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M5 Report 06-07-2021CAMPAIGN TREASURER'S RERdRT SUMMAR_ (1) res mss- ®EG10 E ONLY Name - �`� T_ (2) `7�.� Al " _ _A4 <5 :..• JUN 0 7 2021 Address (number and stre et) CITY OF BOYNTo BEACH City, State, Zip Code Check here if address has changed (3) ID Number: Bt{ NTCN BEACH CLERK (4) Check appropriate box(es): -3iatt 21 11.11FIfq R-Cra'ndidate Office Sou ht: (�'1 Political Committee',PC) ❑ EI ectJoneering 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 S-/ Original ❑ Amendment (6) Contributions This Report Cash & Checks Loans Total Monetary In -Kind (5) Report Identifiers - / To I 3 % I ( Report Type: M Special Election Report $ 0 (9) TOTAL Monetary Contributions To Date C q., (7) Expenditures This Report Monetary Expenditures S 7, o fl Transfers to Off ce Account $ Total Monetary (8) Other Distributions (10) TOTAL Monetary Expenditures To Date ,76 a 1 (11) Certification It is a first degree misdemeanor for any person to falsity a public record (ss. 839.13, F.S.) 1 certify that I have examined this re ort and it is true, correct; and complete: r a (Type name} .� (�;^`�t I (Type name} ❑ JrdMdual (oily for IE _ ire-a;i,rer re�s�i,�e[r Candid oretectioneerin con ,� Chairpers ly rPd CAMPAIGN TREe.ASURER'S REPORT — ITEMIZED EXPENDITURES (1) Name j�e-r4s- t-r� r—� (2) I.D. Number (3) Cover Period Sl 1 / -21 through S / 3E I C (4) Page of (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 (10) Amendment (s) Sequence Number 1 i i 1 CAMPAIGN TREASURER'S REPORT SUMMARY (1) �-eur at d f- c --- OFMFIVM ONLY � (�6 Name �(� •a.`C� (2) 7 i 3 �T JUN 11 2021 Address (number and street d 13 0 f�—i—� �4 f Q_�\ , '� I.3� ��� CITY OF BOYNTON BEACH CITY CLERK'S OFFICE City, State, Zip Code ❑ Check here if address has changed (3) ID Number - (4) Check i ppropriate box(es): `f 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) (5) Report Identifiers Cover Period: From / f 12,1 To 5-/,31 / Report Type: M ❑ Original ❑ Amendment ❑ Special Election Report (6) Contributions This Report (7) Expenditures This Report Monetary Expenditures $ Cash & Checks $ Loans $ Transfers to Office Account $ , Total Monetary $ Total Monetary $ , In -Kind $ > (8) Other Distributions $ , (9) TOTAL Monetary Contributions To Date (10) TOTAL Monetary Expenditures To Date $ $ 0 : d,l (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: 1 � r (Type name) �A F t' G vX f11,, (Type name) t ❑ Individual (only for IE ❑ Treasurer ❑ Deputy Treasurer ❑ Candidate ❑ Chairpers only for PC and PTY) or electioneenn comm.) Signature Signature DS -DE 12 (Rev. 11113) SEE REVERSE FOR INSTRUCTIONS CAMPAIGN TREASURER'S REPORT — ITEMIZED EXPENDITURES (1) Name 7E� dj -L'i _ Gt =` (2) I.D. Number (3) Cover Period/ / through (4) Page of (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)Amendment (9) Expenditure Type (10) (11) Amount (6) Sequence Number 73. s - DS -DE 14 (Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES