STATE OF FLORIDA FLORIDA ELECTIONS COMMISSION€¦ · official record of the hearing, the...

In Re: Maria Vickers-Henry

TO: Maria Vickers-Herny 1241 S. Kirkman Road Apt 1145 Orlando, FL 32811

STATE OF FLORIDA FLORIDA ELECTIONS COMMISSION

Case No.: FEC 13-057

Division of Elections 500 S Bronough Street Room316 I allahassee, FL 32399

NOTICE OF HEARING (INFORMAL HEARING)

A heating will be held in this case before the Flotida Elections Commission on August 6, 2014, at 8:30 am, or as soon thereafter as the parties can be heard, at the following location: Senate Office Building, Room S-110, 404 South Monroe Stt eet, I allahassee, FL 32399

Failure to appear in accordance with this notice will constitute a waiver of your right to pa1ticipate in the heating Continuances will be granted only upon a showing of good cause.

This hearing will be conducted pursuant to Section 106.25, Florida Statutes, which governs your pa1ticipation as follows:

If you are the Respondent, you may attend the hearing, and you 01 your attorney will have 5 minutes to present yom case to the Commission. However, some cases (including those in which consent 01ders 01 recommendations fo1 no probable cause are being considered) may be decided by an en masse vote and, unless you request to be heard 01 the Commission requests that your case be considered separately on the day of the hearing, yom case will not be individually heaid.

If you are the Complainant, you may attend the hearing, but you will not be permitted to address the Commission. In addition, some cases (including those in which consent orders 01 1ecommendations fo1 no p1obable cause aie being considered) may be decided by an en masse vote and, unless the Respondent requests to be heard m the Commission requests that the case be considered separntely on the day of the hearing, the case will not be individually heard.

If you are an Appellant, and you have requested a hearing, you may attend the heaiing, and you or yom attorney will have 5 minutes to present your case to the Commission.

Please be advised that both confidential and public cases are scheduled to be heaid by the Florida Elections Commission on this date As an Appellant, Respondent 01 Complainant in one case, you will not be pe1mitted to attend the hearings on other confidential cases

The Commission will electionically record the meeting. Although the Commission's recording is considered the official record of the hearing, the Respondent may provide, at his own expense, a certified comt reporte1 to also record the hearing

If you require an accommodation due to a disability, contact Donna Malphms at (850) 922-4539 or by mail at I 07 West Gaines Street, The Collins Building, Suite 224, Tallahassee, Florida 32399, at least 5 days before the hearing

See further instructions on the reverse side ..

}!_my :MCKeever 'Toman Executive Director Florida Elections Commission July 16, 2014

Please refor to the information below for further instructions related to your particular hearing:

If this is a hearing to consider an appeal from an automatic fine, the Filing Officer has imposed a fine on you for your failure to file a campaign treasurer's report on the designated due date and, by filing an appeal, you have asked the Commission to consider either (1) that the report was in fact timely filed; or (2) that there were unusual circumstances that excused the failure to file the report timely. You are required to prove your case. If the Commission finds that the report was filed timely or that there were unusual circumstances that excused the failure, it may waive the fine, in whole or in part The Commission may reduce a fine after considering the factors in Section 106.265, Florida Statutes .. If the Commission finds that the report was not timely filed and there were no unusual circumstances, the fine will be upheld

If this is a hearing to consider a consent order before a determination of probable cause has been made, the Commission will decide whether to accept or reject the consent order If the Commission accepts the consent order, the case will be closed and become public If the Commission rejects the consent order or does not make a decision to accept or deny the consent oi:der, the case will remain confidential, unless confidentiality has been waived

If this is a hearing to consider a consent order after a determination of probable cause has been made, the Commission will decide whether to accept or reject the consent order .. If the Commission accepts the consent order, the case will be closed If the Commission rejects the consent order or does not make a decision to accept or deny the consent order, the Respondent will be entitled to another hearing to determine if the Respondent committed the violation(s) alleged

If this is a probable cause hearing, the Commission will decide if there is probable cause to believe that the Respondent committed a violation of Florida's election laws. Respondent should be prepared to explain how the staff in its recommendation incorrectly applied the law to the facts of the case Respondent may not testif;, call others to testifj;, or introduce any documentary or other evidence at the probable cause hearing The Commission will only decide whether Respondent should be charged with a violation and, befo1e the Commission determines whether a violation has occurred or a fine should be imposed, Respondent will have an opportunity for another hearing at which evidence may be introduced

If this is an informal hearing, it will be conducted pursuant Sections 120 . .569 and 1205'7(2), Florida Statutes; Chapter 28 and Commission Rule 2B-l 004, Florida Administrative Code. At the hearing, the Commission will decide whether the Respondent committed the violation(s) charged in the Order of Probable Cause. The Respondent will be pe1mitted to testify Howeve1 the Respondent may not call witnesses to testify

Respondent may argue why the established facts in the Staff Recommendation do not support the violations charged in the 01der of Probable Cause At Respondent's request, the Commission may determine whether Respondent's actions in the case were willful The Respondent may also address the appropriateness of the recommended fine If Respondent claims that his limited resources make him unable to pay the statutory fine, he must provide the Commission with written proof of his financial resources at the hearing A financial affidavit form is available from the Commission Clerk.

30 April 2014

Maria Vickers -Henry

1241 5 Kirkman Rd Apt 1145

Orlando, FL 32811

To whom it may concern;

First I would like to start by apologizing for the tardiness of this letter and the enclosed Affidavit of

Financial Support In the past three months I have experienced the loss of both my mother-in- law

shortly followed by the passing of my grandmother. While I do work full time I am experiencing

financial hardship as I have two children under the age of 4 years old who are both in daycare fulltime

and my total income does not support my total debts per month I would like to ask that if penalty is

imposed after determination from the Commissioner to please consider a payment plan

In addition, I would like to request that FEC Case No 13-021 be postponed and to be combined with

another case that I have going before the Commissioner as both cases are dealing with the same matter ..

Again, I am truly sorry for the tardiness of this letter

Thank you for your consideration,

\{YlevtJa_, ()H!~ ~/r' Maria Vickers-Henry {_j

The Florida Elections Commission has issued an Order of Probable Cause in your case If you would like the Commission to consider your finances for the purpose of mitigation at the hearing in this case, please complete the enclosed Financial Affidavit Please keep in mind, any and all information you provide below must be verified by submitting supporting documentation If you fail to return the financial affidavit below along with any supporting documentation within 30 days, the Commission will presume that you are not raising financial hatdship in this matter

AFFIDAVIT OF FINANCIAL SUPPORT

I, fVIJ.r! Ci R. \/1 ck us · /-khl'Ci , Respondent in FEC Case No. 13 ,. () 2/ , state: 1 I have Z:: dependents. (Do nbt include children not lMng at home and do not include a working •pouse or yow self)

2 I have a take home income of $ <f4 0 ___ paid: ( ) weekly <>§every two weeks () semi-· monthly ( ) monthly ()yearly (Take home income equal~ sala.~:Y wage~, bonuses, commissions, allowances, ove1time_ tips and similar payments, minus deductions required by law and other court-ordered support payments)

l Place of E.ml))oyment. ,.;F:-::,/ O':or':;1c:;cl:::;':::1;---;;':F='~~""'-Add1ess: '100 Win. e.::;r~e,~~~..!-\~~=,.,--

.. ='1faT n - . l.

4 I have other income paid: ()weekly ()every two weeks ()semi-monthly ()monthly () yeatly.

(Circle 'Yes and fill m the amount if you have this kind of mcome. otherwise circle "No")

- Social Security benefits?- :=-:-T= YES o O• $

-Veterans' benefits? _ ---------==-YES ~rNO $ -------·---Unemployment compensation? YES or $

Child support or regular support from family YES or<l:!.§;;-··-'-$------·----members/soouse?

Workers compensation? $ ----Rental income? $

·~-Retire1nent/ Pensions? $

Dividends or interest? $

Trusts/ Gifts? ';,4'----1-$

----""""---1-------------1 $

'-· ---------Any other income not on the list?

to p1ov1de additional information)

·-- ·-----Y~or\>(]Q'\ Cash? $ -iYES'-'r N-Cl $ Savings? --

Bank account(s)]_ <Y1"<l>orNO $ ----·--- --2lJ2Q__ __ _

2:2_L_?;f5 __ Stocks/ Bonds? YES or(t\0) $ ·-· -·--------Money m!!!'ket accounts? YES oKNO) $ -

a Certificates of deposit or Equity* in real YES or~ $

estate (excluding homestead) if yes, please list the address of this proper(y below. _.., ____ -----·--·---

5 I have other assets: (Circle "yes" and fill in the value of the property, otherwise circle "No", use the back

---------··---··--------------· ---·-··--------, -----

b Equity* in motor vehicles/boats/other (y_E or NO $ tangible property expectancy in an interest in such property?) if yes, please list the informationfm this property below.

*Equity means value minus loans

----··---...... __ _ b List the year/make/model & tag#:

cvr·ren+-J~,Q dealtr.c;h!_e clu-e. fv reco....lf .... Check one: I ()DO 9(l DO NOT expect to receive more assets in the near future The asset is

6 I have total liabilities and debts of$ ~,lJCC { ~C as follows:

,_, q20- IOJ<J(IA~-fUS -""'~~..,,- _ - d Motor Vehicle$ Credit Cards$ Medical bills$ --- Costs of medicine$ ·--

Child Suppmtpaict direct$ -· Other$ 80BO·· lrfLl~:C;;:), Id. care 6C1'$1 l='oDd~ 7 I have a private lawyer in this case Yes No j(__ · Aurc I n:SO'l'OnC{'i S·r(Jder\T'

/,_ l)(J, (i 'j 8 I receive: (Circle 'Ye1" or "No") Tempora1y Assistance fo1 Needy Families-· Cash Assistance Poverty -related Veterans' Benefits

Yes Yes Yes Supplemental Security Income (SS!)

OATH STAIE OF FLO~IDA COUNTY OF \.) (0.rtJ.t I swear or alfirm that the above information is true and correct to the best of my knowledge

~ R u1cJM.1.Jd£JU1;1J Signature of Respondent U

Sworn to and subsctibed befo1e me this.&' a·rl.. day of

--+-/----·-· _,, ___ ,20_Llj_

~'.e ~~./~ . Si ~re of OfficeAuthorized to Administer Oaths or Notary public.

l'"y p(/ J . .,o~~<'<> erem1ah E Campbell ~ \) • State of Florida :;,~OF •'-o<?-~ My Commission Expires 10/8/201 yrin~--Type, or Stamp CommissionedName ofNotaryPublic

Commission No FF 61197 Personally Known __ Or Produced Identification --~ Type ofldentification Producedz:/.0-,;a<, h~)ok.~~e

Wells Fargo Account Activity

·--)

Wells Fargo Online0

Account Activity

WELLS FARGO AT WORK(SM) CHECKING

Activity Summary

.9!:!r.i:~n~ .~.~t~g .~.?..1~.r:i~ Pending Withdrawals/ Debits

Pending Deposits/ Credits

Available Balance

Transactions

Show: for Last 90 Days

Date .i. Description

Pending Transactions Noto: Amounts may change

$249 29

.. $21.94

$0.00

$227 35

05101114 CHKCARDDEMOCRACY ENGINE LLC WASHINGTON DC

05/01/14 FL MAITLAND ORLANDO FL

05/01/14 CHICK-FIL··A #01 ORLANDO FL ······-····························-·····················

05/01/14 MCDONALD'S F202 ORLANDO FL

Postod Transactions

04/30/14 SAVE AS YOU GO TRANSFER DEBIT TO XXXXXXXXXXX7748

04130/14 POS PURCHASE - CLEAN CLEANERS ORLANDO Fl 6313 00384120777026758

04130/14 CHECK CRO PURCHASE 04/30 DRl .. MICROSOFT HUP http:/lsuppor MN 4 73702XXX.XXX6313 4641197 40733607 ?MCC::-4816

CHECK CRO PURCHASE 04/28 SHELL OIL 57542483 ORLANDO FL 473702XXXXXX.6313 384118804733945 ?MCC=5542

Or1ando Utl!itie PAYMENT 140427 3964804989 Vickers-Henry.Maria ·················+··· ... 04/29114

04/28/14

04/28/14

04/28/14

04/28/14

04128/14

04128/14

04128/14

04/28/14

04/28/14

04/28114

POS PURCHASE· FAMILY DOLLAR 6536 ORLANDO FL 6313 00384119608136990

SAVE AS YOU GO TRANSFER DEBIT TO XXXXXXXXXXX7748

POS PURCHASE· SHELL Service Station ORLANDO FL 6313 00384118801757755

POS PURCHASE .. Wal Mart Super Center ORLANDO FL 6313 00000000454578333

POS PURCHASE· FRESHFIELDS ORLANDO ORLANDO FL 6313 00384116661387447

POS PURCHASE· THE CHILDREN$ PLACE 1 OCOEE FL 6313 00464116603865186

PCS PURCHASE· .JCPENNEY STORE 2722 OCOEE FL 6313 00384116593215759

POS PURCHASE· MURPHY6707ATWALMRT ORLANDO FL 6313 00304116528968255

CHECK CRD PURCHASE 04126 MCDONALDS F26548 ORLANDO FL 473702XXXXXX6313 584116505947438 ?MCC=5814

RECUR DEBIT CRD PMT04f26AT&T"BILL PAYMENT 800·288·2020 TX 473702XXXXXX6313 584116478532293 ?MCC=4814

CHECK CRD PURCHASE 04f25 FL MAITLAND ORLANDO FL 473702XXXXXX6313 084115469145565 ?MCC=5999

04125114 SAVE AS YOU GO TRANSFER DEBIT TO XXXXXXXXXXX7748

04125/14 WITHDRAWAL MADE IN A BRANCH/STORE

04125/14 POS PURCHASE· TARGET T2264 TARGET T2 WINTER GAROENFL 6313 00584115676576548

04125/14 l ONLINE TRANSFER TO HENRY J REF #IBE8FFF7Y2 CHECKING VIA MOBILE

! Totals '

Deposits I Credits

.] '"' ···~-···

$7,867 .. 94

https://online.,wellsfargo,.com/das/cgi-bin/sessioncgi?sessargs=StKbl vZDVf,

Page 1 of5

Withdrawals I Debits

$500

$6.94

$543

$457

$300

$8.31:

$995'

$3014 !

$373'

$6.33

$5010

$11 38

$300

$350 00

$22 38 i

$6000

$7,805.07

5/1/2014


Date .:. Description

L---·--·-···J ....•........ ··-···· ·······- ·-····-···--···-· .... --·····------ ..... 04/25114 CHECK CRD PURCHASE 04124 STARBUCKS #08337 0 Orlando FL 473702XXXXX.X6313

464115028173450 ?MCC>=5814

04125114 CHECK CRD PURCHASE 04/24 ENTERPRISE RENT-A- ORLANDO FL 473702XXXXX.X6313 584114737394903 ?MCC=3405

04125/14 AH$-S INC DBA FL PAYROLL XXXXX4296 VICKERS-HENRY.MARIA RE

04/24/14 WITHDRAWAL MADE IN A BRANCH/STORE


04123114 CHECK CRD PURCHASE 04/22 PROGRESSIVE •1NSUR 800-776-473'7 OH 473702XXX.XXX6313 464112663407547 7MCC=6300

04/23/14 CHECK CRD PURCHASE 04/21 SUBWAY 0031 ORLANDO FL 473702XXXXXX6313 464111836075879 ?MCC=5814

04123/14 CHECK CRD PURCHASE 04/21 Fl MAITLAND ORLANDO FL 473702XXXXXX6313 004111587749034 ?MCC=5999

04/22114 INTEREST PAYMENT

04122114 SAVE AS YOU GO TRANSFER DEBIT TO XXXXXXXXXXX7748

04122/14 CHECK CRD PURCHASE 04/21 ANF GYROS AND GRIL ORLANDO FL 473702XXXX.XX6313 384111003027913 ?MCC=5812

04/22/14 CHECK CRD PURCHASE 04/21 CIRCLE K 2708961 ORLANDO FL 473702X.XXXXX6313 384111389987052 ?MCC=5541

04/22114 DEPOSIT MADE IN A BRANCH/STORE #727539337

04/22114 TELE· TRANSFER FR XXXXXX0954 REFERENCE# TFEQWN7FOS

04121114 POS PURCHASE .. PUBLIX SUPER MAR 2435 ORLANDO FL 6313 00384111822659262

04/21114 POS PURCHASE·· WALGREEN$ 920 S KIRKMA ORLANDO Fl 6313 00384111017354062

04/21/14 CHECK CRO PURCHASE 04120 SONIC DRIVE IN #44 ORLANDO Fl 473702XX.XXX.X6313 384110795918528 ?MCC::5814

04/21/14 POS PURCHASE • MURPHY6707A TWALMRT ORLANDO Fl 6313 00304110785870139

04/21/14 CHECK CRD PURCHASE 04/19 HUNGRY HOWlES #30 ORLANDO Fl 473702X.XXXXX6313 084110086490357 7MCC=5814

04/21/14 POS PURCHASE· ONCE UPON A CHILD OCOEE FL 6313 00000000540196801

04/21/14 POS PURCHASE· 7 ELEVEN ORLANDO FL.6313 00000000455430886

04/21/14 POS PURCHASE· 7 ELEVEN ORLANDO FL6313 00000000240267133

04/21/14 CHECK CRD PURCHASE 04/17 MCDONALDS F26548 ORLANDO FL 473702X.XXXXX6313 464108111429192 ?MCC=5814

04/21114 CHECK CRD PURCHASE 04/17 CHICK··FIL·A#1031 ORLANDO FL 473702XXXXXX6313 464107391503403 ?MCC=5814

04/21114 TELE· TRANSFER FR XXXX.XX0954 REFERENCE# TFEK4.JT638

04/18114 SAVE AS YOU GO TRANSFER DEBIT TO XXX.XXXXXXXX7748

04/18114 :' POS PURCHASE· ALO! 74010 0624 OCOEE FL 6313 00000000246619223

04/18/14 , POS PURCHASE·· WALGREENS 8802 WCOLON OCOEE FL 6313 00384108815599768 ••••• 1. ••.•.• ._ ...... - ............ _. ___ •

04/18/14 ' POS PURCHASE·· Wal Mart Super Center ORLANDO FL 6313 00000000542332195

04/18114 POS PURCHASE· TOYS R US OCOEE FL 6313 00304108625570227

04/18114 POS PURCHASE·· DOLLAR TREE4376 4600 ORLANDO FL 6313 00000000857762305

04/18114 ATM TRANSFER FROM SAVINGS· 2435 S HIAWASSEPUBUX SUPORLANOO Fl 6313 ' 00304108642705306

04/18114 'TELE-TRANSFER FR X.XXXXX0954 REFERENCE #TFEQW!v1HP4C

'NON-WF ATM BAL INQUIRY FEE· 04/18 MACH IDA027601 2435 S HtAWASSEPUBLIX i SUPORLANOO Fl6313

... ···--··-···--"·---- . ··- .. -·-·--.. ---·--· .. --~·---- - . " --- ·-•"•"' '"

] SAVE AS YOU GO TRANSFER DEBIT TO XXXXXXXXXXX7748

i POS PURCHASE· ROSS STORES 239 ORLANDO FL 6313 00000000051195408

Deposits I Credits

$0.01

$160.00

$1,280 00

$100. 00

$30 00 !

$50 00:

Page 2 of5

Withdrawals I Ce bits

$10 00:

$3,00;

$128011

$10 65 !

$2 98 :'

$2 00

$14 90

$15 00

$24 26 i

$3 17 ~

$20.01 :

$8 51 :

$772 i

$10 59;

$11 17

$5 95 i $543 ,!

$5 00

$23 26;

$6.56

$8.30

$17 87

$13 52 :

$2 00'

$4 00:

$20 23 --- "". ----·-··· ....•.. ••' ·-· _._ ___ ... --·········-···-··· ··-··- ···--------····-·····--··. ···-·-···-- .. -··········-··· ... .......•..... .... ........ . . ......••.. , .. ····-··························

$8 31

$7,867 .. 94 $7 805.07

https:// online. wellsfargo .com/das/cgi-bin/session .. cgi?sessargs=StKb lvZDV f:.. 5/1/2014


-I i

-._]

~;i

i

[o;~;···;- -······· ·1·: ~~~:'.'..~.t'.::_____ . ·---· -·----· -· ____ ··-·······--------···- ___ _ 04/17/14 j CHECK CRD PURCHASE 04/15 FL MAITLAND ORLANDO FL 473702XXXXXX6313

! 164105486139914 ?MCC=5999 - . ·-·-------L .. ----~- ..... -·-·----------. 04117/14 i CHECKCRD PURCHASE 04115 HESS 09501 ORLANDO FL 473702XXXXXX6313

i 584105360563185 ?MCC=5542

04116114 --.l~~~-:~-~-.-~?.~- ~O TRANSFER O~-B~!-~?..-~.~~~- .. r ···04/16/:j-~ ! CHECK CRD PURCHASE 04/15 US DEPT OF EDU SQQ .. 872-5327 DC ) 473702XXXXXX6313 284105553764010 ?MCC=9399

04/16/14 ) CHECK CRD PURCHASE 04/14 CHICK-FIL-A #685 ORLANDO FL 473702XXXXXX6313 ' 584104547892404 ?MCC=5814

04115/14 SAVE AS YOU GO TRANSFER DEBIT TO XXXXXXXXXXX77 48

04115114 ?.~-~~~-o.:~~!~~e ._P~ YfV'.E~_T 14~~.~ :.396~~?:1_~~: ~~c-~~!~:~-~~~~aria _ .. _

04115/14 POS PURCHASE - ANNAS NAILS SPA ORLANDO FL 6313 00304105841458528

04/14114 SAVE AS YOU GO TRANSFER DEBIT TO XXXX:XXXXXXX.7748

04114114 POS PURCHASE - WINN DIXIE 21401 S ORLANDO FL 6313 00464104839411780 ····+··········· ........... -.•...... """'"""""""""'"••

04/14114 CHECK CRD PURCHASE 04/13 CAFE TU TU TANGO ORLANDO FL 473702XXXXXX.6313 584103058959571 ?MCC=5812

04/14114 PCS PURCHASE - HESS 09229 ORLANDO Fl 6313 00464103811438887

04114114 CHECK CRD PURCHASE 04113 FIVE GUYS-FL# 047 ORLANDO FL 473702XXXXXX6313 164103804865472 ?MCC=5814

04/14114

04114114

CHECKCRD PURCHASE 04113 PIE·FECTION BRAZIL ORLANDO FL 473702XXXXXX6313 164103797667483 ?MCC=5812

CHECK CRD PURCHASE 04113 SBARRO 781 ORLANDO FL 473702)()()()()()(6313 384103754889809 ?MCC=5814

04114/14 CHECK CRO PURCHASE 04/13 HOLIDAY MALL PHOTO ORLANDO FL 473702XXXXXX6313 304103743064570 ?MCC=7221

04/14114

04/14114

04/14114

~~4~~~~~~~~~~~8!=~~~3 SQ *THE SA-~~~~±b~~~-~~- .. ~-~---~~-37-~2~·~·3·1 .. ~-CHECK CRD PURCHASE 04/12 AIT"BILL PAYMENT 800-288 .. 2020 TX 473702XX.XXXX6313 384100038566715 ?MCC=4814

POS PURCHASE - T J T J fv'l.l>.XX KISSIMMEE FL 6313 00000000644759760 !·--

04/14/14

04/14114

04/14114

ATM WITHDRAWAL- 8801 WCOLONIAL DRIVE OCOEE FL 6313 0002605

NON-WELLS FARGO ATM TRANSACTION FEE

ATM \AJITHORAWAL .. 1201 Hiawassee CTVCOM Orlando FL 6313 00384102445083253

Deposits I Credits

Page 3 of5


--- . -·+ ·-- -·· ··- ·-·--· --$3 99

$2003

$2.00 ....... -- ..................... -

. ·I-,

$42 00

$203'

$200

$5000

$32.00

$15 00

$3532

$87 75 :

$19 23 :

$40.00

$2 50

$2295 ............. ·········!· ········

-~

04/14114

04/14/14

04/14114

04114/14

04/11/14

04111/14

04111114

POS PURCHASE - 7 ELEVEN ORtANDO FL 6313 00000000331600646

CHECK CRO PURCHASE 04/11 ~! l PAYMfNI £100-288·2020 TX 473702XXXXXX6313 304102104326371 ?MCC=4814

CHECK CRD PURCHASE 04/11 PEI WE! #0174 ORlANDO FL 473702X.XXXXX6313 584102009792272 ?MCC=5814

CHECK CRO PURCHASE 04/11 FL MAITtAND ORlANDO FL 473702XXXXXX6313 084101469189524 ?MCC=5999

CHECK CRD PURCHASE 04/10 Fl MAITLAND ORLANDO Fl 473702XXXXXX6313 084100546631435 ?MCC=5999

NON··VVF ATM BAL INQUIRY FEE·· 04/12 MACH ID 2978901V 1201 Hiawassee CT VCOM Orlando Fl 6313


Island Club WEB PMTS 041114 ODWN42 Vickers-Henry Maria !<ENT-POS PURCHASE -WHOLE FOODS MARK 8003 Orlando Fl 6313 00304102026271347

--······ j- __ ......

04/11/14 ., ·--·----·" ...

04/11/14

04111/14

PCS PURCHASE - 00088 Orlando Factor ORLANDO Fl 6313 00000000744362827

POS PURCHASE -WAL MART 1220 ORLANDO FL 6313 00000000241617607

Transfer in Branch/Store - From MARIA R VICKERS-HENRY DOA XXXXXX0057 6306 W COLONIAL DR ORlANOO FL

-·-- ·-·--·--·······--'··-··- . -·--04111114

Totals

Transfer in Branch/Store - From MARIA R VICKERS-HENRY ODA X.XXXXX0057 6306 W COLONIAL DR ORLANDO Fl

$499 !

$119 i

$200 ,!

$5322

$2817

$100000

$150 00'

$7,867.94 $7,805.07'

https://online .. wellsfargo .. com/das/cgi-bin/session.cgi?sessru:gs=StKbl vZDVf . 5/1/2014


Date Description Deposits I Credits

Page 4 of 5


.. ···-·· ----- --·------ ·-·-·····-i---·-····- ·-·-·-··· ·-·- ···---·- ..•. POS PURCHASE· MURPHY6707A1WAL ORLANDO FL 6313 00000000043047594

04/11/14 CHECK CRD PURCHASE 04/09 Fl. MAITLAND ORLANDO FL 413702XXXXXX.6313 004099620048377 ?MCC=5999

CHECK CRO PURCHASE 04/09 Fl MAITLAND ORLANDO Ft. 473702XXXX.XX6313 284099449432994 ?MCC=5999

AHS-S INC OBA FL PAYROLL XXXXX4296 VICKERS-HENRY MARIA RE


RECUR DEBIT CRD PMT04/09 NETFLIX COM NETFUX COM CA 473702XXXXXX6313 384099442062533 ?MCC=5968


04/09/14 POS PURCHASE- PUBLIX SUPER MAR 2435 ORLANDO FL6313 00304099858947463

04/09/14 ATM WITHDRAWAL- 637'9 WCOLONIAL DR ORLANDO FL6313 0005685

04109/14 TELE-TRANSFER TO CHECKING XXXXXX8105 REFERENCE# TFEG705PSZ

04/08114 ONLINE TRANSFER TO HENRY J REF #IBEK4FGHT9 CHECKING VIA MOBILE

04/08/14 DEPOSIT MADE IN A BRANCH/STORE#718130925


04/07/14 CHECK CRD PURCHASE 04/06 KRYSTAL BIRF06 HUEYTOWN AL 473702X.XXXXX6313 004096685352720 ?MCC=5814

04/07/14 CHECK CRD PURCHASE 04/05 BP FOOD MART BESSEMER AL 473702XXX.XXX6313 4640-95605197289 ?MCC=5541

·--·-------··--· 04/07/14 CHECK CRD PURCHASE 04/04 SONIC DRIVE IN #45 BESSEMER AL

473702XXXXXX6313 384094513349657 ?MCC=5814

04/03/14

CHECK CRD PURCHASE 04/04 MCDONALD'$ F14630 BESSEMER AL 473702XXXXXX6313 464094501795033 ?MCC==5814


CHECK CRD PURCHASE 04/02 MCDONALD'$ F23753 ATLANTA GA 473702XXXXXX6313 584092619876508 ?MCC=5814

CHECK CRD PURCHASE 04/02 QUALITY INNS VALDOSTA GA 473702XXXXXX6313 584092353469503 ?MCC=3508

SAVE AS YOU GO TRANSFER DEBIT TO XXXXXXXXXXX.7748

POS PURCHASE - TARGET T2375 TARGET T2 BEALEMER AL 6313 00584093583919042

CHECK CRD PURCHASE 04/02 MARATHON PETR01208 FORSYTH GA

$223910

~ .... "

' .! ··········-··················-··

473702X.XXXXX6313 464092579340862 ·?MCC=5541 l

CHECK CRD PURCHASE 04102 PENN CREDIT PCC TR 800-800-3328 PA De ..... S -;l ·.p.:)·;;:LO:'.:ih .. . 473702)()()()()()(6313 284092519921700 ?MCC•7299 .f?~ .. 1;1 S2../('(} <?!.:: ... . CHECK CRD PURCHASE 04/01 L2GORANGE CO COC 877-513-5465 FL j : 473702X.XXXXX6313 304091721380369 ?MCC=9399

.! SAVE AS YOU GO TRANSFER DEBIT TO XXXXXXXXXXX7748

04102114 : POS PURCHASE-· SHELL Service Station ATLANTA GA 6313 00304092615102079

04/02114 POS PURCHASE· SHELL Service Station VALDOSTA GA 6313 00384092481015850

04102114 CHECK CRD PURCHASE 03131 FL MAITLAND ORLANDO FL 473702XXXX.XX6313 284090568701935 ?MCC=5999


-7_ 04/01/14 Orlando Utilitie PAYMENT 140329 3964804989Vickers-Henry,Maria

: 04/01114 ONLINE TRANSFER TO HENRY J REF #IBEG7B62PX CHECKING VIA MOBILE

04/0111 4 ;-.. ~-~~ -~-~~?-~-~~.: __ ::._wa~ ~~~-s.~~~-r .?.:.~-t~!-O?.?~.:.-.~-~ .. ~~-~ .. :._~?.?..~.?.-~?o. '..~-~~:~.~--~-~-- .. 04/01/14 ' ONLINE TRANSFER FROM .JONES F REF #JBE2M46RZ8 WAY2SAVE SAVINGS VIA

MOBILE

03/31!14 SAVE AS YOU GO TRANSFER DEBIT TO X.XXXXXXXXXX7748

03/31!14 POS PURCHASE· THE CHILDRENS PLACE 1 ORLANDO FL 6313 00000000745866436

$100000

···-·····"-·-···-·· . . ......................... . :----·· -- -···- ·--Totals $7,867.94

$1949

$3000

$4.00

$879

$24 14

$856

$263

$200

$13 25

$5595

......... ~°.oi $37 16 !

$3 97

$507 95 i

. $ss99i

$3 00:

$27 02:

$29.31 :

$4 97'

$200'

$186 74

$18000'

$254:

$10 00 I

$3169

$7,805 .. 07:

https://online .. wellsfargo .com/das/cgi-bin/session..cgi ?sessargs=StKb lvZDV f..... 5/1/2014


Description Deposits I Credits :

- - - -----··--·-· -· ·-·--··'·-·-·-· -03/31/14 CHECK CRO PURCHASE 03/30 SQ "THE SANCTUARY Locl<hart FL 473702XXXXX.X6313

384089689630801 ?MCC=8398

03/31/14 POS PURCHASE- WAL MART 1220 ORLANDO FL 6313 00000000933118460 -·-·--·-·---- __ ,_ -- -- - ·- ---·- -- ---- - . -·-··-- ·-··-···-----···-·---·----·-·-·-- ······-·-----------·-·"·-- ··-·- .. ··--·---··-.. ·-· ......... -----·- ·-·-·'-03/31/14 POS PURCHASE·· WAL MART 1220 ORLANDO FL 6313 00000000134191147

03/31/14 CHECK CRO PURCHASE 03/29 AT&T 0436 ORLANDO FL 4'73702XXXXXX.6313 304088762448721 ?MCC:;:4812

03/31/14 CHECK CRD PURCHASE 03/29 AT&T 0436 ORLANDO FL 473702XXXXXX.6313 584088751803526 ?MCC=4812

03/31/14 CHECK CRD PURCHASE 03/29 CHICK-FIL·A #0768 OCOEE FL 473702X.XXXXX6313 304088646686791 ?MCC=5814

Page 5 of5

Withdrawals / Debits

$9000

$34.81

$3.85

$4517

$163 41

$12 34

-- ·--· ·-- . -·-··· ···-·-···-····-·--03/31/14 CHECK CRD PURCHASE 03/28 PAPAS GYRO INC ORLANDO Fl 473702XXXXXX6313

004087827618329 ?MCC=5814

CHECK CRD PURCHASE 03/28 FL MAITLAND ORLANDO FL 473702XXXXXX6313 284087475414072 ?MCC=5999

CHECK CRD PURCHASE 03127 7-ELEVEN 25608 MAITLAND FL 473702XXXXXX.6313 584086647813600 ?MCC=5542

03/28114 SAVE AS YOU GO TRANSFER DEBITTO XXXXXXXXXXX7748

03/28/14 Cash eWithdrawal in Branch/Store .. 351 N STATE ROAD 434 ALTAMONTE SPRINGS FL 6313

03/28/14 POS PURCHASE· MURPHY6707ATWALMRT ORLANDO FL 6313 0058408761296'7586 --------·-------·-·····-···· ...... _._ ... '

03/28/14 AHS-S INC DBA FL PAYROLL XXXXX4296 VICKERS··HENRY MARIA RE ; ··--· ............. , .... ---·-···" -· ---·--·-·-· ··-------·· ·-----· ·-- -·······--·······-··-··-···-···--· ..................... _

03/27/14 SAVE AS YOU GO TRANSFER DEBITTO XXXXXXXXXXX7748

03/27/14 PROG SELECT INS INS PREM 140327 44390336 MARIA MARIA R VICKERS HENRY ···············-··-····-- '··-··--"""'"'~"'"'"'"~- .. 03127/14 CHECK CRD PURCHASE 03/26 MCDONALDS F25790 ORLANDO FL

473702XXXXXX6313 384085434235507 ?MCC=5814

03127/14 ATM TRANSFER ON FROM MARIA R VICKERS-HENRY SAVINGS 2630 MAGUIRE ROAD OCOEE FL 6313 0003

i To1als

® Equal Housing Lender

© 1995 ~· 2014 Wells Fargo All rights reseived

$983.81

$19 00

$7,86'7 94 :

https://online ... wellsfargo .. com/das/cgi-bin/session .. cgi?sessargs=StKb 1 vZDVf.

$298

$1003

$1.00

$350 00

$20.06 !

$200

$157.57

$585.

$7,805,.07

5/1/2014

POODDD-OOOSlrn& iol

ouc The Reliable One'

Account#

MARIA VICKERS .. HENRY 1241 S KIRKMAN RD APT 1145

ORLANDO, FL 32811-2289

Page 1 of 1 Bill Date: 04/14/14

_,i~~~~~~j~~ia¥~£1~~.j~kfW~~~·~~,~~:f 'i~~'-'.'.:·~-iJ',~f~¥r/';~I·,~~~;~~t¥~f !:;,; '.

Last payment of $50 .. 00 received on 04/12/14

Residential Electric Meter Electric Service Charge

03/14/14 Reading 04/14/14 Reading

Consumption for 31 Days Current OUC Electric Charges

City of Orlando Charges Orlando Wastewater Orlando Taxes

8,314 8,806

492 KWH @O 10143

Current City of Orlando Charges

State of Florida Charges Gross Receipts Tax

Current State of Florida Charges

Late Payment Charge

'. Itemized Charges Total Charees

8 00

49 91

43 70 442

1 48

__ _,_,,_L_. ___ ,, ___ ... ···---·- -·

Deposit on Account $230 00 Total Current Charges Due 05/02/14 $110 .. 51

Pay PAST DUE now to avoid service interruption

M8ii a E5iiiatd c~arci~oii mioiiliuin · $3 ~har((e'ny fia~iri3'1i)':111e due ciafo

PAST DUE $58.95

ouc Return this portion of the bill with your payment ft!t@jitijiB~t@1t@I Make check payable to: Orlando Utilities Commission : -._, .. _,-....... ,,-. . __ ... :-

The Reliable One' PO Box 31329 Tampa. FL 33631-3329

Past Due Charges·· PAY NOW [-----·-] $58. 95 ------

Total Current Charges Due 05/02/14

Total Account Balance

39648049896000001694630502146011

?Sl? 0200 NO ~O l4 04l4i?Ol4 NNNNN/il/N 0004'134 Non•Q lo~

MARIA VICKERS-HENRY 1241 S KIRKMAN RD APT 1145 ORLANDO, FL 32811-2289 ll•1l1•1'•11'·'ll1•l11111111111 11•1•11••111"'1'''1·1'11l•l'l'111

~~FLORIDA II~ HOSPITAL

H1>mon Re$Ollf~<!'S Re(fi.litment 5.,,..,:;,., C<i11t<>r 71 l E Mt~n\Wtc Onve SuiH ·~00 A!T,irrm'l:~Spri11q: .. FL .'lJ1o·~ !-<m: 200· ns~ ·

Humlll'l ll:c!Qurc;cs lldmi1'is1r111ivc Olfo.1c ~OOW.nd~'!o:-;1'1~<'' $v•t•O 1500 Mn11l~<1:rl,FL ~;751 (401: :200-?4'>4

FH Altomonte Hmru:iO.;w,.'.l1:rcu Wt€ /\ltJ:n~ni<!- ;)1i1·1' Alt""1[,fltl'S;mn~~ •t :;,:.(11 (!-O'l\303·~.700frt H;.~

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FH !;.lS! Orl~1>d() Hurl'.~n <lt•V"'"~' -,.;)" L~k<~'lnrlNh.l'fo:1• Orhr-clv.l'l ~J:.;;:./ MOi; 30~·<>;C)

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Operate-cl by the S~venth·day Adventist Church

Thursday, May 01, 2014

FLORIDA HOSPITAL EtviPLOYMENT VERIFICATION

To Whom It May Concern:

Page 1of1

Please be advised that Maria Vickers-hemy is an active employee with Florida Hospital. Maria was hired on 1/9/2012 and is currently working as a Billing Representative-pfo in a full-time position earning $12.81 per hour

Sincerely,

Human Resources Administration Florida Hospital

https ://sba2 .floridahospital .. org/hI/voe/Public/PrintHTML .aspx 5/112014

HR Online Personal Info - View Paycheck Page 1 of 1

/;;\ Print Close -AHS-5 INC OBA FLORIDA HOSPITAL 00000000

DATE EARNINGS STATEMENT FOR 04/25/2014 PAY PERIOD 09 ENDING 04/19/2014

( ···-·--·-·-··--··· ·-·--.. --.. ···-···-···-···· EMPLOYEE ··-·· .. -·-----·-.. ··-.. --... ·-····---···--· .. ) STATE (···DEPENDENTS···) EMPLOYEE ID NAME LOC DEPT ID FEDERAL STATE

VICKERS-HENRY.MARIA RENEE 77 9349 FL 2/M

RE!Z RATE DIF-2 RATE Q!E::l..Bfil WI< RATE orr RATE POO PQT EICAGROS§

12 810 1.665 1 922 1 665 19 215 9 00 9,921.10

* * PDO BANK*" ELIGIBLE FOR 75~ C/ISH O!,!T T~I§ YEAR: .00 = .00 HR

QLD BALANQE CURR AQQR!,!AL CURR !,!§A!ZE CURR SQLD @75% * *"" NEW§ALANQE *" * *

368 92 90 53 54.57 00 404 88

28.80 HR 7.07 HR 4.26 HR .00 PD 31.61 HR - -• • TOT i,. PQQ AVAILABLE • •

404 88

31.61 HR ,____ """"*"*"*"******EARNINGS******"*"""""*"" "* * * "* *"" DEDUCTIONS ................

PAYMENT CURRENT YEAR TO DATE DEDUCTION CURRENT YTD TYPE HOURS AMOUNT HOURS AMOUNT TYPE AMOUNT AMOUNT EMP BONU 222.07 FEDERAL TAX 46 11 403 94 REGULAR 74 27 951 40 587 82 7529 98 FICATAX 83 39 758.97 OVERTIME 1 47 28.24 17 55 337 16 STATE TAX

PDO USED 4 26 54 57 42 83 548.70 STATE TAX(2)

AD-OPT 32 31 290 79 COUNTY TAX

PERF-PAY 225 00 CITY TAX

BEREAVE 48 00 614 88 GIFTCERF 25.00 165 00 GIFTCERF 25 00 165 00 LIFE INS 1 56 12 48 'TOTAL• 80 00 1091 52 696 20 9933 58 DPND LI/AT 3 01 24 08

SUPL LI/AT 210 16 80 TOTAL NET PAY 205 09 NET PAY-DD1 930 35 834722

.. TOTAL•• 1091 52 9728 49 •AVERAGE 13 33

-

••••ALL PDO HOURS ARE COMPUTED BASED ON CURRENT (REGULAR) RATE•••• ''"ALL PDO SOLO IS REMOVED FROM BANK AT 100% AND PAID AT 75% "''

$930 35 DEPOSITED ACCT WELLS FARGO BANK

https://public .. floridahospitaLorglHROnline/personalinfo/paycheck?DEBUG=.... 5/ 1/2014

HR Online Personal Info - View Paycheck Pagel of I

G;J Print Close --AHS-S INC OBA FLORIDA HOSPITAL 00000000

DATE EARNINGS STATEMENT FOR 04/11/2014 PAY PERIOD 08 ENDING 04/05/2014 (-··--·-··-·-··-····-.. ···-· .. ··---···········EMPLOYEE·--.. --.. ·---·--···-· .. ··-···· .... - •• - .• ·--···) STATE ( ...... DEPENDENTS .... )

EMPLOYEE ID NAME LOC DEPT ID FEDERAL STATE

VICKERS-HENRY.MARIA RENEE 77 9349 FL 2/M

REG RATE DIF-2 RATE DIF-3 RATE WK RATE QrT RATE PDOPCT FIQA~RQSS

12 810 1 665 1 922 1 665 19 215 9.00 8,831.14

-* * PDO BANK** ELIGIBLE FOR 75'b CASH OUT THIS YEAR: .QO - .QQ HR

OLD BA~A~Qg QWRB AQQBWti• QWRR WSA~£ Q!:.!RR SOLD @7Q~ •***NEW BALANQE *"' * * 276 69 92.23 00 00 368 92

21.60 HR 7.20 HR .00 HR .00 PD 28.80 HR

• • TQTA• PQQ AVAILABL~ •'

368.92

28.80 HR "***************EARNINGS ..................... .. ,. ••• * ••• DEQUCTIONS . .............

PAYMENT CURRENT YEAR TO DATE DEDUCTION CURRENT YTD TYPE HOURS AMOUNT HOURS AMOUNT TYPE AMOUNT AMOUNT EMP BONU 222.07 FEDERAL TAX 60 72 357 83 REGULAR 5643 722 87 513 55 6578 58 FICATAX 94 56 675 58 OVERTIME 16 08 308 92 STATE TAX

PDO USED 38 57 494.13 ST ATE T AX(2)

AD-OPT 32.31 258 48 COUNTY TAX

PERF-PAY GITTo')'*' 225 00 CITY TAX

24.00 'fi -----..:..-·

48.00 { BEREAVE 307 44 614 88 GIFTCERF 140 00 ----· .... --· ---· GIFTCERF 140 00 LIFE INS 1 56 10 92 *TOTAL* 80 43 1237 62 616 20 8842 06 DPND LI/AT 3 01 21 07

SUPL LI/AT 2 10 14 70 TOTAL NET PAY 205.09 NET PAY-DD1 1075 67 7416 87

0 TOTAL ** 1237 62 8636.97 'AVERAGE 16 48 ____ .. ____

-

••••ALL PDO HOURS ARE COMPUTED BASED ON CURRENT (REGULAR) RATE•••• ••••ALL PDQ SOLD IS REMOVED FROM BANK AT 100% AND PAID AT 75% ••••

- --$1,07567 DEPOSITED ACCT WELLS FARGO BANK

https://public .floridahospital .org/HROnline/personalinfo/paycheck?DEBU G=.. . 5/1/2014

Vickers-Henry, Maria

From: Sent: To: Subject:

I told you not to worry

Thank You,

Jason S. Henry

Henry, Jason S [Jason S Henry@disney com] Thursday, September 12, 2013 2:28 PM Vickers-Henry, Maria FW: ACTION REQUIRED: WDW Family Center Scholarship - Renewal Confirmation - Lake Buena Vista - Jason Henry

From: WDW Family Center Scholarships Sent: Thursday, September 12, 2013 2: 23 PM To: Henry, Jason s .. Cc: WDW Family Center Scholarships; [email protected] Subject: ACTION REQUIRED: WDW Family Center Scholarship - Renewal Confirmation - Lake Buena Vista ·· Jason Henry

Dear Jason:

Thank you for submitting an application for the Walt Disney World® Resort Scholarship Program for the YMCA Family Centers!

We are happy to inform you that according to your application and documentation, you meet the guidelines for eligibility to renew your existing scholarship at a daily rate of H~:.60 .P'-:!:.9~X1.,p.<:r.,,f:QU9<' effective Sunday, September 15, 2013 '"····Ab:@iii:" .. , •.•. t .. •."»A'""'··AA· .. ' '''"

Jn order for the renewal of your scholarship to be active, please complete the following step:

* Print, sign and return the attached agreement form to Cast Activities, Events & Recognition by Friday, September 20, 2013

* Via interof

1

Make a Payment Page 1of1

PROGREIIll/E

Common Questions

When will my online payment be posted'? Online payments are honored the day they are submitted If requested, you will receive a printable email confirmation

Can I make a payment using two different accounts on the same day? You can make only one online check payment per policy per day If splitting payment between tWo checking accounts, it must be done over two days However1 payment can be made using more than one method (e g $100 from your checking account and $100 from a credit card )

How do I know this payment is secure'? Every page on our Web site has a digital certificate by RSA Data Security/Secure Server CA We use Secure Sockets Layer (SSL) and 128-bit encryption

Make a Payment

Review billing snapshot Last payment received: '·$1,280.11 on 04/22/2014 This policy is paid in full, thank you. No payment is due.

https:/ /onlineservice-yourpolicy5 .,progressive,,com/scripts!Display Page.,aspx? . 5/1/2014

STATE OF FLORIDA FLORIDA ELEC1IONS COMMISSION


TO: Maria Vickers-Herny 1241 S Kirkman Road, Apt 1145 Orlando, FL 32811


Division of Elections 500 S Brnnough Street, Room 316 I allahassee, FL 3 23 99

NOTICE OF HEARING (INFORMAL HEARING)

A hearing will be held in this case before the Flotida Elections Commission on May 6, 2014, at 10:00 am, or as soon thereafter as the parties can be heard, at the following location: Senate Office Bnilding, Room S-110, 404 South Monroe Street, Tallahassee, FL 32399 ..

Failure to appeai in accmdance with this notice will constitute a waiver of your right to participate in the hearing Continuances will be granted only upon a showing of good cause

This hearing will be conducted pursuant to Section 106 .25, Florida Statutes, which governs your participation as follows:

If you are the Respondent, you may attend the hearing, and you 01 your attorney will have 5 minutes to present your case to the Commission However, some cases (including those in which consent orders 01 recommendations for no prnbable cause are being considered) may be decided by an en masse vote and, unless you request to be heard 01 the Commission requests that your case be considered separately on the day of the hearing, your case will not be individually heard.

If you are the Complainant, you may attend the hearing, but you will not be permitted to address the Commission. In addition, some cases (including those in which consent orders or recommendations for no probable cause are being considered) may be decided by an en masse vote and, unless the Respondent requests to be heard or the Commission requests that the case be considered separately on the day of the hearing, the case will not be individually heard.

If you are an Appellant, and you have requested a heating, you may attend the hearing, and you or your attorney will have 5 minutes to present your case to the Commission

Please be advised that both confidential and public cases are scheduled to be heard by the Florida Elections Commission on this date. As an Appellant, Respondent or Complainant in one case, you will not be permitted to attend the hearings on other confidential cases

The Commission will electronically record the meeting. Although the Commission's recording is considered the official recotd of the hearing, the Respondent may provide, at his own expense, a certified court ieporter to also record the hearing

If you require an accommodation due to a disability, contact Donna Malphurs at (850) 922-4539 or by mail at 107 West Gaines Street, The Collins Building, Suite 224, Tallahassee, Florida 32399, at least 5 days befo1e the hearing

See f\Irther instructions on the reverse side.

Jl.Ttry :MCKge11er 'l'oman Executive Director Florida Elections Commission April 16, 2014


Florida Elections Commission, Petitioner,

v,

Maria Vickers-Henry, Respondent.

Case No .. : FEC 13-057

ORDER OF PROBABLE CAUSE

, .. /_

THIS MATTER was hea1d by the Florida Elections Commission (Commission) at its

regularly scheduled meeting on May 7, 2014, in Tallahassee, Floiida

Based on the Complaint, Rep01t of Investigation, Staffs Recommendation, and oral

statements (if any) made at the probable cause hearing, the Commission finds that there is

probable cause to charge Respondent with the following violations:

OPC

Count 1:

On or about January 30, 2013, Respondent violated Section I 06 07(2)(b) I , Florida Statutes, when she failed to make the necessary amendments to Jason Hemy's 2012 QI Repo1t

Count 2:

On 01 about Janua1y 30, 2013, Respondent violated Section 106 .. 07(2)(b)l., Florida Statutes, when she failed to make the necessary amendments to Jason Hemy's 2012 FI Report

Count 3:

On or about January 30, 2013, Respondent violated Section 106 07(2)(b)l, Florida Statutes, when she failed to make the necessary amendments to Jason Henry's 2012 F3 Repo1t

Count 4:

On or about January 30, 2013, Respondent violated Section 106 07(2)(b)l ., Florida Statutes, when she failed to make the necessary amendments to Jason Herny' s 2012 Termination Report

I /

DONE AND ORDEKED by the Florida Elections Commissibu on May 7, 2014

Copies fomished to: Jaakan A Williams, Assistant General Counsel Maria Vickers-Herny, Respondent Kristi Bronson, Complainant

Tim Hollada , Chairman Florida Elections Commissi

NOTICE OFRIGHT TOA HEARING

As the Respondent, you may elect to resolve this case in several ways First, you may elect to resolve this case by consent order where you and Commission staff agree to resolve the violations and agree to the amount of the fine.. The agreed to consent order is then presented to · the Commission for its approval . To discuss a consent order, contact the attorney who signed the Staff Recommendation attached to the Order of Probable Cause

Second, you may request an informal hearing held before the Commission, if you do not dispute any material fact in the Staff Recommendation. You have 30 days from the date of the Order of Probable Cause to request such a hearing At the hearing, you will have the right to make wiitten or oral arguments to the Commission concerning the legal issues related to the violations and the potential fine At the request of Respondent, the Commission will consider and determine willfolness at an informal hearing .. Otherwise, live witness testimony is unnecessary.

Third, you may request a formal hearing held before an administrative law judge in the Division of Administrative Hearings (DOAH), if you dispute any material fact in the Staff Recommendation .. You have 30 days from the date of the Order of P10bable Cause to request such a hearing .. At the hearing, you will have the right to present evidence relevant to the violation(s) listed in this order, to cross-examine opposing witnesses, to impeach any witness, and to rebut the evidence presented against you

If you do not elect to resolve the case by consent order or request a formal hearing at the DOAH or an informal hearing before the Commission within 30 days of the date of this Order of Probable Cause, the case will be sent to the Commission and you will be entitled to a formal or informal hearing ..

To request a hearing, please send a wiitten request to the Commission Clerk, Donna Ann Malphurs. The address of the Commission Clerk is 107 W Gaines Street, Collins Building, Suite 224, Tallahassee, Florida 32399-1050 The telephone number is (850) 922-4539 The Clerk will provide you with a copy of Chapter 28-106, Florida Administrative Code, and other applicable rules upon request No mediation is available

OPC



TO: Maiia Vicke1s-Hemy 1241 South Kirkman Road, Apt 1145 Orlando, Florida 32811-2811


Division of Elections 500 South Bronough St1 eet RA Gray Bldg .. , RM 316 Tallahassee, Flo1ida 32399

NOTICE OF HEARING (PROBABLE CAUSE DETERMINATION}

A hearing will be held in this case before the Florida Elections Commission on May 7, 2014, at 8:30 am, 01 as soon thereafter as the parties can be heard, at the following location: Senate Oflice Building, Room 110-S, 404 South Monroe Street, 1 allahassee, FL 32399 ..

Failure to appear in accordance with this notice will constitute a waiver of your right to participate in the hearing Continuances will be granted only upon a showing of good cause.

This hearing will be conducted pursuant to Section 106..25, Florida Statutes, which governs your participation as follows:

Jfyou are the Respondent, you may attend the hearing, and you or your attorney will have 5 minutes to present your case to the Commission. However, some cases (including those in which consent orders or recommendations for no probable cause are being considered) may be decided by an en masse vote and, unless you request to be heard or the Commission requests that your case be considered separately on the day of the hearing, your case will not be individually heard.

If you are the Complainant, you may attend the hearing, but you will not be permitted to address the Commission. In addition, some cases (including those in which consent orders or recommendations for no probable cause are being considered) may be decided by an en masse vote and, unless the Respondent requests to be heard or the Commission requests that the case be considered separately on the day of the hearing, the case will not be individually heard

If you are an Appellant, and you have requested a hearing, you may attend the hearing, and you or your attorney will have 5 minutes to present your case to the Commission

Please be advised that both confidential and public cases are scheduled to be heard by the Florida Elections Commission on this date. As an Appellant, Respondent or Complainant in one case, you will not be permitted to attend the hearings on other confidential cases

The Commission will electronically record the meeting .. Although the Commission's recording is considered the official record of the hearing, the Respondent may provide, at his own expense, a certified court reporter to also record the hearing

If you require an accommodation due to a disability, contact Donna Ann Malphurs at (850) 922-4539 or by mail at 107 West Gaines Street, The Collins Building, Suite 224, Tallahassee, Florida 32399, at least 5 days before the hearing

See further instructions on the reverse side ..

;I."!)' fMCl(ee11er 'Toman Executive Director Florida Elections Commission April 16, 2014

Please refer to the information below for further instructions related to your particular hearing:

If this is a hearing to consider an appeal from an automatic fine, the Filing Officer has imposed a fine on you for your failure to file a campaign treasurer's report on the designated due date and, by filing an appeal, you have asked the Commission to consider either (1) that the report was in fact timely filed; or (2) that there were unusual circumstances that excused the failure to file the report timely You are required to p10ve your case .. If the Commission finds that the report was filed timely or that there were unusual circumstances that excused the failure, it may waive the fine, in whole 01 in part The Commission may reduce a fine after considering the factors in Section 106 265, Florida Statutes If the Commission finds that the report was not timely filed and there were no unusual circumstances, the fine will be upheld.

If this is a hearing to consider a consent order before a determination of probable cause has been made, the Commission will decide whether to accept or reject the consent order.. If the Commission accepts the consent order, the case will be closed and become public.. If the Commission rejects the consent order or does not make a decision to accept or deny the consent order, the case will remain confidential, unless confidentiality has been waived

If this is a hearing to consider a consent order after a determination of probable cause has been made, the Commission will decide whether to accept or reject the consent order . If the Commission accepts the consent order, the case will be closed .. If the Commission rejects the consent order or does not make a decision to accept or deny the consent order, the Respondent will be entitled to another hearing to determine if the Respondent committed the violation(s) alleged

If this is a probable cause hearing, the Commission will decide if there is probable cause to believe that the Respondent committed a violation of Florida's election laws Respondent should be prepared to explain how the staff in its recommendation inconectly applied the law to the facts of the case .. Respondent may not testify, call others to testify, or introduce any documentary or other evidence at the probable cause hearing The Commission will only decide whether Respondent should be charged with a violation and, before the Commission determines whether a violation has occurred or a fine should be imposed, Respondent will have an opportunity for another hearing at which evidence may be introduced

If this is an informal hearing, it will be conducted pursuant Sections 120.569 and 120.57(2), Florida Statutes; Chapter 28 and Commission Rule 2B-1 .004, Florida Administrative Code At the hearing, the Commission will decide whether the Respondent committed the violation(s) charged in the Order of Probable Cause The Respondent will be permitted to testify. However the Respondent may not call witnesses to testify

Respondent may argue why the established facts in the Staff Recommendation do not support the violations charged in the Order of P10bable Cause. At Respondent's request, the Commission may determine whether Respondent's actions in the case were willful The Respondent may also address the appropriateness of the recommended fine If Respondent claims that his limited resources make him unable to pay the statutory fine, he must provide the Commission with written proof of his financial resources at the hearing A financial affidavit form is available from the Commission Clerk.

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In Re: Maria Vickers-Henry Case No.: FEC 1.3-057

STAFF RECOMMENDATION FOLLOWING INVESTIGATION

Pmsuant to Section 10625(4)(c), Florida Statutes, undersigned staff counsel files this written recommendation for disposition of the refenal in this case recommending that there is prnbable cause to charge Respondent with violating Section 106.07(2)(b)l., Florida Statutes .. Based upon a thorough review of the Report of Investigation submitted on January 23, 2014, the following facts and law support this staff recommendation:

1. On January 30, 2013, the Florida Elections Commission ("Commission") received a referral from the Department of State, Division of Elections ("Division"), alleging that Maria Vickers-Herny ("Respondent") violated Chapter 106, Florida Statutes

2 Respondent was Treasurer for Jason Herny, a candidate for State Representative, District 46, during the 2012 election cycle (ROI Exhibit 3) 1

3. By letter dated November 27, 2013, the Executive Director notified Respondent that Commission staff would investigate the following statutory provision:

Section 106.07(2)(b)l., Florida Statutes: Maria Vickers-Herny, tteasmer for Jason Herny, candidate for State Representative, District 46, during the 2012 election cycle, failed to make necessary amendments to the 2012 Ql Report, as alleged in the complaint

Section 106.07(2)(b)l., Florida Statutes: Maria Vickers-Herny, treasurer for Jason Herny, candidate for State Representative, District 46, during the 2012 election cycle, failed to make necessary amendments to the 2012 FI Report, as alleged in the complaint

Section 106.07(2)(b)l., Florida Statutes: Maria Vickers-Herny, treasmer for Jason Herny, candidate for State Representative, District 46, dming the 2012 election cycle, failed to make necessary amendments to the 2012 F3 Report, as alleged in the complaint

1 Report oflnvestigation referred to herein as "ROI "

Staff Recommendation FEC 13-057 1

Section 106 .. 07(2)(b)L, Florida Statutes: Maiia Vickers-Henry, treasurer for Jason Henry, candidate for State Representative, District 46, during the 20 I 2 election cycle, failed to make necessary amendments to the 20 I 2 I ermination Report, as alleged in the complaint

4. Jason Herny filed State of Florida Appointment of Campaign Treasurer and Designation of Campaign Depository for Candidates forms ("DS-DE 9") on April 16, 2012, and May I8, 2012, and appointed Respondent as his campaign treasure1 On June 8, 20I2, Jason Henry filed a third DS-DE 9 fo1m and appointed himself as deputy treasmer (ROI Exhibit 3, pages 2, 3 and 5)

2012 01 Report

5 On April IO, 20I2, Respondent timely filed Mr Henry's 2012 QI Report, but the Division determined the report was incomplete By letters dated June 28, 2012, July 25, 20I2, August 3, 20I2, and October I9, 20I2, the Division notified Respondent that the report was incomplete and needed to be amended All four letters informed Respondent that she had 7 days from receipt of the notice to file an amended report Attached to the letters was a report listing the errors that needed to be conected .. (See Attachment "A", ROI Exhibits 4, 5, 6 ,7 and 1 I)

6 On August 24, 2012, the Division sent Respondent an email reminder regarding the enors that needed to be conected on Mr Hemy's 20I2 QI Report Ms Holdeen stated in the email that she included copies of the notices that were previously mailed to Respondent about Mr Hemy's outstanding campaign report. (ROI Exhibit 8)

7. By letter dated September 20, 20I2, the Division mailed a Final Notice to Mr Henry's address listed on his DS-DE 9 forms; however, the letter does not appear to have been mailed to Respondent The Final Notice to Jason Herny was mailed via certified mail, with delivery confirmation, informing him that he had 7 days to file an amended 2012 QI Report An error report was attached to the letter.. (ROI Exhibit 3, pages 2, 3, and 5 & ROI Exhibit I 0)

8 By email dated December 20, 2012, Ms. Theresa Holdeen from the Division sent Respondent an email to the email address listed on the May 18, 2012 DS-DE 9 form informing her that Mr Henry's 20I2 QI Report still needed to be amended Attached to the email were "screen shots" of the items that needed correcting and instructions on how to make the corrections (ROI Exhibit 13, pages I- 4 and 6)

9 Despite having received five written notices and two email reminders from the Division, Respondent still has not filed an amended 2012 QI Report (See Attachment "B")

2012 Fl Report


10.. Respondent filed Mr Henry's 2012 Fl Report on July 14, 2012; however, the report was incomplete. (See Attachment "A")

11 By letters dated July 18, 2012, August 3, 2012, and October 19, 2012, the Division notified Respondent that Mr .. Henry's 2012F1 Report was incomplete and needed to be amended. All tluee letters informed Respondent that she had 7 days from receipt of the notice to file an amended report An error report was attached to each lettet listing the items that needed to conected. (ROI Exhibits 11, 16 and 17)

12 On August 24, 2012, the Division sent Respondent an email reminder regarding the enots that needed to be corrected on Mr.. Henry's 2012F1 Repott. In the email, Ms .. Holdeen stated that copies of the notices previously mailed to Respondent about the outstanding campaign repott were included (ROI Exhibit 8)

13 By letter dated Septembet 20, 2012, the Division mailed a Final Notice letter to Jason Henry via cettified mail, with delivery confitmation, infotming him that he had 7 days to file an amended 2012F1 Repott The letter does not appear to have been mailed to Respondent The Final Notice letter was mailed to Mt Henry's addtess listed on his DS-DE 9 fotms (ROI Exhibit 3, pages 2, 3 and 5 & ROI Exhibit 10)

14 By email dated December 20, 2012, Ms. Theresa Holdeen sent Respondent an email to the addtess listed on the May 18, 2012 DS-DE 9 form The email explained that Mt Henry's 2012 Fl Repott still needed to be amended. Attached to the email were "screen shots" of the items that needed correcting and instrnctions on how to make the conections (ROI Exhibit 13, pages 1-6)

15. Despite having received three wtitten notices and two email reminders fl om the Division, Respondent still has not filed Mr Henry's amended 2012 Fl Repott (See Attachment

2012 F3 Report

16 Respondent filed Mt .. Henry's 2012 F3 Report on August 10, 2012; however, the report was incomplete (See Attachment "A")

17. By letters dated September 20, 2012, and October 22, 2012, the Division informed Respondent that Mr Henry's 2013 F3 Report was incomplete and needed to be amended. Both letters infotmed Respondent that she had 7 days from receipt of the notice to file an amended report, and both letters contained a list of the errors that needed to be conected (ROI Exhibits 21 and 22)

18 By email dated December 20, 2012, Ms Theresa Holdeen sent Respondent an email to the email address listed on the May 18, 2012 DS-DE 9 form The email explained that Mr.. Henry's 2012 F3 Report still needed to be amended The email stated that "screen shots" of the items that needed conecting and instructions on how to make the corrections were attached to the email.. (ROI Exhibit 23)


19.. Despite having received two written notices and an email reminde1 from the Division, Respondent still has not filed M1 Berny's amended 2012 F3 Repo1t (See Attachment "B")

2012 Termination Report

20. Respondent filed Mr Berny's 2012 Te1mination Report on Decembe1 6, 2012 (See Attachment "A")

21 By letter dated Decembe1 6, 2012, the Division informed Respondent that M1 Berny's 2012 Termination Repo1t was incomplete and needed to be amended.. The lette1 informed Respondent that she had 7 days from receipt of the notice to file an amended report. The letter also contained a list of the enors that needed to be corrected (ROI Exhibit 26)2

22. By email dated Decembe1 20, 2012, Ms Theresa Holdeen sent Respondent an email to the email address listed on the May 18, 2012 DS-DE 9 fo1m The email explained that Mr.. Henry's 2012 F3 Report still needed to be amended The email stated that it contained "screen shots" of the items that needed correcting and instructions on how to make the corrections .. (ROI Exhibit 23)

23. Despite having 1eceived a Wlitten notice and an email 1eminde1 from the Division regarding the outstanding enors listed on M1 Berny's 2012 Termination Repo1t, Respondent still has not filed the requested amendments .. (See Attachment "B")

24. ''Probable Cause" is defined as reasonable grnunds of suspicion supported by circumstances sufficiently strnng to warrant a cautious person in the belief that the person has committed the offense chaiged. Schmitt v State, 590 So . .2d 404, 409 (Fla 1991) Probable cause exists whe1e the facts and circumstances, of which an [investigator] has ieasonably trustwo1thy info1mation, aie sufficient in themselves fo1 a reasonable man to reach the conclusion that an offense has been committed Department of Highway Safety and Motor Vehicles v Favino, 667 So.2d 305, 309 (Fla .. I" DCA 1995).

25 The facts set forth above show that Respondent was the campaign treaswe1 for Jason Samuel Henry, a candidate for Flo1ida House of Representatives, District 46, dwing the 2012 election cycle .. Respondent filed incomplete campaign treasurer 1eports fo1 ML Henry's 2012 QI Repo1t, 2012 Fl Report, 2012 F3 Repo1t, and 2012 Te1mination Report. Despite having received multiple written notifications and email 1eminders from the Division, Respondent still has not filed amended cainpaign 1epo1ts fo1 Mr. Henry's 2012 QI Report, 2012 Fl Report, 2012 F3 Repo1t, and his 2012 Termination Report

Based upon these facts and ci1 cumstances, I 1 ecommend that the Commission find probable cause to charge Respondent with violating the following statutory provision:

2 It appears that the campaign may have accepted more contributions than it made expenditures, which could be a

separate violation of Chapter 106, F S , but that is not an allegation stated in the complaint (ROI Exhibit 26, page 3 .)


Count 1:

On or about January 30, 2013, Respondent violated Section 106 07(2)(b)l, Florida Statutes, when she failed to make the necessary amendments to Jason Berny's 2012 Ql Report

Couut2:

On or about January 30, 2013, Respondent violated Section 106.07(2)(b)l, Florida Statutes, when she failed to make the necessary amendments to Jason Berny's 2012F1 Report

Count3:

On or about January 30, 2013, Respondent violated Section 106 .. 07(2)(b) 1 , Florida Statutes, when she failed to make the necessary amendments to Jason Henry's 2012 F3 Repo1t

Count 4:

On or about Januaiy 30, 2013, Respondent violated Section 106 .. 07(2)(b) 1., Florida Statutes, when she failed to make the necessa1y amendments to Jason Berny's 2012 I ermination Repo1t

Staff Recommendation FEC 13-057

Respectfolly submitted on Febrnary ~ 2014

Jaakan A Williams Assistant Geneial Counsel

5

FEC - Candidate/Committee Filing Histoiy Report (' '

M/Flo~'·"'"' .• search I directory I contact us 1 411 1 subscribe I tour I help

Florida Department of State - Division of Elections Florida Election System Reports

Candidate/Committee Lookup Candidate Name: Jason Henry ··-------·-

Name: Account: 5554 7

Election: Date Due Type Date Status Days Fine

Filed Late Assessed 11/12/2012 TR 12/6/2012 SNT 24 $144 50 ----

Acct· 55547 8/10/2012 F3 8/10/2012 7/27/2012 F2 7/27/2012

Type: Candidate 7/13/2012 F1 7/14/2012 DFS $50 00

r-.Searc.ti: 11.R~.set I 4/10/2012 01 4/10/2012 1/10/2012 04 1/7/2012

ATTACHMENT

Page 1 of 1

Appealed Amount Amount Fined Paid

$144.50 $0 00

$50 00 $0 00

https://doesecure dos . .state .. fl .us/fec/F ilingHistory Asp? AcctNum=55547 &cboElection=&c 2/13/2014

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RE: FEC 13-057 - status of addendums Bronson, Kristi R to: Donna Malphurs 11/08/2013 12:11 PM Show. Details

Secmity:

Page I of I

To ensure privacy, images fiom remote sites were prevented from downloading.. Show Images

No changes have been made

Rega11ls,

Kristi Reid Broman, Chief Division ofE/ectiom, Bureau of Election Records (850) 245-6240

From: Donna Malphurs [mailto:[email protected]] Sent: Wednesday, November 06, 2013 12:13 PM To: Bronson, Kristi R Subject: FEC 1.3-057 ·· status of addendums

Ktisti,

Have the addendums to Jason Hemy's [ID# 55547] 2012 QI; Fl; F3 and IR reports been filed? If yes, please provide us copies of the report addendums Are these reports "complete"? Please advise. Thank you

Donna Ann Malphurs, Agency Clerk Florida Elections Commission 850-922-4539 x 102

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[ ·g_ What's Working Today I -···, . . I The Department of State is leading the commemoration of :.>.:. VivaFlorida500 Florida's 500th anniversary in 2013 For more information, ~-----~ please go to http://www.vivaflorida.org

The Department of State is committed to excellence Please take our Customer Satisfaction Survey

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FEC 13-057 - status of addend urns Donna Malphurs to: Bronson, Kristi R Bee: Donna Malphurs

From: Donna Malphurs/OAG To: "Bronson, Kristi R " <KRBronson@dos .state fl .us>

. Bee: Donna Malphurs/OAG

' I

11/06/201312:13 PM

_,,,M--.~A~'~'''"''"~'~*·-~·--·~•<¥<-~-~~---·~··~~·,e---~~~·~--~M'-"•-------·---·· ----------~-

Kristi,

Have the addendums to Jason Henry's [ID# 55547] 2012 01; F1; F3 and TR reports been filed? If yes, please provide us copies of the report addendums Are these reports "complete"? Please advise .. Thank you.

Donna Ann Malphurs, Agency Clerk Florida Elections Commission 350-922-4539 x 102

(

I

FLORIDA ELECTIONS COMMISSION REPORT OF INVESTIGATION


Respondent: Maria Vickers-Henry Counsel for Respondent: n/a

Complainant: Division of Elections Counsel for Complainant: n/a

Pursuant to Section 10625, Florida Statutes, on January 30, 2013, the Flmida Elections Commission received information from the Division of Elections that Respondent violated Chapter 106, Florida Statutes The Division's 1efonal was mandated pursuant to Section 106..07(8)( d), Florida Statutes Commission staff investigated whethe1 Respondent violated the following statute:

Section 106.07(2)(b)l, Florida Statutes, failure of the treasurer ofa candidate to file an addendum to an incomplete report after receiving notice from the filing officer

I. Preliminary Information:

1. Respondent served as the campaign treasurer to her husband, Jason Hemy's, 2012 election campaign fo1 State Rep1esentative, District 46 Mr Herny lost his election bid

2. Complainant is the Division of Elections.

J. Respondent's filing officer is Kristi Reid-Bronson, Chief, Bureau of Election Reco1ds

II. Alleged Violation of Section 106.07(2)(b)l, Florida Statutes:

4 I investigated whether Respondent violated this section of the election laws by failing to file addendums to the 2012 Ql, 2012 Fl, 2012 F3, and the 2012 Termination Reports (TR), after receiving notices that they were incomplete

5.. A DOE staff representative, Theresa Holdeen, submitted a swom affidavit dated January 29, 2013 regarding Respondent's failure to file addendums to the 2012 Ql, 2012 Fl, 2012 F3, and 2012 TR Reports and her failure to provide a wtitten explanation as to why no addendums have been filed To review the January 29, 2013 sworn affidavit, refer to exhibit 1.

6 On November 18, 2011, the candidate filed his original Appointment of Campaign Treasurer and Designation of Campaign Depository form (DS-DE 9) with his filing officer The candidate appointed himself as his own deputy treasurer To review a copy of the candidate's November 18, 2011 original DS-DE 9 form, refor to exhibit 2

7 On April 16, 2012, the candidate officially appointed Respondent as his campaign treasure1 To review copies of the candidate's April 16, 2012 DS-DE 9 forms, refor to exhibit 3

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i

2012 01 Report

8.. On Ap1il 10, 2012, Respondent filed an original 2012 QI Report with her filing officer Respondent repo1ted receiving cont1ibutions totaling $2,610.00, while making expenditmes totaling $33 L66 du1ing this repo1ting pe1iod To 1eview a copy of the oiiginal 2012 QI Repo1t, refer to exhibit 4

9 On June 28, 2012, Complainant mailed Respondent an incomplete-audit letter regarding the 01iginal 2012 QI Repo1t This letter included an error 1epo1t that detailed the information that Respondent needed to amend.. This letter was mailed to the address that the candidate provided on his DS-DE 9 fotm (Exhibit 3}. To review a copy of the June 28, 2012 incomplete-audit letter with enor repo1t, refer to exhibit 5

I 0. On July 25, 2012, Complainant mailed Respondent a second incomplete-audit letter 1egarding the oiiginal 2012 QI Repott This letter also included an eno1 report that detailed the information that Respondent needed to amend. This letter· was also mailed to the address the candidate provided on his DS-DE 9 form (Exhibit 3}. To review a copy of the July 25, 2012 incomplete-audit letter with e1ror report, refer to exhibit 6 ..

11. On August 3, 2012, Complainant mailed Respondent another incomplete-audit letter regarding the original 2012 QI Repo1t. This letter also included an enot report that detailed the information that Respondent needed to amend. This letter was also mailed to the address the candidate ptovided on his DS-DE 9 fo1m (Exhibit 3). To review a copy of the August 3, 2012 incomplete-audit lette1 with enor repo1t, refer to exhibit 7

12.. On August 24, 2012, Complainant sent Respondent an incomplete-audit email regarding the 2012 QI Repott This email included copies of incomplete-audit letters that had been previously sent to Respondent This email was sent to the email address that the candidate provided on his DS-DE 9 fotm (Exhibit 3). To review a copy of the August 24, 2012 incomplete-audit email, refe1 to exhibit 8 ..

13 On September 11, 2012, Respondent filed an amended 2012 QI Report with the filing officer Respondent repo1ted receiving contributions totaling $2,610 00, while making expenditures totaling $33 L66, and itemized distributions totaling $206.00 during this 1ep01ting peiiod To review a copy of the amended 2012 QI Repo1t, refer to exhibit 9

14 On September 20, 2012, Complainant mailed the candidate a ce1tified mail final notice regarding the incomplete 2012 QI Repmt This final notice included a copy of the eno1 repo1t detailing the info1mation that Respondent needed to amend.. This ce1tified letter was sent to the address the candidate provided on his DS-DE 9 fmm (Exhibit 2). To review a copy of the September 20, 2012 final notice, iefer to exhibit I 0

15 On October 19, 2012, Complainant mailed Respondent an incomplete-audit letter regarding the amended 2012 QI Repo1t. This letter included a copy of the e1ror report detailing the infotmation that Respondent needed to amend. This letter was sent to the address the candidate provided on his DS-DE 9 form (Exhibit 3). To review a copy of the October 19, 2012 incomplete-audit letter, 1efe1 to exhibit 11

16 On December 6, 2012, Complainant mailed Respondent another incomplete-audit

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letter regarding the amended 2012 QI Report1 This letter included a copy of the error report detailing the information that Respondent needed to amend This letter was sent to the address the candidate provided on his DS-DE 9 form (Exhibit 3) To review a copy of the December 6, 2012 incomplete-audit letter, refer to exhibit 12

17. On December 20, 2012, Complainant sent Respondent an incomplete-audit email that summruized all of the information that Respondent needed to runend on all of his filed reports This email included a copy of the error report detailing the information that Respondent needed to amend.. This email was sent to the email address that the candidate provided on his DS-DE 9 form (Exhibit 3). To review a copy of this December 20, 2012 incomplete-audit email summary and candidate response, refer to exhibit 13

18.. As of the date of this report, there is no record that Respondent has filed a complete 2012 QI Report without any errors, or provided a written explanation regarding the same.. To review a copy of Respondent's 2012 QI filing history, refer to exhibit 14.

2012 Fl Report

19 On July 14, 2012, Respondent filed an original 2012 Fl Report with the filing officer Respondent reported receiving contributions totaling $2,560 00, while making expenditures totaling $2,937.72 during this reporting period To review a copy of the original 2012 FI Report, refer to exhibit 15

20 On July 18, 2012, Complainant mailed Respondent an incomplete-audit letter regarding the original 2012 Fl Report This letter included an error report that detailed the information that Respondent needed to amend.. This letter was mailed to the address that the candidate provided on his DS-DE 9 form (Exhibit 3) To review a copy of the July 18, 2012 incomplete-audit letter with error report, refer to exhibit 16

21 On August 3, 2012, Complainant mailed Respondent a second incomplete-audit letter regarding the original 2012 FI Report This letter also included an error report that detailed the information that Respondent needed to amend.. This letter was also mailed to the address the candidate provided on his DS-DE 9 form (Exhibit 3).. To review a copy of the August 3, 2012 incomplete-audit letter with enor report, refer to exhibit 17.

22 On August 24, 2012, Complainant sent Respondent an incomplete-audit email regarding the 2012 FI Report This email included copies of incomplete-audit letters that had been previously sent to Respondent This email was sent to the email address that the candidate provided on his DS-DE 9 form (Exhibit 3). To review a copy of the August 24, 2012 incomplete-audit email, refer to exhibit 8

23 On September II, 2012, Respondent filed an amended 2012 Fl Report with the filing officer Respondent reported receiving contributions totaling $2,560 00, while making expenditures totaling $2,937.72, and other itemized distributions totaling $163 .73 during this reporting period Io review a copy of the runended 2012 Fl Report, refer to exhibit 18

1 These letters were not claimed by Respondent These letters were returned to Complainant due to the PO Box closing The mail was stamped "return to sender/unable to forward" Attachment A

lnv002 (7/08) 3

24. On September 20, 2012, Complainant mailed the candidate a certified mail final notice regarding the amended 2012 F 1 Report. This final notice included a copy of the error report detailing the information that Respondent needed to amend This certified letter was sent to the address the candidate provided on his DS-DE 9 form (Exhibit 2). To review a copy of the September 20, 2012 final notice, refer to exhibit 10

25. On October 19, 2012, Complainant mailed Respondent mailed an incomplete-audit letter regarding the amended 2012 Fl Report This letter included a copy of the error report detailing the information that Respondent needed to amend This letter was sent to the address the candidate provided on his DS-DE 9 form (Exhibit 3).. To review a copy of the October 19, 2012 incomplete-audit letter, refer to exhibit 1 L

26 On December 6, 2012, Complainant mailed Respondent another incomplete-audit letter regarding the incomplete 2012 Fl Report2 This letter included a copy of the error report detailing the information that Respondent needed to amend. This letter was sent to the address the candidate provided on his DS-DE 9 form (Exhibit 3).. To review a copy of the December 6, 20!.2 incomplete-audit letter, refer to exhibit 12

27 On December 20, 2012, Complainant sent Respondent an incomplete-audit email that summarized all of the information that Respondent needed to amend on all of his filed reports.. This email included a copy of the error report detailing the information that Respondent needed to amend This email was sent to the email address that the candidate provided on his DS-DE 9 form (Exhibit 3) .. To review a copy of this December 20, 2012 incomplete-audit email summary and candidate response, refer to exhibit 13.

28.. As of the date of this report, there is no record that Respondent has filed a complete 2012 F 1 Report without any errors, or provided a written explanation regarding the same To review a copy of Respondent's 2012F1 filing history, refer to exhibit 19

2012 F3 Report

29.. On August 10, 2012, Respondent filed an original 2012 F3 Report with the filing officer.. Respondent reported receiving contributions totaling $2,350 00, while making expenditures totaling $3,69022. To review a copy of the original 2012 F3 Report, refer to exhibit 20.

30.. On September 20, 2012, Complainant mailed Respondent an incomplete-audit letter regarding the original 2012 F3 Report. This letter included an error report that detailed the information that Respondent needed to amend.. This letter was mailed to the address that the candidate provided on his DS-DE 9 form (Exhibit 3). To review a copy of the September 20, 2012 incomplete-audit letter with error report, refer to exhibit 21

31. On October 22, 2012, Complainant mailed Respondent a second incomplete-audit letter regarding the original 2012 F3 Report This letter also included an error report that detailed the information that Respondent needed to amend This letter was also mailed to the

2 These letters were not claimed by Respondent. These letters were returned to Complainant due to the PO Box closing. The mail was stamped "return to sender/unable to forward .... Attachment A

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address the candidate provided on his DS-DE 9 form (Exhibit 3) To review a copy of the October 22, 2012 incomplete-audit letter with error report, refer to exhibit 22

32. On December 5, 2012, Complainant sent Respondent an incomplete-audit email regarding the 2012 F3 Report This email included copies of incomplete-audit letters that had been previously sent to Respondent This email was sent to the email address that the candidate provided on his DS-DE 9 form (Exhibit 3). To review a copy of this December 5, 2012 incomplete-audit email, refer to exhibit 23.

33 On December 20, 2012, Complainant sent Respondent an incomplete-audit email that summarized all of the information that Respondent needed to amend on all of his filed reports.. This email included a copy of the error report detailing the information that Respondent needed to amend.. This email was sent to the email address that the candidate provided on his DS-DE 9 form (Exhibit 3). To review a copy of this December 20, 2012 incomplete-audit email summaiy and candidate response, refer to exhibit 1.3

34 As of the date of this report, there is no record that Respondent has filed a complete 2012 F3 Report without any errors, or provided a written explanation regarding the same To review a copy of Respondent's 2012 F3 filing history, refer to exhibit 24 ..

2012 TR Report

35 On December 6, 2012, Respondent filed an original 2012 IR Report with the filing officer Respondent reported receiving contributions totaling $50 00, while making expenditures totaling $577.99. Io review a copy of the original 2012 TR Report, refer to exhibit 25

36. On December 6, 2012, Complainant mailed Respondent an incomplete-audit letter regarding the original 2012 IR Report This letter included an enor report that detailed the information that Respondent needed to amend. This letter was mailed to the address that the candidate provided on his DS-DE 9 form (Exhibit 3). To review a copy of the December 6, 2012 incomplete-audit letter with error report, refer to exhibit 26

37.. On December 20, 2012, Complainant sent Respondent an incomplete-audit email that summarized all of the information that Respondent needed to amend on all of his filed reports This email included a copy of the error report detailing the information that Respondent needed to amend. This email was sent to the email address that the candidate provided on his DS-DE 9 form (Exhibit 3).. To review a copy of this December 20, 2012 incomplete-audit email summary and candidate response, refer to exhibit 13..

38 As of the date of this report, there is no record that Respondent has filed a complete 2012 IR Report disclosing the disposition of all surplus funds, or provided a written explanation regaiding the same. Io review a copy of Respondent's 2012 TR filing history, refer to exhibit 27

39 There is no record that Respondent has previously violated this section of the election laws ..

III. FEC History:

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40 None

Conclusfon:

41. In a final inteiview on Januaiy 21, 2014, Respondent was offered an opportunity to make comments regaiding the findings of this investigation.. Respondent advised me that she was aware of this investigation Respondent states that this was her first time working on a election campaign In Octobet of 2013, Respondent states that she was instructed by the DOE staff NOT to file any reports until she was notified othetwise by the DOE staff3 Respondent states that she will contact DOE today to amend all of the necessary reports ..

42 In a November 21, 2011 acknowledgement letter, Complainant informed the candidate that all of the Division's publications and reporting forms are available on the Division of Elections' website In the Jetter, the candidate was admonished as follows: "It is your responsibility to read, understand, and follow the requirements of Florida's election laws. Therefore, please print a copy of the following documents: Chapters 104 and 106, Florida Statutes, 2010 Candidate and Campaign Treasurer Handbook, 2012 Calendar of Reporting Dates, and Rule lS-2.017, Florida Administrative Code" To review a copy of the Novetnbet 21, 2011 acknowledgement Jetter, refor to exhibit 28

43.. On Novetnber 18, 2011, the candidate filed his original Statement of Candidate for State Representative, District 39 acknowledging that he had been provided access to read and understand the requirements of Chapter 106, Florida Statutes4 To review a copy of the original Statement of Candidate, refer to exhibit 29 ..

3 I have reviewed records from DOE There was no evidence found to support Respondent's statement Attachment B 4 On April 16, 2012, the candidate filed a second Statement of Candidate for State Representative, District 46 due to redistricting

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C~nellt .addre~s ofi:J.l:e~p~11de.(lt Ms. Maria Vickers-Henry 1241 South Kirkman Road, Apt 1145 Orlando, Fl 32811-2811

. N afue and Address of Filing Officer:·

Ms. Kristi Reid-Bronson Chief of Bureau of Election Records 500 South Bronough Street, Room 316 Tallahassee, Fl 32399

Respectfully submitted on January 23, 2014,

Cedtic Oliver Investigation Specialist

Cllxreirt ad<l.ress;~f tomplainan.t ' ' '' ' " ,, ' ,,

Division of Elections 500 South Bronough Street, Room 316 Tallahassee, Fl 3 23 99

Copy furnished to: Mr. David Flagg, Investigations Manager

lnv002 (7108) 7

..

' . 1.

(

FLORIDA ELECTIONS COMMISSION REPOR'I OF INVESTIGATION Maria Vickers-Henry -- FEC 13-057

. . ,,·, . .. ~. . .. .. .•.... . ·. '

> LIST.OF EXHIBITS ' · ... . . : .. · '· '( .. ·•· .

. . . •,\ .' < ·.

Exhibits #s Description of Exhibits

Exhibit I January 29, 2013 sworn affidavit from DOE

Exhibit 2 Original DS-DE 9 form

Exhibit 3 Current DS-DE 9 form along with other registration information

Exhibit 4 Original 2012 QI Report

Exhibit 5 June 28, 2012 incomplete-audit letter with error report

Exhibit 6 July 25, 2012 incomplete-audit letter with error report

Exhibit 7 August 3, 2012 incomplete-audit letter with enor report

Exhibit 8 August 24, 2012 incomplete-audit email

Exhibit 9 Amended 2012 Ql Report

Exhibit 10 September 20, 2012 final notice with error report

Exhibit 11 October 19, 2012 incomplete-audit letter with enor report

Exhibit 12 December 6, 2012 incomplete-audit letter with error report

Exhibit 13 December 20, 2012 incomplete-audit email summary with candidate response

Exhibit 14 Respondent's 2012 QI Report filing history

Exhibit 15 Original 2012 FI Report

Exhibit 16 July 18, 2012 incomplete-audit letter with enor report

Exhibit 17 August 3, 2012 incomplete-audit letter with error report

Exhibit 18 Amended 2012 Fl Report

Exhibit 19 Respondent's 2012 FI Report filing history

Exhibit 20 Original 2012 F3 Report

Exhibit 21 September 20, 2012 incomplete-audit letter with enor report

Exhibit 22 October 22, 2012 incomplete-audit letter with error report

Exhibit 23 December 5, 2012 incomplete-audit email

Exhibit 24 Respondent's 2012 F 3 Report filing history

lnv004 (5/08)

Exhibit 25 Original 2012 TR Report

Exhibit 26 December 6, 2012 incomplete-audit letter with error report

Exhibit 27 Respondent's 2012 TR Report filing history

Exhibit 28 November 21, 2011 acknowledgment letter

Exhibit 29 Statement of Candidate

lnv004 (5/08)

STATE OF FLORIDA County of Leon

AlFlFIDA VIT

Theresa Holdeen, being duly sworn, says:

1 This affidavit is made upon my personal knowledge

2 I am of!egal age and competent to testify to the matters stated herein

3 Jason Henry (55547) was a candidate for the office of State Representative, District 46, dwing the 2012 election cycle Mr Herny has failed to make the necessary amendments on the 2012 Q 1, F 1, F3 and termination (TR) campaign finance reports.

4 On November 18, 2011, Jason Herny filed the Appointment of Campaign Treaswer and Designation of Campaign Depository with the Division. Mr .. Henry appointed himself as tr easw er

5 On May 18, 2012, Mr. Herny withdrew as treaswer, and appointed Ms Maria VickersHenry as the campaign tr easwer.

6 On June 8, 2012, Mt Henry appointed himself as deputy treasurer

7 On September 20, 2012, the Division mailed Ms Vickers-Henry notification of the incomplete 2012 F3 campaign finance report A copy was also mailed to Mr Henry

8 On October 19, 2012, the Division mailed the treasurer notification of the incomplete 2012 QI and 2012 Fl (compliance el!ors) reports. A copy was also mailed to the candidate

9 On October 22, 2012, the Division mailed the treaswer a second notice regarding the incomplete 2012 F3 report A copy was also mailed to the candidate

10 On December 6, 2012, the Division mailed Ms Vickers-Herny a second notice regarding the incomplete 2012 QI & F 1 reports .. A copy was also mailed to Mr Herny

11. On December 6, 2012, the Division mailed the treaswer notification of the incomplete 2012 termination report A copy of this notice was also mailed to the candidate

12 On December 20, 2012, this division employee sent an email to the candidate as well as the treaswer regarding the incomplete QI, Fl, F3, and TR This email had several screen shots with notes of exactly what needed to be corrected. (See attached copy of email and screen shots for 2012 Ql, Fl, F3 & TR reports)

13 On December 26, 2012, this division employee received an emailed resporise from the candidate, with questions about these euors (See attached copy of email)

EXHIBIT INY035 (5/00)

•f

14 On December 27, 2012, this division employee sent yet another email to candidate, 1esponding to his email, again asking that he contact us. (See attached copy of email)..

15. As of Januaiy 29, 2013, the 2012 QI, F 1, F3, and IR campaign finance repo1ts remain incomplete

I hereby swear or affirm that the 1oregoing information is true and correct to the best of my knowledge.

,"$'§.v'l'I,'.', PEARLIEM.WILl.IAMS·MATHIS ' MY COMMISSION! DD 958450

!NV035 (5/00)

EXPIRES: May 16, 2014 Bonded ihtu Noh1ry Publlo Unde!Wf'itera

Sworn to (01 affiimed) and subscribed before me this 29th day of January, 2013.

Q~_,. . ~~.) ~ll:tlw ___ _ Signature ofiotaiy Public - Sta1lofflorida

Print, Type, or Stamp Commissioned Name of Notary Public

Personally Known ./

..... """' '"'.

,.... .- "' ·- I\ I r::' Ii .. ; '. ;_, ... APPOINTMENT OF CAMPAIGN TREASURER

AND DESIGNATION OF CAMPAIGN 11 NOV 18 AH 11: 28 DEPOSITORY FOR CANDIDATES

(Section 106.021(1), F S.) [)!VI.,,. i .• ;;,;_E.CTlONS

(PL.EASE PRINT OR TYPE) SECRE \ARY OF STATE

NOTE: This form must be on file with the qualifying officer before oPenina the campalan account. OFFICE USE ONLY

1. CHECK APPROPRIATE BOX(ES):

~ Initial Filing of Form Re-filing to Change: O Treasurer/Deputy D Depository D Office 0 Party

2 Name of Candidate (in this order: First, Middle, Last) 3. Address (include post office box or street, city, state, zip

Jason Samuel Henry code)

. P 0 Box 51 4. Telephone 5 E-mail address Gotha, FL. 34734 (205 ) 215-2464 Jasonforhouse39@gmail caa

r--·-----· ··- ------r--· 6 Office sought (include district, circuit, group number) 7 If a candidate for a nonpartisan office, check if

State Representative, District 39 applicable:

D My intent is to run as a Write-In 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

0 Write-In 0 No Party Affiliation [gJ Democratic Party candidate

9 I have appointed the follow Ing person to act as my 0 Campaign Treasurer [g] Deputy Treasurer --· _,,,

1 O. Name of Treasurer or Deputy Treasurer

Jason He_r::_ry ___ --·-----·-.. ··----..----11 Mailing Address 12 Telephone

P 0. Box51 ( 205 ) 215 .. 2454 .___. ·---13 City 14. County 15. State 16. Zip Code 17.. E-mail address

Goth a Orange FL. 34734 [email protected]

18 I have designated the following bank as my D Primary Depository ~ Secondary Depository

19 Name of Bank uo Address Suntrust ~00 South Orange #1

·-· 21 City 22 County 23 State 24 Zip Code

Orlando Orange Florida 32801

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 26. Signature of c~·date I 11-14-2011 x li\tJ;) J I ~ .. 'f'~ ' 27 Treasurer's Acceptance of Appointment (fill in t~e blanks and check the j!P(ropriate block)

I, ·----· Jason Henry , do hereby accept the appointment

(Please Print or Type Name)

designated above as: D Campaign Treasurnr igJ Depu'.y Treasurer. I 11-14-2011 x ~ ' . . ,~.f

'..c\\J/)til llf1 /)

Date .

ISignmui'e of Campaign-'fre/)tfrer or Deputy Treasurer

OS-DE 9 Rev .. 10/10

EXHIBIT_~b'-----Rule 1S-2.0001, FAC

/

' I

District Change due to redistricting

To whom it may concern,

I am hereby re-filing to change from a candidate for the Florida House in district 39 to district 46 due

to redistricting .. Thank you ..

Jason Henry

P.O. BoxSl

Gotha, FL. 34734

EXHIBIT 3(\ J \o)

'":' '":' "-' r.: 1 v F. n 12 APR 16 AHll:zg

1~lbW~¥A'lfv ~~E~Jll.s

-?.:. ·'

' I . .... ~,:,

APPOINTMENT OF CAMPAIGN TREASURER i:-r: l""r::\'IEO AND DESIGNATION OF CAMPAIGN DEPOSITORY FOR CANDIDATES

12 APR 16 At111: 29 (Section 106 021(1). F S.)

(PLEASE PRINT OR TYPE) &IVISION OF ELE'.C~\S SECl\ET~IW Of S

NOTE: This form must be on file with the qualifying officer before openinQ the camDailm account. OFFICE USE ONLY


D Initial Filing of Form Re .. filing to Change: (2) Treasurer/Deputy 0 Depository D Office 0 Party

2 Name of Candidate (in this order: First, Middle, Last) 3 Address (include post office box or street city, state, zip


P 0 .. Box 51 4 Telephone ~ E-mail address Gotha, FL 34734 ( 205 >. 215-245'.'1 Jasonforhouse39@gmail. coa

6 Office sought (include district, circuit, group number) 7. If a candidate for a nonpartisan office, check if

State Representative, District 46 applicable:

0 My intent is to run as a Write-In candidate ~- .. ·- ---8 If a candidate for a parllfil!.!l office, check block and fill In name of party as applicable: My intent is to run as a

D Write .. ln D No Party Affiliation ~ Democratic Party candidate

9 I have appointed the following person to act as my IZl Campaign Treasurer 0 Deputy Treasurer ..

10 .. Name of Treasurer or Deputy Treasurer

Maria Vickers-Henry - --11 .. Mailing Address 12 .. Telephone

1241 S Kirkman Road Apt 1145 ( 205 ) 215-2464 13 City 14 County 15 State 16 Zip Code 17. E-mail address

Orlando Orange FL .. 32811 [email protected]

18 I have designated the following bank as my 181 Primary Depository D Secondary Depository ...

19 Name of Bank 20 Address

Suntrust 200 South Orange #1 .. 21 City 22 County 23 State 24 Zip Code


UNDER PENALTIES OF PERJURY, I DECLARE THAT I HAVE READ THE FOREGOING FORM FOR APPOINTMENT OF CAMPAIGN TREASURER ANO DESIGNATION OF CAMPAIGN DEPOSITORY ANO THAT THE FACTS STATED IN IT ARE TRUE.

" " ... 25 Date 26. Signature of Candidate

4 .. 5-2012 x 27 Treasurer's Acceptance of Appointment (fill in the blanks and check the appropriate block)

/, Maria Vickers .. Henry , do hereby accept the appointment ·-·-· (Please Print or Type Name)

designated above as: igJ Campaign Treasurer 0 Deputy Treasurer

4-6 .. 2012 x !( ')).!() 1 )l(J;Oi;\_ .I !u YO.t- __ ---Date ignature of Campaign Treasurer or Deputy (fr iasurer

OS-DE 9 (Rev .. 10/10)

EXHIBIT o(Q ~ loJ Rule 1s .. 2.0001, F.AC,,

.,.._ ..... 0

~-· ~

APPOINTMENT OF CAMPAIGN TREASURER ;r.

t' .•

AND DESIGNATION OF CAMPAIGN ,...,,..."''"='vr.o ,,, ... 5 ~

DEPOSITORY FOR CANDIDA TES I 12 HAY I 8 (Section 106 021(1) F S)

I AH 10: 34 (PLEASE PRINT OR TYPE) DIV/SIL';: Lr ELE:CT!OHS I StCRETARY OF STATE

NOTE: This form must b<> on file with the qualifying I officer before openino the can;ipaign account. I .... - OFFICE USE ONLY

1. CHECK APPROPRIATE BIJX(ES):

D Initial Filing of Form Re.filing to Change: ~ Treasurer/Deputy 0 Depo"' ·ory D Office D Party

2 Name of Candidate (in this order: First Middle Last) 3 Address (include post office box or street, city state zip


-· -~- _ . __ P 0 Box 51 4 Telephone 5 E-·mail address Gotha, FL 34734 (205 ) 215-2464 Jasonforhouse39@gmail coa '-·----- """ ·--··-- -T·--

6 Office sought (include district circuit, group numoerJ 17 if a candidate for a JlQ!lllart~~ office, check if

State Representative, District 46 applicable: D My intent is to run as a Write-In candidate

-----" ··-·· ---· -···------.. -----· 8 If a candidate for a EJ!rt~ office, check block and fill in name of party as applicable: My intent is 10 run as a

0 Write .. 1n 0 No Party Affiliation ~ Democratic Party candidate

9 I have appointed the following person to act as my (2) Campaign Treasurer D Deputy Tre~surer 1.....--·~· - .. -------·-----

10 Name of Treasurer or Deputy Treasurer

Maria Vickers-Henry --- ------------·--·----- ·--~~--

11 Mailing Address 12 Telephone

1241 s Kirkrnan Road Apt 1145 ( 205 ) 215-2456 _,. -·-· --·· --13 City 14 County 15 State 16 Zip Code 17. E-mail address

Orlando Orange FL 32811 [email protected]

18 I have designated the following bank as my ~ Primary Depository 0 Secondary Depository L-. - --··· -- -----··~----

19 Name of Bank 20 Address

Suntrust 200 South Orange #1 --------122 Countv

.... ,_. I Z4 Zip Code 21 City 23 State


UNDER PENAL TIES 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 26 S(gnature of C~e

5-11-2012 X . I ~(1111\ " rw 27 Treasurer's Acceptance of Appointment (fill in t e blanks and check"'t~a~propriate block)

. V H ~ I Mana 1ckers-- enry ___ , do hereby accept the appointment -- (Please Print or Type Name)

designated above as: [81 Campaign Treasurer O Deputy Treasurer

5--11-2012 x ma)L)J() ? )ir·11p11\;-l\en 11' -·--

Date Signature of Campaign Treasurer or Deputy Treas~ri r

DS-DE 9 (Rev .. 10/10) Rule 15-2 .. 0001, FA C ..

)l VIVA flORlllA ~00

FLORIDA DEPARTMENT of STATE RICK SCOTT

Governor KENDETZNER

Secretary of State

May 21, 2012

Ms Maria Vickers-Henry, Treasurer 1241 South Kirkman Road, Apt 1145 Orlando Florida 32811

Dear Ms. Vickers-Henry:

Your appointment as campaign treasurer for Mr Jason Samual Herny was filed in this office on May 18, 2012 Enclosed is a security envelope containing your confidential PIN number to access the Division of Election's electronic filing system (EFS) for submitting campaign treasurer's reports

All of the Division's publications and reporting forms are available on the Division of Elections' web site at http://elections.myflodda.com. It is your responsibility to read, understand, and follow the requirements of Florida's election laws. Therefore, please print a copy of the following documents: Chapte~s 104 and 106, Florida Statutes, 2012 Candidate and Campaign freasuter Handbook, 2012 Calendar of Reporting Dates, and Rule lS-2.017, Florida Administrath e Code.

If you have questions concerning the electronic filing system you may call the EFS Help Desk at (850) 245-6280

Sincerely,

~AAA· :?5~~ .. fs.-.... -··· Kristi Reid Bronson, Chief Bureau of Election Records

KRBlmcc

Enclosure

pc: Jason Samuel Herny, Candidate (55547)

Division of Elections R.A. Gray Bldg., Rm 316 • 500 S Bronaugh St,• Tallahassee, Florida 32399-0250

Telephone: (850) 245-6240 • Facsimile: (850) 245-6259 elections.myflorida .. com Commemorating 500 years of Florida history www.fla500,.com

EXHIBIT 3 C4 d· loJ )l VIVA HORIDA500

APPOINTMENT OF CAMPAIGN TREASURER AND DESIGNATION OF CAMPAIGN

' DEPOSITORY FOR CANDIDATES (Section 106.021(1), F S.)

(PLEASE PRINT OR TYPE)

/ I.

(/)52 "1< n-""~ me' -<~ :i>c ::0 .,,; -< . oP ..,,rti (II C") ........ !io

DepLA....ftj Tr·ec£lµrQ..( ,...z (J)

~

N J (.... c 1 :z:

'.) I CX> !~,

~·-

""' < ::JC

<;? 111 0 .&:"

CX> '.,i '. NOTE: This form must be on file with the qualifying officer before ooenina the camoalan account. '55SL\1 OFFICE USE ONLY

1. CHECK APPROPRIATE BOX{ES): 0 Initial Filing of Form Re-filing to Change: !&J Treasurer/Deputy 0 Depository 0 Office Q Party

2 Name of Candidate (in this or<ler: First, Mi<ldle, Last) 3. Address (include post office box or street, city, state, zip

Jason Henry code)

l-'.-~--,.-------.-------------1 P 0. Box 51 4 Telephone 5 E-mail address Gotha, Florida 34734 ( 407 ) 796-1035 Jason@electjasonhenry .. com

6 Office sought (include district, circuit, group number)

State Representative, District 46

7. If a candidate for a nonpartisan office, check if applicable:

0 My intent is to run as a Write-In 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

O Write-In O No Party Affiliation 181 Democratic Party candidate

9 I have appointed the following person to act as my D Campaign Treasurer 181 Deputy Treasurer 1--- .. - ·- ---- --10 Name of Treasurer or Deputy Treasurer

Jason Henry 11---------·----~~---------------~---------·----11 Mailing Address 12 Telephone

P 0 Box 51 ( 407 ) 796-1035 -------------·--~---------------'-'-----------! 13 City 14. County 15. State 16 Zip Code 17 E-mail address

Gotha Orange FL 34734 [email protected]

18 I have designated the following bank as my l8J Primary Depository 0 Secondary Depository

19 Name of Bank

Suntrust

------,-,..,.--.,--------------------·-----20 Address

200 South Orange #1 t--:--,---~-------·--,--,:-7"----------'---,-~--=-~--·----r-,----=--·-·~ 21 City 22 County 23. State 24. Zip Code


UNDER PENAL T!eS 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. t-::---------------·----- -----r==--:--.,-;;---;:c;-:--·-----------------

25 Date 26 I~ ignature of ca i<li ate

27

I,

&·- ~~·/;:) x b ~ n1ir1 ::< 110. / Treasurer's Acceptance of Appointment (fill in he blanks and check~ appropriate block)

_____ ._")-4-8£-D"'-''-""A"')'=-_}t.L..!.J&"""',l)"-'-L""v~{----------·--·- , do hereby accept the appointment (Please Print ot:'Aiile Name)

designated above as: D Campaign Treasur r 181 Deput' Treasurer

x_~~~j~ --- ignature of Campa1, o Tr~urer or Deputy Treasurer

OS-OE 9 (Rev .. 10/10)

EXHIBIT D ( 5 ot(oJ Rule 15-2 .. 0001, F.AC

-~· fr:oruD_A_D_E_P_iRTM_E_N_T_O~.'f.---S_T_A_T_,E

RICK SCOTT Governor

KENDETZNER Secretary of State

July 11, 2012

Mr Jason Herny (55547) Post Office Box 51 Gotha, Florida 34734

Dear Mr .. Henry:

Your appointment as deputy campaign treasurer for your candidacy for State Representative was filed in this office. Enclosed is a secmity envelope containing your confidential PIN number to access the Division of Election's electronic filing system (EFS) for submitting campaign treasurer's reports

All of the Division's publications and reporting forms are available on the Division of Elections' web site at http://elections.myflorida.com. It is your responsibility to read, understand, and follow the requirements of Florida's election laws. Therefore, please print a copy of the following documents: Chapters 104 and 106, Florida Statutes, 2012 Candidate and Campaign 1Teasure1 Handbook, 2012 Calendar of Reporting Dates, and Rule IS-2 .. 017, Florida Administrative Code

If you have questions concerning your campaign account, or the electronic filing system you may call the EFS Help Desk at (850) 245-6280

Sincerely,

·····f~ ~~-t~~'-P-<.;~.-· Kristi Reid Bronson, Chief Bureau of Election Records

)t_

KRB/ean

Enclosure

R A. Gray Building • 500 South Bronough Street • Tallahassee, Florida 32399·-0250 Telephone: (850) 245·6240 • Facsimile: (850) 245-6259 www.dos.state .. n.us

Commemor·ating 500 year·• of F'Zorida history www.fla500 .. com

VIVA flORIDA 50ll

)t_ VIVA flOilDA5llO ..

1/21/2014 Filed Camaign Treasurer's Report Page i

Jason Henry Elect ID: 20121106-GEN From: 1/1/2012 Amd: Y Wvr:N Filed: FIL 4/10/2012 8:28:53 p

5554 7 - STR 046 Report: 2012 Q1 (2) To: 3/31/2012 Cmplt: COM Reviewed: AUD 9/11/2012 10:34:59 p

Original Report Submitted: 4/10/2012 8:28:53 p

CONTRIBUTIONS Seq Contributor Occupation Errors Date Name Address Type Inkiud Descnption An1d Amount

SCOTT 2022 SUBURBAN CIR FORESTDALE, 3521 ACCOUNTANT 0 S200.00

3/19/2012 RICHARD FORESTDALE AL 35214 CHE

2 PICERNE MANAGEMENT CORPOR 247 N WESTMONTE DRIVE B MANAGEMENT 0 $500.00

1/31/2012 ALTAMONTE SP FL 32714 CHE

j ' PALM KEY PHASE I 247 N_ WESTMONTE DRIVE B CONSTRUCTION 0 ssoo 00 c

~-----,


4 PICERNE DEVELOPMENT CORPOR 247 N. WESTMONTE DRIVE B CONSTRUCTION 0 $500.00


5 HENRY 8161 SUSSEX STREET RETIRED 0 $500.00

1/2312012 WILLIEJ. DETROIT MI 48228 CHE

6 DECLUE 1726 DIAMOND DRIVE ENGINEER 0 $50.00

l/3/20I2 DOUGLAS ORLANDO FL 32807 CHE ~ 7 SPILLER P_O. BOX 2295 ATTORNEY 0 SI00.00 ::::i--

1/1212012 JUSTIN JACKSONVILLE FL 32203 CHE -4 8 HAMMAD 641 WOODWARD STREET ATTORNEY 0 $20.00 ~

l/17/20I2 LAURA ORLANDO FL 32803 CHE

9 CROLLA 319 E. CHURCH STREET#l31 ATIORNEY 0 $30.00

1/23/2012 LAURA ORLANDO FL 32801 CHE I-

' j 10 NUGENT I922 SUNSET PALM DRIVE EDUCATION 0 $10.00 -co

1123/2012 TISO ME APOPKA FL 327I2 CHE s: 11 DOCKERY J 2007 TETON FOREST DRIVE STUDENT 0 $1000 ~

2/21/2012 SHELLEY LITTLE ROCK AR 72212 CHE

12 BATTLE 2156 CHESHIRE DRIVE TEACHER 0 S20.00

212212012 TOMEKA BIRMINGHAM AL 35235 CHE

13 HOPKINS 2123 EMERALD POINTE DRIVE TELECOMMUNICATIONS 0 S50 00

2122/2012 ADRIAN HOOVER AL 35216 CHE

I4 JOHNSON 953 DAVENWOOD COURT 0 $20.00

3/31/2012 TEVRA OCOEE FL 3476I CHE

15 EDWARDS 5937 PINECREEK ROAD MILITARY 0 $50.00

3/31/2012 LAQUINTA FOREST PARK GA 30297 CHE

1121/2014

Jason Henry

55547 - STR 046

Seq Date

CONTRIBUTIONS

1Vame

16 SUTION

1/4/2012

Seq Date

1/30/2012

1/15/2012

3/3/2012

I/3/2012

1/1212012

1/17/2012

1/23/2012

1/23/2012

2/21/2012

KEVIN

EXPENDITURES

Name

HENRY

JASON

2 MOJJCA

MIGUEL

3 HENRY

JASON

4 PAYPALINC.

5 PAYPAL INC.

6 PAYPAL INC.

7 PAYPAL!NC.

8 PAYPALINC.

9 PAYPAL !NC.

10 PAYPAL!NC.

2/22/2012

11 PAYPAL !NC.

2/22/2012

12 PAYPAL!NC.

3/31/2012

Filed Camaign Treasurer's Report Elect ID: 20121106-GEN

Report: 2012 01 (2)

From: 1/1/2012

To: 3/31/2012

Amd: Y

Cmplt: COM

Address

5319 LAKE JESSAMINE DRIVE

ORLANDO FL 32839

Address

1241 S. KIRKMAN ROAD APT. 1145

ORLANDO FL 32811

1234 ORLANDO AVENUE

ORLANDO FL 32817

I241 S. KIRKMAN ROAD APT. 1145

ORLANDO FL 32811

22 l I N FIRST STREET

SAN JOSE CA 95!3I

22I IN FIRST STREET

SAN JOSE CA 95131

2211 N FIRST STREET

SANJOSE FL

2211 N FIRST STREET

SANJOSE CA

2211 N FIRST STREET

SAN JOSE CA

2211 N FlRST STREET

95131

95131

95131

SANJOSE CA 95131

221 l N FIRST STREET

SANJOSE CA

2211 N FIRST STREET

SANJOSE CA 95131

2211 NFJRSTSTREET

SAN JOSE CA 95131

Original Report

Contributor Occupatron Type lnki11d Descnplion

CHE

Type

RMB

MON

MON

MON

MON

MON

MON

MON

MON

MON

MON

MON

ENTERTAINMENT

Office Purpose

REPAYMENT OF LOAN

CAMPAIGN WEB DESIGN

CAMPAIGN PHOTOS

SERVICE CHARGES

SERVICE CHARGES

SERVICE CHARGES

SERVICE CHARGES

SERVICE CHARGES

SERVICE CHARGES

SERVICE CHARGES

SERVICE CHARGES

SERVICE CHARGES

Page 2

Wvr:N Filed: FIL 411012012 82853 P

Reviewed: AUD 9/li/20121034:59P

Submitted: 4110/2012 8:28:53 P

Errors

An1d

0

Errors

Amd

0

0

0

0

0

0

0

0

0

0

0

0

Amount

$50.00

Amount

$100.00

$60.00

$I06.00

$1.75

$3.20

$0.88

$1.17

S0.59

$059

50.88

$1.75

$0.88

'• -

_/ ----,/

1121/2014

Jason Henry

55547 - STR 046

EXPENDITURES Seq Date Name

13 PAYPALINC.

3/31/2012

14 SUNTRUST

3128/2012

15 MOJICA

2/4/2012 MIGUEL

OTHER DISTRIBUTIONS Seq Date Name

HENRY

1/30/2012 JASON

EXPENDITURES Seq Date Name

3 HENRY

3/3/2012 JASON

OTHER DISTRIBUTIONS Seq Date Name

2 HENRY

3/3/2012 JASON

Filed Camaign Treasurer's Report Elect ID: Amd: Y

Report:

20121106-GEN

2012 01 (2)

From: 1/1/2012

To: 3/31/2012 Cmplt: COM

Address

22 I I N FIRST STREET

SAN JOSE CA 95131

200 S. ORANGE AVE

ORLANDO FL 32801

1234 ORLANDO A VENUE

ORLANDO FL 32817

Address

124I S.KIRKMANROADAPT 1145

ORLANDO FL 32811

Address

1241 S.KIRKMANROADAPT.1145

ORLANDO FL 32811

Address

124I S. KIRKMAN ROAD APT 1145

ORLANDO FL 32811

Original Report

Type

MON

MON

MON

Recipient Type

0

RMB

Amended Report

Type

RMB

Ree1p1e11t Type

0

RMB

Office Purpose

SERVICE CHARGES

CHECK ORDER

WEB HOSTING

Office Purpose

REPAYMENT OF LOAN

Office Purpose

CAMPAIGN PHOTOS

Office Purpose

CAMPAIGN PHOTOS

Page 3

Wvr: N Filed: FIL 411012012 3,2g53 P

Reviewed: AUD 9/11/2012 10:34:59 P

Submitted: 4/1012012 g,2353 P

Errors

Amd

0

0

0

Errors Amd

0

Amount

$175

$42.22

$IO.OO

Amou11t

$100.00

Submitted: 911112012 10,3532 P

Errors

A111d An101111t

0 $106.00

UPD

Errors

A11uf An10u11t

0 $I06.00

ADD

=i; ~ ~

!= £9 :c ~

1/21/2014

Jason Henry

55547 - STR 046

Filed Cama1gn Treasurer's Report Page4

Elect ID: 20121106-GEN

Report: 2012 Q1 (2)

From: 1/1/2012 Amd: Y Wvr: N Filed: FIL 4/1012012 8:28:53 P

To: 3/31/2012 Cmplt: COM Reviewed: AUD 9/1112012 10:34:59 P

FLORIDA DEPARTMENT OF STATE Ken Detzner

Secrclar, of Slate

DIVISION OF ELECTIONS

June 28, 2012

Ms Maria Vickers-Henry, Treasurer for Candidate Jason Henry I 241 South Kirkman Road Apartment 1145 Orlando, FL l28I 1-281 l

Dear Ms Vickers-Henry:

The Division of Elections has determined that the report for the following cover period is incomplete for the reasons attached

Cover Period 1 /1 /12 - 3/31 /12

Pursuant to Section I 06 07(2), Florida Statutes, you have 7 days from receipt of this notice to

file an amended report supplying the missing information or provide an explanation for the entries We are required by law to further advise you that failure to supply this information within the time allowed constitutes a violation of Chapter 106, Florida Statutes

lf you need assistance in filing an amendment, please contact the Division's help line at (850) 245 6280

Sincerely, ,,--

~ ~,};_, ~<-12-<."CA 'i~-, Krist\ Reid Bronson Chief, Bureau of Election Records

cc Mr Jason Henry, Candidate Attachment

EXHIBIT _5 ( \ Dl i> Room 316 RA GrJy Building • 500 South Bronaugh Street • Tallahassee, Florida 12199-0250 • (850) 245-6280

FAX: (850) 245.(>260 • WWW Address: http://\rnw,dossrate fl us • E-Mail: DivEleclion<@do' <tateJI '"

612812012 Flmida Department of Slate - llvislon of Electinns

C0uqJfl3l_ICB Repo_rt_ __ Candidate: Jason Henry

Report: 2012 01 (2) Covering Period: 1/1/12 - 3/31/12

Overall

Cootributions

ExJJenditures - - - - - - - -- - - -- - - - - -- -- - - - - - - - -- - - - -- - -- ---- -- -- ---- -- - -- - - - -Statute 106.07

106.07

Fund Transfers

Other Distlibutions

Oescnption Financial acuvitv not reported properlv

Reimbursement without corresponding Other Distribution

j 1/3012012 HCNRY JASON

~ 3/3/2012 HENRY JASON

Office: STR

Account: 55547

Expenditure 9!Y

Page i

l'lru! Amount

RMB $100.00

MON $106.00 .-~

FLORlDA DEPARTMENT OF STATE

Second Notice

.July 25, 2012

Ken Detzner· Secretary of State

DIVISION OF ELEC I IONS

Ms Maria Vickers-Henry, Treasurer for Candidate Jason Henry l 241 South Kirkman Road Apattment 1145 Orlando, Fl 32811-2811


On June 28 .. 20 l 2, you v.ere advised that one or mote of your campaign treasurer's reports were incomplete and that you had 7 days to file amended reports providing the requested information

The Division's electronic filing system indicates that the required amendments have not been made Pursuant to Section l 06 .22, Florida Statutes, the Division is required to notify the Florida Elections Commission of the failure to provide information required by Chapter 106 Accordingly, if the information requested in our prior notice is not received within 7 days of receipt of this letter, we will refer this matter to the Commission A second copy of the error report is attached for your convenience

Kristi Reid Bronson, Chief Bureau of Election Records

cc: Mr Jason Henry, Candidate

Attachment

Room 316 RA Gra) Building • 500 South Bronough Street • Tallahassee Florida 32399-0250 • (850) 245-6280 FAX: (850) 245·6260 • WWW Address: http://www dos state fl.us • E-Mail: DivE/ectiom'dmai! d01 1/ulej/ us

EXHIBIT _k Ct J} Q)

7/20/2012 Florida Department of State - DiVision of Elections

~o"!lltiancu Rlljlort Candidate: Jason Henry

Report: 2012 01

Dveral

Contrlmtions

ExneOOitures

106.07

~ 106.07

:c ffi FllHI Transfers b Other Distrillltlons

\~ .ID

(2) Covering Period: 1/1/12 - 3/31/12

Description Financial aciivi::v no1 reported properly

Reimbursemeni without corresponding Other Distribution

j 1/30/2012 HENRY JASON

3 313/2012 HENRY JASON

Office: STR

Account: 55547

Expenditure City

Page ·j

~ Amount

RMB

MON

$100 00

$106 00 --~---

,

\. I '

FLORIDA DEPARTMENT OF STATE

Second Notice

August 3, 2012

Ken Detzner· Secretary of State


Ms. Maria Vickers-Henry, Treasurer for Candidate Jason Henry 1241 South Kirkman Road Apartment 1145 Orlando, Fl 32811 ··28 I l


SECOND NOTICE

On lune 28, 2012, you were advised that one or more ofyom campaign treasurer's reports were incomplete and that you had 7 days to file amended reports providing the requested information

The Division's electronic filing system indicates that the required amendments have not been made Pursuant to Section l 06 22, florida Statutes, the Division is required to notify the Florida Elections Commission of the failure to prnvide information required by Chapter 106 Accordingly. if the information requested in our prior notice is not received within 7 days of receipt of this letter, we will refer this matter to the Commission A second copy of the error report is attached for your convenience

Sincetely,

Kristi Reid Bronson, Chief Bureau of Election Records


Attachment

Room .316 R.A Gray Building • 500 South Bronough Street • Tallahassee, Florida 32399-0250 • (850) 245-6280 FAX: (850) 245-6260 • WWW Address: http://www.dos .. statc.fl.us • E·Mail: DivEiellion1:ii)mail do> state/I U>

EXHIBIT_ :J (lo~ fi)

812/2012 Flll'ila llepa'tnrent of Stam - DivisiOn or Bections -- ~--· -··

~ Rll\lllrt _. Candidate: Jason Henry

Report: 2012 01 (2) Covering Penod: 111112 - 3131112

Dveral

eootrllltilns

Statute 106 07

106.07

Food Transfers

lltller llistrill!tDls

Descnption Financial actsvitv not reported properly

Reimbursement without corresponding Other Oistribut1cn

Seq Date

1/30/2012

3 3/312012

Office: STR

Account: 55547

Expenditure

9!Y HENRY JASON

HENRY JASON

Pagel

Tu® Amount

RMB

MON

$100.00

$106.00

Unique ID

HISTORY NOTES Jason Henry - 55547

Date Recorded Last Edited Date

30438

2012 F1 Fine:

9/17/2012 12:30:00 PM

Sent the following email:

Ta:.Jason Henry, Former Candidate Maria Vickers-Henry, Treasurer

Orginally Recorded By

taholdeen

Attached are copies of previously mailed notices with regards to the fine that is still owed for the late filing of the 2012 F1 campaign finance report Please pay this fine immediately to avoid referral to the Florida Elections Commission

If you need further assistance, please contact the Division's Help Desk at (850) 245-6280 Thank you in advance for your immediate attention to this matter

30213

2012 Q1 & F1 Audits:

8/24/2012 12:45:00 PM

Sent the following email to the candidate:

Mr Jason Henry

8/27/2012 9:09:48 AM taholdeen

Attached are copies of previously mailed notices regarding errors that neied to be corrected in your campaign finance reports Please correct this reports immediately to avoid referral to the Florida Elections Commission. The Florida Elections Commission can impose civil penalties of up to $1000 per v.iolation

If you need assistance amending this report please contact our Help Desk Line at (850) 245-6280

Thank you in advance for your immediate attention to this matter

SIDE NOTE: Rec'd this emailed response:

Thanks Theresa I will correct them tonight

Sent from my iPhone

28791 5/9/2012 12:14:00 PM lbelyin

RE: Incomplete DS-DE9-Redistricitng

I emailed him instructions because on May 2, 2012 I called and left a message and he never responded Lenard spoke with him on April 17, 2012 and he said that he would overnight the form but never did I put documents in Ms Kristi's office to be boxed

28657 5/2/2012 4:17:00 PM lbelvin

RE: Follow up call OS- DE 9 incomplete

I called and left a message explaining that this was a follow up call regarding the OS-DE 9 form that he said that he would send our office overnight I explained that in order for our office to process this change we need him to submit another original OS-DE 9 form with original signatures Once we receive this new form we can process his change due to redistricting request 1 left my contact information for him to call if he has any questions

28446 4/17/2012 8:30:00 AM ljrandolph

RE: Redistricting Paperwork

I called and spoke with Mr Henry and explained to him about the dsde 9 and that he didn t sign the form in box 26 which requires his signature He said that he would overnight the form to the division asap

Page 3 of 3

EXHIBIT_i)~·, ____ _ 0 ~) {j t; c; 7

1/25/2013

( i '

FLORIDA DEPARTMENT OF STATE, DIVISION OF ELECTIONS

CAMPAIGN TREASURER'S REPORT SUMMARY

(1) Jason Henry (2) 55547

Candidate, Committe or Party Name ID Number

(3) Post Office Box 51 Goth a FL 34734

Address (number and street) City State Zip Code

0 Check box if address has changed since last report

(4) Check appropriate box( es):

lKJ Candidate (office sought):

D Political Committee 0 Check If PC has DISBANDED

D Committee of Continuous Existance 0 Check If CCE has DISBANDED

D Party Executive Committee

(5) REPORT IDENTIFIERS

Cover Period: From 0110112012 To 0313112012 Report Type: 01

0 Original lKJ Amendment D Special Election Report

(6) CONTRIBUTIONS THIS REPORT (7) EXPENDITURES THIS REPORT

Cash & Checks $2,610 00 Monetary Expenditures $331 66

Loans $0 00 Transfers to Office Account $0 00

Total Monetary $2,610 00 Total Monetary $331 66

In-Kind $0 00 (8) Other Distributions

Certification It is a first degree misdemeanor for any person to falsify a public record (ss 839 13, F S)

l certify that I have examined this report and it is I certify that I have examined this report and it is true_ correct and complete true, correct and complete

Name of 0 Treasurer 0 Deputy Treasurer Name of lKJ Candidate 0 Chaiman (PCIPTY Only

)( y

Signature Signature

Prepared on: 1114/14 3:22:59PM Reviewed On: 9/11/12 10:34 pm

EXHIBIT g (1 J- 4J

ID: 55547 CAMPAIGN i .ASURER'S REPORT - ITEMIZED CONl JUTIONS Page 1 of 1

Name: Jason Henry

Seq# Full Name

(Last, Suffix First, Middle Date Street Address & City, State, Zip

1 SCOTT RICHARD 2022 SUBURBAN CIR FORESTOALE 35214

03/19/2012 FORESTOALE AL 35214

2 PICERNE MANAGEMENT CORPORATION 247 N. WESTMONTE DRIVE

01/31/2012 ALTAMONTE SPRINGS, FL 32714

3 PALM KEY PHASE 1 247 N. WESTMONTE DRIVE

01/31/2012 ALTAMONTE SPRINGS FL 32714

4 PlCERNE DEVELOPMENT CORPORATION 247 N. WESTMONTE DRIVE

01/31/2012 ALTAMONTE SPRINGS FL 32714

5 HENRY, WILLIE J. 8161 SUSSEX STREET

01/23/2012 DETROIT Ml 48228

6 DE CLUE, DOUGLAS 1726 DIAMOND DRIVE

01/03/2012 ORLANDO, FL 32807

7 SPILLER, JUSTIN P.O BOX 2295

0111212012 JACKSONVILLE FL 32203

8 HAMMAD, LAURA 641 WOODWARD STREET

01/17/2012 ORLANDO FL 32803

9 CROLLA LAURA 319 E CHURCH STREET #131

0112312012 ORLANDO, FL 32801

10 NUGENT TISOME 1922 SUNSET PALM DRIVE

01/2312012 APOPKA FL 32712

11 DOCKERY, SHELLEY 12007 TETON FOREST DRIVE

02/21/2012 LITTLE ROCK AR 72212

12 BATTLE TOMEKA 2156 CHESHIRE DRIVE

0212212012 BIRMINGHAM AL 35235

13 HOPKINS ADRIAN 2123 EMERALD POINTE DRIVE

02/22/2012 HOOVER AL 35216

14 JOHNSON.TEVRA 953 DAVENWOOD COURT

03/31/2012 OCOEE, FL 34761

15 EDWARDS, LAQUINTA 5937 PINECREEK ROAD

03/31/2012 FOREST PARK, GA 30297

16 SUTTON, KEVIN 5319 LAKE JESSAMINE DRIVE

01/04/2012 ORLANDO FL 32839

" Incomplete Record

Report: 2012 Q1 "'"' Records in Filed Report**

Contributor Occupation

Type In-Kind Description

I ACCOUNTANT

CHE

B MANAGEMENT

CHE

B CONSTRUCTION

CHE

B CONSTRUCTION

CHE

I RETIRED

CHE

I ENGINEER

CHE

I ATTORNEY

CHE

I ATTORNEY

CHE

I ATTORNEY

CHE

I EDUCATION

CHE

I STUDENT

CHE

I TEACHER

CHE

I TELECOMMUNICATIONS

CHE

I CHE

I MILITARY

CHE

I ENTERTAINMENT

CHE

Reviewed On: 9/11/12 10:34 pm

Period: 01/01/2012 to 03/31/2012

Amount

Amend

$200 00

$500 00

$500 00

$500 00

$500 00

$50 00

$100 00

$20 00

$30 00

$10 00

$10 00

$20 00

$50 00

$20 00

$50 00

$50 00

Prepared on: 1/14/14 3:23:00PM

ID: 55547 CAMPAIGN\ 2ASURER'S REPORT - ITEMIZED EXPl JITURES Page 1 of 1

Name: Jason Henry Report: 2012 Q1 Period: 01/01/2012 to 03/31/2012

** Record ·n F.1 d R rt** SI 1e epo

Seq# Full Name

(Last, Suffix First, Middle Amount

Date Street Address & City, State, Zip Type Purpose

Amend

1 HENRY JASON 1241 S. KIRKMAN ROAD APT 1145 RMB REPAYMENT OF LOAN $100 00

01/30/2012 ORLANDO, FL 32811

2 MOJICA MIGUEL 1234 ORLANDO AVENUE MON CAMPAIGN WEB DESIGN

$60.00

01/15/2012 ORLANDO, FL 32817

3 HENRY JASON -- 1241 $. KIRKMAN ROAD APT 1145 RMB CAMPAIGN PHOTOS $106.00

03/03/2012 ORLANDO, FL 32811 UPD

3 HENRY JASON 1241 $. KIRKMAN ROAD APT 1145 MON CAMPAIGN PHOTOS

$106 00

03/03/2012 ORLANDO, FL 32811 History 09/l \/l2

4 PAYPAL INC. 2211 N FIRST STREET MON SERVICE CHARGES

$1.75

01/03/2012 SAN JOSE, CA 95131


$3 20

01/12/2012 SAN JOSE, CA 95131


$0 88

01/17/2012 SAN JOSE, FL 95131


$117

01/23/2012 SAN JOSE, CA 95131


$0 59

01/23/2012 SAN JOSE, CA 95131


$0 59

02/21/2012 SAN JOSE, CA 95131


$0 88

02/22/2012 SAN JOSE, CA


$1 75

02/22/2012 SAN JOSE, CA 95131


$0 88

03/31/2012 SAN JOSE, CA 95131


$1 75

03/31/2012 SAN JOSE, CA 95131

14 SUNTRUST 200 S ORANGE AVE MON CHECK ORDER

$42 22

03/28/2012 ORLANDO, FL 32801

15 MOJICA MIGUEL 1234 ORLANDO AVENUE MON WEB HOSTING

$10 00

02/04/2012 ORLANDO, FL 32817

" Incomplete Record

EXHIBIT g (3 :iw4J 9111112 1034pm

Prepared on: 1/14/14 3:23:01 PM

ID: 55547 CAMPAJGN1 I

EASURER'S REPORT - ITEMIZED DJS"!\ ;UTIONS Page 1 of 1

Name: Jason Henry Report: 2012 Q1 ** Records in Filed Report**

Period: 01/01/2012 to 03/31/2012

Seq# Full Name

{Last, Suffix First, Middle Recipient Purpose Amount

Date Street Address & City, State, Zip Type Related Expenditure Amend

1 HENRY JASON 0 REPAYMENT OF LOAN $100 00 1241 S. KIRKMAN ROAD APT 1145

01/30/2012 ORLANDO, FL 32811 RMB 2012 01 Rpt #2 Seq #1

2 HENRY JASON 0 CAMPAIGN PHOTOS $106 00 1241 S. KIRKMAN ROAD APT 1145

03/03/2012 ORLANDO, FL 32811 RMB 2012 01 Rpt #2 Seq #3 ADD

*Incomplete Record Reviewed On: 9/11/12 10:34 pm

EXHIBIT _C1_(4 cf 4 J Prepared on: 1/14/14 3:23:04PM

RICK SCOTT Governor

~O"itiDA DEPARTMENT dJ_STATE

FIN AL.NOJJCE.=.Qeliv£!y Confirmation~ 0.312 0860 000 I 3406 8 750

September 20, 2012

Mr Jason Henry, Candidate State Representative, District 46 (55547) Post Office Box 51 Gotha, Flotida 34734

Dear Mr Henry:

KEN DETZNER Secretary of State

You have been advised on several occasions that one or more of your campaign treasurer ieports were incomplete and that you had 7 days to file amended reports providing the requested infrnmation The follov.ing report needs amending:

Year _Bepor! Cover:. Perfod

2012 Ql l/l/12-3/31112 2012 n 4;1112-716112

For your convenience, copies of the error reports are anached If the reports are not filed '!YJ!!!i.!! 1 . .!!ID'.!.of receipt of this letter', the Division will forward this matter to the Florida Elections Commission for further action. Section 106 265( l ), Florida Statutes, authorizes the Florida Elections Commission to impose civil penalties of up to $1,000 per violation

If you have any questions please call Theresa Holdeen at (850) 245 .. 6250

Sincerely,

~//{,~-f ~~ 13-. Kristi Reid Bronson, Chief Bureau of Election Records

KRB.itah

Enclosure(s)

)t_ VIVA flOilOA ~00

R,. A. Gray Building • 500 South Bronough Street • -rallahassee, F'lorida 32399·0250 Telephone: (850) 245-6240 • Facsimile: (850) 245-6259 www.dosstate.fl.us

Commemorating 500 years of Florida history www.fla500 .. com

EXHIBIT_JD ( \ o·~ 3)

)t_ VIVA flORIUA 500

911912012

Candidate: Jason Henry

Flurida Department of State - DMsioo af Elections

CollllJiam:e ~art

Report: 2012 Q1 (2) Covering Period: 1/1/12 - 3/31/12

Overal

Conlrillltims

Expelllituros

Statute 106 07

106 07

FIHld Transfers Otll8r Dislrtlllllons

Description Financial activity not reported properly 1 1/30/2012 HENRY JASON

Reimbursement without corresponding Other Distribution 3 3/3/2012 HENRY JASON

Office: STR

Account: 55547

Expenditure City

Page i

~ Amount

RMB

RMB

$100 00

$106 00

911912012


Aorila Dapartmant of Sta!B - DMsion 01 Elections

Cllnda!GI Rlll!Ort

Report: 2012 F1 (3) Covering Period: 4/1/12 - 7/6/12

Over al

Gontrlluti1111s

Experdtnres

Statute 106.07

106.07

106.07

FIRll Transfers

Otltll' IHstri!IJtions

Description Reimbursement wrthout corresponding Other Distribution


Reimbursement withoui correspondmg Other Distribution

--- - -- -- --- - -- -- -----Seq Date Name

10 511812012 HENR.Y JASON

13 6!7/2012 SUITON KEVlN

16 4123/2012 UR18E MAYRA

Page 1

Office: STR

Account: 55547

Expenditure ------------------

9!Y ~ Amount

RMB 515.12

RMB S100.68 -" '· RMB $47.93

·----·. -------

FLORIDA DEPARTMENT OF STATE Ken Detzncr

Secretary of State

DIVISION OF ELEC f!ONS

October 19 .. 2012

Ms. Maria Vickers· Henry. Treasurer for Candidate Jason Henry 1241 South Kirkman Road Apartment I 145 Orlando, FL 32811-2811



Year . Type 2012 Q1

2012 F1

Cover Petiod 111112 - 3131112

411/12 - 716112

Pursuant to Section 106 07(2), Florida Statutes, you have 7 days from receipt of this notice to file an amended report supplying the missing information or provide an explanation for the entries.. We are required by law to further advise you that failure to supply this information within the time allowed constitutes a violation of Chapter I 06, Florida Statutes

If you need assistance in filing an amendment, please contact the Division's help line at (850) 245-6280

~::~~til~-:P----·--·· Kristi Reid Bronson Chief; Bureau of Election Records

cc: Mr Jason Henry, Candidate Attachment

Room 316 RA Gray Building • 500 South Bronaugh Street • Tallahassee, Florida 32399-0250 • (850) 245-6280 FAX: (850) 245 ·6260 • WWW Address: h. ttp:l'ww( rsstatctl.us • E--Mail: DivEfoctions@dos state fl us

. EXHIBIT I rJ ("))

10/19/2012 Florida Department of State - DiVision of Bectillns Page i


Report: 2012 01 (2) Covermg Period: 111112 - 3131112

~ :c

overal

contrlJutions

Expelllitures

Fund Transfers

Otlnr Distnliltions

Statute 106.07(4)

Report:

Dveral 2012 F1

t6 ContrlJutions ~ 1- Expelllitures

!==,Fund Transfers

Q) Ollill' DistrillJtlons

Statute 106.07(4)

106.07(4)

106.07(4)

Description Incorrect Name/Source{S)

(3) Covering Period: 4/1/12 - 7/6/12

Description Incorrect Name/Scurce{s)

Incorrect Name/Source(s}

Incorrect Name/Source(s}

Col11jlliance Repo~t Office: STR

Account: 55547

-------------------0th er D istri bu ti on-------------- -Seq Date Name City ~ Amount

2 3/3/2012 HENR.Y JASON CAM $105.00

Account: 55547

-------------------0th er D tstri bu ti on--------------Seq Date Name Citv ~ Amount

6/7/2012 SUITON KEVIN

2 5/1812012 HENRY JASON

3 4/23/2012 URIBE MAYRA

FOO

FOO

CAM

$100.68

S15.12

$47.93

I .

FLORIDA DEPARTMENT OF STA TE Ken Dctzner

Secretary of State


Second Notice

December 6, .~012

Ms Maria Vickers-I lenry, Treasurer for Candidate Jason Henry 1241 S Kirkman Rd., Apt #1145 Orlando, FL 32811-2811

Dear Ms Vickers-Herny:

SECOND NOl\CE

On October 19, 2012, you were advised that one or more of your campaign treasurer's reports were incomplete and that you had 7 days to file amended reports providing the requested information

The Di\ision's electronic filing system indicates that the required amendments have not been made.. Pursuant to Section 106 22,. Florida Statutes. the Division is required to notify the Florida Elections Commission of the failure to provide information required by Chapter 106 Accordingly, if the information requested in our prior notice is not received within 7 days of receipt of this letter, we will 1efor this matter to the Commission A second copy of the error report is attached for your convenience

Sincerely,

~~~-µ;fr Kristi Reid Bronson, Chief Bureau of Election Records


Attachment

Room 316 R.A Gray Building • 500 South Bronaugh Street • Tallahassee, Florida 32399-0250 • (850) 245 .. 6280 FAX: (850) 215 .. 6260 • WWW Address: http://www .. dos .. stateJt.us • E-Mail: DivEitllions@mai/ dos .1/atejl us

EXHIBIT_.La .. Cl o-P [))

121512012


Aorida Department of State - Division of Elections

comPlian.c;e Roport

Page i

Office: STR

Report: 2012 01 (2) Covering Period: 111112 3131112 Account: 55547

Dveral

&onll'IH!tions

Expelllitures

FUnd Transfers

Dtlur Distrillltions

~ Statute FAC :c 106 07(4)

Description Incorrect Name!Source{SJ

-------------------Qt her D 1stri but 10 n --------------§.gg Date Name City .IY.2.g Amount

2 3/3/2012 l-iENRY JASON CAM $100 00

~ Report: 2012 F1 (3) Covering Period: 411112 - 716112 Account: 55547 =~ ~-'-~~~~~~~~~~~=-~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

~ Dveral

ContrlJUtions

Statute

106.07(4)

106 07(4)

106.07(4)

Description Incorrect Name/Soutcefs)

Incorrect Name/Source(s)

Incorrect Name/Source{sl

-------------------Other Distribution--------------Seq Date Name City ~ Amount

i Bn/2012 SUTTON KEVIN

2 5/18/2012 HENRY JASON

3 4/23/2012 IJRIBE MAYRA

FOO

FOO

CAM

$100.68

515 12

$47.93

Holdeen, Theresa A.

From: Sent: To:

Subject:

Attachments:

Importance:

Holdeen, Theresa A Thursday, December 20, 2012 12:51 PM jason@electjasonhenry com; Jason Henry Oshenry83@gmail com); jrenee0327 @gmailcom ADDRESS ISSUE - POST OFFICE BOX CLOSED - RETURNED MAIL. (outstanding fine, and outstanding audits) #55547 Jason Henry (2012 Ql - ERROR)jpg; #55547 Jason Henry (2012 Ql - ERROR# 2)jpg; #55547 Jason Henry (2012 Fl - ERROR)jpg; #55547 Jason Henry (2012 F3 -ERROR)jpg; #55547 Jason Henry (2012 TR - Fine) pdf; #55547 Jason Henry (2012 TR -Balance After Report Filed) pdf

High

To: Mr. Jason Henry Ms. Maria Vickers-Henry, Treasurer

You have several outstanding issues with your campaign finance records .. There are several errors, on various reports that still have not been corrected I have attached screen shots with notes for everything that needs to be corrected

In addition, when comparing your total contributions VS your total expenditures, after the termination report was filed, you are still showing $40 41 that is not accounted for .. (See attachment)

Since your mail is being returned, because as you stated your post office box is closed, I have also attached a copy of the fine letter for the late filing of your termination report Please read it care.fully, and respond accordingly

Be aware that failure to address these issues can result in referral to the Florida Elections Commission for enforcement.. The Florida Elections Commission can impose civil penalties of Llp to $1000 per violation

If you need assistance with any of this, or have additional questions, please contact the Division's Help Desk at (850) 245-6280.

Thank you in advance for your immediate attention to these matters

Regards, Theresa Bureau of Electron Records

EXHIBIT_122_(j J.-i) 1

eporting System - : -_ ' Jaso~ ,i-lenry{55547-STA)'state Representative : '- -, : ' '·<· ' . , - ~ __ ,.,

• • I ~ -

Transactions Print Queue Campaign Account Sign Out Help

------~==---=-=--==---=--=-=--=-===============-=---=-=--=-=----=-==-=-=-==---==--===----=--=-=========---:::::;-----------------

("', ._, ,...,~I

~-

'

Report: 2012 - Ql - 2 Covers: 1/1/2012 - 3/31/2012 Due: 4/10/2012 status: Reviewed ----------- ----------------------------------------------------

Distribution SeQ #: ri----

Last Name, Suffix: lHENRY l---------

Date: !1i3o12012 ---=-1 --------------

first, Middle Name: bASO_N __ _

Address: !1241 s. KIRKMAN ROAD APT. 1145 --------, ~

oty: !_QgLANDO --------

Distribution Type: iR-;;mbu~serii;;t' ___ ------------------i

Purpose: jREPAYMENT Of LOAN

Office:

Amendment: ;-::-__j

-----·-----·--·--------- ____ J --,

state: Zip: 132811

Reapient: r--_------------· . ~----:------, !Other · -------------

I I

----- --- --.- '' - ' -- --- " ------------------ ' -- ---------- --------- ----------- u --- -- ._,,, _____ , _______ -·----------------11 Go To --- -~ ~---- [ 1

Related Electlc>n: bo121106-GEN Year: 12012 Rpt IQl l Seq#: iL· 11 Rpt #: 2 i !,.1 ~-------~ Type: - - - !

_Expenditure___________________ ____________ _ _____________________________ -------·- ----------------------------------- -----" Error Flag: l------~

_, ----' Amount:! l 100.001

1 I I

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

Transactions Prmt Queue Campaign Account Sign Out Heip

~----------------------------------

Report: 2012 - Fl - 3 Covers: 4/1/2012 - 7/6/2012 Due: 7/13/2012

Page size: i_. -_- 1s: 111 ~~_1;,'•:~Jr~f;'] Page 1 of 1 (Trx's 1 - 3 of 3)

'Vo71ID v [====:~-- =~- -----=----~--_______ [

C.> .C..'1 ~:-'

status: Reviewed

l J

,- , _ _ • >- , ,• <- ,;.« ~ " ,•-;.- _ - ~ > -- -, x~- - "' '-'' ,- - ~, -- • • ;- ~ ,,- '.- • '.( ' r ~ "< • , l · ' - ' - C ,., _, .z.~ l

p~rtlng System . . : · · '. - ~», · . · · ' - · . _..Ja~ori l:l.e~~(5.5547-STAY State ReiJt.eseq;tattve' : ·,. · "~ :~ ~i ; - • - • ~ ·- ~' " - "' ,_ - < "'

- . Transactions Pnnt Queue Campaign A~count Sign Out Help

Due: 8/10/2012 status: Rev1e1.ved L-----·---------------------~--- -- --------·-,.-------------------------------------.-----------------------------------------------·

Page 5"1Ze: [~=-!:~J '!~fl \f I -'f;J J.~l;j Page 1 Of 2 (Tfl{'s t - 15Of18) '(iz ';k, V ,-------------- ... ___________ _

'7 ti! L __ . _____ .. ____________________ .. ____ ---~

~ 08/09/2012 \PADGEIT,MARK -I --$100.0 CAMPAIGNCONSULTING

08/09/2012 \GROOVYDUDECREATIONS I $26.6 CAMPAIGNBUITONS MON I 0

_ .c:;,~i:.µB.xo~#vl~--;:111a])A1:ip~~~~~r,~!;•;,-,; ··•• --·--·------ -·----~a-~~1-l?t~- :~Ji~x~~~1~;,;c.~~;d,i~'J£,~;·~r·.rttr1Q,~;:.1i~{:~;:.~-"\0:}~~~·l~i.£.11tj~;;;l 1

~ 08/08/2012 i VIOLA, MARK $180.0 I CAMPAIGN CONSULTING I MON ! 0 I I ;;-1-··;\·fl~i,o:if20-iz··: ~.~~~'" -·---.•._1--. ·< '.~~1~r9~~Bflf~~~f~~;~~4~~a,e,J{1~;~~~'.~ il'!Jih\¥:~\S~~,'~?elG;;;:o;i ;1 ,

$150.0 CAMPAIGN CONSULTING MON I , 0

Sum of Contributions vs Expenditures Jason Henry

Date of last <::ontribution: 8/17/12

Yea<' Report Contributions ·------~·-·-·-·----

Previous Balance:

12/19/2012 6:11:48 PM

55547

1 After 8/14/12

Expenditures Running Total

--·----·--·------···---·--~---··-··-··· .. --------·---04 $120.00 $120.00 2011

2012 Q1 $2,610.00 $331.66 $2,398.34 _______________________ ,, ____ ,, __ .. ________________________ _ F1 $2,560.00 $2,937. 72 $2,020.62

·-- --------------------F2 $285 .. 00 ----------F 3 $2,350.00

TR $50.00

Campaign Total: $7,975.00

Grand Total:

$397.00 $1,908.62 -----·-·--"-------·---··---·-·-···-----

$3,690.22

$577.99

$7,934.59

$568.40

$40.41

EXHIBIT_l_o(8 J· i)

o 'Eectionsc -.. , .·,·.·: - · · : . · · · · __ -: __ , --· .•::._, · _,_,·--: · :: _.: ;:· ,.': -' .· --·-:--- . · "." - .~".'

eporting S)'!item ·; · _ , ,,Ja,sojt Hency(55547-STA.tstate Representative · " . . • .. ,-: - < - ' - ~

- . - -

Transactions Print Queue Campaign Account Sign Out Help . -- ------------------------ -·- ------ --------- - - - -- -· - --- ------ --------------· _________ ,,_ --

Status: Reviewed : I --------------I

I -------, I __ ,

Expenditure #: .------. \ 11

~--~

Amendment:[ __ _] L. _____ ---- _ _,

r--------------------------- ---- -----··--Last Name, Suffix: !HE_r-l_~Y ______ _

First, Middle Name: GASoN . '--------·----

--------- ·-------- --~~-

------·------------!

oty: lORLANDO Zip:ff2s11 State: fFL __ _ -~-----

' ---, I

C· t,, ,J ,.. ... ...,.,,.._· '" "

~-~!J~!'lc.te>.;~~,d.!;'l,l~l~~l ang5~g!~.re~Ul1!1,~tW?Mit-~cg1;1!f!.IM!-~~g~j,'•· ~J:l...\~9,4\_~e,~fc~t3~~!~i~9!'},l~~p,p:; tl9.l!\!~,¥,eJJ cQ,~~i~~~l'!lc,eW,~HJ!;;aJ)g;, ~n!~J;t.i~~~~a,11~!,J~lill~.aJngp,!J~'i(:";"1q{l,fWJt, ·

(

Holdeen, Theresa A.

. c:·, f'rpm: Sent: To:

.H.oldeen,Theres.a.A .• T~urs~ay,j)e,c~~beh7, 2012 2:20 PM •..... 'Jason Henry'

Subject: RE: ADDRESS ISSUE· POST OFFICE BOX CLOSED - RETURNED MAIL. (outstanding fine, and outstanding audits)

If you need assistance with any of this, or have additional questions, please contact the Division's Help Desk at (850) 245-6280 ..

Regards, Theresa Bureau of Electron Records

.. Fr:om: Jason. Henry[mailto:jshemy83@gmaiLcom] .. Sent: Wednesday, December26, .20l2H:56·PM

To: Holdeen, Theresa A Subject: Re: ADDRESS ISSUE - POST OFFICE BOX CLOSED - RETURNED MAIL. (outstanding fine, and outstanding audits)

Hi Theresa,

Thanks for bringing these enors to my attention

I am a little confused on what I'm doing wrong When I submitted a report <luting the summer with reimbursements, I was told that it was done in en or. I contacted someone at the state office and was told to resubmit as MON

When doing a reimbutsement, are you able to guide me along so that these errors do not continue? I inputted "other distributions" before, but was given an el!or again

On Thu, Dec 20, 2012 at 12:51 PM; Holdeen, Theresa A <[email protected]> wrote:

To: Mr. Jason Henry

Ms .. Maria Vickers-Henry, Treasurer

You have several outstanding issues with your campaign finance records. There are several errors, on various reports that still have not been corrected .. I have attached screen shots with notes for everything that needs to be. corrected.

EXHIBIT_lZ C16f ~) 1

(

In addition, when comparing your total contributions VS your total expenditures, after the termination report was filed, you are still showing $4041 that is not accounted for. (See attachment)

Since your mail is being returned, because as you stated your post office box is closed, I have also attached a copy of the fine letter for the late filing of your termination report. Please read it carefully, and respond accordingly.

Be aware that failure to address these issues can result in referral to the Florida Elections Commission for enforcement. The Florida Elections Commission can impose civil penalties of up to $1000 per violation

If you need assistance with any of this, or have additional questions, please contact the Division's Help Desk at (850) 245-6280

Thank you in advance for your immediate attention to these matters ..

Regards,

Theresa

Bureau of Electron Records

~j:;J;)~ .. 23

1/15/2014

Account: 55547

Rpt Seq: 2

ProceS'sDescrlption

Create Pending Report

Review Pending Report






Recalc Pending Report I otal




File Pending Report

Amend Fi 1 ed Report


File Pending Report

(

I

Queued Items for 2012-01

STR 046 Jason Henry

Status Submittet Oeated

Processing Complete 55547 4/4/2012 11: 11 :28 PM

Processing Complete 55547 4/9/2012 2:53:40 PM

Processing Complete 55547 4/9/20129:18:51 PM







Processing Complete 55547 4/9/2012 11 :03:40 PM






EXHIBIT_._! _ __,~---

Page 1

LastUpdate

4/4/2012 11:11:28 PM

4/9/2012 2:53:40 PM

41912012 9:18:51 PM

4/9/2012 9:46:50 PM

4/9/2012 10:25:20 PM

4/9/2012 10:28:29 PM

4/9/2012 10:48:38 PM

4/9/2012 10:50:13 PM

4/9/2012 10:50:23 PM

4/9/2012 11 :03:41 PM

4/10/2012 8:27:05 PM

4/10/2012 8:28:54 PM

8/24/2012 10:15:50 PM

911112012 10:34:59 PM

911112012 10:35:33 PM

1/21/2014 Filed Camaign Treasurer's Report Page 1

Jason Henry Elect ID: 20121106-GEN From: 4/1/2012 Amd: Y Wvr:N Filed: FIL 7114/2012 12:00:36 A

55547 - STR 046 Report: 2012 F1 (3) To: 7/6/2012 Cmplt: COM Reviewed: AUD 8124/2012 9:56 39 p

Original Report Submitted: 711412012 12:00:36 A

CONTRIBUTIONS Seq Contributor Occupa/1on Errors Date Name Address Type Jnkind Descnption An1d Amount

HENRY 3301 ARENA BLVD_ APT. 240 MILITARY 0 $200.00

417/2012 VIVIAN SACRAMENTO CA 95834 CHE

2 LEWIS 415 E. PINE STREET APT 1012 ATTORNEY 0 $200.00

614/2012 \VILLIAM ORLANDO FL 32801 CHE

3 CROLL 5539 GULL PRAIRIE WAY 0 $40.00

71612012 VIRGINIA KALAMAZOO Ml 49048 CHE

4 CONLEY 680 PARKELL AVENUE SOUTH 0 $5.00

7/6/2012 ROBIN HUEYTOWN AL 35023 CHE

5 REAM 5512 METROWESTBLVD. APT. 105 WORKLOAD ANALYST 0 $40.00

61512012 MATTHEW ORLANDO FL 32811 CAS j

,r-\ 6 CARMONA 5512 METROWEST BLVD APT. 105 ENTERTAINMENT 0 $20.00

61512012 CHRIS ORLANDO FL 32811 CAS

7 PENNINGTON PO. BOX 3083 ATTORNEY 0 $20.00

61512012 CHARLES WINTER PARK FL 32789 CAS

~ 8 HEAD 800 MAYFAIR CIRCLE CONSULTANT 0 $250.00

61112012 DOUGLASD. ORLANDO FL 32803 CHE 1·-

9 ALBURY 38 l MOCKINGBIRD ROAD AUTHOR 0 $10.00 m 41612012 ANTHONY DAVENPORT FL 33896 CHE s:

.. __ _, 10 LYNUM P.O. BOX 555206 ATIORNEY 0 $125.00 x [.LJ

61512012 JUAN ORLANDO FL 32855 CHE

II AUFFANT 2514 E. JACKSON STREET ATIORNEY 0 SI00.00

615/2012 JAMES ORLANDO FL 32803 CHE

12 WALT DISNEY PARKS AND RESOR 1375 E. BUENA VISTA DRIVE B THEME PARKS 0 $500.00

612912012 LAKE BUENA VI FL 32830 CHE

13 WALT DISNEY TRAVEL COMPANY 1375 E. BUENA VISTA DRIVE B TRAVEL 0 $500.00

6129/2012 LAKE BUENA Vl FL 32830 CHE

14 DISNEY DESTINATIONS 220 CELEBRATION SUITE 6300 B TRAVEL 0 $500.00

715/2012 CELEBRATION FL 34747 CHE

15 SUTTON 5319 LAKE JESSAMINE DRIVE 0 $25.00

617/2012 KEVIN ORLANDO FL INK CAMPAIGN EVENT SUPPLIES

1/21/2014 Filed Cama1gn Treasurer's Report Page 2

Jason Henry Elect ID: 20121106-GEN From: 4/1/2012 Amd: Y Wvr:N Filed: FIL 7/14/2012 12:00:36 A

55547 - STR 046 Report: 2012 F1 (3) To: 7/612012 Cmplt: COM Reviewed: AUD 8124/2012 9:56:39 p

Original Report Submitted: 7/1412012 12:00:36 A

CONTRIBUTIONS Seq Contributor Occupat10n Errors Date Name Address Type lnkiltd Descnpt1on Antd Amount

16 NANTON 1308 NORTH PINE HlLLS ROAD NEWS MEDIA 0 $500.00

5113/2012 GILLIAN ORLANDO FL 32808 INK ADVERTISING

17 LONGMORE 1308 NORTII PINE HILLS ROAD NEWS MEDIA 0 $500.00

6/10/2012 KEITH ORLANDO FL 32808 INK ADVERTISING

18 WEST ORLANDO NEWS 1308 NORTII PINE HILLS ROAD B NEWS MEDIA 0 $500.00 "-.._ /

711/2012 ORLANDO FL 32808 INK ADVERTISING

19 VICKERS-HENRY 1241 S. KIRKMAN ROAD APT 1145 MEDICAL 0 $50.00

6/5/2012 MARIA ORLANDO FL 32818 CAS

EXPENDITURES Seq Office Errors Date Na1ne Address TJpe Purpose Amd Amount

MOJICA 1234 ORLANDO A VENUE MON 0 SI0.00 4 5/10/2012 MIGUEL ORLANDO FL 32817 WEBSITE MAINTENANCE ()

2 PAYPALINC. 2211 N FIRST STREET MON 0 $093 Q '--'

416/2012 SAN JOSE CA 95131 SERVICE CHARGES ill 3 PAYPALINC. 2211 N FIRST STREET MON 0 $6.10

41712012 SANJOSE CA 95131 SERVICE CHARGES

, __

4 PAYPALINC. 2211 N FIRST STREET MON 0 56.10 '° 5: 614/2012 SANJOSE CA 95131 SERVICE CHARGES ><

5 PAYPALfNC. 22 l l N FIRST STREET MON 0 $1.46 f..Ll

716/2012 SAN JOSE CA 95131 SERVICE CHARGES

6 PAYPALINC. 2211 N FIRST STREET MON 0 $0.45

716/2012 SAN JOSE CA 95131 SERVICE CHARGES

7 PADGETI 3306 ELLEN DRIVE. MON 0 $100.00

5/2012012 MARK ORLANDO FL 32806 CAMPAIGN WORK

8 USPS 9907 &TH STREET MON 0 $16.00

519/2012 GOTIIA FL 34734 PO BOX RENEW AL

9 DIGITAL PROAGANDA 997 WEST KENNEDY BOULEY ARD SUIT MON 0 $452.63

4/23/2012 ORLANDO FL 32810 CAMPAIGN FLYERS

1/21/2014 Filed Cama1gn Treasurer's Report Page 3

Jason Henry Elect ID: 20121106-GEN From: 4/1/2012 Amd: Y Wvr:N Filed: FIL 7/14/2012 12:00:36 A

55547 - STR 046 Report: 2012 F1 (3) To: 7/6/2012 Cmplt: COM Reviewed: AUD 8/24/2012 9:56:39 p

Original Report Submitted: 7/14/2012 12:00:36 A

EXPENDITURES Seq Office Errors Date Name Address Type Purpose A nut Amount

10 HENRY 1241 S KIRKMAN ROAD APT. 1145 MON 0 $1512

5/1812012 JASON ORLANDO FL 32811 FOOD FOR CAMPAIGN WORKERS

II PADGETT 3306 ELLEN DRIVE, MON 0 $100.00

6/21/2012 MARK ORLANDO· FL 32806 CAMPAIGN WORK

12 DEPARTMENT OF STATE 400 S MONROE STREET#P12 MON 0 $1.781.82 ' . /

6/8/2012 TALLAHASSEE FL 32399 QUALIFYING FEE

13 SUTTON 5319 LAKE JESSAMINE DRlVE MON 0 $100.68

617/2012 KEVIN ORLANDO FL 32839 FOOD FOR CAMPAIGN WORKERS

14 BCV/NATIONAL ALUMNI ASSOCIA PO. BOX 1899 MON 0 $40.00

6/8/2012 DAYTONA FL 32115 ENTRY TO CAMPAIGN EVENT

15 PADGETT 3306 ELLEN DRIVE. MON 0 $150.00

7/3/2012 MARK ORLANDO FL 32806 CAMPAIGN WORK

16 URIBE 5319 LAKE JESSAMINE DRlVE MON 0 $47.93

ORLANDO 32839 CAMPAIGN BUSINESS CARDS ~

4/23/2012 MAYRA FL l()

17 PADGETT 3306 ELLEN DRIVE. MON 0 $100.00

4/4/2012 MAR ORLANDO FL 32806 CAMPAIGN WORK l··-18 SUPERVISOR OF ELECTIONS 119 WEST KALEY STREET MON 0 $8.50 m

4/24/2012 ORLANDO FL 32806 PETITIONS ::c [ii

. / -

,_

1/21/2014

Jason Henry

5554 7 - STR 046

EXPENDITURES Seq Dale Name

10 HENRY

5/18/2012 JASON

13 SUTTON

617/2012 KEVIN

16 URIBE

4/23/2012 MAYRA

OTHER DISTRIBUTIONS Seq Date Na1ne

SUTTON

6/7/2012 KEVIN

2 HENRY

5118/2012 JASON

3 URIBE

4/23/2012 MAYRA

Filed Cama1gn Treasurer's Report Page4

Elect JD: 20121106-GEN

Report: 2012 F1 (3)

From: 4/112012

To: 71612012

Amd: Y Wvr: N Filed: FIL 7114/2012 1i,oo,36 A

Cmplt: COM Reviewed: AUD 8/2412012 9,56 39 P

Amended Report Submitted: 9/1112012 10:36:08 P

Office Errors

Address Type Purpose Aff1d Amount

1241 S. KIRKMAN ROAD APT. 1145 RMB 0 $15.12

ORLANDO FL 32811 FOOD FOR CAMPAIGN WORKERS UPD

5319 LAKE JESSAMINE DRIVE RMB 0 $100.68

ORLANDO FL 32839 FOOD FOR CAMPAIGN WORKERS UPD

5319 LAKE JESSAMINE DRIVE RMB 0 $47.93

ORLANDO FL 32839 CAMPAIGN BUSINESS CARDS UPD

Recipient Office Errors

Address Type Purpose Amd A1nount

5319 LAKE JESSAMINE DRIVE 0 0 $100.68

ORLANDO FL 32839 RMB FOOD FOR CAMPAIGN WORKERS ADD

1241 S. KJRKMAN ROAD APT. 1145 0 0 $15.12

ORLANDO FL 32811 RMB FOOD FOR CAMPAIGN WORKERS ADD

5319 LAKE JESSAMINE DRIVE 0 0 $47.93

ORLANDO FL 32839 RMB CAMPAIGN BUSINESS CARDS ADD

'----" i.D _J

i--I m s: x HJ

1121/2014

Jason Henry

55547 - STR 046

Filed Camaign Treasurer's Report Elect ID: 20121106-GEN

Report: 2012 F1 (3)

From: 4/1/2012

To: 7/6/2012

Page 5

Amd: Y Wvr: N Filed: FIL 7/14/2012 12'00,36 A

Cmpit: COM Reviewed: AUD 8124/2012 956'39 P

(

FLORIDADEPARTMENTOF STATE

July 18, 2012

Ken Detzner Secretary of State


Ms Maria Vickers-Henry, T reasurcr for Candidate Jason Henry 1241 South Kirkman Road Apartment 1145 Orlando, FL 32811-2811

Dear Ms Vickers-Herny;

\


Cover Period 4/1/12 - 716/12

Pursuant to Section 106 07(2), Florida Statutes, you have 7 days from receipt of this notice to file an amended report supplying the missing information or provide an explanation for the entries We are required by law to forther advise you that failure to supply this information within the time allowed constitutes a violation of Chapter 106, Florida Statutes.


~!:~di-~~-.~ ~isti Reid Brnnson Chief, Bureau of Election Records

cc: Mr. Jason Henr), Candidate

Attachment

Room 316 RA Gray Building • 500 South Bronough Street • Tallahru;see, Florida 32399-0250 • (850)245·6280 FAX: (850) 245-6260 • WWW Address: http://www .. dossta1eJl us • E-Mail: DivE/ections@dos Slate fl us

EXHIBIT _ _l(o_ U oi ())

7/1812012


florida Department of Statu - Division of Elections

__ CompHa_nce R8llort


overal

Contrlmtions

Expelllitures

Statute 106.07

106.07

106.07

fund Trans!Brs

Othir Distrillrtions

Description Reimbursement without corresponding Other Distribution



- - --------- -- ------ --Seq Date Name

10 511812012 HENRY JASON

13 617/2012 SUITONKEVtN

16 4/2312012 URIBE MAVRA

Page 1

Office: STR

Account: 55547

Expenditure ------------------City ~ Amount

MON $15.12

MON $100.68

MON $47.93 ,-,,

/


Secretary of State

DIVISION 01' ELECTIONS

Second Noiice

August 3, 2012

Ms Maria Vickers-Herny, Treasurer for Candidate Jason Herny 1241 South Kirkman Road Apartment 1145 01 lando, FL .)2811 2811

Dear Ms Vickers·Herny:

SECOND NOTICE

On July 18, 2012, you were advised that one or more of your campaign treasurer's reports were incomplete and that you had 7 days to file amended reports providing the requested information

The Division's electronic filing system indicates that the requited amendments have not been made Pursuant to Section 106 22, Florida Statutes, the Division is required to notify the Florida Elections Commission of the failure to provide information required by Chapter I 06. Accordingly, if the information requested in our prior notice is not received within 7 days of receipt of this letter, we will refer this matter to the Commission A second copy of the errnr repoll is attached for your convenience

Sincerely,

~ ,A·~---1 ~~-~ Kristi Reid Brnnson, Chief Bureau of Election Records

cc: Mr. Jason Henry, Candidate

Attachment

Room .l \ 6 R.A Grny Building • 500 SouU1 Bronough Street • Ta\\ahru;see, Florida 32399-0250 • (850) 245-6280 FAX: (850) 245-6260 • WWW Address: http://www dos state,fl us • E·Mail: DivElec1ioml(f,mai! do' I/ale fl u1

EXHIBIT_JJ ( ]tJ_d)

I i

F'I x ::c OJ =i :--i I ·--1 I~ SD C)

\-::;>

~

81212012 florida ll9partnmt of State - DMsm Of Elections


Report: 2012 F1 (3) Covering Period: 4/1/12 - 7/6112

Overal

Contrbrtions

Expeidl!Q'es

Statute 106.07

106.07

106.07

Flftlll Transfers

Dtlur llistrillllions



Re1mbursemeni without corresponding Other Distribution

-- - ---- -~----

Cllll1!1311C8 RlllJO!'I

- - - - --- ----- -- -- -----Seq ~ Name

10 511812012 HEl\:RY JASON

13 61712012 sunON KEVIN

16 4/2312012 URIBE.MAYAA

Page i

Office: STR

Account: 5554 7


MON $15 12

MON 5100 68

MON $47.93.

(







D Check box if address has changed since last report

(4) Check appropriate box( es):

IKl Candidate (office sought):

D Political Committee D Check If PC has DISBANDED

D Committee of Continuous Existance D Check If CCE has DISBANDED



Cover Period: From 04/01/2012 To 07/06/2012 Report Type: F1

D Original IKJ Amendment D Special Election Report


Cash & Checks $2,560 00 Monetary Expenditures $2,937 72

Loans $0 00 Transfers to Office Account $0 00

Total Monetary $2,560 00 Total Monetary $2,937 72

In-Kind $1,525 00 (8) Other Distributions

Certification It is a first degree misdemeanor for any person to falsify a public record (ss 83913, F S)

I certify that I have examined this report and it is I certify that I have examined this report and it is true, correct and complete true, correct and complete

Name of D Treasurer D Deputy Treasurer Name of IKJ Candidate D Chaiman (PC/PTY Only

y y

Signature Signature

Prepared on: 1/14/14 3:35:47PM Reviewed On: 8/24/12 9:56 pm

EXHIBIT _J~_c 1 b-JJ4)

ID: 55547

Name: Jason Henry

Seq#

( CAMPAIGN

Full Name {Last, Suffix First, Middle

( .EASURER'S REPORT - ITEMIZED CON\ •• ,SUTIONS Page 1 of 1

Report: 2012 F1 ** Records in Filed Report**

Period: 04/01/2012 to 07/06/2012

Contributor Occupation Amount

Date Street Address & City, State, Zip Type In-Kind Description Amend

1 HENRY, VIVIAN $200 00 3301 ARENA BLVD APT 240 I MILITARY

04/07/2012 SACRAMENTO, CA 95834 CHE 2 LEWIS, WILLIAM $200 00

415 E PINE STREET APT 1012 I ATTORNEY

06/04/2012 ORLANDO FL 32801 CHE 3 CROLL, VIRGINIA $4000

5539 GULL PRAIRIE WAY I 07/06/2012 KALAMAZOO. Ml 49048 CHE 4 CONLEY, ROBIN $500

680 PAR KELL AVENUE SOUTH I 07/06/2012 HUEYTOWN AL 35023 CHE 5 REAM, MATTHEW $40 00

5512 METROWEST BLVD APT 105 I WORKLOAD ANALYST

06/05/2012 ORLANDO FL 32811 CAS 6 CARMONA, CHRIS $20 00

5512 METROWEST BLVD APT 105 I ENTERTAINMENT

06/05/2012 ORLANDO, Fl 32811 CAS 7 PENNINGTON, CHARLES $20.00

P 0. BOX 3083 I ATTORNEY

06/05/2012 VVlNTER PARK FL 32789 CAS 8 HEAD, DOUGLAS D $250 00

800 MAYFAIR CIRCLE I CONSULTANT

06/01/2012 ORLANDO FL 32803 CHE 9 ALBURY, ANTHONY $10 00

381 MOCKINGBIRD ROAD I AUTHOR

04/06/2012 DAVENPORT FL 33896 CHE 10 LYNUM, JUAN $125 00

P 0 BOX 555206 I ATTORNEY

06/05/2012 ORLANDO FL 32855 CHE 11 AUFFANT, JAMES $100 00

2514 E. JACKSON STREET I ATTORNEY

06/05/2012 ORLANDO FL 32803 CHE 12 WALT DISNEY PARKS AND RESORTS $500 00

1375 E. BUENA VISTA DRIVE B THEME PARKS

06/29/2012 LAKE BUENA VISTA FL 32830 CHE 13 WALT DISNEY TRAVEL COMPANY $500 00

1375 E. BUENA VISTA DRIVE B TRAVEL

06/29/2012 LAKE BUENA VISTA FL 32830 CHE 14 DISNEY DESTINATIONS $500 00

220 CELEBRATION SUITE 6300 B TRAVEL

07/05/2012 CELEBRATION, FL 34747 CHE 15 SUTTON, KEVIN $25 00

5319 LAKE .JESSAMINE DRIVE I 06/07/2012 ORLANDO FL INK CAMPAIGN EVENT SUPPLIES

16 NANTON, GILLIAN $500 00 1308 NORTH PINE HILLS ROAD I NEWS MEDIA

05/13/2012 ORLANDO FL 32808 INK ADVERTISING

17 LONGMORE, KEITH $500 00 1308 NORTH PINE HILLS ROAD I NEWS MEDIA


18 WEST ORLANDO NEWS $500 00 1308 NORTH PINE HILLS ROAD B NEWS MEDIA


19 VICKERS-HENRY MARIA $50 00 1241 S. KIRKMAN ROAD APT 1145 I MEDICAL

06/05/2012 ORLANDO, FL 32818 CAS

"Incomplete Record Prepared on: 1/14/14 3:35:48PM

, .. "·

ID: 55547 CAMPAIGN, .cASURER'S REPORT - ITEMIZED EX~l:: •• i.>ITURES Page 1 of 1

Name: Jason Henry Report: 2012 .E1 Period: 04/01/2012 to 07/06/2012 .. R ecor d . F"I d R sm 1e eport *

Seq# Full Name

(Last, Suffix First, Middle Amount


Amend

1 MOJICA MIGUEL 1234 ORLANDO AVENUE MON WEBSITE MAINTENANCE

$10 00

05/10/2012 ORLANDO, FL 32817

2 PAYPAL INC. 2211 N FIRST STREET MON SERVICE CHARGES $0 93

04/06/2012 SAN JOSE, CA 95131

3 PAYPAL INC. 2211 N FIRST STREET MON SERVICE CHARGES $6 10

04/07/2012 SAN JOSE, CA 95131


$6 10

06/04/2012 SAN JOSE, CA 95131

5 PAYPAL INC. 2211 N FIRST STREET MON SERVICE CHARGES $1.46

07/06/2012 SAN JOSE, CA 95131

6 PAYPAL INC. 2211 N FIRST STREET MON SERVICE CHARGES $045

07/06/2012 SAN JOSE, CA 95131

7 PADGEITMARK 3306 ELLEN DRIVE MON CAMPAIGN WORK

$100 00

05/20/2012 ORLANDO, FL 32806

8 USPS 9907 8TH STREET MON PO BOX RENEWAL

$16 00

05/09/2012 GOTHA, FL 34734

9 DIGITAL PROAGANDA 997 WEST KENNEDY BOULEVARD SUITE#A12 MON CAMPAIGN FLYERS $452 63

04/23/2012 ORLANDO, FL 32810

10 HENRY .JASON 1241 S. KIRKMAN ROAD APT 1145 RMB FOOD FOR CAMPAIGN WORKERS

$15 12

05/18/2012 ORLANDO, Fl 32811 UPD

10 HENRY .JASON 1241 S. KIRKMAN ROAD APT 1145 MON FOOD FOR CAMPAIGN WORKERS $15 12

05/18/2012 ORLANDO, FL 32811 History 09/11/12

11 PADGETT MARK 3306 ELLEN DRIVE MON CAMPAIGN WORK

$100 00

06/21/2012 ORLANDO, FL 32806

12 DEPARTMENT OF STATE 400 S MONROE STREET#P12 MON QUALIFYING FEE $1,781 82

06/08/2012 TALLAHASSEE, FL 32399

13 SUTTON KEVIN 5319 LAKE JESSAMINE DRIVE RMB FOOD FOR CAMPAIGN WORKERS

$100 68

06/07/2012 ORLANDO, Fl 32839 UPD

13 SUTTON KEVIN 5319 LAKE JESSAMINE DRIVE MON FOOD FOR CAMPAIGN WORKERS

$100 68

06/07/2012 ORLANDO, FL 32839 History 09/11/12

14 BCU/NATIONAL ALUMNI ASSOCIATION P 0. BOX 1899 MON ENTRY TO CAMPAIGN EVENT

$40 00

06/08/2012 DAYTONA, FL 32115

15 PADGETT MARK 3306 ELLEN DRIVE MON CAMPAIGN WORK

$150 00

07/03/2012 ORLANDO, FL 32806

16 URIBE MAYRA 5319 LAKE JESSAMINE DRIVE RMB CAMPAIGN BUSINESS CARDS $47 93

04/23/2012 ORLANDO, FL 32839 UPD

16 URIBE MAYRA 5319 LAKE JESSAMINE DRIVE MON CAMPAIGN BUSINESS CARDS $47 93

04/23/2012 ORLANDO, FL 32839 History 09/11112

17 PADGETT MAR 3306 ELLEN DRIVE MON CAMPAIGN WORK $100 00

04/04/2012 ORLANDO, FL 32806

18 SUPERVISOR OF ELECTIONS 119 WEST KALEY STREET MON PETITIONS $8 50

04/24/2012 ORLAN DO, FL 32806

* Incomplete Record Reviewed On: 8/24/12 9:56 pm Prepared on: 1/14/14 3:35:48PM

EXHIBIT_Jii(3 a?· !{)

ID: 55547

,. CAMPAIG~1

•• EASURER'S REPORT - ITEMIZED 01s+, .. dUTIONS Page 1 of 1

Name: Jason Henry Report: 2012 f1 ** Records in Filed Report "I<*

Period: 04/01/2012 to 07/06/2012

Full Name Amount Seq# {Last, Suffix First. Middle Recipient Purpose

Date Street Address & City, State, Zip Type Related Expenditure Amend

1 SUTTON KEVIN 0 FOOD FOR CAMPAIGN WORKERS $100 68 5319 LAKE JESSAMINE DRIVE

06/07/2012 ORLANDO, FL 32839 RMB 2012 F1 Rpt #3 Seq #13 ADD

2 HENRY ,JASON 0 FOOD FOR CAMPAIGN WORKERS $1512 1241 $.KIRKMAN ROAD APT 1145

05/18/2012 ORLANDO, FL 32811 RMB 2012F1 Rpt#3$eq#10 ADD

3 URIBE MAYRA 0 CAMPAIGN BUSINESS CARDS $47 93 5319 LAKE JESSAMINE DRIVE

04/23/2012 ORLANDO, FL 32839 RMB 2012 F1 Rpt#3Seq#16 ADD

--------~-------------·-·--·-----· -----·----------·---------------* Incomplete Record Reviewed On: 8/24/12 9:56 pm Prepared on: 1/14/14 3:35:49PM

EXHIBIT_.!~-<~ ~ Y J

I

\

1/15/2014 Queued Items for 2012-F1 Page 1

Account: 55547 STR 046 Jason Henry Rpt Seq: 3

PtocessDescription Status Submittet C'reated LastUpdate

Create Pending Report Processing Complete 55547 7/13/2012 8:19:51 PM 7/13/2012 8:19:51 PM

Review Pending Report Processing Complete 55547 7/13/2012 9:53:31 PM 7/13/2012 9:53:31 PM

Review Pending Report Processing Complete 55547 7/13/2012 9:55:01 PM 7/13/2012 9:55:01 PM

Review Pending Report Processing Complete 55547 7/13/2012 11 :44:21 PM 7113/2012 11 :44:21 PM

Review Pending Report Processing Complete 55547 7/13/2012 11:45:03 PM 7/1312012 11:45:03 PM

Review Pending Report Ptocessing Complete 55547 7/13/2012 11:46:43 PM 7/1312012 11 :46:43 PM

Recalc Pending Report I otal Processing Complete 55547 7/13/201211:46:55 PM 7/1312012 11:46:55 PM

Review Pending Report Processing Complete 55547 7/1312012 11:49:28 PM 7/1312012 11:49:28 PM

Review Pending Report Ptocessing Complete 55547 7113/2012 11:58:36 PM 7/13/201211:58:36PM

Review Pending Report Processing Complete 55547 7/13/201211:59:11 PM 7/1312012 11:59:11 PM

File Pending Report Processing Complete 55547 7/1412012 12:00:36 AM 711412012 12:00:36 AM

Amend Filed Report Processing Complete 55547 8/2412012 9:37:35 PM 8/2412012 9:37:37 PM

Review Pending Report Processing Complete 55547 8124/2012 9:56:39 PM 8/2412012 9:56:39 PM

F'ile Pending Report Processing Complete 55547 9/11/2012 10:36:08 PM 9/111201210:36:08 PM

EXHIBIT_J9 ______ _

' I








(4) Check appropriate box(es):

~ Candidate (office sought):





Cover Period: From 07/21/2012 To 08/09/2012 Report Type: F3

~Original D Amendment D Special Election Report


Cash & Checks $2,350 00 Monetary Expenditures

Loans $0 00 Transfers to Office Account

Total Monetary $2,350 00 Total Monetary


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 l certify that I have examined this report and it is true, correct and complete true, correct and complete

$3,690 22

$0 00

$3,690 22

Name of D Treasurer 0 Deputy Treasurer Name of ~Candidate 0 Chaiman (PC/PTY Only

y y

Signature Signature

Prepared on: 1/14/14 3:37:36PM Reviewed On: 8/10/12 11 :38 pm

ID: 55547 CAMPAIGN·:

Name: Jason Henry

Seq# Full Name

(Last, Suffix First, Middle

I .ASURER'S REPORT - ITEMIZED CON .. 1

Report: 2012 F3 ** Records in Filed Report**


Date Street Address & City, State, Zip Type In-Kind Description

1 WADE JA.JA 810 N. PINE HILLS ROAD I CONSTRUCTION

07/31/2012 ORLANDO, FL 32808 CHE '

2 GRAY, PATRICK 4314 FLORA VISTA DRIVE I INSURANCE

08/03/2012 ORLANDO FL 32837 CHE

3 ASHTON LAKE APARTMENTS OBA 24 7 N. WESTMONTE DRIVE B REAL ESTATE

08/02/2012 ALTAMONTE SPRINGS FL 32714 CHE

4 LAKE POINT SENIOR APARTMENTS LP 247 N. WESTMONTE DRIVE B REAL ESTATE

08/02/2012 ALTAMONTE SPRINGS FL 32714 CHE

5 LEWIS, WILLIAM 415 E. PINE STREET APT 1012 I ATTORNEY

08/07/2012 ORLANDO, FL 32801 CHE

6

;UTIONS Page 1 of 1

Period: 07/21/2012 to 08/09/2012

Amount

Amend

$300 00

$150 00

$500 00

$500 00

$200 00

CRAWLEY, JENNA $50 00 1470 AL OMA AVENUE I CEO/PLANNED PARENTHOOD

08/09/2012 WINTER PARK FL 32789 CHE

7 DELOACH LAW LLC $150 00 1115 E. LIVINGSTON STREET B LAW OFFICE

08/09/2012 ORLANDO, FL 32803 CHE

8 FLORIDA HOSPITAL ASSOCIATION POLITICAL $500 00 ACTION COMMITTEE F HEALTHCARE

08/06/2012 306 EAST COLLEGE AVENUE CHE TALLAHASSEE, FL 32301

•Incomplete Record Reviewed On: 8/10/12 11 :38 pm Prepared on: 1/14/14 3:37:37PM

ID: 55547

( ,/

CAMPAIGN. ..:ASURER'S REPORT - ITEMIZED EX~l. JITURES Page 1 of 1

Name: Jason Henry Report: 2012 F3 Period: 07/21/2012 to 08/09/2012 ** Rec ds . F'I d R rt** or '"

,. epo

Seq# Full Name

{Last, Suffix First, Middle Amount


Amend

1 DIGITAL PROAGANDA 997 W KENNEDY AVE MON CAMPAIGN FLYERS $750 00

08/0912012 ORLANDO, FL 32810 2 UNITED STATES POSTAL SERVICE

5087 EDGEWATER DR MON CAMPAIGN MAILER $510 00

08/09/2012 ORLANDO. FL 32810 3 PADGETT MARK

3101 CARISUDO COURT MON CAMPAIGN CONSULTING $100 00

08/09/2012 ORLANDO, FL 32812

4 ABC SIGNS 54 NORTH TAMPA AVENUE MON CAMPAIGN YARD SIGNS

$386 00

08/09/2012 ORLANDO, FL 32805

5 GROOVY DUDE CREATIONS P 0 BOX 560715 MON CAMPAIGN BUTTONS

$26 63

08/09/2012 ORLANDO. FL 32856

6 FINN MIKE 2855 MARSALA COURT MON CAMPAIGN CANVASSING

$130 00

08/08/2012 ORLANDO, FL 32806

7 CROLLA LAURA 319 E CHURCH STREET#131 MON CAMPAIGN WORK

$160 00

08/08/2012 ORLANDO. FL 32801

8 BIG DADDY SIGNS 1319 GREEN FOREST COURT MON CAMPAIGN YARD SIGNS

$382 34

08/08/2012 WINTER GARDEN, FL 34787

9 VIOLA MARK 5712 DONNELLY CIR MON CAMPAIGN CONSUL TING

$180 00

08/08/2012 ORLANDO, FL 32821

10 NEW DESTINY CHRISTIAN CENTER 505 EAST MCCORMICK ROAD MON BACK TO SCHOOL DRIVE

$200 00

08/03/2012 APOPKA, FL 32703

11 PADGETT MARK 3101 CARISUDO COURT MON CAMPAIGN CONSUL TING

$150 00

07/31/2012 ORLANDO, FL 32812

12 FLORIDA DEMOCRATIC PARTY 214 SOUTH BRONOUGH STREET MON MAILING UST

$100 00

08/08/2012 TALLAHASSEE, FL 32301

13 HENRY ,JASON 1241 S. KIRKMAN ROAD APT 1145 MON FOOD FOR CAMPAIGN WORKERS

$26 63

08/08/2012 ORLANDO. FL 32811

14 HENRY JASON 1241 S. KIRKMAN ROAD APT 1145 MON FOOD FOR CAMPAIGN WORKERS

$30 77

08/08/2012 ORLANDO, FL 32811


$6 10

08/07/2012 SAN JOSE, CA 95131


$1 75

08/09/2012 SAN JOSE, FL 95131

17 STEWART DERRICK 815 HANKINS CIRCLE MON CAMPAIGN CANVASSING

$500 00

08/08/2012 ORLANDO, FL 32805

18 INNOVATIONS CHARTER MIDDLE SCHOOL 2768 NORTH HIAWASSEE RO MON BACK TO SCHOOL DRIVE

$50 00

08/08/2012 ORLANDO. FL 32818

*Incomplete Record Reviewed On: 8/10/12 1 :38 pm

EXHIBIT_~[) ( 2J o-S Prepared on: 1/14/14 3:37:37PM

( I

FLORIDA DEPARTMENT OF STATE Ken Dctzncr·

Sec1etaiy of State

D1V1SION OF ELECTIONS

September 20, 2012

Ms .. Maria Vickers-Henry, Treasurer for Candidate Jason Henry 1241 South Kitkman Road Apartment 1145 Orlando, FL 32811-2811

Dea1 Ms Vickers··Heruy:

The Division of Elections has determined that the report fot the following cover pet iod is incomplete for the reasons attached

Year Type Cover Per'iod 2012 F3 7 /21 /12 - 8/9/12

Pursuant to Section 106.07(2), Florida Statutes, you have 7 days from 1eceipt of this notice to file an amended repo1t supplying the missing infmmation or provide an explanation for the ent1ies We are requited by law to furthet advise you that failure to supply this information within the time allowed constitutes a violation of Chapter 106, Florida Statutes

If you need assistance in filing an amendment, please contact the Division's help line at (850) 245-6280.

Sincerely,

~L /lA-.-~u_,;.vl~-Kristi Reid Brnnson Chief, Bureau of Election Records

cc: M1 Jason Henry, Candidate

Attachment

EXHIBIT_ ;?_l Ci of c?) Room 316 RA Gray Bui !ding • 500 South Bronough Street • Tallahassee, Flo1ida 323 99-0250 • (850) 245-628 0

f AX: (850) 245-6260 • WWW Address: http://www dos state fl. us • E-Mail: DivE/ections@do> state fl us

912012012 Aorida Dmiartment of state - lliYlslun nf Elecunns


Report: 2012 F3 (5) Covering Period: 7/21/12 - 819/12

0¥11'31

Contrllutluns

Expelllitures

Statute 106.07

106.07

FlOUI Tl'llllSfllrs

nuur mstrillltions



&ompllanc:e Report _____ _

---------------------Seq Date Name



Page 1

Office: STR

Account: 55547


MON $26.63

MON 530.77

(


October 22, 2012

Ken Dctzncr Secretary of State

DlVISION OF ELECTlONS

Ms. Maria VickerS··Henry, Treasurer for Candidate Jason Henry 1241 South Kirkman Road Apartment 1145 Orlando, FL 3?.811-281 l


On September .20, 2012,, you were advised that one or more of your campaign treasurer's reports v,ere incomplete and that you had 7 days to file amended reports providing the requested information

The Division's electronic liling system indicates that the required amendments have not been made Pursuant to Section 106 22, Florida Statutes, the Division is required to notify the Florida Elections Commission of the failure to provide information required by Chapter I 06 Accordingly, if the information requested in our prim notice is not received within 7 days of receipt of this letter, we will refer this matter 10 the Commission A second copy of the enor repmt is attached for your convenience

Sincerely,

4~~.:_;$_,,. Kristi Reid Bronson, Chief Bureau of Election Records

cc: Mr Jaslm Herny., Candidate

Attachment

Room 3 t6 R.A Gray Building • 500 South Bronough Street • Tallahassee, Florida 32399-0250 • (850) 245-6280 FAX: (850) 245-6260 o WWW Address: http://wwwdos . .statefl.us • E-Mail: DivE/ecriom(ij_":mail dos.llatefl u>

112512013 Aurilia Department of State - Division of Bections

_________ C0111pllaflCllRepor~t __ Candidate: Jason Henry


DveraR

Contributions

Expenditures

Statute 106.07

106.07

Fund Transfers

Other Distributions

Description Reimbursement without corresponding Other Distribution 13 8/8/2012 HENRY JASON

Reimbursement without corresponding Other Distribution 14 8/8/2012 HENRY JASON

Office: STR

Account: 55547

Expenditure City

Page ·1

~ Amount

MON

MON

$26.63

$30.77

'·


Unique ID Date Recorded Last Edited Date Orginally Recorded By

31825 121201201212:41:00 PM 121201201212:57:14 PM taholdeen

2012 Q1, F1 F3, TR Audits) & 2012 TR Fine: candidates post office box is now closed, and mail has been returned I sent him & the treasurer an email with screen shots of exactly what needed to be fixed: 2012 01 - expenditures - seq #1, needs to be deleted. Refund back to candidate for$ he loaned himself. Explained in screen shot notes that it needed to be placed under 'contributions', and coded as a negative refund 2012 Q1 - other distributions - Seq #1 - needs to be deleted 2012 F1 - other distributions - Seq #1 .2,3 - 'incorrect name source' Take a look, you'll know what I mean 2012 F3 - expenditures ··Seq. #13 14 - these are reimbursements, and are not coded correctly, nor are there any corresponding 'other distributions' 2012 TR - 'reflects balance after tr filed) (self explanatory)

To:Mr. Jason Henry Ms Maria Vickers-Henry Treasurer

You have several outstanding issues with your campaign finance records There are several errors, on various reports that still have not been corrected I have attached screen shots with notes for everything that needs to be corrected. In addition, when comparing your total contributions VS your total expenditures. after the termination report was filed, you are still showing $40 41 that is not accounted for (See attachment) Since your mail is being returned, because as you stated your post office box is closed, I have also attached a copy of the fine letter for the late filing of your termination report. Please read it carefully and respond accordingly Be aware that failure to address these issues can result in referral to the Florida Elections Commission for enforcement The Florida Elections Commission can impose civil penalties of up to $1000 per violation If you need assistance with any of this, or have additional questions, please contact the Division's Help Desk at (850) 245-6280 Thank you in advance for your immediate attention to these matters

31638

2012 F3 Audit:

1215/2012 4:27:00 PM

Sent the candidate & treasurer the following email:

'To:Mr .. Jason Henry Ms Maria Vickers-Henry Treasurer

121612012 9:09:33 AM taholdeen

Attached are copies of previously mailed notices with regards to compliance errors in your campaign finance report, which to date has not been corrected

While this report remains incomplete, you are in violation of Florida Statutes 106, and if this matter ls referred to the Florida Election Commission. subject to possible civil penalties of up to $1000 per violation

lf you need assistance with amending this report please contact the Division Help Desk line at (850) 245-6280


SIDE NOTE: Rec'd this emailed response from candidate:

Hi Theresa

I am so sorry that this report has not been submitted It will be in tonight before midnight My PO Box was closed as well as the bank account so) had to petition my bank for my last bank statements

At any rate, thank you for the e-mail and I apologize for the tardiness in attending to this matter

-JH

6 Page 2 of3 112512013

1/15/2014

Account: 55547

Rpt Seq: 5

ProcessDescription











File Pending Report

Queued Items for 2012-F3

STR 046 Jason Henry

Status Submittet created

Processing Complete 55547 8/1012012 7:44:15 PM







Processing Complete 55547 8/10/2012 11 :26:41 PM

Processing Complete 55547 8/10/201211:33:20PM

Processing Complete 55547 8/1012012 11 :38:58 PM


EXHIBIT __ ~'--~"----

Page 1

LastUpdate

8/10/2012 7:44:15 PM

8/10/2012 8:20:31 PM

8/10/2012 8:25:27 PM

8/1012012 8:35:27 PM

8110/2012 8:40:19 PM

8/10/2012 9:27:32 PM

8/10/2012 11:24:55 PM

8/10/2012 11 :26:41 PM

8/10/2012 11:33:20 PM

8/10/2012 11 :38:58 PM

8/10/201211:58:27 PM

' 1.








(4) Check appropriate box(es):

18:1 Candidate (office sought):





Cover Period: From 0811012012 To 1111212012 Report Type: TR

18:] Original 0 Amendment D Special Election Report


Cash & Checks $5000 Monetary Expenditures $577 99

Loans $0 00 Transfers to Office Account $0.00

Total Monetary $50 00 Total Monetary $577 99


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 I certify that I have examined this report and it is true correct and complete true_ correct and complete

Name of 0 Treasurer D Deputy Treasurer Name of 18:] Candidate 0 Chaiman (PCIPTY Only

y v

Signature Signature

Prepared on: 1/14/14 3:32:4SPM Reviewed On: 12/6/12 12:11 am

(" (-ID: 55547 CAMPAIGN\, "ASURER'S REPORT - ITEMIZED CON'~ JUTIONS Page 1 of 1

Name: Jason Henry

Full Name Seq# (Last, Suffix First, Middle Date Street Address & City, State, Zip

1 SCHEININE, ALAN 200 GEORGANN OR. APT E6

08/17/2012 VICKSBURG MS 39180

Report: gQll TR "* Records in Filed Report"'*


Type In-Kind Description

I CHE

Reviewed On: 12/6/12 12:11 am • Incomplete Record

EXHIB!T_&5 (Qc± ;3)

Period: 0811012012 to 11 /1212012

Amount

Amend

$50.00

Prepared on: 1/14/14 3:32:45PM

ID: 55547 (

CAMPAIGN\

,, 2ASURER'S REPORT - ITEMIZED EX~·1:.__ ;!TURES Page 1 of 1

Name: Jason Henry Report: 2012 TR ** Records in Filed Report~*

Period: 08/10/2012 to 11/12/2012

Full Name Amount Seq# (Last, Suffix First, Middle Type Purpose Date Street Address & City, State, Zip Amend

1 PADGETT MARK $400 00 3101 CARISUDO COURT MON CAMPAIGN CONSULTING

08/14/2012 ORLANDO, FL 32812

2 ELEPHANT BAR $107 99 4054 CONROY ROAD MON ELECTION DAY CAMPAIGN FOOD

08/17/2012 ORLANDO, FL 32839

3 URIBE MAYRA $70 00 5319 LAKE .JESSAMINE DRIVE MON CAMPAIGN CONSULTING

08/13/2012 ORLANDO, FL 32839

• Incomplete Record Reviewed On: 12/6/12 12:11 am Prepared on: 1/14/14 3:32:46PM

EXHIBIT_~~($ cl ;)J

( / I

FLORIDADEPARTMENTOF STATE Ken Detzner

Secretary of State

DIVISION OF ELECT!ONS

December 6, 2012

Ms Maria Vickeis-Henry, Treasurer for Candidate Jason Henry 1241 SKirkman Rd, Apt #1145 Orlando, FL 32811-2811



Year Type. 2012 TR

Cover PeriOd 8/10/12 ·· 11/12/12

Pursuant to Section 106 .. 07(2), Florida Statutes, you have 7 days from receipt of this notice to file an amended report supplying the missing information 01 provide an explanation for the entries We are required by law to farther advise you that failure to supply this information within the time allowed constitutes a violation of Chapter I 06, Florida Statutes.

If you need assistance in filing an amendment, please contact the Division's help line at (850) 245-6280.

;ii~/q~P-Kristi Reid Bronson Chief, Bureau of Election Records

cc: Mr Jason Herny, Candidate

Attachment

EXHIBIT Room 316 RA Gray Building • 500 South Bronough Street • Tallahassee, Florida 32399-0250 • (850) 245-628 0

FAX: (850) 245-6260 • WWW Address: http://www.dos .. statc.fl us • E-Mail: DhE/ections@dos state fl us

121612012 Florida Oe113rtrnent of State - DiVision of Hect!ons ------ ---~ ----- complian~_ Report __ _


Report: 2012 TR (6) Covering Penod: 8/10/12 - 11/12112

Overal

Statute 106.141

COntrllUtions

Expell!itul'llS

FUndlransters

Otlul' Disliillltions

Description Reflects balance after termination report filed

Page 1

Office: STR

Account: 55547

(


Oate of last Contribution: 8117112

Year . ~epo~ Contributions

Previous Balance:

2011 04 $120 00

2012 01 $2.610.00 ---- ·-- - - -

F1 $2,560.00 - -- - - --

F2 $285 00

F3 $2,350 00

TR $50.00

Campaign Total: $7,975 00

Grand Total:

EXHIBIT_

1216/2012 12:14:20 PM

55547

1 After 8/14/12


$331 66

$2,937.72

$397.00

$3,690 22

$577 99

$7,934 59

$120.00

$2,398 34

$2,020 62

$1,908.62

$568.40

$40 41

1/15/2014

Account: 55547

Rpt Seq: 6

ProcessDesc,.i'ption




File Pending Report

Queued Items for 2012-TR

STR 046 Jason Henry

Status Submittet Created


Processing Complete 55547 12/612012 12:10:18 AM

Processing Complete 55547 12/6/2012 12:11:41 AM

Processing Complete 55547 12/6/2012 12:24:19 AM

EXHIBIT ___ ~/--'----

Page 1

LastUpdate

12/5/2012 9:43:24 PM

12/6/2012 12:10:19 AM

12/6/2012 12:11:41 AM

12/6/2012 12:24:20 AM

RICK SCOTT Governor

KURT S. BROWNING Secretary of State

November 21, 2011

Mi Jason Samuel Henry Post Office Box 51 Gotha, Florida 34734

Dear Mr. Hemy:

This will acknowledge receipt of the Appointment of Campaign Treasurer and Designation of Campaign Depository for the office of State Representative, which was placed on file in our office on November J 8, 201 J Your name has been placed on the 2012 active candidate list

C!!mpaign I reasurer's Reports

Your first campaign treasurer's report will be due on January 10, 2012 The report will cover the peiiod of October l - December 3 J, 201 J All candidates who file reports with the Division of Elections are required to file by means of the Division's electronic filing system (EFS).

Credentials and Sign-ons

Below is the web address to access the EFS and your user identification number The enclosed sealed envelope contains your initial passwo1d Once you have logged in using the initial password, you will be immediately prompted to change it to a confidential sign-·on You, your campaign treasurer, and deputy treasurers me responsible for protecting these passwords from disclosure and are responsible for all filings using these credentials, unless the Division is notified that your credentials have been compromised

~ VIVA flORIUA 500

EFS Web site Address: https://efs dos state.fl us Identification Number: 55547

R. A. Gray Building • 500 South Bronaugh Street • Tallahassee, Florida 32399 .. 0250 Telephone: (850) 245-6240 • Facsimile: (8501 245-6259 www.dos .. state.fi us

Commemorating 500 year·s of Florida history WWW fia500 .com ~ VIVA flOirnA5~0

(

Mr. lason Samuel Herny November 21, 2011 Page Two

PinJ"umbcrs.

/

I,

Pin numbers are confidential secure credentials that allow you to submit 1eports and update personal information.. The enclosed sealed envelope contains your confidential pin numbers

Each candidate is required to provide the Division of Elections with confidential personal information that may be used to allow access in the event that password is forgotten or lost When you enter the campaign account screen, there will be a drop down box where you pick a question (such as What is your mother's maiden name?) and supply an answer. All passwords and answers to questions arc stored as encrypted data and cannot be viewed by Division staff and given out over the phone.. Please notify the Division if yom credentials have been compromised.

Jimely F ili!!_g

All reports filed must be completed and filed through the EFS not later than midnight of the due date Reports not filed by midnight of the due date are late filed and subject to the penalties in Section 106 07(8), Florida Statutes. In the event that the EFS is inoperable on the due date, the report will be accepted as timely filed if filed no later than midnight ofrhe first business day the EFS becomes operable No fine will be levied during the period the EFS was inoperable.

Any candidate failing to file a report on the designated due date shall be subject to a fine of $50 per day for the first 3 days late and, thereafter, $500 per day for each late day, not to exceed 25% of the total receipts or expenditures, whichever is greater, for the period covered by the late 1eport However, for reports immediately preceding each primary and general election, the fine shall be $500 per day for each late day, not to exceed 25% of the total receipts or expenditures, whichever is g1eater, for the period covered by the late report

Electronic Receipts

The person submitting the report on the EFS will be issued an electronic receipt indicating and verifying the report was filed.. Each campaign treasurer's report filed by means of the EFS is conside1ed to be under oath by the candidate and campaign treasurer and such persons ate subject to the provisions of Section 106.07(5), Florida Statutes

(

Mr .. Jason Samuel Henry November 2 L 20 I I Page Three

Instructions and.Assista'!g

An online instruction guide is available to you on the EFS to assist with navigation, data entry, and submission of reports. The Division of Elections will also provide assistance to all users by contacting the EFS Help Desk at (850) 245-6280

All of the Division's publications and repor·ting forms are available on the Division of Elections' web site at http://elcctions.myflorida,,com. It is your r·esponsibility to read, understand, nnd follow the requirements of Florida's election laws. Therefore, please prfot a copy of the following documents: Chapters 104 and 106, Florida Statutes, 2010 Candidate and Campaign Treasurer Handbook, 2012 Calendar of Reporting Dates, and Rule lS-2 .. 017, Florida Administrative Code ..

Please let me know if you need additional information

Sincerely,

1i ~/i ··:t}Jl~~-:·~~ Kristi Reid Bronson, Chief Bureau of Election Records

KRB/ljr

Enclosures

(

.-----------------

STATEMENT OF CANDIDATE

(Section 106 .. 023, F .. S .. )

(Please print or type}

1. JA<st2n.L~l~~-ra~")~t ~-+-----

.. ,.

I

'

OFFICE USE ONL ~ I'_;·

".':! r-l"'r.:IVED

12 APR 16 AKlli 29

ll>VISluN OF ELECTJ.ti.s SEGRETAftY EJF STIErE

candidate for the office of ~ t rt Ae Kc:}ICV<&-biAflvg \ h1sttv .t: _!L,l._ ;

have been provided access to read and understand the requirements of

Chapter 106, Florida Statutes

x Date

Each candidate must file a statement with the qualifying officer within 1 O 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), 106265(1), Florida Statutes)

DS-DE 84 (05/11)

-------·-··-------


(Section 106 .. 023, F .. S.)

(Please print or type)

,... OFF1Gf1,l1,~f._~L Y

11NOV\8 l\t\\\:ZS

. . , _ " :c\tONS 01~1:,."; ':' -····sTf.l.iE SECRI:. 11\;r"t OF

I, ) A<!..,('_j,j , _ __._h\U,,e.,.4-'iA"'-J \,__,· \):,~------· )

candidate for the office of ~,{rite ~t;i-«"t,,Jri7.!V t~1>·~1ic t .4 ;


Chapter 106, Florida Statutes ..

\\·\~ -a~~te .. __

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) (,

EXHIBIT d C\ \ Q oJ> "I)

·.

FLORIDA ELECTIONS COMMISSION REPORT OF INVESTIGATION Maria Vickers-Henry -- FEC 13-057

-

·.·~·. • .. ' ~-- ' . .·, ·r

. .. Attachments Description of Attachments

Attachment A Returned Mail

Attachment B Chronological notes from DOE

Attachment C

Attachment D

Attachment E

Attachment F

Attachment G

Attachment H

Attachment I

Attachment J

Attachment K

Attachment L

Attachment M

Attachment N

Attachment 0 .

lnv005 (6/08)

.. .· .

( \

' I .' '. '•·• •-~": .... · .... ·

,• ~ .• ~ ~· .. :_, ~

,; i" . j '\/ i~ :, . ,:

,_ , . ' ' ; ) :( ,..,; ~ :· .

F' -: ·r . c t r ~·. :: :-: I\ : ·: .... ~· -~ c : l)•';:·~.\~·~·> ~·,:{

Mr Jason Henry P 0 Box 51 Gotha, H 34734

! I !, ! ; I! : ! ):

2UJ2 DEG 19 AM fO: 24

ATTACHMENT AG 9~W-,

' I '

FLORJDA DEPARTMENT OF STATE Ken Detzner

Secretary of State


December 6, 2012

Ms Matia Vickers-l lenry. Treasuret fot Candidate Jason Henry 1241 S Kirkman Rd, Apt #1145 Orlando, H. 32811-2811


SECOND NOl\Cc

On October 19, 2012, you were advised that one or more of your campaign treasurer's reports were incomplete and that you had 7 days to file amended reports providing the requested inllirrnation.

The Di,isi,m's electronic filing system indicates that the required amendments have not been made Pmsuant to Section 106 22 Florida Statutes, the Division is required to notify the florida Elections Commission of the failure to provide information required by Chapter 106 According!}, if the infon'nation requested in our prior notice is not received within 7 days of receipt of this letter.. we will refer this matter to the Commission A second copy of the erro1 report is attached for your convtlliencc

Sincere!),

c~ /V-7f 4),.# 7> Ktisti Reid Bronson, C hieJ Bureau of Election Records /

cc Mr Jason Henry Candidate

Attachment

ATTACHMENT·-~-Room .316 R.A Gra} Building • 500 South Bronaugh Stree1 • Tallahassee Florida 32399-0250 • (850) 245··6280 FAX: (850) 245·-6260 • WWW Address: http://www .. dos.statefl us • E-Mail: DivE/euiomi(;mail dos '1atejl 111

121512012 Florida DB!lartment of State - Dlvlsmn of Elections Compliance Report

Page i


Report: 2012 01 {2) Covering Period: 1/1/12 - 3/31/12

Dveral

Contrlmtions

Expelllitures

Fund Transfers

Dthll' Dlstrilxltions

)> 106.07(4)

~ Report: 2012 F1

O averal :J: ifi ContrlJutions z -f Expelllilll'es

Qund Transfers

Description Incorrect Narne/Source(sl

(3) Covering Period: 4/1/12 - 7/6/12

0 Dlllll' Distrillltilns ~ --------------------------------------------------------

Statute 106 07(4)

106 07(4)

106 07(4)

Description Incorrect NameJSourceis>

Incorrect Name/Sourceis)

lnconet:1 Name/Source(S}

Office: STR

Account: 55547

-------------------Other D1stribution--------------Seg Date Name City ~ Amount

2 3/3/2012 HENRY JASON. CAM $106 00

Account: 55547

- - - - - - -- - - - - - - - - - - - 0 t h e r D i s I r i b u I i o n - - - - - - - - - - - - - - -Seq Date Name City ~ Amount

1 5n12012 SUTION KEV1N FOO $100.68

2 511812012 HENRY JASON FOO 515 12

3 412312012 URIBE t...tAYRA CAM $47 93 -- \


Secretary of State


Decembe1 6, 2012

Ms Maria Vickers-Herny, Treasurer for Candidate Jason Herny 1241 S Kirkman Rd, Apt. #J 145 Orlando, Fl 32811-281 I

Deai Ms Vickers-Henry:

The Division of Elections has determined that the report for the following cove1 period is incomplete for the reasons attached

Year Type. __ C_o_v_er_.P_e_r..,.io,..d_ 2012 TR 6/10/12 ·· 11/12/12

Pursuant to Section I 06 07(2), Florida Statutes, you have 7 days from receipt of this notice to file an amended report supplying the missing information or provide an explanation fo1 the entries We aie required by law to further advise you that failure to supply this information within the time allowed constitutes a violation of Chapter 106, Florida Statutes


;?r:~,f~~:p_ Kristi Reid Bronson Chief, Bureau ofEl.ection Records /

cc: Mr Jason Henry, Candidate V Attachment

ATTACHMENT ~(Yo~ pJ Room 316 RA Gray Building • 500 South Bronaugh Street • Tallahassee, Florida .32399··0250 • (850) 245··6280

FAX: (850) 245-6260 • WWW Address: http://www.dos.statc.fl us • E-Mail: DivEle<tions@dos. stareflus

12/612012 Rorida llB11artment of State - llivision of Bections ----·· ·-----

Comp~ance Repof'.! __ _ Candidate: Jason Henry

Report: 2012 TR (6) Covering Period: 8/10/12 -11/12/12

Overal

Descnption Statute 106.141 Reflects balance after termination report filed

Cllntrlltltiuns

Experdtures

flmtl TransfOrs Dlllll' llistrillllions

Page 1

Office: STR

Account: 55547 •

' I

•


Date of last Contribution: 8/17/12

Year Report Contributions

Previous Balance:

2011

2012

Q4

Q1

$120 00

$2,610 00

F1 $2,560 00

F2 $285.00

F3 $2,350 00

TR $50.00

Campaign Total: $'7,975 00

Grand Total:

12/6/2012 12:14:20 PM

55547

1 After 8/14/12


$331 66

$2,937 72

$397.00

$3690 22

$577 99

$7,934 59

$120.00

$2,398 34

$2,020 62

$190862

$568 40

$40.41

ATTACHMENT A-(c,J}(;)

Unique ID

32139

2012 TR Fine (2nd Notice):

I \



1/11/201310:45:00AM 1/11/201311:12:11 AM


taholdeen

Since we don't have a current email address on this candidate J am 'emailing' his 2nd notice to him, as he has been responding to emails (not going to waste postage when the po box is closed). Sent him the following email: (also cc'd treasurer):

Mr Henry

Since you have not given us a new address to mail correspondence, attached is a copy of the 2nd notice concerning the fine for the late filing of the 2012 terirlination report Please read the notice carefully, and respond accordingly, as currently you are in violation of the Florida Statutes Chapter 106, and subject to referral to the Florida Elections Commission

If you have any questions regarding this fine please contact us at (850) 245-6280


Rec'd this emailed response from candidate:

Ms Holden

I will be responding to this on Monday day I haven't had time lately due to my work schedule but will have time this Monday as it is my off day

Thanks

31954 12/27/2012 2:20:00 PM taholdeen

Rec-d emailed response from candidate:

(see previous notes):

Hi Theresa, Thanks for bringing these errors to my attention

1 am a little confused on what I'm doing wrong When I submitted a report during the summer with reimbursements, l was told that it was done in error I contacted someone at the state office and was told to resubmit as MON When doing a reimbursement, are you able to guide me along so that these errors do not continue'? I inputted "other distributions" before, but was given an error again

SIDE NOTE Again I replied:

If you need assistance with any of this or have additional questions please contact the Divisions Help Desk at (850) 245~ 6280

ATTACHMENT.D( l ~o'J Page 1 of 3 1/25/2013

Unique ID

31825

' I '

' '



12120/2012 12:41:00 PM 121201201212:57:14 PM

2012 Q1, F1 F3, TR Audits) & 2012 TR Fine:


taholdeen

candidates post office box is now closed, and mail has been returned I sent him & the treasurer an email with screen shots of exactly what needed to be fixed: 2012 Q1 • expenditures. seq #1, needs to be deleted. Refund back to candidate for$ he loaned himself. Explained in screen shot notes that it needed to be placed under 'contributions', and coded as a negative refund 2012 01 - other distributions - Seq #1 - needs to be deleted 2012 F1 - other distributions - Seq #1,2,3 - 'incorrect name source' Take a look, you'll know what I mean 2012 F3 - expenditures - Seq. #13, 14 - these are reimbursements, and are not coded correctly, nor are there any corresponding 'other distributions' 2012 TR - 'reflects balance after tr filed) (self explanatory)


You have several outstanding issues with your campaign finance records There are several errors, on various reports that still have not been corrected I have attached screen shots with notes for everything that needs to be corrected In addition, when comparing your total contributions VS your total expenditures after the termination report was filed, you are still showing $40 41 that is not accounted for (See attachment) Since your mail is being returned, because as you stated your post office box is closed, I have also attached a copy of the fine letter for the late filing of your termination report. Please read it carefully and respond accordingly Be aware that failure to address these issues can result in referral to the Florida Elections Commission for enforcement The Florida Elections Commission can impose civil penalties of up to $1000 per violation If you need assistance with any of this, or have additional questions please contact the Division's Help Desk at (850) 245-6280 Thank you in advance for your immediate attention to these matters ----·-·-------------·- --------------·--------

31638

2012 F3 Audit:

12/5/2012 4:27:00 PM



12/6/2012 9:09:33 AM taholdeen

Attached are copies of previously mailed notices with regards to compliance errors in your campaign finance report, which to date has not been corrected

While this report remains incomplete, you are in violation of Florida Statutes 106, and if this matter is referred to the Florida Election Commission subject to possible civil penalties of up to $1000 per violation

If you need assistance with amending this report please contact the Division Help Desk line at (850) 245-6280


SIDE NOTE: Recd this emailed response from candidate:

Hi Theresa

I am so sorry that this report has not been submitted It will be in tonight before midnight My PO Box was closed as well as the bank account so .t had to petition my bank for my last bank statements

At any rate thank you for the e-mail and I apologize for the tardiness in attending to this matter

-JH

,· .. ·,_ .. s· 1.! c' '1 t ·

Page 2 of 3 1/25/2013

Unique ID

(


/ I '


30438

2012 F1 Fine:

9/17/2012 12:30:00 PM


To:.Jason Henry, Former Candidate Maria Vickers-Henry Treasurer


taholdeen

Attached are copies of previously mailed notices with regards to the fine that is still owed for the late filing of the 2012 F1 campaign finance report Please pay this fine immediately to avoid referral to the Florida Elections Commission

lf you need further assistance, please contact the Divlsion·s Help Desk at (850) 245-6280 Thank you in advance for your immediate attention to this matter

30213

2012 01 & F1 Audits:

8/24/201212:45:00 PM


Mr -Jason Henry

8/27/2012 9:09:48AM taholdeen

Attached are copies of previously mailed notices regarding errors that nEied to be corrected in your campaign finance reports Please correct this reports immediately to avoid referral to the Florida Elections Commission The Florida Elections Commission can impose civil penalties of up to $1000 per v.iolation



SIDE NOTE: Rec'd this emailed response:


Sent from my iPhone --------------- ----------------------------------------------- ---------------

28791 5/9/201212:14:00PM lbelyin


I emailed him instructions because on May 2, 20121 called and left a message and he never responded Lenard spoke with him on April 17 2012 and he said that he would overnight the form but never did I put documents in Ms Kristi's office to be boxed

28657 5/212012 4:17:00 PM lbelvin

RE Follow up call DS- DE 9 incomplete

l called and left a message explaining that this was a follow up call regarding the OS-DE 9 form that he said that he would send our office overnight I explained that in order for our office to process this change we need him to submit another original OS-DE 9 form with original signatures Once we receive this new form we can process his change due to redistricting request 1 left my contact information for him to call if he has any questions

28446 4/17/2012 8:30:00AM ljrandolph


J called and spoke with Mr Henry and explained to him about the dsde 9 and that he didn-"t sign the form in box 26 which requires his signature He said that he would overnight the form to the division asap

Page 3 of3 1/25/2013

',,l!l.S. l?ostal Servicer. · · .,

'° .Jl CERTIFIED MAll.:ir• RECEIPT '.

er .-'I

(Domestic Mail Only; No Insurance Coverage Provided)

er·

'° .-'I FICiA

er Postage $ r---------1-

.:T CJ ~~~rtlfled Fae

CJ ReiUm Rec!ept Fee CJ (Endorsement Required)

D Restricted Oolivory Foo ...0 (Endorsement Required)

r---------1

.-'I >---.,---.• ~.-.. -. _ _,

.-'I $ Total Postage & Fees ~----~

Postmark Here

PS form 3800, June 2002 See Reverse for Instructions

FLORIDA ELECTIONS COMMISSION 107 W. Gaines Street,

Suite 224 Collins Building Tallahassee, Florida 32399-1050

Telephone: (850) 922-4539 Fax: (850) 921-0783

November 27, 2013

CERTIFIED MAIL 7004 1160 0004 9189 1968

Maria Vickers-Herny 1241 South Kirkman Road, Apt 1145 Orlando, FL 32811-2811

RE: Case No.: FEC 13-057; Respondent: Maria Vickers-Henry


On January 31, 2013, the Florida Elections Commission received a referral from the Division of Elections alleging that you violated Florida's election Jaws I have reviewed the referral and find that it contains one or more legally sufficient allegations The Commission staff will investigate the following alleged violations:

ComOl l (10/07)

Section106.07(2)(b)l., Florida Statutes: Maria Vickers-Herny, treasurer for Jason Herny, candidate for State Representative, District 46, during the 2012 election cycle, failed to make necessary amendments to the 2012 Q 1 Report, as alleged in the complaint

Section106.07(2)(b)l., Florida Statutes: Maria Vickers-Herny, treasurer for Jason Herny, candidate fot State Representative, District 46, dUling the 2012 election cycle, failed to make necessary amendments to the 2012 F 1 Report, as alleged in the complaint

Section106.07(2)(b)l., Florida Statutes: Maria Vickers-Herny, treasurer for Jason Herny, candidate for State Representative, District 46, dUling the 2012 election cycle, failed to make necessary amendments to the 2012 F 3 Report, as alleged in the complaint.

Section106.07(2)(b)l.., Florida Statutes: Maria Vickers-Herny, treasurer for Jason Herny, candidate for State Representative, District 46, during the 2012 election cycle, failed to make necessary amendments to the 2012 I ermination Report, as alleged in the complaint

You may respond to the allegations above by filing a notarized statement providing any information regarding the facts and circumstances surrounding the allegations If you choose to file a response to the alleged violations, you should do so within 20 days of the date you receive this letter Your response will be included as an attachment to the investigator's report

When we conclude the investigation, you will receive a copy of the Report of Investigation. You may file a response to the report within 14 days from the date the report is mailed to you Based on the results of the investigation, legal staff will make a written recommendation to the Commission on whether there is probable cause to believe you have violated Chapter 104 or 106, Florida Statutes You will receive a copy of the Staff Recommendation and may file a response within 14 days from the date the recommendation is mailed to you Your timely filed response(s) will be considered by the Commission when determining probable cause

The Commission will then hold a hearing to determine whether there is probable cause to believe you have violated Chapters 104 or 106, Florida Statutes You and the complainant will receive a notice of hearing at least 14 days before the hearing. The notice of hearing will indicate the location, date, and time of your hearing. You will have the opportunity to make a brief oral statement to the Commission, but you will not be permitted to testify or call others to testify, or introduce any documentary or other evidence

At any time before a probable cause finding, you may notify us in writing that you want to enter into negotiations directed towards reaching a settlement via consent agreement.

The Report of Investigation, Staff Recommendation, and Notice of Hearing will be mailed to the same address as this letter Therefore, if your address changes, you must notify the investigator assigned to this case of your new address Otherwise, you may not receive the correspondence from the staff Failure to receive the documents will not delay the probable cause hearing

Under section 106 25, Florida Statutes, complaints, Commission investigations, investigative reports, and other documents relating to an alleged violation of Chapters 104 and 106, Florida Statutes, are confidential until the Commission finds probable cause or no probable cause. The confidentiality provision does not apply to the person filing the complaint. However, it does apply to you, the Respondent, unless you waive confidentiality in writing. The confidentiality provision does not preclude you from seeking legal counsel. However, if you retain counsel, your attorney must file a notice of appearance with the Commission before any member of the Commission staff can discuss this case with him or her

If you have any questions or need additional information, please contact Cedric Oliver, the investigator assigned to this case.

Sincerely,

AMT/em

Como 11 (8/08)

( 1'5-05?

-·------------~--

Jason Henry

DIVISION OF ELEC710NS REFERRAL. FORM

Candidate: Jason Henry Treasurer: Maria Vickers-Henry

Person named/notified: Jason Henry

55547

The Division of Elections is referring this issue to the Florida Elections Commission pursuant to s .. 106 . .25, F.S.. Addendums have not been filed pursuant to s .. 106 .. 07(2)(b)1, F. S for the following reports:

2012 Q1 2012 F1 2012 F3 2012 TR

•

w

-:; ' :~ ."."') :·1 ··-,,-~

:-; \JI

--------------------·---------···-----·

Sent By: Date:

Kristi Bronson *.itJ January 31, 2013

000001

Jason Henry

Candidate: Jason Henry Treasurer: Jason Henry

(/

DIVISION OF ELECTION~ REFERRAL FORM

Person named/notified: Jason Henry

55547

The Division of Elections is referring this issue to the Florida Elections Commission pursuant to s 106..25, F..S Addendums have not been filed pursuant to s 106. 07(2)(b)1, F S. for the following reports:

2012 Q1 2012 F1 2012 F3 2012 TR -

Sent By: Kristi Bronson Date: January 29, 2013

OOOGG2

·.~':

~

I

....., """' ;:::; '-· :;:::- ... ::::: '-"-' CJ

·u .f;·

,..,.

~ '1 ' ;, ' ~· (:>

'"' ~

' '< ~·n Cj

STATE OF FLORIDA County of Leon

AFFIDAVIT

Theresa Holdeen, being duly sworn, says:

I . This affidavit is made upon my personal knowledge

2 I am of legal age and competent to testify to the matters stated herein

3. Jason Henry (55547) was a candidate for the office of State Representative, District 46, dming the 2012 election cycle .. Mr.. Herny has failed to make the necessary amendments on the 2012 QI, FI, F3 and termination (TR) campaign finance reports.

4 On November 18, 2011, Jason Herny filed the Appointment of Campaign Treasmer and Designation of Campaign Depository with the Division. Mr Herny appointed himself as treasurer

5 On May 18, 2012, Mr Herny withdrew as treasmer, and appointed Ms Maria VickersHerny as the campaign treasmer

6 On June 8, 2012, Mr Herny appointed himself as deputy treasmer

7 On September 20, 2012, the Division mailed Ms Vickers-Herny notification of the incomplete 2012 F3 campaign finance report. A copy was also mailed to Mr Herny ..

8 On October 19, 2012, the Division mailed the treasurer notification of the incomplete 2012 QI and 2012 Fl (compliance e11ors) reports A copy was also mailed to the candidate

9 On October 22, 2012, the Division mailed the treasmer a second notice regarding the incomplete 2012 F3 report A copy was also mailed to the candidate

10. On December 6, 2012, the Division mailed Ms Vickers-Herny a second notice regarding the incomplete 2012 QI & FI reports .. A copy was also mailed to Mr Henry.

11. On December 6, 2012, the Division mailed the treasurer notification of the incomplete 2012 termination report. A copy of this notice was also mailed to the candidate

12 On December 20, 2012, this division employee sent an email to the candidate as well as the treasurer regarding the incomplete QI, FI, F3, and TR This email had several screen shots with notes of exactly what needed to be corrected (See attached copy of email and screen shots for 2012Q1, FI, F3 & TR reports).

13 On December 26, 2012, this division employee received an emailed response from the candidate, with questions about these errors (See attached copy of email)

INV035 (5/00)

(

14 On December 27, 2012, this division employee sent yet another email to candidate, responding to his email, again asking that he contact us (See attached copy of email)

15 As of January 29, 2013, the 2012 QI, Fl, F3, and TR campaign finance reports remain incomplete ..

I hereby swear or affirm that the foregoing information is true and correct to the best of my knowledge.

~' PEARLIE M. WIWAMS·MATHIS '"' MY COMMISSION I DD 958450 ·'I EXPIRES: May 16, 2014

Bonded rhru Notary Publ!c Undorwriters

INV035 (5/00)

Sworn to (or affirmed) and subscribed before me this 291

h day of January, 2013.

9~.~· ~~(!f4/ Signature of otary Public - StatofFlorida

Print, Type, or Stamp Commissioned Name of Notary Public

Personally Known /

Unique ID

32139

2012 TR Fine (2nd Notice):


Date Recorded last Edited Date

1/11/201310:45:00 AM 1/11/201311:12:11 AM


taholdeen

Since we don't have a current email address on this candidate l am 'emailing' his 2nd notice to him, as he has been responding to emails (not going to waste postage when the p o box is closed) Sent him the following email: (also cc'd treasurer):

Mr Henry

Since you have not given us a new address to mail correspondence, attached is a copy of the 2nd notice concerning the fine for the late filing of the 2012 termination report Please read the notice carefully, and respond accordingly, as currently you are in violation of the Florida Statutes Chapter 106 and subject to referral to the Florida Elections Commission

lf you have any questions regarding this fine please contact us at (850) 245-6280


Rec'd this emailed response from candidate:

Ms Holden,

1 will be responding to this on Monday day I haven't had time lately due to my work schedule but will have time this Monday as it is my off day

Thanks

31954 12/27/2012 2:20:00 PM taholdeen

Recd emailed response from candidate:

(see previous notes):

Hi Theresa. Thanks for bringing these errors to my attention

I am a little confused on what I'm doing wrong When I submitted a report during the summer with reimbursements I was told that it was done in error I contacted someone at the state office and was told to resubmit as MON When doing a reimbursement, are you able to guide me along so that these errors do not continue? I inputted ··other distributions" before but was given an error again

SIDE NOTE: Again I replied:

If you need assistance with any of this or have additional questions please contact the Divisions Help Desk at (850) 245-6280

Page 1 of3 1/25/2013

(


Unique ID Date Recorded Last Edited Date Orginally Recorded By

31825 12/20/201212:41:00 PM 12/20/2012 12:57:14 PM taholdeen

2012 Q1, F1 F3, TR Audits) & 2012 TR Fine: candidates post office box is now closed, and mail has been returned I sent him & the treasurer an email with screen shots of exactly what needed to be fixed: 2012 Q1 - expenditures - seq #1, needs to be deleted. Refund back to candidate for$ he loaned himself. Explained in screen shot notes that it needed to be placed under 'contributions', and coded as a negative refund 2012 Q1 - other distributions - Seq #1 - needs to be deleted 2012 F1 - other distributions - Seq #1 2 3 - 'incorrect name source' Take a look, you'll know what I mean 2012 F3 - expenditures - Seq. #13. 14 - these are reimbursements, and are not coded correctly, nor are there any corresponding -other distributions' 2012 TR - 'reflects balance after tr filed) (self explanatory)


You have several outstanding issues with your campaign finance records There are several errors, on various reports that still have not been corrected I have attached screen shots with notes for everything that needs to be corrected ln addition, when comparing your total contributions VS your total expenditures after the termination report was filed, you are still showing $40 41 that is not accounted for (See attachment) Since your mail is being returned, because as you stated your post office box is closed, I have also attached a copy of the fine letter for the late filing of your termination report. Please read it carefully and respond accordingly Be aware that failure to address these issues can result in referral to the Florida Elections Commission for enforcement The Florida Elections Commission can impose civil penalties of up to $1000 per violation If you need assistance with any of this, or have additional questions please contact the Division's Help Desk at (850) 245~6280 Thank you in advance for your immediate attention to these matters

31638

2012 F3 Audit:

12/5/2012 4:27:00 PM 12/6/2012 9:09:33 AM taholdeen



Attached are copies of previously mailed notices with regards to compliance errors in your campaign finance report which to date has not been corrected

While this report remains incomplete, you are in violation of Florida Statutes 106, and if this matter is referred to the Florida Election Commission subject to possible civil penalties of up to $1000 per violation

If you need assistance with amending this report- please contact the Division Help Desk line at (850) 245-6280


SIDE NOTE: Rec'd this emailed response from candidate:

Hi Theresa

I am so sorry that this report has not been submitted It will be in tonight before midnight My PO Box was closed as well as the bank account so ,I had to petition my bank for my last bank statements

At any rate thank you for the e-mail and I apologize for the tardiness in attending to this matter

-JH

6 Page 2 of 3 1/25/2013

(

Unique ID



30438

2012 F1 Fine:

9/17/201212:30:00 PM


To: Jason Henry, Former Candidate Maria Vickers-Henry Treasurer


taholdeen

Attached are copies of previously mailed notices with regards to the fine that is still owed for the rate filing of the 2012 F1 campaign finance report Please pay this fine immediately to avoid referral to the Florida Elections Commission

If you need further assistance, please contact the Divisions Help Desk at {850) 245-6280 Thank you in advance for your immediate attention to this matter

30213

2012 01 & F1 Audits:

8/24/201212:45:00 PM


Mr Jason Henry

8/27/2012 9:09:48 AM taholdeen

Attached are copies of previously mailed notices regarding errors that n0ed to be corrected in your campaign finance reports Please correct this reports immediately to avoid referral to the Florida Elections Commission The Florida Elections Commission can impose civil penalties of up to $1000 per violation



SIDE NOTE: Recd this emailed response:


Sent from my iPhone

28791 5/9/2012 12: 14:00 PM


lbelyin

I emailed him instructions because on May 2, 20121 called and left a message and he never responded Lenard spoke with him on April 17 2012 and he said that he would overnight the form but never did t put documents in Ms Kristi's office to be boxed

28657 5/212012 4:17:00 PM lbelvin

RE: Follow up call OS- DE 9 incomplete

I called and left a message explaining that this was a follow up call regarding the OS-DE 9 form that he said that he would send our office overnight I explained that in order for our office to process this change we need him to submit another original OS-DE 9 form with original signatures Once we receive this new form we can process his change due to redistricting request I left my contact information for him to call if he has any questions

28446 4/17/2012 8:30:00 AM ljrandolph


I called and spoke with Mr Henry and explained to him about the dsde 9 and that he didn't sign the form in box 26 which requires his signature He said that he would overnight the form to the division asap

Page 3 of 3 1/25/2013

' ! (

FLORIDA DEPARTMENT OF STA1E Ken Dctzncr

Secretary of State


September 20, 2012

Ms. Maria Vickers-Henry, Treasurer for Candidate Jason Henry 1241 South Kirkman Road Apartment 1145 Orlando, FL .32811-2811

Dear Ms VickerS··Heruy:


Year Type Cover Period 2012 F3 7/21/12 - 8/9/12

Pursuant to Section 106 .. 07(2), Florida Statutes, you have 7 days from receipt of this notice to file an amended report supplying the missing information or provide an explanation for the entries We are required by law to further advise you that failure to supply this information within the time allowed constitutes a violation of Chapter I 06, Florida Statutes


Sincerely,

~1 /l_._A,~~~--Kristi Reid Bronson Chief, Bureau of Election Records

cc: Mr. Jason Heruy, Candidate

Attachment

Room 316 RA Gray Building • 500 South Bronough Street • Tallahassee, Florida 32399-0250 • (850) 245-6280 FAX: (850) 245-6260 • WWW Address: http://Www.dos.statefl.us • E-Mail: DivE/<clion<@dos.statefl us

. I (


October 22, 2012

Ken Detzncr Secretary of State


Ms Maria Vickers-·Hemy, Treasurer for Candidate Jason Henry 124 l South Kirkman Road Apartment 114 5 Orlando, FL 32811-2811


On September 20, 2012, you were advised that one or more of your campaign treasurer's reports \\ere incomplete and that you had 7 days to file amended reports providing the requested information

The Division's electronic filing system indicates that the requited amendments have not been made Pursuant to Section 106.22, Florida Statutes, the Division is required to notify the Florida Elections Commission of the failure to provide information required by Chapter 106 Accoidingly, if the information iequested in our prior notice is not received within 7 days ot re<:eipt of this letter, we will refer this matter to the Commission A second copy of the error report is attached for yoUt convenience

Sincerely.

4~~-~-;$ .. --Kristi Reid Bronson, Chief Bureau of E lcction Records

cc: Mr. Jason Henry .. Candidate

Attachment

Room 316 R.A Gray Building • 500 South Bronough Street • Tallahassee, Florida 32399-0250 • (850) 245-6280 FAX: (850) 245-6260 • WWW Address: http://w"w .. dos state tl us • E-Mail: Divf!Jeotiom<q:mail dos .. >latefl us

1/25/2013 Aoritla Department of State - DiVision of Bections

__ ... ____ Com!Jli8111J11_R81JO_l'_t ____ _ Candidate: Jason Henry


Overal

Cuntrlmtions

Expenditures

Statute 106.07

106.07

Fund Transfers

Other Distributions



- - - - -- - -- ---- --- - - - - -Seq Date Name



Page 1

Office: STR

Account: 55547

Expenditure - - - - - ---- ----- -- - -City Tull£ Amount

MON $26.63

MON $30.77 -,

.,. I /

\

FLORIDA DEPARTMENT OF STATE Ken Detzncr

Secretary oi'State


October 19 .. 2012

Ms. Maria Vickers-Henry, Treasurer for Candidate Jason Henry 1241 South Kirkman Road Apartment 1145 Orlando, FL 32811-28 J J

Dear Ms Vicke1s-Heruy:


Year Type 2012 01

2012 F1

Cover Period 1/1/12 - 3/31/12

4/1/12 - 7/6/12

Pursuant to Section l 06 .07(2), Florida Statutes, you have 7 days from receipt of this notice to file an amended report supplying the missing information or provide an explanation fot the entries We are required by law to fonhet advise you that failure to supply this information within the time allowed constitutes a violation of Chapter l 06, Florida Statutes


_:yerely,

c::J~~~{~-~-----Kristi Reid Bronson Chief, Bureau of Election Records

cc: Mr. Jason Henry, Candidate Attaclunent

Room 316 RA Gray Building • 500 South Bronaugh Srreet • Tallahassee, Florida32399-0250 • (850) 245-6280 f AX: (850) 245-6260 • WWW Address: http://www,dos. statc.fl,us • E--Mail: Di1•Efocrions@dos stare fl us

(

FLORIDA DEPARTMENT OF STATE Ken Dctzner

Secretaiy ()f State


Second Notice

December 6, 2012

Ms Maria Vickers-l lenry, Treasurer for Candidate Jason Henry 1241 S Kitkman Rd., Apt. #1145 Otlando, FL 32811-2811


SECOND NO\\CE

On October 19, 2012, you were advised that one or more of your campaign treasurer 's reports were incomplete and that you had 7 days to file amended reports providing the requested information

The Di,ision's electronic filing system indicates that the required amendments have not been made Pursuant to Section 106. 22, Florida Statutes. the Division is required to notify the Florida Elections Commission of the failure to provide information required by Chapter 106 Accordingly, if the information requested in ow prior notice is not received within 7 days of receipt of this letter, we will refor this matter to the Commission A second copy of the enm report is attached for your convenience

Sincerely,

~~~-~~·p, Kiisti Reid B1onson, Chief Bureau of Election Records


Attachment

Room 316 R.A Gray Building • 500 South Bronough Street • Tallahassee, Florida 32399-0250 • (850) 245-6280 FAX: (850) 215-6260 • WWW Address: http://www.dos .state .fl us • E-Mail: DivEl<'<cions@mail dontate fl us

1/25/2013 Flurida Department of State - DiVision of Elections Page 1

---------~~--~~Dance Report_ Candidate: Jason Herny Office: STR

Report: 2012 Q1

Overal

ContrlJUtlons

Expelllitllres

fllllll Transfers

Other Distrillltions

Statute 106.07(4)

Report: 2012 F1

Overal

ContrlJUtlons

Expelllitllres

FWJll Transfers

Other Distributions

Statute 106.07(4)

106.07(4)

106.07(4)

(2) Covering Period: 1/1/12 - 3/31/12

Description Incorrect Name/Source(s)

(3) Covering Period: 4/1/12 - 7/6/12

Description Incorrect Name/Source(s}

Incorrect Name/Source(s)

Incorrect Name/Source(_s}

Account: 55547

-------------------0th er Dist rib u t ion--------------Seq Date Name City ~ Amounf

2 3/3/2012 HENRY JASON CAM $106.00

Account: 55547

-------------------Other Distribution--------------Seq Date Name City ~ Amount

617/2012 SUTTON KEVlN


3 4/23/2012 URIBE MAYRA

FOO

FOO

CAM

$100.68

$15.12

$47.93

,-

(

FLORIDA DEPARTMENT OF STATE Ken Detzner'

Secretary of State


December 6, 2012

Ms Maria Vickers-Henry, Treasurer for Candidate Jason Henry 1241 SKirkman Rd,• Apt. #1145 Orlando, FL 32811-2811



Year _Type ___ C;..oo_ve...,r_P __ e_11.,.,·o_d_ 2012 TR 8110/12, 11/12/12

Pursuant to Section 106,07(2), Florida Statutes, you have 7 days from receipt of this notice to file an amended report supplying the missing information or provide an explanation for the entries, We are required by law to further advise you that failure to supply this information within the time allowed constitutes a violation of Chapte1 106, Florida Statutes


~~~::_/·8~11 Kristi Reid Bronson Chief~ Bureau of Election Records

cc: Mr Jason Herny, Candidate

Attachment

Room 316 RA Gray Building • 500 South Bronaugh Street • Tallahassee, Florida 32399-0250 • (850) 245-6280 FAX: (850) 245-6260 • WWW Address: http://www dos,,state fl us • E-Mail: Dil'E/[email protected] "'

1/25/2013 Rorida Dapartment of State - DivisiOn of Bections ----------·----


Report: 2012 TR (6) Covering Period: 8/10/12 -11/12/12

overal

Statute 106.141

ContrlJUtions

ExpelllitUres

Furul Transfers

Other Distrillltions

Description Reflects balance after termination report filed

Page 1

Office: STR

Account: 55547

Holdeen, Theresa A.

From: Sent: To:

Subject:

Attachments:

Importance:

To: Mr Jason Henry

Ho ldeen, Theresa A Thursday, December 20, 2012 12:51 PM jason@electjasonhenry com; Jason Henry [email protected]); jrenee0327 @gmail.com

ADDRESS ISSUE - POST OFFICE BOX CLOSED - RETURNED MAIL (outstanding fine, and outstanding audits) #55547 Jason Henry (2012 Ql - ERROR)jpg; #55547 Jason Henry (2012 Ql - ERROR# 2)jpg; #55547 Jason Henry (2012 Fl - ERROR).jpg; #55547 Jason Henry (2012 F3 -ERROR)jpg; #55547 Jason Henry (2012 TR - Fine) pdf; #55547 Jason Henry (2012 TR -Balance After Report Filed) pdf

High

Ms. Maria Vickers-Henry, Treasurer

You have several outstanding issues with your campaign finance records. There are several errors, on various reports that still hav.e not been corrected .. I have attached screen shots with notes for everything that needs to be corrected.

In addition, when comparing your total contributions VS your total expenditures, after the termination report was file.cl, you are still showing $4041 that is not accounted for (See attachment)

Since your mail is being returned, because as you stated your post office box is closed, I have also attached a copy of the fine letter for the late filing of your termination re.port Please read it carefully, and respond accordingly

Be aware that failure to address these issues can result in referral to the Florida Elections Commission for enforcement. The Florida Elections Commission can impose civil penalties of up to $1000 per violation

If you need assistance with any of this, or have additional questions, please contact the Division's Help Desk at (850) 245-6280 ..

Thank you in advance for your immediate attention to these matters.

Regards, Theresa Bureau of El ectton Records

1

Transactions Pnnt Queue Campaign Account Sign Out Help -------- --------~------~---~· ·-----~-------~~-~----,-

Report: 2012 - Fl - 3 Covers: 4/1/2012 - 7/6/2012 Due: 7/13/2012 -----~~-~------. .

Status: Reviewed I ------------ ---~

Page 1 C)f'~,(TIX'S 1 - 3 Of 3) I Go To Page Ii

• • I - -

Transactions Pnnt Queue Campaign Account Sign Out Help -------------------------- ------------------------- ---------------~--,-------c----

I

'--- ..

Covers: 1/1/2012 - 3/31/2012 Due: 4/10/2012 status: Reviewed ' ; Report: 2012 - Ql - 2 ----------------------·-------------------'I

i-1--_-_-~_J Date: !1/30/:2012--l Amendment: l__J Distribution Seq #:

Last Name, Suffix: [HENRY

First, Middle. Name: iJASON ~------

_Address: \1241 s. KIRKMAN ROAD APT. 1145

otv: jORLAN __ D0 _______ ~ ____ 1_,i ·• $tii~e_;J,_F_l _ _; Zlp:l32s11

DistnbutiQn Tyge: I Reimbursement

Purpose: i!<EPAYMENT OF LOAN

Office:

Amount:f L ____ 1_0_0_.0_0l

Roopient: - """-

Er::l479/:2UlL-:o:26:27 PM ,_Re: !4/9/~n i) 1 ;_l'.J[L l); P~-·'i -- --- ' .----- - -- ~.

55547

55547 ---~(--

- . Trans actions Pnnt Queue Campaign Account Sign Out Help

- f3 - 5 Covers: 7/21/2012 - 8/9/2012 Due: 8/10/2012

Page Size: i 1s1 ~Efj~~ Page 1 Qf2(Trx's1 -15 Of18)

·~··.~vC- -~~~~~

status: Reviewed

i GOTO Page I' . J j GO To Record IL.-.. _c-'

--------·--·----~-- ___ ,, __ , __ ,_,,,,_, ______ , ______ , .... _, ___ ""'""" ___ _

' I


Date of last ~ontribution: 8117112

Previous Balance:

1211912012 6:11:48 PM

5554"7

1 After 8/14/12


------··--------·····----·--·--·--·····--------·-·-2011 04 $120.00 $120.00

2012 01 $2,610.00 $331.66 $2,398.34 ----------·-----------·····--········--··--·-·--··-·-·····--------

F 1 $2, 560 .. 00 ____________ ,, __ .____ --F2 $285 .. 00

$2,937.72

$397.00

$2,020.62

$1,908.62 ----------·---·-·-··-··----·-.. -- ... -~-·--···-···-~--"""~-·--·--- .. ·------

F3 $2,350.00

TR $50 00

Campaign Total: $7,975 00

Grand Total:

$3,690.22

$577.99

$7,934.59

$568.40

$40.41

ti J j ·. 20

TransactJons Print Queue Campaign Account Sign Out Help

Report: 2012 - Ql - 2 Covers: 1/1/2012 - 3/31/2012 Due: 4/10/2012 Status: Reviewed

. 1-Expenditure #: '---~ oate: F--:11.

Last Name, Suffix: !HENRY _______ _ -------------·-------,

___J

Rrst, Mk:!dle Name: ~ON Ad.dress: ~ll-24_1_S_._KIRKMAN ___ R!_O_AD_APT_. __ 1_1_4_5 __

.Qty: · jORLANDO Zip:l32811 1> 1 Distnbution Links j Expenditure Type: \Reimbursement ---------

Purpase: . ~YMENT_O_F_LO_AN ____ _

Officei c ~iTor®: • --: ·-'/·::--- -- -- ,.--<-~' -~ Amount: 100.00i. ·· Distlibuted '-------~ - __ <~r__: 4/9/2012 2:23;47 Pt·i

--- :R~.-.::'. A/<>1211'2 l'!J'.}Q•'J") p~ ... , ,• • -~ _v..t . •""-V·"--- , I ,5554_7 __ _,

S5S4l credit Card Amt: I o.ool

---~

100.ooj

C:J c:;-.>

. c._~)

---'---'-----------~~---------

Holdeen, Theresa A.

From: Sent: To:

' I,

Holdeen, Theresa A Thursday, December 27, 2012 2:20 PM 'Jason Henry'

(

Subject: RE: ADDRESS ISSUE - POST OFFICE BOX CLOSED - RETURNED MAIL (outstanding fine, and outstanding audits)

If you need assistance with any of this, or have additional questions, please contact the Division's Help Desk at (850) 245-6280.

Regards, Theresa Bureau of Election Records

From: Jason Henry [mailto:[email protected]] Sent: Wednesday, December 26, 2012 11:56 PM To: Holdeen, Theresa A. Subject: Re: ADDRESS ISSUE - POST OFFICE BOX CLOSED - RETURNED MAIL .. (outstanding fine, and outstanding audits)

Hi Theresa,

Thanks for bringing these errors to my attention.

I am a little confused on what I'm doing wiong When I submitted a report during the summer with reimbursements, I was told that it was done in error I contacted someone at the state office and was told to resubmit as MON.

When doing a reimbursement, are you able to guide me along so that these errors do not continue? I inputted "othet distributions" before, but was given an errnr again

On Thu, Dec 20, 2012 at 12:51 PM, Holdeen, The1esa A <[email protected]> wiote:

To: Mr Jason Henry

Ms Maria Vickers-Henry, Treasurer

You have several outstanding issues with your campaign finance records .. There are several errors, on various reports that still have not been corrected I have attached screen shots with notes for everything that needs to be corrected.

1

( / (

In addition, when comparing your total contributions VS your total expenditures, after the termination report was filed, you are still showing $4041 that is not accounted for (See attachme.nt)

Since your mail is being re.turned, because as you stated your post office box is close.d, I have also attached a copy of the fine letter for the late filing of your termination report. Please read it carefully, and respond accordingly ..

Be aware that failure to address these issues can result in referral to the Florida Elections Commission for enforcement. The Florida Elections Commission can impose civil pe.nalties of up to $1000 per violation

If you need assistance with any of this, or have additional questions, please contact the Division's Help Desk at ffi.50) 245-6280 ..

Thank you in advance for your immediate attention to these matters ..

Regards,

Theresa

Bureau of Election Records

2

( ....

?'°'-,... - ~ ... ~\!!:'!"1 - ·' ,_, ""

APPOINTMENT OF CAMPAIGN TREASURER AND DESIGNATION OF CAMPAIGN DEPOSITORY FOR CANDIDATES

(Section 106.021(1), F S)

11HOVl8 1\1111:28

DtV\,,,. '·· ;:_;_f.CTIONS SEGRE 1ARY OF STATE

(PLEASE PRINT OR TYPE)

NOTE: This form must be on file with the qualifying officer before openinll the campallln account.


OFFICE USE ONLY

l8J Initial Filing of Form Re-filing to Change: 0 Treasurer/Deputy 0 Depository 0 Office 0 Party

2 Name of Candidate (in this order: First, Middle, Last) 3. Address (include post office box or street, city, state, zip

Jason Samuel Henry code) t-,.--:=---:----··--.--=--::---------1 PO Box 51

4 .. Telephone 5 E-mail address Goth a, FL. 34 734

(205 ) 215··2464 Jasonforhouse39@gmail coa -----------'----------·-----r---------------------1 6 Office sought (include district, circuit, group number) 7 If a candidate for a nonpartisan office, check If

State Representative, District 39 applicable: 0 My intent is to run as a Write-In candidate t-----·--· .. ----·-------------~------------------1

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

O Write .. ln O No Party Affiliation 181 Democratic Party candidate

9 I have appointed the following person to act as my O Campaign Treasurer 181 Deputy Treasurer ·····------!

10 Name of Treasurer or Deputy Treasurer

Jason Hei:_ry ------------··--·---·-.. -----·-·-·-.. --,.--------------1 11 Mailing Address 12 Telephone

P 0 Box 51 ( 205 ) 215 .. 2454 13· City ---14--C-ou-n-ty _____ 15-.-S-ta-te--1-6-Z-ip_C_o_d_e--1-7.-. E---m-ai~I a-d-d-re_s_s ________ __,

Gotha Orange FL. 34734 [email protected]

18 I have designated the following bank as my D Primary Depository ~ Secondary Depository

19 Name of Bank

Suntrust I _20 Acdress

21 City Orlando

.. J~.oo South Orange #1 ···------....,2,...2-c""o_u_n-ty___ 23. State

Orange Florida

24 Zip Code

32801

UNDER PENALTIES OF PERJURY, I DECLARE THAT I HAVE READ THE FOREGOING FORM FOR APPOINTMENT OF CAMPAIGN TREASURER ANO OESIGNATION OF CAMPAIGN DEPOSITORY AND THAT THE FACTS STATED IN IT ARE TRUE

25 Date

11-14-2011

26 Signature of c~·date I x , ~;i 11! I J\7,, Ki1rtt--,'· +-,I--,

27. Treasurer's Acceptance of Appointment (fill in i~e blanks and check the b(ropriate block)

I ---------· Jason Henry .... _._________ , do hereby accept the appointment (Please Print or Type Name)

designated above as: 0 Campaign Treasurer ~ Deputy Tre11surer

X ~ - . ~?J? Li'.,, ' . \!,\Jf)i l'I '°"\_.. f 1 / J 11-14-2011

Date ' 18ign'al"ure of Campaign rre~rer or Deputy Treasurer

DS·DE 9 Rev. 10/10) Rule 1S-2 0001, F .. A C ..

------------·----

I,


(Section 106 .. 023, F .. S.)

(Please print or type)

,.... OFR~1.11,~f-_ql'lL Y

n NOV I 8 l\tt \\: 2S

. . . , " : cno11s 0\~1~ ... • '·' ....... T•JE. SE'CRE. it\H't OF S "

·-----------

candidate for the office of _.S:, hi.Jc t1't'yiif$-i,1.rt8+ 1 l£4~i S·i.1i< -I:- .4 ;


Chapter 106, Florida Statutes.

\\"\l{--.y~1le ··--

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 (05111) ·. "\ .. '5 t_j:)·~J{, .G

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