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HomeMy WebLinkAboutFiling Papers and Campaign Reports DW 2014 kijiloilk CITY OF CAPE CANAVERAL, FLORIDA CANDIDATE PACKET ACKNOWLEDGEMENT I ----e);•3 N 4 6 ANbRes.) fill a i-t t 5 would like to qualify as a candidate for City Council and do hereby 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. OFFICE USE ONLY 1 Signature EAUG 182014Hui 8//8//Y .'2z Date Enter Date&Time Received and Initials of Clerk's Office Staff Member APPOINTMENT OF CAMPAIGN TREASURER AND DESIGNATION OF CAMPAIGN AUG 1 8 2014 DEPOSITORY FOR CANDIDATES (Section 106.021(1), F.S.) (PLEASE PRINT OR TYPE) (--- ki) Y. !tc, dime _ NOTE: This form must be on file with the qualifying G 1,e 69.c(.9der..r officer before opening the campaign account. OFFICE USE ONLY 1.CHECK APPROPRIATE BOX(ES): d Initial Filing of Form Re-filing to Change: ❑ Treasurer/Deputy ❑ Depository ❑ Office ❑ Party 2. Name of Candidate(in this order: First, Middle, Last) 3.Address(include post office box or street, city, state,zip code) bows,1tD A-1410Rew (A)i't-i<<s 014.4 P.Ert'lb b ei- Rt.c, 1-A. 4. Telephone 5. E-mail address ix 301 ( 3d- )20 6813 10s. w..-t,.ts- 4 14K,4 .° 6.4 � _ .Gc.+N LRAE Cm,ow �214c.- I �'l, 3 Z9Zo 6.Office sought(include district, circuit, group number) 7. If a candidate for a nonpartisan office,check if ,�vy _� ,,pp //� applicable: `t�1Q� (-�iQNI�V 6AL Al I C.�O,,t, LaL D 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. el. I have appointed the following person to act as my fl Campaign Treasurer ❑ Deputy Treasurer 10. Name of Treasurer or Deputy Treasurer . boNe i RNbJ2EW O1i.t..;5 11. Mailing Address 12. Telephone brie P(46 R.:7-t. be, R,,, JIQ. . 3 cr ( z34, ) z9 (73 13. City 14. County 15. State 16. Zip Code 17. E-mail address CAPE 6`.WilVeePL ( .cVAI FZ 3.?.. 20 D. t.,.wt,,,,s g_PoR,--„.Wcu.2s .GG".. 18. I have designated the following bank as my 0 Primary Depository ❑ Secondary Depository 19. Name of Bank 20.Address 1,06 t.L.5 ?ftkG-a /56) l\J . kr di-ou i c- A-V E 21. City 22. County 23. State 24. Zip Code CAP E Ni A41 Ei2-14 4- 6 R.E V(1,2--a F-1.- 3247 z C) UNDER PENALTIES OF PERJURY,I DECLARE THAT I HAVE READ THE FOREGOING FORM FOR APPOINTMENT OF CAMPAIGN TREASURER AND DESIGNATION OF CAMPAIGN DEPOSITORY AND TH CTS STATED IN IT ARE TRUE. 25. Date Signature Candid zjize zo f)tte044 Si" 20 I 4* 27. Treasurer's Acceptance of Appointment(fill in the blanks and check the appropriate block) I, b i. - /u_. A1v2 LA.)''-c_t 5 , do hereby accept the appointment (Please Print or Type Name) Lesignated above as: ai Campaign Treasur Deputy Treasurer. 0 1 20 Ai,lCs nST %1 d� (A, Date Date 4-4- Signature of Campaign Treasurer or Deputy Treasurer DS-DE 9(Rev. 10/10) Rule 1S-2.0001, F.A.C. (be CANDIDATE OATH - AUG 2 1 2014 NONPARTISAN OFFICE ri (Not for use by Judicial or School Board Candidates) OFFICE USE ONLY OATH OF CANDIDATE T • (Section 99.021,Florida Statutes) • I, I o N (1Q (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 L 1-rti COt4t (office) (district#) ; I am a qualified elector of t iRE'V AR) 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. A1y _6,073 • Pogn ..W ew Signature of Candidate Telephone Number Email Address •CL)M 81(oat fidv 12-rt).1)64. Aa ba CAp CAD.; F-- 3Z 1 w Address 30 1 City State ZIP Code Candidate's Florida Voter Registration Number(located on your voter information card): I I 1610 2.56 '7 *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): 4NI W 11,.Lv s STATE OF FLO EtIEJA COUNTY OF r/ -V19-/2 Sworn to(or affirmed)and subscribed before me this G/S1 day of U I ,20/ Personally Known: or Signat e of Notary Public Produced Identification: 1,7 Pri .e .r - . • Notary Public w.wy� IMA fiOFORTM Type of Identification Produced: � i✓�/ ti CSQ ,%' Notary Public•Stale of Flotilla IAy comm.E>tp►a May 16,1017 Commission N EE eee93�9.r 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] jddress,agency name,and position below: FOR OFFICE USE ONLY: LAST NAME. FIRST NAME-MIDDLE NAME: • ILL.I WI - 1)0A.)Ai•,.a — 1lntDR,OVJ MAILING ADDRESS: • 89 404 Pt4Ckr, Dfsl.. RID btRtvE gr 30) CITY: ZIP: COUNTY: CAPE L' A11A,YER-RA , 32,5 Zo Cir��Ra,� AUG 2 1 2014 • NAME OF AGENCY: /f _ CAPE CANAvcm.L. 61-1 NAME OF OFFICE OR POSITION HELD OR SOUGHT: . CAPE 0-Ari �u eiLit cl'r4 Coq mc You are not limited to the space on the lines on this for&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): Ur DECEMBER 31,2013 QE ❑ 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 rther details). CHECK THE ONE YOU ARE USING: ❑ COMPARATIVE(PERCENTAGE)THRESHOLDS QE �� 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 Pbtaxv UJu.t s } 1 Nc. f 7.o WG gsr-c. &R4) OC.2724 SoFR•►Ataf aEVEt4 fntar- 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 Po cz W 44.I' RS I k-Il 1/41:EIZNIATIDAAL. i `""ti.. t r71C3'j REs itac.e+ l ev. tt q1L(.# VYIfr1-+^IDA &tar% µ�q t� gjcc1 C�tlA2tTR8l.E C�iK !cRL E_caomt nor.-l-a� LN 47¢C Z MED icRL_ b£v'c eS 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 N f� form are located at the bottom of page 2. INSTRUCTIONS on who must 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 INTANGIBLE BUSINESS ENTITY TO WHICH THE PROPERTY RELATES 41111101 6"rbiGg.6 -- I R* CA-JdP L65 SC H w A Gk Ec4-i /5/011X14.6 µ41E—5 .#IRG.-o . t1 PART E—LIABILITIES [Major debts-See instructions] (If you have nothing to report,write"none"or"n/a") NAME OF CREDITOR ADDRESS OF CREDITOR PART F—INTERESTS IN SPECIFIED BUSINESSES [Ownership or positions in certain types of businesses-See instructions] (If you have nothing to report,write"none"or"n/a") BUSINESS ENTITY#1 BUSINESS ENTITY#2 NAME OF BUSINESS ENTITY /1/410h.,- JU0�.£- ADDRESS OF BUSINESS ENTITY PRINCIPAL BUSINESS ACTIVITY POSITION HELD WITH ENTITY I OWN MORE THAN A 5%INTEREST IN THE BUSINESS NATURE OF MY OWNERSHIP INTEREST IF ANY OF PARTS A THROUGH F ARE CONTINUED ON A SEPARATE SHEET, PLEASE CHECK HERE ❑ ISIGNATURE (reauired): DATE SIGNED (required): 4.1-e . :;):,,-,......de_44ele,,,,J )-1 Zo Aur 2...01 y- 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, Including If you were mailed the form by the Commission Initially, each local officer/employee, state officer, sianina 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 days of the date of his or her appointment location. or of the beginning of employment g g 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.) at the same time they file their qualifying papers.MULTIPLE FILING UNNECESSARY: State officers or specified state employees file Generally, a person who has filed Form 1 for a Thereafter,local officers/employees,state officers, with the Commission on Ethics,P.O.Drawer 15709, 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 Candidates file this form together with their Finally, at the end of office or employment, each his or her original Form 1 when qualifying. quali in local officer/employee, state officer, and specified fy g papers. state employee is required to file a final disclosure Li . 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. Statement of Financial Interests)does> relieve Facsimiles will not be accepted. 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. PAGE 2 Adopted by reference in Rule 34-8.202(1),F.A.C. OFFICE USE ONLY STATEMENT OF CANDIDATE (Section 106.023, F.S.) AUG 2 1 2014 (Please print or type) I, �oNAt-D 0.1a W lLI.15 candidate for the office of Ci-r1 Gout L of £Ap e_nn(AveRiv . ; have been provided access to read and understand the requirements of Chapter 106, Florida Statutes. L ) zo Zo e Li' Signa ure 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-S JMMARY I I ftoi (1) 'OiV 0i.a A ., WILL-is OFFICE USE ONLY '' Name ;' ' AUG 2 1 2014 1 (2) el&i# PP£a& 1361, Ra . 30 t Address (number and street) �' J CDE 6410hV c9ArL_ FL- 32 _ City, State, Zip Code ❑ Check here if address has changed (3) ID Number: (4) Check appropriate box(es): /� _ ['Candidate Office Sought: f-rry CN 1Uc., V ❑ Political Committee(PC) ❑ Electioneering Communications Org. (ECO) 0 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 B I 9 I /ii To 9 / Z/ / /4' Report Type: P 7- ❑ Original ❑Amendment ❑ Special Election Report (6) Contributions This Report (7) Expenditures This Report L., Monetary Cash & Checks $ , , 5 0 . 0-4.-, Expenditures $ , , �y • 00 Loans $ , , O() Transfers to Office Account $ , , • ap Total Monetary $ , , ft) • 4)6 Total Monetary $ , ,39 • a© In-Kind $ , , .----. • 04) (8) Other Distributions $ , , —� • c,c3 (9) TOTAL Monetary Contributions To Date (10) TOTAL Monetary Expenditures To Date $ , ,So • v-D $ , , 31 . 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: i (Type name) -DoNA4-2. A . 1A.):a--d..Is (Type name) Da Nd3, -b /4'c-1 S- ❑Individual(only for IE igTreasurer 0 Deputy Treasurer Candidate 0 Chairperson(only for PC and PTY) or electioneering comm.) 1sQ ° 1t/A1/Z--‘X Signature Signature DS-DE 12(Rev.11/13) SEE REVERSE FOR INSTRUCTIONS Instructions for Campaign Treasurer's Report Summary (1) Name: full name of the candidate, political committee, party executive committee, electioneering communications organization, or individual making an independent expenditure or electioneering communication. (2) AddreSS: the f tll'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 speciallelection add front 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 totd4 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: I 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 o 1J A I-I) W h. .1 5 (2) I.D. Number kire (3) Cover Period T/ / _ / 14 through Et3 I 2! / /5'' (4) Page 1 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 ° a" _ 5000 C40661144144144-5: / / / / / / / / / / 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'dommunications 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:Mrsiber assigned to:�it,.Sequence numbers • are to be assigned within each'repbrting 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 igYegeifed•for responding to requests from the filing officer and for reporting amendments. For example, a M1 report having 75 contributions would use sequence numbers 1 through 75. The next report(M2), comprised of 40 contributions would use sequence numbers 1 through 40. Contributions on amended M1 reports would begin with sequence number 76 and on amended M2 reports would begin with sequence number 41. See the Amendment Type instructions below. (7) Type full name and address of contributor(including city, state and zip code). (8) Enter the type of contributor using one of the following codes: Occupation of contributor for contributions over$100 only. (If a business, please indicate nature of business.) Individual B Business (also includes corporations,organizations, groups, etc.) E Electioneering Communications Organizations F Political Committee (federal or state) P Political Parties (includes federal, state and county executive committees) O Other (e.g., candidate surplus funds to party, etc.) S Candidate to Self (9) Enter Contribution Type using one of the following codes: NOTE: Cash includes cash and cashier's checks. Code Description CAS Cash or Cashier's Check CHE Check COF Carryover Funds from Previous Campaign INK In-Kind INT Interest LOA Loan MO Money Order MUC Multiple Uniform Contributions RCT Other Receipts REF Refund (Negative Amount Only) CAMPAIGN TRE_ASURFR'S REPORT— ITEMIZED EXPENDITURES 4.1" (1) Name DO N/p -b w 1d 1— S 9 (2)I.D. Number (3)Cover Period 8 / / �q through / Z� / 1 (4) Page ( of (5) (7) (8) (9) (1 0) (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 /21/ Cep] jeF (' 60iAt'Egio... -(MP hT'e 144s 324z, Q QP), Di 5 ,70 eAp. / / / / / L DS-DE 14(Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES INSTRUCTIONS FOR CAMPAIGN TREASURER'S REPORT -.ITEMIZED EXPENDITURESj (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). ?•rt' ' `• (6) Sequence Number- Each detail line shall have a sequence number,pgigneci tQ.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 ""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. WAIVER OF REPORT SEP 5 2014 (Section 106.07(7), F.S.) I Z'S9r�r� (PLEASE TYPE) -OFFICE-08E0M? Don Willis City Council Name Office Sought 8964 Puerto Del Rio Drive, #301 Cape Canaveral, FL 32920 Address City State Zip Code ElCandidate ®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 Indicate report# Indicate report# Indicate report# Indicate report type and# M P G 1 as applicable: ❑ TERMINATION REPORT 0 SPECIAL ELECTION NOTIFICATION OF NO ACTIVITY IN CAMPAIGN ACCOUNT FOR THE REPORTING PERIOD OF 08/22/14 THROUGH 08/29/14 X �� 4/a • 09/05/14 Sig tore Date 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. 11/131 WAIVER OF REPORT SEP 1 9 2014 (Section 106.07(7), F.S.) ' (PLEASE TYPE) ��'' /4.'5Z-44 OFFICEUSE Don Willis Cape Canaveral City Council Name Office Sought 8964 Puerto Del Rio Dr. #301 Cape Canaveral, FL 32920 Address City State Zip Code CICandidate ®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 El GENERAL ELECTION ®OTHER REPORT TYPE Indicate report# Indicate report# Indicate report# Indicate report type and# M P G2 as applicable: ❑ TERMINATION REPORT D SPECIAL ELECTION NOTIFICATION OF NO ACTIVITY IN CAMPAIGN ACCOUNT FOR THE REPORTING PERIOD OF 8/30/14 THROUGH 09/12/14 x.r..6 09/19/14 Signa re Date 09/19/14 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) CAMPAIGN TREASURER'S REPORT SUMMARY L I (1) ') p/J 1/lLL1-l.S • OFFICE USE ONLY Name p _ __. (2) UG.'L Prt Earp !D et.. J Dove 4.3°I Address (number and street) ��T - 3 2014 awe e14NAJ�R+�L Vic-, 32.112. k_____;:;e. City, State, Zip Code ..;#1. _..., //`„5y ? ❑ Check here if address has changed (3) ID Number: (4) Check appropriate box(es): ��!! [Candidate Office Sought: !14P* ehAv4-'rEAE}L G,-rj &d-we-I L ❑ Political Committee(PC) / ❑ Electioneering Communications Org. (ECO) ❑ Check here if PC or ECO has disbanded ❑ Party Executive Committee(PTY) ❑ Check here if PTY has disbanded ❑ Independent Expenditure(IE)(also covers an ❑ Check here if no other IE or EC reports will be filed individual making electioneering communications) (5) Report Identifiers Cover Period: From al i /3 I /y/ To G y / ,24 / /!f Report Type: G '3 Original ❑Amendment ❑ Special Election Report (6) Contributions This Report (7) Expenditures This Report Monetary Cash & Checks $ , / , 1 Lj-0 . Pe, Expenditures $ , , 633 . '14-1 Loans $ , , Transfers to Office Account $ , , • Total Monetary $ , / , 1 /O • o D Total Monetary $ , 603' • "7 t+ In-Kind $ , , • (8) Other Distributions $ , , . (9) TOTAL Monetary Contributions To Date (10) TOTAL Monetary Expenditures To Date $ , / , / 7O • C)o $ , , yLZ . 71- (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) by W I x--15 (Type name) b 0 ts3 WI I-L.t 5 ❑Individual(only for IE [Treasurer 0 Deputy Treasurer Er6andidate 0 Chairperson(only for PC and PTY) or electioneering comm.) - v., _ Nil CX--gLe -it— Icl Lci. X /(...,,'E+, 6C--i.,,,t- ---- Signature Signature DS-DE 12(Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS Instructions for Campaign Treasurer's Report Summary (1) Name: full name of the candidate, political committee, party executive committee,electioneering communications organization, or individual making an independent expenditure or electioneering communication. • . (2) Address: the full address or post office box,city, state, and zip code. Check,the box if the address has changed since'the Last report filed., •a (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 fora ioal'flection 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. 16) 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 lc,IQ 0ii..L.i,s (2) I.D. Number (3) Cover Period of / /3 / if4 through ea? / .26 / 1' (4) Page / of 2- , (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 ,of t /3 //ii. A2T 5 p4/ cL- DrL 1401 CRS $zo ,00 / Ft- 52.9'W v/ 1ik , /I41/02&A T 2' .LR.1. •1- C/f6 f j1).op Pei / / 7 //y VIA f3CRADA44-• 1 e4;it 14So i :Tr) De: an,e0 GNG $tee AAA g.(ity ,325.00 4,4? / / ,t,. LNDA 6(274.7— g9 7- 89 z), R,.teizr-o .2)cc 7$/ao,ce. /A1a bte. 3,01 Ite 49pe-C,4,09V6i29L JCL L' 3 zgz1) - O9/ 1 S 1 //7 eAti Ko L 89 q-FLae i)l_ Rr r,rz4--2) SNE $300 feia Da- C+Yc CRN,)Ve7.2,g _ PL 32_1 7� 09 Ifs /IT 1;ws�b�- gZ� aE� - ea 0 e_44 f) -69.JAte6 L_ ./ rL- 3292,0 9 / /9 //� n ALZE.-) 1V`/ P.(FA -R; -- 12]z ;JF �/ tN1- V oo,dD 7 C_AaNAve)22_ 3�. 2 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 assignee,tolt;. 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.contribu#ion, 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 riutnbers 1 througli 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 arkd zte 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.) �.' `•mil) 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) J CAMPAIGN TREASURER'S REPORT — ITEMIZED CONTRIBUTIONS (1) Name 77)0 to (A) I L_U 5 (2) I.D. Number (Ilare • (3) Cover Period O I 1 3 / /4- through Ol I Z1, / /y- (4) Page of z- (5) (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 PprrzLK aq / 23 / / taq14- PNQA Ga CAr)A/E,QP'L— gi— 32-9 za / / / / / / / / / / 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 ,400) (ECO)or party executive committee(PTY). (2) The identification number assigned by the filing officer. (3) Cover period dates(e.g., 1/1/15 through 1/31/15). (See filing officer's reporting dates calendar for appropriate year and cover periods.) (4) Page numbers(e.g., 1 of 3 ). (5) Date contribution was RECEIVED(Month/Day/Year). (6) Sequence Number—Each detail line shall have a sequence number assigned to it. Sequence numbers are to be assigned within each reporting period and for each type of detail line. Thus the report type, detail line type, and sequence number will combine to uniquely identify a specific contribution, expenditure, distribution or fund transfer. This method of unique identification is required for responding to requests from the filing officer and for reporting amendments. For example, a M1 report having 75 contributions would use sequence numbers 1 through 75. The next report(M2), comprised of 40 contributions would use sequence numbers 1 through 40. Contributions on amended M1 reports would begin with sequence number 76 and on amended M2 reports would begin with sequence number 41. See the Amendment Type instructions below. (7) Type full name and address of contributor(including city, state and zip code). (8) Enter the type of contributor using one of the following codes: Occupation of contributor for contributions over$100 only. (If a business, please indicate nature of business.) Individual B Business (also includes corporations,organizations, groups, etc.) E Electioneering Communications Organizations F Political Committee (federal or state) P Political Parties (includes federal, state and county executive committees) O Other (e.g., candidate surplus funds to party, etc.) S Candidate to Self (9) Enter Contribution Type using one of the following codes: NOTE: Cash includes cash and cashier's checks. Code Description CAS Cash or Cashier's Check CHE Check COF Carryover Funds from Previous Campaign INK In-Kind INT Interest LOA Loan MO Money Order MUC Multiple Uniform Contributions RCT Other Receipts REF Refund (Negative Amount Only) j CAMPAIGN TREASURER'S REPORT- ITEMIZED EXPENDITURES (1) Name oN 14/l --1-15 (2)I.D. Number (3)Cover Period D / /3 / /�f through <XI / 26. I /of (4) Page / of I (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 o .23 /4 FI t /4o u 5 Gf i t+icy 2-SS Ca Ar�T�.,tet_{ r.Kr..3 ,I16 22 r r-r- )5"Loon a ��— G Pc ti► 2, Zµ 32_95 3 5pa N1,3 5- 1v}rs / l4 /°p 6, CE10Aura 2 3 2-1 / / / / L DS-DE 14(Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES INSTRUCTIONS FOR CAMPAIGN TREASURER'S REPORT - ITEMIZED EXPENDITURES j (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) pate 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 Nu) 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 SUMMARY „ (1) N 1 —(-t S OFFICE USE ONLY Name n OCT 1 0 2014 (2) 0/(01-1-- ?uERTL) �EL_ ICIa 2 3 a( '_ --.., Address (number and street) (_27–,,,,--'i0 0,07,7 e_l4pi rJi ivE24L FL 345 2-D City, State, Zip Code ❑ Check here if address has changed (3) ID Number: (4) Check appropriate box(es): [Candidate Office Sought: CAPE e14 n1�v"E. t_ �� u,q ( 7) ac/ ❑ 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 2? I 2-7 / / L- To /if:, / d 3 / / '- Report Type: G Z}- [KOriginal ❑Amendment ❑ Special Election Report (6) Contributions This Report (7) Expenditures This Report Le Monetary Cash & Checks $ , 560. 06) Expenditures $ , , . ._-- Loans $ , , •• —' Transfers to Office Account $ , , . Total Monetary $ , , 550 • ba Total Monetary $ , In-Kind $ , , • (8) Other Distributions $ , , . (9) TOTAL Monetary Contributions To Date (10) TOTAL Monetary Expenditures To Date $ , l :HD . 00 $ , , `1Z2- . 7y- (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) )6 f•-) IA-- h 11--t--1 5 (Type name) o rJ (Ai I L - s- ❑Individual(only for IE E Treasurer 0 Deputy Treasurer Er6andidate 0 Chairperson(only for PC and PTY) orLoy elect' comm.) / ' X ze""� (A._11 X 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. "44201) (2) Addl./ass: the full address or post office box, city, state, and zip code. Check the box if the address has changed since the last report filed. (3) ID Number: identification number assigned by the filing officer. (4) Check the appropriate box(es). (5) Report Identifiers Cover Period: the dates this report covers(i.e., From 1/1/15 To 1/31/55). Important: use the appropriate cover period dates as published by the filing officer. Report Type: refer to the filing officer's calendar of reporting dates for the correct codes to be used for each reporting period. If report is for a special election add"S" in front of the report code(i.e., SG3). Check one of the appropriate boxes: Original: first report filed for this reporting period. - Amendment: must summarize only contributions/fund transfers and expenditures/distributions being reported as additions or deletions. Read instructions for sequence numbers and amendment types on the back of Forms DS-DE 13A and 14A. Special Election Report: Important: once a special election report is filed, the entity is required to file all remaining reports due for the special election. (6) Contributions This Report: Cash and Checks: total amount for this reporting period. Loans: total amount for this reporting period. Total Monetary: sum of Cash and Checks and Loans. In-Kind: the fair market value of the in-kind contribution at the time it is given for this reporting period. (7) Expenditures This Report: Monetary Expenditures: total amount of monetary expenditures for this reporting period. Transfers to Office Account: total amount transferred to an office account by elected candidates only. Total Monetary: sum of Monetary Expenditures and Transfers to Office Account. (8) Other Distributions: the total amount of goods and services contributed to a candidate or other committee by a PC, ECO, or PTY. (9) TOTAL Monetary Contributions To Date: the amount of total monetary contributions to date. Candidates keep cumulative totals from the time the campaign depository is opened through the termination report. (10) TOTAL Monetary Expenditures To Date: the amount of total monetary expenditures to date. Candidates keep cumulative totals from the time the campaign depository is opened through the termination report. (11) Type or print the required officer's name and have them sign the report: Candidate report: treasurer and candidate must sign. PC report: treasurer and chairperson must sign. PTY report: treasurer and chairperson must sign. ECO report: organization's treasurer must sign. IE or EC report: individual must sign (this applies when an individual acts alone to make these expenditures) AMENDMENT REPORTS: An amendment report summary should summarize only contributions, expenditures, distributions, &fund transfers being reported as additions or deletions. Read the instructions for the sequence number&amendment type fields on the back of forms DS-DE 13, 14, 14A and 94. CAMPAIGN TREASURER'S REPORT — ITEMIZED CONTRIBUTIONS (1) Name 1 e ti /X), LA-t s (2) I.D. Number (3) Cover Period O / c31 / 19- through / O / O 3 / P-1. (4) Page 11 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 Dpi , L7 / /q K 0&64 3 effit 439 2-4- P -ro D6i-- gla -I)2 3ch IL / err Rig:T. c -i C 15.00. aP d pi Cso,Av6 eAi. 3 2-5 a 2 c (,JEST=c O7 ,y_ 896 3 � P Pt- Z atfC Cp-OAVtR EL_ 329 0 / / / / / / / / 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.) ‘.1) 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) 1 . CAMPAIGN TREASURER'S REPORT SUMMARY (1) bGt1/43 td1ir .1S OFFICE USE ONLY Name (2) 6' Pcter r ti- Ric) -1)R # 3451 OCT 1 7 2014 Address (number and street) GAPE Ci vc�h� FL 32.9 2---z) ( � - City, State, Zip Code fi% �ZL ❑ Check here if address has changed (3) ID Number: (4) Check appropriate box(es): (Candidate Office Sought: G'r4ps CAN iV Ext.A4- Cull Coy,w4,1t_ 1:1 Political Committee(PC) 1 ❑ 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 El Check here if no other IE or EC reports will be filed individual making electioneering communications) (5) Report Identifiers Cover Period: From ,o / yc / 14 To /0 / /0 I pt; Report Type: ('S' gOriginal ❑Amendment ❑ Special Election Report (6) Contributions This Report (7) Expenditures This Report Monetary Cash & Checks $ , , . ,!o' Expenditures $ , , 37/ • vv Loans $ , , • -0' Transfers to Office Account $ , Total Monetary $ , , • a' Total Monetary $ 37! • oZ In-Kind $ , , . 4V (8) Other Distributions $ , , . 60 - (9) TOTAL Monetary Contributions To Date (10) TOTAL Monetary Expenditures To Date $ , 1 , 71.1-0. 00 $ , 1 ,a�_3 • 7q- (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' l1report and it is true, correct, and complete: (Type name) 'LW /'-� L..L i S (Type name) b 0/U Id ii.,..S 0 Individual(only for IE [Treasurer 0 Deputy Treasurer atandidate 0 Chairperson(only for PC and PTY) Le mon g comm.) r 04.----- , X ca-i--- kike---r Signature Signature DS-DE 12(Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS Instructions for Campaign Treasurer's Report Summary (1) Name: full name of the candidate, political committee, party executive committee, electioneering communications organization, or individual making an independent expenditure or electioneering communication. (2) Address: the full address or post office box, city, state, and zip code. Check ietox if'the address has changed since the last report filed. . • - d.F (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 pfficer's calendar of reporting dates for the correct codes to be used for each reporting perioti. If report%for a seecial-elactio nadd "S",ir►°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. Tradsers 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. Cagdidates keep cumulative totals from the time the campaign depository is opened through the terrAtnation 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: F 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 detetiQasl Read the instructions for the sequence numberamendment type fields on the back of forms DS-DE 13, 14, 14A and 94. J CAMPAI,GW TREASURER'S REPORT— ITEMIZED EXPENDITURES kite (1) Name WILL- •5 (2)I.D. Number (3)Cover Period 1p / / /if through / / / / (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 pig/8 feoEriouS7 6ireirp fr I(dis • C p p., -7,4,5 14-3 Cc",03-1Q yyk ft"r,— is..R•JZ' A 3rr53 516„0 := s 5 3/i 00 (be / / / / / / 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. ;-eq,upnge 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 1E1 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 'la) 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 SUMMARY (1) Z0,4 kJ 1 L L I S OFFICE USE ONLY Name (2) 8/y6y" I"p LtE270 I rL Rio' io' .62, 30 l Address (number and street) OCT 2 4 2014 )P-E C. NA-V-6?2RL I i — 3.21i 2-D __ _100 . , City, State, Zip Code 4"I W.3K 0 Check here if address has changed (3) ID Number: (4) Check appropriate box(es): (Candidate Office Sought: CAPE: CA N A v Fi2lotL C,� Coc,kni�..�,_ ❑ Political Committee(PC) ❑ Electioneering Communications Org. (ECO) 0 Check here if PC or ECO has disbanded ❑ Party Executive Committee(PTY) 0 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 ID I /1 / pi To /1' I 17 I i `/ Report Type: G-(, g Original 0 Amendment 0 Special Election Report (6) Contributions This Report (7) Expenditures This Report Monetary Cash & Checks $ , , 350 r c Expenditures $ , , 7''5 • o0 Loans $ , , • AX Transfers to Office Account $ , • Total Monetary $ , ,3Y3C� • r-_,0 Total Monetary $ , 77`ti", (Do In-Kind $ , • (8) Other Distributions $ , . 0 (9) TOTAL Monetary Contributions To Date (10) TOTAL Monetary Expenditures To Date $ , 2 , 1 -10 • o 0 $ , 2-, ( 33 . 7`t (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) b4/LD w i I-1...15 (Type name) �pN LA.)11,.-Li $ 0 Individualignly for IE p Treasurer ❑Deputy Treasurer I, .. - 0 Chairperson(on or PC and PTY) or ele eering m.) I/ - ePL• Signature Signature DS-DE 12(Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS Instructions for Campaign Treasurer's Report Summary (1) Name: full name of the candidate, political committee, party executive committee,electioneering communications organization, or individual making an independent expenditure or electioneering communication. (2) Address: the full address or post office box, city, state, and zip code. Check the box if the address has changed since the last report filed. (3) ID Number: identification number assigned by the filing officer. (4) Check the appropriate box(es). (5) Report Identifiers Cover Period: the dates this report covers(i.e., From 1/1/15 To 1/31/55). Important: use the appropriate cover period dates as published by the filing officer. Report Type: refer to the filing officers calendar of reporting dates for the correct codes to be used for each reporting period. If report is for a special election add"S" in front of the report code (i.e., SG3). Check one of the appropriate boxes: _ Original: first report filed for this reporting period. Amendment: must summarize only contributions/fund transfers and expenditures/distributions being reported as additions or deletions. Read instructions for sequence numbers and amendment types on the back of Forms DS-DE 13A and 14A. Special Election Report: Important: once a special election report is filed, the entity is required to file all remaining reports due for the special election. (6) Contributions This Report: Cash and Checks: total amount for this reporting period. Loans: total amount for this reporting period. Total Monetary: sum of Cash and Checks and Loans. In-Kind: the fair market value of the in-kind contribution at the time it is given for this reporting period. (7) Expenditures This Report: Monetary Expenditures:total amount of monetary expenditures for this reporting period. Transfers to Office Account: total amount transferred to an office account by elected candidates only. Total Monetary: sum of Monetary Expenditures and Transfers to Office Account. (8) Other Distributions: the total amount of goods and services contributed to a candidate or other committee by a PC, ECO, or PTY. (9) TOTAL Monetary Contributions To Date: the amount of total monetary contributions to date. Candidates keep cumulative totals from the time the campaign depository is opened through the termination report. (10) TOTAL Monetary Expenditures To Date: the amount of total monetary expenditures to date. Candidates keep cumulative totals from the time the campaign depository is opened through the termination report. (11) Type or print the required officer's name and have them sign the report: Candidate report: treasurer and candidate must sign. PC report: treasurer and chairperson must sign. PTY report: treasurer and chairperson must sign. ECO report: organization's treasurer must sign. _ IE or EC report: individual must sign(this applies when an individual acts alone to make these expenditures) AMENDMENT REPORTS: An amendment report summary should summarize only contributions, expenditures, distributions, &fund transfers being reported as additions or deletions. Read the instructions for the sequence number&amendment type fields on the back of forms DS-DE 13, 14, 14A and 94. CAMPAIGN TREASURER'S REPORT— ITEMIZED CONTRIBUTIONS (1) Name N LA.) 1 r-L I S (2) I.D. Number /0 1D 'L (3) Cover Period / 1 I /'f through / / /7 / 17 (4) Page I of J (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 / // / /y- 171 AT121u r8 PeTT-1 erIEN. A.+e ftro / &MID* 1 ger) ,D C-Ft 250 xr Ob1 I CAPE C04.114ivE2a1__ /a / l 3 / /`L par RI 0393 ► FIAERThbEL Pro 8t) .Z) 4101/ R£D C-J-t 6,4,E G -i veRet. RL /D/ /3 01-1- 1t 1J w 655 EU- BF? 3 /t6u -4 LrF 3!3o'f j, RE!r R QRS 57), 4D0 SPE64Avr-om__�c / / / / / / 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 ,vaii) (ECO)or party executive committee(PTY). (2) The identification number assigned by the filing officer. (3) Cover period dates(e.g., 1/1/15 through 1/31/15). (See filing officer's reporting dates calendar for appropriate year and cover periods.) (4) Page numbers(e.g., 1 of 3 ). (5) Date contribution was RECEIVED(Month/Day/Year). (6) Sequence Number—Each detail line shall have a sequence number assigned to it. Sequence numbers are to be assigned within each reporting period and for each type of detail line. Thus the report type, detail line type, and sequence number will combine to uniquely identify a specific contribution, expenditure, distribution or fund transfer. This method of unique identification is required for responding to requests from the filing officer and for reporting amendments. For example,a M1 report having 75 contributions would use sequence numbers 1 through 75. The next report(M2), comprised of 40 contributions would use sequence numbers 1 through 40. Contributions on amended M1 reports would begin with sequence number 76 and on amended M2 reports would begin with sequence number 41. See the Amendment Type instructions below. (7) Type full name and address of contributor(including city, state and zip code). (8) Enter the type of contributor using one of the following codes: Occupation of contributor for contributions over$100 only. (If a business, please indicate nature of business.) Individual B Business (also includes corporations, organizations, groups, etc.) E Electioneering Communications Organizations F Political Committee (federal or state) P Political Parties (includes federal, state and county executive committees) O Other (e.g., candidate surplus funds to party, etc.) S Candidate to Self (9) Enter Contribution Type using one of the following codes: NOTE: Cash includes cash and cashier's checks. Code Description CAS Cash or Cashier's Check CHE Check COF Carryover Funds from Previous Campaign INK In-Kind INT Interest LOA Loan MO Money Order MUC Multiple Uniform Contributions RCT Other Receipts REF Refund (Negative Amount Only) j CAMPAIGN,TREASURER'S REPORT- ITEMIZED EXPENDITURES (1) Name 101v (2)I.D. Number (3)Cover Period /0 / /1 / /'t through /0 / j'7 / /4- (4) Page I of (5) (7) (8) (9) (10) (11) Date Full Name Purpose (6) (Last,Suffix,First,Middle) (add office sought if Sequence Street Address& contribution to a Expenditure Number City,State,Zip Code candidate) Type Amendment Amount /a //5//9. i<6.41 l A 1 /Lc 3 los Mott 2 2 5 FiQ"--nv‘- ��N ITAANEs-r.,N,) I PL 2-7152- 5, D// / i1 orJeg2 P2 r�r�N . I 7 ! 4,600 N, A r-LAN v& C w!rJ 160 Gape 44 N Rvr;2A �L- 1 / / L DS-DE 14(Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES INSTRUCTIONS FOR CAMPAIGN TREASURER'S REPORT - ITEMIZED EXPENDITURES ,44) (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 '411111°) 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. (1) bo.0 +Lc,�SCAMPAIGN TREASURER'S REPORT SUMMARY L��t"I L5 Name D (2) gq jt PUE2'Tb 7)c-e, R fie. ±' 301 OCT 31 2014 Address(number and street) CPPEJ L'Ai1/41eA/ AL- , rt. 3 2g20 __ , do.,),..0•• ,, City, State, Zip Code //J YY ❑ Check here if address has changed (3) ID Number: (4) Check appropriate box(es): /� Candidate Office Sought: CAPE }ti1AYtRAZ lOu"0c.�+ L. ❑ Political Committee(PC) ❑Electioneering Communications Org. (ECO) 0 Check here if PC or ECO has disbanded ❑Party Executive Committee(PTY) 0 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 la I l f, I /c` To /0 1 30 / 1 4I Report Type: g ❑Original 0 Amendment 0 Special Election Report (6) Contributions This Report (7) Expenditures This Report Monetary Cash &Checks $ , / , /q5 • Ov Expenditures $ , / , 4043 • 0 w Loans $ • - Transfers to Office Account $ , , • Pr Total Monetary $ I , / 05 • 0 0 Total Monetary $ , I ,09•3 • ©q- In-Kind $ , • .‘;' (8) Other Distributions $ , , S6 . 38 (9) TOTAL Monetary Contributions To Date (10) TOTAL. Monetary Expenditures To Date $ , 3, z�,5 . o© $ , 3 , 1 393 • 1 (0 (11) Certification It is a first degree misdemeanor for any person to falsify a public record(ss.839.13, F.S.) I certify that I have examined this report and it is true,correct, and complete: ` , (Type name) .l.)d/J �) i_i (Type name) 1 ) 1J w I LA-45 0 Individual(only for IE 2'rreasu -r 0 Deputy Treasurer 0 Candidate 0 Chairperson only for PC and PTY) or • g comm.) / / c • X )C-2E-Dei:/k--.4..4.— Signature Signature DS-DE 12(Rev.11/13) SEE REVERSE FOR INSTRUCTIONS Instructions for Campaign Treasurer's Report Summary (1) Name: full name of the candidate, political committee, party executive committee,electioneering communications organization,or individual making an independent expenditure or electioneering communication. (2) Address: the full address or post office box,city,state, and zip code. Check the box if the address has changed since the last report filed. (3) ID Number: identification number assigned by the filing officer. (4) Check the appropriate box(es). (5) Report Identifiers Cover Period: the dates this report covers(i.e., From 1/1/15 To 1/31/55). Important: use the appropriate cover period dates as published by the filing officer. Report Type: refer to the filing officer's calendar of reporting dates for the correct codes to be used for each reporting period. If report is for a special election add"S"in front of the report code(i.e., SG3). Check one of the appropriate boxes: Original: first report filed for this reporting period. Amendment: must summarize only contributions/fund transfers and expenditures/distributions being reported as additions or deletions. Read instructions for sequence numbers and amendment types on the back of Forms DS-DE 13A and 14A. :_ Special Election Report: Important: once a special election report is filed,the entity is required to file all remaining reports due for the special election. (6) Contributions This Report: Cash and Checks: total amount for this reporting period. Loans: total amount for this reporting period. Total Monetary: sum of Cash and Checks and Loans. In-Kind: the fair market value of the in-kind contribution at the time it is given for this reporting period. (7) Expenditures This Report: Monetary Expenditures:total amount of monetary expenditures for this reporting period. Transfers to Office Account: total amount transferred to an office account by elected candidates only. Total Monetary: sum of Monetary Expenditures and Transfers to Office Account. (8) Other Distributions: the total amount of goods and services contributed to a candidate or other committee by a PC, ECO, or PTY. (9) TOTAL Monetary Contributions To Date: the amount of total monetary contributions to date. Candidates keep cumulative totals from the time the campaign depository is opened through the termination report. (10) TOTAL Monetary Expenditures To Date: the amount of total monetary expenditures to date. Candidates keep cumulative totals from the time the campaign depository is opened through the termination report. (11) Type or print the required officer's name and have them sign the report: Candidate report: treasurer and candidate must sign. - PC report: treasurer and chairperson must sign. - PTY report: treasurer and chairperson must sign. - ECO report: organization's treasurer must sign. - IE or EC report: individual must sign(this applies when an individual acts alone to make these expenditures) AMENDMENT REPORTS: An amendment report summary should summarize only contributions, expenditures, distributions, &fund transfers being reported as additions or deletions. Read the instructions for the sequence number&amendment type fields on the back of forms DS-DE 13, 14, 14A and 94. CAMPAIGN TREASURER'S REPORT — ITEMIZED CONTRIBUTIONS (1) Name NI W I L-t. I5 (2) I.D. Number (3) Cover Period / 0 / /F� / / y- through /O / 3d / / 't (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 /v / / /4 GRt- 1 tA) .JF 04c- 2e'n0.42 C N 2_5;00 CAPE 64.AyEcAL) FL- 32?zv lU / Z5 / 'Li t.L A N DfZ.Eos eggq- Pue-gra g_RIO CAPE C,¢OAV�-7ZP Qt^Tr2t� )5-e) Cl-( Z 3ZS z) /o/ z2 / / MvAT 5 895" I. 2-on 9zt. . ea-E )00 30� e-44PE 044NAV ML. 3 FL_ 34'zd to Z Tss� 1r4.c / 7 / pr At/ WGfW.1Z ea 2_9L)N- ATz.�457-6R€ 8/oa CAPE 34&) Out, FZ 32 zd / / / / 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 via) (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 I through 40. Contributions on amended M1 reports would begin with sequence number 76 and on amended M2 reports would begin with sequence number 41. See the Amendment Type instructions below. (7) Type full name and address of contributor(including city, state and zip code): (8) Enter the type of contributor using one of the following codes: Occupation of contributor for contributions over$100 only. (If a business, please indicate nature of business.) Individual B Business (also includes corporations, organizations, groups, etc.) E Electioneering Communications Organizations F Political Committee (federal or state) P Political Parties (includes federal, state and county executive committees) O Other (e.g., candidate surplus funds to party, etc.) S Candidate to Self (9) Enter Contribution Type using one of the following codes: NOTE: Cash includes cash and cashier's checks. Code Description CAS Cash or Cashier's Check CHE Check COF Carryover Funds from Previous Campaign INK In-Kind INT Interest LOA Loan MO Money Order MUC Multiple Uniform Contributions RCT Other Receipts REF Refund (Negative Amount Only) J CAMPAIGN TREASURER'S REPORT- ITEMIZED EXPENDITURES (ow (1) Name T'bA) 1,(.) I-L i 5 (2)ID. Number (3)Cover Period /0 / / I'1 through /0 / 3G' / >1 (4) Page / of I (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 206 . Co u g-rtwAi COWRY-ea C 14- z , le/1,-rY � /ScryrnATER!,gZ e( is f1" CarEA.4 r►t t�',t m pit,6,� /a/30/14/ Z B5 Fo> u B� R)4 CSI vLi 767 4141 2- 3 �Z / / / / / 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 svgaii) 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 ''""1111) 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 (111Py (1) Name —Do/0 .5 (2) I.D. Number (3) Cover Period .b / /9 / m through /o / 3e) / /9 (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 _ Mu-,s PAW,. $9GN potarb bac FNria RA'Rio -e b ,3$ �ZEi'1L 3-2A 20 I • I I / I / I 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). (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 CCP Credit Card Purchase INK In-Kind Distribution CAMPAIGN TREASURER'S REPORT SUMMARY (1) .1oN W 1.1-4—I, SOFFICE USE ONLY _L� Name !� D C I G V E (2) 891-4 A"_ -0 mi.. f(�a bR. 4/ 301 Address (number and street) JAN 2 9 2015 CspE GOJA-✓EA A-L 1 FL. 32-9 Zo City, State, Zip Code ❑ Check here if address has changed (3) I , . er. .. (4) Check appropriate box(es): []'Candidate Office Sought: CAME c. ANAvg--AA, (s-rt.1 wlcli. ❑ Political Committee(PC) El Electioneering Communications Org. (ECO) El Check here if PC or ECO has disbanded El Party Executive Committee(PTY) ❑ 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 j o / 31 / )A1. To Z / - / /S Report Type: -•rit. 2Original ❑Amendment El Special Election Report (6) Contributions This Report (7) Expenditures This Report L. Monetary Cash & Checks $ , Expenditures $ , , /2-4. • 8 1-1- , Loans $ , , • Or Transfers to Office Account $ . Total Monetary $ , • Total Monetary $ , / Z6 • Bid In-Kind $ , , • F (8) Other Distributions $ , , ..40 (9) TOTAL Monetary Contributions To Date (10) TOTAL Monetary Expenditures To Date $ , 3 ,2.45 . oo $ , 3 ,2[05 . 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) low) 11.4.—/ S (Type name) 'bdW u+v l s 0 Individual(only for IE Treasurer 0 Deputy Treasurer • 0 Chairperson(only for PC and PTY) LI • - - 1.nee : comm.) // / / • X4_ _ X Signature Signa ure 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 fuil address or post office box, city, state, and zip code. A Check the box if the address.has changed since the last report filed.. (3) ID Number: identification nurpber assigned by the filing officer. (4) Check the appropriate-box(es). ' (5) Report Identifiers Cover Period: the dates fhis'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. •yri) Transfers to Office Account: total amount transferred to an office account by elected candidates only. Total Monetary: sum of Monetary Expenditures and Transfers to Office Account. (8) Other Distributions: the total amount of goods and services contributed to a candidate or other committee by a PC, ECO, or PTY. (9) TOTAL Monetary Contributions To Date: the amount of total monetary contributions to date. Candidates keep cumulative totals from the time the campaign depository is opened through the termination report. (10) TOTAL Monetary Expenditures To Date: the amount of total monetary expenditures to date. Candidates keep cumulative totals from the time the campaign depository is opened through the termination report. (11) Type or print the required officer's name and have them sign the report: Candidate report: treasurer and candidate must sign. - PC report: treasurer and chairperson must sign. - PTY report: treasurer and chairperson must sign. ECO report: organization's treasurer must sign. IE or EC report: individual must sign(this applies when an individual acts alone to make these expenditures) AMENDMENT REPORTS: An amendment report summary should summarize only contributions, expenditures, distributions, &fund transfers being reported as additions or deletions. Read the instructions for the sequence number&amendment type fields on the back of forms DS-DE 13, 14, 14A and 94. CAMPAIGN TREASURER'S REPORT- ITEMIZED EXPENDITURES (1) Name .110/..1 �l IrL-I 5 (2) I.D. Number (3)Cover Period 60 / 3/ / / through 2 / 2 / /S (4) Page l 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 /2/18// W CAA-6 .A-lec,.a 45tra K NA Po Cion (o9i5 MoNrNL� 5tgyed_6- /p,oz, 1 aZr & 1 c4'5 772.B FEs C�1N / /7i://5U.0 rrra WA/ cF UrL6VART Co b N rsTIoiQ OP 931 b�)cc,� t3 Ib, RE.NaINLALS 1)15 0116.,641 ea.0, 1 ri-- 32j u-6 2°6 fZ4p4 bs I (1110e • 1 1 l 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 ip requiregi;for responding to-requests from`the filing loflicer 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 ‘,441) 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 'I") 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. 1 CITY OF CAPE CANAVERAL CANDIDATE FOR CITY COUNCIL TRACKING FORM NAME: bor.)A.i-.7) )1,•177 Gc)iIA.Is PHONE: Yz/- /2-2 42 ADDRESS: ei.it Put:12r6 bet, R,c IDA. 3a1 - e6 vEItRL FE 319 ao Date Qualified/Paid Qualifying Fee: 21 . 9 . on QUALIFYING FEE: $39.00 ($15.00 Qualifying + $24.00 Election Assessment) PAPERS FILED DATE FILED Candidate Packet Acknowledgement 0 0 V DS-DE 9, Appointment of Campaign Treasurer and Designation of Campaign Depository for Candidates 5/4/C DS-DE 25, Loyalty Oath for Non-Partisan Office with Candidate �/2--1 Name Pronunciation Request 2 //I CE Form 1,(Jan 1, 2013) Statement of Financial Interests a-b_/// DS-DE 84, Statement of Candidate // , (due 10 days after DS-DE9) OR �/ 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 ,/2741 08/22/14- 08/29/14 G1 September 5, 2014 c/ /S-/g 08/30/14-09/12/14 G2 September 19, 2014 9V/9 j 09/13/14- 09/26/14 _ G3 _ October 3, 2014 /p/.;/ 09/27/14- 10/03/14 G4 October 10, 2014 /v�,% `/ 10/04/14 - 10/10/14 G5 October 17, 2014 /o p7711 10/11/14 - 10/17/14 G6 October 24, 2014 /,/y (/r 10/18/14 - 10/30/14 G7 October 31, 2014 /o/... /& Campaign Treasurer's TR February 2, 201,4's l / 9 /is Report Period: Date (NOTE: if no opposition at / ` varies end of Qualifying Period, Due Date is 11/20/2014) viii ii/_1114 4:02 PH 494906404 total 33.00 '.:i;n i4eount $8.88 :oamt 8.88 +:r; siukff Wit) Hmount $39.80 1 CITY OF CAPE CANAVERAL CANDIDATE FOR CITY COUNCIL TRACKING FORM NAME: .,GN,A-i t) _A Nrakevo MIA.•4 PHONE: 3Z/- / -2162 ADDRESS: Yi-ti- Pu&ie 'i. R,c DA''301 � 6-6A,;fivEt R 319 zo Date Qualified/Paid Qualifying Fee: 1/2/ 9 . co QUALIFYING FEE: $39.00 ($15.00 Qualifying + $24.00 Election Assessment) PAPERS FILED DATE FILED Candidate Packet Acknowledgement g//5514 DS-DE 9, Appointment of Campaign Treasurer and Designation of Campaign Depository for Candidates l/C 1 DS-DE 25, Loyalty Oath for Non-Partisan Office with Candidate Name Pronunciation Request /2-I/1 CE Form 1,(Jan 1, 2013) Statement of Financial Interests / ab-//4 DS-DE 84, Statement of Candidate // (due 10D � days after DS-DE9) / 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 54(// 08/22/14 - 08/29/14 G1 September 5, 2014 9 /shit 08/30/14 -09/12/14 __ G2 September 19, 2014 9'//9709/13/14 - 09/26/14 G3 October 3, 2014 /0/SA 09/27/14 - 10/03/14 G4 October 10, 2014 ///j' `,t 10/04/14- 10/10/14 G5 October 17, 2014 /o/ill/f1 10/11/14- 10/17/14 G6 October 24, 2014 /e/21/, 10/18/14 - 10/30/14 G7 October 31, 2014 _ /0 3i f; Campaign Treasurer's TR February 2, 201.4'5 / /y9 J/S' Report Period: Date (NOTE: if no opposition at varies end of Qualifying Period, Due Date is 11/20/2014) lJ,;,iici;4 J:1d rih 11k10 6404 tutai 33.88 I.::n Hmount $8.88 .nanbe 8.88 LN a ksi ki'i, Hmount $39.88