jul 2 9 2016 - jacksonville beach, florida · campaign treasurer's report summary (1)...
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CAMPAIGN TREASURER'S REPORT SUMMARY
(1) Christine Hoffman Name
REG et!)Y
(2) 1026 13th St. N. JUL 2 9 2016 Address (number and street)
Jacksonville Beach, FL 32250 City Clerk City, State, Zip Code
D Check here if address has changed (3) ID Number: NIA
(4) Check appropriate box(es):
0 Candidate I City of Jacksonville Beach - At Large Seat 1 Office Sought:
D Political Committee (PC) D Electioneering Communications Org. (ECO) D Check here if PC or ECO has disbanded D Party Executive Committee (PTY) D Check here if PTY has disbanded D Independent Expenditure (I E) (also covers an D Check here if no other IE or EC reports will be filed individual making electioneering commun ications)
(5) Report Identifiers
Cover Period: From 07 I 09 I 16 To 071 22 I 16 Report Type: 2016-P3 -- - - - - -- -- - -
0 Original D Amendment D Special Election Report
(6) Contributions This Report (7) Expenditures This Report
Cash & Checks $ ' 10 ,800 00
Monetary Expenditures $
' ' 00 00
- - -- -- -- -- -- -- --
Loans $ ' ' Transfers to -- -- - - - -
Office Account $ ' ' -- - - -- --
Total Monetary $ ' ' -- -- - - - -Tota l Monetary $
' 00. 00 ' -- -- - - --
In-Kind $ ' ' -- - - - - --(8) Other Distributions
$ ' ' -- -- -- --
(9) TOTAL Monetary Con.tributions To Date (10) TOTAL Monetary Expenditures To Date
$ 16 229 71 $ ' 1,484 . 94
' ' ' -- -- -- --
( 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 th is report and it is true, correct, and complete:
(Type name) Matthew C. Bothwell (Type QRme) Christine Hoffman 0 Individual (only for IE 0 Treasurer 0 Deputy Treasurer 0 Ca id id, ~ Ch''''"''" (ooly Im ~c '"' PTY) : ,,oct,oo'[)Jf;ll
/
I x \ j
Signature S ignat~ l'J OS-DE 12 (Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS
CAMPAIGN TREASURER'S REPORT - ITEMIZED CONTRIBUTIONS
(1) Name Christine Hoffman (2) l.D. Number N/A
(3) Cover Period 07 I 09 I 2016 through 07/ 22 / 2016 (4) PaQe 1 of 3 (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 Amendment Amount
07/07/2016 Bell & Roper, P.A. 2707 E. Jefferson St. B Attorney CHE $1 ,000.00
1 Orlando, FL 32803
07/08/2016 Brown & Brown of FL Inc. P.O. Box2412 B Insurance CHE $1 ,000.00
2 Daytona Beach , FL 32115
07/08/2016 George A. Helm Ill , P.A. P.O. Box 958464 B Attorney CHE $500.00
3 Lake Mary, FL 32795
07/08/2016 USIS P.O. Box 616648 B Insurance CHE $1 ,000.00
4 Orlando, FL 32861
07/112016 Public Risk Underwriters of Florida, Inc. B Insurance CHE $1 ,000.00
5 P.O. Box 958455
Lake Mary, FL 32795
Roberts , Reynolds , 07/11/2016 Bedard & Tuzzio, PLLC
470 Columbia Dr B Attorney CHE $1 ,000.00 Building C
6 W. Palm Beach , FL
33409
07/12/2016 Brown & Brown, Inc. PO Box 2412 B Insurance CHE $1 ,000.00
7 Daytona Beach , FL 32115
07/12/2016 Preferred Gov. Claim Solutions, Inc. B Insurance CHE $1 ,000.00
P.O. Box 958456 8 Lake Mary, FL 32795
DS-DE 13 (Rev. 08/03) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES
CAMPAIGN TREASURER'S REPORT - ITEMIZED CONTRIBUTIONS
(1) Name Christine Hoffman (2) l.D. Number N/A
(3) Cover Period 07/ 09 / 2016 through 07/ 22 / 2016 (4) Page 2 of 3 (5) (7) (8) (9) (10) (11) (12)
Date Full Name
(6) (Last, Suffix, First, Middle) Sequence Street Address & Contributor Contribution In-kind Number Citv, State , Zio Code Type Occupation Tvoe Description Amendment Amount
07/1 2/2016 William G. Warner PO Box 1820 I Attorney CHE $500.00
9 Panama City, FL 32402
07/12/2016 Timothy M. Warner 812 Balboa Ave. I Attorney CHE $500.00
10 Panama City, FL 32401
07 /12/2016 William J. Carter 1884 Nightfal l Dr. I Business CHE $250.00
11 Neptune Beach , FL Owner/Arts
32666 & Crafts
07/1 4/2016 John C. Schmidt 55 San Juan Dr. I Retired CHE $500.00
12 Ponte Vedra Beach , FL
32082
07/15/2016 Works of Tab, LLC 333 N. 1st St. N. STE 100 B Restaurant CHE $250.00
13 Jacksonville Beach, FL
7/15/15 Works of B and L LLC 333 1st St. N. STE 150 B Restaurant CHE $250.00
14 Jacksonville Beach , FL
32250
7/18/2016 Lindsey Godfrey 1026 13th St. N. I CHE $50.00
15 Jacksonville Beach, FL
32250
7/19/2016 Helen Dixon Coppedge 24272 Marsh Landing I Retired CHE $500.00
Parkway 16 Ponte Vedra , FL 32082
DS-DE 13 (Rev. 08103) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES
CAMPAIGN TREASURER'S REPORT - ITEMIZED CONTRIBUTIONS
(1) Name Christine Hoffman (2) l.D. Number N/A
(3) Cover Period 07 I 09 I 2016 through 07 I 22 I 2016 (4) Page 3 of 3 (5) (7) (8) (9) (1 0) (11) (12)
Date Ful l Name
(6) (Last , Suffix, First, Midd le)
Sequence Street Address & Contributor Contribution In-kind Number Citv, State, Zio Code Tvpe Occupation Type Description Amendment Amount
07/1 9/2016 Walter Dickinson 5187 Dixie Landing Dr I Retired CHE $500.00
17 Jacksonvil le, FL 32224
\
OS-DE 13 (Rev. 08/03) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES
CAMPAIGN TREASURER'S REPORT - ITEMIZED EXPENDITURES
(1) Name Christine Hoffman (2) l.D. Number --'-N""'"'/A~-----
(3) Cover Period 07 /~/ 2016 through 07 l_ll__l--1Ql.Q_ (4) Page __ ...,:.1 __ of 1
(5) (7) (8) (9) (10) (11)
Date Full Name Purpose
(6) Sequence (Last, Suffix, First, Middle) Street (add office sought if
Number Address & contribution to a Expenditure
City, State, Zip Code candidate) Type Amendment Amount
I I
OS-DE 14 (Rev. 08/03) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES