G3 Report 03-04-2022 CAMPAIGN TREASURER'S REPORT SUMMARY
(1) Ty Penserga OFFICE USE ONLY
RECEIVED 3y M
Name �
(2) P.O. Box 742831 MAR 0 4 2022 Tc�
Address (number and street)
Boynton Beach, FL 33474 CITY OF BOYNTON BEACH
City, State, Zip Code CITY CLERK'S OFFICE
[ Check here if address has changed (3) ID Number:
(4) Check appropriate box(es):
❑✓ Candidate Office Sought: Mayor, City of Boynton Beach
El 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
El Independent Expenditure (IE) (also covers an El Check here if no other IE or EC reports will be filed
individual making electioneering communications)
(5) Report Identifiers
Cover Period: From ,), / ,96 / 03)--. To C3 / C3 /,,90a9, Report Type: C—,3
Af Original El Amendment El Special Election Report
(6) Contributions This Report (7) Expenditures This Report
Monetary
Cash & Checks $ , I , o6b . Cc Expenditures $ , ' 9 b). . I C:
Loans $ , , 0 • Go Transfers to
(� �, Office Account $ , , 0 . C 0
Total Monetary $ , -1 ,C6 Lb . 00
Total Monetary $ , D I )-. ,' O
In-Kind $ , , 0 • (i C
(8) Other Distributions
$ , C .
(9) TOTAL Monetary Contributions To Date (10) TOTAL Monetary Expenditures To Date
$ , 3 , 15c„ . $ , .33 , SI0 • oI
(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 Treasurer ❑ Deputy Treasurer ❑O Candidate ❑Chairperson(only for PC and PTY)
or electioneering comm.)
4.
x " , __. x �� /
Signature Signatur 40.4.-
DS-DE 12 (Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS
CAMPAIGN TREASURER'S REPORT - ITEMIZED CONTRIBUTIONS
(1) Name Ty Penserga (2) I.D. Number 00000
(3) Cover Period 02/25/2022-03/03/2022 (4) Page 1 of 3
(5) (7) (8) (9) (10) (11) (12)
Date
Full Name Contributor
(6) (Last,Suffix,First,Middle)
Sequence Street Address& Contribution In-kind
Number City,State,Zip Code Type Occupation Type Description Amendment Amount
02/25/2022 Omega, Conchita P. I Nurse CHE $ 100.00
4033 Arthurium Avenue
Lake Worth, FL 33462-0000
1
02/25/2022 IBEW PAC Voluntary Fund F Political CHE $250.00
900 Seventh St. NW Committe
Washington, DC 20001-0000 e
2
02/25/2022 Shutts B Law Firm CHE $ 1000.00
200 South Biscayne Boulevard Ste.
4100
Miami, FL 33131-0000
3
02/25/2022 Sluggett, Geoffrey I CHE $ 100.00
500 S Australian Ave. Ste 710
West Palm Beach, FL 33401-0000
4
02/28/2022 Boynton Boundless, LLC B Real CHE $500.00
10 SE 1st Ave Suite C Estate
Delray Beach, FL 33444-0000
5
03/01/2022 Realtors Political Action Committee F Political CHE $ 1000.00
Florida Committe
200 Monroe St. e
Tallahassee, FL 32301-0000
6
03/01/2022 Realtors Political Advocacy F Political CHE $ 1000.00
Committee Committe
7025 Augusta National Drive e
Orlando, FL 32822-5017
7
03/01/2022 Realtors Political Activity Committee F Political CHE $ 1000.00
Florida Committe
200 Monroe St. e
Tallahassee, FL 32301-0000
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 Ty Penserga (2) I.D. Number 00000
(3) Cover Period 02/25/2022-03/03/2022 (4) Page 2 of 3
(5) (7) (8) (9) (10) (11) (12)
Date
Full Name Contributor
(6) (Last,Suffix,First,Middle)
Sequence Street Address& Contribution In-kind
Number City,State,Zip Code Type Occupation Type Description Amendment Amount
03/01/2022 Dubose, Cynthia I Retired CHE $250.00
206 SE 3rd Ave
Boynton Beach, FL 33435-0000
9
03/01/2022 Bertino Consulting and Associates B Property CHE $250.00
P.O. Box 1290 Manager
Boynton Beach, FL 33435-0000
10
03/01/2022 Bertino, Michael S. I Real CHE $250.00
P.O. Box 1290 Estate
Boynton Beach, FL 33425-1290
11
03/01/2022 Law Real Estate Corporation B CHE $ 100.00
625 S. Federal Hwy
Boynton Beach, FL 33435-4952
12
03/01/2022 SEIU Florida Public Service Union F Political CHE $ 1000.00
PAC Committe
400 Hibiscus St. Suite 200 e
West Palm Beach, FL 33401-0000
13
03/02/2022 Dorotheo, Jocelyn R. I CHE $ 100.00
4075 Laurelwood Ln
Delray Beach, FL 33445-3506
14
03/02/2022 Gordon, Jennifer I Consulta CHE $250.00
3853 Southwest 29th Street nt
Miami, FL 33134-0000
15
03/02/2022 Perez, Luis I Owner/ CHE $ 1000.00
200 Edgewater Drive Real
Coral Gables, FL 33133-0000 Estate
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 Penserga (2) I.D. Number 00000
(3) Cover Period 02/25/2022-03/03/2022 (4) Page 3 of 3
(5) (7) (8) (9) (10) (11) (12)
Date
Full Name Contributor
(6) (Last,Suffix,First,Middle)
Sequence Street Address& Contribution In-kind
Number City,State,Zip Code Type Occupation Type Description Amendment Amount
03/02/2022 Carney, Thomas I Attorney CHE $500.00
135 SE 5th Ave. Suite 202
Delray Beach, FL 33483-0000
17
03/03/2022 Simbajon, Bella I Retired CHE $200.00
5250 Jog Lane
Delray Beach, FL 33484-0000
18
03/03/2022 Rubenstein, Paul I CHE $ 100.00
1240 NE 24th St. APT 3116
Wilton Manors, FL 33305-0000
19
03/03/2022 Burleigh, Peter A. I CHE $ 100.00
111 Southeast 8th Avenue 1601
Fort Lauderdale, FL 33301-0000
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 Ty Penserga (2) I.D. Number 00000
(3) Cover Period 02/25/2022-03/03/2022 (4) Page 1 of 1
(5) (7) (8) (9) (10) (11)
Date
Full Name
(6) (Last,Suffix,First,Middle) Purpose
Sequence Street Address& (add office sought if Expenditure
Number City,State,Zip Code contribution to a candidate) Type Amendment Amount
02/25/2022 Anedot Online Donation MON $4.30
1340 Poydras Street, Suite 1770 Processing Fee
New Orleans, LA 70112-0000
1
02/25/2022 Cornerstone Solutions Printing Services MON $2500.00
9200 Belvedere Road, Suite 202
West Palm Beach, FL 33411-0000
2
02/25/2022 Cornerstone Solutions Radio Advertising MON $ 1500.00
9200 Belvedere Road, Suite 202
West Palm Beach, FL 33411-0000
3
02/25/2022 Cornerstone Solutions Phonebanks/Texting MON $2800.00
9200 Belvedere Road, Suite 202 Services
West Palm Beach, FL 33411-0000
4
03/02/2022 Anedot Online Donation MON $70.90
1340 Poydras Street, Suite 1770 Processing Fee
New Orleans, LA 70112-0000
5
03/02/2022 Cornerstone Solutions Consulting Services MON $2000.00
9200 Belvedere Road, Suite 202
West Palm Beach, FL 33411-0000
6
03/03/2022 Anedot Online Donation MON $ 16.90
1340 Poydras Street, Suite 1770 Processing Fee
New Orleans, LA 70112-0000
7
This form is based on DS-DE 14(Rev.11/13) Adjutant Workshop,Inc.-Campaign ToolBox