CAMPAIGN TREASURER' S REPORT SUMMARY ) Tom Keller ORFfrAMDT Name 2) 707 Algonquin Dr. Address ( number and street) Clearwater, FL 33755 Check here if address has changed 3) ID : NOV 0 9 OFFICIAL RECORDS AND LEGISLATIVE SRVCS DEPT, 4) Check appropriate box( es): Candidate Office Sought: Clearwater City Political Committee ( PC) Council Seat 4 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) 5) 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, 050. 00 Monetary Expenditures 5. 94 Loans $, 0, 000. 00 Transfers to Office Account Total Monetary $, 2, 050. 00 Total Monetary In -Kind $ Other Distributions r 5. 94 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. 839. 3, 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 Deputy Treasurer E Candidate or electio X i ering comm.) at 7._ - X Chairperson ( only for PC and PTY) Signature Si ature DE 2 ( Rev. / 3) SEE REVERSE FOR INSTRUCTIONS
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 5) 0) ) 2) Contributor Contribution In -Kind Occupation Description Metropolitan Media Co 0/ 0/ 207 304 W. Horatio St. Tampa, FL 33609 00 B Outdoor Adv. CHE, 000. 00 0/ Tom Keller 0/ 2007 707 Algonquin Drive Clearwater, FL 33755 002 5 LOA 0, 000. 00 0/ James W. Shaw 23/ 207 2742 Clearwater, Burning Tree FL 3376 Ln 003 I Claims Adj. CHE 500. 00 0/ 30/ 207 Jay Keller Jr 502 Manatee Drive Ruskin, FL 004 I Sales Rep. CHE 250. 00 0/ 3/ 207 005 Walter Burnside P. A. Attorney at Law 304 S. Westland Ave. Tampa, FL 33606 B Law office CHE 300. 00 DS -DE 3 ( Rev. / 3) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES
) 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 5) 0) ) Purpose add office sought if contribution to a candidate) Expenditure 0/ 23/ 20/ Custom Graphics of Tampa 669 78th St., Ste. A Riverview, FL 33578 Badges CAN 5. 94 DS - DE 4 ( Rev. / 3) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES
y CAMPAIGN ) Tom Keller Campaign Name 2) 707 Algonquin Dr. Address ( number and street) Clearwater, FL 33755 TREASURER' S REPORT SUMMARY O NOV 27 OFFICIAL RECORDS AND LEGISLATIVF SRV) EPT Check here if address has changed 3) ID : 4) Check appropriate box(es): Candidate Office Sought: Commissioner Political Committee ( PC) Seat 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) 4 5) 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, 050. 00 Monetary Expenditures 5. 94 Loans $, 0, 000. 00 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. 839. 3, F. S.) I certify that I have examined this report and it is true, correct, and complete: name) Kathy Watson 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
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 669 78th St., Ste. A Badges Riverview, FL 33578 CAN 5. 94 DS - DE 4 ( Rev. / 3) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES
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 5) 0) ) 2) Contributor Contribution In- kind Occupation Description Metropolitan Media Co. 0/ 0/ 207 304 W. Horatio Street Tampa, F 33609 00 B CHE, 000. 00 Tom Keller 0/ 0/207 707 Algonquin Drive Clearwater, F 33755 002 S LOA 0, 000. 00 James W. Shaw 0/ 23/ 207 2742 Burning Tree Ln Clearwater, FL 3376 I CHE 500. 00 0/ 30/ 207 Jay Keller Jr 502 Manatee Drive Ruskin, FL 33570 I CHE 250. 00 0/ 3/ 207 Walter Burnside P. A. Attorney at Law 304 S. Wstland Ave. Tampa, FL 33606 B CHE 300. 00 DS -DE 3 ( Rev. / 3) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES