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Bloom 2021-M12 Report CAMPAIGN TREASURER'S REPORT SUMMARY (1) Amit Bloom OFFICE USE ONLY Name (2) 20454 NE 34 Court CITY Address (number and street) Office1 Aventura, EL 33180 City, Mate, dip Code RECEIVED1/7/2022 ❑ Check here if address has changed (3) ID Number: (4) Check appropriate box(es): d Candidate Office Sought: Aventura Commission Seat 0 ❑ Political Committee (PC) El 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 12 / 01 /2021 To 12 / 31 /2021 Report Type: M 12 Ci Original ❑ Amendment ❑ Special Election Report (6) Contributions This Report (7) Expenditures This Report Monetary Cash & Checks $ 0 00 Expenditures $ 0 .00 Loans $ Transfers to Office Account $ Total Monetary $ Total Monetary $ 0 .00 r In-Kind $ (8) Other Distributions (9) TOTAL Monetary Contributions To Cate (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 ❑Individual(only for IE L�Treasurer uty Treasurer (�Candi El Chairperson(only for PC and PTY) or electioneering comm. X Signature Signature DS-DE 12(Rev.11/13) SEE REVERSE FOR INSTRUCTIONS