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
Regina (Qualified) Hill
4630 S. Kirkman Road, Suite 107
Orlando, FL 32811
2021D5001
4 District 5, Orlando City Commissioner
G-3
4
4
16 830 21
0 00
16 830 21
756 62
16 133 18
0 00
16 133 18
102 337 89
0 00
59 096 79
10 16 21 10 28 21
C9559F23-A6DE-4596-AC39-23DAA3E2CB0B
10/29/21 - 10:32:36
10/29/21 - 10:32:36
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
Regina (Qualified) Hill 2021D5001
10 210 11
10 Solomon Vereen
Individual
Self
employed
Check
$1,000.001
Individual
Business
Owner
Check
$250.002
Business
Attorney Check
$500.003
Business
Attorney Check
$500.004
Individual
Retired Check
$1,000.005
Individual
CashOrCash
iersCheck
$20.006
Individual
CashOrCash
iersCheck
$20.007
16 21 28 21
22 21
10 22 21
10 22 21
10 22 21
10 22 21
10 22 21
10 22 21
124 Hager Dr
Riverdale, FL 30274
Christopher & Lauren
Carmody
2804 Stanfield Ave
Orlando, FL 32814
NeJame Law PA
189 S Orange Ave Suite
1800
Orlando, FL 32801
Gray Robinson PA
301 E Pine St Suite 1400
Orlando, FL 32801
Angela Hill
930 Arlington St
Orlando, FL 32805
Sonya Hill
1834 Aaron Ave
Orlando, FL 32811
9972 Kilgore Rd
Orlando, FL 32836
Irving & Darlene
Matthews
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
Regina (Qualified) Hill 2021D5001
10 310 11
10 Angelina Tmms
Individual
CashOrCash
iersCheck
$20.008
PoliticalCommittee
Political
Group
Check
$500.009
Individual
Attorney Check
$250.0010
Business
Developer Check
$250.0011
Business
Hospitality Check
$300.0012
Individual
Pastor Check
$1,000.0013
Business
Developer Check
$250.0014
16 21 28 21
22 21
10 22 21
10 22 21
10 28 21
10 28 21
10 28 21
10 28 21
6840 Moorhen Circle
Orlando, FL 32810
The Southern Group of
Florida Political
Committee
P.O. Box 10570
Tallahassee, FL 32302
Kelly Cohen
100 S Eola Drive, Apt
514
Orlando, FL 32801
Ustler Development, Inc
800 N. Orange Ave, STE
200
Orlando, FL 32801
Terence Gray
899 Bloomington Court
Ocoee, FL 34761
Orlando Neighborhood
Properties, LLC
800 N. Orange Ave, STE
200
Orlando, FL 32801
9168 Balmoral Mews Sq
Windermere, FL 34786
Superior Hospitality
Group
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
Regina (Qualified) Hill 2021D5001
10 410 11
10 Willie Ross
Individual
Check
$100.0015
Business
Sports
Company
Check
$1,000.0016
PoliticalCommittee
Political
Group
Check
$1,000.0017
Individual
Check
$100.0018
Individual
Check
$100.0019
Individual
Check
$100.0020
Individual
Check
$100.0021
16 21 28 21
28 21
10 28 21
10 28 21
10 28 21
10 28 21
10 28 21
10 28 21
5531 Long Lake Hills
Blvd
Orlando, FL 32810
Orlando City Soccer
655 W Church St
Orlando, FL 32805
Realtors Political
Advocacy Committee
7025 Augusta National
Drive
Orlando, FL 32822
Alfreda Clark
2017 W Gore St
Orlando, FL 32805
Alzo Reddick
2116 Monte Carlo Trail
Orlando, FL 32805
Jaminika & Macene Isom
912 Wooden Blvd
Orlando, FL 32805
1797 Croghan Drive
Melbourne, FL 32940
Alfonso & Cinderella
Washington
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
Regina (Qualified) Hill 2021D5001
10 510 11
10 Central FL Hotel &
Lodging
PoliticalCommittee
Political
Group
Check
$500.0022
PoliticalCommittee
Political
Group
Check
$500.0023
Individual
Sports Team
Owner
Check
$1,000.0024
Business
Restaurant InKind
$756.6225
Individual
Check
$100.0026
Business
Check
$100.0027
Individual
Homemaker Check
$1,000.0028
16 21 28 21
28 21
10 28 21
10 28 21
10 21 21
10 28 21
10 28 21
10 28 21
6675 Westwood Blvd
Suite 210
Orlando, FL 32821
CFHLA Political
Committee
6675 Westwood Blvd
Suite 210
Orlando, FL 32821
Mark Wilf
820 Morris TPKE Suite
301
Short Hills, NJ 07078
Church Street
Entertainment
33 W Church Street
Orlando, FL 32801
Bruce Mount
2090 Date Palm Court
Ocoee, FL 34761
Keisha Francis
6226 Cartmel Lane
Windermere, FL 34786
8785 Alegre Cir
Orlando, FL 32836
Katherine Starkey
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
Regina (Qualified) Hill 2021D5001
10 610 11
10 Dawn Curtis
Individual
Check
$20.2129
Individual
Business
Developmen
t
Check
$1,000.0030
Individual
Director Check
$250.0031
Individual
Check
$100.0032
Individual
Check
$100.0033
Individual
Check
$100.0034
Individual
Check
$50.0035
16 21 28 21
28 21
10 28 21
10 28 21
10 28 21
10 28 21
10 28 21
10 28 21
4529 Cove Drive
Orlando, FL 32812
Kimberly Rosier Jean-
Louis
11 North Summerlin Ave
Orlando, FL 32801
Kenneth Goodwin
8116 Saint Andrews
Circle
Orlando, FL 32835
Roberta Walton
1411 Calathea Drive
Orlando, FL 32818
Reginald McGill
1417 Addie Ave
Orlando, FL 32818
GILLIAN HEWITT
PO BOX 616292
ORLANDO, FL 32806
825 Garden Plz
Orlando, FL 32803
Kay Rawlins
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
Regina (Qualified) Hill 2021D5001
10 710 11
10 Michael Arrington
Individual
General
Contractor
Check
$500.0036
Individual
Public
Sector
Check
$500.0037
Individual
Check
$100.0038
Individual
Check
$100.0039
Individual
Attorney Check
$250.0040
Individual
Check
$50.0041
Individual
Check
$50.0042
16 21 28 21
28 21
10 28 21
10 28 21
10 28 21
10 28 21
10 28 21
10 28 21
3401 Lake Breeze Drive,
Blvd
Orlando, FL 32808
Roosevelt Holmes
5172 Millenia Waters
Drive , A
Orlando, FL 32839
Russell Drake
4434 Bradley Ave
Orlando, FL 32839
Yogesh Melwani
P.O. Box 394
Windermere, FL 34786
Patricia Rumph
9999 Confidential Street
Orlando, FL 32808
James Lawrence
9907 132nd St
Live Oak, FL 32060
4611 Morris Street
Philadelphia, PA 19144
Deneen Wilkerson
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
Regina (Qualified) Hill 2021D5001
10 810 11
10 Williams Chelsa
Individual
Check
$100.0043
Individual
VP Gilchrist
Enterprise
Check
$1,000.0044
Individual
President
Gilchrist
Enterprise
Check
$1,000.0045
16 21 28 21
28 21
10 28 21
10 28 21
4822 Nantucket Ln
Orlando, FL 32808
KATHYMAE GILCHRIST
5 SOUTH ORTMAN
DRIVE
ORLANDO, FL 32805
JAME GILCHRIST
5 SOUTH ORTMAN
DRIVE
ORLANDO, FL 32805
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)
Regina (Qualified) Hill 2021D5001
10 16 21 10 28 21 9 11
10 29 21 ActBlue CandidateEx
pense $143.94
1 PO Box 441146
Somerville, MA 02144
Sunoco
10 15 21 CandidateEx
pense $40.00
2
843 SOBT
Orlando, FL 32805
Negril
10 18 21 CandidateEx
pense $119.28
3
6301 Silver Star Rd
Orlando, FL 32818
WAWA-#5308
10 18 21
CandidateEx
pense $57.825810 Raleigh St.
Orlando, FL 328354
Family Dollar
10 18 21 CandidateEx
pense $89.14918 W Colonial Drive
Orlando, FL 328045
Sandra Lewis-Canvassers
10 18 21 CandidateEx
pense $2,740.003320 Lennox Blvd
Orlando, FL 328116
Zoolix CandidateEx
pense $197.00101621
5401 S Kirkman Rd
Orlando, FL 328197
Zoolix CandidateEx
pense $375.00101021
5401 S Kirkman Rd
Orlando, FL 328198
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)
Regina (Qualified) Hill 2021D5001
10 16 21 10 28 21 10 11
10 15 21 BEATCREATIVE MARKETING LLC CandidateEx
pense $3,800.00
9 1302 Olympia Park Circle
Ocoee, FL 34761
Sephora
10 19 21 CandidateEx
pense $177.10
10
4200 Conroy Rd
Orlando, FL 32839
Mac
10 20 21 CandidateEx
pense $124.62
11
4200 Conroy Rd
Orlando, FL 32839
Cato
10 20 21
CandidateEx
pense $34.042266 S Kirkman Rd
Orlando, FL 3281112
Sandra Lewis-Canvassers
10 20 21 CandidateEx
pense $2,000.003320 Lennox Blvd
Orlando, FL 3281113
All Graphics
10 25 21 CandidateEx
pense $197.006130 Edgewater Drive
Orlando, FL 3281014
Wal-Mart CandidateEx
pense $370.28102521
2500 S Kirkman Rd
Orlando, FL 3281115
Sandra Lewis-Field Director CandidateEx
pense $1,825.00102521
3320 Lennox Blvd
Orlando, FL 3281116
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)
Regina (Qualified) Hill 2021D5001
10 16 21 10 28 21 11 11
10 27 21 Circle K CandidateEx
pense $68.46
17 2705 Silver Star
Orlando, FL 32808
BEATCREATIVE MARKETING LLC
10 27 21 CandidateEx
pense $257.50
18
1302 Olympia Park Circle
Ocoee, FL 34761
Enterprise Rental
10 28 21 CandidateEx
pense $517.00
19
35 E Colonial Drive
Orlando, FL 32801
Sandra Lewis-Field Director
10 28 21
CandidateEx
pense $3,000.003320 Lennox Blvd
Orlando, FL 3281120
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