HomeMy Public PortalAboutCampaign Treasurer's Report (12)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
Samuel B. (Qualified) Ings
P.O. Box 551306
Orlando, FL 32855
2019MC006
4 Orlando City Mayor
G-1
4
4
9 760 00
8 000 00
17 760 00
0 00
31 892 81
0 00
31 892 81
86 125 19
0 00
82 072 34
09 01 19 10 04 19
18FB4121-6ABB-4F46-97B3-08387012C7D2
10/11/19 - 10:06:40
10/11/19 - 10:06:40
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
Samuel B. (Qualified) Ings 2019MC006
09 210 18
09 Dr. Dorsey C. Miller, Jr.
Individual
Retired Check
$150.001
Individual
Check
$100.002
Individual
Check
$50.003
Individual
CashOrCash
iersCheck
$25.004
Individual
Retired/Stain
ed Glass
Artist
Check
$250.005
Individual
Retired Check
$150.006
Individual
Check
$25.007
01 19 04 19
01 19
09 01 19
09 04 19
09 07 19
09 08 19
09 08 19
09 09 19
6008 N. W, 62nd Terr.
Parkland, FL 33067
Charles T. Winfield
4818 Courville
Detroit, MI 48224
Macene S. Isom
912 Wooden Blvd.
Orlando, FL 32805
Vicki Felder
3501 Rogers Dr.
Orlando, FL 32805
Kristina Brough
454 Moffat Loop
Oviedo, FL 32765
Angela Cowan
1930 North St.
Longwood, FL 32750
1415 Briercliff Dr.
Orlando, FL 32806
Lynne Ghioto
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
Samuel B. (Qualified) Ings 2019MC006
09 310 18
09 Willie C. Merrell
Individual
Chief
Operations
Officer
Check
$1,000.008
Individual
Check
$25.009
Individual
CashOrCash
iersCheck
$10.0010
Individual
MoneyOrder
$50.0011
Individual
MoneyOrder
$50.0012
Business
Soccer
Sports
Organization
Check
$1,000.0013
Individual
Check
$25.0014
01 19 04 19
12 19
09 13 19
09 14 19
09 14 19
09 14 19
09 14 19
09 17 19
823 Hallowell Cir.
Orlando, FL 32828
Labrit D. Jackson
6547 Georgian Way
Columbus, GA 31909
Karen Heasley
4300 Chelsea St.
Orlando, FL 32803
Joseph Winfield
17373 Bradford St.
Detroit, MI 48208
Florida Cup LLC
4705 S. Apopka
Vineland Rd.
Orlando, FL 32819
Carl Maultsby
3943 Thomas St.
Orlando, FL 32805
17266 Puritan
Clinton Township, MI
48038
Chanelle Manus
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
Samuel B. (Qualified) Ings 2019MC006
09 410 18
09 Dr. Janice Choice
Individual
Retired Check
$125.0015
Individual
Check
$100.0016
Individual
Retired Check
$200.0017
Business
Property
Managemen
t
Check
$1,000.0018
Business
Hotel Check
$1,000.0019
Individual
Entrepreneu
r
Check
$250.0020
Individual
Construction Check
$250.0021
01 19 04 19
18 19
09 18 19
09 20 19
09 24 19
09 24 19
09 24 19
09 24 19
2515 Caribbean Ct.
Orlando, FL 32805
Nancy Trulock Glenn
518 Lakeview St.
Orlando, FL 32804
Joseph W. Kittinger, Jr.
608 Mariner Way
Altamonte Springs, FL
32701
Lutfi Rental Collection
720 S. Orange Blossom
Trl.
Orlando, FL 32805
Martine Joseph
1339 Madison Ivy Cir.
Apopka, FL 32712
Brian M. Butler
800 W. Gore St.
Orlando, FL 32805
720 S. Orange Blossom
Trl.
Orlando, FL 32805
Vacation Lodge
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
Samuel B. (Qualified) Ings 2019MC006
09 510 18
09 1405 Hospitality Group
LLC
Business
Hospitality Check
$500.0022
Individual
Check
$100.0023
CandidateToSelf
Elected
Official
Loan
$3,000.0024
CandidateToSelf
Elected
Official
Loan
$5,000.0025
Individual
Check
$50.0026
Individual
Physician Check
$250.0027
Individual
Physician Check
$500.0028
01 19 04 19
25 19
09 26 19
10 01 19
10 03 19
10 03 19
10 03 19
10 03 19
1405 S. Orange Ave.,
#603
Orlando, FL 32806
Sarah Gulati
P. O. Box 917554
Longwood, FL 32791
Samuel B. Ings
P.O. Box 551306
Orlando, FL 32855
Samuel B. Ings
P.O. Box 551306
Orlando, FL 32855
Ravi P. Akella
6713 Valhalla Way
Windermere, FL 34786
Dr. Nazim Merchant
9032 Dancy Tree Ct.
Orlando, FL 32836
6656 Andrea Rose Dr.
Orlando, FL 32835
Helen C. Lamb
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
Samuel B. (Qualified) Ings 2019MC006
09 610 18
10 Prabin C. Miskra
Individual
Physician Check
$250.0029
Individual
Physician Check
$250.0030
Individual
Pastor Check
$200.0031
Individual
Counselor Check
$500.0032
Individual
Retired Check
$125.0033
Individual
CPA Check
$200.0034
Individual
Check
$100.0035
01 19 04 19
03 19
10 03 19
10 03 19
10 03 19
10 03 19
10 03 19
10 03 19
130 Riviera Dunes Way,
Apt. 205
Palmetto, FL 34221
Raghu D. Ganjam
11049 Ullswater Ln.
Windermere, FL 34786
David Ellis Stephens
11552 Alepat Ln.
Orlando, FL 32836
Wilbert Shaw
3872 Long Branch Ln.
Apopka, FL 32712
Shyam Kotwal
13574 Village Pk. Dr.,
Ste. 255
Orlando, FL 32837
Dr. Harry Behzadi
3302 Butler Bay Dr. N.
Windermere, FL 34786
2515 Caribbean Ct.
Orlando, FL 32805
Dr. Janice Choice
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
Samuel B. (Qualified) Ings 2019MC006
09 710 18
10 Sudhir Bhaskar
Individual
Physician Check
$150.0036
Individual
Consultant Check
$500.0037
Individual
Physician Check
$250.0038
01 19 04 19
03 19
10 03 19
10 03 19
9048 Great Heron Circle
Orlando, FL 32836
Akash Patel
13114 Willshire Ct.
Orlando, FL 32836
Srikiran Pothamsetty
1507 S. Hiawassee Rd.
Orlando, FL 32835
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)
Samuel B. (Qualified) Ings 2019MC006
09 01 19 10 04 19 8 18
09 03 19 Amazon.com Signage Yard Spikes CandidateEx
pense $107.98
1 410 Terry Ave. North
Seattle, WA 98109
Hotcards.com
09 03 19 Marketing Materials CandidateEx
pense $1,002.29
2
2400 Superior Ave. East
Cleveland, OH 44114
Angela James
09 03 19
GOTV CandidateEx
pense $156.00
3
4619 Edgemoor St.
Orlando, FL 32811
Ursula Singleton
09 03 19
GOTV CandidateEx
pense $156.001460 Heber Cir.
Orlando, FL 328114
Sharon Reed
09 03 19
GOTV CandidateEx
pense $180.004619 Edgemoor St.
Orlando, FL 328115
Maureen Lewis
09 03 19
GOTV CandidateEx
pense $300.00586 Smokemont Ct.
Apopka, FL 327126
Vicki Jordan GOTV CandidateEx
pense $400.00090319
1503 Dess Dr.
Orlando, FL 328187
Shirley Hawks GOTV CandidateEx
pense $156.00090319
4798 Danzig Court
Orlando, FL 328118
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)
Samuel B. (Qualified) Ings 2019MC006
09 01 19 10 04 19 9 18
09 03 19 Michelle McCoy GOTV CandidateEx
pense $156.00
9 4619 Edgemoor St.
Orlando, FL 32811
Sandra Lewis
09 03 19 GOTV CandidateEx
pense $500.00
10
4236 Lenox Blvd.
Orlando, FL 32811
Sandra Lewis
09 03 19
GOTV
Supplies/Water/Snac
ks
CandidateEx
pense $100.00
11
4236 Lenox Blvd.
Orlando, FL 32811
Gregory Jordan
09 03 19
GOTV CandidateEx
pense $225.001503 Dess Dr.
Orlando, FL 3281812
Darrell Hairston
09 03 19
GOTV CandidateEx
pense $225.007719 Senjill Ct.
Orlando, FL 3281813
Ray Jones
09 03 19
GOTV CandidateEx
pense $225.0074 Dorcas Ct.
Orlando, FL 3281114
LaRonda Allen GOTV CandidateEx
pense $225.00090319
6206 Medford Dr.
Orlando, Fl , FL 3280815
Gravis Marketing Marketing Materials CandidateEx
pense $500.00090619
920 Belle Ave., #1330
Winter Springs, FL 3270816
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)
Samuel B. (Qualified) Ings 2019MC006
09 01 19 10 04 19 10 18
09 06 19 Home Depot Signage Supplies CandidateEx
pense $48.99
17 7022 W. Colonial Drive
Orlando, FL 32818
Uline
09 10 19 Marketing Materials CandidateEx
pense $370.93
18
P. O. Box 88741
Chicago, IL 60680
Jill Slater
09 10 19
GOTV CandidateEx
pense $60.00
19
5417 Karen Court
Orlando, FL 32811
Rosalyn Robinson
09 10 19
GOTV CandidateEx
pense $60.003138 C. R. Smith St.
Orlando, FL 3280520
Michelle Peart
09 10 19
GOTV CandidateEx
pense $60.00800 S. Ivey Lane, #A
Orlando, FL 3281121
Shirley Hawks
09 10 19
GOTV CandidateEx
pense $195.004798 Danzig Court
Orlando, FL 3281122
Michele McCoy GOTV CandidateEx
pense $240.00091019
4619 Edgemoor St.
Orlando, FL 3281123
Sharon Reed GOTV CandidateEx
pense $272.00091019
4619 Edgemoor St.
Orlando, FL 3281124
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)
Samuel B. (Qualified) Ings 2019MC006
09 01 19 10 04 19 11 18
09 10 19 Angela James GOTV CandidateEx
pense $195.00
25 4619 Edgemoor St.
Orlando, FL 32811
Ursula Singleton
09 10 19 GOTV CandidateEx
pense $240.00
26
1460 Heber Cir.
Orlando, FL 32811
Gravis Marketing
09 10 19
Marketing Materials CandidateEx
pense $500.00
27
920 Belle Ave., #1330
Winter Springs, FL 32708
Vicki Jordan
09 10 19
GOTV CandidateEx
pense $500.001503 Dess Dr.
Orlando, FL 3281828
Gregory Jordan
09 10 19
GOTV CandidateEx
pense $225.001503 Dess Dr.
Orlando, FL 3281829
Maureen Lewis
09 10 19
GOTV CandidateEx
pense $400.00586 Smokemont Ct.
Apopka, FL 3271230
Darrell Hairston GOTV CandidateEx
pense $225.00091019
7719 Senjill Ct.
Orlando, FL 3281831
LaRonda Allen GOTV CandidateEx
pense $225.00091019
6206 Medford Dr.
Orlando, FL 3280832
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)
Samuel B. (Qualified) Ings 2019MC006
09 01 19 10 04 19 12 18
09 10 19 Ray Jones GOTV CandidateEx
pense $225.00
33 74 Dorcas Ct.
Orlando, FL 32811
Vicki Jordan
09 10 19 GOTV Signage CandidateEx
pense $500.00
34
1503 Dess Dr.
Orlando, FL 32818
City of Orlando
09 12 19
Candidate Filing Fee CandidateEx
pense $5,872.17
35
400 S. Orange Ave.
Orlando, FL 32801
Jason Anderson
09 12 19
GOTV Marketing CandidateEx
pense $600.005838 E. 11 Mile Rd.
Warren, MI 4809136
Home Depot
09 12 19
Signage Supplies CandidateEx
pense $454.767022 W. Colonial Dr.
Orlando, FL 3281837
Sandra Lewis
09 13 19
GOTV CandidateEx
pense $500.004236 Lenox Blvd.
Orlando, FL 3281138
Sam Service Station GOTV Gas & Food CandidateEx
pense $245.70091419
1208 Bruton Blvd.
Orlando, FL 3280539
Angela James GOTV CandidateEx
pense $300.00091719
4619 Edgemoor St.
Orlando, FL 3281140
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)
Samuel B. (Qualified) Ings 2019MC006
09 01 19 10 04 19 13 18
09 17 19 Shirley Hawks GOTV CandidateEx
pense $300.00
41 4798 Danzig Ct.
Orlando, FL 32811
Sharon Reed
09 17 19 GOTV CandidateEx
pense $340.00
42
4619 Edgemoor St.
Orlando, FL 32811
Michelle McCoy
09 17 19
GOTV CandidateEx
pense $300.00
43
4619 Edgemoor St.
Orlando, FL 32811
Ursula Singleton
09 17 19
GOTV CandidateEx
pense $345.001460 Heber Cir.
Orlando, FL 3281144
Sandra Lewis
09 17 19
GOTV CandidateEx
pense $100.004236 Lenox Blvd.
Orlando, FL 3281145
Darrell Hairston
09 17 19
GOTV CandidateEx
pense $375.007719 Senjill Ct.
Orlando, FL 3281846
LaRonda Allen GOTV CandidateEx
pense $375.00091719
6206 Medford Dr.
Orlando, FL 3280847
Ray Jones GOTV CandidateEx
pense $375.00091719
74 Dorcas Ct.
Orlando, FL 3281148
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)
Samuel B. (Qualified) Ings 2019MC006
09 01 19 10 04 19 14 18
09 17 19 Vicki Jordan GOTV CandidateEx
pense $500.00
49 1503 Dess Dr.
Orlando, FL 32818
Maureen Lewis
09 17 19 GOTV CandidateEx
pense $500.00
50
586 Smokemont Ct.
Apopka, FL 32712
Gregory Jordan
09 17 19
GOTV CandidateEx
pense $375.00
51
1503 Dess Dr.
Orlando, FL 32818
Office Max/Office Depot
09 19 19
Office Supplies CandidateEx
pense $50.582847 S. Orange Avenue
Orlando, FL 3280652
Sandra Lewis
09 20 19
GOTV CandidateEx
pense $600.004236 Lenox Blvd.
Orlando, FL 3281153
Office Max/Office Depot
09 20 19
GOTV CandidateEx
pense $36.992847 S. Orange Avenue
Orlando, FL 3280654
Office Max/Office Depot GOTV CandidateEx
pense $36.99092019
2847 S. Orange Avenue
Orlando, FL 3280655
Home Depot Signage Supplies CandidateEx
pense $48.99092019
7022 W. Colonial Drive
Orlando, FL 3281856
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)
Samuel B. (Qualified) Ings 2019MC006
09 01 19 10 04 19 15 18
09 24 19 Vicki Jordan GOTV CandidateEx
pense $500.00
57 1503 Dess Dr.
Orlando, FL 32818
Maureen Lewis
09 24 19 GOTV CandidateEx
pense $500.00
58
586 Smokemont Ct.
Apopka, FL 32712
Ray Jones
09 24 19
GOTV CandidateEx
pense $375.00
59
74 Dorcas Ct.
Orlando, FL 32811
LaRonda Allen
09 24 19
GOTV CandidateEx
pense $375.006206 Medford Dr.
Orlando, FL 3280860
Gregory Jordan
09 24 19
GOTV CandidateEx
pense $375.001503 Dess Dr.
Orlando, FL 3281861
Darrell Hairston
09 24 19
GOTV CandidateEx
pense $375.007719 Senjill Ct.
Orlando, FL 3281862
Ursula Singleton GOTV CandidateEx
pense $255.00092419
1460 Heber Cir.
Orlando, FL 3281163
Angela James GOTV CandidateEx
pense $315.00092419
4619 Edgemoor St.
Orlando, FL 3281164
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)
Samuel B. (Qualified) Ings 2019MC006
09 01 19 10 04 19 16 18
09 24 19 Shirley Hawks GOTV CandidateEx
pense $300.00
65 4798 Danzig Ct.
Orlando, FL 32811
Sharon Reed
09 24 19 GOTV CandidateEx
pense $357.00
66
4619 Edgemoor St.
Orlando, FL 32811
Michelle McCoy
09 24 19
GOTV CandidateEx
pense $315.00
67
4619 Edgemoor St.
Orlando, FL 32811
Uline
09 24 19
GOTV Supplies CandidateEx
pense $72.61P. O. Box 88741
Chicago, IL 6068068
Sandra Lewis
09 24 19
GOTV CandidateEx
pense $600.004236 Lenox Blvd.
Orlando, FL 3281169
Sam Service Station
09 24 19
GOTV Gas & Food CandidateEx
pense $375.851208 Bruton Blvd.
Orlando, FL 3280570
Square Space Monthly Fee CandidateEx
pense $26.00093019
510 Townsend St.
San Francisco, CA 9410371
STRIPE Transaction Fees CandidateEx
pense $119.28093019
510 Townsend St.
San Francisco, CA 9410372
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)
Samuel B. (Qualified) Ings 2019MC006
09 01 19 10 04 19 17 18
10 01 19 Angela James GOTV CandidateEx
pense $180.00
73 4619 Edgemoor St.
Orlando, FL 32811
Ursula Singleton
10 01 19 GOTV CandidateEx
pense $315.00
74
1460 Heber Cir.
Orlando, FL 32811
Shirley Hawks
10 01 19
GOTV CandidateEx
pense $300.00
75
4798 Danzig Ct.
Orlando, FL 32811
Michelle McCoy
10 01 19
GOTV CandidateEx
pense $300.004619 Edgemoor St.
Orlando, FL 3281176
Sharon Reed
10 01 19
GOTV CandidateEx
pense $340.004619 Edgemoor St.
Orlando, FL 3281177
Vicki Jordan
10 01 19
GOTV CandidateEx
pense $500.001503 Dess Dr.
Orlando, FL 3281878
Maureen Lewis GOTV CandidateEx
pense $500.00100119
586 Smokemont Ct.
Apopka, FL 3271279
Gregory Jordan GOTV CandidateEx
pense $375.00100119
1503 Dess Dr.
Orlando, FL 3281880
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)
Samuel B. (Qualified) Ings 2019MC006
09 01 19 10 04 19 18 18
10 01 19 Darrell Hairston GOTV CandidateEx
pense $375.00
81 7719 Senjill Ct.
Orlando, FL 32818
LaRonda Allen
10 01 19 GOTV CandidateEx
pense $300.00
82
6206 Medford Dr.
Orlando, FL 32808
Ray Jones
10 01 19
GOTV CandidateEx
pense $300.00
83
74 Dorcas Ct.
Orlando, FL 32811
Vicki Jordan
10 01 19
GOTV CandidateEx
pense $200.001503 Dess Dr.
Orlando, FL 3281884
Uline
10 02 19
Marketing Materials CandidateEx
pense $284.70P. O. Box 88741
Chicago, IL 6068085
Sandra Lewis
10 04 19
GOTV CandidateEx
pense $600.004236 Lenox Blvd.
Orlando, FL 3281186
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