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Home My Public Portal AboutCampaign Treasurer's Report (19)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 Aretha Janine (Qualified) Simons P.O. Box 550415 Orlando, FL 32855 2019MC002 4 Orlando City Mayor G-1 4 4 2 060 00 0 00 2 060 00 1 500 00 8 021 68 0 00 8 021 68 47 481 90 0 00 42 248 56 09 01 19 09 30 19 042ED961-255B-42E5-954E-6D704BC92A54 10/06/19 - 10:50:39 10/06/19 - 10:50:39 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 Aretha Janine (Qualified) Simons 2019MC002 09 209 9 09 Martha Agramonte Individual Self Employed Check $50.001 Individual Navy Check $25.002 Individual Real Estate Investor Check $10.003 Individual Sales Manager Check $1,000.004 Individual Banquet Manager Check $25.005 Individual IT Professional Check $10.006 Individual Unemployed Check $25.007 01 19 30 19 01 19 09 02 19 09 04 19 09 06 19 09 06 19 09 06 19 09 07 19 202 S Parker St Tampa, FL 33606 Jamarcus Bell Po Box1532 Port Hueneme, CA 93044 Lori Wheeler 11854 VIA LUCERNA CIR Windermere, FL 34786 Tabitha Nelson 14416 Lake Underhill Rd Orlando, FL 32828 Darryl Matthews 9204 Mountain Magnolia Dr. Riverview, FL 33578 Edna Ulysse 2319 Savoy Drive Orlando, FL 32808 3714 Daleford Rd Orlando, FL 32808 Jonathan Hacker 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 Aretha Janine (Qualified) Simons 2019MC002 09 309 9 09 Sarai Martin Individual Self Employed Check $100.008 Individual Non Profit Director Check $50.009 Individual Land Surveyor CashOrCash iersCheck $50.0010 Individual Hotel Manager Check $25.0011 Individual Real Estate Investor Check $10.0012 Individual Project Manager Check $25.0013 Individual Dietary Aide Check $100.0014 01 19 30 19 08 19 09 08 19 09 08 19 09 08 19 09 08 19 09 09 19 09 09 19 PO BOX 121273 Ft. Lauderdale, FL 33312 Katrina Shadix 1133 Covington St. Oviedo, FL 32765 Kim Buchheit 6500 Swain Rd Sorrento, FL 32766 Angela Pittman 3152 Integra Lakes Lane #420 Casselberry, FL 32707 Sharonda Steverson 2132 Eagle Rock Road Virginia Beach, VA 23456 Betty Hart 2241 Brookridge Trail Sanford, FL 32773 11854 VIA LUCERNA CIR Windermere, FL 34786 Lori Wheeler 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 Aretha Janine (Qualified) Simons 2019MC002 09 409 9 09 Thomas Campbell Individual Marketing Specialist Check $10.0015 Individual Medical Support Assistant Check $100.0016 Individual Construction Laborer Check $25.0017 Individual Consultant Check $10.0018 Individual Nurse Check $10.0019 Individual Publisher-Gr aphic Designer Check $50.0020 Individual Corrections Officer Check $25.0021 01 19 30 19 10 19 09 10 19 09 11 19 09 15 19 09 19 19 09 19 19 09 19 19 1101 Montana Street Orlando, FL 32803 Brenda Dixon 4430 Capital Blvd St. Cloud, FL 34769 Donovan Boyd 100 Sabal Palm Lane Chesapeake, FL 23320 Scheretta Jeffries 12401 holborn Cleveland, OH 44105-2618 Tarsha Campbell 815 Daisy Hill Ct Apopka, FL 32717 Jacquelyn Dixon P.O. Box 203 Arcadia, FL 34265 3548 Hage Way Orlando, FL 32805 Angela Lowe 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 Aretha Janine (Qualified) Simons 2019MC002 09 509 9 09 Likisha Gilliam Individual Unemployed Check $10.0022 Individual Corporate Trainer Check $25.0023 Individual Unemployed Check $25.0024 Individual Social Worker Check $25.0025 Individual Marketing Agent Check $100.0026 Individual Pharmacy tech Check $10.0027 Individual Self Employed Check $50.0028 01 19 30 19 20 19 09 20 19 09 20 19 09 21 19 09 21 19 09 23 19 09 23 19 1423 Oak Street Nile, MI 49120 William Craig III 13004 Mears Court Upper Marlboro, MD 20774 Belinda Szymanski 383 Emerson Plz 617 Altamonte, FL 32701 Mirlande Francois 3112 Erskine Drive Orlando, FL 32825 Tericho Dericho PO BOX 243 Clarcona, FL 32710 Joel Ramjohn 8537 Abbotsbury Drive Windermere, FL 34786 5156 Creusot Court Orlando, FL 32839 Linda Higgins 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 Aretha Janine (Qualified) Simons 2019MC002 09 609 9 09 Kimberly Butler Individual Marketing Analyst Check $5.0029 Individual Retired CashOrCash iersCheck $20.0030 Individual Retired CashOrCash iersCheck $10.0031 Individual Credit Repair Agent Check $25.0032 Individual Licensed Insurance Agent Check $10.0033 CandidateToSelf Consultant InKind $1,500 of Consulting Services from Meyers & Washington 1105 E. Concord St. Orlando, FL 32803 $1,500.0034 Individual Director of Young Adult Ministry Check $10.0035 01 19 30 19 23 19 09 25 19 09 25 19 09 25 19 09 26 19 09 26 19 09 30 19 777 N. Orange Ave 101 Orlando, FL 32801 George Hill 551 Dollins Ave Orlando, FL 32805 James Richet 937 Seburn Rd Apopka, FL 32703 Laquita Clark 8 Elmer Miller Rd Trenton, TN 38382 Aretha Simons 552 N Dollins Ave Orlando, FL 32805 Johnine Mowatt 1011 Red Dandy Drive Orlando, FL 32818 5882 N.W. 41st Lane Coconut Creek, FL 32861 Audrey Folson 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) Aretha Janine (Qualified) Simons 2019MC002 09 01 19 09 30 19 7 9 09 01 19 Community Staple Media,LLC Advertisement CandidateEx pense $14.99 1 4208 W. Jackson St Orlando, FL 32811 Meyers & Washington 09 03 19 Consulting CandidateEx pense $1,500.00 2 1105 E. Concord St Orlando, FL 32803 All about Art 09 04 19 Post Card Design CandidateEx pense $103.00 3 1910 Arroyo Ave Oceanside, CA 92056 Actblue 09 05 19 credit card fee processing fee CandidateEx pense $18.94PO Box 441146 Somerville, MA 021444 Stephanie Bowman 09 06 19 Canvassing CandidateEx pense $500.00914 almond tree cr Orlando, FL 328355 Jamice Lewis 09 08 19 Makeup CandidateEx pense $110.001722 Elsie Park Ct Kissimmee, FL 347446 Sandra Thomas Canvassing CandidateEx pense $160.00090819 4443 King Love Blvd Orlando, FL 328117 In The Mirror Video CandidateEx pense $200.00090919 4500 Ring Neck Rd Orlando, FL 328088 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) Aretha Janine (Qualified) Simons 2019MC002 09 01 19 09 30 19 8 9 09 08 19 Lisa Mays Canvassing CandidateEx pense $160.00 9 4443 King Love Blvd Orlando, FL 32811 Pamela Gaines 09 08 19 Canvassing CandidateEx pense $160.00 10 4402 King Love Blvd Orlando, FL 32811 City of Orlando 09 09 19 Qualifying Fee CandidateEx pense $3,914.78 11 400 S. Orange Ave Orlando, FL 32801 Veterand Canteen 09 09 19 Flag CandidateEx pense $16.995201 Raymond St. Orlando, FL 3280312 FastSpring 09 12 19 Facebook Video Promotion CandidateEx pense $7.98801 Garden St. Santa Barbara, CA 9310113 Eric Brown 09 12 19 Canvassing CandidateEx pense $75.002503 N Alafaya Trail #1 Orlando, FL 3282614 All About Art Post Card Design CandidateEx pense $62.00091319 1910 Arroyo Ave Oceanside, CA 9205615 Henry Halbert Signs CandidateEx pense $500.00091819 2711 East Michigan St. Orlando, FL 3280616 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) Aretha Janine (Qualified) Simons 2019MC002 09 01 19 09 30 19 9 9 09 19 19 Wardell Harp Signs CandidateEx pense $300.00 17 7818 Holmes Dr. Orlando, FL 32808 Jamice Lewis 09 24 19 Makeup CandidateEx pense $65.00 18 1722 Elsie Park Ct Kissimmee, FL 34744 US Post Office 09 24 19 Stamps CandidateEx pense $55.00 19 440 S. Orange Blossom Trail Orlando, FL 32805 Constant Contact 09 29 19 Marketing Fee CandidateEx pense $95.003675 Precision Drive Loveland, CO 8053820 Suntrust 09 30 19 Paper Statement Fee CandidateEx pense $3.004582 S Kirkman Road Orlando, FL 3280121 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