CAMPAIGN TREASURER'S REPORT SUMMARY. (5) Report Identifiers. (7) Expenditures This Report. Monetary Expenditures $ , I

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1 (1) RYAN MATTHEW DONOVAN,-J Name 1487 E 1st Avenue CAMPAGN TREASURER'S REPORT SUMMARY OFFCE USE ONLY Address (number and street) P0 1 : 0 6 N City, State, Zip Code D Check here if address has changed (3) D Number: (4) Check appropriate box(es): ~Candidate Office Sought: Cit~ Council District 1 D Political Committee (PC) D Electioneering Communications Org. (ECO) D Party Executive Committee (PTY) D ndependent Expenditure (E) (also covers an individual making electioneering communications) D Check here if PC or ECO has disbanded D Check here if PTY has disbanded D Check here if no other E or EC reports will be filed (5) Report dentifiers Cover Period: From To Report Type: TR ~Original DAmendment D Special Election Report (6) Contributions This Report.Ash & Checks $ -0- Loans $ -0- -'-' -- Total Monetary $-0-, n-kind $ (9) TOTAL Monetary Contributions To Date $ 1,925.00, -- (7) Expenditures This Report Monetary Expenditures $ , Transfers to Office Account $ -0-,, Total Monetary $ (8) Other Distributions $ ' (10) TOTAL Monetary Expenditures To Date $ 1,925.00,, - (11) Certification t is a first degree misdemeanor for any person to falsify a public record (ss , F.S.) certify that have examined this report and it is true, correct, andcomplete: (Type name) Rozann Abato (Type name) Ryan Matthew Donovan ~ -7,;/ao- D ndividual (only for E.BfTreasurer D Deputy Treasurer &'6andidate O Chairperson (only for PC and PTY) or electioneering comm.) ~c:ll«5lo DS-DE 12 (Rev. 11/13) SEE REVERSE FOR NSTRUCTONS

2 CAMPAGN TREASURER'S REPORT - TEMZED CONTRBUTONS (1) Name RYAN MATTHEW DONOVAN (2).D. Number 1) Cover Period 10 / 30 / 15 through~1~1-~/ 13 / 15 (4) Page 1 of ---'--- 1 (5) Date (6) Sequence Number (7) Full Name (Last, Suffix, First, Middle) Street Address & City, State, Zip Code Type (8) (9) (10) (11) (12) Contributor Occupation Contribution Type n-kind Descriotion Amendment Amount DS-DE 13 (Rev. 11/13) SEE REVERSE FOR NSTRUCTONS AND CODE VALUES

3 CAMPAGN TREASURER'S REPORT - TEMZED EXPENDTURES (1) Name RYAN MATTHEW DONOVAN (2).D. Number,J)CoverPeriod 10 /_JQ/_15~_through 11 /_jl_/_15_ (4) Page_... 1 of 1 (5) (7) (8) (9) (10) (11) Date Full Name Purpose (6) {Last, Suffix, First, Middle) (add office sought if Expenditure Sequence Street Address & contribution to a Number City, State, Zip Code candidate) Type Amendment Amount 10/31/15 Google AdWords Dept No nternet Service CAN PO Box TR 1 San Francisco, CA /15 TR 2 11/13As TR 3 Google AdWords Dept No nternet Service CAN PO Box San Francisco, CA Patriot Cruise and Salute, nc Grist Mill Woods Court 501 (c)(3) DS Alexandria, VA organization OS-DE 14 (Rev.11/13) SEE REVERSE FOR NSTRUCTONS AND CODE VALUES

4 CAMPAGN TREASURER'S REPORT SUMMARY (1) RYAN MATTHEW DONOVAN (4) Name 1487 E 1 51 Avenue Address (number and street) City, State, Zip Code D Check here if address has changed Check appropriate box(es): (3) D Number: OFFCE USE ONLY PO l: 4 9 N gj Candidate Office Sought: -=C::..:i~tyi...::Cc.:o:...::u:..:..n:..:c:..:..il:...:D=is:..:t:...:ri.:.c.:..t_,_1 D Political Committee (PC) D Electioneering Communications Org. (ECO) D Party Executive Committee (PTY) D ndependent Expenditure (E) (also covers an individual making electioneering communications) D Check here if PC or ECO has disbanded D Check here if PTY has disbanded D Check here if no other E or EC reports will be filed (5) Report dentifiers Cover Period: From 10 / 17 / 15 To 10 / Report Type: G4 ~Original 0Amendment D Special Election Report (6) Contributions This Report sh & Checks $_--=-0--,, Loans $ _,_, -0- Total Monetary $-0- n-kind $-0- (9) TOTAL Monetary Contributions To Date $ 1, (7) Expenditures This Report Monetary Expenditures Transfers to $ ,, Office Account $ -0-,, Total Monetary $ (8) Other Distributions $ ~., (10) TOTAL Monetary Expenditures To Date $ (11) Certification t is a first degree misdemeanor for any person to falsify a public record (ss , F.S.) certify that have examined this report and it is true, correct, and complete: (Type name) Rozann Abato (Type name) Ryan Matthew Donovan O ndividual (only for E (la Treasurer O Deputy Treasurer!X Candidate O Chairperson (only for PC and PTY) or electioneering comm.) DS-DE 12 (Rev. 11/13) SEE REVERSE FOR NSTRUCTONS

5 CAMPAGN TREASURER'S REPORT - TEMZED CONTRBUTONS (1) Name RYAN MATTHEW DONOVAN (2) 1.0. Number '3)CoverPeriod 10 / 17 / 15 through,_1=-0,/ 29 / 15 (4) Page 1 of --'1 (5) (7) (8) (9) (10) (11) (12) Date Full Name (6) (Last, Suffix, First, Middle) Sequence Street Address & Contributor Contribution n-kind Number City, State, Zip Code Type Occupation Tvoe Description Amendment Amount P0 1:5 b N DS-DE 13 (Rev. 11 /13) SEE REVERSE FOR NSTRUCTONS AND CODE VALUES

6 CAMPAGN TREASURER'S REPORT - TEMZED EXPENDTURES (1) Name RYAN MATTHEW DONOVAN (2).D. Number ,) Cover Period 10 /_1_7_/_15_through 10 /--1]_/_15_ (4) Page_~1 of 1 (5) (7) (8) (9) (10) (11) Date Full Name Purpose (6) (Last, Suffix, First, Middle) (add office sought if Expenditure Sequence Street Address & contribution to a Number City, State, Zip Code candidate) Type Amendment Amount 10 / 28/ 15 ntegrity Bulk Mail Service Mailing service CAN Lake Center Drive #5 G 4 1 ) ::i o 1 : 5o N DS-DE 14 (Rev. 11 /13) SEE REVERSE FOR NSTRUCTONS AND CODE VALUES

7 CAMPAGN TREASURER'S REPORT SUMMARY (1) RYAN MATTHEW DONOVAN OFFCE USE ONLY Name 1487 E 1st Avenue Address (number and street) City, State, Zip Code D Check here if address has changed (3) D Number: (4) Check appropriate box(es): P03 :38 N 18] Candidate Office Sought: Cit~ Council District 1 D Political Committee (PC) D Electioneering Communications Org. (ECO) D Check here if PC or ECO has disbanded D Party Executive Committee (PTY) D Check here if PTY has disbanded D ndependent Expenditure (E) (also covers an individual making electioneering communications) D Check here if no other E or EC reports will be filed (5) Report dentifiers Cover Period: From To OOriginal ~Amendment D Special Election Report Report Type: G3 (6) Contributions This Report.sh & Checks $ ' (7) Expenditures This Report Monetary Expenditures $ '- Loans $_, -- Total Monetary $ -- ' -- ' n-kind $ -- ' -- ' Transfers to Office Account $ ' Total Monetary $ ' - - '-- (8) Other Distributions $ -0- ' (9) TOTAL Monetary Contributions To Date $ 1, ' ' (10) TOTAL Monetary Expenditures To Date -- $1,562.92, ' -- (11) Certification t is a first degree misdemeanor for any person to falsify a public record (ss , F.S.) certify that have examined this report and it is true, correct, and complete: (Type name) Rozann Abato O ndividual (only for E ~ Treasurer O Deputy Treasurer X~ &b/c or electioneering comm.) {]tay~ Signature (- DS-DE 12 (Rev. 11/13) (Type name) Ryan Matthew Donovan 81 Candidate D Chairperson (only for PC and PTY) iii!;~~ SEE REVERSE FOR NSTRUCTONS

8 CAMPAGN TREASURER'S REPORT - TEMZED ~(?~j-~lr~blfns (1) Name RYAN MATTHEW DONOVAN (2).D. Number '3) Cover Period 1 O / 3 / 15 through.,,1.,,, 0,/ 16 / 15 (4) Page 1 of '1-~ (5) (7) (8) (9) (10) (11) (12) Date Full Name (6) (Last, Suffix, First, Middle) Sequence Street Address & Contributor Contribution n-kind Number City, State, Zip Code Type Occupation Type Description Amendment Amount / 15 Professional Firefighters of Mt. Dora Local Firefighters CHE $ G 3 1 PO Box 286 Mount Dora, FL / 15 / 15 Debi Harbin 1439 E ih Ave. Professional CHE $ G 3 2 Photographer OS-DE 13 (Rev.11/13) SEE REVERSE FOR NSTRUCTONS AND CODE VALUES

9 P0 3:38 CAMPAGN TREASURER'S REPORT - TEMZED EXPENDTURES (1) Name RYAN MATTHEW DONOVAN (2).D. Number ;) Cover Period 10 /_3_/_15_through 10 /_16_/_15_ (4) Page_...;.1 of 1 (5) (7) (8) (9) (10) (11) Date Full Name Purpose (6) (Last, Suffix, First, Middle) (add office sought if Sequence Street Address & contribution to a Expenditure Number City, State, Zip Code candidate) Type Amendment Amount 10 / 9/15 A Sign Company Yard signs & stands CAN Old Hwy 441 G 3 1 Tavares, FL /14 /15 G 3 2 Sharp Design 1125 Robie Avenue Campaign sign CAN Mt. Dora, FL /15 /15 G 3 3 Leigh Smith 1760 Edgewater Dr. Postcard design CAN /16/15 G 3 4 Office Depot US Hwy 441 Printing CAN /16/15 GRAVS 910 Belle Ave., Ste 1180 Political Phone Calls CAN Winter Springs, FL G 3 5 ' OS-DE 14 (Rev.11/13) SEE REVERSE FOR NSTRUCTONS AND CODE VALUES

10 CAMPAGN TREASURER'S REPORT SUMMARY (1) RYAN MATTHEW DONOVAN OFFCE USE ONLY Name 1487 E 1st Avenue Address (number and street) City, State, Zip Code D Check here if address has changed (3) D Number: (4) Check appropriate box(es): P0 2 :57 N [81 Candidate Office Sought: Cit~ Council District 1 D Political Committee (PC) D Electioneering Communications Org. (ECO) D Check here if PC or ECO has disbanded D Party Executive Committee (PTY) D Check here if PTY has disbanded D ndependent Expenditure (E) (also covers an D Check here if no other E or EC reports will be filed individual making electioneering communications) (5) Report dentifiers Cover Period : From To Report Type: G UOriginal 0Amendment D Special Election Report (6) Contributions This Report sh & Checks $ Loans $_, -- Total Monetary $ -- ' -- ' n-kind $ -- ' -- ' (9) TOTAL Monetary Contributions To Date $ 1,925.00, ' ' ' -- (7) Expenditures This Report Monetary Expenditures $ Transfers to Office Account $ -0-, Total Monetary $ '-- ' -- (8) Other Distributions $ ' (10) TOTAL Monetary Expenditures To Date $ , - ' ' ' (11) Certification t is a first degree misdemeanor for any person to falsify a public record (ss , F.S.) certify that have examined this report and it is true, correct, and complete: (Type name) Rozann Abato O ndividual(only for E igj_treasurer D Deputy Treasurer or electioneering comm.) CdoSL6 ~~ DS-DE 12 (Rev. 11/13) (Type name) Ryan Matthew Donovan D!;l.Candidate D Chairperson (only for PC and PTY) ~ ci~ SEE REVERSE FOR NSTRUCTONS

11 CAMPAGN TREASURER'S REPORT - TEMZED CONTRBUTONS (1) Name RYAN MATTHEW DONOVAN (2) 1.0. Number <3) Cover Period 10 / 3 / 15 through.-----'-1.:::...0,/ 16 / 15 (4) Page 1 of '-- (5) Date (6) Sequence Number (7) Full Name (Last, Suffix, First, Middle) Street Address & City, State, Zip Code (8) Contributor Type Occupation (9) Contribution Type (10) n-kind Description (11) Amendment (12) Amount / 15 G 3 1 Professional Firefighters of Mt. Dora Local 3088 PO Box 286 Mount Dora, FL B Firefighters CHE $ / G / 15 Debi Harbin ~39 E ih Ave. Professional Photographer CHE $ OS-DE 13 (Rev. 11/13) SEE REVERSE FOR NSTRUCTONS AND CODE VALUES

12 CAMPAGN TREASURER'S REPORT - TEMZED EXPENDTURES (1) Name RYAN MATTHEW DONOVAN (2) 1.0. Number J) Cover Period 10 /_ 3_ /_15_through 10 /_16_ /_ 15_ (4) Page 1 of 1 (5) (7) (8) (9) (10) (11) Date Full Name Purpose (6) (Last, Suffix, First, Middle) (add office sought if Expenditure Sequence Street Address & contribution to a Number City, State, Zip Code candidate) Type Amendment Amount 10 / 9 / 15 A Sign Company Yard signs & stands CAN Old Hwy 441 G 3 1 Tavares, FL / 14 / 15 Sharp Design 1125 Robie Avenue Campaign sign CAN Mt. Dora, FL G /15 / 15 Leigh Smith 1760 Edgewater Dr. Postcard design CAN G /15/ 15 Office Depot US Hwy 441 Printing CAN G 3 4 DS-DE 14 (Rev. 11/13) SEE REVERSE FOR NSTRUCTONS AND CODE VALUES

13 CAMPAGN TREASURER'S REPORT SUMMARY.. ' RYAN MATTHEW DONOVAN OFFCE USE ONLY (2) Name 1487 E 1 51 Avenue Address (number and street) City, State, Zip Code D Check here if address has changed (3) D Number: (4) Check appropriate box(es): 5(1 Candidate Office Sought: Cit~ Council District 1 D Political Committee (PC) D Electioneering Communications Org. (ECO) D Party Executive Committee (PTY) D ndependent Expenditure (E) (also covers an individual making electioneering communications) PO 1: 27 N D Check here if PC or ECO has disbanded D Check here if PTY has disbanded D Check here if no other E or EC reports will be filed (5) Report dentifiers Cover Period: From To ~Original 0Amendment D Special Election Report Report Type: G2 (6) Contributions This Report vash & Checks $ 1 000,_. -- Loans $_, -- Total Monetary $ n-kind $ (9) TOTAL Monetary Contributions To Date $ (7) Expenditures This Report Monetary Expenditures $ Transfers to Office Account $ Total Monetary $ (8) Other Distributions $, -0- (10) TOTAL Monetary Expenditures To Date $ , (11) Certification t is a first degree misdemeanor for any person to falsify a public record (ss , F.S.) certify that have examined this report and it is true, correct, and complete: (Type name) Rozann Abato (Type name) Ryan Matthew Donovan O ndividual (only for E [8"Treasurer O Deputy Treasurer 181 Candidate D Chairperson (only for PC and PTY) or electioneering comm.) X ~_,./:; 6t'- Signature./ ( ) DS-DE 12 (Rev. 11/13) SEE REVERSE FOR NSTRUCTONS

14 CAMPAGN TREASURER'S REPORT - TEMZED CONTRBUTONS (1) Name RYAN MATTHEW DONOVAN (2).D. Number ) Cover Period 9 /_1./ 15 through.,_1""'-0 J/ 2 / 15 (4) Page 1 of --=2, (5) (7) (8) (9) (10) (11) Date Full Name (12) (6) (Last, Suffix, First, Middle) Sequence Street Address & Contributor Contribution n-kind Number City, State, Zip Code Type Occupation Tvpe Description Amendment Amount Dunkel, Richard C. 636 N. Tremain CHE N G / 15 Custom Realty Services, B Real Estate nc. Brokerage CHE N G E 1st Ave / 15 GC Development of Lake B County Real Estate CHE N G 2 3 PO Box 1273 Developer Mount Dora, FL i 9 18 / 15 Renee Milota 1701 Lakeshore Dr. Retired CHE N G /15 Maureen Donovan 69 Zieglers Lane CHE N G 2 5 Hamilton Square, NJ / 15 Grandview Bed & Breakfast B Bed & CHE N G E 3rd Avenue Breakfast 9 24 /15 Michael Berube 737 E 11th Avenue CAS N G 2 7 '">S-DE 13 (Rev.11/13) SEE REVERSE FOR NSTRUCTONS AND CODE VALUES

15 CAMPAGN TREASURER'S REPORT - TEMZED CONTRBUTONS (1) Name RYAN MATTHEW DONOVAN (2).D. Number,) Cover Period 9 /_1., / 15 through.,_1.:::...0 / 2 / 15 (4) Page 2 of --=2'--- (5) Date (7) Full Name (8) (9) (10) (11) (12) (6) Sequence Number (Last, Suffix, First, Middle) Street Address & City, State, Zip Code Contributor Type Occupation Contribution Tvoe n-kind Description Amendment Amount 9 22 G Calvin & Shirley Rolfson 8014 St. James Way CHE N / 30 G 2 9 / 15 Uohn & Bonnie Koester 6031 Spring Creek Court CHE N S-DE 13 (Rev.11/13) SEE REVERSE FOR NSTRUCTONS AND CODE VALUES

16 CAMPAGN TREASURER'S REPORT - TEMZED EXPENDTURES 1 ) Name RYAN MATTHEW DONOVAN (2).D. Number (3) Cover Period 9 / /_15_through 10 /_2 /_15_ (4) Page 1 of 1 (5) (7) (8) (9) (10) (11) Date Full Name Purpose (6) (Last, Suffix, First, Middle) (add office sought if Expenditure Sequence Street Address & contribution to a Number City, State, Zip Code candidate) Type Amendment Amount 9 /14 / 15 Office Depot US Hwy 441 Photocopies CAN G 2 1 DS-DE 14 (Rev. 11/13) SEE REVERSE FOR NSTRUCTONS AND CODE VALUES

17 CAMPAGN TREASURER'S REPORT SUMMARY ) RYAN MATTHEW DONOVAN OFFCE USE ONLY Name (2) 1487 E 1st Avenue Address (number and street) City, State, Zip Code D Check here if address has changed (3) D Number: (4) Check appropriate box(es): 0 Candidate Office Sought: City Council District 1 D Political Committee (PC) D Electioneering Communications Org. (ECO) D Party Executive Committee (PTY) D ndependent Expenditure (E) (also covers an individual making electioneering communications) PO 2 : 11 N D Check here if PC or ECO has disbanded D Check here if PTY has disbanded D Check here if no other E or EC reports will be filed - (5) Report dentifiers Cover Period: From 8/4/115 To 8/31115 Report Type: G Original 0Amendment D Special Election Report (6) Contributions This Report Cash & Checks $425., Loans $ Total Monetary $ n-kind $ (9) TOTAL Monetary Contributions To Date $ , (7) Expenditures This Report Monetary Expenditures $ 61.1, Transfers to Office Account $ Total Monetary $ '-- -- (8) Other Distributions $ (10) TOTAL Monetary Expenditures To Date $ (11) Certification t is a first degree misdemeanor for any person to falsify a public record (ss , F.S.) certify that have examined this report and it is true, correct, and complete: (Type name) Rozann Abato (Type name) Ryan M. Donovan 0 ndividual (only for E 0 Treasurer D Deputy Treasurer 0 Candidate D Chairperson (only for PC and PTY) or electioneering comm.) X/ / / ~~Uu Uba<la Signature ' / } ~ /~a~ DS-DE 12 (Rev. 11/13) SEE REVERSE FOR NSTRUCTONS

18 CAMPAGN TREASURER'S REPORT-TEMZED CONTRBUTONS RYAN MATTHEW DONOVAN (1) Name (2) 1.0. Number (3) Cover Period 8/4/15 / through 8/31/15 / (4) Page 1 of 1 (5) (7) (8) (9) (10) (11) (12) Date Full Name (6) (Last, Suffix, First, Middle) Sequence Street Address & Contributor Contribution n-kind Numbe r City, State, Zip Code Tvoe Occuoation Type Description Amendment Amount Donovan, Ryan Matthew 8/4/ E 1st Avenue G 1 1 s CHE N Smathers, Judy M. 8/28/ Forest Road G 1 2 Retired CHE N Shelley, Donna 8/30/ E 7th Avenue G 1 3 CHE N Abato, Rozann 8/30/ E 1st Avenue G 1 4 CHE N OS-OE 13 (Rev. 11/13) SEE REVERSE FOR NSTRUCTONS ANO CODE VALUES

19 CAMPAGN TREASURER'S REPORT - TEMZED EXPENDTURES (1) Name RYAN MATTHEW DONOVAN (2) 1.0. Number /' 1 1 (3) Cover Period / / through / (4) Page of (5) Date (6) Sequence Number (7) Full Name (Last, Suffix, First, Middle) Street Address & City, State, Zip Code (8) Purpose (add office sought if contribution to a candidate) (9) (10) (11) Expenditure Type Amendment Amount 8/5/Y, City of Mount Dora 510 N. Baker St. City Council Member 1% Election Assessment CAN G 1 1 DS-DE 14 (Rev. 11/13) SEE REVERSE FOR NSTRUCTONS AND CODE VALUES

20 "-PPONTMENT OF CAMPAGN TREASURER AND DESGNATON OF CAMPAGN DEPOSTORY FOR CANDDATES (Section (1), F.S.) P0 7:oa N P02 : 3Q RCVD (PLEASE PRNT OR TYPE) 18. have designated the following bank as my '5f- ~ TltJ/l. 71 " 1 OFFCE USE ONLY 1. <;HECK APPROPRATE BOX(ES): 5d' nitial Filing of Form Re-filing to Change: D Treasurer/Deputy D Depository D Office D Party 2. Name of Candidate (in this order: F. st Middle, Last) -~/ ~,.. 4. Tele hone 5. aadress (36J ):)..16't;?iJ(} r y c,,/lmdo//&1zje1~-&fyl 6. Office sought (include distric~ uit, group number) i!,1' (Ju/le// j/1d-/"1cf 8. f a candidate for a artisan office, check block and fill in name of party as applicable: My intent is to run as a 0 Write-n No Party Affiliation D Party candidate. have appointed the following person to act as my Campaign Treasurer D Deputy Treasurer,. Name of Treasurer or Deputy Treasurer ~ - ;.:;"1 A. ~-~-c> 11. Mailing Address 12. Telephone (C/S/ );l3t. -151/.l/! 13. City 14. County 15. State 16. Zip Code 17. address f,t:;.!t>(i2;t1-<> c /lt///ll 3~75 ' 19. Name of Bank 20. Address ~ /-}/Ll.f' rj- ~v/ CitY,'. 3. Address (in.elude post office box or street, city, state, zip code) ;7'cf7. / ~-t-/?ye. /lfor.m r µ r CC._,, / i:::-l. Primary Depository 1. 3,; f a candidate for a nonpartisan office, check if applicable: D My intent is to run as a Write-n candidate. D Secondary Depository 24. Zip Code -%<75" UNDER PENALTES OF PERJURY, DECLARE THAT HAVE READ THE FOREGONG FORM FOR APPONTMENT OF CAMPAGN TREASURER AND DESGNATON OF CAMPAGN DEPOSTORY AND THAT THE FACTS STATED N T ARE TRUE. 27. /,) T-~easurer's Acceptance _ of Appointment (fill in t e blanks and check the appropriate block), T)DZ. AN/V /i-ba t O (Please Print or Type Name) signated above as: [Xf Campaign Treasurer D Deputy Treasurer. OS-DE 9 (Rev. 10/10), do hereby accept the appointment 1 - Z q - 5 ~X~=---=~~~~0'... C-d~~~a.~~6~-- oate Rule , F.A.C.

21 POJ :Q8 N CANDDATE OATH - NONPARTSAN OFFCE P02 :3 o RC VD (Not for use by Judicial or School Board Candidates) OFFCE USE ONLY, OATH OF CANDDATE (Section , Florida Statutes) wc1tl/?~ c/ OU WSH T TO APPEAR ON THE BALLOT NAME MAY NOT BE CHANGED AFTER THE END OF QUALFYNG)!;z- {AV/?(? / (office) (district#) am a candidate for the nonpartisan office of v / (circuit#) ; am a qualified elector of (group or seat#) 4k County, Florida; am qualified under the Constitution and the Laws of Florida to hold the office to which desire to be nominated or elected; have qualified for no other public office in the state, the term of which office or any part thereof runs concurrent with the office seek; and have resigned from any office from which am required to resign pursuant to Section , Florida Statutes; and will support the Constitution of the United States and the Constitution of the State of Florida. ature of Candidate Telephone Number City 7 State ZP Code Candidate's Florida Voter Registration Number (located on your voter information card): * Please print name phonetically on the line below as you wish it to be pronounced on the audio ballot for persons with disabilities (see i ructions on page 2 of this form): L'e). 11/1ti STATE OF FLORDA COUNTY OF L c..k e.. -~-~--- Sworn to (or affirmed) and subscribed before me this e}q day of_---=;j"-"' 4..._\-"'1,, 20h_. 1 Personally Known:-~ --or c /(J,J 1oaoatd~ p 1,,,z11 C?ph ~ ~ lure of Notary Pubic Produced dentification: Print, Type, or Stamp Commissioned Name of Notary Public Type of dentification Produced: OS-DE 25 (Rev. 5/11) Rule 1S , F.A.C.

22 AFFDAVT OF CANDDACY & RESDENCY PQ7 :os N Gwen Keough-Johns, MMC City Clerk City of Mount Dora 510 North Baker Street P02 :3Q RC VD Mount Dora FL RE: AFFDAVT OF CANDDACY & RESDENCY, '-----'--,'----'~ ~ %'-- /l/ 2)/l~'#./;';p_ ~ /'"""'- :;-~ 7 _, a candidate for City of Mount Dora City Council Member, District --~ (if applicable), or at-large in the du "'1/l/<.., e ect10n. h ere b y swear or a fft trm t h at rest ct e at: -~~~10-~~~~----~~ L /i/c;,? '.'7 ~ b_,_ r--. / f,;_f-- /?~!L'~-,d?, 1,,,.,,.,,, ;;_~ --=-= o..:c.:--1,1.'--''-l- '----'---:::: /,,...:- -l----'r, '-...,'---"""""'"'=--'-...:...:::...L. _...- where have resided for,,_ ""5: '--- years/months, and which hereby swear and affirm is located in District / (if applicable) in the City of Mount Dora, Florida, and that meet the eligibility requirements as identified in Ordinance (attached). n accordance with the provisions ofthe City of Mount Dora Charter and Code ofordinances, certify that meet the qualifications for candidacy. am a registered voter ofthe City of Mount Dora and reside at the above stated address within the City of Mount Dora. do not hold any other public office in the City, with the following exceptions: that of Notwy Public, or membership in the Nalional Guard, or the organized Reserve of the Armed Forces ofthe United States, or in any other defense agency recognized by the City, or in a status ofretirement from any oftheforegoing. acknowledge that must subscribe to the Oath ofoffice as outlined in Part ll, Section 15 of the City Charter. UNDER PENALTES OF PERJURY, DECLARE THAT HAVE READ THE FOREGONG AFFDAVT ~%2:2;,~E FACTS STATED N T ARE TRUE, Office Use Only: Signature Date Date filed: Received by: _ Received: Loyalty Oath / Oath of Candidate Candidate Name Pronunciation Request Statement of Financial nterests Form Affidavit of Candidacy & Residency Date Candidate Qualified: cc: Candidate

23 FORMl STATEMENT OF 2014 FNANCAL NTERESTS ""-,lease print or type your name, mailing!dress, agency name, and position below: LAS_T ~ ME -- FRST NAME -- MDDLE NAMM _i.-b/?y 1:///.J.W ~,1/;-J MALNG ADDRESS : /,..tht/.f-c v.../ FOR OFFCE USE ONLY: /'/g'"7 1:_--: / :f hf/<". PO 1: 08 N /tivn/ 'u,rc;~ s,;;7..57 / t?,# e' CTY : - ZP: COUNTY : J5P02:3o Rc vo NAME OF AGENCY: 6h ~/liv/1./- 1 U,A NAME OF OFFCE OR POSl:i'ON HELD OR S0UGH'?5k~ ' / ~ t::i./1 <!. t You are not limited to the space on the lines on this form. Attaci additional sheets, if necessary. CHECK ONLY F CJ CANDDATE OR CJ NEW EMPLOYEE OR APPONTEE **** BOTH PARTS OF THS SECTON MUST BE COMPLETED **** DSCLOSURE PEROD: THS STATEMENT REFLECTS YOUR FNANCAL NTERESTS FOR THE PRECEDNG TAX YEAR, WHETHER BASED ON A CALENDAR YEAR OR ON A FSCAL YEAR. PLEASE STATE BELOW WHETHER THS STATEMENT S FOR THE PRECEDNG TAX YEAR ENDNG ETHE~st check one): DECEMBER 31, 2014 QB D SPECFY TAX YEAR F OTHER THAN THE CALENDAR YEAR: MANNER OF CALCULATNG REPORTABLE NTERESTS: FLERS HAVE THE OPTON OF USNG REPORTNG THRESHOLDS THAT ARE ABSOLUTE DOLLAR VALUES, WHCH REQURES FEWER ~ALCULATONS, OR USNG COMPARATVE THRESHOLDS, WHCH ARE USUALLY BASED ON PERCENTAGE VALUES (see instructions r further details). CHECK THE ONE YOU ARE USNG: D COMPARATVE (PERCENTAGE) THRESHOLDS QB ~ DOLLAR VALUE THRESHOLDS PART A.. PRMARY SOURCES OF NCOME (Major sources of income to the reporting person - See instructions] (f you have nothing to report, write "none" or "n/a") NAME OF SOURCE SOURCE'S DESCRPTON OF THE SOURCE'S OF NCOME ADDRESS PRNCPAL BUSNESS ACTVTY.'"~1Jf'(.- lr-;~.f J~AJ '.JtJ 1/~oo, / )H, /,Ji,k/.,,,,,-1 /).(JJr-Mttf.FJ.5~ / Afu#~c'd.1~ ('J/r1?4.f Smt1,. ;_;1_l (/3?i,: / S-f$<: ;~, /J/Zl!ZY,;1~-7 ~ ]_:;;;> < <ri/1('."~ -. PART B SECONDARY SOURCES OF NCOME [Major customers, clients, and other sources of income to businesses owned by the reporting person See instructions] (f you have nothing to report, write "none" or "n/a") NAME OF NAME OF MAJOR SOURCES AD DRESS BUSNE~S ENTTY OF BUSNESS' NCOME OF SOURCE ~//A / PRNCPAL BUSNESS ACTVTY OF SOURCE PART C.. REAL PROPERTY [Land, buildings owned by the reporting person - See instructions] (f you have nothing to report, write "none" or "n/a") l 44! ( FLNG NSTRUCTONS for when and where to file this form are located at the bottom of page 2. NSTRUCTONS on who must file this form and how to fill it out begin on page 3. CE FORM 1. Effective: January 1, 2015 Adopted by reference in Rule (1), F.A C. (Continued on reverse side) PAGE 1

24 STATEMENT OF CANDDATE (Section , F.S.) (Please print or type) OFFCE USE ONLY PO) :oa N P02 :30 RCVD, candidate for the office of have been provided access to read and understand the requirements of Chapter 106, Florida Statutes. Date Each candidate must file a statement with the qualifying officer within 10 days after the Appointment of Campaign Treasurer and Designation of Campaign Depository is filed. Willful failure to file this form is a first degree misdemeanor and a civil violation of the Campaign Financing Act which may result in a fine of up to $1,000, (ss (1 )(c), (1 ), Florida Statutes). OS-DE 84 (05/l )