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HomeMy Public PortalAboutMPAC - Statement of Organizationo�3�3g� nC nr c In -.. nnln7� OF ORGANIZATION OF POLITICAL COMMITTEE Supporting or opposing any candidate, issue, or political party and which accepts contributions or makes expenditures during a calendar year in an aggregate amount in excess of $500. (Section 106.03, Florida Statutes) (PLEASE TYPE) 1. Full Name Of Committee Date MPAC (Management Poliltical Action Committee of 7/8/99 Palm Beach County) Mailing Address (If post office box or drawer, please add street address) Telephone 230 Royal Palm Way, Suite 211 ( 561 -)55 -6311 City County State . Zip Code Palm Beach Palm Beach FL 33480 2. Affiliated Or Connected Organizations (includes other committees of continuous existence and political committees) Name Of Affiliated Or Connected Organization Mailing Address Relationship N/A 3. Area, Scope And Jurisdiction Of The Committee To support issues & /or candidates for county races, state legislator �Ce selected municipal races, and committees involved in issue /bond reTi!rQ-ndu J 4. Nature Of Organization Or Organization's Special Interest (e.g., medical, legal, education, etc.) N/A S. Identify By Name, Address And Position, The Custodian Of Books And Accounts (Include treasurer's name) Full Name Mailing Address Committee Title Or Position Lennart E. Lindahl, Jr. 2090 Palm Bch Lks Blvd Treasurer West Palm Beach, FL 33409 Cheryl Carpenter 230 Royal Palm Way #211 Executive Director Palm Beach,FL 33480 nC nr c In -.. nnln7� 3D '-f -0 _j�- 6. List by Name, Address and Position, Other Principal Officers, Including Officers and Members of the Finance Committee, If Any (include chairman's name) Full Name Mailing Address Committee Title or Position John R. Smith 7930 Valid Appeal Chairman Palm Beach Gardens,FL 3341 John Corbett 319 Clematis St. ;'409 Vice — Chairman es a m eac PL 534UI 7. List By Name, Address, Office Sought and Party Affiliation each Candidate or Other Individual that this Committee is Supporting. Full Name Mailing Address Office Sought Party To Be Determined 8. List Any Issues this Committee is Supporting: None at the present time List Any Issues this Committee is Opposing: None at the present time 9. If this Committee is Supporting the Entire Ticket of a Party, Give Name of Party: N/A 10. In the Event of Dissolution, What Disposition will be Made of Residual Funds? Funds to be donated to a registered 501(C)(3) non profit organization. 11. List all Banks, Safety Deposit Boxes, or Other Depositories Used for Committee Funds. Name of Bank or Depository & Account Number Mailing Address Mellon United National Bank 1645 Palm Beach Lakes Blvd. if0211109962 West Palm Beach, FL 33401 12. List all Reports Required to be Filed by this Committee with Federal Officials & the Names, Addresses & Positions of Such Officials, If Any. Report Title Dates Required to be Filed Name & Position of Official Mailing Address "N /A STATE OF Florida Palm Beach COUNTY I, John R. Smith certify that the infor n,irr this Statement of Organization is complete, true and correct. X Kr hairma of Political Committee y' i . DIVISIONS OF FLORIDA DEPARTMENT OF STATE Office of the Secretary Office of International Relations Division of Elections Division of Corporations Division of Crdnual Affairs Division of Historical Resmrrces Division of Library and Information Services Division of Licensing Division of Administrative Services FLORIDA DEPARTMENT OF STATE Katherine Harris Secretary of State DIVISION OF ELECTIONS August 10, 1999 MEMBER OF THE FLORIDA CABINET State Boud of Education Trustees of the internal Improvement Tnast Fiord Administration Commission Florida Land and Water Adjudiratory COmmk sign Siting Board Division of Bond Finance Deparbnent of Revenue Department of Law Enforcement Deprrtment of Highway Safety and Motor Vehldes Department of Veterans' Affairs Mr. John R. Smith, Chairperson MPAC (Management Political Action Committee of Palm Beach County) 230 Royal Palm Way, Suite 211 Palm Beach, FL 33480 Oi��Vtr Dear Mr. Smith: We have received the Statement of Organization and the Appointment of Campaign Treasurer and Designation of Campaign Depository for MPAC (Management Political Action Committee of Palm Beach County). This information appears to comply with the requirements of Section 106.03, Florida Statutes, and the name of this organization has been included on our committee list as a committee that supports candidates and issues. Listed below is the identification number associated with your committee. Please use this number when submitting your reports so they may be processed in a more timely and efficient manner. Identifcation Number: 30405 Enclosed is a copy of Chapter 106, Florida Statutes, along with a Committee Handbook, Campaign Treasurer's Report Forms and 2000 Election Cycle Calendar. Attached is a copy of the electronic filing information along with the list of vendors which you may contact to obtain your software package that will assist you with the filing of your campaign treasurer's reports. A magnetic diskette of the itemized information required by Chapter 106, F.S., must be filed with the Division of Elections (along with an original hard copy of the Summary Sheet [Form DS -DE 12]). Your first campaign treasurer's report will be due October 12, 1999. Any political action committee failing to file a report on the designated due date shall be subject to a fine of $50 per day for the first 3 days late and, thereafter, $500 per day for each late day, not to exceed 25% of the total receipts or expenditures, whichever is greater, for the period covered by the late report. However, for the reports immediately preceding each primary and general election, the fine shall be $500 per day for each late day, not to exceed 25% of the total receipts or expenditures, whichever is greater, for the period covered by the late report. A report which is postmarked by midnight of the due date is considered timely filed. The Capitol • Room 1802 • Tallahassee, Florida 32399 -0250 • (850) 488 -7697 FAX: (850) 921 -1293 • http: / /www.dos.state.fl.us • E -Mail: election@mail.dosstate.fl.us Mr. John R. Smith August 10, 1999 Page Two If we may be of assistance to you at any time, please do not hesitate to contact Inez Williams at (850) 488 -7697. Sincerely, Connie A. Evans, Chief Bureau of Election Records CAE/ilw Enclosures REGISTERED AGENT OFFICE US '1 STATEMENT OF APPOINTMENT (Section 106.022, F.S.) ?pD6j4N (Please Type) 3 -57 S:,af ✓� Original Appointment ❑ Change of Appointment E; Registered Agent and Office Information Name John R. Smith Telephone 561 -655 -7224 Street Address 224 Datura Street, Suite 311 City West Palm Beach State FL Zip Code 33401 Mailing Address 224 Datura Street, Suite 311 City West Palm Beach State FL Zip Code 33401 I accept this app intment and confirm that I am familiar with and accept the obligations of the position as set forth in Section( 06.022, F.S. I also understand that I may resign this appointment by executing a written statement of/ ignatioh and f ' g it with the Division of Elections. 12/30/05 S. n of egistered gent Date Former Registered Agent and Office Information (for changes only) Name Telephone Street Address City State Zip Code Committee or Organization Information Name of Committee or Organization MPAC (Management PAC of Palm Beach County) Street Address 224 Datura Street, Suite 311 Telephone 561- 655 -7224 City West Palm Beach State FL Zip Code 33401 Committee or organization is registered with: 0 Division of tions County ❑ City Si tune o Chairperson John R. Smith 12/30/05 Print Name of Chairperson Date Form DS -DE 41 (revised 12105) RICK scorn Governor January 15, 2014 John R. Smith, Registered Agent MPAC (Management Political Action Cmte. of Palm Beach Cnty) (30405) 224 Dantura Street, Suite 311 West Palm Beach, Florida 33401 RE: NOTICE OF INTENT TO REVOKE Dear Mr. Smith: KEN D=NER Secretary of State Pursuant to Section 106.03(7), Florida Statutes, and Rule 1S- 2.021, Florida Administrative Code, you are hereby notified of the Division's intent to revoke your committee's registration as a political committee based on the following: The committee's aggregate reported financial activity during the 2013 calendar year was less than $500. If you object to this revocation you must provide documentation showing that the committee's registration should not be revoked. Documentation must be provided within 30 days of the date of this letter to the Department of State, Division of Elections, Bureau of Election Records, The R.A. Gray Building, Room 316, 500 South Bronough Street, Tallahassee, Florida 32399 -0250, If you have any questions, please call (850) 245 -6280. Sincerely, Kristi Reid Bronson, Chief Bureau of Election Records KRB /mcc Enclosure Division of Elections R.A. Gray Bldg., Rm. 316 • 500 S Bronough St. • Tallahassee, Florida 32399.0250 Telephone: (850) 245 -6240 • Facsimile; (850) 245 -6259 elections.myllorida.com MA f10RIIA 500_ Commemorating 500 years of Florida history www.f1a500.com VIVI 11111111 Feb 06 14 01;08p Carpenter Klimek 561 -655 -7225 p.1 MPAC (MANAGEMENT POLITICAL ACTION COMMITTEE OF PBCo.) 224 Datura Street, Suite 1114 West Palm Beach, FL 33401 14fE' -6 Pty Sent via Fax February 6, 2014 850 -245 -6259 Ms. Kristi Reid Bronson Bureau of Election Records RA Gray Bldg., Room 316 500 S. Bronough St. Tallahassee, FL 32399 -0250 Re: MPAC Identification #30405 Dear Ms. Reid Bronson: `J ti 10115 ✓SEC; ...,;; i . t STATE We have received the Division's intent to revoke our committee's registration as a political committee based on having aggregate financial activity of less than $500 for last year. We are requesting that this committee's registration not be revoked and that we be allowed to continue to be active in the election process. While MPAC's did not incur expenses in 2013 for this election cycle, we already have plans for municipal elections in March and the Primary and General elections later this year. We will be accepting contributions shortly and plan to file them in the next report if our registration is not revoked. If you need further information to continue this committee, I may be reached at 561 -655 -7224. Sincerely. A. r ' C I 'arpente Klimek Secretary cc_ John R. Smith, Chairman Feb 21 14 02'00p Carpenter Klimek 561- 655 -7225 p.1 MPAC (MANAGEMENT POLITICAL ACTION COMMITTEE OF PBCo.) 224 Datura Street, Suite 1114 West Palm Beach, FL 33401 February 20, 2014 Division of Elections Attn: Lenard Randolph RA Gray Bldg., Room 316 500 S. Bronough St. Tallahassee, FL 32399 -0250 Re: MPAC Identification #30405 Dear Lenard: Please update our records to show the following changes: Treasurer Mark Klimek Address: 224 Datura St. Suite 1114 West Palm Beach, FL 33401 Registered Agent John R. Smith Address: 224 Datura St. Suite 1114 West Palm Beach, FL 33401 14 FELL 21 P,9 2: OG :.,r, ., STATES If you need any further information to complete these changes, I may be reached at 561- 315 -0481. Sinew jy, Joh . Smith, Chairman cc: Mark Klimek Treasurer FLORIDA DEPARTMENT OSTATE RICK SCOTT Governor February 21, 2014 John R, Smith, Registered Agent MPAC (Management Political Action Cmte. of Palm Beach Cnty (30405) 224 Datura Street, Suite 311 West Palm Beach, Florida 33401 RE: FINAL NOTICE OF INTENT TO REVOKE Dear Mr. Smith: KEN DETZNER Secretary of State The Division is in receipt of your letter dated February 6, 2014, in response to the Division's Notice of Intent to Revoke. The Division has determined the explanation to be insufficient and will proceed with the revocation of the committee's certification. If you object to this revocation you must file a request for hearing within 30 days of the date of this final notice of intent to revoke. The request must be filed with the Department of State, Division of Elections, Bureau of Election Records, The R.A. Gray Building, Room 316, 500 South Bronough Street, Tallahassee, Florida 32399 -0250 and will be forwarded to the Florida Elections Commission for a hearing based upon the notice and any supporting documentation. If you desire a personal appearance before the Commission, you must include in your request for hearing a separate request for a personal appearance. Failure to file a request for a hearing constitutes a waiver of your right to a hearing and will cause a final order to be entered revoking the committee's certification. If you have any questions, please call (850) 245 -6280. Sincerely, Kristi Reid Bronson, ief Bureau of Election Records KRB /Ijr Enclosure Division of Elections R.A. Gray Building, Suite 316 • 500 South Bronough Street • Tallahassee, Florida 32399 850.245.6200 • 850.245.6217 (Fax) election.dos.state.fl.us FLORIDA *"'"Promotin Florida's History and Culture VivaFlorida.or g ELEC'rlws d VIVA ElORIOA. CAMPAIGN TREASURER'S REPORT SUMMARY (1) MPAC (Management PAC of Palm Bch. Co.) OFFICE USE ONLY Name (2) 224 Datura Street, Ste. 1114 Address (number and street) West Palm Beach, FL 33401 City, State, Zip Code ❑ Check here if address has changed (3) ID Number: 30405 (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 02 / 22 /2014 To 02 / 22 2014 Report Type: ✓ Original ❑ Amendment ❑ Special Election Report ❑ (6) Contributions This Report (7) Expenditures This Report Monetary Cash & Checks $ 6 , 100 00 Expenditures $ 3 , 890. 29 Loans $ 0 Transfers to Office Account $ 0 Total Monetary $ , 6 ,100 00 Total Monetary $ 3 890.29 In -Kind $ 0 (8) Other Distributions $ , 0 (9) TOTAL Monetary Contributions To Date (10) TOTAL Monetary Expenditures To Date $ 8 , 100 . 00 $ 3 , j�q 0 • Qq (11) Certification It is a first degree misdemeanor for any person to falsify a public record (ss. 839.13, F.S.) this report and it is true, correct, and complete: I certify that I ha�vGe� le�xamined (Type name) 1 1 �7 �'� �, 1)i C.1� (Type name) ❑ Individual (only for IE Treasurer El Deputy Treasurer El C di to Chairperson (only for PC and PTY) or electioneering comm.) X X SignatX Si n ture DS -DE 12 (Rev. 11113) ✓ SEE REVERSE FOR INSTRUCTIONS CAMPAIGN TREASURER'S REPORT — ITEMIZED CONTRIBUTIONS MPAC (Management PAC of Palm Bch. Co.) 30405 (1) Name (2) I.D. Number 02 22 2014 03 06 2014 1 (3) Cover Period / / through / / (4) Page 1 of (5) (7) (8) (9) (10) (11) (12) Date Full Name (Last, Suffix, First, Middle) (6) Sequence Street Address & Contributor Contribution In -kind Number City, State, Zip Code Tvpe I Occupation TVpe Description Amendment Amount William Boardman 02 26 2014 3251 Polo Drive Gulf Stream, FL 33483 I Retired CHK 1,000.00 001 Barrant V. Merrill 02 26 3525 Polo Drive /2014 / Gulf Stream, FL 33483 I Retired CHK 500.00 002 George T. Elmore 02 27 1320 N. Ocean Blvd. /2014 / Gulf Stream, FL 33483 I Constructior CHK 1,000.00 003 Patricia L. Randolph 02 28 3883 Gulfstream Rd. /2014 / #4S Gulf Stream, FL 33483 I Retired CHK 1000.00 004 Laura Londoff Koch 03 03 2014 543 Middle Road Gulf Stream, FL 33483 I Retired CHK 1000.00 005 William F. Koch III 03 03 2014 900 E. Atlantic Ave. Delray Beach, FL 33483 I Real Estate CHK 1000.00 006 Joanne Hayes 03 06 2014 3126 Gulfstream Rd. Gulf Steam, FL 33483 I Retired CHK 600.00 007 DS -DE 13 (Rev. 11113) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES CAMPAIGN TREASURER'S REPORT — ITEMIZED EXPENDITURES (1) Name MPAC (Management PAC of Palm Bch. Co.) (2) I.D. Number 30405 (3) Cover Period 02 22 2014 through 03 06 / 2014 (4) Page 1 of (5) Date (7) Full Name (Last, Suffix, First, Middle) Street Address & City, State, Zip Code (8) Purpose (add office sought if contribution to a candidate) (9) Expenditure Type (1 0) Amendment (11) Amount (6) Sequence Number 02 25 014 Coastal Star 5011 N Ocean Blvd Ocean Ridge, FL 33435 Advertisement IEC 1,600.00 001 02 28 014 ASAP Graphix & Signs, Inc. 15895 93rd Street N. West Palm Beach, FL 33412 Signs IEC 396.44 002 02 28 2014 Sir Speedy 430 Clematis Street West Palm Beach, FL 33401 Printing /postage IBC 893.85 003 03 03 2014 Carpenter Klimek & Associates, Inc. 224 Datura Street, Ste. 1114 West Palm Beach, FL 33401 Consulting iEC 1,000.00 DS -DE 14 (Rev. 11113) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES 04: 51:03,0 r -03-07-2014 1 1 561 655 7225 Mar C7 14 04:56p Carpenter Klimek 561- 655 -7225 p.1 CAMPAIGN TREASURER'S REPORT SUMMARY (1) MPAC (Management PAC of Palm Bch. Co.) Name (2) 224 Datura Street, Ste. 1114 Address (number and street) West Palm Beach, FL 33401 City, State; Zip Code ❑ Check here if address has changed (4) Check appropriate box(es): ❑ Candidate Office Sought: V Political Committee (PC) ❑ Electioneering Communications Org. (ECO) ❑ Party Executive Committee (PTY) ❑ Independent Expenditure (I E) (also covers an individual making electioneering communications) OFFICE USE ONLY (3) ID Number. 30455 ❑ Check here if PC or ECO has disbanded ❑ Check here if PTY has disbanded ❑ Check here if no other lE or EC reports will be filed (5) Report Identifiers Cover Period: From 02 1 22 12014 To 02 1 22 12014 Report Type: ❑ /_ Originai ❑ Amendment ❑ Special Election Report (6) Contributions This Report (7) Expenditures This Report Monetary Cash & Checks $ 6 ,100. 00 Expenditures $ 3 , 890. 29 Loans 1 0 Transfers to Office Account $ Q • Total Monetary 6 , 100 00 Total Monetary $ 3 890.29 In -Kind $ 0 (8) Other Distributions $ 1 1 0 (9) TOTAL Monetary Contributions To Date (10) TOTAL Monetary Expenditures To Date $ s , 100 00 $ :QC' (11) Certification It is a first degree misdemeanor for any person to falsify a public record (ss. 839.13, F.S.) certify that I have`` examined this report and it is true, correct, and complete: Vl (. (Type name) t �� � K p i llf n do (Type name) ❑ Individual (only for IE Treasurer ❑ Deputy Treasurer © C dilate ; Chairperson (only for PC and PTY) or electioneering comm.) a � X .- _ x Signat a Sin tune DS.DE 12 May. 11 1131 V RPM 0=U= Q= r=no rnre'rof rrrrnwic 04:51:03,i�.M.03 -07 -2014 1 2 1 561 655 7225 Mar 07 14 04:57p Carpenter Klimek 561- 655 -7225 p,2 CAMPAIGN TREASURER'S REPORT — ITEMIZED CONTRIBUTIONS MPAC {Management PAC of Palm Bch. Co.} 30405 {1) Name (2) J.D. Number 02 22 2014 " t3) Cover Period ! ! 03 06 2024 1 through 1 ! {4) Page of (5) (7) ($) (9) (10) (11) (12) Date Full Name (Last, Suffix, First, Middle) (6) Sequence Street Address & Contributor Contribution In -kind Number City, State, Zip Code Type Occupation Typ e Description Amendment Amount William Boardman 02 26 2014 3251 Polo Drive / / © Gulf Stream, FL 33483 I Retired CHK 1,000.D0 001 Barrant V. Merrill 02 26 3525 Polo Drive f2014 r Gulf Stream, FL 33483 I Retired CHK 500.00 002 George T. Elmore 02 27 2014 1320 N. Ccean Blvd. , Gulf Stream, FL 33463 I Constrcctio CHK 1,00.0.00 003 Patricia L. Randolph 02 28 3883 Gulfstream Rd. 1201= r #4S Gulf Stream, FL 33483 I Retired CHK 1000.00 004 Laura Londoff Koch 03 03 2014 543 Middle Road i Gulf Stream, FL 33432 I Retired CHK 1000.00 005 William F. Koch III 03 03 2014 000 E. Atlantic Ave. Delray Beach, FL 33483 I Real Estate CHK 1000.00 006 03 06 2014 Joanne Hayes f I 3126 Gulfstream Rd. Gulf Steam, FL 33483 I Retired CHK 9-03.00 007 D5 -DE 13 (Rev. 11113) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES 51:0 ?.p , 03 -07 -2014 1 3 561 655 7225 Mar 07 14 04:57p Carpenter Klimek 561 - 655 -7225 p,3 CAMPAIGN TREASURER'S REPORT - ITEMIZED EXPENDITURES (1) Name MPAC (Management PAC of Pa=m Bch. cc.) (2) I.D. Number 30405 (3) {Mover Period 02 / 22 / 2114 through 03 1 06 1 2014 (4) Page 1 of 1 (5) Date (7) Full Name (Last, Suffix, First, Middle) Street Address & City, State, Zip Code (8) Purpose (add office sought if contribution to a candidate) (9) Expenditure Type (10) Amendment (11) Amount (6) Sequence Number 02 25 014 Coastal Star 5011 N Ocean Blvd Ocean Ridge, FL 33435 Advertisement IEC 1,600.00 001 C2 28 014 ASAF Graphix & Signs, Inc. 15895 93rd Street N. West Palm Beach, FL 33412 Signs IEC 396.44 002 02 28 2015 Sir Speedy 430 Clematis Street Nest Palm Beach, FL 33401 Printing!postage IEC 843.85 CO3 03 03 2014 Carpenter Klimek & Associates, Inc. 224 Datura Street, Ste. 1114 West Palm Beach, FL 33401 Consulting IEC 1,000.00 DS -DE 14 (Rev. 11113) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES rCAMPAIGN TREASURER'S REPORT SUMMARY (1) MPAC (Management PAC of Palm Bch. Co.) Name (2) 224 Datura Street, Suite 1114 I Address (number and street) West Palm Beach, FL 33401 City, State, Zip Code ❑ Check here if address has changed (4) Check appropriate box(es): ❑ Candidate Office Sought: ❑✓ Political Committee (PC) ❑ Electioneering Communications Org. (ECO) ❑ Party Executive Committee (PTY) ❑ Independent Expenditure (IE) (also covers an individual making electioneering communications) OFFICE USE ONLY (3) ID Number: 30405 ❑ Check here if PC or ECO has disbanded ❑ Check here if PTY has disbanded ❑ Check here if no other IE or EC reports will be filed (5) Report Identifiers Cover Period: From 02 / 08 / 14 To 02 / 21 / 14 Report Type: ❑ ✓ Original ❑ Amendment ❑ Special Election Report (6) Contributions This Report (7) Expenditures This Report Monetary Cash & Checks $ 2,000 . 00 Expenditures $ 0 .00 Loans $ 0 • 00 Total Monetary $ 2, 000 • 00 In -Kind $ , 0 . 00 (9) TOTAL Monetary Contributions To Date $ 2 000 00 Transfers to Office Account $ 0 . 00 Total Monetary $ 0 . 00 (8) Other Distributions $ , , 0 00 (10) TOTAL Monetary Expenditures To Date $ , 0 00 (11) Certification It is a first degree misdemeanor for any person to falsify a public record (ss. 839.13, F.S.) I certify that I have examined this report and it is true, correct, and complete: (Type name) Mark P. Klimek (Type name) JOhn R. Smith ❑ Individual (only for IE ❑� Treasurer ❑ Deputy Treasurer ❑ Candid e ❑� C irperson (only for PC and PTY) or electioneering comm.) X X Signature Signat e r)Q_nr: 19 117-1.1-1/411 y c�� DCVL'�QC r�r� eu�rn nr�uc+ CAMPAIGN TREASURER'S REPORT — ITEMIZED CONTRIBUTIONS MPAC (Management PAC of Palm Beach County) 30405 (1) Name (2) I.D. Number 02 08 14 02 21 14 1 (3) Cover Period / / through / / (4) Page of 1 (5) Date (7) Full Name (Last, Suffix, First, Middle) Street Address & City, State, Zip Code (8) Contributor Type I Occupation (9) Contribution Type (10) In -kind Description (11) Amendment (12) Amount (6) Sequence Number ` Nancy D. Touhey 1200 N. Ocean Blvd. Gulf Stream, FL 33483 I Retired CHE 1,000.00 DO I / /I Anthony W Graziano Jr. 3259 Polo Drive Gulf Stream, FL 33483 I Retired CHE 1000.00 Dot. DS -DE 13 (Rev. 11113) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES CAMPAIGN TREASURER'S REPORT - ITEMIZED EXPENDITURES (1) Name MPAC (Management PAC of Palm Beach County) (2) I.D. Number 30405 (3) Cover Period 02 / 08 / 14 through 02 / 21 / 14 (4) Page of (5) Date (7) Full Name (Last, Suffix, First, Middle) Street Address & City, State, Zip Code (8) Purpose (add office sought if contribution to a candidate) (9) Expenditure Type (10) Amendment (11) Amount (6) Sequence Number NONE DS -DE 14 (Rev. 11113) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES