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HomeMy WebLinkAboutFiling papers and Campaign Reports BH 2014 kAi2L1-(:: 4115ggiff CITY OF CAPE CANAVERAL, FLORIDA CANDIDATE PACKET ACKNOWLEDGEMENT 4C) would like to qualify as a candidate for City Council and do her�y acknowledge receipt of: 1. 2014 Election Information 2. Form DS-DE 9 (rev. 10/10), Appointment of Campaign Treasurer and designation of campaign depository for candidates 3. Form DS-DE 25 (rev. 05/11), Candidate Oath —Non-Partisan Office 4. CE Form 1 (Jan 1, 2014), Statement of Financial Interests and Instructions 5. Form DS-DE 84 (05/11), Statement of Candidate 6. Election Laws of the State of Florida (August 2013) 7. Candidate and Campaign Treasurer Handbook (November 2013) 8. 2014 Campaign Treasurer's Report Due Dates and General information.about filing reports 9. Do's and Don'ts for Campaign Treasurer's Reports 10. Form DS-DE 12 (rev. 11/13), Campaign Treasurer's Report Summary 11. Form DS-DE 13 (rev. 11/13), Campaign Treasurer's Report—Itemized Contributions 12. Form DS-DE 13A (rev. 11/13), Campaign Treasurer's Report—Fund Transfers 13. Form DS-DE 14 (rev. 11/13), Campaign Treasurer's Report—Itemized Expenditures 14. Form DS-DE 14A (rev. 11/13), Campaign Treasurer's Report—Itemized Distributions 15. Form DS-DE 87 (rev. 11/13), Waiver of Report 16. Notification of Public Logic and Accuracy Tests / Canvassing Board Meeting 17. Certification of Municipal Elections Results 18. Public Service Request Form 19. Political Sign Regulations for City and County I understand to have my name appear on the November 4, 2014 Municipal Election Ballot, I must complete qualifying paperwork and pay qualifying fees during the qualifying period which begins on August 8,2014 at noon and ends on August 22,2014 at noon. 49j1 OFFICE USE ONLY Signatu e AUG 1 22014 ii Date Enter Date&Time Received and Initials of Clerk's Office Staff Member C APPOINTMENT OF CAMPAIGN TREASURER �`� �j Ili AND DESIGNATION OF CAMPAIGN ,' AUG 11 42014 i s DEPOSITORY FOR CANDIDATES ; 11 1 , (Section 106.021(1), F.S.) �:. j� (PLEASE PRINT OR TYPE) S. :5Z9, -i NOTE: This form must be on file with the qualifying officer before opening the campaign account. OFFICE USE ONLY 1.CHECK APPROPRIATE BOX(ES): [l Initial Filing of Form Re-filing to Change: ❑ Treasurer/Deputy ❑ Depository 0 Office p Party 2. Name of Candidate(in this order: First, Middle, Last) 3. Address(include post office box or street, city, state,zip code) ,7$err �. 400 - �lv c/47- 56) / 5' 'K 4.Telephone 5. E-mail address d/9/JEC-�/t/4//F2XL 4 FL ( 3:1 ) 5oV-Tt 1G. -06@jJo6 14606 . C'om 3 al Za 6. Office sought(include district,circuit, group number) 7. If a candidate for a nonpartisan office,check if applicable: S17,,oe axi,e)v ..4,262-G d dCJ ;Z ❑ My intent is to run as a Write-In candidate. 8. If a candidate for a partisan office,check block and fill in name of party as applicable: My intent is to run as a Write-In ❑ No Party Affiliation ❑ Party candidate. . I have appointed the following person to act as my '® Campaign Treasurer ❑ Deputy Treasurer 10. Name of Treasure or Deputy Treasurer svyce //,m/L TD AJ 11. Mailing Address 12. Telephone (D- A0 Ili (3.4 )5 /6 6 4/ 13. City 14. County 15. State 16. Zip Code 17. E-mail address OW(09/Je9()(8, (144:0 -1,--0 re. 399 ao Adop) ?jeb-i"a COOL.E®fI 18. I have designated the following bank as my g Primary Depository ❑ Secondary Depository 19. Name of Bank 20.Address 6-(toJQ/SL 6721)AA-- 5 d Rio/n/1kr)yvz,c A' 21. City 22. County 23. State 24. Zip Code C 6 c cr n cii egIt i,0o4 n fL 0 A_, bn y,a.9 3/ UNDER PENALTIES OF PERJURY,I DECLARE THAT I HAVE READ THE FOREGOING FORM FOR APPOINTMENT OF CAMPAIGN TREASURER AND DESIGNATION OF CAMPAIGN DEPOSITORY AND THAT THE FACTS STATED IN IT ARE TRUE. 25. Date 26. Signal of Ca di•.t� y 27. Treasurer's Acceptance of Appointment(fill in the blanks and ch: appropriate block, I, O/C� /11311/L ro ' , do here ..y,:7, the ap,.! r. . /, (Please Print or Type Name) • 1,: .4 MYCOMMISSION1FF118066 `•:-,: EXPIRES:May 11,2018 esignated above as: / ® Campaign Treasurer ElDeputy Treas er. ' Bo�eathufiey eUnaarwa Oil/V/47 X ure l.L / �`� Date Sig of Campaign Treasurer or Deputy Treasurer DS-DE 9(Rev. 10/10) Rule 1S-2.0001, F.A.C. CANDIDATE OATH — AUG 1 4 2014 NONPARTISAN OFFICE (Not for use by Judicial or __.__._.,__...__._..__. ._ School Board Candidates) OFFICE USE ONLY OATH OF CANDIDATE (Section 99.021,Florida Statutes) . za ,,z4 (PLEASE PRINT NAME AS YOU WISH IT TO APPEAR ON THE BALLOT*— NAME MAY NOT BE CHANGED AFTER THE END OF QUALIFYING) am a candidate for the nonpartisan office of rvZaaiC, (office) (district#) ; I am a qualified elector of /S (eZ'¢'c_P County, Florida; (circuit#) (group or seat#) I am qualified under the Constitution and the Laws of Florida to hold the office to which I desire to be nominated or elected; I have qualified for no other public office in the state, the term of which office or any part thereof runs concurrent with the office I seek; and I have resigned from any office from which I am required to resign pursuant to Section 99.012, Florida Statutes; and I will support the Constitution of the United States and the Constitution of the State of Florida. X (j2() $ - 9/� / • �s . Signature of err.idate Telephone Number Email Address d 2.,, • (-‘0-if�,�,r/oyer ( 32s d Address CiState ZIP Code Candidate's Florida Voter Registration Number(located on your voter information card): /00 9t X7/3 * Please print name phonetically on the line below as you wish it to be pronounced on the audio ballot for persons with disabilities(see instructions on page 2 of this form): .8—/V/713 /hij STATE OF FLORIDA J COUNTY OF'—Fre"42 --1� Sworn to(or affirmed)and subscribed before me this A''-- day of la/SOS/ ,20 AL . Personally Known: v Or = 4111.6. ri gnature of Notary P c Produced Identification: Print,Type,or Stamp Commissi ne N e f Notary Public _ •"�:YPte•• MIA GOFORTH Type of Identification Produced: iryl Notary Public-State of Florida liMy Comm.Expires May 16,2017 • r Commission EE 066939 • 9� �.1 Th,._r�Nldieael Nelp MM. DS-DE 25(Rev.5111) — Rule 1S-2.0001,F.A.C. FORM 1 STATEMENT OF 2013 Please print or type your name,mailing FINANCIAL INTERESTS Siwie ddress,agency name,and position below: FOR OFFICE USE ONLY: LAST NAME--FIRST NAME--MIDDLE NAME: HOOD, 1 o t r . MAILING ADDRESS: 7/0 SSgcE.)ZSOa A\[. l:A P E UAvEreALI FL 324120 312Eya CITY: ZIP: COUNTY: AUG 1 4 2014 NAME OF AGENCY: CA? Cpk 0.vaRQL.L. NAME OF OFFICE OR POSITION HELD OR SOUGHT: v CO J N t L, You are not limited to the space on the lines on this form.Attach additional sheets,if necessary. CHECK ONLY IF [CANDIDATE OR ❑ NEW EMPLOYEE OR APPOINTEE **** BOTH PARTS OF THIS SECTION MUST BE COMPLETED **** DISCLOSURE PERIOD: THIS STATEMENT REFLECTS YOUR FINANCIAL INTERESTS FOR THE PRECEDING TAX YEAR,WHETHER BASED ON A CALENDAR YEAR OR ON A FISCAL YEAR. PLEASE STATE BELOW WHETHER THIS STATEMENT IS FOR THE PRECEDING TAX YEAR ENDING EITHER(must check one): Er DECEMBER 31, 2013 Qg ❑ SPECIFY TAX YEAR IF OTHER THAN THE CALENDAR YEAR: MANNER OF CALCULATING REPORTABLE INTERESTS: FILERS HAVE THE OPTION OF USING REPORTING THRESHOLDS THAT ARE ABSOLUTE DOLLAR VALUES, WHICH REQUIRES FEWER CALCULATIONS, OR USING COMPARATIVE THRESHOLDS, WHICH ARE USUALLY BASED ON PERCENTAGE VALUES (see instructions for ether details). CHECK THE ONE YOU ARE USING: ❑ COMPARATIVE(PERCENTAGE)THRESHOLDS Q5 ❑ DOLLAR VALUE THRESHOLDS PART A--PRIMARY SOURCES OF INCOME [Major sources of income to the reporting person-See instructions] (If you have nothing to report,write"none"or"n/a") NAME OF SOURCE SOURCE'S DESCRIPTION OF THE SOURCE'S OF INCOME ADDRESS PRINCIPAL BUSINESS ACTIVITY 6G ECE.CrR C �QQ a/o _re iI'*'E,rQ o,..) J. Ce. GEC neacAL L�ouT'z. PART B- SECONDARY SOURCES OF INCOME [Major customers,clients,and other sources of income to businesses owned by the reporting person-See instructions] (If you have nothing to report,write"none"or"n/a") NAME OF NAME OF MAJOR SOURCES ADDRESS PRINCIPAL BUSINESS BUSINESS ENTITY OF BUSINESS'INCOME OF SOURCE ACTIVITY OF SOURCE AllA NI N/4 7V A PART C-REAL PROPERTY [Land,buildings owned by the reporting person-See instructions] FILING INSTRUCTIONS for (If you have nothing to report,write"none"or"n/a") when and where to file this 139 Las P%Inl qs A . illeefaitnistatuD form are located at the bottom /� 0 page 2. 72. D'x O " `o e. I �'- INSTRUCTIONS on who must �o �O �£-S 4v\ G.2$Co ► . file this form and how to fill it out begin on page 3. CE FORM 1-Effective:January 1,2014. (Continued on reverse side) PAGE 1 Adopted by reference in Rule 34-8.202(1),F.A.C. PART D—INTANGIBLE PERSONAL PROPERTY[Stocks,bonds,certificates of deposit,etc.-See instructions] (if you have nothing to report,write"none"or"n/a") TYPE OF I TANGIBLE BUSINESS ENTITY TO WHICH THE PROPERTY RELATES NA /VA A71/4 PART E—LIABILITIES [Major debts-See instructions] (If you have nothing to report,write"none"or"n/a") NAME OF CREDITOR ADDRESS OF CREDITOR Ai/41 h� – ! Y PART F—INTERESTS IN SPECIFIED BUSINESSES [Ownership or positions in certain 1 (If you have nothing to report,write"none"or"n/a") types of businesses-See Instructions] BUSINESS ENTITY#1 BUSINESS ENTITY#2 NAME OF BUSINESS ENTITY ADDRESS OF BUSINESS ENTITY PRINCIPAL BUSINESS ACTIVITY /V/A POSITION HELD WITH ENTITY A/A I OWN MORE THAN A 5%INTEREST IN THE BUSINESS NATURE OF MY OWNERSHIP INTEREST IF ANY OF PARTS A THROUGH F ARE CONTINUED ON A SEPARATE SHEET, PLEASE CHECK HERE ❑ T - r.fired): DATE SIGNED (reauired): kir If a certified public accountant licensed under Chapter 473, or attorney in good standing with the Florida Bar prepared this form for you, he or she must complete the following statement: I, ,prepared the CE Form 1 in accordance with Section 112.3145, Florida Statutes,and the instructions to the form. Upon my reasonable knowledge and belief, the disclosure herein is true and correct. Signature Date FILING INSTRUCTIONS: WHAT TO FILE: WHERE TO FILE: WHEN TO FILE: After completing all parts of this form, jnciudinq If you were mailed the form by the Commission Initially, each local officer/employee, state officer, #ianina and datina it, send back only the first on Ethics or a County Supervisor of Elections for and specified state employee must file within sheet(pages 1 and 2)for filing. your annual disclosure filing,return the form to that 30 daysof the date of his or her appointment location. or of the beginning of employment. Appointees If you have nothing to report in a particular Local officers/employees file with the Supervisor who must be confirmed by the Senate must file section, you must write "none" or "n/a" in that of Elections of the county in which they permanently prior to confirmation, even if that is less than section(s). reside.(If you do not permanently reside in Florida, 30 days from the date of their appointment file with the Supervisor of the county where your Candidates for publicly-elected local office must file NOTE: agency has its headquarters.) MULTIPLE FILING UNNECESSARY: at the same time they file their qualifying papers. Generally, a person who has filed Form 1 for a State officers or specified state employees file with the Commission on Ethics,P.O.Drawer 15709, Thereafter,local officers/employees,state officers, calendar or fiscal year is not required to file a Tallahassee, FL 32317-5709; physical address: and specified state employees are required to file second Form 1 for the same year. However, a 325 John Knox Road, Building E, Suite 200, by July 1st following each calendar year in which candidate who previously filed Form 1 because of Tallahassee,FL 32303. they hold their positions. another public position must at least file a copy of his or her original Form 1 when qualifying. Candidates file this form together with their Finally, at the end of office or employment, each qualifying papers. local officer/employee, state officer, and specified (IIIWstate employee is required to file a final disclosure To determine what category your position falls form(Form 1F)within 60 days of leaving office or under, see the "Who Must File" Instructions on employment. However,filing a CE Form 1F(Final page 3. Facsimiles will not be accepted. Statement of Financial Interests)does gag relieve the filer of filing a CE Form 1 if he or she was in their position on December.31,2013. CE FORM 1-Effective:January 1,2014. Adopted by reference in Rule 34-8.202(1),FAC. PAGE 2 STATEMENT OF 9FFICE USE 4NLY(fkiw CANDIDATE ' AUG 1 4 2014 (Section 106.023, F.S.) I' (Please print or type) a I 7 c' candidate for the office of 67Y11/72e- �G -�'�'G`t • have been provided access to read and understand the requirements of Chapter 106, Florida Statutes. ,,• x A Sign. of Candidate Date Each candidate must file a statement with the qualifying officer within 10 days after the Appointment of Campaign Treasurer and Designation of Campaign Depository is filed. Willful failure to file this form is a first degree misdemeanor and a civil violation of the Campaign Financing Act which may result in a fine of up to $1,000, (ss. 106.19(1)(c), 106.265(1), Florida Statutes). L DS-DE 84(05/11) CAMPAIGN TREASURER'S REPORT SUMMARY (1) Ro I2,4ii r E. 1.46 6 6 OFFICE USE ONLY,. Name (2) AUGoVo -s��rf�so floe - 1 4 2014 Address (number and street) (writ ( ( r: 1 Ft, 3, 5 \.L City, State, Zip Code ❑ Check here if address has changed (3) ID Number: (4) Check appropriate box(es): Candidate Office Sought: ell,,G i ,L CA PLT C/-+Xi, U�1'-11 L, 6011-e 0/7 ❑ 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 El Independent Expenditure(IE)(also covers an ❑ Check here if no other IE or EC reports will be filed individual making electioneering communications) (5) Report Identifiers Cover Period: From 0' / 09 / lfl To 0 g / a.a / y y Report Type: p' Er Original ❑Amendment ❑ Special Election Report (6) Contributions This Report (7) Expenditures This Report NW Monetary Cash & Checks $ , , . Expenditures $ , , 3 y • ca Loans $ , >, 'OL) • 63 Transfers to Office Account $ , , • Total Monetary $ , , • Total Monetary $ , .-3% • a 0 In-Kind $ , , • (8) Other Distributions $ , , . (9) TOTAL Monetary Contributions To Date (10) TOTAL Monetary Expenditures To Date $ , ,___20a . da $ , , -.3 d o (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) mac►, Ca! 6 /VI To Dv (Type name)/o'tx 7 C. /id 06 0 Individual(only for IE gi Treasurer 0 Deputy Treasurer 0 Candidate 0 Chairperson(only for PC and PTY) / or electioneering comm.) -- `1_ Signature 2'.--6c7r—iSignature ..- DS-DE 12(Rev.11/13) SEE REVERSE FOR INSTRUCTIONS Instructions for Campaign Treasurer's Report Summary (1) Name: full name of the candidate, political committee, party executive committee, electioneering communications organization, or individual making an independent expenditure or electioneering communication. (2) Address: the full address or post office box, city, state, and zip code. I Check the box if the address has changed since the last report filed. (3) ID Number: identification number assigned by the filing officer. (4) Check the appropriate box(es). (5) Report Identifiers Cover Period: the dates this report covers(i.e., From 1/1/15 To 1/31/55). Important: use the appropriate cover period dates as published by the filing officer. Report Type: refer to the filing officer's calendar of reporting dates for the correct codes to be used for each reporting period. If report is for a special election add"S" in front of the report code(i.e., SG3). Check one of the appropriate boxes: _. Original: first report filed for this reporting period. I Amendment: must summarize only contributions/fund transfers and expenditures/distributions being reported as additions or deletions. Read instructions for sequence numbers and amendment types on the back of Forms DS-DE 13A and 14A. Special Election Report: Important: once a special election report is filed, the entity is required to file all remaining reports due for the special election. (6) Contributions This Report: Cash and Checks: total amount for this reporting period. Loans: total amount for this reporting period. Total Monetary: sum of Cash and Checks and Loans. In-Kind: the fair market value of the in-kind contribution at the time it is given for this reporting period. (7) Expenditures This Report: Monetary Expenditures:total amount of monetary expenditures for this reporting period. Transfers to Office Account: total amount transferred to an office account by elected candidates only. Total Monetary: sum of Monetary Expenditures and Transfers to Office Account. (8) Other Distributions: the total amount of goods and services contributed to a candidate or other committee by a PC, ECO, or PTY. (9) TOTAL Monetary Contributions To Date: the amount of total monetary contributions to date. Candidates keep cumulative totals from the time the campaign depository is opened through the termination report. (10) TOTAL Monetary Expenditures To Date: the amount of total monetary expenditures to date. Candidates keep cumulative totals from the time the campaign depository is opened through the termination report. (11) Type or print the required officer's name and have them sign the report: Candidate report: treasurer and candidate must sign. PC report: treasurer and chairperson must sign. PTY report: treasurer and chairperson must sign. ECO report: organization's treasurer must sign. := IE or EC report: individual must sign (this applies when an individual acts alone to make these expenditures) AMENDMENT REPORTS: An amendment report summary should summarize only contributions, expenditures, distributions, &fund transfers being reported as additions or deletions. Read the instructions for the sequence number& amendment type fields on the back of forms DS-DE 13, 14, 14A and 94. CAMPAIGN TREASURER'S REPORT— ITEMIZED CONTRIBUTIONS (1) Name Ra AA-7u- 6 g G (2) I.D. Number (3) Cover Period ()g / /4c through / / (4) Page / of /. (5) (7) (8) (9) (10) (11) (12) Date Full Name (6) (Last,Suffix, First, Middle) Sequence Street Address& Contributor Contribution In-kind Number City, State,Zip Code Type Occupation Type Description Amendment Amount Dr/ /5t l (11 I/006 �- ' �„! elks- X300- U� ,c/1, .0 (4r'bCb/ ,./akt u,fi O / / / / / / / / / DS-DE 13(Rev.11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES INSTRUCTIONS FOR CAMPAIGN TREASURER'S REPORT - ITEMIZED CONTRIBUTIONS (1) Candidate's full name or name of the political committee (PC), electioneering communications organizations (ECO)or party executive committee(PTY). (2) The identification number assigned by the filing officer. (3) Cover period dates(e.g., 1/1/15 through 1/31/15). (See filing officer's reporting dates calendar for appropriate year and cover periods.) (4) Page numbers(e.g., 1 of 3 ). (5) Date contribution was RECEIVED(Month/Day/Year). (6) Sequence Number—Each detail line shall have a sequence number assigned to it. Sequence numbers are to be assigned within each reporting period and for each type of detail line. Thus the report type, detail line type, and sequence number will combine to uniquely identify a specific contribution, expenditure, distribution or fund transfer. This method of unique identification is required for responding to requests from the filing officer and for reporting amendments. For example, a M1 report having 75 contributions would use sequence numbers 1 through 75. The next report(M2), comprised of 40 contributions would use sequence numbers 1 through 40. Contributions on amended M1 reports would begin with sequence number 76 and on amended M2 reports would begin with sequence number 41. See the Amendment Type instructions below. (7) Type full name and address of contributor(including city, state and zip code). (8) Enter the type of contributor using one of the following codes: Occupation of contributor for contributions over$100 only. (If a business, please indicate nature of business.) I Individual B Business (also includes corporations, organizations, groups, etc.) E Electioneering Communications Organizations F Political Committee (federal or state) P Political Parties (includes federal, state and county executive committees) O Other (e.g., candidate surplus funds to party, etc.) S Candidate to Self (9) Enter Contribution Type using one of the following codes: NOTE: Cash includes cash and cashier's checks. Code Description CAS Cash or Cashier's Check CHE Check COF Carryover Funds from Previous Campaign INK In-Kind INT Interest LOA Loan MO Money Order MUC Multiple Uniform Contributions RCT Other Receipts REF Refund (Negative Amount Only) /n� CAMPAIGN TREASURER'S REPORT — FUND TRANSFERS (1) Name 1Qt L/LT l� 4 C (2) I.D. Number (3)Cover Period a / 09 l/ce through U S' l0-/ / /y (4) Page J of / (5) (7) (8) (9) (10) (11) Date Name of Financial (6) Institution Sequence Street Address& Transfer Nature of Number City,State,Zip Code Type Account Amendment Amount / / (11111, 1 DS-DE 13A(Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES INSTRUCTIONS FOR CAMPAIGN TREASURER'S REPORT— FUND TRANSFERS J (1) Type candidate's full name or name of the political committee (PC), electioneering communications organization (ECO), or party executive committee (PTY). (2) Type identification number assigned by the filing officer. (3) Type cover period dates (e.g., 1/1/15 through 1/31/15). (See filing officer's reporting dates calendar for appropriate cover periods.) (4) Type page numbers(e.g., 1 of 3). (5) Type date of fund transfer(Month/Day/Year). (6) Sequence Number - Each detail line shall have a sequence number assigned to it. Sequence numbers are to be assigned within each reporting period and for each type of detail line. Thus the report type, detail line type, and sequence number will combine to uniquely identify a specific contribution, expenditure, distribution or fund transfer. This method of unique identification is required for responding to requests from the filing officer and for reporting amendments. For example, a M1 report having 2 fund transfers would use sequence numbers 1 thru 2. The next report (M2), comprised of 4 fund transfers would use sequence numbers 1 thru 4. Fund transfers on amended M1 reports would begin with sequence number 3 and on amended M2 reports would begin with sequence number 5. See the Amendment Type instructions below. (7) Type full name and address of financial institution (including city, state and zip code). (8) Enter Transfer Type using one of the following codes: DESCRIPTION CODE Transfer FROM identified account to campaign account F Transfer TO identified account from the campaign account T (9) Nature of Account(e.g., certificate of deposit, money market, etc...) (10) Amendment Type (required on amended reports) - To add a new(previously unreported)fund transfer for the reporting period being amended, enter"ADD" in amendment type on a line with ALL of the required data. The sequence number for fund transfers with amendment type "ADD" will start at one plus the number of fund transfers in the original report. For example, amending an original M1 report that had 75 fund transfers, means the sequence number of the first fund transfer having amendment type"ADD" will be 76; the second "ADD"fund transfer would be 77, etc. When amending an original M2 report that had 40 fund transfers,the sixth"ADD"fund transfer would have sequence number 46. To correct a previously submitted fund transfer use the following drop/add procedure. Enter "DEL" in amendment type on a line with the sequence number of the fund transfer to be corrected. In combination with the report number being amended, this sequence number will identify the fund transfer to be dropped from your active records. On the next line enter "ADD" in amendment type and ALL of the required data with the necessary corrections thus replacing the dropped data. Assign the sequence number as described above. (11) Type amount of fund transfer. j CAMPAIGN TREASURER'S REPORT- ITEMIZED EXPENDITURES (1)Name , O t-r- L' 0 C (2) I.D. Number (3)Cover Period 0 / d /Al through 0 /�/ / 19 (4) Page / of / (5) (7) (8) (9) (10) (1 1) 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 b // // C 'r 0 r C'Ay�!'u C/1n/a C/'1�I v;sn.ra c_ l yv /os PoLK Ih' )z-' G IUG ,.3q DO rt-Lia /00 / C-yanw,44,nuc-,..45 L, / l I L DS-DE 14(Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES INSTRUCTIONS FOR CAMPAIGN TREASURER'S REPORT - ITEMIZED EXPENDITURES (1) Candidate's full name or name of the political committee (PC), electioneering communications organization (ECO), or party executive committee(PTY). (2) Identification number assigned by the filing officer. (3) Cover period dates (01/01/15 through 01/31/15). (See filing officer's reporting dates calendar for appropriate cover periods.) (4) Page numbers(e.g., 1 of 3). (5) Date of expenditure(Month/Day/Year). (6) Sequence Number- Each detail line shall have a sequence number assigned to it. Sequence numbers are to be assigned within each reporting period and for each type of detail line. Thus the report type, detail line type, and sequence number will combine to uniquely identify a specific contribution, expenditure, distribution or fund transfer. This method of unique identification is required for responding to requests from the filing officer and for reporting requirements. For example, a M1 report having 40 expenditures would use sequence numbers 1 through 40. The next report (M2), comprised of 30 expenditures would use sequence numbers 1 through 30. Expenditures on amended M1 reports would begin with sequence number 41 and on amended M2 reports would begin with sequence number 31. See Amendment Type instructions below. (7) Full name and address of entity receiving payment(including city, state and zip code). (8) Purpose of expenditure(if expenditure is a contribution to a candidate, also type the office sought by the candidate). PLEASE NOTE: This column does not apply to candidate expenditures, as candidates cannot contribute to other j candidates from campaign funds. However, PCs (supporting candidates) and party executive committees contributing to candidates must report office sought(Section 106.07, F.S.). (9) Enter Expenditure Type using one of the following codes: Code Description CAN Candidate Expense DIS Disposition of Funds DFC Disposition of Funds to Future Campaign(effective 11/1/13) DPP Disposition of Funds to Political Party(effective 11/1/13) DPV Disposition of Funds to Petition Verification(effective 11/1/13) ECC Electioneering Communication IEC Independent Expenditure Regarding a Candidate IEI Independent Expenditure Regarding an Issue MON Monetary(Not to a Candidate) PCW Petty Cash Withdrawn PCS Petty Cash Spent PPD Pre-paid Distribution REF Refund (Negative Amount Only) RMB Reimbursements TOA Transfer to Office Account(Disposition of Funds) (10) Amendment Type (required on amended reports) - To add a new (previously unreported) expenditure for the reporting period being amended, enter"ADD" in amendment type on a line with ALL of the required data. The sequence number for expenditures with amendment type "ADD" will start at one plus the number of expenditures in the original report. For example, amending an original M1 reports that had 75 expenditures, means the sequence number of the first expenditure having amendment type "ADD" will be 76; the second "ADD" expenditure would have sequence number 39. CAMPAIGN TREASURER'S REPORT - ITEMIZED DISTRIBUTIONS (1) Name 12p8L Q,T L No" (2) I.D. Number (3) Cover Period OY / 09 / J f through o8 I a I / /(/ (4) Page / of / (5) (7) (8) (9) (10) (1 1) (12) Date Full Name Purpose (6) (Last,Suffix,First,Middle) (add office sought if Sequence Street Address& contribution to a Related Distribution Number City,State,Zip Code candidate) Expenditures Amendment Amount Type / / LI ' / I I I / I / / Le DS-DE 14A(Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES CAMPAIGN TREASURER'S REPORT - ITEMIZED DISTRIBUTIONS THIS FORM IS USED TO REPORT DISTRIBUTIONS OF GOODS OR SERVICES CONTRIBUTED TO A CANDIDATE OR COMMITTEE, INDIRECT EXPENDITURES AND REIMBURSEMENTS. (1) Name of the entity. (2) Identification number assigned by the filing officer. (3) Cover period dates(e.g., 03/01/14 through 03/31/14). (See the filing officer's reporting dates calendar for appropriate cover periods.) (4) Page numbers(e.g., 1 of 3). (5) Date of distribution(Month/Day/Year). (6) Sequence Number- Each detail line shall have a sequence number assigned to it. Sequence numbers are to be assigned within each reporting period and for each type of detail line. Thus the report type, detail line type, and sequence number will combine to uniquely identify a specific contribution, expenditure, distribution or fund transfer. This method of unique identification is required for responding to requests from the filing officer and for reporting amendments. For example, a M1 report having 40 distributions would use sequence numbers 1 through 40. The next report (M2), comprised of 30 distributions would use sequence numbers 1 through 30. Distributions on amended M1 reports would begin with sequence number 41 and on amended M2 reports would begin with sequence number 31. See Amendment Type instructions below. (7) Full name and address of entity receiving distribution (including city, state and zip code). (8) Purpose of distribution(if distribution is a contribution to a candidate, also type the office sought by the candidate). „44) (9) For each distribution that is related to an itemized expenditure previously listed on Itemized Expenditures (Form DS-DE 14), enter the Year, Report Type and Sequence Number associated with the expenditure. *PARTY EXECUTIVE COMMITTEES ONLY - If distribution is allocable toward the contribution limits, type an"A" in this box. If distribution is nonallocable,type and "N". (10) Amendment Type (required on amended reports) - To add a new (previously unreported) distribution for the reporting period being amended, enter"ADD" in amendment type on a line with ALL of the required data. The sequence number for distributions with amendment type "ADD" will start at one plus the number of distributions in the original report. For example, amending and original M1 report that had 75 distributions, means the sequence number of the first distribution having amendment type "ADD" will be 76; the second "ADD" distribution would be 77, etc. When amending an original M2 report that had 30 distributions, the ninth "ADD" distribution would have sequence number 39. To correct a previously submitted distribution use the following drop/add procedure. Enter "DEL" in amendment type on a line with the sequence number of the distribution to be corrected. In combination with the report number being amended, this sequence number will identify the distribution to be dropped from your active records. On the next line enter "ADD" in amendment type and ALL of the required data with the necessary corrections thus replacing the dropped data. Assigns the sequence number as described above. (11) Amount of distribution. (12) Distribution Type Code Description PPD Pre-paid Distribution RMB Reimbursements Nmir) CCP Credit Card Purchase INK In-Kind Distribution CAMPAIGN TREASURER'S REPORT SUMMARY (1) 2013 t- T� j00 OFFICE USE ONLY Name (2) c.2/0StriA7!!r6A) /9p: Address 2014 Address (number and street) ( _ / � 0/eh-�sv/3 3%at.A c- t f a N M 3 0? 5' J -- v �l tiA-- City, State, Zip Code ❑ Check here if address has changed (3) ID Number: (4) Check appropriate box(es):Eir andidate Office Sought: C/71 (Gttit/</G / t�'°2 (fiii/r)vc /iv? Political PL-J2/hCommittee(PC) ❑ Electioneering Communications Org. (ECO) ❑ Check here if PC or ECO has disbanded Cl Party Executive Committee(PTY) El Check here if PTY has disbanded ❑ Independent Expenditure(IE)(also covers an ❑ Check here if no other IE or EC reports will be filed individual making electioneering communications) (5) Report Identifiers Cover Period: From O / a,Q- / /if To p 5) I a, / // Report Type: tj'f Original ❑Amendment ❑ Special Election Report (6) Contributions This Report (7) Expenditures This Report col Monetary Cash & Checks $ , , Expenditures $ • Loans $ , , • Transfers to Office Account $ , , • Total Monetary $ , , Total Monetary $ ' 0-er In-Kind $ , , .5 • Oc (8) Other Distributions $ , , . (9) TOTAL Monetary Contributions To Date (10) TOTAL Monetary Expenditures To Date $ , ,3a d • 60 $ , ,_3l da (11) Certification It is a first degree misdemeanor for any person to falsify a public record (ss. 839.13, F.S.) I certify that I have examined this report and it is true, correct, and complete: n 1 (Type name) c)y 06 71-k ti /Lr d N/ (Type name) /G Q.6�JZ 7 F /-/J 0 d 4._. ID Individual(only for IE 29 Treasurer 0 Deputy Treasurer Candidate 0 Chairperson(only for PC and PTY) (4600, or electioneering comm.) / r . -,.c,i'.-- ----- X A AfitedAidr Signature Signature DS-DE 12(Rev.11/13) SEE REVERSE FOR INSTRUCTIONS Instructions for Campaign Treasurer's Report Summary (1) Name: full name of the candidate, political committee, party executive committee,electioneering communications organization, or individual making an independent expenditure or electioneering communication. No) (2) Address: the full address or post office box, city, state, and zip code. ▪ Check the box if the address has changed since the last report filed. (3) ID Number: identification number assigned by the filing officer. (4) Check the appropriate box(es). (5) Report Identifiers Cover Period: the dates this report covers(i.e., From 1/1/15 To 1/31/55). Important: use the appropriate cover period dates as published by the filing officer. Report Type: refer to the filing officer's calendar of reporting dates for the correct codes to be used for each reporting period. If report is for a special election add"S" in front of the report code(i.e., SG3). Check one of the appropriate boxes: ▪ Original: first report filed for this reporting period. --Amendment: must summarize only contributions/fund transfers and expenditures/distributions being reported as additions or deletions. Read instructions for sequence numbers and amendment types on the back of Forms DS-DE 13A and 14A. Special Election Report: Important: once a special election report is filed, the entity is required to file all remaining reports due for the special election. (6) Contributions This Report: Cash and Checks: total amount for this reporting period. Loans: total amount for this reporting period. Total Monetary: sum of Cash and Checks and Loans. In-Kind: the fair market value of the in-kind contribution at the time it is given for this reporting period. (7) Expenditures This Report: Monetary Expenditures: total amount of monetary expenditures for this reporting period. Transfers to Office Account: total amount transferred to an office account by elected candidates only. Total Monetary: sum of Monetary Expenditures and Transfers to Office Account. (8) Other Distributions: the total amount of goods and services contributed to a candidate or other committee by a PC, ECO, or PTY. (9) TOTAL Monetary Contributions To Date: the amount of total monetary contributions to date. Candidates keep cumulative totals from the time the campaign depository is opened through the termination report. (10) TOTAL Monetary Expenditures To Date: the amount of total monetary expenditures to date. Candidates keep cumulative totals from the time the campaign depository is opened through the termination report. (11) Type or print the required officer's name and have them sign the report: Candidate report: treasurer and candidate must sign. PC report: treasurer and chairperson must sign. PTY report: treasurer and chairperson must sign. ▪ ECO report: organization's treasurer must sign. • IE or EC report: individual must sign (this applies when an individual acts alone to make these expenditures) AMENDMENT REPORTS: An amendment report summary should summarize only contributions, expenditures, distributions, &fund transfers being reported as additions or deletions. Read the instructions for the sequence number&amendment type fields on the back of forms DS-DE 13, 14, 14A and 94. j CAMPAIGN TREASURER'S REPORT— ITEMIZED CONTRIBUTIONS (1) Name gaiszfur � : IJOoG (2) I.D. Number LP' (3) Cover Period 0 9 / , / /se through b / 7 // / (4) Page / of / (5) (7) (8) (9) (10) (11) (12) Date Full Name (6) (Last,Suffix, First, Middle) Sequence Street Address& Contributor Contribution In-kind Number City, State,Zip Code Type Occupation Type Description Amendment Amount /rOUG L---L&L 117—f 3 CZ zntkot. r n/ g �-(5r op (t7ry CAnMur 5/4- eens/ v' / / L / / / / DS-DE 13(Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES L INSTRUCTIONS FOR CAMPAIGN TREASURER'S REPORT - ITEMIZED CONTRIBUTIONS (1) Candidate's full name or name of the political committee (PC), electioneering communications organizations (ECO)or party executive committee(PTY). (2) The identification number assigned by the filing officer. (3) Cover period dates(e.g., 1/1/15 through 1/31/15). (See filing officer's reporting dates calendar for appropriate year and cover periods.) (4) Page numbers(e.g., 1 of 3 ). (5) Date contribution was RECEIVED(Month/Day/Year). (6) Sequence Number—Each detail line shall have a sequence number assigned to it. Sequence numbers are to be assigned within each reporting period and for each type of detail line. Thus the report type, detail line type, and sequence number will combine to uniquely identify a specific contribution, expenditure, distribution or fund transfer. This method of unique identification is required for responding to requests from the filing officer and for reporting amendments. For example, a M1 report having 75 contributions would use sequence numbers 1 through 75. The next report(M2), comprised of 40 contributions would use sequence numbers 1 through 40. Contributions on amended M1 reports would begin with sequence number 76 and on amended M2 reports would begin with sequence number 41. See the Amendment Type instructions below. (7) Type full name and address of contributor(including city, state and zip code). (8) Enter the type of contributor using one of the following codes: Occupation of contributor for contributions over$100 only. (If a business, please indicate nature of business.) Noi) Individual B Business (also includes corporations, organizations, groups, etc.) E Electioneering Communications Organizations F Political Committee (federal or state) P Political Parties (includes federal, state and county executive committees) O Other (e.g., candidate surplus funds to party, etc.) S Candidate to Self (9) Enter Contribution Type using one of the following codes: NOTE: Cash includes cash and cashier's checks. Code Description CAS Cash or Cashier's Check CHE Check COF Carryover Funds from Previous Campaign INK In-Kind INT Interest LOA Loan MO Money Order MUC Multiple Uniform Contributions RCT Other Receipts REF Refund (Negative Amount Only) (10) Type the description of any in-kind contribution received. Candidate's Only—If in-kind contribution is from a party executive committee and is allocable (11100, toward the contribution limits,type an "A" in this box. If contribution is not allocable,type an "N". (11) Amendment Type(required on amended reports)—To add a new(previously unreported)contribution for the reporting period being amended, enter"ADD" in amendment type on a line with ALL of the required data. The sequence number for contributions with amendment type"ADD"will start at one plus the number of contributions in the original report. For example, amending an original M1 report that had 75 contributions means the sequence number of the first contribution having amendment type"ADD"will be 76; the second "ADD"contribution would be 77, etc. When amending an original M2 report that had 40 contributions, the sixth "ADD" contribution would have sequence number 46. To correct a previously submitted contribution use the following drop/add procedure. Enter"DEL" in amendment type on a line with the sequence number of the contribution to be corrected. In combination with the report number being amended, this sequence number will identify the contribution to be dropped from your active records. On the next line enter"ADD" in amendment type and ALL of the required data with the necessary corrections thus replacing the dropped data. Assign the sequence number as described above. (12) Type amount of contribution received. Political Committees ONLY: Multiple uniform contributions from the same person, aggregating NMT$250 per calendar year, collected by an organization that is the affiliated sponsor of a PC, may be reported by the PC in an aggregate amount listing the number of contributors together with the amount contributed by each and the total amount contributed during the reporting period. The identity of each person making such uniform contribution must be reported to the filing officer by July 1 of each calendar year, or, in a general election year, NLT the 60th day immediately preceding the primary election. L L CAMPAIGN TREASURER'S REPORT - FUND TRANSFERS Le (1) Name RG/3/-7717 L 1-�(JO C (2) I.D. Number (3)Cover Period 0,51 / / pct through o7 / .-.5 / /4! (4) Page of (5) (7) (8) (9) (10) (11) Date Name of Financial (6) Institution Sequence Street Address& Transfer Nature of Number City,State,Zip Code Type Account Amendment Amount /1) / / L / / � / / / I I L DS-DE 13A(Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES INSTRUCTIONS FOR CAMPAIGN TREASURER'S REPORT— FUND TRANSFERS (1) Type candidate's full name or name of the political committee (PC), electioneering communications organization (ECO), or party executive committee (PTY). (2) Type identification number assigned by the filing officer. (3) Type cover period dates (e.g., 1/1/15 through 1/31/15). (See filing officer's reporting dates calendar for appropriate cover periods.) (4) Type page numbers (e.g., 1 of 3). (5) Type date of fund transfer(Month/Day/Year). (6) Sequence Number - Each detail line shall have a sequence number assigned to it. Sequence numbers are to be assigned within each reporting period and for each type of detail line. Thus the report type, detail line type,and sequence number will combine to uniquely identify a specific contribution, expenditure, distribution or fund transfer. This method of unique identification is required for responding to requests from the filing officer and for reporting amendments. For example, a M1 report having 2 fund transfers would use sequence numbers 1 thru 2. The next report (M2), comprised of 4 fund transfers would use sequence numbers 1 thru 4. Fund transfers on amended M1 reports would begin with sequence number 3 and on amended M2 reports would begin with sequence number 5. See the Amendment Type instructions below. (7) Type full name and address of financial institution (including city, state and zip code). (8) Enter Transfer Type using one of the following codes: DESCRIPTION CODE Transfer FROM identified account to campaign account F Transfer TO identified account from the campaign account T (9) Nature of Account(e.g., certificate of deposit, money market, etc...) (10) Amendment Type (required on amended reports) - To add a new(previously unreported)fund transfer for the reporting period being amended, enter"ADD" in amendment type on a line with ALL of the required data. The sequence number for fund transfers with amendment type "ADD" will start at one plus the number of fund transfers in the original report. For example, amending an original M1 report that had 75 fund transfers, means the sequence number of the first fund transfer having amendment type"ADD" will be 76; the second "ADD"fund transfer would be 77, etc. When amending an original M2 report that had 40 fund transfers,the sixth"ADD"fund transfer would have sequence number 46. To correct a previously submitted fund transfer use the following drop/add procedure. Enter "DEL" in amendment type on a line with the sequence number of the fund transfer to be corrected. In combination with the report number being amended, this sequence number will identify the fund transfer to be dropped from your active records. On the next line enter "ADD" in amendment type and ALL of the required data with the necessary corrections thus replacing the dropped data. Assign the sequence number as described above. (11) Type amount of fund transfer. CAMPAIGN TREASURER'S REPORT- ITEMIZED EXPENDITURES (tie (1) Name 7Z O6L`?ZT L - (;/ (2) I.D. Number (3)Cover Period ,/; /c /1c/ through •;' /,?() ///c,/ (4) Page ` of (5) (7) (8) (9) (10) (11) Date Full Name Purpose (6) (Last,Suffix,First,Middle) (add office sought if Sequence Street Address& contribution to a Expenditure Number City,State,Zip Code candidate) Type Amendment Amount A/17// L DS-DE 14(Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES INSTRUCTIONS FOR CAMPAIGN TREASURER'S REPORT - ITEMIZED EXPENDITURES (1) Candidate's full name or name of the political committee (PC), electioneering communications organization (ECO), or party executive committee(PTY). (2) Identification number assigned by the filing officer. (3) Cover period dates (01/01/15 through 01/31/15). (See filing officer's reporting dates calendar for appropriate cover periods.) (4) Page numbers(e.g., 1 of 3). (5) Date of expenditure(Month/Day/Year). (6) Sequence Number - Each detail line shall have a sequence number assigned to it. Sequence numbers are to be assigned within each reporting period and for each type of detail line. Thus the report type, detail line type, and sequence number will combine to uniquely identify a specific contribution, expenditure, distribution or fund transfer. This method of unique identification is required for responding to requests from the filing officer and for reporting requirements. For example, a M1 report having 40 expenditures would use sequence numbers 1 through 40. The next report (M2), comprised of 30 expenditures would use sequence numbers 1 through 30. Expenditures on amended M1 reports would begin with sequence number 41 and on amended M2 reports would begin with sequence number 31. See Amendment Type instructions below. (7) Full name and address of entity receiving payment(including city, state and zip code). (8) Purpose of expenditure (if expenditure is a contribution to a candidate, also type the office sought by the candidate). PLEASE NOTE: This column does not apply to candidate expenditures, as candidates cannot contribute to other candidates from campaign funds. However, PCs (supporting candidates) and party executive committees contributing to candidates must report office sought(Section 106.07, F.S.). (9) Enter Expenditure Type using one of the following codes: Code Description CAN Candidate Expense DIS Disposition of Funds DFC Disposition of Funds to Future Campaign(effective 11/1/13) DPP Disposition of Funds to Political Party(effective 11/1/13) DPV Disposition of Funds to Petition Verification(effective 11/1/13) ECC Electioneering Communication IEC Independent Expenditure Regarding a Candidate IEI Independent Expenditure Regarding an Issue MON Monetary(Not to a Candidate) PCW Petty Cash Withdrawn PCS Petty Cash Spent PPD Pre-paid Distribution REF Refund (Negative Amount Only) RMB Reimbursements TOA Transfer to Office Account(Disposition of Funds) (10) Amendment Type (required on amended reports) - To add a new (previously unreported) expenditure for the reporting period being amended, enter"ADD"in amendment type on a line with ALL of the required data. The sequence number for expenditures with amendment type "ADD" will start at one plus the number of expenditures in the original report. For example, amending an original M1 reports that had 75 expenditures, means the sequence number of the first expenditure having amendment type "ADD" will be 76; the second "ADD" expenditure would have sequence number 39. (1111, To correct a previously submitted expenditure use the following drop/add procedure. Enter "DEL" in amendment type on a line with the sequence number of the expenditure to be corrected. In combination with the report number being amended, this sequence number will identify the expenditure to be dropped from your active records. On the next line enter"ADD" in amendment type and ALL of the required data with the necessary corrections thus replacing the dropped data. Assign the sequence number as described above. (11) Amount of expenditure. L CAMPAIGN TREASURER'S REPORT - ITEMIZED DISTRIBUTIONS 41w (1) Name AGl3 z r . 40 (2) I.D. Number (3) Cover Period OS' /.1D._ / ly through 657 1,1, / /L/ (4) Page / of / (5) (7) (8) (9) (10) (11) (12) Date Full Name Purpose (6) (Last,Suffix,First,Middle) (add office sought if Sequence Street Address& contribution to a Related Distribution Number City,State,Zip Code candidate) Expenditures Amendment Amount Type /1//() / / ‘1101, / / DS-DE 14A(Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES CAMPAIGN TREASURER'S REPORT - ITEMIZED DISTRIBUTIONS THIS FORM IS USED TO REPORT DISTRIBUTIONS OF GOODS OR SERVICES CONTRIBUTED TO A CANDIDATE NEOF OR COMMITTEE, INDIRECT EXPENDITURES AND REIMBURSEMENTS. (1) Name of the entity. (2) Identification number assigned by the filing officer. (3) Cover period dates(e.g., 03/01/14 through 03/31/14). (See the filing officer's reporting dates calendar for appropriate cover periods.) (4) Page numbers (e.g., 1 of 3). (5) Date of distribution (Month/Day/Year). (6) Sequence Number- Each detail line shall have a sequence number assigned to it. Sequence numbers are to be assigned within each reporting period and for each type of detail line. Thus the report type, detail line type, and sequence number will combine to uniquely identify a specific contribution, expenditure, distribution or fund transfer. This method of unique identification is required for responding to requests from the filing officer and for reporting amendments. For example, a M1 report having 40 distributions would use sequence numbers 1 through 40. The next report (M2), comprised of 30 distributions would use sequence numbers 1 through 30. Distributions on amended M1 reports would begin with sequence number 41 and on amended M2 reports would begin with sequence number 31. See Amendment Type instructions below. (7) Full name and address of entity receiving distribution(including city, state and zip code). (8) Purpose of distribution(if distribution is a contribution to a candidate, also type the office sought by the candidate). (9) For each distribution that is related to an itemized expenditure previously listed on Itemized Expenditures (Form DS-DE 14), enter the Year, Report Type and Sequence Number associated with the expenditure. *PARTY EXECUTIVE COMMITTEES ONLY - If distribution is allocable toward the contribution limits, type an"A" in this box. If distribution is nonallocable,type and "N". (10) Amendment Type (required on amended reports) - To add a new (previously unreported) distribution for the reporting period being amended, enter"ADD"in amendment type on a line with ALL of the required data. The sequence number for distributions with amendment type "ADD" will start at one plus the number of distributions in the original report. For example, amending and original M1 report that had 75 distributions, means the sequence number of the first distribution having amendment type "ADD" will be 76; the second "ADD" distribution would be 77, etc. When amending an original M2 report that had 30 distributions, the ninth "ADD" distribution would have sequence number 39. To correct a previously submitted distribution use the following drop/add procedure. Enter "DEL" in amendment type on a line with the sequence number of the distribution to be corrected. In combination with the report number being amended, this sequence number will identify the distribution to be dropped from your active records. On the next line enter "ADD" in amendment type and ALL of the required data with the necessary corrections thus replacing the dropped data. Assigns the sequence number as described above. (11) Amount of distribution. (12) Distribution Type Code Description PPD Pre-paid Distribution RMB Reimbursements 'Nur) CCP Credit Card Purchase INK In-Kind Distribution WAIVER OF REPORT SEP 1 8 2014 lime (Section 106.07(7), F.S.) ,-(16,12i3 tf l `121' (PLEASE TYPE) -- ._.OFFICE-USE ONLY VW Z/ Ro61-' r E. /to d 6 CITY Ca /Ve- Name Office Sought , 2/D 3-e- L-/LSON `/(1 • C# eL IvA u�AAL_ fL 2,,,)q .)-0 Address City State Zip Code ®Candidate ❑Political Committee ❑Electioneering Communications Organization ❑Party Executive Committee ❑ Check here if address has changed since last report. ❑ Check here if PC or ECO has DISBANDED and will no longer file reports. TYPE OF REPORT(Check Appropriate Box and Complete Applicable Line beneath Box) MONTHLY REPORT ❑PRIMARY ELECTION RGENERAL ELECTION EITHER REPORT TYPE ce Indicate report# Indicate report# Indicate report# Indicate report type and# M P G '-a- as applicable: ^ 0 TERMINATION REPORT 0 SPECIAL ELECTION NOTIFICATION OF NO ACTIVITY IN CAMPAIGN ACCOUNT FOR THE REPORTING PERIOD OF MO Al THROUGH 4 9 42- 7/ X / F//Y//y Signature Date X --i_. V-4 ,,e,Pe' 0 1/ S' !A{ Signature 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.) Electioneering Communications Organizations: Treasurer (s. 106.0703(4)(c), F.S.) Party Executive Committees: Treasurer and Chairman (s. 106.29(2), F.S.) 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. 11/13) WAIVER OF REPORT F` SEP 2 6 �1-4- -1''I'la)it_I,''' 4 (Section 106.07(7), F.S.) t (PLEASE TYPE) EiiI . ' -OFFICE USE ONLY 8d 2 r Z.22 A/o o4 C I 7 y Cau/J c/L Name Office Sought ,9./d IL /cFL'W2 SOP tO tri.- Cha' CR' N.4 t)t1v1-6 ) rt. __20 501-0 Address City State Zip Code 1 Candidate 0 Political Committee ❑Electioneering Communications Organization ❑Party Executive Committee ❑ Check here if address has changed since last report. ❑ Check here if PC or ECO 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 Le Indicate report# Indicate report# Indicate report# Indicate report type and# M P G_ as applicable: ❑ TERMINATION REPORT 0 SPECIAL ELECTION NOTIFICATION OF NO ACTIVITY IN CAMPAIGN ACCOUNT FOR THE REPORTING PERIOD OF CI /13 1/4 THROUGH 0 722 ` j/� X .d .:-) 7/20 5L .ignatu�re Date X ----7-..?_ .,,e--e--' ` Signature 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.) Electioneering Communications Organizations: Treasurer (s. 106.0703(4)(c), F.S.) Party Executive Committees: Treasurer and Chairman (s. 106.29(2), F.S.) 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.11/13) OCT - 82014 WAIVER OF REPORT �_ _:;. (Section 106.07(7), F.S.) (PLEASE TYPE) OFFICE USE ONLY 026AL' /LT t . liDU a (/ry CvuNcR_ Name Office Sought O/ p Z-L7/'L5rLJ-a /�0 J 1 vra®ficcGf Ciel Pe rA iom // 71A(, fiWtrhl, 3c)-901-0 Address City State Zip Code Candidate El Political Committee ❑Electioneering Communications Organization ❑Party Executive Committee ❑ Check here if address has changed since last report. ❑ Check here if PC or ECO 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 EIOTHER REPORT TYPE L. Indicate report# Indicate report# Indicate report# Indicate report type and# M P G ,• , as applicable: 0 TERMINATION REPORT 0 SPECIAL ELECTION NOTIFICATION OF NO ACTIVITY IN CAMPAIGN ACCOUNT FOR THE REPORTING PERIOD OF 9/a7//9 THROUGH / Oid3//y X / /6/0 Ff//V Sign.,,ure Date X /diC ' a/ ° a1 Signature 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.) Electioneering Communications Organizations: Treasurer (s. 106.0703(4)(c), F.S.) Party Executive Committees: L, Treasurer and Chairman (s. 106.29(2), F.S.) 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. 11/13) • WAIVER OF REPORT 160. (Section 106.07(7), F.S.) OCT 1 42014 (PLEASE TYPE) _.__-- OFFICE USE ONLY 49 Pe)ALCIZT E. I/0O G C/J`7 (JwNe/L Name Office Sought a/o 3-E77-7L-2SON fi UeOL/e 09P,aTNn OCA/9 fi aitio dr 3d 9 Address City State Zip Code ®Candidate ID Political Committee Electioneering Communications Organization 0 Party Executive Committee ❑ Check here if address has changed since last report. ❑ Check here if PC or ECO 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 DOTHER REPORT TYPE Indicate report# Indicate report# Indicate report# Indicate report type and# as applicable: M P G- 0 TERMINATION REPORT 0 SPECIAL ELECTION NOTIFICATION OF NO ACTIVITY IN CAMPAIGN ACCOUNT FOR THE REPORTING PERIOD OF /v/61.74/>e THROUGH Jo I/ o /Al I /`w/ X - . n /0449- ature Date X _____)7,4-, r/ee21 /U//y // l Signature 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.) Electioneering Communications Organizations: Treasurer (s. 106.0703(4)(c), F.S.) Party Executive Committees: Treasurer and Chairman (s. 106.29(2), F.S.) 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. 11/13) WAIVER OF REPORT OCT 2 12014 (Section 106.07(7),F.S.) _ ----zi-i - � (PLEASE TYPE) / e� ____OFFICt= ?d ,et.r £ H 006 C11-YCOUP1JCIL Name Office Sought 462./a j FrGfZSONAU&aC/c CCSa - Cei,thivLAfit 1 voi, 3c).9a.o Address City State Zip Code �w Candidate ❑Political Committee ❑Electioneering Communications Organization ❑Party Executive Committee ❑ Check here if address has changed since last report. ❑ Check here if PC or ECO has DISBANDED and will no longer file reports. TYPE OF REPORT(Check Appropriate Box and Complete Applicable Line beneath Box) ElMONTHLY REPORT ❑PRIMARY ELECTION GENERAL ELECTION ❑OTHER REPORT TYPE Indicate report# Indicate report# Indicate report# Indicate report type and# M P G —lc as applicable: 0 TERMINATION REPORT ❑ SPECIAL ELECTION NOTIFICATION OF NO ACTIVITY IN CAMPAIGN ACCOUNT FOR THE REPORTING PERIOD OF , i�// Ji y THROUGH f D//"7 //V X ,C ,C-Il /016/ bq Sign re Date X /oda/ //5 Signature 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.) Electioneering Communications Organizations: c Treasurer (s.106.0703(4Xc), F.S.) Party Executive Committees: Treasurer and Chairman (s. 106.29(2), F.S.) 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.11113) LAG � OMC�Th WAIVER OF REPORT --I LJ OCT 31 2014 J (Section 106.07(7),F.S.) c - )7(%---) ' (PLEASE TYPE) OFFICE USE ONLY Reei ET J7'/ itG at y Cwiit Name Office Sought (>210 jiff files aM g 0111d aye 090 /g 5.- .Ra 9)-() Address City State Zip Code Candidate El Political Committee Electioneering Communications Organization ElParty Executive Committee ❑ Check here if address has changed since last report. ❑ Check here if PC or ECO has DISBANDED and will no longer file reports. TYPE OF REPORT(Check Appropriate Box and Complete Applicable Line beneath Box) ElMONTHLY REPORT ❑PRIMARY ELECTION 15ZIGENERAL ELECTION ®OTHER REPORT TYPE Indicate report# Indicate report# Indicate report# Indicate report type and# as applicable: M P G_-_-.1_ 0 TERMINATION REPORT 0 SPECIAL ELECTION NOTIFICATION OF NO/ ACTIVITY IN CAMPAIGN ACCOUNT FOR THE REPORTING PERIOD OF /d/ii /iv THROUGH /0/361//9' X ZA1/1 /1-1— - /0%14/ /611,IN 'Srgnature Date X C I /o/i///9' Signatu 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.) Electioneering Communications Organizations: Treasurer (s.106.0703(4xc),F.S.) -- Party Executive Committees: Treasurer and Chairman (s. 106.29(2), F.S.). 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.11/13) CAMPAIGN TREASURER'S REPORT SUMMARY kire I (1) KO13&et-? Z— • A0OFFICE USE ONLY Name &Wu 3L5 (© IOV (Z(2) n?/h -S�f[G~2so .) 4:- D V 15 Address (number and street) NOV 13 2014 City, State, Zip Code Per ❑ Check here if address has changed (3) . ��6eL- (4) Check appropriate box(es): (•Candidate Office Sought: C/--9C1 aJGi(— ❑ 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 /44, / 3/ / /v To 4 / 1.3 / /� Report Type: T g ❑ Original ❑Amendment ❑ Special Election Report (6) Contributions This Report (7) Expenditures This Report L, Monetary Cash & Checks $ , , Expenditures $ , , G/ , Uo Loans $ , ,300 • 0 0 Transfers to Office Account $ , Total Monetary $ , , • Total Monetary $ , 014/ . triO In-Kind $ , , • (8) Other Distributions $ , - (9) TOTAL Monetary Contributions To Date (10) TOTAL Monetary Expenditures To Date $ , , ..gua . oo $ , ,3UU . ria (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: Ito(Type name) J O yr�f 1/.///�O/L%O/1J (Type name) 12 6136 AT L-. ,4 o u G o Individual(only for IE 1 Treasurer 0 Deputy Treasurer gpandidate / 0 Chairperson(only for PC and PTY) Lor electioneering comm.) .,,-2frii.- ____ x 4 Signature ��J/ 'V Signature AL DS-DE 12(Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS Instructions for Campaign Treasurer's Report Summary (1) Name: full name of the candidate, political committee, party executive committee, electioneering communications organization, or individual making an independent expenditure or electioneering communication. (2) Address: the full address or post office box, city, state, and zip code. - Check the box if the address has changed since the last report filed. (3) , ID Number: identftieation number assigned by the filing officer. (4) Check the appropriate boxjes). (5) Report Identifiers Cover Period: the dates this report covers(i.e., From 1/1/15 To 1/31/55). Important: use the appropriate cover period dates as published by the filing officer. Report Type: refer to the filing officer's calendar of reporting dates for the correct codes to be used for each reporting period. If report is for a special election add "S" in front of the report code(i.e., SG3). Check one of the appropriate boxes: _. Original: first report filed for this reporting period. Amendment: must summarize only contributions/fund transfers and expenditures/distributions being reported as additions or deletions. Read instructions for sequence numbers and amendment types on the back of Forms DS-DE 13A and 14A. Special Election Report: Important: once a special election report is filed, the entity is required to file all remaining reports due for the special election. (6) Contributions This Report: Cash and Checks: total amount for this reporting period. Loans: total amount for this reporting period. Total Monetary: sum of Cash and Checks and Loans. In-Kind: the fair market value of the in-kind contribution at the time it is given for this reporting period. (7) Expenditures This Report: `11)Monetary Expenditures: total amount of monetary expenditures for this reporting period. Transfers to Office Account: total amount transferred to an office account by elected candidates only. Total Monetary: sum of Monetary Expenditures and Transfers to Office Account. (8) Other Distributions: the total amount of goods and services contributed to a candidate or other committee by a PC, ECO, or PTY. (9) TOTAL Monetary Contributions To Date: the amount of total monetary contributions to date. Candidates keep cumulative totals from the time the campaign depository is opened through the termination report. (10) TOTAL Monetary Expenditures To Date: the amount of total monetary expenditures to date. Candidates keep cumulative totals from the time the campaign depository is opened through the termination report. (11) Type or print the required officer's name and have them sign the report: - Candidate report: treasurer and candidate must sign. I PC report: treasurer and chairperson must sign. PTY report: treasurer and chairperson must sign. ▪ ECO report: organization's treasurer must sign. • IE or EC report: individual must sign (this applies when an individual acts alone to make these expenditures) AMENDMENT REPORTS: An amendment report summary should summarize only contributions, expenditures, distributions, &fund transfers being reported as additions or deletions. Read the instructions for the sequence number& amendment type fields on the back of forms DS-DE 13, 14, 14A and 94. j CAMPAIGN T �ASURER'S REPORT— ITEMIZED EXPENDITURES (1) Name /d n T L DU 6 (2) LD. Number (3)Cover Period /0 /3/ / through /// / 13 / /y (4) Page / of (5) (7) (8) (9) (10) (11) Date Full Name Purpose (6) (Last,Suffix,First,Middle) (add office sought if Sequence Street Address& contribution to a Expenditure Number City,State,Zip Code candidate) Type Amendment Amount ///3 //q #006 LE6 /C. ,, I /o �t'F`�'SG� L R/n3 �6/, 6a dao , / / / / / / / / / / / / / / L DS-DE 14(Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES INSTRUCTIONS FOR CAMPAIGN TREASURER'S REPORT - ITEMIZED EXPENDITURES (1) Candidate's full name or name of the political committee (PC), electioneering communications organization (ECO), or party executive committee(PTY). (2) Identification number assigned by the filing officer. (3) Cover period dates (01/01/15 through 01/31/15). (See filing officer's reporting dates calendar for appropriate cover periods.) (4) Page numbers(e.g., 1 of 3). (5) Date of expenditure(Month/Day/Year). (6) Sequence Number- Each detail line shall have a sequence number assigned to it. Sequence numbers are to be assigned within each reporting period and for each type of detail line. Thus the report type, detail line type, and sequence number will combine to uniquely identify a specific contribution, expenditure, distribution or fund transfer. This method of unique identification is required for responding to requests from the filing officer and for reporting requirements. For example, a M1 report having 40 expenditures would use sequence numbers 1 through 40. The next report (M2), comprised of 30 expenditures would use sequence numbers 1 through 30. Expenditures on amended M1 reports would begin with sequence number 41 and on amended M2 reports would begin with sequence number 31. See Amendment Type instructions below. (7) Full name and address of entity receiving payment(including city, state and zip code). (8) Purpose of expenditure (if expenditure is a contribution to a candidate, also type the office sought by the candidate). „qui) PLEASE NOTE: This column does not apply to candidate expenditures, as candidates cannot contribute to other candidates from campaign funds. However, PCs (supporting candidates) and party executive committees contributing to candidates must report office sought(Section 106.07, F.S.). (9) Enter Expenditure Type using one of the following codes: Code Description CAN Candidate Expense DIS Disposition of Funds DFC Disposition of Funds to Future Campaign(effective 11/1/13) DPP Disposition of Funds to Political Party(effective 11/1/13) DPV Disposition of Funds to Petition Verification(effective 11/1/13) ECC Electioneering Communication IEC Independent Expenditure Regarding a Candidate IEI Independent Expenditure Regarding an Issue MON Monetary(Not to a Candidate) PCW Petty Cash Withdrawn PCS Petty Cash Spent PPD Pre-paid Distribution REF Refund(Negative Amount Only) RMB Reimbursements TOA Transfer to Office Account(Disposition of Funds) (10) Amendment Type (required on amended reports) - To add a new (previously unreported) expenditure for the reporting period being amended, enter"ADD"in amendment type on a line with ALL of the required data. The sequence number for expenditures with amendment type "ADD" will start at one plus the number of '111) expenditures in the original report. For example, amending an original M1 reports that had 75 expenditures, means the sequence number of the first expenditure having amendment type "ADD" will be 76; the second "ADD" expenditure would have sequence number 39. CITY OF CAPE CANAVERAL CANDIDATE FOR CITY COUNCIL TRACKING FORM NAME: a PHONE: 56g - Xq/G ADDRESS: 2© --c--c-72-.1-04/ ar c Date Qualified/Paid Qualifying Fee: Sf ith�- itiq „oo QUALIFYING FEE: $39.00 ' ($15.00 Qualifying + $24.00 Election Assessment) PAPERS FILED DATE FILED Candidate Packet Acknowledgement 5"///2--//4664 DS-DE 9, Appointment of Campaign Treasurer and Designation of )i J Campaign Depository for Candidates I /I DS-DE 25, Loyalty Oath for Non-Partisan Office with Candidate Name Pronunciation Request 1 CE Form 1,(Jan 1, 2013) Statement of Financial Interests j/��I DS-DE 84, Statement of Candidate / (due 10 days after DS-DE9) F/4// 2014 Candidate Reporting Deadlines Section 106.07(1), F.S Period Covered Report Due Date Date Filed Code 08/02/14 -08/08/14 P6 August 15, 2014 08/09/14-08/21/14 P7 August 22, 2014 14 VW 08/22/14-08/29/14 G1 September 5, 2014 ��fib/ 08/30/14-09/12/14 G2 September 19, 2014 /i,/,y N} 09/13/14 - 09/26/14 G3 October 3, 2014 _ 9/26/1/ 09/27/14- 10/03/14 G4 October 10, 2014 /%/SSL 10/04/14- 10/10/14 G5 October 17, 2014 14 // /s' 44- 10/11/14 Q4.10/11/14- 10/17/14 G6 October 24, 2014 /p/ 10/18/14- 10/30/14 G7 October 31, 2014 In/..i>/// Campaign Treasurer's TR February 2, 201,4'$ Report Period: Date (NOTE: if no opposition at varies end of Qualifying Period, Due Date is 11/20/2014) //7/ '// 61/14/0614 c!:.s9 H'ri eiMe6256 iotas 39.96 d:,7 Hmount 16. 9 Lr, ,;v- 8.99 ..K li,;. a uL11 Hmtunt $.'9.86