2023 Report Type: G2 ❑ Original ❑✓ Amendment ❑ Special Election Report (6) Contributions This Report (7) Expenditures This Report Monetary Cash & Checks $ , , 0.00 Expenditures $ , , 51 . 20 Loans $ , , . Transfers to Office Account $ , , . Total Monetary $ , , . Total Monetary $ , , . In-Kind $ , , . (8) Other Distributions $ , , (9) TOTAL Monetary Contributions To Date (10) TOTAL Monetary Expenditures To Date $ , , 100 . 00 $ , , 9 0 . 20 (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) Kay Jackson (Type name) Kay Jackson ❑ Individual (only for IE ❑ X Treasurer ❑ Deputy Treasurer X Candidate ❑Chairperson(only for PC and PTY) or electioneering comm.) X Kay Jackson X Kay Jackson Signature Signature DS-DE 12 (Rev. 1 /13) SEE REVERSE FOR INSTRUCTIONS CAMPAIGN TREASURER'S REPORT- ITEMIZED EXPENDITURES (1) Name Kay Jackson (2) I.D. Number G1 (3) Cover Period 09 / 02 /2023 through 09 / 15 / 2023 (4) Page 1 of 1 (5) (7) (8) (9) (10) (11) Date Full Name Purpose (Last, Suffix, First, Middle) (add office sought if (6) Street Address & contribution to a Expenditure Amendment Amount Sequence City, State, Zip Code candidate) Type Number 09/ 14/ 2023 Circle K Gas Station Gas for Campaign 8797 N. Atlantic Avenue errands Cape Canaveral, FL 32920 CAN ADD $51.20 / / / / / / / / / / / / / / DS-DE 14 (REV. 11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES CAMPAIGN TREASURER'S REPORT SUMMARY (1) Kay Jackson Name (2) PO Box 1029 Address (number and street) Cape Canaveral, FL 32920 City, State, Zip Code OFFICE USE ONLY RECEIVED By: CCO DL Check here if address has changed (3) ID Number: (4) Check appropriate box(es): X Candidate Office Sought: City Council El Political Committee (PC) El Electioneering Communications Org. (ECO) El Check here if PC or ECO has disbanded El Party Executive Committee (PTY) 0 Check here if PTY has disbanded LI Independent Expenditure (IE) (also covers an EI Check here if no other IE or EC reports will be filed individual making electioneering communications) (5) Report Identifiers Cover Period: From 9 / 16 / 2023 To 9 / 29 /2023 Report Type: G3 El Original X Amendment El Special Election Report (6) Contributions This Report (7) Expenditures This Report Monetary Cash & Checks $ , , 100 . 00 Expenditures $ , , 159 . 19 Loans $ , , . Transfers to Total Monetary $ , , . Office Account $ , , . Total Monetary $ , , . In-Kind $ , , . (8) Other Distributions $ , , . (9) TOTAL Monetary Contributions To Date (10) TOTAL Monetary Expenditures To Date $ , , 200 . 00 $ , , 249 . 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) Kay Jackson (Type name) Kay Jackson 0 Individual (only for IE X Treasurer 0 Deputy Treasurer X Candidate 0 Chairperson(only for PC and PTY) or electioneering comm.) X Kay Jackson X Kay Jackson Signature Signature DS-DE 12 (Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS CAMPAIGN TREASURER'S REPORT- ITEMIZED EXPENDITURES (1) Narne Kay Jackson (2) 1.D. Number G3 (3) Cover Period 09 / 16 / 2023 through /09 /29 / 2023 (4) Page 1 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 Number City, State,Zip Code candidate) Expenditure Amendment Amount 09 /27 / 2023 GoDaddy Type Website & Domain for Campaign ECC N $35.16 9/17/2023 Circle K 8797 N. Atlantic Ave Gas for Campaigning RMB ADD $30.66 Cape Canaveral, FL 32920 9 / 21 / 2023 Circle K Gas for Campaigning 8797 N. Atlantic Ave Cape Canaveral, FL. 32920 RMB ADD $41.00 9 / 21 / 2024 DollarTree 3015 N. Atlantic Ave Event Supplies Cocoa Beach, FL RMB ADD $27.02 9 /28 / 2023 DollarTree Event Supplies 3015 N. Atlantic Ave Cocoa Beach, FL RMB ADD $5.35 9 / 29 / 2023 Sunrise Bank Bank Fees 109 E Church St. Orlando, FL 32801 CAN ADD $20.00 / / / / DS-DE 14 (Rev. lin 3) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES CAMPAIGN TREASURER'S REPORT - ITEMIZED CONTRIBUTIONS (1) Name Kay Jackson (2) I.D. Number G3 (3) Cover Period 09 / 16 / 2023 through 09/ 29 / 2023 (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 9 / 18 / 2023 Joan Schmeck PO Box 627 Cape Canaveral, FL 32920 I Retired CHE 100.00 / / / / / / / / / / / / DS-DE 13 (Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES CAMPAIGN TREASURER'S REPORT SUMMARY (1) Kay Jackson Name (2) PO Box 1029 Address (number and street) Cape Canaveral, FL 32920 City, State, Zip Code OFFICE USE ONLY RECEIVED FEB 05 2024 I Check here if address has changed (3) ID Number: (4) Check appropriate box(es): [I] Candidate Office Sought: City Council El Political Committee (PC) El Electioneering Communications Org. (ECO) El Check here if PC or ECO has disbanded E] Party Executive Committee (PTY) El Check here if PTY has disbanded El Independent Expenditure (IE) (also covers an El Check here if no other IE or EC reports will be filed individual making electioneering communications) (5) Report Identifiers Cover Period: From 9 / 30 / 2023 To 10 / 06 / 2023 Report Type: G4 O Original X Amendment O Special Election Report (6) Contributions This Report (7) Expenditures This Report Monetary Cash & Checks $ , , 200. 00 Expenditures $ , , 49 . 50 Loans $ , , . Transfers to Office Account $ , , . Total Monetary $ , , . Total Monetary $ , , . In-Kind $ , , . (8) Other Distributions $ , , . (9) TOTAL Monetary Contributions To Date (10) TOTAL Monetary Expenditures To Date $ , , 400 . 00 $ , , 298 . 89 (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) Kay Jackson (Type name) Kay Jackson O Individual (only for IE X Treasurer 0 Deputy Treasurer X Candidate 0 Chairperson (only for PC and PTY) or electioneering comm.) X Kay Jackson X Kay Jackson Signature Signature DS-DE 12 (Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS CAMPAIGN TREASURER'S REPORT SUMMARY (1) Kay Jackson Name (2) PO Box 1029 Address (number and street) Cape Canaveral, FL 32920 City, State, Zip Code OFFICE USE ONLY RECEIVED FEB 05 2024 By: CCO DL I I Check here if address has changed (3) ID Number: (4) Check appropriate box(es): 0 Candidate Office Sought: 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 I I 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 / 07 2023 To 10 / 13 / 2023 Report Type: G5 ❑ Original 0 Amendment ❑ Special Election Report (6) Contributions This Report (7) Expenditures This Report Monetary Cash & Checks $ , , 1000. 00 Expenditures $ , , 738 . 60 Loans $ , , 100. 00 Transfers to Office Account $ , , . Total Monetary $ , , . Total Monetary $ , , . In-Kind $ , , . (8) Other Distributions $ , , . (9) TOTAL Monetary Contributions To Date (10) TOTAL Monetary Expenditures To Date $ 1500 . 00 $ 1037 . 49 (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) Kay Jackson (Type name) Kay Jackson ❑ Individual(only for IE X Treasurer ❑ Deputy Treasurer X Candidate ❑Chairperson (only for PC and PTY) or electioneering comm. X Kay Jackson X Kay Jackson Signature Signature DS-DE 12(Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS CAMPAIGN TREASURER'S REPORT - ITEMIZED CONTRIBUTIONS (1) Name Kay Jackson (2) I. D. Number G5 (3) Cover Period 10 / 07 / 2024 through 10 / 13 / 2024 (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 10 / 11 / 2023 Wave Developments, LLC 109 Long Point Rd Cape Canaveral, FL 32920 B Development CHB 1000.00 10 / 11 / 2023 Kay Jackson PO Box 1029 Cape Canaveral, FL 32920 S PropertyMgtr LOA 100.00 / / / / / / / / / / DS-DE 13 (Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES CAMPAIGN TREASURER'S REPORT - ITEMIZED EXPENDITURES (1) Name Kay Jackson (2) I.D. Number G5 (3) Cover Period 10 / 07 / 2023 through 10 / 13 / 2023 (4) Page 1 of 1 (5) (7) (8) (9) (10) (11) Date Full Name Purpose (Last, Suffix, First, Middle) (add office sought if (6) Street Address & contribution to a Expenditure Sequence City, State, Zip Code candidate) Type Amendment Amount Number 10 / 04 / 2022 All Service Graphics, Inc. Campaign Mailers 1020 West Eau Gallie Blvd, Suite I ECC $461.49 Melbourne, FL 32935 321-259-8957 www.asgprinting.com 10 / 13 / 2023 FedEx Fedex Campaign 3640 Hacks Cross Road Report G4 Memphis, TN 38125-7305 LOA $19.23 10 / 13 / 2023 GoDaddy Operating Company, LLC. GoDaddy Website 2155 E. GoDaddy Way Hosting/ Tempe, AZ 85284 USA LOA $191.88 10 / 13 /2023 United States Postal Service Stamps for 8700 Astronaut Blvd Mailers Cape Canaveral, FL 32920 LOA $66.00 / / / / / / / / DS-DE 14 (Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES CAMPAIGN TREASURER'S REPORT SUMMARY (1) Kay Jackson Name (2) PO Box 1029 Address (number and street) Cape Canaveral, FL 32920 City, State, Zip Code OFFICE USE ONLY RECEIVED FEB 05 2024 By: CCO DL Check here if address has changed (3) ID Number: (4) Check appropriate box(es): [X] Candidate Office Sought: City Council ❑ Political Committee (PC) ❑ Electioneering Communications Org. (ECO) L 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 / 14 2023 To 10 / 20 /2023 Report Type: G6 ❑ Original ❑✓ Amendment ❑ Special Election Report (6) Contributions This Report (7) Expenditures This Report Monetary Cash & Checks $ , , 1000. 00 Expenditures $ , , 157 . 94 Loans $ , , 500.00 Transfers to Office Account $ , , . Total Monetary $ , , . Total Monetary $ , . . In-Kind $ , , . (8) Other Distributions $ , , . (9) TOTAL Monetary Contributions To Date (10) TOTAL Monetary Expenditures To Date $ , , 3000 .00 $ , , 1195 . 43 (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) Kay Jackson (Type name) Kay Jackson ❑ Individual (only for IE X Treasurer ❑ Deputy Treasurer X Candidate ❑ Chairperson (only for PC and PTY) or electioneering comm.) X Kay Jackson X Kay Jackson Signature Signature DS-DE 12 (Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS CAMPAIGN TREASURER'S REPORT - ITEMIZED EXPENDITURES (1) Name Kay Jackson (2) ID. Number G6 (3) Cover Period 10 / 14 / 2023 through 10 20 / 2023 (4) Page 1 of 1 (5) (7) (8) (9) (10) (11) Date Full Name Purpose (Last,Suffix, First, Middle) (add office sought if (6) Sequence Street Address & contribution to a Expenditure Number City,State,Zip Code candidate) Type Amendment Amount 10 / 20 / 2023 Dollartree 755 North Courtenay Campaign Event ECC $31.57 Merritt Island, FL 32953 Supplies 10 / 20 / 2023 BJ's 415 East Merritt Avenue Campaign Event ECC $107.01 Merritt Island, FL 32953 Supplies 10 / 20 / 2023 Dollartree 3015 N. Atlantic Campaign Event Cocoa Beach, FL 32931 Supplies ECC $19.36 / / / / / / / / / / DS-DE 14 (Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES CAMPAIGN TREASURER'S REPORT SUMMARY (1) Kay Jackson Name (2) PO Box 1029 Address (number and street) Cape Canaveral, FL 32920 City, State, Zip Code OFFICE USE ONLY RECEIVED By: CCO DL Check here if address has changed (3) ID Number: (4) Check appropriate box(es): X Candidate Office Sought: City Council EI Political Committee (PC) El Electioneering Communications Org. (ECO) El Check here if PC or ECO has disbanded I I Party Executive Committee (PTY) El Check here if PTY has disbanded El Independent Expenditure (IE) (also covers an El Check here if no other IE or EC reports will be filed individual making electioneering communications) (5) Report Identifiers Cover Period: From 10 / 21 2023 To 11 / 02 /2023 Report Type: G7 X Original X Amendment El Special Election Report (6) Contributions This Report (7) Expenditures This Report Monetary Cash & Checks $ , , 00 .00 Expenditures $ , ,636 . 88 Loans $ , , . Transfers to Office Account $ , , . Office Account $ Total Monetary $ , , . Total Monetary $ , , . In-Kind $ , , . (8) Other Distributions $ , , . . (9) TOTAL Monetary Contributions To Date (10) TOTAL Monetary Expenditures To Date $ , ,3000 . 00 $ , ,1803 .21 (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) Kay Jackson (Type name) Kay Jackson 0 Individual (only for IE X Treasurer El Deputy Treasurer X Candidate 0 Chairperson (only for PC and PTY) or electioneering comm.) X X Signature Signature DS-DE 12 (Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS CAMPAIGN TREASURER'S REPORT - ITEMIZED EXPENDITURES (1) Name Kay Jackson (2) I.D. Number G7 (3) Cover Period 10 / 21 /2023 through 11 / 02 / 2023 (4) Page 1 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 /21 /2023 VFW 105 Long Point Road Campaign Event Cape Canaveral, FL 32920 ECC $200.00 10 /24 /2023 City of Cape Canaveral Campaign Event - 100 Polk Ave Fridayfest Booth Cape Canaveral, FL 32920 ECC $42.80 10 / 24 / 2022 GoSigns Campaign Event 8105 Canaveral Blvd Supplies Cape Canaveral, FL 32920 ECC $267.50 11 / 02 / 2023 Office Depot Campaign Event 550 East Merritt Island Cswy Supplies Merritt Island, FL 32953 ECC $49.21 11 / 02 /2023 BJs Campaign Event 415 East Merritt Avenue Supplies Merritt Island, FL 32953 ECC $39.98 11 / 02 / 2023 Office Depot Campaign Event 550 East Merritt Island Cswy Supplies Merritt Island, FL 32953 ECC $18.39 / / / / DS-DE 14 (Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES CAMPAIGN TREASURER'S REPORT SUMMARY (1) Kay Jackson Name (2) PO Box 1029 Address (number and street) Cape Canaveral, FL 32920 City, State, Zip Code OFFICE USE ONLY RECEIVED FEB 05 2024 By: CCO DL I I Check here if address has changed (3) ID Number: (4) Check appropriate box(es): X Candidate Office Sought: City Council EI Political Committee (PC) El Electioneering Communications Org. (ECO) El Check here if PC or ECO has disbanded EI Party Executive Committee (PTY) EI Check here if PTY has disbanded El Independent Expenditure (IE) (also covers an El Check here if no other IE or EC reports will be filed individual making electioneering communications) (5) Report Identifiers Cover Period: From 11 / 02 2023 To 02 / 05 /2024 Report Type: TR X Original El Amendment El Special Election Report (6) Contributions This Report (7) Expenditures This Report Monetary Cash & Checks $ , , 00 .00 Expenditures $ , , 1230. 61 Loans $ , , . Transfers to Office Account $ , , . ° Total Monetary $ , , . Total Monetary $ , , . In-Kind $ , , . (8) Other Distributions $ , , . . (9) TOTAL Monetary Contributions To Date (10) TOTAL Monetary Expenditures To Date $ , ,3000 . 00 $ , ,3033 .82 (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) Kay Jackson (Type name) Kay Jackson 0 Individual (only for IE X Treasurer El Deputy Treasurer X Candidate 0 Chairperson (only for PC and PTY) or electioneering comm.) X Kay Jackson X Kay Jackson Signature Signature DS-DE 12 (Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS CAMPAIGN TREASURER'S REPORT - ITEMIZED EXPENDITURES (1) Name Kay Jackson (2) I.D. Number TR (3) Cover Period 11 / 02 / 2023 through 02 / 05 /2024 (4) Page 1 of 1 (5) (7) (8) (9) (10) (11) Date Full Name Purpose (6) (Last, Suffix, First, Middle) (add office sought if Expenditure Amendment Amount Sequence Street Address & contribution to a Type Number City, State, Zip Code candidate) 11 /2 /2023 Office Depot 550 East Merritt Island Cswy Campaign Event Sign ECC $49.21 Merritt Island, FL 32953 Fridayfest 11 / 02 / 2023 BJs Event Supplies Campaign Event - ECC $39.98 415 East Merritt Avenue Fridayfest Booth Merritt Island, FL 32953 11 / 02 / 2024 Office Depot Campaign Event ECC $18.39 550 East Merritt Island Cswy Supplies Merritt Island, FL 32953 11 / 03/ 2023 City of Cape Canaveral Campaign ECC $50.00 Supplies 11 / 02/ 2023 BJs Campaign Event ECC $39.98 415 East Merritt Avenue Supplies Merritt Island, FL 32953 11 / 02 / 2023 Office Depot Campaign Event ECC $18.39 550 East Merritt Island Cswy Supplies Merritt Island, FL 32953 / / / / DS-DE 14(Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES CAMPAIGN TREASURER'S REPORT (1) Kay Jackson Name (2) PO Box 1029 Address (number and street) Cape Canaveral, FL 32920 City, State, Zip Code OFFICE USE ONLY RECEIVED FEB 12 2024 By: MG ❑ Check here if address has changed (3) ID Number: (4) Check appropriate box(es): ✓ Candidate Office Sought: 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 8 / 1 / 2023 To 9 / 1 / 2023 Report Type: G 1 ❑ Original ✓ Amendment ❑ Special Election Report (6) Contributions This Report Cash & Checks $ , , 100 . 00 Loans $ , , . Total Monetary $ , , . In-Kind $ , , . (7) Expenditures This Report Monetary Expenditures $ , 65 . 50 Transfers to Office Account $ , , . Loans $ , Total Monetary $ , , . (8) Other Distributions $ , , . (9) TOTAL Monetary Contributions To Date $ , ,100. 00 (10) TOTAL Monetary Expenditures To Date $ , ,65 . 50 (11) Certification It is a first degree misdemeanor for any person to falsify a public record (ss. 839., F.S.) I certify that I have examined this report and it is true, correct, and complete: (Type name) Kay Jackson • Individual (only for IE X Treasurer ■ Deputy Treasurer or electioneering comm.) X Kay Jackson Signature (Type name) Kay Jackson X Candidate • Chairperson (only for PC and PTY) X Kay Jackson Signature DS-DE 12 (Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS CAMPAIGN TREASURER'S REPORT - ITEMIZED EXPENDITURES (1) Kay Jackson (2) I.D. Number G1 (3) Cover Period 09 02 2023 through 09 / 15 2023 (4) Page 1 of 1 (5) 8 / 17 / 2023 Date (6) Sequence Number 1 (7) Full Name (Last, Suffix, First, Middle) Street Address & City, State, Zip Code City of Cape Canaveral 100 Polk Avenue Cape Canaveral, FL 32920 (8) Purpose (add office sought if contribution to a candidate) Filling Fee to Run for City Council (9) Expenditure Type CAN (10) Amendment (11) Amount $39.00 8 / 17 / 2023 2 City of Cape Canaveral 100 Polk Avenue Cape Canaveral, FL 32920 60th Anniversary Mercandise for 2 supporters who are assisting me with my campaign CAN ADD $26.50 / / / / / / / / / / / / DS-DE 14 (Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES CAMPAIGN TREASURER'S REPORT SUMMARY (1) Kay Jackson Name (2) PO Box 1029 Address (number and street) Cape Canaveral, FL 32920 City, State, Zip Code OFFICE USE ONLY RECEIVED FEB 12 2024 By: MG ❑ Check here if address has changed (3) ID Number: (4) Check appropriate box(es): ✓ Candidate Office Sought: 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 9 / 2 / 2023 To 9 / 15 / 2023 Report Type: G2 ❑ Original ✓ Amendment ❑ Special Election Report (6) Contributions This Report Cash & Checks $ , , 0 00 Loans $ , , . Total Monetary $ , , . In-Kind $ , , . (7) Expenditures This Report Monetary Expenditures $ , , 52 . 70 Transfers to Office Account $ , , . Total Monetary $ , , . (8) Other Distributions $ , , . (9) TOTAL Monetary Contributions To Date $ , ,100 .00 (10) TOTAL Monetary Expenditures To Date $ , , 118 .20 (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, (Type name) Kay Jackson to falsify a public record (ss. 839.13, F.S.) and complete: (Type name) Kay Jackson • Individual (only for IE X Treasurer ■ Deputy Treasurer or electioneering comm.) X Kay Jackson Signature (Type name) Kay Jackson X Candidate • Chairperson (only for PC and PTY) X Kay Jackson Signature DS-DE 12 (Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS CAMPAIGN TREASURER'S REPORT - ITEMIZED EXPENDITURES (1) Name Kay Jackson (2) I.D. Number G2 (3) Cover Period 09 / 02 / 2023 through 09 / 15 / 2023 (4) Page 1 of 1 (5) Date 09 / 14 / 2023 (6) Sequence Number 1 (7) Full Name (Last, Suffix, First, Middle) Street Address & City, State, Zip Code Circle K 8797 N. Atlantic Avenue Cape Canaveral, FL 32920 (8) Purpose (add office sought if contribution to a candidate) Gas for Campaigning (9) Expenditure Type CAN (10) Amendment Add (11) Amount $51.20 9 / 22 /2024 2 USPS 8700 N. Atlantic Avenue Cape Canaveral, FL 32920 Postage for campaign mail ECC ADD $1.50 / / / / / / / / / / / / DS-DE 14 (Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES CAMPAIGN TREASURER'S REPORT SUMMARY (1) Kay Jackson Name (2) PO Box 1029 Address (number and street) Cape Canaveral, FL 32920 City, State, Zip Code OFFICE USE ONLY RECEIVED FEB 12 2024 By: MG ❑ Check here if address has changed (3) ID Number: (4) Check appropriate box(es): ✓ Candidate Office Sought: 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 9 / 16 / 2023 To 9 / 29 / 2023 Report Type: G3 ❑ Original ✓ Amendment ❑ Special Election Report (6) Contributions This Report Cash & Checks $ , , 100 . 00 Loans $ , , . Total Monetary $ , , . In-Kind $ , , . (7) Expenditures This Report Monetary Expenditures $ , , 160 . 69 Transfers to Office Account $ , , . Total Monetary $ , , . (8) Other Distributions $ , , . (9) TOTAL Monetary Contributions To Date $ , , 200 . 00 (10) TOTAL Monetary Expenditures To Date $ , , 278 .89 (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) Kay Jackson • Individual (only for IE X Treasurer ■ Deputy Treasurer or electioneering comm.) X Kay Jackson Signature (Type name) Kay Jackson X Candidate EI Chairperson (only for PC and PTY) X Kay Jackson Signature DS-DE 12 (Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS CAMPAIGN TREASURER'S REPORT - ITEMIZED EXPENDITURES (1) Name Kay Jackson (2) I.D. Number G3 (3) Cover Period 09 / 16 / 2023 through 09 / 29 / 2023 (4) Page 1 of 1 (5) Date 09 / 27 / 2023 (6) Sequence Number 1 (7) Full Name (Last, Suffix, First, Middle) Street Address & City, State, Zip Code GoDaddy (8) Purpose (add office sought if contribution to a candidate) Website & Domain for campaign (9) Expenditure Type ECC (10) Amendment N (11) Amount $ 35.16 9/17/ 2023 2 Circle K 8797 N. Atlantic Ave Cape Canaveral, FL 32920 Gas for Campaigning RMB ADD $30.66 9 /21 / 2023 3 Circle-K 8797 N. Atlantic Avenue Cape Canaveral, FL 32920 Gas for Campaigning RMB ADD $41.00 9 / 21 / 2024 4 DollarTree 3015 N. Atlantic Ave Cocoa Beach, FL Event Supplies RMB ADD $27.02 9 / 28 / 2023 5 DollarTree Event Supplies 3015 N. Atlantic Ave Cocoa Beach, FL RMB ADD $5.35 9 / 29 / 2023 6 Sunrise Bank 109 E Church St. Orlando, FL 32801 Bank Fees CAN ADD $20.00 9 / 22 /2023 7 USPS 8700 N. Atlantic Ave. Cape Canaveral, FL 32920 Postage for Campaign Mail ECC ADD $1.32 / / DS-DE 14 (Rev: 11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES CAMPAIGN TREASURER'S REPORT SUMMARY (1) Kay Jackson Name (2) PO Box 1029 Address (number and street) Cape Canaveral, FL 32920 City, State, Zip Code OFFICE USE ONLY RECEIVED FEB 12 2024 By: MG ❑ Check here if address has changed (3) ID Number: (4) Check appropriate box(es): X Candidate Office Sought: 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 9 / 30 / 2023 To 10 / 06 / 2023 Report Type: G4 ❑ Original X Amendment ❑ Special Election Report (6) Contributions This Report Cash & Checks $ , , 200. 00 Loans $ , , . Total Monetary $ , , . In-Kind $ , , . (7) Expenditures This Report Monetary Expenditures $ , ,49 5.0 Transfers to Office Account $ , , . Total Monetary $ , , . (8) Other Distributions $ , , . (9) TOTAL Monetary Contributions To Date $ , ,400 • 00 (10) TOTAL Monetary Expenditures To Date $ , , 328 • 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) Kay Jackson • Individual (only for IE X Treasurer ■ Deputy Treasurer or electioneering comm.) X Kay Jackson Signature (Type name) Kay Jackson X Candidate ■ Chairperson (only for PC and PTY) X Kay Jackson Signature DS-DE 12'(Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS CAMPAIGN TREASURER'S REPORT - ITEMIZED EXPENDITURES (1) Name Kay Jackson (2) I.D. Number G4 (3) Cover Period 9 / 30 / 2023 through 10 / 06 / 2023 (4) Page 1 of 1 (5) Date 10 / 02 / 2023 (6) Sequence Number 1 (7) Full Name (Last, Suffix, First, Middle) Street Address & City, State, Zip Code Circle K 8797 N. Atlantic Avenue Cape Canaveral, FL 32920 (8) Purpose (add office sought if contribution to a candidate) Gas for Campaigning (9) Expenditure Type CAN (10) Amendment ADD (11) Amount $49.50 / / / / / / / / / / / / / / DS-DE 14 (Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES CAMPAIGN TREASURER'S REPORT SUMMARY (1) Kay Jackson Name (2) PO Box 1029 Address (number and street) Cape Canaveral, FL 32920 City, State, Zip Code OFFICE USE ONLY RECEIVED FEB 12 2024 By: MG ❑ Check here if address has changed (3) ID Number: (4) Check appropriate box(es): ✓ Candidate Office Sought: 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 / 07 2023 To 10 / 13 / 2023 Report Type: G5 ❑ Original ✓ Amendment ❑ Special Election Report (6) Contributions This Report Cash & Checks $ , , 1000. 00 Loans $ , , . Total Monetary $ , , . In-Kind $ , , . (7) Expenditures This Report Monetary Expenditures $ , , 783 . 26 Transfers to Office Account $ , , . Total Monetary $ , , . (8) Other Distributions $ , , . (9) TOTAL Monetary Contributions To Date $ , ,1500 • 00 (10) TOTAL Monetary Expenditures To Date $ , ,1111 • 65 (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) Kay Jackson ■ Individual (only for IE X Treasurer ■ Deputy Treasurer or electioneering comm.) (Type name) Kay Jackson X Candidate • Chairperson (only for PC and PTY) X Kay Jackson Signature DS-DE 12 (Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS CAMPAIGN TREASURER'S REPORT - ITEMIZED EXPENDITURES (1) Name Kay Jackson (2) I.D. G5 (3) Cover Period 10 / 07 / 2023 through 10 / 13 / 2023 (4) Page 1 of 1 (5) Date 10/ 04 / 2023 (6) Sequence Number 1 (7) Full Name (Last, Suffix, First, Middle) Street Address & City, State, Zip Code All Service Graphics, Inc. 1020 West Eau Gallie Blvd, Suite I Melbourne, FL 32935 321-259-8957 www.aagprinting.com (8) Purpose (add office sought if contribution to a candidate) Campaign Mailers (9) Expenditure Type ECC (10) Amendment N (11) Amount $461.49 10 /13 / 2023 2 FedEx 3640 Hacks Cross Road Memphis, TN 38125-7305 Fedex Campaign Report G4 ECC N $19.23 10 / 13 / 2023 3 GoDaddy Operating Company, LLC. 2155 E. GoDaddy Way Tempe, AZ 85284 USA GoDaddy Website Hosting ECC N $191.88 10 / 13 / 2023 4 United States Postal Service 8700 Astronaut Blvd Cape Canaveral, FL 32920 Stamps for Mailers ECC ADD $66.00 10 / 7 / 2023 5 Circle K 8797 N. Atlantic Avenue Cape Canaveral, FL 32920 Gas for Campaigning ECC ADD $44.66 / / / / / / DS-DE 14 (Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES CAMPAIGN TREASURER'S REPORT SUMMARY (1) Kay Jackson Name (2) PO Box 1029 Address (number and street) Cape Canaveral, FL 32920 City, State, Zip Code OFFICE USE ONLY RECEIVED FEB 12 2024 ❑ Check here if address has changed (3) ID Number: (4) Check appropriate box(es): ✓ Candidate Office Sought: 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 / 14 2023 To 10 / 20 / 2023 Report Type: G6 ❑ Original ✓ Amendment ❑ Special Election Report (6) Contributions This Report Cash & Checks $ , , 1000. 00 Loans $ , , 500.00 Total Monetary $ , , . In-Kind $ , , . (7) Expenditures This Report Monetary Expenditures $ , , 216 . 99 Transfers to Office Account $ , , . Total Monetary $ , , . (8) Other Distributions $ , , . (9) TOTAL Monetary Contributions To Date $ , , 3000 . 00 (10) TOTAL Monetary Expenditures To Date $ , , 1328. 64 (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) Kay Jackson ■ Individual (only for IE X Treasurer • Deputy Treasurer or electioneering comm.) X Kay Jackson Signature (Type name) Kay Jackson X Candidate • Chairperson (only for PC and PTY) X Kay Jackson Signature DS-DE 12 (Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS CAMPAIGN TREASURER'S REPORT - ITEMIZED EXPENDITURES (1) Name Kay Jackson (2) I.D. Number G6 (3) Cover Period 10 / 14 / 2023 through 10 / 20 / 2023 (4) Page 1 of 1 (5) Date 10 / 20 / 2023 (6) Sequence Number 1 (7) Full Name (Last, Suffix, First, Middle) Street Address & City, State, Zip Code Dollartree 755 North Courtenay Merritt Island, FL 32953 (8) Purpose (add office sought if contribution to a candidate) Campaign Event Supplies (9) Expenditure Type ECC (10) Amendment (11) Amount $31.57 10 / 20 / 2023 2 BJ's 415 East Merritt Avenue Merritt Island, FL 32953 Campaign Event Supplies ECC $107.01 . 10 / 20/ 2022 3 Dollartree 3015 N. Atlantic Cocoa Beach, FL 32931 Campaign Event Supplies ECC $19.36 10/19/2023 4 Office Depot Store #284 550 E. Merritt Island Causeway Merritt Island, FL 32952 Ink for Addressing Campaign Mailers ECC ADD $59.05 / / / / / / / / DS-DE 14 (Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES CAMPAIGN TREASURER'S REPORT SUMMARY (1) Kay Jackson Name (2) PO Box 1029 Address (number and street) Cape Canaveral, FL 32920 City, State, Zip Code OFFICE USE ONLY RECEIVED FEB 12 2024 By: MG C Check here if address has changed (3) ID Num•er: (4) Check appropriate box(es): ✓ Candidate Office Sought: 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 / 21 2023 To 11 / 02 /2023 Report Type: G7 ❑ Original ✓ Amendment ❑ Special Election Report (6) Contributions This Report Cash & Checks $ , , 500. 00 Loans $ , , . Total Monetary $ , , . In-Kind $ , , . (7) Expenditures This Report Monetary Expenditures $ , ,520 . 30 Transfers to Office Account $ , , . Total Monetary $ , , . (8) Other Distributions $ , , . (9) TOTAL Monetary Contributions To Date $ , , 3050 • 93 (10) TOTAL Monetary Expenditures To Date $ , , 1848 . 94 (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) Kay Jackson ■ Individual (only for IE 0 Treasurer ■ Deputy Treasurer or electioneering comm.) X Kay Jackson Signature (Type name) Kay Jackson X Candidate ■ Chairperson (only for PC and PTY) X Kay Jackson Signature DS-DE 12 (Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS CAMPAIGN TREASURER'S REPORT - ITEMIZED EXPENDITURES (1) Name Kay Jackson (2) I.D. Number G7 (3) Cover Period 10 /21 /2023 through 11 / 02 / 2023 (4) Page 1 of 1 (5) Date 10 / 21 / 2023 (6) Sequence Number 1 (7) Full Name (Last, Suffix, First, Middle) Street Address & City, State, Zip Code VFW 105 Long Point Road Cape Canaveral, FL 32920 (8) Purpose (add office sought if contribution to a candidate) Campaign Event (9) Expenditure Type ECC (10) Amendment (11) Amount $200.00 10 / 24/ 2023 2 City of Cape Canaveral 100 Polk Ave Cape Canaveral, FL 32920 Campaign Event - Fridayfest Booth ECC $42.80 10 / 24/ 2023 3 GoSigns 8105 Canaveral Blvd Cape Canaveral, FL 32920 Campaign Event Supplies ECC $267.50 10 / 30 / 2023 4 Sunrise Bank 109 E. Church St. Orlando, FL 32801 Bank Fees CAN ADD $10.00 / / / / / / / / DS-DE 14 (Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES CAMPAIGN TREASURER'S REPORT SUMMARY (1) Kay Jackson Name (2) PO Box 1029 Address (number and street) Cape Canaveral, FL 32920 City, State, Zip Code OFFICE USE ONLY RECEIVED FEB 12 2024 By: MG ❑changed Check here if address has B (3) ID Number: (4) Check appropriate box(es): ✓ Candidate Office Sought: 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 11 / 02 2023 To 02 / 05 /2024 -Report Type: TR ❑ Original ✓ Amendment ❑ Special Election Report (6) Contributions This Report Cash & Checks $ , , 00 .00 Loans $ , , . Total Monetary $ , , . In-Kind $ , , . (7) Expenditures This Report Monetary Expenditures $ , , 1274. 69 Transfers to Office Account $ , , . Total Monetary $ , , . (8) Other Distributions $ , , . (9) TOTAL Monetary Contributions To Date $ , , 3000 . 00 (10) TOTAL Monetary Expenditures To Date $ , , 3123.. 63 (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) Kay Jackson • Individual (only for IE X Treasurer • Deputy Treasurer or electioneering comm.) X Kay Jackson Signature (Type name) Kay Jackson ❑ X Candidate ❑ Chairperson (only for PC and PTY) X Kay Jackson Signature DS-DE 12 (Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS CAMPAIGN TREASURER'S REPORT - ITEMIZED EXPENDITURES (1) Name Kay Jackson (2) I.D. Number TR (3) Cover Period 11 / 02 / 2023 through 02 / 05 /2024 (4) Page 1 of 2 (5) Date 11 / 2 / 2023 (6) Sequence Number 1 (7) Full Name (Last, Suffix, First, Middle) Street Address & City, State, Zip Code Office Depot 550 East Merritt Island Cswy Merritt Island, FL 32953 (8) Purpose (add office sought if contribution to a candidate) Campaign Event Sign Fridayfest (9) Expenditure Type ECC (10) Amendment (11) Amount $49.21 11/ 2 / 2023 2 BJs Event Supplies 415 East Merritt Avenue Merritt Island, FL 32953 Campaign Event - Fridayfest Booth ECC $39.98 11 / 2 / 2024 3 Office Depot 550 East Merritt Island Cswy Merritt Island, FL 32953 Campaign Event Supplies ECC $18.39 11 / 03 / 2023 4 City of Cape Canaveral 100 Polk Ave Cape Canaveral, FL 32920 campaign Event Supplies ECC $50.00 11 / 02 / 2023 5 BJs 415 East Merritt Avenue Merritt Island, FL 32953 Campaign Event Supplies ECC $44.08 11 / 2 / 2023 6 Crackers N. Atlantic Ave Cape Canaveral, FL 32920 Candidate and Supporter Lunch for Polls ECC $50.08 11 / 2 / 2023 7 Kay Jackson Candidate PO Box 1029 Cape Canaveral, FL 32920 Candidate Reimbursement ECC $713.58 11 /20 / 2023 8 Kay Jackson PO Box 1029 Cape Canaveral, FL 32920 Candidate Reimbursement ECC ADD $109.37 DS-DE 14 (Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES CAMPAIGN TREASURER'S REPORT - ITEMIZED EXPENDITURES (1) Name Kay Jackson (2) I.D. Number TR (3) Cover Period 11 / 02 / 2023 through 02 / 05 /2024 (4) Page 2 of 2 (5) Date 12/ 15 / 2023 (6) Sequence Number 9 (7) Full Name (Last, Suffix, First, Middle) Street Address & City, State, Zip Code Brevard Republican Executive Committee Holiday Event (8) Purpose (add office sought if contribution to a candidate) Spoke at Event as Elected Official (9) Expenditure Type ECC (10) Amendment ADD (11) Amount 1 31 / 2023 10 Brevard Federated Republican Women 301 Tucker Lane Cocoa, FL 32926 Event for Elected Woman Official ECC ADD $150.00 / / / / / / / / / / / / DS-DE 14 (Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES