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Allbritton, David - Seat 4
' CAMPAIGN TREASURER'S REPORT (1) DAVID ALLBRITTON SUMMARY OFFICE USE ONLY "''' ,.:.CIRDS AND LEGl:SLA1-41 rti•VCS D'" -PT. Name (2) 217 PALM ISLAND NW Address (number and street) CLEARWATER, FL 33767 City, State, Zip Code Check here if address has changed (4) Check appropriate box(es): (3) CITY ID Number: N/A COUNCIL, SEAT 4 Candidate Office Sought: CLEARWATER O Political Committee (PC) Electioneering Communications Org. (ECO) O Party Executive Committee (PTY) O Independent Expenditure (IE) (also covers an individual making electioneering communications) 0 Check D Check here if PC or ECO has disbanded here if PTY has disbanded here if no other IE or EC reports will be filed III Check (5) Report Identifiers Cover Period: From 03 / 09 / 18 To 06 / 11 / 18 Report Type: TR Election Report " Original E Amendment I Special (6) Contributions This Report Cash & Checks $ , , . 00 (7) Expenditures Monetary Expenditures Transfers Office Account Total Monetary This Report $ , 6 , 598 . 05 Loans $ , , . 00 to $ , , . 00 Total Monetary $ , , . 00 $ , 6 , 598 . 05 In -Kind $ , , . 00 (8) Other $ Distributions , , . 00 (9) TOTAL Monetary Contributions To Date $ , 45 , 792 . 00 (10) TOTAL $ Monetary Expenditures To Date , 45 , 792 . 00 (11) Certification It is a first degree misdemeanor for any person I certify that I have examined this report and it is true, correct, JAY POLG A17 to falsify a public record (ss. 839.13, F.S.) and complete: (Type name) DAVID ALLBRITTON (Type name) 0 Individual (only for IE t2 reasurer M Deputy Treasurer 12 Candidate E Chairperson (only for PC and PTY) or electioneering comm.), 41 Lir 4 f X.414,4174 i r IJ! / &_ X ignatur. Signature - v. SEE REVERSE FOR INSTRUCTIONS CAMPAIGN TREASURER'S REPORT - ITEMIZED EXPENDITURES (1) Name DAVID ALLBRITTON (2) I.D. Number NIA (3) Cover Period 03 / 09 / 18 through 06 / 11 / 18 (4) Page 1 of 2 DS -DE 14 (Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES (5) Date (7) Full Name (8) Purpose (add office sought if contribution to a candidate) (9) Expenditure Type (10) Amendment (11) Amount (6) Sequence Number (Last, Suffix, First, Middle) Street Address & City, State, Zip Code Office Depot, Inc. 3 / 10 / 18 6600 North Military Trail Boca Raton, FL 33496 CAN $ 323.71 1 3 12 18 Office Depot, Inc. 6600 North Military Trail / / Boca Raton, FL 33496 CAN $ 359.91 2 Office Depot, Inc. 3 13/ 18 6600 North Military Trail / Boca Raton, FL 33496 CAN $ 500.00 3 45 18 Southern Campaign Resources, Inc. / / 235 E Virginia St Tallahassee, FL 32301 CAN $ 2780.20 4 Lubrano Creative Consulting 4 5 18 920 Jackson Ct. / / Palm Harbor, FL 34683 CAN $ 389.00 5 Jeremiah Khokhar Photography 42 18 1113 Woodcrest Ave / 0 Safety Harbor, FL 34695 CAN $ 500.00 6 Rumba's Grill 3 15 18 1800 Gulf to Bay Blvd / / Clearwater, FL 33765 CAN $ 1000.00 7 Culver's 568 3 16/ 18 Clearwater, FL / CAN $ 23.39 8 DS -DE 14 (Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES CAMPAIGN TREASURER'S REPORT - ITEMIZED EXPENDITURES (1) Name DAVID ALLBRITTON (3) Cover Period 03 / 09 / 18 through 06 / 11 / 18 (2) I.D. Number N/A (4) Page 2 of 2 DS -DE 14 (Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES (5) Date (7) Full Name (Last, Suffix, First, Middle) Street Address & City, State, Zip Code (8) Purpose (add office sought if contribution to a candidate) (9) Expenditure Type (10) Amendment (11) Amount (6) Sequence Number 3 / 13 / 18 Papa John's Pizza 411 S Missouri Ave Clearwater, FL 33756 CAN $ 16.05 8 3 / 19/ 18 Home Depot 2495 Gulf to Bay Blvd Clearwater, FL 33765 CAN $ 90.44 9 611 18 / / Habitat for Humanities of Pinellas 13355 49th St N Clearwater, FL 33762 DONATION DIS $ 616.21 10 / / / / / / / / /1 DS -DE 14 (Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES CAMPAIGN TREASURER'S REPORT (1) DAVID ALLBRITTON SUMMARY I� T , OFFICIAL RECORDS LEGISLATIVE SRVCS Y AND DEPT Name (2) 217 PALM IS N.W. Address (number and street) CLEARWATER, FL 33767 City, State, Zip Code ❑ Check here if address has changed (4) Check appropriate box(es): CLEARWATER (3) CITY ID Number: N/A COUNCIL, SEAT 4 Candidate Office Sought: ❑ 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 3 / 02 / 18 To 3 / 08 / 18 Report Type: G7 Election Report 6, Original ❑ Amendment ❑ Special (6) Contributions This Report Cash & Checks $ , 3 , 820 . 00 (7) Expenditures Monetary Expenditures Transfers Office Account Total Monetary This Report $ , 4 , 013 . 95 Loans $ , . 00 to $, , . 00 Total Monetary $ , 3 , 820. 00 $ , 4 , 013 . 95 In -Kind $ , , . 00 (8) Other Distributions $, , . 00 (9) TOTAL Monetary Contributions To Date $ , 45 , 792 , 00 (10) TOTAL Monetary Expenditures To Date $ , 37 , 867 . 48 (11) Certification It is a first degree misdemeanor for any person I certify that I have examined this report and it is true, correct, (Type name) JAY POLGLAZE to falsify a public record (ss. 839.13, F.S.) and complete: (Type name) DAVID ALLBRITTON ■ Individual (only for IE ; Ul Tr: -surer • Deputy Treasurer CI Candidate ■ Chairperson (only for PC and PTY) or electioneering comm.) -% X )44 X Signature gnature y DS -DE 12 (Rev. Ilt 1/13) SEE REVERSE FOR INSTRUCTIONS CAMPAIGN TREASURER'S REPORT - ITEMIZED EXPENDITURES (1) Name DAVID ALLBRITTON (2) I.D. Number N/A (3) Cover Period 3 / 02 / 18 through 3 / 08 / 18 (4) Page 1 of 1 DS -DE 14 (Rev. 11113) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES (5) Date (7) Full Name (Last, Suffix, First, Middle) Street Address & City, State, Zip Code (8) Purpose (add office sought if contribution to a candidate) (9) Expenditure Type (10) Amendment (11) Amount (6) Sequence Number 3 / 05/ 18 DIRECT MAIL SYSTEMS 12450 AUTOMOBILE BLVD CLEARWATER, FL 33762 1 CAN $ 3970.69 308 / / 18 ANEDOT, INC. P.O.BOX 84314 BATON ROUGE, LA 70884 CAN $ 20.30 2 303 / / 18 MCDONALD'S F11017 DUNEDIN, FL CAN $ 22.96 3 / / / 1 / / 1 / / 1 DS -DE 14 (Rev. 11113) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES CAMPAIGN TREASURER'S REPORT — ITEMIZED CONTRIBUTIONS DAVID ALLBRITTON (1) Name 3 2 18 3 08 18 (3) Cover Period / / through (2) I.D. Number N/A (4) Page 1 of 1 DS -DE 13 (Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES (5) Date (7) Full Name (Last, Suffix, First, Middle) Street Address & City, State, Zip Code Contributor Type (8) Occupation (9) Contribution Type (10) In-kind Description (11) Amendment (12) Amount (6) Sequence Number 3 8 18 MID ATLANTIC FINANCE CO. / / 4592 ULMERTON RD STE 200 B FINANCE CHE $ 1000.00 CLEARWATER, FL 33762 1 TIMOTHY MARIANI 3 8 18 145 WILLADEL DR. / / BELLEAIR, FL 33756 I CHE $ 100.00 2 QUALITY BOATS OF CLW 3 5 18 235 WINDWARD PASSAGE / / CLEARWATER BEACH, FL 33767 B SALES CHE $ 1000.00 3 SPACE CENTER PROPERTIES 3 8 18 22067 US 19 N. / / CLEARWATER, FL 33765 B PROP MANAGE ONLINE $ 500.00 4 LAWRENCE DIMMITT III 3 08 18 25485 HWY 19 N. / / CLEARWATER, FL 33763 I AUTO SALES CHE $ 1000.00 5 KOCH HOFFMAN & KASZUBA 3 08 18 200 N. GARDEN AVE STEA / / CLEARWATER, FL 33755 B ATTYS CHE $ 200.00 6 SEAN SCHRADER 3 05 18 1541 SOUTH FREDRICA AVE / / CLEARWATER, FL 33756 I CAS $ 20.00 7 DS -DE 13 (Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES CAMPAIGN TREASURER'S REPORT (1) DAVID ALLBRITTON SUMMARY 1,9f4V 2 CFFiC+/v Ew iK:sS AND LEGISLATIVE SRVCS DEPT. Name (2) 217 PALM ISLAND NW Address (number and street) CLEARWATER, FL 33767 City, State, Zip Code ❑ Check here if address (4) Check appropriate box(es): has changed (3) Sought: CLEARWATER CITY ID Number: N/A COUNCIL, SEAT 4 6, Candidate Office ❑ Political Committee ❑ Electioneering Communications ❑ Party Executive Committee ❑ Independent Expenditure individual making electioneering (PC) Org. (ECO) ❑ Check here if PC or ECO has disbanded (PTY) ❑ Check here if PTY has disbanded (1E) (also covers an ❑ Check here if no other IE or EC reports will be filed communications) (5) Report Identifiers Cover Period: From 2 / 23 / 18 To 3 / 1 / 18 Report Type: G6 ❑ Special Election Report Original ❑ Amendment (6) Contributions This Report Cash & Checks $ , , 295.00 (7) Expenditures Monetary Expenditures Transfers Office Account Total Monetary This Report $ , 5 , 880. 40 Loans $ , , . 00 to $, , . 00 Total Monetary $ , , 295.00 $ , 5 , 880. 40 In-Kind $ , , . 00 (8) Other Distributions $, , . 00 (9) TOTAL Monetary Contributions To Date $ , 41 , 972 . 00 (10) TOTAL Monetary Expenditures To Date $ , 33 , 853 . 53 (11) Certification It is a first degree misdemeanor for any person I certify that I have examined this report and it is true, correct, (Type name) JAY POLGLAZE to falsify a public record (ss. 839.13, F.S.) and complete: (Type name) DAVID ALLBRITTON • Individual (only for IE 12 T - - rer ■ Deputy Treasurer 19 Candidate IN Chairperson (only for PC and PTY) or electioneering comm.) X N X Signat Signature DS -DE 12 (Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS • CAMPAIGN TREASURER'S REPORT - ITEMIZED CONTRIBUTIONS DAVID ALLBRITTON (1) Name (2) I.D. Number 2 23 18 3 1 18 (3) Cover Period / / through / / N/A 1 (4) Page of 1 DS -DE 13 (Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES (5) Date (7) Full Name (Last, Suffix, First, Middle) Street Address & City, State, Zip Code Contributor Type (8) Occupation (9) Contribution Type (10) In-kind Description (11) Amendment (12) Amount (6) Sequence Number 2 / 28 / 18 CLINT & KATHERINE COLE 21 EVONAIRE CIR BELLEAIR, FL 33756 I ATTY CHE $ 250.00 1 2 / 28 / 18 JACK & RACHEL MURRAY 2951 BAY MEADOW CT CLEARWATER, FL 33761 I CAS $ 25.00 2 2 / 28 / 18 RAY & CHERYL MURRAY 2968 MEADOW HILL DR. CLEARWATER, FL 33761 1 CAS $ 20.00 3 / / / / / / / / DS -DE 13 (Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES CAMPAIGN TREASURER'S REPORT - ITEMIZED EXPENDITURES (1) Name DAVID ALLBRITTON (2) I.D. Number N/A (3) Cover Period 2 / 23 / 18 through 3 / 1 / 18 (4) Page 1 of 1 (5) Date (7) Full Name (Last, Suffix, First, Middle) Street Address & City, State, Zip Code (8) Purpose (add office sought if contribution to a candidate) (9) Expenditure Type (10) Amendment (11) Amount (6) Sequence Number CITY OF CLEARWATER 2 / 26/ 18 112 S. OSCEOLA AVE CLEARWATER, FL 33756 CAN $ 32.00 1 2 28 18 LUBRANO CREATIVE 920 JACKSON CT. / / PALM HARBOR, FL 34683 CAN $ 471.44 2 DATA TARGETING 226 18 6211 NW 132ND ST / / GAINSVILLE, FL 32653 CAN $ 750.00 3 ELIZABETH PIERCE 2 28 18 13215 SAN BLASS LOOP / / LARGO, FL 33774 CAN $ 187.50 4 DIRECT MAIL SYSTEMS 3/ 1 18 12450 AUTOMOBILE BLVD / CLEARWATER, FL 33762 CAN $ 3176.96 5 tbnweekly.com 2 26 18 9911 Seminole Boulevard / / Seminole, FL 33772 CAN $ 1262.50 6 / / // DS -DE 14 (Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES CAMPAIGN TREASURER'S REPORT (1) DAVID ALLBRITTON SUMMARY `i �--� P:- a , OFFICIAL <ECORDS AND LEGISLATIVE SRVCS DEPT. Name (2) 217 PALM ISLAND NW Address (number and street) CLEARWATER, FL 33767 City, State, Zip Code ❑ Check here if address (4) Check appropriate box(es): has changed (3) Sought: CLEARWATER CITY ID Number: N/A COUNCIL, SEAT 4 Candidate Office ❑ Political Committee (PC) ❑ Electioneering Communications ❑ Party Executive Committee ❑ Independent Expenditure individual making electioneering Org. (ECO) ❑ Check here if PC or ECO has disbanded (PTY) ❑ Check here if PTY has disbanded (IE) (also covers an ❑ Check here if no other IE or EC reports will be filed communications) (5) Report Identifiers Cover Period: From 2 / 16 / 18 To 2 / 22 / 18 Report Type: G5 ❑ Special Election Report Original ❑ Amendment (6) Contributions This Report Cash & Checks $ , 2 , 900. 00 (7) Expenditures Monetary Expenditures Transfers Office Account Total Monetary This Report $ , , 412.00 Loans $ , , • 00 to $, , . 00 Total Monetary $ , 2 , 900. 00 $ 412. 00 In-Kind $ , , . 00 (8) $, Other Distributions . 00 (9) TOTAL Monetary Contributions To Date $ , 41 , 677 . 00 (10) TOTAL Monetary Expenditures To Date $ , 27 , 973 . 13 (11) Certification It is a first degree misdemeanor for any person I certify that 1 have examined this report and it is true, correct, (Type name) JAY P• LAZE to falsify a public record (ss. 839.13, F.S.) and complete: (Type name) DAVID ALLBRITTON ■ Individual (only for IE D Tr: or electioneering comm.) as rer ■ Deputy Treasurer 0 Candidate ■ Chairperson (only for PC and PTY) 111V&-,. gnature Signature DS -DE 12 (Rev. 1 1/13) SEE REVERSE FOR INSTRUCTIONS (1) Name CAMPAIGN TREASURER'S REPORT — ITEMIZED CONTRIBUTIONS DAVID ALLBRITTON 2 16 (3) Cover Period / 18 / through 2 22 18 / / (2) I.D. Number N/A 1 (4) Page of 2 DS -DE 13 (Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES (5) Date (7) Full Name (Last, Suffix, First, Middle) Street Address & City, State, Zip Code Contributor Type (8) Occupation (9) Contribution Type (10) In-kind Description (11) Amendment (12) Amount (6) Sequence Number 2 19 18 PEPIN DISTRIBUTING COMPANY / / 4121 N. 50TH ST TAMPA, FL 33610 B DISTRIB CHE $ 1000.00 1 GERALD FIGURSKI, P.A. 2 16 18 2975 EAGLE ESTATES CIR / / W. CLEARWATER, FL 33761 B CHE $ 100.00 2 CHRISTOPHER MARIANI 2 20 18 193 DEVON DR. / / CLEARWATER, FL 33767 I SALES CHE $ 500.00 3 KYMM MARIANI 2 20 18 193 DEVON DR. / / CLEARWATER, FL 33767 I "p‘ e1 Ltc' CHE $ 500.00 4 PHIL JESTER 2 18 18 2086 LONG BOW LANE / / CLEARWATER, FL 33764 I CONTRACTOR CHE $ 200.00 5 DONALD O'DELL 2 17 18 331 CLEVELAND ST / / CLEARWATER, FL 33755 I RETIRED CHE $ 200.00 6 JANICE CASE 2 20 18 205 PALM ISLAND NW / / CLEARWATER, FL 33767 I RETIRED CHE $ 250.00 7 DS -DE 13 (Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES CAMPAIGN TREASURER'S REPORT — ITEMIZED CONTRIBUTIONS DAVID ALLBRITTON (1) Name (3) Cover Period 2 / 16 / 18 through 2 22 18 / / (2) I.D. Number N/A (4) Page 2 of 2 DS -DE 13 (Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES (5) Date (7) Full Name (Last, Suffix, First, Middle) Street Address & City, State, Zip Code Contributor Type (8) Occupation (9) Contribution Type (10) In-kind Description (11) Amendment (12) Amount (6) Sequence Number 2 / 16 / 18 JOHN LANIGAN 768 SNUG ISLAND CLEARWATER, FL 33767 I CHE $ 100.00 8 2 / 16 / 18 THOMAS MCMURTRY 309 GLENWOOD AVE N CLEARWATER, FL 33755 I CHE $ 50.00 9 / / / / / / / / / / DS -DE 13 (Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES CAMPAIGN TREASURER'S REPORT - ITEMIZED EXPENDITURES (1) Name DAVID ALLBRITTON (3) Cover Period 2 / 16 / 18 through 2 / 22 / 18 (2) I.D. Number N/A 1 (4) Page of 1 (5) Date (7) Full Name (Last, Suffix, First, Middle) Street Address & City, State, Zip Code (8) Purpose (add office sought if contribution to a candidate) (9) Expenditure Type (10) Amendment (11) Amount (6) Sequence Number 2)/ 20/18 GRIFFIN PRODUCTIONS PO BOX 1314 INDIAN ROCKS BEACH, FL 33785 CAN $ 412.00 1 / / / / / / / / / / / / / / DS -DE 14 (Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES CAMPAIGN TREASURER'S REPORT (1) DAVID ALLBRITTON SUMMARY REC\YNLY ,- 1 c OFFICIAL RECORDS AND LEGISLATIVE SRVCS DEPT. Name (2) 217 PALM ISLAND N.W. Address (number and street) CLEARWATER, FL 33767 City, State, Zip Code ❑ Check here if address has changed (4) Check appropriate box(es): (3) CITY ID Number: N/A COUNCIL, SEAT 4 v Candidate Office Sought: CLEARWATER ❑ Political Committee (PC) ❑ Electioneering Communications Org. (ECO) ❑ Check here if PC or ECO has disbanded ❑ Party Executive Committee (PTY) ❑ Check here if PTY has disbanded ❑ Independent Expenditure (IE) (also covers an ❑ Check here if no other IE or EC reports will be filed individual making electioneering communications) (5) Report Identifiers Cover Period: From 2 / 09 / 18 To 2 / 15 / 18 Report Type: G 4 Election Report 61 Original ❑ Amendment ❑ Special (6) Contributions This Report \ Cash & Checks $ , 8 , 700. 00 (7) Expenditures Monetary Expenditures Transfers Office Account Total Monetary This Report $ , 9, 022.83 Loans $ , . 00 to $, , . 00 Total Monetary $ , 8 , 700. 00 $, 9 022. 83 In -Kind $ , , . 00 (8) Other Distributions $, , . 00 (9) TOTAL Monetary Contributions To Date $ , 38 , 777 . 00 (10) TOTAL Monetary Expenditures To Date $ , 27 , 561 . 13 (11) Certification It is a first degree misdemeanor for any person I certify that 1 have examined this report and it is true, correct, (Type name) JAY POLGLAZE to falsify a public record (ss. 839.13, F.S.) and complete: (Type name) DAVID ALLBRITTON • Individual (only for lE 2 Treas rer ■ Deputy Treasurer l9 Candidate ■ Chairperson (only for PC and PTY) or electioneering comm.) X 6" X I' ignature Signatures DS -DE 12 (R .,11/13) SEE REVERSE FOR INSTRUCTIONS CAMPAIGN TREASURER'S REPORT — ITEMIZED CONTRIBUTIONS DAVID ALLBRITTON (1) Name (3) Cover Period 2 09 18 / / (2) I.D. Number through 2 / 15 18 / N/A 1 (4) Page of 3 DS -DE 13 (Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES (5) Date (7) Full Name (Last, Suffix, First, Middle) Street Address & City, State, Zip Code Contributor Type (8) Occupation (9) Contribution Type (10) In-kind Description (11) Amendment (12) Amount (6) Sequence Number THOMAS RUGGLES 2 14 18 331 CLEVELAND ST. / / CLEARWATER, FL 33755 I Airy, ONLINE $ 200.00 1 THOMAS PEPIN 2 15 18 4121 N. 50TH ST / / TAMPA, FL 33610 I CEO ONLINE $ 1000.00 2 ROWLAND MILAM 2 08 18 1828 VENETIAN PT. / / CLEARWATER, FL 33755 I tiLlaf/'j Jdtl. ONLINE $ 200.00 3 SAI VIVEK VISWANADHA 2 09 18 401 ROSERY RD. N.E. / / LARGO, FL 33770 I SOFTWARE DEV CHE $ 1000.00 4 DANIEL MCCRADY 2 09 18 810 1ST AVE NW #4 / / LARGO, FL 33770 I HR MANAGER CHE $ 1000.00 5 CG ELIAS & COMPANY 2 09 18 2555 ENTERPRISE BLVD / / CLEARWATER, FL 33763 B $ 100.00 6 COMPASS ENGINEERING 2 09 18 565 S. HERCULES AVE / / CLEARWATER, FL 33764 B 4 100.00 7 DS -DE 13 (Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES CAMPAIGN TREASURER'S REPORT — ITEMIZED CONTRIBUTIONS DAVID ALLBRITTON (1) Name (3) Cover Period 2 09 18 / / (2) I.D. Number through 2 / 15 18 / N/A (4) Page 2 of 3 DS -DE 13 (Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES (5) Date (7) Full Name (Last, Suffix, First, Middle) Street Address & City, State, Zip Code Contributor Type (8) Occupation (9) Contribution Type (10) In-kind Description (11) Amendment (12) Amount (6) Sequence Number HUPP MANAGEMENT, LLC 2 14 18 907 S. FT. HARRISON / / AVE STE 102 CLEARWATER, FL 33756 B PROPERTY MAN CHE $ 400.00 8 JOHN P. CONNELLY 2 13 18 11 HARBORSIDE DR. / / BELLEAIR, FL 33756 I INSURANCE CHE $ 1000.00 9 EDWARD DROSTE 2 12 18 107 HAMPTON RD, STE 120 / / CLEARWATER, FL 33759 I CEO CHE $ 250.00 10 GEORGE ROUSE 2 12 18 510 ORANGEVIEW / / CLEARWATER, FL 33755 I CHE $ 100.00 11 MARK MCCLINTOCK 2 13 18 1930 DUNLOE CIRCLE / / DUNEDIN, FL 34698 I CHE $ 100.00 12 IWG, INC. 2 13 18 18395 GULF BLVD STE 204 / / INDIAN SHORES, FL 33785 B REST. $ 500.00 13 DIRECT SEAFOODS 2 13 18 18395 GULF BLVD STE 204 / / INDIAN SHORES, FL 33785 B SEAFOOD CO $ 500.00 14 DS -DE 13 (Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES CAMPAIGN TREASURER'S REPORT — ITEMIZED CONTRIBUTIONS DAVID ALLBRITTON (1) Name (3) Cover Period 2 09 18 / / through (2) I.D. Number 2 15 18 / / N/A 3 (4) Page of 3 DS -DE 13 (Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES (5) Date (7) Full Name (Last, Suffix, First, Middle) Street Address & City, State, Zip Code Contributor Type (8) Occupation (9) Contribution Type (10) In-kind Description (11) Amendment (12) Amount (6) Sequence Number ABQ RESTAURANT, INC 2 13 18 18395 GULF BLVD STE 204 / / INDIAN SHORES, FL 33785 B REST. CHE $ 500.00 15 HOOTERS MANAGEMENT CORP 2 13 18 107 HAMPTON ROAD 3200 / / CLEARWATER, FL33759 B REST. MAN. CHE $ 250.00 16 SHERATON SAND KEY 2 13 18 1160 GULF BLVD / / CLEARWATER, FL 33767 B HOTEL CHE $ 250.00 17 RICHARD COPE 2 13 18 1188 MANDALAY POINT / / CLEARWATER, FL 33767 I REALTOR CHE $ 250.00 18 JARAD.D. BROWN 2 13 18 635 COURT ST. STE 120 / / CLEARWATER, FL 33756 I PROP. MNR CHE $ 250.00 19 H.G. BROWN 2 13 18 635 COURT ST. STE 120 / / CLEARWATER, FL 33756 1 PROP. MNR CHE $ 250.00 20 H.G. BROWN & ASSOC. 2 13 18 635 COURT ST. STE 120 / / CLEARWATER, FL 33756 B PROP. MNR. CHE $ 500.00 21 DS -DE 13 (Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES CAMPAIGN TREASURER'S REPORT - ITEMIZED EXPENDITURES (2) I.D. Number N/A (1) Name DAVID ALLBRITTON (3) Cover Period 2 / 09 / 18 through 2 / 15/ 18 (4) Page 1 of 1 DS -DE 14 (Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES (5) Date (7) Full Name (Last, Suffix, First, Middle) Street Address & City, State, Zip Code (8) Purpose (add office sought if contribution to a candidate) (9) Expenditure Type (10) Amendment (11) Amount (6) Sequence Number 2 1 091 18 ANEDOT, INC. P.O.BOX 84314 BATON ROUGE, LA 70884 CAN $ 8.30 1 2 14 18 / / ANEDOT, INC. P.O.BOX 84314 BATON ROUGE, LA 70884 CAN $ 8.30 2 21 I 15- 18 ANEDOT, INC. P.O.BOX 84314 BATON ROUGE, LA 70884 CAN $ 40.30 3 2 09 18 / / DIRECT MAIL SYSTEMS 12450 AUTOMOBILE BLVD. CLEARWATER, FL 33762 CAN $ 8965.93 1 1 / / / 1 1 1 DS -DE 14 (Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES CAMPAIGN TREASURER'S REPORT (1) DAVID ALLBRITTON SUMMARY OFFaI UFS QTY t a _ _ ° 1 r.. L ' ti '- OFFICIAL k:ECORDS AND LFG1SI ATIVE C1W-S DEPT. Name (2) 217 PALM ISLAND N.W. Address (number and street) CLEARWATER, FL 33767 City, State, Zip Code ❑ Check here if address has (4) Check appropriate box(es): changed (3) CLEARWATER CITY ID Number: N/A COUNCIL, SEAT 4 Candidate Office Sought: ❑ Political Committee (PC) ❑ Electioneering Communications ❑ Party Executive Committee ❑ Independent Expenditure individual making electioneering Org. (ECO) ❑ Check here if PC or ECO has disbanded (PTY) ❑ Check here if PTY has disbanded (IE) (also covers an ❑ Check here if no other IE or EC reports will be filed communications) (5) Report Identifiers Cover Period: From 10 / 01 / 17 To 10 / 31 / 17 Report Type: M-10 ❑ Special Election Report ❑ Original " Amendment (6) Contributions This Report Cash & Checks $ , 10 , 740 , 00 (7) Expenditures Monetary Expenditures Transfers Office Account Total Monetary This Report $ , 1 , 217. 00 Loans $, , • 00 to $, , . 00 Total Monetary $ , 10 , 740 .00 $ 1 217. 00 In -Kind $, 500 , 00 (8) $, Other Distributions . 00 (9) TOTAL Monetary Contributions To Date $ , 13 , 647 . 00 (10) TOTAL Monetary Expenditures To Date $ , 1 , 424 . 69 It is a first degree misdemeanor 1 certify that I have examined this (Type name) JAY POLGLAZE (11) Certification for any person report and it is true, correct, to falsify a public record (ss. 839.13, F.S.) and complete: (Type name) DAVID ALLBRITTON Deputy Treasurer / • Individual (only for IE El -asurer IS Candidate • Chairperson (only for PC and PTY) or electioneering comm.) Signat a Signature DS -DE 12 (Rev. 11/13 SEE REVERSE FOR INSTRUCTIONS CAMPAIGN TREASURER'S REPORT — ITEMIZED CONTRIBUTIONS DAVID ALLBRITTON (1) Name (3) Cover Period 10 01 2017 10 through / 31 (2) ID. Number 2017 (4) Page N/A 8 of 8 -VG J. IRCV. SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES (5) Date (7) Full Name Contributor Type (8) Occupation (9) Contribution Type (10) In-kind Description (11) Amendment (12) Amount (6) Sequence Number (Last, Suffix, First, Middle) Street Address & City, State, Zip Code 10 / 17 2017 / BAREFOOT BEACH HOUSE 322 S. GULFVIEW BLVD. CLEARWATER, FL 33767 B PROP. MGMT CHE $500.00 50 10 / 17 2017 / KEN & LISA HAMILTON 200 PALM IS NW CLEARWATER, FL 33767 I REST. OWNER CHE $200.00 51 10 / 17 2017 / ROBERT & TERESSA CLARK 320 ISLAND WAY #603 CLEARWATER, FL 33767 I CHE $100.00 52 10 / 17 2017 / ISLAND WAY GRILL 20 ISLAND WAY CLEARWATER, FL 33767 B RESTAURANT INK $g 00.00 53 / / / / / / -VG J. IRCV. SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES CAMPAIGN TREASURER'S REPORT SUMMARY (1) DAVID ALLBRITTON RCELY Name (2) 217 PALM ISLAND NW FEL . 'Ole Address (number and street) CLEARWATER, FL 33767 OFFICIAL RECORDS AND City, State, Zip Code LEGISLATIVE SRVCS DEPT. ❑ Check here if address has changed (3) ID Number: N/A (4) Check v appropriate box(es): Candidate Office Sought: CLEARWATER CITY COUNCIL, SEAT 4 ❑ Political Committee (PC) ❑ Electioneering Communications Org. (ECO) ❑ Check here if PC or ECO has disbanded ❑ Party Executive Committee (PTY) ❑ Check here if PTY has disbanded ❑ Independent Expenditure (IE) (also covers an ❑ Check here if no other IE or EC reports will be filed individual making electioneering communications) (5) Report Identifiers Cover Period: From 1 / 26 / 18 To 2 / 08 / 18 Report Type: G3 v Original ❑ Amendment ❑ Special Election Report (6) Contributions This Report Cash & Checks $ , 3 , 880. 00 (7) Expenditures This Report Monetary Expenditures $ , , 695 . 30 Loans $ , , • 00 Transfers to Office Account $, , . 00 Total Monetary $ , 3 , 880. 00 Total Monetary $ , , 695. 30 In -Kind $ , 1, 000. 00 (8) Other Distributions $, , . 00 (9) TOTAL Monetary Contributions To Date $ , 30 , 077 . 00 (10) TOTAL Monetary Expenditures To Date $ , 18 538 . 30 , (11) Certification It is a first degree misdemeanor for any person I certify that I have examined this report and it is true, correct, (Type name) JAY POLGLAZE to falsify a public record (ss. 839.13, F.S.) and complete: (Type name) DAVID ALLBRITTON ❑ Individual (only for IE , Tre=sur-r ■ Deputy Treasurer or electioneering comm.)/ X 0 Candidate ■ Chairperson (only for PC and PTY) X %' Si. nat e Signature -ut iz (rcev. i SEE REVERSE FOR INSTRUCTIONS CAMPAIGN TREASURER'S REPORT - ITEMIZED CONTRIBUTIONS DAVID ALLBRITTON (1) Name 1 26 18 (3) Cover Period / / through (2) I.D. Number 2 08 18 / / N/A 1 (4) Page of 3 DS -DE 13 (Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES (5) Date (7) Full Name (Last, Suffix, First, Middle) Street Address & City, State, Zip Code Contributor Type (8) Occupation (9) Contribution Type (10) In-kind Description (11) Amendment (12) Amount (6) Sequence Number 2 / 6 / 18 ROBERT JOANNE MCINTYRE 1720 STARKEY RD LARGO, FL 33771 I CEO CHE $ 500.00 1 2 / 6 / 18 WILLIAM FRANCES WALLACE 606 TURNER ST. CLEARWATER, FL 33756 I CHE $ 100.00 2 2 / 6 / 18 JUDY, JEFFREY MITCHELL 508 BEACH DR NE ST. PETEERSBURG, FL 33701 I BANKING CHE $ 250.00 3 2 / 6 / 18 ED & TARA ARMSTRONG 1614 SANTA BARBARA DR. DUNEDIN, FL34698 I ATTORNEY CHE $ 150.00 4 2 / 6 / 18 KEN MARKS PO BOX 2336 CLEARWATER, FL 33757 I AUTO SALES CHE $ 200.00 5 2 / 8 / 18 JAY & LINDA POLGLAZE 522 RICHARDS AVE CLEARWATER, FL 33755 I EXECUTIVE CHE $ 500.00 6 2 / 8 / 18 DANIEL SHOUVLIN 425 BUTTONWOOD LN LARGO, FL 33770 I RESTAURANT CHE $ 500.00 7 DS -DE 13 (Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES (1) Name CAMPAIGN TREASURER'S REPORT — ITEMIZED CONTRIBUTIONS DAVID ALLBRITTON • (3) Cover Period 1 (2) I.D. Number 26 18 2 08 18 / / through / / N/A (4) Page 2 of 3 • DS -DE ! 3 (Rev. SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES (5) Date (7) Full Name Contributor Type (8) Occupation (9) Contribution Type (10) In-kind Description (11) Amendment (12) Amount (6) Sequence Number (Last, Suffix, First, Middle) Street Address & City, State, Zip Code BRUCE RECTOR 2 8 18 1801 WOOD THRUSH WAY / / PALM HARBOR, FL 34683 I CHE $ 50.00 8 FRANK & LYNN DAME 2 8 18 407 LEEWARD IS / / CLEARWATER, FL 33767 I C.O.O CMA CHE $ 150.00 9 JOHN & JANICE DRAHEIM 2 8 18 224 WINDWARD IS / / CLEARWATER, FL 33767 I CHE $ 100.00 111 10 STEPHEN GERLACH INC. 2 8 18 15841 REDINGTON DR. / / REDINGTON BEACH, FL 33708 B CHE $ 100.00 11 DOUGLAS MANUFACTURING 2 8 18 1115 CLEVELAND ST / / CLEARWATER, FL 33755 B SALES CHE $ 300.00 12 JOHN, STEPHANIE DORAN 2 8 18 TR / / 65 VERBANA ST CLEARWATER, FL 33767 I CHE $ 50.00 13 WILLIAM JACOBSEN 2 8 18 600 PACARD CT. / / SAFETY HARBOR, FL 34695 I HOME BLDR CHE $ 500.00 14 • DS -DE ! 3 (Rev. SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES (1) Name CAMPAIGN TREASURER'S REPORT — ITEMIZED CONTRIBUTIONS DAVID ALLBRITTON (3) Cover Period 1 / 26 / 18 through 2 (2) I.D. Number 8 18 / / (4) Page N/A 3 of 3 -uL 1J (Kev. SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES (5) Date (7) Full Name Contributor Type (8) Occupation (9) Contribution Type (10) In-kind Description (11) Amendment (12) Amount (6) Sequence Number (Last, Suffix, First, Middle) Street Address & City, State, Zip Code 2 / 08 18 / MICHAEL ANDERSON 223 ISLAND WAY 8G CLEARWATER, FL 33767 I ONLINE $ 100.00 15 2 / 08 18 / STEPHAN MCCELLAND 15 AURORA AVE CLEARWATER, FL 33765 I CAS $ 100.00 16 2 / 08 18 / CONNOLLY & JAMES MCAURTHER 504 PARK AVE BELLEAIR, FL I CAS $ 30.00 17 2 / 08 18 / CHARLES & LOUISE ROBINSON 65 N. PINE CIRCLE BELLEAIR, FL 33756 I ATTORNEY CHE $ 200.00 18 2 / 08 18 / RUMBA'S GRILL 1800 GULF TO BAY BLVD CLEARWATER, FL 33756 B RESTAURANT INK FUNDRAISER A $ 1000.00 19 / / / / -uL 1J (Kev. SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES CAMPAIGN TREASURER'S REPORT — ITEMIZED EXPENDITURES (1) Name DAVID ALLBRITTON (2) I.D. Number N/A (3) Cover Period 1 / 26 / 18 through 2 / 08 18 (4) Page 1 of 1 DS -DE 14 (Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES (5) Date (7) Full Name (8) Purpose (add office sought if contribution to a candidate) (9) Expenditure Type (10) Amendment (11) Amount (6) Sequence Number (Last, Suffix, First, Middle) Street Address & City, State, Zip Code 2 / 6 / 18 LUBRNO CREATIVE CONSULTING 920 JACKSON CT. PALM HARBOR, FL 34683 CAN $ 691.00 1 2 / 6 / 18 ANEDOT, INC. P.O.BOX 84314 BATON ROUGE, LA70884 CAN $ 4.30 2 / / / / / / / / / / / / DS -DE 14 (Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES CAMPAIGN TREASURER'S REPORT (1) DAVID ALLBRITTON SUMMARY R 1 LY JAN 2 6 2018 OFFICIAL RECORDS AND LEGISLATNE SRVCS DEPT. Name (2) 217 PALM ISLAND N.W. Address (number and street) CLEARWATER, FL 33767 City, State, Zip Code ❑ Check here if address has changed (4) Check appropriate box(es): (3) CITY ID Number: N/A COUNCIL, SEAT 4 v Candidate Office Sought: CLEARWATER ❑ Political Committee (PC) ❑ Electioneering Communications Org. (ECO) ❑ Check here if PC or ECO has disbanded ❑ Party Executive Committee (PTY) ❑ Check here if PTY has disbanded ❑ Independent Expenditure (IE) (also covers an ❑ Check here if no other IE or EC reports will be filed individual making electioneering communications) (5) Report Identifiers Cover Period: From 1 / 12 / 18 To 1 / 24 / 18 Report Type: G-2 Election Report ✓ Original ❑ Amendment ❑ Special (6) Contributions This Report Cash & Checks $ , 3 , 500.00 (7) Expenditures Monetary Expenditures Transfers Office Account Total Monetary This Report $ , 12 , 231 . 79 Loans $ , • 00 to $, , . 00 Total Monetary $ , 3 , 500. 00 $ , 12 , 231 . 79 In -Kind $ , , . 00 (8) $, Other Distributions , . 00 (9) TOTAL Monetary Contributions To Date $ , 26 , 197. 00 (10) TOTAL Monetary Expenditures To Date $ , 17 , 843 . 00 (11) Certification It is a first degree misdemeanor for any person I certify that I have examined this report and it is true, correct, (Type name)JAY POLGLAZE to falsify a public record (ss. 839.13, F.S.) and complete: (Type name) DAVID ALLBRITTON • Individual (only for IE li Treasu er ■ Deputy TreasurerCandidate • Chairperson (only for PC and PTY) or electioneering comm.) X :_% / ARO /,. . X -'•nat e Signature DS -DE 12 (Rf. 11/13) SEE REVERSE FOR INSTRUCTIONS CAMPAIGN TREASURER'S REPORT - ITEMIZED EXPENDITURES (1) Name DAVID ALLBRITTON (2) I.D. Number N/A (3) Cover Period 1 / 12 18 through 1 / 24 / 18 (4) Page 1 of 1 DS -DE 14 (Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES (5) Date (7) Full Name (Last, Suffix, First, Middle) Street Address & City, State, Zip Code (8) Purpose (add office sought if contribution to a candidate) (9) Expenditure Type (10) Amendment (11) Amount (6) Sequence Number JIFFY REPROGRAPHICS 1 f 16/ 18 411 S. GARDEN AVE CLEARWATER, FL 33756 CAN $ 41.15 1 1 18 18 JIFFY REPROGRAPHICS 411 S. GARDEN AVE / CLEARWATER, FL 33756 CAN $ 8.40 2 JIFFY REPROGRAPHICS 118 18 411 S. GARDEN AVE / / CLEARWATER, FL 33756 CAN $ 72.04 3 B -HIVE AWARDS 1 15 18 1810 N. HERCLES AVE / / CLEARWATER, FL 33765 CAN $ 26.48 4 DIRECT MAIL SYSTEMS 124 18 12450 AUTOMOBILE BLVD / / CLEARWATER, FL 33762 CAN $8,709.78 5 DIRECT MAIL SYSTEMS 124 18 12450 AUTOMOBILE BLVD / / CLEARWATER, FL 33762 CAN $3,365.34 6 ANEDOT 1 18 18 P.O.BOX 84314 / / BATON ROUGE, LA 70884 CAN $ 8.60 7 /1 DS -DE 14 (Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES (1) Name CAMPAIGN TREASURER'S REPORT — ITEMIZED CONTRIBUTIONS DAVID ALLBRITTON 1 (3) Cover Period / / through / / (2) I.D. Number 12 18 1 24 18 (4) Page N/A 1 of 2 DS -DE 13 (Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES (5) Date (7) Full Name Contributor Type (8) Occupation (9) Contribution Type (10) In-kind Description (11) Amendment (12) Amount (6) Sequence Number (Last, Suffix, First, Middle) Street Address & City, State, Zip Code CLEARPAC 1 17 18 1130 CLEVELAND ST / / CLEARWATER, FL 33755 F PAC CHE $1,000.00 1 GEORGE'S VACUUM SALES 1 18 18 1261 S. FT. HARRISON / / CLEARWATER, FL 33756 B SALES CHE $ 50.00 2 JANICE CASE 1 18 18 205 PALM ISLAND N.W. / / CLEARWATER, FL 33767 I CONSULTANT CHE $ 250.00 3 TIGHE QUIGLEY 1 12 18 P.O. BOX 16661 / / CLEARWATER, FL 33766 I SOFTWARE CHE $1,000.00 4 ROBERT METZ 1 23 18 1478 MAPLE FORREST DR. / / CLEARWATER, FL 33764 I REAL ESTAT CHE $ 500.00 5 JOE BLANTON 1 18 18 2373 WINDGAP DR. / / CLEARWATER, FL 33765 I ONLINE $ 100.00 6 LYNNE FAIMALIE 1 12 18 433 S. PAULA DR. #12 / / DUNEDIN, FL 34698 I ONLINE $ 100.00 7 DS -DE 13 (Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES CAMPAIGN TREASURER'S REPORT — ITEMIZED CONTRIBUTIONS DAVID ALLBRITTON (1) Name (3) Cover Period (2) I.D. Number N/A 1 12 18 1 24 18 2 / / through / / (4) Page of 2 (5) Date (7) Full Name (Last, Suffix, First, Middle) Street Address & City, State, Zip Code Contributor Type (8) Occupation (9) Contribution Type (10) In-kind Description (11) Amendment (12) Amount (6) Sequence Number 1 / 21 18 / ALAN STOWELL 2873 THORNTON RD. CLEARWATER, FL 33759 I RETIRED CHE $ 500.00 8 / / / / / / / / / / / / DS -DE 13 (Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES CAMPAIGN TREASURER'S REPORT (1) DAVID ALLBRITTON SUMMARY OFFICE USE ONLY Pr.— ' A,. OFF1(14 _- ;:.._ ;" > AND Name (2) 217 PALM ISLAND N.W. Address (number and street) CLEARWATER, FL 33767 City, State, Zip Code ❑ Check here if address has changed (4) Check appropriate box(es): CLEARWATER (3) CITY COUNCIL, ,.- ' = T+': MS L- T. ID Number: SEAT 4 v Candidate Office Sought: ❑ Political Committee (PC) ❑ Electioneering Communications Org. (ECO) ❑ Check here if PC or ECO has disbanded ❑ Party Executive Committee (PTY) ❑ Check here if PTY has disbanded ❑ Independent Expenditure (IE) (also covers an ❑ Check here if no other IE or EC reports will be filed individual making electioneering communications) (5) Report Identifiers Cover Period: From 1 / 01 / 18 To 1 / 11 / 18 Report Type: G1 .gi Original ❑ Amendment ❑ Special Election Report (6) Contributions This Report Cash & Checks $ 5. 600. 00 (7) Expenditures Monetary Expenditures Transfers Office Account Total Monetary This Report $ 00 Loans $ , , 00 to $00 , , Total Monetary $ 5 600. 00 $00 , , In -Kind $ 00 (8) Other Distributions $ 00 (9) TOTAL Monetary Contributions To Date 22 697 00 (10) TOTAL Monetary Expenditures To Date $ 5 612 00 (11) Certification It is a first degree misdemeanor for any person I certify that I have examined this report and it is true, correct, JAY POLGLAZE (Type name) to falsify a public record (ss. 839.13, F.S.) and complete: DAVID ALLBRITTON (Type name) 0 Candidate • Chairperson (only for PC and PTY) ■ Individual (only for IE ss'` cJ r- - urer • Deputy Treasurer or electioneering comm. X took f/ X Signa r Signature DS -DE 12 (Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS (1) Name CAMPAIGN TREASURER'S REPORT - ITEMIZED CONTRIBUTIONS DAVID ALLBRITTON 1 01 18 (3) Cover Period / / 1 through (2) I.D. Number N/A 1 (4) Page of 1 DS -DE 13 (Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES (5) Date (7) Full Name (Last, Suffix, First, Middle) Street Address & City, State, Zip Code Contributor Type (8) Occupation (9) Contribution Type (10) In-kind Description (11) Amendment (12) Amount (6) Sequence Number MICHAEL J. ANDRIOLA 1 11 18 3 AMBLESIDE DRIVE / / BELLEAIR, FL 33756 I CHE $100.00 1 BRIAN AUNGST JR. 1 11 18 1683 MIDNIGHT PASS WAY / / CLEARWATER, FL 33765 I ATTORNEY C$E $500.00 2 PINELLAS REALTORS 1 11 18 ASSOCIATION / / 4590 ULMERTON RD. CLEARWATER, FL 33762 B TRADE ASSOC. CHE $1000.00 3 INFI SYSTEMS, LLC 1 11 18 529 CLEVELAND ST. / / CLEARWATER, FL 33755 B SOFTWARE CO. CHE $1000.00 4 OLGA & DEVCHAND 1 11 18 KUMBHANI / / 4471 AMBERLY OAKS CT TAMPA, FL 33614 I CORP. DIR. CHE $1000.00 5 VENKAT DEVINENI 1 11 18 1A RICHLAND LN #T1 / / CAMP HILL, PA 17011 I PRES. INFI CHE $1000.00 6 LEELA SANYESA RAO DADI 1 11 18 2500 WRANGLE HILL RD. / / #224 BEAR, DE 19701 I PROGRAMMER CHE $1000.00 7 DS -DE 13 (Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES (1) CAMPAIGN TREASURER'S REPORT SUMMARY DAVID ALLBRITTON Name (2) 217 PALM ISLAND N.W. Address (number and street) CLEARWATER, FL 33767 City, State, Zip Code ❑ Check here if address has changed (4) Check appropriate box(es): O Candidate Office Sought: OF Ip4Sc 9g s g r L OFF'' LEGS [A S AND (3) ID Number: N/A CLEARWATER CITY COUNCIL, SEAT 4 ❑ Political Committee (PC) El Electioneering Communications Org. (ECO) El Party Executive Committee (PTY) ❑ Independent Expenditure (1E) (also covers an individual making electioneering communications) ❑ Check here if PC or ECO has disbanded ❑ Check here if PTY has disbanded ❑ Check here if no other IE or EC reports will be filed (5) Report Identifiers Cover Period: From 12 / 01 / 17 To 12 / 31 / 17 Report Type: M 12 0 Original ❑ Amendment ❑ Special Election Report (6) Contributions This Report Cash & Checks $ , 400. 00 Loans $ . 00 Total Monetary $ , 400. 00 In -Kind $ . 00 (7) Expenditures This Report Monetary Expenditures $ , 2 , 435 . 79 Transfers to Office Account $ . 0 Total Monetary $ , 2 , 435 . 79 (8) Other Distributions . 00 (9) TOTAL Monetary Contributions To Date $ , 17 , 097 , 00 (10) TOTAL Monetary Expenditures To Date $ , 5, 612 . 27 (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) JAY POLGLAZE ❑ Individual (only for IE or electioneering comm. f asurer 0 Deputy Treasurer (Type name) DAVID ALLBRITTON 0 Candidate X Signature 0 Chairperson (only for PC and PTY) SEE REVERSE FOR INSTRUCTIONS CAMPAIGN TREASURER'S REPORT — ITEMIZED EXPENDITURES (1) Name DAVID ALLBRITTON (2) I.D. Number N/A (3) Cover Period 12 / 01 / 17 through 12 31 / 17 (4) Page 1 of 1 (5) Date (6) Sequence Number 12 / 04/17 1 (7) Full Name (Last, Suffix, First, Middle) Street Address & City, State, Zip Code CITY OF CLEARWATER 112 S. Osceola Ave. CLEARWATER, FL 33756 (8) Purpose (add office sought if contribution to a candidate) (9) Expenditure Type (10) Amendment Amount FILING FEE CAN $318.92 12/ 08/17 2 PROFORMA INC. P.O.BOX 640814 CINCINATTI, OH 45264 PRINTING CAN $469.75 12/08/ 17 3 DVC MARKETING 411 S. GARDEN AVE CLEARWATER, FL 33756 PRINTING CAN $33.28 12 08 17 4 LUBRANO CREATIVE CONSULTING 1261 BAY HARBOR DR. PALM HARBOR, FL 34685 SOCIAL MEDIA SERVICES CAN $1440.00 12 / 01/ 17 5 HOME DEPOT 2495 GULF TO BAY CLEARWATER, FL 33765 FLAGS CAN $3.12 12/ 12 17 6 WALGREENS 703 COURT ST. CLEARWATER, FL 33756 PHOTOS CAN $72.72 12 / 19/ 17 7 USPS PO 11166701 CLEARWATER, FL 33755 STAMPS CAN $98.00 / / DS -DE 14 (Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES (1) Name CAMPAIGN TREASURER'S REPORT — ITEMIZED CONTRIBUTIONS DAVID ALLBRITTON (2) I.D. Number N/A 12 01 17 12 31 17 1 (3) Cover Period / / through / / (4) Page of 1 DS -DE 13 (Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES (5) Date (7) Full Name (Last, Suffix, First, Middle) Street Address & City, State, Zip Code Contributor Type (8) Occupation (9) Contribution Type (10) In-kind Description (11) Amendment (12) Amount (6) Sequence Number 12 09. / / 17 PRESSMAN & ASSOC. 334 EAST LAKE ROAD PALM HARBOR, FL 33685 B CONSULTANT CHE $200.00 1 12. 09. / / 17 DAVID & KATHRYN YATES 4110 GRANDCHAMP CIR. PALM HARBOR, FL 34685 I CEO CHE $200.00 2 / / / / / / / / / / DS -DE 13 (Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES CAMPAIGN TREASURER'S REPORT (1) DAVID ALLBRITTON SUMMARY o �`� "` r�. irer5 217 OFFICIAL_ ,,=`L ,iI)S AND LEGISLAII'VE SWCS DEPT. Name (2) 217 PALM ISLAND N.W.DE Address (number and street) CLEARWATER, FL 33767 City, State, Zip Code ❑ Check here if address has changed (4) Check appropriate box(es): (3) CITY ID Number: N/A COUNCIL, SEAT 4 v Candidate Office Sought: CLEARWATER ❑ 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 11 / 01 / 2017 To 11 / 31 / 2017 Report Type: M11 Election Report v Original ❑ Amendment ❑ Special (6) Contributions This Report Cash & Checks $ , 3, 050. 00 (7) Expenditures Monetary Expenditures Transfers Office Account Total Monetary This Report $ , 1, 751 . 79 Loans $, , . 00 to $, , . 00 Total Monetary $ , 3, 050. 00 $ , 1 , 751 . 79 In -Kind $, , . 00 (8) $, Other Distributions . 00 (9) TOTAL Monetary Contributions To Date $ , 16 , 697 . 00 (10) TOTAL Monetary Expenditures To Date $, 3 , 176 , 48 (11) Certification It is a first degree misdemeanor for any person I certify that I have examined this report and it is true, correct, JAY POLG E to falsify a public record (ss. 839.13, F.S.) and complete: (Type name) DAVID ALLBRITTON (Type name) ■ Individual (only for IE 0 T easurer • 2 : • uty Treasurer el Candidate • Chairperson (only for PC and PTY) or electi.' -eying comm.) X 1t��/ X — .nature Signature DS -DE 12 (Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS CAMPAIGN TREASURER'S REPORT — ITEMIZED CONTRIBUTIONS DAVID ALLBRITTON (1) Name (3) Cover Period 11 / 01 / 17 through 11 (2) I.D. Number 31 17 / / N/A (4) Page 1 of 3 DS -DE 13 (Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES (5) Date (7) Full Name (Last, Suffix, First, Middle) Street Address & City, State, Zip Code Contributor Type (8) Occupation (9) Contribution Type (10) In-kind Description (11) Amendment (12) Amount (6) Sequence Number ANGEL DELGATTO 11 09 17 8 CAMBRIA ST #303 / / CLEARWATER, FL 33767 I $ 100.00 1 WILLIAM & BETTE CROWN 11 17 17 III / / 1219 FRANKLIN CIRCLE CLEARWATER, FL 33756 I $ 100.00 2 JOHN & JANICE DRAHEIM 11 15 17 224 WINDWARD ISLAND / / CLEARWATER, FL 33767 I $ 100.00 3 FRANK & TERESA HIBBARD 11 15 17 308 DRUID RD. / / CLEARWATER, FL 33756 I FINANCIAL $ 350.00 4 CHARLES CASTAGNA 11 15 17 MEDIATION, INC. / / 611 DRUID RD. #512 CLEARWATER, FL 33756 B $ 50.00 5 HARRY & SANDRA JAMIESON 11 15 17 301 JASMINE WAY / / CLEARWATER, FL 33756 I RETIRED $ 200.00 6 FRANK & LYNN DAME 11 15 17 407 LEEWARD IS / / CLEARWATER, FL 33767 I CEO $ 200.00 7 DS -DE 13 (Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES CAMPAIGN TREASURER'S REPORT — ITEMIZED CONTRIBUTIONS DAVID ALLBRITTON (1) Name (3) Cover Period 11 / 01 / 17 (2) I.D. Number 11 31 17 N/A 2 3 through / / (4) Page of DS -DE 13 (Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES (5) Date (7) Full Name (Last, Suffix, First, Middle) Street Address & City, State, Zip Code Contributor Type (8) Occupation (9) Contribution Type (10) In-kind Description (11) Amendment (12) Amount (6) Sequence Number PATRICK CAREY 11 15 17 619 SNUG IS / / CLEARWATER, FL 33767 I $ 100.00 8 JOHN & JANET MORTIMER 11 17 17 331 CLEVELAND ST #805 / / CLEARWATER, FL 33755 I $ 100.00 9 RODNEY FISCHER 11 15 17 30031 U.S.HWY 19 N / / CLEARWATER, FL 33761 I $ 100.00 10 DEBRA GREGORY 11 17 17 732 SNUG IS / / CLEARWATER, FL 33767 I $ 100.00 11 GYNETH STANLEY 11 17 17 421 DRUID RD W / / CLEARWATER, FL 33756 I ATTORNEY $ 300.00 12 PRESSMAN & ASSOCIATES 11 15 17 334 EAST LAKE RD #102 / / PALM HARBOR, FL 34685 B CONSULTANT $ 200.00 13 DAVID & KATHRYN JONES 11 15 17 YATES / / 4110 GRANDCHAMP CIRCLE PALM HARBOR, FL 34685 I CEO $ 200.00 14 DS -DE 13 (Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES CAMPAIGN TREASURER'S REPORT — ITEMIZED CONTRIBUTIONS DAVID ALLBRITTON (1) Name (3) Cover Period 11 / 01 / 17 (2) I.D. Number through 11 / 31 / 17 N/A 3 (4) Page of 3 DS -DE 13 (Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES (5) Date (7) Full Name (Last, Suffix, First, Middle) Street Address & City, State, Zip Code Contributor Type (8) Occupation (9) Contribution Type (10) In-kind Description (11) Amendment (12) Amount (6) Sequence Number 11 / 09 17 / DAVID WILCOX 31 Hyacinth Ln FAIRPORT, NY 14450 I INVESTOR $ 500.00 15 11 / 15 17 / GRANT WOOD 2807 WESTCHESTER DR. CLEARWATER, FL 33761 N I CONSULTANT $ 250.00 16 11 / 18 17 / PATRICIA JUCHA 763 HARBOR ISLAND CLEARWATER, FL 33767 I $ 100.00 17 / / / / / / / / DS -DE 13 (Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES CAMPAIGN TREASURER'S REPORT - ITEMIZED EXPENDITURES (2) I.D. Number N/A (1) Name DAVID ALLBRITTON (3) Cover Period 11 / 01 / 17 through 11 / 31/ 17 (4) Page 1 of 1 (5) Date (7) Full Name (Last, Suffix, First, Middle) Street Address & City, State, Zip Code (8) Purpose (add office sought if contribution to a candidate) • (9) Expenditure Type (10) Amendment (11) Amount (6) Sequence Number COUNTRYSIDE COUNTRY CLUB 11/ 15/17 3001 COUNTRYSIDE BLVD CLEARWATER, FL 33761 CAN $1603.00 1 11 / 14 / 17 THE HOME DEPOT CLEARWATER, FL CAN $ 33.89 2 BOB COLMER 1116 17 2200 TUSCANY TRACE #1724 / / PALM HARBOR, FL 34683 CAN $ 80.00 3 ANEDOT 11 22 17 PO.BOX 84314 / / BATON ROUGE, LA 70884 CAN $ 34.90 4 / / / / / / / / DS -DE 14 (Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES CAMPAIGN TREASURER'S REPORT (1) DAVID ALLBRITTON SUMMARY oFr II �� rb NOYQ1� OFFICIAL RECORDS AND LEGISLATIVE SRVCS DCrT. Name (2) 217 PALM IS N.W. Address (number and street) CLEARWATER, FL 33767 City, State, Zip Code ❑ Check here if address has changed (4) Check appropriate box(es): CLEARWATER (3) CITY ID Number: N/A COUNCIL, SEAT 4 Candidate Office Sought: ❑ Political Committee (PC) ❑ Check here if PC or ECO has disbanded ❑ Check here if PTY has disbanded ❑ Check here if no other IE or EC reports will be filed • Electioneering Communications Org. (ECO) ❑ Party Executive Committee (PTY) ❑ Independent Expenditure (IE) (also covers an individual making electioneering communications) (5) Report Identifiers Cover Period: From 10 / 01 2017 To 10 / 31 2017 Report Type: M-10 Election Report " Original • Amendment ❑ Special (6) Contributions This Report Cash & Checks $ , 10 , 740. 00 (7) Expenditures Monetary Expenditures Transfers Office Account Total Monetary This Report $ , 1 , 217 . 00 Loans $ . 00 to $, , . 00 Total Monetary $ , 10 , 740. 00 $ , 1, 217 . 00 In -Kind $ , 1, 000. 00 (8) Other Distributions $, , 00 (9) TOTAL Monetary Contributions To Date $ , 13 , 647 . 00 (10) TOTAL Monetary Expenditures To Date $ , 1 , 424 .69 (11) Certification It is a first degree misdemeanor for any person • I certify that I have examined this report and it is true, correct, (Type name) JAY POLGLAZE to falsify a public record (ss. 839.13, F.S.) and complete: (Type name) DAVID ALLBRITTON ❑ Individual (only for IE ^. Treasurer 0 Deputy Treasurer or electioneering comm.) D Candidate 0 Chairperson (only for PC and PTY) gnatur / Signature DS -DE 12 (Rev(11/13) SEE REVERSE FOR INSTRUCTIONS CAMPAIGN TREASURER'S REPORT - ITEMIZED EXPENDITURES (1) Name DAVID ALLBRITTON (2) I.D. Number N/A (3) Cover Period 10 / 01 / 2017 through 10 / 31 / 2017 (4) Page of 1 DS -DE 14 (Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES (5) Date (7) Full Name (Last, Suffix, First, Middle) Street Address & City, State, Zip Code (8) Purpose (add office sought if contribution to a candidate) (9) Expenditure Type (10) Amendment (71) Amount (6) Sequence Number USPS 10 / 13/ 17 650 CLEVELnd st clearwater, fl 33755 CAN $49.00 1 10 12/ 17 Elizabeth Pierce 13215 San Blass Loop / Largo, F1 33774 CAN $800.00 2 JIFFY REPROGRAPHICS 1015 17 411 S. GARDEN AVE / / CLEARWATER, FL 33756 CAN 8.03 3 COUNTRYSIDE COUNTRY CLUB 10 19 17 3001 COUNTRYSIDE BLVD / / CLEARWATER, FL 33761 CAN $250.00 4 ANEDOT 10 14/ 17 PO Box 84314 / Baton Rouge, LA 70884 CAN $14.60 5 OFFICE DEPOT 10 02 17 CLEARWATER, FL / / CAN 32.08 6 JIFFY REPROGRAPHICS 10 05 17 411 S. GARDEN AVE / / CLEARWATER, FL 33756 CAN $42.00 7 VISTA PRINT 275 Wyman St 10 05/ 17 Waltham, MA 02451 / CAN $21.98 8 DS -DE 14 (Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES CAMPAIGN TREASURER'S REPORT - ITEMIZED EXPENDITURES (1) Name DAVID ALLBRITTON (2) I.D. Number N/A (3) Cover Period 10 / 01 / 2017 through 10 / 31 / 2017 1 (4) Page of 1 DS -DE 14 (Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES (5) Date (7) Full Name (Last, Suffix, First, Middle) Street Address & City, State, Zip Code (8) Purpose (add office sought if contribution to a candidate) (9) Expenditure Type (70) Amendment (11) Amount (6) Sequence Number 10 / 13/ 17 USPS 650 CLEVELnd st clearwater, fl 33755 CAN $49.00 1 10 / 12/ 17 Elizabeth Pierce 13215 San Blass Loop Largo, F1 33774 CAN $800.00 2 1015 / / 17 JIFFY REPROGRAPHICS 411 S. GARDEN AVE CLEARWATER, FL 33756 CAN 8.03 3 10 / 13 / 17 COUNTRYSIDE COUNTRY CLUB 3001 COUNTRYSIDE BLVD CLEARWATER, FL 33761 CAN $500.00 4 10 / 14/ 17 ANEDOT PO Box 84314 Baton Rouge, LA 70884 CAN $14.60 5 / / / / / / DS -DE 14 (Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES (1) Name CAMPAIGN TREASURER'S REPORT — ITEMIZED CONTRIBUTIONS DAVID ALLBRITTON 10 01 2017 10 (2) I.D. Number 31 2017 N/A 1 (3) Cover Period / / through / / (4) Page of 8 DS -DE 13 (Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES (5) Date (7) Full Name (Last, Suffix, First, Middle) Street Address & City, State, Zip Code Contributor Type (8) Occupation (9) Contribution Type (10) In-kind Description (11) Amendment (12) Amount (6) Sequence Number 10 01 2017 WAYNE SHELOR / / 3031 COUNTRYSIDE BLVD CLEARWATER, FL 33761 I RETIRED CHE $200.00 1 1ST FLORIDA MANAGEMENT 10 02 2017 600 DRUID RD. E. / / CLEARWATER, FL 33756 B REAL ESTATE CHE $500.00 2 ALAN BOMSTEIN 10 02 2017 620 DREW ST. / / CLEARWATER, FL 33755 I CONTRACTOR CHE $250.00 3 ANDREW CAUDELL 10 02 2017 818 WOODCREST AVE / / CLEARWATER, FL 33756 I CONTRACTOR CHE $250.00 4 BECCA KAYE 10 02 2017 / / I CA $ 15.00 5 BRIAN AUNGST, SR 10 02 2017 2633 BRATTLE LN / / CLEARWATER, FL 33761 I RETIRED CHE $200.00 6 BRIAN YATZKAN 10 02 2017 P.O.BOX 2817 / / GLEN ELLYN, IL 60138 I REAL ESTATE $100.00 7 DS -DE 13 (Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES (1) Name CAMPAIGN TREASURER'S REPORT — ITEMIZED CONTRIBUTIONS DAVID ALLBRITTON 10 01 2017 10 (3) Cover Period / (2) I.D. Number 31 2017 N/A 2 / through / / (4) Page of 8 DS -DE 13 (Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES (5) Date (7) Full Name (Last, Suffix, First, Middle) Street Address & City, State, Zip Code Contributor Type (8) Occupation (9) Contribution Type (10) In-kind Description (11) Amendment (12) Amount (6) Sequence Number BRUCE & HEATHER BROCK 10 02 2017 211 WINDWARD PASSAGE / / CLEARWATER, FL 33767 I RETIRED CHE $250.00 8 C.G.ELIAS & CO. 10 02 2017 2555 ENTERPRISE RD. / / CLEARWATER, FL 33761 B INSURANCE CHE $100.00 9 CARDINAL DOOR & 10 02 2017 HARDWARE / / 5218 126TH AVE N CLEARWATER, FL 33756 B SALES CHE $500.00 10 CHARLES ROBINSON 10 02 2017 55 N. PINE CIRCLE / / BELLEAIR, FL 33756 I ATTORNEY CHE $100.00 11 CLEARWATER FERRY 10 02 2017 SERVICE / / 615 PINELLAS ST.#2 CLEARWATER, FL 33756 B FERRY CHE $200.00 12 CONSUS GROUP, LLC 10 02 2017 P.O.BOX 4268 / / CLEARWATER, FL 33758 B CONSULTING CHE $500.00 13 DAVID JELASO 10 02 2017 80 ROGERS ST. UNIT A / / CLEARWATER, FL 33756 I CHE $ 50.00 14 DS -DE 13 (Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES (1) Name CAMPAIGN TREASURER'S REPORT — ITEMIZED CONTRIBUTIONS DAVID ALLBRITTON 10 01 2017 10 (3) Cover Period / / through / / (4) Page of (2) I.D. Number 31 2017 N/A 3 8 DS -DE 13 (Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES (5) Date (7) Full Name (Last, Suffix, First, Middle) Street Address & City, State, Zip Code Contributor Type (8) Occupation (9) Contribution Type (10) In-kind Description (11) Amendment (12) Amount (6) Sequence Number 10 / 02 2017 / DAVID LLOYD 1710 BRENTWOOD DR. CLEARWATER, FL 33756 I CHE $100.00 15 10 / 02 2017 / DEAN ANDRESON 2046 BRENDLA RD. CLEARWATER, FL 33755 I CHE $ 50.00 16 10 / 02 2017 / DENIS DEVLAMING 1101 TURNER ST. CLERWATER, FL 33756 I ATTORNEY CHE $500.00 17 10 / 02 2017 / DONALD EWING 660 ISLAND WAY #708 CLEARWATER, FL 33767 I CHE $100.00 18 10 / 02 2017 / EARLE COOPER 1697 MIDNIGHT PASS WY CLEARWATER, FL 33765 I CONSTRUCTIO CHE $250.00 19 10 / 02 2017 / EDGAR & DELLA DAY 430 WINDWARD PASSAGE CLEARWATER, FL 33767 I CHE $100.00 20 10 / 02 2017 / FRANK & LYNN DAME 407 LEEWARD IS CLEARWATER, FL 33767 I CHE $100.00 21 DS -DE 13 (Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES CAMPAIGN TREASURER'S REPORT — ITEMIZED CONTRIBUTIONS DAVID ALLBRITTON (1) Name (3) Cover Period 10 / 01 2017 10 (2) LD. Number / through / 02 / 2017 (4) Page of N/A 4 8 DS -DE 13 (Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES (5) Date (7) Full Name (Last, Suffix, First, Middle) Street Address & City, State, Zip Code Contributor Type (8) Occupation (9) Contribution Type (10) In-kind Description (11) Amendment (12) Amount (6) Sequence Number GEORGE MANTZARIS 10 02 2017 408 CASLER WAY / / CLEARWATER, FL 33755 I AUTO SALES CHE $150.00 22 GRANT & KATHY TRIER 10 02 2017 860 ISLAND WAY / / CLEARWATER, FL 33767 I CHE $100.00 23 10 02 2017 GULF COAST CONSULTING, INC / / 13825 ICOT BLVD, STE 605 B CONSULTING CHE $300.00 CLEARWATER, FL 33760 24 JAMES MARTIN 10 02 2017 P.O.BOX 3921 / / CLEARWATER, FL 33767 I CHE $ 50.00 25 JOHN DORAN 10 02 2017 P.O.BOX 3266 / / CLEARWATER, FL 33767 I CHE $ 50.00 26 JOHN DRAHEIM 10 02 2017 224 WINDWARD IS. / / CLEARWATER, FL 33767 I CHE $100.00 27 KATHRYN TEW 10 02 2017 470 PALM IS N.E. / / CLEARWATER, FL 33767 I RENTAL CHE $250.00 28 DS -DE 13 (Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES (1) Name CAMPAIGN TREASURER'S REPORT — ITEMIZED CONTRIBUTIONS DAVID ALLBRITTON 10 01 2017 10 (2) I.D. Number 31 2017 N/A (3) Cover Period / / through / / (4) Page 5 of 8 DS -DE 13 (Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES (5) Date (7) Full Name (Last, Suffix, First, Middle) Street Address & City, State, Zip Code Contributor Type (8) Occupation (9) Contribution Type (10) In-kind Description (11) Amendment (12) Amount (6) Sequence Number KEN & ANN DAYTON 10 02 2017 210 SARASOTA RD / / BELLEAIR, FL 33756 I CHE $100.00 29 KEN MEYER 10 02 2017 2944 BAY MEADOW CY / / CLEARWATER, FL 33761 I CHE $100.00 30 PRESSMAN & ASSOC. 10 02 2017 334 EAST LAKE RD. #102 / / PALM HARBOR, FL 33685 B CONSULTANT CHE $300.00 31 PROFORMA N & M COMM. 10 02 2017 434 HAZEN AVE. / / 434 BELLEVUE, KY 41073 B MARKETING CHE $500.00 32 RICHARD & CINDY OWENS 10 02 2017 28 MIDWAY IS. / / CLEARWATER, FL 33767 I CHE $100.00 33 ROBERT BAUER, JR. 10 02 2017 1550 S. HIGHLAND, STE C / / CLEARWATER, FL 33756 I CHE $100.00 34 ROBERT METZ 10 02 2017 1478 MAPLE FOREST DR. / / CLEARWATER, FL 33764 I REALTOR CHE $500.00 35 DS -DE 13 (Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES (1) Name CAMPAIGN TREASURER'S REPORT — ITEMIZED CONTRIBUTIONS DAVID ALLBRITTON (2) I.D. Number N/A 10 01 2017 10 31 2017 6 (3) Cover Period / / through / / (4) Page of 8 DS -DE 13 (Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES (5) Date (7) Full Name (Last, Suffix, First, Middle) Street Address & City, State, Zip Code Contributor Type (8) Occupation (9) Contribution Type (10) In-kind Description (11) Amendment (12) Amount (6) Sequence Number SAM MCCLELLAND 10 02 2017 715 N. HIGHLAND AVE / / CLEARWATER, FL 33755 1 CHE $100.00 36 THOMAS BOWERS 10 02 2017 827 VICTORIA DR. / / DUNEDIN, FL 34698 I RETIRED CHE $200.00 37 TOMMY DUFF 10 02 2017 670 ISLAND WAY #705 / / CLEARWATER, FL 33767 I CHE $100.00 38 THOMAS MICHAELS 10 02 2017 3056 OAK CREEK DR. / / CLEARWATER, FL 33761 I ATTORNEY CHE $200.00 39 WILLIAM STURTEVANT 10 02 201' P.O. BOX 472 / / CLEARWATER, FL 33756 I CONSULTANT CHE $200.00 40 MATTHEW CRUM 10 02 2017 2125 SCARLET OAKS DR. / / CLEARWATER, FL 33759 I INSURANCE CHE $100.00 41 WILLIAM HANCOCK 10 02 2017 228 PINE ROAD / / CLEARWATER, FL 33756 I INSURANCE ONLINE $250.00 42 DS -DE 13 (Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES (1) Name CAMPAIGN TREASURER'S REPORT — ITEMIZED CONTRIBUTIONS DAVID ALLBRITTON 10 (3) Cover Period / / through / / (4) Page of 01 2017 10 (2) I.D. Number 31 2017 N/A 7 8 DS -DE 13 (Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES (5) Date (7) Full Name (Last, Suffix, First, Middle) Street Address & City, State, Zip Code Contributor Type (8) Occupation (9) Contribution Type (10) In-kind Description (11) Amendment (12) Amount (6) Sequence Number ROSEMARY WINDSOR TRUST 10 02 2017 649 POINSETTA RD / / BELLEAIR, FL 33756 I DIR. TROLLEY CHE $175.00 43 GERTRUDE & DAVID LITTLE 10 02 2017 1734 CASEY JONES CT. / / CLEARWATER, FL 33765 I CHE $100.00 44 TRT Management, LLC 10 02 2017 P•O.BOX 743 / / CLEARWATER, FL 33757 B PROP MGMT CHE $250.00 45 A CORNU 10 02 2017 354 LARBOARD WAY / / CLEARWATER, FL 33767 I CHE 8100.00 46 BRIAN AUNGST, JR 10 02 201' 1683 MIDNIGHT PASS WAY / / CLEARWATER, FL 33765 I ATTORNEY CHE $500.00 47 RAY FERRARA 10 02 2017 611 Druid Rd, ste. 105 / / CLEARWATER, FL 33756 I CHE $150.00 48 ALEXANDRA OF CLW BEACH 10 02 2017 P.O.BOX 3337 / / CLEARWATER, FL 33767 B CONCESSIONS CHE $500.00 49 DS -DE 13 (Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES (1) Name CAMPAIGN TREASURER'S REPORT — ITEMIZED CONTRIBUTIONS DAVID ALLBRITTON (2) I.D. Number N/A 10 01 2017 10 31 2017 8 (3) Cover Period / / through / / (4) Page of 8 DS -DE 13 (Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES (5) Date (7) Full Name (Last, Suffix, First, Middle) Street Address & City, State, Zip Code Contributor Type (8) Occupation (9) Contribution Type (10) In-kind Description (11) Amendment (12) Amount (6) Sequence Number 10 / 17 2017 / BAREFOOT BEACH HOUSE 322 S. GULFVIEW BLVD. CLEARWATER, FL 33767 B PROP. MGMT CHE $500.00 50 10 / 17 2017 / KEN & LISA HAMILTON 200 PALM IS NW CLEARWATER, FL 33767 I REST. OWNER CHE $200.00 51 10 / 17 2017 / ROBERT & TERESSA CLARK 320 ISLAND WAY #603 CLEARWATER, FL 33767 I CHE $100.00 52 10 / 17 2017 / ISLAND WAY GRILL 20 ISLAND WAY CLEARWATER, FL 33767 B RESTAURANT INK $1000.00 53 / / / / / / DS -DE 13 (Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES CAMPAIGN TREASURER'S REPORT SUMMARY (1) David Allbritton Name (2) 217 Palm Is N.W. Address (number and street) Clearwater, FL 33767 City, State, Zip Code LJ Check here if address has changed (4) Check appropriate box(es): 151 Candidate Office Sought: O Political Committee (PC) OFFICE USE ONLY Of') 2017 (3) ID NUIMb‘r\Kiii"4-'):1/4 Clearwater City Council, Seat 4 O Electioneering Communications Org. (ECO) 0 Party Executive Committee (PTY) O Independent Expenditure (IE) (also covers an individual making electioneering communications) O Check here if PC or ECO has disbanded 0 Check here if PTY has disbanded O Check here if no other IE or EC reports will be filed (5) Report Identifiers Cover Period: From 09 / 18 /2017 To 09 / 30 / 2017 Report Type: M9 pi Original 0 Amendment 0 Special Election Report (6) Contributions This Report Cash & Checks Loans Total Monetary In-Kind $ , 2 , 700. 00 , 207. 00 $ , 2 , 907. 00 (7) Expenditures This Report Monetary Expenditures $ , 207. 00 Transfers to Office Account $ , 0. Total Monetary $ 207. 00 (8) Other Distributions 0 (9) TOTAL Monetary Contributions To Date 2, 907 , 00 (10) TOTAL Monetary Expenditures To Date $ , , 207 , 00 (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) Jay Polglaze (Type name) David Allbritton 0 Individual (only for IE or electioneering comm.) X rer 0 Deputy Treasurer ignatur DS-DE 12 ( . 11/13) SEE REVERSE FOR INSTRUCTIONS Candidate X Signature 0 Chairperson (only for PC a TY) (1) Name CAMPAIGN TREASURER'S REPORT — ITEMIZED CONTRIBUTIONS David Allbritton 09 18 2017 09 (2) I.D. Number N/A 30 2017 1 1 (3) Cover Period / / through / / (4) Page of DS -DE 13 (Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES (5) Date (7) Full Name (Last, Suffix, First, Middle) Street Address & City, State, Zip Code Contributor Type (8) Occupation (9) Contribution Type (10) In -kind Description (11) Amendment (12) Amount (6) Sequence Number Southern Cross 09 18 2017 Building Solutions, / / Inc. 1 3536 Camelia PL B mechanical CHE $1000.00 Largo, FL 33771 Marshall Brett Harris 09 18 2017 3536 Camelia PL / / Largo, FL 33771 2 I CEO, Preside CHE $1000.00 David Allbritton 09 18 2017 217 Palm IS N.W. / / Clearwater, FL 33767 3 S LOA $ 207.00 Brian Yatzkan 09 21 2017 P.O.BOx 2817 / / Glen Ellen, IL 60138 4 1 CHE $ 100.00 Robert & Shirley 09 26 2017 Galatas / / 1732 Brentwood Dr. 5 Clearwater, FL 33756 I CHE $ 100.00 Alan Stowell 09 26 2017 2873 Thornton RD / / Clearwater, FL 33759 6 I Retired CHE $ 500.00 / / DS -DE 13 (Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES CAMPAIGN TREASURER'S REPORT - ITEMIZED EXPENDITURES (1) Name David Allbritton (2) I.D. Number N/A (3) Cover Period 09 / 18 2017 through 09 / 30 / 2017 (4) Page 1 of 1 (5) Date (7) Full Name (Last, Suffix, First, Middle) Street Address & City, State, Zip Code (8) Purpose (add office sought if contribution to a candidate) (9) Expenditure Type (10) Amendment (11) Amount (6) Sequence Number 09/ 18/2017 GoDaddy 14455 N. Hayden Rd Scottsdale AZ 85260 CAN $ 12.17 1 09 182017 / / Florida Dept of State sunbiz.org CAN $ 96.00 2 09/ 18/2017 misc. office expense CAN $ 98.83 3 / / / / / / / / / / DS -DE 14 (Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES STATEMENT OF CANDIDATE (Section 106.023, F.S.) (Please print or type) OFFICE USE ONLY SEP192017 OFHCIA. ;, , °,;: A.. LEGISLAH E SkyC LCi I, David Estes Allbritton candidate for the office of Clearwater City Council Seat 4 have been provided access to read and understand the requirements of Chapter 106, Florida Statutes. X Signature of Candidate 9/19/2017 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) APPOINTMENT OF CAMPAIGN TREASURER AND DESIGNATION OF CAMPAIGN DEPOSITORY FOR CANDIDATES (Section 106 021(1), F . ) (PLEASE PRINT OR TYPE) NOTE: This form must be on file with the qualifying officer before opening the campaign account. RECEIVED: EP 1 j 2017 OFFICIAL RECORDS AND LEGISLATIVE SRVCS DEP=T. 1. CHECK APPROPRIATE BOX(ES): © Initial Filing of Form Re- Filing to Change: 2. Name of Candidate (in this order: First, Middle, Last) David Allbritton OFFICE USE ONLY Treasurer /Deputy ❑ Depository ❑ Office Party 4. Telephone 5. E -mail address ( 727 ) 481 -5102 info @VoteAllbritton.com 6. Office sought (include district, circuit, group number) Clearwater City Council, Seat 4 3. Address (include post office box or street, city, state, zip code) 217 Palm Island N.W. Clearwater, FL 33767 8. If a candidate for a partisan office, check block and fill in 0 Write -In No Party Affiliation 7. If a candidate for a nonpartisan office, check if applicable: ❑ My intent is to run as a Write -In candidate. name of party as applicable: My intent is to run as a El Party candidate. 9. 1 have appointed the following person to act as my ❑ Campaign Treasurer ® Deputy Treasurer 10. Name of Treasurer or Deputy Treasurer David Allbritton 11. Mailing Address 217 Palm Island N.W. 13. City 114. County Clearwater Pinellas 18. I have designated the following bank as my 19. Name of Bank USAmeribank 21. City 12. Telephone (727 ) 481 -5102 15. State 16. Zip Code 17. E-mal address Florida l 33767 I info @VoteAllbritton.com Primary Depository ❑ Secondary Depository Clearwater 22. County Pinellas 120. Address 2571 Countryside Blvd 123, State Florida 24. Zip Code 33761 UNDER PENALTIES OF PERJURY, I DECLARE THAT I HAVE READ THE FOREGOING FORM FOR APPOINTMENT OF CAMPAIGN TREASURER AND DESIGNATION OF CAMPAIGN DEPOSITORY AND THAT THE FACTS STATED IN IT ARE TRUE. 25. Date 27. 09 / 18 /2017 26. Signet X andidate Treasurer's Acceptance of Appointment (fill in the blanks and check the appropriate block) David Allbritton designated above as: 09 / 18 /2017 (Please Print or Type Name) El Campaign Treasurer DS -DE 9 (Rev. 10/10) Date X do hereby accept the appointment Deputy Treasurer . Signature mpaign Treasurer or Deputy Treasurer Rule 1S- 2.0001, F.A.C. APPOINTMENT OF CAMPAIGN TREASURER AND DESIGNATION OF CAMPAIGN DEPOSITORY FOR CANDIDATES (Section 106 021(1), F . ) (PLEASE PRINT OR TYPE) NOTE: This form must be on file with the qualifying officer before opening the campaign account. 1. CHECK APPROPRIATE BOX(ES): © Initial Filing of Form Re- filing to Change: ED '1' OFFICIAL RECORDS AND LEGISLATIVE SkVCS DEFT. 2. Name of Candidate (in this order: First, Middle, Last) David Allbritton OFFICE USE ONLY Treasurer /Deputy ❑ Depository ❑ Office ❑ Party 4. Telephone 5. E -mail address ( 727 ) 481 -5102 info @VoteAllbritton.com 6. Office sought (include district, circuit, group number) Clearwater City Council, Seat 4 3. Address (include post office box or street, city, state, zip code) 217 Palm Island N.W. Clearwater, FL 33767 7. If a candidate for a nonpartisan office, check if applicable: ❑ My intent is to run as a Write-1n candidate. 8. If a candidate for a partisan office, check block and fill in name of party as applicable: My intent is to run as a ❑ Write -In © No Party Affiliation a 9. I have appointed the following person to act as my ® Campaign Treasurer ❑ Deputy Treasurer Party candidate. 10. Name of Treasurer or Deputy Treasurer Jay Polglaze 11. Mailing Address 600 Cleveland St, Ste 450, Clearwater, FL 33755 13. City 1 14. County Clearwater Pinellas 18.1 have designated the following bank as my 19. Name of Bank USAmeribank 21. City 15. State 16. Zip Code 17. E -ma.I address Florida, 33755 I jaypolglaze @gmail.com 12. Telephone (727 ) 410 -3270 0 Primary Depository [J Secondary Depository Clearwater 22. County Pinellas 20. Address I 2571 Countryside Blvd 23. State Florida 24. Zip Code I 33761 UNDER PENALTIES OF PERJURY, I DECLARE THAT I HAVE READ THE FOREGOING FORM FOR APPOINTMENT OF CAMPAIGN TREASURER AND DESIGNATION OF CAMPAIGN DEPOSITORY AND THAT THE FACTS STATED IN IT ARE TRUE. 25. Date 09 / 18 /2017 26. Signature of Candidate x 27. Treasurer's Acceptance of Appointment (fill in the blanks and check the appropriate block) Jay Polglaze designated above as' 09 / 18 /2017 (Please Print or Type Name) , do hereby accept the appointment Campaign Treasurer (—j Depyty Tre- -urer. DS-DE 9 (Rev. 10/10) Date Sig ' . ture .f Campaign Tr f surer Treasurer Rule 1S- 2.0001, F.A.C.