CAMPAIGN TREASURER' S REPORT SUMMARY ) Name 2) 006 Magnolia Dr. Address (number and street) Check here if address has changed 4) Check appropriate box(es): Candidate Office Sought: Clearwater Political Committee ( PC) Electioneering Communications Org. ( ECO) Party Executive Committee ( PTY) Independent Expenditure ( IE) ( also covers an individual making electioneering communications) 3) City Council OFFICE USE ONLY IDN ral; ' f( Seat 5 S DE 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 / / 208 To / / 208 Report : G Original Amendment Special Election Report Contributions This Report Expenditures This Report Cash & Checks $,, Monetary Expenditures 0. 00 Loans $,, Transfers to Office Account Total Monetary $,, Total Monetary In -Kind $,, 0. 00 Other Distributions TOTAL Monetary Contributions To 3, 977. 72 0) TOTAL Monetary Expenditures To 3, 83. 27 ) Certification It is a first degree misdemeanor for any person to falsify a public record (ss. 839. 3, F. S.) I certify that I have examined this report and it is true, correct, name) and complete: name) Individual ( only for IE 0 Treasurer Deputy Treasurer 0 Candidate Chairperson ( only for PC and PTY) or electioneering comm. Signatur Sig ure I X DS -DE 2 ( 7ev. / 3) SEE REVERSE FOR INSTRUCTIONS
CAMPAIGN TREASURER' S REPORT SUMMARY ) c tl PP,ISY Name 2) 006 Magnolia Dr. Address (number and street) Check here if address has changed 3) f I `' a 2z A OFFHCH ': EC,Mr s AND LEGISLAI krie S \... i D[: j ID : NA 4) Check appropriate box(es): Candidate Office Sought: Clearwater Political Committee (PC) Electioneering Communications Org. ( ECO) Party Executive Committee ( PTY) Independent Expenditure ( IE) ( also covers an individual making electioneering communications) City Council Seat 5 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 2 / / 207 To 2 / 3 / 20 7 Report : D2 Original Amendment Special Election Report Contributions This Report Expenditures This Report Cash & Checks $,, 32. 72 Monetary Expenditures, 805. 47 Loans $ 000. 00 Transfers to Office Account Total Monetary $, 32. 72 Total Monetary In -Kind $,, 0. 00 Other Distributions 805. 47 TOTAL Monetary Contributions To 3, 977. 72 0) TOTAL Monetary Expenditures To 3, 83. 27 ) Certification It is a first degree misdemeanor for any person to falsify a public record (ss. 839. 3, F.S.) I certify that I have examined this report and it is true, correct, name) and complete: name) Individual ( only for IE 0 Treasurer Deputy Treasurer 7 Candidate Chairperson ( only for PC and PTY) or electioneering comm.) X,, 67- vt/ Signature Signat i r. X 6(,,,,,, DS -DE 2 ( Rev. / 3) SEE REVERSE FOR INSTRUCTIONS
CAMPAIGN TREASURER' S REPORT - ITEMIZED EXPENDITURES ) Name ( 2) ID. NA 3) Cover Period 2 / / 207 through 2 / 3 / 207 4) Page of 0) ) Purpose add office sought if contribution to a candidate) Expenditure Amendment Amount City of Clearwater 2 / 5/ 207 2 S. Osceola Ave. Election Fees CHE 38. 92 0 2 5 207 Griffin Productions P. O. BOX 34 Advertising Indian Rocks, Beach FL 33785 CHE 695 THE UPS STORE 2 23/ 07 6 S. FT. Harrison Rental CHE 5 2 ZIP Printing 22 207 237 S. Lincoln Ave. Ste. C Printing CHE 580 3 City of Clearwater 2 2807 2 S. Osceola Ave. Copies CHE 5. 85 4 City of Clearwater 2 2 07 2 S. Osceola Ave. Signature Verify CHE 29. 70 5 Zip Prining 2 / 07 237 S. Lincoln Ave. 28 Printing CHE 25 6 7 DS -DE 4 ( Rev. / 3) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES
CAMPAIGN TREASURER' S REPORT ITEMIZED CONTRIBUTIONS ) Name 2) I. D. NA 2 207 2 3 207 3) Cover Period / / through / / ( 4) Page of 0) ) 2) Contributor Contribution In- kind Occupation Description Amendment Amount 2 5 207 Funk, John 006 Magnolia Dr. S Bus. Owner CHE, 000 3 2 0 207 Repper, Mary 28366 Peterson Camp Brooksville, FL 3460 4 I Bus. Owner CHE 00 2/ 8 207 Chenault, Michelle 468 Mandalay Ave. Clearwater, FL 33767 5 I Realtor RCT 93. 90 2/ 8 207 6 Zayas, Ricardo 0800 US Highway 9 Unit 4 Pinellas Park, FL 33782 I IT Tech. RCT 9. 4 2/ 8 207 7 Funk, John 006 Magnolia Dr. S Bus. Owner RCT 9. 4 DS DS - - DE DE 3 3 ( ( Rev. Rev. / / 3) 3) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES
CrFcp4, ;:, CAMPAIGN TREASURER' S REPORT SUMMARY ) Name 2) 006 Magnolia Dr. Address (number and street) Check here if address has changed 3) or,fitremiff LEGSD,,,;,, ID : NA AND DEPT. 4) Check appropriate box(es): Candidate Office Sought: Clearwater Political Committee ( PC) Electioneering Communications Org. ( ECO) Party Executive Committee ( PTY) Independent Expenditure ( IE) ( also covers an individual making electioneering communications) City Council Seat 5 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 / / 207 To / 30 / 207 Report : M Original Amendment Special Election Report Contributions This Report Cash & Checks $,, 565. 00 Expenditures This Report Monetary Expenditures 258. 79 Loans $,, 0. 00 to Transfers Office Account Total Monetary $,, 565. 00 Total Monetary In -Kind $,, 0. 00 Other Distributions 258. 79 TOTAL Monetary Contributions To 2, 665. 00 0) TOTAL Monetary Expenditures To 2, 007. 80 ) Certification It is a first degree misdemeanor for any person to falsify a public record (ss. 839. 3, F.S.) I certify that I have examined this report and it is true, correct, name) and complete: name) Individual ( only for IE 2 Treasurer Deputy Treasurer Q Candidate Chairperson (only for PC and PTY) or electioneering comm.) X l /? Oi - Signature / X?;(,' Signatur V. i- DS -DE 2 ( Rev. / 3) SEE REVERSE FOR INSTRUCTIONS
CAMPAIGN TREASURER' S REPORT ITEMIZED CONTRIBUTIONS ) Name 2) I. D. NA 3) Cover Period / / 207 through 30 207 4) Page of 2 28 207 5 Arnold, Yankee 48 George Rd. Tampa, F 33635 Contributor Contribution 0) In- kind ) 2) Occupation Description Amendment Amount I Pastor CHE 50 GRACE, Tom 28 207 220 Belleview Blvd. 407 6 Belleair, FL 33756 I Attorney CHE 00 MURPHY, Jerry 28 207 959 MANDALAY AVE. CLEARWATER, FL 33767 7 I Army Officer CHE 00 28 207 Shapiro, David 308 Hickory Lane Largo, FL 33770 8 I MD CHE 00 28 207 9 Beach Tran Clearwater LLC 373 Drew St. Clearwater, FL 33759 B APR Transit CHE 50 28 207 KELLY, MARTIN D. 45 Sandy Lane Clearwater, FL 33755 0 I AuthorWriter CHE 00 28 207 FUNK, BRIANA 0800 US Highway 9 Unit 4 Pinellas Park, FL 33782 I Optician CAS 40 DS -DE 3 ( Rev. / 3) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES
CAMPAIGN TREASURER' S REPORT ITEMIZED CONTRIBUTIONS ) Name JOHN FUNK 2) I. D. NA 3) Cover Period / / 207 through / / ( 30 20: 2 2 4) Page 0) ) 2) Contributor Occupation Contribution In- kind Description Amendment Amount 28 207 Wentworth, Glenna 2227 BARN BLVD. CLEARWATER, FL 33764 2 I COUNSELOR CHE 25 DS -DE 3 ( Rev. / 3) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES
CAMPAIGN TREASURER' S REPORT - ITEMIZED EXPENDITURES ) Name ( 2) I. D. NA 3) Cover Period / / 207 through / 30 / 207 4) Page of 0) ) Purpose add office sought if contribution to a candidate) Expenditure Amendment Amount / 2/ 207 THE UPS STORE 6 S. FT. HARRISON CLEARWATER, FL 33756 PRINTING CHE 49. 6 7 / 0 / 207 ONE STOP PRINTING 867 GULF TO BAY BLVD. CLEARWATER, FL 33765 SIGN/ PRINTING CHE 73. 34 8 / 27 07 THEUPS T. STORE 6 S. FT. HARRISON CLEARWATER, FL 33756 PRINTING CHE 35. 69 9 / DS -DE 4 ( Rev. / 3) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES
CAMPAIGN TREASURER' S REPORT SUMMARY ) Name 2) 006 MAGNOLIA DR. Address (number and street) CLEARWATER, FL, 33756 Check here if address has changed 3) 0Qf fempyly itc,, C / tj NOV 207 OFFICIAL RECORDS AND LEGISIATINE SINCS DEPT. ID : NA 4) Check appropriate box(es): Candidate Office Sought: Clearwater Political Committee (PC) Electioneering Communications Org. ( ECO) Party Executive Committee (PTY) Check Independent Expenditure ( IE) ( also covers an individual making electioneering communications) City Council Seat 5 Check here if PC or ECO has disbanded here if PTY has disbanded Check here if no other IE or EC reports will be filed Report Identifiers Cover Period: From 0 / / 207 To 0 / 3 / 207 Report : M0 Original Amendment Special Election Report Contributions This Report Expenditures This Report Cash & Checks $,, 00. 00 Monetary Expenditures, 749. 0 Loans $,, 500. 00 Transfers to Office Account Total Monetary $,, 600. 00 Total Monetary In -Kind $,, 0. 00 Other Distributions, 749. 0 TOTAL Monetary Contributions To 2, 0 0) TOTAL Monetary Expenditures To, 749. 0 ) Certification It is a first degree misdemeanor for any person to falsify a public record (ss. 839.3, F. S.) certify that I have examined this report and it is true, correct, and complete: name) name) Individual ( only for IE fl Treasurer 0 Deputy Treasurer 7 Candidate Chairperson (only for PC and PTY) or electioneering com Signa f Al DS -DE 2 ( Rev. / 3) Cx Signatu SEE REVERSE FOR INSTRUCTIONS
CAMPAIGN TREASURER' S REPORT ITEMIZED CONTRIBUTIONS ) Name JOHN FUNK 2) I. D. NA 3) Cover Period 0 / 207 0 through / 3 207 4) Page of Contributor Occupation Contribution 0) In- kind Description ) Amendment 2) Amount 0/ 4 207 2 0 Funk, John 006 Magnolia Dr. s Bus Owner CHE 500 0/ 0 207 3 Beach, Dan 262 Druid East Clearwater, FL 33764 I Barber CHE 00 0 24 207 Funk, John 4 006 Magnolia Dr. s Bus. Owner CHE, 000 SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES ut ut is is ( ( rcev. rcev. SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES
CAMPAIGN TREASURER' S REPORT - ITEMIZED EXPENDITURES ) Name ( 2) I. D. NA 3) Cover Period 0/ / 207 through 0 / 3 / 207 ( 4) Page of Purpose add office sought if contribution to a candidate) Expenditure 0) Amendment ) Amount 0/ 2 / 20i a Supervisor of Elections 35 Court St Clearwater, FL IT Data CHE 27. 62 0 4 20; /. Roberts Printing 2049 Calumet St Clearwater, FL 33765 Printing CHE 49. 44 2 0 / / 4 207 9 3 Supervisor of Elections 35 Court St. Clearwater, FL. 33756 IT Data CHE 5. 52 0/ 5 / 207 d PH Media 0800 US Hwy 9N # 4 Pinellas Park, FL 33782 Website CBE 320. 00 4 0 / 24/ 20') a Computerized Results MAILER SERVICE 4420 Manhattan Ave. Tampa, FL 3364 CHE 203. 7 5 0 / 2420 CI POSTMASTER C/ O Computerized Results 4420 Manhattan Ave_ Tampa, FL 3364 POSTAGE CHE 662. 72 6 DS DS - - DE DE 4 4 ( ( Rev. Rev. / / 3) 3) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES
CAMPAIGN TREASURER' S REPORT SUMMARY ) Name 2) 006 Magnolia Dr. Address (number and street) Check here if address has changed 3) OFFICE USE ONLY RECEIVED NOV 0 8 20 OFFICIAL RECORDS AND ivcs DEPT. IDIticTIVF 4) Check appropriate box(es): SI Candidate Office Sought: Clearwater Political Committee (PC) Electioneering Communications Org. ( ECO) Party Executive Committee ( PTY) Independent Expenditure ( IE) ( also covers an individual making electioneering communications) City Council Seat 5 Check here if PC or ECO has disbanded Check here if PTY has disbanded here if no other IE or EC reports will be filed 0 Check Report Identifiers Cover Period: From 9 / 4 / 207 To 9 / 30 / 207 Report : M9 Original Ei Amendment Special Election Report Contributions This Report Cash & Checks $,, 500.00 Expenditures This Report Monetary Expenditures 0. 00 Loans $ 0. 00 to Transfers Office Account Total Monetary $,, 500..00 Total Monetary In- Kind $,, 86. 67 Other Distributions 0 00 0. 00 TOTAL Monetary Contributions To 500. 00 0) TOTAL Monetary Expenditures To 0. 00 ) Certification It is a first degree misdemeanor for any person to falsify a public record (ss. 839.3, F. S.) I certify that I have examined this report and it is true, correct, and complete: name) name) Individual ( only for IE NI Treasurer Deputy Treasurer GI Candidate Chairperson (only for PC and PTY) or electioneering comm.) / X, I, / 6e, C x Signature ' Signatu," DS -DE 2 ( Rev. / 3) SEE REVERSE FOR INSTRUCTIONS
CAMPAIGN TREASURER' S REPORT ITEMIZED CONTRIBUTIONS ) Name JOHN FUNK 2) I. D. NA 3) Cover Period 9 4 207 through 9 / 30, 207 4) Page of 0) ) 2) Contributor Contribution In- kind Occupation Description Amendment Amount 9 4 207 Funk, John 006 Magnolia Dr. S Bus. Owner CHE 500 9/ 25 207 2 Funk, John 006 Magnolia Dr. Clearwater, F 33756 S Bus. Owner INK P. O. BOX 86. 67 DS DS - - DE DE 3 3 ( ( Rev. Rev. / / 3) 3) SEE REVERSE FOR FOR INSTRUCTIONS INSTRUCTIONS AND AND CODE CODE VALUES
,_ CAMPAIGN TREASURER' S REPORT SUMMARY ) Campaign Fund oficoruse otio i : w Name 2) 006 Magnolia Dr. Address (number and street) g 207 i. r,-, ` :, LE; LL», L..,. y D Check here if address has changed ( 3) ID : na 4) Check appropriate box(es): NI Candidate Office Sought: Clearwater City Council Seat 5 Political Committee ( PC) Electioneering Communications Org. ( ECO) Party Executive Committee ( PTY) Independent Expenditure ( IE) ( also covers an individual making electioneering communications) 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 9 / 4 / 207 To 9 / 30 / 207 Report : M9 Original Amendment Special Election Report Contributions This Report Cash & Checks $,, 500.00 Expenditures This Report Monetary Expenditures $,, 0. 00 Loans $,, 0.00 Transfers to Total Monetary $,, 500.00 In -Kind $,, 86. 67 Office Account $,, 0 00 Total Monetary $ 0. 00 Other Distributions TOTAL Monetary Contributions To 500. 00 0) TOTAL Monetary Expenditures To 0. 00 It is a first degree misdemeanor for any person ) Certification to falsify a public record (ss. 839. 3, F.S.) I certify that I have examined this report and it is true, correct, and complete: name) name) Individual ( only for IE F4 Treasurer Deputy Treasurer or electioneering comm.) GI Candidate Chairperson ( only for PC and PTY) Signature DE 2 ( Rev. X Sig re SEE REVERSE FOR INSTRUCTIONS
CAMPAIGN TREASURER' S REPORT ITEMIZED CONTRIBUTIONS ) Name JOHN FUNK CAMPAIGN FUND 2) I. D. NA 3) Cover Period 9 / 4 / 207 through 9 30 207 4) Page of 0) ) 2) Contributor Contribution In- kind Occupation Description Amendment Amount 9 4 207 Funk, John 006 Magnolia Dr. S Bus. Owner CHE 500 9/ 25 207 Funk, John 006 Magnolia Dr. Clearwater, Fl 33756 2 S Bus. Owner INK P. O. BOX 86. 67 DS DS - - DE DE 3 3 ( ( Rev. Rev. / / 3) 3) SEE SEE REVERSE REVERSE FOR FOR INSTRUCTIONS INSTRUCTIONS AND AND COD COD bb IL IL ^ ^ u, rrr COT COT.. 00 20I 20I
STATEMENT OF CANDIDATE OFFICE USE ONLY Section 06.023, F. S.) Please print or type) JOI7n/ GC. ni candidate for the office of CL Pfd r u i 6o / c L- s - have been provided access to read and understand the requirements of Chapter 06, Florida Statutes. x / Signature of Candidate z3) ate 2_n/ 7 Each candidate must file a statement with the qualifying officer within 0 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 $, 000, ( ss. 06. 9( )( c), 06.265( ), Florida Statutes). DS ḎE 84 ( 05/ )
APPOINTMENT OF CAMPAIGN TREASURER AND DESIGNATION OF CAMPAIGN DEPOSITORY FOR CANDIDATES Section 06.02( ), F. S.)'( ry PLEASE PRINT OR TYPE) C' - j NOTE: This form must be on file with the qualifying officer before opening the campaign account. OFFICE USE ONLY. C)-IECK APPROPRIATE BOX( ES): l' Initial Filing of Form Re- filing to Change: Treasurer / Deputy Depository Office Party 2. Name of Candidate (in this! order: First, Middle, Last) 4. Telephone d i-i n/ 22 s4q, 3 6f r,, N k 5. E -mail address 446, kksgy,,/,,,, row 6. Office sought (include district, circuit, group number) tv GC rtl G L- Sc-oo 3. Address ( include post office box or street, city, state, zip code) % D c3 6 %r) A tr_ r OL/ A Di- 375-Z GLe rw i ` L 3 7. 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 artisan office, check block and fill in name of party as applicable: My intent is to run as a Write -In No Party Affiliation J Party candidate. 9. I have appointed the following person to act as my Campaign Treasurer Deputy Treasurer 0. Name of Treasurer or Deputy Treasurer Thh,i yu., /c. Mailing Address / 3. City c> 0 6 ma / V v* 0r 6- r k,. p r en 4. County nvp / // as 5. State F -- 6. Zip Code 337C-6 2. Telephone 7. E -ma I address 02 5, 9-3,x. y ric2f a_ cam- v,) /cqy 4ao. Cc,. i 8. I have designated the following bank as my [ Primary Depository Secondary Depository 9. Name of Bank! 69 /- 7t 30d 2. City e e / / c-. Ai 3Luifs 22. County Ai ' e //' ' 20. Address 7/ cl Ai / G/eS 44 Pi. 23. State FLT - d,v 24. Zip Code 33-770 UNDER PENALTIES OF PERJURY, I DECLARE THAT I HAVE READ THE FOREGOING FORM FOR APPOINTMENT OF CAMPAIGN TREASURER AND DESIGNATION OF CAMPAIGN DEPOSITORY AND THAT THE FACTS STATED IN IT ARE TRUE. 25. 26. Signature of Can : te S7- e: l 6 e,-- ) V 2 2 (/ 7 x -% 27. Treasurer's Acceptance of Appointment (fill in the bl -f% s and check the appropriate block) I, D /, V ) z, A)' -, Please Print or Name) do hereby accept the appointment designated above as: Er Campaign Treasurer puty Tre surer. Sefre"-, 6 / DS -DE 9 ( Rev. 0/ 0) y 20/ 7 x ature of Campaign Treasurer or Deputy Treasurer Rule S- 2.000, F.A.C.