HomeMy Public PortalAboutCampaign Treasurer's Report (G-2)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
Nicolette (Qualified) Fariello Springer
1217 Reading Drive
Orlando, FL 32804
2021D3004
District 3, Orlando City Commissioner
G-2
4
4
8 968 97
0 00
8 968 97
0 00
12 352 14
0 00
12 352 14
57 554 50
0 00
34 656 88
10 02 21 10 15 21
BCCAF168-41A0-45A7-A92D-2906573AB48C
10/22/21 - 08:58:52
10/22/21 - 08:58:52
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
Nicolette (Qualified) Fariello Springer 2021D3004
10 210 14
10 Linda Chapin
Individual
Retired
Educator
Check
$103.451
Individual
Digital Editor Check
$15.002
Individual
Accountant Check
$103.453
Individual
Nonprofit
Administrato
r
Check
$200.004
Individual
Retired Check
$26.015
Individual
Public affairs
director
Check
$480.006
Individual
City
Commission
er
Check
$103.457
02 21 15 21
02 21
10 02 21
10 02 21
10 02 21
10 03 21
10 03 21
10 04 21
2022 Hoffner Ave
Belle Isle, FL 32809
Lindsey Kaetzel
4006 Maplegrove Dr
Orlando, FL 32818
Julie Hoffmeyer
103 E Winter Park St
Orlando, FL 32804
George Wallace
937 Baltimore Dr
Orlando, FL 32810
Ben Friedman
630 Renaissance Pointe
Apt 102
Altamonte Springs, FL
32714Todd Weaver
1051 Lake Bell Dr
Winter Park, FL 32789
630 Vassar St Unit 2507
Orlando, FL 32804
Gayle Lashley
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
Nicolette (Qualified) Fariello Springer 2021D3004
10 310 14
10 James Sullivan
Individual
Retired Check
$500.008
Individual
Executive Check
$500.009
Individual
Retired Check
$500.0010
Individual
Software
Engineer
Check
$15.0011
Individual
Self
Employed
Check
$51.8312
Individual
Writer Check
$25.0013
Individual
Manager Check
$100.0014
02 21 15 21
04 21
10 04 21
10 04 21
10 04 21
10 05 21
10 05 21
10 05 21
901 Georgia Ave
Winter Park, FL 32789
William Dennis
1328 Spring Lake Dr
Orlando, FL 32804
Maura Smith
901 Georgia Ave
Winter Park, FL 32789
Daniel McNaughton
1474 Canal Cross Ct
Oviedo, FL 32766
Garret Wade
1701 Lee Rd
Winter Park, FL 32789
Craig Frede
434 E Harding St
Orlando, FL 32806
13547 Eyas Rd
Orlando, FL 32837
John Harris
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
Nicolette (Qualified) Fariello Springer 2021D3004
10 410 14
10 Pat Michaels
Individual
Director Check
$100.0015
Individual
sales Check
$50.0016
Individual
Associate
Attorney
Check
$15.0017
Individual
Teacher Check
$25.0018
Individual
Unemployed Check
$25.0019
Individual
Finance
Director
Check
$25.0020
Individual
Executive Check
$100.0021
02 21 15 21
05 21
10 06 21
10 06 21
10 06 21
10 06 21
10 06 21
10 06 21
2425 Oglesby Ave
Winter Park, FL 32789
Lisa Brown
2504 Lauderdale Ct
Orlando, FL 32805
Ben King
1110 Martin Blvd
Orlando, FL 32825
Willie S Williams
8 W Par St Apt 3
Orlando, FL 32804
Cathrine Pierson
481 Reider Ave
Longwood, FL 32750
Thor Falk
4177 N Orange Blossom
Trl Unit 610
Orlando, FL 32804
4036 Bermuda Grove Pl
Longwood, FL 32779
Harrison Angelis
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
Nicolette (Qualified) Fariello Springer 2021D3004
10 510 14
10 Ron STUDDARD
Individual
Retired Check
$25.0022
Individual
Media
Relations
Manager
Check
$50.0023
Individual
Vet tech Check
$20.0024
Individual
Retired Check
$33.0025
Individual
Campaign
Manager
Check
$26.0126
Individual
Organizer Check
$200.0027
Individual
Attorney Check
$100.0028
02 21 15 21
06 21
10 06 21
10 06 21
10 06 21
10 06 21
10 06 21
10 06 21
736 N Hyer Ave
Orlando, FL 32803
Brandon Wolf
820 Main Ln Apt 1121
Orlando, FL 32801
Jamie Gainey
1626 N Bumby Ave
Orlando, FL 32803
Gerald Rogers
2867 Conway Rd Apt
222
Orlando, FL 32812
Geraldo Gabriel Atiles
Reyes
776 N Orange Ave Apt
5211
Orlando, FL 32801
Brian Hess
231 E Yale St
Orlando, FL 32804
12311 Greenwich Dr
Glen Allen, VA 23059
Kevin Lata
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
Nicolette (Qualified) Fariello Springer 2021D3004
10 610 14
10 Michael Lewis
Individual
Sales
executive
Check
$51.8329
Individual
Director Check
$103.4530
Individual
Designer Check
$50.0031
Individual
Communicat
ions
Check
$25.0032
Individual
Attorney Check
$100.0033
Individual
Banker Check
$25.0034
Individual
Executive Check
$15.0035
02 21 15 21
06 21
10 06 21
10 06 21
10 06 21
10 06 21
10 06 21
10 06 21
940 W Canton Ave
Winter Park, FL 32789
Ronald Fry
14103 Talladega Ct
Orlando, FL 32826
Jamie DeHay
2416 Dawley Ave
Orlando, FL 32806
Maeven Rogers
950 Balch Ave
Winter Park, FL 32789
Joe Lonergan
56 Cotton Ln
Levittown, NY 11756
Josh Bell
157 Sedgefield Cir
Winter Park, FL 32792
722 Woodward St
Orlando, FL 32803
Lewis Van Alstyne
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
Nicolette (Qualified) Fariello Springer 2021D3004
10 710 14
10 Orlando Torres
Individual
Unemployed Check
$5.0036
Individual
Non profit
director
Check
$250.0037
Individual
Artist Check
$25.0038
Individual
Flight
attendant
Check
$10.5339
Individual
Realtor Check
$516.4540
Individual
"Representat
ive, District
49"
Check
$103.4541
Individual
Attorney Check
$200.0042
02 21 15 21
06 21
10 06 21
10 06 21
10 06 21
10 06 21
10 07 21
10 07 21
2029 Las Palmas Cir
Orlando, FL 32822
Stephanie Porta
1835 Palm Ln
Orlando, FL 32803
Michael Barimo
704 Kiwi Cir
Winter Park, FL 32789
Jose Fuentes Cruz
400 Grand Blvd Los
Prados Apt 34201
Caguas, PR 00727
Carlos Smith
2237 Stonington Ave
Orlando, FL 32817
James Carlin
900 Vassar St
Orlando, FL 32804
540 Meridale Ave
Orlando, FL 32803
Carla Stanton
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
Nicolette (Qualified) Fariello Springer 2021D3004
10 810 14
10 Amy Mercado
Individual
Director of
Operations
Check
$100.0043
Individual
Realtor Check
$100.0044
Individual
Editor Check
$34.2745
Individual
Business
Owner
Check
$250.0046
Individual
Hillel
Director
Check
$5.0047
Individual
Securities
Associate
Check
$15.0048
Individual
Manager Check
$150.0049
02 21 15 21
07 21
10 07 21
10 07 21
10 07 21
10 08 21
10 08 21
10 08 21
5910 Bent Pine Dr Apt
102
Orlando, FL 32822
Melissa Vance
504 Buckminster Cir
Orlando, FL 32803
Michelle Tauber
303 Partridge Ln
Longwood, FL 32779
David Forrester
800 Westwind Ct
Maitland, FL 32751
Jorge Londono
130 Spanish Bay Dr
Sanford, FL 32771
Dawn Callaway
1600 Alden Rd Apt 461
Orlando, FL 32803
880 Sutter Loop
Longwood, FL 32750
Sam Friedman
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
Nicolette (Qualified) Fariello Springer 2021D3004
10 910 14
10 Adam Woodhall
Individual
Business
Developmen
t
Check
$28.0850
Individual
Public affairs
director
Check
$103.4551
Individual
Retired Check
$26.0152
Individual
Investor Check
$500.0053
Individual
Model Check
$33.0054
Individual
Owner Check
$250.0055
Individual
non profit Check
$103.4556
02 21 15 21
09 21
10 09 21
10 10 21
10 10 21
10 10 21
10 11 21
10 11 21
2223 Black Mangrove Dr
Orlando, FL 32828
Ben Friedman
630 Renaissance Pointe
Apt 102
Altamonte Springs, FL
32714Gayle Lashley
630 Vassar St Unit 2507
Orlando, FL 32804
Charles ONeal
2329 Park Village Pl
Apopka, FL 32712
andy swart
2626 Edgewater Dr
Orlando, FL 32804
Christine Bramuchi
810 Delaney Park Dr
Orlando, FL 32806
518 S Lake Formosa Dr
Orlando, FL 32803
Lisa Adkins
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
Nicolette (Qualified) Fariello Springer 2021D3004
10 1010 14
10 Cathy Lieblich
Individual
Social
Worker
Check
$26.0157
Individual
Manager Check
$50.0058
Individual
owner Check
$500.0059
Individual
Unemployed Check
$100.0060
Individual
Engineer Check
$206.7061
Individual
Retired Check
$51.8362
Individual
Engineer Check
$51.8363
02 21 15 21
11 21
10 11 21
10 11 21
10 12 21
10 12 21
10 12 21
10 12 21
1832 Meeting Pl Apt 201
Orlando, FL 32814
Samuel Vilchez Santiago
8933 Fort Jefferson Blvd
Orlando, FL 32822
Jason Lambert
1235 N Orange Ave
Orlando, FL 32804
Chuck Moffat
4109 Fairview Vista Pt
Orlando, FL 32804
Victor M. Collazo Collazo
3913 Peppervine Dr
Orlando, FL 32828
Zach McNaney
101 E Yale St
Orlando, FL 32804
919 Golfview St
Orlando, FL 32804
Andrew Valente
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
Nicolette (Qualified) Fariello Springer 2021D3004
10 1110 14
10 Susan Clary
Individual
Consultant Check
$26.0164
Individual
Retired Check
$26.0165
Individual
Retired Check
$100.0066
Individual
PI Check
$103.4567
Individual
Shopper Check
$20.0068
Individual
Designer Check
$155.0869
Individual
Retired Check
$250.0070
02 21 15 21
12 21
10 12 21
10 12 21
10 13 21
10 13 21
10 14 21
10 14 21
221 Driggs Dr # 4112
Winter Park, FL 32792
Mary Basham
815 Seminole Ave
Orlando, FL 32804
William Gabrenya
1129 Yates St
Orlando, FL 32804
Lori Parker
910 Alameda St
Orlando, FL 32804
Katherine Lischke
1317 Belleaire Cir
Orlando, FL 32804
Patricia Drago
325 Pelican Avenue
Daytona Beach, FL
32118
1103 Carlson Dr
Orlando, FL 32804
Sarah Wissig
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
Nicolette (Qualified) Fariello Springer 2021D3004
10 1210 14
10 Leander Aulisio
Individual
Retired Check
$250.0071
Individual
Director Check
$100.0072
Individual
Attorney Check
$155.8873
Individual
Self Check
$100.0074
02 21 15 21
14 21
10 15 21
10 15 21
10 15 21
4303 Glennis Dr
Lakeland, FL 33813
Timothy Wagner
4335 Burlington Ave N
Saint Petersburg, FL
33713
Jennifer Frank
1818 Center Dr
Casselberry, FL 32707
Bob Poe
2207 Bowmont Dr
Beverly Hills, CA 90210
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)
Nicolette (Qualified) Fariello Springer 2021D3004
10 02 21 10 15 21 13 14
10 04 21 JustCall Auto dial fee Monetary
$10.00
1 3260 Hillview Ave
Palo Alto, CA 94304
JustCall
10 05 21 Auto Dial Fee Monetary
$10.00
2
3260 Hillview Ave
Palo Alto, CA 94304
JustCall
10 06 21 Auto Dial Fee Monetary
$30.00
3
3260 Hillview Ave
Palo Alto, CA 94304
Mitch Emerson
10 06 21
Staff Monetary
$7,320.005308 Glasgow Ave
Orlando, FL 328194
Mitch Emerson
10 07 21 Staff Monetary
$3,006.005308 Glasgow Ave
Orlando, FL 328195
JustCall
10 08 21 Auto Dial Fee Monetary
$50.003260 Hillview Ave
Palo Alto, CA 943046
The Hammered Lamb Team Lunch Monetary
$325.14101221
1235 N Orange Ave
Orlando, Fl 328047
Watermark Ad Monetary
$541.00101221
1300 N Semoran Blvd
Orlando, FL 328078
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)
Nicolette (Qualified) Fariello Springer 2021D3004
10 02 21 10 15 21 14 14
10 12 21 JustCall Auto Dial Fee Monetary
$30.00
9 3260 Hillview Ave
Palo Alto, CA 94304
Deborah Coffy
10 12 21 Communications Monetary
$1,000.00
10
5151 Rebecca Ct
Orlando, Fl 32810
JustCall
10 15 21 Auto Dial Fee Monetary
$30.00
11
3260 Hillview Ave
Palo Alto, CA 94304
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