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Home My WebLink AboutSebastian Citizens Speak Out - 2011FLORIDA DEPARTMENT OF STATE DIVISION OF ELECTIONS CAMPAIGN TREASURER'S REPORT SUMMARY (1) �-J' �O OFFICE U�ONLY y�me C�`jV�,O c2� `/ ��s �A ��Addr ss (n u ber a street) _ �, C�� N � 4?0,? ��, ��- 3�9 S � ��,eseb�e . City, State, Zip Code �8 p t�an CHECK IF ADDRESS HAS CHANGED (3) ID Number: — � (4) Check appropriate box(es): ❑ Candidate (office sought): [�olitical 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 1 J l� l�� To �/ �// �� Report Type �� iginal ❑ Amendment ❑ Special Election Report ❑ Independent Expenditure Report (6) CONTRIBUTIONS THIS REPORT (7) EXPENDITURES THIS REPORT Monetary Cash & Checks $ Expenditures $ Loans � Transfers to Office Account $ Total Monetary � Total Monetary $ In-Kind � (8) Other Distributions $ (9) TOTAL Monetary Contributions To Date (10) TOTAL Monetary Expenditures To Date $ y��r"�� O�9 (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 exam ined this report and it is true, I certify that I have exam ined this report and it is true, correct, and com plete. correct, and com plete. (Type name) � //� G� � �� f'^ (Type name) � Individual (only for Treasurer ❑ Deputy Treasurer � Candidate hairperson (only for PC, PTY 8 electioneering commun.) ele oneering commun. organization) X X Signature Signature ,(,v�,`Se vT,��vy-�' DS-DE 12 (Rev. 08/04) CAMPAIGN TREASU R' EPORT - ITEMIZED EXPENDITURES (1) Name �� 7%� G�� 5%�� d��(2) I.D. Number ��p-- 35a �a 39 (3) Cover Period �� / "� /�through ��/ � �/� (4) Page � of � (5) ��) ($) �9) 1��) I��) Date Full Name Purpose (s� (Last, Suffix, First, Middle) (add office sought if Sequence Street Address & contribution to a Expenditure Number City, State, Zip Code candidate) TYpe Amendment Amount RFc Np 0 c� �fseb ? 1? ej'A�S `�st/ n �j DS-DE 14 (Rev. 08/03) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES CAMPAIGN TREASURER'S REPORT - ITEMIZED CONTRIBUTIONS (1) Name L��r ��i'f �� %%S o�� /U7 (2) I.D. Number � C�- 5 a��-�39 (3) Cover Period �/ / � / ! / through ��` / � � / 1 (4) Pa e ! of [ (5) (7) (8) (9) (10) (11) (12) Date Full Name (6) (Last, Suffix, First, Middle) Sequence Street Address & Contributor Contribution In-kind Number Cit , State, Zi Code T e Occu ation T e Descri tion Amendment Amount / / RFc� JqH 0 / / C�;y� f e % e�se8 � � i i i i i i i i r i i i i DS-DE 13 (Rev. 08/03) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES OFFICE USE ONLY STATEMENT OF ORGANIZATION RECEIVED OF POLITICAL COMMITTEE DEC 12 2011 (PLEASE TYPE) City of Sebastian 1. Full Name of Committee Telephone �� ?A �Tr A.� �,'t-� �xe.rJ c� �ja-QAI� 6 v� Mailing Address (include city, state and zip code) 9'I� D.�uu�� v�. �'�.6 ��; �A,� �l, � a��'� Street Address (include city, state and zip code) 2. Affiliated or Connected Organizations (includes other committees of continuous existence and political committees) Name of Affiliated or Connected Organiiation Mailing Address Relationship 3. Area, Scope and Jurisdiction of the Committee 4. Nature of Organization or Organization's Special Interest (e.g., medical, legal, education, etc.) � �' � 5. Identify by Name, Address and Position, the Custodian of Books and Accounts (include treasurer's name) Full Name Mailing Address Committee Title or Position ,Li.c�e�i4- LC)A,�1�' �r %3 � N�-I � C�n� °�`er. �� v'�ti°. ��b�� 4 ��, ��. �a�s� DS-DE 5(Rev. 05/06) (continued on reverse side) RECEIVED DEC 2 2 2011 Gity of Sebastian Ciry Clerk's Office 6. List by Name, Address and Positfon, Other Principal Officers, inciuding Officers and Members of the Finance Committee, if Any {include chairman's name) Fuli Name Mailing Address Committee Title or Position �� d A �' � �� ,�o v r,5�� vr�,d�9vl^ � �8 � �i,r�i �',y�-J ° �e�i� sr, `A�,r�, �� 3� 9�� 7. List by Name, Address, Office Sought and Party Affiliation Each Candidate or Other Individual that this Committee is Supporting (if none, please indicate) Full Name Mailing Address Office Sought Party 8. List Any Issues this Committee is Supporting: List Any Issues this Committee is Opposing: 9. If this Committee is Supporting the Entire Ticket of a Party, Give Name of Party 10. In the Event of Dissolution, What Disposition wili be Made of Residual Funds? 11. List all Banks, Safety Deposit Boxes, or Other Depositories Used for Committee Funds Name of Bank or Depository & Account Number Mailing Address �eA CoAS`t" /��i a.r1 A I I-�ANk // /D ��,v� �c% �` `�3 a+'7OS'� �8/ �.e�ASY��A''� � /i/. �3a�S� 12. List all Reports Required to be Filed by this Committee with Federai Officials and the Names, Addresses and Positions of Such Officials, if Any Report Title Dates Required to be Filed Name & Position of Official Mailing Address STATE OF /�/D I^/ GC/�i 1.,tJ�i /�itl /` �%�e �' COUNTY I, U6 v � S e /11�JTe,�,� � r 6 , certify that the information in this Statement of Organization is complete, true and correct. �K�� Cc'��-d /o`� �/ /� _ h irm n of Political mmittee � Date Signature C a a REGISTERED AGENT OFFICE USE ONLY STATEMENT OF APPOINTMENT RECEIVED (Section 106.022, F.S.) DEC 2 2 2011 {� City of Sebastian ❑ Original Appointment ILy Change of Appointment City Clerk'S OffiCe ❑ Change of Mailing Address � Change of Physical Address Registered Agent and Office Information Name Telephone �ov�s� AvT� v�� a-�9�-�7� Street Address �% o �. �v.e � A �� • c�ty � e� � s�'�, A�% state r� Zip Code �y �� Mailing Address City State Zip Code I accept this appointment and confirm that I am familiar with and accept the obligations of the position as set forth in Section 106.022, F.S. 1 also understand that I may resign this appointment by executing a written statement of resignation and filing it with the applicable filing officer. �2�J �.�%a�� o� l � t�/ Signature of Registered Agent Date Former Registered Agent and Office Information (for changes only) Name �`J � lr/� �� t'� � 6�, L l 1-�-� Telepho7i �C� — O�[� s Street Address �l '7 �( S � A �-. �G}SS 1=� U City ��S ,� �� u State �L Zip Code GS 8 Committee or Organization Information Name of Committee or Organization f/ s �-� � c f"[ Z.2/L� � �1�- o U�` Street Add ess Telephone -73 uJn_ a � �J� State Zip Code �} City �% , � �� o��c� d' Sig ature of Chairp on ,C.�o�:�e ��Te,�J��r� /�� /,, Printed Name of Chairperson Date Form DS-DE 41 (revised 6/11) FLORIDA DEPARTMENT OF STATE DIVISION OF ELECTIONS CAMPAIGN TREASURER'S REPORT SUMMARY (1) Q%'� C� �Q�f� �U OFFICE USE ONLY Name RECEIVED c2� ss Address (num nd street) n N�V 0 4 2011 v�7'"J� City of Sebastien �� Ci Clerk's O�ce � City, State, Zip Code � ❑ CHECK IF ADDRESS HAS CHANGED (3) ID Number: p� �'-3 So� ��-3 � (4) Check appropriate box(es): ❑ ndidate (office sought): 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 1MLL BE FILED �.��i ��Tv a t C�c7R o f�r � 1� (5) REPORT IDENTIFIE S Cover Period: From �Q l��l � To �� l� l �/ Report Type � � �Original ❑ Amendment ❑ Special Election Report ❑ Independent Expenditure Report (6) CONTRIBUTIONS THIS REPORT (n EXPENDITURES THIS REPORT , ,1 � 1C. Monetary Cash 8� Checks � �r�� Expenditures $ ��3, � Loans $ Transfers to Office Account $ Total Monetary $ Total � � � Monetary $ � In-Kind � (8) Other Distributions . $ (9) T$OTAL Mone ry Con 'butions To Date (10) T�OT�o�etary �xpenditures To Date --��zT � � 0 ��, �; �� (11) CERTIFICATION It is a first degree misdemeanor for any person to falsify a public record (ss. 839.13, F.S.) I certify that I have examined this report and it is true, I certify that I have examined this report and it is true, correct, and com plete. correct, and com plete. f (Type name) � � Q �7� ` (Type name) � C�G�� , � r l h �Individual (oNy for � Treasurer � Deputy Treasurer � Can � te Chairperson (ony fw PC, & elec�ioneering cAB4mun.) eclio, comm m anization) X v Signature • Signature DS-0E 12 (Rev. 08/04) CAMPAIGN TREASURER'S REPORT — ITEMIZED CONTRIBUTIQNS (1) Name Z (2) I.D. Number �IJ �3Sa�a� � ,. . � ,, � . , .-, � (3) Cover Period � U l �� l�� through �� /,i /�� 4) Pa e � of � (5) (7) (8) (9) (10) (11) (12) Date Full Name (6) (Last, Suffix, First, Middle) Sequence Street Address & Contributor Contribution In-kind Number Cit , State, Zi Code T e Occu ation T e Descri tion Amendment Amount I�, a o, l 1 �o�./ Vl�r�lrf . n� ` �2 � `%�o l� r1,5�'.=�r �-/�c.� �� Se�lQn3�8 � � � � � � �'�" D # �'01i ,�L�,,.. �'``"' f �'�b��tl�n ' Clfy �r��g p�Ce i � i i i i i i DS-DE 13 (Rev. 08/03) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES �C AIG T EASUR 'S PORT — ITEMIZED (1) Name � � (2) (3) Cover Period 1� l lJ /� through �/ �/� (4 EXPENDITU� �35a ( � I.D. Number r, °� 3 ) Page l of � (5) (�) (81 (9) (��) (��l Date Full Name Purpose (s� (Last, Suffix, First, Middle) (add office sought if Sequence Street Address & contribution to a Expenditure Number City, State, Zip Code candidate) TYPe Amendment Amount f� �d S"C� l Pf�-5 "� e.n crSeix� 3 �� j�PQS�''� �r� /V r3 �, l'►'I Dlll � � o � (,�c5 ��'y' I ' r �� 32y� �� C ��G�l V D �'��, �� r`'�� Y �l�r� � �ati n �e DS-DE 14 (Rev. 08/03) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES (71Y4�F � t�l�� p �1�� R HOME OF PELICAN IS(AND 1225 Main Street Sebastian, Florida 32958 (772) 388-8214 October 25, 2011 Mr. Edward Herlihy Chairperson Sebastian Citizens Speak Out 474 Seagrass Avenue Sebastian, FL 32958 Dear Mr. Herlihy: In accordance with Florida Statutes Section 106.07, the G4 campaign treasurer's report for your committee for the period Saturday, October 15, 2011 through THURSDAY, November 3, 2011 is due by Friday, November 4, 2011. This is the 4t" 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 4tn For political committees, in accordance with FS 106.08 (4) Any contribution received by the chair, campaign treasurer, or deputy campaign treasurer of a political committee supporting or opposing a candidate with opposition in an election or supporting or opposing an issue on the ballot in an election on the day of that election or /ess than 5 days prior to the day of that election may not be obligated or expended by the committee until after the date of the election. AISO if you Choose to mail: (2)(a)1.A1/ reports required of a candidate by this section shall be filed with the officer before whom the candidare 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 mai/ing obtained from and dated by the United States Posta/ Service at the time of mai/ing, or a receipt from an estab/ished courier company, which bears a date on or before the date on which the report is due, sha// be proof of mailing in a timely manner. Reports sha// contain information of a// previous/y unreported contributions received and expenditures made as of the preceding Friday, except that the report filed on rhe 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. 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. Sin �ly, / �_ Sally A. aio, MMC City Clerk cc: Linda Wansesr WAIVER OF REPORT (Section 106.07(7), F.S.) (PLEASE TYPE) JC �� 5 i� L� t'E G L T � Z��--( 5�" g'��[� � ��`i Name Office Sought �t � � 5 �%A � �z� ��S 1�- v �ca�a� � r A �-r , �L � � � S 8 Address City State Zip Code ❑ Candidate ❑ Committee of Continuous ❑ Electioneering Communication Organization Existence � Political Committee ❑ 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 ❑ January ❑ April ❑ July ❑ October PRIMARY ELECTION ❑ 32nd day prior ❑ 18th day prior ❑ 4th day prior GENERAL ELECTION ❑ 46th day prior ❑ 32nd day prior [� 18th day prior ❑ 4th day prior ❑ TERMINATION REPORT ❑ SPECIAL ELECTION NOTIFICATION OF NO ACTIVITY IN CAMPAIGN ACCOUNT FOR THE REPORTING PERIOD OF �G- �� I � �, � l � THROUGH �� l L( � X�i;, ,�„ 0 �� l t � l � � < < Signature Date SIGNATURES REQUIRED FOR: Candidates Candidate, Campaign Treasurer or Deputy Treasurer (s. 106.07(5), F.S.) Political Committees Chairman, Campaign Treasurer or Deputy Treasurer (s. 106.07(5), F.S.) Committees of Continuous Existence 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) STATEMENT OF ORGANIZATION OFFI�L��1D' OF POLITICAL COMMITTEE OCT 1 Q 2011 C+tY of Sebas6an (PLEASE TYPE) C�tY Clerk�s p�� 1. Full Name of Committee Telephone JC��S�'T� C� I�t C ��"c z �='NS � PL�A1•C �? �`T" `z7�' - 388�a�� S Mailing Address (include city, state and zip code) ��`l� 5 �A G12A55 t�v'C= ��-rt3�5T�� r-l� �� 3 Z�iSB Street Address (include city, state and zip code) �r�w�� 2. Affiliated or Connected Organizations (includes other committees of continuous existence and political committees) Name of Affiliated or Connected Organization Mailing Address Relationship �� L 3. Area, Scope and Jurisdiction of the Committee 5 U� P� ��' �. C� t�L 'SZ G� i� 5 T l�l L l� 1-/ �f t 1D �-� i �—� ��1 � � 5 5 c.� � 5 4. Nature of Organization or Organization's Special Interest (e.g., medical, legal, education, etc.) C t % � D � �7 L= l� i7 �7 r L (� �l Cr-C? �,%L lC �1 �C'. �-1 � 5. Identify by Name, Address and Position, the Custodian of Books and Accounts (include treasurer's name) Full Name Mailing Address Committee Title or Position r��t?��1� �• �I `� � 5 L a �- �z �� 5 S r� v � C� t.l � y � C-- J�j�-�- �'T- L�� N ��L 3�`� S�� G E� �� iz U�t � l�l ��cv�a wa�5r� � 3 ( ��.-��c�^� T��. 5�_ �'3 A 5`T t A� r C"� '3 �. �� c'� i t2r� �-�� C�L� �' DS-DE 5(Rev. 05/06) (continued on reverse side) 6. List by Name, Address and Position, Other Principal Officers, Including Officers a Members of the Finance Committee, If Any (include chairman's name) �ECE�V Full Name Mailing Address C 'ttee Title or Position � CL% � 5 �i 1l �i Cisrle�$ a�ce 7. List by Name, Address, Office Sought and Party Affiliation Each Candidate or Other Individual that this Committee is Supporting (if none, please indicate) Full Name Mailing Address O�ce Sought Party j��tDR�A co y 5o t 8 a�u� av,�C=�yt�57t��1,F �tTX �o� �uc tZ tV l I� RoG�QT u�tcPA�'rl� L$O 3�L.XF15T' T�'� 5�'8�s's7►� i, �� plll'f3t-� Ili1►LGL%E' P1aT �Vf�/j,.�Y31�,5�iYik7� i1 r� !�a N gC�D �9 �(Gk1-`r Zfl �J • ft srN�� p Z 5�-�Y�9N i< < c 8. List Any Issues this Committee is Supporting: �� qJ � ListAny Issues this Committee is Opposing: �,� �C � 9. If this Committee is Supporting the Entire Ticket of a Party, Give Name of Party �,� 10. In the Event of Dissolution, What Disposition will be Made of Residual Funds? 1�-� A L�� ¢-E � fZ �= i � 1�L� �� C-�, �� C= IZ 5 11. List all Banks, Safety Deposit Boxes, or Other Depositories Used for Committee Funds Name of Bank or Depository & Account Number Mailing Address Sc�ASc �Ca`rc��c�� a�� t� rn tzp5��c�Y..c.v� �u� S �% V3C-��'�`"c � t-� t� L 3� �z 5 c"� 12. List all Reports Required to be Filed by this Committee with Federal Officials and the Names, Addresses and Positions of Such Officials, If Any Report Title Dates Required to be Filed Name & Position of Official Mailing Address �0�[ L✓ STATE OF �� 1D �`1•I�D t A�! �� IIL.—�� COUNTY I, (� �(,� �� j � • �C� L [ � � , certify that the information in this Statement of Organization is complete, true and correct. �. X � � � 1i� � / �O L ( ig ature of hairman of Political Com ittee Date . . .i � � . '� � _ �a„ .��,� �.�.�_� �--' �. 3:� • � ' i 1225 Main Street Sebastian, Florida 32958 (772) 388-8214 October 14, 2011 Mr. Edward Herlihy Chairperson Sebastian Citizens Speak Out 474 Seagrass Avenue Sebastian, FL 32958 Dear Mr. Herlihy: In accordance with Florida Statutes Section 106.07, the G3 campaign treasurer's report for your committee for the period October 1, 2011 through Friday, October 14, 2011 is due by Friday, October 21, 2011. This is the 18t" 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 14t" 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 mai/ing obtained from and dated by the United States Posta/ Service at the time of mai/ing, or a receipt from an established courier company, which bears a date on or before the date on which the report is due, sha// be proof ot mailing in a time/y manner, Reports shal/ contain information of all previously unreported contributions received and expenditures made as of the preceding Friday, except that the report filed on the Friday immediate/y preceding the election shall contain information of all previous/y 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 at 388-8214 or smaio ci _tyofsebastian.org. Just a reminder that your registered agent form will stay on file with me as qualifying officer in accordance with a change in Florida law and any changes should be submitted to me. You will also need to update your Statement of Organization form if and when you decide to support any of the current candidates. 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. Sin ely, �_ � � ��-_. Sally A. Maio, MMC City Clerk sam WAIVER OF REPORT (Section 106.07(7), F.S.) (PLEASE TYPE) Sebastian Citizens Speak Out Name 474 Seagrass Avenue ❑ Candidate � Political Committee Address ❑ Committee of Continuous Existence ❑ Party Executive Committee Office Sought Sebastian, FI 32958 City State Zip Code ❑ Electioneering Communication Organization ❑ 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 ❑ January ❑ April ❑ July ❑ October � PRIMARY ELECTION ❑ 32nd day prior ❑ 18th day prior ❑ 41h day prior GENERAL ELECTION ❑ 46th day prior � 32nd day prior ❑ 18th day prior ❑ 4th day prior ❑ TERMINATION REPORT ❑ SPECIAL ELECTION NOTIFICATION OF NO ACTIVITY IN CAMPAIGN ACCOUNT FOR THE REPORTING PERIOD OF 7/2011 Signature THROUGH 9/30/2011 2- � ��" �/ � Date SIGNATURES REQUIRED FOR: Candidates Candidate, Campaigrt Treasurer or Deputy Tre�urer (s. 106.07(5), F.S.) Political Committees Chairman, Campaign Treasurer or Deputy Treasurer (s. 106.07(5), F.S.) ComrMttees of Continuous Existence and Electioneering Communication Organizadons Treasurer (s. 106.04(4)(c), F.S.) Party Execudve Commitbees Treasurer or Chairman (s. 106.29(2), F.S.) In any reporting period when there has been no activiry 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) WAIVER OF REPORT (Section 106.07(7), F.S.) (PLEASE TYPE) C% �'i3 l(-� }-1 C t T � Z GtJ 5 �i ��%Ak p�`T � Name Office Sought l-�`Z �( 5 Ct� Gt�A55 /�1t� SCf3�5Tt[�l� ,��- 3Z�t �� Address City State Zip Code ❑ Candidate � Political Committee ❑ Committee of Continuous Existence ❑ Party Executive Committee ❑ Electioneering Communication Organization ❑ Check box if address has changed since last report. ❑ Check here if PC, CCE, or ECO has DISBANDED and wiil no longer file reports. TYPE OF REPORT (Check Appropriate Box) QUARTERLY REPORTS ❑ January ❑ April ❑ July ❑ October PRIMARY ELECTION ❑ 32nd day prior ❑ 18th day prior ❑ 4th day prior GENERAL ELECTION �46th day prior ❑ 32nd day prior ❑ 18th day prior ❑ 4th day prior ❑ TERMINATION REPORT ❑ SPECIAL ELECTION NOTIFICATION OF NO ACTIVITY IN CAMPAIGN ACCOUNT FOR THE REPORTING PERIOD OF �L, ( THROUGH SC(�T(�"7,GilJ3C � I�a1 �O1 I � �i�r ��,o � t Signature Date SIGNATURES REQUIRED FOR: Candidates Candidate, Campaign Treasurer or Deputy Treasurer (s. 106.07(5), F.S.) Political Committees Chairman, Campaign Treasurer or Deputy Treasurer (s. 106.07(5), F.S.) Committees of Continuous Existence 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) anoF � ;,,'� �'�`1�� N4lWIE �F PELICAN ISLA�JD 1225 Main Street Sebastian, Florida 32958 (772) 388-8214 September 13, 2011 Mr. Edward Herlihy Chairperson Sebastian Citizens Speak Out 474 Seagrass Avenue Sebastian, FL 32958 Dear Mr. Herlihy: In accordance with Florida Statutes Section 106.07, the G1 campaign treasurer's report for your political committee 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. City Hall is closed for furlough day on Friday, September 23�d, 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 22"d or the report can be mailed anytime after September 16th up to midnight of the due date September 23�d if it meets the requirements set out in FS 106.07 (2) (a) below: (2)(a)1.A1/ reports required of a candidate (also applies to committees) by this section shall be filed with the officer before whom the candidate is required by /aw 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 courie� 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 e%ction 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'll send another reminder at that time. Just a reminder that your registered agent form will stay on file with me as qualifying officer in accordance with a change in Florida law and any changes should be submitted to me. You will also need to update your Statement of Organization form if and when you decide to support any of the current candidates. 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.� Sincerely, ., �( r� _---- Sally A. aio, MMC City Clerk sam WAIVER OF REPORT �sace�o� �os.o�p), Fs.� (P�EASETYPE) SEBASTIAN CITIZEN5 SPEAK OUT Candidate's Name (Last, Suffix. First, Middle) OR Political Committee, CCE or Party Name 474 SEA GRASS A VE Address (Number and Street) SEBASTIAN, FL 32955 City State Zip Code .�* �� 7/>/� �� OFFICE USE ONLY 26-3526239 Identification Number (Assigned by Division of Elections) Office Sought Qnclude District, Circuit or Group Number) � Candida[e � Commit�ee of Conlinuous � Check box if adtlress has changed since last Existence report. � Polilical Committee � Party Exeative Commitlee � Check here if PC or CCE has DISBANDED and vnll no longer flle reports. TYPE OF REPORT (Check Approprfate Box) QUARTERLY REPORTS PRIMARY ELECTION - GENERAL ELECTION ❑ January ❑ 32nd day pnor ❑ 46th day prior ❑ April � July ❑ Octobar ❑ 18fh tlay prior ❑ 4ih day prior ❑ 32ntl day pnor � TERMINATION REPORT ❑ i8�h tlay pnor ❑ 4ih da � SPECIAL ELECT�ON y prior NOTIFICATION OF NO ACTIVITY IN CAMPAIGN ACCOUNT FOR THE REPORTING PERIOD OF p �� - CJ 1�- 2 0 1 1 througn O�—�3 0— z. 0 I 1 �? cv�,/�-� �� /��:,� � 1 � p ��-�— Signature SIGNATURES REQUIRED FOR: Candidates Candidale, Campaign Treasurer or Deputy Treasurer (s. tO6. W(5), F.S.) Political Committees Chairmaq Campeign Treasurer or Deputy Treasurer (s. 106.07(5), ES.) Committees oi Continuous Existence Treasurer (s. 10fi.04(4)(c), F.S.) Parry Enecutive Committees Treasurer or Chairtnan (s. 10629(2), F.S.) In any reportinq periotl when ihere has been no ac�ivity in ihe account (no funds expended or received) the filing of the required report is waived. However, the (ling o@icer must be notified in writing on lhe prescribed reporting date that no report is being filed. DS-OE e7 (Rev. 06/03) CIiY OF ��,��M��T .�,�� HOME OF PEUCAN ISLAND 1225 Main Street Sebastian, Florida 32958 (772) 388-8214 phone - (772) 589-5570 fax June 17, 2011 Mr. Edward Herlihy Chairperson Sebastian Citizens Speak Out 474 Seagrass Avenue Sebastian, FL 32958 Dear Mr. Herlihy: In accordance with Florida Statutes 106.07, a quarterly report for your political committee for the period April 1, 2011 through June 30, 2011 will be due to me by July 10, 2011. Because July 10th falls on a Sunday, the report must be submitted no later than Monday, July 11, 2011. I have received notice from the Florida Division of Elections that registered agent forms are now filed with the filing officer rather than the Division of Elections, and they returned the registered agent form you previously submitted. We will keep it on file in your PAC folder. Also just a reminder as we get closer to the election, you will need to update your Statement of Organization to reflect the candidates you will be supporting and any other information that may have changed. 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. Sin r ly, "} w �-7 /� �..�".- - �,�-�.. � Sally A. aio, MMC City Clerk sam CfTYOF �� ;� .�� HOME OF PELICAN ISLAND 1225 Main Street Sebastian, Florida 32958 (772) 388-8214 phone - (772) 589-5570 fax June 17, 2011 Linda R. Wanser 631 Helicon Terrace Sebastian, FL 32958 Dear Ms. Wanser: In accordance with Florida Statutes 106.07, a quarterly report for your political committee for the period April 1, 2011 through June 30, 2011 will be due to me by July 10, 2011. Because July 10th falls on a Sunday, the report must be submitted no later than Monday, July 11, 2011. I have received notice from the Florida Division of Elections that registered agent forms are now filed with the filing officer rather than the Division of Elections, and they returned the registered agent form you previously submitted. We will keep it on file in your PAC folder. Also just a reminder as we get closer to the election, you will need to update your Statement of Organization to reflect the candidates you will be supporting and any other information that may have changed. 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. Sin�ly, ^ 4 � ��_ �� . r �� Sally A. aio, MMC City Clerk sam FLORIDA DEPARTMENT OF STATE DIVISION-OF�,L _�'IrO.�NS CAMPAIGN TREASURER'S REPO .'� ;S j,' V�`".: x �.� _ ._��n, (�) 4 � � �� ,�� OFFICE USE ONLY Name ��11 APR 6 A�1 10 29 (2� �f 7`f ��-�� '� � �� '��dr.ess (n mber and tree� � _-,�"-�� `'� � City, State, Zip Code ❑ CHECK IF ADDRESS HAS CHANGED (3) ID Number: , r.� �� ,j �, (4) Check appropriate box(es): ❑ ndidate (office sought): Political Committee ❑ CHECK IF PC HAS DISBANDED ❑ Committee of Continuous Existence ❑ CHECK IF CCE HAS DISBANDED ❑ Party Executive Committee ❑ Electioneering Communication ❑ CH�CK 9F NO OTHER ELECTIONEtRiNG COMMUNICATION REPORTS WILL BE FILED (5) REPORT IDENTIFIERS Co r Period: From r� �` / ;;J '' / ,�.' To �� / '� � / %% Report Type Original ❑ Amendment ❑ Special Election Report ❑ Independent Expenditure Report (6) CONTRIBUTIONS THIS REPORT (7) EXPENDITURES THIS REPORT Monetary Cash & Checks $ Expenditures $ Loans � Transfers to Office \ Account $ Total Monetary � Total Monetary $ I n-Kind $ \. (8) Other Distributions $ (9) TOTAL Monetary Contributions To Date (10) TOTAL Monetary Expenditures To Date $ T � �� :� � � �`� "' r�' � , �,��I (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 exam ined this report and it is true, I certify that I have exam ined this report and it is true, correct, and com plete. correct, and com plete. J � ,J �J / d� (TYPe name) ,G� � t� � �• �, �-� �� (Type name) ��,�"� �� R • 't�a°�'/e i? � Individual (only for Treasurer � Deputy Treasurer � Candidate hairperson (only for PC, TY & electioneering commun.) ,. electione�ring commun. arga ation) �....!� / � , X�"� �.�-- XL �' �,� � � / Signature Signature DS-DE 12 (Rev. 08/04) CAMPAIGN TREASUREF2'S REPORT — ITEMIZED CONTRIBUTIONS (1) Name;��,, l�/llj� t/'�j{7t�'� 4��/) C.�C..� (2) I.D. Number ='�i�'`J'`�� ---�-;a- (3) Cover Period � �� / � / � � through �� / :�%` / � ,� (4) Page of (5) (7) (8) (9) (10} (11) (12) Date Full Name (6) (Last, Suffix, First, Middle) Sequence Street Address & Contributor Contribution In-kind Number Cit , State, Zi Code T e Occu ation T e Descri tion Amendment Amount / / '�� `o ,� s , , ��, ,,� ., � i i '� � ,� .,� ,, i i � .� \ � ti � a �.. —r, - �� _ % � � � �'7 _ .. � rn �. � � -m; �� \ n r--. �. � � F--► / / `�'�� O r�—� -� � N rn \� � �-, •. �, / / / / v�-u�e i3 (rZEv. voi'�3j .°iEE °EVE°SE F�° �"�I..�aT°v�T�C�,�L.c, �P:�.' �.^.'�E v�.^-.LUE,°i - AMP tGN T E SURER�Si REP R,- ITEMIZED EXPENQITURES �.�� t� (1) Name �F (2) I.D. Number ��.�-,�'" �1 �c-� u � J {3) Cover Period _�I�I� through �/ .�� %� (4) Page � of �__ �5� (7) t�) �9) i��) {11) Date ��, Fult Name Purpose �s� (Last, Suffix, First, Middle) (add office sought if treet Address & contribution to a Expenditure Sequence C� , State, Zip Code candidate) TYPe Amendment Amount Number � \ ,` �` � � i i` � � �t\ \l \ �, . :� -Tj -n r�� -� `,,`\ n �'.' � '_.. -� :. r: �.. r,-� � DS-DE 14 (Rev. 08/03) SEE REVERSE FOR INSTRUCTIONS AND CODE VAIUES cm oF �� , �.,�_-_�_._. _ HOME OF PELICAN ISLAND 1225 Main Street Sebastian, Florida 32958 (772) 388-8214 phone - (772) 589-5570 fax April 1, 2011 Mr. Edward Herlihy Chairperson Sebastian Citizens Speak Out 474 Seagrass Avenue Sebastian, FL 32958 Dear Ms. Herlihy: In accordance with Florida Statutes 106.07, a quarterly report for your political committee for the period January 1, 2011 through March 31, 2011 is due to me by April 10, 2011. Because April 10t" falls on a Sunday, the report must be submitted no later than Monday, April 11, 2011. 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. Sin ely, � �� Sally A. aio, MMC City Clerk sam CITY OF �� ..r x.. HOME OF PELICAN ISLAND t225 Main Street Sebastian, Florida 32958 (772) 388-8214 phone - (772) 589-5570 fax April 1, 2011 Linda R. Wanser 631 Helicon Terrace Sebastian, FL 32958 Dear Ms. Wanser: In accordance with Florida Statutes 106.07, a quarterly report for your political committee for the period January 1, 2011 through March 31, 2011 is due to me by April 10, 2011. Because April 10th falls on a Sunday, the report must be submitted no later than Monday, April 11, 2011. 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. Sinc y, Sally A. M io, City Clerk sam �� \�' !( ---__ uf�T►LC�? , FLORIDA DEPARTMENT OF STATE DIVISION; O�;EI�E�TI�� C L E R K CAMPAIGN TREASURER'S REPORT SUMMAR (1) �� F E U ��L�� Name (2) / / �eQ ��> ��' Address (nu ber nd street) �� .�GL� %"G ��J� City, State, Zip Code ❑ CHECK IF ADDRESS HAS CHANGED (3) ID Number: c��p- 3�a ��.3 (4) Check appropriate box(es): �❑ C ndidate (office sought): !itica! 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 1� l� l 1 U� To J�-1 3� l J(� Report Type � �iginal ❑ Amendment ❑ Special Election Report ❑ Independent Expenditure Report (6) CONTRIBUTIONS THIS REPORT (7) EXPENDITURES THIS REPORT Monetary Cash & Checks $ ;� ,�, :� r7 Expenditures $ � ` Loans � Transfers to Office Account $ Total Monetary � ��j • 3 7 Total Monetary $ In-Kind � (8) Other Distributions $ (9) TOTAL Monetary Contributions To Date (10) TOTAL Monetary Expenditures To Date � �� 55� 37 � � C��-%•%� (11) CERTIFICATION It is a first degree misdemeanor for any person to falsify a public record (ss. 839.13, F.S.) I certify that I have examined this report and it is true, I certify that I have examined this report and it is true, correct, and com plete. correct, and com plete. (Type name) � � i�� .� Vl/C�-�7,S.P Y- (Type name) ��'�-'Ul' vt � [ r �`'�r! � � � Individual (only for reasurer � Deputy Treasurer � Candidate Chairperson (only for PC, PTY & election(�mun.E��"`-� ��`�-- X tione g commun.�ion) X r 4- ,. Signature Signature DS-DE 12 (Rev. 08/04) CAMPAIGN TREASURER'S REPORT — ITEMIZED CONTRIBUTIONS (1) Name � l-.��{�%� �}� / (2) I.D. Number ��j'�S� �s�� a� (3) Cover Period %c�� / �/ � � through ��/ �� / � � (4) Page � of � (5) (7) (8) (9) (10) (11) (12) Date Full Name (6) (Last, Suffix, First, Middle) Sequence Street Address & Contributor Contribution In-kind Number Cit , State, Zi Code T e Occu ation T e Descri tion Amendment Amount Il � / l� , !� �-�!� ; �1:� N,e,u�°�o�� - � �o> �� °� i /��" ��.� .� l ✓��,�� , , , , � _ � � �-- �-; �_ �'" _ � c� . � m F"� G -. ' G� } / / � � � � � �; a. � � (; ": ►—' r =' m - � o_ / / / / / / DS-DE 13 (Rev. 08/03) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES CfIYOF �� .--`*� :_�`�. - HOME OF PELICAN ISLAND 1225 Main Street Sebastian, Florida 32958 (772) 388-8214 phone - (772} 589-5570 fax November 9, 2010 Ed Herlihy Sebastian Citizens Speak Out Political Action Committee 474 Seagrass Avenue Sebastian, FL 32958 Dear Mr. Herlihy: Should you choose to terminate your Political Committee following the 2010 election, a termination report will be due by January 31, 2011, however, as long as you wish to continue your committee, you must file reports by the 10th of the month following each calendar quarter until we begin the 2011 election process, at which time you will file reports on the 46tn 32nd �$cn and 4th days prior to the election. Next year's election date is November 8, 2011. If you have any questions, please do not hesitate to contact me at 388-8214 or e- mail me at smaio@cityofsebastian.org. Sinc _ely, . - �`� R Sally A. aio, MMC City Clerk sam FLORIDA DEPARTMENT OF STATE DIVISION 0�'E�:CTiONS CAMPAIGN TREASURER'S REPOF�� Y;�.;_� �� G F � I � � (} �0��E�S��ILY Name �010 OCT �9 P{'� �' 3y t2) .�'e �'SS � Address (n m er and �tre_et) �� ,,_.p � S � i , te, Zip Code ❑ CHECK IF ADDRESS HAS CHANGED (3) ID Numbe�: O�� ,�a (�23 (4) Check appropriate box(es): ❑ C ndidate (office sought): 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 %C� / � � / %� To lQ�/ ,�� / �� Report Type � [a Original ❑ Amendment ❑ Special Election Report ❑ Independent Expenditure Report (6) CONTRIBUTIONS THIS REPORT (7) EXPENDITURES THIS REPORT D O Monetary 0 � Cash & Checks $ �� Expenditures $ �� Loans � Transfers to Office o � Account $ Total Monetary � ��O Total � � Monetary $ 33� In-Kind � (8) Other Distributions $ (9) TOTAL, �onetary Contributions To Date (10) TOTAL Monetary Expenditures To Date � "7;�5�'(��' � � o �!, 9' `� ,. (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 exam ined this report and it is true, I certify that I have exam ined this report and it is true, correct, and co plete. correct, and co plete. �i n.da� • V�ian.�r ��varc�. {� �.u-/ � (Type name) (Type name) �Individual (only for Treasurer ❑ Deputy Treasurer ❑ Candidate Chairperson (only for PC, PTY & electio ering co un. ction ' g commun or ization) i Signature igna ure DS-DE 12 (Rev. 08/04) CAMPAIGN TREASURER'S REPORT - ITEMIZED CONTRIBUTIONS (1) Name ��'� j� N. C'�-t-t ZC �S � �� bf �i `i� (2) I.D. Number .� -- 3 S��-3�' (3 Cover Period /�'1 /� D through � / g/ �(4 Pa e of (5) (�) ($) (9) (10) ��) (12) Date Full Name (6) (Last, Suffix, First, Middle) Sequence Street Address & Contributor Contribution In-kind Number Cit , State Zi Code T e Occu ation T e Descri tion Amendment Amount u�Rtc-S D i � � l O �.y�G}�. C. c�cG � $�-I 4 GiZO 55 � � G{-E � 3�•Q C7 � 5�8�`nAu L � � � 43 �3c?J3arLr� � s » Lu� �.r C �-1 � �'.�b �U L�c.%L°� i x 30. a a „'�,� SC�.�;'r-t&�i1 �� Dou�}�� iv��µ'r i i l l.'� -� 2 c7 �i •�� StfC�'S � G t 2ccc= � CN"� 1 D� � � � ��'riA�1� �F � i � i i � o ° � c:, a � � ---� n `� m �; ca -*, � ��, � m / / � -� =i �*, ", 3 � x„ +,, cn t-j � n � r - � � � � / / / ! DS-DE 13 (Rev. 08/03) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES AM AIGN�� ASU '��'S,� PO — ITEMIZED EXPENDITURES (1) Name ��.S�Qi1 �Z"��` �'�. Q� (2) I.D. Number O� ��sa �a39 (3) Cover Period �0 /�l �� through �� l�l lD (4) Page � of � l51 (7) (8) (9) (�ol 1��1 Date Full Name Purpose (s� (Last, Suffix, First, Middle) (add office sought if Sequence Street Address & contribution to a Expenditure Number City, State, Zip Code candidate) TYPe Amendment Amount f o�' fo scr��s -r� �'� I3 ��c�'e�m¢��' �/10� . ,$� 200� a.�- � 1 0 � �, -� - - -� � � �� o � � � �� n � rs , —1 � � � ni rt� � r-- -- rn =� x� � x DS-DE 14 (Rev. 08/03) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES �� ST �� HOME OF PELICAN ISLAND 1225 Main Street Sebastian, Florida 32958 (772) 388-8214 phone - (772) 589-5570 fax October 19, 2010 Mr. Edward Herlihy Chairperson Sebastian Citizens Speak Out 474 Seagrass Avenue Sebastian, FL 32958 Dear Mr. Herlihy: In accordance with Florida Statutes Section 106.07, the campaign treasurer's report for your political committee 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 28th with the report due the next day Friday, October 2gtn If you intend to continue your committee, you witl go back to filing quarterly reports starting in January. 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 ,citvofsebastian.orq. Sinc ely, �� . � Sally A. aio, MMC City Clerk cc: Linda Wanser, Campaign Treasurer FLORIDA DEPARTMENT OF STATE DIVI,�1Qhl �t3F_. �LECTIONS CAMPAIGN TREASURER'S ��OR��1��#RY �� ,� <• - i ICE OF CITY Lt��P�ti Na e 2010 GCT 15 �(�1 10 �12 � t2) A re s(numbe d street) p --- ,y i., O - ___ - City,- State, Zip Cod ❑ CHECK IF ADDRESS HAS CHANGED (3) ID Number� c�-(��--� (4) Check appropriate box(es): ❑ Candidate (office sought): [L]�olitica) Committee ❑ CHECK IF PC HAS DISBANDED ❑ Gommittee of Continuous Existence ❑ CHECK IF CCE HAS DISBANDED ❑ Pariy Executive Committee ❑ Electioneering Communication ❑ CHECK IF NO OTHER ELEGTIONEERING COMMUN1CATiON REPORTS WtLL BE FIlED (5) REPORT IDENTIFIERS Cover Period: From �%�� f To % �`� Report Type �� .� �1��-- ..�._ - ❑ Original ❑ Amendment ❑ Special Election Report ❑ Independent ExpenditureReport (6) CONTRIBUTIONS THIS REPORT (7) EXPENDtTURES THIS REPORT Monetary . . � � Cash & Check � Expenditures $ � Loans � Transfers to Office � Account $ Total Monetary � Total ° �r ��; Monetary $ !n-Kind $ (8) Other Distributions $ (9) 'i''OT Monetary Contributions To Date (10) TOTAL Mon tary Expenditures To Date $ � - / -- -- l . (11) CERTIFICATION tt is a first degree misderneanor for any person ta falsify a pubiic record (ss. 839.13, F.S.} I certify that- I have examined this report and it is true, 1 certify that I have examined this report and it is true, correct, and complete. correct, and complete�. iTYPe name) �.� ,`' �� (TYpe name) J � f �Individual (oniy for reasurer � Deputy Treasurer � Candidate Chairperson (onty for PC, P 8� ele — p� � neerine-eommun_ or.panj�Alion) � � Signature i na re � DS-DE 12 (Rev. 0$104) , .. � ' (1) Name CAMPAIGN TREASURER'S REPORT - ITEMIZED CONTRIBUTIONS ��a�►._�i �r � � ,�� / � .- - - ,. . _ (3) Couer Period (/ ` / °2`S / � b through �(% / � d / /� (4) Page of � (5) i7) i8) (9) i10) (11} {12) Date Fuil Name (6) (Last, Suffix, First, Middte) Sequence Street Address & Contributor Contribution in-kind - Number Ci , State. Zi Code T e Occu ation T Descri tion �^� Amount ! l / / ( ��° i / ! / / � � G � ; , 'T1 - �'? � rn c _ -n < c� m `_` / / � c� f ° -< T" L� ; - C� _; , r -- tT �~ � .� / / i� / ! DS-DE 13 (Rev. 08/03) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES :� CAM . AIGN T E SURER;a, EP T- IT�MIZED EXPENDITU ES (1) Name J�� / (2) I.D. Number " 9 (3) Cover Period �/ �✓ / d through �/ �d / � v (4) Page _� of ° �5) (7) �$) �9) �10) ��) Date Full Name Purpose (Last, Suffix, First, Middle) (add office sought if �6� Street Address & contribution to a Expenditure Sequence City, State, Zip Code candidate) TYPe Amendment Amount Number �� o� �o ��--,�p� %c. ��.�� :� �- ►�� 33a`� � �oi �s �fwy , Ve n� �c�, �L ,3;�yr� ,: ; , / G '.r-� '*1 ` . � C� .� � �; O -.-; �_ � C'� � `_ --i C^' � � : � � r -. rn� � ::- � DS-DE 14 (Rev. 08103) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES �� R ';�� :-..�-�.. HOME �7F PEi.IU�N ISLAIV[7 1225 Main Street Sebastian, Florida 32958 (772) 388-8214 phone - (772) 589-5570 fax October 7, 2010 Mr. Edward Herlihy Chairperson Sebastian Citizens Speak Out 474 Seagrass Avenue Sebastian, FL 32958 Dear Mr. Herlihy: In accordance with Florida Statutes Section 106.07, the campaign treasurer's report for your committee n 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 report at any time during the week of October 11tn through October 15, 2010. If you have any questions, please do not hesitate to contact me at 388-8214 or ss�aio :ei�ofsebastian.org. Sincerely, _ �-C' ��Y� �" Sally A. aio, MMC City Clerk cc: Linda Wanser, Campaign Treasurer FLORIDA DEPARTMENT OF STATE DIVISION OF ELECTIONS CAMPAIGN TREASURER'S R � � MMARY �� C • �� S��A��ICE USE ONLY Name I E OF CITY CLERK t2i 7 S 5 P 2 9 fl�i 8 53 __ Addre s(nu er and street) � � � City,-State, Zip Code ❑ CHECK IF ADDRESS HAS CHANGED (3) ID Number: ��Jp� (paL� (4) Check appropriate box(es): ❑ C didate (office sought): olitical 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 �� / � � / / � To � / �/ � (� Report Type � 2 �Original ❑ Amendment ❑ Special Election Report ❑ Independent Expenditure Report (6) CONTRIBUTIONS THIS REPORT (7} EXPENDITURES THIS REPORT Monetary . Cash & Checks $ �� O � Expenditures $ Loans $ Transfers to Office %� � Account $ Total Monetary � Total Monetary $ In-Kind $ (8) Other Distributions $ (9) TOTAL Moneta Contributions To Date (10) TOTAL Monetary Expenditures To Date $_ ?� o m� $ 3, 3�/. 99' (11) CERTIFICATION It is a first degree misdemeanor for any person to falsify a public record (ss. 839.13, F.S.) I certify that I have examined this report and it is true, I certify that I have examined this report and it is true, correct, and complete. correct, and complete. iTYPe name) �%��(Y� � Y y(/ti%i�� (Type name�(Na� %� ��C �//' �Individual (oniy for Treasurer � Deputy Treasurer � Candidate Chairperson (only for PC, TY & electione ring commun.} ectioneering commun. organization) X Signature Signature DS-DE 12 (Rev. 08I04) CAMPAIGN TREASURER'S REPORT — ITEMIZED CONTRIBUTIONS (1) Name ,��SrlA1-F C�Tl2�-i•t5 S��'A� D�7� (2) I.D. Number�(, -352..� 23�'j (3) Cover Period � / / �� through O�'! / / (4) Pa e of (5) (�) �8) (9) (10) (��) (12) Date Full Name ' (6) (Last, Suffix, First, Middle) Sequence Street Address & Contributor Contribution In-kind Number Cit State Zi Code T e Occu ation T e Descri tion Amendment Amount REi}LT'y k� NG, � uc � 23 r lv q�(5 SC 8 t�STlpN ^ sC�Sr� A u ��- g C�f � �c�o• o 3z�� o�1 i Z, i � l��1ll,cfl � su� � 9''13a5w� t�V � G�L jpp•O s��asrca�� L 3��s� �'S � 23 � /c� ��w� �. ��K �� s. C��c 5-T � G85 � o. Qo �gASrc Au�FL 32�iS� i i i i '� o v T -=i / / tG"*� G'> —[ � fT'� � i� EV � � �� it �'4 tD cn r;-, c�rn�� -� � �* / / � '; r�n %' � .. � / / DS-DE 13 (Rev. 08/03) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES AM AIGN R ASURF,�it'S R P RT - ITEMIZED EXPENDITU S f,�`x��_nQ / (1) Name � ��' (2) I.D. Number � �J �� (3) Cover Period �/ �� / �� through v ` /�/�� (4) Page [ of� �5� (7) �8) �9) ��) ��) Date Full Name Purpose (Last, Su�x, First, Middle) (add office sought if �6� Street Address 8� contribution to a Expenditure Sequence City, State, Zip Code candidate) TYPe Amendment Amount Number �-r7 :.: 9 � .�a C� —: {71 ,� �i��..�1 � � ' � � T L!� ,1 CT f*t 3 � q' � C� rc�- � �y A � � � � � DS-DE 14 (Rev. 08103) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES � �tECEIYED STATEMENT OF ORGANIZATION p��G� �b�'��Y OF POLITICAL COMMITTEE �p�� p �"� R�1 8�0 (PLEASE TYPE) 1. Fuil Name of Committee Telephone ��2- S��STI�}!�l CtTIZl�lS SPEAK C�UI �S�Sd) 38�-�C,�S Mailing Address (include city, state and zip code) �� sc� �eass �v�. � s�=0�A5f� � t-� � FL 3� -�-� S� Street Address (include city, state and zip code) SA�,E 2. Affiliated or Connected Organizations (includes other committees of conUnuous existence and political committees) Name of Affiliated or Connected Organization Mailing Address Relationship 'N-C�1�1� 3. Area� Scope and Jurisdiation of the Committee SG—f5A5'T �A N 1��. �- �r--�rc a� s 4. Nature of Or�anization or Organization's Spectat Interest (e.g., medical, legal, education� etc.) �-,��,�,Y�C�t�1 GIT� tSSU�S 5. Identify by Nams, Address and Position, the Custodian of Books and Accounts (inciude treasurer's name) Full Name Mailing Address Committee Title or Position L1 N�+�}- R b 3 I 4��LlCo �L �C'� � `�"RC-ASu1��1� f.r>Ar15�T� 5��t�5`r�t�c�tt�� 3��tSB DS-DE 5(Rev. 06/06) (continued on reverse sicle) 6. List by Name, Address and Position, Other Principal Officers, including Officers and Members of the Flnance Committee, If Any (include chairman's name) Full Name Mailing Address Committee Title or Position �.�w�� e� �-I� • N 7�! S�C: A G�t� 55 A V[= , c�-A r R►,� r� N �-i� �ZLI �-1—� SG-63 F�51 ( !� %a i �� 3 z�. � � 7. List by Name, Address, Office 3ought and Parly Affiliation Each Candidate or Other Individual that this Committee fs Supporting (if none� please indicate) Full Name Mailing Address Office Sought Party fZ<<1�A R� t-t• C�tt,MO � c�y k�o�GEL Av�' C t Ty c�j t.t� � L ttii o�� L` Aw+�=S l��L� t 13 w1o��.p� C��?c� G� r7� co�+�c�L ``"� °�1 � S�BasTia c�� F�- 32 �s8 � �, 8. List Any Issues this Committee is Supporting: �1 t� [� (.,,�= � "'"� _ .� � � -� List Any Issues this Committee is Opposing: �l Q�l (.,— � o� 9. If this Committee is Supporting the Entire Ticket of a Party, Give Name of Party � ��m � D 3 � �'' � 10, in the Event of Dissolution, What Disposition will he Made of Residual Funds? �� '� 1 V l I�c-I� �� D hl� !.%1cr,�1 r�L=lZS �Q(� �t-L. y o��.. 11. List aii Banks, Safety Deposit Boxes� or Other Depositories Used for Committee Funds Name of Bank or Depository & Account Number Mailing Address St�coa5yr -�? �. �o�aL 1I lC� �'DS�L�NID �zu�. �f3 A r} K �C g �s�r t a N,� c. 3��;� 12. Ust ali Reports Requi�ed to be Filed by this Committee with Federal Officials and the Names, Addresses and Positions of Such Officials, If Any Report Title Dates Required to be Filed Name & Position of Official Mailing Address �t�! O 9.! �' STATE OF �Q l 1D f� ( 1�l 1D l��1 R�,UC � COUNTY �, � D I,a9 ja �� i�C �Ll l-� Y , certify that the information in this Statement of �rganization is complete, true and correct. �� t � Signature of Chairman of Political Committe Date 'a an�� •��1M � �;�",a� � FtOME OF PE�KaN ISLAND 1225 Main Street Sebastian, Florida 32958 (772) 388-8214 phone - (772) 589-5570 fax September 23, 2010 Mr. Edward Herlihy Chairperson Sebastian Citizens Speak Out 474 Seagrass Avenue Sebastian, FL 32958 Dear Mr. Herlihy: 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 27th through October 1, 2010. If you have any questions, please do not hesitate to contact me at 388-8214 or smaio(cr�.cityofsebastian.orq. Sincerely, �y,.: ; � � � , � J�,�_------. � Sally A. Maio, MMC City Clerk cc: Linda Wanser, Campaign Treasurer � .:a.� _ ., . ,. ��. ��,�,�� '��,��°��i�:�i` �aF �'�� . 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F�:aH 7�rRL s'i�z�', 1,}�� .��"'� °� M� ,•''__ 1225 Maln Sreet SebasOary Rontla 32858 Q]2J 38&8214 pM1One-Q]2J 58&55]0 hs September $ 2010 Mr. Edward Hetlihy Chairperson Sebasfian Cifizens Speak Out 4]4 Seagrass Avenue Sebasfiaq FL 32958 Dear Mr. Hetlihy. In accordance with Ronda StaNtes Secfion 106.0], the campaign treasureYS report for your polifical committee forthe penod July 1, 2010 through September 1Q 2010 is due in the Office of the City Clerk by 5 pm on Fnday, September 1], 2010. Vou are welcome to submit your campaign report at any fime dunng the week of September 13 through 1], 2010. Any report postmarked bythe United States Postal Service nolater than midnight of the due date, shall be deemed to have been submitted in a fimely manner Vour committee will now be filing reports on the 46�h (this report), 32ntl, 18�h and 4�h days pnor to the elecfion. The reporting penods and filing deadlines are as follows: aaoon�ava�oa aagono�aoaa July1,A10 Sep�emberl0,]f110 A6 tlayrepotl(Gi)tlue Sep�emberi],]f110 by5 pm f f Sep�emberll�M1mugM1 Sep�embe2A,]f110 32'°tlayrepotl(GJJ tlue Otloberi ]f110 by5p m Sep�ember25�M1mugM1 Odober8 ]f110 18° tlayrepotl(Gi)tlue OdoberiS ]f110 by5 pm Odober9�M1mugM1Otlober]H,]f110 A°tlayrepotl(GA)tlue0dober29,]f110by5pm Odober29�M1mugM190 tlays(ollowing eletlion Termina�ion Repotl Ql� tlue by January3l,]f111 I am also induding an updated linkto Ronda Ditision of Elecfions elecfion lawswhere you can accessthe revised FS106.In 2010,the State Legislature revised certain elecfion laws thatpertain to elecfioneenng communicafionsand disdaimers. M1ttpl/elec00n.tlO5sbtz.fl.u5/publla[IOnS/ptlf/2010/2010E1ec[IOnLaWSptlf Fortns necessary to amend your Statement of Organizafion, and an updated Polifical Committee Handbookare also available on the Division website. If you have any questions, please do not hesitate to contact me at38&8214 or smaio(�ciNofsebastian.orq. Sincerely, Sally A. Maio, MMC ciry aenc m LindeWereeS Campe�n Treesurer FLORIDA DEPARTMENT OF STATE DIVISION OF ELECTIONS CAMPAIGN TREASURER'S REPOR��I��II�I�ARY �� /r '�;1 1 'i �.: � S �C��,��E ONLY Name « ��t=FiC� OF CITY CLEftK �2� O10 JUL ? P�1 3 y3 A dre s(numbe d street) s � � City,� State, Zip Cod ❑ CHECK IF ADDRESS HAS CHANGED (3) ID Number�j�—, �a�a39 (4) Check appropriate box(es): ❑ Candidate (office sought): [1]�'t�olitical Committee ❑ CHECK IF PC HAS DiSBANDED ❑ Committee of Continuous Existence ❑ CHECK IF CCE HAS DISBANDED ❑ Party Executive Committee ❑ Electioneering Communication ❑ CHECK IF NO OTHER ELECTIONEERfNG COMMUNICATION REPORTS WILL BE FILEQ (5) REPORT IDENTIFIERS Cover Period: From� / � / � (� To �� / �° � / � (� Report Type ❑ Original ❑ Amendment ❑ Special Election Report ❑ Independent Expenditure Report (6) CONTRIBUTIONS THIS REPORT (7) EXPENDITURES THIS REPORT Monetary Cash & Check $ Expenditures $ � �� Loans $ Transfers to Office � Account $ Total Monetary � Total Monetary $ r � ` � Q � In-Kind $ (8) Other Distributions $ (9) TOTAL Monetary Contributions To Date (10) TOTAL Monetary Expenditures To Date � 3�`751� . d v �-�� .� b 1.9.9� (11) CERTIFICATION It is a first degree misdemeanor for any person to falsify a public record (ss. 839.13, F.S.} I certify that I have examined this report and it is true, I certify that I have examined this report and it is true, correct, and complete. correct, and complete�. (Type name) �� , • %� (Type name) � �/ �Individual (oniy for reasurer � Deputy Treasurer � Candidate Chairperson (only for PC, P Y& ele tion ring commun.} el neer mmun. o an ion) Signature Si nature DS-DE 12 (Rev. 08104) CAMPAIGN TREASURER'S REPORT — ITEMIZED CONTRIBUTIONS (1) Name�6�a%� L%��%� �'��'��-� ��U� (2) I.D. Number oCfO'��J�(�� (3) Cover Period �� / Q � l 1 V through � �/ / �/� / � � (4) Page � of / (5) �7) �$) �9) �1�) �11} (12) Date Full Name (6) (Last, Suffix, First, Middle) Sequence Street Address & Contributor Contribution In-kind Number Cit , State, Zi Code T e Occu ation T e Descri tion Amendment Amount I I / / / / � % ,y'4 � I / +�x 4� `,p �V � y �� C� .i � � � I I _�' � � -� � � _ � � �'i � � l^ �_'J V i � i. � W � 3 � �r f': � �-y � � �1 � � r — -�C � � � � / / � � ,� , / / DS-€3E 13 (Rev. 08f03) 5EE REVERSE FOR lNSTRUCT�ONS AND COQE VALUES (1) (3) , CA PAIG T_I�EA ��R'S EPQftT�TEMiZED Name %�� Cover Period �/�/� through ��(J l�vl � v (4) EXPENDITURES�r ) I.D. Number��i'��7o2��9 Page �_ of / �5� (7) ($) �9) ��) ��) Date Full Name Purpose �6� (Last, Suffix, First, Middle) (add office sought if Street Address 8� contribution to a Expenditure Sequence City, State, Zip Code candidate) TYPe Amendment Amount Number �0 f�l /'d S'2. �5 CL/'l ��JS � •r I � l��i.s � D �' `�,5�� 01,�-� s � �' C� / S�e 1� S�14n �I �9� �"� � � �✓ n -,, :-> -� — _� � � S,`, � � �T7 !'?.., -�y C i CI� �-rl n � _ � � �; Ua t ) _.-{ �1 -'` � ..-" � DS-DE 14 (Rev. 08103) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES . • r�"� ` :-��;�r� -- �- _...... n:� _ • • ' � � �225 Main Street Sebostian, Fiorido 32958 (772) 388-8214 phone - (Tl2) 589-5570 fax July 1, 2010 Mr. Edward Herlihy Chairperson Sebastian Citizens Speak Out 474 Seagrass Avenue Sebastian, FL 32958 Dear Mr. Herlihy: In accordance with Florida Statutes 106.07, a quarterly report for your political committee for the period April 1, 2010 through June 30, 2010 is due by July 10, 2010. Because July 10�' falis on a Saturday, the report must be submitted no later than Monday, July 12, 2010. 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. Sin ely, �� ;__.__-- Sally A. aio, MMC City Clerk sam �� ' �� HOME OF PELtCAN tS1AND 1225 Main Street Sebastian, Florida 32958 (772) 388-8214 phone - (772) 589-5570 fax July 1, 2010 Linda R. Wanser 631 Helicon Terrace Sebastian, FL 32958 Dear Ms. Wanser. In acxordance with Florida Statutes 106.07, a quarterly report for your political committee for the period April 1, 2010 through June 30, 2010 is due by July 10, 2010. Because July 10�' falls on a Saturday, the report must be submitted no later than Monday, July 12, 2010. If you have any questions or if there is anything I can do to assist you, please do not hes'rtaate to contact me at 388-8214. Sin ely, , �l - ! / ! Sally A. io, MMC City Clerk sam (1) FLORIDA DEPARTMENT OF STATE DIVISION OF ELECT�IONS CAMPAIGN TREASURER'S REPO � '-� _ ' [3Y, i'J �a`tiZ,��2S �� r1 T � F F I G E 0 F 9�� L��tPN�Y Name 2010 APR 8 P� ��7 (z) S�d.d 1''�7.5� ., Addre s (numbe nd street) ,�7� �' �I1 �L .3�-�,5�' 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 (3) ID Number: ❑ CHECK IF PC HAS DISBANDED ❑ CHECK IF CCE HAS DISBANDED '�L,.� ❑ CHECK tF NO OTHER ELECTI�NEERING COMMUNIGATION REPORTS WlLL BE FELEE} (5) REPORT IDENTIFIERS Cover Period: From �� l�� l� CC� To (,%, j I � f I I� Report Type ��_ ❑ Original ❑ Amendment ❑ Special Election Report ❑ Independent Expenditure Report (6) CONTRIBUTIONS THIS REPORT Cash & Checks Loans Total Monetary In-Kind $ �'`� $ $ p� �a (9} TOTAL Monetary Contributions To Date $ ?��•�D (7) EXPENDITURES THIS REPORT Monetary . � Expenditures $ � �. � Transfers to Office Account $ Total C% Monetary $ � �. � / (8) Other Distributions $ (10) TOTAL Mon� ry Expenditures To Date $ _�� GI 6 Y �`� (11) CERTIFICATION It is a first degree misdemeanor for any person to falsify a public record (ss. 839.13, F.S.} I certify that I have examined this report and it is true, I certify that I have examined this report and it is true, correct, and complete. correct, and complete. � T e name � V V' l,�- V l� � r (Type name) � 7� �� i YP ) LI � �Individual (only for Treasurer � Deputy Treasurer � Candidate Chairperson (only for PC, PTY election rAg commun.) el neerin commun. or nization) �� ` , - � Signature Signature DS-DE 12 (Rev. 08104) CAMPAIGN TREASURER'S REPORT — ITEMIZED CONTRIBUTIONS (1) Name �� /� �% (2) I.D. Number �(� � a ��39 (3) Cover Period � / �/ / �� through �,� / �� / / � (4) Page of / �5) (7) (8) (9) (10} (11) (12) Date Full Name (6) (Last, Suffix, First, Middle) Sequence Street Address & Contributor Contribution in-kind Number Cit , State, Zi Code T e Occu ation T e Descri tion Amendment Amount D% �� , /� ��Q Q � /�; �►� �� j ✓�rside , �l �' �-fT� ��.._ � s ��r�r , , , , , , N O G� .. T7 �-� _ ..�7 �; / / O -,: � "rl C�"� n � : � � . � � ' n � f'- — rn� ! / � _. � / / / / DS-�� 13 (Rev. �&f�3} S�E !2E`✓EP.S� �04 !�lSTR:,'CT;C�vS ;NQ C^�� `d."-,LJES . • CA PAIG T EASU R'S E O�T - ITEMIZED EXPENDITUR�Sy 3sa �3 (1) Name (2) I.D. Number E� g (3) Cover Period V� l �%� l�� through �� l J� l�� (4) Page � of � �5� (7) �$) �9) i��) �� Date Fuil Name Purpose (Last, Suffix, First, Middle) (add office sought if �6� Street Address & contribution to a Expenditure Sequence City, State, Zip Code candidate) TYpe Amendment Amount Number � � � jD Ch��/V �1��- t.�r��s� �(�;S' �34, � 3,�� - � ��y � / ��,��"a v Cs, � ��/.3 �; �, �> � �, G -- (f`� C"� �- , ' _.4 C^' , -< �' �,,� G� - r — rn = � �-- x DS-DE 14 (Rev. 08I03) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES CtiY OF ��I�� ,�-'�._. HOME OF PELICAN ISLAND 1225 Main Str2et Sebastian, Florida 32958 (772) 388-8214 phone - (772) 589-5570 fax April 2, 2010 Mr. Edward Herlihy Chairperson Sebastian Citizens Speak Out 474 Seagrass Avenue Sebastian, FL 32958 Dear Mr. Herlihy: In accordance with Florida Statutes 106.07, a quarterly report for your political committee for the period January 1, 2010 through March 31, 2010 is due to me by April 10, 2010. Because April 10th falls on a Saturday, the report must be submitted no later than Monday, April 12, 2010. 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. Sincerely, � � ��ti �. � �� Sally A. aio, MMC City Clerk sam CtiYOF �� ;�� HOME OF PELICAN ISLAND 1225 Main Street Sebastian, Florida 32958 (772) 388-8214 phone - (772) 589-5570 fax April 2, 2010 Linda R. Wanser 631 Helicon Terrace Sebastian, FL 32958 Dear Ms. Wanser: In accordance with Florida Statutes 106.07, a quarterly report for your political committee for the period January 1, 2010 through March 31, 2010 is due to me by April 10, 2010. Because April 10th falls on a Saturday, the report must be submitted no later than Monday, April 12, 2010. 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. Sinc r y, ... �� ---- � Sally A. io, MMC City Clerk sam FLORIDA DEPARTMENT OF STATE DIVISION OF �LEC�Fp,N:S CAMPAIGN TREASURER'S REPORT S-UNI� �s,+�1K5�i1�� ) �C/� �-!/<Ze� �� v�FICfD�fFl�[I NLY Name A�r'� �0 �� (2) �I'S V e. 2014 J�1� 6 Address (num and street) �o � �c, �� 3�-� -Cyv ,-State, Zip Code ❑ CHECK IF ADDRESS HAS CHANGED (3) ID Number: q�� k�`�� ' (4) Check appropriate box(es): ❑ Candidate (office sought): olitical 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 FILEQ (5) REPORT IDENTIFIERS Cover Period: From � / � p / � To l02, / ,� � / � � Report Type � Original ❑ Amendment ❑ Special Election Report ❑ Independent Expenditure Report (6) CONTRIBUTIONS THIS REPORT (7) EXPENDITURES THIS REPORT Monetary Cash & Checks $ �` Expencfitures $ Loans $ Transfers to Office Account $ Total Monetary � Total Monetary $ In-Kind $ (8) Other Distributions $ (9) TOTAL Monetary Contributions To Date (10) TOTAL Monetary Expenditures To Date $ � ��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, I certify that I have examined this report and it is true, correct, and complete. correct, and complete. (Type name)!jf/% (�!�- � • / r�Jer (Type name) C4Gtj��jJ/� „ �ey!/�j � Individual (oniy for T easurer � Deputy Treasurer � Candidate hairperson (only for PC, PT�B� electione ing commun.) � p�, tionee g commun. or�nizalion) � X ` � � J ,� Signature Signature DS-DE 12 (Rev. 08104) CAMPAIGN TREASURER'S REPORT — ITEMIZED CONTRIBUTIONS (1) Name j�L°/1s d� (2) I.D. Number��,,s-a �39 (3) Cover Period I!/ l�� l�/ through ��/ ,�j �/ � 9 (4) Page � of � �5) �7) �$) �9) (1�) (11) (12) Date Full Name (6) (Last, Suffix, First, Middle) Sequence Street Address & Contributor Contribution In-kind Number Cit , State, Zi Code T e Occu ation T e Descri tion Amendment Amount / / / / / / � / / / / , � o cw 'r� � G �.� ^ iT1 . � 4. T� . ^ V / i C� fT1 � � —G 77- � � r rn = � I I / / DS-C3E 13 (Rev. 08/03� SEE REVERSE FOR lNSTRUCTtONS AND CODE VALUES C MP IGN T SURE ' R PO T=1TEMIZED EXPENDITURES (1) Name 1)1 (2) I.D. Number�3sa �.23 � (3) Cover Period �/ ✓cr%/� through �� /�/� (4) Page �_ of � �5� (7) �$) �9) (��) �� Date Full Name Purpose �s� (Last, Suffix, First, Middle) (add office sought if Street Address & contribution to a Expenditure Sequence City, State, Zip Code candidate) TYPe Amendment Amount Number V � r:% -n -n - � . m o -�; . -`' cn . � m —i p -< 7' '. G'� n -� r �- � �-- � DS-DE 14 (Rev. 08103) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES cmr c� �]�/�T r �� ''��' ��. �;_ � - ,, -- HOME OF PELICAN ISLAND 7�� -+r� �� '��i + ; '+ =:L �. .W : � t ■; � January 5, 2010 Mr. Edward Herlihy Chairperson Sebastian Citizens Speak Out 474 Seagrass Avenue Sebastian, FL 32958 Dear Mr. Herlihy: In accordance wi#h Florida Statutes 106.07, a quarterly report for the period 10/30/09 through 12/31/09 is due to me by January 10, 2010. 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. Sinc �ely, _ C�'1 `'v/ -i� Sally A. aio, MMC City Cterk sam cmroF T � � �i �� f�� HOME OF PELICAN ISLAND 1225 Main Street Sebastian, Florida 32958 (772) 388-8214 phone - (772) 589-5570 fax November 4, 2009 Ed Herlihy Sebastian Citizens Speak Out Political Action Committee 474 Seagrass Avenue Sebastian, FL 32958 Dear Mr. Herlihy: Should you choose to terminate your Political Committee following the 2009 election, a termination report will be due by February 1, 2010, however, as long as you wish to continue your committee, you must file reports by the 10t" of the month following each calendar quarter until we begin the 2010 election process, at which time you will file reports on the 46tn 32nd �$tn and 4th days prior to the election. If you have any questions, please do not hesitate to contact me at 388-8214 or e- mail me at smaio@cityofsebastian.org. Sinc ly, + V vf / � � � Sally A. Maio, MMC City Clerk sam FLORIDA DEPARTMENT OF STATE DIVISION OF ELECTIONS CAMPAIGN TREASURER'S REPORT SUMII�IA�2�(�':":� .;,i�i �� %�� Ck1T �;r�=F��'�� c��RK Name c2� 1-�-7� 5e�r�s.5 ,�v-� Z009 oCT 30 RI7 3a �8 Addre s(nu ber and street)�� City,� State, Zip Code ❑ CHECK IF ADDRESS HAS CHANGED (3) (D Number: o�! -3Sa(�a�3 q (4) Check appropriate box(es): ❑ Candidate (office sought): �olitical Committee ❑ CHECK IF PC HAS DISBANDED ❑ Committee of Continuous Existence ❑ CHECK IF CCE HAS DISBANDED ❑ Party Executive Committee ❑ Electioneering Communicatian ❑ CHECK IF NO OTHER ELECTtONEERING COMMUNICATION REPORTS WILL BE FILED (5) REPORT IDENTIFIERS Cover Period: From �D l�� l Q� To �v l�/ l j! / Report Type � [�Original ❑ Amendment ❑ Special Election Report ❑ Independent Expenditure Report (6) CONTRIBUTIONS THIS REPORT (7) EXPENDITURES THIS REPORT Monetary , Cash & Checks � Q7(�,S Q� Expenditures $ � 3 �, U � Loans � Transfers to Office Account $ Total Monetary � Total O Monetary $ 3 � Q , i� In-Kind $ (8) Other Distributions $ � (9) TOTAL Moneta Contributions To Date (10) TOTAL Monetary Expenditures To Date $ �3, '7.��, � d $ 3, a � � . �-a (11) CERTIFICATION It is a first degree misdemeanor for any person to falsify a public record (ss. 839.13, F.S.) I certify that I have examined this report and it is true, I certify that I have examined this report and it is true, correct, and complete. correct, and complete. (Type name) � J2 Q� %�, �a/i �j�' l� (Type name) C�VV ,(� �� {�%��/`l �Individual (only for Treasurer � Deputy Treasurer � Candidate Chairperson (o�ly for PC, PTY 8� election ring commun.) ,r..glectioye ing com un. • anization) � !�'1�, / r _ � � �� 'CJ V Signature Signature DS-DE 12 (Rev. 08l04) CAMPAIGN TREASURER'S REPORT - ITEMIZED CONTRIBUTIONS (1) Name �„�Tj � �•�s � � (2) I.D. Number ��D -�a �3 9 (3) Cover Period �� l J � / �-! through �d / 2 9/ � 9 (4) Page f of � (5) (7) (8) (9} (10) (11} (12) Date Full Name (6) (Last, Suffix, First, Middle) Sequence Street Address & Contributor Contribution In-kind Number Cit , State, Zi Code T e Occu ation T e Descri tion Amendment Amount �d � � � D 9 � ��r� � � �s q,er�.s�i r� �� o2S', 4� � ._`ie�rs�i Q�� 3 � d � �3 � o .�m��, L� v�� . � 5�3 �s'�° � �'��L aoa.o� �an, �l (��I �— 3�-9�8 � � � � � � ,� r: i � � -„ �� c� -. � F w a � ' � � / / � � �. r C� --� r -- m :� �, _ i � t3S-Ut 'iS (Kev. UtflU3j 5EE REVERSE FQR lNSTRUCTlONS AND CODE VALUES CAMPAIG REASU R'S PORT - ITEMIZED EXPENDITURES (1) Nam �% �Zt.°�7 � (2) I.D. Number p?d-�a��-39 (3) Cover Period ��' �0 /�through �/�/� (4) Page � of � (5� �7) �$) �9) �10) ��) Date Full Name Purpose �s� (Last, Suffix, First, Middle) (add office sought if Sequence Street Address & contribution to a Expenditure Number City, State, Zip Code candidate) TYPe Amendment Amount / � °?�Oq �i2�u� C�T �s� Qrs � oa Js�o� vs �r �� /�o�' 330 � v�o ,��, 3a-�� -�, . -,, _ m `` . c_; o -�-, � cn ' � � .. -� �- ` ,{ c� t`; r — rn � r� � DS-DE 14 (Rev. 08103) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES a�voF ,��T :� HOME OF PELICAN ISIAND 1225 Main Street Sebastian, Florida 32958 (772) 388-8214 phone - (772) 589-5570 fax smaio@cityofsebastian.org October 22, 2009 Mr. Edward Herlihy Chairperson Sebastian Citizens Speak Out 474 Seagrass Avenue Sebastian, FL 32958 Dear Mr. Herlihy: In accordance with Florida Statutes Section 106.07, the treasurer's report for your committee for the period October 10th through October 29th, 2009 (G4) is due in the Office of the City Clerk by 5 pm on Friday, October 30, 2009. Should you decide to continue your committee, you will need to follow FS 106.08 (4) (a) as set out below: (4)(a) Any contribution received by the chair, campaign treasurer, or deputy campaign treasurer of a political committee supporting or opposing a candidate with opposition in an election or supporting or opposing an issue on the ballot in an election on the day of that election or less than 5 days prior to the day of that election may not be obligated or expended by the committee until after the date of the election. Future reports will go back to the quarterly due dates as set out in FS. The next reporting period for you would begin October 30, 2009 and end December 31, 2009. 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 _cityofsebastian.orq. Sincer�l , - - . , N- -�..��, �,� �f� ; ��;1 a --� ,C. ( . ,..�...�.__._... Sally A. fallaio, MMC City Clerk sam cc: Linda Wanser, Campaign Treasurer FLORIDA DEPARTMENT OF STATE DIVISION OF��w � Q S ,, ;- CAMPAIGN TREASURER'S REPO. (�) Q" �l//Z�/iS �FFICE O�Fgi�'�'�Y Name ZOQ9 QGT 13 A�1 i0 3y (2) P Ad ess_(number d street) �� ,�� g� City, State, Zip Code ❑ CHECK IF ADDRESS HAS CHANGED (3) ID Number: o��o� ,� ,�j 9 (4) Check appropriate box(es): ❑ Candidate (office sought): (�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 �� /02(0 / �%� To � /� � / � Report Type �+„3 [+�Original ❑ Amendment ❑ Special Election Report ❑ Independent Expenditure Report (6) CONTRIBUTIONS THIS REPORT (7) EXPENDITURES THIS REPORT .�. Monetary � � r, �� Cash & Checks $ �.� Q v Expenditures $ v Loans $ Transfers to Office Account $ Total Monetary $ l�, �� Total Monetary $ � �� 9� In-Kind $ (8) Other Dist$butions � � (9) TOTAL Monetary Contributions To Date (10) TOTAL Monetary Expenditures To Date $ 3� 505, d0 $ �9 �! , .� (11) CERTIFICATION It is a first degree misdemeanor for any person to falsify a public record (ss. 839.13, F.S.) I certify that I have examined this report and it is true, I certify that I have examined this report and it is true, correct, and complete. correct, and complete. l//� /� T e name , �TYPe name) !�l/ i�� (�� i YP ) ,, �/�/� � Individual (on�y for reasurer ❑ Deputy Treasurer � Candidate Chairperson (only for PC, Y& ele tione ing comm� ectionee ng commun. anization) Signature Signature DS-DE 12 (Rev. 08104) ►. �� CAMPAIGN TREASURER'S REPORT — ITEMIZED CONTRIBUTIONS (1) Name ,s�� GN-s S�"(�Jj`�� VU/ (2) I.D. Number ��-3�a�39 (3) Cover Period � l�� l �/ through �b / Q�/Q (4) Page � of / (5) (7) (8) (9) (10) (11) (12) Date Full Name (6) (Last, Su�x, First, Middle) Sequence Street Address & Contributor Contribution In-kind Number Cit , State, Zi Code T e Occu ation T e Descri tion Amendment Amount �d, v�,o9 ��s�,� "y a�s� � s a� c.��" � �o � s��3,.�� ` � v� v9 � �� 2� d>o 11 � o / � � � �5ebd�sfi`ar�, `� �-f 02 3 �9�' �d � v9 � � g �l�har/�brr � %7� �y�'r� I�r, � �, �7(i �pc7 � �,°i�%S°f7�1/7i �• �� -' � , ; o ` c-� - c_ . � -� / / � � cr� n rn � _� � . - � -t �,, p-�► � -� r- -- t�.a �7 =--- / ! � � / / DS-DE 13 (Rev. 08/03S SEE REVERSE FOR lNSTRt1CTlONS AND COQE VALUES ,• � (�) Name -�j�i AM� I��Uj��R`�� — IT�IZED EXPENDITUR �S�3�a�a3 g Ct'��6 DcJ7 (2) I.D. Number �'� (3) Cover Period �/ 2 � / � / through /0 /�/� (4) Page �_ of �_ �5� (7) i$) �9) ��) ��) Date Full Name Purpose (Last, Suffix, First, Middle) (add office sought if �s� Street Address & contribution to a Expenditure Sequence City, State, Zip Code candidate) TYPe Amendment Amount Number /� d`� � ��►� � �. � � ��K �� ,� q� seQc�as�- �on � �� s� /o 0 9 � %�� '�`'yPP ,,,�emb� rsh�P o � .�r,,�> I � � °.s �� gd, v.s y . � 33� - � 1iP✓o ��i � 3�9�i pr-- RR+� "tt • � C:� - C'] G'� . t-� � ,'', C� � �� C'� �'i � •-� a 3 -c � F-+ c� --� � � �-- s x DS-DE 14 (Rev. 08103) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES cnvoF � �fI `"' � �^ � HOME OF PELICAN ISLAND 1225 Main Street Sebastian, Florida 32958 (772) 388-8214 phone - (772) 589-5570 fax smaio@cityofsebastian. org October 8, 2009 Mr. Edward Herlihy Chairperson Sebastian Citizens Speak Out 474 Seagrass Avenue Sebastian, FL 32958 Dear Mr. Herlihy: In accordance with Florida Statutes Section 106.07, the campaign treasurer's report for your political committee for the period September 26th through October 9t", 2009 is due in the Office of the City Clerk by 5 pm on Friday, October 16, 2009. 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 12tn through 16th, 2009. If you have any questions, please do not hesitate to contact me at 388-8214 or smaioCa�cityofsebastian.orq. Sincerely, � � �`"��4_ - .., Sally A. Maio, MMC City Clerk cc: Linda Wanser, Campaign Treasurer �f FLORIDA DEPARTMENT OF STATE DIVISIOIa1 OF ELECTIOI�S �a CAMPAIGN TREASURER'S REPORT SU�M _� � �� (� )�� 2' C Z� � f.�t.,f� U� O F F l@�l� 05�ALfi� R K Name �2) �E'� %��,� � � ��iT �. . � �1 �� A dre s(nu er and treet) � � � �-c�� `Serac City, State, Zip Code ❑ CHECK IF ADDRESS HAS CHANGED �� (3) ID Number: v� �p `f J �� (4) Check appropriate box(es): ❑ Candidate (office sought): [[�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 Q"/ � ia � r� 9 To � g l r�,�// � 9 Report Type �� [�Original ❑ Amendment ❑ Special Election Report ❑ Independent Expenditure Report (6) CONTRIBUTIONS THIS F�EPORT (7) EXPENDITURES THIS REPORT Monetary O Cash & Checks $ � Expenditures $ Loans $ � Transfers to Office � Account $ Total Monetary $ � Total Monetary $ Q In-Kind � � (8) Other Distributions � $ (9) TOTAL/JMonetary Contributions To Date (10) TOTAL Monetar� Expen�/ditures To Date W ✓ / / � � i V V W �i � / �r�.. V �J � (11) CERTIFICATION It is a first degree misdemeanor for any person to falsify a public record (ss. 839.13, F.S.) I certify that I have examined this report and it is true, I certify that I have examined this report and it is true, correct, and complete. correct, and complete. (Type name) ��%)C..'-Q � VI%n��r (Type name) �GC,�' %\� l�@ I�/� � � Individual (only for Treasurer � Deputy Treasurer � Candidate � Chairperson (only for PC, PTY 8 election ering commun.) ectione ing commun. organ'zation) Signature Signature DS-DE 12 (Rev. 08/04) '�t� �:� CAMPAIGN TREASURER'S REPORT - ITEMIZED CONTRIBUTIONS J (1) Name ��1/� �.(� ��I��i�'-S �U�2) I.D. Number�(? �� ' �J� % (3) Cover Period Q � / �O� / � % through � / / o��/ � (4) Page / of � (5) (7) (8) (9) (10) (11) (12) Date Full Name (6) (Last, Suffix, First, Middle) Sequence Street Address & Contributor Contribution In-kind Number Cit , State, Zi Code T e Occu ation T e Descri tion Am dment Amount / / __ /� ._ U � � -Q� Y � , �� -�� r '-J "� }��. - ul C7 .1 , t� L1' r� z �� _ U � ' -_ � � ._' � ewr / / yo� / / ��f / / � 0.,.�-- / / ..-- DS-DE 13 (Rev. 08/03) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES "4 p C PAI N TRE ER'S R ORT - I E�ED EXPENDITURES (1) Name ,�� Q/% �Z� c ��_'_� (2) I.D. Number o'2 � � S �� ,,,39 (3) Cover Period �/ �OZ /� through 0 � / ��J /� (4) Page � of (5) �7) i8) �9) ��) ��) Date Fuli Name Purpose �s� (Last, Suffix, First, Middle) (add office sought if Sequence Street Address 8� contribution to a Expenditure Number City, State, Zip Code candidate) TYPe Amendment Amount �.-Q .r � J � �-- a-': t.� U / _� � � ; � CJ 3 � �� - �y R.,_ � �� , ��1 � � �� . � ;�� . _i �� , DS-DE 14 (Rev. 08/03) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES CtnoF � "'�'1'�ie�,�+� �� HOME OF PELICAN ISLAND 1225 Main Street Sebastian, Florida 32958 (772) 388-8214 phone - (772) 589-5570 fax smaio@cityofsebastian. org September 25, 2009 Mr. Edward Herlihy Chairperson Sebastian Citizens Speak Out 474 Seagrass Avenue Sebastian, FL 32958 Dear Mr. Herlihy: In accordance with Florida Statutes Section 106.07, the cam�aign treasurer's report for your political committee for the period September 12th through 25t , 2009 is due in the Office of the City Clerk by 5 pm on Friday, October 2, 2009. 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 28tn through October 2"d, 2009. This letter also serves as notification to you that I have received your amended Statement of Organization of Political Committee, Appointment of Campaign Treasurer and Depository, and DS-DE 12 summary page forms in accordance with FS 106. If you have any questions, please do not hesitate to contact me at 388-8214 or smaio `tyofsebastian.org. Sinc ly, � � ��- �� Sally A. aio, MMC City Clerk cc: Linda Wanser, Campaign Ti�easurer STATEMENT OF ORGANIZATION a��'��'��r:�i o�Fic� oF c�rY c��K OF POLITICAL COMMITTEE �9 �E�� C� fl11'1 4 �3 . (PLEASE TYPE) 1. Full Name of Committee Telephone ��4 C-35 r� �3 N c cT�Z�s s�-- E: �vr � ��6� s � Mailing Address (include ciry, state and zip code) L�� S�A �fZ �55 Art9 L% tir—�3��K-�� '3��i�� Street Address (include city, state and zip code) '-� 7�! S�A G-� � 5 S � V� C i-� �� S��S`flA l-� �L �2 l S� 2. Affiliated or Connected Organizations (includes other committess of corrtinuous existence and political committees) Name of Affiliated or Connected Organization Mailing Address Relationship �n�� 3. Area, Scope and Jurisdiction of the Committee s c- r� As� �� -r� y 4. Nature of Organization or Organization's Special Interest (e.g., medical, legal, education, etc.) pn��-r �c�� Gou-� �r `t-�-c � 5. Identify by Name, Address and Position, the Custodian of Books and Accounts (include treasurer's name) Full Name Mailing Address Committee Title or Position �'�I,vt�ed� �-fc't2�� '-I?�-I S�A G-FLA'S5 A-c>� C�+A-ctZrP�cZSp t.[ 5��8 AS 'r4 l� !-� �� 3a� SB i�%l�-19'rL%"��O A�"�T t� i.1 A.A fZ wauti� 6'3 ��NCU�c�u. ✓t' � 'T e��-Q�= e 5r�3sa5�r �� '� L� 3'za s� DS-DE 5(Rev. 05/06) (continued on reverse side) 6. List by Name, Address and Position, Other Principal Officers, Including Officers and Members of the Finance Committee, If Any (include chairman's name) Full Name Mailing Address Committee Title or Position �1�1�Ac2�J �L�tZLI[.E� Ll'71-c SCAGrZ€�5 5 AV� C`N�Ct1GG[ E�- L�( SErgA�s'�`c� r-1 � FL 3zgs� 7. List by Name, Address, Office Sought and Party Affiliation Each Candidate or Other Individual that this Committee is Supporting (if none, please indicate) Full Name Mailing Address Office Sought Party p�o e�ca cvv 501 �PA� �t r� ur ct7-y ��c�� c��s�c-� �v -� R,og+�2't'tRicPARit-A�.t ��"m �Aj��ST 7'� 1r t� . � << r< < < L1SAwsrE 2o$►uSou liz�' VS 6FW5� i LS C� �� po t.[ 1�9 2tG I•E-� `T2o 1�. �I�SCtEC%C� Gc� 8. List Any Issues this Committee is Supporting: CB(f 1� U.l,. CA �� 'S' �� P}� �3 v� t�-T�� °r � t�� a ��r.,c�c,� r� � List Any Issues this Committee is Opposing: 9. If this Committee is Supportin,g the Entire Ticket of a Party, Give Name of Party � jA 10. in the Event of Dissolutton� What Disposition wili be Made of Residual Funds? � �..� C.a Pc �t'F�1 � ( C� C' �s-! `�� 1 �v�l ��- l 11. List all Banks, Safety Deposit Boxes, or Other Depositories Used for Committee Funds Name of Bank or Depository 8� Account Number Mailing Address St�Got� i � � � � 1 ? � � �o�a�� cD ��D 5��i `�-t � c� � �'L 3Z4� �° � � �� -� � 12. List all Reports Required to be Filed by this Commiitee with Federai Officials and the Names, Ac�ess� �"' ^' and Positions of Such OFficials� If Any ��' ' � Report Title Dates Required to be Filed Name & Position of Official Mailing A ss� n C3p � -�i � D � � � S � STATE OF � I.�� L(� E� ��(I L A L1 FZ l(j!�'�T COUNTY �, (_%(�1,1� ��(� H- + 4-� �� l. �� Y , certiiy that the information in this Statement of Organization is complete, true and correct. X � � 2 �� Signature of Chairman of Political Comm ee Date APPOINTMENT OF CAMPAIGN TREASURER OFFIC��I��L AND DESIGNATION OF CAMPAIGN v11'Y 4�' SE6AST�AN DEPOSITORY FOR POLITICAL 0 F F 1 C E 0 F C I T Y C l. ��t K COMMITTEES AND ELECTIONEERING COMMUNICATION ORGANIZATIONS Z� �� '� (Sectlons 106.011(1) and 106.021(1), F.S.) CHECK APPROPRWTE BOX: � Original Appointment of Treasurer � Reappointment of Treasurer � Deputy Treasurer 1. Committ e or Organization 2. Account Number 3. Telephone �e6�ia�Cr�zens spea�C' Dv�' ��17a, 38�8'�a�3 4. Name of Treasurer or Deputy Treasurer 5. Email (optional) 6. Telephone (optional) //� �i � l.� / V � N� � ( ) 7. Mailing Addres i / �e�i�o n %�r�'�e � iQ� GI .3�-9�� 8. Street Address 9. The following bank has been designated as the � Primary Depository ❑ Secondary Depository 10. Name of Bank 11. Street Address ��°sf- / ll d ��se�a� �'� 12. City 13. State 14. Zip Code ��has�-�� -. 3�.�,s� 15. ' na re of Chairman 16. Name of Chairman (Print or Type) ��varrC iy�r/�1�. Camaais�n Treasurer's Acceotance of A��ointrnent I, L/ {�� %� �!�,/� � , do hereby accept the appointment as (P ease Print or Type treasurer or deputy treasurer for �_� �� % / / t �S � CJ (,� . (Committee or Organizab UNDER PENALTIES OF PERJURY, I DECLARE THAT I HAVE READ THE FOREGOING CAMPAIGN TREASURER'S ACCEPTANCE OF APPOINTMENT AND THAT THE FACTS STATED ARE TRUE. � 9' ��/� X � �o ��c,� Date Signature of Campaign Treasurer or Deputy Treasurer DS-DE 6 (Rev. 01/08) Prin# R�SBL �, ��, D AGENT OFFICE USE ONLY �� }� PPOINTMENT c 'on 6.022, F.S.) ��3 uEP �� "fl�! � 8 �� Original Appointment � Change of Appointment �Change of Mailing Address � Change of Physical Address Registered Agent and Office Information Name Telephone ��I��r�7 �� -�t-�� °�� o�� Street Address �-[ � �SCA G-� c� 5 5 � t�� Ciry � �+� �� ` i � � State r-'"� Zip Code .3,� � � g �� J � Mailing Address S� �� City State Zip Code I accept this appointment and confirm that I am familiar with and accept the obligafions of the position as set forth in Section 106.022, F.S. I also understand that I may resign this appointment by executing a written st ent of resignation and filing it with the Division of Elections. � f �3�4� Signature of Registered Agent Date Former Registered Agent and Office Information (for changes only) Name � D � � Telephone � � � 1,� � `T - �t t3 --Y Street Address 7� �i. � c�c�C Grr�c�� c��, S��.` `� � State �� Zip Code 3�� s� Committee or Organization Information Name of Committee or Organization S�' �-r- c� v._t c c`� r� �� -tS �-'A- �C o�� Street Address Telephone �-1 " �{ SC� � �2 r.}c,� A tJ � � 7 -3� v �- � � � Ciry � C�� Y ` � � State �� Zip Code � � � „� Committee or organization is registered with: ❑ Division of Elections ❑ Counry � City r7C�J �`� � t�� Signature of Chairperson _ . L:. � i,t�si �C% �I ' HC� L ! L� y 2' � � %� � Print Name of Chairperson Date Form DS-DE 41 (revised 1/09) (1) c2� FLORIDA DEPARTMENT OF STATE DIVISION O,F,�E,�ECTIONS CAMPAIGN TREASURER'S Y � OF CITY�E�€IQ�SE ONLY Nl�._...�.��'i,.��i��I ,� �� P �� fl� � �3 r ss (nu ber and et) ---., — 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 (3) iD Number: ❑ CHECK IF PC HAS DISBANDED ❑ CHECK IF CCE HAS DISBANDED ❑ CHECK tF NO OTHER ELECTIUNEERING COMMUNtCATION REPORTS WILL BE FtLED (5) REPORT IDENTIFIERS Cover Period: From � / � / � To � / � �� Report Type . l �� ❑ Original Amendment ❑ Special Election Report ❑ Independent Expenditure Report (6) CONTRIBUTIONS THIS REPORT (7) EXPENDITURES THIS REPORT � Monetary . Cash & Checks � Expenditures $ ��.� Loans $ Total Monetary � In-Kind $ (9) TOTAL Monet ry Contributions To Date $ � Transfers to Office Account $ Total Monetary $ (8) Other Distributions $ (10) TOTAL Monetary Ex nditu es To Date $ �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, I certify that I have examined this report and it is true, correct, and complete. , correct, and complete. (Type name) ( ype name) ��ry,qi� �iv Gv�G sf�' �Indiv' ual (oniy for Treasurer ❑ Deputy Treasurer ❑ Candidate � Chairperson (only for PC. PTY 8� electio e'ng commun.) � � etectioneering cor�mun. organization) x ��,:� Si nature Signature 12 (Rev. 08104) (1) FLORIDA DEPARTMENT OF STATE DIVISION CAMPAIGN TREASURER'S REPQ�-� ,�: r ICE I�FQ'��g��NLY (2) ��m�-�• �T��.�I/i , 20Q9 SEP 1? fll'110' �'� dr ss n er and str �r�C�� G City, State, Zip Code _ ❑ CHECK IF ADDRESS HAS CHANGED (4) Check appropriate box(es): ❑ Candidate (office sought): �PoG`ical Committee �1';ommittee of Continuous Existence jJ �'arty Executive Committee ❑ Electioneering Communication (3) ID Number: ❑ CHECK IF PC HAS DISBANDED ❑ CHECK IF CCE HAS DISBANDED ❑ CHECK IF NO OTHER ELECTIOIdEERING COMMUNICATtON REPORTS WILL BE FILED (5) REPORT IDENTIFIERS Cover Period: From ( J� I� l� To �/�/ ` Report Type � I ''�+-+f- � � Original ❑ Amendment ❑ Special Election Report ❑ Independent Expenditure Report ' (6) CONTRIBUTIONS THIS REPORT (7) EXPENDITURES THIS REPORT � Monetary Cash & Checks $ �O • Expenditures $ �O� ,�p� Loans $ Total Monetary $ In-Kind $ (9) TOTAL Moneta ntributions To Date $ ��D � Transfers to Office Account $ Total Monetary ,; $ (8) Other Distributions $ (10) TOTAL Monetar Expenditures To Date $ 7 �r�. ss (11) CERTIFICATION It is a first degree misdemeanor for any person to falsify a public record (ss. 839.73, F.S.) I certify that I have examined this report and it is true, I certify that I have examined this report and it is true, correct, and complete. y _�, � correct, and complete. (only for � (Type name) Deputy Treasurer ❑ Candidate ❑ Chairperson (only for PC, PTY 8� • electioneering commun. organization) X � Signature 12 (Rev. 08/04) , (1) Name CAMPAIGN TREASURER'S REPORT — ITEMlZED Ct�NTRiBUTIpNS � .: 1 �:,.-' �� 3 Cover Period � I / through / i� 4 Pa e v of �5) (7) (8) ig) (1 �) (� � � �� 2� �e Ful! Name �6) (�ast. Suffix. Frst, Middle) SeQuence Str�et Add�e,s,s & Contributor C.artributibn IM�d Number C' State. Z� Code T Occu ' n T p�� nma,a� . q�t �! / �'�i��. �a.�- � w � llQu3 �US 1 �!�.� � � � ' � �1t,c,k� � S � c.� �� z ��S 32 � 4� y�(1�C(.l(� P . Cc.� �� 5 , C�S � . �� !: �o�,�,�� w �r��cn��r: � . ��S , I��c��;�� w 12� t�y�' � . S 5 3 , I , + � �' � �-� ,��.�, �AS . �:, ._� � �� 3 o�f. , � fl ��. -,c a � �1 �7� �� : � �� r rn x�. � _= / �C'� .!'�- GJ ? ' �� vts DS-DE 13 (Rev. 08/03) E REVERSE FnR ��.._� _ _ . .••••• � eviM3 AND CODE VALUES (1) CAMPAIGN TREASURER'S REPORT — iTEMIZED CONTRIBUTIONS , . _ �, � �� Ii �, ,,,� - 3) Cover Period / / through / /- 4 Pa e of (5) (7) (8) (9) (10} (11) (12) pate Full Name (6) (Last, Suffix. Frst. Middle) Sequen� Street Add�ess & ConVibutor Contribution IMdnd Number ' State Caie T n T � Amount , ` ,i('G1,,'11L�,1 .� ..Jr c�.> y � �-��.►�� A-S , ,� � �� > �s, � � � �m��I CIA� �I - ,3 � �� I �- $oi �c�n�t� �� 5 , �c��'V ��I � � � 5 � y �� I� ro�'�� , , � �o � �� , -,� -_ � � ��: � . . . }'� � Q T'a ... _ ..' / / � C'> mf � : ` �i � CT"i _ a . 3 � D 4 ,: � � G,� c ; Q r , ..0 � `_ � / ! DS-DE 13 (Rev. 08tQ3) SEE RE1f@RSE FOR INSTRUCTIONS AND CODE VALUES RE (1) Name`=y�� c (3) Cover Period �/�/� through POR - E ZED EXPENDITUR (2) I.D. Number • '�/�__L�1 (4) Page � of �—� (5) �7) (8) (9) (10) (11) Date Full Name Purpose �s� (Last, Suffix, First, Middle) (add office Sought if Sequence Street Address & contribution to a Expenditure Number City, State, Zip Code candidate) TYpe Amendment Amount . �.�.�`'1� C�(✓� �Q(ii �O ao v�r�� 7� 1 � � � c��c�� $a� �o b�k � 33 2 �� o �� `�``�' 3c�c� 3 t�o I �s �.� �� C� c� ��ss � ' `f � �� s ��, � � �1�'1 � � �� -� � � �� ,�^�` !-+ o -Y3 C . r . �ri 'TI < '. c� m '..' ' � -�.c��3 �•+ c� � C� � �, ( �� DS-DE 14 (Rev. 08l03) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES CffYOF ��i��, � ��' �� HOME OF PELICAN ISLAND 1225 Main Street Sebastian, Florida 32958 (772) 388-8214 phone - (772) 589-5570 fax smaio@cityofsebastian.org September 11, 2009 Don Wright Sebastian Citizens Speak Out Political Action Committee 720 North Fischer Circle Sebastian, FL 32958 Dear Mr. Wright: In accordance with Florida Statutes Section 106.07, the G-1 (46t" day) campaign treasurer's report for your committee for the period July 1, 2009 through September 11, 2009 is due in the Office of the City Clerk by 5 pm on Friday, September 18, 2009. 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 14 through18, 2009. Also I want to remind you that you are going to have to amend your original paperwork to indicate the candidates you are supporting for 2009 since your paperwork still lists 2008 candidates. If you have any questions, please do not hesitate to contact me at 388-8214 or smaioCa�citvofsebastian.orq. Sinc ly, �' � Sally A. aio, MMC City Clerk sam (1) �2� -- FLORIDA DEPARTMENT OF STATE DIVIStOj��.�OF�E�:��TIONS CAMPAIGN TREASURER'S RE� � I��iS�119l�i�� t�E OF C i e ^ . �EP ;�� R�i � �� ..��-� r ss (nu ber and t) 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 (3) ID Number:��- ❑ CHECK IF PC HAS DISBANDED ❑ CHECK IF CCE HAS DISBANDED ONLY ❑ CHECK tF NO OTHER ELECTfONEERING COMMUNICATION REP�RTS WILL BE FILED (5) REPORT IDENTIFIERS Cover Period: From � I� l� To � l,� l� Report Type 2, ❑ Original Amendment ❑ Special Election Report ❑ Independent Expenditure Report (6) CONTRIBUTIONS THIS REPORT (7) EXPENDITURES THIS REPORT Monetary . Cash & Checks $ � V '— Expenditures $ �5� Loans $ Total Monetary � In-Kind $ (9) 1`OTAL Monet�v Contri� tions To Date � �i-I��t 7 Transfers to O�ce Account $ Total Monetary $ (8) Other Distributions $ (10) TOTAL I o etar ��nditures To Date $ S� (11) CERTIFICATION It is a first degree misdemeanor for any person to falsify a public record (ss. 839.13, F.S.) 1 certify that� I have examined this report and it is true, I certify that I have examined this report and it is true, correct, and complete. correct, and complete. (Type name) (Type name) /��C�,1.,�,°! !j{% �il/�� Individ I only for Treasurer � Deputy Treasurer ❑ Candidate /� Chairperson (only for PC, PTY 8� elec �onee n commun.} � electioneering commun. organization) . X X .��/.c/ %� �� —�. --� �, S an ture Signature DS-DE �2 (Rev. 08104) FLORIDA DEPARTMENT OF STATE DIVISION OF ELECTIONS CAMPAIGN TREASURER'S REPORT SUM A_-l�,`�+�,.... :�. .f-' ;:; r F! ��1��1�� --- � (., , � Name,� ,� ,�; �� 200� Ji1L 4 P('1 2 1��, ( ) �]� ��✓(.��,,�� d ress ( mbe^ d stree �✓� .��,�� C�,lr � � City, State, Zip Code � , ❑ CHECK IF ADDRESS HAS CHANGED (3) ID Number: ;i , (4) Check appropriate box(es): ❑ Candidate (office sought): ❑ Political Committee ❑ CHECK IF PC HAS DISBANDED �ommittee of Continuous Existence ❑ CHECK IF CCE HAS DISBANDED ❑ Party Executive Committee ❑ Electioneering Cammunication ❑ CHECK IF NO OTHER ELECTIONEERING COMMUNICATION REPORTS WILL BE FILED (5) REPORT IDENTIFIERS Cover Period: From � / � /�j�j ,/ To � /�( � / � Report Type �_ �.CFa� �� ,�( Original ❑ Amendment ❑ Special Election Report ❑ Independent Expenditure Report (6) CONTRIBUTIONS THIS REPORT (7) EXPENDITURES THIS REPORT Monetary �,a Cash & Checks $ Expenditures $ �j� Loans $ Transfers to Office Account $ Total Monetary $ Total Monetary $ In-Kind $ (8) Other Distributions $ (9) TOTAL Monetary� ontr�butions To Date (10) TOTAL Moneta � ditures 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 1 have examined this report and it is true, I certify that I have examined this report and it is true, correct, and complete. correct, and complete. (Type name) l�� (Type name) � Indivi aal (only for �asurer � Deputy Treasurer � Candidate � Chairperson (only for PC, PTY 8� election ri g commun.) etectioneering commun. organization) X X S�g ature Signature DS-D 12 (Rev. 08/04) (1) Name CAMPAIGN TREASURER'S REPORT — ITEMIZED CONTRIBUTIONS (2) I.D. Number (3) Cover Period / / through / / (4) Page of (5) (7) (8) (9) (10) (11) (12) Date Fuil Name (6) (Last, Suffix, First, Middle) Sequence Street Address & Contributor Contribution In-kind Number Cit , State, Zi Code T e Occu ation T e Descri tion Amendment Amount / / / / / / , / / rv / / o� �.: co --ry c r 'T� — r� .'7 "K. m _ tfl -.� � <.. n � ` / / -D � � .... � � � . Cn � �'V � .._.; � rn � t--► x ! / / / DS-DE 13 (Rev. 08/03) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES CAMPAIGN TREASURER'S REPORT - ITEMIZED EXPENDITU ES 6�, n (1) Name (2) I.D. Number ��•� �� , � � (3) Cover Period / through / (4) Page of (5) �7) �8) �9) �10) ��) Date Full Name Purpose �s� (Last, Suffix, First, Middle) (add office sought if Sequence Street Address & contribution to a Expenditure Number City, State, Zip Code candidate) TYPe Amendment Amount �,�� %3�� . �� s,� � �� Q� � �� _. � �- �- m -� `: _ a-r,. c� -� �, , c, �, `.... ,.� ��,.W � � � ` �y n --� r - rn =- F-. � �; � � DS-DE 14 (Rev. 08/03) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES (1 �2) (4) FLORIDA DEPARTMENT OF STATE DIV,IS CAMPAIGN TREASURER'S f�FPO i c� v i �• � 1.-_�►..� .� K—��1f dr ss (nu ber and t City,-State, Zip Code ❑ CHECK IF ADDRESS HAS CHANGED Check appropriate box(es): ❑ Candidate (office sought): ICE OF GiTY�B�SE ONLY �� (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 lF NO OTHER ELECTtONEERING COMMUNICATtON REPORTS WILL BE FILED (5) REPORT IDENTIFIERS Cover Period: From � / � � / � To � / � /�� Report Type � ❑ Original �Cmendment ❑ 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 /'1 �' � r� l Monetary $ � ��J �.� (8) Other Distributions $ (9) TOTAL M netary Con�butions To Date (10) TOTAL Mong ��res To Date $ $ � (11) CERTIFICATION It is a first degree misdemeanor for any person to falsify a public record (ss. 839.13, F.S.) I certify that i have examined this report and it is true, I certify that I have examined this report and it is true, correct, and complete. � correct, and complete. (Type name) : (Type name).��,pyq �U ��`y �Indivi al oniy for Treasurer � Deputy Treasurer ❑ Candidate �Chairperson (only for PC, PTY & elec'one rin ommun.} + electioneering commun. organization) z X� ` �! '" �//�C .�i� ign ture Signature 2 (Rev. 08I04) FLORIDA DEPARTMENT OF STATE DIVISION OF ELECT.�ONS CAMPAIGN TREASURER'S REPORT. S`U (1) . �; ��, �. . .�,� � � � � � �; F i= : C � O F�Fl��LY Name �—�—T—� " T t2) -�� •�`�`''�d ��- �" ZOQ9 APR 6 fl�l 8 57 Address (nur�ber and stre t �i�,l �'`d..�,`^%�( �a/� i`' r ��'�`�� City, State, Zip Code ❑ CHECK IF ADDRESS HAS CHANGED (3) ID Number: �� -�"�� yl_ (4) Check appropriate box(es): �� ❑ Candidate (office sought): ❑ Political Committee ❑ CHECK IF PC HAS DISBANDED Committee of Continuous Existence ❑ CHECK IF CCE HAS DISBANDED Party Executive Committee ❑ Electioneering Cammunication ❑ CHECK !F NO OTHER ELECT(ONEERING COMMUNICATEON REPORTS WILL BE FILED (5) REPORT IDENTIFIERS ,_.� Cover Period: From � / � / � To � /� / � Report Type � ❑ Original ❑ Amendment ❑ Special Election Report ❑ Independent Expenditure Report (6) CONTRIBUTIONS THIS REPORT (7) EXPENDITURES THIS REPORT Monetary Cash & Checks $ Expenditures $ Loans $ Transfers to Office Account $ �`,� �-�° Total Monetary $ Total '"�� ,��`" Monetary $ In-Kind $ !`� C� (8) Other Distributions $ � (9) TOTAL Monetary Contributions To Date (10) TOTAL Monetary Ex�enditures To Date � �. � $ �-�-�� ' ��%.J $ � ��II �, • ?5 � —��, (11) CERTIFICATION It is a first degree misdemeanor for any person to falsify a public record (ss. 839.13, F.S.) I certify that I have examined this report and it is true, I certify that I have examined this report and it is true, correct, and complete. correct, and complete. (Type name) � t ai �C.f� � �� (.�� J(�' �'� (Type name) � fndividu oniy for �Treasurer ❑ Deputy Treasurer ❑ Candidate ❑ Chairperson (only for PC, PTY 8� electio eer g commun.) electioneering commun. organization) X f .fl �l �. X Sign ure Signature DS-DE (Rev.08/04) (1) Name CAMPAIGN TREASURER'S REPORT — ITEMIZED CONTRIBUTIONS (2) I.D. Number (3) Cover Period / / through / / (4) Page of (5) (�) (8) (9) (��) (��) (12) Date Full Name (6) (�ast, Suffix, First, Middle) Sequence Street Address & Contributor Contribution In-kind Number Cit , State, Zi Code T e Occu ation T e Descri tion Amendment Amount / / / / / / / / .-;, ^-i � � ;-ri o _.., i.� G7 tT ' -." m � � � � � '.. �'i -i � __ m= � ;.._ / / � / / / DS-DE 13 (Rev. 08/03) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES CAMPAIGN TREASURER'S REPORT - ITEMIZED EXPENDITURES (1) Name (2) I.D. Number (3) Cover Period / / through / / (4) Page of �5� �7) �$) �9) (��) i��) Date Fuil Name Purpose �s� (Last, Suffix, First, Middle) (add office sought if Street Address & contribution to a Expenditure Sequence City, State, Zip Code candidate) TYPe Amendment Amount Number T, T. - Ci -.. n� { -T' � , c � rn _{ �: � -< � �� > n __.�, C7O T-- .- R� ~ � � DS-DE 14 (Rev. 08/03) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES i'i (1) t2� FLORIDA DEPARTMENT OF STATE. DIVISION OF ELECTIONS .�:.m. CAMPAIGN TREASURER'S� RE�,�?RTy�I�MMARY d ess (n ber and et) 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 E OF CITY 23 Rfii 8 �5 (3) ID Number: USE ONLY ❑ CHECK IF PC HAS DISBANDED ❑ CHECK IF CCE HAS DISBANDED ❑ CHECK IF NO OTHER ELECTIONEERING COMMUNtCATI�N REPORTS WILL BE FILED (5) REPORT IDENTIFIERS Cover Period: From � /� / � To � / � / �� Report Type ❑ Original Amendment ❑ Special Election Report ❑ Independent Expenditure Report (6) CONTRIBUTIONS THIS REPORT (7) EXPENDITURES THIS REPORT Cash & Checks Loans Total Monetary In-Kind � $ � �(7 �-- �—�- $ $ � Monetary . � / ,� Expenditures $ V " Transfers to Office Account $ Total Monetary $ (8) Other Distributions $ (9) TOTAL Monetary Contributions To Date (10) TOTAL Monetary Ex enditures To Date $ �`Y 1''`J � � �� (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) �Indivi I(oniy for Treasurer Deputy Treasurer elec'one ri commun.) � X �`�1,� p rnr,n �;� (Rev. 08104) I certify that I have examined this report and it is true, correct, and complete. (Type name) �� fi(� !/"2J�/,E'l— � Candidate � Chairperson (only for PC, PTY & electioneering eommun. organization) X � , S�qnature � i�) CAMPAIGN TREASURER'S REPORT — ITEMIZED CONTRIBUTIONS D. Number ' �� (3) Cover Period / / through / / (4) Page of I (5} (7) �$) i9) ��) ��) �12) Date Full Name (6) (Last, Suffix, First, Middle) Sequence Street Address 8 Contributor Contribution In-kind Number Cit , State, Zi �Code T e Occu ation T e Descri tion Amendment Amount 1 � I i.�w��.u�en r�-1 CI� � � 3Z l �� , , , , , , , , � a �, �:; i i -� � =. r� -*� ' , w �, r:;` rFy _ � es� � ._3 � -.'{ � � � �y i w � � DS-DE '{3 (Rev. 08103} SEE REVERSE FOR lNSTRUCTlONS AND CODE VALUES I , (1) FLORIDA DEPARTMENT OF STATE DIVISION OF ELECTIONS CAMPAIGN TREASURER'S EPORT SUMMARY , ' OFFICE USE"ONtY .� Name � ' � . �, ; � ._ _ c2� ��1�; i� • �---1�1�'�� ,Il dress (n mber and s t) � y �d ti/ � YCity, State, Zip Code ❑ CHECK IF ADDRESS HAS CHANGED (4) Check appropriate box(es): ❑ Candidate (office sought): (3) ID Number: ❑ Political Committee ❑ CHECK IF PC HAS DISBANDED �� Committee of Continuous Existence ❑ CHECK IF CCE HAS DISBANDED ❑ Party Executive Committee ❑ Electioneering Communication ❑ CNECK tF NO OTHER ELECTiONEERlNG COMMUNICATION REPORTS WILL BE FILED (5) R ORT IDENTIFIERS Cover Period: From ��f�) /� / To ��,�/ �/ Report Type -{-l-f— +,f ❑ Original ❑ Amendment ❑ Special Election Report ❑ Independent Expenditure Report (6) CONTRIBUTIONS THIS REPORT (7) EXPENDITURES THIS REPORT �� Monetary Cash & Checks $ Expenditures $ � � � Loans $ Total Monetary In-Kind Transfers to Office Account $ $ Total Monetary $ $ (8) Other Distributions $ (9) TOTAL Mon tary Contributions To Date (10) TOTAL Monetary��ditures To Date $ ( �� $ � I r�� , � �.--r� �--� (11) CERTIFICATION It is a first degree misdemeanor for any person to falsify a public record (ss. 839.13, F.S.) I certify that I have examined this report and it is true, I certify that I have examined this report and it is true, correct, and complete. correct, and complete. (Type name) L r � (Type name) � Indiviy}ual (only for Treasurer Deputy Treasurer � Candidate ❑ Chairperson (only for PC, PTY & electjnneknng commun.} �_ electioneering commun. organization) X re DS-DE 12 (Rev. 08/04) X Signature CAMPAIGN TREASURER'S REPORT — ITEMIZED CONTRIBUTIONS � ' (1) Name z< a��,�w, �t ��, % ?.�==ne ��r� � �.. (2) I.D. Number�,s�Yr ` '�) � �' 1 % (3) Cover Period O�% l -� l / � � through %?Z= / � � / �� '� (4) Page � of � (5) (7) (8) (9) (10) (11) (12) Date Full Name (6) (Last, Suffix, First, Middle) Sequence Street Address & Contributor Contribution In-kind Number Cit , State, Zi Code T e Occu ation T e Descri tion Amendment Amount ,� I,CA�t.�C, �Ci,U ±Cr1� � �� L, �� 1 „ „ � ,, __,, � _� . ,, „ „ „ DS-DE 13 (Rev. 08/03) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES CAMPAIGN TREASURER'S REPORT - ITEMIZED EXPENDITURES (1} Name (2) I.D. Number (3) Cover Period / / through / / (4) Page of �5� ��) �$) �9) ��) ��) Date Full Name Purpose �s� (Last, Suffix, First, Middle) (add office sought if Street Address & contribution to a Expenditure Sequence City, State, Zip Code candidate) TYpe Amendment Amount Number __ , _..J _ ' l.�,� DS-DE 14 (Rev. 08/03) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES C(TY OF ��.��,�`s�ru'�N .� HOME QF PELICAN ISLAND 1225 Main Street Sebastian, Florida 32958 (772) 388-8214 phone - (772) 589-5570 fax January 5, 2009 Don Wright Sebastian Citizens Speak Out Political Action Committee 720 North Fischer Circle Sebastian, FL 32958 Dear Mr. Wright: Since you have decided to continue your committee following the November 2008 election, in accordance with Florida Statutes 106.07, a quarterly report for the period 10/31/08 through 12/31/08 is due to me by January 10, 2009. Typically a quarterly report would cover the entire quarter but you filed a G4 report on 10/31/08 which included activity through 10/30/08. Keep in mind that your total expenditures were $3220.00 and total contributions were $1816.83 as of the G4 report. Your quarterly report will continue from those numbers. 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. Sinc � ly, � � �_�� .�� --- Sally A. io, MMC City Cterk sam cm �-� SE� �.� �. HOME OF PELICAN ISLAND 1225 Main Street Sebastian, Florida 32958 (772) 388-8214 phone - (772) 589-5570 fax November 3, 2008 Don Wright Sebastian Citizens Speak Out Political Action Committee 720 North Fischer Circle Sebastian, FL 32958 Dear Mr. Wright: Should you choose to close out your committee following this election, in accordance with Florida Statutes 106.07, following the election a campaign treasurer's termination report (TR) must be filed with me by February 2, 2009. The TR report (blank forms enclosed) will include a summary page showing the amount of your expenditures since 10/31/08 and an equal amount of total contributions and total expenditures for the entire campaign period. It will also include an expenditure page showing all lawful expenditures in accordance with 106.11(5) and 106.141(4) (enclosed). You need not wait until February to submit the TR report. Once your funds are closed out you can bring in the completed form at any time. However, if you are planning to continue the committee as you have discussed with me, you will need to continue to file reports in accordance with FS 106. 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. Since el �, , � .� � ;, __..--� � -��---- Sally A. M io, MMC City Clerk sam Enclosures (2) (1 c2� (n FLORIDA DEPARTMENT OF STATE DIVISION OF EL�C�IONS„ CAMPAIGN TREASURER'S REPORT SL1�1AIVl��1� `: and ,- 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 � F F I O�r�Q��'c�N:.�xR K � ��P :�� Rt'1 `8 3� (3) ID Number: ,.��- ❑ CHECK IF PC HAS DISBANDED ❑ CHECK IF CCE HAS DISBANDED ❑ CHECK IF NO OTHER ELECTIONEERiNG COMMUNICATION REPORTS WILL BE FILEQ (5) REPORT IDENTIFIERS Cover Period: From � / � / � To � /�� /�� Report Type � ❑ Original �Amendment ❑ Special Election Report ❑ Independent Expenditure Report (6) CONTRIBUTIONS THIS REPORT Cash & Checks Loans Total Monetary In-Kind ' / I.� $ (7) EXPENDITURES THIS REPORT Monetary, �r� c� Expenditures $ �� Transfers to Office Account $ $ Total �� Monetary $ � �� $ (8) Other Distributions $ (9) TOTAL onetary Contributions To Date (10) TOTAL Mon t ry Exp��ures To Date $ � � $ (11) CERTIFICATION It is a first degree misdemeanor for any person to falsify a public record (ss. 839.13, F.S.) I certify that I have examined this report and it is true, I certify that I have examined this report and it is true, correct, and complete. . correct; and complete. (Type name) (Type name) � �� /I�L �/f" �Indivi (only for reasurer � Deputy Treasurer � Candidate � Chairperson (only for PC, PTY 8� elect one ri commun.) electioneering co; mun. organization) X X g t re Signature 2 (Rev. 08104) FLORIDA DEPARTMENT OF STATE DIVISION OF ELECTIONS CAMPAIGN TREASURER'S REPORT SUMMARY -, �� 71!� �,� � -V'i� ��_ j'] � ' OFFICE US�-QNLY Name � �� ; �� , �. (2) �cJ1V I �! ��1%�I�.G1,� - . ._ . . _ .�� r � '1 � � : ;� �dress (n mber and s�et) � .k��;�� i�( . 3� . City, State, Zip Code ❑ CHECK IF ADDRESS HAS CHANGED (3) ID Number: _ r (4) Check appropriate box(es): ❑ Candidate (office sought): �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 �4(�� / /� To / / Report Type r� � t'� � C�� -� a� �.�'� ❑ Original ❑ Amendment ❑ Special Election Report ❑ Independent Expenditure Report (6) CONTRIBUTIONS THIS REPORT (7) EXPENDITURES THIS REPORT L, Monetary � 4 Cash & Checks � ��,�� Expenditures $ I� �� . U� Loans ' $ Transfers to Office Account $ Total Monetary � Total .-� Monetary $ ( � � �� In-Kind $ (8) Other Distributions $ (9) TOTAL Monetary Contributions To Date (10) TOTAL Monetary Expenditures To Date $ �� ( � �v $ I � I lr� �� -� (11) CERTIFICATION It is a first degree misdemeanor for any person to falsify a public record (ss. 839.13, F.S.) I certify that I have examined this report and it is true, I certify that I have examined this report and it is true, correct, and complete. � correct, and complete. (Type name) �, I � nl�� V��'�;� (Type name) � Individua on�y for �easurer � Deputy Treasurer ❑ Candidate � Chairperson (on�y for PC, PTY & electi eeri commun.} electioneering commun. organization) X , ,� X Signa ure Signature DS-DE 1 (Rev. 08/04) � CAMPAIGN TREASURER'S REPORT -1TEMIZED CONTRtBUTIONS � � (1) Name e . ,� � [�� (2) 1 D. Number ? ' � 3) Cover Period ��✓ / / through / (4) Page r of (5} i7) �$) �9) ��) �� 12) Date Full Name (6) (Last, Suffix, First, Middle) Sequence Street Address & Contributor Contribution In-kind Number Ci . State, 2� Code T e Occu ation T Descri tion ��"� Amount � , ��./c�� ; Y ^ � C �� 5� .� 1 i I �et�.c� � �-� �Tr��.1 �-� � � ' � ��.t��n 2�� ac� � � � � i r'�r' G I 1 nii �� ),I� � ,�� 5 ,1 � � ►, , � ��/�e� �-I�.,�rl�..�1�J . � � y� ��,r�� ,?�c�fi.� K�,�? : � L� S��tt �� .�nn i� ( �� L��nt ►�n� I 12� �5 �t�,u�� ( I � � � DS-DE 13 (Rev. 08/03) � u��;�-t _ N. �-��v�C i��. .� �� m .� � �n. �� cN� � � �� _ �� SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES 2� � :_ 1�(.� `_' _.� � �� -- � _ ��1i�U _, : - �;� _ � CAMPAIGN TREASURER'S REPORT - iTEMIZED CONTRIBUTIONS (1) Name��,L�T .��1Y� l�a �l�ol��L�l.��1�1 �� (2) 1-D. Number �� J� � (3} Cover Period 1� through , / / 4 Pa e of � i5) i7) �8) �9) i��) ��) �12) Date Fuli Name (6) (Last, Suffix, First, Middte) Sequence Street Address � Contributor Contribution In-kind Number Ci , State. Zi Code T e Occu ation T Descri 6on �^��t Amount � I � �� 1 -, � ll�- ��G; ;nr� �' i�.�� r�� C�� 3 � �.n Gt� ZC�� °I .� I , �.u�� . � 1 �,��; 1� l� N ��i��, � {�� Z�� — ^ /��/�� 4 , � 1 ��S �Zc� -- � � I�SI �cker�s Il� , �,� �h-n�� t��c,�;� � 32zs ��11 1 �� I�t�� cx� _ la ��n , , �,�,nl��c �. - �.�; .� r �� . �u� ✓ C� Lfi� � �� ' i'YIC��Ic� � fi ��1 , , � .> � � _ � , ��-. _ : r..--a - r .....: / % DS-DE 13 (Rev. 08/03) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES , CAMP IGN TR � SURER'S RE RT - i EMIZE EXPENDITURES (1) Name ��'CD. Number (3) Cover Period 1 1 //�/ rough �/ � (4) Page �_ of 6� —�v (5) �7) �$) �9) ��) ��) Date Full Name Purpose �s� (Last, Suffix, First, Middle) (add office sought if Sequence Street Address & contribution to a Expenditure Number City, State, Zip Code candidate) TYPe Amendment Amount � I S��u.n-ir c4�� c � - � � I�I�� >� f, f-'�' , _ , i _. �.J - 1 � ',�rA DS-DE 14 (Rev. 08/03) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES CfiY OF ��4� ��,,� � �.�.�'_'�I HOME OF PELICAN ISLAND 1225 Main Street Sebastiar, Florida 32958 {772) 388-8214 phone - (772) 589-5570 fax October 29, 2008 Don Wright Sebastian Citizens Speak Out Political Action Committee 720 North Fischer Circle Sebastian, FL 32958 Dear Mr. Wright: This letter is sent at your request and in response to your question as to whether your committee could continue after the election and the process by which you would do so. Because I have not dealt with the question of continuation of committees in the past, I contacted the State of Florida Division of Elections. Because yours is a local committee which deals only with City of Sebastian issues, under Florida law, you are required to submit your committee forms to the City Clerk as filing officer. The City Charter states that the City follows Florida election laws in all areas not covered by our Charter. The response I received from one of the Elections Division staff members today was that a political committee can remain in effect for as long as it chooses and would continue to file campaign treasurer reports as long as it remains in effect. The committee would not file a termination report (TR) until there was a decision to finally close out the committee. When I asked about the form your committee filed with me listing specific 2008 candidates it was supporting, his first response was that that section did not need to be filled in, but then when I stated you already had candidates' names listed for 2008 he said an amended page could be filed and that section can be listed as "to be determined". In accordance with the Division's response, you will be required to file a G4 report on Friday, October 31, 2008, and as long as the committee continues, you must file reports by the 10t" of the month following each calendar quarter until we get to the 46th da�r prior to the next annual election, at which time you will file reports on the 46t 32�a 18tn and 4t" days prior to the election. That process would be followed until you choose to close out the committee and then a termination report would be filed. Don Wright Sebastian Citizens Speak Out Political Action Committee Page Two As to the question of whether you are obligated to register your committee with the State of Florida, I have been told by them that you do, but as you stated to me, two phone calls from your committee to the State Division of Elections resulted in you being told you do not. I suggest you call again, ask the question again, and get the name of the staff member for your records. Please always keep in mind, these are State laws, and while I have some responsibilities under Florida Statutes, it is your responsibility to understand provisions of FS 106 as they relate to committees. Final determination of alleged violations of election laws lies with the State of Florida Elections Commission. If you have any questions, please do not hesitate to contact me at 388-8214 or e- mail me at smaio@cityofsebastian.org. Sincer_ely, �i � i/j � _ _(,�,�� ' I .�-- `�__ ; �� c � Sally A. M �o, MMC City Clerk sam cc: Interim City Attorney City Manager cm �� SE��T�'�N HOME OF PELICAN ISLAND 1225 Main Street Sebastian. Florida 32958 (772) 388-8214 phone - (772) 589-5570 fax October 20, 2�008 Don Wright Sebastian Citizens Speak Out Political Action Committee 720 North Fischer Circle Sebastian, FL 32958 Dear Mr. Wright: In accordance with Florida Statutes Section 106.07, the campaign treasurer's report for your political action comittee for the period October 11, 2008 through October 30, 2008 is due in the Office of the City Clerk no later than 5 pm on Friday, October 31, 2008 (G4). No further contributions can be accepted after midnight on Thursday, October 30, 2008. Any report postmarked by the United States Postal Service no later than midnight of the due date, shall be deemed to have been submitted in a timely manner. Please read FS 106.07(2)(a) for further details. Please familiarize yourself at this time as to proper disbursement of remaining funds in accordance with FS 106. A termination report (TR) will be due once all funds are disbursed properly. The TR report submittal deadline is February 2, 2009. If you have any questions, please do not hesitate to contact me at 388-8214 or e- mail me at smaio@cityofsebastian.org. Sinc�.r-ely, �� ; �) � — Sally A. aio, MMC City Clerk sam , —� y / G z- 7 /�'�'�'T `'�'�"�°-- ��, ; /` �"�',�� --/ WAIVER OF REPORT (Section 106.07(7), F.S.) (PLEASE TYPE) Can�idate's Name (Last, 3dffix, First, MPddle) OR Political Committee, CCE or Party Name �,�c� 1�< �[S�I��' Address (Number and Street) � 1G�j� �� ' 3a-I�� Cit�r State Zip Code � Candidate � Committee of Continuous F�cistence OFFICE USE ONLY _ � . ``i 'v �._ .__ � , �`, _ , __ \ . �. � ( i f `=t j � � �. s� �� l�l�� -3��` Identification Number (Assigned by Division of Elections) Office Sought (Include District, Circuit or Group Number) � Chedc box if address has changed since last report. �j Political Committee � Party F�cecufive Committee � Chedc here if PC or CCE has DISBANDED �4 and will no longer file reports. TYPE OF REPORT (Check Appropriate Box) QUARTERLY REPORTS ❑ January ❑ April ❑ July ❑ October PRIMARY ELECTION ❑ 32nd day prior ❑ 18th day prior ❑ 4th day prior GENERAL ELECTION ❑ 46th day prior ❑ 32nd day prior � 18th day prior ❑ 4th day prior � TERMINATION REPORT � SPECIAL ELECTION NOTIFICATION OF O ACTIVITY IN CAMPAIGN ACCOUNT FOR THE REPORTING PERIOD OF I through c�� ' I� � I l� �«�S —�— Signature Date SIGNATURES REQUIRED FOR: Candidates Candidate, Campaign Treasurer or Deputy Treasurer (s. 106.07(5), F.S.) Political Committees Chairman, Campaign Treasurer or Deputy Treasurer (s. 106.07(5), F.S.) Committees of Continuous Existence Treasurer (s. 106.04(4)(c), F.S.) Party Executive Committees Treasurer or Chairman (s. 106.29(2), F.S.) In any reporting period when there has been no activiry 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 fited. DS-0E 87 (Rev. 08/03) STATEMENT OF ORGANIZATION oFFICE USE ONLY OF POLITICAL COMMITTEE " v' j�`' �- -'"' '�::;; �: ; �.� �f� � 1 13 (PLEASE TYPE) 1. Full Name of Committee Telephone � i1d� C�il �� C� c�- �a Mailing Address (include city, state and zip code) � �l �� N � ��k�,� Cc,�' � fi��'1 � . ��g Street Address (include city, state and zip code) � �,,� 1 `�—" 2. Affiliated or Connected Organizations (includes other committees of continuous existence and political committees) Name of Affiliated or Connected Organization Mailing Address Relationship nv� 3. Area, Scope and Jurisdiction of the Committee c�?�,�-�1��1 �1�.. 4. Nature of Organization or Organizati n'sSpecial Interest (e.g., medical, legal, education, etc.) t,��; .� ec��,��C 5. Identify by Name, Address and Position, the Custodian of Books and Accounts (include treasurer's name) Full Narpe Mailing Address Committee Title or Position (��Iti�` 7o�c�N. ��.I�.�Ci,�� . c�le �� i � • � ��.�:r� �� /1��) � � �,��1� 1 �� , �� DS-DE 5(Rev. 05/O6) (continued on reverse side) 6. List by Name, Address and Position, Other Principal Officers, Including Officers and Members of the Finance Committee, If Any (include chairman's name) Full Name Mailing Address Committee Title or Position t� � � �ac� � �I�'C��' c�:.�x'm� � 7. List by Name, Address, Office Sought and Party Affiliation Each Candidate or Other Individual that this Committee is Supporting (if none, please indicate) Full Name Mailing Address Of�ce Sought Party ` ��..�, �yt� 1'7`'c lJ�c./V� , ��• li� , �� n� A- 8. List Any Issues this Committee is Supporting: ��,��,%t �� p'� e�{�j -�� I� w� ��.. List Any Issues this Committee is Opposing: (��"d,�� (�� '�� 9. If this Committee is Supporting the Entire Ticket of a Party, Give Name of Party ( 7 � 10. In the Event of Dissolution, What Disposltion will De Made of Residual Funds? (�.tf I 11. List all Banks, Safety Deposit Boxes� or Other Deposltories Used for Committee Funds Name of Bank or Depository � Account Number Mailing Address ��'�=� �l ��c��.� ��1 � �- -: �s �_� _. « :_, 12. List all Reports Required to be Filed by this Commlttee wlth Federal Offlcials and the Names, �4ddresses and Positlons of Such Officials� ff Any ° �' � Report Title Dates Required to be Filed Name 8� Position of Official Mailing dress ' �-+ c-� r.-� - i 1-• - � STATE OF COUNTY I, , certify that the information in this Statement of Organization is complete, true and correct. X _ G��/�c��4 c� Signature of Chai an of Political Committee -� Date APPOINTMENT OF CAMPAIGN TREASURER AND DESIGNATION OF CAMPAIGN DEPOSITORY FOR POLITICAL COMMITTEES AND ELECTIONEERING COMMUNICATION ORGANIZATIONS (Sections 106.011(1) and 106.021(1), F.S.) OFFICE USE ONLY ,; _ ,. '�i i `T �;_�,;;. . :" ��. 10 �;�i 1� I� CHECK APPROPRIATE BOX: � � Original Appointment of Treasurer ❑ Reappointment of Treasurer 1. Committee or Organization 2. Account Number ��'.�.�STj?'N C�iI i1 ��'er.,� ��/� Q �� 4. Name of Treasurer or Deputy Treasurer 5. Email (optional) 7. Mailing Address 8. Street Address 9. The following bank has been designated as the 10. Name of Bank � 12. City � 15. Sianature of Chairman � Primary Depository 11. Street Address 13. State � Deputy Treasurer 3. Telephone c 7�2� yi3 �- y 7� a 6. Telephone (optionai) �-��a� s��-z��.� � Secondary Depository 14. Zip Code 16. Name of Chairman (Print or Type) /c�l�/1J.�-� � 1L� L%U.�/6 Camaais�n Treasurer's Acce�tance of Aaaointment I, �.!� 1�11 s_.�`1 � v , do hereby accept the appointment as treasurer or depury treasurer for UNDER PENALTIES OF PERJURY, I DECLARE THAT I HAVE READ THE FOREGOING CAMPAIGN TREASURER'S ACCEPTANCE OF APPOINTMENT AND TFjAT THE FACTS STATED ARE TRUE. /� ` . �� ? a� �' DS-DE 6 (Rev. 01/08) or Deputy rer Prin# Reset REGISTERED AGENT OFFICrE USE ONLY STATEMENT OF APPOINTMENT - �� 4 � � '; c �.._;;;; (Section 106.022, F.S.) . ,.. : i; :; i �. � �!'i 1 � �, `� (Please Type) � Original Appointment � Change of Appointment Registered Agent and Office Information Name Telephone n:,ac,� �% l - y " a Street Addres � � � g Ciry � � �� State�� Zip �C�Od�e' SS � , Mailing Address Ciry State Zip Code I accept this appointment and confirm that I am familiar with and accept the obligations of the position as set forth in Section 106.022, F.S. I also understand that I may resign this appointment by executing a written statement of resignation and filing it with the Division of Elections. F�J 1��`"" 1D�1 ��o� Signa ure of Registered Agent Date Former Registered Agent and Office Information (for changes only) Telephone < � o � � 7 .3' � Street Address . City Stat� Zip Cod� Committee or Organization Information Name of Committee or Organization „ �' � ��..y s� � f�� /- Street Address �, Telephone CU /U !✓ c��if� �C�` G 7� —!'i3 ' `� 7 � � City State �, Zip Code � � �� Committee or organization is registered with: ❑ Division of Elections ❑ County � City S�i�i��Ti�lr1 � � �'" Signature of Chairperson ��o G�J ��.�/,.P��.�T" �D/ .� �d � Print Name of Chairperson Date Form DS-DE 41 (revised 12/05)