HomeMy WebLinkAboutAnderson Bruce 03-13-2007FLORIDA DEPARTMENT OF STATE DIVISION OF ELECTIONS
CAMPAIGN TREASURER'S REPORT SUMMARY
1 -' ~ ~J ,~
( ) ~/'~CCc /1/I~UG.~JC~i! _ OFFICE t7SE ONLY
il~~
Name
Address (number and street)
City, State, Zip Code
^ CHECK IF ADDRESS HAS CHANGED (3) ID Number:
(4) Check appropriate box(es):
Candidate (office sought): ~~= ~~eas -~ ~ .~~~ ~~ ~•, ~ << ~~ c. ~
^ Political Committee ^ CHECK 1 PC HAS DISBANDED
^ Committee of Continuous Existence ^ CHECK IF CCE HAS DISBANDED
^ Party Executive Committee
^ Electioneering Communication ^ CHECK IF NO OTHER ELECTIONEERING
COMMUNICATION REPORTS WILL BE FILED
(5) REPORT IDENTIFIERS
Cover Period: From 3 / ~j' l Z~j-7 To y l ~ / Z~ Report Type
^ Original ^ Amendment ^ Special Election Report ^ Independent Expenditure Report
(6) CONTRIBUTIONS THIS REPORT (7) EXPENDITURES THIS REPORT
Monetary
Cash 8~ Checks $ Expenditures $ r'. ~(
Loans $ Transfers to Office
Account $
Total Monetary $ Total
^
Monetary $ ~ `{ S
In-Kind $
(8) Other Distributions
(9) TOTAL Monetary Contributions To Date (10) TOTAL Monetary Expenditures To Date
$ ~OL ~vU $ ~,~~.vv
(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, I certify that I have examined this report and it is true,
correct, and complete. correct, and complete.
(Type name) ~j jZte L~ ~ ~ ~~~ZS6/...~ (Type name) ~ %(~;. C~~ ~ ~~.,~}~1c"~'.~~
^ Individual only for 'Treasurer ^ Deputy Treasurer Candidate ^ Chairperson (only for PC, PTY &
election ring co un.) ~" electioneering commun. organization)
Signature Signature
DS-0E 72 (Rev. 08/04)
CAMPAIGN TREASURER'S REPORT -ITEMIZED EXPENDITURES
(1) Name (2) I.D. Number
(3) Cover Period 3 / ~ l ~'~ through ~/ l ~ l 2D6~ (4) Page of
(5)
Date h)
Full Name ($)
Purpose (9) ho) h~)
(s)
Sequence
Number (Last, Suffix, First, Middle)
Street Address &
City, State, Zip Code (add office sought if
contribution to a
candidate)
Expenditure
TYPe
Amendment
Amount
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Y ~ 7
F-
C :;
C,.
-~!
DS-DE 14 (Rev. 08!03) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES
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HOME OF PELICAN ISLAND
1225 Main Street
Sebastian, Florida 32958
(772) 589-5330 phone - (772) 589-5570 fax
March 14, 2007
Bruce E. Anderson
134 Pelican Island Place
Sebastian, FL 32958
Dear Mr. Anderson:
Though you were not successful in your bid for election, I hope you found your
campaign a positive experience. I applaud your effort to represent the citizens
of Sebastian.
In accordance with Florida Statutes 106.07 a campaign treasurer's termination
report for (TR) for your campaign must be filed by June 11, 2007 and will include
all lawful expenditures in accordance with 106.11(5) and final disposition of
surplus funds in accordance with 106.141.
If you have any questions or if there is anything I can do to assist you, please do
not hesitate to contact me at 589-5330.
Sinc y,
.~-
Sally A. io, MMC
City Clerk
sam
WAIVER OF REPORT
(Section 106.07(7), F.S.)
(PLEASE TYPE)
OFFIE~'USE ONLY
~-
Candidate's Name (Last, Suffix, First, Middle)
OR Polit(ic~al Committee, CCE or Party Name
Address (Number and Street)
City State Zip Code
~[ l Candidate ~ Committee of Continuous
}~ Existence
Political Committee ~ Party Executive Committee
Identification Number (Assigned by Division
of Elections)/~
Office Sought (Include istrict, Circuit or
Group Number)
Check box if address has changed since last
report.
Check here if PC or CCE has DISBANDED
and will no longer file reports.
TYPE OF REPORT
(Check Appropriate Box)
QUARTERLY REPORTS
^ January
^ April
^ July
^ October
PRIMARY ELECTION
^ 32nd day prior
^ 18th day prior
^ 4th day prior
GENERAL ELECTION
^ 46th day prior
^ 32nd day prior
^ 18th day prior
4th day prior
^ TERMINATION REPORT
^ SPECIAL ELECTION
NOTIFICATION OF NO ACTIVITY IN CAMPAIGN ACCOUNT FOR THE REPORTING PERIOD OF
L ,
~~ (~. ~~ Z~~ through ~ G~ ~ ~L~'
X ~ ,
~ z~~
Signature ate
SIGNATURES REQUIRED FOR: Candidates
Candidate, Campaign Treasurer or Deputy Treasurer (s. 106.07(5), F.S.)
Political Committees
Chairman, Campaign Treasurer or Deputy Treasurer (s. 106.07(5), F.S.)
Committees of Continuous Existence
Treasurer (s. 106.04(4)(c), F.S.)
Party Executive Committees
Treasurer or Chairman (s. 106.29(2), F.S.)
In any reporting period when there has been no activity in the account (no funds expended or received) the filing of
the required report is waived. However, the filing officer must be notified in writing on the prescribed reporting date
that no report is being filed.
DS-DE 87 (Rev. 08/03)
..
~~
~~, ;-
HOME OE PELICAN ISLAND
1225 Main Street
Sebastian, Florida 32958
(772) 388-8214 phone - (772) 589-5570 fax
March 6, 2007
Bruce E. Anderson
134 Pelican Island Place
Sebastian, FL 32958
Dear Mr. Anderson:
I received your waiver of report form in the mail today for your campaign for the period February
17, 2007 through March 8, 2007. Because it is dated 3/5/07 I did not stamp it in but will retain it
in your campaign file.
Though the intent is clear that you do not plan to take contributions or expend funds in this
period, because the reporting period does not end until midnight on Thursday, March 8, 2007, I
would ask you to either mail out or drop off another waiver of report form on Friday, March 9,
2007 which is the actual due date. I have enclosed another form for you to use.
Any report postmarked by the United States Postal Service no later than midnight of the due
date, shall be deemed to have been submitted in a timely manner. Please read FS 106:07(2)(a)
for further details.
For future reference and in preparation of your termination report, which will be due by June 11,
2007, please see FS 106.11 and 106.141 relative to expenditure of remaining funds and final
disbursement of funds. In your case because there is no activity for this reporting period, the
next report filed must specify that the report covers the entire period between the last submitted
report and the report being filed (see 106.07(7)).
Any report postmarked by the United States Postal Service no later than midnight of the due
date, shall be deemed to have been submitted in a timely manner. Please read FS 106.07(2)(a)
for further details.
If you have any questions, please do not hesitate to contact me at 388-8214 or a-mail me at
smaio@cityofsebastian.org.
Si ly,
~~
Sally A. aio, MMC
City Clerk
Enclosure (1)
WAIVER OF_REPORT_
(Section 106.07(7), F.S.)
OFFICE USE ONLY
(PLEASE TYPE)
~~^^~~ a
C ndidate's Name (Last, Suffix, First, Middle)
OR Political Committee, CCE or Party Name
Address (Number and Street)
city state zip code
Identification Number (Assigned by Division
of Etections)
S~ G ~s ~ , ~-- ~~~~ ~ ~
Office Sought (Include Distria ,Circuit or
Group Number)
Candidate ~ Committee of Continuous ~ Check box if address has changed since last
Existence report.
Political Committee ~ Party Executive Committee ~ a~ wkill no longer file Creports. DISBANDED
TYPt3 OF REPORT
(Check Appropriate Box)
SIUARTERLY REPORTS PRIMARY ELECTION GENERAL ELECTION
^ January ^ 32nd day prior ^ 48th day prior
^ April ^ 18th day prior ^ 32nd day prior
^ TERMINATION REPORT
^ July ^ 4th day prior ^ 18th day pria'
^ ~~ ~ 4th da ^ SPECIAL ELECTION
Y Prime
NOTIFICATION OF NO ACTMTY IN CAMPAIGN ACCOUNT FOR THE REPORTING PERIOD OF
_ - ~~~ ~ ~ . 2i1 a~~ through 7')~l,wt.c- ~ ~~~ p ~
x ~ ~~
. ___x.~
_~,
ignature ate
SIGNATURES REQUIRED FOR: Candidates
Candidate, Campaign Treasurer or Deputy Treasurer (s. 106.07(5), F.S.)
Political Committees
Chairman, Campaign Treasurer or Deputy Treasurer (s. 108.07(5), F.S.)
Committees of Continuous Existence
Treasurer (s.106.04(4)(c), F.S.)
Party Executive Committees
Treasurer or Chaimman (s. 106.29(2), F.S.)
In any reporting period when there has been no activity in the account (no fiords expended or received) the filing of
the required report is waived. However, the filing officer must be notified in writing on the prescribed reporting date
that no report is being filed.
DS-0E t37 (Rev. Oti103)
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HOME OF PELICAN !BLAND
1225 Main Street
Sebastian, Florida 32958
(772) 388-$214 phone - (772) 589-5570 fax
March 2, 2007
Bruce E. Anderson
134 Pelican. Island Place
Sebastian, FL 32958
Dear Mr. Anderson:
In accordance with Florida Statutes Section 106.07, the campaign treasurer's report for
your campaign for the period February 17, 2007 through March 8, 2007 is due in the
Office of the City Clerk by 5 pm on Friday, March 9, 2006.
Do not. accept any campaign contributions after midnight on Thursday, March 8, 2006.
Any contributions accepted after that time will have to be returned.
For future reference and in preparation of your termination report, which will be due by
June 11, 2006, please see FS 106.11 and 106.141 relative to expenditure of remaining
funds and final disbursement of funds.
Any report postmarked by the United States Postal Service no later than midnight of the
due date, shall be deemed to have been submitted in a timely manner. Please read FS
106.07(2)(a) for further details.
If you have any questions, please do not hesitate to contact me at 388-8214 or a-mail
me at smaio@cityofsebastian.org.
Sin ely,
(.~ ~~
Sally A. aio, MMC
City Clerk
' •'~t
. ~ FLORIDA DEPARTMENT OF STATE DIVISION OF ELECTIONS_
. ~ ~ CAMPAIGN TREASURER'S REPORT SUMMAR~(_
.. ,,
• r` ~ ~~K- ~ ~ ~ ~OFFH3E kJ8E O~IL1E
Name 1 ~.
Address (number anrd--street)
lClty, Stats, Zip Code ~ .. ~ ~ ~ .
^ CHECK IF ADDRESS HAS CHANGED ~ (3) ID Number.
(4) Check appropriate box(es): /~
[Candidate (office sought): ~ ~ bA.S ~~A~ Ci -~y ~~~~~/c r ~
_.
^ Politicai Committee CHEGi{ iF PC HAS ~ibl3ANDED
^ Committee of Continuous Existence ^ CHECK IF.CCE HAS DISBANDED
^ Party F~cecutive Committee
^ Electioneering Communication ^ CHECK IF NO OTHER ELECTIONEERING
COMMUNICATION REPORTS WILL BE FILED
.. .. ~ . (5) REPORT.IDENTIFIERS .. ~ ~ .
Cover Period: From • ~ 1 ~ ! Z~l To ~ / ~(~; ~ /~ Report Type ~.~- 3
^ Originai ^ Amendment ~ Special Election Report ^ Independent Expenditure Report
(6) CONTRIBUTIONS THIS REPORT ~ (7) EXPENDITURES THIS REPORT
Monetary
Cash 8~ Checks $ Expenditures ~$ ~ J 3 ~ • S
Loans $ ~ Z- ~ ~ ~~ ~ Transfers to Office ~ .
~. •• 'Account $.
Total Monetary $. ~ ~L • y~ Total Q _
Monetary $ ~ `3 I E ~ ~
. ~ In-Kind, .. $ . j ~ - ,U ~ . .
(8) Other Distributions ~•
(9) TOTAL Monetary Contributions To Date ~ (10) TOTAL Monetary Expenditures To Date
(11) CERTIFICATION
lt.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, I certify that I have examined this report and it is true;
correct, and complete. correct, and complete.
(TYPe name) ~ I ~ G E_' L ~iJ tk~/zScS'i~- (TYPe name) ~ ~ C E" ~- ~.~,,- c: r: ~~,,jd .J
Ind'nridual (only for ~ ''f reasurer ~ Deputy Treasurer Candidate Q Chairperson (only for PC, PTY 8~
elections un.) electioneering commun. organization)
. .Signature ~ Signature
DS-DE 12 (Rev. 08104}
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CAMPAIGN TREASURER'S REPORT -ITEMIZED CONTRIBUTIONS
I (1) Name ~i2-u.~-~ _ ~ ,~iy(~~~Su,J (2) L>~ Number • •
(3) Cosier Period Z / -~ / ~) through '~ / ~~ / ~~ (4) Page ~_ of
(5)
Date . (7}
Full Name (8) ~ (9) (10) (11) (~~
• (6)
Sequence
Number (Last, Suffix, First, Middle)
Stt~eet Address &
C State Code
Contributor
T Occu tion
Contribution
~ T e •
~ In-kind
Descri tion
.
~
Amount
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DS-DE 13 (Rev. 08/03) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES
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• C~A~APAIGN TREASUit R'S REPORT - ITEMIZED,EXPENDiTURES ~ '
(1) Name L~rZIL ts~ _ ~ • ~.i<i~ ~n5~.~ (2) I.D. Number
(3) Cover Period ~- / i ~ ~7 through ~ 'I ~_! ~Q7 (4) Pags ~_ of l •
(~ ,(7) (8) (9) (10) (11)
' . Date Full Name Purpose
6 (Last, Suffbc~ First, Mtddle)
' ~~ Address ~ (add office sought N .
contribution to a
Expenditure
3equsnce~
Number City, State Zip Code candidate) ~ ~Yps Amendment Amount
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DS-DE 14 (Rev. 08/03) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES
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HOME OF .PELICAN ISLAND
1225 Main Street
Sebastian, Florida 32958
(772) 388-8214 phone - (772) 589-5570 fax
smaio@cityofsebastian.org
February 15, 2007
Bruce E. Anderson
134 Pelican Island Place
Sebastian, FL 32958
Dear Mr. Anderson:
In accordance with Florida Statutes Section 106.07, the campaign treasurer's report for
your campaign for the period February 3, 2007 through February 16, 2007 is due in the
Office of the City Clerk by 5 pm on Friday, February 23, 2007.
Any report postmarked by the United States Postal Service no later than midnight of the
due date, shall be deemed to have been submitted in a timely manner. Please read FS
106.07(2)(a) for further details.
I also want to notify you that the Canvassing Board for the City of Sebastian will meet at
the Supervisor of Elections Office on Wednesday, February 21, 2007 at 2:30 p.m. and
immediately following will witness and certify as to the accuracy of the public test of the
election equipment as required by Florida law. This test is open to the public. For your
information, the Canvassing Board is the City Clerk (chair - by Charter) and the City
Attorney (by Charter); and I have selected the City Manager as the third member.
If you have any questions, please do not hesitate to contact me at 388-8214.
Since ely,
~-----
~Y~/
Sally A. aio, MMC
City Clerk
... °'
i
- FLORIDA DEPARTMENT OF STATE DMSION OF ELECTIONS
. ~ CAMPAIGN TREASURER'S REPORT SU;1VI Y' ,`;; ~. -.-, :...
. .. _. , .
- -
Name -
(2) I~ JAI ~~ I iC J+a~.~.yS~ ~~-~L ~ _ ~ ~' t ._:~; v `~,' ~. ~ u
Address (number and street) - ~'
- CHy, State, Ilp Code ~ - - ~ ~ ~ -
^ CHECK IF ADDRESS HAS CHANGED (3) tD Number.
(4) . heck appropriate box(es):
2
andidate (office sought): ~~.. ~ ~ ~~+~~ ~ f= ~ ~
- ~- -.
^ Political Committee CHECK IF PC S DISBANDED
^ Committee of Continuous Existence ^CHECK IF.CCE HAS DISBANDED
^ Party Executive Committee
^ Electioneering Communication . ^CHECK 1F NO OTHER ELECTIONEERING
• COMMUN1CATiON REPORTS WILL BE FILED
.. .. ~ ~. (S) REPORT.IDENTIFIERS .. ~ . .
Cover Period: From ~ / ~ / To ~1 / ~ "/ ZGb"~ Report Type ~ -Z,
^ Original ^ Amendment ^ Special Electlon Report ^ Independent Expenditure Report
(6) CONTRIBUTIONS THIS REPORT (T) EXPENDITURES THIS REPORT
Monetary
Cash >~ Checks $ Expenditures ~$ - ~ 1 U ~
Loans $ ~~• ~ ~ ~ Transfers to Office .
.. 'Account ~ $,
'Total Monetary $. '2Q1~ , ®~~ Total
" Monetary $ ~, j, ~ U
(8) Other Dist~butions
(9) TOTAL Monetary Contributions To Date (10} TOTAL Monetary Expendres 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, i certify that I have examined this report and it is true;
correct, and complete. correct, and complete.
l
RYPe name) ~ (~ U LG L' /Q7~~ ~/~ (Type name) ~ jZ flLt ~ ~J ~ c: i23 Qr J
^Individual (only for Treasurer ^ Deputy Treasurer ~ Candidate ^ Chairperson (only for PC, PTY r~
electioneering c~mmun.) on Bring common. organization)
r~ ~
- X ~ ,~ X ~`
r
. .Signature ~ Signature
DS-DE 12 (Rev. 08104)
- ~ .. ~'
CAMPAIGN TREASURER'S REPORT -ITEMIZED CONTRIBUTIONS
. ~ .
(1) NamA ~ `~tZe.~ Lf ~" ~<L.~ c~ .(2) LQ Number '
(3) Cover Period ~ / ~ / 'through ~ / ~ / ~'uJ`~ (4) Page ~ of
(5)
Date . Ch ~
Full Name (8) ~ (9) (10) (11) (121
(6)
Sequence
Number. (Last, Suttbc, First, Middle)
St[eetAddress~
C State Zi Code
Contributor
T Occu atlon '
Conbibutbn
T e
In-kind
Descri 'on
,
ame~-dment
Amo~t
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DS-DE 13 (Rev. 08f03) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES
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AMPAI,~N TREASURER'S REPO~itT-ITEMIZED EXPENDITURES •
(1) Name fLtt ~~ ~ ' • ,U c> ~~-.> ~t - ~ (2) LD. Numbsr
(3) Cover Period _~!~ ~~through ~~ •~' ~ (4) Page ~_ of j .
~5)
.Date •~~
~ Full Name (0)
Purpose l9) (10)
• (71)
(B)
Sequence '
Number (Last, Suffix, First, Mtddie)
Street Address &
City, State, Zip Code (add office sought ff .
contribution to a
candidate)
Expenditure
~ TYpe
Amendment
Amount
6 ~~~ ~~ 1~~-,5~/A%;
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DS-DE 14 (Rev. 08!03) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES
arvoF
~~~~
HOME OF PELICAN ISLAND
1225 Main Street
Sebastian, Florida 32958
(772) 388-8214 phone -(772) 589-5570 fax
smaio@cityofsebastian.org
January 30, 2007
Bruce E. Anderson
134 Pelican Island Place
Sebastian, FL 32958
Dear Mr. Anderson:
In accordance with Florida Statutes Section 106.07, the campaign treasurer's.
report for your campaign for the period January 26, 2007 through February 2,
2007 is due in the Office of the City Clerk by 5 pm on Friday, February 9, 2007.
Any report postmarked by the United States Postal Service no later than midnight
of the due date, shall be deemed to have been submitted in a timely manner.
Just a reminder, in accordance with the Land Development Code, political signs
can be posted beginning on February 11, 2007. Please refer to the candidate
handbook for LDG sign provisions and FS 106 for applicable campaign
advertising provisions:
If you have any questions, {Tease do not hesitate to contact me at 589-5330.
Sin ly,
Sally A. M 'o, MMC
City Clerk
sam
CITY OF SEBASTIAN
CITY CLERK'S OFFICE ~ ~'71
~~ RECEIPT N
Name(, / l~ ^ Cash J~
Date ~ ~cneck# y~
No. Amount Paid
001001 208001 Sales Tax
001501322900 Garage Sales.
001501341920 Copies/Bid Specs.
001501341910 LDC/Code of Ordinances
001501341930
Election Q
lif
in
F n'~
~ ~"
y
g
ua
ees
601010343800 Cemetery Lots
LotMiche ,Block ,Unit
001501 343805 Cemetery Fees
Total Paid i/
n' Is
White -Dept. of ngm • Yellow -Finance • Pink • Applica~i !•--._..
- - STATE OF FLORIDA- ~ oFF~~~-~EQNuX
- _ ..,
AP-POINTMENT OF CAMPAIGN TREASURER = -
,
ANDDESIGNATION OF CAMPAIGN
DEPOSITORY FOR CANDIDATES - - - ~ ~ ~ ~' ~ I s'i 1:' ', `,
(Section 106.021(1), F.S.) -
(PLEASE TYPE)
CHECK APPROPRIATE BOX:
Original Appointment ^ Deputy Treasurer ^ Reappointment of Treasurer ^ Secondary Depository
Name of Candidate 1. Address (includ post office box or street, city, state, zip code) .
PL
~
~
A~f
~: (, ~~a~~ ~s~~~~
~3
1
Te phone (optional) 2. Party (Partisan candidates only) 3.Office (add disUict, circuit, group number)
I have appointed the following person to act as my Campaign Treasurer ^ Deputy Treasurer
4. Name of Treasurer or Deputy Treasurer
~~ ~ ~ ~ / ~~ ZJ~.c.~
5. Malting Add (If post office box or drawer add street address) 6. Telephone
T. City
,v 8. County ff~~
,~ iA~ K' v~ t c 9. State //
I v,~ i /',~ 10. Zip Code CC
Z ~S O/
I have designated the fotkwving named bank as my Primary Deposftory ^ Secondary Depository
11. Namge o~f /Bunk J , r 12. Street Address
13. City ~
-~~~~~ 14. County ~
~D~a~~ ~ ~~~~ 15. State
- 1o~,~a 16. Zip Code
z~s~'
17. Signatur an ' ate ~~ Date
1 zG z~7 .
Campaign Treasurer's Acceptance of Appointment
do hereby accept the appointment as
(Please Print or Type)
~"
Campaign Treasurer ^ Deputy Treasurer for the campaign of ~ (~ L~ ,y~E;~~/J
who is seeking nomination or election as a candidate to the office of
/} ~P~Y) `
~f ~ l ' Or/~~ i r~ . As a duly registered voter in .~j ~ }'¢~ ~~,,q,c~
County, Florida, I am qualified to accept this appointment.
UNDER PENALTIES OF PERJURY, l DECLARE THAT 1 HAVE READ THE FOREGOING CAMPAIGN TREASURER'S
ACCEPTANCE OF APPOINTMENT AND THAT THE FACTSD ARE TRUE.
~_-___--
J Z~ ~d~~ X --- ~
Date a ure of mpaign Treasurer or Deputy Treasurer
us-ut y trtev. u~vof
FORM 1 .STATEMENT OF 20Q~
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FINANCIAL INTERESTS
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LAST NAME -FIRST NAME -MIDDLE NAME
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FOR OFFICE
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MAILING ADD SS : ,~
ID Code
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CITY : ~ ZIP : COUNTY
ID Na _ _,
NAME OF AGENCY
Conf. Code rte: _ : _
NAME OF OFFIC OR POSITION HELD OR SOUGHT : P Req Code
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CHECK ONLY IF ®CANDIDATE OR ^ NEW EMPLOYEE ORAPPOINTEE
PDF 2005
*`BOTH PARTS OF THIS SECTION MUST BE COMPLETED"'
DISCLOSURE PERIOD:
THIS STATEMENT REFLECTS YOUR FINANCIAL INTERESTS FOR THE PRECEDING TAX YEAR, WHETHER BASED ON A CALENDAR YEAR OR ON
A FISCAL YEAR. PLEASE STATE BELOW WHETHER THIS STATEMENT IS FOR THE PRECEDING TAX YEAR ENDING EITHER (check one):
DECEMBER 31, 2005 Qjj ^ SPECIFY TAX YEAR IF OTHER THAN THE CALENDAR YEAR:
MANNER OF CALCULATING REPORTABLE INTERESTS:
THE LEGISLATURE ALLOWS FILERS THE OPTION OF USING REPORTING THRESHOLDS THAT ARE ABSOLUTE DOLLAR VALUES
WHICH
,
REQUIRES FEWER CALCULATIONS, OR USING COMPARATIVE THRESHOLDS, WHICH ARE USUALLY BASED ON PERCENTAGE VALUES (see
instnictions for further details). PLEASE STATE BELOW WHETHER THIS STATEMENT REFLECTS EITHER (check one):
^ COMPARATIVE (PERCENTAGE) THRESHOLDS QB DOLLAR VALUE THRESHOLDS
PART A -PRIMARY SOURCES OF INCOME [Major sources of income to the reporting person)
NAME OF SOURCE SOURCE'S DESCRIPTION OF THE SOURCE'S
OF INCOME ADDRESS PRINCIPAL BUSINESSACTMT'Y
y
c ~ c- oiz'~ l a r-f 4,v i~ L ~ a1 ~
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PART B -SECONDARY SOURCES OF INCOME [Major customers, diems, and other sources of income to businesses owned by the reporting person]
NAME OF NAME OF MAJOR SOURCES ADDRESS PRINCIPAL BUSINESS
BUSINESS ENTITY OF BUSINESS' INCOME OF 50URCE ACTMTY OF SOURCE
PART C -REAL PROPERTY [Land, buildings owned by the reporting person] FILING INSTRUCTIONS for when
~ and where to file this form are locat-
p
t~ r .DGNC-C ~ ) 3`~ E ` 1 ~I~~ ~~Iq~J~ ~~ . S ~:.p~'~-iAN ed at the bottom of page 2.
INSTRUCTIONS on who must file
this form and how to fill It out begin
on page 3.
OTHER FORMS you may need to
file are described on page 6.
~S
CE FORM 1 - Eff. if2006 (Continued on revense side) PAGE 1
v
PART D - INTAN616LE PERSONAL PROPERTY [Stocks, t-onds, certfficates of deposit, etc.]
WHICH THE
PART E -LIABILITIES [Major debts]
NAME OF CREDITOR
~
ADDRESS OF CREDITOR
DrJ ~1~ OC ~ ~ ~• ~~' ~~ DN ~raD D-~ , ~ISS~Of- i'~S~CJ'
~16wAL, ' A-~D .5~?~IccS PJ J'u~- i (n ~oL~r, v. ~~~ K . ~az~~ - iol7~
w>~ h ov f~•+ ~ a~ K ,J. A , . r> 6 d>r D ~' ~ ~ A P ~~ ~ c, ye -- cx~7
tom. h q- ~ A~ D ~Iz i1 / c ~S ~ D 6 S~ S 3 (.t~i ~~f I'N ~ ~ . ~~ ° S 1 S-3
PART F -INTERESTS 1N SPECIFIED BUSINESSES [Ownership or positions in certa~t types of businessesj
~ BUSINESS ENTITY # 1 I BUSINESS ENTITY # 2 I BUSINESS ENTITY # 3
INTEREST
IF ANY OF PARTS A THROUGH F ARE CONTINUED ON A SEPARATE SHEET, PLEASE CHECK HERE
SIGNATURE (required}: ~ '~ ~~~ DATE SIGNED (required): ` Z ~ /Z UU
r -- -- //~ ~ =---
WHAT TO FILE:
After completing ail parts of this form, including
signir~ and dating It, send balk oNy the first
sheet (pages 1 and 2) for filing.
if you have nothing to report in a particular
section, you must write 'none" or "nla" in that
section(s):
Facsim0es will not Ge accepted.
NOTE:
MULTIPLE FILING UNNECESSARY:
Generally, a person who has filed Form 1 for a
calendar or fiscal year is not required to file a
second Form 1 for the same year. However, a
candidate who previously filed Form 7 because
of another public position must at least file a copy
of his or her original Form 1 when qualifying.
FILING INSTRUCTIONS:
WHERE TO FILE:
If you were mailed the form by the Commission
on Ethics or a County Supervisor of Electlons for
your annual disclosure filing, return the form to
that location.
Local oiiicers!employeesfilewith the Supervisor
of Eiedions of the county in which they pemra-
nently reside. (If you do not permanenty reside
in Florida, file with the Supervisor of the county
where your agency has its headquarters.)
State officers or specified state employees
file with the Commission on Ethics, P.O. Drawer
15709, Tallahassee, FL 32317.5709; physical
address: 3600 Macay Boulevard, South, Suite
201, Tallahassee, FL 32312.
Candidates file this form together with their
qualifying papers.
To determine what category your position
falls under, see the "Who Must File' Instructions
on page 3.
WHEN TO FILE:
Inifta0y, each local officedemployee, state
officer, and spedfted state employee must
file within 30 days of the date of his or her
appointment or of the beginning of employ-
ment. Appointees who must be confirmed by
the Senate must file prior to confirmation, even
if that is less than 30 days from the date of their
appointment.
Candidates for publicly-elected local office
must file at the same time they file their
qualifying papers.
Thereafter, local officers/empioyees, state
officers, and spedfied state employees are
required to file by July 1st following each
calendar year in which they hold their posi-
tions.
Finatty, at the end of office or employment,
each local officerlemployee, state officer, and
specified state employee is required to file a
final disclosure form (Form 1F7 within 60 days
of leaving office or employment.
CE FORM 1 -Eft. 112006 PAGE 2
STATEMENT OF
CANDIDATE
(Seetlon 106.023, F.S.)
(Please Type)
I, ~~2~c~ ~ ~~~~: ~Sd~
candidate for the office of C ~ -~~ C a ~ ,J ~ ~
Florida Statutes.
x ~- ~
Signature of Candidate
/~-2 ~ - Zyy`7
Date
Each candidate must file a statement with the qualifying officer within 10 days after the
Appointment of Campaign Treasurer and Designation of Campaign Depository is filed. Willful
failure to file this form is a first degree misdemeanor and a civil violation of the Campaign
Financing Act which may result in a fine of up to $1,000, (ss. 106.19(1)(c), 106.265(1), Florida
Statutes).
DS-DE 84 (Rev. 08/03)
ELIGIBILITY. TO HOLD OFFICE
OF COUNCILMEMBER
2.02 -ELIGIBILITY
No person shall be eligible to hold the office of council member unless he or she
s a qualified elector in said city and actually continually resided in said city for a
period of one (1) year immediately preceding the final date for qualification as a
~andidate for said office."
I, `~
~~= w .~ ~~./z 5~.~ candidate for the office
:ilmember; meet ttie qualifications to be eligible to hold office as required
n 2.02' of the City of Sebastian Charter, above.
Signature-of Candidate
to and subscribed before me this~~(~Z=--day o
2Z•
__---~
~' - % > ~ ..
of
""d Sall A.
~~qx•.L~;. y Maio
•• Commission # DD595269
~' ~~`` Expires October 5. ?.010
,~~~i ~~~~` Bonded troy Fmn Insurance. Inc 600.7BS7019
O~F7CE ~E'~tJL`~ -~ ~ ~ ,
LOYALTY OATH .
CANDIDATES WITH NO PARTY AFFILIATION 4 % ~ ~ .~ ~ ~ ~ ~'; ? .
(Sections 878.05.878.10, Florida Statutes) `
STATE OF FLORIDA
I,
~~,~~~~ ' ~ ~ ~ x couNTY
PLEASE PRIN
~~•~~~-~ L- 111~c-,es~~~
F~rSL Name ~ Mitltlle Namelinitial Last Nerve
a citizen of the State of Florida and of the United States of America, ... and a candidate for public office ... do
hereby solemnly swear or affirm that I will support the Constitution of the United States and of the State of Florida.
OATH OF CANDIDATE
(Section 99.021, Fbrida Statutes)
(PLEASE PRINT NAME AS YOU WISH R 70 APPEAR O/N;THE BALLOT -NAME MAY NOT BE CHANGED AFTER THE END OF GlUWF17NG)
am a candidate for the office of _ C, I ~y L' ~ Un)C !' ~ ,
(ofNce) (distriet) (dreutt}
. I am a qualified elector of yid ~; A~.- k~i UC rG County, Florida. I am qualified
(9ro~P)
under the Constitution and the Laws of Florida to hold the office to which I desire to be nominated or elected. I
have qualfied for no other public office in the state, the term of which office or any part thereof runs concurrent
with the office I seek; and 1 have resigned from any office from which I am required to resign pursuant to Section
99.012, Florida Statutes.
SIGN HERE
13y ~~I,c~;~ ~s~,~,~~ ~~~~t
Mailing Address
~~z-s~i- ~ll~
Day Phone
City State rp Code
Fax Number
J -' Z L Z: L> ~'
Date Signed
DS-DE 246 (Rev. 08/03)
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