M11 Report Amendment 12-07-2021CAMPAIGN TREASURER'S REPORT SUMMARY
(1) Gregory Hartmann
OFF�JGE u ONLY
Name
(2) 1083 SW 25 PL
Address (number and street)
jA'Yri
Boynton Beach, FL 33426
tiro 3 ...`
City, State, Zip Code
❑ 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)
(5) Report Identifiers
Cover Period: From 11 / 1 / 2021 To
11 / 30 / 2021 Report Type: M 11
❑ Original ® Amendment ❑ Special Election Report
(6) Contributions This Report
(7) Expenditures This Report
Monetary
Cash & Checks $ 1 '000 00
Expenditures $ 233 33
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
$ 1150.00
$ 264.32
(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
m Individual (only for IE ❑ Treasurer ❑ Deputy Treasurer
QJ Candidate ❑ Chairperson (only for PC and PTY)
or electioneering comm.)
X v
_X -
Signature
Signature
DS -DE 12 (Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS
CAMPAIGN TREASURER'S REPORT - ITEMIZED EXPENDITURES
(1) Name Gregory Hartmann
(3) Cover Period 11 / 1 / 2021 through 11 / 30 / 21
(2) I.D. Number
1 1
(4) Page -of-
(7)
of
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
(1 0)
Amendment
(11)
Amount
(6)
Sequence
Number
it 22 021
100 E Ocean Ave, Boynton Beach, FL
33435 City Clerks Office
State assessment
fee
CAN
ADD
198.53
002
11 22 021
100 E Ocean Ave, Boynton Beach, FL
33435 City Clerks Office
petitions
certification
CAN
ADD
3.80
003
11 22 .021
100 E Ocean Ave, Boynton Beach, FL
33435 City Clerks Office
city filing fee
CAN
ADD
25.00
004
DS -DE 14 (Rev. 11113) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES