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M11 2021 Report 12-02-21
CAMPAIGN TREASURER'S REPORT SUMMARY (1) Gregory Hartmann OFFICE U�SE,ONLY t Name (2) 1083 SW 25 PL u X02) Address (number and street) �e-G Boynton Beach, FL 33426�- City, State, Zip Code 1YNTONiO� ❑ Check here if address has changed (3) ID Number: (4) Check appropriate box(es): ❑✓ Candidate Office Sought: Boynton Beach 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) (6) Report Identifiers Cover Period: From 11 / 1 /2021 To 11 /30 /2021 Report Type: M11 © Original ❑ Amendment ❑ Special Election Report (6) Contributions This Report (7) Expenditures This Report Monetary Cash & Checks $ 1,000 00 Expenditures $ 3 00 Loans $ 0 Transfers to Office Account $ 0 . Total Monetary $ 0 , , Total Monetary $ . In -Kind $ 0 , , (8) Other Distributions $ . (9) TOTAL Monetary Contributions To Date (10) TOTAL Monetary Expenditures To Date $ 1,150 00 $ 36 99 (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) Gregory Hartmann (Type name) Gregory Hartmann ❑ Individual (only for IE 0 Treasurer ❑ Deputy Treasurer ® Candidate ❑ Chairperson (only for PC and PTY) or electioneering comm.) X X Signature Signature DS -DE 12 (Rev. 11113) SEE REVERSE FOR INSTRUCTIONS CAMPAIGN TREASURER'S REPORT — ITEMIZED CONTRIBUTIONS (1) Name Gregory Hartmann (3) Cover Period 11 / 1 / 2021 (2) I.D. Number through 11 / 30 / 2021 (4) Page _ g 1 1 Of (5) (7) (8) Date Full Name (6) (Last, Suffix, First, Middle) Sequence Street Address & Contributor Number City, State, Zip Code Type Occupation (9) Contribution Type (10) In-kind Description (11) Amendment (12) Amount 11 16 2021 Mike Chumney 660 N US1 North Palm Beach FL 33408 1 Partner CHE $1,000 001 DS -DE 13 (Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES CAMPAIGN TREASURER'S REPORT - ITEMIZED EXPENDITURES (1) Name Gregory Hartmann (2) I.D. Number (3) Cover Period 11 / 1 / 2021 through 11 / 30 / 21 (4) Page 1 of 1 (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 11 19 X021 PNC BANK 500 N Congress Ave, Boynton Beach, FL 33426 checks CAN 3.00 001 DS -DE 14 (Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES