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Carper- DSDE 12, 13, 14 - Treasurers Report- 2019-M12 - 1-9-20CARh to Ricky L. Carper P /1 DO I TR J R S Rh,POR T SUMIkJi Name (2) 1810 Selva Grande Dr. Address (number and street) Atlantic Beach, FL. 32233 City, State, Zip Code Check here if address has changed (4) Check appropriate box(es): Candidate Office Sought: Mayor - Seat One 1 JAN 9 2020 0656 4 (3) ID Number: U Political Committee (PC) ❑ Electioneering Communications Org. (ECO) ❑ Party Executive Committee (PTY) ❑ Independent Expenditure (IE) (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 Cover Period: From 121112019 / 17 Original (a) Report Identifiers To 12/31/2019/ Amendment ❑ Special Election Report (6) Contributions This Report Cash & Checks $ Loans $ > Total Monetary $ > In -Kind $ 5 • • • • (9) TOTAL Monetary Contributions To Date $l60 . C 0 Report Type: 2019-M12 (7) Expenditures This Report Monetary Expenditures Transfers to Office Account $ Total Monetary $ • • • Other Distributions • (10) TOTAL Monetary Expenditures To Date 50 . S (11) Certification It is a first degree misdemeanor for any person to falsify a public record (ss. 839.13, F.5.) certify that I have examined this report and it is true, correct, and complete: (Type name) Ricky L. Carper ❑ Individual (only for IE ✓ Treasurer ❑ Deputy Treasurer or electioneering comm.) (Type name) Ricky L. Carper 1 Candidate Chairperson (only for PC and PTY) DS -DE 12 (Rev. 11 /13) SEE REVERSE FOR INSTRUCTIONS CAMPAIGN TREASURER'S REPORT - ITEMIZED CONTRIBUTIONS Ricky L. Carper (1) Name 12/1/2019 (3) Cover Period / / throu h 12/31/2019 9 (2) I.D. Number / (4) Page 1 of 1 (5) Date (7) Full Name Middle) & Code Type Contributor (8) Occupation (9) Contribution Type (10) In-kind Description (11) Amendment (12) Amount (6) Sequence Number (Last, Suffix, First, Street Address City, State, Zip 12/5/2019 / / Carper, Ricky 1810 Selva Grande Atlantic Beach, L. Dr. FL. S CAS $50.00 1 32233 / / / / / / / / / / / / DS -DE 13 (Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES CAMPAIGN TREASURER'S REPORT — ITEMIZED EXPENDITURES (1) Name Ricky L. Carper (2) I.D. Number (3) Cover Period 12/1/2919 / through 12/31/019 / (4) Page 1 of 1 (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 12/50019/ Ricky L. Carper 1810 Selva Grande Dr. Atlantic Beach, FL. Refund due to re -filing of DSDE-9 4 32233 to change depository. RMB $50.00 / / / / / / / / / / / / / / DS -DE 14 (Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES