Bloom 2021-M10 Report CAMPAIGN TREASURER'S REPORT SUMMARY
(1) Amit Bloom OFFICE USE ONLY
Name
(2) 20454 NE 34 Court CITY OF AVENTURA
Address (number and street) Office of the City Clerk
Ave'ntura, FL 33180 RECEIVED
City, State, Zip Code
El Check here if address has changed (3) ID Number:
(4) Check appropriate box(es):
R Candidate Office sought: Aventura Commission Seat 6—
El Political Committee (PC)
El Electioneering Communications Org. (ECO) Check here if PC or EGO has disbanded
0 Party Executive Committee(PTY) El Check here if PTY has disbanded
El Independent Expenditure(IE)(also covers an E]Check here if no other IE or EC reports will be filed
individual making electioneering communications)
(5) Report Identifiers
Cover Period: From 10 / 01 /2021 To 10 / 31 /2021 Report Type: M 10
2 Original [] Amendment ❑ Special Election Report
(6) Contributions This Report (7) Expenditures This Report
Monetary
Cash & Checks $ 150 , 00 Expenditures $ 6 a31
Loans $ Transfers to
Office Account $
Total Monetary $
Total Monetary $ 6 .31
In-Kind $
(8) Other Distributions
(9) TOTAL Monetary Contributions To Date (10) TOTAL Monetary Expenditures To Data
$ 1106 410 00 $ 271 ,79
(11) Certification
It Is a first degree misdemeanor for any person to falsify a public record (ss. 839.13, r,S.)
I certify that I have examined this report and It Is true, correct, and complete:
('type name) David Bloom (Type norne) ,emit Bloom
tit 0 Deputy Treasurer Candkiale f_j Chat(pofson(only for PC and PTY)
—Tro-'a-s
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Or 010004111010M WITIM)
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Sign Signature
DS-OE 12 (Rev. 11113) SEE REVERSE FOR INSTRUCTIONS
CAMPAIGN TREASURER'S REPORT— ITEMIZED CONTRIBUTIONS
Amit Bloom
(1) Name (2) I.D. Number
10 01 2021 10 31 2021 1 1
(3) Cover Period / / through / / (4) Page of
(5) (7) (8) (9) (10) (11) (12)
Date Full Name
(6) (Last, Suffix, First, Middle)
Sequence Street Address& Contributor Contribution In-kind
Number City, State,Zip Code Type Occupation Type Description Amendment Amount
John Dellagloria
10 05 2021 13898 Southwest 90th
Ave.
1 EE-104 I Attorney CHE $150.00
Miami, FL 33176
DS-DE 13(Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES
CAMPAIGN TREASURER'S REPORT- ITEMIZED EXPENDITURES
(1) Name Amit Bloom (2) I.D. Number
(3) Cover Period 10 01 / 2121 through 10 31 2021 (4) Page 1 of 1
(5) (7) (8) (9) (1 0) (11)
Date Full Name Purpose
(6) (Last,Suffix, First, Middle) (add office sought if
Sequence
Street Address& contribution to a Expenditure
Number City,State,Zip Code candidate) Type Amendment Amount
Anedot Inc.
10 07 2021 1340 Poydras Street Merchant services
Suite 1770 fees
New Orleans LA 70112 CAN $6.31
1
DS-DE 14(Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES