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Campaign Treasurer's Report (15)
OFFICE USE ONLY STATEMENT OF CANDIDATE (Section 106.023, F.S.) (Please print or type) 1, Aretha Olivarez candidate for the office of Orlando City Commissioner District 4 have been provided access to read and understand the requirements of Chapter 106, Florida Statutes. 5-4-2015 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). DS -DE 84 (05/11) DS-DE 25 (Rev. 5/11) CANDIDATE OATH - NONPARTISAN OFFICE (Not for use by Judicial or School Board Candidates) OFFICE USE ONLY OATH OF CANDIDATE (Section 99.021, Florida Statutes) I, /Lre+k ~ll(~~es. (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 f hb G $ ca Mmlsslhex . Y , (office) (dbtrid #) , ; I am a qualified elector of 9 rwf . County, Florida; (clrcuR #) (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 ten 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 (07) W.S=%Y/S r/l&;5 3 ~@,~a~ao., Signature of candid& Telephone Number Emall Address ~bb~Pemb-Xf( gy~ % 3bg I( Address city State ZIP Code Candidate's Florida Voter Registration Number (located on your voter information card): * Please print name phonetically on the line below as you wish it to be pronounced on the audio ballot for persons COUNTY OF o (Lw 6G Sworn to (or affirmed) and subscribed before me this 3 ( day of Wby 5r Personally Known: Produced Identification: 6 Print, Type, or Stamp Commissioned Name of Notary Public Type of Identification Produced: FL 9%~ OC* ~c~ sG AFFIDAVIT OF FINANCIAL HARDSHIP (Section 99.093(2), Florida Statutes) Aretha Olivarez Print Name Orlando City Commissioner, District 4 , a candidate for the office of do hereby certify, pursuant to Section 99.093(2), Florida Statutes, that I am unable to pay the 1% election assessment of $ 5 3 3 , 9 2) to qualify for nomination or election to public office because paying the assessment would be an undue burden on my personal financial resources or on the financial resources available to me. Under penalty of perjury, I declare that I have read the foregoing and that it is a true and correct statement. ()OM (5 -- Date aggz4, 19-6, Signature of Candidate Address: l a a 6, x (pl 5�S City: Di l State: Zip: 32"S--`) Sworn to (or affirmed) and subscribed before me this `i day of ,20 lc by pre) --h& D!Fiaxz_ ,� PAULA ABIGAIL JIMENEZ r Y 1 MY COMMISSION #FF16053I °rr ,, EXPIRES September 16, 2018 WI) 3J8 0153 FloridallotaryService.con) Signature of Notary Public --- State ofFTorida Print, Type, or Stamp Commissioned Name of Notary Public Personally Known or Produced�� Identification Type of Identification Produced�1X>1d bOVer. Received by: Name: Telephone: City Date of Election: Remit within 30 days of close of qualifying to: Florida Elections Commission 107 West Gaines Street, Suite 224 Tallahassee, Florida 32399 Telephone: 850.922A539 Fax: 850.921.0783 AFFIDAVIT OF UNDUE BURDEN (Section 99.097(4), Florida Statutes) IMPORTANT: (1) Paying signature gatherers will preclude or invalidate the filing of an undue burden oath. Section 99.097(6), Florida Statutes, provides: (a) If any person is paid to solicit signatures on a petition, an undue burden oath may not subsequently be filed in lieu of paying the fee to have signatures verified for that petition. (b) If an undue burden oath has been filed and payment is subsequently made to any person to solicit signatures on a petition, the undue burden oath is no longer valid and a fee for all signatures previously submitted to the supervisor of elections and any submitted thereafter shall be paid by the candidate, person, or organization that submitted the undue burden oath. If contributions as defined in s. 106.011 are received, any monetary contributions must first be used to reimburse the supervisor of elections for any signature verification fees that were not paid because of the filing of the undue burden oath. [Note: The second sentence in (b) applies only when payment is made to a signature gatherer after an undue burden oath had been filed.] (2) Upon a candidate terminating the campaign, any candidate who qualified by the petition process and who has surplus funds, must first apply the surplus funds to the reimbursement of the signature verification fee (if applicable) and thereafter to the election assessment. Sees. 106.141(6), Florida Statutes. I certify under oath that I intend to qualify as a candidate for the office of Orlando City Commissioner, District 4 and that I am unable to pay the fee for verification of petition signatures for that office without imposing an undue burden on my personal resources or on resources otherwise available to me. Aretha Olivarez Signature of Candid Print Candidate's Name 4668 Pembrook Place Orlando Address City FL 32811 (407 ) 505-9515 State Zip Telephone Number State of Florida County of A"A' PAULA ABIGAIL JIMENEZ { MY COMMISSION #FF1f30'.,37 EXPIRES September 16. 2018 o1o3 FloridallotaryServICU.Cnm Sworr to (or affirmed) and subscribed before me this vl day of by ' Q� i lett - Personally Known: or Produced Identification: • n cake -- Type of Identification Produced: 20 Signature of Notary Public — State of Florida Print, Type or Stamp Commissioned Name of Notary Public Altematlw Method Affidavit (FINN Type) I certify that I Intend to qualify by the alternative method as a cenddate for the ace of Qr i C 1tritG7 r -v\ 1.5.s , e„ L i 31,7 01- K as a: (Mx uda , alit, group or seat numbers) Partisan Candidate, Member of the Party Ei No Party Affiliation Candidate (formedy Independent) Nonpartisan Candidate (Includes judicial offices) Under peladtiee: of:*jury..I,.*miss Ihim read the foregoing affidavit smith* dui its stolid in 1t am true. Print Nuns d Candidele alansturr of Candidate (A1- P , broo P1 ce Residence Address (do not use. post doe boat) alY Day Phone Stele 1 Fax Number . Zlp Gods FORM 1 STATEMENT OF 20 14 NAME OF AGENCY : I Pirur pint w typ your nam, mailing addmms, agency nam, and porNkn klow: NAME OF OFFICE OR POSITION HELD OR SOUGHT : 6<(.~.-Oh C L- Lumm (1i.u- Dl\ +;ct V You am nol IlmW to the 8p~1 on the lha on thb form. Atbch addnhl sheets, If nweaury. I CHECK ONLY IF CANDIDATE OR 9 NEW EMPLOYEE OR APPOINTEE ) FINANCIAL INTERESTS - BOTH PARTS OF THlS 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 THlS STATEMENT IS FOR THE PRECEDING TAX YEAR ENDING EITHER (must check one): . FOR OFFICE USE ONLY: ,, . ,': .. -- -- - LAST NAME - FIRST NAME - MIDDLE NAME : (3 I ~qve. L AV--C+K,- S. q, m7 MAILING ADDRESS : V\obg P+bruui~ PI / (yla40 kc 3L&U CITY : ZIP : COUNTY : 0 DECEMBER 31,2014 PB 0 SPECIFY TAX YEAR IF OTHER THAN ME CALENDAR YEAR: ;:>; S! < .> : <. f*< :- :-;;*= ? ,.:: . -..!7-. .. ;7~ . : z:: . c3 .! my:{=i < -z . . -: 77* c ..<.!:-- <-""' . . -- - =--* ,.-- L-.L? - : A>L : -..!j;> MANNER OF CALCULATING REPORTABLE INTERESTS: FILERS HAVE THE OPTION OF USING REPORTING THRESHOLDS THAT ARE ABSOLUTE DOLLAR VALUES, WHICH REQUIRES FEWER CALCULATIONS, OR USING COMPARATIVE THRESHOLDS, WHICH ARE USUALLY BASED ON PERCENTAGE VALUES (see instructions for further details). CHECK THE ONE YOU ARE USING: Cl COMPARATIVE (PERCENTAGE) THRESHOLDS pB O DOLLAR VALUE THRESHOLDS I PART A - PRIMARY SOURCES OF INCOME IMalor sourer of hm to the re^^ mnon - See instructioml I I . ". (If you have nothing to report, wrik "none" or "dam) I I NAME OF SOURCE OF INCOME I SOURCE'S ADDRESS DESCRIPTION OF THE SOURCE'S ( PRINCIPAL BUSINESS ACTlVln I 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 "dam) NAME OF NAME OF MAJOR SOURCES ADDRESS PRINCIPAL BUSINESS t begln on page 3. - I I I I I I I CE FORM 1 - ENectke: Jwrary 1 2015 (Conllnwd on nvmrn .Id#) Adoptd by ntlmncd n Rule 344'.202(1). F.A.C. PAGE 1 ACTlVW OF SOURCE BUSINESS ENTITY PART C - REAL PROPERTY [Land, buildings owned by the reporting person - See Instructions] (If you have nothing to report, write "none" or "nla") 6.-M ?fiPw+, 417 L~ IUII~ P~U ~~u~d f~;~:~ -R. FILING INSTRUCTIONS for when and where to file this form are located at the bottom of page 2. ~NSTRUCT~ONS on who must file this form and how to fill it out OF BUSINESS' INCOME OF SOURCE ( PART D - INTANGIBLE PERSONAL PROPERTY [Stocks, bonds, certificates of deposit, etc. - See instructions] 1 PARTE - LIA~I~TTES [Major debts - See instructions] r (H you have nothlng to report, wrlte "none" or "nla") (H you have nothlng to report, wrlte "nonen or "nla") \ TYPE OF INTANGIBLE I PART F -INTERESTS IN SPEClFlED BUSINESSES [Ownemhlp or posltlon~ In certaln types of burlnesser See lnrtructlons] I BUSINESS ENTITY TO WHICH THE PROPERTY RELATES NAME OF CREDITOR S-Co- (H yw have nothlng to report, wrlte "none' or 'nh") BUSINESS ENTITY # 1 ADDRESS OF CREDITOR b.AS Gotjw~o--e BUSINESS ENTITY # 2 I . *. VV-. I I I OWN MORE THAN A 5% INTEREST IN THE BUSINESS I In17 3fd I I I Signature: - NAME OF BUSINESS ENTITY ADDRESS OF BUSINESS ENTITY PRINCIPAL BUSINESS ACTIVITY PoslT~oN HELD WITH ENTITY I 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: ~v\,\hp(~, &Joi(l2/v\h &(a6 ~h'b~ik PI Wk Coc<-/hnq ad,. do_: 1, prepared the CE Form 1 in accordance with Se~lOn 112.31i5, Florida Statutes, and the instructions to the form. Upon my reasonable knowledge and belief, the disclosure herein is true and correct. Date Signed: CPAlAttorney Signature: , Date Signed: I G INSTRUCTIONS; WHAT TO FILE: WHERE TO FILE: WHEN TO FILE: After completing all parts of this form, iacludlna send back only the first sheet (pages 1 and 2) for filing. If you have nothlng to report in a particular section, you must write 'none" or "nla" in that section(s). NOTE MULTIPLE FlUNG UNNECESSAW A candidate who previously filed Form 1 because of another public position must at least file a copy of his or her original Form 1 when qualifying. A candidate who files a Form 1 with a qualifying officer is not required to file with the Commission or Supervisor of Elections. If you were malled the form by the Commission on Ethics or a County Supe~isor of Elections for your annual disclosure filing, return the form to that location. Locd ~Mcerdemployees file with the Supervisor of Electiis of the county in which they permanently reside. (If you do not permanently reside in Florida, file wlth the Supervisor of Re county where your agency has Its headquarters.) State ofBcen or rpeclled state empkyeer file with the Cornmlssion on Ethics, P.O. Drawer 15709, Tallahassee. FL 32317-5709; physical address: 325 John Knox Road, Building E. Sulte 200, Tallahassee, FL 32303. Candidates file this form together with their qualifying papers. To determine what category your position falls under, we the "Who Must File* Instructions on page 3. Inltl.lly, each local officerlemployee, state officer, and spedfied state employee must file Win 30 daya of the date of Or her appointmen! or of the beeinning of ~Pbyment. Appointees who must be confamed by the Senate mst fils prior to confirmation. even if that is leas than 30 days fmm the date of their appointment. C.nd&tes for PubliCb-elected local office must file at the same they file their qualifying Papers. ThereaiYer, 10-1 officedernployees, state officers, and specified state employees are requlred to file by July 1 st fokN4ng each calendar year in which they hdd th* posh. Flnally, at the end of office or employment, each local officer/employee, state ofimr, and specified state employee is required lo file a fnral disdosure form (Form IF) within 60 days of leaving or employment. Hwever, filing a CE Form IF (Final Statement of Financial Interests) does relieve the filer of filing a CE Form 1 if he or she was in their position on December 31,2014. CE FORM 1 - EWec(ive: Januuy 1 2015. Adoptsd by Rfwsm in Rule 344:~2(1). F.AC. I PAGE 2 APPOINTMENT OF CAMPAIGN TREASURER AND DESIGNATION OF CAMPAIGN DEPOSITORY FOR CANDIDATES (Section 106.021(1), F.S.) (PLEASE PRINT OR TYPE) NOTE: This form must be on file with the qualifying officer before opening the campaign account. OFFICE USE ONLY 1. M CHECK APPROPRIATE BOX(ES): Initial Filing of Form Re -filing to Change: ❑ Treasurer/Deputy [] Depository ■ Office p Party 2. Name of Candidate (in this order: First, Middle, Last) Aretha Janine Olivarez 3. Address (include post office box or street, city, state, zip code) P.O. Box 618585 Orlando, FL 32861 4. Telephone ('1t,1 ) 505-9515 5. E-mail address mti535@yahoo.com 6. Office sought (include district, circuit, group number) City Commissioner, District 4 7. If a candidate for a nonpartisan office, check if applicable: 0 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. 9. I have appointed the following person to act as my Mi Campaign Treasurer ❑ Deputy Treasurer 10. Name of Treasurer or Deputy Treasurer Aretha Olivarez 11. Mailing Address 4668 Pembrook Place 12. Telephone ( 407 ) 505-9515 13. City Orlando 14. County Orange 15. State FL 16. Zip Code 32811 17. E-mail address mti535@yahoo.com 18. I have designated the following bank as my rj Primary Depository ❑ Secondary Depository 19. Name of Bank Suntrust 20. Address 4582 Kirkman Rd 21. City Orlando 22. County Orange 23. State FL 24. Zip Code 32811 UNDER PENALTIES OF PERJURY, I DECLARE THAT I HAVE READ THE FOREGOING FORM FOR APPOINTMENT OF CAMPAIGN TREASURER AND DESIGNATION OF CAMPAIGN DEPOSITORY AND THAT THE FACTS STATED IN IT ARE TRUE. 25. Date 4-4-2015 26. Si ture of Candid to x 27. Treasurer's Acceptance of Appointment (fill in the blanks and check the appropriate block) Aretha Olivarez , do hereby accept the appointment (Please designated above as: 4-4-2015 Print or Type Name) E.13 Campaign Treasure ❑ Deputy Trees rer. X Date Signature of Campaign Trea r or Deputy Treasurer APPOINTMENT OF CAMPAIGN TREASURER AND DESIGNATION OF CAMPAIGN DEPOSITORY FOR CANDIDATES (Section 106.021(1), F.S.) (PLEASE PRINT OR TYPE) NOTE: This form must be on file with the qualifying officer before opening the campaign account. OFFICE USE ONLY 1. CHECK APPROPRIATE BOX(ES): ❑ Initial Filing of Form Re -filing to Change: l Treasurer/Deputy Depository ❑ Office ❑ Party 2. Name of Candidate (in this order: First, Middle, Last) Aretha Janine Olivarez 3. Address (include post office box or street, city, state, zip code) P.O. Box 618685 Orlando, FL 31-644 4. Telephone (407 ) 505-9515 5. E-mail address mti535@yahoo.com 6. Office sought (include district, circuit, group number) Orlando City Commissioner, District 4 7. If a candidate for a nonpartisan office, check if applicable: ❑ 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 5:] No Party Affiliation [] Party candidate. 9. I have appointed the following person to act as my ❑ Campaign Treasurer ® Deputy Treasurer 10. Name of Treasurer or Deputy Treasurer Adreanna Simons 11. Mailing Address 1641 S. Kirkman Rd 12. Telephone ( 407 ) 575-0685 13. City ORLANDO 14. County orange 15. State FL 16. Zip Code 32811 17. E-mail address adreanna.si©gmail.com 18. I have designated the following bank as my 4 Primary Depository 0 Secondary Depository 19. Name of Bank .v` -fir s ,1-- 20. Address i� c r ..ti 21. City 0r� 1L-4-7 22. County 0 4- el-'—�.er 23. State F' - 24. Zip Code 3 -r'/ UNDER PENALTIES OF PERJURY, I DECLARE THAT I HAVE READ THE FOREGOING FORM FOR APPOINTMENT OF CAMPAIGN TREASURER AND DESIGNATION OF CAMPAIGN DEPOSITORY AND THAT THE FACTS STATED IN IT ARE TRUE. 25. Date 0%% 22D/ -s 26. Sig ture of Candidate X 27. Treasurer's Acceptance of Appointment (fill in the blanks and check the appropriate block) Adreanna Simons , do hereby accept the appointment (Please Print or Type Name) designated above as: ❑ Campaign Treasurer 0 Deputy Treasurer. . 6/5 X Date Sianature of CamDaian Treasurer or Deputy Treasurer CAMPAIGN TREASURER'S REPORT SUMMARY (1) Aretha Olivarez OFFICE USE ONLY Name (2) P.O. Box 618585 Address (number and street) Orlando, FL 32861 City, State, Zip Code ❑ Check here if address has changed (3) ID Number: (4) Check appropriate box(es): Candidate Office Sought: Orlando City Commisioner, District 4 ❑ ❑ ■ • individual 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 making electioneering communications) (5) Report Identifiers Cover Period: From 05 / 01 / 2015 To 05 / 31 / 2015 Report Type: M5 0 Original ❑ Amendment ❑ Special Election Report (6) Contributions This Report Cash & Checks $ , 1 , 105 , 00 (7) Expenditures This Report Monetary Expenditures $ , , 84 87 Loans $ , 5 000 , 00 Transfers to Office Account $ . Total Monetary $ , 6 , 105. 00 Total Monetary $ , , 84 . 87 In -Kind $ - (8) Other Distributions $ - (9) TOTAL Monetary Contributions To Date $ , 6 , 105 . 00 (10) TOTAL Monetary Expenditures To Date $ , , 84 . 87 (11) Certification It is a first degree misdemeanor for any person I certify that I have examined this report and it is true, correct, (Type name)Adreanna Simons to falsify a public record (ss. 839.13, F.S.) and complete: (Type name) Aretha Olivarez 0 Individual (only or electioneering - for IE • Treasurer El Deputy Treasurer co ) ID Candidate ■ Chairperson (only for PC and PTY) OL4"1-- X X AAIDUVU Signature Signature CAMPAIGN TREASURER'S REPORT - ITEMIZED EXPENDITURES (1) Name Aretha Olivarez (2) I.D. Number (3) Cover Period 05 / 01 /2015 through 05 / 31 / 2015 (4) Page 1 of 1 (5) Date (7) Full Name (Last, Suffix, First, Middle) Street Address & City, State, Zip Code (8) Purpose (add office sought if contribution to a candidate) (9) Expenditure Type (10) Amendment (11) Amount (5) Sequence Number 05 /31 /2015 PayPal 2211 North First St San Jose, California 95131 Processing Fees bruit MON 29.47 000001 05 15 / / 2015 Nicole Leeper PO Box 3324 Orlando, FL 32806 Postcard Desi, MON 55.00 000002 / / / / / / / / / / 1 / DS -DE 14 (Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES CAMPAIGN TREASURER'S REPORT — ITEMIZED CONTRIBUTIONS Aretha Olivarez (1) Name (2) I.D. Number 05 01 2015 05 31 2015 1 (3) Cover Period / / through / / (4) Page of (5) Date (7) Full Name (Last, Suffix, First, Middle) Street Address & City, State, Zip Code Contributor Type (8) Occupation (9) Contribution Type (10) In -kind Description (11) Amendment (12) Amount (6) Sequence Number 05 / 04 2015 / Multiplying Talents P.O. Box 618585 Orlando, FL 32861 B Consultant LOA 5,000.00 000001 05 / 06 2015 / Laurie Nelson 14416 Lake Underhill Rd Orlando, FL 32828 1 Consultant CHE 300.00 000002 05 / 12 2015 / Wild, Christopher 1241 Iris Lake Drive Apt 302 Tampa, FL 33619 I CHE 30.00 000003 05 / 14 2015 / Smith, April 19504 SW 103 Court Cutler Bay, FL 33157 I Minister CHE 10.00 000004 05 / 14 2015 / Flawless Fitness Spa 1626 London Crest Dr 212 Orlando, FL 328118 B Fitness Spa CHE 10.00 000005 05 / 14 2015 / Holliday, Tara 1601 Eva Lane Hephziba, GA 30815 I Aft( t't Al17 CHE 25.00 000006 05 / 14 2015 / Cooks, Fayshonda 7124 Hiawassee Overlook Dr Orlando, FL 32835-1700 I NI tet-rje_. CHE 25.00 000007 DS -DE 13 (Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES CAMPAIGN TREASURER'S REPORT — ITEMIZED CONTRIBUTIONS Aretha Olivarez (1) Name (3) Cover Period 05 (2) I.D. Number 01 2015 05 31 2015 2 through / / (4) Page of (5) Date (7) Full Name (Last, Suffix, First, Middle) Street Address & City, State, Zip Code Contributor Type (8) Occupation (9) Contribution Type (10) In -kind Description (11) Amendment (12) Amount (6) Sequence Number 05 / 14 2015 / Hollimon, Tonya PO BOX 600294 North Miami Beach, FL 33160 I ,r rr 1.9 (,p Cis CHE 20.00 000008 05 / 14 2015 / Johnson, Arvella 2518 Middleton Grove Dr Bradenton, FL 33511 I CHE 10.00 000009 05 / 14 2015 / Women Empowered 726 Sail Fish Quay Chesapeake, VA 23320 B CHE 25.00 000010 05 / 14 2015 / Parries, Jerry 1709 Elsie Park Ct Kissimmee, FL 34744 I 'pasT"r CHE 20.00 000011 05 / 14 2015 / Ponder, DeAnna 4636 Barbara Hester Rd Valdosta, GA 31605 I CHE 10.00 000012 05 / 14 2015 / Jacobs, Ronette 3216 Knox Street Portsmouth, VA 23704 I I CHE 25.00 000013 05 / 14 2015 / Bell, JaMarcus 4666 Pembrook P1 Orlando, FL I PL/,d4-9 CHE 40.00 000014 DS -DE 13 (Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES CAMPAIGN TREASURER'S REPORT — ITEMIZED CONTRIBUTIONS Aretha Olivarez (1) Name (3) Cover Period 05 (2) I.D. Number 01 2015 05 31 2015 through / / (4) Page of (5) Date (7) Full Name (Last, Suffix, First, Middle) Street Address & City, State, Zip Code Contributor Type (8) Occupation (9) Contribution Type (10) In -kind Description (11) Amendment (12) Amount (6) Sequence Number 05 / 14 2015 / Alsace of New York -Events 5214 Brookmeade Dr Houston, TX 77045 I CHE 20.00 000015 05 / 14 2015 / Lattimore, Reginald 513 Ave J NW Winter Haven, FL 33881 I CHE 20.00 000016 05 / 14 2015 / Goss, Christel 7633 Pleasantville Way Grovetown, GA 30813 $ CHE 10.00 000017 05 / 14 2015 / Corprew-Mcfarland, Patricia 698B Liberty St Chesapeake, VA 23324 1 CHE 20.00 000018 05 / 14 2015 / Jarrell, Maureen 1198 Southampton Drive Port Orange, FL 32129 I CHE 25.00 000019 05 / 14 2015 / Alexander, Tara 118 Climbing Vine Run Elizabeth City, NC 27909 I CHE 10.00 000020 05 / 14 2015 / Coone, Ashley 907 S. Orange Ave Arcadia, FL I CHE 10.00 000021 DS -DE 13 (Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES CAMPAIGN TREASURER'S REPORT — ITEMIZED CONTRIBUTIONS Aretha Olivarez (1) Name 05 01 2015 05 (3) Cover Period / / through (2) I.D. Number 31 2015 (4) Page 't of (5) Date (7) Full Name (Last, Suffix, First, Middle) Street Address & City, State, Zip Code Contributor Type (8) Occupation (9) Contribution Type (10) In -kind Description (11) Amendment (12) Amount (6) Sequence Number 05 14 2015 / / Blowe, LaVonya 908 Taft Drive Portsmouth, VA 23701 I CHE 10.00 000022 05 14 2015 / / Wilson, April 10624 Meadowlea Dr Jacksonville, FL 32218 I Teacher CHE 50.00 000023 05 15 2015 / / Chaney, Duska PO BOX 616225 Orlando, FL 32861 I Nurse CHE 10.00 000024 05 17 2015 / / Boyd, Dawn 726 Sail Fish Quay Chesapeake, VA 23320 I Student CHE 10.00 000025 05 18 2015 / / Rooke, Demetree 6924 Nawadaha Blvd Hiawassee, FL 32818 I Navy CHE 20.00 000026 05 15 2015 / / Spencer, Tyhesia 612 Cannon Ridge AVe 2514 Orlando, FL 32818 I Hair Stylist CHE 20.00 000027 05 19 2015 / / Simons, Doretha 5269 Champagne Cir Orlando, FL 32808 I Retired CHE 150.00 000028 DS -DE 13 (Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES CAMPAIGN TREASURER'S REPORT ITEMIZED CONTRIBUTIONS Aretha Olivarez (1) Name (2) I.D. Number 05 01 2015 05 31 2015 (3) Cover Period / / through (4) Page of (5) Date (7) Full Name (Last, Suffix, First, Middle) Street Address & City, State, Zip Code Contributor Type (8) Occupation (9) Contribution Type (10) In -kind Description (11) Amendment (12) Amount (6) Sequence Number 05 / 20 2015 / Birden, Evetta PO BOX 3354 Merrifield, VA 22116 I /vySr / �'� CHE 25.00 000029 05 / 23 2015 / Green, David 701 17th Ave Bradenton, FL 34205 I CAS 10.00 000030 05 / 23 2015 / Wright, James 361 Delaware Ave Ft. Lauderdale, FL 33312 I Q� (`�`' CAS 10.00 000031 05 / 23 2015 / Wilson, Kenya 716 Lincoln Ave Arcadia, FL I CAS 20.00 000032 05 / 23 2015 / Chandler, Edward 8900 NW 20th Ave Miami, FL 33147 I Aohrid CAS 30.00 000033 05 / 23 2015 / Jones, Terez 817 17th St F Bradenton, FL 34208 I CAS 10.00 000034 05 / 23 2015 / Hollimon, Richard 19322 NW 23 Ct Miami, FL 33086 I CAS 5.00 000035 DS -DE 13 (Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES CAMPAIGN TREASURER'S REPORT — ITEMIZED CONTRIBUTIONS Aretha Olivarez (1) Name 05 (3) Cover Period / / through 01 207.5 05 (2) I.D. Number 31 2015 (4) Page �P of (5) Date (7) Full Name (Last, Suffix, First, Middle) Street Address & City, State, Zip Code (8) Contributor Type Occupation (9) Contribution Type (10) In -kind Description (11) Amendment (12) Amount (6) Sequence Number Hollimon, Taryn & 05 23 2015 Derrick / / 30127 Ratlana Ct 000036 Wesley Chapel, FL 33045 I CAS 10.00 Edmonds, Peg 05 23 2015 5261 Ashna Ln / / Orlando, FL 32806 000037 I CAS 20.00 Wilson, Felicia 05 23 2015 5209 Champagne Cir / / Orlando, FL 32808 000038 I CAS 20.00 Canada, Faye 05 31 2015 4815 Normandy 91 / / Orlando, FL 32811 000039 I CAS 10.00 / / / / / / DS -DE 13 (Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES CAMPAIGN TREASURER'S REPORT SUMMARY (1) Aretha Olivarez OFFICE USE ONLY Name (2) PO Box 618585 ORL CITY CLERK Address (number and street) Orlando, FL 32861 NOV10'15 PM4:23 City, State, Zip Code ❑ Check here if address has changed (3) ID Number: (4) Check v appropriate box(es): Candidate Office Sought: City Commissioner, District 4 ❑ 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 05 / 01 /2015 To 05 / 31 1 15 Report Type: M5 ❑ Original v Amendment ❑ Special Election Report (6) Contributions This Report Cash & Checks $ , 1 , 105 .00 (7) Expenditures This Report Monetary Expenditures $ , , 84 . 47 Transfers to Office Account $ , Loans $ , 5 , 000.00 Total Monetary $ , 6 , 105. 00 Total Monetary $ , , 84 . 47 In -Kind $ (8) Other Distributions $ report off by .10cents on original summary (9) TOTAL Monetary Contributions To Date $ , 6 , 105 . 00 (10) TOTAL Monetary Expenditures To Date $ , , 84 . 47 (11) Certification It is a first degree misdemeanor for any person I certify that I have examined this report and it is true, correct, (Type name) Adreanna Simons to falsify a public record (ss. 839.13, F.S.) and complete: (Type name) Aretha Olivarez • Individual (only for IE ■ Treasurer 12 Deputy Treasurer or electioneering comm.) X MI Candidate 0 Chairperson (only for PC and PTY) X Sign re Signature CAMPAIGN TREASURER'S REPORT SUMMARY (1) Aretha Olivarez OFFICE USE ONLY Name (2) P.O. Box 618585 Address (number and street) Orlando, FL 32861 City, State, Zip Code ■ Check here if address has changed (3) ID Number: (4) Check appropriate box(es): Q Candidate Office Sought: Orlando City Commisioner, District 4 ❑ 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 06 / 01 / 2015 To 06 / 30 /2015 Report Type: M6 Q Original ❑ Amendment ❑ Special Election Report (6) Contributions This Report Cash & Checks $ , , 711 00 (7) Expenditures This Report Monetary Expenditures $ , , 10 . 54 Loans $ , , • Transfers to Office Account $ Total Monetary $ , , 711 . 00 Total Monetary $ , , 10 . 54 In -Kind $ , , • (8) Other Distributions $ . (9) TOTAL Monetary Contributions To Date $ , 6 , 816 . 00 (10) TOTAL Monetary Expenditures To Date $ , , 95 . 41 (11) Certification It is a first degree misdemeanor for any person I certify that I have examined this report and it is true, correct, (Type name) Adreanna Simons to falsify a public record (ss. 839.13, F.S.) and complete: (Type name) Aretha Olivarez ❑ Individual (only for IE 0 Treasurer 2 Deputy Treasurer or electioneering comm.) 2 0 Candidate 0 Chairperson (only for PC and PTY) X ' ~t' X Signature Signature " C A M P A I G N T R E A S U R E R '