CAMPAIGN TREASURER' S REPORT SUMMARY. 5) Report Identifiers. Monetary. Transfers to Office Account. Total Monetary. 8) Other Distributions
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1 CAMPAIGN TREASURER' S REPORT SUMMARY ) Tom Keller Name 2) 707 Algonquin Dr. Address ( number and street) Clearwater, FL Check here if address has changed 3) 9 lref', EB 2. I20 Y OFFICIAL RECORDS AND FGISLATIVE SRVCS DEPT. ID : 4) Check appropriate box(es): Candidate Office Sought: Clearwater City Council Seat 4 Political Committee ( PC) Electioneering Communications Org. ( ECO) Check here if PC or ECO has disbanded Party Executive Committee ( PTY) Check here if PTY has disbanded Independent Expenditure ( IE) ( also covers an Check here if no other IE or EC reports will be filed individual making electioneering communications) Report Identifiers Cover Period: From 02/ 6/ 208/ To 02/ 22/ 208/ Report : G5 Original Special Election Report Contributions This Report Cash & Checks $,, 0. Expenditures This Report Monetary Expenditures 0. Loans $,, 0 Transfers to Office Account Total Monetary $ 0 Total Monetary In -Kind $,, 700, Other Distributions 0. TOTAL Monetary Contributions To 4, 275,00 0) TOTAL Monetary Expenditures To 7, 32, 8 ) Certification It is a first degree misdemeanor for any person to falsify a public record (ss , F. S.) I certify that have examined this report and it is true, correct, name) Kathy Watson and complete: name) Tom Keller Individual ( only for IE Treasurer O Deputy Treasurer 0 Candidate 0 Chairperson (only for PC and PTY) or electione:, ' ng comm.) X Signature DS -DE 2 ( Rev. / 3) eq.. / /, I X,, SJ * ature SEE REVERSE FOR INSTRUCTIONS
2 CAMPAIGN TREASURER' S REPORT ITEMIZED CONTRIBUTIONS ) Name Tom Keller 2) I. D. 3) Cover Period 2/ 6/ 208 throu9 h 02/ 22/ 208 4) Page of 02/ 6/ Accent 204 W. Horatio St. Tampa, FL Contributor Contribution 0) In ': ind ) Occupation Description B Printing INK Yard signs ) DS -DE 3 ( Rev. / 3)
3 ) Name Tom Keller CAMPAIGN TREASURER' S REPORT - ITEMIZED EXPENDITURES 2) I. D. 3) Cover Period o2/ 6/ p8 / through 02/ 22// 208 / 4) Page of 0) ) Purpose add office sought if contribution to a candidate) Expenditure DS -DE 4 ( Rev. / 3)
4 CAMPAIGN TREASURER' S REPORT SUMMARY ) Tom Keller Name 2) 707 Algonquin Dr. OFFICE USE ONLY` RECEIVED Address ( number and street) Clearwater, FL FEE 208 Check here if address has changed 3) ID Num OFFICIAL RECORDS AND ISLATIVE SRVCS DEPT. 4) Check appropriate box(es): Candidate Office Sought: Clearwater City Political Committee ( PC) Electioneering Communications Org. ( ECO) Party Executive Committee ( PTY) Independent Expenditure ( IE) ( also covers an individual making electioneering communications) Council Seat 4 Check here if PC or ECO has disbanded Check here if PTY has disbanded Check here if no other IE or EC reports will be filed Report Identifiers Cover Period: From 02/ 09/ 208/ To 02/ 5/ 208 Report : G4 Original Special Election Report Contributions This Report Expenditures This Report Cash & Checks $,, 0. Monetary Expenditures 0. Loans $ Total Monetary $, 0 0 Transfers to Office Account Total Monetary In- Kind $, Other Distributions 0. TOTAL Monetary Contributions To 3,575, 00 0) TOTAL Monetary Expenditures To 7, 32, 8 ) Certification It is a first degree misdemeanor for any person to falsify a public record (ss , F. S.) I certify that I have examined this report and it is true, correct, name) Kathy Watson and complete: name) Tom Keller Individual ( only for IE Treasurer GI Deputy Treasurer 0 Candidate or electio eering comm. X I, A. Signature Si ture DS -DE 2 ( Rev. / 3) X Chairperson ( only for PC and PTY) SEE REVERSE FOR INSTRUCTIONS
5 ) Name Tom Keller CAMPAIGN TREASURER' S REPORT - ITEMIZED EXPENDITURES 2) I. D. 3) Cover Period o2/ o9f2oia / through 02/ 5// 208 / 4) Page of 0) ) Purpose add office sought if contribution to a candidate) Expenditure DS -DE 4 ( Rev. / 3)
6 CAMPAIGN TREASURER' S REPORT ITEMIZED CONTRIBUTIONS ) Name Tom Keller 2) I. D. 3) Cover Period 02/ 09/ 28 02/ 5/ 208 through / 4) Page of 0) ) 2) Contributor Occupation Contribution In- kind Description DS -DE 3 ( Rev. / 3)
7 CAMPAIGN TREASURER' S REPORT SUMMARY ) Tom Keller Name 2) 707 Algonquin Dr. Address ( number and street) Clearwater, FL Check here if address has changed 3) OFFICE USE ONLY RECEIVED r r: 3 ',. '' 206 OFFICIAL RECORDS AND tss IS( IrIVt I<VC. 00'. ID Numbe 4) Check appropriate box(es): Candidate Office Sought: Clearwater City Council Seat 4 Political Committee ( PC) Electioneering Communications Org. ( ECO) Check here if PC or ECO has disbanded Party Executive Committee ( PTY) Check here if PTY has disbanded Independent Expenditure ( IE) ( also covers an Check here if no other IE or EC reports will be filed individual making electioneering communications) Report Identifiers Cover Period: From 0/ 26/ 208/ To 02/ 08/ 208/ Report : G3 Original Special Election Report Contributions This Report Cash & Checks $,, 0. Expenditures This Report Monetary Expenditures Loans $ 0 Transfers to Office Account Total Monetary $, 0 Total Monetary In- Kind $ Other Distributions 0. TOTAL Monetary Contributions To 3, 575, 00 0) TOTAL Monetary Expenditures To 7, 32: 8 ) Certification It is a first degree misdemeanor for any person to falsify a public record (ss , F. S.) I certify that I have examined this report and it is true, correct, name) Kathy Watson and complete: name) Tom Keller Individual ( only for IE 0 Treasurer 0 Deputy Treasurer GI Candidate 0 Chairperson (only for PC and PTY) or electioneering comm.) X_ gi Signature Si_)i ture X DS -DE 2 ( Rev. / 3) SEE REVERSE FOR INSTRUCTIONS
8 CAMPAIGN TREASURER' S REPORT ITEMIZED CONTRIBUTIONS ) Name Tom Keller 2) I. D. 3) Cover Period / 0/ 26/ / 08/ 208 through / / ( 4) Page of 0) ) 2) Contributor Contribution In- kind Occupation Description DS -DE 3 ( Rev. / 3)
9 ) Name Tom Keller CAMPAIGN TREASURER' S REPORT ITEMIZED EXPENDITURES 2) I. D. 3) Cover Period 0/ 26/ 08 / through 02/ 08// 208 / 4) Page of Purpose add office sought if contribution to a candidate) Expenditure 0) ) 0/// Official Records and Legislative Services City of Clearwater 2 S. Osceola Avenue Clearwater, FL Verification of signatures contained on petitions CAN DS -DE 4 (Rev. / 3)
10 CAMPAIGN TREASURER' S REPORT SUMMARY ) Tom Keller Name 2) 707 Algonquin Dr. OFFICE USE ONLY RECEIVED Address ( number and street) Clearwater, FL FEE, ; n 208 Check here if address has changed 3) ID OFFICIAL RECORDS AND F(' j ATNE SRVCS DEPT. rrl 4) Check appropriate box(es): Candidate Office Sought: Clearwater City Political Committee ( PC) Electioneering Communications Org. ( ECO) Party Executive Committee (PTY) Independent Expenditure ( IE) ( also covers an individual making electioneering communications) Council Seat 4 Check here if PC or ECO has disbanded Check here if PTY has disbanded Check here if no other IE or EC reports will be filed Report Identifiers Cover Period: From 0/ 2/ 208 To 0/ 25/ 208/ Report : G2 Original Special Election Report Contributions This Report Cash & Checks $,, 0. Expenditures This Report Monetary Expenditures 0. Loans $ 0 Transfers to Office Account Total Monetary $, 0 Total Monetary In -Kind $,, Other Distributions 0. TOTAL Monetary Contributions To 3, ) TOTAL Monetary Expenditures To 7, 06. 7$ ) Certification It is a first degree misdemeanor for any person to falsify a public record ( ss , F. S.) I certify that have examined this report and it is true, correct, name) Kathy Watson and complete: name) Tom Keller Individual ( only for IE Treasurer I] Deputy Treasurer Candidate or electi.i eering comm.) Chairperson ( only for PC and PTY) x /», X i!c/ Signature 0 Si ature DS -DE 2 ( Rev. / 3) SEE REVERSE FOR INSTRUCTIONS
11 CAMPAIGN TREASURER' S REPORT ITEMIZED EXPENDITURES ) Name Tom Keller ( 2) I. D. 3) Cover Period of/ 2/ bola / through o/ 25// 2o8 / 4) Page of 0) ) Purpose add office sought if contribution to a candidate) Expenditure DS -DE 4 ( Rev. / 3)
12 CAMPAIGN TREASURER' S REPORT ITEMIZED CONTRIBUTIONS ) Name Tom Keller 2) I. D. 3) Cover Period 0/ 2/ 78 0/ 25/ 208 through / / ( 4) Page of 0) ) 2) Contributor Contribution In- kind Occupation Description DS -DE 3 ( Rev. / 3)
13 ) Tom Keller Name 2) 707 Algonquin Dr. Address (number and street) Clearwater, FL CAMPAIGN TREASURER' S REPORT SUMMARY Check here if address has changed 4) Check appropriate box(es): p Candidate Office Sought: Political Committee ( PC) O Electioneering Communications Org. ( ECO) O Party Executive Committee ( PTY) O Independent Expenditure ( IE) ( also covers an individual making electioneering communications) RErpE\ JAN 2e 208 NLY OFFICIAL RECORDS AND LEGISLATIVE SRVCS DEPT. 3) ID : Clearwater City Council - Seat 4 0 Check here if PC or ECC has disbanded 0 Check here if PTY has disbanded 0 Check here if no other IE or EC reports will be filed Report Identifiers Cover Period: From 0/ /2/ 208 To 0/ 25/208/ Original 0 0 Special Election Report Report : G2 Contributions This Report Cash & Checks $ Expenditures This Report Monetary Expenditures Loans $ Total Monetary $ In -Kind $ Transfers to Office Account $ Total Monetary $ Other Distributions TOTAL Monetary Contributions To 3, ) TOTAL Monetary Expenditures To 7, 06.7$ ) Certification It is a first degree misdemeanor for any person to falsify a public record (ss , F. S.) I certify that I have examined this report and it is true, correct, and complete: name) Kathy Watson Individual ( only for IE 0 Treasurer 0 Deputy Treasurer or electio9eering comm.) name) Tom Keller 2 Candidate 0 Chairperson (only for PC and PTY) X Signature DS -DE 2 ( Rev. / 3) X Si ire SEE REVERSE FOR INSTRUCTIONS
14 CAMPAIGN TREASURER' S REPORT ITEMIZED CONTRIBUTIONS ) Name Tom Keller 2) I. D. 3) Cover Period / 0/ 2/ 208 through / 0/ 25/ 208 4) Page of g) 0) ) 2) Contributor Occupation Contribution In- kind Desc:ri tion ne_ne 44 / Co-.. n FOR INSTRUCTIONS AND CODE VALUES
15 ) Name Tom Keller CAMPAIGN TREASURER' S REPORT ITEMIZED EXPENDITURES 2) I. D. 3) Cover Period 0/ 2/ bo8 / through 0/ 25// 208 / 4) Page of Purpose add office sought if contribution to a candidate) Expenditure 0) DS -DE 4 ( Rev. / 3)
16 CAMPAIGN TREASURER' S REPORT SUMMARY ) Tom Keller Name 2) 707 Algonquin Dr. Address ( number and street) Clearwater, FL Check here if address has changed 3) OFFICE USE ONLY RECEIVED N ` OFFIck REKt7RPS ANS? IKs(5LA- ID : Dior 4) Check appropriate box(es): Candidate Office Sought: Clearwater City Political Committee ( PC) Electioneering Communications Org. ( ECO) Party Executive Committee (PTY) Independent Expenditure ( IE) ( also covers an individual making electioneering communications) Council Seat 4 Check here if PC or ECO has disbanded Check here if PTY has disbanded Check here if no other IE or EC reports will be filed Report Identifiers Cover Period: From 0/ 0/ 208 To 0/ / 208/ Report : G Original Special Election Report Contributions This Report Cash & Checks $ - 0-, Expenditures Monetary Expenditures This Report Loans $ Total Monetary $ In -Kind $ Transfers to Office Account Total Monetary 4, Other Distributions TOTAL Monetary Contributions To 3, ) TOTAL Monetary Expenditures To 7, 06. 7$ ) Certification It is a first degree misdemeanor for any person to falsify a public record ( ss , F. S.) certify that I have examined this report and it is true, correct, name) Kathy Watson Individual ( only for IE Treasurer El Deputy Treasurer or electioneering comm.) a and complete: name) Tom Keller El Candidate 0 Chairperson ( only for PC and PTY) X X _ Sign ture Sig! ure DS -DE 2 ( Rev. / 3) SEE REVERSE FOR INSTRUCTIONS
17 ) Name Tom Keller CAMPAIGN TREASURER' S REPORT - ITEMIZED EXPENDITURES 2) I. D. 3) Cover Period min/ pis / through 0/,208 / 4) Page of 0) ) Purpose add office sought if contribution to a candidate) Expenditure Strategic Solutions of Florida Professional fees 0/ 09/ 20/ 30 W. Platt Street Tampa, FL CAN / 09/ 208 Strategic Solutions of Florida 30 W,=. Platt Street Tampa, FL Professional fees, Logo, yard signs, Website set up and hosting. CAN DS -DE 4 ( Rev. / 3)
18 CAMPAIGN TREASURER' S REPORT SUMMARY ) Tom Keller OFFICE USE ONLY Name 2) 707 Algonquin Dr. Address ( number and street) Clearwater, FL Check here if address has changed 3) ID : 4) Check appropriate box(es): Candidate Office Sought: Clearwater City Council Seat 4 Political Committee ( PC) Electioneering Communications Org. ( ECO) Check here if PC or ECO has disbanded Party Executive Committee ( PTY) Check here if PTY has disbanded Independent Expenditure ( IE) ( also covers an Check here if no other IE or EC reports will be filed individual making electioneering communications) Report Identifiers Cover Period: From 0/ 0/ 208 To 0/ / 208i Report : G Original Special Election Report Contributions This Report Expenditures This Report Cash & Checks $ - 0-,, Monetary Expenditures Loans $ Transfers to Office Account Total Monetary $ Total Monetary 4, In -Kind $ Other Distributions TOTAL Monetary Contributions To 3,, ) TOTAL Monetary Expenditures To 7, 06. 7$ ) Certification It is a first degree misdemeanor for any person to falsify a public record ( ss , F. S.) certify that I have examined this report and it is true, correct, name) Kathy Watson and complete: name) Tom Keller Individual ( only for IE 0 Treasurer 0 Deputy Treasurer 0 Candidate 0 Chairperson ( only for PC and PTY) or electioneering comm.) X Sign ture 4_wml X r: Sig lure DS -DE 2 ( Rev. / 3) SEE REVERSE FOR INSTRUCTIONS
19 CAMPAIGN TREASURER' S REPORT - ITEMIZED EXPENDITURES ) Name Tom Keller ( 2) I. D. 3) Cover Period 0/ 0qo8 / through 0/ // 208 4) Page of 0) ) Purpose add office sought if contribution to a candidate) Expenditure Strategic Solutions of Florida Professional fees 0/ 09/ 20/ 30 W. Platt Street Tampa, FL CAN o'/ o J208 Strategic Solutions of Florida 30 W,=. Platt Street Professional fees, Logo, yard signs, Tampa, FL Website set up and hosting. CAN DS -DE 4 ( Rev. / 3)
20 CAMPAIGN TREASURER' S REPORT SUMMARY ) Tom Keller Name 2) 707 Algonquin Dr. Address (number and street) Clearwater, FL Check here if address has changed( 3) OFFICE USE `ONLY JAN ; spy aa. R JR OFFICIAL,; t DS ANn Iv' L ) ID. CS DEPT. 7`\' 4) Check appropriate box(es): Candidate Office Sought: Clearwater City Council Seat 4 Political Committee ( PC) Electioneering Communications Org. ( ECO) Check here if PC or ECO has disbanded Party Executive Committee ( PTY) Check here if PTY has disbanded Independent Expenditure ( IE) ( also covers an Check here if no other IE or EC reports will be filed individual making electioneering communications) Report Identifiers Cover,Period: From 2/ / 207 / To 2/ 3/ / 207/ Report : M2 I Original Special Election Report Contributions This Report Expenditures This Report Cash & Checks $,, Monetary Expenditures 0. Loans $ Total Monetary $,, In -Kind $,, Transfers to Office Account Total Monetary 0, Other Distributions 0-, -tlz- TOTAL Monetary Contributions To 3, ) TOTAL Monetary Expenditures To 2, ) Certification It is a first degree misdemeanor for any person to falsify a public record (ss , F. S.) I certify that I have examined this report and it is true, correct, name) Kathy Watson and complete: name) Tom Keller Individual ( only for IE Treasurer El Deputy Treasurer GI Candidate Chairperson (only for PC and PTY) or electioneering comm.) X ( f / ] Signature y 9(6/ 4- Inature DE 2 ( Rev. / 3 SEE REVERSE FOR INSTRUCTIONS
21 CAMPAIGN TREASURER' S REPORT ITEMIZED CONTRIBUTIONS ) Name Tom Keller 2) I. D. 3) Cover Period 2/ 0/ 207 2/ 3/ 207 through / / ( 4) Page of 2/ 3/ Andrew Stinnette, pa 597 Main Street Dunedin, FL Contributor Contribution 0) In- kind Occupation Description ) 2) B Attorney CHE / 3/ Accent 304W. Horatio Street Tampa, FL b Printing INK Yards signs DS -DE 3 ( Rev. / 3)
22 CAMPAIGN TREASURER' S REPORT SUMMARY ) Tom Keller Name 2) 707 Algonquin Dr. Address (number and street) Clearwater, FL Check here if address has changed 3) ID Numbe, ol DEC U lr f OFFICIAL RECORDS AND LEGISLATIVE SR CS DEPT. 4) Check appropriate box(es): Candidate Office Sought: Clearwater City Political Committee ( PC) Electioneering Communications Org. ( ECO) Party Executive Committee ( PTY) Independent Expenditure ( IE) ( also covers an individual making electioneering communications) Council Seat 4 Check here if PC or ECO has disbanded Check here if PTY has disbanded Check here if no other IE or EC reports will be filed Report Identifiers Cover Period: From / 0/ 207i To / 30/ 207i Report : MI Original Special Election Report Contributions This Report Expenditures This Report Cash & Checks $, 00,0. 00, Monetary Expenditures 2, 35,4. 00,. Loans $,, Transfers to Office Account Total Monetary $, 00,0. 00,. Total Monetary In -Kind $,, 2, Other Distributions TOTAL Monetary Contributions To 3, 050,00, 0) TOTAL Monetary Expenditures To 2,370.,4, ) Certification It is a first degree misdemeanor for any person to falsify a public record (ss , F. S.) I certify that I have examined this report and it is true, correct, name) Kathy Watson and complete: name) Tom Keller Individual ( only for IE Treasurer 0 Deputy Treasurer r Candidate j_] Chairperson ( only for PC and PTY) or elections ring comm.) X _ Adjtflir a/ 7, t.-/ Signa ure Si. ature - _ X. DS -DE 2 ( Rev. / 3) SEE REVERSE FOR INSTRUCTIONS
23 CAMPAIGN TREASURER' S REPORT ITEMIZED CONTRIBUTIONS ) Name Tom Keller 2) I. D. / 0/ 207 / 30/ 207 3) Cover Period / / through / / ( 4) Page of 0) ) 2) Contributor Occupation Contribution In- kind Description / 5/ 207 Rocker Corporation 304 W. Horatio St. Tampa, FL B Real Estate CHE, DS -DE 3 ( Rev. / 3)
24 ) Name Tom Keller CAMPAIGN TREASURER' S REPORT - ITEMIZED EXPENDITURES 2) I. D. 3) Cover Period / 0/ 07 / through / 30// 207 / 4) Page. of 0) ) S) Purpose add office sought if contribution to a candidate) Expenditure / 03{ 20/ Strategic Solutions of Florida Professional Fees Voter data system CAN 2, DS -DE 4 (Rev. / 3)
25 CAMPAIGN TREASURER' S REPORT SUMMARY ) Tom Keller Name 2) 707 Algonquin Dr. Address (number and street) Clearwater, FL Check here if address has changed 3) ID : ORFfrAMDT NOV 0 9 OFFICIAL RECORDS AND LEGISLATIVE SRVCS DEPT, 4) Check appropriate box(es): Candidate Office Sought: Clearwater City Council Seat 4 Political Committee ( PC) Electioneering Communications Org. ( ECO) Check here if PC or ECO has disbanded Party Executive Committee ( PTY) Check here if PTY has disbanded Independent Expenditure ( IE) ( also covers an Check here if no other IE or EC reports will be filed individual making electioneering communications) Report Identifiers Cover Period: From 0/ 0/ 207/ To 0/ 3/ 207/ Report : M 0 Original d Special Election Report Contributions This Report Expenditures This Report Cash & Checks $, 2, Monetary Expenditures Loans $, 0, Transfers to Office Account Total Monetary $, 2, Total Monetary In -Kind $ Other Distributions r TOTAL Monetary Contributions To 2, 050, 00 0) TOTAL Monetary Expenditures To 5, 94 ) Certification It is a first degree misdemeanor for any person to falsify a public record ( ss , F. S.) I certify that I have examined this report and it is true, correct, name) Kathy Watson and complete: Individual (only for IE Treasurer Deputy Treasurer E Candidate or electio X i ering comm.) at 7._ - Signature Si ature name) Tom Keller X Chairperson (only for PC and PTY) DE 2 ( Rev. / 3) SEE REVERSE FOR INSTRUCTIONS
26 CAMPAIGN TREASURER' S REPORT ITEMIZED CONTRIBUTIONS ) Name Tom Keller 2) I. D. 3) Cover Period 0/ 0/ 207 through 9 0/ 3/ 207 4) Page of 0) ) 2) Contributor Occupation Contribution In -Kind Description 0/ 0/ 207 Metropolitan Media Co 304 W. Horatio St. Tampa, FL B Outdoor Adv. CHE, / Tom Keller 0/ Algonquin Drive Clearwater, FL LOA 0, / James W. Shaw 23/ Burning Tree Ln Clearwater, FL I Claims Adj. CHE / 30/ 207 Jay Keller Jr 502 Manatee Drive Ruskin, FL 004 I Sales Rep. CHE / 3/ Walter Burnside P. A. Attorney at Law 304 S. Westland Ave. Tampa, FL B Law office CHE DS -DE 3 ( Rev. / 3)
27 ) Name Tom Keller CAMPAIGN TREASURER' S REPORT - ITEMIZED EXPENDITURES 2) I. D. 3) Cover Period to/ 0l/ 07 / through 0/ 3// 207 / 4) Page of Purpose add office sought if contribution to a candidate) Expenditure 0) ) 0/ 23/ 20/ Custom Graphics of Tampa th St., Ste. A Riverview, FL Badges CAN DS -DE 4 ( Rev. / 3)
28 y ) Tom Keller Campaign CAMPAIGN TREASURER' S REPORT SUMMARY O Name 2) 707 Algonquin Dr. Address ( number and street) Clearwater, FL Check here if address has changed 3) NOV 27 OFFICIAL RECORDS AND LEGISLATIVF SRV) EPT ID : 4) Check appropriate box(es): Candidate Office Sought: Commissioner Seat 4 Political Committee (PC) Electioneering Communications Org. ( ECO) Check here if PC or ECO has disbanded Party Executive Committee ( PTY) Check here if PTY has disbanded Independent Expenditure ( IE) ( also covers an Check here if no other IE or EC reports will be filed individual making electioneering communications) Report Identifiers Cover Period: From 0/ 0A/ 207/ To 0/ 3/ / 207/ Report : M 0 Original Special Election Report Contributions This Report Expenditures This Report Cash & Checks $ 2, Monetary Expenditures Loans $, 0, Transfers to Office Account Total Monetary $ In -Kind $, Total Monetary Other Distributions TOTAL Monetary Contributions To 2, 050, 00 0) TOTAL Monetary Expenditures To 5 94 ) Certification It is a first degree misdemeanor for any person to falsify a public record (ss , F. S.) I certify that I have examined this report and it is true, correct, name) Kathy Watson and complete: name) Tom Keller Individual ( only for IE Treasurer 0 Deputy Treasurer El Candidate D Chairperson (only for PC and P Y ) or electioneering comm.) Signature / gnature DS -DE 2 ( Rev. / 3) 5 7E REVERSE FOR INSTRUCTIONS
29 f CAMPAIGN TREASURER' S REPORT - ITEMIZED EXPENDITURES ) Name Tom Keller Campaign ( 2) I. D. 3) Cover Period 0/ 0/ 07 / through o/ 3// 207 / 4) Page g) 0) ) Purpose add office sought if contribution to a candidate) Expenditure 0/ 2320/ Custom Graphics of Tampa th St., Ste. A Riverview, FL Badges CAN DS -DE 4 (Rev. / 3)
30 s ', CAMPAIGN TREASURER' S REPORT ITEMIZED CONTRIBUTIONS ) Name Tom Keller Campaign 2) I. D. 3) Cover Period 0/ 0/ 207 0/ 3/ 207 through / 4) Page of 0) ) 2) Contributor Contribution In- kind Occupation Description 0/ 0/ 207 Metropolitan Media Co. 304 W. Horatio Street Tampa, F B CHE, Tom Keller 0/ 0/ Algonquin Drive Clearwater, F S LOA 0, / 23/ 207 James W. Shaw 2742 Burning Tree Ln Clearwater, FL 3376 I CHE / 30/ 207 Jay Keller Jr 502 Manatee Drive Ruskin, FL I CHE / 3/ 207 Walter Burnside P. A. Attorney at Law 304 S. Wstland Ave. Tampa, FL B CHE DS -DE 3 ( Rev. / 3)
31 APPOINTMENT OF CAMPAIGN TREASURER AND DESIGNATION OF CAMPAIGN DEPOSITORY FOR CANDIDATES Section 06.02( ), F. S.) PLEASE PRINT OR TYPE) L ri n' t 04 '''',ilt? v. -,, I ',,,_. 2, H. NOTE: This form must be on file with the qualifying officer the cam ai n account. 22Z iavow9_...l OFFICE USE ONLY. CHECK APPROPRIATE BOX(ES): i Er Initial Filing of Form Re- filing to Change: [ 2( Treasurer/ Deputy Depository Office Party 2. Name of Candidate (in this order: First, Middle, Last) 4. Telephone J e,' 5. E- mail address ) ) 3-3/- - cici 9 ro/4k 6 Al c.rrv AUte-4, C o an 6. Office sought (include district, circuit, group number) z-- i 3. Address (include post office box or street, city, state, zip code) e ) & -20Q illgoaquin) lor, 72tr- A,' Prj 'Cr I7-7. If a candidate for a non artisan office, check if applicable: fl My intent is to run as a Write- In candidate. 8. If a candidate for a. artisan office, check block and fill in name of party as applicable:. My intent is to run as a El Write- In J No Party Affiliation fl 9. I have appointed the following person to act as my fl Campaign Treasurer Deputy Treasurer 0. Narrle of Treasurer or Deputy Treasurer q. Mailing Address warsofj 3/f7 SAIME-fe i 00SE_ bett2t 3. City WAD 4. County 5. State &_ i_ Sett Zip Code AO Party 2. Telephone 7. E- mail address illill candidate. g-5 )767- / I have designated the following bank as my Primary Depository Secondary Depository 9. Name of Bank C e. N TerST- Arc- 6,4/ v i< 2. CityCity 22. County Pt NY M i II--; lickui- 20. Address s-. macoill 23. State 9 - An.* t) eir%" 2C4. A) Zip Code el UNDER PENALTIES OF PERJURY, I DECLARE THAT I HAVE READ THE FOREGOING FORM FOR APPOINTMENT OF CAMPAIGN TREASURER AND DESIGNATION OF CAMPAIGN DEPOSITORY AND THAT THE FACTS STATED IN IT ARE TRUE Signature of Candidate x e 27. Treasurer's Acceptance of Appointment (fill he blanks and check the appropriate block) I, kkgei WPRK-OQ, do hereby accept the appointment Please Print or Name) designated above as: J Campaign Treasurer n Deputy Treasurer. 0 / Z+. MIVAilMA D r) x 0/Mar e Signature of Cam, aign Treasurer or Deputy Treasurer DS- DE 9 ( Rev. 00) Rule S , F.A.C.
32 DS -DE 9 ( Rev. 0/ 0) Rule S , F.A.C. APPOINTMENT OF CAMPAIGN TREASURER AND DESIGNATION OF CAMPAIGN DEPOSITORY FOR CANDIDATES Section ( ), F. S.) PLEASE PRINT OR TYPE) NOTE: This form must be on file with the qualifying officer before opening the campaign account. OFFICE USE ONLY. CHECK APPROPRIATE BOX(ES): Er Initial Filing of Form Re- filing to Change: Treasurer / Deputy Depository Office Party 2. Name of Candidate (in this order: First, Middle, Last) a// Y\ Ehw - ll e-r 4. Telephone 5. E -mail address 6. Office sought (include district, circuit, group number) SeRtr q 3. Address ( include post office box or street, city, state, zip code) / 7o7 / 4' IgoNgv, A) / 0i^, re47 e-f- E/ If a candidate for a non artisan office, check if applicable: My intent is to run as a Write -In candidate. 8. If a candidate for a partisan, office, check block and fill in name of party as applicable: My intent is to run as a Write -In No Party Affiliation Party candidate. 9. I have appointed the following person to act as my Campaign Treasurer Deputy Treasurer 0. Name of Treasurer or Deputy Treasurer To / /<' e ' e,,-. Mailing / Adddrress - / 0 - A. I OA) / V O Or /&/ c / 9-,-/--- / / 3. City eie 4 4. ounty Y e/// State F- %, 6. Zip Code 3 "7_S.S 2. Telephone 7. E -mat address 7 2 6' 3 i 2, 4-69ri Al g ine,-) 3 c4', cv 8. I have designated the following bank as my Primary Depository Secondary Depository 9. Name of Bank 0 e. / re( J) re- %.74 e 2. City -'! County N-;// A.---/4 20. Address f;. S 23. State rvit9c P; II l' h-- -- t. / il 24. Zip Code 3 34 nq, UNDER PENALTIES OF PERJURY, I DECLARE THAT I HAVE READ THE FOREGOING FORM FOR APPOINTMENT OF CAMPAIGN TREASURER AND DESIGNATION OF CAMPAIGN DEPOSITORY AND THAT THE FACTS STATED IN IT ARE TRUE Signature of Candidate X04 / 2 -a /- 7 X 27. Treasurer's Acceptance of Appointment (fill i e blanks and check the appropriate block) I,, do hereby accept the appointment Please Print or Name) designated above as: Campaign Treasurer I] Deputy Treasurer. 2' AL- % 2-e/ - 7 X,,,,,/._,'''- - S' re of Campaign Treasurer or Deputy Treasurer
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