STATE OF FLORIDA
FLORIDA ELECTIONS COMMISSION
In Re: Wells Fargo Florida Employees
Good Government Fund
TO:
Case No.: FEC 14-108
Wells Fargo Florida Employees Good Government Fund
Attn: Kai C Bjerkness, Chairperson
MAC N9305-084
90 South ih Street
Minneapolis, IN 55402-5402
Division of Elections
500 S Bronough Street
Room 316
Tallahassee, FL 32399
NOTICE OF HEARING (AUTOMATIC FINE)
A hearing will be held in this case before the Florida Elections Commission on August 5, 2014, at 9:00 am, 01 as soon
the1eajle1 as the pm ties can be heard, at the following location: Senate Oflice Building, Room S-110, 404 South Monroe
Street, Tallahassee, 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 10625, Florida Statutes, which governs your participation as
follows:
If you 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 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.
J!my :MCJ(ee1Jer'l'oman
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 (I) 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 rue required to prove your
case If the Commission finds that the report was filed timely 01 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 pr·obable cause has
been made, the Commission will decide whether to accept 01 reject the consent order.. If the Commission
accepts the consent 01der, the case will be closed and become public . If the Commission r('.jects 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 heruing to consider a consent order after a deter·mination 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 heruing to determine if
the Respondent committed the violation(s) alleged
If this is a probable cause hearing, the Commission will decide ifthere is probable cause to believe that
the Respondent committed a violation of Florida's election laws . Respondent should be preprued to explain
how the staff in its recommendation inconectly applied the law to the facts of the case . Respondent may not
testifj;, 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 occu11ed or a fine should be imposed, Respondent will have an
opportunity for another heruing 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-l 004, Florida Administrative Code . At the hearing, the
Commission will decide whether the Respondent committed the violation(s) charged in the Order of Prnbable
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
chruged in the Order 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 statuto1y fine,
he must provide the Commission with written proof of his financial resources at the heruing. A financial
affidavit form is available from the Commission Clerk
FLORIDA ELECTIONS COMMISSION
CASE REPORT
Case Number: FEC-14-108
NAME:
WELLS FARGO FLORIDA EMPLOYEES GOOD GOVERNMENT FUND
DAIE APPEAL RECEIVED: 4115114
DAIEHEARDBYFEC: NIA
DAIE HEARINGREQUESI RECEIVED: NIA
DAIE REPORT DUE: 3/7114 (2014 SF2)
DAIE OF ELECTRONIC RECEIPT: 3/18/14
DAIE FILING OFFICER RECEIVED REPORT: 3118114
NUMBEROFDAYSLAIE: 11
AMOUNT OF FINE:
$125.00
FINE BASED ON:
( ) NUMBER OF DAYS
TOI AL RECEIPTS FOR REPORIING PERIOD:
( ) 25% OF RECEIPTS
(X) 25% OF EXPENDITURES
$0
TOI AL EXPENDIIURES FOR REPORIING PERIOD: $500 . 00
DAIE FIRST NOIIFICAIIONWAS SEN!: 3/11/14
SUMMARY: Wells Fargo Florida Employees Good Government Fund is a political committee (PC)
registered with the State of Florida. The PC's chair and treasurer is Kai C Bjerkness
The PC is appealing the fine claiming that unusual circumstances existed that caused the 2014 SF2 Report
to be untimely filed According to Ms Bjerkness, "On February 27, the Fund made a contribution to the
campaign of Eric Eisnaugle, a candidate tunning in the March 11 Special Primary Election The Fund
disclosed the contribution on the campaign treasurer's monthly report due on Mai ch 10 At the time, we
were unaware that the contribution triggered a requirement to submit a special report due on March 7 as
that report does not appear on the 2014 Calendar of Reporting Dates for Political Committees, a copy of
which is enclosed with this letter. Furthermore, we never. received written notice from the Division of
Elections that contributions to candidates running in a special election would require disclosure in addition
to the monthly reports Upon receiving notice from the Division of Elections that the Fund was required to
file the special report, we did so promptly"
•
•
•
•
The 2014 SF2 Report covers the time period from 218/14 through 3/6114
The PC reported receiving 0 contributions, while making 1 expenditure during this reporting
period
The 2014 SF2 Queued-Transactions Report reflects that this report was created on 3/18/14 at
approximately 12:21 pm, reviewed once, before being filed on 3118/14 at approximately 1:49 pm
DOE representatives informed FEC staff that all schedules of reporting dates/publications/elections
materials ar·e available online through the DOE website
PRIOR CASES: This PC has not had any prior cases before the Commission
·-------
co
I
Government & Comm~n1t}' Relations
II
MAC N9305·084
90 So 7th St
Minneapolis. MN 55402
Ie], 612 667 9406
Faxo 612 667 9403
April 8, 2014
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F lo1ida Elections Commission
Attn: Agency Clerk
107 West Gaines Street
Collins Building, Suite 224
Tallahassee, FL 32399-1050
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Notice of Appeal fm Wells Fargo Florida Employees
Good Government Fund (#610751
Dear Madam or Sii:
Per the enclosed March 19 letter from the Florida Division of
Elections, the Wells Fargo Florida Employees Good Government Fund (the "Fund")
has been fined $125 00 fo1 failing to timely submit a campaign treasurer's report due
on March 7 Please accept this letter as an explanation fo1 the late filing and as a
request for waiver of the penalty
On February 27, the Fund made a cont1ibution to the campaign of
Eric Eisnaugle, a candidate running in the March 11 Special Primary Election. The
Fund disclosed the contiibution on the campaign treasmer's monthly 1eport due on
March 10 At the time, we were unaware that the contribution triggered a
requirement to submit a special repo1t due on March 7 as that report does not appear
on the 2014 Calendar of Repo1ting Dates for Political Committees, a copy of which
is enclosed with this letter.. Fmthe1more, we never received written notice from the
Division of Elections that con!Iibutions to candidates running in a special election
would 1equire disclosme in addition to the monthly reports. Upon 1eceiving notice
from the Division of Elections that the Fund was required to file the special repott,
we did so promptly
~.
I
II
Government & Comm~hntRelations
MAC N9305-084
90 So 7th St
Minneapolis. MN 55402
Je], 612 667 9406
Fax, 612 667 9403
Based on these circumstances, we ask that the penalty fo1 late filing
be waived. If you need additional information, please feel free to contact me at (612)
316-3 857 or kai . c . bjerkness@wellsfargo . com. We appreciate your consideration of
this request.
Sincerely,
2~!Cchairperson
Wells Fargo Florida Employees
Good Government Fund
Enclosures
cc: Kristi Reid Bronson, Chief
Bureau of Election Records
2014 Calendar of Reporting Dates for
Political Committees/Independent Expenditure-Only Organizations that file with the Division of Elections
Cover Period
12/01/13 - 12/31/13
01/01/14 - 01/31/14
02/01/14 - 02/28/14
03/01/14 - 03/31/14
04/01/14 - 04/30/14
OS/01/14 - OS/31/14
11/01/13 - 12/31/13*
ReeortCode
2013 M12
2014 Ml
2014 M2
2014 M3
2014 M4
2014 MS
2014 MUC*
Due Date
01/10/14
02/10/14
03/10/14
04/10/14
05/12/14
06/10/14
06/27/14
06/01/14 - 06/20/14
06/21/14 - 06/27/14
06/28/14 - 07/04/14
07/OS/14 - 07/11/14
07/12/14 - 07/18/14
07/19/i4 - 07/2S/14
07/26/14 - 08/01/14
08/02/14 - 08/08/14
08/09/14 - 08/21/14
08/22/14
2014 Pl
2014 PlA
2014 P2
2014 P2A
2014 P3
2014 P4
2014 PS
2014 PG
2014 P7
2014 P7A
06/27/14
07/04/14
07/11/14
07/18/14
07/2S/14
08/01/14
08/08/14
08/lS/14
08/22/14
08/29/14
2014 Gl
2014G1A
2014 G2
2014G2A
2014 G3
2014 G4
2014GS
2014G6
09/0S/14
09/12/14
09/19/14
09/26/14
10/03/14
10/10/14
10/17/14
10/24/14
10/24/14**
10/25/14**
10/26/14**
10/27/14**
10/28/14**
10/29/14**
2014 01**
2014 02**
2014 03**
2014 04**
2014 OS**
2014 06**
10/2S/14**
10/26/14**
10/27/14**
10/28/14**
10/29/14**
10/30/14**
10/18/14 - 10/30/14
2014 G7
10/31/14
10/31/14
11/01/14 -11/30/14
12/01/14 -12/31/14
2014 MlO
2014 Mll
2014 M12
11/10/14
12/10/14
01/12/lS
08/23/14 - 08/29/14
08/30/14 - 09/0S/14
09/06/14 - 09/12/14
09/13/14 - 09/19/14
09/20/14 - 09/26/14
09/27/14 - 10/03/14
10/04/14 - 10/10/14
10/11/14 -10/17/14
.
* If not reported as individual contributions when received, a political committee must report contributions that comprise
multiple uniform contributions from the same person aggregating no more than $250 per calendar year, collected by an
organization that is the affiliated sponsor of the political committee. The report must list the name, address, and occupation of
the person making the contribution; however, the occupation need not be listed if the aggregate contribution from the person
is $100 or less. Even if the political committee has nothing to report, the committee must file a waiver report (Because the
law containing this provision did not go into effect until 11/01/13, this first report will not cover a full calendar year.)
**These reports need only contain information on all previously unreported contributions received as of the preceding day
Expenditures need not be reported
FLORIDA DEPARTMENT OF STATE
Ken Detzner
Secretary of State
DIVISION OF ELECTIONS
March 19,2014
Kai C Bjerkness, Chairperson
Wells Fargo Florida Employees Good Government Fund
MAC N9305-084
90 South 7th Street
Minneapolis, MN55402·5402
Re: PAC 61075
Dear Mr. Bjcrkness:
fhe campaign treasurer's repmt that was due March 7, 2014, was not filed until March 18, 2014. Accordingly,
you a1e flned in the amount of $125 .00 The tine must be paid to the Division of Elections within 20 days of
receipt of this notice unless appealed to the Florida Elections Commission
If you wish to appeal the fine, you must submit a notice of appeal to the Commission within 20 days of the date
of the receipt of this notice (See Rules 2B· l .005, 2B-l 0052 and 2B-l .0055, Florida Administrative Code.) The
Flolida Elections Commission's address is 107 West Gaines Street, Suite 224, Tallahassee, Florida 32399-0100
Please send a copy of yom notice of appeal lo the Bureau of Election Records at the address listed below
lfyou have any questions, please contact us at (850) 245 . 6240
Sincerely,
4
~--'t-~--~ ~13 . . -
Ktisti Reid Bronson, Chief
Bureau of Election Recotds
;
The RA G1ay Building-Room 316 • 500 SoutJ\ Bronough Sn·eet • Tallahassee Fl 32399-0250 • (850) 245-624()
/
FAX: (850) 245-6260 • WWW Ad~ress: http://www.dos state. fl.us • E· Mail DtvEle<lions@,dos.s'/ate../I U5
r
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FLORIDA DEPARTMENT OF STATE
Ken Detzner
Secretary of State
DIVISION OF ELECTIONS
March 11,2014
Kai C Bjerkness, T!'easurer
Wells Fargo Florida Employees Good Government Fund
MAC N9305-084
90 South 7th Street
Minneapolis, MN 55402 -5402
Re: PAC 61075
Dear Mr Bjerkness:
Your campaign treasurer's report, which was due March?, 2014, has not been received
Section 106 . 07(8)(b), Florida Statutes, requires that the filing officer immediately notify you of the failure
to file this report and that a fine will be assessed of $50 per day for the first 3 days late and, thereafter $500
per day, although a fine cannot exceed 25% of the total receipts or expenditures, whichever is greater, for
the period covered by the late report. However, for the 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 greater, for the period covered by the late report
Once your report is filed, this office will notify you of the specific amount of your fine Fines must be paid
to the filing officer within 20 days ofreceipt of the payment due notice
Please be advised, however, that failure to file a campaign treasurer's report may constitute a violation of
Chapter I 06, Florida Statutes, independent of the automatic fine violation referenced above Therefore, if
you fail to file a report the division will tum the matter over to the Florida Elections Commission
Section I06 .265( I), Florida Statutes, authorizes the Florida Elections Commission to impose a civil penalty
up to $1,000 per count for each willful violation of Chapter 106
lfyou have any questions, please contact the help desk at (850) 245-6280.
Sincerely,
00~--~
Kristi Reid Bronson, Chief
Bureau of Election Records
The RA Gray Building-Room 316 • 500 South Bronaugh Street • Tallahassee FL 32399-0250 • (850) 245-6240
FAX: (850) 245-6260 •
WWW Address: http://www. dos state fl us
• E-Mail DivE/ections(tiJdos stotefl us·
(
FLORIDA DEPARTMENT OF STATE, DIVISION OF ELECTIONS
CAMPAIGN TREASURER'S REPORT SUMMARY
(1)
Wells Fargo Florida Employees Good Government Fund
61075
(2)
Candidate, Committe or Party Name
(3)
ID Number
MAC N9305-084
Minneapolis
MN
55402
Address (number and street)
City
State
Zip Code
0
Check box if address has changed since last report
Check appropriate box( es):
(4)
0
IBJ
D
0
Candidate (office sought):
D Check If PC has DISBANDED
D Check If CCE has DISBANDED
Political Committee
Committee of Continuous Existance
Party Executive Committee
(5) REPORT IDENTIFIERS
Cover Period:
IBJ
From
To
0210812014
0
Original
IBJ
Amendment
Report Type:
0310612014
Special Election Report
(6) CONTRIBUTIONS THIS REPORT
Cash & Checks
SF2
(7) EXPENDITURES THIS REPORT
$0 00
Loans
Total Monetary
$0 00
Transfers to Office Account
$0 00
Total Monetary
$0 00
In-Kind
$500 00
Monetary Expenditures
$0 00
$500 00
(8) Other Distributions
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
true correct and complete
Name of
D
Treasurer
"Signature
Prepared on: 5/12114 4:04:22PM
0
Deputy Treasurer
I certify that I have examined this report and it is
true correct and complete
Name of
D Candidate
IB)
Chaiman (PC/PTY Only
"Signature
Reviewed On:
3/18/14 1:49 pm
CAMPAIG~
ID:
Name:
.{EASURER'S REPORT - ITEMIZED
co\ •..{IBUTIONS
Wells Fargo Florida Employees Good Government Fund
Report: 2014 SF2
** Records in Filed Report*~
Seq#
Date
"Incomplete Record
Full Name
(Last, Suffix First, Middle
Street Address & City, State, Zip
Contributor
Type
Reviewed On:
Page 1 of 1
Period: 02/08/2014
to 03/06/2014
Amount
Occupation
In-Kind Description
3/18114 1:49 pm
Amend
Prepared on: 5/12/14 4:04:23PM
ID: 61075
Name:
Wells Fargo Florida Employees Good Government Fund
Report: 2014 SF2
** Records in Filed Report**
Date
02/27/2014
ERIC EISNAUGLE CAMPAIGN
150 TERRA MANGO LOOP
ORLANDO, FL 32855
• Incomplete Record
Period: 02/08/2014
to 03/06/2014
Amount
Full Name
(Last, Suffix First, Middle
Street Address & City, State, Zip
Seq#
1
Page 1 of 1
CAMPAIGC . REASURER'S REPORT- ITEMIZED EX. .. NDITURES
Type
(Office: STR 044)
Reviewed On:
CAN
Purpose
2014 SPECIAL STATE HOUSE 044
3/18/14 1:49 pm
Amend
$500 00
Prepared on: 5/12/14 4:04:23PM
5/12/2014
Page 1
Filed Camaign Treasurer's Report
Wells Fargo Florida Employees Good Government Fun
61075 - PAC
Elect ID: 20140408-501
From: 2/8/2014
To: 3/612014
Report: 2014 SF2 (6)
Filed: FIL 3/18/2014 1:49:52 P
Wvr:N
Reviewed: AUD 3/1812014 1:49:52 P
Cmplt: COM
Amd: N
Subtmtted: 3/18/2014 1:49:52 P
Original Report
EXPENDITURES
Seq
Date
N"me
ERIC EISNAUGLE CAMPAIGN
2/27/2014
,_,'
Address
Type
150 TERRA MANGO LOOP
CAN
ORLANDO
FL
32855
Office
Errors
Purpose
An1d
An1011nt
0
$500.00
STR 044
2014 SPECIAL STATE HOUSE 044
(
5/12/2014
Account: 61075
Rpt Seq:
Page 1
Queued Items for 2014-SF2
Wells Fargo Florida Employees Good Government Fund
6
P1·ocessDescri'ption
Create Pending Report
Status
Processing Complete
LastUpdate
61075
Cleated
3/18/2014 12:21:25 PM
3118/2014 12:21 :25 PM
Submittet
Review Pending Report
Processing Complete
61075
3/18/2014 12:26:47 PM
3/18/2014 12:26:47 PM
File Pending Report
Processing Complete
61075
3/18/2014 1:49:52 PM
3/18/2014 1 :49:52 PM
Florida Department of State - Division of Elections
Florida Election System Reports
Committee Name: Wells Fargo Florida Employees Good Government Fund
Account: 61075
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5/12/2014
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4/4/2014
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3/7/2014
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1/10/2014
12/10/2013
11/12/2013
M4
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https ://doesecure . dos. state fl. us/foc/F ilingJ:Iist.<JD' J\1>£?~c;ct1:'!1!111"'~1. 07.5_~c.!J_o~~e(;!i<J.~=&~~ . 51_1_2/_2_0_1_4_______,
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HISTORY NOTES
Wells Fargo Florida Employees Good Government Fund - 61075
Unique ID
34530
RE: Incomplete paperwork
Date Recorded
10/8/2013 3:52:00 PM
Last Edited Date
Orginally Recorded By
ljrandolph
9/26/2013
I spoke with Mr. Bjerkness assistant and explained to him that the application that we received is complete but we arent able
to process until the CCE with the same name is closed LJR 9/26/2013
34529
10/8/2013 3:49:00 PM
ljrandotph
RE: Incomplete Paperwork (Email) 9-26-2013
Dear Mr Bjerkness
T_his will acknowledge receipt of the Statement of Organization of Political Committee for Wells Fargo Florida
Employees Good Government Fund which was received on September 25, 2013. The application that we received is
complete, However we aren't able to process the application because the active CCE has the same name of the new PAC
order for the division to process the new application the CCE has to be closed ·
ln
Thank you,
Lenard Randolph
Regulatory Specialist I
Page 1 of 1
5/12/2014
II
GovPrnn1Ent & Community Relations
MAC N9305 084
90 So, 7th St
Minneapolis, MN 55402
0£ ftECE.JVED
p,~1, PENT OF STAIE
Tel 6126679406
fax: 612 667 9403
2013 SEP 25 AM 9, 59
O!~~~ION OF ELECTIONS
· · AHASSEE. fl
September 24, 2013
Florida Division of Elections
Room 316, RA. Gray Building
500 South Bronough Street
Tallahassee, FL 32399-0250
RE:
Political Committee Initial Registration
To whom it may concern:
Enclosed please find the following three documents for the Wells
Fargo Florida Employees Good Government Fund (the "Fund"):
I Statement of Organization;
2. Appointment of Campaign Treasurer and Designation of Campaign
Depository; and
3 Registered Statement of Appointment.
Please accept this submission as a request to register with the Division
of Elections as a Political Committee The Fund is cunently registered as a
Continuing Committee of Existence but that registration will expire on September
30, 2013
Please do not hesitate to contact me at (612) 316-3857 if you have any
questions or need additional information
'.\c;Ic}----·
Kai C. Bjerkness
Chairman and Treasurer
Together we'll go far
----
(
'1EP
'·
APPOINTMENT OF CAMPAIGN TREASURER
AND DESIGNATION OF CAMPAIGN
DEPOSITORY FOR
POLITICAL COMMITTEES
RECEIVED
APi'1£HT OF STAIE
2013 SEP 25 AM 9: 59
'Jl~1.{,lllN CF ELECT/OHS
AHASSEE. Ft
(Sections 106. 011(1)and 106..021(1), F.S)
OFFICE USE ONLY
CHECK APPROPRIATE BOX:
1.81
D
Original Appointment of Treasurer
Deputy Treasurer
2 Telephone
1 Committee or Organization
Wells Fargo Florida Employees Good Government Fund
-------
..
f-·-·
3 Name of Treasurer or Deputy Treasurer
Kai C. Bjerkness
D
Reappointment of Treasurer
4 Email (optional)
kai . c . bjerkness@wellsfargo . com
--
"""6 Mailing Address
) 316-3857
(612
-----
5 Telephone (optional)
(612
) 316-3857
--
MAC N9305-084, 90 South 7th Street, Minneapolis, MN 55402
-
7 Street Address
90 South 7th Street, Minneapolis, MN 55402
--
[8J
8 The following bank has been designated as the
--
9 Name of Bank
D
Secondary Depository
-
10 Street Address
Wells Fargo Bank, N.A.
--
12 State
11 City
Charlotte
t:.
13 Zip Code
NC
28288
15 Name of Chairman (Print or Type)
c lb J,..__.
14 Signatuz;,f Cha.irman
·~·-
301 South College Street
-
x 1
Primary Depository
..
Kai C . Bjerkness
'-"
CamoaiQn Treasurer's Acceotance of Aooointment
I
Kai C . Bjerkness
(Please Print or Type)
treasurer or deputy treasurer for
do hereby accept the appointment as
--
Wells Fargo Florida Employees Good Government Fund
---
(Committee or Organization)
UNDER PENALTIES OF PERJURY, I DECLARE THAT I HAVE READ THE FOREGOING CAMPAIGN TREASURER'S
ACCEPTANCE OF APPOINTMENT AND THAT THE FACTS STATED ARE TRUE .
l\
__ Jili:_£> >
Date
DS-DE 6 (Rev 7/10)
x ')(ii,_, "\k-
--
Sia nature of Camni:; nn Treasurer or Deoutv Treasurer
---·---·
r:r• R~t.:1rEN
REGISTERED AGENT
STATEMENT OF APPOINTMENT
(Section 106 .022, F S.)
I{!
Original Appoin~ment
0
Change of Mailing Address
0
D
•· '' " '·
Tl VE6FF1CE
OF SlAlf
USE ONLY
013 SEP 25 AM 9: 59
________,. !VISION OF ELECTIONS
TA! AHASSEE. FL
Change of Appointment
Change of Physical Address
Registered Agent and Office Information
.
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Telephone
Name
I(904) 489-5711
Paul Grube
Street Address
225 Water Street
I
[;~ate
City
Jacksonville
Zip Code
32202 .
Mailing Address
225 Water Street
City
Jacksonville
·-----··
I32202
Zip Code
[;{ate
1 appointment and confirm that I am familiar with and accept the obligations of the position as set
forth 1n Se ion 106.022, F.S. I also understand that I may resign this appointment by executing a written
f resignation d filing it with the applicable filing officer
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,______________
Former Registered .Agent and Office Information (for changes only)
Name
j
Telephone
Street Address
I St~te
City
Zip Code
Committee or Organization Information
Name of Committee or Organization
Wells Fargo Florida Employees Good Government Fund
Street Address
Telephone
MAC N9305-084, 90 South 7th Street
(612) 316-3857
City
Minnea olis
IMStNate
fC."''-=-='-='-------·-·-----~~--
Zip Code
55402 ----------t
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__
' ·-76.£0-..·-_-··_,- - - Signature of Chairperson
Kai C. Bjerkness
Printed Name of Chairperson
Form OS-DE 41 (revised 6111)
__6/)_g) 11
Date
RF'f'f'"'' , __
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oM.M
STATEMENT OF ORGANIZATION
OF POLITICAL COMMITTEE
201a srp 25
AH 9: 59
:J'~ISIO/i OF ELECTIONS
(PLEASE TYPE)
,Iii · AHASSff. Fl
Telephone
1. Full Name of Committee
(612) 316-3857
Wells Fargo Florida Employees Good Government Fund
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--···-----·------·······
Mailing Address (include city, state and zip code)
MAC N9305-084, 90 South 7th Street, Minneapolis, MN 55402
..
Street Address (include city, state and zip code}
90 South 7th Street, Minneapolis, MN 55402
2. Affiliated or Connected Organizations (includes other committees of continuous existence and political
committees)
·-·--·-----·-o:-··---------
Name of Affiliated or
Connected Organization
Wells Fargo &
Company
Mailing Address
····---·······- -·
MAC N9305-084
90 South lth Street
Minneapolis, MN 55402
-··-
Relationship
Connected Organization
3 . Area, Scope and Jurisdiction of the Committee
Florida State, County, Multi-County, and Municipal Elections
4. Nature of Organization or Organization's Special Interest (e . g., medical, legal, education, etc ..)
Banking and Financial Services
5. Identify by Name, Address and Position, the Custodian of Books and Accounts (Include treasurer's name)
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Full Name
KaiC Bjerkness
OS-DE 5 (Rev . 05/06)
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·-··-- ·--··
Mai ling Address
MAC N9305-084
90 South 7th Street
Minneapolis, MN 55402
..
Committee Title or Position
Chairman and Treasurer
(continued on reverse side)
6.. List by Name, Address and Position, Other Principal Officers, Including Officers and Members of the
Finance Committee, If Any (include chairman's name)
Full Name
Mailing Address
Committee Title or Position
-
225 Water Street
Jacksonville, FL 32202
Paul Grube
7, List by Name, Address, Office Sought and Party Affiliation Each Candidate or Other' Individual that this
Committee is Supporting (if none, please Indicate)
--
Full Name
-
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Resident Agent
--
Mailing Address
__
"""
Office Sought
Party ,,
To be determined
8., List Any Issues this Committee Is Supporting: N/A
List Any Issues this Committee Is Opposing: N/A
9, If this Committee Is Supporting the Entire Ticket of a Party, Give Name of Party
N/A
10 . In the Event of Dissolution, What Disposition will be Made of Residual Funds?
To candidates or political committees as determined by the Chairman and Treasurer
11 List all Banks, Safety Deposit Boxes, or Other Depositories Used for Committee Funds
Name of Bank or Depository & Account Number
Wells Fa~
Account
·-·
Mailing Address
301 South College Street
Charlotte, NC 28288
12,. List all Reports Required to be Filed by this Committee with Federal Officials and the Names, Addresses
and Positions of Such Officials, If Any
""
Report Title
Dates Required to be Filed
--
Name & Position of Official
Mailing Address
----
N/A
STATE OF
I,
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KA i 13>:JUQ(N b ss
-
COUNTY
certify that the information in this Statement of
~anizati1i:m-~~~ and correct
~ /i.ic) l~
Signature ots;hairman of Political Committee
Date
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ll'ICCMISSION~01~1~S
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