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G3CAMPAIGN 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 Katia Saint Fleur 9314 NW 2nd Avenue Miami Shores, FL 33150 4 Council Member G-3 4 4 15 660 00 0 00 15 660 00 0 00 650 70 0 00 650 70 15 695 00 0 00 650 70 02 26 21 03 18 21 22B95734-B6E7-459D-BAAD-6788903A0C12 03/19/21 - 09:23:45 03/19/21 - 09:23:45 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 Katia Saint Fleur 02 203 14 03 Jose Diaz Individual Lobbyist Check $500.001 Individual Lobbyist Check $100.002 Individual Lobbyist Check $250.003 Individual Consultant Check $250.004 Individual Program Director Check $100.005 Individual Managing Partner Check $250.006 Individual Attorney Check $50.007 26 21 18 21 18 21 03 18 21 03 18 21 03 18 21 03 18 21 03 18 21 03 18 21 8906 Southwest 69th Street Miami, FL 33173 Cesar Fernandez 480 ne 30th st Miami, FL 33137 Jonathan Kilman 5600 Pine Tree Drive Miami Beach, FL 33140 Da-Venya Armstrong 8004 Northwest 154th Street Miami Lakes, FL 33016 Kaven Jean-Charles "3250 NE 1st Avenue, Suite 305" Miami, FL 33137 Gera Peoples 8239 Northeast 8th Place Miami, FL 33138 4490 Camrose Lane West Palm Beach, FL 33417 Afifa Khaliq 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 Katia Saint Fleur 02 303 14 03 Emma Collum Individual Attorney Check $50.008 Individual President & CEO Check $100.009 Individual Lobbyist Check $100.0010 Individual Consultant Check $100.0011 Individual Executive Director Check $100.0012 Individual Communicat ions Dir. Check $50.0013 Individual Chief of Staff Check $150.0014 26 21 18 21 18 21 03 18 21 03 18 21 03 18 21 03 18 21 03 18 21 03 18 21 "1700 E Sunrise Blvd, #1412" Fort Lauderdale, FL 33304Lucy Sedgwick 3050 8th Street North St. Petersburg, FL 33704 Joseph Salzverg 333 S.E. 2nd Avenue Miami, FL 33131 Ria Khan 6332 NW 173rd Terrace Miami Lakes, FL 33015 Cheryl Waide 312 NE 211th Terrace Miami, FL 33179 Victricia Simmons 1001 Southwest 75th Avenue Plantation, FL 33317 6809 Southwest 12th Street Pembroke Pines, FL 33023 Evan Fancher 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 Katia Saint Fleur 02 403 14 03 Debra Owens Individual Government Relations Check $100.0015 Individual Executive Director Check $250.0016 Individual Asst. Project Manager Check $100.0017 Individual Realtor Check $50.0018 Individual Execuitive Director Check $50.0019 Individual Consultant Check $1,000.0020 Individual Co Executive Director Check $50.0021 26 21 18 21 18 21 03 17 21 03 17 21 03 17 21 03 17 21 03 17 21 03 17 21 "555 NE 34th Street, Apt 1407" Miami, FL 33137 Donna Stewart 915 Northeast 96th Street Miami Shores, FL 33138 Aaron McKinney 1790 Northwest 51st Street Miami, FL 33142 Andreana Jackson 1801 South Treasure Drive North Bay Village, FL 33141 Heather Turnbull 4564 Grove Park Drive Tallahassee, FL 32311 Stephanie Porta 1835 Palm Lane Orlando, FL 32801 910 Bay Drive Miami Beach, FL 33141 marialegria rodriguez 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 Katia Saint Fleur 02 503 14 03 Eric Brakken Individual Consultant Check $100.0022 Individual Account Executive Check $100.0023 Individual Consultant Check $250.0024 Individual Managing Director Check $250.0025 Individual Nursing Professor Check $150.0026 Individual National Sales Executive Check $50.0027 Individual Gov Consultant Check $50.0028 26 21 18 21 16 21 03 16 21 03 16 21 03 16 21 03 16 21 03 15 21 03 15 21 620 Forest Street Windermere, FL 34786 Peter-John Barr 1146 Northwest 132nd Avenue Pembroke Pines, FL 33028Todd Wilder 2132 Orleans Drive Tallahassee, FL 32308 fabiano aguilar 9935 Northeast 13th Avenue Miami Shores, FL 33138 Lili Bach 301 P Street Sacramento, CA 95814 Tiffany Bowers 1423 South Gadsden Street Tallahassee, FL 32301 19830 Northeast 14th Avenue Miami, FL 33179 Marie Etienne 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 Katia Saint Fleur 02 603 14 03 Giselle Kovac Individual Executive Director Check $250.0029 Individual Customer Service Agent Check $50.0030 Individual Owner Check $10.0031 Individual Teacher Check $200.0032 Individual Adminstrator Check $100.0033 Individual Adminstrator Check $25.0034 Individual Attorney Check $100.0035 26 21 18 21 15 21 03 12 21 03 12 21 03 11 21 03 10 21 03 10 21 03 09 21 290 Northeast 98th Street Miami Shores, FL 33138 Malaysiah Adams "1108 Bartow Rd, Apt G78" Lakeland, FL 33801 Ace Tucker 335 Alderman Trace Southwest Austell, GA 30168 Adrian Carter 8147 Lagos de Campo Blvd Tamarac, FL 33321 Kassandra Timothe PO Box 611274 Miami, FL 33261 Theresa Jean-Pierre Coy 317 Fern Gulley Drive Seffner, FL 33584 7857 Briarcreek Road West Tallahassee, FL 32312 KENNETH PRATT 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 Katia Saint Fleur 02 703 14 03 Carlecia Collins Individual Consultant Check $100.0036 Individual Attorney Check $250.0037 Individual Retiree Check $25.0038 Individual Consultant Check $250.0039 Individual Coordinator Check $25.0040 Individual College Adminstrator Check $100.0041 Individual Architect Check $50.0042 26 21 18 21 09 21 03 09 21 03 09 21 03 08 21 03 07 21 03 07 21 03 06 21 1942 Celtic Road Tallahassee, FL 32317 Yolanda Jackson 8339 Northwest 195th Terrace Hialeah, FL 33015 William Eaton 12712 Buckingham Drive Bowie, MD 20715 Christian Ulvert 29 Northeast 102nd Street Miami Shores, FL 33138 Koren Bedeau 2323 Race St Unit 918 Philadelphia, PA 19103 Rafeeq Asad 822 East Washington Avenue Madison, WI 53703 333 NE 24 St. Miami, FL 33137 Kalynn Cook 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 Katia Saint Fleur 02 803 14 03 Jason Blank Individual Attorney Check $250.0043 Individual Retiree Check $100.0044 Individual Organizer Check $250.0045 Individual Adminstrator Check $250.0046 Individual Retiree Check $200.0047 Individual Attorney Check $100.0048 Individual Non-Profit Administrato r Check $50.0049 26 21 18 21 05 21 03 05 21 03 04 21 03 04 21 03 04 21 03 02 21 03 02 21 888 S Andrews Ave Ft Lauderdale, FL 33316 LaVon Bracy 5315 Woodstead Way Orlando, FL 32819 Angela Nixon 5571 Longspur Avenue Jacksonville, FL 32219 Travaris McCurdy PO Box 555454 Orlando, FL 32855 Byrnes Guillaume 9209 Delemar Court Wellington, FL 33414 Leonie Hermantin 6321 Southwest 63rd Terrace South Miami, FL 33143 1701 NW 191 Street Miami Gardens, FL 33056 Oscar J Braynon 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 Katia Saint Fleur 02 903 14 03 Santra Denis Individual Non-Profit Administrato r Check $100.0050 Individual Executive Check $1,000.0051 Individual Retiree Check $500.0052 Individual Entrepeneur Check $1,000.0053 Individual Non-Profit Adminstrator Check $25.0054 Individual Organizer Check $200.0055 Individual Church Adminstrator Check $50.0056 26 21 18 21 02 21 03 02 21 03 01 21 03 01 21 02 28 21 02 26 21 02 26 21 5835 Washington Street Hollywood, FL 33023 Russell Benford 4944 Windward Way Fort Lauderdale, FL 33312 Janet Taylor POB 764 Clewiston, FL 33440 Claudel Beauplan 41 Scott Drive Southeast Marietta, GA 30067 Anne Pierre 1852 Southeast Carvalho Street Port St. Lucie, FL 34983 Lynda Jean 638 Northeast 141st Street North Miami, FL 33161 1011 Bay Drive Miami Beach, FL 33141 Rebecca Pelham 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 Katia Saint Fleur 02 1003 14 02 Rodney Murray Individual Retired Veteran Check $500.0057 Individual Aide Check $50.0058 Individual Attorney Check $500.0059 Individual Retiree Check $100.0060 Individual Entrepeneur Check $150.0061 Individual Accountant Check $150.0062 Individual Consultant Check $500.0063 26 21 18 21 26 21 02 26 21 02 26 21 02 26 21 02 26 21 02 26 21 02 26 21 14801 Northwest 5th Avenue Miami, FL 33168 tajmaus johnson 8205 White Falls Blvd Jacksonville, FL 32256 Kemay Jackson 2330 Scenic Highway South Snellville, GA 30078 Patricia Braynon 1701 NW 191 ST Miami Gardens, FL 33056 Stephen Nesi 11980 Northwest 4th Court Plantation, FL 33325 Oscar Braynon II 19010 NW 14th Ave Rd Miami Gardens, FL 33169 11980 Northwest 4th Court Plantation, FL 33325 Shareeke Edmead-Nesi 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 Katia Saint Fleur 02 1103 14 02 Alecia Collins Individual Adminstrator Check $50.0064 Individual Adminstrator Check $1,000.0065 Individual Organizer Check $100.0066 Individual Retiree Check $50.0067 Individual IT Professional Check $250.0068 Individual Adminstrator Check $100.0069 Individual Consultant Check $100.0070 26 21 18 21 26 21 02 26 21 02 26 21 02 26 21 02 26 21 02 26 21 02 26 21 1942 Celtic Road Tallahassee, FL 32317 Sandy Dorsainvil 18708 Northwest 14th Street Pembroke Pines, FL 33029Jamecia Gray 7856 Hidden Hollow Dr Orlando, FL 32822 Gloria Battle 1240 Southwest 6th Way Deerfield Beach, FL 33441 Carlos Nathan 826 West Georgia Street Tallahassee, FL 32304 Joy Friedman 7521 Diven Street Norfolk, VA 23505 164 Deep Woods Way Ormond Beach, FL 32174 Derby Johnson 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 Katia Saint Fleur 02 1203 14 02 Alia Leroy Individual Aide Check $200.0071 Individual Delegate Check $200.0072 Individual Campaign Director Check $100.0073 Individual Attorney Check $250.0074 Individual Organizer Check $50.0075 Individual Consultant Check $100.0076 Individual Organizer Check $100.0077 26 21 18 21 26 21 02 26 21 02 26 21 02 26 21 02 26 21 02 26 21 02 26 21 1225 Northwest 186th Street Miami, FL 33169 Marcia Price 935 Shore Drive Newport News, VA 23607 Whitney Murray 1521 Millbrook Court Orange Park, FL 32003 Michele Rayner 3605 1st Avenue South St. Petersburg, FL 33711 Maya Brown 1326 W Hiawatha St Tampa, FL 33604 Roxey Nelson 600 63rd St. N St Peterburg, FL 33710 275 NW 157th St Miami, FL 33169 Linda Joseph 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 Katia Saint Fleur 02 1303 14 02 Jasmen Rogers Individual Consultant Check $100.0078 Individual Director Check $50.0079 Individual Adminstrator Check $100.0080 Individual Adminstrator Check $500.0081 26 21 18 21 26 21 02 26 21 02 26 21 02 26 21 514 NE 26th Drive Wilton Manors, FL 33334 Kilan Ashad- Bishop 201 SE 2nd Ave Miami, FL 33131 Ryan Hawkins 8955 Nw 1st Ave El Portal, FL 33150 Larry Spring 16477 Southwest 32nd Street Miramar, FL 33027 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) Katia Saint Fleur 02 26 21 03 18 21 14 14 03 18 21 Anedot Inc.CandidateEx pense $650.70 1 1340 Poydras Street, Suite 1770 New Orleans, LA 70112 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