25
C M M / D D / Y Y Y Y M M / D D / Y Y Y Y M M / D D / Y Y Y Y M M / D D / Y Y Y Y M M / D D / Y Y Y Y FEC FORM 3 1. NAME OF COMMITTEE (in full) ADDRESS (number and street) Check if different than previously reported. (ACC) FEC FORM 3 (Revised 05/2016) Office Use Only NOTE: Submission of false, erroneous, or incomplete information may subject the person signing this Report to the penalties of 52 U.S.C. §30109. I certify that I have examined this Report and to the best of my knowledge and belief it is true, correct and complete. Type or Print Name of Treasurer Signature of Treasurer Date 4. TYPE OF REPORT (Choose One) (a) Quarterly Reports: 12-Day PRE-Election Report for the: Primary (12P) General (12G) Runoff (12R) Convention (12C) Special (12S) 30-Day POST-Election Report for the: General (30G) Runoff (30R) Special (30S) CITY STATE ZIP CODE 2. FEC IDENTIFICATION NUMBER 3. IS THIS NEW AMENDED REPORT (N) OR (A) in the Election on State of TYPE OR PRINT REPORT OF RECEIPTS AND DISBURSEMENTS For An Authorized Committee 5. Covering Period through in the Election on State of STATE DISTRICT Office Use Only April 15 Quarterly Report (Q1) July 15 Quarterly Report (Q2) October 15 Quarterly Report (Q3) January 31 Year-End Report (YE) Termination Report (TER) (b) Example: If typing, type over the lines. (c) 12FE4M5 07/15/2017 19 : 14 Image# 201707159066744225 PAGE 1 / 25 Ken Russell for Congress Exploratory Committee PO Box 331572 Miami FL 33233 C00646901 FL 27 04 01 2017 06 30 2017 Moskwa, Shelly, R, , Moskwa, Shelly, R, , [Electronically Filed] 07 15 2017

REPORT OF RECEIPTS FEC AND DISBURSEMENTS FORM 3docquery.fec.gov/pdf/225/201707159066744225/201707159066744225.pdfGolden Acre Real Estate Realtor Cox, Douglas, C., , 1172 S Dixie Hwy,

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Page 1: REPORT OF RECEIPTS FEC AND DISBURSEMENTS FORM 3docquery.fec.gov/pdf/225/201707159066744225/201707159066744225.pdfGolden Acre Real Estate Realtor Cox, Douglas, C., , 1172 S Dixie Hwy,

C

M M / D D / Y Y Y Y

M M / D D / Y Y Y Y

M M / D D / Y Y Y Y M M / D D / Y Y Y Y

M M / D D / Y Y Y Y

FEC FORM 3

1. NAME OF COMMITTEE (in full)

ADDRESS (number and street)

Check if different than previously reported. (ACC)

FEC FORM 3(Revised 05/2016)

Office Use Only

NOTE: Submission of false, erroneous, or incomplete information may subject the person signing this Report to the penalties of 52 U.S.C. §30109.

I certify that I have examined this Report and to the best of my knowledge and belief it is true, correct and complete.

Type or Print Name of Treasurer

Signature of Treasurer Date

4. TYPE OF REPORT (Choose One)

(a) Quarterly Reports:12-Day PRE-Election Report for the:

Primary (12P) General (12G) Runoff (12R) Convention (12C) Special (12S)

30-Day POST-Election Report for the:

General (30G) Runoff (30R) Special (30S)

CITY STATE ZIP CODE2. FEC IDENTIFICATION NUMBER

3. IS THIS NEW AMENDED REPORT (N) OR (A)

in the Election on State of

TYPE OR PRINT

REPORT OF RECEIPTS AND DISBURSEMENTS

For An Authorized Committee

5. Covering Period through

in the Election on State of

STATE DISTRICT

Office Use Only

April 15 Quarterly Report (Q1)

July 15 Quarterly Report (Q2)

October 15 Quarterly Report (Q3)

January 31 Year-End Report (YE)

Termination Report (TER)

(b)

Example: If typing, type over the lines.

(c)

12FE4M5

07/15/2017 19 : 14Image# 201707159066744225

PAGE 1 / 25

Ken Russell for Congress Exploratory Committee

PO Box 331572

Miami FL 33233

✘C00646901FL 27

04 01 2017 06 30 2017

Moskwa, Shelly, R, ,

Moskwa, Shelly, R, ,

[Electronically Filed]07 15 2017

Page 2: REPORT OF RECEIPTS FEC AND DISBURSEMENTS FORM 3docquery.fec.gov/pdf/225/201707159066744225/201707159066744225.pdfGolden Acre Real Estate Realtor Cox, Douglas, C., , 1172 S Dixie Hwy,

, , . , , .

, , . , , .

, , . , , .

, , . , , .

, , . , , .

, , . , , .

, , .

, , .

, , .

M M / D D / Y Y Y Y M M / D D / Y Y Y Y

COLUMN BElection Cycle-to-Date

COLUMN AThis Period

6. Net Contributions (other than loans)

(a) Total Contributions (other than loans) (from Line 11(e)) ....

(b) Total Contribution Refunds (from Line 20(d)) ..................................

(c) Net Contributions (other than loans) (subtract Line 6(b) from Line 6(a)) ...... 7. Net Operating Expenditures

(a) Total Operating Expenditures (from Line 17) ......................................

(b) Total Offsets to Operating Expenditures (from Line 14) ................

(c) Net Operating Expenditures (subtract Line 7(b) from Line 7(a)) ...... 8. Cash on Hand at Close of Reporting Period (from Line 27) .................

9. Debts and Obligations Owed TO the Committee (Itemize all on Schedule C and/or Schedule D) ................

10. Debts and Obligations Owed BY the Committee (Itemize all on Schedule C and/or Schedule D) ................

For further information contact:

Federal Election Commission999 E Street, NW

Washington, DC 20463

Toll Free 800-424-9530Local 202-694-1100

FEC Form 3 (Revised 05/2016) Page 2

SUMMARY PAGEof Receipts and Disbursements

Report Covering the Period: From: To:

Write or Type Committee NameKen Russell for Congress Exploratory Committee

04 01 2017 06 30 2017

Image# 201707159066744226

PAGE 2 / 25

133850.00 133850.00

0.00 0.00

133850.00 133850.00

5071.10 5071.10

0.00 0.00

5071.10 5071.10

128778.90

0.00

0.00

Page 3: REPORT OF RECEIPTS FEC AND DISBURSEMENTS FORM 3docquery.fec.gov/pdf/225/201707159066744225/201707159066744225.pdfGolden Acre Real Estate Realtor Cox, Douglas, C., , 1172 S Dixie Hwy,

, , . , , .

, , . , , .

, , . , , .

, , . , , .

, , . , , .

, , . , , .

, , . , , .

, , . , , .

, , . , , .

, , . , , .

, , . , , .

, , . , , .

, , .

, , .

M M / D D / Y Y Y Y M M / D D / Y Y Y Y

, , .

, , .

COLUMN BElection Cycle-to-Date

COLUMN ATotal This Period

11. CONTRIBUTIONS (other than loans) FROM:

(a) Individuals/Persons Other Than Political Committees (i) Itemized (use Schedule A) ........... (ii) Unitemized .................................... (iii) TOTAL of contributions from individuals .......................

(b) Political Party Committees ................. (c) Other Political Committees (such as PACs) ...................................

(d) The Candidate .................................... (e) TOTAL CONTRIBUTIONS (other than loans) (add Lines 11(a)(iii), (b), (c), and (d)) ..

12. TRANSFERS FROM OTHER AUTHORIZED COMMITTEES ....................

13. LOANS: (a) Made or Guaranteed by the Candidate ............................................

(b) All Other Loans ................................... (c) TOTAL LOANS (add Lines 13(a) and (b)) ....................

14. OFFSETS TO OPERATING EXPENDITURES (Refunds, Rebates, etc.) ............................

15. OTHER RECEIPTS (Dividends, Interest, etc.) ...........................

16. TOTAL RECEIPTS (add Lines 11(e), 12, 13(c), 14, and 15) (Carry Total to Line 24, page 4) ............

DETAILED SUMMARY PAGEof Receipts

I. RECEIPTS

FEC Form 3 (Revised 05/2016) Page 3

Report Covering the Period: From: To:

Write or Type Committee Name

Ken Russell for Congress Exploratory Committee

04 01 2017 06 30 2017

Image# 201707159066744227

PAGE 3 / 25

133850.00 133850.00

0.00 0.00

133850.00 133850.00

0.00 0.00

0.00 0.00

0.00 0.00

133850.00 133850.00

0.00 0.00

0.00 0.00

0.00 0.00

0.00 0.00

0.00 0.00

0.00 0.00

133850.00 133850.00

Page 4: REPORT OF RECEIPTS FEC AND DISBURSEMENTS FORM 3docquery.fec.gov/pdf/225/201707159066744225/201707159066744225.pdfGolden Acre Real Estate Realtor Cox, Douglas, C., , 1172 S Dixie Hwy,

, , . , , .

, , . , , .

, , . , , .

, , . , , .

, , . , , .

, , . , , .

, , . , , .

, , . , , .

, , . , , .

, , . , , .

, , .

, , .

, , .

, , .

, , .

COLUMN BElection Cycle-to-Date

COLUMN ATotal This Period

17. OPERATING EXPENDITURES .....................

18. TRANSFERS TO OTHER AUTHORIZED COMMITTEES .....................

19. LOAN REPAYMENTS: (a) Of Loans Made or Guaranteed by the Candidate .................................

(b) Of All Other Loans .............................. (c) TOTAL LOAN REPAYMENTS (add Lines 19(a) and (b)) .....................

20. REFUNDS OF CONTRIBUTIONS TO: (a) Individuals/Persons Other Than Political Committees ..................

(b) Political Party Committees .................. (c) Other Political Committees (such as PACs) ....................................

(d) TOTAL CONTRIBUTION REFUNDS (add Lines 20(a), (b), and (c)) ..............

21. OTHER DISBURSEMENTS .........................

22. TOTAL DISBURSEMENTS (add Lines 17, 18, 19(c), 20(d), and 21)

II. DISBURSEMENTS

DETAILED SUMMARY PAGEof DisbursementsFEC Form 3 (Revised 05/2016) Page 4

III. CASH SUMMARY

23. CASH ON HAND AT BEGINNING OF REPORTING PERIOD ...............................................

24 TOTAL RECEIPTS THIS PERIOD (from Line 16, page 3) .....................................................

25. SUBTOTAL (add Line 23 and Line 24) ..................................................................................

26. TOTAL DISBURSEMENTS THIS PERIOD (from Line 22) ......................................................

27. CASH ON HAND AT CLOSE OF REPORTING PERIOD (subtract Line 26 from Line 25)..............................................................................................

, , . , , .

Image# 201707159066744228

PAGE 4 / 25

5071.10 5071.10

0.00 0.00

0.00 0.00

0.00 0.00

0.00 0.00

0.00 0.00

0.00 0.00

0.00 0.00

0.00 0.00

0.00 0.00

5071.10 5071.10

0.00

133850.00

133850.00

5071.10

128778.90

Page 5: REPORT OF RECEIPTS FEC AND DISBURSEMENTS FORM 3docquery.fec.gov/pdf/225/201707159066744225/201707159066744225.pdfGolden Acre Real Estate Realtor Cox, Douglas, C., , 1172 S Dixie Hwy,

SCHEDULE A (FEC Form 3)

ITEMIZED RECEIPTS

Any information copied from such Reports and Statements may not be sold or used by any person for the purpose of soliciting contributions or for commercial purposes, other than using the name and address of any political committee to solicit contributions from such committee.

NAME OF COMMITTEE (In Full)

, , .

, , .SUBTOTAL of Receipts This Page (optional) ............................................................................

TOTAL This Period (last page this line number only) ...............................................................

Full Name (Last, First, Middle Initial)

Mailing Address

City State Zip Code

Receipt For:

Primary General

Other (specify)

A.

Election Cycle-to-Date

Date of Receipt

Name of Employer Occupation

, , .

FEC ID number of contributingfederal political committee. C

Full Name (Last, First, Middle Initial)

Mailing Address

City State Zip Code

Receipt For:

Primary General

Other (specify)

B.

Election Cycle-to-Date

Date of Receipt

Name of Employer Occupation

, , .

FEC ID number of contributingfederal political committee. C

Full Name (Last, First, Middle Initial)

Mailing Address

City State Zip Code

Receipt For:

Primary General

Other (specify)

C.

Election Cycle-to-Date

Date of Receipt

Name of Employer Occupation

, , .

FEC ID number of contributingfederal political committee. C

PAGE OFFOR LINE NUMBER: (check only one)Use separate schedule(s)

for each category of the Detailed Summary Page

11a 11b 11c 11d

12 13b 13a 14 15

M M / D D / Y Y Y Y

M M / D D / Y Y Y Y

M M / D D / Y Y Y Y

Amount of Each Receipt this Period

, , .

Amount of Each Receipt this Period

, , .

Amount of Each Receipt this Period

, , .

FEC Schedule A (Form 3) (Revised 05/2016)

Memo Item

Memo Item

Memo Item

Image# 201707159066744229

5 25

Ken Russell for Congress Exploratory Committee

Abbott, Daniel, , ,4709 Adams St.

06 29 2017

Hollywood FLTransaction ID : SA11AI.4165

33021

750.00

Weiss, Serota et al Attorney

2018

✘750.00

Beasley, Randy, , ,PO Box 593809

06 29 2017

Orlando FL 32859Transaction ID : SA11AI.4183

2700.00

Rachels Steak House Owner Operator

2018

✘2700.00

Berkowitz, Jeffrey, L., ,2665 S. Bayshore Drive, Suite 1200

06 15 2017

Coconut Grove FL 33133Transaction ID : SA11AI.4149

2700.00

Berkowitz Development Group Developer

2018

2700.00

6150.00

pbasupally
Typewritten Text
Page 6: REPORT OF RECEIPTS FEC AND DISBURSEMENTS FORM 3docquery.fec.gov/pdf/225/201707159066744225/201707159066744225.pdfGolden Acre Real Estate Realtor Cox, Douglas, C., , 1172 S Dixie Hwy,

SCHEDULE A (FEC Form 3)

ITEMIZED RECEIPTS

Any information copied from such Reports and Statements may not be sold or used by any person for the purpose of soliciting contributions or for commercial purposes, other than using the name and address of any political committee to solicit contributions from such committee.

NAME OF COMMITTEE (In Full)

, , .

, , .SUBTOTAL of Receipts This Page (optional) ............................................................................

TOTAL This Period (last page this line number only) ...............................................................

Full Name (Last, First, Middle Initial)

Mailing Address

City State Zip Code

Receipt For:

Primary General

Other (specify)

A.

Election Cycle-to-Date

Date of Receipt

Name of Employer Occupation

, , .

FEC ID number of contributingfederal political committee. C

Full Name (Last, First, Middle Initial)

Mailing Address

City State Zip Code

Receipt For:

Primary General

Other (specify)

B.

Election Cycle-to-Date

Date of Receipt

Name of Employer Occupation

, , .

FEC ID number of contributingfederal political committee. C

Full Name (Last, First, Middle Initial)

Mailing Address

City State Zip Code

Receipt For:

Primary General

Other (specify)

C.

Election Cycle-to-Date

Date of Receipt

Name of Employer Occupation

, , .

FEC ID number of contributingfederal political committee. C

PAGE OFFOR LINE NUMBER: (check only one)Use separate schedule(s)

for each category of the Detailed Summary Page

11a 11b 11c 11d

12 13b 13a 14 15

M M / D D / Y Y Y Y

M M / D D / Y Y Y Y

M M / D D / Y Y Y Y

Amount of Each Receipt this Period

, , .

Amount of Each Receipt this Period

, , .

Amount of Each Receipt this Period

, , .

FEC Schedule A (Form 3) (Revised 05/2016)

Memo Item

Memo Item

Memo Item

Image# 201707159066744230

6 25

Ken Russell for Congress Exploratory Committee

Berkowitz, Yolanda, , ,2665 S. Bayshore Drive, Suite 1200

06 29 2017

Coconut Grove FLTransaction ID : SA11AI.4119

33133

2700.00

N/A N/A

2018

✘2700.00

Chirino, Raymond, , ,19165 NW 90th Court

06 30 2017

Hialeah FL 33018Transaction ID : SA11AI.4197

2700.00

Golden Acre Real Estate Realtor

2018

✘2700.00

Cox, Douglas, C., ,1172 S Dixie Hwy, Suite 396

06 30 2017

Coral Gables FL 33146Transaction ID : SA11AI.4121

2700.00

Drive Development LLC Manager

2018

2700.00

8100.00

pbasupally
Typewritten Text
Page 7: REPORT OF RECEIPTS FEC AND DISBURSEMENTS FORM 3docquery.fec.gov/pdf/225/201707159066744225/201707159066744225.pdfGolden Acre Real Estate Realtor Cox, Douglas, C., , 1172 S Dixie Hwy,

SCHEDULE A (FEC Form 3)

ITEMIZED RECEIPTS

Any information copied from such Reports and Statements may not be sold or used by any person for the purpose of soliciting contributions or for commercial purposes, other than using the name and address of any political committee to solicit contributions from such committee.

NAME OF COMMITTEE (In Full)

, , .

, , .SUBTOTAL of Receipts This Page (optional) ............................................................................

TOTAL This Period (last page this line number only) ...............................................................

Full Name (Last, First, Middle Initial)

Mailing Address

City State Zip Code

Receipt For:

Primary General

Other (specify)

A.

Election Cycle-to-Date

Date of Receipt

Name of Employer Occupation

, , .

FEC ID number of contributingfederal political committee. C

Full Name (Last, First, Middle Initial)

Mailing Address

City State Zip Code

Receipt For:

Primary General

Other (specify)

B.

Election Cycle-to-Date

Date of Receipt

Name of Employer Occupation

, , .

FEC ID number of contributingfederal political committee. C

Full Name (Last, First, Middle Initial)

Mailing Address

City State Zip Code

Receipt For:

Primary General

Other (specify)

C.

Election Cycle-to-Date

Date of Receipt

Name of Employer Occupation

, , .

FEC ID number of contributingfederal political committee. C

PAGE OFFOR LINE NUMBER: (check only one)Use separate schedule(s)

for each category of the Detailed Summary Page

11a 11b 11c 11d

12 13b 13a 14 15

M M / D D / Y Y Y Y

M M / D D / Y Y Y Y

M M / D D / Y Y Y Y

Amount of Each Receipt this Period

, , .

Amount of Each Receipt this Period

, , .

Amount of Each Receipt this Period

, , .

FEC Schedule A (Form 3) (Revised 05/2016)

Memo Item

Memo Item

Memo Item

Image# 201707159066744231

7 25

Ken Russell for Congress Exploratory Committee

DiMercurio, Christopher, J., ,11404 SW 106th Ave

06 30 2017

Miami FLTransaction ID : SA11AI.4141

33176

2700.00

Self Contractor

2018

✘2700.00

Eidson, Lewis, , ,255 Alhambra Circle

06 30 2017

Coral Gables FL 33134Transaction ID : SA11AI.4187

2700.00

Colson Hicks Eidson Attorney

2018

✘2700.00

Eidson, Margaret, , ,3307 Devon Court

06 30 2017

Miami FL 33133Transaction ID : SA11AI.4199

2700.00

Self Physician

2018

2700.00

8100.00

pbasupally
Typewritten Text
Page 8: REPORT OF RECEIPTS FEC AND DISBURSEMENTS FORM 3docquery.fec.gov/pdf/225/201707159066744225/201707159066744225.pdfGolden Acre Real Estate Realtor Cox, Douglas, C., , 1172 S Dixie Hwy,

SCHEDULE A (FEC Form 3)

ITEMIZED RECEIPTS

Any information copied from such Reports and Statements may not be sold or used by any person for the purpose of soliciting contributions or for commercial purposes, other than using the name and address of any political committee to solicit contributions from such committee.

NAME OF COMMITTEE (In Full)

, , .

, , .SUBTOTAL of Receipts This Page (optional) ............................................................................

TOTAL This Period (last page this line number only) ...............................................................

Full Name (Last, First, Middle Initial)

Mailing Address

City State Zip Code

Receipt For:

Primary General

Other (specify)

A.

Election Cycle-to-Date

Date of Receipt

Name of Employer Occupation

, , .

FEC ID number of contributingfederal political committee. C

Full Name (Last, First, Middle Initial)

Mailing Address

City State Zip Code

Receipt For:

Primary General

Other (specify)

B.

Election Cycle-to-Date

Date of Receipt

Name of Employer Occupation

, , .

FEC ID number of contributingfederal political committee. C

Full Name (Last, First, Middle Initial)

Mailing Address

City State Zip Code

Receipt For:

Primary General

Other (specify)

C.

Election Cycle-to-Date

Date of Receipt

Name of Employer Occupation

, , .

FEC ID number of contributingfederal political committee. C

PAGE OFFOR LINE NUMBER: (check only one)Use separate schedule(s)

for each category of the Detailed Summary Page

11a 11b 11c 11d

12 13b 13a 14 15

M M / D D / Y Y Y Y

M M / D D / Y Y Y Y

M M / D D / Y Y Y Y

Amount of Each Receipt this Period

, , .

Amount of Each Receipt this Period

, , .

Amount of Each Receipt this Period

, , .

FEC Schedule A (Form 3) (Revised 05/2016)

Memo Item

Memo Item

Memo Item

Image# 201707159066744232

8 25

Ken Russell for Congress Exploratory Committee

Fischer, Walter, , ,3598 Yatch Club Dr. #2001

06 29 2017

Aventura FLTransaction ID : SA11AI.4153

33180

2150.00

Man-Co USA, LLC CFO

2018

✘2150.00

Fisher, Mark, , ,301 W 41st Street, suite 300

06 30 2017

Miami Beach FL 33140Transaction ID : SA11AI.4219

2700.00

MBF Clearing Corp Trader

2018

✘2700.00

Fuentes, Maria Elena, , ,3257 SW 58th Avenue

06 30 2017

Miami FL 33155Transaction ID : SA11AI.4201

2700.00

Maria Elena Headpieces Designer

2018

2700.00

7550.00

pbasupally
Typewritten Text
Page 9: REPORT OF RECEIPTS FEC AND DISBURSEMENTS FORM 3docquery.fec.gov/pdf/225/201707159066744225/201707159066744225.pdfGolden Acre Real Estate Realtor Cox, Douglas, C., , 1172 S Dixie Hwy,

SCHEDULE A (FEC Form 3)

ITEMIZED RECEIPTS

Any information copied from such Reports and Statements may not be sold or used by any person for the purpose of soliciting contributions or for commercial purposes, other than using the name and address of any political committee to solicit contributions from such committee.

NAME OF COMMITTEE (In Full)

, , .

, , .SUBTOTAL of Receipts This Page (optional) ............................................................................

TOTAL This Period (last page this line number only) ...............................................................

Full Name (Last, First, Middle Initial)

Mailing Address

City State Zip Code

Receipt For:

Primary General

Other (specify)

A.

Election Cycle-to-Date

Date of Receipt

Name of Employer Occupation

, , .

FEC ID number of contributingfederal political committee. C

Full Name (Last, First, Middle Initial)

Mailing Address

City State Zip Code

Receipt For:

Primary General

Other (specify)

B.

Election Cycle-to-Date

Date of Receipt

Name of Employer Occupation

, , .

FEC ID number of contributingfederal political committee. C

Full Name (Last, First, Middle Initial)

Mailing Address

City State Zip Code

Receipt For:

Primary General

Other (specify)

C.

Election Cycle-to-Date

Date of Receipt

Name of Employer Occupation

, , .

FEC ID number of contributingfederal political committee. C

PAGE OFFOR LINE NUMBER: (check only one)Use separate schedule(s)

for each category of the Detailed Summary Page

11a 11b 11c 11d

12 13b 13a 14 15

M M / D D / Y Y Y Y

M M / D D / Y Y Y Y

M M / D D / Y Y Y Y

Amount of Each Receipt this Period

, , .

Amount of Each Receipt this Period

, , .

Amount of Each Receipt this Period

, , .

FEC Schedule A (Form 3) (Revised 05/2016)

Memo Item

Memo Item

Memo Item

Image# 201707159066744233

9 25

Ken Russell for Congress Exploratory Committee

Fuentes, Raul, , ,3257 SW 58th Avenue

06 30 2017

Miami FLTransaction ID : SA11AI.4203

33155

2700.00

Crowe Horwath LLP Accounting

2018

✘2700.00

Galeano, Miriam, , ,10182 NW 41st Street

06 30 2017

Doral FL 33178Transaction ID : SA11AI.4123

2700.00

Edgewater Managements Service LLC Comptroller

2018

✘2700.00

Garces de Marcilla, Anamarie, , ,4779 Collins Ave, Apt. 2903

06 30 2017

Miami Beach FL 33140Transaction ID : SA11AI.4129

2700.00

Urban Health Epidemiologist

2018

2700.00

8100.00

pbasupally
Typewritten Text
Page 10: REPORT OF RECEIPTS FEC AND DISBURSEMENTS FORM 3docquery.fec.gov/pdf/225/201707159066744225/201707159066744225.pdfGolden Acre Real Estate Realtor Cox, Douglas, C., , 1172 S Dixie Hwy,

SCHEDULE A (FEC Form 3)

ITEMIZED RECEIPTS

Any information copied from such Reports and Statements may not be sold or used by any person for the purpose of soliciting contributions or for commercial purposes, other than using the name and address of any political committee to solicit contributions from such committee.

NAME OF COMMITTEE (In Full)

, , .

, , .SUBTOTAL of Receipts This Page (optional) ............................................................................

TOTAL This Period (last page this line number only) ...............................................................

Full Name (Last, First, Middle Initial)

Mailing Address

City State Zip Code

Receipt For:

Primary General

Other (specify)

A.

Election Cycle-to-Date

Date of Receipt

Name of Employer Occupation

, , .

FEC ID number of contributingfederal political committee. C

Full Name (Last, First, Middle Initial)

Mailing Address

City State Zip Code

Receipt For:

Primary General

Other (specify)

B.

Election Cycle-to-Date

Date of Receipt

Name of Employer Occupation

, , .

FEC ID number of contributingfederal political committee. C

Full Name (Last, First, Middle Initial)

Mailing Address

City State Zip Code

Receipt For:

Primary General

Other (specify)

C.

Election Cycle-to-Date

Date of Receipt

Name of Employer Occupation

, , .

FEC ID number of contributingfederal political committee. C

PAGE OFFOR LINE NUMBER: (check only one)Use separate schedule(s)

for each category of the Detailed Summary Page

11a 11b 11c 11d

12 13b 13a 14 15

M M / D D / Y Y Y Y

M M / D D / Y Y Y Y

M M / D D / Y Y Y Y

Amount of Each Receipt this Period

, , .

Amount of Each Receipt this Period

, , .

Amount of Each Receipt this Period

, , .

FEC Schedule A (Form 3) (Revised 05/2016)

Memo Item

Memo Item

Memo Item

Image# 201707159066744234

10 25

Ken Russell for Congress Exploratory Committee

Gonzalez, Yoleidis, , ,4560 NW 79th Avenue, Apt 2E

06 30 2017

Doral FLTransaction ID : SA11AI.4195

33166

2700.00

Premier Real Estate Sales Real Estate

2018

✘2700.00

Goodman, Robert, S., ,300 41st St. Suite 214

06 12 2017

Miami Beach FL 33140Transaction ID : SA11AI.4113

500.00

Garber & Goodman Advertisement

2018

✘500.00

Grimes, Julie, G., ,1717 N Bayshore Drive, Apt 4134

06 30 2017

Miami Beach FL 33139Transaction ID : SA11AI.4127

2700.00

Heafey Group Vice President

2018

2700.00

5900.00

pbasupally
Typewritten Text
Page 11: REPORT OF RECEIPTS FEC AND DISBURSEMENTS FORM 3docquery.fec.gov/pdf/225/201707159066744225/201707159066744225.pdfGolden Acre Real Estate Realtor Cox, Douglas, C., , 1172 S Dixie Hwy,

SCHEDULE A (FEC Form 3)

ITEMIZED RECEIPTS

Any information copied from such Reports and Statements may not be sold or used by any person for the purpose of soliciting contributions or for commercial purposes, other than using the name and address of any political committee to solicit contributions from such committee.

NAME OF COMMITTEE (In Full)

, , .

, , .SUBTOTAL of Receipts This Page (optional) ............................................................................

TOTAL This Period (last page this line number only) ...............................................................

Full Name (Last, First, Middle Initial)

Mailing Address

City State Zip Code

Receipt For:

Primary General

Other (specify)

A.

Election Cycle-to-Date

Date of Receipt

Name of Employer Occupation

, , .

FEC ID number of contributingfederal political committee. C

Full Name (Last, First, Middle Initial)

Mailing Address

City State Zip Code

Receipt For:

Primary General

Other (specify)

B.

Election Cycle-to-Date

Date of Receipt

Name of Employer Occupation

, , .

FEC ID number of contributingfederal political committee. C

Full Name (Last, First, Middle Initial)

Mailing Address

City State Zip Code

Receipt For:

Primary General

Other (specify)

C.

Election Cycle-to-Date

Date of Receipt

Name of Employer Occupation

, , .

FEC ID number of contributingfederal political committee. C

PAGE OFFOR LINE NUMBER: (check only one)Use separate schedule(s)

for each category of the Detailed Summary Page

11a 11b 11c 11d

12 13b 13a 14 15

M M / D D / Y Y Y Y

M M / D D / Y Y Y Y

M M / D D / Y Y Y Y

Amount of Each Receipt this Period

, , .

Amount of Each Receipt this Period

, , .

Amount of Each Receipt this Period

, , .

FEC Schedule A (Form 3) (Revised 05/2016)

Memo Item

Memo Item

Memo Item

Image# 201707159066744235

11 25

Ken Russell for Congress Exploratory Committee

Grosskopf, Manuel, , ,284 S Island Dr.

06 29 2017

Golden Beach FLTransaction ID : SA11AI.4161

33160

2350.00

Man-Co USA, LLC CEO

2018

✘2350.00

Hankin, Paulie, , ,901 Brickell Key Blvd. Apt. 3208

06 29 2017

Miami FL 33131Transaction ID : SA11AI.4171

2700.00

Paulie Hankin PA Realtor

2018

✘2700.00

Havenick, Barbara, , ,PO Box 350940

06 30 2017

Miami FL 33135Transaction ID : SA11AI.4131

2700.00

Hecht Properties Partner

2018

2700.00

7750.00

pbasupally
Typewritten Text
Page 12: REPORT OF RECEIPTS FEC AND DISBURSEMENTS FORM 3docquery.fec.gov/pdf/225/201707159066744225/201707159066744225.pdfGolden Acre Real Estate Realtor Cox, Douglas, C., , 1172 S Dixie Hwy,

SCHEDULE A (FEC Form 3)

ITEMIZED RECEIPTS

Any information copied from such Reports and Statements may not be sold or used by any person for the purpose of soliciting contributions or for commercial purposes, other than using the name and address of any political committee to solicit contributions from such committee.

NAME OF COMMITTEE (In Full)

, , .

, , .SUBTOTAL of Receipts This Page (optional) ............................................................................

TOTAL This Period (last page this line number only) ...............................................................

Full Name (Last, First, Middle Initial)

Mailing Address

City State Zip Code

Receipt For:

Primary General

Other (specify)

A.

Election Cycle-to-Date

Date of Receipt

Name of Employer Occupation

, , .

FEC ID number of contributingfederal political committee. C

Full Name (Last, First, Middle Initial)

Mailing Address

City State Zip Code

Receipt For:

Primary General

Other (specify)

B.

Election Cycle-to-Date

Date of Receipt

Name of Employer Occupation

, , .

FEC ID number of contributingfederal political committee. C

Full Name (Last, First, Middle Initial)

Mailing Address

City State Zip Code

Receipt For:

Primary General

Other (specify)

C.

Election Cycle-to-Date

Date of Receipt

Name of Employer Occupation

, , .

FEC ID number of contributingfederal political committee. C

PAGE OFFOR LINE NUMBER: (check only one)Use separate schedule(s)

for each category of the Detailed Summary Page

11a 11b 11c 11d

12 13b 13a 14 15

M M / D D / Y Y Y Y

M M / D D / Y Y Y Y

M M / D D / Y Y Y Y

Amount of Each Receipt this Period

, , .

Amount of Each Receipt this Period

, , .

Amount of Each Receipt this Period

, , .

FEC Schedule A (Form 3) (Revised 05/2016)

Memo Item

Memo Item

Memo Item

Image# 201707159066744236

12 25

Ken Russell for Congress Exploratory Committee

Head, Doug, , ,1415 West Robinson Street

06 21 2017

Orlando FLTransaction ID : SA11AI.4151

32805

250.00

Doug Head, PA Insurance Consultant

2018

✘250.00

Heafey, Nathalie, , ,1900 Sunset Harbour Dr. No. TS1

06 30 2017

Miami Beach FL 33139Transaction ID : SA11AI.4125

2700.00

Bentley Real Estate Real Estate

2018

✘2700.00

Herman, Michael, , ,901 Brickell Key Blvd Apt 3208

06 30 2017

Miami FL 33131Transaction ID : SA11AI.4205

2700.00

IQE Sales Director

2018

2700.00

5650.00

pbasupally
Typewritten Text
Page 13: REPORT OF RECEIPTS FEC AND DISBURSEMENTS FORM 3docquery.fec.gov/pdf/225/201707159066744225/201707159066744225.pdfGolden Acre Real Estate Realtor Cox, Douglas, C., , 1172 S Dixie Hwy,

SCHEDULE A (FEC Form 3)

ITEMIZED RECEIPTS

Any information copied from such Reports and Statements may not be sold or used by any person for the purpose of soliciting contributions or for commercial purposes, other than using the name and address of any political committee to solicit contributions from such committee.

NAME OF COMMITTEE (In Full)

, , .

, , .SUBTOTAL of Receipts This Page (optional) ............................................................................

TOTAL This Period (last page this line number only) ...............................................................

Full Name (Last, First, Middle Initial)

Mailing Address

City State Zip Code

Receipt For:

Primary General

Other (specify)

A.

Election Cycle-to-Date

Date of Receipt

Name of Employer Occupation

, , .

FEC ID number of contributingfederal political committee. C

Full Name (Last, First, Middle Initial)

Mailing Address

City State Zip Code

Receipt For:

Primary General

Other (specify)

B.

Election Cycle-to-Date

Date of Receipt

Name of Employer Occupation

, , .

FEC ID number of contributingfederal political committee. C

Full Name (Last, First, Middle Initial)

Mailing Address

City State Zip Code

Receipt For:

Primary General

Other (specify)

C.

Election Cycle-to-Date

Date of Receipt

Name of Employer Occupation

, , .

FEC ID number of contributingfederal political committee. C

PAGE OFFOR LINE NUMBER: (check only one)Use separate schedule(s)

for each category of the Detailed Summary Page

11a 11b 11c 11d

12 13b 13a 14 15

M M / D D / Y Y Y Y

M M / D D / Y Y Y Y

M M / D D / Y Y Y Y

Amount of Each Receipt this Period

, , .

Amount of Each Receipt this Period

, , .

Amount of Each Receipt this Period

, , .

FEC Schedule A (Form 3) (Revised 05/2016)

Memo Item

Memo Item

Memo Item

Image# 201707159066744237

13 25

Ken Russell for Congress Exploratory Committee

Hernandez, Iliana, , ,14241 SW 48th Street

06 30 2017

Miami FLTransaction ID : SA11AI.4207

33175

2700.00

Self Physician

2018

✘2700.00

Hinds, Lisa, , ,1440 Talcott Road

06 30 2017

Woodridge IL 60517Transaction ID : SA11AI.4227

2700.00

SPE Inc Manager

2018

✘2700.00

Hoffmann, Peter, , ,2333 Brickell Avenue

06 29 2017

Miami FL 33129Transaction ID : SA11AI.4173

2700.00

Turgo, LLC Developer- Contractor

2018

2700.00

8100.00

pbasupally
Typewritten Text
Page 14: REPORT OF RECEIPTS FEC AND DISBURSEMENTS FORM 3docquery.fec.gov/pdf/225/201707159066744225/201707159066744225.pdfGolden Acre Real Estate Realtor Cox, Douglas, C., , 1172 S Dixie Hwy,

SCHEDULE A (FEC Form 3)

ITEMIZED RECEIPTS

Any information copied from such Reports and Statements may not be sold or used by any person for the purpose of soliciting contributions or for commercial purposes, other than using the name and address of any political committee to solicit contributions from such committee.

NAME OF COMMITTEE (In Full)

, , .

, , .SUBTOTAL of Receipts This Page (optional) ............................................................................

TOTAL This Period (last page this line number only) ...............................................................

Full Name (Last, First, Middle Initial)

Mailing Address

City State Zip Code

Receipt For:

Primary General

Other (specify)

A.

Election Cycle-to-Date

Date of Receipt

Name of Employer Occupation

, , .

FEC ID number of contributingfederal political committee. C

Full Name (Last, First, Middle Initial)

Mailing Address

City State Zip Code

Receipt For:

Primary General

Other (specify)

B.

Election Cycle-to-Date

Date of Receipt

Name of Employer Occupation

, , .

FEC ID number of contributingfederal political committee. C

Full Name (Last, First, Middle Initial)

Mailing Address

City State Zip Code

Receipt For:

Primary General

Other (specify)

C.

Election Cycle-to-Date

Date of Receipt

Name of Employer Occupation

, , .

FEC ID number of contributingfederal political committee. C

PAGE OFFOR LINE NUMBER: (check only one)Use separate schedule(s)

for each category of the Detailed Summary Page

11a 11b 11c 11d

12 13b 13a 14 15

M M / D D / Y Y Y Y

M M / D D / Y Y Y Y

M M / D D / Y Y Y Y

Amount of Each Receipt this Period

, , .

Amount of Each Receipt this Period

, , .

Amount of Each Receipt this Period

, , .

FEC Schedule A (Form 3) (Revised 05/2016)

Memo Item

Memo Item

Memo Item

Image# 201707159066744238

14 25

Ken Russell for Congress Exploratory Committee

Hollo, Jerome, , ,688 North Island Road

06 29 2017

Golden Beach FLTransaction ID : SA11AI.4163

33160

2700.00

EPMS Management

2018

✘2700.00

Holz, Fernando, , ,425 NE 25th Street

06 30 2017

Miami FL 33132Transaction ID : SA11AI.4145

2700.00

Cervera Real Estate Real Estate

2018

✘2700.00

Izquierdo, Maritza, , ,4441 SW 13th Terrace

06 30 2017

Miami FL 33134Transaction ID : SA11AI.4137

2700.00

Lemon Law Group Partners Legal

2018

2700.00

8100.00

pbasupally
Typewritten Text
Page 15: REPORT OF RECEIPTS FEC AND DISBURSEMENTS FORM 3docquery.fec.gov/pdf/225/201707159066744225/201707159066744225.pdfGolden Acre Real Estate Realtor Cox, Douglas, C., , 1172 S Dixie Hwy,

SCHEDULE A (FEC Form 3)

ITEMIZED RECEIPTS

Any information copied from such Reports and Statements may not be sold or used by any person for the purpose of soliciting contributions or for commercial purposes, other than using the name and address of any political committee to solicit contributions from such committee.

NAME OF COMMITTEE (In Full)

, , .

, , .SUBTOTAL of Receipts This Page (optional) ............................................................................

TOTAL This Period (last page this line number only) ...............................................................

Full Name (Last, First, Middle Initial)

Mailing Address

City State Zip Code

Receipt For:

Primary General

Other (specify)

A.

Election Cycle-to-Date

Date of Receipt

Name of Employer Occupation

, , .

FEC ID number of contributingfederal political committee. C

Full Name (Last, First, Middle Initial)

Mailing Address

City State Zip Code

Receipt For:

Primary General

Other (specify)

B.

Election Cycle-to-Date

Date of Receipt

Name of Employer Occupation

, , .

FEC ID number of contributingfederal political committee. C

Full Name (Last, First, Middle Initial)

Mailing Address

City State Zip Code

Receipt For:

Primary General

Other (specify)

C.

Election Cycle-to-Date

Date of Receipt

Name of Employer Occupation

, , .

FEC ID number of contributingfederal political committee. C

PAGE OFFOR LINE NUMBER: (check only one)Use separate schedule(s)

for each category of the Detailed Summary Page

11a 11b 11c 11d

12 13b 13a 14 15

M M / D D / Y Y Y Y

M M / D D / Y Y Y Y

M M / D D / Y Y Y Y

Amount of Each Receipt this Period

, , .

Amount of Each Receipt this Period

, , .

Amount of Each Receipt this Period

, , .

FEC Schedule A (Form 3) (Revised 05/2016)

Memo Item

Memo Item

Memo Item

Image# 201707159066744239

15 25

Ken Russell for Congress Exploratory Committee

Jantaworn, Melissa, C., ,479 NE 30th St. Apt. 510

06 30 2017

Miami FLTransaction ID : SA11AI.4139

33137

2700.00

Drive Development Real Estate

2018

✘2700.00

Kasdin, Neisen, , ,4520 Jefferson Ave

06 30 2017

Miami Beach FL 33140Transaction ID : SA11AI.4221

2700.00

Akerman, LLP Attorney

2018

✘2700.00

Katz, Leonad, , ,12120 Neptune Peak Dr.

06 29 2017

Boyton Beach FL 33473Transaction ID : SA11AI.4157

2700.00

N/A Retired

2018

2700.00

8100.00

pbasupally
Typewritten Text
Page 16: REPORT OF RECEIPTS FEC AND DISBURSEMENTS FORM 3docquery.fec.gov/pdf/225/201707159066744225/201707159066744225.pdfGolden Acre Real Estate Realtor Cox, Douglas, C., , 1172 S Dixie Hwy,

SCHEDULE A (FEC Form 3)

ITEMIZED RECEIPTS

Any information copied from such Reports and Statements may not be sold or used by any person for the purpose of soliciting contributions or for commercial purposes, other than using the name and address of any political committee to solicit contributions from such committee.

NAME OF COMMITTEE (In Full)

, , .

, , .SUBTOTAL of Receipts This Page (optional) ............................................................................

TOTAL This Period (last page this line number only) ...............................................................

Full Name (Last, First, Middle Initial)

Mailing Address

City State Zip Code

Receipt For:

Primary General

Other (specify)

A.

Election Cycle-to-Date

Date of Receipt

Name of Employer Occupation

, , .

FEC ID number of contributingfederal political committee. C

Full Name (Last, First, Middle Initial)

Mailing Address

City State Zip Code

Receipt For:

Primary General

Other (specify)

B.

Election Cycle-to-Date

Date of Receipt

Name of Employer Occupation

, , .

FEC ID number of contributingfederal political committee. C

Full Name (Last, First, Middle Initial)

Mailing Address

City State Zip Code

Receipt For:

Primary General

Other (specify)

C.

Election Cycle-to-Date

Date of Receipt

Name of Employer Occupation

, , .

FEC ID number of contributingfederal political committee. C

PAGE OFFOR LINE NUMBER: (check only one)Use separate schedule(s)

for each category of the Detailed Summary Page

11a 11b 11c 11d

12 13b 13a 14 15

M M / D D / Y Y Y Y

M M / D D / Y Y Y Y

M M / D D / Y Y Y Y

Amount of Each Receipt this Period

, , .

Amount of Each Receipt this Period

, , .

Amount of Each Receipt this Period

, , .

FEC Schedule A (Form 3) (Revised 05/2016)

Memo Item

Memo Item

Memo Item

Image# 201707159066744240

16 25

Ken Russell for Congress Exploratory Committee

Klinger, Eduardo, , ,20201 E Country Club Drive

06 29 2017

Aventura FLTransaction ID : SA11AI.4155

33180

2150.00

Man-Co USA, LLC Developer

2018

✘2150.00

Koffsmon, Esteban, , ,763 NE 193rd Terrace

06 29 2017

Miami FL 33179Transaction ID : SA11AI.4175

2150.00

Manco Architect

2018

✘2150.00

Leon, Christina, , ,9001 SW 94th Street

06 30 2017

Miami FL 33176Transaction ID : SA11AI.4209

2700.00

Ford Interiors Architect

2018

2700.00

7000.00

pbasupally
Typewritten Text
Page 17: REPORT OF RECEIPTS FEC AND DISBURSEMENTS FORM 3docquery.fec.gov/pdf/225/201707159066744225/201707159066744225.pdfGolden Acre Real Estate Realtor Cox, Douglas, C., , 1172 S Dixie Hwy,

SCHEDULE A (FEC Form 3)

ITEMIZED RECEIPTS

Any information copied from such Reports and Statements may not be sold or used by any person for the purpose of soliciting contributions or for commercial purposes, other than using the name and address of any political committee to solicit contributions from such committee.

NAME OF COMMITTEE (In Full)

, , .

, , .SUBTOTAL of Receipts This Page (optional) ............................................................................

TOTAL This Period (last page this line number only) ...............................................................

Full Name (Last, First, Middle Initial)

Mailing Address

City State Zip Code

Receipt For:

Primary General

Other (specify)

A.

Election Cycle-to-Date

Date of Receipt

Name of Employer Occupation

, , .

FEC ID number of contributingfederal political committee. C

Full Name (Last, First, Middle Initial)

Mailing Address

City State Zip Code

Receipt For:

Primary General

Other (specify)

B.

Election Cycle-to-Date

Date of Receipt

Name of Employer Occupation

, , .

FEC ID number of contributingfederal political committee. C

Full Name (Last, First, Middle Initial)

Mailing Address

City State Zip Code

Receipt For:

Primary General

Other (specify)

C.

Election Cycle-to-Date

Date of Receipt

Name of Employer Occupation

, , .

FEC ID number of contributingfederal political committee. C

PAGE OFFOR LINE NUMBER: (check only one)Use separate schedule(s)

for each category of the Detailed Summary Page

11a 11b 11c 11d

12 13b 13a 14 15

M M / D D / Y Y Y Y

M M / D D / Y Y Y Y

M M / D D / Y Y Y Y

Amount of Each Receipt this Period

, , .

Amount of Each Receipt this Period

, , .

Amount of Each Receipt this Period

, , .

FEC Schedule A (Form 3) (Revised 05/2016)

Memo Item

Memo Item

Memo Item

Image# 201707159066744241

17 25

Ken Russell for Congress Exploratory Committee

Llorente, Michelle, , ,10905 SW 85 Ave

06 30 2017

Miami FLTransaction ID : SA11AI.4211

33156

1000.00

LSN Attorney

2018

✘1000.00

Mait, Jarred, , ,1545 Euclid Avenue, 4F

06 29 2017

Miami Beach FL 33139Transaction ID : SA11AI.4179

2700.00

Pulse and Remedy LLC Physician

2018

✘2700.00

Mana, Moishe, , ,16720 Senterra Dr.

06 30 2017

Delray Beach FL 33484Transaction ID : SA11AI.4191

2700.00

Self Developer

2018

2700.00

6400.00

pbasupally
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Page 18: REPORT OF RECEIPTS FEC AND DISBURSEMENTS FORM 3docquery.fec.gov/pdf/225/201707159066744225/201707159066744225.pdfGolden Acre Real Estate Realtor Cox, Douglas, C., , 1172 S Dixie Hwy,

SCHEDULE A (FEC Form 3)

ITEMIZED RECEIPTS

Any information copied from such Reports and Statements may not be sold or used by any person for the purpose of soliciting contributions or for commercial purposes, other than using the name and address of any political committee to solicit contributions from such committee.

NAME OF COMMITTEE (In Full)

, , .

, , .SUBTOTAL of Receipts This Page (optional) ............................................................................

TOTAL This Period (last page this line number only) ...............................................................

Full Name (Last, First, Middle Initial)

Mailing Address

City State Zip Code

Receipt For:

Primary General

Other (specify)

A.

Election Cycle-to-Date

Date of Receipt

Name of Employer Occupation

, , .

FEC ID number of contributingfederal political committee. C

Full Name (Last, First, Middle Initial)

Mailing Address

City State Zip Code

Receipt For:

Primary General

Other (specify)

B.

Election Cycle-to-Date

Date of Receipt

Name of Employer Occupation

, , .

FEC ID number of contributingfederal political committee. C

Full Name (Last, First, Middle Initial)

Mailing Address

City State Zip Code

Receipt For:

Primary General

Other (specify)

C.

Election Cycle-to-Date

Date of Receipt

Name of Employer Occupation

, , .

FEC ID number of contributingfederal political committee. C

PAGE OFFOR LINE NUMBER: (check only one)Use separate schedule(s)

for each category of the Detailed Summary Page

11a 11b 11c 11d

12 13b 13a 14 15

M M / D D / Y Y Y Y

M M / D D / Y Y Y Y

M M / D D / Y Y Y Y

Amount of Each Receipt this Period

, , .

Amount of Each Receipt this Period

, , .

Amount of Each Receipt this Period

, , .

FEC Schedule A (Form 3) (Revised 05/2016)

Memo Item

Memo Item

Memo Item

Image# 201707159066744242

18 25

Ken Russell for Congress Exploratory Committee

Matheson, Bruce, , ,3191 Grand Avenue, ut.330667

06 30 2017

Miami FLTransaction ID : SA11AI.4213

33233

500.00

N/A Retired

2018

✘500.00

Myers, Eric, , ,7445 SW 147th Street

06 30 2017

Miami FL 33158Transaction ID : SA11AI.4133

2700.00

Self General Contractor

2018

✘2700.00

Navarro, Jorge, , ,7450 SW 79 Ct

06 30 2017

Miami FL 33143Transaction ID : SA11AI.4215

500.00

Greenberg Traurig Attorney

2018

500.00

3700.00

pbasupally
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Page 19: REPORT OF RECEIPTS FEC AND DISBURSEMENTS FORM 3docquery.fec.gov/pdf/225/201707159066744225/201707159066744225.pdfGolden Acre Real Estate Realtor Cox, Douglas, C., , 1172 S Dixie Hwy,

SCHEDULE A (FEC Form 3)

ITEMIZED RECEIPTS

Any information copied from such Reports and Statements may not be sold or used by any person for the purpose of soliciting contributions or for commercial purposes, other than using the name and address of any political committee to solicit contributions from such committee.

NAME OF COMMITTEE (In Full)

, , .

, , .SUBTOTAL of Receipts This Page (optional) ............................................................................

TOTAL This Period (last page this line number only) ...............................................................

Full Name (Last, First, Middle Initial)

Mailing Address

City State Zip Code

Receipt For:

Primary General

Other (specify)

A.

Election Cycle-to-Date

Date of Receipt

Name of Employer Occupation

, , .

FEC ID number of contributingfederal political committee. C

Full Name (Last, First, Middle Initial)

Mailing Address

City State Zip Code

Receipt For:

Primary General

Other (specify)

B.

Election Cycle-to-Date

Date of Receipt

Name of Employer Occupation

, , .

FEC ID number of contributingfederal political committee. C

Full Name (Last, First, Middle Initial)

Mailing Address

City State Zip Code

Receipt For:

Primary General

Other (specify)

C.

Election Cycle-to-Date

Date of Receipt

Name of Employer Occupation

, , .

FEC ID number of contributingfederal political committee. C

PAGE OFFOR LINE NUMBER: (check only one)Use separate schedule(s)

for each category of the Detailed Summary Page

11a 11b 11c 11d

12 13b 13a 14 15

M M / D D / Y Y Y Y

M M / D D / Y Y Y Y

M M / D D / Y Y Y Y

Amount of Each Receipt this Period

, , .

Amount of Each Receipt this Period

, , .

Amount of Each Receipt this Period

, , .

FEC Schedule A (Form 3) (Revised 05/2016)

Memo Item

Memo Item

Memo Item

Image# 201707159066744243

19 25

Ken Russell for Congress Exploratory Committee

Nieto, Gabriel, , ,2479 eagle Run Drive

06 30 2017

Weston FLTransaction ID : SA11AI.4225

33327

1000.00

Rasco Klock Perez Nieto Attorney

2018

✘1000.00

Norman, Scott, , ,1001 Reads Lake Road

06 30 2017

Chattanooga TN 37415Transaction ID : SA11AI.4185

2700.00

ARS Advertiseing, Inc. President/CEO

2018

✘2700.00

Nunez, Lisandra, , ,6511 SW 109th Court

06 30 2017

Miami FL 33173Transaction ID : SA11AI.4135

2700.00

Melo Contractors Architect

2018

2700.00

6400.00

pbasupally
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Page 20: REPORT OF RECEIPTS FEC AND DISBURSEMENTS FORM 3docquery.fec.gov/pdf/225/201707159066744225/201707159066744225.pdfGolden Acre Real Estate Realtor Cox, Douglas, C., , 1172 S Dixie Hwy,

SCHEDULE A (FEC Form 3)

ITEMIZED RECEIPTS

Any information copied from such Reports and Statements may not be sold or used by any person for the purpose of soliciting contributions or for commercial purposes, other than using the name and address of any political committee to solicit contributions from such committee.

NAME OF COMMITTEE (In Full)

, , .

, , .SUBTOTAL of Receipts This Page (optional) ............................................................................

TOTAL This Period (last page this line number only) ...............................................................

Full Name (Last, First, Middle Initial)

Mailing Address

City State Zip Code

Receipt For:

Primary General

Other (specify)

A.

Election Cycle-to-Date

Date of Receipt

Name of Employer Occupation

, , .

FEC ID number of contributingfederal political committee. C

Full Name (Last, First, Middle Initial)

Mailing Address

City State Zip Code

Receipt For:

Primary General

Other (specify)

B.

Election Cycle-to-Date

Date of Receipt

Name of Employer Occupation

, , .

FEC ID number of contributingfederal political committee. C

Full Name (Last, First, Middle Initial)

Mailing Address

City State Zip Code

Receipt For:

Primary General

Other (specify)

C.

Election Cycle-to-Date

Date of Receipt

Name of Employer Occupation

, , .

FEC ID number of contributingfederal political committee. C

PAGE OFFOR LINE NUMBER: (check only one)Use separate schedule(s)

for each category of the Detailed Summary Page

11a 11b 11c 11d

12 13b 13a 14 15

M M / D D / Y Y Y Y

M M / D D / Y Y Y Y

M M / D D / Y Y Y Y

Amount of Each Receipt this Period

, , .

Amount of Each Receipt this Period

, , .

Amount of Each Receipt this Period

, , .

FEC Schedule A (Form 3) (Revised 05/2016)

Memo Item

Memo Item

Memo Item

Image# 201707159066744244

20 25

Ken Russell for Congress Exploratory Committee

Ovelmen, Richard, J., ,6901 SW 134th Street

06 29 2017

Miami FLTransaction ID : SA11AI.4115

33156

2500.00

Carlton Fields Lawyer

2018

✘2500.00

Pearl, Nicole, , ,1172 S Dixie Highway

06 30 2017

Coral Gables FL 33146Transaction ID : SA11AI.4189

2700.00

Self Attorney

2018

✘2700.00

Pinto, Jorge, , ,13611 Deering Bay Drive

06 29 2017

Coral Gables FL 33158Transaction ID : SA11AI.4159

2700.00

Intelligent Constructions Inc. Developer

2018

2700.00

7900.00

pbasupally
Typewritten Text
Page 21: REPORT OF RECEIPTS FEC AND DISBURSEMENTS FORM 3docquery.fec.gov/pdf/225/201707159066744225/201707159066744225.pdfGolden Acre Real Estate Realtor Cox, Douglas, C., , 1172 S Dixie Hwy,

SCHEDULE A (FEC Form 3)

ITEMIZED RECEIPTS

Any information copied from such Reports and Statements may not be sold or used by any person for the purpose of soliciting contributions or for commercial purposes, other than using the name and address of any political committee to solicit contributions from such committee.

NAME OF COMMITTEE (In Full)

, , .

, , .SUBTOTAL of Receipts This Page (optional) ............................................................................

TOTAL This Period (last page this line number only) ...............................................................

Full Name (Last, First, Middle Initial)

Mailing Address

City State Zip Code

Receipt For:

Primary General

Other (specify)

A.

Election Cycle-to-Date

Date of Receipt

Name of Employer Occupation

, , .

FEC ID number of contributingfederal political committee. C

Full Name (Last, First, Middle Initial)

Mailing Address

City State Zip Code

Receipt For:

Primary General

Other (specify)

B.

Election Cycle-to-Date

Date of Receipt

Name of Employer Occupation

, , .

FEC ID number of contributingfederal political committee. C

Full Name (Last, First, Middle Initial)

Mailing Address

City State Zip Code

Receipt For:

Primary General

Other (specify)

C.

Election Cycle-to-Date

Date of Receipt

Name of Employer Occupation

, , .

FEC ID number of contributingfederal political committee. C

PAGE OFFOR LINE NUMBER: (check only one)Use separate schedule(s)

for each category of the Detailed Summary Page

11a 11b 11c 11d

12 13b 13a 14 15

M M / D D / Y Y Y Y

M M / D D / Y Y Y Y

M M / D D / Y Y Y Y

Amount of Each Receipt this Period

, , .

Amount of Each Receipt this Period

, , .

Amount of Each Receipt this Period

, , .

FEC Schedule A (Form 3) (Revised 05/2016)

Memo Item

Memo Item

Memo Item

Image# 201707159066744245

21 25

Ken Russell for Congress Exploratory Committee

Rinaldi, Humberto, , ,199 Ocean Lane Drive

06 29 2017

Key Biscayne FLTransaction ID : SA11AI.4167

33149

2700.00

CWV Realty Developer

2018

✘2700.00

Rok, Serigio, , ,48 East Flagler Street

06 29 2017

Miami FL 33131Transaction ID : SA11AI.4177

2700.00

Rok Enterprise Real Estate Developer

2018

✘2700.00

Schneider, Brett, , ,8151 Lost Creek Lane

06 30 2017

Delray Beach FL 33446Transaction ID : SA11AI.4193

750.00

Weiss Serota Helfman Attorney

2018

750.00

6150.00

pbasupally
Typewritten Text
Page 22: REPORT OF RECEIPTS FEC AND DISBURSEMENTS FORM 3docquery.fec.gov/pdf/225/201707159066744225/201707159066744225.pdfGolden Acre Real Estate Realtor Cox, Douglas, C., , 1172 S Dixie Hwy,

SCHEDULE A (FEC Form 3)

ITEMIZED RECEIPTS

Any information copied from such Reports and Statements may not be sold or used by any person for the purpose of soliciting contributions or for commercial purposes, other than using the name and address of any political committee to solicit contributions from such committee.

NAME OF COMMITTEE (In Full)

, , .

, , .SUBTOTAL of Receipts This Page (optional) ............................................................................

TOTAL This Period (last page this line number only) ...............................................................

Full Name (Last, First, Middle Initial)

Mailing Address

City State Zip Code

Receipt For:

Primary General

Other (specify)

A.

Election Cycle-to-Date

Date of Receipt

Name of Employer Occupation

, , .

FEC ID number of contributingfederal political committee. C

Full Name (Last, First, Middle Initial)

Mailing Address

City State Zip Code

Receipt For:

Primary General

Other (specify)

B.

Election Cycle-to-Date

Date of Receipt

Name of Employer Occupation

, , .

FEC ID number of contributingfederal political committee. C

Full Name (Last, First, Middle Initial)

Mailing Address

City State Zip Code

Receipt For:

Primary General

Other (specify)

C.

Election Cycle-to-Date

Date of Receipt

Name of Employer Occupation

, , .

FEC ID number of contributingfederal political committee. C

PAGE OFFOR LINE NUMBER: (check only one)Use separate schedule(s)

for each category of the Detailed Summary Page

11a 11b 11c 11d

12 13b 13a 14 15

M M / D D / Y Y Y Y

M M / D D / Y Y Y Y

M M / D D / Y Y Y Y

Amount of Each Receipt this Period

, , .

Amount of Each Receipt this Period

, , .

Amount of Each Receipt this Period

, , .

FEC Schedule A (Form 3) (Revised 05/2016)

Memo Item

Memo Item

Memo Item

Image# 201707159066744246

22 25

Ken Russell for Congress Exploratory Committee

Serota, Joseph, , ,10160 SW 57th Court

06 30 2017

Pinecrest FLTransaction ID : SA11AI.4223

33156

750.00

Weiss Serota Helfman Attorney

2018

✘750.00

Shackleford, Chris, , ,10372 SW 114th Terrace

06 30 2017

Miami FL 33176Transaction ID : SA11AI.4217

2700.00

Drive Development Project Superintendant

2018

✘2700.00

Sierra, Richard, , ,340 W Flagler St.

06 30 2017

Miami FL 33130Transaction ID : SA11AI.4147

2700.00

Drive Development LLC Architect

2018

2700.00

6150.00

pbasupally
Typewritten Text
Page 23: REPORT OF RECEIPTS FEC AND DISBURSEMENTS FORM 3docquery.fec.gov/pdf/225/201707159066744225/201707159066744225.pdfGolden Acre Real Estate Realtor Cox, Douglas, C., , 1172 S Dixie Hwy,

SCHEDULE A (FEC Form 3)

ITEMIZED RECEIPTS

Any information copied from such Reports and Statements may not be sold or used by any person for the purpose of soliciting contributions or for commercial purposes, other than using the name and address of any political committee to solicit contributions from such committee.

NAME OF COMMITTEE (In Full)

, , .

, , .SUBTOTAL of Receipts This Page (optional) ............................................................................

TOTAL This Period (last page this line number only) ...............................................................

Full Name (Last, First, Middle Initial)

Mailing Address

City State Zip Code

Receipt For:

Primary General

Other (specify)

A.

Election Cycle-to-Date

Date of Receipt

Name of Employer Occupation

, , .

FEC ID number of contributingfederal political committee. C

Full Name (Last, First, Middle Initial)

Mailing Address

City State Zip Code

Receipt For:

Primary General

Other (specify)

B.

Election Cycle-to-Date

Date of Receipt

Name of Employer Occupation

, , .

FEC ID number of contributingfederal political committee. C

Full Name (Last, First, Middle Initial)

Mailing Address

City State Zip Code

Receipt For:

Primary General

Other (specify)

C.

Election Cycle-to-Date

Date of Receipt

Name of Employer Occupation

, , .

FEC ID number of contributingfederal political committee. C

PAGE OFFOR LINE NUMBER: (check only one)Use separate schedule(s)

for each category of the Detailed Summary Page

11a 11b 11c 11d

12 13b 13a 14 15

M M / D D / Y Y Y Y

M M / D D / Y Y Y Y

M M / D D / Y Y Y Y

Amount of Each Receipt this Period

, , .

Amount of Each Receipt this Period

, , .

Amount of Each Receipt this Period

, , .

FEC Schedule A (Form 3) (Revised 05/2016)

Memo Item

Memo Item

Memo Item

Image# 201707159066744247

23 25

Ken Russell for Congress Exploratory Committee

Sotolongo, Daisy, M., ,3789 NE 170 Street, A-2

06 29 2017

North Miami Beach FLTransaction ID : SA11AI.4181

33160

2150.00

Man-Co USA, LLC Executive Assistance

2018

✘2150.00

Winters, Robert, J., ,15554 SW 16th Street

06 30 2017

Weston FL 33326Transaction ID : SA11AI.4143

2700.00

2018

✘2700.00

Yagodnik, Florencia, , ,199 Ocean Lane Drive

06 29 2017

Key Biscayne FL 33149Transaction ID : SA11AI.4169

2700.00

CWV Realty Real Estate

2018

2700.00

7550.00

pbasupally
Typewritten Text
Page 24: REPORT OF RECEIPTS FEC AND DISBURSEMENTS FORM 3docquery.fec.gov/pdf/225/201707159066744225/201707159066744225.pdfGolden Acre Real Estate Realtor Cox, Douglas, C., , 1172 S Dixie Hwy,

SCHEDULE A (FEC Form 3)

ITEMIZED RECEIPTS

Any information copied from such Reports and Statements may not be sold or used by any person for the purpose of soliciting contributions or for commercial purposes, other than using the name and address of any political committee to solicit contributions from such committee.

NAME OF COMMITTEE (In Full)

, , .

, , .SUBTOTAL of Receipts This Page (optional) ............................................................................

TOTAL This Period (last page this line number only) ...............................................................

Full Name (Last, First, Middle Initial)

Mailing Address

City State Zip Code

Receipt For:

Primary General

Other (specify)

A.

Election Cycle-to-Date

Date of Receipt

Name of Employer Occupation

, , .

FEC ID number of contributingfederal political committee. C

Full Name (Last, First, Middle Initial)

Mailing Address

City State Zip Code

Receipt For:

Primary General

Other (specify)

B.

Election Cycle-to-Date

Date of Receipt

Name of Employer Occupation

, , .

FEC ID number of contributingfederal political committee. C

Full Name (Last, First, Middle Initial)

Mailing Address

City State Zip Code

Receipt For:

Primary General

Other (specify)

C.

Election Cycle-to-Date

Date of Receipt

Name of Employer Occupation

, , .

FEC ID number of contributingfederal political committee. C

PAGE OFFOR LINE NUMBER: (check only one)Use separate schedule(s)

for each category of the Detailed Summary Page

11a 11b 11c 11d

12 13b 13a 14 15

M M / D D / Y Y Y Y

M M / D D / Y Y Y Y

M M / D D / Y Y Y Y

Amount of Each Receipt this Period

, , .

Amount of Each Receipt this Period

, , .

Amount of Each Receipt this Period

, , .

FEC Schedule A (Form 3) (Revised 05/2016)

Memo Item

Memo Item

Memo Item

Image# 201707159066744248

24 25

Ken Russell for Congress Exploratory Committee

Zichella, Eric, , ,2635 Tigertail Avenue

06 29 2017

Coconut Grove FLTransaction ID : SA11AI.4117

33133

1000.00

P3 Management Lobbyist

2018

✘1000.00

1000.00

133850.00

pbasupally
Typewritten Text
Page 25: REPORT OF RECEIPTS FEC AND DISBURSEMENTS FORM 3docquery.fec.gov/pdf/225/201707159066744225/201707159066744225.pdfGolden Acre Real Estate Realtor Cox, Douglas, C., , 1172 S Dixie Hwy,

SCHEDULE B (FEC Form 3)ITEMIZED DISBURSEMENTS

Any information copied from such Reports and Statements may not be sold or used by any person for the purpose of soliciting contributions or for commercial purposes, other than using the name and address of any political committee to solicit contributions from such committee.

NAME OF COMMITTEE (In Full)

, , . , , .SUBTOTAL of Disbursements This Page (optional) .......................................................................

TOTAL This Period (last page this line number only) ....................................................................

FEC Schedule B (Form 3) (Revised 05/2016)

Full Name (Last, First, Middle Initial)

Mailing Address

City State Zip Code

A. Date of Disbursement

Full Name (Last, First, Middle Initial)

Mailing Address

City State Zip Code

B. Date of Disbursement

Full Name (Last, First, Middle Initial)

Mailing Address

City State Zip Code

C. Date of Disbursement

Purpose of Disbursement

Candidate Name

Office Sought: House

Senate

President

State: District:

PAGE OFFOR LINE NUMBER: (check only one)Use separate schedule(s)

for each category of the Detailed Summary Page

Category/Type

17 18 19a 19b

20a 20b 20c 21

Disbursement For:

Primary General

Other (specify)

Purpose of Disbursement

Candidate Name

Office Sought: House

Senate

President

State: District:

Category/Type

Disbursement For:

Primary General

Other (specify)

Purpose of Disbursement

Candidate Name

Office Sought: House

Senate

President

State: District:

Category/Type

Disbursement For:

Primary General

Other (specify)

M M / D D / Y Y Y Y

M M / D D / Y Y Y Y

M M / D D / Y Y Y Y

Amount of Each Disbursement this Period

Amount of Each Disbursement this Period

Amount of Each Disbursement this Period

FEC Identification Number

FEC Identification Number

FEC Identification Number

▲ ▲ ▲ , , .

▲ ▲ ▲ , , .

▲ ▲ ▲ , , .

Memo Item

Memo Item

Memo Item

C

C

C

Image# 201707159066744249

25 25

Ken Russell for Congress Exploratory Committee

Stripe

185 Berry St Ste 550 06 30 2017

San Francisco CA 94107

Contribution Process Fee

2018 4964.45

✘ Transaction ID : SB17.4232

4964.45

4964.45