CAMPAIGN TREASURER'S REPORT SUMMARY. D Check here if PTY has disbanded. (5) Report Identifiers. (7) Expenditures This Report. Monetary Expenditures

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1 (1) Georgette E. Dumont Name (2) th Avenue South Address (number and street) Jacksonville Beach, FL CAMPAGN TREASURER'S REPORT SUMMARY City, State, Zip Code 0 Check here if address has changed (4) Check appropriate box(es): OFFCE USE ONLY RECEVED OCT candidate Office sought City Council Seat #5, District 2 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 ;2017 To Report Type: 2017 M9 D Original 0 Amendment D Special Election Report (6) Contributions This Report 3 ' Cash & Checks $ -- ' Loans $ -- ' Total Monetary $ 3 ' n-kind $ (9) TOTAL Monetary Contributions To Date $ (7) Expenditures This Report Monetary Expenditures $ 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) William G. Hillegass 0 ndividual (only for E D Treasurer D Deputy Treasurer or electioneering comm.) (Type name) Georgette E. Dumont x Signature DS-DE 12 (Rev. 11/13) SEE REVERSE FOR NSTRUCTONS

2 CAMPAGN TREASURER'S REPORT - TEMZED CONTRBUTONS (1) Name ~orgette E. Dumont (2) 1.0. Number N/A (3) Cover Period through (4) Page 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 Bush, Richard R Duval Drive Jacksonville Beach, FL Retired CHE Candler, Gaylor th Avenue South, Jacksonville Beach, " FL Professor CHE Lightsey, Beth th Avenue North Jacksonville Beach, FL Accountant CHE Soderberg, Nancy Duval Drive Jacksonville Beach, FL Professor CHE Clark, James Marsh Hawk Place Ponte Vedra Beach, FL Exec Dir. CHE Glasser, Ellen Beach Avenue Atlantic Beach, FL Professor CHE Anderson, Lori s. Roscoe Blvd. Ponte Vedra Beach, FL Exec. Dir CHE DS-DE 13 (Rev. 11/13) SEE REVERSE FOR NSTRUCTONS AND CODE VALUES

3 CAMPAGN TREASURER'S REPORT - TEMZED CONTRBUTONS ' ~eorgette E. Dumont (1) Name (2) l.d. Number N/A (3) Cover Period through (4) Page of 8 (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 Hixon, J oseph Ponte Vedra Blvd. Jacksonville Beach, FL Retired CHE 1, Meyers, Michael R st Street South Jacksonville Beach, " FL Retired CHE 1, Labenz, Chad st Street South Jacksonville Beach, FL Fin Consult CHE 1, OS-DE 13 (Rev. 11/13) SEE REVERSE FOR NSTRUCTONS AND CODE VALUES

4 '.. '. CAMPAGN TREASURER'S REPORT - TEMZED EXPENDTURES (1) Name George t te E. Dumont (2) l.d. Number _ N_f_A _ (3) Cover Period _ 0 _ 9 _/ through _ 0 _ 9 _;_ 3 _ 0 _;~ 1 1 (4) Page of (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 09 ; 19/ William G. Hillegass, CPA PA Preprinted checks 20:_ 427 3rd Street North - reimbursement.. J acksonville Beach, FL RMB / 29/ 20 ~ 02 Paypal Paypal collection 2211 North First Street fees San Jose, CA MON DS-DE 14 (Rev. 11/13) SEE REVERSE FOR NSTRUCTONS AND CODE VALUES

5 Name (2) th Avenue South Address (number and street) Jacksonville Beach, FL City, State, Zip Code D Check here if address has changed (4) Check appropriate box(es): (3) D Num 0 candidate Office sought: City Council Seat #5, District #2 D Political Committee (PC ) D Electioneering Communications Org. (ECO) D Party Executive Committee (PTY) D ndependent Expenditure (E) (also covers an individual making electioneering commun ications) OFFCE USE ONLY RECEVED OCT O 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: 2017 M9 ~ r i g i nal D Amendment D Special Election Report (6) Contributions This Report Cash & Checks $ 3, Loans $, 0.00 Total Monetary $ 3, n-kind $, 0.00 (7) Expenditures This Report Monetary Expenditures $ Transfers to Office Account $ Total Monetary $ (8) Other Distributions $, (9) TOTAL Monetary Contributions To Date $ (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) William G. Hillegass D ndividual (only for E 0 Treasurer D Deputy Treasurer or electioneering comm.) (Type name) Georgette E. Dumont hairperson (only for PC and PTY) OS-DE 12 (Rev. 11/13) SEE REVERSE FOR NSTRUCTONS

6 CAMPAGN TREASURER'S REPORT - TEMZED EXPENDTURES (1) Name Georgette E. Dumont (2) l.d. Number N/A (3) Cover Period 1_ 0 _ 1 _1~ through _ 0 _ 9 _/_ 3 _ _1~ (4) Page of (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 William G. Hillegass, CPA PA Preprinted checks 09 ; 19/ 20 :_ rd Street North - reimbursement Jacksonville Beach, FL RMB ~ 02 Paypal Paypal collection 2211 North First Street fees San Jose, CA MON OS-DE 14 (Rev. 11/13) SEE REVERSE FOR NSTRUCTONS AND CODE VALUES

7 CAMPAGN TREASURER'S REPORT - TEMZED CONTRBUTONS (1) Name Georgette E. Dumont (2) l.d. Number N/ A through (3) Cover Period (4) Page of 1 (5) (7) (8) (9) (10) (11) (12) Date Full Name (6) (Last, Suffix, First, Middle) Sequence Street Address & Contributor Contri bution n-kind Number City, State, Zip Code Type Occupation Type Description Amendment Amount Bus h, Richard R Duval Drive J acksonville Beach, FL Retired CHE Candler, Gayl or t h Avenue South, J acksonville Be a ch, " FL Professor RCT Lightsey, Beth th Avenue North Jacksonville Beach, FL Accountant RCT Soderberg, Nancy Duval Drive J acksonville Beach, FL Pr ofessor RCT Cl ark, James Marsh Hawk Pl ace Ponte Vedra Beach, FL Exec Dir. RCT Gl asser, Ellen Be a c h Avenue At l antic Beach, FL Professor RCT Anderson, Lori s. Roscoe Bl vd. Ponte Vedra Beach, FL Exec. Di r RCT DS-DE 13 (Rev. 11/13) SEE REVERSE FOR NSTRUCTONS AND CODE VALUES

8 CAMPAGN TREASURER'S REPORT - TEMZED CONTRBUTONS (1) Name Georgette E. Dumont (2) 1.0. Number N/ A (3) Cover Period through (4) Page of 8 (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 Hixon, Joseph Ponte Vedra Bl v d. Jacksonville Beach, FL Retired CHE 1, Meyers, Mi c h ael R st Str eet South J acksonville Beach, " FL Retired CHE 1, Labenz, Chad st Street South Jacksonville Beach, FL Fin Consult CHE 1, DS-DE 13 (Rev. 11/13) SEE REVERSE FOR NSTRUCTONS AND CODE VALUES

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