M8 2021 Report 09-08-2021CAMPAIGN TREASURER'S REPORT SUMMARY
(1)
OFFICE USE ONLY
Name
RECEIVED
(2) -213 N. d
_
Address (number and street)
SEP 0 S 2021
City, State, Zip Code
CITY OF BOYNTON BEACH C�
❑ Check here if address has changed
(3) ID Number:
(4) Chepropriate box(es):
andidate 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)
(6). Report Identifiers
Cove Period: From / /
To / j(/ Report Type: rye
Original ❑ Amendment ❑ Special Election Report
I (6) Contributions This Report
(7) Expenditures This Report
Cash & Checks $
Monetary
Expenditures $ , —7 7, •�
Loans $
Transfers to
Office Account $ ,
Total Monetary $
Total Monetary $
In-Kind $
(8) Other Distributions
$ ,
(9) TOTAL Monetary Cont[1rib'utionsA Date
(10) TOTAL Monetary Expenditures To Date
�)To
(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:
<•eAA At,. *
� JIQ��
(Type name) ru
(TYp name)
❑ Individual (only for IE Treasurer Deputy Treasu
andidate 01 Chair erson (only for PC and PTYF
or electioneering comm.)
X
X
Signature
Signature
DS -DE 12 (Rev. 11113) SEE REVERSE FOR INSTRUCTIONS
CPAMPAIGN TREASURER'S REPORT — ITEMIZED EXPENDITURES
(1) Name I-4ad—d 1-:3fL-c-�'i�_ _ (2) I.D. Number
(3) Cover Period 6' l// 02 [ through _�l_,l (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
p
Type
(10) (11)
Amendment Amount
(6)
Sequence
Number
C'"
l Z x'17
z
0,z��
bo
z z
DS-DE 14 (Rev. 11113) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES