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HomeMy Public PortalAbout2012District4ShawenOFFICE USE ONLY STATEMENT OF CANDIDATE (Satan i06.023, F.S.) (Please Type) 2011 JUL 28 m10:31 Brje .r; c. S vveh, candidate for the office of CQ m rn i SS I. o ra e r 21' have received, read and understand the requirements of Chapter 106, Florida Statutes. Signature of Candidate 67/2S/2o II 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 filed. 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 $1,000, (ss. 106.19(1Xc),106265(1), Florida Statutes): APPOINTMENT OF CAMPAIGN TREASURER AND DESIGNATION OF CAMPAIGN DEPOSITORY FOR CANDIDATES (Section 106.021(1), F.S.) (PLEASE PRINT OR TYPE) NOTE: This form must be on file with the qualifying officer before opening the campaign account. 2011 C- F ►) p 12 µ F, OFFICE USE ONLY 1. CHECK APPROPRIATE BOX(ES): 0 Initial Filing of Form RI Re -filing to Change: 21 Treasurer/Deputy El Depository 0 Office 0 party 2. Name of Candidate (in this order: First, Middle, Last) Qrv(.e Er cc Slnawe 3. Address (include post office box or street, city, state, zip code) 6Z`t l to ej„i"y ,v‘ Svc O r to k ck o,, ri. 3 2$ 0 1 4. Telephone (-to/ )44.5-0011 5. E-mail address kl4kwetAct, i1 %ct14.0,,c 6. Office sought (include district, circuit, group &Amber) C , t -y Govv1 vt, 5 51',.. t.1,.. p,S -tip- 1- L t- ; 9 7. If a candidate for a nonpartisan office, check if applicable: ill My intent is to run as a Write -In candidate. 8. If a candidate for a partisan office, check Write -In ;,1 No Party Affiliation block ■ y and fill in name of party as applicable: My intent is to run as a Party candidate. 9. I have appointed the following person to act as my ® Campaign Treasurer D Deputy Treasurer 10. Name of Treasurer or Deputy Treasurer M.Gllssa DcAwIn Movie 11. Mailing Address / Ge kcra` D I'vtvy 12. Telephone ( ) 13. City yy 0 r bati.uo 14. County Grcrrtcif. 15. State (" L . 16. Zip Code 32q02- 17. E-mai address 18. I have designated the following bank as my 10 Primary Depository • Secondary Depository 19. Name of Bank F0.v^rwinots C e.r,1i`1LL V v\ � ov\ 20. Address �^ ? O75 Ipp vr� 1 -An Al c,t`ayq I vu, 1 21. City II C)v-Lv‘do 22. County Gv-avto2e 23. State F1. 24. Zip Code 3ZB 2. G UNDER PENALTIES OF PERJURY, I DECLARE THAT I HAVE READ THE FOREGOING FORM FOR APPOINTMENT OF CAMPAIGN TREASURER AND DESIGNATION OF CAMPAIGN DEPOSITORY AND THAT THE FACTS STATED IN IT ARE TRUE. 25. Date /C/lo/ l/ 26. Signature of Candidate X 27. Treasurer's Acceptance of Appointment (fill in the blanks and check the appropriate block) I, nil e ! i ,-sQ,o t) C toy o iY , (0 i--1 ,0 1 , do hereby accept the appointment (Please Print or Type Name) designated above as: 12 Campaign Treasurer 0 Deputy Treasurer. I D- In -- 11 X _, Date Signature of Campaign reasurer or Deputy reasurer DS -DE 9 (Rev. 10/10) Rule 18.2.0001, F.A.C. FLORIDA DEPARTMENT OF STATE DIVISION OF ELECTIONS CAMPAIGN TREASURER'S REPORT SUMMARY (1) 13r ��--- vice 4� . s-kawev1 OFFIC r pmI'?° , Name (2) 2.'i .L ex I t/i5-vvti ' Gl je w Address (number and street) Dv -14.,.,_ 0; Ff. ? gOI. City, State, Zip Code m_ (3) ID Number: • CHECK IF ADDRESS HAS CHANGED (4) Check appropriate box(es): 7-- w Candidate (office sought): ', t'� i.----L' In^ 11 ( S r o In 9 r D t' T r c ❑ Political Committee ❑ Committee of Continuous Existence El ❑ CHECK IF PC HAS DISBANDED CHECK IF CCE HAS DISBANDED ❑ CHECK IF NO OTHER ELECTIONEERING COMMUNICATION REPORTS WILL BE FILED • Party Executive Committee ❑ Electioneering Communication (5) REPORT IDENTIFIERS Cover Period: From 7/ 0 1 / 11 To 9/ Report 20 / I I Report Type Q 3 Er Original ❑ Amendment ❑ Special Election ❑ Independent Expenditure Report (6) CONTRIBUTIONS THIS REPORT Cash & Checks $ 5 _ • 0 .00 (7) Monetary Expenditures Transfers Account Total Monetary EXPENDITURES THIS REPORT $ � � � 1-1- 0 Loans $ to Office $ Total Monetary $ $ 33'1, q a In -Kind $ (8) Other Distributions $ (9) TOTAL Monetary Contributions To Date $ ccc/ . 0 0 (10) TOTAL Monetary Expenditures To Date $ 3- LL.'to (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) I certify that I have examined this report and it is true, correct, and complete. (Type name) ❑ Individual (only for El Treasurer ❑ Deputy Treasurer electioneering commun.) X `-tY;),2.14 a. a.A .. -di VY) cot0 M X Candidate ❑ Chairperson (only for PC, PTY & electioneering commun. organization) (4--, Signature Signature DS -DE 12 (Rev. 08/04) CAMPAIGN TREASURER'S REPORT — ITEMIZED CONTRIBUTIONS (1) Name - G c -� (r1;l v+.' e v- 3) Cover Period 7 a) / H through (2) I.D. Number G3 I I I (4) Page - of (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 f::'' , FY T z. 703 / '., / 'kw, i ,-V 213 'arI? Lt. OrI.,r.d,,, F{. 25; D6 M0 2 / / / / / / / / / / / / DS -DE 13 (Rev. 08/03) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES CAMPAIGN TREASURER'S REPORT — ITEMIZED EXPENDITURES (1) Name K r"Ld � (i ' 6i -1.4,4A)( ' ;? /',.,� (2) I.D. Number (3) Cover Period / 0 i / / 1, through 4? / / /1 (4) Page 4 of -52 (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 (s) Sequence Number / l�/r / .rr�44)11 C -L 13b Ce C- 60A 0rIa..r) 0CI Lot.603 O : 41 •;'',1:.-1) L-LNutildactoa4 PC.L) JCS, 00 ci q1 ,11 / 135 r C,�r 01 v(.. Cr / do FI 608 03 a)I' �- .1d vault/ ,(w�,J/�`///� 1 u q /03/ii Pace:ria.t. i 67 r 1 � t IrID '6r.0-1166/1 ,1n61:. .., cl3 71716 -1 y ,',:!..0:j.) 4441 itaAixtii p C ; I, 75 ii q /0.5111 P arse 8' wZ.. G , Ga 6,3/14 Or (o n d� 0 (.:1 C .wnpl:X..f 0 i Man 10 •7 3 1 q/V 'WY I I a ir�, roof Litt Ise .) 4w^ j^i 1 P MM�..+Lu 6 A� Y ot. (9r)culd. 0 4-i 03 Pet 1 f ` . .,.Y, ��' d� {„ .. E» i �. ti Cl.) 6b, 00 4 ' 65 k;. C.r laxao 0 39, 0 r :� 1. =). q 7/ II P�.:r a iti of • Grla.f . 0(6, 0-C.I op ii Q_': � ki /./ DS -DE 14 (Rev. 08/03) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES , ,, CAMPAIGN TREASURER'S REPORT - ITEMIZED EXPENDITURES K:� (1) Name c e (2) I.D. Number 3 (3) Cover Period .12._/ %� / l i I through ' /,iQ / / i (4) Page / of Q (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 19W If Fe. Cx s .. . , 47 c insor) &-.,.., Or1 ^ b -Fl 3aEni �rirn�� f , ad ver-0€ d}'i , 3,�3 _ I e///r J2olicLr lrve S{arC3, Inc. l rL4-Sala. l.n/iniol.. ,lr Orlando473p28O OWice., Stppir . 'YID A a, If 3 Z. Mill O i'C<v,fie `t arc. `. 81 a..'r;1,. ( CC61Oni L. fir: O rla-nol o - - 13a60.2) D44:'''e' S pit Mon 7,0 I M / i r~ cai rco nd3 l3,5 (A)C. ei ral 1 iici., OH c Ind 0 -,.4. 30zE 03 Pet y CA)(. a‘ to;i4-)ct.:rau x OC , ii) '4Q, 00 9 12b/I1 Cal r.i01.v); 3 CL? I W CLn -rai rdt1. Or/o-recto 0 & O3 'k4i CI:i i) tt,.)i{: ' Y;`.t.t ,..L ,` U) W 00 4r 6 /Il l q02. .rod. /('^.. ::- 4(.cx ' u.)1trio r..„. . j• i.t. . ' ►, Hw r k;,jjirlityi .) : 131474 �.rz�rY� po...rr r� nr) 0 r.) 8j 1(-1( (7- 8 / O(l1 n'-w.Dor . Li , 101,305 (A.nivvt & 151vct Or/ a i 3,2t 1 ii Ca1->>)ac./ /1 lei «)e/. Itylo r, 3, 83 7 q'/ 11 Fe,:. ex ' :e. J -I-1 L aD n tan n 0- ia4101o =1 (ZS 0 Pr i fli.' it's Vert in M o n x.3,43 DS -DE 14 (Rev. 08103) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES FLORIDA DEPARTMENT OF STATE DIVISION OF ELECTIONS CAMPAIGN TREASURER'S REPORT SUMMARY (1) Bru e S vtckv ev. OFFICE USE ONLY Name, (2) 2(1 Lexit„ jhvt Avg Address (number and street) 0 Lied, n , i-1. 3-2-101 City, State, Zip Code El CHECK IF ADDRESS HAS CHANGED (4) Check appropriate box(es): El Candidate (office sought): C t ry rW l' SS (3) ID Number: 1q t_ CON -et,- D i`S trt'T "t • Political Committee 0 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 to / U ( / t ( To ["1 / 3 1 / t I Report Type 0 Zt 0 Original ❑ Amendment ❑ Special Election Report ■ Independent Expenditure Report (6) CONTRIBUTIONS THIS REPORT Cash & Checks $ (7) I, Monetary Expenditures Transfers Account Total Monetary EXPENDITURES THIS REPORT $ i` i) Loans $ Ct. 60 , 00 to Office $ Total Monetary $ $ u &) , /D In -Kind $ (8) Other Distributions $ (9) TOTAL Monetary Contributions To Date $ 9, 6O 00 (10) TOTAL Monetary Expenditures To Date $ 3i,fi, (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. rY ! l (Type name) M I I5Sa au-Jv f1€ I certify that I have examined this report and it is true, correct, and complete. c (Type name) NU . e S V -,,c,1, W e v- ❑ Individual (only for 1:1 Treasurer ❑ Deputy Treasurer electioneering commun.) X etQyi,k_ -,tw-fi(f)kr,-,(0.Lts to Candidate ❑ Chairperson (only for PC, PTY & electioneering common, organization) X 1 Signature Signature DS -DE 12 (Rev, 08/04) CAMPAIGN TREASURER'S REPORT ITEMIZED CONTRIBUTIONS ('I) Name Br.LJC€ S tT\Ct �e h 3) Cover Period / ©! / I II through ! a. (2) I.D. Number / l (4) Page of (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 1 if / f) 0! a .i r� � �}' .l ► >U :, '' : ,,^Y ac.:. 1 I �' v _, Drrci)V7 pia mod, Cam -6 - Cwt p10 Loan go. 00 I / / / / / I / / / / / / / DS -DE 13 (Rev. 08/03) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES CAMPAIGN TREASURER'S REPORT - ITEMIZED EXPENDITURES rn (1) Name 3 iU ce C lj wek\ (2) I.D. Number fi (3) Cover Period /U / U / / // through / /3 / / /1 (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 Cal •r Inca 5 �'.i` e. ' 1 �- 12°.:r) Or l ° El, oe /d /li/ f,! I✓Qrr ;r) 1.3 1J :r (AP ' Orl r 5 ate, w / t' r .,i ji vul, OH04CdD , ,„A:n. 03 P . ef14310 u.):' ci..m...toaI J�f,,j Li c, o0 2 r• /0 /v�o4/ II i nu; f\:! ].' 'fired .t . 0 it 13 LA), r',` .r r I raj vcc . Or; -'t I, ,3a803 P12. 4- Co t,),q4c .rc a,. fM_ v v 6 0, OD 40...t -,e Gam. (3 re.a dk )1 Drip-, . 2 ;-/ Jge ] I (21.i ,n i , Ike) r he.� r. , L I / /07/1! A-a)rw;no C`ed if LtA:on I L) . n- Qr!a ) o r" 1 %3Q8'03 )0 [2 - ? t,c.) PAL 0, /a %,3/1l c a 'JCw wool CrI ; ; C,(v': v 1`3,.5 C) (/'ea,,.I', .i X;), /v CI , q 4 , _, .:; J.. to . .. x,14 ,I "-' 1 ., 0,ir Inds Cre.1+ [ini0h ., 1 :/c/ Orc...r= 0 l3sa::)3 P • c i. sio _ 0 . 1 /OR, /3'1 1-0u r L 'n;7.l.d ':TJ ,.. n at) 135 W , C e_r i). I I2-1 v.cil „ Or,' 0 t=l cx,, 'U3 w p , a a . , 'r r r pp „,7 Q 00 y DS -DE 14 (Rev. 08/03) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES Alternative Method Affidavit (Please Type) OCT 21 A I certify that I intend to qualify by the alternative method as a candidate for the office of C ify Cornm,ssioner DI '44 4, (include district, circuit, group or seat numbers) as a: Partisan Candidate, Member of the Party JZI No Party Affiliation Candidate (formerly independent) Nonpartisan Candidate (includes Judicial offices) Under penalties of perjury, .l.declare that I have read the foregoing affidavit and that the facts stated in :it are true. B ry e ShoLweh Print Name of Candidate Signature of Candidate G211 Lex�Wrj-otA Ave, Residence Address (do not use post office box) riAv\dC7 F(o'riaq 32801 City State . Zip Code (407)11c15--oCl2. ( ) Day Phone Fax Number AFFIDAVIT OF FINANCIAL HARDSHIP r V C e. 1 l et. W e v1 , a candidate for the office of Comft, I55C(iV r do hereby certify, pursuant to Section 99.093, Florida Statutes, that I am unable to pay the 1% election assessment to qualify for nomination or election to public office because paying the assessment would be an undue burden on my personal financial resources or on the financial resources available to me. UNDER PENALTY OF PERJURY, I DECLARE THAT I HAVE READ THE FOREGOING AND THAT IT IS A TRUE AND CORRECT STATEMENT. Date Signature of Candidate 62-4 Leyv9-1-oo (Olt vvlctv,d0 F"l �2 AN 1 Address of Candidate 4U AFFIDAVIT OF UNDUE BURDEN (Section 99.097(4), Florida Statutes) IMPORTANT: Paying signature gatherers will preclude or invalidate the filing of an undue burden oath. Section 99.097(6), Florida Statutes, provides: (a) 1f any person is paid to solicit signatures on a petition, an undue burden oath may not subsequently be filed in lieu of paying the fee to have signatures verified for that petition. (b) If an undue burden oath has been filed and payment is subsequently made to any person to solicit signatures on a petition, the undue burden oath is no longer valid and a fee for all signatures previously submitted to the supervisor of elections and any submitted thereafter shall be paid by the candidate, person, or organization that submitted the undue burden oath. If contributions as defined In s. 108.011 are received, any monetary contributions must flEel be used to reimburse the supervisor of elections for any signature verification fees that were not paid because of the filing of the undue burden oath. (Note: The second sentence in (b) applies only when payment is made to a signature gatherer after an undue burden oath had been filed.] rwtr r****+t*** klariInt******* *****#MItrntrr **** r,w,wrr<****, **#,*, r****tr************* r******. I certify under oath that I intend to qualify) as a candidate for the office of V-1cu o C4 (aw,w\s 5 ov+eir Pf51-rt°J and that I am unable to pay the fee for verification of petition signatures for that office without imposing an undue burden on my personal resources or on resources otherwise available to me. x pp 1 �-�f Brue c ciw i Signature of Candidate Print Candidate's Name Address City State 32J0► Zip (407) Lfcts -GOI2 Telephone Number State of Florida County of 0 r a vt u1 e -- Sworn to (or affirmed) and subscribed before me this / 5 day of IU ') , by (2-U C ` itit lit) t Personally Known: or Produced Identification: Type of identification Produced: FLO C . D . K -f 20.1 Signature of Notary - ublic - State T Florida Print, Type or Stamp Commissioned Name of Notary Public '"°'9, DENISE HOLDRIDGE MY COMMISSION # DD947618 'co":" EXPIRES: February 03; 2014 r I. NQIary Dumont Assoc. Co. _, _, _ FLORIDA DEPARTMENT OF STATE DIVISION OF ELECTIONS CAMPAIGN TREASURER'S REPORT SUMMARY e. < OFFICE USE ONLY . ,-�, F- Name (2) (--;:.2 Li 1_P\/,n fuIA yVc , Address (number ad street) UN-(ai,do I F l , z, ? YG i City, State, Zip Code • CHECK IF ADDRESS HAS CHANGED (3) ID Number: (4) Check 12. appropriate box(es): I i Candidate (office sought): Li* 14 v, GAO L i *% 6-4 ley‘ AAA SS i ovI e r C)' 5 r J- '119 • Political Committee 0 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 �t I et /12_ To C 1 / ( 2. / 12. Report Type 1• R Original ❑ Amendment ❑ Special Election Report ❑ Independent Expenditure Report (6) CONTRIBUTIONS THIS REPORT Cash & Checks $ (5. 00 (7) EXPENDITURES THIS REPORT Monetary Expenditures $ 0100 Loans $ 0. C C) Transfers to Office Account $ 0.00 Total Monetary $ Ca, 00 Total Monetary $ 0, (3G In -Kind $ 0, CQ _ (8) Other Distributions $ (9) TOTAL Monetary Contributions To Date $ 9‘0,00 (10) TOTAL Monetary Expenditures To Date $ 460.00 (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. A (Type name) McI,S5a. Dc.,,,,,, I`Ao1i I certify that I have examined this report and it is true, correct, and complete. (Type name) 13YU(,-2 5if,6.W-e\f‘ ❑ electioneering X Individual (only for commun,) L .s Treasurer L NA. ❑ IT) Deuty Treasurer Candidate ❑ Chairperson (only for PC, PTY & electioneering commun. organization) x i-'. . ...4„._________________ Signature Signature DS -DE 12 (Rev. 08/04) CAMPAIGN TREASURER'S REPORT — ITEMIZED EXPENDITURES (1) Name E y vi c e S h a w e iA (2) I.D. Number (3) Cover Period 01 / C 1/ I Z through 6/ / 02 OZ (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) (8) Expenditure Type (10) Amendment (11) Amount (6) Sequence Number ozjc ,a @rvie Shuwen G:14 Lex+1•14a4N otve. G y L (j H. 325701 RelUvir. of 1 u 4 h I ON? X16), On 1 / / / / / / / / / / / / / / DS -DE 14 (Rev. 08/03) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES