HomeMy WebLinkAboutHerrold - 2026-Q2 - 6-3-26CAMPAIGN TREASURER'S REPORT SUMMARY
OFFICE USE ONLY
Name
Address (number and street)
City, State, Zip Code
ID Number:
Check appropriate box(es):
Candidate Office Sought:
Political Committee (PC)
Electioneering Communications Org. (ECO)
Party Executive Committee (PTY)
Independent Expenditure (IE) (also covers an Check here if no other IE or EC reports will be filed
(5) Report Identifiers
Cover Period: From / / To / / Report Type:
Original Amendment Special Election Report
(6)Contributions This Report (7)Expenditures This Report
Monetary
Expenditures Cash & Checks $ , , . $ , , .
Loans $ , , . Transfers to
Office Account $ , , .
Total Monetary $ , , .
Total Monetary $ , , .
In-Kind $ , , .
$ ,, .
(9)TOTAL Monetary Contributions To Date (10)TOTAL Monetary Expenditures To Date
$ , , .$ , , .
It is a first degree misdemeanor for any person to falsify a public record (ss. 839.13, F.S.)
I certify that I have examined this report and it is true, correct, and complete:
(Type name) (Type name)
Individual (only for IE Treasurer Deputy Treasurer Candidate Chairperson (only for PC and PTY)
or electioneering comm.)
X X
Signature Signature
DS-DE 12 (Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS
By City Clerk
Lisa Herrold
659 Sherry Drive
Atlantic Beach, FL 32233
4 Commissioner - Seat 4
2026-Q2
4
Lisa Herrold Lisa Herrold
4 4
3 516 62
0 00
3 516 62
350 00
1 942 95
0 00
1 942 95
8 181 58
0 00
2 276 79
04 01 26 05 31 26
06/03/26 - 10:58 AM
06/03/26 - 10:58 AM
06/03/26 - 10:58 AMLisa HerroldLisa Herrold
CAMPAIGN TREASURER’S REPORT – ITEMIZED CONTRIBUTIONS
(1) Name (2)I.D. Number
(3)Cover Period / / through / / (4) Page of
(5) (7) (8) (9) (10) (11) (12)
Date Full Name
(6) (Last, Suffix, First, Middle)
Sequence Street Address & Contributor Contribution In-kind
Number City, State, Zip Code Type Occupation Type Description Amendment
DS-DE 13 (Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES
Lisa Herrold
04 205 9
04 Carole B. Powell
Individual
Retired Check
$200.001
Individual
Retired Check
$500.002
Individual
Retired Check
$51.753
Individual
Retired Check
$103.204
Individual
Retired Check
$500.005
Individual
Retired Check
$250.006
Individual
Retired Check
$50.007
01 26 31 26
01 26
04 03 26
04 11 26
04 16 26
04 21 26
04 28 26
04 29 26
1871 Selva Marina Drive
Atlantic Beach, FL
32233
John Flynn
315 5th Street
Atlantic Beach, FL
32233
Beth Cottrell
1656 Park Terrace East
Atlantic Beach, FL
32233
Kenneth Cebeck
13705 SW 12th Street
#107
Pembroke Pines, FL 33027
Mary K. Emmerson
3148 8th Street
Atlantic Beach, FL
32233
Liz Hullender
1649 Park Terrace East
Atlantic Beach, FL
32233
315 5th Street
Atlantic Beach, FL
32233
John Flynn
CAMPAIGN TREASURER’S REPORT – ITEMIZED CONTRIBUTIONS
(1) Name (2)I.D. Number
(3)Cover Period / / through / / (4) Page of
(5) (7) (8) (9) (10) (11) (12)
Date Full Name
(6) (Last, Suffix, First, Middle)
Sequence Street Address & Contributor Contribution In-kind
Number City, State, Zip Code Type Occupation Type Description Amendment
DS-DE 13 (Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES
Lisa Herrold
04 305 9
04 Jane Wytzka
Individual
Life
Coach
Check
$250.008
Individual
Retired Check
$50.009
Individual
Physicia
n
Check
$103.2910
Individual
Retired Check
$200.0011
Individual
Part
Time
Retail
Check
$103.2912
Individual
Retired CashOr
Cashier
sCheck $10.0013
Individual
CashOr
Cashier
sCheck $5.0014
01 26 31 26
30 26
05 05 26
05 05 26
05 16 26
05 20 26
05 21 26
05 21 26
352 2nd Street
Atlantic Beach, FL
32233
Mark and Jeannie
Gabrynowicz
1307 Sherry Drive N.
Atlantic Beach, FL
32233
Joe and Jill
Mignogna
100 Ocean Terrace
Indianlantic, FL 32903
Ronald G. Smith
526 Upper 8th Ave. S>
Jacksonville Beach, FL
32250
Ruthie and Allen
Cody
1880 George Street
Atlantic Beach, FL
32233
Christine Spinder
30 Ardella Lane
Atlantic Beach, FL
32233
2016 Selva Madera Court
Atlantic Beach, FL 32233
Jeannie Greenwald
CAMPAIGN TREASURER’S REPORT – ITEMIZED CONTRIBUTIONS
(1) Name (2)I.D. Number
(3)Cover Period / / through / / (4) Page of
(5) (7) (8) (9) (10) (11) (12)
Date Full Name
(6) (Last, Suffix, First, Middle)
Sequence Street Address & Contributor Contribution In-kind
Number City, State, Zip Code Type Occupation Type Description Amendment
DS-DE 13 (Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES
Lisa Herrold
04 405 9
05 Claire M. Gertz
Individual
Check
$50.0015
Individual
CashOr
Cashier
sCheck $10.0016
Individual
CashOr
Cashier
sCheck $50.0017
Individual
CashOr
Cashier
sCheck $50.0018
Individual
Check
$100.0019
Individual
Check
$20.0020
Individual
Check
$100.0021
01 26 31 26
21 26
05 21 26
05 21 26
05 21 26
05 21 26
05 21 26
05 21 26
28 17th Street
Atlantic Beach, FL
32233
Octavia Woods
1620 Francis Avenue
Atlantic Beach, FL
32233
Lynda Padrta
1113 1st Street
Neptune Beach, FL
32266
Mike Whalen
1420 Mayport Road
Atlantic Beach, FL
32233
Mary Campbell
1592 Linkside Drive S.
Atlantic Beach, FL
32233
Sandra L. Martin
2206 Fleet landing
Boulevard
Atlantic Beach, FL 32233
157 Belvedere Street
Atlantic Beach, FL
32233
Bob and Leslee
Burch
CAMPAIGN TREASURER’S REPORT – ITEMIZED CONTRIBUTIONS
(1) Name (2)I.D. Number
(3)Cover Period / / through / / (4) Page of
(5) (7) (8) (9) (10) (11) (12)
Date Full Name
(6) (Last, Suffix, First, Middle)
Sequence Street Address & Contributor Contribution In-kind
Number City, State, Zip Code Type Occupation Type Description Amendment
DS-DE 13 (Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES
Lisa Herrold
04 505 9
05 Darlene Owens
Individual
CashOr
Cashier
sCheck $15.0022
Individual
CashOr
Cashier
sCheck $5.0023
Individual
Check
$100.0024
Individual
CashOr
Cashier
sCheck $10.0025
Individual
CashOr
Cashier
sCheck $25.0026
Individual
CashOr
Cashier
sCheck $10.0027
Individual
Check
$100.0028
01 26 31 26
21 26
05 21 26
05 21 26
05 21 26
05 21 26
05 21 26
05 21 26
1849 Forsyth Street
Atlantic Beach, FL
32233
Katie Colson
1530 Francis Avenue
Atlantic Beach, FL
32233
Claire Brennen
2042 Cherokee Drive
Neptune Beach, FL
32266
Henry Peavie
70 Jackson Road
Atlantic Beach, FL
32233
Marguerite Williams
185 Ocean Gate Drive
Atlantic Beach, FL
32233
Elizabeth G. Sams
2232 Oceanforest Drive
W.
Atlantic Beach, FL 32233
1920 Francis Avenue
Atlantic Beach, FL
32233
Wanda Martin
CAMPAIGN TREASURER’S REPORT – ITEMIZED CONTRIBUTIONS
(1) Name (2)I.D. Number
(3)Cover Period / / through / / (4) Page of
(5) (7) (8) (9) (10) (11) (12)
Date Full Name
(6) (Last, Suffix, First, Middle)
Sequence Street Address & Contributor Contribution In-kind
Number City, State, Zip Code Type Occupation Type Description Amendment
DS-DE 13 (Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES
Lisa Herrold
04 605 9
05 Rosalind S. Hoffman
Individual
Check
$50.0029
Individual
Check
$15.7530
Individual
Retired Check
$200.0031
Individual
Retired InKind VooSwar
Meet &
Greet
Food &
Drink
$350.0032
Individual
Retired Check
$103.2933
Individual
Retired Check
$26.0534
Individual
Retired Check
$100.0035
01 26 31 26
21 26
05 21 26
05 22 26
05 21 26
05 25 26
05 30 26
05 30 26
266 Magnolia Street
Atlantic Beach, FL
32233
Diane Dyal
321 3rd Street
Atlantic Beach, FL
32233
Chris Rule
383 2nd Street
Atlantic Beach, FL
32233
Ellen Glasser
2060 Beach Avenue
Atlantic Beach, FL
32233
Kimberly Perritti
415 Sherry Drive
Atlantic Beach, FL
32233
Jay and Nanci
Faulkner
439 Lora Street
Neptune Beach, FL
32266
393 3rd Street
Atlantic Beach, FL
32233
Connie Craven
CAMPAIGN TREASURER’S REPORT – ITEMIZED EXPENDITURES
DS-DE 14 (Rev. 11/13)
(1)Name
(3) Cover Period ______/______/______ through ______/______/______
(2) I.D. Number
(4) Page ____________ of _____________
Full Name
(Last, Suffix, First, Middle)
Street Address &
City, State, Zip Code
(5)
Date Purpose
(add office sought if
contribution to a
candidate) Amount
SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES
Expenditure
Type Amendment
(6)
Sequence
Lisa Herrold
04 01 26 05 31 26 7 9
04 02 26 Signs on The Cheap Yard Sign Sample CandidateE
xpense $7.51
1 11525A Stonehollow Drive
Austin, TX 78758
Stripe
04 06 26 Processing Fee Monetary
$6.10
2
345 Oyster Point Blvd. S.
San Francisco, CA 94080
Campaign Partners
04 10 26 Monthly Website CandidateE
xpense $49.00
3
118 Still River Road
Harvard, MA 01451
Signs on The Cheap
04 11 26
Yard Sign Sample CandidateE
xpense $7.5111525A Stonehollow Drive
Austin, TX 787584
Next Day Flyers
04 11 26
Campaign Flyers CandidateE
xpense $121.23435 N. Midland Avenue
Saddle Brook, NJ 076635
Stripe
04 11 26
Processing Fee Monetary
$1.80345 Oyster Point Blvd. S.
San Francisco, CA 940806
Stripe Processing Fee Monetary
$3.29041626
345 Oyster Point Blvd. S.
San Francisco, CA 940807
Yard Signs Plus Yard Signs CandidateE
xpense $1,325.00042026
16107 Kensington Drive Suite 314
Sugarland , TX 774798
CAMPAIGN TREASURER’S REPORT – ITEMIZED EXPENDITURES
DS-DE 14 (Rev. 11/13)
(1)Name
(3) Cover Period ______/______/______ through ______/______/______
(2) I.D. Number
(4) Page ____________ of _____________
Full Name
(Last, Suffix, First, Middle)
Street Address &
City, State, Zip Code
(5)
Date Purpose
(add office sought if
contribution to a
candidate) Amount
SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES
Expenditure
Type Amendment
(6)
Sequence
Lisa Herrold
04 01 26 05 31 26 8 9
04 21 26 U Printing Campaign Banner CandidateE
xpense $110.49
9 8000 Haskey Avenue
Van Nuys, CA 91406
Stripe
04 29 26 Processing Fee Monetary
$1.75
10
345 Oyster Point Blvd. S.
San Francisco, CA 94080
Community First Credit Union of
Florida042926 Bank Service Fee Monetary
$5.95
11
701 West Adams Street
Jacksonville, FL 32202
Pure Buttons
05 05 26
Campaign Buttons CandidateE
xpense $124.952991 Interstate Parkway
Brunswick, OH 4421212
Stripe
05 11 26
Processing Fee Monetary
$3.29345 Oyster Point Blvd. S.
San Francisco, FL 9408013
Campaign Partners
05 10 26
Monthly Website CandidateE
xpense $49.00118 Still River Road
Harvard, MA 0145114
Stripe Processing Fee Monetary
$3.29052026
345 Oyster Point Blvd. S.
San Francisco, CA 9408015
Publix Food / Beverages
Meet and Greet
CandidateE
xpense $111.72052126
580 Atlantic Boulevard
Neptune Beach, FL 3226616
CAMPAIGN TREASURER’S REPORT – ITEMIZED EXPENDITURES
DS-DE 14 (Rev. 11/13)
(1)Name
(3) Cover Period ______/______/______ through ______/______/______
(2) I.D. Number
(4) Page ____________ of _____________
Full Name
(Last, Suffix, First, Middle)
Street Address &
City, State, Zip Code
(5)
Date Purpose
(add office sought if
contribution to a
candidate) Amount
SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES
Expenditure
Type Amendment
(6)
Sequence
Lisa Herrold
04 01 26 05 31 26 9 9
05 21 26 Stripe Processing Fee Monetary
$0.76
17 345 Oyster Point Blvd. S.
San Francisco, CA 94080
Stripe
05 25 26 Processing Fee Monetary
$3.30
18
345 Oyster Point Blvd. S.
San Francisco, CA 94080
Stripe
05 30 26 Processing Fee Monetary
$1.06
19
345 Oyster Point Blvd. S.
San Francisco, CA 94080
Community First Credit Union of
Florida053126
Bank Service Fee Monetary
$5.951425 Atlantic Boulevard
Neptune Beach, FL 3226620
Instructions for Campaign Treasurer’s Report Summary
(1)Name: full name of the candidate, political committee, party executive committee, electioneering
communications organization, or individual making an independent expenditure or electioneering
communication.
(2)Address: the full address or post office box, city, state, and zip code.
Check the box if the address has changed since the last report filed.
(3)ID Number: identification number assigned by the filing officer.
(4)Check the appropriate box(es).
(5)Report Identifiers
Cover Period: the dates this report covers (i.e., From 1/1/15 To 1/31/55). Important: use the appropriate
cover period dates as published by the filing officer.
Report Type: refer to the filing officer’s calendar of reporting dates for the correct codes to be used for
special election
Check one of the appropriate boxes:
Original: first report filed for this reporting period.
Amendment: must summarize only contributions/fund transfers and expenditures/distributions being
reported as additions or deletions. Read instructions for sequence numbers and amendment types on
the back of Forms DS-DE 13A and 14A.
Special Election Report: Important: once a special election report is filed, the entity is required to file all
remaining reports due for the special election.
(6)Contributions This Report:
Cash and Checks: total amount for this reporting period.
Loans: total amount for this reporting period.
Total Monetary: sum of Cash and Checks and Loans.
In-Kind: the fair market value of the in-kind contribution at the time it is given for this reporting period.
(7)Expenditures This Report:
Monetary Expenditures: total amount of monetary expenditures for this reporting period.
Transfers to Office Account: total amount transferred to an office account by elected candidates only.
Total Monetary: sum of Monetary Expenditures and Transfers to Office Account.
(8)Other Distributions: the total amount of goods and services contributed to a candidate or other
committee by a PC, ECO, or PTY.
(9)TOTAL Monetary Contributions To Date: the amount of total monetary contributions to date.
Candidates keep cumulative totals from the time the campaign depository is opened through the
termination report.
(10)TOTAL Monetary Expenditures To Date: the amount of total monetary expenditures to date.
Candidates keep cumulative totals from the time the campaign depository is opened through the
termination report.
(11)Type or print the required officer’s name and have them sign the report:
Candidate report: treasurer and candidate must sign.
PC report: treasurer and chairperson must sign.
PTY report: treasurer and chairperson must sign.
ECO report: organization’s treasurer must sign.
IE or EC report: individual must sign (this applies when an individual acts alone to make these
expenditures)
AMENDMENT REPORTS: An amendment report summary should summarize only
contributions, expenditures, distributions, & fund transfers being reported as additions or
deletions. Read the instructions for the sequence number & amendment type fields on
INSTRUCTIONS FOR CAMPAIGN TREASURER’S REPORT – ITEMIZED CONTRIBUTIONS
(1)Candidate’s full name or name of the political committee (PC), electioneering communications organizations
(ECO) or party executive committee (PTY).
(2)The identification number assigned by the filing officer.
(3)Cover period dates (e.g., 1/1/15 through 1/31/15). (See filing officer’s reporting dates calendar for
appropriate year and cover periods.)
(4)Page numbers (e.g., 1 of 3 ).
(5)Date contribution was RECEIVED (Month/Day/Year).
(6)Sequence Number – Each detail line shall have a sequence number assigned to it. Sequence numbers
are to be assigned within each reporting period and for each type of detail line. Thus the report type, detail
line type, and sequence number will combine to uniquely identify a specific contribution, expenditure,
distribution or fund transfer. This method of unique identification is required for responding to requests from
the filing officer and for reporting amendments.
For example, a M1 report having 75 contributions would use sequence numbers 1 through 75. The next
report (M2), comprised of 40 contributions would use sequence numbers 1 through 40. Contributions on
amended M1 reports would begin with sequence number 76 and on amended M2 reports would begin with
sequence number 41. See the Amendment Type instructions below.
(7)Type full name and address of contributor (including city, state and zip code).
(8)Enter the type of contributor using one of the following codes:
Occupation of contributor for contributions over $100 only. (If a business, please indicate nature of
business.)
I Individual
B Business (also includes corporations, organizations, groups, etc.)
E Electioneering Communications Organizations
F Political Committee (federal or state)
(includes federal, state and county executive P Political Parties committees)
O Other (e.g., candidate surplus funds to party, etc.)
S Candidate to Self
(9)Enter Contribution Type using one of the following codes:
NOTE: Cash includes cash and cashier’s checks.
Code Description
CAS Cash or Cashier’s Check
CHE Check
COF Carryover Funds from Previous Campaign
INK In-Kind
INT Interest
LOA Loan
MO Money Order
MUC Multiple Uniform Contributions
RCT Other Receipts
REF Refund (Negative Amount Only)
(10)Type the description of any in-kind contribution received.
Candidate’s Only – If in-kind contribution is from a party executive committee and is allocable
toward the contribution limits, type an “A” in this box. If contribution is not allocable, type an “N”.
(11)Amendment Type (required on amended reports) – To add a new (previously unreported) contribution for
the reporting period being amended, enter “ADD” in amendment type on a line with ALL of the required
data.
The sequence number for contributions with amendment type “ADD” will start at one plus the number of
contributions in the original report. For example, amending an original M1 report that had 75 contributions
means the sequence number of the first contribution having amendment type “ADD” will be 76; the second
“ADD” contribution would be 77, etc. When amending an original M2 report that had 40 contributions, the
sixth “ADD” contribution would have sequence number 46.
To correct a previously submitted contribution use the following drop/add procedure. Enter “DEL” in
amendment type on a line with the sequence number of the contribution to be corrected. In combination
with the report number being amended, this sequence number will identify the contribution to be dropped
from your active records. On the next line enter “ADD” in amendment type and ALL of the required data
with the necessary corrections thus replacing the dropped data. Assign the sequence number as described
above.
(12)Type amount of contribution received. Political Committees ONLY: Multiple uniform contributions from the
same person, aggregating NMT $250 per calendar year, collected by an organization that is the affiliated
sponsor of a PC, may be reported by the PC in an aggregate amount listing the number of contributors
together with the amount contributed by each and the total amount contributed during the reporting period.
The identity of each person making such uniform contribution must be reported to the filing officer by July 1
of each calendar year, or, in a general election year, NLT the 60th day immediately preceding the primary
election.
INSTRUCTIONS FOR CAMPAIGN TREASURER’S REPORT – FUND TRANSFERS
(1)Type candidate’s full name or name of the political committee (PC),
organization (ECO), or party executive committee (PTY).
Type identification number assigned by the filing officer.
Type cover period dates (e.g., 1/1/15 through 1/31/15). (See
for appropriate cover periods.)
Type page numbers (e.g., 1 of 3).
Type date of fund transfer (Month/Day/Year).
(6)Sequence Number -
be assigned within each reporting period and for each type of detail line. Thus the re
transfer. This method of unique identification is required for responding to requests from the filing officer and
reporting amendments.
For example, a M1 report having 2 fund transfers would use sequence numbers 1 thru 2. The next report (M
comprised of 4 fund transfers would use sequence numbers 1 thru 4. Fund transfers on amended M
would begin with sequence number 3 and on amended M
Amendment Type instructions below.
Type full name and address of financial institution (including city, state and zip code).
Enter Transfer Type using one of the following codes:
DESCRIPTION
Transfer FROM identified account to campaign account
Transfer TO identified account from the campaign account
CODE
F
T
certificate of deposit, money market, etc...)
Amendment Type (required on amended reports) -
the reporting period being amended, enter “ADD” in amendment type on a line with ALL of the required data.
The sequence number for fund transfers with amendment type “ADD” will start at one plus
transfers in the original report. For example, amending an original M
the sequence number of the first fund transfer having amendment type “ADD” will be 76; the second “ADD” fund
transfer would be 77, etc. When amending an original M
transfer would have sequence number 46.
amendment type
active records. On the next line enter “ADD” in am
necessary corrections thus replacing the dropped data. Assign the sequence number as described above.
Type amount of fund transfer.
INSTRUCTIONS FOR CAMPAIGN TREASURER'S REPORT - ITEMIZED EXPENDITURES
(1)Candidate's full name or name of the political committee (PC), electioneering communications organization (ECO),
or party executive committee (PTY).
(2)Identification number assigned by the filing officer.
(3)Cover period dates (01/01/15 through 01/31/15). (See filing officer’s reporting dates calendar for appropriate cover
periods.)
(4)Page numbers (e.g., 1 of 3).
(5)Date of expenditure (Month/Day/Year).
(6)Sequence Number - Each detail line shall have a sequence number assigned to it. Sequence numbers are to be
assigned within each reporting period and for each type of detail line. Thus the report type, detail line type, and
sequence number will combine to uniquely identify a specific contribution, expenditure, distribution or fund transfer.
This method of unique identification is required for responding to requests from the filing officer and for reporting
requirements.
For example, a M1 report having 40 expenditures would use sequence numbers 1 through 40. The next report
(M2), comprised of 30 expenditures would use sequence numbers 1 through 30. Expenditures on amended M1
reports would begin with sequence number 41 and on amended M2 reports would begin with sequence number 31.
See Amendment Type instructions below.
(7)Full name and address of entity receiving payment (including city, state and zip code).
(8)Purpose of expenditure (if expenditure is a contribution to a candidate, also type the office sought by the candidate).
PLEASE NOTE: This column does not apply to candidate expenditures, as candidates cannot contribute to other
candidates from campaign funds. However, PCs (supporting candidates) and party executive committees
contributing to candidates must report office sought (Section 106.07, F.S.).
(9)Enter Expenditure Type using one of the following codes:
Code Description
(10)Amendment Type (required on amended reports) - To add a new (previously unreported) expenditure for the
reporting period being amended, enter "ADD" in amendment type on a line with ALL of the required data.
The sequence number for expenditures with amendment type "ADD" will start at one plus the number of
expenditures in the original report. For example, amending an original M1 reports that had 75 expenditures, means
the sequence number of the first expenditure having amendment type "ADD" will be 76; the second "ADD"
expenditure would have sequence number 39.
To correct a previously submitted expenditure use the following drop/add procedure. Enter "DEL" in amendment
type on a line with the sequence number of the expenditure to be corrected. In combination with the report number
being amended, this sequence number will identify the expenditure to be dropped from your active records. On the
next line enter "ADD" in amendment type and ALL of the required data with the necessary corrections thus replacing
the dropped data. Assign the sequence number as described above.
(11) Amount of expenditure.
CAMPAIGN TREASURER'S REPORT - ITEMIZED DISTRIBUTIONS
THIS FORM IS USED TO REPORT DISTRIBUTIONS OF GOODS OR SERVICES CONTRIBUTED TO A CANDIDATE
OR COMMITTEE, INDIRECT EXPENDITURES AND REIMBURSEMENTS.
(1)Name of the entity.
(2)Identification number assigned by the filing officer.
(3)Cover period dates (e.g., 03/01/14 through 03/31/14). (See the filing officer’s reporting dates calendar for
appropriate cover periods.)
(4)Page numbers (e.g., 1 of 3).
(5)Date of distribution (Month/Day/Year).
(6)Sequence Number - Each detail line shall have a sequence number assigned to it. Sequence numbers are to be
assigned within each reporting period and for each type of detail line. Thus the report type, detail line type, and
sequence number will combine to uniquely identify a specific contribution, expenditure, distribution or fund transfer.
This method of unique identification is required for responding to requests from the filing officer and for reporting
amendments.
For example, a M1 report having 40 distributions would use sequence numbers 1 through 40. The next report
(M2), comprised of 30 distributions would use sequence numbers 1 through 30. Distributions on amended M1
reports would begin with sequence number 41 and on amended M2 reports would begin with sequence number
31.See Amendment Type instructions below.
(7)Full name and address of entity receiving distribution (including city, state and zip code).
(8)Purpose of distribution (if distribution is a contribution to a candidate, also type the office sought by the candidate).
(9)For each distribution that is related to an itemized expenditure previously listed on Itemized Expenditures (Form
DS-DE 14), enter the Year, Report Type and Sequence Number associated with the expenditure.
*PARTY EXECUTIVE COMMITTEES ONLY - If distribution is allocable toward the contribution limits, type
an "A" in this box. If distribution is nonallocable, type and "N".
(10)Amendment Type (required on amended reports) - To add a new (previously unreported) distribution for the
reporting period being amended, enter "ADD" in amendment type on a line with ALL of the required data.
The sequence number for distributions with amendment type "ADD" will start at one plus the number of
distributions in the original report. For example, amending and original M1 report that had 75 distributions, means
the sequence number of the first distribution having amendment type "ADD" will be 76; the second "ADD"
distribution would be 77, etc. When amending an original M2 report that had 30 distributions, the ninth "ADD"
distribution would have sequence number 39.
To correct a previously submitted distribution use the following drop/add procedure. Enter "DEL" in amendment
type on a line with the sequence number of the distribution to be corrected. In combination with the report number
being amended, this sequence number will identify the distribution to be dropped from your active records. On the
next line enter "ADD" in amendment type and ALL of the required data with the necessary corrections thus
replacing the dropped data. Assigns the sequence number as described above.
(11)Amount of distribution.
(12)Distribution Type
PPD Pre-paid Distribution
RMB Reimbursements
CCP Credit Card Purchase
INK In-Kind Distribution