Treasurer Report_M12_Kristi Johnson_1/9/2018 t Jn CAMPAIGN TREASURER'S REPORT SUMMARY
OFF
Name I I
Address (number and street) 3
-
City, State, Zip Code
❑ Check here if address has changed (3) ID Number:
(4) Check appropriate box(es):
Candidate Office Sought: V l L-t}aC-,:C CbvNG1 t_ , SIZ�R
❑ 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 1'Z / / l�1 To k' Report Type:
Original ❑Amendment ❑ Special Election Report
(6) Contributions This Report (7) Expenditures This Report
^�, Monetary
Cash & Checks $ , , � Vv
0 Expenditures $ t p-5 .
Loans $ , Transfers to
Office Account $
Total Monetary $
Total Monetary $ ,
In-Kind $ ,
(8) Other Distributions
(9) TOTAL Monetary Contributions To Date (10) TOTAL Monetary Expenditures To Date
$ , 200 . 00 $ t O�
(11) Certification
It is a first degree misdemeanor for any person to falsify a public record(ss. 839.13, F.S.)
I certify that I have examined this report and it is true, correct, and complete:
(Type name) ,O WN)So� (Type name)
❑Individual(only for IE Treasurer ❑Deputy Treasurer n:zandidate ❑Chairperson(only for PC and PTY)
or electioneering comm.)
X
Signature Signature
IDS-DE 12(Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS
CAMPAIGN TREASURER'S REPORT — ITEMIZED CONTRIBUTIONS
(1) Name (2) I.D. Number 1}t
(3) Cover Period through �2— / �j� / �� (4) Page of
(5) (7) (8) (9) (10) (11) (12)
Date Full Name
(6) (Last, Suffix, First, Middle)
Sequence Street Address& Contributor Contribution In-kind
Number City, State,Zip Code -Type Occupation Type Description I Amendment Amount
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()�tibN NA'Y
RECEIVE
JAN 17 2018 �AN��
VILLAGE CLERKS OFO,ICE `�I
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DS-DE 13(Rev.11113) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES
CAMPAIGN TREA S RER'S REPORT - ITEMIZED EXPENDITURES
(1) Name �LS-xc�T (2) I.D. Number
(3)Cover Period 2 / / n through \2 / 31 / (D (4) Page�_of
(5) (7) (8) (9) (10) (11)
Date Full Name Purpose
(6) (Last,Suffix,First, Middle) (add office sought if
Sequence Street Address& contribution to a Expenditure
Number City,State,Zip Code candidate) Type Amendment Amount
1o5.44
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R CEI ED
J N 17 2 18
DS-DE 14(Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES
0 Complete items 1, 2, and 3.
0 Print your name and address on the reverse
so that we can return the card to you.
0 Attach this card to the back of the mailpiece,
or on the front if space permits.
Article Addressed to:
M S - ryl,541, j oh V\ Tor,
11111111111111111111111111111111111111111111
9590 9402 2216 6193 2096 41
2. Article Number (Transfer from service label)
0 Agent
q Addresse
4of Deliver
D. Is delivery address different from item 1? ILU Yes
If YES, enter delivery address below: [3 No
3. Service Type
0 Priority Mail Express(D
0 Adult Signature
0 Registered MailTM
El Adult Signature Restricted Delivery
0 Registered Mail Restrict
El Certified Mail(D
Delivery
0 Certified Mal Restricted Delivery
0 Return Receipt for
Oco c ton Delivery
Merchandise
ect on Delivery Restricted Delivery
Co��e
D Signature ConfirmationT
El Signature Confirmation
7016 1970 0000 0265 16(c icted Delivery Restricted Delivery
'2Q1 1
Village of `requesta
345 Tequesta Drive 561-768-0700
Tequesta, FL 33469 www.tequesta.org
Ms. Kristi Johnson
Dear Ms.Johnson:
Thank you for submitting your M12 Campaign Treasurer's Report on 1/9/18 at 9:30 a.m. Florida
Statutes 106.07(2)(b)1 governs that, "Any report that is deemed to be incomplete by the officer with
whom the candidate qualifies shall be accepted on a conditional basis" to allow me time to review
for completeness and accuracy. I am required to send a certified letter notifying you of any issues
that need to be corrected and/or amended. Upon review of your report,please amend the following
minor item:
• Campaign Treasurer's Report—Itemized Expenditures (DS-DE 14)
o Each section of the report needs to complete. Please fill in Item #8 listing the
purpose of the expense (ex: candidate qualifying fee).
Please submit amendments within seven (7) days of receipt of this notice for the two above reports.
Please feel free to contact me if you have any questions, I understand these reports can be
confusing.
Sincerely,
��(-n&t)
Lori McWilliams, MMC
Village Clerk
Enclosure:
DS-DE 14 report
Vice-Mayor Frank D'Ambra Mayor Abby Brennan Council Member Tom Patemo
Council Member Steve Okun Council Member Vince Arena
Village Manager Michael R.Couzzo,Jr.
CAMPAIGN T S RER'S REPORT— ITEMIZED EXPENDITURES
(1)Name �L- 5�� �'()C�1-1� (2)I.D. Number
(3)Cover Period n through k2 / 31 (4)Page. of
(5) m (8) (9) (10) (11)
Date Full Name Purpose
(6) (Last,Suffix,First,Middle) (add office sought if
Sequence Street Address& contribution to a Expenditure
Number City,State,Mp Code candidate) Type Amendment Amount
IZ 1g 1 V�l, EaF ZA
T
Conc�,a4�
�e
DS-DE 14(Rev.11113) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES
INSTRUCTIONS FOR CAMPAIGN TREASURER'S REPORT - ITEMIZED EXPENDITURES
(1) Candidate's full name or name of the political committee (PC), electioneering communications organization (ECO),
or party executive committee(PTY).
(2) Identiflication number assigned by the filing officer.
(3) Cover period dates 01/01/15 through 01/31/15). (See filing officer's reporting dates calendar for appropriate cover
periods.)
(4) Page numbers (e.g., 1 of 3).
(5) Date of expenditure(Month/Day/Year).
(6) Sequence Number- Each detail line shall have a sequence number assigned to it. Sequence numbers are to be
assigned within each reporting period and for each type of detail line. Thus the report type, detail line type, and
sequence number will combine to uniquely identify a specific contribution, expenditure, distribution or fund transfer.
This method of unique identification is required for responding to requests from the filing officer and for reporting
requirements.
For example, a M1 report having 40 expenditures would use sequence numbers 1 through 40. The next report
(M2), comprised of 30 expenditures would use sequence numbers 1 through 30. Expenditures on amended M1
reports would begin with sequence number 41 and on amended M2 reports would begin with sequence number 31.
See Amendment Type instructions below.
(7) Full name and address of entity receiving payment(including city, state and zip code).
(8) Purpose of expenditure(if expenditure is a contribution to a candidate, also type the office sought by the candidate).
PLEASE NOTE: This column does not apply to candidate expenditures, as candidates cannot contribute to other
candidates from campaign funds. However, PCs (supporting candidates) and party executive committees
contributing to candidates must report office sought(Section 106.07, F.S.).
(9) Enter Expenditure Type using one of the following codes:
Code Description
CAN Candidate Expense
DIS Disposition of Funds
DFC Disposition of Funds to Future Campaign effective 11/1/13
DPP Disposition of Funds to Political Pa effective 11/1/13
DPV Disposition of Funds to Petition Verification effective 11/1/13
ECC Electioneering Communication
IEC Independent Expenditure Regarding a Candidate
IEI Independent Expenditure Regarding an Issue
MON Monetary Not to a Candidate
PCW PettyCash Withdrawn
PCs PettyCash Spent
PPD Pre-paid Distribution
REF Refund(Negative Amount Only)
RMB Reimbursements
TOA Transfer to Office Account(Disposition of Funds
(10) Amendment Type (required on amended reports) - To add a new (previously unreported) expenditure for the
reporting period being amended, enter"ADD" in amendment type on a line with ALL of the required data.
The sequence number for expenditures with amendment type "ADD" will start at one plus the number of
expenditures in the original report. For example, amending an original M1 reports that had 75 expenditures, means
the sequence number of the first expenditure having amendment type "ADD" will be 76; the second "ADD"
expenditure would have sequence number 39.