M12 2020 Report 1-7-2021•
WAIVER OF REPORT RECEIVED
(Section 106.07(7), F.S) JAN 7 2021
t CITY OF BOYNTON BEACH
,PLEASE TYPE] CITY CLEWBORMENLY
Nerve Office S--zjght
"71 (9A& -d
.S
ccr�ssC �ty Slate Zip Go""o, I
y
NOTE: 7r- s fcr-, aces n,-- app ,yrc an electionee,,ing com�r.n;catlons organization (ECO., Ar7 —E -CO sthic- a report (not a
walver', f"at -�: re�)cr,,a,1;e contributions or exoero z�,!e5v;e,e na a . . I
-
Gne
j -k r`e-e.4 --acress raS C-iarged s:nce 12,E: epi; -t Crieck. here f PC ray D!SB[-NC'K aT-r,, 7io longer file
TYPE OF REPORT (Check Appropriate Box and Complete Applicable Line beneath.Box)
77 r — OTHER REPORT TYPE
MONTHLY REPORT L 1 PRIMARY ELECTION GENERAL ELECTION —
Indicate report Indicate report# Indicate report # Indicate report type and t
P as applicable:
;-7 TERMINATION REPOR-, SPECIAL ELECTION
NOTIFICATION OF NO ACTIVITY IN CAMPAIGN ACCOUNT FOR THE REPORTING PERIOD OF
DS -DE 87 ;Rev 461 , 5)
THROUGH
ure
Date
-7 —a
Si- ature
Date
"7 D--1
REQUIRED SIGNATURES FOR:
Candidates:
Cand:dare Z-,-71- Tieasurer or Dez),,,4 e�.5urer (E.
Political Committees:
CrIai--Inan ald Car,,,,agr, 11-*-&asurar0- Depit} -,rea�uie,(s.
106.07(5), F
S.'.
Party Executive Committees:
a ---c
Fxcept as no*eo a:)o,.e *o, ar, EGO. ;, ary reporting pe,;oa -,0er- t"isre rias been no act vty n
c",,,.E re%,eo report is waive,-. Hcva,,er —E, 'if --c o�f.cer r-ust
re-.oqi.,)c date ric repos is Delig filed,
tre aoco,-t'rc `j.
or *,ncr
,os expenaeo Or
pescrihed
DS -DE 87 ;Rev 461 , 5)
CAMPAIGN! TREASURER'S REPORT SUMMARY
d�f'ejI-
�c�
Name �OFrL�I�iESI ONLY
(2) '7 17 d
-_2 XL CS
Address (number and street) JAN 7 2.021 U�
City, State, Zip Cade __ - CITY OF BOYNTON BEACH
CITY CLERK'S OFFICE
❑ Check here if address has changed
(4) Check appropriate box(es): (3) ID Number:
Candidate Office Sought:(--
❑ 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 -� /
❑ Original ❑ Amendment
(5) Report Identifiers
/ To 3I 1
❑ Special Election Report
(6) Contributions This Report
Cash & Checks $
Loans $
Total Monetary $ ,
In -Kind $
(9) TOTAL Monetary Contributions To Date
$
Report Type: ,p„._L-1
(7) Expenditures This Report
Monetary
Expenditures $
Transfers to
Office Account $
Total Monetary $
(8)
Other Distributions
(113) TOTAL Monetary Expenditures To Date
$,��,�
It is a first degree misdemeanor for any Certification
�--
y person to falsify a public record (ss. 839.13, F.S.)
certify that I have examined this report and it is true, correct, and complete:
(Type name)
(Type name)2 T µ�t-d � r L(,�
or enol nee (only for IE Treasurer ❑ Deputy Treasurer
or electioneering comm.) Candidate El Chairperson (only for PG and P7Y)
I
Signature Si
� Signature-
11-
- E-- is tKev. 71113)
CAMPAIGN TREASURER'S REPORT - ITEMIZED EXPENDITURES
(1) Name Ae r qt - l l H- (2) I.D. Number
(3) Cover Period 1 --� l l / ;;LQ through / I / 3 f / a (4) Page -=� _ of -2-
(5)
Date
(7)
Full Name
(Last, Suffix, First, Middle)
Street Address &
City, State, Zip Code
(8)
Purpose
(add office sought if
contribution to a
candidate)
(9)
Expenditure
Type
(1 0)
Amendment
(6)
Sequence
Number
1� 2v
o ��_ � �
CA, -d S
1-2J42,11
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