CAMPAIGN TREASURER'S REPORT SUMMARY

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Chastity Baker
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1 . f) War(, &, _ Ct-r. J Name CAMPAGN TREASURER'S REPORT SUMMARY (2) 1{:?f:, ~~ ;3(!,_'t Addres;;umber and street) OFFC E USE ONLY A11 : 3 6 N {hz_u~ D6?112, :_1:L 32.z5_ 7 City, S tate, Zip Code D Check here if address has changed (3) D Number: -(R--nna) (4) Check appropriate box(es): [ia"candidate Office Sought: e;ikr eau(l(, J.-- VYlt7Ut1) Dora D,~+-r-;c t-~ D Political Committee (PC) D Electio neering Communications Org. (ECO) D Party Executive Committee (PTY) D ndependent Expenditure (E) (also covers an individ ual 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 j_f2 ~ 12 -r Cover Period: From _!1_ ( To Report Type: D Original D Amendment D Special Election Report '6) Contributions This Report Cash & Checks $ Loans $ Total Monetary $ ' ' n-kind $ - - ' -- ' (7) Expenditures This Report Monetary Expenditures $ -i?2_,i_.!}_q Transfers to Office Account $ Total Monetary $_!{._2.L 912 (8) Other Distributions $ ' (9) TOTAL Monetary Contributions To Date $ - ' _J)_ ' _f}_.j]{)_ (10) TOTA~ onetary Expec itures 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 namejta-ct,+-h KW~) ch D ndividual (only for E ~Treasurer D Deputy Treasurer or electioneering comm.) ~~,c,e )<;Jg&~ DS-DE 12 Rev. 11/13 (Type name) ~Candidate X Signature Hr!"'n-re c<q:1\,( D Chairperson (only for PC and PTY) '\ 1SEE REVERSE FOR NSTRUCTONS

2 To correct a previously submitted expenditure use the following drop/add procedure. Enter "DEL" in amendment type on a line with the sequence number of the expenditure to be corrected. n combination with the report number being amended, this sequence number will identify the expenditure to be dropped from your active records. On the next line enter "ADD" in amendment type and ALL of the required data with the necessary corrections thus replacing the dropped data. Assign the sequence number as described above. (11) Amount of expenditure.

3 CAMPAGN TREASURER'S REPORT - TEMZED CONTRBUTONS (1) Name (2).D. Number -r '\Z -h (}C( ) (3) Cover Period _3 _ J2 through JQ_ 2 J2 (4) Page _j_ of \ (5) (7) (8) (9) (10) (11) (1 2) Date Full Name (6) (Last, Suffix, First, Middle) Sequence Street Address & Contributor Contribution n-kind Number Citv, State, Zip Code TvPe Occupation TvPe Description Amendment Amount 7 \. w \~ ~ DS-DE 13 (Rev. 11/13) SEE REVERSE FOR NSTRUCTONS AND CODE VALUES

4 MAMPAGN TR~A urer's REPORT - 1TEM1zED EXPEND1TuREs (1) Name LJ...J{k.CC [;(R-\ L (2).D. Number :[R.--- r V' e>, (3) Cover Period g 1_L1_j_Q_ through _!J) 1 3_1J2 (4) Page of _~i c: l (5) Date (6) Sequence Number Cf13t11G (}CJ9C/ (7) Full Name (Last, Suffix, First, Middle) Street Address & City, State, Zip Code {hclkc- ~Ced d -j-3/p!??(a_7ib~/\./ (Jc-lDt!t_a_ 1?-L 3275""7 (8) (9) (1 0) (1 1) Purpose (add office sought if contribution t o a candidate) Expenditure Type fe~rtfof )~(~ \pe< Y"\ Amendment Amount ~3?,fo OS-DE 14 (Rev.11/13) SEE REVERSE FOR NSTRUCTONS AND CODE VALUES

5 11!!1.o cc ~ ro, Nam CAMPAGN TREASURER'S REPORT SUMMARY -L l (2) ;;llj8b "?3ac D Dc,boc D~ Address (number and street) 3 ;;1'] s1 (4) D\'OkHY~ J)oca r:l 1 City, State, Zip Code D Check here if address has changed Check appropriate box(es): []}Candidate Office Sought: 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) OFFCE USE ONLY A10:00 N (3) D Number:..,Q-...,_ ' i,, _ 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 i E_1 f 5 To _K_ 21 j_5_ Report Type: f5toriginal D Amendment D Special Election Report '6) Contributions This Report Cash & Checks $,, Loans Total Monetary $ j_, 0, 12_. OD n-kind $,, (9) TOTAL Monetary Contributions To Date $ _5_ ' _Q_ ' _Q_. _i2q_ (7) Expenditures This Report Monetary Expenditures $ Transfers to Office Account $ Total Monetary $ -, _L ' _J_. _j_j2 (8) Other Distributions $,, (10) TOTAL Monetary Expenditures To Date $_, b_,-/-- JO (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)jvs o{,'th k ukjcb D ndividu al (only for E pa. Treasurer D Deputyh easurer or electioneering comm.) f:-~.rirlfif Y kjdr DS-DE 12 (Rev.11/13) (Type name) ~ Candidate D Chairperson (only for PC and PTY) X Signature SEE REVERSE FOR NSTRUCTONS

6 CAMPAGN TREASURER'S REPORT - TEMZED CONTRBUTONS (1) Name «lace, C.ca~ l (2) 1.0. Number b:,...,,:,, ' 1=---- (3) Cover Period l Jj_ J.!j_ through _$..1}_ J_j_ (4) Page _J_ of _ / _ (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 i,2.,1!{ 5 (Y)vllC, &'eti {. J,f3& /jartfatb r'f rze-h~ev/.i {(]} J)p(C\_ 1L-Jffl57 LtJr+ 6{l{),Pt) DS-DE 13 (Rev. 11/1 3) SEE REVERSE FOR NSTRUCTONS AND CODE VALUES

7 * J!:"of-,~.f.!ST nat1onal BA~~ Spruce up your home with a home improvement loan. FDC T t m 1S \ 0l"RKCC[ll'T.\\111:S;\lU,.XC,\O(l"OST l l W.\lSOR1' \l"<,\-.otcl.\l. ~ r <. t~ll't.cll,(lmij. e1l.uimn ht,.,uu,tdfof,.h~o1 n }itf1 o 1htroo i...,,jd,,l'ail"' C-,fUC..a.-. 1t.,,_L n,lo...s 1rx,oli1M',...J r,jnj~,.j s,.rt" "' t) O{nS.U fi'.,,,r1,.ll:tll~l!c l 'f',r l\f.\lfjll ra:.11nlll' l ltt\,',. l"l/&',lt/f.1.\..i.t<t/0.\..\ '.\JRH t..f,\1).l\t '1L T!Jf 'rr.-l\l.1(7(),\ ',fj(l M/0 1\S,ff;O/ C

8 /hcamp~gn.t~easurer's REPORT- TEMZED EXPENDTURES /7 (1) Name LL.JC{((, _[(u.1;t- (2) 1.0. Number...,.l:,-1~--- c._., (3) Cover Period _ $_1_2{/_1_f_J_ through i 1_jj_1 j;j_ (4) Page / of, (5) (7) Date Full Name (6) Sequence Number (Last, Suffix, First, Middle) Street Address & City, State, Zip Code (8) Purpose (add office sought if contribution to a candidate) (9) Expenditure Type (10) Amendment (11) Amount f9 /~11 LS j (2;~i:,frr\ac,if- ])ry (CV.::, 1;dJ:ef sf. fh t11t<ttf- J}J (/J.,1t- J:J.JS1 ~~pci.,cyi r,!1 f;1 e-e..-- rno,-j bl, JO OS-DE 14(Rev.11/13) SEE REVERSE FOR NSTRUCTONS AND CODE VALUES

9 ti "-., nw Date $ b//o 0097 tw / 631 ~ 01!P!l o o nrs A '"""' w ~;~rt::" a.c. ~ MW{\T Clc:xo. C.ond ido,e.c, C,\~ C,,\~ C)~~ ~re. ~\e_/~

10 POZ: '\PPONTMENT OF CAMPAGN TREASURER AND DESGNATON OF CAMPAGN DEPOSTORY FOR CANDDATES (Section (1 ), F.S.) (PLEASE PRNT OR TYPE) NOTE: This form must be on file with the qualifying officer before openina the camoaian account. 1. CHECK APPROPRATE BOX(ES): ~ nitial Filing of Form Re-filing to Change: D Treasurer/Deputy 0 Depository D 2. Name of Candidate (in this order: First, Middle, Last) \'1[)(C l. C('Q\ \ 4. Telephone 5. address ( ) 6. Office sought (include district, circuit, group number) \~J ~().fc\ C:~Y C.ai,\,/\c) D ~S)r'1ct Y OFFCE USE ONLY Office D Party applicable: My intent is to run as a Write-n candidate. 8. f a candidate for a partisan office, check block and fill in name of party as applicable: My intent is to run as a D Write-n D D 3. Address (include post office box or street, city, state, zip code) 'L43 6 6~-r \~ o.rbo'(' (6 0 "Y \"lowt t 'DMtt f't... 3'(15} 7. f a candidate for a nonpartisan office, check if No Party Affiliation Party candidate. have appointed the following person to act as my Campaign Treasurer Deputy Treasurer,. Name of Trerurer fx Deputy Trea~. ~ ~dr+h K, 'p/c.h 11. Mailing A~ss i{ D ~ D 12. Telephone 3'055 er/) 9'.ven :PL <35J_ ) , 7 b m+. borec- 13. City 14. County l-- '-ke 15. State \:::-L 16. Zip Code 17. address 3d..7S7 t k Lt7c0k h dj C{m:~/, \, [mi 18. have designated the following bank as my D Primary Depositoryc,, D Secondary Depository 19. Name ofbank 20. Address h~s\ ~cr):\l\'{\u.\ ic\~\ ~ \\~~ \)o(oi 11 L.\ ~ b ti {){\e_\ \", t51. \"'\o~ \y)<~ fl 321-S? 22. County 24. Zip Code t) i)l,, ~ )on: Lo.~-1}_ 3 2_ 7 S7 21. City 23. State t L, 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. 25. Date 26. Signature of Candidate ~t?/\$ X ~(-~ ~ 27. Treasurer's Acceptance of Appointment (fill in the blanks an< check the appropriate block), j\a~ \-\-h \( -We\c~, do hereby accept the appointment (Please Print or Type Name) signated above as: Campaign Treasurer D Deputy Treasurer. i\2~\1s DS-DE 9 (Rev.10/10) D te ~ x~ /A orfft : J) OYr_,;2 ~ature of Campaign Treasurer or Deputy Treasurer Rule 1S , F.A.C.

11 P03: CANDDATE OATH - NONPARTSAN OFFCE (Not for use by Judicial or School Board Candidates) OFFCE USE ONLY, OATH OF CANDDATE (Section , Florida Statutes) (PLEASE PRNT NAME AS YOU WSH T TO APPEAR ON THE BALLOT *.. NAME MAY NOT BE CHANGED AFTER THE END OF QUALFYNG) am a candidate for the nonpartisan office of ~ 'A'i)\ l>o (C\ C~ \r Q '!-Vl.'f) l", \ (office) (circuit#) ; am a qualified elector of Lo.\<e.. (group or seat#) L\ (district#) 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. X Signature of Telephone Number 3i. 5} City 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 instructions on page 2 of this form): STATE OF FLORDA county of Lok e. +h Sworn to (or affirmed) and subscribed before me this Q v dayof Ausu s-f, 20 i:s. Personally Known : or c:=:: Produced dentification: / Type of dentification Produced: valid l~l d rr ve,,ten se Signature f.natacyj~_ublic, Print, Type, or Stamp Commissioned Name of Notary Public CHRSTNE URYNOWCZ Notary Public Slate ot Florida DS-DE 25 (Rev. 5/11)

12 OE- : ~-1~ rj3: oo. STATEMENT OF CANDDATE OFFCE USE ONLY (Section , F.S.) (Please print or type), candidate for the office of have been provided access to read and understand the requirements of Chapter 106, Florida Statutes. X Signature of Ca~~ 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). DS-DE 84 (05/1 1)

$<'c L, STATEMENT OF FNANCAL NTERESTS 2014 FOR OFFCE USE ONLY: ZP: COUN Y: 32-+$"/ ~ NAME OF AGENCY: ~ A. L ~ C~-\ of,n~ '(\\ Lx~{l\ You are not limited to the space on he lines on this form.$

13 FORMl " lease print or typ e your name, mailing!dress, agency name, and position below: LAST NAME -- FRST NAME -- MDDLE NAME : Q~,).<'c L, STATEMENT OF FNANCAL NTERESTS 2014 FOR OFFCE USE ONLY: ZP: COUN Y: 32-+$"/ ~ NAME OF AGENCY: ~ A. L ~ C~-\ of,n~ '(\\ Lx~{l\ You are not limited to the space on he lines on this form. Attach additional sheets, if necessary. CHECK ONLY F ~ CANDDATE OR 0 NEW EMPLOYEE OR APPONTEE **** BOTH PARTS OF THS SECTON MUST BE COMPLETED **** DSCLOSURE PEROD: THS STATEMENT REFLEC TS 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 ETHER (must check one): ~ DECEMBER 31, 2014 QB O 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 r;alculatons, OR USNG COMPARATVE THRESHOLDS, WHCH ARE USUALLY BASED ON PERCENTAGE VALUES (see instructions r further details). CHECK THE ONE YOU ARE USNG: 0 COMPARATVE (PERCENTAGE) THRESHOLDS QB XJ 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 OF NCOME SOURCE'S ADDRESS DESCRPTON OF THE SOURCE'S PRNCPAL BUSNESS ACTVTY 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 "nla") NAME OF BUSNESS ENTTY NAME OF MAJOR SOURCES OF BUSNESS' NCOME ADDRESS OF SOURCE 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") 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 - EffecUve: January 1, 2015 (Continued on reverse side) PAGE 1 Adopled by reference in Rule (1), F A.C

14 G~+{\~ c~~;,-c\\ eo-(~. Pa.~ox 2 \C\ 133 \~~ C~y) ~"\Q ~L.l l?j Lf)t f('{\f\i\c\t.\ Y?ol btcjh~ tu,. S()\'(\ l);e.y\ CA q'211\ /\~~rla (~~ Of"ic~(A, NE. (;g,o3 ~.a.~x i-i.oct A.t"ir;<',Cct'f\ 'N ~1,e1i'lf.\\ lit~ 'hl ~0.ff:ox \OL\11 S~, N\jtt_p,\~ 1 Ma re si 0 i

15 CTY OFN Office of the City Manager 510 N. Baker St. Mount Dora, FL MOUNT Fax: DORA PQ3 : 00 ELECTON ASSESSMENT (one percent) COUNTY: Lake A. OFFCE Mayor City Council X B. Address C. ANNUAL SALARY: City Council Member % Election Assessment $6, $ Submitted by: Mayor % Election Assessment $10, $ O 1.29 Undue Burden: Yes: NO:,_X_,, (Note: f 'Yes' is checked, attach Affidavit of Undue Burden) Name Address City Telephone S...: gsk S_'D----'-.]~ 3--='D:::.... l..{ ~-...::.C?...::: '6----'

16 AFFDAVT OF CANDDACY & RESDENCY Gwen Keough-Johns, MMC City Clerk City of Mount Dora 5 10 North Baker Street Mount Dora FL P0 2 RE: AFFDAVT OF CANDDACY & RESDENCY, \'<'\ ;._ Ct, c _ c...:: C=---.,,c co. '-'\,._\ _., a candidate for City of Mount Dora C ity Council Member, District Y (if applicable), or at-large in the / 3/\~ elecho,, do heceby sweac o,affi,m thatl c,s;deat: 2-43 G; A-r ~ Q<\:,~'<' 8 G\Y. O\J.t\1 Do,G\) R s2-1s1 where have resided for Y yes. years/months, and which hereby swear and affirm is located in District L (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 ofmount Dora Charter and Code ofordinances, certify that meet the qualifications for candidacy. am a registered voter of the 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 fo llowing exceptions: that of Notary Public, or membership in the Nat ional 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 ofthe foregoing. 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 OF RESDENCY AND THAT THE FACTS STATED N T ARE TRUE. Office Use Only: ~~ 'v? Signature Date filed: f\0'5~\- d'7.~ \S Rece;,ed by 9.2')Q[YT'\c:0...:<:) Received: / Loyalty Oath / Oath of Candidate Candidate Name Pronunciation Request /_ Statement of Financial nterests Form Affidavit of Candidacy & Residency Date Candidate Qualified: cc: Candidate Date

D Check here if address has changed (3) ID Number:

D Check here if address has changed (3) ID Number: CAMPAGN TREASURER'S REPORT SUMMARY 1) Cq, { f2_o C:S. o V) OFFCE use ONL v Name (2) 8D lff sf. Ad ress (nujllber and street) Of.tt/1,-- b om. /- L 3 2 7 S City, State, Zip Code D Check here if address