M10 2021 Report 11-10-2021CAMPAIGN TREASURER'S REPORT SUMMARY
(1) Angela Cruz
OFFICE USE ONLY
Name
RECOED
(2) 1420 Via De Pepi
Address (number and street)
NOV 10 2021
Boynton Beach, FL 33426►c�
?
City, State, Zip Code
CITYOF BOYNTON BEAE H
❑ Check here if address has changed
(3) ID Number.
(4) Check appropriate box(es):
❑✓ Candidate Office Sought: (Cry
❑ 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 10/1/2p21 / To
1p /311202/1 Report Type: M102021
❑✓ Original ❑ Amendment ❑ Special Election Report
(6) Contributions This Report
(7) Expenditures This Report
Monetary
Cash & Checks $ 560 00
Expenditures $ ,
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
$ , 201 170 .09
$ , , 84.28
(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 El Treasurer ❑ Deputy Treasurer
El Candidate ❑ Chairperson (only for PC and PTY)
or electioneering comm.)
X ' � !"-�J
X
Signature I
Signature
DS -DE 12 (Rev. 11113) SEE REVERSE FOR INSTRUCTIONS
CAMPAIGN TREASURER'S REPORT — ITEMIZED CONTRIBUTIONS
(1) Name (2) I.D. Number (3) Cover Period / / through / / (4) Page of
(5)
(7)
1 (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
10/1/2021
Reed Surdovel
I
Technician
Debit
$50
732-618-5237
rsurdovel@gmail.com
6339 La Costa Dr
1
K
Boca Raton FL 33433
10/1/2021
Rachel Reed
I
Housewife
Debit
$10
216-414-3885
msrrhawk@yahoo.com
2
1322 Piazza Pitti
Boynton Beach FL
33426
10/18/2021
Heather R. Hall/
I
Housewife/
Check
$500
Robert M. Hall
1499 sw 21 St
Real Estate
3
Boca Raton, FL
DS -DE 13 (Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES