M9 Report 10-07-2020CAMPAIGN TREASURER'S REPORT SUMMARY
(1) 1 p- P"�r �y OFFICE USE ONLY
RECEIVED
Name
tZi � 3 rte, c� . �+� �. :� r
Address (number and str OCT 0 7 2020 '�;oS-er
City, State, Zip Code CITY OF BOYNTON BEACH
❑ Check here if address has changed (3) ID Number:
(4) k appropriate box(es):
Che7ndidate Office Sought: np,
❑ Political Committee (PC)
❑ Electioneering Communications Org. (ECO) ❑ Check here if PC or ECO has disbanded
❑ Party Executive Committee (PTY) ❑ Check here If PTY has disbanded
❑ Independent Expenditure (IE) (also covers an ❑ Check here if no other IE or EC reports will be filed
individual making electioneering communications)
Cover Period: From / C
Original ❑ Amendment
(6) Contributions This Report
Cash & Checks
Loans
Total Monetary
In -Kind
(5) Report Identifiers
AL3 To q/ 3(D/
❑ Special Election Report
Report Type: Xr-t _I
(7) Expenditures This Report
Monetary
Expenditures $ ,
$ Transfers to
Office Account $ ,
$ ,
Total Monetary $ ,
$ _
(8) Other Distributions
$ , 1
(9) TOTAL Monetary Contributions To Date (10) TOTAL Monetary Expenditures To Date
$ 1 9 ��17% » DD $ f 0,
(11) 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: r
(Type name) (-k 1A fv, L I (Type�me) a '-X. L �Er, Y4T
❑ Individual (only for IE Treas ❑ Deputy Treasurer Candidate ❑ Chairperson (only for PC and PTY)
or electioneering comm. L ,
Signature �` Signature
DS -DE 12 (Rev. 11113)
SEE REVERSE FOR INSTRUCTIONS
CAMPAIGN TREASURER'S REPORT - ITEMIZED CONTRIBUTIONS
(1) Name O) ca!- td W t-% "( k-1
(3) Cover Period q / / / Ali through
(2) I.D. Number
q / -3c3/ a 0 (4) Page of %
(5)
Date
(7)
Full Name
(Last, Suffix, First, Middle)
Street Address &
City, State, Zip Code
(B)
Contributor
T e Occupation
(9)
Contribution
Type
(10)
In-kind
Description
(11)
Amendment
(12)
Amount
(6)
Sequence
Number
G -'t- ILLC
1 1
I I
DS -DE 13 (Rev. 11113)
SEE REVERSE FOR INSTRUCTIONS
AND CODE VALUES