M8 Amendment 10-04-2021CAMPAIGN TREASURER'S REPORT SUMMARY
(1) Angela Cruz
MTM USE ONLY
Name
OCT 0 4 2021
(2) 1420 Via de Pepi
Address (number and street)
H
Boynton Beach, FL 33426
C� M CSR CTS OFFICE
City, State, Zip Code
❑ Check here if address has changed
(3) ID Number
(4) Check appropriate box(es):
❑✓ Candidate Office Sought: City Commission,
District 1
❑ 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 08 / 01 2021 To
08 / 31 2021 Report Type: M8 2021
❑ Original ✓❑ Amendment ❑ Special Election Report
(6) Contributions This Report
(7) Expenditures This Report
Monetary
Cash & Checks $ 6 687 65
Expenditures$ 25 82
Loans $
Transfers to
Office Account $
Total Monetary $ ,
Total Monetary $ 25.82
In -Kind
(8) Other Distributions
$ ,
(9) TOTAL Monetary Contributions To Date
(10) TOTAL Monetary Expenditures To Date
$ 18 010.09
$ 79.66
(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) Angela Cruz
(Type name) Angela Cruz
+❑ Individual (only for IE Treasurer ❑ Deputy Treasurer
El Candidate ❑ Chairperson (only for PC and PTY)
or electioneering comm.)
X �, 9/30/2021
X(, 9/30/2021
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 / / through / / (1) Page of 2
(5)
(7)
(8)
(9) (10)
(11)
(12)
Date
Full Name
(Last, Suffix, First,
(6)
Middle) Street Address
Contributor
Contribut In-kind
Sequence
&
Type Occupation
ion Type Description
Amendment
Amount
Number
City, State, Zip Code
8/17/2021
Fusion Chiropractic
B
Chiropracto
Check
$500
Boynton PLLC
3717 W Boynton Beach
r
8
Blvd Suite 9, Boynton
Beach, FL 33436
8/17/2021
B
Real Estate
Check
$700
WAC STARBOARD LLC
3425 S Lake Dr Boynton
Beach, FL 33436
9
8/17/2021
Law offices of Lee Cohen
B
Attorney
Check
$500
411 E. Atlantic Ave Suite
200-E Delray Beach, FL
10
33433
8/28/2021
MICHAEL DUBOSE
B
Property
Check
$500
217 N Seacrest Blvd
Boynton Beach, FL
33425
Manageme
nt
11
8/31/2021
REZ REAL ESTATE
B
Real Estate
Check
$1000
SERVICES LLC
1000 Brickell Plaza
Suite 4104 Miami, FL
12
33131