Termination Report 05-22-2022CAMPAIGN TREASURER'S REPORT SUMMARY
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(1) I �. ,-p, -5- ,--* -7 -e OFFICES'
Name
(2) s ! Sw .2 rt''t r, r" MAY 2 2 2022
Address (nupnber and street)
CITY OF BOYNTON BEACH
CITYCLERK"S OFFICE T 06 r
City, State, Zip Code
❑ Check here if address has changed (3) ID Number: `—
(4) Check appropriate box(es):
[Candidate Office Sought:�P`LG
❑ 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 I E or EC reports will be filed
individual making electioneering communications)
(5) Report Identifiers
Cover Period: From / `/ / W27.- To ReportType: �--
(� Original ❑ Amendment ❑ Special Election Report
(6) Contributions This Report
(7) Expenditures This Report
Monetary
Cash & Checks $ , Cfj I r"'
Expenditures $
Loans $ - , vy
Transfers to
Office Account $ ,
Total Monetary $ 0&
Total Monetary $ ,
In -Kind $�
(8) Other Distributions
(9) TOTAL Monetary Contributions To Date
(10) TOTAL Monetary Expenditures To Date
$ �D�S CSC)
(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:
�1
(Type name) 7 ppA l'U,,t,7 _(Type name) _J47U'�.`Z S ✓�J
❑ Individual (only for IE ❑ Treasurer Deputy Treasurer P/Candidate ❑ Chairperson (only for PC and PTY)
or electioneering comm.),,,
X Gam, X is
t
Signature Signature
DS -DE 12 (Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS
AMPAK3 TREASURER'S REPORT — ITEMIZED EXPENDITURE
(1) Name (2) I.D. Number
---- ---_
(3) Cover Period f�� /!r'.—through _ �L ✓�(4) Page----/ of
DS -DE 14 (Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES