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HomeMy Public PortalAbout2006District3HornOFFICE USE ONLY STATEMENT OF CANDIDATE (Section 106.023, F.S.) (Please Type) 2005 MAR 10 Phi 4:29 Jeff Horn candidate for the office of Orlando City Commission District 3 have received. read and understand the requirements of Chapter 106, Florida Statutes. X nature ofndidate 3.1c. ' Date Each candidate must file a statement with the qualifying officer within 10 days after the Appointment of Campaign Treasurer and Designation of Campaign Depository is fled, Willful failure to file this form is a first degree misdemeanor and a civil violation of the Campaign Financing Act which may result in a fine of up to $1,000, (ss_ 106,19(1)(c), 106.265(1)r Florida Statutes) DS -DE 84 !Rev. 08/03} STATE OF FLORIDA APPOINTMENT OF CAMPAIGN TREASURER AND DESIGNATION OF CAMPAIGN DEPOSITORY FOR CANDIDATES (Section 106.02111h F.S.) (PLEASE TYPEl CHECK APPROPRIATE BOX; OFFICE USE ONLY 2005 MAR 10 Phi 4:29 n Original A ppoinl meat D Deputy Treasurer [1 Reappointment of Treasurer l i Secondary Depository Name of Candidate Jeff Horn 1. 1219 Address (include pose office box or street, oily, 5tate, zip code) West Smith Street Telephone (optional) 407-999-9059 2. Parly (Partisan candidates only) 3. Office (add district, cireuIt or group number} Orlando Corrlmission District 3 1 have appointed the following person lo act as my Ed Campaign Treasurer LI Deputy Treasurer 4. Narne of Treasurer or Deputy Treasurer M. Wayne Gebnardt 5. Mailing Address (if post Once box or drawer add street address) 401 Niblick Avenue Apartment 5 i 6. Telephone 407-649-6580 7- City Orlando B. County Orange 9. Slate Florida Ia. Zip Code 32304 I have designated the following named bank as my Primary Depository Secondary Depository i t , Name of Bank SunTrust 12. Street Address 2213 Edgewater Drive_ 13. City Orlando 14- County Orange 15- State Florida 16. Zip Cade 32804 17. k nature o ndid edl ate Dale • 1 p. i, M. Wayne Gebharcft Campaign Treasurer's Acceptance Di Appointment - do hereby accept the appointment as ri (Please Print or Type) Campaign Treasurer El Deputy Treasurer for ihe campaign at Jeff Horn who is seeking nbnlinaflon or alecliorl ass Non -Partisan candkate to the office of {Party) Orlando Commission District 3 . Asa duly registered voter in Orange County. Florida, I am qualified to accept this appointment. UNDERPENALTIES DF PERJURY, I DECLARE THAT I HAVE READ THE FOREGOING CAMPAIGN TREASURER'S ACCEPTANCE OF APPOINTMENT AND THAT E FACTS STATED ARE TRUE. Date Sign are of Campaign ti--easuV or Deputy Treasurer DS -DE 9(Rev.08103} WAIVER F REPORT (Section II MGM, F..%) (PLEASE TYPE) Candidate's Name (Dist„ Su x. First, Middto) OR Ponca! Committee, CE or Party Name —7 Address (Number and Street) City Stale Zip Cods acanthi -me padiccF CCmmiltce n Comrrlitie1 of Cortllnuoirs Ea lance ❑ Party Execuliva Committee OFFICE USE ONLY 200 APR 25 PM 3:50 identification Number (AssIgrled by Division of Elections) rifil� +i i/ 5 kY .fJJlp�-_ 7 Office Sought grictude District, Circuit or Group Nurnher) 0 0 Chock box '4 address haN r_hangad' ine° WI. repot* Chock hire i# PC or GCE has DLSBAN DED and wilF ne longer file reports, TYPE OP REPORT (Check Appropriate Box) it3ARTERLYREP RTS PRIMARY1`LEC1IO{ ❑ JAnuary ❑ 32r- day pdEur Aprit © 121111 day prx Q July 0 4111 dey Prior • October x NERAL LE t N o Atlih day rimer Q 32nd day prior 0 181h day prior ❑ 4th. day prior • TERMI IATIQN REISQRT O : PECiAL ELECTflON NOTIFICATION OF NO ACTIVITY IN CAMPAIGN ACCOUNT FOR THE REPORTING PERIOD OP #h rough A, i YL 0 5 — Signature Date SIGNATURES REQUIRED FOR: Candidates Cantdste, Campaign Treasurer or Deputy Troamoor (a. 106.07(5), F.S.} Political Committees Charman, Campaign Treasurer or Deputy Treasurer (s. 10647(611, 17.S.) Committees of Co riliniiektia Fxistancs Treasurer (s. 1Q6,0.4(.)(r<), F -S.1 Party Executive Committees Treasurer orChairman ls. tQ6. hi any reporiin4 pent i. lion titian has been no activity iii 1I Oacrrint {np luiids expended or rettjhra+]} the riling of Ufa ramrod mix(' ir1 waived, However. the fling officer must be warped in veiling on the vesrrribed roppiir j delis that PVC rgpprt i5 being MEd, DS DE 87 (Rov- 06107} FLORIDA DEPARTMENT OF STATE DIVISION OF ELECTIONS CAMPAIGN TREASURER'S REPORT SUMMARY (1) Jeff Horn Nance (2) .2.9 West SztiL"h Street Address (number and street) 0riando FL 32004 City, State, Zip Code D CHECK IF ADDRESS HAS CHANGED (4) Check appropriate box(es): ▪ Candidate (office sought): Orlando Q Political Committee Q Committee of Continuous Existence ❑ Party Executive Committee ❑ Ele oneering Communication OFFICE USE ONLY 2005 JUL GPI 1:1$ (3) ID Number; City Council i❑-Sv. jj ❑ CHECK IF PC HAS DISBANDED 0 CHECK IF CCE HAS DISBANDED CHECK IF NO OTHER ELECTIONEERING COMMUNICATION REPORTS WILL BE FILED (5) REPORT IDENTIFIERS Cover Period: From / of f 05 WI Original Q Amendment To 06 1 3 0 / U v Report Type Q2 ❑ peciar Erection Report 0 Independent Expenditure Report (6) CONTRIBUTIONS THIS REPORT Cash & Checks Loans Total Monetary In -€tine€ 4,470.00 0.00 4,070.00 0.00 (7) EXPENDITURES THIS REPORT Monetary Expenditures Transfers to Office Account Total Monetary S 361.48 0.00 361.08 (8) Other Distributions 0.00 (9) TOTAL Monetary Contributions To Date 4,074.40 (10) TOTAL Monetary Expenditures To Date 361.08 (11) CERTIFICATION It is a first degree misdemeanor for any person to falsify a public record iss, ] certify that r have examined this report and it is true, correct, and complete. (type name) r!.11- Wayne Gebhardt ElIndlviduel;Rniyfar ETreasurer nDepictyTreasurer coactore2rirg corn mu X Signatur I certify that I have examined this report and ft is true, correct, and complete. (Type name) ❑ Candidate ❑ Chairperson (aniy for P.G, PTY & 2=G-none-.1.ISgrammur n{ganization) Jeff iforn A Signatu DS -DE 12 ' el). oa/04j CAMPAIGN TREASURER'S REPORT — ITEMIZED CONTRIBUTIONS (1) Name Jeff Horn (3) Cover Period } 01 1 d5 (2) I.D. Number through 06 / 30 (4) Page 1 c f 6 (5) Clete (7) Full Nome (Last. &L.EFfix. First, Middle). Street Address& Citf, State,.4ip Ude Conlributar T (8) Occupation (0) (10) Canlribullorr En- ind Type DesrxiptIon (11) 1l,'efndrr rlt (7.2j Amount 4r} Sequence Nurnher 1 (6) 4 - IQE Powers, Rev. Tim 2695 Stallion Dr- O4l ,ndo, FL 32822 1 CAS 25.00 1 Cramer, Jerry = Computer CIE 500.00 46 20 05 115 S Brown Ave Orlando, F1. 1 Pragramm er 2 32801 Creech, ter:ny I ruc 10(1_00 0.6 / 20 { 05 1805 E Grant St Orlando, FL 3 21306 I?eck°, Michael I CHE 140.00 06 / 28 / 05 1_860 Farrington Dr, MerritT_ stand, FL 4 32952 3laymak r, - 0- 50 06 1 28 i 05 Michael P 0 Sox_ 9471st. 5 Maitland, FL 32751 black. Richard, o - ---E 100.00 46 26 05 71D Fa.i.aroaks Ln Maitland, FL 5 32751 uoxivenat, dock - CAE 20.00 U5 / 28 i 05 4950 r E Stephens Se, Roseburg, OR 7 97470 B3ber, Keith & 1 CHE 75.00 06 29 f 05 char Steven 2011 E Concord $t Li Orlando. FL 32003 DS -DE 13;Rev. Oi3I43) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES CAMPAIGN TREASURER'S REPORT— ITEMIZED CONTRIBUTIONS (1) Name Jeff Horn {3) Cover Period 04 / 01. f 05 () I.0, Number through 06 / 30 / 05 (4) Page 2 of (5) Date (7) Full Name (Last, Suffix, First, Middle) StreeI Address & OityiState, Zip Code Cor}krfbutor Ty. (8) (g) Gontributfon OOcupalIon TIT (10) In-kirrd Deer ripiion (11) Ame+4mem (T2) Amount ($} segtaerlce Number 015 { 29 /0E Barber, Elliot 1 1B12 Biscayne Dr, Orland, FL 32904 1 + iE 50.00 9 Bartsch, Carol, j I CHE 50.00 06 { 29 { 05 {418 Hyland Oaks Dr, Orlando, FL 10 32618 Bouiden, John, D I CHE 140.00 06 1 29 / 05 2 Spruce St, W Or].ando, FL 11 32804 Spume, Craig, il = 100.90 06 / 29 / 05 1520 E Livingstor St, Orlando, FL 2603 12 Capozzi, 5ai = .._-= 100.00 0. 9 / Q5 2312 S Brown Ave Orlando, FL 13 32806 Carpenter, 1 ,_:-r 25.0.0 46 { 29 05 Randall, W 364 Lakeview St 14 Orlando, FL 32804 D$i11ar Pinny, A & 1 Physi- CUE 500.00 0S 2B 05 8ailiEf, Christine 1 ciao & Nurse 15 1222 Heron it Orlando, III 32803 1 Franco, Jack I 1 CAS lM,00 06 Jr 29 { 05 1317 Myrtle S,.:. Orlando, FL 16 32907 DS -DE 13 (Rev. 08/031 SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES CAMPA[ON TREASURER'S REPORT -. ITEMIZED CONTRIBUTIONS (11 Name Jeff Horn {) Cover Period 04 / 01 f 05 through 06 (2) LE. Number J0 / 05 (5) Date (6) Sequence Number 06 25 105 17 {7) {83 (8) Full Name (Last, Suffix, First, Middle) Street Address & Contributor Contribution City. Stale. Zip Code _ Type oca a1ion 7Ype - Gebhardt , M Wayne 401 Niblick Ave, Apt 5, Orlando, FL 32804 I 06 i 29 i OS 18 06 / 29 1 05 15 nick, Michael I 1033 Lake Davis Dr, Orlando, FL, 32806 CHB (4) Page 3 of 5 In -kind Description sea -tor CHF Grajales, Luis, E 1 500 E Grant St Orlando, FL 32846 CHE Anse ndm en1 {12) Amount 100.00 250.00 50.00 06 / 29 / 05 20 Howe. John, R 1 4011 Finch 6t Orlando, 9'L 32683 06 , 29 , 05 21 Jacobson., Nancy, C 1734 Reppard Rd Orlando, FL 32803 1 50.00 C]JE 06 29 , 05 Jewelry Etc. 5 6 B S Red Bug Lake Rd, Winter Springs, FL 32708 Jewelry C.T:L, & Fine Class Retailer 50.00 06 . 29 . 05 23 Jordan, Alan, R & Manes, 9Vi1 tam a3.8 E Concord St Orlando, VI, 32803 1 06 29 05 2.1 Kennedy, Kenneth 10309 8eaverkil1 Rd, Or],ando, FL 32817 CIE 100,00 50,40 100.44 13S -DE 13 (Rev- 48108) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES CAMPAIGN TREASURER'S REPORT — ITEMIZED CONTRIBUTIONS ('f) Narne Jeff Horn (3) Cover Period 04 / 01 f GAS (5) Date (a) Sequence Number 06 { 29 05 25 06 25 05 {7} Full Name (Last, Suffix, Fir , Middle) Street Address & City, S#ale, Zip Code Langston, Rev, James, E 2221 N Westmoreland Dr, Orlando FL 32804 26 () I.D. Number through 06 f a f 05 (a) Contributor Type Occup lion C4) Page 4 of 6 sir (-10) Contribution In-1Sin Typo €]escrjptiorl Amendment CHF Lee, Jimmy, D & I Moore, Gregory 3300 Amherst Ave Orlando, FL 32804 06 ( 29 f 05 27 Lynum, l]aiby, W 411 Rock Lake Dr Orlando, FL 32905 06 f 29 t 05 19 06 / 29 i 05 25 06 , 29 3.0 I Marco, Carl, P & Marco. Ade±a, L 36.06 Wilder Lri Orlando, FL 32305 CIIE The Markman Law Firm, B 0 O N Ferncreek Ave Orlando, FL 32903 Law Practice McL-ain, C, Shaun t P 0 Box 17211/ Tampa, FL 33672 (12) A no urrt 50,00 50.00 CHE 25.00 100,00 L't E 100.00 15.00 06 . 29 . 05 3I Merkt, Diane, Harper 1331 Azora Llr De.tonar FL 32725 I CE 06 i 29 f 05 32 Scout Gregory's Inc. 3300 Amhersc. Ave, Orlando, FL 32804 Image CFEE Consuitants - 100.00 50.00 DS -0E 13 (Rev_ OB/03) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES CAMPAIGN TREASURER'S REPORT — ITEMIZED CONTRIBUTION (1) Name Jeff Horn () I.D. Number (3) Cover Period 04 / 01 / d5 through 00 J 30 / 0=. (5) Date (13) Sequence Nurnber 06 29 05 .32 0& 29 05 24 06 f 29 j OS 35 0) Full Name (Last, Suffix, HIrsl, Middle) Skeet Address & 2tty, Slate, 2 Gode Mottolo, Frank, P 601 Grand sr.. Orlando, FL 2605 Mundy, .Tr, Joseph, T & Bastian, Thomas, E, 3E3 E Yale St Orlando, 11., 32804 (8) Camributor ConIritaulion Type DOGErpation Type T CRC (4) Page 5 of 6 (10) kn-kind Description Arr&ru1n nt Cnsttnt, SPLtvr. Qtsa1, Assur. Recruitr i=HL- Peck°, Paul, G 1063 Narrow Gauge Ct, Winter Garden, FL 34787 05 / 29 / as 36 Piriera, Rafael, E 1216 T Ratlkpton Ave Orlando, PL 32503 I 05 / 29 / 05 37 Soma, Robert, W g P a 50x 680065 Orlando, FL 32988 C1=L 04 , 29 05 39 Walsh, Kevin, P 437 noriaon Dr Winter gpringa, FL 22708 06 29 05 39 Wanz ee Michas_ 6714 Nina Rosa Er Orlando, FL 32819 CHF (12) Amount 25.00 150.00 100.0❑ 100-00 B=AS 100.00 75,00 25.00 06 / 29 05 40 Wolf, James, P & Curtis, Lisa, A 611 R Kaley Str Orl ,rdorr, FL yy CIE 75.00 GS -DE 13 (Rev. 08/03) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES CAMPAIGN TREASURER'S REPORT— ITEMIZED CONTRIBUTIONS (1) Name Jeff Horn (3) Cover Period 04 f 01 j ❑ 5 through 06 / 30 Date (6) Sequence Number 46 29 /0 41 (7) Full Name (Last. Suffix, First, Middle) Street Address & City, Stale, Zip Coda Woods, William, m & Tai i ce , E 1058 Aarcnd Tree Cir, Orlando, FL 32835 (8) Contributor Type Occupation 1 06 30 , 05 i2 Lyons, Jr., c, Clint 1991 {imberwickc C-1, Oviedo FL 32765 1 05 / 30 { 4S e3 Wi1Sian . Brianr C. & O'Neil, Cxaig, M, 1318 Maury Rd, Orlando FL 32804 T. (9) (2) ID. Number / c5 (4) Page 6 of 6 Contribuilon Type (10) In -kind Description C FF CZE Amendmirit (12) Amount 100,00 140.00 75_00 DS DE 13 iRev. 081'03) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES (1) &lame CAMPAIGN TREASURER'S REPORT — ITEMIZED EXPENDITURES _ _ = Horn (2) I.D. Number (31 Cower Period ? - / &trough c1fi / 30 05 r' (5) Date Sequence Number C7._./127 05 1 06 /27 f05 2 (7) Full Name (Last. Suffix, First. Middle} street Address eL City, State, Zip Code Tap ROOm Dub5dread 549 W Par st Or1ar_do FL 32604 Staples 2774 E Colonial Dr O rlai,do FL 32803 06 pa im 3 (9} (41 Page 1 of Purpose (add office sought if contribution to a candidate) Meeting with Phone Committee Office Supplies Staples Office 2774 E Colonial Dr Supplies O rlando FL 32603 06 28 05 4 l 1 I 1 (9) (%01 (11} Expenditure Type MIDN MON Amendment Amount $57.02 Pu.,EL-N-Stuff Catering E-eaz Catering MON 158 Lake Ave Maitland FL 32751 $1$-09 $17>_ti0 1 ! DS -DE 14 (Rev. 08103} SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES Alternative Method Affidavit (Please Type) OFFICE USE ONLY 2005 OCT I0 2:30 certify that 1 intend to quarify by the alternative method as a candidate for the office of (include district, circuit, group or seat numbers) as a L Partisan Candidate, Member of the Party No Party Affiliation Candidate (formerly independent) L1Jonparsan Candidate (includes judicial offices) Under penalties of perjury, I cteclare that I have read the foregoing affidavit and that the facts stated in it are true. Print Name of Candidate Residence Address (do not use post office box) rL kw, GI city (LW -IL 1' - iv c Day Phone DS -DE 1 (Rev. NM) State Fax Number Zap Code 1 2005OCT 1OPN2: $ AFFIDAVIT OF UNDUE BURDEN FOR ? EUNI FPAL CANDIDATES (Section 21.07-! Code of the City of Orlando, Florida and Section 99.093 Florida SEatutes) swear (or affirm) under oath that I intend to qualify as a candidate Far the office of and that 1 am unable to pay the 2% City or the l% State election assessment fee for that office without imposing an undue burden on my personal resources or on resources otherwise available to me, Sigriatu Print Name: G ► STATE OF FLORIDA COUNTY OF ORANGE Sworn to and subscribed before me this kit day of _ rr 2005. (Signiat o�} �1ic) Y Co+rartrn U1337A S ESpireS July 11, 3008 (Prins, Type or Stamp Conrnissiancd hfame of Notary Public) Personally Known _Lor Produced Identification Type of Identification Produced 2005 OCT 10 ph : l FLORIDA DEPARTMENT OF STATE DIVISION OF ELECTIONS CAMPAIGN TREASURER'S REPORT SUMMARY Cl) 'left Horn Name (2) 1215 Wes_Smit n St --- Address (number and street) br? ado FL 32804 City, State, Zip Code ❑ CHECK IF ADDRESS HAS CHANGED (4) Check appropriate box(es): ▪ Candidate (office sought); ❑ Political Committee D Committee of Continuous Existence 0 Party Executive Committee j Eiectroneering Communication OFFICE USE ONLY (3) ID Number: OrLa S&, Ciiy Coun.1_ (Dint, 3 } ▪ CHECK IF PC HAS DISBANDED ❑ CHECK IF CCE HAS DISBANDED ❑ CHECK IF NO OTHER ELECTIONEERING COMMUNICAT1ON REPORTS WILL I3E FILED (5) REPORT IDENTIFIERS Cover Period; From 07 / e1 / 05 To c,y / / r,; Report Type 12 Original ❑ Amendment ❑ Special Election Report (6) CONTRIBUTIONS THIS REPORT Cash & Checks Loans Total Monetary In -Kind $ 7,484.5 Q, 0 0 7484..54 1.300.0Q (9) TOTAL NNNlonetary Contributions To Date 11r534.50 Q3 ❑ Independent Expenditure Report (7) EXPENDITURES THIS REPORT Monetary Expenditures $ Transfers to Office Account Total Monetary 8,009.53 0.00 8,009.53 ( ) Other Distributions 0.00 (10) TOTAL Monetary Expenditures To Date $ 8,350.57 (11) CERTIF[CATION It is a first degree misdemeanor for any person to falsify a public record (as. 539.13, F.S.) I certify that I have examined thls report and it is tare. i certif=y that ] have examined this report and it is true, correct, and complete. correct, and complete. (Type Hamel M. Wayne C-ebharrit 0Indrvidual turfy for ,J+oraeeT•]9ior Signature 7ITreasu rer ❑ Deputy Treasurer DS -DE 12 (Rev, 08104) (Type name) 0 Candidate X Signatu Jeff Horn ❑ Cha irpar an (only for PC, PTY & TechoneernQ cpmmun. 4rganlAnban) CAMPAIGN TREASURER'S REPORT — ITEMIZED EXPENDITURES (1) Name L1e f Born_ _ (2)1,D, Number (3) Cover Period i of / 45 through 09 30 o5 (4) Page '- of (51 Date (6) Sequence Number (7) Full Name (Last, Suffix, first, Midd[ej Street Address & City, State, Zip Code 07 .45 AS. 1 Iel Purpose (add office sought it contribution to a candidate} Tap Room at Dubsdread 540 W Par St Orlando FL 32804 (9) Expenditure Type Finance rdee t i ng Puffin Stuff Catering, LLC 15a Lake Ave Maitland FL 32751 07 19 05 3 7 09 0 4 5 07 09 Jos 07 /15 /05 7 Staples 2774 E Colonial Dr Orlando FL 32803 Rai Liauw 1219 W Smith SC - Orlando FL 32804 Staples 2774 E Colonial Dr Orlando FL 32803 Event Catering MON 110} Amendment Amount $45.15 Of ice Supplies Rcinthu semert Office Supplies, Stickers, £ Web. Site MON $104.11 MON OMce Supplies MON USIDS. College Park Office Orlando, 51, 32804 Postage MOtt Olive Garden 3675 E Colonial Dr Orlando FL 32803 DFA Meeting Repast MON $418.23 $11.00 07 /21/05 Rai1baw Dems Post Office 3Ox 532041 Orlando 51 32853 Third Thursday Event MON $37.00 $97.63 DS -DE 14 (Rev. 08!03} SEA REVERSE FOR INSTRUCTIONS AND CODE VALUES $15.00 ) Name CAMPAIGN TREASURER'S REPORT— ITEMIZED EXPENDITURES Jeff Horn (2) I,0, Number (3) overPeriod 07 ; Oz / 45 through 0° , 20 i iv; Date (6) Sequence Number 08 10 /05 10 {7) P ull blame (I-aSt. Suffix, First, Middle) Street Address & City, State, Zip Code S tances 2774 F Colonial Dr Orlando FL 32.802 Suzy Creighton 20 l 1dgewood Dr Akron PA 17501 (B) (4) Page Purpose (add office sought If Contribution to a candidate) of 5 091 Expendilure Type Otfic2k Sunn;ie❑ [4•;N (10) Amendmom Graphic Arts MON 08 /24 /05 11 DaP5 College Park Of5lce Orlando FL 32504 8 /25105 12 CCD2C 633 1* Colonial 0r Orlando FL 32803 B /30 05 13 Pins 10 J /05 14 USPS College Park Office Orlando FL 32804 ACLU P'dtrn of FL 4%x00 Biscayne nlvd Ste 340 Miami FL M37 7 Amount $53.23 Postage MON $250.00 $6.66 Grand Opening MON Party $150.00 Postage Ar. Fvei ing With Congressman Frank 49 d o 1S Staples 2774 E Colonial Dr Orlando liL 32803 Office Supplies MON MOST $100.00 $72.77 09 /10/ 05 16 MBA 130E Lang Ave Orlando FL 32803 Parade MON DS -DE 14 (i ew, Q8103) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES $350.00 CAMPAIGN TREASURER'S REPORT — ITEMIZED EXPENDITURES (i}Nartte Jeff Horfx (2) 1.D. Number (3) Cover Period Date u7 ) 01 J 05 through _09 /_30 / 05 (6} Sequence Number {7} Futl Name (Las', Suffix. First, Middle) Street Address & City, Stag, Zip Cods 09 / /05 17 Staples 2774 E Colonial Dr Orlando Fes, 32803 i}9 f10 05 18 09 12 05 1.9. C9 1 05 20 Staples 2774 E COloria1 Dr Orlando FL X2803 (S) Purpose (add office sought contribution to a candidate} Page of 5 (9} Expenditure Type Office Supplies I--;;:ocopying (10) Amermirnent Amount 1 -800 -My -Buttons 5703 Tied Bug Lake Rd Ste 187 Winter Springs FL 32708 NBL Marketing 1255 Belle Ave # 125 Winter Springs FL 32708 09 23 05 1_ 21 09 25 u 22 Buttons Are 51 Graphics 1717 Minnesota Ave Unit H Winter Pax -3c FL 32789 MON Yard Signs MON MON 227,09 $$63.45 T -Shirts 1 MON $311.36 $1,120.00 Area 551 .3raDhics 1717 Minnesota Ave Unit fI Winter park FL 327$9 05 /26/05 23 09 /26 / OS 24 sVaoles ?774 E Colonial Dr Orlando FL 32803 D5 -DE 14 (Rev. D$iO3) Shelbie Press 1308 Lang Ave Orlando FL 32803 Bumpezretickers 1 MON 456,20 Photocopying 1 MON $.26.65 Printing 1 MON $673.5. SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES (1) Name CAMPAIGN TREASURER'S REPORT - ITEMIZED EXPENDITURES .Jett Ian,-== (2) I.C. Number (31 Cover Period 07 .1 05 through (5} Date (5) Sequence Number C9 46 45 1'-3 fi_5 f05 (7} 09 30 / C5 Fill Name (Last, Suffix, First, Middle) Street Address & City, State, Zip Cade (4) Page Purpose (add office sought if COrtrrbutian to a candidata) ABC 3333 Edgewater Drive Orlar+.do FL 3280, 26 Beverages Staples 2774 E Colonial Dr Orlando FL 32803 09 2s 05 27 Lill Anthony's 3612 E Colonial Dr Orlando FL 32803 09j/27 0 29 31(27/0 29 Staples 2774 2 Colonial Dr Orlando FL 32903 Photocopying of (97 (1ETT Expenditure Ty pe Amendment MJN Fund-raising Luncheon: us45 College Park office Orlando FL. 2804 9 27 05 30 FG9 37 Us 31 Office Supplies MON (1 t) Amount $32.00 $9.19 EON Postage MON Staples 2774 E Colonial Dr Orlando FL 32804 Phut ocOpyi ng Costs 741 Or'a ge Ave Altamonte Springs FL 32714 09 /274)5 Target 5821 W Colonial Dr Orlando FL 32506 DS -DE 14 (Rev. 08!43) Event Catering MOTS $29.50 $94,61 $2.44 $5.31 MON $335.7; Beverages MON $155-52 SEE REVERSE FOR INSTRUCTIONS ANO CODE VALUES (1) Name [3} Cover Period 07 t73 ! G5 through D9 / 30 / G5 f5a {7} {8} Date f6} Sequence Number 33 Fu€I Marne {Last, Suffix. First, Middle) Street Address & City, State, Zip Code Rai Liauw 1219 W Stith St Orlando FL 32804 34 09 30 05 3$ Marriott 730 N Magnolia Ave Orlando FL 32903 S-aples 2774 E Colonial Dr Orlando VI. 32803 Purpose {add office sought if contribution to a CandidateM ?eimbta.reen-,o,3t 1Ce & Wine CAMPAIGN TREASURER'S ER' REPORT— ITEMIZED EXPENDITURES .7e: = rte: r (2)1.D. Number (4113Age 5 Meeting Room Catering Office Supplies of 5 9} Expenditure TYPe MON MON (10) Amendment Arn o u rat MON $0$.13 $9.18,.3s $34.19 G9 30 05 36 l SunT{us 2315 Edgewater Dr Orlando FT, 32x04 Harlan Che:ks LI DS -DE 14 {lea, 08i'03} J- MON $16-25 SEE REVERSE FOR 1NSTRUDTION$ AND CODE VALUES CAMPAIGN TREASURER'S REPORT ITEMIZED CONTRIBUTIONS (1 } Name Jeff Horn I,D. Number (3) Cover Period 07 { 01 j 05 through 09 { 0 1 05 (5) hate {6) Sequence Number 07 06 /05 1 O} Full name (Last, Suffix, Forst, Middle) Street Address & Clly, State...ip Code Davis, Brian, ri 610? Beaumont Ave Orlando FL 32809 07 , c5 05 2 (8) Contributor TypeI Occupation 2 Rader, Shawn, G 1418 S Lake Davis Dr, Orlando FL 32806 07 1 06 i 05 Nicastro, Laurent, J 1501 Shadwell Cir Lake Mary FL 32746 1 (4) Page 1 of 11 (9) r (10) Contribution Type CITE c1rE 07 06 f 05 4 07 1 / 05 Parliament House 410 N Orange Blossom Tr Orlando FL 3n6o5 Cr Enter- tainme[1i, Complex In -kind Description Arm rrilm@nt (12) Anncunt 25.00 100.00 100.00 5 Rot erv, Michael, k, 3901 Wren Ln Orlando'L ��8M3 1 CHE 07 13 05 Unger, George, M 8033 Sunset Blvd 933 Los Angeles CA 90046 T Software Consult- ant CHE 07 1.3 f C5 7 Nottolor 1Trarlkr P 601 Grand St Orlando FL 32805 07 } 13 / 05 6 Dorn, Terrance 3000 Haigi11 D± Orlando FL 32806 S00.00 100.00 CBE. 500,00 12.00 25.00 DS -DE 13 tRev. CUf03j SEE REVERSE FOR 3NSTRLfCT!ONS AND CODE VALUES CAMPAIGN TREASURER'S REPORT — ITEMIZED CONTRIBUTIONS (1) Name _ gaff Elorn (2) I.D. Number (3) Cover Period 07 I 01 { 05 tnr0ugt1 05 I 30 / os (4) Page 2 of 11 (5) (}) Date Full Name (8) (Last, Suffix, FIN!, Middle) Sequence Slreel Address & Number City, Slate, Zip Code 07 f 18 /05 9 Murray, Ramon, V 943 Fremont Ave Winter Park FL 327$9 07 18 05 10 1 (3) (9) Contributor Typo Occupation Gary, Susan 127 Y Fairbanks Ave, PM6 412 4ini:er Park FL 32789 07 / 18 ) 05 11 Parks, Edwin, & Grayson Hann 5703 Shasta Dr Orlando. FL 32810 T Contribution Type C1:E (10) Indcirrd Descflptian An9ehdment (12) Amount 25.00 40,00 cis 07 18 j 05 12 Youree, James, M 4011 Finch St Orlando F14 32903 7 C r, 07 ) 21 f 45 13 Roberts, Michael, B, 3505 Pinetree Rdr Orlando FL 32804 oa 02 05 14 Crag°, Judith, Track, 513 Lake Shore Dr, Mail.lard FL 32751 08 02 05 15 Holt, Larry, C 3031 s Atlantic Ave, 4 402 COCoa Beach FL 32931 08 15 r 05 16 N uaial, Maureon, C 4993 Heatherstone P1, Orlando FL 32812 1 Cosme- tologist CHE 100.04 25.00 100.0.0 Soo . 00 DS -DE 13 (Rev. 08/03) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES CAMPAIGN TREASURER'S REPORT— ITEMIZED CONTRIBUTIONS (1) Narne iJo_f Horn (3) Cover Period 07 / 01 f os (5) Dale (6) Sequence Number 08 / 15 105 17 01 FWI Name (Last, suffix, First, Middle) Street Address & City, tale, LIR curie Truffles & Trifles 711 W Smith St Orlando FL 32804 49 15 05 18 Pepper Heid & Aesooiores p O Box 1170 Winter bark FL 32790 through 09 (8) Coaributar Type 3 Occupation {} LID, Number / 30 / 05 (4) Page of 11 (9) (10) Ganinbutioi In -kind Description Cooking CHE Classes Gourmet Shop Public e1a- tions 08 / 24 / 05 19 Keith McIntyre 52; h Yale Sr Orlando FL 32804 I 08 + 24 G5 20 Wanuie, Michael 571 Nina Rosa Dr Orlando FL 32819 Ewen, Elaine 00 08 05 792 Greeland Ave 21 Jacksonville FL 32221 I CT -E 09 08 05 22 Martin, Bbby, 7211 Matchett Rd Orlando tit 32849 05 14 { 05 23 Arriendmead (12) AinoLint 100.00 50.00 50.00 75.00 20.00 CEE Gates, Terry, L 940 Douglas Ave 132, Altamonte Springs FL 32714 I TrUss Services Manager 0132 49 22 ❑5 24 3rower, Christopher, R 3658 S St Lucie Dr CaSSelber y FL 32707 1 50.00 300,00 25.00 DS -DE 13 Rev. rJ8/03) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES CAMPAIGN TREASURER'S REPORT — ITEMIZED CONTRIBUTIONS (1) Name Jeff Horn (3) Cover Period 07 1 01 / 05 through c C5) Dale {6} Sequence Number 09 22 0.05 25 09 22 05 (7) Full Name (Last, Suffix, First, Middle) Street Address & Cit State, Zip Code J & ID of Orlando, Inc, 1326 N Mille Ave Orlando FL 32803 26 Mottolo, Frank, 6.01 Grand St Orzanda FL 32835 Q9 / 22 / 05 27 ype S (2) Number / 3 rJ / 05 (4) Page 4 Of 11 (8) Contributor Occupation Restau- rant Macali Eye Clinic, P 1135 5 vireland Rd, # 101 , Winter Garden FL ' 34797 8 (9) (1 0) Contribution In -kind Type Description cgE CHE Opto- metry 09 it 22 / 05 28 Euribe, Cesar 535 Maxaret Ct Orlando FL 32801 09 22 / OS 29 Wilson, GCO;ge B36 Arderfleigb Dr Orlando FL 32829 09 22 05 30 Watkins, 3 8teveri & Weigle, Rob 333 Rack Lake Dr Orlando FL 32905 I rR� Art i dment (12) Armvunl 100.00 1 .50 45 22 05 31 Curamer_g, Calvin, A & Theresa. S. 708 W Smith $ Orlando FL 32804 09 22 i 05 3arvela, Leslie, 'rf 6526 Nina Rosa Dr Orlando FL 32819 CAS 450.00. 100.00 50.00 103.00 THE 79.00 DS -DE 13 (Rev. 08(03) SEE REVERSE FOR INSTRUCTIONS AND CODE VALEJES 50.00 CAMPAIGN TREASURER'S REPORT - ITEMIZED CONTRIBUTIONS (1) Name _ _ Jeff Horn (2) I.D. Number (3) Cover Period 07 j 01 if 05 through 09 { 30 / 05 {4) Page 5 of 11 (5) (7) (8) (9) Date FOName (6) (Last, Suffix, First, Middle) Sequence Skeet Add MSS & CDrbtributor Contribution Number city, $tatejip COUe — Type Occupation T pe 09 f 22 /05 33 GOcdermote, David, A, ur, barrin_9to1, Sean 1007 River Glen Ct Orlando FL 32825 09 22 05 35 CHE Orlando Flame 8 Realtors CE Sales, Inc 1314 Spearman Ct Orlando FL 32825 09 / 22 / 05 35 Darmar_, David & Pertyak, 8nott 295 Hig'.ibraoke 91v Ocoee FL 34751 09 22 05 36 (U0} In -kind Destdiption CHE Aitd+ m t {12} Amount 100.00 Second E Interior CHE Impressions Inc Decor 1101 Palma Dr Orlando FL 32805 09 7 22 / 05 37 100.00 she Bolick Chiro- Clinic, Inc practie 500 E Horatio Av= 8hyaic- Miitaand FL ian 32751 22 / OS 38 4actli Eye Opta- CHE Clinic, P A metry 1155 S Vineland Rd 1/10], Winter Garden FL 3787 09 22 05 39 50.00 SC.00 50.00 Concept Software, E Software CHE Inc Consul - P 0 Hox 770459 tants Winter Garden FL 34777 09 22 05 40 Lantern LighL H Studios, Inc 12 E Harvard Et Orlando EL 32804 Film/ Video Producer CI -1E 50.00 150..00 50.00 OS -DE 13 (Rev. 08/03) SEE REVERSE FOR INSTRUCTIONS MID CODE VALUES CAMPAIGN TREASURER'S REPORT-. ITEMIZED CONTRIBUTIONS (1) Name _ Jeff Horn (2) I.D. Number (3) Cover period 07 / 01 / 05 through 09 f 30 / 05 4) Page 6 of 11 (5) (7) Dale Full Name I$) (Last, Suffix, First, Middle) Sequence Street Address & Number City, State, 2i Cade Shade, uesse, P, 09 22 ;05 & Darlene, V 1115 Carew Ave 41 Orlando FL 32E04 (8) Cordributor Type Oocupa[ion T. 09 22 05 r12 Atwell, Linda 19 E Steele st Orlando FL 32804 05 1 22 f 05 43 1 (9) Contribution. Type CI -1E Description raj aies , Luis, , E 500 E Grant St Orlando FL 32806 09 1 22 05 44 Capozzi, Silvestro, J & Si=Teeter 2312 9 Brown Ave Orlando FL 225,06 09 22 05 45 Ewen, Elaine 792 Greeland Ave Jacksonville f'L 32221 Civil Engineer CHE amendment Amount 100.00 50.00 I Educa- t-xonal Tech Expert= fE 9 22. 46 Dixon, John, Jr & :largo 4879 Spring Run Av Orlando FL 32819 I 09 22 05 47 Dixon, John, Jr & Margo 4579 Spring Run Av Orlando FL 32819 C]E CI:: 150.00 94,00 50,00 50.00 09 22 f 139 48 Miller, Jordan, s 444 BamntOn Ave S Orlando FL 32803 CHE 50.40 DS-t3E 13 (Rev. 05103) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES CAMPAIGN TREASURER'S REPORT— ITEMIZED CONTRIBUTIONS (1) Name ;Jeff Horn (2) I.D. Number (3) Cover Period 07 / 01 / 05 through s / 34 / 05 ) Dare (B} Sequence Number 09 22 /05 (7) Full Name {Last $ufflx, First, Middle) Street Addr®ss & Ctti, SIatekZip Code 09 49 Gaines, Patti, A 500 Rugby St Orlando FL 32804 22 05 50 Woods, Wiliam, M & Janice, E 1058 Aamond Tree Cir, Orlando FL 3283 5 05 2 / 0{ 51 (6) Conlributor Type Oocupatron Hutt, Misty, M & Cnoa.trce, Jody 647 N Shine Ave Orlando FL 32e03 09 22 / 05 52 09 + 22 05 53 09 29 05 54 I 1 Invest- ment Advisor l Nurse Admin. (9) Contrlbulidn Ty Miller, 53arry I 5105 Turkey Lk Pd Orlando FL 32919 Howard, Kenny 1 5105 Turkey Lk Rd Orlando FL 32819 Smith, Carol 1221 Gay St Apopka FL 32703 09 29 05 55 Mason, Uei1, R 3119 Oakland Shores Dr, # C-209 Oakland Pak FL 33309 Attorney (4) Page 7 of 11 (10) tn-kind Descriptlun Amcndmern (12) Arnount 50.00 50.00 75.00 INK Event Catering Manager 1Nx CAS I CIIE 450.00 Event Catering 450.00 50.00 03 25 05 55 Murray, TLawewat, T 6929 Crescent Ridge Rd, Orlando FL 32910 D$ -DE 13 {Rev. 68!03} C_E L 25_00 100.00 SEE REVERSE FOR tNSTRUCTIONS AND CODE VALUES CAMPAIGN TREASURER'S REPORT— rTEMIZED CONTRIBUTIONS (7 ) Name (3) Cover Period 07 (5) Date (S) Sequence Number 09 29 '05 Jeff Horn (2) I.D. Number / 01 / 05 through 05 (7) 1 Full Neale (Las, Suffix, First, Middle) Street Add€es & City.,Slate, ip Rode 57 Farris, Jean, C 5935 Ru.b,i,o Ave Van Nuys CA 91406 09 i 29 , 05 5B Palms Properties of Cenral Florida, Inc 927 N Mille Ave Orlando FL 32803 09 r 29 / OS 59 Ware. J Douglas, DKD & Candace. 1 405 Alexandria lv 1# 110 Oviedo FL 32755 S Murphy, Grant, L, 09 / 29 / O5 & Elizabetrh. D 913 6I Bola or Orlando FL 60 3280a 09 29 05 King, Kenny 9423 Lake Lotta C 51 Gotha PL 34714 Gough, Tim, & Con(ribulvr Type Occupation Caeltrlautio fl _Type CHE Realtors Dental Office 09 29 05 62 Hoban,, Michael, J, & For}unas, Flair, A 2309 S TEumby Ave Orlando FL 32606 09 29 O5 63 Framing of Central Florida, Inc 808 Virginia Dr Orlando FL 32803 CBE C F. 04) Page (10) ]n•kind Descriptlbn _8 of 11 (11) (12} Am ndmert Amour X0,00 100.(10 CHE 25.00 CHE Framing 09 / 23 oFp 61. Hill, Farrier Carlos 3304 t4a1Ch&m Cc Yardley PA 1.9087 I OS -DE 13 (Rev. 03103) CHE CEE 30.00 100,00 75.00 SEE REVERSE FOR € ISTRUCT1ONS AND CODE VALUES CAMPAIGN TREASURER'S REPORT - ITEMIZED CONTRIBUTION S (1) Narne (3) Cover Period (5) Gate (0) Sequence Nuirter 0a { 29 /05 65 09 29 05 66 09 1 29 f 6S 67 43 29 ; 05 Jeff Horn 07 / 01 / (7) NJ Name {L&st, Suffix, First, Middle) Street Address & City, Slate, Zip Sods O'Br#enr Charles, A, & Vicki 1364 Black Willow Tr, Altamonte Springs, FL 32714 (2) I.D. Number 05 _ threugi 09 / 30 / 09 (4) Page 9 of 11 0, r--(9) T Contributor D4ntributIon Type occu align T Goldman., J02sine 8441 Bowden. Way Windermere FL 34786 Tennis P. ofesai anal / Merma1 Health I�— Langston, Fr James E 2221 N Wesvinorlai:d Dr Orlando FL 32804 66 Vazquez, Gorge P 0 Sax 533926 Orlando FL 32353 CHE CHE L I Priest Rinn, Jason, M 09 l 2? f 05 2507 Coolidge Ave Orlando FL 59 32804 CHE I fl-krnd De5ciiplian Amemnlar~ {1 2} Amount ?00.00 50.00 100.00 CHE 09 29 4S 70 nut 9, John, x, 211 1960 Farrington Dr Merritt Island FL 32552 I 09 29 0S 71 Capazzl Sal 2312 5 Brown Ave Orlando FL 32805 I CITE 25,00 Educa- tional Tech Expert c 09 29 i 45 'deed, Tracy, A, Mary, P 7019 Tynan Ave Jacksonville FL 32211 DS -DE 13 (13ev. 08/03) 100.00 SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES 25.00 25.00 25.00 CAMPAIGN TREASURER'S REPORT — ]TBMIZED CONTRIBUTIONS (1) Name _ Jeff Horn (2) I.D, Number (3) Cover Period 07 1 01 / 05 through 09 / 30 _ / 05 (4) Page 10 of J.1 (5) Date (6) Sequence Number 29 /05 73 09 i 29 05 '74 {71 Furl Nerne (LAs1, Sufic Flrst, Middle) Street Address & City, Stale, Zip Code Suer, Marni 1750 walker Ave winter Park FL 32783 (8) Contributor Type Occupetioei 1 Abney, Dennis, A, Barbara, Compton 1319 W Smith SL Orlando FL 32804 09 29 or 05 75 Pecko, Michael, L 19E0 Farrington Dr Merritt Island FL 32952 09 25 45 76 Sr-elzner, Doug P 0 3426 Orlando FL 32802 ❑9 29 45 77 055 29 05 78 1 I (9) Conlrlt}uliDr Type CPS {10) Fn -kind Description Arrerirmrrt (12) Amount 50,00 C7iE Food Service Manager 'ME Marcum, Jeff, J, & Fowkes, Guy, L 40 E Orlando St Orlando FL 32804 LaPha, Strvvenr G & $caber, Keith 2011 E Concord St Orlando FL 32803 09 29 05 79 ❑9 29 i p5 30 I Micro- soft Ex^aert / M6ntal Hea1Eh CUE 50.00 LEE Hord, Michael, D 1221 Gay 3t Apopka FL 32703 Wanaie, Mic17ae1 6714 Ulna Rosa Dr Orlando Fla 32819 1 50.00 100.00 25.00 100.00 100.00 Play- wright / Director DS -DE 13 (Rev. 08103) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES 1/5,00 CAMPAIGN TREASURER'S REPORT —ITEMIZED CONTRIBUTIONS {1 } Name Jeff Horn (2) I.D_ Number (3) Cover Period D7 ! 01 } 05 through 09 1 30 / 05 (4) Page 11 of 21 (5) Date (6) Segraenue Number 09 29 OS 63 09 29 (7} FuPI Nome (Last, Suffix. Fits!, Middle) Streel Address & Clt , State, Zip Cade Scott, Chris, J & +Suite, E 2220 Oregon St Orlando FL 32'803 05 82 (8) Corirributof Type Occupation (9) Contribution _ Type CHE StevenS, Richard, Allan 5134 La Lorna St Sall Diego CA 92115 Zim, Ronald, P u5 29 / 05 P 0 Sox 1010 Geneva FL 83 09 / 29 / 05 84 32712 Szymanski, Rdward, L7, J 4440 Waterside Pointe Cir Orlando FL 32829 I CBE (10) (11) I (12) 1 in -kind Description Am namont Amount 25,00 Jones, David 05 / 29 05 610 S Conway Rd, Ant C 85 Orlando FL 32807 Truffles & Trifles 09 29 05 711 W Smith St Orlando FL 86 32804 1 Cooking Classes Gourmet Shop CHU 25.00 Catering 75-00 50,00 FecL4 50.00 09 , 29 05 87 Mrekt , Diane 1381 Aziora Dr Dehtona F1 32725 03 / 29 t 05� B8 1 County Cammise- ioner Aide Scap]es 2774 1 Colonial 0 Orlando FL 32803 C. erinQ 250.00 Office Supplies Ink Cartridge 20.04 DS -DE 13 (Rev_ 08f03 SEE REVERSE FOR 1NSTRUCTl0lNS AND CODE VALUES FLORIDA DEPARTMENT OF STATE DIVISION OF ELECTIONS CAMPAIGN TREASURER'S REPORT SUMMARY (1) Jeff Horn OF'FigerOiVoititY Name (2) 1219 West Smith Street y w Address (number and street) Orlando FL 32804 City, State, Zip Code ❑ CHECK IF ADDRESS HAS CHANGED (3) ID Number: (4) Check appropriate box(es): © Candidate (office sought): Orlando City Council (Dist. 3) ■ 0 • ❑ Political Committee Committee of Continuous Existence Party Executive Committee Electioneering Communication ■ 0 • CHECK IF PC HAS DISBANDED CHECK IF CCE HAS DISBANDED CHECK IF NO OTHER ELECTIONEERING COMMUNICATION REPORTS WILL BE FILED (5) REPORT IDENTIFIERS Cover Period: From 10 / 01 / 05 To 12 / 31 / 05 Report Type Q4 F4 Original ❑ Amendment ❑ Special Election Report ❑ Independent Expenditure Report (6) CONTRIBUTIONS THIS REPORT Cash & Checks $ 2,413.17 (7) EXPENDITURES THIS REPORT Monetary Expenditures $ 1,156.33 Transfers to Office Account $ 0.00 Loans $ 0.00 Total Monetary $ 2,413.17 Total Monetary $ 1,156.33 In -Kind $ 500.00 (8) Other Distributions $ 0.00 (9) TOTAL Monetary Contributions To Date $ 13,947.67 (10) TOTAL Monetary Expenditures To Date $ 9,506.90 (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) M. Wayne Gebhardt I certify that I have examined this report and it is true, correct, and complete. (Type name) Jeff Horn r] Candidat ❑ Chairperson (only for PC, PTY & electioneering commun. organization) ❑ Individ I (o y for r c mun.) 0 Treasurer ❑ Deputy Treasurer electi g Signet re g atur DS -DE 12 (l v. 08/04) (1) Name CAMPAIGN TREASURER'S REPORT — ITEMIZED EXPENDITURES Jeff Horn (2) I.D. Number (3) Cover Period 10 / 01 / 05 through 12 / 31 D5 (4) Page 1 of 2 (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 (B) Sequence Number 10 A1/05 Creighton, Suzy 20 Ridgewood Dr Akron PA 17501 Graphic Artist MON $250.00 1 10 /01 /05 Staples 2774 E Colonial Dr Orlando FL 32803 Office Supplies MON $95.36 2 10 p4)(05 LISPS College Park Station Orlando, FL 32804 Postage MON $109.00 3 10 /05/ 05 C Staples 2774 E Colonial Dr Orlando FL 32803 Photocopying MON $10.59 4 10 /05/05 LISPS College Park Station Orlando FL 32804 Postage MON $87.95 5 10 /07/05 Staples 2774 E Colonial Dr Orlando FL 32803 Photocopying MON $3.26 6 10 /07/05 Logan's Bistro 802 Virginia Ave Orlando FL 32803 Campaign Team Meeting MON $40.00 7 10/09/05 Rainbow Cafe 410 North Orange Blossom Tr Orlando FL 32805 Campaign Team Meeting MON $29.66 8 DS -DE 14 (Rev. 08/03) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES (1) Name CAMPAIGN TREASURER'S REPORT — ITEMIZED EXPENDITURES Jeff Horn (2) LD. Number (3) Cover Period l0 / 01 / 05 through 12 / 31 / 05 (4) Page 2 of 2 (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 1Q /20 /05 Orlando Regional Chamber of Commerce 75 S Ivanhoe Blvd Orlando FL 32804 Hob Nob MON $100.00 9 11 /30 /05 Staples 2774 E Colonial Dr Orlando FL 32803 Office Supplies MON $21.29 10 12 /08 /05 Publix 2015 Edgewater Dr Orlando FL 32804 Volunteer Gift MON $16.59 17. 12/10/05 L Staples 2774 E Colonial Dr Orlando FL 32803 Office Supplies MON $21.16 12 12 /20/05 USPS College Park Station Orlando FL 32804 Postage Stamps MON $13.32 13 12 p1/05 USPS College Park Station Orlando FL 32804 Postage Stamps MON $19.98 14 12 /23 /05 ( Costco 741 Orange Ave Altamonte Springs FL 32714 Volunteer Appreciation Gifts $303.17 15 12 p8/05 MBA 1308 Lang Avenue Orlando FL 32803 Additional Charge for Parade $35.00 16 DS -DE 14 (Rev. 08103) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES CAMPAIGN TREASURER'S REPORT - ITEMIZED CONTRIBUTIONS (1) Name Jeff Horn (3) Cover Period (2) I.D. Number 10 / 01 / 05 through 12 / 31 / 05 (4) Page 1 of 4 (5) Date (7) Full Name (Last, Suffix, First, Middle) Street Address & City, State, Zip Code Contributor Type (8) Occupation (9) Contribution Type (10) In -kind Description (11) Amendment (12) Amount (6) Sequence Number 10 / 06 /05 Trowbridge, Brad 4254 Coronado Rd Orlando FL 32804 I CHE 50.00 1 10 / 06 / 05 , Riza, Nabeel A & Amana Bolchari 1862 Royal Majesty Ct Oviedo FL 32765 1 CHE 90.00 2 10 / 06 / 05 Sillman, Michael 1504 8 Palmetto Ave Sanford FL 32771 I CHE 50.00 3 10 / 06 / 05 Payne, Sherry L & Robert F 1207 W Smith St Orlando FL 32804 I CHE 100.00 4 10 / 06 / 05 Booth, Debra M & Carl E, Jr 917 Bloomington Ct Ocoee FL 34761 I CHE 50.00 5 10 / 06 / 05 Ramsey, John Phillip 412 Thunder Ridge Lake In The Hills IL 60156 T Tech Writer CHE 500.00 6 10 / 06 05 / Jouvenat, Jock 1916 Lone Rock Rd Glide, OR 97443 1 CAS 20.00 7 10 / 06 / 05 Kennedy, Kenneth 10309 Beaverkill Ct Orlando FL 32817 I CHE 50.00 8 DS -DE 13 (Rev. 08/03) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES CAMPAIGN TREASURER'S REPORT — ITEMIZED CONTRIBUTIONS (1) Name Jeff Horn (2) ID. Number (3) Cover Period 10 / 01 / 05 through 12 / 31 / 05 (4) Page 2 of 4 (5) Date (7) Full Name (Last, Suffix, First, Middle) Street Address & City, State, Zip Code Contributor Type (8) Occupation (9) Contribution Type (1 0) In -kind Description (11) Amendment (12) Amount (6) Sequence Number 10 / 06 /05 Creech, Penny 1805 E Grant St Orlando FL 32806 1 CAS 40.00 9 10 / 06 / 05 Lapha, Steven & Baber, Keith 2011 E Concord St Orlando FL 32803 I CHE 50.00 10 10 / 06 / 05 Lucas, Susan E 385 Mashie Ln Orlando FL 32804 I CHE 50.00 11 10 / 06 / 05 Unique Cleaners 2509 Citrus Club Ln Orlando FL 32839 B House Cleaners CHE 25.00 12 10 / 06 / 05 Moore, Greg 3300 Amherst Ave Orlando FL 32804 I Cosme- tologist INK Party Supplies 250.00 13 10 / 06 / 05 Griffiths, Kathryn 1522 Charlotte Ln Orlando FL 32804 I CHE 55.00 14 10 / 06 05 / Morris, Charles A & Sheila M 1936 Fawsett Rd Winter Park FL 32789 I CHE 50.00 15 10 / 06 / 05 Hatoum, Nayef 2611 Chelsea St Orlando FL 32803 I CHE 50.00 16 DS -DE 13 (Rev. 08/03) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES CAMPAIGN TREASURER'S REPORT -- ITEMIZED CONTRIBUTIONS (1) Name Jeff Horn (2) I.D. Number (3) Cover Period la / 01 / 05 through 12 / 31 / 05 (4) Page 3 of 4 (5) Date (7) Full Name (Last, Suffix, First, Middle) Street Address & City, State, Zip Code Contributor Type (8) Occupation (9) Contribution Type (10) In -kind Description (11) Amendment (12) Amount (6) Sequence Number 10 / 18 /05 Jewelry Etc 5685 Red Bug Lake Rd Winter Springs FL 32708 B Jewelry & Fine Glass Sales CHE 50.00 17 10 / 18 / 05 I -Tippler, Charles & Rose -Marie 4722 Faust Ct Orlando FL 32817 1 CHE 50.00 18 10 / 18 / 05 Marsee, Ernest 917 S 12 ST Baton Rouge LA 70802 1 CHE 100.00 19 10 / 18 / 05 Gilliam, Marcia 4019 Hargill Dr Orlando FL 32806 1 CHE 25.00 20 10 / 20 / 05 Paco's Restaurant, Inc. 1801 W Fairbanks Ave Winter Park FL 32789 B Restau- rant CHE 100.00 21 10 / 20 / 05 Nguyen, Ann 3024 Corrinne Dr Qrlando FL 32803 I CHE 100.00 22 10 / 20 / 05 Mottolo, Frank 601 Grand St Orlando FL 32805 1 CHE 5.00 23 10 / 27 / 05 McGeoch, Benjamin 2806 Ardsley Dr Orlando FL 32804 I CHE 25.00 24 DS -DE 13 (Rev. 08/03) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES CAMPAIGN TREASURER'S REPORT — ITEMIZED CONTRIBUTIONS (1) Name Jeff Horn (3) Cover Period 10 (2) I.D. Number / 01 / 05 through 12 / 31 / 05 (4) Page 4 of 4 (5) Date (7) Full Name (Last, Suffix, First, Middle) Street Address & City, State, Zip Code Contributor Type (8) Occupation (9) Contribution Type (10) In -kind Description (11) Amendment (12) Amount (8) Sequence Number 10 / 27 /05 Hinshaw, Larry 1715 E Kaley Ave Orlando FL I Banking Software Tech CHE 200.00 25 32806 Williams, Wilford I CHE 25.00 10 / 27 / 05 & Gwendolyn 8630 Oldbridge Ln 26 Orlando FL 32819 Smither, Robert & I CHE 50.00 11 / 22 / 05 Janan 1120 S Lake Sybelia Dr Maitland FL 27 32751 Floyd, Karen i CHE 50.00 11 / 27 / 05 2409 Napa Valley Dr Villa Rica GA 28 30180 Thomas, Ezzie I CHE 50.00 12 / 14 / 05 929 Wooden Blvd Orlando FL 29 32805 Lindberg -Randolph, I CHE 50.00 12 / 14 / 05 Susannah 1400 Mt Vernon St 30 Orlando FL 32803 Horn, Jeffrey I Coach CHE 303.17 12 / 28 / 05 1219 W Smith St Orlando FL 31 32804 Jones, David I Correc- INK 250.00 12 / 28 / 05 610 S Conway Rd tions Apt C Officer 32 Orlando FL 32807 DS -DE 13 (Rev. 08/03) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES FLORIDA DEPARTMENT OF STATE DIVISION OF ELECTIONS CAMPAIGN TREASURER'S REPORT SUMMARY (1) Jeff Horn OFFICE USE ONLY 2OCI ,_"A 5', Set Name (2) 1219 West Smith Street Address (number and street) Orlando FL 32804 City, State, Zip Code • CHECK IF ADDRESS HAS CHANGED (4) Check appropriate box(es): Fl Candidate (office sought): Orlando City Council (3) ID Number: (Dist. 3) El Political Committee ❑ CHECK IF PC HAS DISBANDED ❑ Committee of Continuous Existence ■ CHECK IF CCE HAS DISBANDED ❑ Party Executive Committee ❑ Electioneering Communication 0 CHECK IF NO OTHER ELECTIONEERING COMMUNICATION REPORTS WILL BE FILED (5) REPORT Cover Period: From 01 / 01 / 06 To IDENTIFIERS 01 / Report 20 / 06 Report Type GI !I Original ■ Amendment ■ Special Election ■ Independent Expenditure Report (6) CONTRIBUTIONS THIS REPORT Cash & Checks $ 0.00 (7) Monetary Expenditures Transfers Account Total Monetary EXPENDITURES THIS REPORT $ 831.83 Loans $ 0.00 to Office $ 0.00 Total Monetary $ 0.00 $ 831.83 In -Kind $ 375.00 (8) Other Distributions $ 0.00 (9) TOTAL Monetary Contributions To Date $ 13,947.67 (10) TOTAL Monetary Expenditures To Date $ 10,338.73 (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) M. Wayne Gebhardt I certify that I have examined this report and it is true, correct, and complete. (Type name) Jeff Horn ❑ Individual (only for ❑✓ Treasurer ❑ Deputy Treasurer election n co un.) ✓ Candidate - ❑ Chairperson (only for PC, PTY & 1 electioneering commun. organization) X X Sig at a Signature DS -DE 12/ Rev. 08/04) CAMPAIGN TREASURER'S REPORT - ITEMIZED EXPENDITURES (1) Name Jeff Horn (3) Cover Perlod 01 / 01 / 06 through 01 / 20 / 06 (2) I.D. Number (4) Page 1 of 1 (6) 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 USE'S Postage MON $6.66 01 /07/06 College Park Station 1705 Edgewater 17r 1 Orlando FL 32804 Staples Photocopying MON $11.14 01 /10 /06 2774 East Colonial Dr Orlando FL 32803 2 City of Orlando Filing Fee MON $785.95 01 k0/06 400 South Orange Ave Orlando FL 32802 3 USPS Postage MON $28.08 1 / 13 /06 011/13/06 ( College Park Station 1705 Edgewater 17r Orlando FL 32804 4 / / / / / / / / DS -DE 14 (Rev. 08/03) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES CAMPAIGN TREASURER'S REPORT — ITEMIZED CONTRIBUTIONS (1) Name Jeff Horn (2) I.D. Number (3) Cover Period 01 / 01 / 06 through 01 / 20 / 06 (4) Page 1 of 1 (5) Date (7) Full Name (Last, Suffix, First, Middle) Street Address & City, State, Zip Code Contributor Type (8) Occupation (9) Contribution Type (10) In -kind Description (11) Amendment (12) Amount (6) Sequence Number 01 / 10 /06 Pecko, Michael 1960 Farrington Sr Merritt Island FL 32952 1 Food Service Sales INK Food 50.00 1 01 / 10 / 06 Wiseman, Rob 4483 Anson Ln Orlando FL 32814 1 INK Party Supplies 75.00 2 01 / 10 / 06 Slaymaker, Michael P 0 Box 947752 Maitland FL 32794 I INK Party Supplies 50.00 3 01 / 10 / 06 Food With Care 6995 Venture Cir Orlando FL 32807 B Food Service INK Food 200.00 4 / / / / / / / / DS -DE 13 (Rev. 08/03) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES FLORIDA DEPARTMENT OF STATE DIVISION OF ELECTIONS CAMPAIGN TREASURER'S REPORT SUMMARY (1) Jeff Horn OFFICE USE ONLY a Name (2) 1219 West Smith Street Address (number and street) Orlando FL 32804 City, State, Zip Code • CHECK IF ADDRESS HAS CHANGED (4) Check appropriate box(es): © Candidate (office sought): Orlando City Council (3) ID (Dist. Number: 3) ❑ Political Committee ■ CHECK IF PC HAS DISBANDED ❑ Committee of Continuous Existence ❑ CHECK IF CCE HAS DISBANDED ❑ Party Executive Committee • Electioneering Communication ■ CHECK IF NO OTHER ELECTIONEERING COMMUNICATION REPORTS WILL BE FILED (5) REPORT IDENTIFIERS Cover Period: From of / 21 / 06 To 02 / 03 / 06 Report Type G2 Report 0 Independent Expenditure Report PI Original ❑ Amendment ❑ Special Election (6) CONTRIBUTIONS THIS REPORT Cash & Checks $ 625.00 (7) EXPENDITURES Monetary Expenditures Transfers to Office Account Total Monetary THIS REPORT $ 841.60 Loans $ 0.00 $ 0.00 Total Monetary $ 625.00 $ 841.60 In -Kind $ 0.00 _ (8) Other Distributions $ 0.00 (9) TOTAL Monetary Contributions To Date _ $ 14,572.67 (10) TOTAL Monetary Expenditures To Date $ 11,180.33 (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) M. Wayne Gebhardt I certify that I have examined this report and it is true, correct, and complete. (Type name) Jeff Horn ❑ Individual ( ly for ✓❑Treasurer ❑ Deputy Treasurer electio g un.) C% Candidate ❑ Chairperson (only for PC, PTY & electioneering commun. organization) '_ X X SI u Signet re r I DS -DE 1 ev. 08/04) CAMPAIGN TREASURER'S REPORT — ITEMIZED CONTRIBUTIONS (1) Name Jeff Horn (2) LID. Number (3) Cover Period 01 / 21 / 06 through 02 / 03 / 06 (4) Page 1 of 2 (5) Date (7) Full Name (Last, Suffix, First, Middle) Street Address & City, State, Zip Code Contributor Type (8) Occupation (9) Contribution Type (10) In -kind Description (11) Amendment (12) Amount (6) Sequence Number 01 / 24 /06 Hartman, John 160 Marion Ln Casselberry FL 32707 I CAS 20.00 1 01 / 24 / 06 Magarian, Gary 808 E Harwood St Orlando FL 32803 I CAS 40.00 2 01 / 24 / 06 Slaymaker, Michael P 0 Box 947752 Maitland FL 32794 I CHE 50.00 3 01 / 24 / 06 Clarkson, David & Jensen, Bruce 4113 Fairview Vista Pt Orlando FL 32804 I CHE 50.00 4 01 / 24 / 06 Woodard, Thomas W. 3705 Lochinvar Ln Orlando FL 32803 I CHE 50.00 5 01 / 24 / 06 Spears, Garrick 346 Mashie Ln Orlando FL 32804 I CHE 50.00 6 01 / 24 / 06 Williams, Brian C. & O'Neil, Craig M. 1318 Maury Rd Orlando FL 32804 I Banker/ promo_ t i on S CHE 100.00 7 02 / 03 / 06 Head, Douglas D. 800 Mayfair Cir Orlando FL 32803 I CITE 100.00 8 DS -DE 13 (Rev. 08/03) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES CAMPAIGN TREASURER'S REPORT — ITEMIZED CONTRIBUTIONS (1) Name Jeff Horn (3) Cover Period (2) I.D. Number 01 / 21 / 06 through 02 / 03 / 06 (4) Page 2 of 2 (5) Date (7) Full Name (Last, Suffix, First, Middle) Street Address & City, State, Zip Code Contributor Type (8) Occupation (9) Contribution Type (10) In -kind Description (11) Amendment (12) Amount (6) Sequence Number Ocasio, Ricky & I CAS 5.00 02 / 03 /06 Clemento, Vincent 1826 D Muscat Ct 9 Kissimmee FL 34741 Martin, Jeffrey I CAS 10.00 02 / 03 / q6 633 A Clayton St Orlando FL 10 32804 Davis, Bill 1 CAS 10.00 02 / 03 / 06 1709 Arlington St Orlando FL 32805 11 Meyer, Jodie I CAS 20.00 02 / 03 / 06 1510 Roosevelt Ave Orlando FL 32804 12 Osborne, Spencer I CHE 100.00 02 / 03 / 06 4814 Cherokee Rose Dr, Orlando FL 13 32808 Baus, Allene I CITE 20.00 02 / 03 / 06 1417 Oriole Ave Orlando FL 14 32803 / / / / DS -DE 13 (Rev. 08/03) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES (1) Name CAMPAIGN TREASURER'S REPORT - ITEMIZED EXPENDITURES Jeff Horn (2) ID. Number (3) Cover Period 01 / 21 / 06 through 02 / 03 / 06 (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 (8) Sequence Number 01 /23 /06 Staples 2774 E. Colonial Dr. Orlando FL 32803 Office Supplies MON $70.94 1 01 /25/06 McGeoch, Ben P 0 Box 660112 Orlando FL 32816 El Clerical MON $75.00 2 01 /26/06 Staples 2774 E. Colonial Dr. Orlando FL 32803 Fax MON $3,65 3 01 /27/ 06 Friends Restaurant 1326 N. Mills Ave. Orlando FL 32803 Meeting MON $26.00 4 01 /30/06 Colonial Photo & Hobby 634 N. Mills Ave. Orlando FL 32803 Photography MON $181.04 5 01 /31 /06 Staples 2774 E. Colonial Dr. Orlando FL 32803 Photocopying & Office Supplies MON $7.54 6 02 /2 ,06 MBA 1308 Lang Ave Orlando FL 32803 Organization Meeting MON $20.00 7 02/03/06 NBL Marketing 1255 Belle Ave. # 125 Winter Springs, FL 32708 Signs MON $457.43 8 DS -DE 14 (Rev. 08/03) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES CONTRIBUTIONS RETURNED (Section 106.07(4)(b), F.S.) (PLEASE TYPE) OFFICE USE ONLY This report applies only to contributions received by any candidate or committee, but retumed to the contributor before being deposited in the campaign account. Candidate Full Name: Jeff Horn ❑ Political Committee ❑ Committee of Continuous Existence Full Address: 1219 West Smith Street, Orlando, Florida 32804 Full Name and Address of Contributor: Real Estate Collaborative, LLC Post Office Box 547037 Orlando, Florida 32854 Amount of Contribution: $ 200.00 Date Received: January 2, 2006 Date Returned: January 3, 2006 Full Name and Address of Contributor: Amount of Contribution: $ Date Received: Date Returned: Full Name and Address of Contributor: Amount of Contribution: $ Date Received: Date Returned: Full Name and Address of Contributor: Amount of Contribution: $ Date Received: Date Returned: 1 CERTIFY THAT I HAVE EXAMINED THIS REPORT AND IT IS TRUE, CORRECT AND COMPLETE. Jeff Horn X Type or Print Name of Candidate, Treasurer or Chairman ature DS -DE 2 (Rev. 08103) FLORIDA DEPARTMENT OF STATE DIVISION OF ELECTIONS CAMPAIGN TREASURER'S REPORT SUMMARY (1) Jeff Horn OFFICE USE ONLY f="Vu4 gar, 1:- 7 Name (2) 1219 West Smith Street Address (number and street) Orlando 1+L 32804 City, State, Zip Code • CHECK IF ADDRESS HAS CHANGED (4) Check appropriate box(es): Q Candidate (office sought): Orlando City Council (3) ID Number: (Dist. 3) ❑ Political Committee ❑ CHECK IF PC HAS DISBANDED ❑ Committee of Continuous Existence ❑ CHECK IF CCE HAS DISBANDED ❑ Party Executive Committee ❑ Electioneering Communication 0 CHECK IF NO OTHER ELECTIONEERING COMMUNICATION REPORTS WILL BE FILED (5) REPORT Cover Period: From 02 / 04 / 06 To IDENTIFIERS 02 / 17 Report / 06 Report Type G3 Expenditure Report rid Original ❑ Amendment ❑ Special Election ■ Independent (6) CONTRIBUTIONS THIS REPORT Cash & Checks $ 3,845.00 (7) EXPENDITURES Monetary Expenditures Transfers to Office Account Total Monetary THIS REPORT $ 1,455.79 Loans $ 0.00 $ 0.00 Total Monetary $ 3,845.00 $ 1,455.79 In -Kind $ 0.00 (8) Other Distributions $ 0.00 (9) TOTAL Monetary Contributions To Date $ 18,417.67 (10) TOTAL $ Monetary Expenditures To Date 12,636.12 (11) CERTIFICATION It is a first degree misdemeanor for any person to falsify a public record (as. 839.13, F.S.) I certify that I have examined this report and it is true, correct, and complete. (Type name) M. Wayne Gebhardt I certify that I have examined this report and it is true, correct, and complete. (Type name) Jeff Horn ❑Individual for QTreasurer D Deputy Treasurer election o un.) ® Candidate X , , )N, ❑ Chairperson (only for PC, PTY & electioneering commun. organization) X -) 1 Sig atur Signature - 1 DS -DE 12 (Rev. 08/04) CAMPAIGN TREASURER'S REPORT — ITEMIZED EXPENDITURES (1) Name Jeff Horn (2) ID. Number (3) Cover Period 02 / 04 / 06 through 02 / 17 / 06 (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 (1 0) Amendment (11) Amount (6) Sequence Number On The Com Web $9.95 02 /07 /06 www.onthecom.net Hosting No Mailing Address Available 1 On The Com Web $22.19 02 /07 /06 www.onthecom.net Domain & No Mailing Address Available E-mail 2 Miracle Copy & Printing Printing $1,294.65 02 p8/06 1203 N Mills Ave Orlando FL 32803 3 Orange County Supervisor Voter $21.00 02/14/06 of Elections Data 119 W Kaley St Orlando FL 32806 4 a Orange County Democratic Voter $108.00 02 /17 /06 Party Data 633 E Colonial Dr Ste 200 Orlando FL 5 32803 / / / / / / DS -DE 14 (Rev. 08/03) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES CAMPAIGN TREASURER'S REPORT — ITEMIZED CONTRIBUTIONS (1) Name Jeff Horn (2) I.D. Number (3) Cover Period 02 / 04 / 06 through 02 / 17 / 06 (4) Page 1 Of 2 (5) Date (7) Full Name (Last, Suffix, First, Middle) Street Address & City, State, Zip Code Contributor Type (8) Occupation (9) Contribution Type (10) In -kind Description (11) Amendment (12) Amount (8) Sequence Number 02 / 08 /06 Liauw, Angelica 3719 Rose Glenn Dr Toledo OH 43615 I Lab Tech CHE 500.00 1 02 / 08 / 06 Liauw, Andreas 2384 Delray Ln Avon, OH 44011 I Pharma- Cist CHE 500.00 2 02 / 08 / 06 Behrens, Mark 1100 S Delaney Ave Orlando FL 32806 I CHE 50.00 3 02 / 10 / 06 C&S Consulting 795 30 St Orlando FL 32806 B Account- ing CHF 500.00 4 02 / 15 / 06 Powers, William 1434 Norfolk Ave Winter Park FL 32789 I CHE 30.00 5 02 / 15 / 06 Salinas, Ric 412 Thunder Ridge Lake In The Hills IL 60156 I Mechanic CAS 100.00 6 02 / 15 / 06 Horn, Jeffrey 1219 W Smith St Orlando FL 32804 I Coach CHE 400.00 7 02 / 15 / 06 The Exchange 11 North Summerlin Ave Orlando FL 32801 B Real. Estate CHE 500.00 8 DS -DE 13 (Rev. 08/03) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES CAMPAIGN TREASURER'S REPORT — ITEMIZED CONTRIBUTIONS (1) Name Jeff Horn (2) I.D. Number (3) Cover Period 02 / 04 / 06 through 02 / 17 / 06 (4) Page 2 of 2 (5) Date (7) Full Name (Last, Suffix, First, Middle) Street Address & City, State, Zip Code Contributor Type (8) Occupation (9) Contribution Type (10) In -kind Description (11) Amendment (12) Amount (6) Sequence Number 02 / 17 /06 Mottolo, Frank 601 Grand St Orlando FL 32805 1 Homeless Shelter Director CHE 15.00 9 02 / 17 / 06 Burket, Pat & Dale 1505 The Oaks Dr Maitland FL 32751 1 Home- maker & Attorney CHE 250.00 10 02 / 17 / 06 WBAYCO LLC #123 1201 8 Vineland Rd Winter Garden FL 34787 B Office Complex CHE 500.00 11 02 / 17 / 06 MINNECO LLC 1201 S Vineland Rd Winter Garden FL 34787 B Apart- ment Building CHE 500.00 12 / / / / / / / / DS -DE 13 (Rev. 08/03) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES FLORIDA DEPARTMENT OF STATE DIVISION OF ELECTIONS CAMPAIGN TREASURER'S REPORT SUMMARY (1) Jeff Horn OFFICE USE ONLY Name (2) 1219 West Smith Street Address (number and street) Orlando FL 32804 `' , -Ii;r i:H1 1 ° ,r City, State, Zip Code ❑ CHECK IF ADDRESS HAS CHANGED (3) ID Number: (4) Check appropriate box(es): ig Candidate (office sought): Orlando City Council (Dist. 3) ❑ Political Committee ❑ CHECK IF PC HAS DISBANDED ❑ Committee of Continuous Existence ❑ CHECK IF CCE HAS DISBANDED ❑ Party Executive Committee ❑ Electioneering Communication ❑ CHECK IF NO OTHER ELECTIONEERING COMMUNICATION REPORTS WILL BE FILED (5) REPORT IDENTIFIERS Cover Period: From 02 / 18 / 06 To 03 / 09 / 06 Report Type G4 2 Original ❑ Amendment ❑ Special Election Report ❑ Independent Expenditure Report (6) CONTRIBUTIONS THIS REPORT Cash & Checks $ 1,386.00 (7) EXPENDITURES THIS REPORT Monetary Expenditures $ 6,434.83 Transfers to Office Account $ 0.00 Loans $ 0.0 0 Total Monetary $ 1,386.00 Total Monetary $ 6,434.83 In -Kind $ 0 . 0 0 (8) Other Distributions $ 0.00 (9) TOTAL Monetary Contributions To Date $ 19,803.67 (10) TOTAL Monetary Expenditures To Date $ 19,070.95 (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) M. Wayne Gebhardt I certify that I have examined this report and it is true, correct, and complete. (Type name) Jeff Horn III electioneerin Individual (o for ❑✓ Treasurer ❑ Deputy Treasurer mm Candidate X 10 0 II electioneering Chairperson (only for PC, PTV & commun. organization) . to - Signature DS -DE 12 (Rev. 08/04) CAMPAIGN TREASURER'S REPORT — ITEMIZED CONTRIBUTIONS (1) Name Jeff Horn (2) I.D. Number (3) Cover Period 02 / 18 / 06 through 03 / 09 / 06 (4) Page 1 of 2 (5) Date (7) Full Name (Last, Suffix, First, Middle) Street Address & City, State, Zip Code Contributor Type (8) Occupation (9) Contribution Type (10) In -kind Description (11) Amendment (12) Amount (6) Sequence Number 03 / 03 /06 Kennedy, Kenneth 10309 Beaverkill Ct, Orlando FL 32817 1 Computer Program- mer CHE 100.00 1 03 / 03 / 06 Wolf, James P & Curtis, Lisa A 611 E Kaley St Orlando FL 32806 I Computer Tech / Teacher CHE 50.00 2 03 / 07 / 06 D. Soto Law Offices, P.A. 809 Irma Ave., Ste 4, Orlando FL 32803 B Attorney CHE 50.00 3 03 / 07 / 06 Chevalier, B. L. 3550 SW 121 Ave Davie, FL 33330 I Retired CHE 500.00 4 03 / 07 / 06 Weiss, Jerry 718 S Lake Formosa Dr, Orlando FL 32803 I CHE 50.00 5 03 / 07 / 06 Stelzner, Doug P 0 Box 3426 Orlando FL 32802 I Invest- ment Broker CHE 200.00 6 03 / 07 / 06 Rothery, Michael 3901 Wren Lane Orlando FL 32803 I Engineer CHE 100.00 7 03 / 07 / 06 Capozzi, Sal 2312 S Brown Ave Orlando FL 32806 1 A/V Tech CAS 100.00 8 DS -DE 13 (Rev. 08/03) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES CAMPAIGN TREASURER'S REPORT -- ITEMIZED CONTRIBUTIONS (1) Name Jeff Horn (2) I.D. Number (3) Cover Period 02 / 18 / 06 through 03 / 09 / 06 (4) Page 2 of 2 (5) Date (7) Full Name (Last, Suffix, First, Middle) Street Address & City, State, Zip Code Contributor Type (8) Occupation (9) Contribution Type (10) In -kind Description (11) Amendment (12) Amount (6) Sequence Number Horn, Jeffrey I CHE 36.00 03 / 07 /06 1219 W Smith St Orlando FL 32804 9 Unique Cleaners B House CHE 50.00 03 / 09 / 06 2509 Citrus Club Cleaners Ln, Orlando 10 FL 32839 Unique Cleaners B House CHE 50.00 03 / 09 / 06 2509 Citrus Club Cleaners Ln, Orlando FL 32839 11 McDaniels, Lisa I CHE 50.00 03 / 09 / 06 P 0 Box 383 Iowa City IA 52244 12 Preston, Alfred I CHE 50.00 03 / 09 / 06 467 Little Aspen Ct, Ocoee 13 FL 34761 / / / / / / DS -DE 13 (Rev. 08/03) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES (1) Name CAMPAIGN TREASURER'S REPORT - ITEMIZED EXPENDITURES Jeff Horn (2) I.D. Number (3) Cover Period 02 / 18 / 06 through 03 / 09 / 06 (4) Page 1 of 2 (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 p Type (10) Amendment (11) Amount (6) Sequence Number 02 /18/06 Friends Restaurant 1326 N Mills Ave Orlando FL 32803 Volunteer Meeting MON $100.00 1 02 /20 /06 Orange County Young Democrats 1415 W Robinson St Orlando FL 32805 Awards Banquet MON $80.00 2 02 /21/06 Staples 2774 E Colonial Dr Orlando FL 32803 Office Supplies MON $22.96 3 02/22/06 McRae's Florist 1814 - A Edgewater Dr Orlando FL 32804 Gift Plant MON $31.95 4 02/24/06 Area 51 Graphics 1717 Minnesota Ave, Unit H Winter Park, FL 32789 Promotional Materials MON $555.49 5 02 /24 /06 Orange County Young Democrats 1415 W Robinson St Orlando FL 32805 Membership MON $25.00 6 03 /02 /06 Staples 2774 E Colonial Dr Orlando FL 32803 Office Supplies MON $358.99 7 03 /04/06 Friends Restaurant 1326 N Mills Ave Orlando FL 32803 Volunteer Meeting MON $55.00 8 DS -DE 14 (Rev. 08/03) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES (1) Name CAMPAIGN TREASURER'S REPORT - ITEMIZED EXPENDITURES Jeff Horn (2) I.D. Number (3) Cover Period 02 / 18 / 06 through 03 / 09 / 06 (4) Page 2 of 2 (g) 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 03 /06 /06 Innovative Printing 4700 Parkway Commerce Blvd Orlando FL 32808 Printing MON $1,763.64 9 03 /07/06 Orange County Supervisor of Elections 119 W Kaley St Orlando FL 32806 Data Access MON $6.00 10 03 p7/06 USPS 1705 Edgewater Dr Orlando FL 32804 Postage MON $35.10 11 03/09/06 Mailtropolis 1429 Dolgner P1 Sanford FL 32771 Mailing MON $3,400.70 12 / / / / / / / / DS -DE 14 (Rev. 08/03) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES FLORIDA DEPARTMENT OF STATE DIVISION OF ELECTIONS CAMPAIGN TREASURER'S REPORT SUMMARY Its Jeff Horn OFFICE USE ONLY Name (2) 1219 smith Street 2006 MAR 222 ng10: 29 Address (number and street) Orlando F 32809 City, State, Zip Code ❑ CHECK IF ADDRESS HAS CHANGED (3) ID NumbH: (4) Check appropriate box(es): 21 Candidate (office sought)_ orlana0 City Council (Diet. 3) D Political Committee ❑ CHECK IF PC HAS DISBANDED ❑ Committee of Continuous Existence ❑ CHECK IF CCE HAS DISBANDED ❑ Party Executive Committee E Electioneering Communication ❑ CHECK IF NO OTHER ELECTIONEERING COMMUNICATOR REPORTS WILL BE FILED (5) REPORT IDENTIFIERS Cover Period: From 03 / 10 / 06 To on / 20 / 06 Report Type Ti 7 Onginal ❑ Amendment 9 Special Election Report 9 Independent Expenditure Report (6) CONTRIBUTIONS THIS REPORT Cash B Checks $ 0.00 (7) EXPENDITURES THIS REPORT Monetary Expenditures $ 732.72 Loans $ o . oo Transfers to Office Account $ 0.00 Total Monetary $ 0.00 Total Monetary $ 732.72 In -Kind $ 0.00 (8) Other Distributions $ 0.00 (9) TOTAL Monetary Contributions To Date $ 19,803.67 (10) TOTAL Monetary Expenditures To Date $ 19,803.67 (11) CERT FICATION Il is a first degree misdemeanor for any person to falsify a public record tss. 839.13, F.SJ_ I certify that I have examined this report and it is true, correct, and complete. M. (Tyte ewe) Wayne Gebhardt I cedify that I have examined this report and it is true, correct, and complete. (Type name) Jeff Horn 4amn ("only ❑D my Treasurer �eaeomaN Si /I 1 / ' 4eeeeceno Pore W tir n,eau, ow a � 7� Sig at t Signature \ DSO€ 12 (Rev /9M4) CAMPAIGN TREASURER'S REPORT -ITEMIZED EXPENDITURES 11)Name Jeff Horn 1211.D. Numb.r 3)CoverPeriod 03 / 10 / 06 Mmugl 03 0 3 06 DO S ge 151 Dab O) Full Name (Lnt. Suffix. Pirate Mp01e) Address City. saa,21. 01 Purpose Mg office gouging bNiun a Candidate) (9) ExY^aitre Type 110) AmeAmendmentCm. Amendment 119 Amount l•l Sequence Stayer Humber 03 /ID /O6 Orange County C Democratic par y 633 8 Colonial Or Ste 100 Orlando FL 32803 Database MON 3104.09 03 /l0 /06 Frank Mottolo Orlando 601 Grand a Ave905 Data Entry MON $52.95 2 03 /10 /06 Staples 2774 Or FL Colonial 32603 Ea0 Photocopying MON $21.25 03 /10/ 06 ItSPS 05 EdgewaterDr Orlando FL 32603 eostage MON $91.26 4 03/14/06 741. Orange Ave Altamonte Springs Di 32714 Party supplies Mox $347.22 03 /20/06 Tap t Dubedreatl Wrap-Up Orlando FL 32804640 W Pan St Meeting MON $115.95 6 or DS -DE 14 (Rev. 013/03) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES CONTRIBUTIONS RETURNED (Section 106.0T(CNb), F.S.) (PLEASE TYPE) OFFICE USE ONLY 20OSHNR24va°:26 This report applies only to contributions received by any candidate or committee, but returned to the contributor before being deposited in the campaign account. 0 Candidate Full Name: Jeff Hom ❑ POIXical Committee ❑ Committee of Continuous Existence Full Address. 1219 West Smith Street Full Name and Address of Contributor: The Melrose Management Group 1600 W Colonial Dr Orlando Florida 32805 Amount of contribution: $ 500.00 Date Received: 03-10-06 Date Returned 03-15-06 Full Name and Address of Contributor: Amount of Contribution: $ Date Received: Date Returned: Full Name and Address of Contributor: Amount of Contribution: S Date Received'. Date Returned'. Full Name and Address of Contributor: Amount of Contribution. S Date Received. Date Returned'. I CERTIFY THAT I HAVE EXAMINED THIS REPORT AND IT Is TRUE, CORRECT AND COMPLETE. Jeff Hom X DS -DE 2 (Rev. 08103) Type or Print,NNaafm/ee of an Mate, Treasurer or Chairman arr Sig ure 1, a citizen hereby LOYALTY OATH CANDIDATES WITH NO PARTY AFFILIATION Isemmsaeseee7OID, Honda alatureq STATE OF FLORIDA (PLEAS OFFICE USE ONLY 2006 JAN 40 P4 2:07 Orange COUNTY PRIn9 Iex ❑ Hnrn FYN Name max Napennmai Last Name of the State of Fronde and of he wiled Stares 0f amens, and a Candidate for public Office do solemnly swear or affirm that I will Support the Odnatrtutidn of the United States and of State or Florida. 1. am OATH OF CANDIDATE haeolmn 0021, Gonda Statutes]. Jeff Horn_ I _ _ a candidate for theofficeor Orlando CitveCommissionmwest omo®e3 m orowunml Office) ldlstri t o- idM N - I am a qualified elector of Orenpe County, Florida. I am qualified femur, under the Constitution and the Laws of Florida to hold me office to which I desire to be nominated Or elected. have qualified for no other public office in the state, the term at which office or any pan thereof mns wnwnent with be office I seek; and I have resigned from any offoe from which I am required to resign pursuant to Section 98.012, Florida Statutes. UNDER CANDIDATE PENALTIES OF PERJURY, I OECIME THATI HAVE AND THAT THE FACTS STATED IN EACH ARERE SIGN HERE U°JI, READ THE FOREGOING LOYALTYOAID AND OATH TRUE. \," OF ke-- OSeptets.,maandid e 1219 Wrest Smith Street 401599-9059 ailing Address Day Phone Fax Number v, Orlando Florida 32804 1-i pee et CID state 2JPC Oay sienna oa.DE 218IR^+. abwl FORM 1 STATEMENT OF FINANCIAL INTERESTS 2005 Please print or type your name, mailing address, agency name, and position below: su"9c tP .i°;° .�.• F :m Pfli1 LAST NAME -FIRST NAME MIDDLE NAME : kAtO C2,1\ '5-�r�F F R'c-,--( �V /4"..t--0 FOR OFFICE USE ONLY: MAILING ADDRESS : t z- t C1 NA1 S t t. _.-� 1-i S --c" ID Code ID No. Conf. Code P. Req. Code 0R.\.-a0n0 32-30Lk 0k,11,.xe, CITY : ZIP : COUNTY : C -z—, `c D�z.d,unra NAME OF AGENCY : e NAME OF OFFICE OR POSITION HELD OR SOUGHT : PDF 2005 OR ❑ NEW EMPLOYEE OR APPOINTEE CHECK ONLY IF CANDIDATE DISCLOSURE PERIOD: THIS STATEMENT REFLECTS YOUR A FISCAL YEAR. PLEASE STATE BELOW DECEMBER 31, 2005 MANNER OF CALCULATING REPORTABLE THE LEGISLATURE ALLOWS FILERS REQUIRES FEWER CALCULATIONS, Instructions for further details). PLEASE `"'BOTH PARTS OF THIS SECTION MUST BE COMPLETED'" FINANCIAL INTERESTS FOR THE PRECEDING TAX YEAR, WHETHER BASED WHETHER THIS STATEMENT IS FOR THE PRECEDING TAX YEAR ENDING QE 0 SPECIFY TAX YEAR IF OTHER THAN THE CALENDAR INTERESTS: THE OPTION OF USING REPORTING THRESHOLDS THAT ARE ABSOLUTE OR USING COMPARATIVE THRESHOLDS, WHICH ARE USUALLY BASED STATE BELOW WHETHER THIS STATEMENT REFLECTS EITHER (check THRESHOLDS DB Er DOLLAR ON A CALENDAR YEAR OR ON EITHER (check one): YEAR: DOLLAR VALUES, WHICH ON PERCENTAGE VALUES (see one): VALUE THRESHOLDS • COMPARATIVE (PERCENTAGE) r PART A -- PRIMARY SOURCES OF INCOME NAME OF SOURCE OF INCOME [Major sources of income to the reporting person] SOURCE'S ADDRESS DESCRIPTION OF THE SOURCE'S PRINCIPAL BUSINESS ACTIVITY 5 t` f - 4\0 L- v'(. D t t w W twin- oc. S"r r cA-4 NHS -R,.o eISSM_014,4 PART B - SECONDARY SOURCES NAME OF BUSINESS ENTITY OF INCOME [Major customers, clients, NAME OF MAJOR SOURCES OF BUSINESS' INCOME and other sources of income to businesses ADDRESS OF SOURCE owned by the reporting person] PRINCIPAL BUSINESS ACTIVITY OF SOURCE PART C -- REAL PROPERTY [Land buildings owned by the reporting person] FILING INSTRUCTIONS for when and where to file this form are locat- ed at the bottom of page 2. INSTRUCTIONS on who must file this form and how to fill It out begin on page 3. OTHER FORMS you may need to file are described on page 6. "49— CE FORM 1 - Eff. 1/2006 (Continued on reverse side) PAGE 1 PART D --- INTANGIBLE PERSONAL PROPERTY [Stocks, bonds, certificates of deposit, etc.] TYPE OF INTANGIBLE BUSINESS ENTITY TO WHICH THE PROPERTY RELATES PART E — LIABILITIES [Major debts] NAME OF CREDITOR ADDRESS OF CREDITOR -�J PART F — INTERESTS IN SPECIFIED BUSINESSES [Ownership or positions In certain types of businesses] BUSINESS ENTITY # 1 BUSINESS ENTITY # 2 BUSINESS ENTITY # 3 NAME OF BUSINESS ENTITY ADDRESS OF BUSINESS ENTITY PRINCIPAL BUSINESS ACTIVITY POSITION HELD WITH ENTITY 1 OWN MORE THAN A 5% INTEREST IN THE BUSINESS NATURE OF MY OWNERSHIP INTEREST IF ANY OF PARTS A THROUGH F ARE CONTINUED ON A SEPARATE SHEET, PLEASE CHECK HERE ❑ SIGNATURE (required): WHAT TO FILE: After completing all parts of this form, including signing and dating it, send back only the first sheet (pages 1 and 2) for filing. If you have nothing to report in a particular section, you must write "none" or "n/a" in that section(s). Facsimiles will not be accepted. NOTE: MULTIPLE FILING UNNECESSARY: Generally, a person who has filed Form 1 for a calendar or fiscal year Is not required to file a second Form 1 for the same year. However, a candidate who previously filed Form 1 because of another public position must at least file a copy of his or her original Form 1 when qualifying. DATE SIGNED (required): t3.O(Q FILING INSTRUCTIONS: WHERE TO FILE: If you were mailed the form by the Commission on Ethics or a County Supervisor of Elections for your annual disclosure filing, return the form to that location, Local officers/employees file with the Supervisor of Elections of the county in which they perma- nently reside. (If you do not permanently reside in Florida, file with the Supervisor of the county where your agency has its headquarters.) State officers or specified state employees file with the Commission on Ethics, P.O. Drawer 15709, Tallahassee, FL 32317-5709; physical address: 3600 Maclay Boulevard, South, Suite 201, Tallahassee, FL 32312. Candidates file this form together with their qualifying papers. To determine what category your position falls under, see the "Who Must File" instructions on page 3. WHEN TO FILE: Initially, each local officer/employee, state officer, and specified state employee must file within 30 days of the date of his or her appointment or of the beginning of employ- ment. Appointees who must be confirmed by the Senate must file prior to confirmation, even If that is less than 30 days from the date of their appointment. Candidates for publicly -elected local office must file at the same time they file their qualifying papers. Thereafter, local officers/employees, state officers, and specified state employees are required to file by July 1st following each calendar year in which they hold their posi- tions. Finally, at the end of office or employment, each local officer/employee, state officer, and specified state employee Is required to file a final disclosure form (Form 1F) within 60 days of leaving office or employment. CE FORM 1 - Eff. 1/2006 PAGE 2