Bloom 2021-M11 Report CAMPAIGN TREASURER'S REPORT SUMMARY
(1) Amit Bloom OFFICE USE ONLY
Name CITY OF AVENTURA
(2) 20454 NE 34 Court Office of the City Clerk
Address (number and street)
RECEIVED 12/7/2021
Aventura, FL 33180 ROM
City, State, Zip Code
E] Check here if address has changed (3) ID Number:
(4) Check appropriate box(es):
H Candidate Office Sought: Aventura Commission Seat 6
El Political Committee (PC)
n Electioneering Communications Org. (ECO) E] Check here if PC or ECO has disbanded
E] Party Executive Committee (PTY) ❑ Check here if PTY has disbanded
El 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 / 01 /2021 To 11 / 30 /2021 Report Type: Mil
n-, Original El Amendment El Special Election Report
(6) Contributions This Report (7) Expenditures This Report
Monetary
Cash & Checks $ 36 , 00 Expenditures $ 47 72
Loans Transfers to
Office Account $
Total Monetary $
Total Monetary $ 47 72
In-Kind
(8) Other Distributions
$
(9) TOTAL Monetary Contributions To Date (10) TOTAL Monetary Expenditures To Date
$ 10, 446 . 00 319. 51
(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) David Bloom (Type name) Amit Bloom
C]Individual(only for IE 0 Treasurer eputy Treasurer i can El Chairperson(only for PC and PTn
'ram�)
or oloction in comm)
X
Signature Signature
DS-DE 12(Rev.11113) SEE REVERSE FOR INSTRUCTIONS
CAMPAIGN TREASURER'S REPORT— ITEMIZED CONTRIBUTIONS
Amit Bloom
(1) Name (2) I.D. Number
11 01 2021 11 30 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
Albert Justin Angel
11 17 2021 1895 NE 214 Terrace
North Miami Beach, FL
1 33180 I CHE $36.00
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 11 11 / 2121 through 11 30 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
Bloom, Amit
11 01 2021 20454 NE 34 Court Reimbured expense:
Aventura, FL 33180 campaign business
cards RMB $45.98
1
Anedot Inc. Merchant services
11 22 2021 1340 Poydras Street fees
Suite 1770
New Orleans LA 70112 CAN $1.74
2
DS-DE 14(Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES