o:~,~ fl 32250 ··------- · 2016. 6. 20. · nov 1 0 2015 ' city clerk (4) check...

CAMP IGN TREASURER!S REPORT SUM ARY

f1t Kt.\ T ~ Oc*r:e:..fl....)'J >••• ·"r.'!o-'~, • ..-.-.... <\.X ___ _

Name R~t.r

(2) Cfl..I 4 ~ P.'V'E.. ~a.. Yf-1 Address (numbef' and street)

Jaekson\l\U& Seach, Fl 32250

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-· .-,,.- ··-------City, State, Zip Code

() Chtcll h•re if add"'" has Changed

NOV 1 0 2015

' City Clerk

(4) Check approf)Jlate box(e&):

0 ca~te Office &truQht .£ity Council Seat # ~ , District# A 1 - l.fl1CrE. 0 Potttu~ Cmmttee (PC) . . . .

O Efectioneeri~ Communieations 0rg. tECOJ 0 Chock het& If Pe oreco has nchd 0 Party Execuriw CQfnmtttee tPTY) 0 Chock tt.ff If P'fY dliSballeled 0 tndependeot Experuftture (lf) (atso tQV6f$ an 0 Chacit hOf9 ii »O ot..,_ E or IC rctpoftS individual IDIJking etect~mg eonm~)

fSt Report ldontifttm1

Cover Pettod. From I D J 0 \ I \ S To l C> I~ \ I l ':J Report Type; 1PE> ..... t"t'\,lo

·Odginal

( ) Contrfbutlons Thia Report

Can&Checb

Loans $ I 4 • a::o • ct::>

totalMo ry $ • '-t t a:;o . co ~ - · _............ '·"-'~~""""·,;.;

(9) TOTAL MonetatY Contrlbutfon1 To . ta $ . 4 , CCO CC>

..._....__. - --- ---

(7) pendttu

Monetmy ~ditwes

Tr~ rsto Office Account

$ D .

$ C> • • --- -- -T otat Morietarv $ 0 .

{8) 08*' Dfattfbutfont $

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(10) tOTAL Monetaty &pendl t To Date $ £::> __ ·-

(11} Certlfklation ttisafilst tn~for ypenonto · ifyapubtic~f . Bn.13.F.S.)

I certify that I haw ~ed thit ~ Md it ls true. c;orrect, and complete:

_Q)"P&~~CC>~ L;:::-1~ f'f'ypensrne) I~ ~ CJ lftlfWfUll {tlftly tot fE 0 Tttmtrtf a Deputy TllliWdt ~ a Ch '" -·--~ ... -pC_MJ_P_TY)_

or~ilnQ CMUlll

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CAMPAIGN TREASURER'S REPORT "" ITEMIZED CONTRtBtJTIONS

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City Clerk

CAMPAIGN TREASURER'S REPORT - ITEMlZED EXPf!NOITUR!S (1} __l~~---~~~!:"Z...--~ _ (2)U).Num~~-------

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CAMPAIGN TREASURER'S REPORT SUMMARY

(1) J{{.JIH OOHf:.FJ...1-7 OFFICE USE ONLY n~ol/(~

Name ~ ~ ~c.L- ;Jt,s-~. ~d<."'~ (2) Of'},/ 4..,-,.. AV~ ~ca:r+-\ WaA P4bJ fr l?t-~ /&t?.vvL /l'l-.' /,

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Address (number and street) &l'»-7. - - ~,,p,.,. .~ µ. /(10• ~ ~ - °'I°"'-' ~.,..,,. fl>-/ 1.

Jacksonville Beach, FL 32250

City, State, Zip Code

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

(4) Check appropriate box(es):

0 Candidate Office Sought: City Council Seat# ~ , District# ~-~ D Political Committee (PC) 0 Electioneering Communications Org. (ECO) 0 Check here if PC or ECO has disbanded 0 Party Executive Committee (PTY) 0 Check here if PTY has disbanded 0 Independent Expenditure (IE) (also covers an 0 Check here if no other IE or EC reports will be filed individual making electioneering communications)

(5) Report Identifiers

Cover Period: From \l I ' I \S To ,, I ~C> I 15 Report Type: (V"\- '")

-- -- -- -- -- --

~Original D Amendment 0 Special Election Report

(6) Contributions This Report (7) Expenditures This Report

Monetary

Cash & Cl1ecks $ , , C> 0 Expenditures $ , , v . 0 -- -- -- -- -- -- -- --

Loans $ , ·_Q_· C5 Transfers to -- -- --Office Account $ , , O· 0

-- -- -- --Total Monetary $ , , 0 a -- -- -- --

Total Monetary $ , ,_C2_· 0 -- -- --ln-l<ind $ , , o.O

-- -- -- --(8) Other Distributions

$ , , 0 0 -- -- -- --

{9) TOTAL Monetary Contributions To Date (10) TOTAL Moneta1y Expenditures To Date

$ ' L..\

' oo:::> . CO $ ' '

0 0 -- -- --

( 11) Certification It is a first degree misdemeanor for any person to falsi·fy 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) 1LG;.\~ ~);..~ . 0 Individual (only for IE 0 Treasurer ~ Deputy Treasurer [8Candidate D Chairperson (only for PC and PTY) or electioneering comm.)

- - 0 _;) -~~ x ( ----- x \:::: _,)

Signature ') Signa·tu1e "-..._ ~ DS-DE 12 (Rev. ·1"1fn) SEE REVERSE FOR INSTRUCTIONS

(1) Name

CAMPAIGN TREASURER'S REPORT - ITEMIZED CONTRIBUTIONS

N/_n,_ (2) l.D. Number

{3) Cover Period \ ) I ) I \S through \) I '1::,0 I 16 {4) Page __ of _l_

(5) Date

(6) Sequence

Number

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(7) (8) (9) (10) (11) Full Name

(Last, Suffix, First, Middle)

Street Address & Contributor Contribution In-kind

Citv, State, Zip Code Type I Occupation Type Description Amendment

DS-DE 13 (Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES

(12)

Amount

CAMPAIGN TREASURER'S REPORT - ITEMIZED EXPENDITURES (1) Name ia..t °U-f Q°""r~l'L.,-,.0 (2) 1.D. Numbe~_l_A ___ ~--(3) Cover Period _\_)_/_\_/ LS through _ _ I)_/ ~ I rs (4) Page of __ J __ _

(5) (7) (8) (9) (10) (11) Date Full Name Purpose

(6) (Last, Suffix, First, Middle) (add office sought if Sequence Street Address & contribution to a Expenditure

Number Ci~y. State, Zip Code candidate) Type Amendment Amount

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DS-DE 14 (RGv. 11113) SEE REVERSE FOR lNSTRUCTlONS ,1.ND CODE VP.LUES


ili::_ I\~) ~H··'4fL~ REC~l~N[Y (1) . Name

(2) '4L_/ '-+~ ~~ ~JN

Address (number and street) JAN 1 3 2016 Jacksonville Beach, FL 32250

City Clerk City, State, Zip Code

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


0 Candidate Office Sought: City Council Seat# ~ , District# AT- U=12G'~

D Political Committee (PC) D Electioneering Communications Org. (ECO) 0 Check here if PC or ECO has disbanded D Party Executive Committee (PTY) D Check here if PTY has disbanded 0 Independent Expenditure (IE) (also covers an D Check here if no other IE or EC reports will be filed individual making electioneering communications)


Cover Period: From lL... I 01 I IS To \""L I ~\ I IS Report Type: f"\\'L -- -- -- -- -- --

llJ Original D Amendment D Special Election Report


Monetary C) Cash & Checks $ , . o 0 Expenditures $ , , 0

-- -- -- -- -- -- -- --

Loans $ , . o . o Transfers to -- -- -- --Office Account $ , , 0 . o

-- -- -- --Total Monetary $ , , 0 . C>

-- -- -- --Total Monetary $ ,

I 0 .o -- -- -- --

In-Kind $ , , 0 0 -- -- -- --

(8) Other Distributions

$ -- , _Q ,cx:D . eo (9) TOTAL Monetary Contributions To Date (10) TOTAL Monetary Expenditures To Date

$ , L\ , oc:c:> . a::> $ , , () . 0 -- -- -- --

( 11) Certification It is a first degree misdemeanor for any person to falsify a public record (ss. 839.13, F.S.)


(Type name) ilt::Jw C):)r1 t:.Q_.--;-_, (Type name) 'LE)'B ~')_~ 0 Individual (only for IE 0 Treasurer ~ Deputy Treasurer .8 Candidate D Chairperson (only for PC and PTY) or electioneering comm.)

x ~ ~ x ~ Signature Signature

DS-DE 12 (Rev.11/13) SEE REVERSE FOR INSTRUCTIONS


(1) Name (2) l.D. Number N/ A

(3) Cover Period \'"L I C>\ I b through \L I ~) I \S (4) Page } of \

(5) (7) (8) (9) (10) (11) (12)

Date Full Name

(6) (Last, Suffix, First, Middle)

Sequence Street Address & Contributor Contribution In-kind

Number Citv, State, Zip Code Type Occupation Type Description Amendment Amount

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--..z:,: -- -DS-DE 13 (Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS ~ND ce'f>~-1.limsV ED

JAN 1 r· ,. " :) L.~.

City Clerk

CAMPAIGN TREASURE.__R'S REPORT - ITEMIZED EXPENDITURES (1) Name l(.E)~ r:=::o.-1~)'.,l (2) l.D. Number"_f_A _____ _

(3) Cover Period re /~/ IS through fl_ /~/ E::. (4) Page of _ ___.) __

(5) (7) (8) (9) (10) (11)

Date Full Name Purpose

(6) (Last, Suffix, First, Middle) (add office sought if Expenditure

Sequence Street Address & contribution to a

Number City, State, Zip Code candidate) Type Amendment Amount

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DS-DE 14 (Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE lAUJES -

Laurie Scott

From: Laurie Scott Sent: Thursday, January 14, 2016 5:00 PM

Keith Doherty To: Subject: Election Campaign Reports [2015-M12]

January 14, 2016

Dear Keith :

This is a reminder that election campaign reports [2015-M12] were due on Monday, January 11, 2016.

As we discussed on Monday, January 11, 2016, prior to the City Council Executive Session (Shade Meeting), your election campaign reports would need to be submitted that day.

Late reports are subject to fines as provided in 106.07(8) Florida Statutes. The fine is $50 per day for the first 3 days late and, thereafter, $500 per day for each late day, not to exceed 25 percent of the total receipts or expenditures, whichever is greater, for the period covered by the late report. A copy of 106.07(8) of the statute is shown below for your reference.

As the filing officer, I am required by the statute to "immediately notify the candidate or chair of the political committee as to the failure to file a report by the designated due date and that a fine is being assessed for each late day."

As of today, assessed fines total $150.

Please submit the required reports as soon as possible.

If you have any questions, please contact me.

Laurie Scott City Clerk, City of Jacksonville Beach

Florida Statutes 106.07{8}: Any candidate or political committee failing to file a report on the designated due date is subject to a fine as provided in paragraph (b) for each late day, and, in the case of a candidate, such fine shall be paid only from personal funds of the candidate. The fine shall be assessed by the filing officer and the moneys collected shall be deposited:

1. In the General Revenue Fund, in the case of a candidate for state office or a political committee that registers with the Division of Elections; or

2. In the general revenue fund of the political subdivision, in the case of a candidate for an office of a political subdivision or a political committee that registers with an officer of a political subdivision.

No separate fine shall be assessed for failure to file a copy of any report required by this section. (b) Upon determining that a report is late, the filing officer shall immediately notify the candidate or chair of

the political committee as to the failure to file a report by the designated due date and that a fine is being assessed for each late day. The fine is $50 per day for the first 3 days late and, thereafter, $500 per day for each late day, not to exceed 25 percent of the total receipts or expenditures, whichever is greater, for the period covered by the late report. However, for the reports immediately preceding each special primary election, special election, primary election, and general election, the fine is $500 per day for each late day, not to exceed 25 percent of the total

1

,._ receipts or expenditures, whichever is greater, for the period covered by the late report. For reports required under s. 106.141{8}, the fine is $50 per day for each late day, not to exceed 25 percent of the total receipts or expenditures, whichever is greater, for the period covered by the late report. Upon receipt of the report, the filing officer shall determine the amount of the fine which is due and shall notify the candidate or chair or registered agent of the political committee. The filing officer shall determine the amount of the fine due based upon the earliest of the following :

1. When the report is actually received by such officer. 2. When the report is postmarked. 3. When the certificate of mailing is dated. 4. When the receipt from an established courier company is dated. 5. When the electronic receipt issued pursuant to s. 106.0705 or other electronic filing system authorized in this

section is dated. Such fine shall be paid to the filing officer within 20 days after receipt of the notice of payment due, unless

appeal is made to the Florida Elections Commission pursuant to paragraph (c). Notice is deemed complete upon proof of delivery of written notice to the mailing or street address on record with the filing officer. In the case of a candidate, such fine is not an allowable campaign expenditure and shall be paid only from personal funds of the candidate. An officer or member of a political committee is not personally liable for such fine .

(c) Any candidate or chair of a political committee may appeal or dispute the fine, based upon, but not limited to, unusual circumstances surrounding the failure to file on the designated due date, and may request and shall be entitled to a hearing before the Florida Elections Commission, which shall have the authority to waive the f ine in whole or in part. The Florida Elections Commission must consider the mitigating and aggravating circumstances contained ins. 106.265(2) when determining the amount of a fine, if any, to be waived. Any such request shall be made within 20 days after receipt of the notice of payment due. In such case, the candidate or chair of the political committee shall, within the 20-day period, notify the filing officer in writing of his or her intention to bring the matter before the commission.

( d} The appropriate filing officer shall notify the Florida Elections Commission of the repeated late filing by a candidate or political committee, the failure of a candidate or political committee to file a report after notice, or the failure to pay the fine imposed. The commission shall investigate only those alleged late filing violations specifically identified by the filing officer and as set forth in the notification. Any other alleged violations must be separately stated and reported by the division to the commission under s. 106.25{2}.

2

CTIY CF JCO<S:NJIU£ ID'D-l, FLCRim REPRINT

*** DE1U1:R RHEIPT *** ~: IffiIFFfIH TYFE: FR Ircw:r: 1 Date: l/21/lb 01 Receipt no: 207t6

I'.escription Q.iantity Anount t'P MIS::EUJH:a.E PA'MNTS

1.00 $1'.l).00

PCGT TO 001-0:X:0-:-341-.s:ooJ ili mt-ER ~ PHJTO ITPIE s

Tend?r d?tail (}\ DIDi 1EN[ffi Total tenc:Era:J Total pcr.,Arent

Trans date: 1/20/16

E¥17 sJ '.:().00 $1'.l). 00 $J '.l).00

Tine: 12:07:00

\


(1) Keith Doherty Name

(2) 927 4th Avenue North Address (number and street)

Jacksonville Beach, FL, 32250


D Check here if address has changed

City Clerk

(3) ID Number: ----------


0 candidate Office sought: Jacksonville Beach Council, Seat 3, At-Large 0 Political Committee (PC) 0 Electioneering Communications Org. (ECO) 0 Check here if PC or ECO has disbanded 0 Party Executive Committee (PTY) 0 Check here if PTY has disbanded 0 Independent Expenditure (IE) (also covers an D Check here if no other IE or EC reports will be filed individual making electioneering communications)


CoverPeriod: From 01 I 01 I 16 To 01 I 31 I 16 Report Type: 2016-M1

0 Original 0 Amendment 0 Special Election Report

(6) Contributions This Report

Cash & Checks $ ' ' -- -- -- --

Loans $ ' 4' 000 . 00 -- --

Total Monetary $ 4 I 000 .00

In-Kind $ ' ' -- -- -- --

(9) TOTAL Monetary Contributions To Date $ 4 000 00

-- --

(7) Expenditures This Report

Monetary Expenditures

Transfers to

$

Office Account $

Total Monetary $

(8) Other Distributions $

' 0 0

-- -- --

0. 0

0.0

0 . 0

(10) TOTAL Monetary Expenditures To Date $ 0 0

---

( 11) Certification It is a first degree misdemeanor for any person to falsify a public record (ss. 839.13, F.S.)


(Type name) Nicola Lynch D Individual (only for IE 0 Treasurer 0 Deputy Treasurer or electioneering comm.)

x Signature

OS-DE 12 (Rev. 11/13)

(Type name) Keith Doherty 0 Candidate 0 Chairperson (only for PC and PTY)

x b Signature

SEE REVERSE FOR INSTRUCTIONS

CAMPAIGN TREASURER'S REPORT-ITEMIZED EXPENDITURES (1) Name ~t:._\ ' \-\ ~H £ <Z... "\"--! (2) l.D. Number _______ _

(3) Cover Period~/~/~ through~/~~ (4) Page ____ of ____ _

(5) (7) (8) (9) (10) (11)





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(1) Name (2) l.D. Number

(3) Cover Period 0 l I C> l I ~ through 0 \ I ~ \ I I b (4) Page _\_of _j_

(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

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DS-DE 13 (Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS ~ND cd'oWAt:u~s" l.J

City Clerk


(1) IZtJ \l-' OC>t-ti:fl_T'-j ¥tifc~l'3~ Name

(2) '42 / Lt~' ~~ \.)"&,. ~\'f-; MAR ·1 O 2016

Address (number and street) <::5IC ">( ~ l FL, 'b '1..L:E::P City Clerk


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


Ill Candidate Office Sought: ~ ~ C\ t"'-1 Cbo "'7C) L . 'Et~T ~ A\" Le«<€. D Political Committee (PC) D Electioneering Communications Org. (ECO) D Check here if PC or ECO has disbanded 0 Party Executive Committee (PTY) 0 Check here if PTY has disbanded D Independent Expenditure (IE) (also covers an 0 Check here if no other IE or EC reports will be filed individual making electioneering communications)


Cover Period: From 0'2.. I Ol I 16 To 02. I '"l.~ I 16 Report Type: L.s:>tb- 0")'2_ - - - - -- -- -- --

0 Original 0 Amendment D Special Election Report


Monetary

Cash & Checks $ I I 0 . 00 Expenditures $ I ' o .oo

-- -- -- -- -- -- -- - -

Loans $ ' ' 0 . ex:> Transfers to - - -- -- --Office Account $ I I o . oD

-- -- -- --Total Monetary $ I I o . CO

-- -- -- --Total Monetary $

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-- -- -- --In-Kind $

' ' o .oo -- -- -- --


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(9) TOTAL Monetary Contributions To Date (10) TOTAL Monetary Expenditures To Date

$ I 4 I OC'X::J . ex:> $ o .oo I I -- -- --

(11) Certification It is a first degree misdemeanor for any person to falsify a public record (ss. 839.13, F.S.)


(Type name) N 1wLA lYl'-1{1-1 (Type name) i(t;.)l\4 Cci--l~Q...l'-/

0 Individual (only for IE Sl Treasurer 0 Deputy Treasurer ~Candidate 0 Chairperson (only for PC and PTY) or electioneering comm.)

x Ji/uh k~/_ x b ~~ ,

~ Signature Signature

DS-DE 12 (Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS

CAMPAIGN TREASURER'S REPORT - ITEMIZED EXPENDITURES (1) Name ll:.t::..1\\-1 ~~Q... 1-; (2) l.D. Number _______ _

(3) Cover Period 07- /~_12._ through O'Z.. I "L~ 1___l:Q_ (4) Page ____ of ____ _

(5) (7) (8) (9) (10) (11)


(6) {Last, Suffix, First, Middle) {add office sought if Expenditure



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DS-DE 14 {Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES

CAMPAIGN TREASURER'S REPORT-ITEMIZED CONTRIBUTIONS

(1) Name (2) 1.0. Number

(3) Cover Period 0'1- IO) I~ through OL.. I '1..0\ I~ (4) Page

(5) (7) (8) (9) (10) (11) (12)

Date Full Name


Sequence Street Address & Contributor Contribution In-kind

Number City, State, Zip Code Type Occupation Type Description Amendment Amount

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OS-DE 13 (Rev.11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES

RECEIVED

CAMPAIG

(1)

Name (2) O\'L...I

Address (number and street)

~A~ ~ ) PL I fl:::,~ City, State, Zip Code

0 Check here if address has changed


(3) ID Number: ---------

~Candidate Office Sought: _~_A_~_><. __ ~ _____ c..rl'-1 ____ ~ _____ ·L____,1'--~-t:J_-=_~_Y_~_ D Political Committee (PC) A\~ D Electioneering Communications Org. (ECO) 0 Check here if PC or ECO has disbanded 0 Party Executive Committee (PTY} 0 Check here if PTY has disbanded 0 Independent Expenditure (IE} (also covers an D Check here if no other IE or EC reports will be filed individual making electioneering communications)


Cover Period: From ~ I C:>\ I lb To 6~ I 'b1 I \b Report Type:~& rn~

~Original 0 Amendment 0 Special Election Report

(6) Contributions This Report (7) Expenditur~s This Report

Monetary

Cash & Checks $ ' '

C> .C> Expenditures $ ' o .o -- -- -- -- -- -- --

Loans $ '

, O . o Transfers to -- -- -- --Office Account $

Total Monetary $ ' o .o


' 0 . 0

In-Kind $ , , o . o -- -- -- --(8) Other Distributions

$ 0 . 0 --


$ ~ ' C:X:C. cc $ 0 . o

( 11 ) Certification It is a first degree misdemeanor for any person to falsify a public record (ss. 839.13, F.S.)


(Type name)

0 Individual (only for IE 0 Treasurer 0 Deputy Treasurer or electioneering comm.)

x Signature

OS-DE 12 (Rev. 11/13)

(Type name)

[il"Candidate

x Signature

0 Chairperson (only for PC and PTY)

SE;E REVERSE FOR INSTRUCTIONS

CAMPAIGN TREASURER'S REPORT - ITEMIZED EXPENDITURES (1) Name 1<.~r~-~ OC>'b&-"6.fL "l'--1' (2) 1.0. Number ______ _

(3) Cover Period~ I c:f) I ) 6 through q I ~) I l h (4) Page of_) __ _

(5) (7) (8) (9) (10) (11)


(6) (Last, Suffix, First, Middle) (add office sought If Expenditure



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DS·DE 14 (Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES


(1) Name (2) l.D. Number

(3) Cover Period ~ I O) I ) 6 through O 'S I ~) I lb (4) Page )

(5) (7) (8) (9) (10) (11) (12) Date Full Name (tl) (Last. Suffix, First, Middle)

Sequence Street Address & Contributor Contribution In-kind Number City, State, Zip Code Type Occupation Type Description Amendment Amount

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(1) Keith Doherty R .. ..---t;;;;;'.MED _ . ___LY

Name MAY 1 0 2016 (2) 927 4th Avenue North

Address (number and street) City Clerk ~ D Jax Beach, FL. 32250


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

(4) Check appropriate box( es):

0 Candidate Office Sought: Jax Beach City Council At Large - Seat 3 0 Political Committee (PC) D Electioneering Communications Org. (ECO) D Check here if PC or ECO has disbanded 0 Party Executive Committee (PTY) D Check here if PTY has disbanded 0 Independent Expenditure (IE) (also covers an D Check here if no other IE or EC reports will be filed individual making electioneering communications)


Cover Period: From 04 /01 ,2016 To 04 I 31 ,2016 Report Type: 2016-M4 -- -- -- -- -- --

0 Original 0 Amendment D Special Election Report


Monetary

Cash & Checks $ ' ' 0 . oo Expenditures $

' ' 0 . CC> -- -- -- -- - - - - - - - -

Loans $ ' ' 0 .oc Transfers to -- -- -- --Office Account $

' ' o .oo -- -- -- --

Total Monetary $ ' ' 0 -0D


' ' 0 - 00 -- -- -- --

In-Kind $ ' ' o .oo -- -- -- --


' ' 0 . a::::;


$ ' 4 ' co::>. c::c:; $ ' '

C) .cO -- --

(11) Certification It is a first degree misdemeanor for any person to falsify a public record (ss. 839.13, F.5.)


(Type name) Nicola Lynch (Type name) Keith Doherty D Individual (only for IE 0 Treasurer D Deputy Treasurer 0 Candidate D Chairperson (only for PC and PTY) or electioneering comm.)

x 1U~/i x l? -~ () -

Signature Signature

DS·DE 12 (Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS


(1) Name Ke i th Doherty

(2) l.D. Number

0 4 01 2 01 6 0 4 30 2016 1 1 (3) Cover Period I through I I (4) Page of

(5) (7) (8) (9) (10) (11) (1 2) Date Full Name

(6) (Last, Suffix, First, Middle) Sequence Street Address & Contributor Contribution In-kind Number Citv, State, Zip Code Type Occupation Type Description Amendment Amount

NOTHI NG TO RE PORT

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OS-DE 13 (Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES

CAMPAIGN TREASURER'S REPORT - ITEMIZED EXPENDITURES (1) Name Keith Doherty (2) l.D. Number _______ _

(3) Cover Period 04 I 01 I 2016 through 04 /

30 /

2016 ------ ------

1 1 (4) Page _____ of ____ _

(5) (7) (8) (9) (10) (11)





NOTHING TO REPORT

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DS-DE 14 (Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES

(1) Keith Doherty Name

(2) 927 4th Avenue North Address (number and street)

Jacksonville Beach, FL, 32250 City, State, Zip Code

D Check here if address has changed

JUN 1 0 2016

City Clerk

(3) ID Number: ----------


D candidate Office sought: City Council Seat 3 At-Large 0 Political Committee (PC) 0 Electioneering Communications Org. (ECO) 0 Check here if PC or ECO has disbanded D Party Executive Committee (PTY) D Check here if PTY has disbanded D Independent Expenditure (IE) (also covers an D Check here if no other IE or EC reports will be filed individual making electioneering communications)


Cover Period: From 05 I 01 JW16 To 05 / 31 ~016 Report Type: 2016-M5

0 Original 0 Amendment 0 Special Election Report

(6) Contributions This Report

Cash & Checks $ '

,0 0 -- -- -- --

Loans $ ' ' -- -- -- --

Total Monetary $ -- -- -- - -

In-Kind $ ' ' -- -- - - - -

(9) TOTAL Monetary Contributions To Date

$ ~-'~-4 ,000 .QQ___

(7) Expenditures This Report

Monetary Expenditures

Transfers to

$

Office Account $

Total Monetary $


' 0 .0

-- --- --

(10) TOTAL Monetary Expenditures To Date $ 0.0 --

(11) Certification It is a first degree misdemeanor for any person to falsify a public record (ss. 839.13, F .S.)


(Type name) Nicola Lynch (Type name) Keith Doherty D Individual (only for IE 0 Treasurer D Deputy Treasurer 0 Candidate D Chairperson (only for PC and PTY) or electioneering comm.)

x x Signature

OS-DE 12 (Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS

·-

CAMPAIGN TREASURER'S REPORT - ITEMIZED EXPENDITURES (1) Name KEITH DOHERTY (2) l.D. Number _______ _

(3) Cover Period _05 __ ;_0_1_/~ through _0_

5 _;_

3_1 _!~

1 1 (4) Page _____ of ____ _

(5) (7) (8) (9) (10) (11)





NOTHING TO REPORT THIS SEQUENCE

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OS-DE 14 (Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES


KEITH DOHERTY (1) Name (2) 1.0. Number

05 01 2016 05 31 2016 1 1 (3) Cover Period I through I I (4) Page of

(5) (7) (8) (9) (10) (11) (12) Date Full Name


Sequence Street Address & Contributor Contribution In-kind Number City, State, Zip Code Type Occupation Type Description Amendment Amount

NOTHING TO RE PORT THIS SEQUENCE

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o:~,~ fl 32250 ··------- · 2016. 6. 20. · nov 1 0 2015 ' city clerk (4) check...

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