HomeMy WebLinkAboutGILLMOR RICHARD 11-2-2010FLORIDA DEPARTMENT OF STATE DIVISION OF ELECTIONS
CAMPAIGN TREASURER'S REPORT SUMMARY
Richard Gillmor
OFFICE USE ONLY o
c
-n
T
C7
rn c:
c' m
r.) o
f -n Cr)
`2 rn
Name
744 Kroegel Ave.
Address (number and street)
Sebastian, FL. 32958
City, State, Zip Code
CHECK IF ADDRESS HAS CHANGED
(4) Check appropriate box(es):
(►J Candidate (office sought): Sebastian City Council
(3) ID Number: 3 cc
cc
t--• f
r
fi t
Political Committee CHECK IF 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 io 29 2010 To 11 10 2010 Report Type m
Report Independent Expenditure Report
FA Original Amendment Special Election
(6) CONTRIBUTIONS THIS REPORT
Cash Checks 0.00
(7)
Monetary
Expenditures
Transfers
Account
Total
Monetary
EXPENDITURES THIS REPORT
435.73
Loans
to Office
Total Monetary 0.00
435.73
In -Kind
(8)
Other Distributions
(9) TOTAL Monetary Contributions To Date
2,742.50
(10)
TOTAL Monetary Expenditures To Date
2,742.50
(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) Elizabeth Walton
I certify that I have examined this report and it is true,
correct, and complete.
(Type name) Richard Gillmor
Individual (only for Treasurer Deputy Treasurer
Candidate Chairperson (only for PC, PTY
lei i. a "ng commun. organization)
0 1 1
electioneering commun.)
X
X
�Lj
Signature
Signature
DS -DE 12 (Rev. 08104)
(5)
Date
Full Name
Purpose
(add office sought if
contribution to a
candidate)
Expenditure
Type
Amendment
Amount
(6)
Sequence
Number
(Last, Suffix, First, Middle)
Street Address
City, State, Zip Code
10 /29 /10
Walmart
2001 US HWY 1
Campaign
party
supplies and
food
MON
$132.97
1
Sebastian, FL. 32958
10 /29 /10
Home Depot
13361 US HWY 1
Sebastian, FL. 32958
Sign Supplies
MON
$26.65
2
11 /1 /10
Richard Gillmor
744 Kroegel Ave.
Sebastian, FL. 32958
Campaign
Party
supplies and
food
PCW
$106.63
3
11 /10/10
Hometown News
1102 S US 1
Fort Pierce, FL. 32950
Newspaper Ad
MON
$69.48
4
LI/ 1
f111
1 roe�L
1 —7 Z5ffi
(Ac
WI
UFF
C—T
S HAN
CLERK
1 ft Iles
(1) Name
DS -DE 14 (Rev. 08103)
0107eiru,keD 46e
CAMPAIGN TREASURER'S REPORT ITEMIZED EXPENDITURES
Richard Gillmor (2) I.D. Number
(3) Cover Period 1° 3 1° through If 1
(4) Page 1 of
SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES
(5)
Date
Full Name
(Last, Suffix, First, Middle)
Street Address
City, State, Zip Code
(8)
Purpose
(add office sought if
contribution to a
candidate)
Expenditure
Type
Amendment
Amount
(6)
Sequence
Number
10 /29 /10
Walmart
2001 US HWY 1
Sebastian, FL. 32958
Campaign
party
supplies and
food
MON
$132.97
1
10 /29 /10
Home Depot
13361 US HWY 1
Sebastian, FL. 32958
Sign Supplies
MON
$26.65
2
11 /1 /10
Richard Gillmor
744 Kroegel Ave.
Sebastian, FL. 32958
Campaign
Party
supplies and
food
PCW
$106.63
3
11 /10/10
Hometown News
1102 S US 1
Fort Pierce, FL. 32950
Newspaper Ad
MON
$69.48
4
2010
f SE:bA
'ICE OF CIT)
DEC 21 Prl
3
CLERK
1 59
CAMPAIGN TREASURER'S REPORT ITEMIZED EXPENDITURES
(1) Name Richard Gillmor (2) I.D. Number
(3) Cover Period 10 30 10 through fl 10 10 (4) Page 1 of
DS -DE 14 (Rev. 08/03)
SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES
1
FLORIDA DEPARTMENT OF STATE DIVISION OF ELECTIONS
CAMPAIGN TREASURER'S REPORT SUMMARY
Richard Gillmor
N
OFFICE USE ONLY T
0
r c-)
c rrl
N o
i✓ r,
n ri
3
Name
(2) 744 Kroegel Ave.
Address (number and street)
Sebastian, FL. 32958
City, State, Zip Code
CHECK IF ADDRESS HAS CHANGED
(4) Check appropriate box(es):
FI Candidate (office sought): Sebastian City Council
(3) ID Number: r-
Political Committee CHECK IF 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 10 9 2010 To 10 28 2010 Report Type G4
Report Independent Expenditure Report
Original Amendment Special Election
(6) CONTRIBUTIONS THIS REPORT
Cash Checks 1,000.00
(7)
Monetary
Expenditures
Transfers
Account
Total
Monetary
EXPENDITURES THIS REPORT
886.47
Loans
to Office
Total Monetary 1,000.00
886.47
In -Kind
(8)
Other Distributions
(9) TOTAL Monetary Contributions To Date
2,742.50
(10)
TOTAL Monetary Expenditures To Date
2,306.77
(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) Elizabeth Walton
I certify that I have examined this report and it is true,
correct, and complete.
(Type name) Richard Gillmor
Individual (only for ❑Treasurer 1 Deputy Treasurer
Candidate Chairperson (only for PC, PTY
ectio,v.-ring commun. organization)
ell ...if 4
electioneering commun.)
X ti
X
Signature
Signature
DS -DE 12 (Rev. 08104)
FLORIDA DEPARTMENT OF STATE DIVISION OF ELECTIONS
CAMPAIGN TREASURER'S REPORT SUMMARY
Richard Gillmor
OF USE ONLY CD T'
c:
r'
-n
c7
n
a
(r
f-
Name
(2) 744 Kroegel Ave.
Address (number and street)
Sebastian, FL. 32958
City, State, Zip Code
CHECK IF ADDRESS HAS CHANGED
(4) Check appropriate box(es):
1g Candidate (office sought): Sebastian City Council
(3) ID
crI M
Number:
Political Committee CHECK IF PC HAS DISBANDED
Committee of Continuous Existence CHECK IF CCE HAS DISBANDED
Party Executive Committee
Electioneering Communication n CHECK IF NO OTHER ELECTIONEERING
COMMUNICATION REPORTS WILL BE FILED
(5) REPORT IDENTIFIERS
Cover Period: From 9 25 2010 To 10 8 2010 Report Type G3
Report Independent Expenditure Report
Original I% Amendment Special Election
(6) CONTRIBUTIONS THIS REPORT
Cash Checks 582.50
(7) EXPENDITURES
Monetary
Expenditures
Transfers to Office
Account
Total
Monetary
THIS REPORT
333.34
Loans
Total Monetary 582.50
333 .31
In -Kind
(8) Other
Distributions
(9) TOTAL Monetary Contributions To Date
1,742.50
(10)
TOTAL Monetary Expenditures To Date
1,420.30
(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) Elizabeth Walton
I certify that I have examined this report and it is true,
correct, and complete.
(Type name) Richard Gillmor
ndividua (only for Treasurer Deputy Treasurer
Can. 'ate
I Irl�,
lip Chairperson (only for PC, PTY
j �f c tioneering commun. organization)
electioneering commun.)
X EO Wej
X
Signature
Signature
DS -DE 12 (Rev. 08104)
(1) Name
3► Cover Period
DS -DE 13 (Rev. 08/03)
CAMPAIGN TREASURER'S REPORT ITEMIZED CONTRIBUTIONS
Richard Gillmor
9 25 2010 through
10
(2) I.D. Number
8 2010 Pa
SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES
1
of
1
(5)
Date
Full Name
(Last, Suffix, First, Middle)
Street Address
City, State, Zip Code
Contributor
Type
Occupation
Contribution
Type
In -kind
Description
Amendment
Amount
(6)
Sequence
Number
9
24
t10
Braell, Pagner
1302 Laconia St.
Sebastian, FL.
32958
I
CAS
$6.00
1
OFrIC
r.
t-
SELASI
E OF CITY C
1w nA r ftl
u
LERK
r11
(1) Name
3► Cover Period
DS -DE 13 (Rev. 08/03)
CAMPAIGN TREASURER'S REPORT ITEMIZED CONTRIBUTIONS
Richard Gillmor
9 25 2010 through
10
(2) I.D. Number
8 2010 Pa
SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES
1
of
1
December 6, 2010
Richard hard H. Gil!mor
744 Kroegei Avenue
Sebastian, FL 32958
Dear Mr. Gillmor:
In accordance with Florida Statutes Section 106.07, your campaign treasurer's
Termination Report T1 for your campaign for the period from Friday, October 29th is
due in the Office of the City Clerk by January 31, 2011.
The Termination Report will include a summary page showing the amount of your
expenditures since October 29, 2010 and an equal amount of contributions and
expenditures for the entire campaign. It will also include an expenditure page with all
lawful expenditures in accordance with 106.11 and 106.141(4).
You need not wait until the deadline to provide your report. As soon as your funds are
disbursed you may complete the form and submit it.
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. If you have any
questions, or if there is anything I can do to assist you, please do not hesitate to contact
me at 388 -8214 or smaio@cityofsOastiansorg.
Sincerely,
t7 1
Sally A. -"Ilaio, MMC
City Clerk
VUt editt-6
CITY OF
HOME OF PELICAN ISLAND
1225 Main Street
Sebastian, Florida 32958
(772) 388 -8214 phone (772) 589-5570 fax
smaio@cityofsebastian.org
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November 9, 2010
Richard H. Gillmor
744 Kroegel Avenue
Sebastian, FL 32958
Dear Mr. Gillmor:
In accordance with Florida Statutes Section 106.07, your campaign treasurer's
Termination Report (TR) for your campaign for the period from Friday, October 29th is
due in the Office of the City Clerk by January 31, 2011.
The Termination Report will include a summary page showing the amount of your
expenditures since October 29, 2010 and an equal amount of contributions and
expenditures for the entire campaign. It will also include an expenditure page with all
lawful expenditures in accordance with 106.11(5) and 106.141(4).
You need not wait until the deadline to provide your report. As soon as your funds are
disbursed you may complete the form and submit it.
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. If you have any
questions, or if there is anything I can do to assist you, please do not hesitate to contact
me at 388 -8214 or smaio @cityofsebastian.orq.
Sin .ely,
2
Sally A. aio, MMC
City Clerk
cmc
SEBASTIAN
HOME OF PELICAN ISLAND
1225 Main Street
Sebastian, Florida 32958
(772) 388 -8214 phone (772) 589 -5570 fax
smaio @cityofsebastian.org
Sally A
City Clerk
(SEAL)
aio, MMC
CITYOF
HOME OF PELICAN ISLAND
SEBASTIAN CITY COUNCIL MEMBER
OATH OF OFFICE
I, Richard H. Gillmor, do solemnly swear that I will support,
protect, and defend the Constitution and Government of the United
States, and of the State of Florida; that I am duly qualified to hold
office under the Constitution of the State; and that I will faithfully
perform the duties of the office of Council Member for the City of
Sebastian of which I am now about to ente s elp e God.
Richard H. Gillmor
Sebastian City Council Member
and subscribed before me this 8 day of November, 2010.
FLORIDA DEPARTMENT OF STATE DIY s
CAMPAIGN TREASURER'S RIP() �1,
(1) Richard Gillmor
OFFICE USE ONLY
OCT 29 P1r112 59
Name 210
(2) 744 Kroeqel Ave.
Address (number and street)
Sebastian, FL. 32958
City, State, Zip Code
CHECK IF ADDRESS HAS CHANGED
(4) Check appropriate box(es):
1g Candidate (office sought): Sebastian City Council
(3) ID Number:
Political Committee CHECK IF 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 10 9 2010 To 10 28 2010 Report Type G4
Report Independent Expenditure Report
Original Amendment Special Election
(6) CONTRIBUTIONS THIS REPORT
Cash Checks 1,000.00
(7)
Monetary
Expenditures
Transfers
Account
Total
Monetary
EXPENDITURES THIS REPORT
886.47
Loans
to Office
Total Monetary 1,000.00
886.47
In -Kind
(8)
Other Distributions
(9) TOTAL Monetary Contributions To Date
2,743.50
(10)
TOTAL Monetary Expenditures To Date
2,306.77
(11) CERTIFICATION
It is a first degree misdemeanor for any person to falsify a putt record (ss. 839.13, F.S.)
I certify that I have examined this report and it is true,
correct, and complete.
hype name) Elizabeth Walton
I certify that I have examined this report and it is true,
correct, and complete.
(Type name) Richard Gillmor
Individual (only for [J Treasurer at Deputy Treasurer
Candidate Chairperson (only for PC, PTY
electioneering commun.)
x tkLayt\----...
«)k ring commun. organization)
e N
_04,
Signature
Signature
DS 12 (Rev. 08104)
(5)
Date
Full Name
(Last, Suffix, First, Middle)
Street Address
City, State, Zip Code
Contributor
Type
Occupation
(9)
Contribution
Type
In -kind
Description
Amendment
Amount
(6)
Sequence
Number
Realtors Political
C
{-iThrtleed
CHE
$599,99
10 13 /10
Action Comm.
(Cron
7025 Augusta
National Dr.
1
Orlando, FL. 32822
About FL. Native
B
Bus.
CHE
$100.00
10 14 /10
Plants
Owner
26 Airport Dr.
West
2
Sebastian,FL.32958
Windstar Builders
B
CAS
$50.00
10 15 1p
INC.
1069 Main St.
Sebastian,FL.32958
3
Taperoll.com INC.
B
CAS
$50.00
10 15 10
5280 95th St.
Sebastian,FL.32958
4
Donna Keys
I
CHE
$50.00
10 15 10
725 Layport Dr.
Sebastian, FL.
32958
5
Capt. Hirams
B
Bus.
CHE
$200.00
10 19 0
PO Box 781507
Owner
Sebastian, FL.
32958
6
p
rt t"•
10 22
1 0
Andrea Coy
501 Palm Ave.
I
CHE
Sebastian, FL.
01
32958
7
i
I
1
CLERK
12 59
10
(1) Name Richard Gilimor (2) I.D. Number
DS-DE 13 (Rev. 08/03)
CAMPAIGN TREASURER'S REPORT ITEMIZED CONTRIBUTIONS
9 2010 throu
10 28 2010 Pa g e
SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES
1
of
1
(5)
Date
(7)
Full Name
(Last, Suffix, First, Middle)
Street Address
City, State, Zip Code
(8)
Purpose
(add office sought if
contribution to a
candidate)
(9)
Expenditure
Type
Am lefit
(11)
Amount
(6)
Sequence
Number
10 114 /10
Home Depot
13361 US Hwy 1
Sebastian, FL. 32958
Sign Supplies
MON
$46.90
1
10 /14/10
Christian FM
6767 20th St.
Vero Beach, FL. 32966
Radio Ad
MON
$300.00
2
10 /15 /10
Winn Dixie
995 Fellsmere Rd.
Sebastian, FL. 32958
Food for
campaign meet
and greet
MON
$22.89
3
10/21/10
Vero Beach Press Journal
1801 US HWY 1
Vero Beach, FL. 32961
Newspaper Ad
MON
$330.00
4
10/25/10
Home Depot
13361 US Hwy 1
Sebastian, FL. 32958
Sign Supplies
MON
$44.68
5
10 /26/10
Hometown News
1102 South US 1
Ft. Pierce, FL. 34950
Newspaper Ad
MON
OFFICE OF
0111 OCT 29
6
)ITY CLERK
Pty 12 59
(1) Name
(3) Cover Period 1° 9 2010 through 10 28 2010
DS-DE 14 (Rev. 08/03)
CAMPAIGN TREASURER'S REPORT ITEMIZED EXPENDITURES
Richard Gillmor (2) I.D. Number
SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES
(4) Page 1 of
1
1.
October 19, 2010
Richard H. Gilimor
744 Kroegel Avenue
Sebastian, FL 32958
Dear Mr. Gilimor:
In accordance with Florida Statutes Section 106.07, the campaign treasurer's report for
your campaign for the period from Saturday, October 9 through Thursday, October
28, 2010 is due in the Office of the City Clerk by 5 pm on Friday, October 29, 2010
(G4).
Please keep in mind that this report has a different reporting period from the previous
two, since it is a longer period; and ends on Thursday, October 28 with the report due
the next day Friday, October 29
In accordance with Florida law, no contributions can be accepted after midnight on
Thursday, October 28 (106.07 (2) a.1.)
Now is a good time to become familiar with FS 106.11(5) and 106.141 in regard to
closeout and disposition of campaign 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.
If you have any questions, please do not hesitate to contact me at 388 -8214 or
smaio(c�cityofsebastian.orq.
Sin -r -Iy,
Sally A. Maio, MMC
City Clerk
OP/ OF
SEBASTIAN
HOME OF PELICAN ISLAND
1225 Main Street
Sebastian, Florida 32958
(772) 388 -8214 phone (772) 589 -5570 fax
smaio @cityofsebastian.org
FLORIDA DEPARTMENT OF STATE DIVISION OF ELECTIONS
CAMPAIGN TREASURER'S REPORT St
Richard Gillmor
Orriut ur uii U E.
OFFICE U s e ON
2010 OCT 13 PM 1 53
Name
744 Kroeqel Ave.
Address (number and street)
Sebastian,FL. 32958
City, State, Zip Code
CHECK IF ADDRESS HAS CHANGED
(4) Check appropriate box(es):
!7 Candidate (office sought): Sebastian City Council
(3) ID Number:
Political Committee CHECK IF 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 9 25 2010 To io 8 2010 Report Type G3
Report Independent Expenditure Report
Original Amendment Special Election
(6) CONTRIBUTIONS THIS REPORT
Cash Checks 58).50
(7)
Monetary
Expenditures
Transfers
Account
Total
Monetary
EXPENDITURES THIS REPORT
333 `h 2 0
Loans
to Office
Total Monetary 583.50
3 33.3 Y
In -Kind
(8)
Other Distributions
3r4o1ie6re-
(9) TOTAL Monetary Contributions To Date
1, 74 .50
(10)
TOTAL Monetary Expenditures To Date
30
1
(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) Elizabeth Walton
I certify that I have examined this report and it is true,
correct, and complete.
(Type name) Richard Gillmor
Individual (only for ❑Treasurer Deputy Treasurer
Candidate
Chairperso (only for PC, PTY
electioneering commun.)
e l' oaL_ 46-024------
AIIM
Sure
/r lone •rinj•mmun. organization)
AI'
Signature .J
DS-DE 12 (Rev. 08/04)
Date
Full Name
(Last, Suffix, First, Middle)
Street Address
City, State, Zip Code
Contributor
Type
(8)
Occupation
(9)
Contribution
Type
In -kind
Description
Amendment
Amount
(6)
Sequence
Number
Thompson, Irene
I
CAS
$50.00
9 24 /10
1531 Spinnaker Ln.
Sebastian, FL.
32958
1
Duffell, Daniel
I
CHE
$50.00
9 24 /10
717 W. Fischer Cir
Sebastian, FL
32958
2
Perez, Rappy
I
CHE
$50.00
9 24 1p
9650 Mockingbird
Ln.
Sebastian, FL.
3
32958
Burgarella, Judith
i
CHE
$25.00
9 24 10
110 Thunderbird
Dr.
Sebastian, FL.
4
32958
Flescher, Joseph
I
County
CHE
$100.00
9 24 10
279 Joy Haven Dr.
comm.
Sebastian, FL.
32958
51(
c)
5
--t
SEAST
F CITY 01
Cecrele, Tom
I
CAS
1--+
9 240
10749 US HWY 1
C..1
Sebastian, FL.
32958
C
6
9 24 0
L sk Bill
Yn Y'
I
CAS
c
t 0
;}3 :0
856 Tulip Dr.
Cw)
Sebastian, FL.
32958
7
Berry, Harry
I
CAS
$5.00
9 24 p
731 Atlantis Dr.
Sebastian, FL.
32958
8
CAMPAIGN TREASURER'S REPORT ITEMIZED CONTRIBUTIONS
(1) Name Richard Gilimor (2) I.D. Number
3 Cover Period
9 25 2010 through 10 8 2010 (4) Page
1
of
3
DS -DE 13 (Rev. 08/03)
SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES
(5)
Date
(7)
Full Name
(Last, Suffix, First, Middle)
Street Address
City, State, Zip Code
Contributor
Type
(8)
Occupation
(9)
Contribution
Type
(10)
In -kind
Description
(11)
Amendment
(12)
Amount
(6)
Sequence
Number
Robinson, Joe
I
CAS
$5.00
9 24 /10
32 LaVilla Way
Fr. Pierce, FL.
34951
9
Kerkela, Corey
I
CAS
$2.00
9 24 /10
600 Bay Harbor Ter
Sebastian, FL.
32958
10
Brown, Gary
I
CAS
$5.00
9 24 1p
375 18th Ave.
Vero Beach, FL.
32960
11
Elward, Daniel
I
CAS
$10.00
9 24 10
7517 Montauk Ave.
Sebastian, FL.
32958
12
Kraff, Robert
I
CAS
$5.00
9 24 10
992 Sequoia St.
Sebastian, FL.
32958
2
0
13
ri c-
Frascino, Hana
i
CAS
Ln
;E OF CITY
9 24 }0
200 Turtle Run
#108
Sebastian, FL.
14
32958
N
C.
r -v
r
9 24 0
Boris, Mike
726 Beard Ave.
I
CAS
CI
x:00
Sebastian, FL.
W
32958
15
Braell, Pagner
I
CAS
$7.00
9 24 }0
1302 Laconia St.
Sebastian, FL.
32958
16
(1) Name
DS -DE 13 (Rev. 08/03)
CAMPAIGN TREASURER'S REPORT ITEMIZED CONTRIBUTIONS
Richard Gillmor
(3) Cover Period 9 25 2010 through
1 0
8
2010
(2) I.D. Number
4) Paae
SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES
2
of
3
(5)
Date
(7)
Full Name
(Last, Suffix, First, Middle)
Street Address
City, State, Zip Code
Contributor
Type
(8)
Occupation
(9)
Contribution
Type
(10)
In -kind
Description
(11)
Amendment
(12)
Amount
(6)
Sequence
Number
9 24 /10
Griffin, Denise
688 Gossamer Wing
Way
Sebastian, FL.
32958
1
CHE
$50.00
17
9 24 X10
Walton, Anthony
878 Wentworth St.
Sebastian, FL.
32958
I
CAS
$5.00
18
9 27 1p
Flaherty, T.
William
789 Vocelle Ave.
Sebastian, FL.
32958
I
CHE
$50.00
19
10 4 10
Sissons, V.
Jacqueline
186 Chaloupe Terr.
Sebastian, FL.
32958
I
CHE
$50.00
20
10 5 10
Pohlner C. Kenneth
240 Watercrest St.
Sebastian, FL.
32958
I
CHE
$50.00
21
c�
F-
OFFICE OF
I—
Cl
EBAS1 V.,‘!
CITY CLERK
(1) Name
3) Cover Period 9
DS -DE 13 (Rev. 08/03)
CAMPAIGN TREASURER'S REPORT ITEMIZED CONTRIBUTIONS
Richard Gillmor
25 2010 through 10
(2) I.D. Number
8 2010 Paae
SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES
3
of
3
(5)
Date
(7)
Full Name
(Last, Suffix, First, Middle)
Street Address
City, State, Zip Code
Purpose
(add office sought if
contribution to a
candidate)
(9)
Expenditure
Type
Amendment
Amount
(6)
Sequence
Number
Party Treasures
Raffel Tickets
MON
$6.69
9 /25/10
1701 US HWY 1 STE: 5
Sebastian, FL. 32958
1
Walton, Laura
Web Design
MON
$50.00
9 /28 /10
c /o: 878 Wentworth St.
Sebastian, FL. 32958
2
Seacoast National Bank
Sign Supplies
PCW
$30.00
9 /29j/10
1112 Roseland Rd.
Sebastian, FL. 32958
3
Richard Gillmor
RMB
RMB
$94.45
9 /29/(10
744 Kroegel Ave.
Sebastian, FL. 32958
Campaign Kick
off party
supplies
4
food
Walton, Elizabeth
RMB Mailing
RMB
9 p9/10
878 Wentworth St.
Sebastian, FL. 32958
labels,
business cards
JOT
ICE
5
Home Depot
Sign Supplies
MON
0
ITY CLERK
10 /4 /10
13361 US HWY 1
Sebastian, FL 32958
1
6
Walton, Elizabeth
RMB Web Host
RMB
$8.95
10 /8 /10
878 Wentworth St.
Rental
Sebastian, FL. 32958
7
ik Peri
Steals) soy(' e3
10/1 /10
(33 671 05 t}wY t
0._F
X33 us
bac-( -tar►, V 3 2y 4
(1) Name
CAMPAIGN TREASURER'S REPORT ITEMIZED EXPENDITURES
Richard Gillmor (2) I.D. Number
(3) Cover Period 9 25 /2010 through 10 8 2010
(4) Page 1 of
1
DS-DE 14 (Rev. 08/03)
SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES
(5)
Date
(7)
Full Name
(Last, Suffix, First, Middle)
Street Address
City, State, Zip Code
(8)
Purpose
(add office sought if
contribution to a
candidate)
(9)
Related
Expenditures
(10)
Amendment
(11)
Amount
(6)
Sequence
Number
Walmart
Mailing Labels
2010
$8.56
2001 US HWY 1
G3
9 20 /10
Sebastian, FL. 32958
5
1
Walmart
Mailing Labels
2010
$20.54
2001 US HWY 1
G3
9 22 /10
Sebastian, FL. 32958
5
2
Vista Print USA
Business cards
2010
$42.10
95 Hayden Ave.
G3
9/ 24 10
Lexington, MA. 02421
5
3
Family Dollar
Envelopes
2010
$4.28
728 S. Fleming St.
G3
9/ 21 10
Sebastian, FL. 32958
4
4
Dollar Store, INC.
Campaign party:
2010
$12.84
1921 US HWY 1
paper plates,
G3
9/ 24 10
Sebastian, FL. 32958
cutlery
4
O
-11
5
r
C)
Walmart
Campaign Party:
2010
2001 US HWY 1
Food
G3
F
9/ 24 10
Sebastian, FL. 32958
4
C
6
Rochen Limited
Web Host Rental
2010
LERK
1 S3
11 Dudhope Terr.
G3
10/ 4 10
Dundee, DD3 6TS
7
United Kingdom
7
Name
Cover Period
CAMPAIGN TREASURER'S REPORT ITEMIZED DISTRIBUTIONS
Richard Gillmor
9 25 2010 through 10 8 /2010
(2) I.D. Number
DS -DE 14A (Rev. 12/07) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES
(4) Page 1 of 1
October 7, 2010
Richard H. Gillmor
744 Kroegel Avenue
Sebastian, FL 32958
Dear Mr. Gillmor:
Sincerely,
Sally A. Maio, MMC
City Clerk
HOME OF PELICAN ISLAND
1225 Main Street
Sebastian, Florida 32958
(772) 388 -8214 phone (772) 589 -5570 fax
smaio @cityofsebastian.org
In accordance with Florida Statutes Section 106.07, the campaign treasurer's report for
your campaign for the period September 25 through October 8, 2010 is due in the
Office of the City Clerk by 5 pm on Friday, October 15, 2010.
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.
You are welcome to submit your campaign report at any time during the week of
October 11 through October 15, 2010.
If you have any questions, please do not hesitate to contact me at 388 -8214 or
smaio(cityofsebastian.org.
FLORIDA DEPARTMENT OF STATE DIVISION i.t IO NS
CAMPAIGN TREASURER'S REPORT t- Y r
Richard Gillmor
OFFICE OF °Mee UN pNLY
2010 SEP 29 PP1 12 06
Name
(2) 744 Kroeqel Ave.
Address (number and street)
Sebastian, FL. 32958
City, State, Zip Code
CHECK IF ADDRESS HAS CHANGED
(4) Check appropriate box(es):
I2 Candidate (office sought): Sebastian City Council
(3) ID Number:
Political Committee CHECK IF 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 9 11 2010 To 9 24 2010 Report Type G2
Report Independent Expenditure Report
!I Original Amendment Special Election
(6) CONTRIBUTIONS THIS REPORT
Cash Checks 50.00
(7)
Monetary
Expenditures
Transfers
Account
Total
Monetary
EXPENDITURES THIS REPORT
304.00
Loans
to Office
Total Monetary 50.00
304.00
In -Kind 55.00
(8)
Other Distributions ziarmegOt
(9) TOTAL Monetary Contributions To Date
1,160.00
(10)
TOTAL Monetary Expenditures To Date
1,086.96
(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) Elizabeth Walton
I certify that I have examined this report and it is true,
correct, and complete.
(Type name) Richard Gilimor
Individual (only for Treasurer 1 Deputy Treasurer
J
Candidate Chairperson (only for PC, PTY
o ring commun. organization)
electioneering commun.)
X A9A- 16/0121----
X
Signature
Signature
DS DE 12 (Rev. 0W04)
CAMPAIGN TREASURER'S REPORT ITEMIZED CONTRIBUTIONS
(1) Name Richard Gillmor (2) I.D. Number
3) Cover Period
9 11 2010 through
9 24 2010 (4) Paae
1
of
1
DS-DE 13 (Rev. 08/03)
SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES
(5)
Date
Full Name
(Last, Suffix, First, Middle)
Street Address
City, State, Zip Code
Contributor
Type
(8)
Occupation
Contribution
Type
in -kind
Description
(11)
Amendment
Amount
(6)
Sequence
Number
9
20
/10
Daniel Dragonetti
1355 Barber St.
Sebastian, FL
32958
1
CHE
$50.00
1
9
24
/10
Tim Timinsky
Kroegel Market
11230 Indian River
Dr. Sebastian, FL
32958
B
INK
Box of
Corn, six
Watermelon
$55.00
2
2010 SEP 2
CITY OF
OFFICE 0
Pig 120
OLIVL
SEBASTIAN
F CITY CLEF
CAMPAIGN TREASURER'S REPORT ITEMIZED CONTRIBUTIONS
(1) Name Richard Gillmor (2) I.D. Number
3) Cover Period
9 11 2010 through
9 24 2010 (4) Paae
1
of
1
DS-DE 13 (Rev. 08/03)
SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES
(5)
Date
Full Name
(Last, Suffix, First, Middle)
Street Address
City, State, Zip Code
Purpose
(add office sought if
contribution to a
candidate)
Expenditure
Type
(10)
Amendment
Amount
6
Sequence
Number
9 /24 /10
Richard Gillmor
744 Kroegel Ave.
Sebastian, FL. 32958
Food campaign
party
PCW
$40.00
1
9 /24/10
Sebastian Post Office
1290 Main St.
Sebastian FL. 32958
Stamps
CHE
$264.00
2
2010
OFF
3EP 29 Pfl
TY OF SEBA
ICE or cin
12 06
CLERK
(1) Name
CAMPAIGN TREASURER'S REPORT ITEMIZED EXPENDITURES
Richard Gillmor (2) I.D. Number
(3) Cover Period 9 11 2010 through 9 24 2010
(4) Page 1 of
1
DS-DE 14 (Rev. 08/03)
SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES
FLORIDA DEPARTMENT OF STATE DIVISION OF E 'LE .Y A
CAMPAIGN TREASURER'S REPORftSb
('I) Richard Gillmor
or r 1 u G OF I USE ONLY
2010 SEP 29 P19 1 Pil 12 05
Name
(2) 744 Kroeqel Ave.
Address (number and street)
Sebastian, FL. 32958
City, State, Zip Code
CHECK IF ADDRESS HAS CHANGED
(4) Check appropriate box(es):
iI Candidate (office sought): Sebastian City Council
(3) ID Number:
Political Committee CHECK IF 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 7 1 2010 To 9 10 2010 Report Type Gi
Report Independent Expenditure Report
Original FA Amendment Special Election
(6) CONTRIBUTIONS THIS REPORT
Cash Checks 1, 010.00
(7)
Monetary
Expenditures
Transfers
Account
Total
Monetary
EXPENDITURES THIS REPORT
782.96
Loans
to Office
Total Monetary 1,010.00
782.96
In -Kind
(8)
Other Distributions
(9) TOTAL Monetary Contributions To Date
1,110.00
(10)
TOTAL Monetary Expenditures To Date
782.56
(11) CERTIFICATION
It is a first degree misdemeanor for any person to falsify a public record (ss. 839.13, F.S.)
I certify that 1 have examined this report and it is true,
correct, and complete.
(Type name) Elizabeth Walton
I certify that I have examined this report and it is true,
correct, and complete.
(Type name) Richard Gillmor
Individual (only for Treasurer J Deputy Treasurer
electioneering commun.)
X
1
X
Signature
Candidate Chairperson (only for PC, PTY
1 ng commun. organization)
i/
Signature v
DS-DE 12 (Rev. 08/04)
Date
Full Name
(Last, Suffix, First, Middle)
Street Address
City, State, Zip Code
Purpose
(add office sought if
contribution to a
candidate)
Related
Expenditures
Amendment
Amount
(6)
Sequence
Number
Family Dollar
Thank you cards
2010
$3.21
728 S. Fleming St.
41
7
6
/10
Sebastian, F1. 32958
(Sebastian city
council)
3
1
Family Dollar
Envelopes
2010
$2.07
728 S. Fleming St.
-41 G.
7
6
/10
Sebastian, F1. 32958
(Sebastian city
council)
3
2
Family Dollar
Envelopes
2
$2.14
728 S. Fleming St.
-Qa GI
7/
13
/10
Sebastian, F1. 32958
(Sebastian city
council)
3
Cumberland Farms
Fuel
2
$10.00
957 Fellsmere Rd.
7/
14
10
Sebastian, FL. 32958
(Sebastian city
council)
4
Staples
Printer ink
2010
1191 US HWY 1
-$ids
7/
20
10
Vero Beach, FL. 32960
(Sebastian city
council)
5
SEP
'ICE
5
Cumberland Farms
Fuel
2010
0
0
S #BASTIAN
CITY CLERi
957 Fellsmere Rd.
AN- gI
7/
20
10
Sebastian, FL. 32958
5
1:
(Sebastian city
council)
6
Walmart
Sign Supplies
2010
$4.$0
2001 HWY 1
•$1 a)
7/
25
10
Sebastian,FL. 32958
(Sebastian city
council)
6
7
Cumberland Farms
Fuel
2010
$20.00
957 Fellsmere Rd.
42-1 ts)
7/
27
10
Sebastian, FL. 32958
6
(Sebastian city
council)
9
(1)
(3)
Name
CAMPAIGN TREASURER'S REPORT ITEMIZED DISTRIBUTIONS
Richard Gillmof
Cover Period 07 01 /2010 through 09 10 /2010
DS-DE 14A (Rev. 12/07) SEE REVERSE FOR INSTRUCT
(2) I.D. Number
(4) Page 1 of 2
(5)
Date
Full Name
(Last, Suffix, First, Middle)
Street Address
City, State, Zip Code
Purpose
(add office sought if
contribution to a
candidate)
Related
Expenditures
Amendment
Amount
(6)
Sequence
Number
09/
09
/10
Network Solutions
13861 Sunrise Valley
Dr.
Department CCD
Herndon, VA. 20171
Purchase of
domain name:
votegillmor.com
(Sebastian city
council)
IN
2010
¢1C-s1
8
$6.99
9
09
09
/10
Rochen Limited
11 Dudhope Terr.
Dundee, DD3 6Ts
United Kingdom
Website host
monthly rental
(Sebastian city
council)
2010
Q-1Cr1
8
$8.95
10
2010 SE
o IT'
OFFIC
P29 PP1 1
OF SEEMS
E OF CITY
C
tY']
LERK
(1)
(3)
Name
CAMPAIGN TREASURER'S REPORT ITEMIZED DISTRIBUTIONS
Richard Gillmor
Cover Period 07 01 /2010 through 09 10 /2010
DS-DE 14A (Rev. 12/07) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES
(2) I.D. Number
(4) Page 2 of
2
September 23, 2010
Richard H. Gillmor
744 Kroegel Avenue
Sebastian, FL 32958
Dear Mr. Gillmor:
In accordance with Florida Statutes Section 106.07, the campaign treasurer's report for
your campaign for the period September 11th through 24th, 2010 is due in the Office of
the City Clerk by 5 pm on Friday, October 1, 2010.
Any report postmarked by the United States Postal Service no later than midnight of the
due date, shall be deemed to have been submitted in a timely manner.
You are welcome to submit your campaign report at any time during the week of
September 27 through October 1, 2010.
If you have any questions, please do not hesitate to contact me at 388 -8214 or
smaioAcityofsebastian.org.
Sincerely,
Sally A. Maio, MMC
City Clerk
CITY OF
SEBASTIAN
HOME OF PELICAN ISLAND
1225 Main Street
Sebastian, Florida 32958
(772) 388 -8214 phone (772) 589 -5570 fax
smaio @cityofsebastian.org
v4., FLORIDA DEPARTMENT OF STATE DIVISION OlTEL #CTjPN STIAN
CAMPAIGN TREASURER'S REPORT c$LIAM�►F y CLERY
Richard Gillmor
2010 sEF 9F 1 FJ,CE A LJSEONLY
C bb Y
Name
(2) 744 Kroegel, Ave.
Address (number and street)
Sebastian, Fl. 32958
City, State, Zip Code
CHECK IF ADDRESS HAS CHANGED
(4) Check appropriate box(es):
rig Candidate (office sought): Sebastian City Council
(3) ID Number:
Political Committee CHECK IF PC HAS DISBANDED
Committee of Continuous Existence CHECK IF CCE HAS DISBANDED
Party Executive Committee
Electioneering Communication n CHECK IF NO OTHER ELECTIONEERING
COMMUNICATION REPORTS WILL BE FILED
(5) REPORT IDENTIFIERS
Cover Period: From 7 1 2010 To 9 10 2010 Report Type Gi
(Original Amendment Special Election Report Independent Expenditure Report
(6) CONTRIBUTIONS THIS REPORT
Cash Checks 1,010.00
(7)
Monetary
Expenditures
Transfers
Account
Total
Monetary
EXPENDITURES THIS REPORT
782.96
Loans
to Office
Total Monetary 1,010.00
782.96
In -Kind
(8)
Other Distributions
(9) TOTAL Monetary Contributions To Date
1,010.00
(10)
TOTAL Monetary Expenditures To Date
782.96
(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) Elizabeth Walton
I certify that I have examined this report and it is true,
correct, and complete.
(Type name) Richard Gilimor
Individual (only for Treasurer Deputy Treasurer
Candidate Chai rson (only for PC, PTY
ectio. -ring commun. organization)
electioneering commun.)
X
w1. x l
X
.Y/
_IAti
Signatur
Signature
DS -DE 12 (Rev. 08 /04)
(1) Name Richard Gillmor
DS -DE 13 (Rev. 08/03)
CAMPAIGN TREASURER'S REPORT ITEMIZEDaC ITR$BUT OM
OFFICE OF CITY CLERK
t0 throu 0
2010 ?ti r i l 13
o 4) Pa e 1 of
SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES
1
(5)
Date
(7)
Full Name
(Last, Suffix, First, Middle)
Street Address
City, State, Zip Code
Contributor
Type
(8)
Occupation
(9)
Contribution
Type
(10)
In -kind
Description
(11)
Amendment
(12)
Amount
(6)
Sequence
Number
Brognano, Todd A.
1
Builder
CHE
$200.00
7
1
/2010
PO Box 780874
Sebastian, FL
32978
1
Brognano,Daniel,
B
Builder
CHE
$200.00
7
1
/2010
J. Trust
PO Box 780874
Sebastian, FL
2
32978
Realty King, INC.
B
CHE
$100.00
7
2
2plo
DBA RE /MAX Crown
Realty
945 Sebastian BLVD
3
Sebastian F1 32958
Wolff, Eugene
I
CHE
$50.00
7
10
?010
757 Wimbrow Dr.
Sebastian F1.
32958
4
Arnouil, Sally S.
I
CHE
$100.00
7
10
2010
398 Belfast Ter.
Sebastian, FL
32958
5
Barton,Clarence W.
I
CHE
$10.00
7
13
010
491 Kumquat Ave.
Sebastian, F1
32958
6
7
Firehouse Garage
B
CHE
$100.00
30
010
800 Louisiana Ave
Sebastian, FL
32958
7
Collier Club, INC.
B
CHE
$250.00
7
30
?010
Mechling, Charles
6knt�
1999 Pointe West D;
Vero Beach,FL
8
32966
(1) Name Richard Gillmor
DS -DE 13 (Rev. 08/03)
CAMPAIGN TREASURER'S REPORT ITEMIZEDaC ITR$BUT OM
OFFICE OF CITY CLERK
t0 throu 0
2010 ?ti r i l 13
o 4) Pa e 1 of
SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES
1
(5)
Date
Full Name
Purpose
(add office sought if
contribution to a
candidate)
Expenditure
Type
(10)
Amendment
(11)
Amount
(6)
Sequence
Number
(Last, Suffix, First, Middle)
Street Address
City, State, Zip Code
/8 /10
IRC Supervisor of Elections
Super -Voter
MON
$5.85
7
4375 43rd Ave.
List
Vero Beach, FL. 32967
1
Vista Print USA
Business cards
MON
$198.86
7 /8 /10
95 Hayden Ave.
car magnets
Lexington, MA. 02421
2
Richard Gillmor
40g gas,
4NEW
$17.42
7 /14/10
744 Kroegel Ave.
Sebastian, FL. 32958
office
supplies
flli.
3
Total Print, INC.
Advertisment/
MON
$107.00
7 /20/10
1132 US HWY 1 STE. 101
fliers
Sebastian, FL. 32958
4
Richard Gillmor
R ztat d ink,
lina
$52.09
7 p9/10
744 Kroegel Ave.
gas
Sebastian, FL. 32958
5
Rill t3
Richard Gillmor
mid gas,
mil!
$24.80
7 p8/10
744 Kroegel Ave.
sign supplies
r M p
Sebastian, FL. 32958
6
City of Sebastian
Qualifying
MON
$61.00
8 /23
1225 Main St.
Fees
Sebastian, FL. 32958
7
Elizabeth Walton
jiii.11
$15.94
9 /7
878 Wentworth St.
Sebastian, FL. 32958
purchase of
domain name
web hosting
R m 3
8
0f SEO 3Ti ;',r
CAMPAIGN TREASURER'S REPORT ITEfi i E PtisiIlIf J
(1) Name Richard Gillmor 22) I.D. Number
07 O1 2010 09 10 2012 S E 16 11 1
(3) Cover Period through (4) Page of
2
ut 14IN @V.
SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES
(5)
Date
Full Name
(Last, Suffix, First, Middle)
Street Address
City, State, Zip Code
Purpose
(add office sought if
contribution to a
candidate)
Expenditure
yp
Type
Amendment
Amount
(6)
Sequence
Number
9 /9
/10
WWCI -TV10
1082 12th ST.
Vero Beach, FL. 32960
Political
Broadcast
MON
$300.00
9
SLUAS t'I' N
CAMPAIGN TREASURER'S REPORT ITEMIZED meagawFues. E R K
(1) Name Richard Gilimor (2) I.D. Number
7
1 2o10 through 9 10 2010 21 E E119 3 11 2
(3) Cover Period
DS -DE 14 (Rev. 08/03)
SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES
(5)
Date
(7)
Full Name
(Last, Suffix, First, Middle)
Street Address
City, State, Zip Code
(8)
Purpose
(add office sought if
contribution to a
candidate)
(9)
Related
Expenditures
(10)
Amendment
(11)
Amount
(6)
Sequence
Number
Family Dollar
Thank you cards
2010
$3.21
728 S. Fleming St.
Q1
7
6
/10
Sebastian, F1. 32958
(Sebastian city
council)
3
1
Family Dollar
Envelopes
2010
$2.07
728 S. Fleming St.
Q1
7
6
/10
Sebastian, F1. 32958
(Sebastian city
council)
3
2
Family Dollar
Envelopes
2010
$2.14
728 S. Fleming St.
Q1
7/
13
10
Sebastian, F1. 32958
(Sebastian city
council)
3
3
Cumberland Farms
Fuel
2010
$10.00
957 Fellsmere Rd.
Q1
7/
14
10
Sebastian, FL. 32958
3
(Sebastian city
council)
4
Staples
Printer ink
2010
$32.09
1191 US HWY 1
Q1
7/
20
/10
Vero Beach, FL. 32960
(Sebastian city
council)
5
5
Cumberland Farms
Fuel
2010
$20.00
957 Fellsmere Rd.
Q1
7/
20
10
Sebastian, FL. 32958
5
(Sebastian city
council)
6
Walmart
Sign Supplies
2010
$4.80
2001 HWY 1
Q1
7/
25
10
Sebastian,FL. 32958
(Sebastian city
council)
6
7
Cumberland Farms
Fuel
2010
$20.00
957 Fellsmere Rd.
Q1
7/
27
10
Sebastian, FL. 32958
6
(Sebastian city
council)
8
Name
((,a�, EE SE f?, t *a 4 r
CAMPAIGN TREASURER'S REPORT ITEMIZ�DD1STR�� FFI��BUTIONS K
(2)201434Zniar R19 11 13
Richard Gillmor
Cover Period 07 01 /2010 through 09 10 /2010 (4) Page 1
of
2
DS -DE 14A (Rev.12/07) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES
(5)
Date
(7)
Full Name
(Last, Suffix, First, Middle)
Street Address
City, State, Zip Code
(8)
Purpose
(add office sought if
contribution to a
candidate)
(9)
Related
Expenditures
(10)
Amendment
(11)
Amount
(6)
Sequence
Number
09/ 09
/10
Network Solutions
13861 Sunrise Valley
Dr.
Department CCD
Herndon, VA. 20171
Purchase of
domain name:
votegillmor.com
(Sebastian city
council)
0
2010
Q1
8
$6.99
9
09/ 09
/10
Rochen Limited
11 Dudhope Terr.
Dundee, DD3 6Ts
United Kingdom
Website host
monthly rental
(Sebastian city
council)
2010
Q1
8
$8.95
10
€f_ SEBAS 1
CAMPAIGN TREASURER'S REPORT ITEMI� R�TI�1
Name Richard Gillmor (2)2014D5igr 1.0 r APi 11 13
Cover Period 07 01 2010
DS -DE 14A (Rev. 12/07)
through 09 10 /2010
(4) Page 2
SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES
of
2
September 7, 2010
Richard H. Gillmor
744 Kroegel Avenue
Sebastian, FL 32958
Dear Mr. Gillmor:
OTYCE
HOME OF PELICAN ISLAND
1225 Main Street
Sebastian, Florida 32958
(772) 388 -8214 phone (772) 589 -5570 fax
smaio @cityofsebastian.org
In accordance with Florida Statutes Section 106.07, the campaign treasurer's report for
your campaign for the period July 1, 2010 through September 10, 2010 is due in the
Office of the City Clerk by 5 pm on Friday, September 17, 2010. You are now no
longer filing quarterly reports, but will start the regular reporting 46 32 18 and 4
day prior.
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.
You are welcome to submit your campaign report at any time during the week of
September 13 throughl7, 2010.
I am also including updated links to the Florida Division of Elections and paper copies of
revised FS 106 and Candidate and Campaign Treasurer Handbook should you not be
able to access them on the internet.
Florida Election Laws revised August 2010 includes revised FS 106
http:/ /election. dos. state.fl. us /publications /pdf /201012010Election Laws. pdf
State of Florida Candidate and Campaign Treasurer Handbook Revised July 2010
http:/ /election. dos.state.fl. us /publications pdf 2010 /2010CandCampTreasHandbook. pdf
In 2010, the State Legislature revised certain election laws that pertain to electioneering
communications and disclaimers. The laws went into effect after the City Candidate
Handbook was prepared and I want to be sure you have up to date information.
If you have any questions, please do not hesitate to contact me at 388 -8214 or
smaio(c�cityofsebastian.orq.
Sincerely,
4 i
Sally A. Maio, MMC
City Clerk
STATE OF FLORIDA
APPOINTMENT OF CAMPAIGN TREASURER
AND DESIGNATION OF CAMPAIGN
DEPOSITORY FOR CANDIDATES
(Section 106.021(1), F.S.)
(PLEASE PRINT OR TYPE)
O USE ONLY
,t- S E B A J
oFF ICE OF CITY CLERK
2010 SEP 3 Pig 3 18
1. CHECK APPROPRIATE BOX:
Original Appointment Change in: Z] Treasurer /Deputy Depository Office Party
2. Name of Candidate in thi order First, Middle, Last)
N.
ichfivc0, I 17 Mo�
3. Address (include post office box or street, city, state, zip
code)
���t 4v'e,
7 e
Se G /fS ("P vii/ 1- 4.. Z `f �'le`
4. Telephone (optional)
5. E -mail address (optional)
f_h 5 I/lI'Yk3U )9vfA(L- ,Ccf
6. Office sought (include district, circuit, group number)
C ITY CIMAILIL MPlbEK_
7. If a candidate for a nonpartisan office, check if
applicable: My intent is to run as a Write -In candidate.
8. If a candidate for a partisan office, check block and fill in name of party as applicable: My intent is to run as a
Write -In No Party Affiliation Party candidate.
9. I have appointed the following person to act as my 0 Campaign Treasurer q Deputy Treasurer
10. Name of Treasurer o ut Tre f
E- 1-/ a�9e M T°"-
11. Mailing Address (If post office box or drawer, also include street address)
1 W c 4 i e l (1
12. Telephone
(7 7 z) cP (/co o q Y
13. City
Se t is 1 e
14. County,..,
P«a� y I iek
State
pi--
16. Zip Code
3 zq .37
17. E -mail address (optional)
18. I have designated the following bank as my Primary Depository Secondary Depository
19. Name of Bank Ld'-
/g 7 7 1
20. Street Address
21. City
e
22. County
22. D/ f A) t
23. State
24. Zip Code
3 )--1 S
UNDER PENALTIES OF PERJURY, I DECLARE THAT I HAVE READ THE FOREGOING FORM FOR APPOINTMENT OF CAMPAIGN TREASURER AND
DESIGNATION OF CAMPAIGN DEPOSITORY AND THAT THE FACTS STATED IN IT ARE TRUE.
25. Date
26. re of di.
X fj`i
27. Treasurer's Acceptance of Appointment (fill in the blanks and check the appropriate block)
I, E Z q %eA lti ti G-T Oi\-) do hereby accept the appointment
(Please Print or Type Name)
designatedd above as: Campaign Treasurer Deputy Treasurer.
//0 X IdCtitk
Date Signa re of Campaign Treasurer or Deputy Treasurer
DS -DE 9 (Rev. 11/09)
FORM 1
STATEMENT Oi I
1 FINANCIAL INTERESTS 1
2009 °4
Please print or type your name, mailing
address, agency name, and position below:
LAST NAME FIRST NAME MIDDLE NAME
FOR OFFICE
USE ONLY:
MAILING Richard H. Gillmor
Mayor Sebastian
221986
r ti
I., t
ID Code
N
O p
-n
n
ID No rn (7
n rrl
O --1-1 r
Conf. Code I—. cn
m
P. Req. Code i L
744 Kroegel Ave
CITY Sebastian ,FL 32958
NAME OF
C. f'
NAME OF O �y FICE OR HELD OR SOUGHT
i
(....1
rn
w
You are not limited to the space on the lines on this form. Attach additional sheets, if necessary.
CHECK ONLY IF CANDIDATE OR Li NEW EMPLOYEE OR APPOINTEE
**BOTH PARTS OF THIS SECTION MUST BE COMPLETED
DISCLOSURE PERIOD:
THIS STATEMENT REFLECTS YOUR FINANCIAL INTERESTS FOR THE PRECEDING TAX YEAR, WHETHER BASED
A FISCAL YEAR. PLEASE STATE BELOW WHETHER THIS STATEMENT IS FOR THE PRECEDING TAX YEAR ENDING
DECEMBER 31, 2009 OR SPECIFY TAX YEAR IF OTHER THAN THE CALENDAR
MANNER OF CALCULATING REPORTABLE INTERESTS:
THE LEGISLATURE ALLOWS FILERS THE OPTION OF USING REPORTING THRESHOLDS THAT ARE ABSOLUTE
REQUIRES FEWER CALCULATIONS, OR USING COMPARATIVE THRESHOLDS, WHICH ARE USUALLY BASED
instructions for further details). PLEASE STATE BELOW WHETHER THIS STATEMENT REFLECTS EITHER (check one):
COMPARATIVE (PERCENTAGE) THRESHOLDS OR DOLLAR VALUE THRESHOLDS
ON A CALENDAR YEAR OR ON
EITHER (check one):
YEAR:
DOLLAR VALUES, WHICH
ON PERCENTAGE VALUES (see
PART A PRIMARY SOURCES OF INCOME
(If you have nothing to report, you
NAME OF SOURCE
OF INCOME
[Major sources of income to the reporting person]
must write "none" or "n /a
SOURCE'S
ADDRESS
DESCRIPTION OF THE SOURCE'S
PRINCIPAL BUSINESS ACTIVITY
tr/eL (j y' /1161 "W
.l o e(,-T
11�DZ� J i /r1�'.vT�
�j �rf
a 6,, 8i�k,1)') ra f-1 i ly
1 g ,yI s; 15
p -vel
1 _6 J
.�"Il}5o.erlfv r S J
So c i A ,..Cc.-4-4) v l is
fi l
PART B SECONDARY SOURCES
(If you have nothing to report
NAME OF
BUSINESS ENTITY
OF INCOME [Major customers, clients,
you must write "none" or "n /a
NAME OF MAJOR SOURCES
OF BUSINESS' INCOME
and other sources of income to businesses
ADDRESS
OF SOURCE
owned by the reporting person]
PRINCIPAL BUSINESS
ACTIVITY OF SOURCE
PART C REAL PROPERTY [Land buildings owned by the reporting person]
(If you have nothing to report, you must write "none" or "n /a
FILING INSTRUCTIONS for
when and where to file this form
are located 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.
r U Se, 1 f
tF slit f tf"T Prue R
t�
1/ 03 i Si- key` A, 6 i- ,)..jU�' a° 'i si -1r 1
CE FORM 1 Eff. 1/2010
(Continued on reverse side)
L- /J r/Yl l'` 2( p it! :)t t 2c -/U
PAGE 1
PART D INTANGIBLE PERSONAL PROPERTY [Stocks, bonds, certificates of deposit, etc.]
(If you have nothing to report, you must write "none" or "n /a
TYPE OF INTANGIBLE
ideL ih riv ved rmetJr S
PART E LIABILITIES [Major debts]
(If you have nothing to report, you must write "none" or "n /a
NAME OF CREDITOR
vzx' home 070171+
PART F INTERESTS IN SPECIFIED BUSINESSES [Ownership or positions in certain types of businesses]
(If you have nothing to report, you must write "none" or "n /a
BUSINESS ENTITY 1
NAME OF BUSINESS ENTITY
ADDRESS OF BUSINESS ENTITY
PRINCIPAL BUSINESS ACTIVITY
POSITION HELD WITH ENTITY
I OWN MORE THAN A 5%
INTEREST IN THE BUSINESS
NATURE OF MY
OWNERSHIP INTEREST
SIGNATURE
WHAT TO FILE:
After completing all parts of this form, including
signing and dating it, send back only the first
sheet (pages 1 and 2) for filing.
If you have nothing to report in a particular
section, you must write "none" or "n /a" in that
section(s).
Facsimiles will not be 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 1 because
of another public position must at least file a copy
of his or her original Form 1 when qualifying.
equi
BUSINESS ENTITY TO WHICH THE PRQPERTY RELATES
307 NT 0,46 w W 7r-e_ L Wes
ADDRESS OF CREDITOR
T r o 7 S601J U! G/ Ft X2 Z
BUSINESS ENTITY 2
IF ANY OF PARTS A THROUGH F ARE CONTINUED ON A SEPARATE SHEET, PLEASE CHECK HERE
DATE SIGNED required):
FILING INSTRUCTIONS:
WHERE TO FILE:
If you were mailed the form by the Commission
on Ethics or a County Supervisor of Elections for
your annual disclosure filing, return the form to
that location.
Local officers /employees file with the Supervisor
of Elections of the county in which they perma-
nently reside. (If you do not permanently 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 Maclay 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.
BUSINESS ENTITY 3
WHEN TO FILE:
Initially, each local officer /employee, state
officer, and specified 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 /employees, state
officers, and specified state employees are
required to file by July 1st following each
calendar year in which they hold their posi-
tions.
Finally, at the end of office or employment,
each local officer /employee, state officer, and
specified state employee is required to file a
final disclosure form (Form 1 F) within 60 days
of leaving office or employment.
CE FORM 1 Eff. 1/2010
PAGE 2
N� i Aly
1,
a citizen
hereby
Florida.
LOYALTY OATH FOR
NON PARTISAN OFFICE
(Sections 876.05 876.10, Florida Statutes)
STATE OF FLORIDA
r�t ,C OUNTY
OFFICE USE ONLY
f F S E. A:,
OFFICE OF CITY C L E R K
2010 AUG 24 All 11 18
1 c� AV' S
it r
G t I I 012
First Name Middle Name /Initial Last Name
of the State of Florida and of the United States of America, and a candidate for public office do
solemnly swear or affirm that I will support the Constitution of the United States and of the State of
I,
am
My
under
have
with
99.012,
OATH OF CANDIDATE
1-) (Section 99.021, Florida Statutes)
GI't c9 69 i /fl?v
I
(PLEASE PRINT NAME AS YOU WISH IT TO APPEAR ON THE BALLOT NAME MAY NOT BE CHANGED AFTER THE END OF QUALIFYING)
a candidate for the office of C 177 Ce.) U N C 1 L
ffi
(oce 1/Ub (district) (group)
legal residence is 7 2/y XhoF' /PL Me ,SP 7 I n RI tier County, Florida. I am qualified
the Constitution and the Laws of Florida to hold the office to which I desire to be nominated or elected.
qualified for no other public office in the state, the term of which office or any part thereof runs concurrent
the office I seek; and I have resigned from any office from which I am required to resign pursuant to Section
Florida Statutes.
1
(7'72
-)2941' 9o44 t- I i, 9 rtImcN ce mfl IV
i t
Signature of Candidate Daytime Telephone Number Email Address
71" jL 40 cabtras1t i A I 7 29 ST
Address
Sworn
Personally
Produced
Type
to (or affirmed) and subscribed
Known: 7 or
City
before me this'Q
State ZIP Code
1' day of 2000
Identification:
Y�
of Identification Produced:
Signature of Lary Public State of Florida
Print, Type or Stamp Commissioned Name of Notary Public
L Sally A. Maio
Commission DD595269
Expires October 5, 2010
Bonded Troy Fain Insurane Inc 1100-365-7019
DS -DE 25 (05108)
CITY OF SEBASTIAN
CITY CLERK'S OFFICE
RECEIPT
3626
Name e,..i.ard I l LL,nLY Cash
Date U /2 9/J 110heck# M
No. Amount Paid
001001 208001 Sales Tax
001501 322900 Garage Sales
001501 341920 Copies/Bid Specs.
001501 341910 LDC /Code of Ordinances
001501 341930 Election Qualifying Fees P
601010 343800 Cemetery Lots
Lot/Niche Block Unit
001501 343805 Cemetery Fees
015.
d Do
nitials
White Dept. of Origin Yellow Finance Pink Applicant
/h
Total Paid Y,
FLORIDA DEPARTMENT OF STATE DIVISION OF ELECTIONS
CAMPAIGN TREASURER'S REPORT S l-M4MA-RY
;Ckare0 t
I lnert
I F "F C[i
S A J I IAN
OFFICE oPFPff HWLY
2010 JUL 8 PM 3 30
Name
(2) T 41 K tsje L 4re-,
Address (number and eet)
Se,bots /6/1 f2 3 Z.9 57
City, State, Zip Code
CHECK IF ADDRESS HAS CHANGED
(4) Check appropriate box(es):
P2 Candidate (office sought):
Political Committee
Committee of Continuous Existence
Party Executive Committee
I I Electioneering Communication
C fry Co-um C/L--
(3) ID Number:
A
CHECK IF PC HAS DISBANDED
n CHECK IF CCE HAS DISBANDED
U CHECK IF NO OTHER ELECTIONEERING
COMMUNICATION REPORTS WILL BE FILED
(5) REPORT IDENTIFIERS
Cover Period: From 4.. f O To 3 0 r 0 Report Type
Original Amendment Special Election Report Independent Expenditure Re ort
(6) CONTRIBUTIONS THIS REPORT
Cash Checks
(7)
Monetary
Expenditures
Transfers
Account
Total
Monetary
EXPENDITURES THIS REPORT
-69,—
Loans c20
to Office
Total Monetary
In-Kind
(8)
Other Distributions
(9) TOTAL Monetary Contributions To Date
O 0. G
(10)
TOTAL Monetary Expenditures To Date
€Z)
(11) CERTIFICATION
It is a first degree misdemeanor for any person to falsify a public record (ss. 839.13, F.S.)
certify that I have examined this report and it is true,
correct, and complete.
(Type name) Rr h H 1/I1 �l f i Ct 1 t rn
I certify that I have examined this report and it is true,
correct, and complete.
(Type name) AC 4 j $l JG /4 (�r J/121
Individual (only for Treasurer
Deputy Treasurer
IWCandidate
w Chairperson (only for PC, PTY
eI n co ry n.
�le eering commun. organization)
Signature
Signature
DS -DE 12 (Rev. 08/04)
(5)
Date
(7)
Full Name
(Last, Suffix, First, ivuuule)
Street Address
City, State, Zip Code
Contributor
Type
(8)
Occupation
(9)
Contribution
Type
(10)
In -kind
Description
(11)
Amendment
(12)
Amount
(6)
Sequence
Number
c
(o
6 moe R k
I.
u
t 6
2010 J
OFFI
uL 8 P('1
SEBAJ
CE OF CITY C
3 30
:LERI;
(1) Name t ChI ref I►'h d!� (2) I.D. Number
3) Cover Period G Z g through
DS -DE 13 (Rev. 08/03)
CAMPAIGN TREASURER'S REPORT ITEMIZED CONTRIBUTIONS
3 12, (4) Pa
SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES
of
(5)
Date
Full Name
(Last, Suffix, First, Middle)
Street Address
City, State, Zip Code
Purpose
(add office sought if
contribution to a
candidate)
Expenditure
Type
Amendment
Amount
(6)
Sequence
Number
2010 JUL
OFFICE C
8 prii 3 3
SLiik,)
F CITY CLEF
O
CAMPAIGN TREASURER'S REPORT ITEMIZED EXPENDITURES
(1) Name gichfrVJ( '-J I r I,31OV_ (2) I.D. Number
(3) Cover Period (P 2 t l f 6 through kr=:' T a (4) Page
DS -DE 14 (Rev. 08/03)
SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES
of
July 1,2010
Richard H. Gilimor
744 Kroegel Avenue
Sebastian, FL 32958
Dear Mr. Gilimor:
Sincerely,
Sall A. M o, MMC
City Clerk
sam
CRY Of
HOME OF PELICAN ISLAND
1225 Main Street
Sebastian, Florida 32958
(772) 388 -8214 phone (772) 589 -5570 fax
smaio @cityofsebastian.org
In accordance with Florida Statutes Section 106.07, the campaign treasurer's report
for your campaign for the period June 28, 2010 through June 30, 2010 is due on the
tenth day following the quarter, however, due to the fact that the deadline falls on a
Saturday, the report is due in the Office of the City Clerk no later than 5 pm on
Monday, July 12, 2010.
Any report postmarked by the United States Postal Service no later than midnight of
the due date (July 10, 2010), shall be deemed to have been submitted in a timely
manner.
The official qualifying period for the November election will begin on August 19, 2010
and run through September 3, 2010. The qualifying fee and all other forms not
submitted during pre qualifying should be filed at this time.
Please call me at 388 -8214 or contact me by e-mail at smaio(a�cityofsebastian.orq if
you have any questions.
STATE OF FLORIDA
APPOINTMENT OF CAMPAIGN TREASURER
AND DESIGNATION OF CAMPAIGN
DEPOSITORY FOR CANDIDATES
(Section 106.021(1), F.S.)
(PLEASE PRINT OR TYPE)
+OFEICS USE ONLY
',11 OF SEBASTIAN
OFFICE OF CITY CLERK
2010 JUN 28 Pig 1 I.10
1. CHECK APPROPRIATE BOX:
Original Appointment Change in: Treasurer /Deputy Depository Office Party
2. Name of Candidate
R I I� r
(in this order: First, Middle, Last)
if t I� a
3. Address l (include post office box or street, city, state, zip
code) 7 7 1 frS ro yeL Ave
Ve f_ s i-t \a� t F=4, `3 A q e
t7
4. Telephone (optional)
('772- .A�$gorv�
5. E -mail address (optional)
6. Office sought (include district, circuit, group number)
C T C DU C, 1 L MEI'll5E.K
7. If a candidate for a non •artisan office, check if
applicable:
My in tent is to run as a Write -In candidate.
8. If a candidate for a artisan office, check block and fill in name of party as applicable: My intent is to run as a
Write -In E
No Party Affiliation Party candidate.
9. I have appointed the following person to act as my Campaign Treasurer Deputy Treasurer
10. Name of Treasurer or Deput y Treasurer
IRtchr vi F4 l((rnalz
11. Mailing Address (If post office box or drawer, also include street address)
744 Kvoey'(- jrve
12. Telephone
(772 2-74 ?Obc
13. City
bA TI ilk
14. County
1N R vet
15. State
f'L.
16. Zip Code
7.1' S g
17. E-mail address (optional)
h h 4 11 Mot' ®l +n A i l. ,c0 a
18. I have designated the following bank as my Primary Depository Secondary Depository
19. Name of Bank
Se4cons7 Ahit4, a,eNt
20. Street Address
//).2, R,seAA
21.0
(.3ibx1
22. County
,z-,444,0 6I Jei
23. State
jZr
24. Zip Code
7 Z S S j
UNDER PENALTIES OF PERJURY, I DECLARE THAT I HAVE READ THE FOREGOING FORM FOR APPOINTMENT OF CAMPAIGN TREASURER AND
DESIGNATION OF CAMPAIGN DEPOSITORY AND THAT THE FACTS STATED IN IT ARE TRUE.
25. Date
b /i h 0
26 ignatu of di.
27. Treasurer's
1, RCGA iwii
Acceptance of Appointment (fill in the blanks and check the appropriate block)
6•tf. do hereby accept the appointment
(Please Pint or Type Name)
designated above as: Campaign Treasurer
Deputy Treasurer.
ii Date
Si• na ure of Campaign Treasurer or Deputy Treasurer
DS -DE 9 (Rev. 11/09)
T
Y or SEERS
Charter Section 2.02 ELIGIBILITY
2010
Notary P •Iic
State of Iorida
SEAL
Ms- word/election/charter eligibility
OFFICE OF CITY CLERK
ana
SE 7 1O JUN 28 P1l 1 40
HOME OF PELICAN ISLAND
ELIGIBILITY TO HOLD OFFICE
OF COUNCILMEMBER
"No person shall be eligible to hold the office of council member
unless he or she is 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
candidate for said office.
J d
I, �1 h m !C candidate for the office
of Council Member, meet the eligibility qualifications to hold office as
required in Section 2.02 of the City of Sebastian Charter, above.
Si na u a of Candidate
Sworn to and subscribed before me this 20 day °N L
Z Sally A. Maio
Commission DD595269
,roC
.0 Expires October 5, 2010
4f i, y Bonded Troy Fain Insurance, Inc 000'386.7010
*166.032 Electors. -Any person who is a resident of a municipality, who has qualified as an elector of this
state, and who registers in the manner prescribed by general law and ordinance of the municipality shall be a
qualified elector of the municipality.
STATEMENT OF
CANDIDATE
(Section 106.023, F.S.)
(Please Type)
I, 1 cj1gr, (-1. 61'
/frtok.
candidate for the office of
have received, read and understand the requirements of Chapter 106,
Florida Statutes.
C i Ty Coe/Mc/4
1 c�►`'l! ONLY
OFFICE OF CITY CLERK
2010 JUN 28 Pig 1 90
orA..r/ 0
Signature of Candidate 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. 03/08)