M12 2020 Amended Report 1-8-2021(1)
(2)
(4)
RECEIVED
JAN 8 2021
C� 1
CITY OF BOYNTON BEACH ��
CITY CLERK'S OFFICE
CAMPAIGN! TREASURER'S REPORT SUMMARY
'7
Address (number and street)
City, State, Zip Code
LD Check here if address has changed (3)
Check appropriate box(es):
Candidate Office Sought: _ ► �' \ (--
❑ Political Committee (PC) -
❑ Elect'
OFIFIV0& ONLY
JAN 7 2-0 21 , ' U`\
CITY OF BOYNTON BEACH
CITY CLERK'S OFFICE
ID Number:
loneermg Communications Org. (ECO) ❑ Check here if PC or ECO has disbanded
❑ Party Executive Committee (PTY) ❑ Check here If PTY has disbanded
El Independent Expenditure (IE) (also covers an ❑ Check here if no other IE or EC reports will be filed
individual making electioneering communications)
(6) Report Identifiers
Cover Period: From I i� / a To 3 f / /�
❑ Original endment - D
❑ Special EI f
(6)
-- ec ion Report
Contributions This Report (7) E
Cash & Checks
Loans
Total Monetary
In -Kind
(9) TOTAL Monetary Contributions To Date
$ 1.1, d 6. ® v
Report Type: _�,.� yq
xpenditures This Report
Monetary
JAP 1111110 -
Expenditures $ 4
Transfers to
Office Account $
Total Monetary $
(8) Other Distributions
(10) TOTAL Monetary Expe ditures To Date
$ � ,& L4 , W.
It is a first degree misdemeanor for any Certification
y person to falsify public ublic record (ss. 839.13, F.S.)
I certify that I have examined this report and it is true, correct, and complete:
—(Type name) 'e- 1 C4_ 0.
`R'PtkftM.r�kA C(i (Type name) ISe.r tilCird � r- �
0 individual (only for IE Treasurer ❑ Deputy Treasurer
or electioneering comm.) Candidate ❑ chairperson I fo PC
Signature
DS -DE 12 (Rev. 111131
y r and PTY)
Signature
CAMPAIGN TREASURER'S REPORT — ITEMIZED EXPENDITURES
(1) Name clSe✓
tj Q t- j L-3 %-, q k
(2) I.D. Number
(3) Cover Period
1 I 1 / -;LO through l 1
f / Ot U
(4) Page ^ of
(5)
(7)
(8)
(9) (10)
Date
Full Name
Purpose
(6)
(Last, Suffix, First, Middle)
(add office sought if
Sequence
Street Address &
contribution to a
Expenditure
P
TYPO
Number
City, State, Zip Code
candidate)
Amendment
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