CAMPAIGN TREASURER'S REPORT SUMMARY

(1) Christine Hoffman Name

REG et!)Y

(2) 1026 13th St. N. JUL 2 9 2016 Address (number and street)

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

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

(4) Check appropriate box(es):

0 Candidate I City of Jacksonville Beach - At Large Seat 1 Office Sought:

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

(5) Report Identifiers

Cover Period: From 07 I 09 I 16 To 071 22 I 16 Report Type: 2016-P3 -- - - - - -- -- - -

0 Original D Amendment D Special Election Report

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

Cash & Checks $ ' 10 ,800 00

Monetary Expenditures $

' ' 00 00

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

Loans $ ' ' Transfers to -- -- - - - -

Office Account $ ' ' -- - - -- --

Total Monetary $ ' ' -- -- - - - -Tota l Monetary $

' 00. 00 ' -- -- - - --

In-Kind $ ' ' -- - - - - --(8) Other Distributions

$ ' ' -- -- -- --

(9) TOTAL Monetary Con.tributions To Date (10) TOTAL Monetary Expenditures To Date

$ 16 229 71 $ ' 1,484 . 94

' ' ' -- -- -- --

( 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 th is report and it is true, correct, and complete:

(Type name) Matthew C. Bothwell (Type QRme) Christine Hoffman 0 Individual (only for IE 0 Treasurer 0 Deputy Treasurer 0 Ca id id, ~ Ch''''"''" (ooly Im ~c '"' PTY) : ,,oct,oo'[)Jf;ll

/

I x \ j

Signature S ignat~ l'J OS-DE 12 (Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS

CAMPAIGN TREASURER'S REPORT - ITEMIZED CONTRIBUTIONS

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

(3) Cover Period 07 I 09 I 2016 through 07/ 22 / 2016 (4) PaQe 1 of 3 (5) (7) (8) (9) (10) (11) (12)

Date Full Name (6) (Last, Suffix, First, Middle)

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

07/07/2016 Bell & Roper, P.A. 2707 E. Jefferson St. B Attorney CHE $1 ,000.00

1 Orlando, FL 32803

07/08/2016 Brown & Brown of FL Inc. P.O. Box2412 B Insurance CHE $1 ,000.00

2 Daytona Beach , FL 32115

07/08/2016 George A. Helm Ill , P.A. P.O. Box 958464 B Attorney CHE $500.00

3 Lake Mary, FL 32795

07/08/2016 USIS P.O. Box 616648 B Insurance CHE $1 ,000.00

4 Orlando, FL 32861

07/112016 Public Risk Underwriters of Florida, Inc. B Insurance CHE $1 ,000.00

5 P.O. Box 958455

Lake Mary, FL 32795

Roberts , Reynolds , 07/11/2016 Bedard & Tuzzio, PLLC

470 Columbia Dr B Attorney CHE $1 ,000.00 Building C

6 W. Palm Beach , FL

33409

07/12/2016 Brown & Brown, Inc. PO Box 2412 B Insurance CHE $1 ,000.00

7 Daytona Beach , FL 32115

07/12/2016 Preferred Gov. Claim Solutions, Inc. B Insurance CHE $1 ,000.00

P.O. Box 958456 8 Lake Mary, FL 32795

DS-DE 13 (Rev. 08/03) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES

CAMPAIGN TREASURER'S REPORT - ITEMIZED CONTRIBUTIONS

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

(3) Cover Period 07/ 09 / 2016 through 07/ 22 / 2016 (4) Page 2 of 3 (5) (7) (8) (9) (10) (11) (12)

Date Full Name

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

07/1 2/2016 William G. Warner PO Box 1820 I Attorney CHE $500.00

9 Panama City, FL 32402

07/12/2016 Timothy M. Warner 812 Balboa Ave. I Attorney CHE $500.00

10 Panama City, FL 32401

07 /12/2016 William J. Carter 1884 Nightfal l Dr. I Business CHE $250.00

11 Neptune Beach , FL Owner/Arts

32666 & Crafts

07/1 4/2016 John C. Schmidt 55 San Juan Dr. I Retired CHE $500.00

12 Ponte Vedra Beach , FL

32082

07/15/2016 Works of Tab, LLC 333 N. 1st St. N. STE 100 B Restaurant CHE $250.00

13 Jacksonville Beach, FL

7/15/15 Works of B and L LLC 333 1st St. N. STE 150 B Restaurant CHE $250.00

14 Jacksonville Beach , FL

32250

7/18/2016 Lindsey Godfrey 1026 13th St. N. I CHE $50.00

15 Jacksonville Beach, FL

32250

7/19/2016 Helen Dixon Coppedge 24272 Marsh Landing I Retired CHE $500.00

Parkway 16 Ponte Vedra , FL 32082

DS-DE 13 (Rev. 08103) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES

CAMPAIGN TREASURER'S REPORT - ITEMIZED CONTRIBUTIONS

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

(3) Cover Period 07 I 09 I 2016 through 07 I 22 I 2016 (4) Page 3 of 3 (5) (7) (8) (9) (1 0) (11) (12)

Date Ful l Name

(6) (Last , Suffix, First, Midd le)

Sequence Street Address & Contributor Contribution In-kind Number Citv, State, Zio Code Tvpe Occupation Type Description Amendment Amount

07/1 9/2016 Walter Dickinson 5187 Dixie Landing Dr I Retired CHE $500.00

17 Jacksonvil le, FL 32224

\

OS-DE 13 (Rev. 08/03) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES

CAMPAIGN TREASURER'S REPORT - ITEMIZED EXPENDITURES

(1) Name Christine Hoffman (2) l.D. Number --'-N""'"'/A~-----

(3) Cover Period 07 /~/ 2016 through 07 l_ll__l--1Ql.Q_ (4) Page __ ...,:.1 __ of 1

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

Date Full Name Purpose

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

Number Address & contribution to a Expenditure

City, State, Zip Code candidate) Type Amendment Amount

I I

OS-DE 14 (Rev. 08/03) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES