M9 2021 Report 10-05-21CAMPAIGN TREASURER'S REPORT SUMMARY
(1) G--� f- .4r"��:;;_�� j OFFICE USE ONLY
Name
(2) ` "7 310 1o2, 22-
Address and street) OCT 5 2021
/(�nnuumLfber
')
Bql
OMONBEACH
City, State, Zip Code CMIYOF RM
❑ Check here if address has changed (3) ID Number:
(4) Check appropriate box(es):
Candidate Office Sought:
❑ 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 / / To / / Report Type:
Original ❑ Amendment ❑ Special Election Report
(6) Contributions This Report
(7) Expenditures This Report
Cash & Checks $ D®
Monetary
Expenditures $
Loans $ ,
Transfers to
Office Account $ ,
Total Monetary $ > -15"o� �
,
Monetary
Total $ 3 .
In-Kind $ >
(8) Other Distributions
(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.)
I certify that I have examined this report and it is true, correct, and complete:,[�
/�� /��,,,
(Type name) , .� - �f' "I (Type name) U t :e&:�1 `�' A � T� VA1
[IIndividual (only for IE Treasurer ❑Deputy Treasurer Candidate ❑ Chairperson (only for PC and PTY)
or electioneering comm.)
_X X
Signature Signatur
DS -DE 12 (Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS
CAMPAIGN TREASURER'S REPORT — ITEMIZED CONTRIBUTIONS
Gregory Hartmann
(1) Name (2) I.D. Number
9 1 2021 9 30 2021 1 1
(3) Cover Period / / through / / (4) Page Of
(5)
Date
(7) (8)
Full Name
(Last, Suffix, First, Middle)
Street Address & Contributor
City, State, Zip Code Type Occupation
(9)
Contribution
Type
(10)
In-kind
Description
(11)
Amendment
(12)
Amount
(6)
Sequence
Number
ft�% 4 2021
l / /
Gregory G. Hartmann
1083 SW 25 PL
Boynton Beach FL 33426
CAS
$50.00
001
DS -DE 13 (Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES
CAMPAIGN TREASURER'S REPORT - ITEMIZED EXPENDITURES
(1) Name Gregory Hartmann
(3) Cover Period 9 / 1 / 2021 through 9 / 30 / 2021
(2) I.D. Number
1 1
(4) Page of _
(5)
Date
(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
(6)
Sequence
Number
9 30 :021
Vista Print
275 Wyman Street
Waltham, MA 02451
business cards
CAN
$33.99
001
DS -DE 14 (Rev. 11113) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES