CAMPAIGN TREASURER' S REPORT SUMMARY. 5) Report Identifiers. Election Report. Monetary. Transfers to. Office Account.
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1 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) 5) Report Identifiers Cover Period: From 0/ 0/ 208 To 0/ / 208i Report : G Original Amendment Special Election Report 6) 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
2 CAMPAIGN TREASURER' S REPORT - ITEMIZED EXPENDITURES ) Name Tom Keller ( 2) I. D. 3) Cover Period 0/ 0qo8 / through 0/ // 208 4) Page of 5) 0) ) Purpose 6) add office sought if contribution to a candidate) Expenditure Amendment Amount 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)
3 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) 5) Report Identifiers Cover,Period: From 2/ / 207 / To 2/ 3/ / 207/ Report : M2 I Original Amendment Special Election Report 6) 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
4 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 5) 6) 2/ 3/ Andrew Stinnette, pa 597 Main Street Dunedin, FL Contributor Contribution 0) In- kind Occupation Description ) 2) Amendment Amount B Attorney CHE / 3/ Accent 304W. Horatio Street Tampa, FL b Printing INK Yards signs DS -DE 3 ( Rev. / 3)
5 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 5) Report Identifiers Cover Period: From / 0/ 207i To / 30/ 207i Report : MI Original Amendment Special Election Report 6) 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
6 CAMPAIGN TREASURER' S REPORT ITEMIZED CONTRIBUTIONS ) Name Tom Keller 2) I. D. / 0/ 207 / 30/ 207 3) Cover Period / / through / / ( 4) Page of 5) 0) ) 2) 6) Contributor Occupation Contribution In- kind Description Amendment Amount / 5/ 207 Rocker Corporation 304 W. Horatio St. Tampa, FL B Real Estate CHE, DS -DE 3 ( Rev. / 3)
7 ) Name Tom Keller CAMPAIGN TREASURER' S REPORT - ITEMIZED EXPENDITURES 2) I. D. 3) Cover Period / 0/ 07 / through / 30// 207 / 4) Page. of 5) 0) ) S) Purpose add office sought if contribution to a candidate) Expenditure Amendment Amount / 03{ 20/ Strategic Solutions of Florida Professional Fees Voter data system CAN 2, DS -DE 4 (Rev. / 3)
8 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) 5) Report Identifiers Cover Period: From 0/ 0/ 207/ To 0/ 3/ 207/ Report : M 0 Original damendment Special Election Report 6) 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
9 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) 6) Contributor Occupation Contribution In -Kind Description Amendment Amount 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)
10 ) 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) 6) Purpose add office sought if contribution to a candidate) Expenditure 0) Amendment ) Amount 0/ 23/ 20/ Custom Graphics of Tampa th St., Ste. A Riverview, FL Badges CAN DS -DE 4 ( Rev. / 3)
11 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) 5) Report Identifiers Cover Period: From 0/ 0A/ 207/ To 0/ 3/ / 207/ Report : M 0 Original Amendment Special Election Report 6) 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
12 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) ) 6) Purpose add office sought if contribution to a candidate) Expenditure Amendment Amount 0/ 2320/ Custom Graphics of Tampa th St., Ste. A Riverview, FL Badges CAN DS -DE 4 (Rev. / 3)
13 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) 6) Contributor Contribution In- kind Occupation Description Amendment Amount 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)
14 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.
15 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
CAMPAIGN TREASURER' S REPORT SUMMARY. 5) Report Identifiers. Monetary Expenditures. Transfers to Office Account $ 8) Other Distributions 10)
) Tom Keller Name 2) 707 Algonquin Dr. Address (number and street) Clearwater, FL 33755 CAMPAIGN TREASURER' S REPORT SUMMARY Check here if address has changed 4) Check appropriate box(es): p Candidate
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