HomeMy WebLinkAboutMILLER AMBER 11-8-2011FLORIDA DEPARTMENT OF STATE DIVISION OF ELECTIONS
CAMPAIGN TREASURER'S REPORT SUMMARY
(1)
(2)
knc,yM
N -et bAph i v Arc
Address (number and street)
\. as 1an w 37A
City, State, Zip Code
❑ CHECK IF ADDRESS HAS CHANGED
(4) Check appropriate box(es):
Candidate (office sought):
❑ Political Committee
❑ Committee of Continuous Existence
❑ Party Executive Committee
• Electioneering Communication
OFFICE USE ONLY
(3) ID Number:
(Luic
['CHECK IF PC HAS DISBANDED
❑ CHECK IF CCE HAS DISBANDED
U CHECK IF NO OTHER ELECTIONEERING
COMMUNICATION REPORTS WILL BE FILED
(5) REPORT IDENTIFIERS
Cover Period: From \ \ / / ' \ To ' / / J I Report Type
EtOriginal ❑ Amendment ❑ Special Election Report ❑ Independent Expenditure Report
(6) CONTRIBUTIONS THIS REPORT
Cash & Checks $
Loans $
Total Monetary $
In -Kind $
(7) EXPENDITURES THIS REPORT
Monetary
Expenditures
$
Transfers to Office
Account $
Total
Monetary
$ acqco
(8) Other Distributions
(9) TOTAL Monetary Contributions To Date
$ 100-C .0
(10) TOTAL Monetary Expenditures To Date
$ C_)c CC
(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) ) name) ATIVOCr. I l I
❑ Individual (only for 71,Treasurer n Deputy Treasurer
electioneering commun.)
X110
X
tak
1 it
Signature
I certify that I have examined this report and it is true,
correct, and complete.
(Type name)
VI Candidate
X
Signature
rn1 ,rMIl'
0 Chairperson (only for PC. PTY &
electioneering commun. organization)
DS -DE 12 (Rev. 08/04)
CAMPAIGN TREASURER'S REPORT — ITEMIZED CONTRIBUTIONS
(1) Name (2) I.D. Number
3 Cover Period
through
4 Pa
of
DS -DE 13 (Rev. 08/03)
SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES
(5)
to
(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)
A• endment
(12)
Amount
(6)
Sequenc
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DS -DE 13 (Rev. 08/03)
SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES
(1) Name
C MPAIGN.T EASURER'S REPORT - ITEMIZED EXPENDITURES
JV ►I (2) I.D. Number
(3) Cover Period I I / / through 1 I / 1 S /
(4) Page
of
(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
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DS -DE 14 (Rev. 08/03)
SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES
HOME OF PELICAN ISLAND
1225 Main Street
Sebastian, Florida 32958
(772) 388 -8214 phone - smaio @cityofsebastian.org
November 9, 2011
Amber Miller
944 Dolphin Avenue
Sebastian, FL 32958
Dear Ms. Miller:
In accordance with Florida Statutes Section 106.141, a Termination Report (TR) for your
campaign is due within 90 days of the day of the election, which is no later than February 6,
2012.
A copy of FS 106.141, which sets out that manner is which excess funds in your campaign
account can be disposed, is attached for your review.
If you have any questions, please don't hesitate to contact me at 388 -82145 or
smaio @cityofsebastian.org.
Sincerel
Sally A.
City Clerk
io, MMC
a
FLORIDA DEPARTMENT OF STATE DIVISION OF ELECTIONS
CAMPAIGN TREASURER'S REPORT SUMMARY
(1) Aim ye Mt 11.&Y
OFFICE USE ONLY
RECEIVED
NOV 0 4 2011
feitr.--
City of Sebastian
City Clerks Office
Name
(2) 144 ,Do i h t vi. J1 ur
Addre s (num er and street) 2 G
1 + F L 32 5P
City, State, Zip Code I
❑ CHECK IF ADDRESS HAS CHANGED
(4) Check appropriate box(es): 0 iy
Candidate (office sought): �U
(3) ID Number:
❑ Political Committee ❑ CHECK IF PC HAS DISBANDED
❑ Committee of Continuous Existence ❑ CHECK IF CCE HAS DISBANDED
❑ Party Executive Committee
n Electioneering Communication ❑ CHECK IF NO OTHER ELECTIONEERING
COMMUNICATION REPORTS WILL BE FILED
(5) REPORT IDENTIFIERS
Cover Period: From ' 0 / 15- / I [ To 1 / 3 / 1 1 Report Type G14
Original ❑ Amendment ❑ Special Election Report ❑ Independent Expenditure Report
(6) CONTRIBUTIONS THIS REPORT
Cash & Checks $ 3s O a°°
(7)
Monetary
Expenditures
Transfers
Account
Total
Monetary
EXPENDITURES THIS REPORT
$ 'C.3 , ce 0
Loans $
to Office
$
Total Monetary $___3__ j c-fi'
$ 3 - tp
In -Kind $
(8)
Other Distributions
(9) TOTAL Monetary Contributions To Date
$ Iva.O .
(10)
TOTAL Mo etary Expenditures To Date
$ %•E!..- �►r. it 753.. 75-
(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) '�I�(/f M 1 1 J(
I certify that I have examined this report
correct, and complete. �p �/
(Type name) / T 1 /( 7 Al
and it is true,
le
) "`-.
❑ Individual (only for Treasurer ❑ Deputy Treasurer
electioneering commun.)
X fn SI LUC
Candidate ❑ Chairperson (only for PC, PTY &
electioneering commun. organization)
X k i A L! •
Signature
Signature
DS -DE 12 (Rev. 08/04)
(1) Name
CAMPAIGN TREASURER'S REPORT — ITEMIZED CONTRIBUTIONS
001( 'VW Lex
through
(2) I.D. Number
4) Paae 1 of
(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
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,
/ /
/ /
/ /
DS -DE 13 (Rev. 08103)
SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES
9 Y ►PAIGN TREASURER'S REPORT - ITEMIZED EXPENDITURES
(1) Name YZX AA I I,(�1/ (2) LD. Number
(3) Cover Period ) O / / 11 through )1 / 3 / )1 (4) Page 1 of
(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
Number
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1 2v 11
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/ /
/ /
RECEIVED
NOV 0 4 2011
City of Sebastian
City Clerks
fr"'f
/ /
ice
/ /
DS -DE 14 (Rev. 08/03)
SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES
OTYOF
HOME OF PELICAN ISLAND
1225 Main Street
Sebastian, Florida 32958
(772) 388 -8214 phone - smaio @cityofsebastian.org
October 25, 2011
Amber Miller
944 Dolphin Avenue
Sebastian, FL 32958
Dear Ms. Miller:
In accordance with Florida Statutes Section 106.07, the G4 campaign treasurer's report for
your campaign for the period Saturday, October 15, 2011 through THURSDAY, November 3,
2011 is due by Friday, November 4, 2011. This is the 4th day prior to the election and the due
date is governed by FS 106.
Please keep in mind that this report is different than the previous three. The reporting period
ends on a Thursday, November 3rd and is due the next day on Friday, November 4th. No
further contributions can be accepted after midnight on November 3rd. This means midnight on
Thursday night, not Wednesday night. This always causes confusion.
(2)(a)1.All reports required of a candidate by this section shall be filed with the officer before
whom the candidate is required by law to qualify. All candidates who file with the Department of
State shall file their reports pursuant to s. 106.0705. Except as provided in s. 106.0705, reports
shall be filed not later than 5 p.m. of the day designated; however, any report postmarked by the
United States Postal Service no later than midnight of the day designated shall be deemed to have
been filed in a timely manner. Any report received by the filing officer within 5 days after the
designated due date that was delivered by the United States Postal Service shall be deemed timely
filed unless it has a postmark that indicates that the report was mailed after the designated due
date. A certificate of mailina obtained from and dated by the United States Postal Service
at the time of mailing, or a receipt from an established courier company, which bears a
date on or before the date on which the report is due, shall be proof of mailing in a
timely manner. Reports shall contain information of all previously unreported
contributions received and expenditures made as of the preceding Friday, except that the report
filed on the Friday immediately preceding the election shall contain information of all previously
unreported contributions received and expenditures made as of the day preceding that designated
due date. All such reports shall be open to public inspection.
If you choose to mail, please make sure the form is completely filled out and signed. If it is not
and received after the deadline, it will be deemed not timely filed and penalties must be
imposed. If you have any questions, please do not hesitate to contact me.
Sincerely,
Sally A. -Maio, MMC
City Clerk
FLORIDA DEPARTMENT OF STATE DIVISION OF ELECTIONS
CAMPAIGN TREASURER'S REPORT SUMMARY
(1) ' - Y to M 1- 11e
OFFickeg %L
OCT 18 2011
City of Sebastian
City Clerk's Office
N e
(2) aJ. iii Ne
A dress (nurhber and street)
ljas- fi F(, 32%5
City, State, Zip Code
❑ CHECK IF ADDRESS HAS CHANGED
(4) Check appropriate box(es):
[ Candidate (office sought): G
j .nu
(3) ID Number:
❑ Political Committee ❑ CHECK IF PC HAS DISBANDED
❑ Committee of Continuous Existence ❑ CHECK IF CCE HAS DISBANDED
❑ Party Executive Committee
P Electioneering Communication ❑ CHECK IF NO OTHER ELECTIONEERING
COMMUNICATION REPORTS WILL BE FILED
(5) REPORT IDENTIFIERS
Co v r Period: From 10 / 1 / 1 ( To 10 / ) `1 / 11 Report Type ? 2�
Original ❑ Amendment ❑ Special Election Report ❑ Independent Expenditure Report
(6) CONTRIBUTIONS THIS REPORT
(7)
Monetary
Expenditures
Transfers
Account
Total
Monetary
EXPENDITURES THIS REPORT
) o e
$ p
Cash & Checks $ { ST ,
Loans $
to Office
$
Total Monetary $
6-0,00
$ NO ,W
In -Kind $
(8)
Other Distributions
$
(9) TOTAL Monetary Contributions To Date
$ k) 70,
(10)
TOTAL Monetary Expenditures To Date
$ (pko,15r
(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) P"y\A\7 i 1 rW
I certify that I have examined this report and it is true,
correct, and complete.
(Type name) Aryl 4- j\A` ` ..,v-
❑ Individual (only for , Treasurer ❑ Deputy
Treasurer
la
Candidate Chairperson (only for PC, PTY &
electioneering commun. organization)
Ok, Y Lipp
electioneering commun.)
X a bei(j `rY\A L1 et-,
X
Signature
t../
Signature
DS -DE 12 (Rev. 08/04)
(1) Name
CAMPAIGN TREASURER'S REPORT — ITEMIZED CONTRIBUTIONS
A-nrirz)( AA I.e-}'
3 Cover Period 10 /
/ / / / through
to /
(2) I.D. Number
(4) Page
(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
) c 1 C) ///
th
1365 extbvic l lit Y'S4
oc -iwl, FL
32. Sv
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OCT
City
RE'CEIVEO
18 20f1
,a
of setatian
/ /
City
Clerk s mice
/ /
/ /
DS -DE 13 (Rev. 08/03)
SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES
1� CAMPAIGN TREASURER'S REPORT - ITEMIZED EXPENDITURES
(1) Name 17), .t/- AA i 1 L6t/ (2) I.D. Number
(3) Cover Period Ub / / /0 through /o // (4) Page 1 of
(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
10/11/ 11
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pt,600
ice
/ /
/ /
DS -DE 14 (Rev. 08/03)
SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES
CITYOF
HOME OF PELICAN ISLAND
1225 Main Street
Sebastian, Florida 32958
(772) 388 -8214 phone - smaio @cityofsebastian.org
October 10, 2011
Amber Miller
944 Dolphin Avenue
Sebastian, FL 32958
Dear Ms. Miller:
In accordance with Florida Statutes Section 106.07, the G3 campaign treasurer's report for
your campaign for the period October 1, 2011 through Friday, October 14, 2011 is due by
Friday, October 21, 2011. This is the 18th day prior to the election and the due date is
governed by FS 106.
City Hall is closed for a furlough day on Friday, October 21st, and during evenings, furloughs,
weekends and holidays when City Hall is closed, all doors lock automatically and A/C systems
shut down.
Because the due date is governed by Florida law, I cannot extend the due date to the following
Monday, so I am asking that you either hand deliver your report anytime between Monday,
October 17th and Thursday, October 20th or the report can be mailed anytime after October
14th up to midnight of the due date October 21st if it meets the requirements set out in FS
106.07 (2) (a) below:
(2)(a)1.All reports required of a candidate by this section shall be filed with the
officer before whom the candidate is required by law to qualify. All candidates who
file with the Department of State shall file their reports pursuant to s. 106.0705.
Except as provided in s. 106.0705, reports shall be filed not later than 5 p.m. of the
day designated; however, any report postmarked by the United States Postal
Service no later than midnight of the day designated shall be deemed to have been
filed in a timely manner. Any report received by the filing officer within 5 days after
the designated due date that was delivered by the United States Postal Service
shall be deemed timely filed unless it has a postmark that indicates that the report
was mailed after the designated due date. A certificate of mailing obtained
from and dated by the United States Postal Service at the time of mailing,
or a receipt from an established courier company, which bears a date on or
before the date on which the report is due, shall be proof of mailing in a
timely manner. Reports shall contain information of all previously
unreported contributions received and expenditures made as of the preceding
Friday, except that the report filed on the Friday immediately preceding the election
shall contain information of all previously unreported contributions received and
expenditures made as of the day preceding that designated due date. All such
reports shall be open to public inspection.
If you choose to mail, please make sure the form is completely filled out and signed. If it is not
and received after the deadline, it will be deemed not timely filed and penalties must be
imposed.
Just a reminder that the Sebastian Property Owners Association and Chamber of Commerce
candidate forums will take place in the City Council Chambers with live broadcasts - -- SPOA
October 13th 7 -9 pm and Chamber October 19th – 7 – 9 pm. You will be contacted by them.
If you have any questions, please do not hesitate to contact me at 388 -8214 or
smaio cCr7cityofsebastian.orq.
Sin .- - ly,
Sally A. Maio, MMC
City Clerk
DS -DE 12 (Rev. 08104)
FLORIDA DEPARTMENT OF STATE DIVISION OF ELECTIONS
CAMPAIGN TREASURER'S REPORT SUMMARY
(1) i1/ I l (I,?N
OFFICE USE ONLY
RECEIVED
OCT 0 3 2011
City of Sebastian
City Clerk's office
Name
(2) �i41 Doi h e n
Address (numbe and street)
i ( L � 5
��c �'Jc�STi Gt.r�
1
City, State, Zip Code
❑ CHECK IF ADDRESS HAS CHANGED (3) ID Number:
(4)
Check appropriate box(es): A
Candidate (office sought): Ul 1 C,61A�c�
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 ci / 11 / 1 l To 1/ C/ 1 1 Report Type G a.
[Original ❑ Amendment ❑ Special Election Report ❑ Independent Expenditure Report
(6) CONTRIBUTIONS THIS REPORT
Cash & Checks $ o
(7) EXPENDITURES THIS REPORT
Monetary
Expenditures $ ) 1.Q , 4
Loans $ SO 0-2-
to Office
Account $
Total Monetary $ ` (�
Total
Monetary $ J 5• o. S L1
In -Kind $ ...,------------
(8) Other Distributions
$
(9) TOTAL Monetary Contributions To Date
$ a-o -
(10) TOTAL Monetary Expenditures To Date
$ In q 3c-
(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) f / /i i 1124/
7 iY 1
I certify that I have examined this report and it is true,
correct, and complete.
(Type name) rn ∎ i \y,I
tt5 dividual (only for gi Treasurer ❑ Deputy Treasurer
- ectioneering commun.)
X Ili &jai ' " i...-__■._ 1 •
Candidate ❑ Chairperson (only for PC, PTY &
\ electioneering commun. organization)
X )
A.
Signature
Signature
DS -DE 12 (Rev. 08104)
(1) Name
CAMPAIGN TREASURER'S REPORT - ITEMIZED CONTRIBUTIONS
Army ►►,ICJ►' M i'
through
(2) I.D. Number
/ c) / i l (4) Page
l
�.,� ...,..........._
(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
/ / a'+ / J f`n
17ranS if7
1357" 13an �
a s Wel, Fl.
32358
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LOA
So °--°
!Q
/ /
RE c:EIVCD
/ /
OCT 03?011
City of Sebas
City Clerk's Office
Gan Pc,vs-
/ /
/ /
/ /
/ /
DS -DE 13 (Rev. 08/03)
SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES
(1) Name
CAMPAIGN TREASURER'S REPORT — ITEMIZED EXPENDITURES
AA/ /l y (2) I.D. Number
ir:i (3) Cover Period / / / 7 / 7/ through / 301 /7 (4) Page / of
(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
9 ! I
/ /
Ci o >c .fir s han
i 4 Mc 5�
/a,n, FL 32c 5
Cad4 ca. c
,
/
C1 1471? 1/
Si VlS on B he l
11 25 .s tb Skirt e Ho
Stv aao
Alain ,TY 1V-151S
Y`9 � S-
4 N
/ � <2 L
/ /
/ /
RECEIVED
/ /
OCT 032111
City of Sebastian
City Cleric's Office
-
/ /
/ /
/ /
DS -DE 14 (Rev. 08/03)
SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES
HOME OF PELICAN ISLAND
1225 Main Street
Sebastian, Florida 32958
(772) 388 -8214 phone - smaio @cityofsebastian.org
September 29, 2011
Amber Miller
944 Dolphin Avenue
Sebastian, FL 32958
Dear Ms. Miller:
In accordance with Florida Statutes Section 106.07, the G2 campaign treasurer's report for
your campaign for the period September 17, 2011 through Friday, September 30, 2011 is
due by 5 pm on Friday, October 7, 2011. This is the 32nd day prior to the election and the due
date is governed by FS 106.
As I have advised previously, reports can be mailed if they meet the requirements set out in FS
106.07 (2).
(2)(a)1. All reports required of a candidate by this section shall be filed with the officer
before whom the candidate is required by law to qualify. All candidates who file with the
Department of State shall file their reports pursuant to s. 106.0705. Except as provided in
s. 106.0705, reports shall be filed not later than 5 p.m. of the day designated; however,
any report postmarked by the United States Postal Service no later than midnight of the
day designated shall be deemed to have been filed in a timely manner. Any report
received by the filing officer within 5 days after the designated due date that was
delivered by the United States Postal Service shall be deemed timely filed unless it has a
postmark that indicates that the report was mailed after the designated due date. A
certificate of mailing obtained from and dated by the United States Postal
Service at the time of mailing, or a receipt from an established courier company,
which bears a date on or before the date on which the report is due, shall be
proof of mailing in a timely manner. Reports shall contain information of all previously
unreported contributions received and expenditures made as of the preceding Friday,
except that the report filed on the Friday immediately preceding the election shall contain
information of all previously unreported contributions received and expenditures made as
of the day preceding that designated due date. All such reports shall be open to public
inspection.
If you have any questions, please do not hesitate to contact me at 388 -8214 or
smaio(c�cityofsebastian.orq.
Si -ly,
Sally A.
City Clerk
io, MMC
FLORIDA DEPARTMENT OF STATE DIVISION OF ELECTIONS
CAMPAIGN TREASURER'S REPORT SUMMARY
(1) NYY N bur r ■A i I IC(
OFFICE USE ONLY
�,iV�D
SEP 19 2011
city otI►atian
CV Clarit'i QM
Name
(2) (1 `4`1 I:lp{'11p1 A1r
Address (number and street)
1000- I rL 3 -2-ci>
,yj
City, State, Zip Code
❑ CHECK IF ADDRESS HAS CHANGED
(4) Check appropriate box(es):
Candidate (office sought): G ki L L l,Li C�
(3)
ID Number:
❑ Political Committee ❑ CHECK IF PC HAS DISBANDED
(l Committee of Continuous Existence ❑ CHECK IF CCE HAS DISBANDED
❑ Party Executive Committee
1 Electioneering Communication 1 1 CHECK IF NO OTHER ELECTIONEERING
COMMUNICATION REPORTS WILL BE FILED
(5) REPORT IDENTIFIERS
C ver Period: From JA./ / 1 / 1 ( To q l
/6
l / f Report Type LI_
Original ❑ Amendment ❑ Special Election Report
❑ Independent Expenditure Report
(6) CONTRIBUTIONS THIS REPORT
Cash & Checks $ �� C, ~�'
(7) EXPENDITURES
Monetary
Expenditures
Transfers
Account
Total
Monetary
THIS REPORT
_
$ ti- ; S-
Loans $ :)-0 ��-
to Office
' (-fl
Total Monetary $ " c7"
$
$ 30-g ,
01)
In -Kind $ 3
(8) Other
Distributions
$
(9) TOTAL Monetary Contributions To Date
$ L • 07
• (10) TOTAL
$
Monetary Expenditures To Date
g s
(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) A rita ri l I ICY-
I certify that I have examined this report and it is true,
correct, and complete.
(Type name) Alr-YllOeAr M. I I Lc y
Individual (only for Treasurer ❑ Deputy Treasurer
electioneering commun.)
Candidate ❑ Chairperson (only for PC, PTY &
electioneering commun. organization)
Signature
Signature
DS -DE 12 (Rev. 08/04)
(1) Name
CAMPAIGN TREASURER'S REPORT — ITEMIZED CONTRIBRF MED
,- \}lip ,r Lc(
3) Cover Period
f /
/ /1
through
(2) I.D. NumbgP 1 9 2011
City of Sebastian
4) Pa Clerks Ofol e
(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
g , /) I
c�'� i I y -t- 0,1
3104 wioctorYley'e
1(00 2_ I
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1112c: 1I
lL, TV
/ /
DS -DE 13 (Rev. 08/03)
SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES
RECEIVED
CAMPAIGN TREASURER'S REPORT — ITEMIZED EXPENDITURES 1 9 2011
(1) Name 1"\--0 l 19,(A7 NI I V i% (2) I.D. Number City of F siimti fl
City Cioi�
(4) Page ( of �f
(3) Cover Period 1 / ) / / 1 through 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
(10)
Amendment
(11)
Amount
(6)
Sequence
Number
/2" 1 i
12 voc !alt
VW' QJECLC t FL 32Q (cr-
1 CLArt $ ,_ .
'') 1—cluk_kA ik,:-
(.,, 6cl ill (-z, i,, , A0, A 0 Lt.A. 21
MQN\
.01 14 3
2
200 I ecr, N tk.j1 1
-.1c00 h rL , F 1(1
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4 25
3
„
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Mon
DS -DE 14 (Rev. 08/03)
SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES
CAMPAIGN D EXPENDITURES
TREASURER'S REPORT — ITEMIZED
Name % / K /�,� 1 I V- " (2) I.D. Number
(3) Cover Period l / / / / ( through 9 / l w / //'
(4) Page
of
(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
/ q/ ii
J Tru YI1 ez , TeQZ.
jtp IBS 1r
,-,--,
c a ri--/CLn FL- 2.(lsg
t__.Shir tS
AA ONI
7 th
Cl
/ /
RECEIVED
/ /
X192011
city ofstibto
city cietv
*11
/ /
/ /
/ /
/ /
/ /
DS -DE 14 (Rev. 08/03)
SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES
1TYOF
HOME OF PELICAN ISLAND
1225 Main Street
Sebastian, Florida 32958
(772) 388 -8214 phone - (772) 589 -5570 fax
smaio @cityofsebastian.org
September 13, 2011
Amber Miller
944 Dolphin Avenue
Sebastian, FL 32958
Dear Ms. Miller:
In accordance with Florida Statutes Section 106.07, the G1 campaign treasurer's report
for your campaign for the period July 1, 2011 through Friday, September 16, 2011 is
due by 5 pm on Friday, September 23, 2011. This is the 46th day prior to the election
and the due date is governed by FS 106. Your last quarterly reporting period ended on
June 30, 2011, and you reported that period on July 7, 2011 prior to the due date of July
10th. Now your reports will be submitted on the 46th 32nd 18th and 4th days prior to the
election.
City Hall is closed for furlough day on Friday, September 23rd, and during evenings,
furloughs, weekends and holidays when City Hall is closed, all doors lock automatically
and A/C systems shut down. I'd be glad to be here on that Friday, but I would have to
park a desk by a first floor doorway to let you in.
Because the due date is governed by Florida law, I cannot extend the due date to the
following Monday, so I am asking that you either hand deliver your report sometime
between Monday, September 19th and Thursday, September 22nd or the report can be
mailed anytime after September 16th up to midnight of the due date September 23rd if it
meets the requirements set out in FS 106.07 (2) (a) below:
(2)(a)1.All reports required of a candidate by this section shall be filed with
the officer before whom the candidate is required by law to qualify. All
candidates who file with the Department of State shall file their reports
pursuant to s. 106.0705. Except as provided in s. 106.0705, reports shall be
filed not later than 5 p.m. of the day designated; however, any report
postmarked by the United States Postal Service no later than midnight of the
day designated shall be deemed to have been filed in a timely manner. Any
report received by the filing officer within 5 days after the designated due
date that was delivered by the United States Postal Service shall be deemed
timely filed unless it has a postmark that indicates that the report was mailed
after the designated due date. A certificate of mailing obtained from and
dated by the United States Postal Service at the time of mailing, or a receipt
from an established courier company, which bears a date on or before the
date on which the report is due, shall be proof of mailing in a timely manner.
Reports shall contain information of all previously unreported contributions
received and expenditures made as of the preceding Friday, except that the
report filed on the Friday immediately preceding the election shall contain
information of all previously unreported contributions received and
expenditures made as of the day preceding that designated due date. All
such reports shall be open to public inspection.
This same situation is going to occur for the October 21st report as well but I'II send
another reminder at that time.
Remember that the funds used to open your account are contributions, and your filing
fee is an expenditure and both should appear in your G1 report.
When I receive the legal ad for the City Canvassing Board meetings that will take place
at the Supervisor of Elections office, I will forward it to you. You had a memo from the
SOE in your packet citing the times, but she will be running a legal ad prior to the first
meeting which is scheduled for October 19th
One other item I wanted to remind you of was that the Sebastian Property Owners
Association and Chamber of Commerce have been approved to conduct candidate
forums in October in the City Council Chambers with live broadcasts - -- SPOA October
13th 7 -9 pm and Chamber October 19 – 7 – 9 pm. You will be contacted by them.
If you have any questions, please do not hesitate to contact me at 388 -8214 or
smaioCa�citvofsebastian.orci.
Sally A. Maio, MMC
City Clerk
sam
CITY OF SEBASTIAN
CITY CLERK'S OFFICE
RECEIPT
4318
Name /4J11 J &1 &4
Date g zs /ii
No.
001001 208001 Sales Tax
001501 322900 Garage Sales
001501 341920 Copies/Bid Specs.
001501 341910 LDC /Code of Ordinances
001501 341930 Election Qualifying Fees
601010 343800 Cemetery Lots
Lot/Niche . Block
001501 343805 Cemetery Fees
0 Cash
, Unit
Amount Paid
Total Paid !n 1, i
White - Dept. of Origin • Yellow - Finance • Pink . Applicant
STATEMENT OF
CANDIDATE
(Section 106.023, F.S.)
(Please print or type)
1, All )96. M i I I,x
OFFICE USE ONLY
RECEIVED
AUG 2 5 2011
City of Sebastian
City Clerk's MOO
candidate for the office of 5.E } t S-i-i oin G Cou-nu I
have been provided access to read and understand the requirements of
Chapter 106, Florida Statutes.
.shut- 1 LOA)
Signature of Candidate
as
Da e
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 (05/11)
CANDIDATE OATH —
NONPARTISAN OFFICE
(Not for use by Judicial or
School Board Candidates)
RECEIVED
AUG 2 5 2011
City of Sebastier,
City Clerks Office
OFFICE USE ONLY
OATH OF CANDIDATE
(Section 99.021, Florida Statutes)
I, / m °X MiIkr
(PLEASE PRINT NAME AS
am a candidate for the nonpartisan
YOU WISH IT TO APPEAR ON THE BALLOT' -- NAME MAY NOT BE CHANGED AFTER THE END OF QUALIFYING)
office of C 1 kl ELI nu 1 ,
; 1 am a qualified elector
Florida
the
Constitution
(office) (district #)
of `n OtA j9 Y \Z t •V ?X County, Florida;
(circuit #) (group or seat #)
I am qualified under the Constitution and the Laws of
elected; I have qualified for no other public office in
concurrent with the office I seek; and I have resigned from
Section 99.012, Florida Statutes; and I will support the
State of Florida.
X ( (TO `I.i
to hold the office to which I desire to be nominated or
state, the term of which office or any part thereof runs
any office from which I am required to resign pursuant to
of the United States and the Constitution of the
3'3(p 1 ho ) .
Signature of Candidate Telephone Number Email Address
WA Doi ph �- Av Se bas -tia-V1 1- I— 5aCIsSII
Address City State ZIP Code
Candidate's Florida Voter Registration Number (located on your
voter information card): 1 0401 8 3(04
* Please print name phonetically on the line below as you wish it to be pronounced on the audio ballot for persons
with disabilities (see instructions on page 2 of this form):
ice( • - h ugh- IA 1--1 u h Y
STATE OF FLO/ DA �,D
COUNTY OF .. &% 1�-4 L
07541 day of r%� , 20 // .
Sworn to (or affirmed) and
Personally Known: l''''.---
subscribed before me this
or
Produced Identification:
Signature Notary Public
+"c: "ty)'k;, SALLY A. MAIO
Print, Ty e, or Stamp Commissioned Name of Notary Public
Type of Identification Produced:
it,: ,A, ' Commission # EE 024350
- ° Expires October 5, 2014
.....w
DS -DE 25 (Rev. 5/11)
Rule 1S- 2.0001, F.A.C.
FORM 1
STATEMENT OF
2010
Please print or type your name, mailing
address, agency name, and position below:
I FINANCIAL INTERESTS 1
v RECE�
E'O
LAST NAME — FIRST NAME — MIDDLE NAME : V
M i I In �rn /..L' /Qxel.
FOR OFFICE
USE ONLY �o,, 2 5 2011
r'f n
"'9� owe
MAILING ADDRESSSj :
1 1
1 /���I hill AV L
9 Nee
L S 1 � — L 3? )nAi a i ✓z /`yeK
ID Code
ID No.
Conf. Code
P. Req. Code
CITY : ZIP : COUNTY :
NAME OF AG NC
e.)1 Gtr,{/"\
NAME OF OFFICE O POSITION HELD OR SOUGHT :
C� C6 0CA
You are not limited to the pace on the lines on this form. Attach additional sheets, if necessary.
CHECK ONLY IF Dek CANDIDATE OR 0 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 EAR. PLEASE STATE BELOW WHETHER THIS STATEMENT IS FOR THE PRECEDING TAX YEAR ENDING EITHER (must check one):
DECEMBER 31, 2010 OR 0 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
instructions for further details). PLEASE STATE BELOW WHETHER THIS STATEMENT REFLECTS EITHER (must check one):
0 COMPARATIVE (PERCENTAGE) THRESHOLDS OR ti DOLLAR VALUE THRESHOLDS
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
A an AA e Nar
' , t . . . Li ti loo-ux -
.. t,�e d
� , .. , �,
.'
PART B — SECONDARY SOURCES
(If you have nothing to report
NAME OF
ENTITY
OF INCOME [Major customers, clients,
, you must write "none" or "n /a ")
NAME OF MAJOR SOURCES
BUSINESS' INCOME
and other sources of income to businesses
ADDRESS
OF SOURCE
owned by the reporting person]
PRINCIPAL BUSINESS
ACTIVITY OF SOURCE
(BUSINESS
/ V e
AU/4-
/ v // I
N/
N / " '
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.
N 6Y1 e
CE FORM 1 - Effective: January 1, 2011. Refer to Rule 34- 8.202(1), F.A.C. (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 ")
TYPE. OF INTANGIBLE
BUSINESS ENTITY TO WHICH THE PROPERTY RELATES
n/A
PART E — LIABILITIES [Major debts]
(If you have nothing to report, you must write "none" or "n/a ")
NAME OF CREDITOR
Ghcvs.e- ac.,k
<IrYk�`ca., -, £d14,c hn- Srv✓rcf=S
&AL /C/ � Al ACc .77iiT Servca
,-ICS, Inc .
ADDRESS OF CREDITOR
JP Mo-r a,,-, Chad.e, N. A .
P.e,4,,ns '7,��,; a PO i .+caii(l thutit4s&44 PA 1710a
09 aak 9 58Q Woks/ cc, PA / 773 .. 3 a
/oy 9a? 13i- c�v- AiJ,/d w �_9(30P5- - CA3o`@ fbI2X 705/ � / Cft, AY 1 s - 7o&i
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 BUSINESS ENTITY # 2
BUSINESS ENTITY # 3
NAME OF BUSINESS ENTITY
ADDRESS OF BUSINESS ENTITY
N/
N/A
PRINCIPAL BUSINESS ACTIVITY
POSITION HELD WITH ENTITY
I OWN MORE THAN A 5%
INTEREST IN THE BUSINESS
NATURE OF MY
OWNERSHIP INTEREST
IF ANY OF PARTS A THROUGH F ARE CONTINUED ON A SEPARATE SHEET, PLEASE CHECK HERE
SIGNATURE (required :
DATE SIGNED (required•
K/ 1(
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 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.
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 - Effective: January 1, 2011. Refer to Rule 34 -8.202 (1), F.A.C.
PAGE 2
t
FLORIDA DEPARTMENT OF STATE DIVISION OF ELECTIONS
CAMPAIGN TREASURER'S REPORT SUMMARY
(1) An' MY Ml I k r
OFFICE USE ONLY
,e o'c 11111 j
Q _ ..,t
Name
(2) CjHO J ),Lpi nil JiLT'
Address (number and street)
City, State, Zip Code
• CHECK IF ADDRESS HAS CHANGED
(4) Check appropriate box(es):
Candidate (office sought): Ikk, \_:�ikVl CI ■
(3) ID Number:
Political Committee 1 CHECK IF PC HAS DISBANDED
• Committee of Continuous Existence [ CHECK IF CCE HAS DISBANDED
❑ Party Executive Committee
rl Electioneering Communication 1 CHECK IF NO OTHER ELECTIONEERING
COMMUNICATION REPORTS WILL BE FILED
(5) REPORT IDENTIFIERS
Cover Period: From 4 / ) / ) 1 To (• / 3C) / 1 I Report Type G
Report ❑ Independent Expenditure Report
0 Original ❑ Amendment • Special Election
(6) CONTRIBUTIONS THIS REPORT
Cash & Checks $
(7)
Monetary
Expenditures
Transfers
Account
Total
Monetary
EXPENDITURES THIS REPORT
/-
$ .x/
Loans $ }X v
to Office
$
_l/
Total Monetary $ ,%
/
$ Es/a7
In -Kind $ ,Lr
(8)
Other Distributions
$
(9) TOTAL Monetary Contributions To Date
$ --e"
(10)
TOTAL Monetary Expenditures To Date
$ fr-
.
(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) i\ (1/09C1( iy i i r k
I certify that I have examined this report and it is true,
A correct, and complete.
(Type name) mi,r,Y M, 11CiY
Individual (only for 12 Treasurer Deputy Treasurer
X
Candidate • Chairperson (only for PC, PTY 8
electioneering commun.)
XC�,.. e�
electioneering commun. organization)
�V,,vz \ , e,1 ■Z?.18__
Signature
Signature
DS -DE 12 (Rev. 08/04)
C OF
SBN
HOME OF PELICAN ISLAND
1225 Main Street
Sebastian, Florida 32958
(772) 388 -8214 phone - (772) 589 -5570 fax
smaio @cityofsebastian.org
June 17, 2011
Amber Miller
944 Dolphin Avenue
Sebastian, FL
Dear Ms. Miller:
In accordance with Florida Statutes Section 106.07, the campaign treasurer's report
for your campaign for the period April 1, 2011 through June 30, 2011 will be due on
the tenth day following the quarter, however, due to the fact that the deadline falls on a
Sunday, the report is due in the Office of the City Clerk no later than 5 pm on Monday,
July 11,2010.
Any report postmarked by the United States Postal Service no later than midnight of
the due date (July 10, 2011), shall be deemed to have been submitted in a timely
manner.
The official qualifying period for the November election will begin on August 25, 2011
and run through September 9, 2011. The qualifying fee and all other forms not
submitted during pre - qualifying should be filed at this time. The City will be closed for
furlough day on Friday, August 26, 2011 and Labor Day on Monday, September 4,
2011.
Please call me at 388 -8214 or contact me by e-mail at smaio(c�cityofsebastian.org if
you have any questions.
Sin.oeiel
Sally A. Fvfaio, MMC
City Clerk
sam
WAIVER OF REPORT
(Section 106.07(7), F.S.) S E C A S ;,,
OFFICE OF CITY CLERK
2011 APR 6 A19 8 14
(PLEASE TYPE)
OFFICE USE ONLY
Y'- be CLU1C1i
Name Office Sought
M Candidate
A∎rt l (J371 L 32 j5b
Address City State Zip Code
[1 Committee of Continuous n Electioneering Communication Organization
Existence
n Political Committee n Party Executive Committee
❑ Check box if address has changed since last report. ❑ Check here if PC, CCE, or ECO has DISBANDED
and will no longer file reports.
TYPE OF REPORT (Check Appropriate Box)
QUARTERLY REPORTS PRIMARY ELECTION GENERAL ELECTION
❑ January ❑ 32nd day prior ❑ 46th day prior
• April ❑ 18th day prior ❑ 32nd day prior
❑ July ❑ 4th day prior ❑ 18th day prior
❑ October ❑ 4th day prior
❑ TERMINATION REPORT
❑ SPECIAL ELECTION
NOTIFICATION OF NO ACTIVITY IN CAMPAIGN ACCOUNT FOR THE REPORTING PERIOD OF
2,0 I ( THROUGH
�> `a
SIGNATURES REQUIRED FOR:
Signature
INIcor 31 0-01 1
Date
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 and Electioneering Communication Organizations
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. 07/10)
CIROF
HOME OF PELICAN MAW
1225 Main Street
Sebastian_ Florida 32958
(772) 388-8214 phone - (772) 589 -5570 fax
smaio @citvofsebasti n.oro
April 1, 2011
Amber Miller
944 Dolphin Avenue
Sebastian, FL
Dear Ms. Miller:
In accordance with Florida Statutes Section 106.07, the campaign treasurer's report
for your campaign for the period March 18, 2011 (the date you became a pre - qualified
candidate) through March 31, 2011 is due in the Office of the City Clerk by April 10,
2011.
Because April 10th falls on a Sunday, the report can be submitted through Monday,
April 11, 2011. You may submit the report beginning anytime after today (April 1).
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.
This report will include all contributions and expenditures made to or from your
campaign for the above referenced period.
J)41
Sally A. aioo,,( MMC
City Clerk
sam
APPOINTMENT OF CAMPAIGN TREASURER
AND DESIGNATION OF CAMPAIGN
DEPOSITORY FOR CANDIDATES
(Section 106.021(1), F.S.)
(PLEASE PRINT OR TYPE)
NOTE: This form must be on file with the qualifying
officer before opening the campaign account.
8/25/1/
Pr J S E B 1-1 S i I .. /IL�� 4
OFFICE OF CITY CLERK A
6 "x_
2011 �flfl 18 fill 10 59
OFFICE USE ONLY
1. CHECK APPROPRIATE BOX(ES):
xInitial Filing of Form Re- filing to Change: J Treasurer /Deputy (J Depository D Office D Party
2. Name of Candidate (in this order: First, Middle, Last)
61beAr M C- �M►Ih�
3. Address (include post office box or street, city, state, zip
code) 9144 DOI P h � n i
3
_bqs 4-t can 1 1, S
4. Telephone
(112 ) 453 33(o,
5. E-mail address
hor-1-14 e 00
6. Office sought (include district, circuit, group
Se,lcas- ice,,,, CA C� > ,mot
Plumber)
I
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 J No Party Affiliation J Party candidate.
9. I have appointed the following person to act as my IN Campaign Treasurer J Deputy Treasurer
10. Name of Treasurer or Deputy Treasurer
1'1�X ) t 1( L LJ f �
11. Mailing Address
12. Telephone
( )
13. City
14. County
15. State
16. Zip Code
17. E -mail address
18. I have designated the following bank as my pf Primary Depository fl Secondary Depository
19. Name of Bank 20. Address
W a.ck►ov► & ahem d-h0 W` o 1.524 lAs ►-►w 1
�22.
21. City
&i✓bc sh oul 1
1IrY,
County
lax, lei ti
23. State
FL
24. Zip Code
q2g58
UNDER PENALTIES OF PERJURY, I DECLARE THAT 1 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
3- IS) 1
I
26. Signature of Candidate
X airY\I\Vb TR '41A1A)
27. Treasurer's Acceptance
I, � Mk,1 1
of Appointment (fill in the blanks and check the appropriate block)
( 'eX , do hereby accept the appointment
(Please Print or Type Name)
designated above as: Campaign Treasurer fl Deputy Treasurer.
' 1 - i ( x , 711-,■. L�
Date S : a ure of ampaign Treasurer or Deputy Trdsurer
DS -DE 9 (Rev. 10/10)
Rule 1S- 2.0001, F.A.C.
APPOINTMENT OF CAMPAIGN TREASURER
AND DESIGNATION OF CAMPAIGN
DEPOSITORY FOR CANDIDATES
(Section 106.021(1), F.S.)
(PLEASE PRINT OR TYPE)
NOTE: This form must be on file with the qualifying
officer before opening the campaign account.
tr FICE OF CITY CLERK.
2011 F1RR 18 1101 10 59
OFFICE USE ONLY
1. CHECK APPROPRIATE BOX(ES):
XInitial Filing of Form Re- filing to Change: ❑ Treasurer /Deputy ❑ Depository ❑ Office ❑ Party
2. Name of Candidate (in this order: First, Middle, Last)
��l'1 ��' M Gll �' Mil VI(
3. Address (include post office box or street, city, state, zip
code) 1,i`) !�(.'! I9 �'1 , (1 AV'('
1 Cas 1l GL. , I- �. 3 2 et Es
s
4. Telephone
(1l2) 3 .3' �.7
5. E -mail address
1 �ry( 1
I>
'
6. Office sought (include district, circuit, group
Se vS-t- i„h--1 (a C,-(A..0 i
number)
)
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
Campaign Treasurer ❑ Deputy Treasurer
10. Name of Treasurer or Deputy Treasurer
/
11. Mailing Address
12. Telephone
( )
13. City
14. County
15. State
16. Zip Code
17. E -mail address
18. I have designated the following bank as my cg Primary Depository ❑ Secondary Depository
19. Name of Bank
W01/4Ci10 v! k,
20. Address
1.14 t1, -> it t. 1
21. City
,bc s -h cul 1
22.
County
IirIA tan lei v-ev
23. State
L
24. Zip Code
qici 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
26. Signature of Candidate
X r Vt I ' l.s
27. Treasurer's Acceptance of Appointment (fill in the blanks and check the appropriate block)
I, ;I )6,,,v `u t ' e,Y , do hereby accept the appointment
(Please Print or Type Name)
designated above as: Campaign Treasurer ❑ Deputy Treasurer.
1 '1,,*
ampaign Treasurer or Deputy Trr asurer
Date Signature of c
DS -DE 9 (Rev. 10/10)
Rule 1S- 2.0001, F.A.C.
STATEMENT OF
CANDIDATE
(Section 106.023, F.S.)
(Please Type)
OFFICE 1.,1§ ONLY
OFFICE: OF CITY CLERK
2011 PIRR 18 Arl 10 59
1, `A 1- V;y_A7 jk,u
candidate for the office of
)ca S CU'1 �l �a i� 1.�.:rt ()
have received, read and understand the requirements of Chapter 106,
Florida Statutes.
Signature of Candidate
( I
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)
.)F E iCE OF CI FY CLERK
cm a
SEBASTIAN 2011 f`1RR 18 Ail 10 59
HOME OF PELICAN ISLAND
ELIGIBILITY TO HOLD OFFICE
OF COUNCILMEMBER
Charter Section 2.02 - ELIGIBILITY
"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, 0.\\). ; v \k; ,l to v , 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.
Th11,AV
Signature of Candidate
Sworn to and subscribed before me this
2011.
1c.
Notary Publip'
State of Florida
SEAL
.tip. SALLY A. MAIO
.,,1 Commission # EE 024350
Expires October 5, 2014
y, of °!�� Bonded Thru Troy Fain Insurance 800,1ES7019
day of
*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.
Ms- word/election/charter eligibility