Candidate: Adam Lane Perez

Office: County Commissioner, District 4

Report Date: Q4 (10/1/2012 - 12/31/2012)

Campaign Treasurer's Report – Itemized Contributions

Seq#	Date	Contributor	Entity	Occupation	Cont. Type	Amend	Amount
Seq# 1	Date 11/14/2012	Contributor Adam Lane Perez 7667 North Wickham Road Apt. 1407 Melbourne, FL 32940	Entity Candidate to Themselves	Occupation WellnessInstructor	Contribution Type Loan	Amend	Amount $200.00
Seq# 2	Date 12/3/2012	Contributor Adam Lane Perez 7667 North Wickham Road Apt. 1407 Melbourne, FL 32940	Entity Candidate to Themselves	Occupation WellnessInstructor	Contribution Type Loan	Amend	Amount $390.00
Seq# 3	Date 12/6/2012	Contributor Adam Lane Perez 7667 North Wickham Road Apt. 1407 Melbourne, FL 32940	Entity Candidate to Themselves	Occupation WellnessInstructor	Contribution Type Loan	Amend	Amount $180.00

Campaign Treasurer's Report – In-Kind Contributions

Seq#	Date	Contributor	Entity	Occupation	In-Kind Description	Amend	Amount
Seq# 1	Date 11/30/2012	Contributor Adam Lane Perez 7667 North Wickham Road Apt. 1407 Melbourne, FL 32940	Entity Candidate to Themselves	Occupation	In-Kind Description Verification of Petitions and Contribution of County Maps	Amend	Amount $47.50
Seq# 2	Date 12/24/2012	Contributor Adam Lane Perez 7667 North Wickham Road Apt. 1407 Melbourne, FL 32940	Entity Candidate to Themselves	Occupation	In-Kind Description Domain Name	Amend	Amount $11.30

Campaign Treasurer's Report – Itemized Expenditures

Seq#	Date	Vendor	Purpose	Exp. Type	Amend	Amount
Seq# 1	Date 12/3/2012	Vendor Wendy Diaz 4165 Dow Road Unit 17 Melbourne, FL 32934	Purpose Payment 1 of 2, 75% of the total campaign shirts (100 count) order cost of $700. Order fulfilled by 'Ms.Behave Custom Screenprinting '	Expenditure Type Monetary	Amend	Amount $525.00
Seq# 2	Date 12/6/2012	Vendor Wendy Diaz 4165 Dow Road Unit 17 Melbourne, FL 32934	Purpose Payment 2 of 2, 25% of the total campaign shirts (100 count) order cost of $700. Order fulfilled by 'Ms.Behave Custom Screenprinting '	Expenditure Type Monetary	Amend	Amount $175.00
Seq# 3	Date 12/24/2012	Vendor Vistaprint 95 Hayden Avenue Lexington, MA 02421	Purpose Premium Business Cards	Expenditure Type Monetary	Amend	Amount $49.39
Seq# 4	Date 12/31/2012	Vendor TD Bank 4551 North Wickham Road Melbourne, FL 32935	Purpose Campaign Account Maintenance Fee	Expenditure Type Monetary	Amend	Amount $8.00

Campaign Treasurer's Report – Fund Transfers

Seq#	Date	Institution	Transfer Type	Nature of Account	Amend	Amount

Campaign Treasurer's Report – Distributions

Seq#	Date	Vendor	Purpose	Expenditure Related Exp.	Amend	Amount