6 à acerporcted 1942 TOWN OF OCEAN BREEZE, FLORIDA CANDIDATE INFORMATION ELECTION: Tuesday, November 4, 2025 QUALIFYING PERIOD: Friday, August 1, 2025 through Thursday, August 21, 2025 REQUIRED FORMS & SUGGESTED READING: 1. Statement of Candidate (DS-DE 84) 2. Candidate Oath (notarized) (DS-DE 302NP) 3. Form 1 Instructions and e-filing Sample Note: Form 1 must be filed clectronically! When e-filing Form 1 on the Commission of Ethics website NsSNA ifyou are filing as a new Candidate click on "I am a Candidate. .If you are filing as a Candidate, but already a municipal official. log on to your account at the Commission ofEthics and print or otherwise provide the verification receipt of your e-filing tothe Town Clerk who is the Qualifying Officer for the election. 4. Memo Re: Campaign Treasurers Appointment and Reports (DS-DE 9, DS-DE 12 & DS-DE 87) 5. Affidavit for Campaign Accounting 6. Logic & Accuracy Test Notice Receipt 7. The Florida Election Code (2024) FL Statutes Chapter 106 htpsy/deslgoveksctionstimsfomemilisitionsnubisamtionsrpens 8. Florida Political Committee Handbook (Revised: 2023) - online 9. The Florida Municipal Officials Handbook (2022) htps/www.fcities.comsusteresourceslethics-civiliy. Hard copy available at Town Office. 10. Government in Sunshine Manual htps/my.leridhlegalcomhseHismfVEMNOSB900P5TIeSumhine-Mmmualpdr Upon request, the Town Clerk will provide hard copies of any ofthe material found at the above-referenced links. Please file all forms with the Town Clerk's office by close ofbusiness 2:00PM Thursday, August 21, 2025. The Town office is located at: 1508 NE Jensen Beach Boulevard, Jensen Beach. Kim Stanton, Town Clerk Town ofOcean Breeze Telephone: (772) 334-6826 Fax: 772) 334-6823 lownclerk@townoloceanbreeze.org Monday Friday, 9:00 a.m. - 2:00 p.m. (Revised 5/24/2025) OFFICE USE ONLY STATEMENT OF CANDIDATE (Section 106.023, F.S.) (Please print or type) , candidate for the office of Town Council have been provided access to read and understand the requirements of Chapter 106, Florida Statutes. X Signature of Candidate 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. 106.19(1)(c), 106.265(1), Florida Statutes). DS-DE 84 (05/11) CANDIDATE OATH NONPARTISAN OFFICE (Dor not use this form if a Judicial or School Board Candidate) Check box only if you are seeking to qualify as a write-in candidate: Write-in candidate OFFICE USE ONLY Candidate Oath Name to appear on ballot: Check box ift two last names without hyphen. (Name cannot be changed after qualifying.) Check box if name includes nickname. (For use of a nickname, you must complete the Nickname Affidavit on reverse side.) Iswear or affirm that am a candidate for the nonpartisan office of Town Council N/A (Office) (District #) N/A N/A lam a qualified elector of Martin County, Florida (Circuit #) (Group or Seat #) am a qualified elector under the Constitution and the Laws of Florida to hold the office to which I desire to be nominated or elected; I have qualified for no other public office in the state, the term of which office or any part thereof runs concurrent with the office I seek; and I have resigned from any office from which I am required to resign pursuant to Section 99.012, Florida Statutes; and I will support the Constitution of the United States and the Constitution of the State of Florida. Statement of Outstanding Fines, Fees, or Penalties I owe outstanding fines, fees, or penalties, that cumulatively exceed $250, for ethics or campaign finance violations (s. 99.021(1)(d), F.S.). YES, 1 Do NO, I Do Not Ify you do, you must also specify the amount owed and each entity that levied the same on the reverse side. X - ) / Signature of Candidate Telephone Number Email Address Ocean Breeze FL 34957 Address of Legal Residence City State ZIP Code STATE OF FLORIDA COUNTY OF Signature of Notary Public Print, Type, or Stamp Commissioned Name of Notary Public below: Sworn to (or affirmed) and subscribed before me by means of online notarization OR physical presence this day of 20 Personally Known OR Produced Identification Type of Identification Produced: DS-DE 302NP (Eff. 10/2023) Rule 1S-2.0001, F.A.C. Phonetic Spelling of Name Phonetic spelling for the audio ballot (not required for qualifying purposes): Print the name phonetically on the line below as you wish it to be pronounced on the audio ballot as may be used by persons with disabilities (see instructions on page 3 of this form): Statement of Outstanding Fines, Fees or Penalties Pursuant to Section 99.021(1)(d), FS., each candidate, whether a party candidate, a candidate with no party affiliation, or a write-in candidate, shall, at the time of subscribing to the oath or affirmation, state in writing whether he or she owes any outstanding fines, fees, or penalties that cumulatively exceed $250 for any violations of s. 8,Art. II of the State Constitution, the Code of Ethics for Public Officers and Employees under part III of chapter 112, any local ethics ordinance governing standards of conduct and disclosure requirements, or chapter 106. Amount Entity Affidavit of Nickname (Only required if using nickname for the ballot.) My legal name is I am over the age of eighteen (18) and the contents of this affidavit are true and correct. My nickname is lam generally known by this nickname or have used it as part of my legal name. have not created the nickname to mislead voters. My nickname does not imply I am some other person, constitute ap political slogan or otherwise associate me with a cause or issue, or that is obscene or profane. Signature of Candidate: STATE OF FLORIDA COUNTY OF Signature of Notary Public Print, Type, or Stamp Commissioned Name of Notary Public below: Sworn to (or affirmed) and subscribed before me by means of online notarization OR physical presence this day of 20 Personally Known OR Produced Identification Type of Identification Produced: DS-DE 302NP (Eff. 10/2023) Rule 1S-2.0001, F.A.C. DO NOT SUBMIT THIS PAGE TO THE FILING OFFICER Guide for Designating Phonetic Spelling of Candidate's Name for Audio Ballot 1. Use the tables below. 2. Use upper case for "stressed" syllables. Use lowercase for "unstressed" syliables. 3. Use dashes (-) to separate syllables. 4. Add any notes such as rhyming examples, silent letters, etc. Vowels Stressed Vowel Sounds Unstressed Vowel. Sounds EE (FEET) feet uh (SO-fuh) sofa (FING-guhr) finger I (FIT) fit E (BED) bed A (KAT) cat (KAD) cad AH (FAH-thur) father (PAHR) par AH (HAHT) hot (TAH-dee) toddy UH (FUHJ) fudge (FLUHD) flood UH (CHUHRCH) church AW (FAWN) fown Certain Vowe!. Sounds with R U (FUL)full AHR (PAHR) par 00 (FOOD) food ER (PER) pair OU (FOUND) found IR (PIR) peer O (FO) foe OR (POR) pour El (FEIT) fight OOR (POOR) poor Al (FAIT) fate UHR (PUHR) purr OI (FOIL)foil YOO (FYOOR-ee-uhs) furious Consonants B (BED) bed R (RED) red D (DET) debt S (SET)set F (FED)fed T (TEN) ten G (GET) get V (VET) vet H (HED) head Y (YET) yet HW (WHICH) which W (WICH) witch J (JUHG) jug CH (CHUCRCH) church K (KAD) cad SH (SHEEP) sheep L (LAIM) lame TS (ITS) its (PITS-feeld) Pittsfield M (MAT) mat TH (THEI) thigh N (NET) net TH (THEI) thy NG (SING-uhr) singer ZH (A-zhuhr) azure (Vi-zhuhn) vision P (PET) pet Z (GOODZ) ) goods! HUH-buhz-tuhn) Hubbardston Examples of Phonetically Spelled Names NAME ON BALLOT PRONOUNCED AS Mishaud mee-SHO ('d' is silent) Jahn HAHN (rhyme: fawn) Beauprez boo-PRAI (rhyme: hooray) Maniscalco man-uh-SKAL-ko Tangipahoa TANj-pah-HO-uh Monte Mahn-TAI Tanya TAWN-yuh (not TAN) DO NOT SUBMIT THIS PAGE TO THE FILING OFFICER 2023 Form 1 - Statement of Financial Interests General Information Name: DISCLOSURE FILER Address: SAMPLE ADDRESS PID SAMPLE County: SAMPLE COUNTY AGENCY INFORMATION - Organization Suborganization Tin SAMPLE SAMPLE SAMPLE Disclosure Period R THIS STATEMENT REFLECTS YOUR FINANCIAL INTERESTS FOR CALEN BARYEAR NDING DECEMBER 31, 2023. Primary Sources of Income PRIMARY SOURCE OF INCOME (Over $2,500 çes of income to the reporting person) (If you have nothing to report, write "r 0 n/a") Description of the Source's Name of Source of Income Sou çe's Address Principal Business Activity a SAMPLE Printed from the Florida EFDMS System Page 1 of 4 2023 Form 1 - Statement of Financial Interests Secondary Sources of Income SECONDARY SOURCES OF INCOME (Major customers, clients, and other sources of income to businesses owned by the reporting person) (If you have nothing to report, write "none" or "n/a") Name of Business Entity Name of Major Sources Address of Source Principal usiness of Business'Income Activity ofSos rce Real Property REAL PROPERTY (Land, buildings owned by the reporting person) (If you have nothing to report, write "none" or "n/a") Location/Description R G Intangible Personal Property INTANGIBLE PERSONAL PROPERTY (Stock bon certificates of deposit, etc. over $10,000) (If you have nothing to report, write "none ny Type of Intangible Business Entity to Which the Property Relates - SAMPLE Printed from the Florida EFDMS System Page 2 of 4 2023 Form 1 - Statement of Financial Interests Liabilities LIABILITIES (Major debts valued over $10,000): (If you have nothing to report, write "none" or "n/a") Name of Creditor Address of Creditor - 6 Interests in Specified Businesses 2 - - INTERESTS IN SPECIFIED BUSINESSES (Ownership or positions in certain types of bus (If you have nothing to report, write "none" or "n/a") Business Entity # 1 C Training Based on the office or position you hold, be Ce ification of training required under Section 112.3142, F.S., is not applicable to you for this form year. - - A e SAMPLE Printed from the Florida EFDMS System Page 3 of 4 2023 Form 1 - Statement of Financial Interests Signature of Filer Digitally signed: Filed with COE: / - A SAMPLE Printed from the Florida EFDMS System Page 4 of 4 2024 Form 1 Instructions Statement of Financial Interests Notice The annual Statement of Financial Interests is due July 1.If the annual form is not submitted via the electronic filing system created and maintained by the Commission by September 1, an automatic fine of $25 for each dayl late will be imposed, up to a maximum penalty of $1,500. Failure to file also can result in removal from public office or employment. [s. 112.3145, F.S.] In addition, failure to make any required disclosure constitutes grounds for and may be punished by one or more of the following: disqualifiçation from being on the ballot, impeachment, removal or suspension from office or employment, demotion, reduction in salary. reprimand. or a civil penalty not exceeding $20.000. [s. 112.317. F.S.) Instructions for Completing and Filing Form 1 Statement of Financial Interests WHEN TO FILE: Initially. each local officer/employee, state officer, and specified state employee must file within 30 days of the date of his or her appointment or of the beginning of employment. Appointees who must be confirmed by the Senate must file prior to confirmation, even if that is less than 30 days from the date of their appointment. Candidates must file at the same time they file their qualifying papers. Thereafter, file by July 1following each calendar year in which they hold their positions. Finally. file a final disclosure form (Form 1F) within 60 days of leaving office or employment. Filing a CE Form 1F (Final Statement of Financial Interests) does not relieve the filer of filing a CE Form 1i if the filer was in his or her position on December 31, 2024. WHOI MUST FILE FORM1: 1. Elected public officials not serving in a political subdivision of the state and any person appointed to fill a vacancy in such office. unless required to file full disclosure on Form 6. 2. Appointed members of each board. commission, authority. or council having statewide jurisdiction, excluding those required to fle full disclosure on Form 6 as well as members of solely advisory bodies, but including judicial nominating commission members; Directors of Enterprise Florida, Scripps Florida Funding Corporation, and Career Source Florida; and members of the Council on the Social Status of Black Men and Boys; the Executive Director, Governors, and senior managers of Citizens Property Insurance Corporation; Governors and senior managers of Florida Workers' Compensation Joint Underwriting Association: board members of the Northeast Fla. Regional Transportation Commission; board members of Triumph Gulf Coast, Inc; board members of Florida Is For Veterans, Inc.; and members of the Technology Advisory Council within the Agency for State Technology. 3. The Commissioner of Education, members of the State Board of Education, the Board of Governors, the local Boards of Trustees and Presidents of state universities. and the Florida Prepaid College Board. 4. Persons elected to office in any political subdivision (such as municipalities, counties, and special districts) and any person appointed to fill a vacancy in such office, unless required to file Form 6. 5. Appointed members of the following boards, councils. commissions, authorities, or other bodies of county, municipality, school district, independent special district, or other political subdivision: the governing body of the subdivision; community college or junior college district boards of trustees: boards having the power to enforce local code provisions; boards of adjustment: community redevelopment agencies; planning or zoning boards having the power to recommend, create, or modify land planning or zoning within a political subdivision, except for citizen advisory committees. technical coordinating committees. and similar groups who only have the power to make recommendations to planning or zoning boards, and except for representatives of a military installation acting on behalf of all military installations within that jurisdiction; pension or retirement boards empowered to invest pension or retirement funds or determine entitlement to or amount of pensions or other retirement benefts, and the Pinellas County Construction Licensing Board. 6. Any appointed member of a local government board who is required to hle a statement of financial interests by the appointing authority or the enabling legislation, ordinance, or resolution creating the board. 7. Persons holding any of these positions in local government: county or city manager; chief administrative employee or finance director of a county, municipality, or other political subdivision; county or municipal attorney; chief county or municipal building inspector; county or municipal water resources coordinator; county or municipal pollution controi director; county or municipal environmental control director; county or municipal administrator with power to grant or deny a land development permit; chief of police; fire chief; municipal clerk; appointed district school superintendent: 1/4 community college president: district medical examiner: purchasing agent (regardless of title) having the authority to make any purchase exceeding $35,000 for the local governmental unit. 8. Officers and employees of entities serving as chief administrative officer of a political subdivision. 9. Members of governing boards of charter schools operated by a city or other public entity. 10. Employees in the office of the Governor or of a Cabinet member who are exempt from the Career Service System, excluding secretarial, clerical, and similar positions. 11. The following positions in each state department, commission, board, or council: Secretary, Assistant or Deputy Secretary, Executive Director, Assistant or Deputy Executive Director, and anyone having the power normally conferred upon such persons. regardless of title. 12. The following positions in each state department or division: Director, Assistant or Deputy Director, Bureau Chief, and any person having the power normally conferred upon such persons, regardless of title. 13. Assistant State Attorneys, Assistant Public Defenders, criminal conflict and civil regional counsel, and assistant criminal conflict and civil regional counsel, Public Counsel, full-time state employees serving as counsel or assistant counsel to a state agency, administrative law judges, and hearing officers. 14. The Superintendent or Director of a state mental health institute established for training and research in the mental health field, or any major state institution or facility established for corrections, training, treatment, or rehabilitation. 15. State agency Business Managers, Finance and Accounting Directors, Personnel Officers, Grant Coordinators, and purchasing agents (regardiess of title) with power to make a purchase exceeding $35,000. 16. The following positions in legislative branch agencies: each employee (other than those employed in maintenance, clerical, secretarial, or similar positions and legislative assistants exempted by the presiding officer of their house); and each employee of the Commission on Ethics. 17. Each member of the governing body of a "large-hub commercial service airport," as defined in Section 112.3144()(c), Florida Statutes, except for members required to comply with the financial disclosure requirements of s. 8, Article II of the State Constitution. ATTACHMENTS: A1 filer may include and submit attachments or other supporting documentation when filing disclosure. PUBLIC RECORD: The disclosure form is a public record and is required by law to be posted to the Commission's website.Your Social Securitynumber. bankaccount. debit. charge.anderditsandnwmbers-matgage or brokerage account numbers. personall identificationr numbers. aasEsetsmanaeA arenot required ands should not be included. If such information is included in the filing. it may be made available for public inspection and copying unless redaction is required by the filer, without any liability to the Commission. If you are an active or former officer or employee listed in Section 119.071, FS., whose home address or other information is exempt from disclosure, the Commission will maintain that confidentiality if yous suhmitawittenandnotarizedrsauest. QUESTIONS about this form or the ethics laws may be addressed to the Commission on Ethics, Post Office Drawer 15709, Tallahassee, Florida 32317-5709; physical address: 325 John Knox Road, Building E, Suite 200, Tallahassee, FL 32303; telephone (850) 488-7864. Instructions for Completing Form 1 Primary Sources of Income 112.3145(3)0b)1. F.S] This section is intended to require the disclosure of your principal sources of income during the disclosure period. Youdo nothavet to disclose anypublics salaryorp public position(s). The income of your spouse need not be disclosed; however, if therei is joint income to you and your spouse from property you own jointly (such as interest or dividends from a bank account or stocks). you should disclose the source oft that income if it exceeded the threshold. Please list in this part of the form the name, address. and principal business activity of each source of youri income which exceeded $2,500 of gross income received by you in your own name or by any other person for your use or benefit. "Gross income" means the same as it does for income tax purposes, even if the income is not actually taxable, such as interest on tax-free bonds. Examples include: compensation for services, income from business, gains from property dealings, interest, rents, dividends. pensions, IRA distributions, social security. distributive share of partnership gross income. and alimony if considered gross income under federal law, but not child support. If disclosure of a primary source of income will place you in violation of confidentiality or privilege pursuant to law or rules governing attorneys, you may write "Legal Client" in each of the disclosure fields without providing any further information. Examples: Ifyou were employed by a company that manufactures computers and received more than $2,500. list the name of the company. its address, and its principal business activity(computer manufacturing). Ifyou were a partner in a law firm and your distributive share of partnership gross income exceeded $2,500, list the name oft the firm, its address, and its principal business activity (practice of law). 2/4 Ifyouv were the sole proprietor of a retail gift business and your gross income from the business exceeded $2,500, list the name of the business, its address, and its principal business activity (retail gift sales). Ify your received income from investments in stocks and bonds, list eachindividual company from which you derived more than $2,500. Do not aggregate all ofy your investment income. If moret than $2,500 of your gross income was gain from the sale of property (not just the selling price). list as a source ofi income the purchaser's name. address and principal business activity. If the purchaser's identityi is unknown, such as where securities listed on an exchange are sold through al brokerage firm, the source of income should be listed as "sale of (name of company) stock," for example. Ifn moret than $2,500 of your gross income was in the form of interest from one particular financial institution (aggregating interest from all CD's, accounts. etc.. at that institution). list the name of the institution. its address, and its principal business activity. Secondary Sources of Income [Required by S. 112.3145(3)(b)2. F.S.J This part is intended to require the disclosure of major customers, clients, and other sources ofi income to businesses in which you own an interest. Itisnoti forreporting! income froms second jobs. That kind of income should be reported in "Primary Sources of Income,"i ifi it meets the reporting threshold. You will not have anything to report unless, during the disclosure period: 1. You owned (either directly or indirectlyi in the form ofa an equitable or beneficial interest) more than 5% of the total assets or capital stock of a business entity (a corporation, partnership. LLC. limited partnership, proprietorship. joint venture, trust, firm, etc., doing business in Florida); and, 2. You received more than $5,000 of your gross income during the disclosure period from that business entity. Ify your interests and gross income exceeded these thresholds. then for that business entity you must list every source of income to the business entity which exceeded 10% of the business entity's gross income (computed on the basis of the business entity's most recently completed fiscal year). the source's address. and the source's principal business activity. Ifo disclosure of a secondary source of income will place you in violation of confidentiality or privilege pursuant to law or rules governing attorneys. you should disclose the name of the business entity for which your ownership and gross income exceeded the two thresholds above, and then write "Legal Client" in the remaining disclosure fields without providing any furtheri information. Examples: Youa are the sole proprietor of a dry cleaning business, from which you received more than $5,000. If only one customer, a uniform rental company. provided more than 10% of your dry cleaning business, you must list the name of the uniform rental company. its address, and its principal business activity (uniform rentals). You are a 20% partner in a partnership that owns a shopping mall and your partnership income exceeded the above thresholds. List each tenant of the mall that provided more than 10% of the partnership's gross income and the tenant's address and principal business activity. Real Property (Required by S. 112.3145(3)(b)3. F.S.] Int this part, list the location or description of all real property in Florida in which you owned directly or indirectly at any time during the disclosure period in excess of 5% of the property's value. You Larenotrequiredt to! listyourresidences. Youshould lista any.vacationl homesi ify you derivei income from them. Indirect ownership includes situations where you are a beneficiary of a trust that owns the property. as well as situations where you own more than 5% of a partnership or corporation that owns the property. The value of the property may be determined by its market value for tax purposes, in the absence of a more accurate fair market value. The location or description of the property should be sufficient to enable anyone who looks at the form to identify the property. A street address should be used, if one exists. Intangible Personal Property (Required by s. 112.3145(3)b)3. F.S.J Describe anyi intangible personal property that, at any time during the disclosure period. was worth more than $10,000 and state the business entity to which the propertyrelated. Intangible personal propertyi includes things such as cash on hand. stocks. bonds, certificates of deposit, vehicle leases, interests in businesses, beneficial interests ini trusts, money owed you (including. but not limited to, loans made as a candidate to your own campaign). Deferred Retirement Option Program (DROP) accounts. the Florida Prepaid College Plan, and bank accounts in which you have an ownership interest. Intangible personal property also includes investment products held in IRAS, brokerage accounts, and the Florida College Investment 3/4 Plan. Note that the producto containedi linal brokerage account. IRA. orthe Florida College Investment Plani is vourasset-not the accountor plani itself. Things like automobiles and houses you own, jewelry, and paintings are not intangible property. Intangibles relating to the same business entity may be aggregated: for example, CDs and savings accounts with the same bank. Property owned as tenants by the entirety or as joint tenants with right of survivorship. including bank accounts owned in such a manner, should be valued at 100%. The value of a leased vehicle is the vehicie's present value minus the lease residual (a number found on the lease document). Liabilities [Required by S. 112.3145(3)(b)4. F.S.) List the name and address of each creditor to whom you owed more than $10,000 at any time during the disclosure period. The amount of the liability of a vehicle lease is the sum of any past-due payments and all unpaid prospective lease payments. You are not required to list the amount of any debt. You do not have to disclose credit card and retail installment accounts, taxes owed (unless reduced to a judgment). indebtedness on a life insurance policy owed to the company of issuance, or contingent liabilities. A "contingent liability" is one that will become an actual liability only when one or more future events occur or fail to occur, such as where you are liable only as a guarantor, surety, or endorser on a promissory note. If you are a "co-maker" and are jointly liable or jointly and severally liable, then it is not a contingent liability. Interests in Specified Businesses [Required by S. 112.3145(7). F.S.) The types of businesses covered in this disclosure include: state and federally chartered banks: state and federal savings and loan associations; cemetery companies; insurance companies; mortgage companies: credit unions; small loan companies; alcoholic beverage licensees: pari-mutuel wagering companies. utility companies, entities controlled by the Public Service Commission; and entities granted a franchise to operate by either a city or a county government. Disclose in this part the fact that you owned during the disclosure period an interest in, or held any of certain positions with the types of businesses listed above. You must make this disclosure if you own or owned (either directly or indirectly in the form of an equitable or beneficial interest) at any time during the disclosure period more than 5% of the total assets or capital stock of one oft the types of business entities listed above. You also must complete this part of the form for each of these types of businesses for which you are, or were at any time during the disclosure period, an officer, director, partner, proprietor, or agent (other than a resident agent solely for service of process). Ify you have or held such a position or ownership interest in one of these types of businesses, list the name of the business, its address and principal business activity, and the position held with the business (if any). If you own(ed) more than a 5% interest in the business, indicate that fact and describe the nature of your interest. Training Certification [Required by S. 112.3142. F.S.] Ify you are a Constitutional or elected municipal officer. appointed school superintendent, a commissioner of a community redevelopment agency created under Part II, Chapter 163, or an elected local officer of an independent special district, including any person appointed to fill a vacancy on an elected independent special district board, whose service began on or before March 31 of the year for which you are filing. you are required to complete four hours of ethics training which addresses Article II, Section 8 of the Florida Constitution, the Code of Ethics for Public Officers and Employees, and the public records and open meetings laws of the state. You are required to certify on this form that you have taken such training. CE FORM 1 Effective: January' 1, 2025 Incorporated by reference in Rules 34-8.001 and 34-8.202, F.A.C 4/4 Town ofOcean Breeze MEMORANDUM DATE: August 1, 2025 TO: All Candidates FROM: Kim Stanton, Town Clerk SUBJECT: Campaign Treasurer's Report Even if Candidate is NOT opening a campaign account or hiring a Campaign Treasurer, Candidate must file a WAIVER OF REPORT (DS-DE 87). The Campaign Treasurer's Reports (Form DS-DE 12) are due as follows: Due Date Period Covered Report Type August 29 August 1 = August 22 G1 September 12 August 23 - September 5 G2 September 26 September 6 - September 19 G3 October 10 September 20 - October 3 G4 October 24 October 4 - October 17 G5 October 31 October 18 - October 30 G6 November 17 File Termination Report by due date if no TR election because of no opposition. February 2, 2026 File Termination Report by due date if an TR election is held. All reports (G1 - G6 & TR) must be filed even ifyou have neither collected nor spent any money. Please note that this form needs to be signed by the candidate and the campaign treasurer. If there is no activity for the reporting period, a waiver of report must be filed. Ify you opened a Campaign Account, remember to save all receipts and cancelled checks as "they must be preserved until the expiration ofthe term of the office the candidate seeks. 97 (FS 106.06)(3) All forms are available at the Town Clerk's office, Town website: htps/www.townofoceambreezeorg and htps/oww.dosmyleraaiicmaimlomespublisamion.fom: Whether you spend money or your campaign or not, everyone must file a DS-DE9 with the Town Clerk . O. Box1025 e Jensen Beack, FL 34958 Office: 772-334-6826 e Fax: 772-334-6823 e toumoforeambreraorg APPOINTMENT OF CAMPAIGN TREASURER AND DESIGNATION OF CAMPAIGN DEPOSITORY FOR CANDIDATES (Section 106.021(1), F.S.) (PLEASE PRINT OR TYPE) NOTE: This form must be on file with the filing officer before opening the campaign account. OFFICE USE ONLY 1. CHECK APPROPRIATE BOX(ES): Initial Filing of Form Re-filing to Change: Treasurer/Deputy Depository Office Party 2. Name of Candidate (in this order: First, Middle, Last): 3. Address (include PO Box or Street, City, State, Zip Code): (Please Print or Type Name) 4. Telephone: 5. Candidate's Voter Registration #: 6. Email Address: (not required for qualifying purposes) 7. Office Sought (include district, circuit, group, or seat #): 8. Ifa candidate for a nonpartisan office, check the box if applicable: Town Council intend to run as a Write-In Candidate. 9.Ifa a candidate for partisan office, check the box and fill in the name of the party as applicable: intend to run as a Write-In Candidate. No Party Affiliation Candidate. N/A Party candidate. 10. I have appointed the following person to act as my: Campaign Treasurer Deputy Treasurer 11. Name of Treasurer or Deputy Treasurer: 12. Telephone: 13. Email Address: - 14. Mailing Address: 15. City: 16. State: 17. Zip Code: 18. I have designated the following bank as my (check appropriate box): Primary Depository Secondary Depository 19. Name of Bank: 20. Address: 21. City: 22. County: 23. State: 24. Zip Code: UNDER PENALTIES OF PERJURY, I DECLARE THATIHAVE READ THE FOREGOING FORM FOR THE APPOINTMENT OF THE CAMPAIGN TREASURER AND DESIGNATION OF THE CAMPAIGN DEPOSITORY AND THAT THE FACTS STATED IN IT ARE TRUE. 26. Signature of Candidate: 25. Date: X 27. Treasurer's Acceptance of Appointment (fill in the blanks and check the appropriate box) I, do hereby accept the appointment designated above as: (Please Print or Type Name) Campaign Treasurer. Deputy Treasurer. 29. Signature of Campaign Treasurer or Deputy Treasurer 28. Date: - DS-DE 9 (Rev. 09/23) Rule 1S-2.0001, F.A.C. WAIVER OF REPORT (Section 106.07(7), F.S.) (PLEASE TYPE) OFFICE USE ONLY Town of Ocean Breeze - Town Council Name Office Sought Address City State Zip Code Candidate Political Committee Party Executive Committee NOTE: This form does not apply to an electioneering communications organization (ECO). An ECO must file a report (not a waiver) that no reportable contributions or expenditures were made during the reporting period (s. 106.0703(6), F.S.). Check here if address has changed since last report. Check here if PC has DISBANDED and will no longer file reports. TYPE OF REPORT (Check Appropriate Box and Complete Applicable Line beneath Box) QUARTERLY REPORT PRIMARY ELECTION GENERAL ELECTION OTHER REPORT TYPE Indicate report # Indicate report # Indicate report # Indicate report type and # as applicable: P G TERMINATION REPORT SPECIAL ELECTION NOTIFICATION OF NO ACTIVITY IN CAMPAIGN ACCOUNT FOR THE REPORTING PERIOD OF August 1 THROUGH August 22, 2025 X Signature Date X Signature Date REQUIRED SIGNATURES FOR: Candidates: Candidate and Campaign Treasurer or Deputy Treasurer (s. 106.07(5), F.S.) Political Committees: Chairman and Campaign Treasurer or Deputy Treasurer (s. 106.07(5), F.S.) Party Executive Committees: Treasurer and Chairman (s. 106.29(2), F.S.) Except as noted above for an ECO, in any reporting period when there has been no activity in the account (no funds expended or received) the filing of the required report is waived. However, the filing officer must be notified in writing on the prescribed reporting date that no report is being filed. DS-DE 87 (Rev. 10/2023) WAIVER OF REPORT (Section 106.07(7), F.S.) (PLEASE TYPE) OFFICE USE ONLY Town of Ocean Breeze - Town Council Name Office Sought Address City State Zip Code Candidate Political Committee Party Executive Committee NOTE: This form does not apply to an electioneering communications organization (ECO). An ECO must file a report (not a waiver) that no reportable contributions or expenditures were made during the reporting period (s. 106.0703(6). F.S.). Check here if address has changed since last report. Check here if PC has DISBANDED and will no longer file reports. TYPE OF REPORT (Check Appropriate Box and Complete Applicable Line beneath Box) QUARTERLY REPORT PRIMARY ELECTION GENERAL ELECTION OTHER REPORT TYPE Indicate report # Indicate report # Indicate report # Indicate report type and # as applicable: P. G TERMINATION REPORT SPECIAL ELECTION NOTIFICATION OF NO ACTIVITY IN CAMPAIGN ACCOUNT FOR THE REPORTING PERIOD OF August 23, 2025 THROUGH September 5, 2025 X Signature Date X Signature Date REQUIRED SIGNATURES FOR: Candidates: Candidate and Campaign Treasurer or Deputy Treasurer (s. 106.07(5). F.S.) Political Committees: Chairman and Campaign Treasurer or Deputy Treasurer (s. 106.07(5), F.S.) Party Executive Committees: Treasurer and Chairman (s. 106.29(2), F.S.) Except as noted above for an ECO, in any reporting period when there has been no activity in the account (no funds expended or received) the filing of the required report is waived. However, the filing officer must be notified in writing on the prescribed reporting date that no report is being filed. DS-DE 87 (Rev. 10/2023) WAIVER OF REPORT (Section 106.07(7), F.S.) (PLEASE TYPE) OFFICE USE ONLY Town of Ocean Breeze - Town Council Name Office Sought Address City State Zip Code Candidate Political Committee Party Executive Committee NOTE: This form does not apply to an electioneering communications organization (ECO). An ECO must file a report (not a waiver) that no reportable contributions or expenditures were made during the reporting period (s. 106.0703(6), F.S.). Check here if address has changed since last report. Check here if PC has DISBANDED and will no longer file reports. TYPE OF REPORT (Check Appropriate Box and Complete Applicable Line beneath Box) QUARTERLY REPORT PRIMARY ELECTION GENERAL ELECTION OTHER REPORT TYPE Indicate report # Indicate report # Indicate report # Indicate report type and # as applicable: P G TERMINATION REPORT SPECIAL ELECTION NOTIFICATION OF NO ACTIVITY IN CAMPAIGN ACCOUNT FOR THE REPORTING PERIOD OF September 6, 2025 THROUGH September 19, 2025 X Signature Date X Signature Date REQUIRED SIGNATURES FOR: Candidates: Candidate and Campaign Treasurer or Deputy Treasurer (s. 106.07/5), F.S.) Political Committees: Chairman and Campaign Treasurer or Deputy Treasurer (s. 106.07(5), F.S.) Party Executive Committees: Treasurer and Chairman (s. 106.29(2), F.S.) Except as noted above for an ECO, in any reporting period when there has been no activity in the account (no funds expended or received) the filing of the required report is waived. However, the filing officer must be notified in writing on the prescribed reporting date that no report is being filed. DS-DE 87 (Rev. 10/2023) WAIVER OF REPORT (Section 106.07(7), F.S.) (PLEASE TYPE) OFFICE USE ONLY Town of Ocean Breeze - Town Council Name Office Sought Address City State Zip Code Candidate Political Committee Party Executive Committee NOTE: This form does not apply to an electioneering communications organization (ECO). An ECO must file a report (not a waiver) that no reportable contributions or expenditures were made during the reporting period (s. 106.0703(6), F.S.). Check here if address has changed since last report. Check here if PC has DISBANDED and will no longer file reports. TYPE OF REPORT (Check Appropriate Box and Complete Applicable Line beneath Box) QUARTERLY REPORT PRIMARY ELECTION GENERAL ELECTION OTHER REPORT TYPE Indicate report # Indicate report # Indicate report # Indicate report type and # as applicable: P G TERMINATION REPORT SPECIAL ELECTION NOTIFICATION OF NO ACTIVITY IN CAMPAIGN ACCOUNT FOR THE REPORTING PERIOD OF September 20, 2025 THROUGH October 3, 2025 X Signature Date X Signature Date REQUIRED SIGNATURES FOR: Candidates: Candidate and Campaign Treasurer or Deputy Treasurer (s. 106.07(5), F.S.) Political Committees: Chairman and Campaign Treasurer or Deputy Treasurer (s. 106.07(5), F.S.) Party Executive Committees: Treasurer. and Chairman (s. 106.29(2), F.S.) Except as noted above for an ECO, in any reporting period when there has been no activity in the account (no funds expended or received) the filing of the required report is waived. However, the filing officer must be notified in writing on the prescribed reporting date that no report is being filed. DS-DE 87 (Rev. 10/2023) WAIVER OF REPORT (Section 106.07(7), F.S.) (PLEASE TYPE) OFFICE USE ONLY Town of Ocean Breeze - Town Council Name Office Sought Address City State Zip Code Candidate Political Committee Party Executive Committee NOTE: This form does not apply to an electioneering communications organization (ECO). An ECO must file a report (not a waiver) that no reportable contributions or expenditures were made during the reporting period (s. 106.0703(6), F.S.). Check here if address has changed since last report. Check here if PC has DISBANDED and will no longer file reports. TYPE OF REPORT (Check Appropriate Box and Complete Applicable Line beneath Box) QUARTERLY REPORT PRIMARY ELECTION GENERAL ELECTION OTHER REPORT TYPE Indicate report # Indicate report # Indicate report # Indicate report type and # as applicable: P. G TERMINATION REPORT SPECIAL ELECTION NOTIFICATION OF NO ACTIVITY IN CAMPAIGN ACCOUNT FOR THE REPORTING PERIOD OF October 4, 2025 THROUGH October 17, 2025 X Signature Date Signature Date REQUIRED SIGNATURES FOR: Candidates: Candidate and Campaign Treasurer or Deputy Treasurer (s. 106.07(5), F.S.) Political Committees: Chairman and Campaign Treasurer or Deputy Treasurer (s. 106.07(5), F.S.) Party Executive Committees: Treasurer and Chairman (s. 106.29(2), F.S.) Except as noted above for an ECO, in any reporting period when there has been no activity in the account (no funds expended or received) the filing of the required report is waived. However, the filing officer must be notified in writing on the prescribed reporting date that no report is being filed. DS-DE 87 (Rev. 10/2023) WAIVER OF REPORT (Section 106.07(7), F.S.) (PLEASE TYPE) OFFICE USE ONLY Town of Ocean Breeze - Town Council Name Office Sought Address City State Zip Code Candidate Political Committee Party Executive Committee NOTE: This form does not apply to an electioneering communications organization (ECO). An ECO must file a report (not a waiver) that no reportable contributions or expenditures were made during the reporting period (s. 106.0703(6), F.S.). Check here if address has changed since last report. Check here if PC has DISBANDED and will no longer file reports. TYPE OF REPORT (Check Appropriate Box and Complete Applicable Line beneath Box) QUARTERLY REPORT PRIMARY ELECTION GENERAL ELECTION OTHER REPORT TYPE Indicate report # Indicate report # Indicate report # Indicate report type and # as applicable: P G TERMINATION REPORT SPECIAL ELECTION NOTIFICATION OF NO ACTIVITY IN CAMPAIGN ACCOUNT FOR THE REPORTING PERIOD OF October 18, 2025 THROUGH October 30, 2025 X Signature Date X Signature Date REQUIRED SIGNATURES FOR: Candidates: Candidate and Campaign Treasurer or Deputy Treasurer (s. 106.07(5), F.S.) Political Committees: Chairman and Campaign Treasurer or Deputy Treasurer (s. 106.07(5), F.S.) Party Executive Committees: Treasurer and Chairman (s. 106. 29(2), F.S.) Except as noted above for an ECO, in any reporting period when there has been no activity in the account (no funds expended or received) the filing of the required report is waived. However, the filing officer must be notified in writing on the prescribed reporting date that no report is being filed. DS-DE 87 (Rev. 10/2023) WAIVER OF REPORT (Section 106.07(7), F.S.) (PLEASE TYPE) OFFICE USE ONLY Town of Ocean Breeze - Town Council Name Office Sought Address City State Zip Code Candidate Political Committee Party Executive Committee NOTE: This form does not apply to an electioneering communications organization (ECO). An ECO must file a report (not a waiver) that no reportable contributions or expenditures were made during the reporting period (s. 106.0703(6), F.S.). Check here if address has changed since last report. Check here if PC has DISBANDED and will no longer file reports. TYPE OF REPORT (Check Appropriate Box and Complete Applicable Line beneath Box) QUARTERLY REPORT PRIMARY ELECTION GENERAL ELECTION OTHER REPORT TYPE Indicate report # Indicate report # Indicate report # Indicate report type and # as applicable: P G TERMINATION REPORT SPECIAL ELECTION NOTIFICATION OF NO ACTIVITY IN CAMPAIGN ACCOUNT FOR THE REPORTING PERIOD OF Termination Report THROUGH Termination Report X Signature Date X Signature Date REQUIRED SIGNATURES FOR: Candidates: Candidate and Campaign Treasurer or Deputy Treasurer (s. 106.07(5), F.S.) Political Committees: Chairman and Campaign Treasurer or Deputy Treasurer (s. 106.07(5), F.S.) Party Executive Committees: Treasurer and Chairman (s. 106.29(2), F.S.) Except as noted above for an ECO, in any reporting period when there has been no activity in the account (no funds expended or received) the filing of the required report is waived. However, the filing officer must be notified in writing on the prescribed reporting date that no report is being filed. DS-DE 87 (Rev. 10/2023) WAIVER OF REPORT (Section 106.07(7), F.S.) (PLEASE TYPE) OFFICE USE ONLY Town of Ocean Breeze - Town Council Name Office Sought Address City State Zip Code Candidate Political Committee Party Executive Committee NOTE: This form does not apply to an electioneering communications organization (ECO). An ECO must file a report (not a waiver) that no reportable contributions or expenditures were made during the reporting period (s. 106.0703(6), F.S.). Check here if address has changed since last report. Check here if PC has DISBANDED and will no longer file reports. TYPE OF REPORT (Check Appropriate Box and Complete Applicable Line beneath Box) QUARTERLY REPORT PRIMARY ELECTION GENERAL ELECTION OTHER REPORT TYPE Indicate report # Indicate report # Indicate report # Indicate report type and # as applicable: P G TERMINATION REPORT SPECIAL ELECTION NOTIFICATION OF NO ACTIVITY IN CAMPAIGN ACCOUNT FOR THE REPORTING PERIOD OF Termination Report THROUGH Termination Report X Signature Date X Signature Date REQUIRED SIGNATURES FOR: Candidates: Candidate and Campaign Treasurer or Deputy Treasurer (s. 106.07(5), F.S.) Political Committees: Chairman and Campaign Treasurer or Deputy Treasurer (s. 106.07(5). F.S.) Party Executive Committees: Treasurer and Chairman (s. 106.29(2), F.S.) Except as noted above for an ECO, in any reporting period when there has been no activity in the account (no funds expended or received) the filing of the required report is waived. However, the filing officer must be notified in writing on the prescribed reporting date that no report is being filed. DS-DE 87 (Rev. 10/2023) CAMPAIGN TREASURER'S REPORT SUMMARY (1) OFFICE USE ONLY Name (2) Address (number and street) Ocean Breeze, FL 34957 City, State, Zip Code Check here if address has changed (3) ID Number: (4) Check appropriate box(es): Candidate Office Sought: Town of Ocean Breeze - Town Council 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 Iif no other IE or EC reports will be filed individual making electioneering communications) (5) Report Identifiers Cover Period: From 08 / 01 / 25 To 08 / 22 / 25 Report Type: G1 Original Amendment Special Election Report (6) Contributions This Report (7) Expenditures This Report Monetary Cash & Checks $ Expenditures $ 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 $ $ (11) Certification It is a first degree misdemeanor for any person to falsify a public record (ss. 839.13, F.S.) I certify that 1 have examined this report and it is true, correct, and complete: (Type name) (Type name) Individual (only for E Treasurer Depuly Treasurer Candidate Chairperson (only for PC and PTY) or electioneering comm.) X Signature Signature DS-DE 12 (Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS Instructions for Campaign Treasurer's Report Summary (1) Name: full name of the candidate, political committee, party executive committee, electioneering communications organization, or individual making an independent expenditure or electioneering communication. (2) Address: the full address or post office box, city, state, and zip code. Check the box if the address has changed since the last report filed. (3) ID Number: identification number assigned by the filing officer. (4) Check the appropriate box(es). (5) Report Identifiers Cover Period: the dates this report covers (i.e., From 1/1/15 To 1/31/55). Important: use the appropriate cover period dates as published by the filing officer. Report Type: refer to the filing officer's calendar of reporting dates for the correct codes to be used for each reporting period. If report is for a special election add "S" in front of the report code (i.e., SG3). Check one of the appropriate boxes: Original: first report filed for this reporting period. Amendment: must summarize only contributions/fund transfers and expendituresdsitbutons being reported as additions or deletions. Read instructions for sequence numbers and amendment types on the back of Forms DS-DE 13A and 14A. Special Election Report: Important: once a special election report is filed, the entity is required to file all remaining reports due for the special election. (6) Contributions This Report: Cash and Checks: total amount for this reporting period. Loans: total amount for this reporting period. Total Monetary: sum of Cash and Checks and Loans. In-Kind: the fair market value of the in-kind contribution at the time it is given for this reporting period. (7) Expenditures This Report: Monetary Expenditures: total amount of monetary expenditures for this reporting period. Transfers to Office Account: total amount transferred to an office account by elected candidates only. Total Monetary: sum of Monetary Expenditures and Transfers to Office Account. (8) Other Distributions: the total amount of goods and services contributed to a candidate or other committee by a PC, ECO, or PTY. (9) TOTAL Monetary Contributions To Date: the amount of total monetary contributions to date. Candidates keep cumulative totals from the time the campaign depository is opened through the termination report. (10) TOTAL Monetary Expenditures To Date: the amount of total monetary expenditures to date. Candidates keep cumulative totals from the time the campaign depository is opened through the termination report. (11) Type or print the required officer's name and have them sign the report: Candidate report: treasurer and candidate must sign. PC report: treasurer and chairperson must sign. PTY report: treasurer and chairperson must sign. ECO report: organization's treasurer must sign. IE or EC report: individual must sign (this applies when an individual acts alone to make these expenditures) AMENDMENT REPORTS: An amendment report summary should summarize only contributions, expenditures, distributions, & fund transfers being reported as additions or deletions. Read the instructions for the sequence number & amendment type fields on the back of forms DS-DE 13, 14, 14A and 94. CAMPAIGN TREASURER'S REPORT SUMMARY (1) OFFICE USE ONLY Name (2) Address (number and street) Ocean Breeze, FL 34957 City, State, Zip Code Check here if address has changed (3) ID Number: (4) Check appropriate box(es): Candidate Office Sought: Town of Ocean Breeze - Town Council 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 08 / 23 / 25 To 09 / 05 / 25 Report Type: G2 Original Amendment Special Election Report (6) Contributions This Report (7) Expenditures This Report Monetary Cash & Checks $ Expenditures $ 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 $ $ (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) (Type name) Individual (only for IE Treasurer Deputy Treasurer Candidate Chairperson (only for PC and PTY) or electioneering comm.) X X Signature Signature DS-DE 12 (Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS Instructions for Campaign Treasurer's Report Summary (1) Name: full name of the candidate, political committee, party executive committee, electioneering communications organization, or individual making an independent expenditure or electioneering communication. (2) Address: the full address or post office box, city, state, and zip code. Check the box if the address has changed since the last report filed. (3) IDI Number: identification number assigned by the filing officer. (4) Check the appropriate box(es). (5) Report dentifiers Cover Period: the dates this report covers (i.e., From 1/1/15 To 1/31/55). Important: use the appropriate cover period dates as published by the filing officer. Report Type: refer to the filing officer's calendar of reporting dates for the correct codes to be used for each reporting period. If report is for a special election add' "S" in front of the report code (i.e., SG3). Check one of the appropriate boxes: Original: first report filed for this reporting period. Amendment: must summarize only contributions/tund transfers and expendituesdsinbutions being reported as additions or deletions. Read instructions for sequence numbers and amendment types on the back of Forms DS-DE 13A and 14A. Special Election Report: Important: once a special election report is filed, the entity is required to file all remaining reports due for the special election. (6) Contributions This Report: Cash and Checks: total amount for this reporting period. Loans: total amount for this reporting period. Total Monetary: sum of Cash and Checks and Loans. In-Kind: the fair market value of the in-kind contribution at the time iti is given for this reporting period. (7) Expenditures This Report: Monetary Expenditures: total amount of monetary expenditures for this reporting period. Transfers to Office Account: total amount transferred to an office account by elected candidates only. Total Monetary: sum of Monetary Expenditures and Transfers to Office Account. (8) Other Distributions: the total amount of goods and services contributed to a candidate or other committee by a PC, ECO, or PTY. (9) TOTAL Monetary Contributions To Date: the amount of total monetary contributions to date. Candidates keep cumulative totals from the time the campaign depository is opened through the termination report. (10) TOTAL Monetary Expenditures To Date: the amount of total monetary expenditures to date. Candidates keep cumulative totals from the time the campaign depository is opened through the termination report. (11) Type or print the required officer's name and have them sign the report: Candidate report: treasurer and candidate must sign. PC report: treasurer and chairperson must sign. PTY report: treasurer and chairperson must sign. ECO report: organization's treasurer must sign. IE or EC report: individual must sign (this applies when an individual acts alone to make these expenditures) AMENDMENT REPORTS: An amendment report summary should summarize only contributions, expenditures, distributions, & fund transfers being reported as additions or deletions. Read the instructions for the sequence number & amendment type fields on the back of forms DS-DE 13, 14, 14A and 94. CAMPAIGN TREASURER'S REPORT SUMMARY (1) OFFICE USE ONLY Name (2) Address (number and street) Ocean Breeze, FL 34957 City, State, Zip Code Check here if address has changed (3) ID Number: (4) Check appropriate box(es): Candidate Office Sought: Town of Ocean Breeze - Town Council 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 09 / 06 / 25 To 09 / 19 / 25 Report Type: G3 Original Amendment Special Election Report (6) Contributions This Report (7) Expenditures This Report Monetary Cash & Checks $ Expenditures $ 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 $ $ (11) Certification It is a first degree misdemeanor for any person to falsify a public record (ss. 839.13, F.S.) - certify that I have examined this report and it is true, correct, and complete: (Type name) (Type name) Individual (only for IE Treasurer Deputy Treasurer Candidate Chairperson (only for PC and PTY) ore electioneering comm.) X Signature Signature DS-DE 12 (Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS Instructions for Campaign Treasurer's Report Summary (1) Name: full name of the candidate, political committee, party executive committee, electioneering communications organization, or individual making an independent expenditure or electioneering communication. (2) Address: the full address or post office box, city, state, and zip code. Check the box if the address has changed since the last report filed. (3) ID Number: identification number assigned by the filing officer. (4) Check the appropriate box(es). (5) Report Identifiers Cover Period: the dates this report covers (i.e., From 1/1/15 To 1/31/55). Important: use the appropriate cover period dates as published by the filing officer. Report Type: refer to the filing officer's calendar of reporting dates for the correct codes to be used for each reporting period. If report is for a special election add "S" in front of the report code (i.e., SG3). Check one of the appropriate boxes: Original: first report filed for this reporting period. Amendment: must summarize only contributions/fund transfers and expendturesdsrbutions being reported as additions or deletions. Read instructions for sequence numbers and amendment types on the back of Forms DS-DE 13A and 14A. Special Election Report: Important: once a special election report is filed, the entity is required to file all remaining reports due for the special election. (6) Contributions This Report: Cash and Checks: total amount for this reporting period. Loans: total amount for this reporting period. Total Monetary: sum of Cash and Checks and Loans. In-Kind: the fair market value of the in-kind contribution at the time it is given for this reporting period. (7) Expenditures This Report: Monetary Expenditures: total amount of monetary expenditures for this reporting period. Transfers to Office Account: total amount transferred to an office account by elected candidates only. Total Monetary: sum of Monetary Expenditures and Transfers to Office Account. (8) Other Distributions: the total amount of goods and services contributed to a candidate or other committee by a PC, ECO, or PTY. (9) TOTAL Monetary Contributions To Date: the amount of total monetary contributions to date. Candidates keep cumulative totals from the time the campaign depository is opened through the termination report. (10) TOTAL Monetary Expenditures To Date: the amount of total monetary expenditures to date. Candidates keep cumulative totals from the time the campaign depository is opened through the termination report. (11) Type or print the required officer's name and have them sign the report: Candidate report: treasurer and candidate must sign. PC report: treasurer and chairperson must sign. PTY report: treasurer and chairperson must sign. ECO report: organization's treasurer must sign. IE or EC report: individual must sign (this applies when an individual acts alone to make these expenditures) AMENDMENT REPORTS: An amendment report summary should summarize only contributions, expenditures, distributions, & fund transfers being reported as additions or deletions. Read the instructions for the sequence number & amendment type fields on the back of forms DS-DE 13, 14, 14A and 94. CAMPAIGN TREASURERS REPORT SUMMARY (1) OFFICE USE ONLY Name (2) Address (number and street) Ocean Breeze, FL 34957 City, State, Zip Code Check here if address has changed (3) ID Number: (4) Check appropriate box(es): Candidate Office Sought: Town of Ocean Breeze - Town Council 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 dentifiers Cover Period: From 09 / 20 / 25 To 10 / 03 / 25 Report Type: G4 Original Amendment Special Election Report (6) Contributions This Report (7) Expenditures This Report Monetary Cash & Checks $ Expenditures $ 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 $ $ (11) Certification Iti 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) (Type name) Individual (only for IE Treasurer Deputy Treasurer Candidate Chairperson (only for PC and PTY) ore electioneering comm.) X Signature Signature DS-DE 12 (Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS Instructions for Campaign Treasurer's Report Summary (1) Name: full name of the candidate, political committee, party executive committee, electioneering communications organization, or individual making an independent expenditure or electioneering communication. (2) Address: the full address or post office box, city, state, and zip code. Check the box if the address has changed since the last report filed. (3) ID Number: identification number assigned by the filing officer. (4) Check the appropriate box(es). (5) Report dentifiers Cover Period: the dates this report covers (i.e., From 1/1/15 To 1/31/55). Important: use the appropriate cover period dates as published by the filing officer. Report Type: refer to the filing officer's calendar of reporting dates for the correct codes to be used for each reporting period. If report is for a special election add "S" in front of the report code (i.e., SG3). Check one of the appropriate boxes: Original: first report filed for this reporting period. Amendment: must summarize only contributions/lund transfers and expendituresdistibutions being reported as additions or deletions. Read instructions for sequence numbers and amendment types on the back of Forms DS-DE 13A and 14A. Special Election Report: Important: once a special election report is filed, the entity is required to file all remaining reports due for the special election. (6) Contributions This Report: Cash and Checks: total amount for this reporting period. Loans: total amount for this reporting period. Total Monetary: sum of Cash and Checks and Loans. In-Kind: the fair market value of the in-kind contribution at the time it is given for this reporting period. (7) Expenditures This Report: Monetary Expenditures: total amount of monetary expenditures for this reporting period. Transfers to Office Account: total amount transferred to an office account by elected candidates only. Total Monetary: sum of Monetary Expenditures and Transfers to Office Account. (8) Other Distributions: the total amount of goods and services contributed to a candidate or other committee by a PC, ECO, or PTY. (9) TOTAL Monetary Contributions To Date: the amount of total monetary contributions to date. Candidates keep cumulative totals from the time the campaign depository is opened through the termination report. (10) TOTAL Monetary Expenditures To Date: the amount of total monetary expenditures to date. Candidates keep cumulative totals from the time the campaign depository is opened through the termination report. (11) Type or print the required officer's name and have them sign the report: Candidate report: treasurer and candidate must sign. PC report: treasurer and chairperson must sign. PTY report: treasurer and chairperson must sign. ECO report: organization's treasurer must sign. IE or EC report: individual must sign (this applies when an individual acts alone to make these expenditures) AMENDMENT REPORTS: An amendment report summary should summarize only contributions, expenditures, distributions, & fund transfers being reported as additions or deletions. Read the instructions for the sequence number & amendment type fields on the back of forms DS-DE 13, 14, 14A and 94. CAMPAIGN TREASURERS REPORT SUMMARY (1) OFFICE USE ONLY Name (2) Address (number and street) Ocean Breeze, FL 34957 City, State, Zip Code Check here if address has changed (3) ID Number: (4) Check appropriate box(es): Candidate Office Sought: Town of Ocean Breeze - Town Council 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 10 / 04 / 25 To 10 / 17 / 25 Report Type: G5 Original Amendment Special Election Report (6) Contributions This Report (7) Expenditures This Report Monetary Cash & Checks $ Expenditures $ 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 $ $ (11) Certification It is a first degree misdemeanor for any person to falsify a public record (ss. 839.13, F.S.) I certify that 1 have examined this report and it is true, correct, and complete: (Type name) (Type name) Individual (only for IE Treasurer Depuly" Treasurer Candidate Chairperson (only for PC and PTY) or electioneering comm.) X X Signature Signature DS-DE 12 (Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS Instructions for Campaign Treasurer's Report Summary (1) Name: full name of the candidate, political committee, party executive committee, electioneering communications organization, or individual making an independent expenditure or electioneering communication. (2) Address: the full address or post office box, city, state, and zip code. Check the box if the address has changed since the last report filed. (3) ID Number: identification number assigned by the filing officer. (4) Check the appropriate box(es). (5) Report Identifiers Cover Period: the dates this report covers (i.e., From 1/1/15 To 1/31/55). Important: use the appropriate cover period dates as published by the filing officer. Report Type: refer to the filing officer's calendar of reporting dates for the correct codes to be used for each reporting period. If report is for a special election add "S" in front of the report code (i.e., SG3). Check one of the appropriate boxes: Original: first report filed for this reporting period. Amendment: must summarize only contributions/lund transfers and expendituesdsributions being reported as additions or deletions. Read instructions for sequence numbers and amendment types on the back of Forms DS-DE 13A and 14A. Special Election Report: Important: once a special election report is filed, the entity is required to file all remaining reports due for the special election. (6) Contributions This Report: Cash and Checks: total amount for this reporting period. Loans: total amount for this reporting period. Total Monetary: sum of Cash and Checks and Loans. In-Kind: the fair market value of the in-kind contribution at the time iti is given for this reporting period. (7) Expenditures This Report: Monetary Expenditures: total amount of monetary expenditures for this reporting period. Transfers to Office Account: total amount transferred to an office account by elected candidates only. Total Monetary: sum of Monetary Expenditures and Transfers to Office Account. (8) Other Distributions: the total amount of goods and services contributed to a candidate or other committee by a PC, ECO, or PTY. (9) TOTAL Monetary Contributions To Date: the amount of total monetary contributions to date. Candidates keep cumulative totals from the time the campaign depository is opened through the termination report. (10) TOTAL Monetary Expenditures To Date: the amount of total monetary expenditures to date. Candidates keep cumulative totals from the time the campaign depository is opened through the termination report. (11) Type or print the required officer's name and have them sign the report: Candidate report: treasurer and candidate must sign. PC report: treasurer and chairperson must sign. PTY report: treasurer and chairperson must sign. ECO report: organization's treasurer must sign. IE or EC report: individual must sign (this applies when an individual acts alone to make these expenditures) AMENDMENT REPORTS: An amendment report summary should summarize only contributions, expenditures, distributions, & fund transfers being reported as additions or deletions. Read the instructions for the sequence number & amendment type fields on the back of forms DS-DE 13, 14, 14A and 94. CAMPAIGN TREASURER'S REPORT SUMMARY (1) OFFICE USE ONLY Name (2) Address (number and street) Ocean Breeze, FL 34957 City, State, Zip Code Check here if address has changed (3) ID Number: (4) Check appropriate box(es): Candidate Office Sought: Town of Ocean Breeze - Town Council 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 10 / 18 I 25 To 10 / 30 / 25 Report Type: G6 Original Amendment Special Election Report (6) Contributions This Report (7) Expenditures This Report Monetary Cash & Checks $ Expenditures $ 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 $ $ (11) Certification Iti is a first degree misdemeanor for any person to falsify a public record (ss. 839.13, F.S.) - certify that I have examined this report and it is true, correct, and complete: (Type name) (Type name) Individual (only for IE Treasurer Deputy Treasurer Candidate Chairperson (only for PC and PTY) or electioneering comm.) X Signature Signature DS-DE 12 (Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS Instructions for Campaign Treasurer's Report Summary (1) Name: full name of the candidate, political committee, party executive committee, electioneering communications organization, or individual making an independent expenditure or electioneering communication. (2) Address: the full address or post office box, city, state, and zip code. Check the box if the address has changed since the last report filed. (3) ID Number: identification number assigned by the filing officer. (4) Check the appropriate box(es). (5) Report Identifiers Cover Period: the dates this report covers (i.e., From 1/1/15 To 1/31/55). Important: use the appropriate cover period dates as published by the filing officer. Report Type: refer to the filing officer's calendar of reporting dates for the correct codes to be used for each reporting period. If report is for a special election add "S" in front of the report code (i.e., SG3). Check one of the appropriate boxes: Original: first report filed for this reporting period. Amendment: must summarize only contributions/fund transfers and expendituresdistibutons being reported as additions or deletions. Read instructions for sequence numbers and amendment types on the back of Forms DS-DE 13A and 14A. Special Election Report: Important: once a special election report is filed, the entity is required to file all remaining reports due for the special election. (6) Contributions This Report: Cash and Checks: total amount for this reporting period. Loans: total amount for this reporting period. Total Monetary: sum of Cash and Checks and Loans. In-Kind: the fair market value of the in-kind contribution at the time it is given for this reporting period. (7) Expenditures This Report: Monetary Expenditures: total amount of monetary expenditures for this reporting period. Transfers to Office Account: total amount transferred to an office account by elected candidates only. Total Monetary: sum of Monetary Expenditures and Transfers to Office Account. (8) Other Distributions: the total amount of goods and services contributed to a candidate or other committee by a PC, ECO, or PTY. (9) TOTAL Monetary Contributions To Date: the amount of total monetary contributions to date. Candidates keep cumulative totals from the time the campaign depository is opened through the termination report. (10) TOTAL Monetary Expenditures To Date: the amount of total monetary expenditures to date. Candidates keep cumulative totals from the time the campaign depository is opened through the termination report. (11) Type or print the required officer's name and have them sign the report: Candidate report: treasurer and candidate must sign. PC report: treasurer and chairperson must sign. PTY report: treasurer and chairperson must sign. ECO report: organization's treasurer must sign. IE or EC report: individual must sign (this applies when an individual acts alone to make these expenditures) AMENDMENT REPORTS: An amendment report summary should summarize only contributions, expenditures, distributions, & fund transfers being reported as additions or deletions. Read the instructions for the sequence number & amendment type fields on the back of forms DS-DE 13, 14, 14A and 94. CAMPAIGN TREASURERS REPORT SUMMARY (1) OFFICE USE ONLY Name (2) Address (number and street) Ocean Breeze, FL 34957 City, State, Zip Code Check here if address has changed (3) ID Number: (4) Check appropriate box(es): Candidate Office Sought: Town of Ocean Breeze - Town Council 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 dentifiers Cover Period: From / To Report Type: TR 1 Original Amendment Special Election Report (6) Contributions This Report (7) Expenditures This Report Monetary Cash & Checks $ Expenditures $ 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 $ $ (11) Certification Iti 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) (Type name) Individual (only for IE Treasurer Deputy Treasurer Candidate Chairperson (only for PC and PTY) or electioneering comm.) X Signature Signature DS-DE 12 (Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS Instructions for Campaign Treasurer's Report Summary (1) Name: full name of the candidate, political committee, party executive committee, electioneering communications organization, or individual making an independent expenditure or electioneering communication. (2) Address: the full address or post office box, city, state, and zip code. Check the box if the address has changed since the last report filed. (3) ID Number: identification number assigned by the filing officer. (4) Check the appropriate box(es). (5) Report Identifiers Cover Period: the dates this report covers (i.e., From 1/1/15 To 1/31/55). Important: use the appropriate cover period dates as published by the filing officer. Report Type: refer to the filing officer's calendar of reporting dates for the correct codes to be used for each reporting period. If report is for a special election add "S" in front of the report code (i.e., SG3). Check one of the appropriate boxes: Original: first report filed for this reporting period. Amendment: must summarize only contributions/fund transfers and expendituresdistbutions being reported as additions or deletions. Read instructions for sequence numbers and amendment types on the back of Forms DS-DE 13A and 14A. Special Election Report: Important: once a special election report is filed, the entity is required to file all remaining reports due for the special election. (6) Contributions This Report: Cash and Checks: total amount for this reporting period. Loans: total amount for this reporting period. Total Monetary: sum of Cash and Checks and Loans. In-Kind: the fair market value of the in-kind contribution at the time it is given for this reporting period. (7) Expenditures This Report: Monetary Expenditures: total amount of monetary expenditures for this reporting period. Transfers to Office Account: total amount transferred to an office account by elected candidates only. Total Monetary: sum of Monetary Expenditures and Transfers to Office Account. (8) Other Distributions: the total amount of goods and services contributed to a candidate or other committee by a PC, ECO, or PTY. (9) TOTAL Monetary Contributions To Date: the amount of total monetary contributions to date. Candidates keep cumulative totals from the time the campaign depository is opened through the termination report. (10) TOTAL Monetary Expenditures To Date: the amount of total monetary expenditures to date. Candidates keep cumulative totals from the time the campaign depository is opened through the termination report. (11) Type or print the required officer's name and have them sign the report: Candidate report: treasurer and candidate must sign. PC report: treasurer and chairperson must sign. PTY report: treasurer and chairperson must sign. ECO report: organization's treasurer must sign. IE or EC report: individual must sign (this applies when an individual acts alone to make these expenditures) AMENDMENT REPORTS: An amendment report summary should summarize only contributions, expenditures, distributions, & fund transfers being reported as additions or deletions. Read the instructions for the sequence number & amendment type fields on the back of forms DS-DE 13, 14, 14A and 94. CAMPAIGN TREASURERS REPORT SUMMARY (1) OFFICE USE ONLY Name (2) Address (number and street) Ocean Breeze, FL 34957 City, State, Zip Code Check here if address has changed (3) ID Number: (4) Check appropriate box(es): Candidate Office Sought: Town of Ocean Breeze - Town Council 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 To Report Type: TR Original Amendment Special Election Report (6) Contributions This Report (7) Expenditures This Report Monetary Cash & Checks $ Expenditures $ 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 $ $ (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) (Type name) Individual (only for IE Treasurer Deputy Treasurer Candidate Chairperson (only for PC and PTY) ore electioneering comm.) X Signature Signature DS-DE 12 (Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS Instructions for Campaign Treasurer's Report Summary (1) Name: full name of the candidate, political committee, party executive committee, electioneering communications organization, or individual making an independent expenditure or electioneering communication. (2) Address: the full address or post office box, city, state, and zip code. Check the box if the address has changed since the last report filed. (3) ID Number: identification number assigned by the filing officer. (4) Check the appropriate box(es). (5) Report Identifiers Cover Period: the dates this report covers (i.e., From 1/1/15 To 1/31/55). Important: use the appropriate cover period dates as published by the filing officer. Report Type: refer to the filing officer's calendar of reporting dates for the correct codes to be used for each reporting period. If report is for a special election add' "S" in front of the report code (i.e., SG3). Check one of the appropriate boxes: Original: first report filed for this reporting period. Amendment: must summarize only contributions/fund transfers and expendituesdstibutons being reported as additions or deletions. Read instructions for sequence numbers and amendment types on the back of Forms DS-DE 13A and 14A. Special Election Report: Important: once a special election report is filed, the entity is required to file all remaining reports due for the special election. (6) Contributions This Report: Cash and Checks: total amount for this reporting period. Loans: total amount for this reporting period. Total Monetary: sum of Cash and Checks and Loans. In-Kind: the fair market value of the in-kind contribution at the time it is given for this reporting period. (7) Expenditures This Report: Monetary Expenditures: total amount of monetary expenditures for this reporting period. Transfers to Office Account: total amount transferred to an office account by elected candidates only. Total Monetary: sum of Monetary Expenditures and Transfers to Office Account. (8) Other Distributions: the total amount of goods and services contributed to a candidate or other committee by a PC, ECO, or PTY. (9) TOTAL Monetary Contributions To Date: the amount of total monetary contributions to date. Candidates keep cumulative totals from the time the campaign depository is opened through the termination report. (10) TOTAL Monetary Expenditures To Date: the amount of total monetary expenditures to date. Candidates keep cumulative totals from the time the campaign depository is opened through the termination report. (11) Type or print the required officer's name and have them sign the report: Candidate report: treasurer and candidate must sign. PC report: treasurer and chairperson must sign. PTY report: treasurer and chairperson must sign. ECO report: organization's treasurer must sign. IE or EC report: individual must sign (this applies when an individual acts alone to make these expenditures) AMENDMENT REPORTS: An amendment report summary should summarize only contributions, expenditures, distributions, & fund transfers being reported as additions or deletions. Read the instructions for the sequence number & amendment type fields on the back of forms DS-DE 13, 14, 14A and 94. Ch. 106 CAMPAIGN FINANCING F.S. 2006 (6) Prior to disposing of funds pursuant to subsec- amount thereof. Such reports shall be on forms pre- tion (4) or transferring funds into an office account pur- scribed by the Division of Elections, signed by the suant to subsection (5), any candidate who filed an elected candidate, certified as true and correct, and oath stating that he or she was unable to pay the elec- filed with the officer with whom campaign reports were tion assessment or fee for verification of petition signa- filed pursuant to S. 106.07(2). tures without imposing an undue burden on his or her (9) Any candidate, or any person on behalf of a personal resources or on resources otherwise avail- candidate, who accepts contributions after such candi- able to him or her, or who filed both such oaths, or who date has withdrawn his or her candidacy, after the can- qualified by the petition process and was not required didate has become an unopposed candidate, or after to pay an election assessment, shall reimburse the the candidate has been eliminated as a candidate or state or local governmental entity, whichever is applica- elected to office commits a misdemeanor of the first ble, for such waived assessment or fee or both. Such degree, punishable as provided in S. 775.082 or S. reimbursement shall be made first for the cost of peti- 775.083. tion verification and then, if funds are remaining, for the (10) Any candidate who is required by the provisions amount of the election assessment. If there are insuffi- of this section to dispose of funds in his or her cam- cient funds in the account to pay the full amount of paign account and who fails to dispose of the funds in either the assessment or the fee or both, the remaining the manner provided in this section commits a misde- funds shall be disbursed in the above manner until no meanor of the first degree, punishable as provided in S. funds remain. All funds disbursed pursuant to this sub- 775.082 or S. 775.083. section shall be remitted to the qualifying officer. Any History. -S. 50,ch. 77-175;s. 6, ch. 79-378: S. 60, ch. 79-400: S. 2, ch. 80-292; reimbursement for petition verification costs which are S. 54, ch. 81-259; S. 28, ch. 81-304:s. 1,ch. 82-404:s. .38, ch. 84-302;s. 10, ch. reimbursable by the state shail be forwarded by the 85-226:s-2.ch. ch. 90-315;s. 15, 86-7:s.2,ch. ch. 91-107;s. 86-276; 645,ch. S. 95-147iss. 11,ch. 87-363;s. 15, 16, 53, 15. ch. ch. 97-13: 89-256; S. 6,ch. s. 34. qualifying officer to the state for deposit in the General 2002-197; 20, ch. 2004-252; S. 70, ch. 2005-277. Revenue Fund. All reimbursements for the amount of 19(), Note.-Thet Art. Ilto of trust the State fund expired, Constitution. offective November 4, 1996, by operation of s. the election assessment shall be forwarded by the qualifying officer to the Department of State for deposit 106.143 Political advertisements circulated prior in the General Revenue Fund. to election; requirements. - (7)(a) Any candidate required to dispose of cam- (1)(a) Aypolcaoerementnt is paid fort by paign funds pursuant to this section shall do sO within acandidaeandihatispubished-dap.hyed. or circu- the time required by this section and shall, on or before latedpriorto, crontedsyohsnyeacion must promi- the date by which such disposition is to have been nently state: "Political advertisement paid for and- made, file with the officer with whom reports are approvediby. mameatcanoatels (partyatiationk for toffice required to be filed pursuant to S. 106.07 a form pre- sougho scribed by the Division of Elections listing: (b) Any other political advertisement published, 1. The name and address of each person or unit of displayed, or circulated prior to, or on the day of, any government to whom any of the funds were distributed election must prominently: and the amounts thereof; 1. Be marked "paid political advertisement" or with 2. The name and address of each person to whom the abbreviation "pd. pol. adv." an expenditure was made, together with the amount 2. State the name and address of the persons thereof and purpose therefor; and sponsoring the advertisement. 3. The amount of such funds transferred to an 3.a.(1) State whether the advertisement and the office account by the candidate, together with the name cost of production is paid for or provided in kind by or at and address of the bank in which the office account is the expense of the entity publishing, displaying, broad- located. casting, or circulating the political advertisement; or (II) State who provided or paid for the advertise- Such report shall be signed by the candidate and the ment and cost of production, if different from the source campaign treasurer and certified as true and correct of sponsorship. pursuant to S. 106.07. b. This subparagraph does not apply if the source (b) The filing officer shall notify each candidate at of the sponsorship is patently clear from the content or least 14 days before the date the report is due. format of the political advertisement. (c) Any candidate failing to file a report on the des- ignated due date shall be subject to a fine as provided This subsection does not apply to campaign messages in S. 106.07 for submitting late termination reports. used by a candidate and the candidate's supporters if (8) Any candidate elected to office who transfers those messages are designed to be worn by a person. surplus campaign funds into an office account pursuant (2) Any political advertisement of a candidate run- to subsection (5) shall file a report on the 10th day fol- ning for partisan office shall express the name of the lowing the end of each calendar quarter until the political party of which the candidate is seeking nomi- account is closed. Such reports shall contain the name nation or is the nominee. If the candidate for partisan and address of each person to whom any disburse- office is running as a candidate with no party affiliation, ment of funds was made, together with the amount any political advertisement of the candidate must state thereof and the purpose therefor, and the name and that the candidate has no party affiliation. address of any person from whom the elected candi- (3) It is unlawful for any candidate or person on date received any refund or reimbursement and the behalf of a candidate to represent that any person or 112 AFFADIVIT I, am a candidate for the office of ("Town Council" or "Mayor") of the Town of Ocean Breeze, Florida, for the election to be held Tuesday, November 4, 2025 at Langford Park, 2369 NE Dixie Highway, Jensen Beach, FL 34957. - hereby declare . am not opening a campaign account, as 1 - will not be accepting contributions, and I I will have no expenditures, as - - will not be conducting a campaign by advertising with signs, brochures, literature, etc. Signature Date TOWN OF OCEAN BREEZE NOTICE TO QUALIFYING CANDIDATES The Public Logic and Accuracy test for the November 4, 2025 election will be held on Wednesday, September 10, 2025 at 8:30 a.m. at Martin County Supervisor of Elections office: Martin County Supervisor of Elections 135 SE Martin Luther King Boulevard Stuart, FL 34994 Telephone: (772) 288-5637 Please sign and date below and return to: Town ofOcean Breeze Post Office Box 1025 Jensen Beach, FL 34958 1508 NE Jensen Beach Blvd. Jensen Beach, FL 34957 Signature Date