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HomeMy Public PortalAboutCampaign Treasurer's Report (2)CAMPAIGN TREASURER'S REPORT SUMMARY (1) OFFICE USE ONLY Name (2) Address (number and street) City, State, Zip Code Check here if address has changed (3)ID Number: (4)Check appropriate box(es): Candidate Office Sought: 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 / / To / / Report Type: Original Amendment Special Election Report (6)Contributions This Report (7)Expenditures This Report Monetary Expenditures Cash & Checks $ , , . $ , , . Loans $ , , . Transfers to Office Account $ , , . Total Monetary $ , , . Total Monetary $ , , . In-Kind $ , , . (8)Other Distributions $ ,, . (9)TOTAL Monetary Contributions To Date (10)TOTAL Monetary Expenditures To Date $ , , .$ , , . (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) (Type name) Individual (only for IE Treasurer Deputy Treasurer Candidate Chairperson (only for PC and PTY) or electioneering comm.) X X Signature Signature DS-DE 12 (Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS By City Clerk Gary Siplin PO BOX 585884 Orlando, FL 32858 2019D6001 4 District 6, Orlando City Commissioner M-8 4 4 7 750 00 0 00 7 750 00 0 00 17 665 91 0 00 17 665 91 128 625 00 0 00 76 617 97 08 01 19 08 31 19 A355B821-1C0B-4802-ADCE-8435D82D3CD6 09/10/19 - 01:37:00 09/10/19 - 01:37:00 CAMPAIGN TREASURER’S REPORT – ITEMIZED CONTRIBUTIONS (1) Name (2)I.D. Number (3)Cover Period / / through / / (4) Page of (5) (7) (8) (9) (10) (11) (12) Date Full Name (6) (Last, Suffix, First, Middle) Sequence Street Address & Contributor Contribution In-kind Number City, State, Zip Code Type Occupation Type Description Amendment Amount / / / / / / / / / / / / / / DS-DE 13 (Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES Gary Siplin 2019D6001 08 208 12 08 AA ALI, CPA Business ACCOUNTI NG FIRM Check $500.001 Business SUGAR Check $500.002 Business AGRICULTU RE Check $500.003 Business CITRUS Check $500.004 Business CITRUS Check $500.005 Business CITRUS Check $500.006 Individual RETIRED Check $100.007 01 19 31 19 02 19 08 12 19 08 12 19 08 12 19 08 12 19 08 12 19 08 13 19 1322 NORTH PINE HILLS ROAD ORLANDO, FL 32808 UNITED STATES SUGAR 111 PONCE DE LEON AVENUE CLEWISTON, FL 33440 SOUTHERN GARDENS GROVES 111 PONCE DE LEON AVENUE CLEWISTON, FL 33440 SOUTHERN GARDENS CITRUS NURSERY 111 PONCE DE LEON AVENUE CLEWISTON, FL 33440 SOUTHERN GARDENS CITRUS HOLDING 111 PONCE DE LEON AVENUE CLEWISTON, FL 33440 LONZIE WELLON 5135 FRYER ROAD ST CLOUD, FL 34771 111 PONCE DE LEON AVENUE CLEWISTON, FL 33440 SOUTHERN GARDENS CITRUS PROCESSING CAMPAIGN TREASURER’S REPORT – ITEMIZED CONTRIBUTIONS (1) Name (2)I.D. Number (3)Cover Period / / through / / (4) Page of (5) (7) (8) (9) (10) (11) (12) Date Full Name (6) (Last, Suffix, First, Middle) Sequence Street Address & Contributor Contribution In-kind Number City, State, Zip Code Type Occupation Type Description Amendment Amount / / / / / / / / / / / / / / DS-DE 13 (Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES Gary Siplin 2019D6001 08 308 12 08 FAISAL SHEIKH Individual DEVELOPE R Check $200.008 Business LAW FIRM Check $400.009 Individual CITY COUNCILM AN Check $100.0010 Business DESIGN SERVICES Check $100.0011 Individual PHYSICIAN Check $100.0012 Individual CONSTRUC TION Check $100.0013 Individual CONSTRUC TION Check $100.0014 01 19 31 19 13 19 08 16 19 08 25 19 08 30 19 08 30 19 08 30 19 08 30 19 219 LIME AVENUE ORLANDO, FL 32805 BOGIN, MUNNS & MUNNS PO BOX 2807 ORLANDO, FL 32802 ALIX DESULME 830 NW 133RD STREET NORTH MIAMI, FL 33168IQUEST CONCEPTS PO BOX 493 CLARCONA, FL 32710 MATTHEW SPENCE 219 WHITTIER CIRCLE ORLANDO, FL 32806 TESKA DILLARD 2783 CULLENS COURT OCOEE, FL 34761 2122 LILYPAD LANE WINDERMERE, FL 34786 ROBERT BAKER CAMPAIGN TREASURER’S REPORT – ITEMIZED CONTRIBUTIONS (1) Name (2)I.D. Number (3)Cover Period / / through / / (4) Page of (5) (7) (8) (9) (10) (11) (12) Date Full Name (6) (Last, Suffix, First, Middle) Sequence Street Address & Contributor Contribution In-kind Number City, State, Zip Code Type Occupation Type Description Amendment Amount / / / / / / / / / / / / / / DS-DE 13 (Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES Gary Siplin 2019D6001 08 408 12 08 THE ORANEVA CONSULTING GROUP Business CONSULTIN G Check $150.0015 Individual ATTORNEY Check $250.0016 Business LAW FIRM Check $250.0017 Individual HEALTHCA RE Check $250.0018 Individual ENGINEER Check $300.0019 Business ENVIRONM ENTAL CONSULTA NTS Check $350.0020 Business ENGINEERI NG Check $500.0021 01 19 31 19 30 19 08 30 19 08 30 19 08 30 19 08 30 19 08 30 19 08 30 19 17753 DEER ISLE CIRCLE WINTER GARDEN, FL 34787VERONICA ANDERSON 1122 SAINT ALBANS LOOP LAKE MARY, FL 32746 ANDERSON AND ASSOCIATES 225 NORTH FRENCH AVENUE SANFORD, FL 32771 ELOISE ABRAHAMS 2605 REEF COURT ORLANDO, FL 32805 BARNES, FERLAND AND ASSOCIATES 1230 HILLCREST STREET, SUITE 100 ORLANDO, FL 32803 AVCON 5555 EAST MICHIGAN STREET, SUITE 200 ORLANDO, FL 32822 260 SOUTH OSCEOLA AVENUE, SUITE 809 ORLANDO, FL 32801 WAYNE ALLRED CAMPAIGN TREASURER’S REPORT – ITEMIZED CONTRIBUTIONS (1) Name (2)I.D. Number (3)Cover Period / / through / / (4) Page of (5) (7) (8) (9) (10) (11) (12) Date Full Name (6) (Last, Suffix, First, Middle) Sequence Street Address & Contributor Contribution In-kind Number City, State, Zip Code Type Occupation Type Description Amendment Amount / / / / / / / / / / / / / / DS-DE 13 (Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES Gary Siplin 2019D6001 08 508 12 08 CHU-TZU HSU Individual ARCHITECT Check $500.0022 Business ENGINEERI NG Check $1,000.0023 01 19 31 19 30 19 08 30 19 559 EAST LAKE SUE AVENUE WINTER PARK, FL 32789SGM ENGINEERING 935 LAKE BALDWIN LANE ORLANDO, FL 32814 CAMPAIGN TREASURER’S REPORT – ITEMIZED EXPENDITURES DS-DE 14 (Rev. 11/13) (1)Name ______________________________________________________ (3) Cover Period ______/______/______ through ______/______/______ (2) I.D. Number _____________________ (4) Page ____________ of _____________ Full Name (Last, Suffix, First, Middle) Street Address & City, State, Zip Code (5) Date Purpose (add office sought if contribution to a candidate) Amount SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES Expenditure Type Amendment (6) Sequence Number (7) (8) (9) (10) (11) Gary Siplin 2019D6001 08 01 19 08 31 19 6 12 08 01 19 BANK OF AMERICA CAMPAIGN CHECK ORDER FEE Monetary $39.76 1 4055 CORPORATE DRIVE GRAPEVINE, TX 76051 NIKKI'S PLACE 08 02 19 CAMPAIGN MEETING Monetary $125.50 2 742 WEST CARTER STREET ORLANDO, FL 32805 VELVA BADAL 08 02 19 CAMPAIGN CONTRACT LABOR Monetary $360.00 3 5127 LESCOT LANE ORLANDO, FL 32811 TERRI HAWKS 08 02 19 CAMPAIGN CONTRACT LABOR Monetary $360.002048 ATTUCKS AVENUE ORLANDO, FL 328114 PAULA CARTER 08 02 19 CAMPAIGN CONTRACT LABOR Monetary $300.001512 MABLE BUTLER AVENUE ORLANDO, FL 328055 OLEY'S KITCHEN 08 02 19 CAMPAIGN FOOD FOR VOLUNTEERS Monetary $142.032700 SOUTH RIO GRAND AVENUE ORLANDO, FL 328056 ZOOLIX CAMPAIGN SIGNS Monetary $552.00080519 5401 SOUTH KIRKMAN ROAD, SUITE 680 ORLANDO, FL 328197 ROSALYN ROBINSON CAMPAIGN CONTRACT LABOR Monetary $224.00080619 3138 CR SMITH STREET ORLANDO, FL 328058 CAMPAIGN TREASURER’S REPORT – ITEMIZED EXPENDITURES DS-DE 14 (Rev. 11/13) (1)Name ______________________________________________________ (3) Cover Period ______/______/______ through ______/______/______ (2) I.D. Number _____________________ (4) Page ____________ of _____________ Full Name (Last, Suffix, First, Middle) Street Address & City, State, Zip Code (5) Date Purpose (add office sought if contribution to a candidate) Amount SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES Expenditure Type Amendment (6) Sequence Number (7) (8) (9) (10) (11) Gary Siplin 2019D6001 08 01 19 08 31 19 7 12 08 06 19 MICHELLE PEART CAMPAIGN CONTRACT LABOR Monetary $224.00 9 800 SOUTH IVEY LANE, UNIT A ORLANDO, FL 32811 JILL SLATER 08 06 19 CAMPAIGN CONTRACT LABOR Monetary $156.00 10 5417 KAREN COURT ORLANDO, FL 32811 SANDRA LEWIS 08 06 19 CAMPAIGN CONSULTING SERVICES Monetary $2,000.00 11 4236 LENOX BOULEVARD ORLANDO, FL 32811 LET'S KICK ASTHMA FOUNDATION 08 06 19 CAMPAIGN SPONSORSHIP FOR EVENT Monetary $500.003737 CHANDLER ESTATES DRIVE APOPKA, FL 3271212 VERIZON WIRELESS 08 06 19 CAMPAIGN TELEPHONE Monetary $322.18PO BOX 4001 ACWORTH, GA 3010113 BACKPACK GEAR 08 06 19 CAMPAIGN T-SHIRTS AND EVENT SUPPLIES Monetary $1,697.501307 EAST LANDSTREET ROAD ORLANDO, FL 3282414 THE BOHEME RESTAURANT CAMPAIGN MEETING Monetary $169.10080819 325 SOUTH ORANGE AVENUE ORLANDO, FL 3280115 VELVA BADAL CAMPAIGN CONTRACT LABOR Monetary $360.00080919 5127 LESCOT LANE ORLANDO, FL 3281116 CAMPAIGN TREASURER’S REPORT – ITEMIZED EXPENDITURES DS-DE 14 (Rev. 11/13) (1)Name ______________________________________________________ (3) Cover Period ______/______/______ through ______/______/______ (2) I.D. Number _____________________ (4) Page ____________ of _____________ Full Name (Last, Suffix, First, Middle) Street Address & City, State, Zip Code (5) Date Purpose (add office sought if contribution to a candidate) Amount SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES Expenditure Type Amendment (6) Sequence Number (7) (8) (9) (10) (11) Gary Siplin 2019D6001 08 01 19 08 31 19 8 12 08 09 19 TERRI HAWKS CAMPAIGN CONTRACT LABOR Monetary $360.00 17 2048 ATTUCKS AVENUE ORLANDO, FL 32811 PAULA CARTER 08 09 19 CAMPAIGN CONTRACT LABOR Monetary $300.00 18 1512 MABLE BUTLER AVENUE ORLANDO, FL 32805 LEGACY PARKING 08 09 19 CAMPAIGN PARKING FEE Monetary $3.00 19 255 SOUTH ORANGE AVENUE ORLANDO, FL 32801 RESTAURANT DEPOT 08 10 19 CAMPAIGN FOOD FOR EVENT Monetary $170.683451 WEST PRINCETON STREET ORLANDO, FL 3280820 ROSALYN ROBINSON 08 13 19 CAMPAIGN CONTRACT LABOR Monetary $238.003138 CR SMITH STREET ORLANDO, FL 3280521 MICHELLE PEART 08 13 19 CAMPAIGN CONTRACT LABOR Monetary $238.00800 SOUTH IVEY LANE, UNIT A ORLANDO, FL 3281122 JILL SLATER CAMPAIGN CONTRACT LABOR Monetary $208.00081319 5417 KAREN COURT ORLANDO, FL 3281123 T34LIFE CAMPAIGN GRAPHIC DESIGN Monetary $50.00081319 6387 WEST COLONIAL DRIVE ORLANDO, FL 3281824 CAMPAIGN TREASURER’S REPORT – ITEMIZED EXPENDITURES DS-DE 14 (Rev. 11/13) (1)Name ______________________________________________________ (3) Cover Period ______/______/______ through ______/______/______ (2) I.D. Number _____________________ (4) Page ____________ of _____________ Full Name (Last, Suffix, First, Middle) Street Address & City, State, Zip Code (5) Date Purpose (add office sought if contribution to a candidate) Amount SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES Expenditure Type Amendment (6) Sequence Number (7) (8) (9) (10) (11) Gary Siplin 2019D6001 08 01 19 08 31 19 9 12 08 13 19 ASSONTA LYSIUS CAMPAIGN CONTRACT LABOR Monetary $700.00 25 5233 WELLINGTON PARK CIRCLE, UNIT B42 ORLANDO, FL 32839 ULINE 08 13 19 CAMPAIGN SUPPLIES Monetary $72.61 26 PO BOX 88741 CHICAGO, IL 60680 PAYPAL 08 13 19 CAMPAIGN PROCESSING FEE Monetary $9.30 27 2211 NORTH 1ST STREET SAN JOSE, CA 95131 VELVA BADAL 08 16 19 CAMPAIGN CONTRACT LABOR Monetary $360.005127 LESCOT LANE ORLANDO, FL 3281128 TERRI HAWKS 08 16 19 CAMPAIGN CONTRACT LABOR Monetary $360.002048 ATTUCKS AVENUE ORLANDO, FL 3281129 PAULA CARTER 08 16 19 CAMPAIGN CONTRACT LABOR Monetary $300.001512 MABLE BUTLER AVENUE ORLANDO, FL 3280530 MAGGIANO'S LITTLE ITALY CAMPAIGN MEETING Monetary $40.00081619 9101 INTERNATIONAL DRIVE, SUITE 2400 ORLANDO, FL 3281931 BJ'S WHOLESALE CAMPAIGN SUPPLIES FOR WORKERS Monetary $53.74081819 4697 MILLENIA PLAZA WAY ORLANDO, FL 3283932 CAMPAIGN TREASURER’S REPORT – ITEMIZED EXPENDITURES DS-DE 14 (Rev. 11/13) (1)Name ______________________________________________________ (3) Cover Period ______/______/______ through ______/______/______ (2) I.D. Number _____________________ (4) Page ____________ of _____________ Full Name (Last, Suffix, First, Middle) Street Address & City, State, Zip Code (5) Date Purpose (add office sought if contribution to a candidate) Amount SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES Expenditure Type Amendment (6) Sequence Number (7) (8) (9) (10) (11) Gary Siplin 2019D6001 08 01 19 08 31 19 10 12 08 20 19 ROSALYN ROBINSON CAMPAIGN CONTRACT LABOR Monetary $210.00 33 3138 CR SMITH STREET ORLANDO, FL 32805 MICHELLE PEART 08 20 19 CAMPAIGN CONTRACT LABOR Monetary $210.00 34 800 SOUTH IVEY LANE, UNIT A ORLANDO, FL 32811 JILL SLATER 08 20 19 CAMPAIGN CONTRACT LABOR Monetary $156.00 35 5147 KAREN COURT ORLANDO, FL 32811 DONNA FLETCHER 08 20 19 CAMPAIGN CONTRACT LABOR Monetary $100.005233 WELLINGTON PARK CIRCLE, UNIT B46 ORLANDO, FL 3283936 VELVA BADAL 08 23 19 CAMPAIGN CONTRACT LABOR Monetary $360.005127 LESCOT LANE ORLANDO, FL 3281137 TERRI HAWKS 08 23 19 CAMPAIGN CONTRACT LABOR Monetary $360.002048 ATTUCKS AVENUE ORLANDO, FL 3281138 PAULA CARTER CAMPAIGN CONTRACT LABOR Monetary $300.00082319 1512 MABLE BUTLER AVENUE ORLANDO, FL 3280539 PAYPAL CAMPAIGN PROCESSING FEE Monetary $3.20082519 2211 NORTH 1ST STREET SAN JOSE, CA 9513140 CAMPAIGN TREASURER’S REPORT – ITEMIZED EXPENDITURES DS-DE 14 (Rev. 11/13) (1)Name ______________________________________________________ (3) Cover Period ______/______/______ through ______/______/______ (2) I.D. Number _____________________ (4) Page ____________ of _____________ Full Name (Last, Suffix, First, Middle) Street Address & City, State, Zip Code (5) Date Purpose (add office sought if contribution to a candidate) Amount SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES Expenditure Type Amendment (6) Sequence Number (7) (8) (9) (10) (11) Gary Siplin 2019D6001 08 01 19 08 31 19 11 12 08 27 19 ROSALYN ROBINSON CAMPAIGN CONTRACT LABOR Monetary $280.00 41 3138 CR SMITH STREET ORLANDO, FL 32805 MICHELLE PEART 08 27 19 CAMPAIGN CONTRACT LABOR Monetary $280.00 42 800 SOUTH IVEY LANE, UNIT A ORLANDO, FL 32811 JILL SLATER 08 27 19 CAMPAIGN CONTRACT LABOR Monetary $247.00 43 5417 KAREN COURT ORLANDO, FL 32811 USPS 08 27 19 CAMPAIGN SERVICE FEE Monetary $53.00811 DEAUVILLE DRIVE ORLANDO, FL 3280844 US 1844672 ONTARIO 08 27 19 CAMPAIGN RENT Monetary $2,500.006900 SILVER STAR ROAD, SUITE 206A ORLANDO, FL 3281845 VERIZON WIRELESS 08 27 19 CAMPAIGN TELEPHONE EQUIPMENT Monetary $74.543120 SOUTH KIRKMAN ROAD ORLANDO, FL 3281146 AA ALI CPA CAMPAIGN PROFESSIONAL SERVICES Monetary $450.00082819 1322 NORTH PINE HILLS ROAD ORLANDO, FL 3280847 OFFICE DEPOT CAMPAIGN SUPPLIES Monetary $16.65082819 7174 WEST COLONIAL DRIVE ORLANDO, FL 3281848 CAMPAIGN TREASURER’S REPORT – ITEMIZED EXPENDITURES DS-DE 14 (Rev. 11/13) (1)Name ______________________________________________________ (3) Cover Period ______/______/______ through ______/______/______ (2) I.D. Number _____________________ (4) Page ____________ of _____________ Full Name (Last, Suffix, First, Middle) Street Address & City, State, Zip Code (5) Date Purpose (add office sought if contribution to a candidate) Amount SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES Expenditure Type Amendment (6) Sequence Number (7) (8) (9) (10) (11) Gary Siplin 2019D6001 08 01 19 08 31 19 12 12 08 29 19 BJ'S WHOLESALE CAMPAIGN DRINKS AND SNACKS FOR VOLUNTEERS Monetary $230.12 49 4697 MILLENIA PLAZA WAY ORLANDO, FL 32839 VELVA BADAL 08 30 19 CAMPAIGN CONTRACT LABOR Monetary $300.00 50 5127 LESCOT LANE ORLANDO, FL 32811 TERRI HAWKS 08 30 19 CAMPAIGN CONTRACT LABOR Monetary $300.00 51 2048 ATTUCKS AVENUE ORLANDO, FL 32811 PAULA CARTER 08 30 19 CAMPAIGN CONTRACT LABOR Monetary $240.001512 MABLE BUTLER AVENUE ORLANDO, FL 3280552 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. INSTRUCTIONS FOR CAMPAIGN TREASURER’S REPORT – ITEMIZED CONTRIBUTIONS (1)Candidate’s full name or name of the political committee (PC), electioneering communications organizations (ECO) or party executive committee (PTY). (2)The identification number assigned by the filing officer. (3)Cover period dates (e.g., 1/1/15 through 1/31/15). (See filing officer’s reporting dates calendar for appropriate year and cover periods.) (4)Page numbers (e.g., 1 of 3 ). (5)Date contribution was RECEIVED (Month/Day/Year). (6)Sequence Number – Each detail line shall have a sequence number assigned to it. Sequence numbers are to be assigned within each reporting period and for each type of detail line. Thus the report type, detail line type, and sequence number will combine to uniquely identify a specific contribution, expenditure, distribution or fund transfer. This method of unique identification is required for responding to requests from the filing officer and for reporting amendments. For example, a M1 report having 75 contributions would use sequence numbers 1 through 75. The next report (M2), comprised of 40 contributions would use sequence numbers 1 through 40. Contributions on amended M1 reports would begin with sequence number 76 and on amended M2 reports would begin with sequence number 41. See the Amendment Type instructions below. (7)Type full name and address of contributor (including city, state and zip code). (8)Enter the type of contributor using one of the following codes: Occupation of contributor for contributions over $100 only. (If a business, please indicate nature of business.) I Individual B Business (also includes corporations, organizations, groups, etc.) E Electioneering Communications Organizations F Political Committee (federal or state) (includes federal, state and county executive P Political Parties committees) O Other (e.g., candidate surplus funds to party, etc.) S Candidate to Self (9)Enter Contribution Type using one of the following codes: NOTE: Cash includes cash and cashier’s checks. Code Description CAS Cash or Cashier’s Check CHE Check COF Carryover Funds from Previous Campaign INK In-Kind INT Interest LOA Loan MO Money Order MUC Multiple Uniform Contributions RCT Other Receipts REF Refund (Negative Amount Only) (10)Typ e the description of any in-kind contribution received. Candidate’s Only – If in-kind contribution is from a party executive committee and is allocable toward the contribution limits, type an “A” in this box. If contribution is not allocable, type an “N”. (11)Amendment Type (required on amended reports) – To add a new (previously unreported) contribution for the reporting period being amended, enter “ADD” in amendment type on a line with ALL of the required data. The sequence number for contributions with amendment type “ADD” will start at one plus the number of contributions in the original report. For example, amending an original M1 report that had 75 contributions means the sequence number of the first contribution having amendment type “ADD” will be 76; the second “ADD” contribution would be 77, etc. When amending an original M2 report that had 40 contributions, the sixth “ADD” contribution would have sequence number 46. To correct a previously submitted contribution use the following drop/add procedure. Enter “DEL” in amendment type on a line with the sequence number of the contribution to be corrected. In combination with the report number being amended, this sequence number will identify the contribution to be dropped from your active records. On the next line enter “ADD” in amendment type and ALL of the required data with the necessary corrections thus replacing the dropped data. Assign the sequence number as described above. (12)Type amount of contribution received. Political Committees ONLY: Multiple uniform contributions from the same person, aggregating NMT $250 per calendar year, collected by an organization that is the affiliated sponsor of a PC, may be reported by the PC in an aggregate amount listing the number of contributors together with the amount contributed by each and the total amount contributed during the reporting period. The identity of each person making such uniform contribution must be reported to the filing officer by July 1 of each calendar year, or, in a general election year, NLT the 60th day immediately preceding the primary election. INSTRUCTIONS FOR CAMPAIGN TREASURER’S REPORT – FUND TRANSFERS (1)Type candidate’s full name or name of the political committee (PC), electioneering communications organization (ECO), or party executive committee (PTY). (2)Type identification number assigned by the filing officer. (3)Type cover period dates (e.g., 1/1/15 through 1/31/15). (See filing officer’s reporting dates calendar for appropriate cover periods.) (4)Type page numbers (e.g., 1 of 3). (5)Type date of fund transfer (Month/Day/Year). (6)Sequence Number - Each detail line shall have a sequence number assigned to it. Sequence numbers are to be assigned within each reporting period and for each type of detail line. Thus the report type, detail line type, and sequence number will combine to uniquely identify a specific contribution, expenditure, distribution or fund transfer. This method of unique identification is required for responding to requests from the filing officer and for reporting amendments. For example, a M1 report having 2 fund transfers would use sequence numbers 1 thru 2. The next report (M2), comprised of 4 fund transfers would use sequence numbers 1 thru 4. Fund transfers on amended M1 reports would begin with sequence number 3 and on amended M2 reports would begin with sequence number 5. See the Amendment Type instructions below. (7)Type full name and address of financial institution (including city, state and zip code). (8)Enter Transfer Type using one of the following codes: DESCRIPTION Transfer FROM identified account to campaign account Transfer TO identified account from the campaign account CODE F T (9)Nature of Account (e.g., certificate of deposit, money market, etc...) (10)Amendment Type (required on amended reports) - To add a new (previously unreported) fund transfer for the reporting period being amended, enter “ADD” in amendment type on a line with ALL of the required data. The sequence number for fund transfers with amendment type “ADD” will start at one plus the number of fund transfers in the original report. For example, amending an original M1 report that had 75 fund transfers, means the sequence number of the first fund transfer having amendment type “ADD” will be 76; the second “ADD” fund transfer would be 77, etc. When amending an original M2 report that had 40 fund transfers, the sixth “ADD” fund transfer would have sequence number 46. To correct a previously submitted fund transfer use the following drop/add procedure. Enter “DEL” in amendment type on a line with the sequence number of the fund transfer to be corrected. In combination with the report number being amended, this sequence number will identify the fund transfer to be dropped from your active records. On the next line enter “ADD” in amendment type and ALL of the required data with the necessary corrections thus replacing the dropped data. Assign the sequence number as described above. (11)Type amount of fund transfer. INSTRUCTIONS FOR CAMPAIGN TREASURER'S REPORT - ITEMIZED EXPENDITURES (1)Candidate's full name or name of the political committee (PC), electioneering communications organization (ECO), or party executive committee (PTY). (2)Identification number assigned by the filing officer. (3)Cover period dates (01/01/15 through 01/31/15). (See filing officer’s reporting dates calendar for appropriate cover periods.) (4)Page numbers (e.g., 1 of 3). (5)Date of expenditure (Month/Day/Year). (6)Sequence Number - Each detail line shall have a sequence number assigned to it. Sequence numbers are to be assigned within each reporting period and for each type of detail line. Thus the report type, detail line type, and sequence number will combine to uniquely identify a specific contribution, expenditure, distribution or fund transfer. This method of unique identification is required for responding to requests from the filing officer and for reporting requirements. For example, a M1 report having 40 expenditures would use sequence numbers 1 through 40. The next report (M2), comprised of 30 expenditures would use sequence numbers 1 through 30. Expenditures on amended M1 reports would begin with sequence number 41 and on amended M2 reports would begin with sequence number 31. See Amendment Type instructions below. (7)Full name and address of entity receiving payment (including city, state and zip code). (8)Purpose of expenditure (if expenditure is a contribution to a candidate, also type the office sought by the candidate). PLEASE NOTE: This column does not apply to candidate expenditures, as candidates cannot contribute to other candidates from campaign funds. However, PCs (supporting candidates) and party executive committees contributing to candidates must report office sought (Section 106.07, F.S.). (9)Enter Expenditure Type using one of the following codes: Code Description CAN Candidate Expense DIS Disposition of Funds DFC Disposition of Funds to Future Campaign (effective 11/1/13) DPP Disposition of Funds to Political Party (effective 11/1/13) DPV Disposition of Funds to Petition Verification (effective 11/1/13) ECC Electioneering Communication IEC Independent Expenditure Regarding a Candidate IEI Independent Expenditure Regarding an Issue MON Monetary (Not to a Candidate) PCW Petty Cash Withdrawn PCS Petty Cash Spent PPD Pre-paid Distribution REF Refund (Negative Amount Only) RMB Reimbursements TOA Transfer to Office Account (Disposition of Funds) (10)Amendment Type (required on amended reports) - To add a new (previously unreported) expenditure for the reporting period being amended, enter "ADD" in amendment type on a line with ALL of the required data. The sequence number for expenditures with amendment type "ADD" will start at one plus the number of expenditures in the original report. For example, amending an original M1 reports that had 75 expenditures, means the sequence number of the first expenditure having amendment type "ADD" will be 76; the second "ADD" expenditure would have sequence number 39. To correct a previously submitted expenditure use the following drop/add procedure. Enter "DEL" in amendment type on a line with the sequence number of the expenditure to be corrected. In combination with the report number being amended, this sequence number will identify the expenditure to be dropped from your active records. On the next line enter "ADD" in amendment type and ALL of the required data with the necessary corrections thus replacing the dropped data. Assign the sequence number as described above. (11) Amount of expenditure. 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