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M1 Report 02-10-2022CAMPAIGN TREASURER'S REPORT SUMMARY "k* (1) Ty Penserga OFFICE SE ONLY Name �EB 10 2022 �l y (2) P.O Box 742831 M Address (number and street) CITY OF BOYNTON BEACH Boynton Beach, FL 33474 City, State, Zip Code ❑ 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 Of / 0/ / a0 as To 01 / 31 / a Q ac)_ Report Type: M .Original ❑ Amendment ❑ Special Election Report (6) Contributions This Report (7) Expenditures This Report Cash & Checks $ , _ , 10 Monetary Expenditures $ . �C Loans $ 00 Transfers to Office Account $ Total Monetary $ � � � ���• ®o Total Monetary $ In -Kind $ C9 00 (8) Other Distributions $ ® . �G (9) TOTAL Monetary Contributions To Date (10) TOTAL Monetary Expenditures To Date (11) Certification It is a first degree misdemeanor for any person to falsify a public record (ss. 839.13, F.S.) 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 ❑� Treasurer ❑ Deputy Treasurer ❑r Candidate ❑ Chairperson (only for PC and PTY) or electioneering comm.) X�� i�� Signature t Signature DS -DE 12 (Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS CAMPAIGN TREASURER'S REPORT - ITEMIZED CONTRIBUTIONS (1) Name T (3) Cover Period 01/0112022 - 01/31/2022 (2) I.D. Number 00000 (4) Page 1 of 3 (5) (7) (8) (9) (10) (11) (12) Date Full Name (Last, Suffix, First, Middle) Contributor In-kind (6) Sequence Number Street Address& City, State, Zip Code Type Occupation Contribution Type Description Amendmeni Amount 01/11/2022 VanDerhoof, Mary I CHE $ 20.00 2333 Southwest 23rd Cranbrook Boynton Beach, FL 33436-0000 1 01/11/2022 Ferguson, Joan I CHE $ 25.00 7086 Chesapeake Circle Boynton Beach, FL 33436-0000 2 01/11/2022 Mahler, Amy I CHE $ 100.00 31 Lyndhurst Street Boston, MA 02215-0000 3 01/13/2022 Rahman, Mahmud I Real CHE $ 500.00 4956 Le Chalet Blvd. Unit 13 Estate Boynton Beach, FL 33436-0000 4 01/14/2022 Rappaport, Steven I Attorney CHE $ 500.00 12110 Colony Preserve Dr Boynton Beach, FL 33436-0000 5 01/16/2022 Sloan, Carl I CHE $ 100.00 39 Hampshire Ln Boynton Beach, FL 33436-0000 6 01/16/2022 Gil, Francisco I Real CHE $ 1000.00 200 Edgewood Dr Estate West Palm Beach, FL 33405-0000 7 AHC Acquisitions LLC 01/18/2022 B Real CHE $ 500.00 7593 Boynton Beach Blvd., Suite 220 Estate Boynton Beach, FL 33437-0000 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 (3) Cover Period 01/01/2022 - 01/31/2022 (2) I.D. Number (4) Page 00000 2of3 (5) (7) (8) (9) (10) (11) (12) Date Full Name (Last, Suffix, First, Middle) Contributor In-kind (6) Sequence Number Street Address & City, State, Zip Code Type Occupation Contribution Type Description mendmeni Amount 01/18/2022 Elev8 Construction Inc. B Construct CHE $ 500.00 7593 Boynton Beach Blvd., Suite 220 ion Boynton Beach, FL 33437-0000 Company 9 01/22/2022 Oasis Builders LLC B General CHE $ 1000.00 1171 Northwest 10th Court Contracto Boynton Beach, FL 33426-0000 r 10 01/25/2022 Colletti, Daniel I CHE $ 50.00 8928 Thumbwood Circle B Boynton Beach, FL 33436-0000 11 01/25/2022 Horne, Paul I CHE $ 10.00 8546 Crown Drive Boynton Beach, FL 33436-0000 12 01/25/2022 Deam, Deborah I CHE $ 100.00 90 Cedar Lane Boynton Beach, FL 33436-0000 13 01/26/2022 Campanaro, Vincent I CHE $ 10.00 8928 B Thumbwood Cir Boynton Beach, FL 33436-0000 14 01/27/2022 Rivers, Charlotte Diane I CHE $ 50.00 8535 Duke Ct. West Boynton Beach, FL 33436-0000 15 01/28/2022 Resch, Betty C. I Attorney CHE $ 200.00 521 Lake Avenue Lake Worth Beach, FL 33460-0000 16 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 Penser a (2) I.D. Number (3) Cover Period 01/0112022 - 01/31/2022 (4) Page 3 of 3 (5) Date (7) Full Name (Last, Suffix, First, Middle) Street Address & City, state, zip code (8) Contributor Type Occupation (9) Contribution Type (10) In-kind Description (11) mendmen (12) Amount (6) Sequence Number 01/28/2022 JMS Delray, LLC 4868 West Dempster St., Suite 2E Skokie, IL 60077-0000 B Real Estate CHE $ 500.00 17 01/28/2022 Oceanside Beach Service Inc. 2650 Lake Shore Drive, Unit 503 Riviera Beach, FL 33404-0000 B Equipme nt Rental Company CHE $ 1000.00 18 01/28/2022 The Knight Group, LLC 740 Havana Dr Boca Raton, FL 33487-4119 B Real Estate CHE $ 500.00 19 01/28/2022 DMR Construction Services Inc. 160 Hopper Avenue Waldwick, NJ 07463-0000 B Construct ion Company CHE $ 1000.00 20 This form is based on DS -DE 13 (Rev. 11/13) Adjutant Workshop, Inc. - Campaign ToolBox CAMPAIGN TREASURER'S REPORT - ITEMIZED EXPENDITURES (1) Name (3) Cover Period 01/01/2022 - 01/31/2022 (2) I.D. Number 00000 (4) Page 1 of 1 (5) (7) (8) (9) (10) (11) Date Full Name (Last, Suffix, First, Middle) Purpose (6) Sequence Number Street Address & City, State, Zip Code Anedot (add office sought if contribution to a candidate) Expenditure Type Amendmen Amount 01/11/2022 Online Donation MON $ 6.70 1340 Poydras Street, Suite 1770 Processing Fee New Orleans, LA 70112-0000 1 01/13/2022 Anedot Online Donation MON $ 20.30 1340 Poydras Street, Suite 1770 Processing Fee New Orleans, LA 70112-0000 2 01/14/2022 Anedot Online Donation MON $ 20.30 1340 Poydras Street, Suite 1770 Processing Fee New Orleans, LA 70112-0000 3 01/16/2022 Anedot Online Donation MON $ 44.60 1340 Poydras Street, Suite 1770 Processing Fee New Orleans, LA 70112-0000 4 01/22/2022 Anedot Online Donation MON $ 40.30 1340 Poydras Street, Suite 1770 Processing Fee New Orleans, LA 70112-0000 5 01/25/2022 Anedot Online Donation MON $ 7.30 1340 Poydras Street, Suite 1770 Processing Fee New Orleans, LA 70112-0000 6 01/26/2022 Anedot Online Donation MON $ 0.70 1340 Poydras Street, Suite 1770 Processing Fee New Orleans, LA 70112-0000 7 01/27/2022 Anedot Online Donation MON $ 2.30 1340 Poydras Street, Suite 1770 Processing Fee New Orleans, LA 70112-0000 8 This form is based on DS -DE 14 (Rev. 11/13) Adjutant Workshop, Inc. - Campaign ToolBox