M1 2021 2-8-21 CAMPAIGN TREASURER'S REPORT SUMMARY
(1) �-µQt—d �-� ,rtil—tOFFICE USE ONLY
Name RECEIVED n��� .
(2) *7/2 ' i and ST . 3
Address (number and street) FEB 0 8 2021 \\'
J3o>l 1-2,4_2.... ci .333 4-3S—
City, State Zip Code ITY OF BOYNTON BEACH
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J Check here if address has changed (3) ID Number.
(4) Check appropriate box(es):
Canctdate Office Sought: m ANIZ r
Li Political Committee ;PC)
❑Electioneering Communications Org. (ECO) Check here if PC or ECO has disbanded
❑ Party Executive Committee(PTY) C Check here If PTY has disbanded
❑ Independent Expenditure(IE) (also covers an ❑ Check here if no other IE or EC reports will be filed
indivicuai making electioneering communications)
(5) Report Identifiers
Co, Period: From ! t . t To / 3f / -( Report Type'�l
Origmai ❑Amendment L Special Ejection Report
(6) Contributions This Report (7) Expenditures This Report
Monetary
Cash & Checks $ , D, Expenditures $ 1 , b . 9
(P
Loans $ P Transfers to
O f.ce Account S , ,
Total Monetary S , O, _
Total Monetary S
In-Kind $ , '
(8) Other Distributions
$
(9) TOTAL Monetary Contributions To Date (10) TOTAL Monetary Expenditures To Date
S $/ D-2 i--, 6 D _A �flp
`./ (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 ,
(Type name) Keu el rA 6,041 . (Type name) e1aP[1 Ciro Q'h %
❑Indrviduai folly fo !E re'r'easurer Cecity ensurer C Cand,d t< D Chairperson(onl(rfor PC and PT'i)
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CAMPAIGN TREASURER'S REPORT- ITEMIZED EXPENDITURES
(1) Name �e- na carr-d -i h r (2) I.D. Number
(3) Cover Period / / 1 / A ( through / / 31 / ( (4) Page 1 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
Number City,State,Zip Code candidate) Type Amendment
/. / .9f C-`TY eF L - < A6f, 2r,c)
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