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M8 Report 09-03-2021CAMPAIGN TREASURER'S REPORT SUMMARY (1)� /1"�1 y ��� -� l OFF1M11SEQNLY Name _ GEIVED (7) S cv y��h �"�`� SEP 0 3 2021 Address (number and street) eB ? 4 e��k L9 ° CIN OF BOYNTON BEACH. City, State, Zip Code CIN CLERICS OFFICE ❑ Check here if address has changed (3) ID Number: (4) Check appropriate box(es): ❑ Candidate Office Sought: L ❑ 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 (I E) (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 / / �p� To _4�(_ / 3 / '203,/ Report Type: ®.Original ❑ Amendment ❑ Special Election Report (6) Contributions This Report (7) Expenditures This Report Monetary Cash & Checks $ , &.9-L (%O Expenditures $ (� Loans $ Total Monetary $ 1 , In -Kind $ I I (9) TOTAL Monetary Contributions To Date $ Q . (SCJ Transfers to Office Account $ pt Total Monetary $ , (� 0 C) (8) Other Distributions $ , (10) TOTAL Monetary Expenditures To Date $ ,. D0 (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) !'I ©l�f f��l'' (Type name) 7hOAv Ui2mC M individual (only for IE 19 Treasurer CJ�Deputy Treasurer ❑ Candidate ❑ Chairperson (only for PC and PTY) or electioneering comm.) Signature Signature DS -DE 12 (Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS CAMPAIGN TREASURER'S REPORT - ITEMIZED CONTRIBUTIONS (1) Name (2) I.D. Number (3) Cover Period / (2 / 2oai through / '3 l / 202oj (4) Page _� of (5) Date (7) Full Name (Last, Suffix, First, Middle) Street Address & City, State, Zip Code (a) - -- Contributor Type Occupation - (9) - - - Contribution T e (10) In-kind Description (11) Amendment (12) Amount (6) Sequence Number 2-3 -1-ho/Ls; 12ult--tre IrG. � 3�fZG +fr >4IIS mCh 1 / DS -DE 13 (Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES 0