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Glasser- Amended Treasurer Report- M4-11-7-17-v-------- -------- -------- -- ------ -------- -- -- -- -- CAMPAIGN TREASURER'S REPORT SUMMARY Ellen Glasser (1) Name (2) 2060 Beach Ave Address (number and street) Atlantic Beach, FL, 32233 City, State, Zip Code 0 Check here if address has changed (4) Check appropriate box(es): OFFtdttYsEONLY 7 2017 Office of City Clerk (3) 10 Number: N/A Atlantic Beach, Seat 1, Mayor0 Candidate Office Sought: D Political Committee (PC) 0 Electioneering Communications Org. (ECO) 0 Check here if PC or ECO has disbanded 0 Party Executive Committee (PTY) 0 Check here if PTY has disbanded 0 Independent Expenditure (IE) (also covers an 0 Check here if no other IE or EC reports will be filed individual making electioneering communications) (5) Report Identifiers Cover Period: From 04 I -­01 I -­17 -­To 04 I -­ 30 I -­17 -­Report Type: M4 0 Original ~Amendment D Special Election Report (6) Contributions This Report 5 525 00 Cash & Checks $ --' --I -- -­ 0 00 I lLoans $ 5 525 00 I ITotal Monetary $ 0 00 I IIn-Kind $ (9) TOTAL Monetary Contributions To Date 34 925 0$ l' (7) Expenditures This Report Monetary 4 015 02Expenditures $ I I Transfers to Office Account $ l I 0. 00 4 015 02Total Monetary $ l ' (8) Other Distributions $ l I (10) TOTAL Monetary Expenditures To Date 12 523 00$ I I {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) Daisy Glas~ 0 Individual (only for IE l:J Treasurer 0 Deputy Treasurer or electioneering comm.) xcKl~~ ~~ Signature (Ty~me) Ellen Glasser e(Candidate 0 Chairperson (only for PC and PTY) X ~(~ Signature ---­ CAMPAIGN TREASURER'S REPORT -ITEMIZED CONTRIBUTIONS Ellen Glasser N/A (1) Name (2) 1.0. Number 04 01 17 04 30 17 1 2 (3) Cover Period I I through I I (4) Page of (5) Date (7) Full Name (Last, Suffix, First, Middle) Street Address & City, State, Zip Code (8) Contributor Type Occupation (9) Contribution Type (1 0) In-kind Description (11) Amendment (12) Amount (6) Sequence Number 04 01 17 I I Harriet s. Fleming 194 High Rock Rd. North Hanover, PA 17331 I Retired CHE N/A DEL $250.00M4-22 04 01 17 I I Harriet s. Fleming 194 High Rock Rd. North Hanover, PA 17331 I Retired CHE N/A ADD $100.00M4-28 03 28 17 I I City of Atlantic Beach 800 seminole Road Atlantic Beach, FL 32233 0 REF CHE N/A DEL $200.00M4-7 04 05 17 I I city of Atlantic Beach 800 Seminole Road Atlantic Beach, FL 32233 REF City Govt CHE N/A ADD $200.00144-29 04 12 17 I I Beach Diner (AB) 501 Atlantic Blvd. Atlantic Beach, FL 32233 II Business CHE N/A DEL $500.00144-16 04 12 17 I I Beach Diner (AB) 501 Atlantic Blvd. Atlantic Beach, FL 32233 B Restaurant CHE N/A ADD $500.00M4-30 04 12 17 I I Beach Diner (PV) 880 AlA North #2 Ponte Vedra, FL 32082 II Business CHE N/A DEL $500.00M4-17 OS-DE 13 (Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES CAMPAIGN TREASURER'S REPORT -ITEMIZED CONTRIBUTIONS Ellen Glasser N/A (1) Name (2) J.D. Number 04 01 17 04 30 17 2 2 (3) Cover Period through I I (4) Page of (5) (7) (8) (9) (1 0) (11) (12) Date Full Name (6) (Last, Suffix, First, Middle) Sequence Street Address & Contributor Contribution In-kind Number City, State, Zip Code Type Occupation Type Description Amendment Amount Beach Diner (PV) 04 12 17 BBO AlA North #2 I I Ponte Vedra, FL H4-31 32082 B Restaurant CHE N/A ~D $500.00 Becca Tindall 03 30 17 4 Old Hickory Lane I I savannah, GA 31411 114-6 I Retired CHE N/A DEL $200.00 Becca Tindall 04 05 17 4 Old Hickory Lane I I savannah, GA 31411 114-32 I Retired CHE N/A ADD $200.00 Robert S. Gast II 03 28 17 485 11yrtlewood Parklet I I Reno, NV 89511 H4-8 I Retired CHE N/A DEL $50.00 Robert s. Gast II 04 17 17 485 Myrtlewood Parklet I I Reno, NV 89511 H4-33 I Retired CHE N/A ADD $50.00 I I I I OS-DE 13 (Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES CAMPAIGN TREASURER'S REPORT-ITEMIZED EXPENDITURES (1) Name Ellen Glasser (2) J.D. Number ____N_IA____ 0 1 7 04 30 17 1 1 (3) Cover Period _ _ 4 _/~/___through _ _/__/__ (4) Page _____ of _____ (5) Date (6) Sequence Number 04 1 051 17 H3-17 o4 I 12l 17 M3-18 I I I I I I I I (7) Full Name (Last, Suffix, First, Middle) Street Address & City, State, Zip Code Stone s TnrovT l'R 2871 Downing Street Jacksonville, FL 32205 Stripe 185 Berry Street, #550 San Francisco, CA 94107 {8) Purpose (add office sought if contribution to a candidate) Wens~te, Soc~a.L H edia Online Donation Credit Card Fee (9) Expenditure Type HON l-ION (10) Amendment ADD ADD (11) Amount $1000.00 $3.25 I I I I OS-DE 14 (Rev.11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES