HomeMy Public PortalAboutCampaign Treasurer's Report (G-3)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-3
4
4
6 311 41
0 00
6 311 41
0 00
700 46
0 00
700 46
63 865 91
0 00
35 357 34
10 16 21 10 28 21
D1541FAB-62EE-4370-B69C-ABD36539A348
10/30/21 - 09:13:50
10/30/21 - 09:13:50
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 10
10 Linda Coffin
Individual
Retired Check
$25.001
Individual
Unemployed Check
$26.012
Individual
Retired Check
$100.003
Individual
SmartBrief Check
$10.534
Individual
Retired Check
$100.005
Individual
Editor Check
$26.016
Individual
Retired Check
$100.007
16 21 28 21
16 21
10 16 21
10 16 21
10 17 21
10 19 21
10 19 21
10 19 21
4590 Sailbreeze Ct
Orlando, FL 32810
Fiona Shannon
512 Birdsong Ct
Longwood, FL 32779
Pamela Stevens
627 Greene Dr
Winter Park, FL 32792
Paula Kiger
4263 Raleigh Way
Tallahassee, FL 32311
Elizabeth Lashley
Rothwell
3707 Wilder Ln
Orlando, FL 32804
David Berelsman
238 Acadia Ter
Kissimmee, FL 34747
170 Kristi Dr
Indian Harbour Beach,
FL 32937
William Lundell
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 10
10 Maureen Johanson
Individual
Retired Check
$26.018
Individual
Attorney Check
$250.009
Individual
Lead
Organizer
Check
$51.8310
Individual
Substitute
teacher
Check
$100.0011
Individual
Waterpark
Attendant
Check
$2.2712
Individual
Deputy
Finance
Director
Check
$250.0013
Individual
Attorney Check
$100.0014
16 21 28 21
20 21
10 20 21
10 20 21
10 20 21
10 20 21
10 20 21
10 20 21
6112 Saint Ives Blvd
Orlando, FL 32819
Alan Grayson
8419 Oak Park Rd
Orlando, FL 32819
Alexa Nelen
2815 Formosa Ave
Orlando, FL 32804
Lisa Keating
2550 Lake Shore Dr
Orlando, FL 32803
Marcello Fischer
1725 17th Ave N
St Petersburg, FL 33713
Asima Azam
4317 New Broad St
Orlando, FL 32814
1276 Palmwood Ct
Cincinnati, OH 45224
Joseph Lamping
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 10
10 Jeremy Dorsett
Individual
Investor Check
$500.0015
Individual
Retired Check
$100.0016
Individual
Software
Engineer
Check
$100.0017
Individual
Retired Check
$103.4518
Business
Campaign
Committee
Check
$500.0019
Individual
Unemployed Check
$50.0020
Individual
Attorney Check
$50.0021
16 21 28 21
20 21
10 20 21
10 20 21
10 21 21
10 21 21
10 21 21
10 21 21
1409 Chapman Cir
Winter Park, FL 32789
Sarah Wolfe
221 Nboyd St
Winter Garden, FL
34787
Michael Blake
534 Clayton St
Orlando, FL 32804
Janice O'Rourke
11211 Lake Louisa Rd
Clermont, FL 34711
Mary Dipboye
938 Golfside Dr
Winter Park, FL 32792
Stephanie vanos
801 S Mills Ave
Orlando, FL 32801
1751 Potomac Greens
Dr
Alexandria, VA 22314
Stephanie Murphy for
Congress
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 10
10 Alex Barrio
Individual
Advocacy
Director
Check
$51.8322
Individual
Attorney Check
$50.0023
Individual
Corrections Check
$50.0024
Individual
Retired Check
$25.0025
Individual
Music
Performance
Check
$100.0026
Individual
Retired Check
$51.8327
Individual
Physician Check
$103.4528
16 21 28 21
21 21
10 21 21
10 21 21
10 22 21
10 22 21
10 22 21
10 25 21
5910 Alderfer Springs Dr
Jacksonville, FL 32258
Patricia R. Sigman
1809 Wingfield Dr
Longwood, FL 32779
Patricia Rumph
9999 CONFIDENTIAL St
Orlando, FL 32808
Sharon Conway
301 Sylvan Dr
Winter Park, FL 32789
Val Mobley
226 W King St
Orlando, FL 32804
Rafael E Pinero
1216 N Hampton Ave
Orlando, FL 32803
800 N Lake Formosa Dr
Orlando, FL 32803
jerry Weiss
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 10
10 Rosie Wallace
Individual
Administrato
r
Check
$26.0129
Individual
Managemen
t
Check
$103.4530
Business
Political
Committee
Check
$500.0031
Individual
Retired Check
$103.4532
Individual
Retired Check
$250.0033
Individual
retired Check
$250.0034
Individual
Retired Check
$500.0035
16 21 28 21
25 21
10 25 21
10 26 21
10 26 21
10 26 21
10 27 21
10 27 21
2923 Harrison Ave
Orlando, FL 32804
Bijoy Sagar
510 Kings Point Trl
Franklin Lakes, NJ
07417
Ruths List Florida
100 E Madison St Ste
302
Tampa, FL 33602
Marilyn Hefferan
11747 Narcoossee Rd
Orlando, FL 32832
Betty Castor
3435 Bayshore Blvd Apt
1601
Tampa, FL 33629
Marilyn King
358 Virginia Dr
Winter Park, FL 32789
1323 Anchor Ct
Orlando, FL 32804
Barbara Weinreich
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 10
10 Jane Radenhausen-
Cowan
Individual
Sales Check
$51.8336
Individual
Engineer Check
$50.0037
Individual
Director Check
$103.4538
Individual
Student Check
$5.0039
Individual
Attorney Check
$15.0040
Individual
Organizer Check
$50.0041
Individual
Rideshare
Driver
Check
$1,000.0042
16 21 28 21
27 21
10 27 21
10 28 21
10 28 21
10 28 21
10 28 21
10 28 21
3208 E Colonial Dr # 196
Orlando, FL 32803
Ricky Ly
11002 Inside Loop
Orlando, FL 32825
Denise Diaz
1000 Douglas Ave Apt
123
Altamonte Springs, FL
32714Kurt Ramos
2834 Curry Woods Dr
Orlando, FL 32822
Chris Furino
312 S Hampton Ave
Orlando, FL 32803
Max Sejour
620 Beverly Ave
Altamonte Springs, FL
32701
582 Andorra Cir NE
Saint Petersburg, FL
33703
Beth Bennion
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 10
10 Ann Mount
Individual
Retired Check
$50.0043
Individual
Retired Check
$250.0044
16 21 28 21
28 21
10 28 21
821 N Eola Dr
Orlando, FL 32803
Frances S. Pignone
1720 Gatlin Ave
Orlando, FL 32806
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 16 21 10 28 21 9 10
10 18 21 JustCall Auto dial fee Monetary
$40.00
1 3260 Hillview Ave
Palo Alto, CA 94304
Great Graphics Photoscan
10 19 21 Printing Monetary
$14.64
2
726 W Smith St
Orlando, Fl 32805
Phone.com
10 20 21 Auto Dial Fee Monetary
$28.33
3
3260 Hillview Ave
Palo Alto, CA 94304
JustCall
10 20 21
Auto Dial Fee Monetary
$40.003260 Hillview Ave
Palo Alto, CA 943044
JustCall
10 22 21 Auto Dial Fee Monetary
$50.003260 Hillview Ave
Palo Alto, CA 943045
JustCall
10 25 21 Auto Dial Fee Monetary
$40.003260 Hillview Ave
Palo Alto, CA 943046
Facebook Digital Ads Monetary
$10.00102521
1 Hacker Way
Menlo Park, CA 940257
JustCall Auto Dial Fee Monetary
$317.49102521
3260 Hillview Ave
Palo Alto, CA 943048
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 16 21 10 28 21 10 10
10 25 21 Facebook Digital Ads Monetary
$10.00
9 1 Hacker Way
Menlo Park, CA 94025
Facebook
10 26 21 Digital Ads Monetary
$10.00
10
1 Hacker Way
Menlo Park, CA 94025
Facebook
10 26 21 Digital Ads Monetary
$15.00
11
1 Hacker Way
Menlo Park, CA 94025
Facebook
10 26 21
Digital Ads Monetary
$15.001 Hacker Way
Menlo Park, CA 9402512
Facebook
10 26 21 Digital Ads Monetary
$25.001 Hacker Way
Menlo Park, CA 9402513
JustCall
10 27 21 Auto Dial Fee Monetary
$50.003260 Hillview Ave
Palo Alto, CA 9430414
Facebook Digital Ads Monetary
$35.00102821
1 Hacker Way
Menlo Park, CA 9402515
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