Bloom 2022-M5 Report CAMPAIGN TREASURER'S REPORT SUMMARY
(1) Amit Bloom OFFICE USE ONLY
Name CITY OF AVE:NTUR]A
(2) 20454 NE 34 Court of 'i
Address (number and street) Office of I the City Clerk
Aventura, FL 33180 FRECEIVED 61/22022
City, State, Zip Code
E] Check here if address has changed (3) ID Number
(4) Check appropriate box(es):
R] Candidate Office Sought: Aventura Commission Seat 6
Political Committee(PC)
Electioneering Communications Org. (EGO) ❑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 05 01 /2022 To 05 131 /2022 Report Type- M5
21 Original El Amendment 171 Special Election Report
(6) Contributions This Report (7) Expenditures This Report
Monetary
Cash & Checks $ 2 , 750 .00 Expenditures $ 1113 17
Loans $ Transfers to
Office Account $
Total Monetary $ Total Monetary $ 113. 17
In-Kind $
(8) Other Distributions
$ - I - I
(9) TOTAL Monetary Contributions To Date (10) TOTAL Monetary Expenditures To Date
$ 25, 696 . 00 $ a 628.28
(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
0 Individual(only for IE E]Treasurer eputy Treasurer El Candidate 0 Chairperson(only for PC and PTY)
Loreloctione:ering comm.) L
X
X
X X
Signature Signature
DS-DE 12(Rev.11113) SEE REVERSE FOR INSTRUCInONS
CAMPAIGN TREASURER'S REPORT— ITEMIZED CONTRIBUTIONS
Amit Bloom
(1) Name (2) I.D. Number
05 01 2022 05 31 2022 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
Brian Adler
05 05 2022 1450 Brickell Avenue
Suite 2300
1 Miami, FL 33131 I Lawyer CHE $250.00
Ronald Book
05 13 2022 491 Coconut Palm Ter
Plantation, FL 33324
2 I Lawyer CHE $1000.00
Ronald L Book PA
05 13 2022 18851 NE 29th Ave
STE 1010
3 Aventura, FL 33180 B Lawyer CHE $1000.00
Pat Book
05 13 2022 2711 So. Ocean Dr.
Hollywood, FL
4 I Lawyer CHE $500.00
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 05 / 01 / 2022 through 05 / 31 / 2022 (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
Google LLC Domain name / email
05 05 2022 1600 Amphitheatre Pkwy
Mountain View, CA 94043
CAN $6.00
1
Vistaprint Campaign business
05 06 2022 275 Wyman Street cards
Waltman, MA 02451
CAN $96.86
2
Anedot Inc Merchant services
05 09 2022 1340 Poydras Street fees
Suite 1770
New Orleans, LA 70112 CAN $10.31
DS-DE 14(Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES