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HomeMy WebLinkAboutSCOZZARI JOSEPH 11-2-2010FLORIDA DEPARTMENT OF STATE DIVISION OF ELECTIONS CAMPAIGN TREASURER'S REPORT SUMMARY (1) C —1 1 'l NLY 2011 JRN 31 AP1 8 2? Name YO j t q l/ (2) 7 l L Address umberMnd street) j 6o k c rL 3 2 F y City, State, Zip Code CHECK IF ADDRESS HAS CHANGED umber: (4) Chock appropriate box(es): L 2 t :i/ Candidate (office r� c e Political Committee CHECK F 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 over Period: From /0 ,36 /0 To 7/ Report Type k Original Amendment Special Election Report 1 Independent Expenditure Report (6) CONTRIBUTIONS THIS REPORT Cash Checks (7) EXPENDITURES THIS REPORT Monetary Expenditures 2 V 10 Loans Transfers to Office Account Total Monetary Total Monetary In -Kind (8) Other Distributions /"C (4 (9) TOTAL Monetary Contributions To Date 0 7• (10) TOTAL Monetary Expenditures To Date X 07. (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 examinedthis report and it is true, correct, and complete. (Type name) i1C. I t f= CQ ZOd! I certify that I have examined this report and it is true, correct, and complete. (Type name) Ter iv oz. 2„,.. C ❑I ndividual (only for Treasurer Deputy Treasurer electioneering commun.) X Irj Carfiite X Chairperson (only for PC, PTY el ring commun. organization) Signal re Sign tore DS-DE 12 (Rev. 08104) (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 (1 Amount (6) Sequence Number i C /3 0 /1 t free -6 COOL-4 tiecD rt' j ge.A___ ,2� S 0 /31/11 -1n S-Cf, 7 r cam, 1V/ r^ t t 7/ Igo' ail 0 26 FFICE OF C 1 JAN 31 ITY CLERK firl 8 27 (1) Name CAMPAIGN T'I URER'S,REPORT ITEMIZED EXPENDITURES r 7 (2) 1.D. Number 3 (3) Cover Period C� 3C' through L (1 (4) Page of DS-DE 14 (Rev. 08103) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES December 2010 Joseph and Julie Scozzari 1401 Thornhill Drive Sebastian, FL 32958 Dear Mr. and Mrs. Scozzari: 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 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 1 can do to assist you, please do not hesitate to contact me at 388 -8214 or srn i it ba ti n.or Sincerely, c Sally A. 11 ai MMC City Clerk CITY Of HOME OF PELICAN ISLAND 1225 Main Street Sebastian, Florida 32958 (772) 388 -8214 phone (772) 589 -5570 fax smaio@cityofsebastian.org November 9, 2010 Joseph and Julie Scozzari 1401 Thornhill Drive Sebastian, FL 32958 Dear Mr. and Mrs. Scozzari: 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 smaioacityofsebastian.orq. Sally A. City Clerk o. MMC aY of 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 SUMMARY. l 1 v_ 6 z.' —1 0 F F I W 'ate. K 2010 OCT 29 111 11 95 Name (2) I/0 7— f t 1/ L.. /I r Add rre s (number and street) City, State, Zip Code CHECK IF ADDRESS HAS CHANGED (3) ID Number: (4) Check appropriate box(es): Candidate (office sought): p C (s "l i iki- P C omm itt ee CHECK IF PC HAS DISBANDED Committee of Continuous Existence CHECK IF CCE HAS DISBANDED Party Executive Committee T Electioneering Communication 1 CHECK IF NO OTHER ELECTIONEERING COMMUNICATION REPORTS WILL BE FILED (5) REPORT IDENTIFIERS Cover Period: From k) 9 /C To /'0 2 S 0 Report Type X Original Amendment Special Election Report Independent Expenditure Report (6) CONTRIBUTIONS THIS REPORT Cash Checks /07 (7) EXPENDITURES THIS REPORT `i Monetary g Expenditures Y 91 Loans 0 Transfers to Office Account Total Monetary Total Monetary In -Kind (8) Other Distributions (9) TOTAL Monetary Contributions To Date 07. (10) TOTAL Monetary Expenditur-s 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) -J t__e_l a Individual (only for 0 "reasurer Deputy Treasurer electioneering commun.) X I certify that I have examined this report and it is true, correct, and complete. (Type name) Qj% i IL Candi to Cha person (only for PC, PTY electioneering commun. organization) Sig ature Sign t e DS -DE 12 (Rev. 08/04) (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 C 2- q (0 n 1 J� /07 .c fqot irft e0 FL- 1010 OC 0FF1( T 29 Rf�� C SEBACi :E OF CITY C r- i F"�� h� CAMPAIGN TREASURER'S REPORT ITEMIZED CONTRIBUTIONS ‘e-OZ-Z-cAr( 2 I.D. Number (1) Name -1 Q ce� (31 /0 Cover Period through (0 Z q P C Page l of 6S -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 (8) Purpose (add office sought if contribution to a candidate) (9) Expenditure Type (10) Amendment (11) Amount (6) Sequence Number 52 10 T c �J©GAL7 C -c( f/t4e04 6-41- ACYA- )l 1101° 1 1 1 OFFICE 01 1 i- 1 SEBAS'i F CITY CLER G" `r■ CAMPAIGN TREASURER'S REPORT ITEMIZED EXPENDITURES (1) Name __l® e_pLL c LC37 z- t (2) I.D. Number (3) Cover Period C©/ /0 through 6) Z-�/ !�3 (4) Page of DS -DE 14 (Rev. 08/03) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES October 19, 2010 Joseph and Julie Scozzari 1401 Thornhill Drive Sebastian, FL 32958 Dear Mr. and Mrs. Scozzari: 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 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(a�cityofsebastian.orq. Sin ely, Sally A. IVlllaio, MMC City Clerk FLORIDA DEPARTMENT OF STATE DIVISION OF ELECTIONS CAMPAIGN TREASURER'S REPORT SUMMARY 0 ,1' �D (1.. S 2.-c). I OFFIC t CITY CLERK 2010 OCT 15 P(9 2 55 1 T -v, I,, i [f Litt A ss (number and stree 3P cam_ 1- ct,�.. l (f J� u City, State, Zip Code n CHECK IF ADDRESS HAS CHANGED (4) C eck appropriate box(es): (office sought): p c.c,r't. C (3) c I ID Number: 4 -er Candidate �'f�. Political Committee 1 CHECK IF PC HAS DISBANDED Committee of Continuous Existence CHECK IF CCE HAS DISBANDED Party Executive Committee n Electioneering Communication Li CHECK IF NO OTHER ELECTIONEERING COMMUNICATION REPORTS WILL BE FILED (5) REPORT IDENTIFIERS Cover Period: From g 2 5/ f 0 To /C, q 6 Report Type 6- 3 Original Amendment Special Election Report Independent Expenditure Report CONTRIBUTIONS THIS REPORT Cash Checks 0 (7) EXPENDITURES Monetary Expenditures Transfers Account Total Monetary THIS REPORT --e Loans to Office Total Monetary In -Kind (8) Other Distributions (9) TOTAL Monetary Contributions To Date SO O. (10) TOTAL Mo etary Expenditures To Date 6 (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. I certify that I have examined this report and it is true, correct, and complete. f c (T pe name) —.___I 4 S L. �JC' c Z w t (Type name) 1 c. 2- Zc Individual (only for Treasurer Deputy Treasurer electioneering commun.) nd'date X CFiairperson (only for PC, PTY electioneering commun. organization) `f Signature Signature DS -DE 12 (Rev. 08/04) (5) Date (7) Full Name (Last, Suffix, First, Middle) Street Address City, State, Zip Code Contributor Type Occupation (9) Contribution Type (10) In -kind Description (11) Amendment (12) Amount (6) Sequence Number l 2 1 4 2 1 4 C L paralcOoS e7z� A- y e.?.or-.1^- 61 0-416*°' 33N Sy 2 i A. 00. 10 g Z1 /0 Se° 62? a v ex s 1 6 7 3 R® C O s OFFICE 2010 OC1 i Z Wd St 110 1,110 30 SEBAS 11; 1 55 CAMPAIGN TREASURER'S REPORT ITEMIZED CONTRIBUTIONS l (1) Name 3) Cover Period 75 0 through DS -DE 13 (Rev. 08/03) (2) I.D. Number f p (4) Pape SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES 1 of Da (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 (10) Amendment (11) Amount (6) Sequence Number OFFICE OF 2010 OCT 15 SS Z Wcl tT lo >EBAST;., CAMPAIGN TREASURER'S REPORT ITEMIZED EXPENDITURES (1) Name (2) I.D. Number (3) over Period DS -DE 14 (Rev. 08/03) through (4) Page SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES of October 7, 2010 Joseph and Julie Scozzari 1401 Thornhill Drive Sebastian, FL 32958 Dear Mr. and Mrs. Scozzari: 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�a cityofsebastian.org. Sin Iy, Sally A. aio, MMC City Clerk CITY of 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 SUMMARY 8 1� S C- Oz.- CITY OF SCII'1$ OFFICE OF CITY CLERK 2010 OCT ;1 fill 10 `I7 Name (2) L P I a GL L c II L Address i(numberrand street) r G 4 2 a L- J s City, State, CHECK IF (4) C eck appropriate Candidate Political Committee Committee Party Executive Electioneering Zip Code ADDRESS HAS CHANGED box(es): (office sought): I (3) ID Number: I' i/ 'at-�L�e.r i CHECK IF PC HAS DISBANDED of Continuous Existence CHECK IF CCE HAS DISBANDED Committee Communication CHECK IF NO OTHER ELECTIONEERING COMMUNICATION REPORTS WILL BE FILED Cover Period: Original (5) REPORT IDENTIFIERS From C3 To 2,6 /6 Report Type -1 /1 Amendment Special Election Report ❑Independent Expenditure Report 1 CONTRIBUTIONS Cash Checks Loans Total Monetary In -Kind THIS REPORT SO (7) Monetary Expenditures Transfers Account Total Monetary EXPENDITURES THIS REPORT --a— to Office (8) Other Distributions 0 (9) TOTAL Monetary Contributions To Date (10) TOTAL Mo tary 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 examinedthis report and it is true, correct, and complete. (Type name) ♦,c. i e JGOsz -zt I certify that I have examined this report and it is true, correct, and complete. (T name) 71 Selip V Individual (only for Treasurer Deputy Treasurer electioneering commun.) Candidate Chairperson (only for. PC, PTY electioneering commun. organization) Sign- ure Sign to DS -DE 12 (Rev. 08/04) (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 zZ, M 6 s. dc-::„, 60. fi 1 !O1O OCT 1 iTY OF Si OFFICE OF nri 10 97 EBAST i, ;ITY CLERK DS -DE 13 (Rev. 08/03) CAMPAIGN TREASURER'S REPORT ITEMIZED CONTRIBUTIONS (1) Name -..__)cs) e_T,L SCCO (2) I.D. Number 3) Cover Period 1f D through a�/ lV (4) Page C of 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 Amendment Amount (6) Sequence Number \NLN 20 OC1 JIt OFFIC 1 Rfi11C r SEBAST OF CITY CL 97 ,ERK ii AMPA GN TRgASURER'S REPORT ITEMIZED EXPENDITURES 44: t (2) LD. Number (3) Cover Period 1( 10 through w (1) Name DS -DE 14 (Rev. 08103) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES (4) Page of September 23, 2010 Joseph and Julie Scozzari 1401 Thornhill Drive Sebastian, FL 32958 Dear Mr. and Mrs. Scozzari: 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 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 smaio @cityofsebastian.org. Sirycerely, Sally A. Maio, MMC City Clerk FLORIDA DEPARTMENT OF STATE DIVISION OF ELECTIONS CAMPAIGN TREASURER'S REPORT SUMMARY (1) 11 5e LL fc6 Z i OF14 USE ONLY OFFICE OF CITY CLERK 2010 SEP 17 PE9 4 32 Name 1 f O ics ellt:(f L a Address (number and street) �a-6t ca.Li rL 3 2 5 S City, State, Zip Code CHECK IF ADDRESS HAS CHANGED (4) Che appropriate box(es): andidate (office sought): C o OM/LUCY (3) j>� ID Number: C4Lt kr' 1 Political Committee CHECK IF PC HAS DISBANDED Committee of Continuous Existence CHECK IF CCE HAS DISBANDED Party Executive Committee n Electioneering Communication 1 CHECK IF NO OTHER ELECTIONEERING COMMUNICATION REPORTS WILL BE FILED (5) REPORT IDENTIFIERS /0 Cover Period: From q 3 /0 To Q /0 /0 Report Type 6/ Original Amendment Special Election Report Independent Expenditure Report (6) CONTRIBUTIONS THIS REPORT Cash Checks 30 p Q. (7) Monetary Expenditures Transfers Account Total Monetary EXPENDITURES THIS REPORT to Office —0-- Loans e Total Monetary _--1 In -Kind (8) Other Distributions (9) TOTAL Monetary Contributions To Date (10) TOTAL Monetary Expenditures To Date C -3 (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) <.n ck_ C-0 5 i I certify that I have examined this report and it is true, correct, and complete. (Type name) __k 0 .ZCL"i Individual (only for Treasurer Deputy Treasurer Y Y electioneering commun.) Ca date son (onl P (only for PC, PTY electioneering commun. organization) kir Sl re Sign t re DS -DE 12 (Rev. 08/04) (5) Date (7) Full Nam (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 q 3 0 Ce xc. t /40/ 71 r& -kd(I Lik. 32 93 1 4" O q i 1 0 '9r. 7,667 _fate 32_962_ 5 Z� r. z C,F SE- FFICE OF C w N fiSTi' Y CLERK. CAMPAIGN TREASURER'S REPORT ITEMIZED CONTRIBUTIONS (1) Name 06 pL C 3) Cover Period DS -DE 13 (Rev. 08/03) r through r U (2) I.D. Number 4) Paae 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 1 1 1 1 Allidi I SEA OFFICE OF CITY NM SEP 17 PP1 1 1 1 LG ERK 32 tir_11‘, 1 III CAMPAIGN TREASURER'S RRPORT ITEMIZED EXPENDITURES (1) Name "OS p G SCcs z 'Zeal t (2) I.D. Number (3) Cover Period 3 to through 1 7 /0/ /0 (4) Page of DS -DE 14 (Rev. 08/03) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES September 7, 2010 Joseph and Julie Scozzari 1401 Thornhill Drive Sebastian, FL 32958 Dear Mr. and Mrs. Scozzari: 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 September 3, 2010 (the day you declared your candidacy) through September 10, 2010 is due in the Office of the City Clerk by 5 pm on Friday, September 17, 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 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 /2010 /2010ElectionLaws. 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(a�cityofsebastian.orq. Sincerely, )7i Sally A. aio, MMC City Clerk Name Date CITY OF SEBASTIAN CITY CLERK'S OFFICE RECEIPT Cash Initials White Dept. of Origin Yellow Finance Pink Applicant 4716 [rk-et ck 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 !V L 601010 343800 Cemetery Lots Lot/Niche Block Unit 001501 343805 Cemetery Fees Total Paid FORM 1 STATEMENT OF 2009 Please print or type your name, mailing address, agency name, and position below: FINANCIAL INTERE SE I F CITY CLERK LAST NAME FIRST NAME MIDDLE NAME C o Z Z-C-. i L ,C'".S L"I�l.� L ���iE :FLYC 3 PIS 2 20 MAILING ADDRESS 1 fO 1 S 0-, t fe1c l C �`I f V Q „1:,,,,,, C/ C �I C C �E'J ID Code ID No. Conf. Code P. Req. Code CITY ZIP COUNTY NAME OF AGENCY NAM .OF OF CE OR POST ION H D OR SOUGHT l You are of limited to the space on the lines on this form. Attach additional sheets, if necessary. CHECK ONLY IF CANDIDATE OR 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 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, 2009 OR SPECIFY TAX YEAR IF OTHER THAN THE CALENDAR YEAR: MANN R OF CALCULATING REPORTABLE INTERESTS: THE GISLATURE 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 instructions for further details). PLEASE STATE BELOW WHETHER THIS STATEMENT FLECTS EITHER (check one): COMPARATIVE (PERCENTAGE) THRESHOLDS 2 DOLLAR VALUE THRESHOLDS PART A PRIMARY SOURCES OF INCOME (If you have nothing to report, you NAME OF SOURCE INC E [Major sources of income to the reporti person] must write "none" or "n /a SOURCE'S ADDRESS DESCRIPTION OF THE SOURCE'S PRINCIPAL BUSINESS ACTIVITY OF 7 E t C tir~ l ti D e 4 /1c ti, PART B SECONDARY SOURCES (If you have nothing to report NAME OF BUSINESS NTITY 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 A /4 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. 9/ 0 ,r 7.. \2 CiK L (1 541 Q CE FORM 1 Eff. 1/2010 (Continued on reverse side) 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 BUSINESS ENTITY TO WHICH THE PROPERTY RELATES TYPE OF INTANGIBLE /CO /Or a eAi-rt PART F INTERESTS IN SPECIFIED BUSINESSES [Ownership or positions in ce (If you have nothing to report, you must write "none" or "n /a BUSINESS ENT TY 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 PART E LIABILITIES [Major debts] (If you have nothing to report, you must write "none" or "n /a NAME OF CREDITOR ADDRESS OF CREDITOR C..tj ain types of businesses] BUSINESS ENTITY 2 BUSINESS ENTITY 3 IF ANY OF PARTS Ar THROUGH F ARE CONTINUED ON A SEPARATE SHEET, PLEASE CHECK HERE SIGNATURE (required): DATE SIGNED (required): 3 /0 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. FILING INSTR1JCTIONS• 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. 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 I, 0 /2._ 7 Cc. a -zck. i s candidate for the office of 6 i "t L)L i1C L 1 Al e-tiL5- have received, read and understand the requirements of Chapter 106, Florida Statutes. x STATEMENT OF CANDIDATE (Section 106.023, F.S.) (Please Type) O E F I E U E N Y OFFICE OF CITY CLERK 2010SEP 3 PM 2 20 u re 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) LOYALTY OATH FOR NON PARTISAN OFFICE (Sections 876.05- 876.10, Florida Statutes) STATE OF FLORIDA Li b �cz��. 1��`�c COUNTY OFFICE USE ONLY �I SE LLA` t OFFICE 0 F CITY CLERK 10 SEP p 9 02 1, a citizen hereby Florida. C L L Cc,-z 5-'I 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 (Section 99.021, Florida Statutes) 0 e TD C.C7. Z_c� r I a candidate legal residence the qualified the office Florida (PLEASE PRINT NAME AS YOU WISH IT T APPEAR ON THE BALLOT NAAME MAY NOT BE CHANGED AFTER THE END OF OUALIFYING) for the office of c .,u4 C t/ edi 1 (office) (district) (group) is TA, ci.,ti i c4 r 0 4 4L ,024/, County, Florida. I am qualified Constitution and the Laws of Florida to hold the office to w h I desire to be nominated or elected. for no other public office in the state, the term of which office or any part thereof runs concurrent I seek; and I have resigned from any office from which I am required to resign pursuant to Section Statutes. X 772 ?—z672,_ vc' y o C ture of Candidate Daytime T lephone Number Email Addres yLI {G l i e) r (A_ L 1 L. c'f iy_k_s cti, r 32 i 6 Address Sworn to Personally Known: Produced Identification: Type of Identification (or affirmed) and subscribed V or City before me this State ZIP Code 3 day o 1 204 j i ,uJ n Produced: Signat e of Notary Pub lc State of Florida Print, Type or Stamp Commissioned Name of Notary Public Ru Notary Public State of Florida o�, Tiffany Lilllquist vl c_ o` My Commission DD781683 'f%'os 0,0c Expire. 05/12/2012 DS -DE 25 (05/08) STATE OF FLORIDA APPOINTMENT OF CAMPAIGN TREASURER AND DESIGNATION OF CAMPAIGN DEPOSITORY FOR CANDIDATES (Section 106.021(1), F.S.) (PLEASE PRINT OR TYPE) OFFICE,USE ONLY I t S F BA S OFFICE OF CITY CLERK 2010 SEP 3 P(9 12 51 CHECK APPROPRIATE BOX: Original Appointment Change in: Treasurer /Deputy Depository Office Party 2. Name of Candidate (in this order: First, Middle, Last) Ire_ .Cc_- 3. Address (include post office box or street, city, state, zip code) vO! ca 4 A 4. Telephone (optional) (`17),)5c 5. E -mail address (optional) SeZet5 /!1 it ,v/ 3 q5 f Se>e„„Sc..ozz.Ar l(°, C G ,s -1,Pd 6. Office sought (include district, circuit, group number) 7. If a candidate for a nonpartisan office, check if 1, COVIVLIL (y t 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 'Campaign Treasurer Deputy Treasurer 10. Name of Treasurer or Deputy Treasurer 11. Mailing Address (If post office box or drawer, also include street address) S,Afiv l.2.5 44c,LPL- 12. Telephone 13. City 14. County 15. State 16. Zip Code 17. E -mail address (optional) 18. I have designated the following bank as my El Primary Depository Secondary Depository 19. Name of Bank R13 k or Aleci!'. 20. Street Address 21. City S ��s A 22. County �,ut,[ /4 e il� C 23. State 1/ 24. Zip Code 3z5,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 THAA THE FACTS STATED IN IT ARE TRUE. 25. Date 9/3//l> 26. X ig'lure of Candidate 27. Tre urer's Acceptance of Appointment (fill I, Le__ �Jf U 6 ,5G o tie blanks and check the appropriate block) ZZGL do hereby accept the appointment (Please Pri t or Type Name) designated above as: (Please Treasurer Deputy Treasurer. J 9/.3/2/ X Date ignature of Campai reasurer or Deputy Treasurer DS -DE 9 (Rev. 11/09) Charter Section 2.02 ELIGIBILITY SEAL Sian Notary Pu State of lorida Q �n Ms- word/election/charter eligibility V 11 ,F OFFICE OF CITY CLERK SLT SEP 3 P19 12 51 U 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." 1 Z P/ candidate for the office of Council Member, meet the eligibility qualifications to hold office as requires in Section 2.02 of the City of Sebastian Charter, above. Sworn to and subscribed before me this 2010 ss.02 4 Sally A. Maio :1 Commission DD595269 Expires October 5. 2010 4 j P Bonded Troy Fain In uronoa Inc 85.3667019 *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.