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Home My Public Portal AboutCampaign Treasurer's Report (G-1)CAMPAIGN TREASURER'S REPORT SUMMARY (1) OFFICE USE ONLY Name (2) Address (number and street) City, State, Zip Code Check here if address has changed (3)ID Number: (4)Check appropriate box(es): Candidate Office Sought: Political Committee (PC) Electioneering Communications Org. (ECO) Check here if PC or ECO has disbanded Party Executive Committee (PTY) Check here if PTY has disbanded Independent Expenditure (IE) (also covers an Check here if no other IE or EC reports will be filed individual making electioneering communications) (5) Report Identifiers Cover Period: From / / To / / Report Type: Original Amendment Special Election Report (6)Contributions This Report (7)Expenditures This Report Monetary Expenditures Cash & Checks $ , , . $ , , . Loans $ , , . Transfers to Office Account $ , , . Total Monetary $ , , . Total Monetary $ , , . In-Kind $ , , . (8)Other Distributions $ ,, . (9)TOTAL Monetary Contributions To Date (10)TOTAL Monetary Expenditures To Date $ , , .$ , , . (11) Certification It is a first degree misdemeanor for any person to falsify a public record (ss. 839.13, F.S.) I certify that I have examined this report and it is true, correct, and complete: (Type name) (Type name) Individual (only for IE Treasurer Deputy Treasurer Candidate Chairperson (only for PC and PTY) or electioneering comm.) X X Signature Signature DS-DE 12 (Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS By City Clerk Shaniqua "Shan" Rose P.O. Box 550163 Orlando, FL 32855 2021D5002 4 District 5, Orlando City Commissioner G-1 4 4 7 248 82 3 000 00 10 248 82 800 00 1 275 06 0 00 1 275 06 22 621 96 0 00 6 585 65 09 01 21 09 30 21 F74F19AA-230F-4582-AF1D-4268DB1CCDE9 10/02/21 - 09:28:49 10/02/21 - 09:28:49 CAMPAIGN TREASURER’S REPORT – ITEMIZED CONTRIBUTIONS (1) Name (2)I.D. Number (3)Cover Period / / through / / (4) Page of (5) (7) (8) (9) (10) (11) (12) Date Full Name (6) (Last, Suffix, First, Middle) Sequence Street Address & Contributor Contribution In-kind Number City, State, Zip Code Type Occupation Type Description Amendment Amount / / / / / / / / / / / / / / DS-DE 13 (Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES Shaniqua "Shan" Rose 2021D5002 09 209 12 09 Zoe Colon Individual Associate Director Check $50.001 Individual retired Check $20.212 Individual truck driver Check $20.213 Individual decorator Check $20.214 Individual retired Check $20.215 Individual counselor Check $20.216 Individual retired Check $20.217 01 21 30 21 03 21 09 03 21 09 06 21 09 06 21 09 06 21 09 09 21 09 09 21 273 Muscogee Ln Orlando, FL 32825 Ronaa Ali 545 Vern Drive Orlando, FL 32805 Gary Leonard 3113 Herbert Lane Orlando, FL 32805 Beverly Shatteen 300 W. Washington Street Orlando, FL 32805 Shante Munns 3701 lasson st Orlando, FL 32835 crystal gibbs 2015 pine st Orlando, FL 32805 308 N. Lakeland Avenue Orlando, FL 32805 Latoya Jones CAMPAIGN TREASURER’S REPORT – ITEMIZED CONTRIBUTIONS (1) Name (2)I.D. Number (3)Cover Period / / through / / (4) Page of (5) (7) (8) (9) (10) (11) (12) Date Full Name (6) (Last, Suffix, First, Middle) Sequence Street Address & Contributor Contribution In-kind Number City, State, Zip Code Type Occupation Type Description Amendment Amount / / / / / / / / / / / / / / DS-DE 13 (Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES Shaniqua "Shan" Rose 2021D5002 09 309 12 09 Rodney Echols Individual Marketing Check $20.218 Individual chaplain Check $20.219 Individual self- employed Check $1,000.0010 Individual Consultant Check $500.0011 Individual self- employed Check $50.0012 Individual sales Check $20.2113 Individual home-maker Check $20.2114 01 21 30 21 09 21 09 08 21 09 09 21 09 11 21 09 13 21 09 12 21 09 12 21 3050 C R Smith Apt 917 Orlando, FL 32805 Spanser Polica 259 Palm Park Circle Longwood, FL 32779 Brendan Rose 19815 Horace Harding Expy Fresh Meadows, FL 11365Kevin Lewis 618 E South Street Suite 500 Orlando, FL 32801 Shaquisha Brown 5402 Karen Court Orlando, FL 32811 Shalor Brown 5402 Karen Court Orlando, FL 32811 2122 Piedmont St Orlando, FL 32805 Andre Smart CAMPAIGN TREASURER’S REPORT – ITEMIZED CONTRIBUTIONS (1) Name (2)I.D. Number (3)Cover Period / / through / / (4) Page of (5) (7) (8) (9) (10) (11) (12) Date Full Name (6) (Last, Suffix, First, Middle) Sequence Street Address & Contributor Contribution In-kind Number City, State, Zip Code Type Occupation Type Description Amendment Amount / / / / / / / / / / / / / / DS-DE 13 (Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES Shaniqua "Shan" Rose 2021D5002 09 409 12 09 Miguel Magione Individual Sales Check $20.2115 Individual cook Check $20.2116 Individual Manager Check $100.0017 Individual self- employed Loan $3,000.0018 Business graphic InKind campaign shirts $200.0019 Individual self- employed InKind Facebook Ads $600.0020 Individual home-maker Check $20.2121 01 21 30 21 12 21 09 15 21 09 16 21 09 20 21 09 14 21 09 30 21 09 20 21 1301 W Robinson St Orlando, FL 32805 Lonnie Leonard 3113 Herbert lane orlando, FL 32805 Michelle Birmingham 3007 Whimsical Lane Kissimmee, FL 34744 Shaniqua Rose 3239 Old Winter Garden, Suite 10 Orlando, FL 32805 Cynthia Kelty 5533 Telipa Drive Orlando, FL 32839 Aja Warner 5102 balboa st Orlando, FL 32808 1700 34th Street St. Petersbnurg , FL 33711 Kustom Kyngz CAMPAIGN TREASURER’S REPORT – ITEMIZED CONTRIBUTIONS (1) Name (2)I.D. Number (3)Cover Period / / through / / (4) Page of (5) (7) (8) (9) (10) (11) (12) Date Full Name (6) (Last, Suffix, First, Middle) Sequence Street Address & Contributor Contribution In-kind Number City, State, Zip Code Type Occupation Type Description Amendment Amount / / / / / / / / / / / / / / DS-DE 13 (Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES Shaniqua "Shan" Rose 2021D5002 09 509 12 09 Audrey Hunt Individual engineer Check $20.2122 Individual truck driver Check $20.2123 Individual property manager Check $20.2124 Individual retired Check $20.2125 Individual retired Check $20.2126 Individual self- employed Check $50.0027 Individual retired Check $50.0028 01 21 30 21 20 21 09 20 21 09 20 21 09 20 21 09 20 21 09 22 21 09 22 21 2771 ELmhurst st Orlando, FL 32810 Cedric Harris 3113 Herbert Lane Orlando, FL 32805 Jay Williams 1308 W Concrod St Orlando, FL 32805 Mae Chester 1100 Bethune Dr Orlando, FL 32805 Valerie Campbell 18 Hudson St Bangor, ME 04401 Pat Roberts 35 Willow Drive Orlando, FL 32807 562 Hartley St Orlando, FL 32805 Mary Longstreet CAMPAIGN TREASURER’S REPORT – ITEMIZED CONTRIBUTIONS (1) Name (2)I.D. Number (3)Cover Period / / through / / (4) Page of (5) (7) (8) (9) (10) (11) (12) Date Full Name (6) (Last, Suffix, First, Middle) Sequence Street Address & Contributor Contribution In-kind Number City, State, Zip Code Type Occupation Type Description Amendment Amount / / / / / / / / / / / / / / DS-DE 13 (Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES Shaniqua "Shan" Rose 2021D5002 09 609 12 09 Crystal Rose Individual manager Check $100.0029 Individual School Administrato r Check $20.2130 Individual retired Check $50.0031 Individual Museum Director Check $100.0032 Individual pastor Check $20.2133 Individual welder Check $20.2134 Individual retired Check $20.2135 01 21 30 21 22 21 09 21 21 09 22 21 09 23 21 09 24 21 09 24 21 09 24 21 118 Cassino Way Kissimmee, FL 34758 Lawrence Johnson PO Box 250275 New York, NY 10025 Waynetta Johnson 1500 Fort Meade Pl Kissimmee, FL 34759 Pasha Baker PO Box 544 Sanford, FL 32772 John Weyrick 2852 W Hardwood St Orlando, FL 32805 Jabez Park 7101 Presidents Dr Ste 350 Orlando, FL 32809 1440 Pine Hills St orlando, FL 32805 Tawana Gary CAMPAIGN TREASURER’S REPORT – ITEMIZED CONTRIBUTIONS (1) Name (2)I.D. Number (3)Cover Period / / through / / (4) Page of (5) (7) (8) (9) (10) (11) (12) Date Full Name (6) (Last, Suffix, First, Middle) Sequence Street Address & Contributor Contribution In-kind Number City, State, Zip Code Type Occupation Type Description Amendment Amount / / / / / / / / / / / / / / DS-DE 13 (Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES Shaniqua "Shan" Rose 2021D5002 09 709 12 09 Anits Gibbs Individual retired Check $20.2136 Individual retired Check $20.2137 Individual contractor Check $100.0038 Business Construction Check $250.0039 Individual sales Check $20.2140 Individual retired Check $20.2141 Individual retired Check $20.2142 01 21 30 21 24 21 09 24 21 09 24 21 09 26 21 09 26 21 09 26 21 09 26 21 5402 Karen court Orlando, FL 32808 Winston Griffin 1200 willow bend circle Orlando, FL 32808 Jessica Burns 832 Driver Ave Winter Park, FL 32789 R L Burns Inc. 1203 W Gore St, Orlando, FL 32805 Orlando, FL 32805 Latasha Cooper 1516 Guinyard Way Orlando, FL 32805 Pearl Redding 320 N Tampa Ave Orlando, FL 32805 508 South Cottage Hill Rd Orlando, FL 32805 Kimberly Jenkins CAMPAIGN TREASURER’S REPORT – ITEMIZED CONTRIBUTIONS (1) Name (2)I.D. Number (3)Cover Period / / through / / (4) Page of (5) (7) (8) (9) (10) (11) (12) Date Full Name (6) (Last, Suffix, First, Middle) Sequence Street Address & Contributor Contribution In-kind Number City, State, Zip Code Type Occupation Type Description Amendment Amount / / / / / / / / / / / / / / DS-DE 13 (Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES Shaniqua "Shan" Rose 2021D5002 09 809 12 09 Regina Clark Individual cook Check $20.2143 Individual inspector Check $250.0044 Individual realtor Check $100.0045 Business real estate Check $500.0046 Business real estate Check $500.0047 Individual retired Check $20.2148 Individual engineer Check $20.2149 01 21 30 21 26 21 09 26 21 09 27 21 09 27 21 09 27 21 09 28 21 09 28 21 6116 Jialeah Street Orlando, FL 32808 Calvin Spencer 12046 Georgia Woods Ct Orlando, FL 32824 Brian Agard 2423 AURORA COURT Kissimmee, FL 34744 Bishop Beale Duncan Realty LLC 250 N. Orange Ave Suite 1500 Orlando, FL 32801 Marcus Bolden 1810 Arlington St Orlando, FL 32805 Whitney Baker 122 23rd St Orlando, FL 32805 1321 Edgewater Drive Orlando, FL 32804 Beale Commercial Realty Services CAMPAIGN TREASURER’S REPORT – ITEMIZED CONTRIBUTIONS (1) Name (2)I.D. Number (3)Cover Period / / through / / (4) Page of (5) (7) (8) (9) (10) (11) (12) Date Full Name (6) (Last, Suffix, First, Middle) Sequence Street Address & Contributor Contribution In-kind Number City, State, Zip Code Type Occupation Type Description Amendment Amount / / / / / / / / / / / / / / DS-DE 13 (Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES Shaniqua "Shan" Rose 2021D5002 09 909 12 09 Ester Timber Individual retired Check $20.2150 Individual retired Check $20.2151 Individual retired Check $20.2152 Individual Construction Check $1,000.0053 Individual home-maker Check $1,000.0054 Individual retired Check $20.2155 Individual retired Check $20.2156 01 21 30 21 28 21 09 28 21 09 28 21 09 28 21 09 28 21 09 30 21 09 30 21 705 Woods Street Orlando, FL 32805 Carter Alexander 1000 Miller Ave Orlando, FL 32805 Sebastian Knowles 1029 Colyer St Orlando, FL 32805 Derrick Wallace 254 S. Ortman Drive Orlando, FL 32811 Jennifer Jones 217 S. Laurel Avenue Orlando, FL 32805 Cupid Green 5015 Nassau Circle Orlando, FL 32808 254 S. Ortman Drive Orlando, FL 32811 Sharon Wallace CAMPAIGN TREASURER’S REPORT – ITEMIZED CONTRIBUTIONS (1) Name (2)I.D. Number (3)Cover Period / / through / / (4) Page of (5) (7) (8) (9) (10) (11) (12) Date Full Name (6) (Last, Suffix, First, Middle) Sequence Street Address & Contributor Contribution In-kind Number City, State, Zip Code Type Occupation Type Description Amendment Amount / / / / / / / / / / / / / / DS-DE 13 (Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES Shaniqua "Shan" Rose 2021D5002 09 1009 12 09 Arthur Poisley Individual DJ Check $20.2157 Individual daycare worker Check $20.2158 Individual retired Check $20.2159 Individual bank teller Check $20.2160 Individual retired Check $100.0061 Individual retired Check $20.2162 Individual retired Check $20.2163 01 21 30 21 30 21 09 30 21 09 30 21 09 30 21 09 30 21 09 30 21 09 30 21 1316 - 37th St Orlando, FL 32805 Tanisha Wynn 4523 Barley Street Orlando, FL 32811 Tangela Grier 4410 Scenic Lake Drive Orlando, FL 32808 Samuel Williams 1316 - 37th St Orlando, FL 32805 Juanita Cool 4322 Clarinda Street Orlando, FL 32805 Gayle Whittied 902 - 24th Street Orlando, FL 32805 310 N. Orange Ave Apt 6 Orlando, FL 32801 Charlie Piston CAMPAIGN TREASURER’S REPORT – ITEMIZED CONTRIBUTIONS (1) Name (2)I.D. Number (3)Cover Period / / through / / (4) Page of (5) (7) (8) (9) (10) (11) (12) Date Full Name (6) (Last, Suffix, First, Middle) Sequence Street Address & Contributor Contribution In-kind Number City, State, Zip Code Type Occupation Type Description Amendment Amount / / / / / / / / / / / / / / DS-DE 13 (Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES Shaniqua "Shan" Rose 2021D5002 09 1109 12 09 Nicole Parker Individual sales Check $20.2164 Individual accountant Check $50.0065 Individual real estate Check $250.0066 Individual accountant Check $250.0067 01 21 30 21 30 21 10 01 21 10 01 21 10 01 21 260 N. Cottage Hill Rd Orlando, FL 32805 Jessica Rodriguez 744 Short Avenue Orlando, FL 32805 Jimy Metrune 1317 Wood Lake Cir St. Cloud, FL 34772 Alfredo Williams 14930 Etowoah street Winter Garden, FL 34787 CAMPAIGN TREASURER’S REPORT – ITEMIZED EXPENDITURES DS-DE 14 (Rev. 11/13) (1)Name ______________________________________________________ (3) Cover Period ______/______/______ through ______/______/______ (2) I.D. Number _____________________ (4) Page ____________ of _____________ Full Name (Last, Suffix, First, Middle) Street Address & City, State, Zip Code (5) Date Purpose (add office sought if contribution to a candidate) Amount SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES Expenditure Type Amendment (6) Sequence Number (7) (8) (9) (10) (11) Shaniqua "Shan" Rose 2021D5002 09 01 21 09 30 21 12 12 09 06 21 Kaplan Strategies Inc CandidateEx pense $600.00 1 2602 Lounsbury Court Kissimmee, FL 34746 Office Depot 09 10 21 CandidateEx pense $4.56 2 2847 S Orange Avenue Orlando, FL 32806 Kaplan Strategies Inc 09 20 21 CandidateEx pense $400.00 3 2602 Lounsbury Court Kissimmee, FL 34746 Domino's Pizza 09 27 21 CandidateEx pense $100.274250 W Plaza Dr Orlando, FL 328164 Office Depot 09 27 21 CandidateEx pense $30.002847 S Orange Avenue Orlando, FL 328065 Stripe 09 30 21 CandidateEx pense $140.23510 Townsend Street San Francisco, CA 941036 Instructions for Campaign Treasurer’s Report Summary (1)Name: full name of the candidate, political committee, party executive committee, electioneering communications organization, or individual making an independent expenditure or electioneering communication. (2)Address: the full address or post office box, city, state, and zip code. Check the box if the address has changed since the last report filed. (3)ID Number: identification number assigned by the filing officer. (4)Check the appropriate box(es). (5)Report Identifiers Cover Period: the dates this report covers (i.e., From 1/1/15 To 1/31/55). Important: use the appropriate cover period dates as published by the filing officer. Report Type: refer to the filing officer’s calendar of reporting dates for the correct codes to be used for each reporting period. If report is for a special election add “S” in front of the report code (i.e., SG3). Check one of the appropriate boxes: Original: first report filed for this reporting period. Amendment: must summarize only contributions/fund transfers and expenditures/distributions being reported as additions or deletions. Read instructions for sequence numbers and amendment types on the back of Forms DS-DE 13A and 14A. Special Election Report: Important: once a special election report is filed, the entity is required to file all remaining reports due for the special election. (6)Contributions This Report: Cash and Checks: total amount for this reporting period. Loans: total amount for this reporting period. Total Monetary: sum of Cash and Checks and Loans. In-Kind: the fair market value of the in-kind contribution at the time it is given for this reporting period. (7)Expenditures This Report: Monetary Expenditures: total amount of monetary expenditures for this reporting period. Transfers to Office Account: total amount transferred to an office account by elected candidates only. Total Monetary: sum of Monetary Expenditures and Transfers to Office Account. (8)Other Distributions: the total amount of goods and services contributed to a candidate or other committee by a PC, ECO, or PTY. (9)TOTAL Monetary Contributions To Date: the amount of total monetary contributions to date. Candidates keep cumulative totals from the time the campaign depository is opened through the termination report. (10)TOTAL Monetary Expenditures To Date: the amount of total monetary expenditures to date. Candidates keep cumulative totals from the time the campaign depository is opened through the termination report. (11)Type or print the required officer’s name and have them sign the report: Candidate report: treasurer and candidate must sign. PC report: treasurer and chairperson must sign. PTY report: treasurer and chairperson must sign. ECO report: organization’s treasurer must sign. IE or EC report: individual must sign (this applies when an individual acts alone to make these expenditures) AMENDMENT REPORTS: An amendment report summary should summarize only contributions, expenditures, distributions, & fund transfers being reported as additions or deletions. Read the instructions for the sequence number & amendment type fields on the back of forms DS-DE 13, 14, 14A and 94. INSTRUCTIONS FOR CAMPAIGN TREASURER’S REPORT – ITEMIZED CONTRIBUTIONS (1)Candidate’s full name or name of the political committee (PC), electioneering communications organizations (ECO) or party executive committee (PTY). (2)The identification number assigned by the filing officer. (3)Cover period dates (e.g., 1/1/15 through 1/31/15). (See filing officer’s reporting dates calendar for appropriate year and cover periods.) (4)Page numbers (e.g., 1 of 3 ). (5)Date contribution was RECEIVED (Month/Day/Year). (6)Sequence Number – Each detail line shall have a sequence number assigned to it. Sequence numbers are to be assigned within each reporting period and for each type of detail line. Thus the report type, detail line type, and sequence number will combine to uniquely identify a specific contribution, expenditure, distribution or fund transfer. This method of unique identification is required for responding to requests from the filing officer and for reporting amendments. For example, a M1 report having 75 contributions would use sequence numbers 1 through 75. The next report (M2), comprised of 40 contributions would use sequence numbers 1 through 40. Contributions on amended M1 reports would begin with sequence number 76 and on amended M2 reports would begin with sequence number 41. See the Amendment Type instructions below. (7)Type full name and address of contributor (including city, state and zip code). (8)Enter the type of contributor using one of the following codes: Occupation of contributor for contributions over $100 only. (If a business, please indicate nature of business.) I Individual B Business (also includes corporations, organizations, groups, etc.) E Electioneering Communications Organizations F Political Committee (federal or state) (includes federal, state and county executive P Political Parties committees) O Other (e.g., candidate surplus funds to party, etc.) S Candidate to Self (9)Enter Contribution Type using one of the following codes: NOTE: Cash includes cash and cashier’s checks. Code Description CAS Cash or Cashier’s Check CHE Check COF Carryover Funds from Previous Campaign INK In-Kind INT Interest LOA Loan MO Money Order MUC Multiple Uniform Contributions RCT Other Receipts REF Refund (Negative Amount Only) (10)Typ e the description of any in-kind contribution received. Candidate’s Only – If in-kind contribution is from a party executive committee and is allocable toward the contribution limits, type an “A” in this box. If contribution is not allocable, type an “N”. (11)Amendment Type (required on amended reports) – To add a new (previously unreported) contribution for the reporting period being amended, enter “ADD” in amendment type on a line with ALL of the required data. The sequence number for contributions with amendment type “ADD” will start at one plus the number of contributions in the original report. For example, amending an original M1 report that had 75 contributions means the sequence number of the first contribution having amendment type “ADD” will be 76; the second “ADD” contribution would be 77, etc. When amending an original M2 report that had 40 contributions, the sixth “ADD” contribution would have sequence number 46. To correct a previously submitted contribution use the following drop/add procedure. Enter “DEL” in amendment type on a line with the sequence number of the contribution to be corrected. In combination with the report number being amended, this sequence number will identify the contribution to be dropped from your active records. On the next line enter “ADD” in amendment type and ALL of the required data with the necessary corrections thus replacing the dropped data. Assign the sequence number as described above. (12)Type amount of contribution received. Political Committees ONLY: Multiple uniform contributions from the same person, aggregating NMT $250 per calendar year, collected by an organization that is the affiliated sponsor of a PC, may be reported by the PC in an aggregate amount listing the number of contributors together with the amount contributed by each and the total amount contributed during the reporting period. The identity of each person making such uniform contribution must be reported to the filing officer by July 1 of each calendar year, or, in a general election year, NLT the 60th day immediately preceding the primary election. INSTRUCTIONS FOR CAMPAIGN TREASURER’S REPORT – FUND TRANSFERS (1)Type candidate’s full name or name of the political committee (PC), electioneering communications organization (ECO), or party executive committee (PTY). (2)Type identification number assigned by the filing officer. (3)Type cover period dates (e.g., 1/1/15 through 1/31/15). (See filing officer’s reporting dates calendar for appropriate cover periods.) (4)Type page numbers (e.g., 1 of 3). (5)Type date of fund transfer (Month/Day/Year). (6)Sequence Number - Each detail line shall have a sequence number assigned to it. Sequence numbers are to be assigned within each reporting period and for each type of detail line. Thus the report type, detail line type, and sequence number will combine to uniquely identify a specific contribution, expenditure, distribution or fund transfer. This method of unique identification is required for responding to requests from the filing officer and for reporting amendments. For example, a M1 report having 2 fund transfers would use sequence numbers 1 thru 2. The next report (M2), comprised of 4 fund transfers would use sequence numbers 1 thru 4. Fund transfers on amended M1 reports would begin with sequence number 3 and on amended M2 reports would begin with sequence number 5. See the Amendment Type instructions below. (7)Type full name and address of financial institution (including city, state and zip code). (8)Enter Transfer Type using one of the following codes: DESCRIPTION Transfer FROM identified account to campaign account Transfer TO identified account from the campaign account CODE F T (9)Nature of Account (e.g., certificate of deposit, money market, etc...) (10)Amendment Type (required on amended reports) - To add a new (previously unreported) fund transfer for the reporting period being amended, enter “ADD” in amendment type on a line with ALL of the required data. The sequence number for fund transfers with amendment type “ADD” will start at one plus the number of fund transfers in the original report. For example, amending an original M1 report that had 75 fund transfers, means the sequence number of the first fund transfer having amendment type “ADD” will be 76; the second “ADD” fund transfer would be 77, etc. When amending an original M2 report that had 40 fund transfers, the sixth “ADD” fund transfer would have sequence number 46. To correct a previously submitted fund transfer use the following drop/add procedure. Enter “DEL” in amendment type on a line with the sequence number of the fund transfer to be corrected. In combination with the report number being amended, this sequence number will identify the fund transfer to be dropped from your active records. On the next line enter “ADD” in amendment type and ALL of the required data with the necessary corrections thus replacing the dropped data. Assign the sequence number as described above. (11)Type amount of fund transfer. INSTRUCTIONS FOR CAMPAIGN TREASURER'S REPORT - ITEMIZED EXPENDITURES (1)Candidate's full name or name of the political committee (PC), electioneering communications organization (ECO), or party executive committee (PTY). (2)Identification number assigned by the filing officer. (3)Cover period dates (01/01/15 through 01/31/15). (See filing officer’s reporting dates calendar for appropriate cover periods.) (4)Page numbers (e.g., 1 of 3). (5)Date of expenditure (Month/Day/Year). (6)Sequence Number - Each detail line shall have a sequence number assigned to it. Sequence numbers are to be assigned within each reporting period and for each type of detail line. Thus the report type, detail line type, and sequence number will combine to uniquely identify a specific contribution, expenditure, distribution or fund transfer. This method of unique identification is required for responding to requests from the filing officer and for reporting requirements. For example, a M1 report having 40 expenditures would use sequence numbers 1 through 40. The next report (M2), comprised of 30 expenditures would use sequence numbers 1 through 30. Expenditures on amended M1 reports would begin with sequence number 41 and on amended M2 reports would begin with sequence number 31. See Amendment Type instructions below. (7)Full name and address of entity receiving payment (including city, state and zip code). (8)Purpose of expenditure (if expenditure is a contribution to a candidate, also type the office sought by the candidate). PLEASE NOTE: This column does not apply to candidate expenditures, as candidates cannot contribute to other candidates from campaign funds. However, PCs (supporting candidates) and party executive committees contributing to candidates must report office sought (Section 106.07, F.S.). (9)Enter Expenditure Type using one of the following codes: Code Description CAN Candidate Expense DIS Disposition of Funds DFC Disposition of Funds to Future Campaign (effective 11/1/13) DPP Disposition of Funds to Political Party (effective 11/1/13) DPV Disposition of Funds to Petition Verification (effective 11/1/13) ECC Electioneering Communication IEC Independent Expenditure Regarding a Candidate IEI Independent Expenditure Regarding an Issue MON Monetary (Not to a Candidate) PCW Petty Cash Withdrawn PCS Petty Cash Spent PPD Pre-paid Distribution REF Refund (Negative Amount Only) RMB Reimbursements TOA Transfer to Office Account (Disposition of Funds) (10)Amendment Type (required on amended reports) - To add a new (previously unreported) expenditure for the reporting period being amended, enter "ADD" in amendment type on a line with ALL of the required data. The sequence number for expenditures with amendment type "ADD" will start at one plus the number of expenditures in the original report. For example, amending an original M1 reports that had 75 expenditures, means the sequence number of the first expenditure having amendment type "ADD" will be 76; the second "ADD" expenditure would have sequence number 39. To correct a previously submitted expenditure use the following drop/add procedure. Enter "DEL" in amendment type on a line with the sequence number of the expenditure to be corrected. In combination with the report number being amended, this sequence number will identify the expenditure to be dropped from your active records. On the next line enter "ADD" in amendment type and ALL of the required data with the necessary corrections thus replacing the dropped data. Assign the sequence number as described above. (11) Amount of expenditure. CAMPAIGN TREASURER'S REPORT - ITEMIZED DISTRIBUTIONS THIS FORM IS USED TO REPORT DISTRIBUTIONS OF GOODS OR SERVICES CONTRIBUTED TO A CANDIDATE OR COMMITTEE, INDIRECT EXPENDITURES AND REIMBURSEMENTS. (1)Name of the entity. (2)Identification number assigned by the filing officer. (3)Cover period dates (e.g., 03/01/14 through 03/31/14). (See the filing officer’s reporting dates calendar for appropriate cover periods.) (4)Page numbers (e.g., 1 of 3). (5)Date of distribution (Month/Day/Year). (6)Sequence Number - Each detail line shall have a sequence number assigned to it. Sequence numbers are to be assigned within each reporting period and for each type of detail line. Thus the report type, detail line type, and sequence number will combine to uniquely identify a specific contribution, expenditure, distribution or fund transfer. This method of unique identification is required for responding to requests from the filing officer and for reporting amendments. For example, a M1 report having 40 distributions would use sequence numbers 1 through 40. The next report (M2), comprised of 30 distributions would use sequence numbers 1 through 30. Distributions on amended M1 reports would begin with sequence number 41 and on amended M2 reports would begin with sequence number 31.See Amendment Type instructions below. (7)Full name and address of entity receiving distribution (including city, state and zip code). (8)Purpose of distribution (if distribution is a contribution to a candidate, also type the office sought by the candidate). (9)For each distribution that is related to an itemized expenditure previously listed on Itemized Expenditures (Form DS-DE 14), enter the Year, Report Type and Sequence Number associated with the expenditure. *PARTY EXECUTIVE COMMITTEES ONLY - If distribution is allocable toward the contribution limits, type an "A" in this box. If distribution is nonallocable, type and "N". (10)Amendment Type (required on amended reports) - To add a new (previously unreported) distribution for the reporting period being amended, enter "ADD" in amendment type on a line with ALL of the required data. The sequence number for distributions with amendment type "ADD" will start at one plus the number of distributions in the original report. For example, amending and original M1 report that had 75 distributions, means the sequence number of the first distribution having amendment type "ADD" will be 76; the second "ADD" distribution would be 77, etc. When amending an original M2 report that had 30 distributions, the ninth "ADD" distribution would have sequence number 39. To correct a previously submitted distribution use the following drop/add procedure. Enter "DEL" in amendment type on a line with the sequence number of the distribution to be corrected. In combination with the report number being amended, this sequence number will identify the distribution to be dropped from your active records. On the next line enter "ADD" in amendment type and ALL of the required data with the necessary corrections thus replacing the dropped data. Assigns the sequence number as described above. (11)Amount of distribution. (12)Distribution Type Code Description PPD Pre-paid Distribution RMB Reimbursements CCP Credit Card Purchase INK In-Kind Distribution