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M8 2021 Report 09-10-2021
CAMPAIGN TREASURER'S REPORT SUMMARY (1) Ty Penserga OFFICE USE ONLY CEM Name (2) P.O. Box 742831 — SEP' I 0 2021 Address (number and street) Boynton Beach, FL 33474 CITY OF BOYNTON BEACH City, State, Zip Code CITY CLERKS OFFICE lQyr% C� ❑ Check here if address has changed (3) ID Number: (4) Check appropriate box(es): ❑✓ Candidate Office Sought: Mayor, City of Boynton Beach ❑ 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 0 / 01 / ®20D_To ©R / f / c,10rD_( Report Type: _ ,Original ❑ Amendment ❑ Special Election Report (6) Contributions This Report (7) Expenditures This Report qMonetary Cash & Checks $ ®a Expenditures $a�- Loans $ 0 00 Transfers to Office Account $ 0 00 Total Monetary $ � � � (� OQ Total Monetary $ In -Kind $ 0 010 (8) Other Distributions $ 1 0 �o (9) TOTAL Monetary Contributions To Date (10) TOTAL Monetary Expenditures To Date $ .�r� $ (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) Kim LeeBove (Type name) Ty Penserga ❑ Individual (only for IE ❑r Treasurer ❑ Deputy Treasurer ❑r Candidate ❑ Chairperson (only for PC and PTY) or electioneering comm.) X Y Yom, X ice - Signature Signatu DS -DE 12 (Rev. 11/13) / �/ SEE REVERSE FOR INSTRUCTIONS CAMPAIGN TREASURER'S REPORT - ITEMIZED CONTRIBUTIONS (1) Name Ty Penserga (2) I.D. Number (3) Cover Period 08/01/2021 - 08/31/2021 (4) Page 1 of 2 (5) (7) (8) (9) (10) (11) (12) Date Full Name (Last, Suffix, First, Middle) Contributor (6) Sequence Street Address& Contribution In-kind Number City, State, Zip Code Type Occupation Type Description Amendmen Amount 08/02/2021 Roque, Roderick I RN CHE $ 150.00 4355 Key Lime Boulevard Boynton Beach, FL 33436-0000 1 08/04/2021 Affiliated Development B Construct CHE $ 1000.00 613 NW 3rd Ave Suite 104 ion Fort Lauderdale, FL 33311-0000 2 08/04/2021 Rojo, Nicholas I Construct CHE $ 1000.00 528 Greenway Drive ion North Palm Beach, FL 33408-0000 Services 3 08/04/2021 Burns, Jeffrey I Construct CHE $ 1000.00 804 N Rio Vista Blvd ion Fort Lauderdale, FL 33301-0000 Services 4 08/04/2021 Vatske, Sari I CHE $ 100.00 7890 Clay Mica Court Delray Beach, FL 33446-0000 5 08/06/2021 Norise, Catherine I CHE $ 25.00 55 Lake Ave N Worcester, MA 01655-0000 6 08/09/2021 Graham, Chauncey I Flight CHE $ 150.00 346 Lake Arbor Drive Attendant Palm Springs, FL 33461-0000 7 08/11/2021 Tan -Chiu, Elizabeth I CHE $ 100.00 12172 NW 72nd St Parkland, FL 33076-4606 8 This form is based on DS -DE 13 (Rev. 11/13) Adjutant Workshop, Inc. - Campaign ToolBox CAMPAIGN TREASURER'S REPORT - ITEMIZED CONTRIBUTIONS (1) Name _ _ Ty Penserga (2) I.D. Number 00000 (3) Cover Period 08/01/2021 - 08/31/2021 (4) Page 2 of 2 (5) (7) (8) (9) (10) (11) (12) Date Full Name (Last, Suffix, First, Middle) Street Address & City, State, Zip Code Contributor Type Occupation Contribution Type In-kind Description Amendmen Amount (6) Sequence Number 08/15/2021 Penserga, Ma Brenda I Registere CHE $ 200.00 1121 256th Street W d Nurse Harbor City, FL 90710-0000 9 08/15/2021 Basa, Ma Cresencia I CHE $ 100.00 5093 S LA Sedona Cir Delray Beach, FL 33484-8740 10 08/27/2021 Grant, Steven I CHE $ 36.00 P.O. Box 424 Boynton Beach, FL 33425-0000 11 08/30/2021 Moya, David V. I CHE $ 100.00 4401 NE 2 Terr Pompano Beach, FL 33064-0000 12 08/30/2021 Bartolome, Annabelle Ganzon I CHE $ 100.00 262 Monaco F Delray Beach, FL 33446-0000 13 08/30/2021 Kirk, Imelda I Office CHE $ 100.00 2840 Southwest 22nd Avenue 317 Assistant Delray Beach, FL 33445-0000 14 This form is based on DS -DE 13 (Rev. 11/13) Adjutant Workshop, Inc. - Campaign ToolBox CAMPAIGN TREASURER'S REPORT - ITEMIZED EXPENDITURES (1) Name Ty Penser a (2) I.D. Number (3) Cover Period 08/01/2021 - 08/3112021 (4) Page K101 one] 1 of 1 (5) (7) (8) (9) (10) (11) Date Full Name (Last, Suffix, First, Middle) Street Address & City, State, Zip Code Purpose (add office sought if contribution to a candidate) Expenditure Type Amendment Amount Sequence Number 08/02/2021 Anedot Online Donation MON $ 6.30 1340 Poydras Street, Suite 1770 Processing Fee New Orleans, LA 70112-0000 1 08/04/2021 Anedot Online Donation MON $ 125.20 1340 Poydras Street, Suite 1770 Processing Fee New Orleans, LA 70112-0000 2 08/06/2021 Anedot Online Donation MON $ 1.30 1340 Poydras Street, Suite 1770 Processing Fee New Orleans, LA 70112-0000 3 08/09/2021 Anedot Online Donation MON $ 6.30 1340 Poydras Street, Suite 1770 Processing Fee New Orleans, LA 70112-0000 4 08/15/2021 Anedot Online Donation MON $ 8.30 1340 Poydras Street, Suite 1770 Processing Fee New Orleans, LA 70112-0000 5 08/27/2021 Anedot Online Donation MON $ 1.74 1340 Poydras Street, Suite 1770 Processing Fee New Orleans, LA 70112-0000 6 08/31/2021 Wells Fargo Banking Supplies MON $ 44.08 1600 S. Federal Highway Boynton Beach, FL 33435-0000 7 This form is based on DS -DE 14 (Rev. 11/13) Adjutant Workshop, Inc. - Campaign ToolBox