Candidate: Derek Chipoletti

Office: School Board District 1

Report Date: M11 (11/1/2021 - 11/30/2021)

Campaign Treasurer's Report – Itemized Contributions

Seq#	Date	Contributor	Entity	Occupation	Cont. Type	Amend	Amount
Seq# 1	Date 11/2/2021	Contributor Preferred Physical Therapy 1835 East West Pkwy Unit 11 Fleming Island, FL 32003	Entity Business	Occupation PhysicalTherapy	Contribution Type Check	Amend	Amount $500.00
Seq# 2	Date 11/5/2021	Contributor Barbara Mitchell 2976 Rosecrans Ln Green Cove Springs, FL 32043	Entity Individual	Occupation Retired	Contribution Type Check	Amend	Amount $100.00
Seq# 3	Date 11/10/2021	Contributor Capital Financial Strategies 10199 Southside Blvd Building One Ste 200 Jacksonville, FL 32256	Entity Business	Occupation FinancialPlanning	Contribution Type Check	Amend	Amount $250.00
Seq# 4	Date 11/7/2021	Contributor Brian Gardiner ***Protected Voter***	Entity Individual	Occupation ComputerCoder	Contribution Type Check	Amend	Amount $95.70
Seq# 5	Date 11/8/2021	Contributor Terry Vaughan 1411 Ree St Starke, FL 32091	Entity Individual	Occupation Retired	Contribution Type Check	Amend	Amount $95.70

Campaign Treasurer's Report – In-Kind Contributions

Seq#	Date	Contributor	Entity	Occupation	In-Kind Description	Amend	Amount

Campaign Treasurer's Report – Itemized Expenditures

Seq#	Date	Vendor	Purpose	Exp. Type	Amend	Amount
Seq# 1	Date 11/10/2021	Vendor Harland Clarke Check Orders 15955 La Cantera Parkway San Antonio, TX 78256	Purpose Ordered checks for campaign	Expenditure Type Monetary	Amend	Amount $10.50

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