Termination Report and Amendment 04-15-2022CAMPAIGN TREASURER'S REPORT SUMMARY
OFFICE USE ONLY
Name
Address (number and street)r-
33 q7 PR 15 N
City, State, Zip Code
❑ Check here if address has changed (3) ID Number:
(4) Check appropriate box(es):
❑ Candidate Office Sought: U
❑ 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
Cover Period: From S/ -4 / a To Report Type:
LIOnginal Amendment ❑ Special Election Report
(6) Contributions This Report
(7) Expenditures This Report
Cash & Checks $ y , . , d
Monetary
Expenditures $ �, a , • b 0
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
$ , %? sem .
$ , 42
(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 re ort and it is true, correct, and complete:
(Type name) �Q_►GI �P�.�+�s ca (Type name)-
1
❑ Individual (only for IE 63freasurer ❑ Deputy Treasurer [$Candidate ❑ irpe on (only for PC a 'PTY)
or electioneering comm.)
X X _
Signature Signature
DS -DE 12 (Rev. 11113) SEE REVERSE FOR INSTRUCTIONS
CAMPAIGN TREASURER'S REPORT — ITEMIZED EXPENDITURES
(1) Name� ' CLd L.0 r VL -r-(2) I.D. Number_
(3) Cover Period c3/ 't / through 'Y' (4) Page of
(5)
Date
(6)
Sequence
Number
(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
(11)
Amount
rt r 3 uc ltk-�
I
DS -DE 14 (Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES
CAMPAIGN TREASURER'S REPORT SUMMARY
C Lj r k
OFFICE USE ONLY
_
Name
RECEIVED
(2) '7 13 14- L3J S T
Address (number and street)
MAR
City, State, Zip Code
CITY OF BOYNTON BEACH
❑ Check here if address has changed
(3) ID Number:
(4) Check appropriate box(es):
Candidate Office Sought: ry1 v4t-�
❑ 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
Cove Period: From I I ;Q To
�l 3 (I �Z Report Type: t
Original ❑ Amendment ❑ Special Election Report
(6) Contributions This Report
(7) Expenditures This Report
Cash & Checks $ 1 41 • , i5
Monetary
Expenditures
A4
Loans $ -45
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
$ �, SV� - [a
$ t S 5�•, �� .
(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
�
4-'t
_(Type name) ^ 4a iP�jll�•
(Type name)
❑ Individual (only for IE ❑ Treasurer ❑ Deputy Treasurer
❑ Candidate ❑ Chairperson (only for PC and PTY)
or electioneering comm.) _
r
iVJ"
C�� J /� -
/Signature
Signature
DS -DE 12 (Rev. 11113) SEE REVERSE FOR INSTRUCTIONS
CAMPAIGN TREASURER'S REPORT - ITEMIZED EXPENDITURES
(1) Name IGr.-4 0- 8 (2) I.D. Number
(3) Cover Period ! / / / 22 through ! / 31 / 2'2 (4) Page l of
(5)
(7)
(8)
(9)
(10)
(11)
Date
Full Name
(Last, Suffix, First, Middle)
Street Address &
Purpose
(add office sought if
contribution to a
Expenditure
(6)
Sequence
Number
City, State, Zip Code
candidate)
Type
Amendment
Amount
('Y
l
(f,44-,
ILIn,
f.'c�S
L•� i T� cam' Rw+c.
��`"�
f �'•-mac �c..r'.
�Ian
1
IrY11-f-1riM��� �/
J
! 1
CA -14
5
Z/2 z2
G
�s
RC -A, 4=L
Gr1S
O. Zai
CA01r<
DS -DE 14 (Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES