DS DE 12 E Urquiza Q1-13 s
FLORIDA DEPARTMENT OF STATE DIVISION OF ELECTIONS
1 rs
CAMPAIGN TREASURER'S REPORT SUMMARY -,
OFFICE USE ONLY((
(1) _C_(S." -
Name
CD
-Ti
(2) 10! - -
Address (number and street) �_, N
A r1r�.r�: {�ttic e L , 1=1 'S.1 1`1 Cl r-.
City, State, Zip Code
❑ CHECK IF ADDRESS HAS CHANGED (3) ID Number:
(4) Check appropriate box(es):
[Candidate (office sought): G np
❑ Political Committee ❑ CHECK IF PC HAS DISBANDED
❑ Committee of Continuous Existence ❑ CHECK IF CCE HAS DISBANDED
❑ Party Executive Committee
❑ Electioneering Communication ❑ CHECK IF NO OTHER ELECTIONEERING
COMMUNICATION REPORTS WILL BE FILED
(5) REPORT IDENTIFIERS
Cover Period: From / l / Zo t To / 3( / 70t, Report Type QC -tS
[Original ❑ Amendment ❑ Special Election Report ❑ Independent Expenditure Report
(6) CONTRIBUTIONS THIS REPORT (7) EXPENDITURES THIS REPORT
Monetary
Cash & Checks $ 77�r 00 Expenditures $ �� Y13,37'
Loans $ gol d 00 -00 Transfers to Office
Account $
Total Monetary $ o?-5-j ,/J'. '00 Total
Monetary $ 4/3, -�7
In-Kind $
(8) Other Distributions
(9) "TOTAL etary Contributions To Date (10) TOTAL Monetary Expenditures To Date
$ $ /.S3C•3L
30 7' S
00
(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, I certify that I have examined this report and it is true,
correct, and complete. correct, and complete. 1D
(Type name) �� o�cL C.a�) I (TYp name) /�• 15/4 /-f.
❑Individual(only for Treasurer ❑Deputy Treasurer EnCandidate ❑Chairperson(only for PC,PTY&
electioneering commun.) ectioneer g commun.organization)
X X — �
Signature Signature
DS-DE 12(Rev.08/04)
O
CAMPAIGN TREASURER'S REPORT — ITEMIZED CONTRIBUTIONS
(1) Name Elsa M. Urquiza (2) I.D. Number
(3) Cover Period 1 / 1 / 13 through 3 / 31 / 13 (4) Page 1 of 2
(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 T e Description Amendment Amount
w.Om
C 43 r rw. 41nbeiS
1/7s 11lo.�or'e 6�r & son CN'C
/y6 . �/ 3-4141
z tAMi' 1A_1 .33a3/
331.01
l l 3 lJ/1y A)ot 1-_V/Ms
gy8 amt a ac 23
/y'aw7;, IO/
� JCO.
/ �0M4
3 �,��.d� 1Go I
ly.6 G'i 33,y/
113 G)V Ilp D/L e co
156s - 51 St qC4,•mod C 14�-
7 ° l ;Vy g
a / PT / /j /�,3eSli e AcAAAa
DS-DE 13(Rev.08/03) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES
CAMPAIGN LOANS REPORT ITEMIZED
Page l of I
(PLEASE TYPE)
FULL NAME AND ADDRESS OF LENDER: FULL NAME AND ADDRESS OF LENDER:
/s�+ /�'• �Q y/4 zo-�
33i3.�
OCCUPATION: rc°, " OCCUPATION:
AMOUNT OF LOAN: �O DdO. 40 AMOUNT OF LOAN:
DATE RECEIVED: - °�°Yao� DATE RECEIVED:
FULL NAME AND ADDRESS OF LENDER: FULL NAME AND ADDRESS OF LENDER:
OCCUPATION: OCCUPATION:
AMOUNT OF LOAN: AMOUNT OF LOAN:
DATE RECEIVED: DATE RECEIVED:
FULL NAME AND ADDRESS OF LENDER: FULL NAME AND ADDRESS OF LENDER:
OCCUPATION: OCCUPATION:
AMOUNT OF LOAN: AMOUNT OF LOAN:
DATE RECEIVED: DATE RECEIVED:
DS-DE 73A(Rev.08103)
CAMPAIGN TREASURER'S REPORT— ITEMIZED CONTRIBUTIONS
(1) Name Elsa M. Urquiza (2) I.D. Number
(3) Cover Period 1 / 1 / 13 through 3 / 31 / 13 (4) Page .1 of 2
(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 T e Description Amendment Amount
A4 46
/spa s�7a A� �jw� CH
q pp P4
l l l.3 ✓A�G��! ✓e/ eav
Td VV
C �l •goo.
/ ,24,9 SW 7a A Co
o P14wlb 137, 9
/a50 cJest �
f/
,..14 '0.).3/ 3S
a ,07a , J3 -
1 g 14r J:' /Orson c N,4ir' 3cc>•&o
�z
l -24 / l 9 V 1 COq'WC W �Jsi n�s:C
,J7"74 97
CHa-
140f 7>Zi o.i
J IiJ d•, IC! 33/ef
4,11 113 9wRe�ce
PT _1Y osteT /J Xh791
113 05,,q RQL)/'ZA /
aa7F ✓d Ali fit, se IF DA
'/ 33s�y
C7 5�I
DS-DE lalliev.08/03) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES
P,-j, ✓
• CAMPAIGN TREASURER'S REPORT- ITEMIZED EXPENDITURES
(1) Name Elsa M. Urquiza (2) I.D. Number
(3) Cover Period 1 / 1 / 13 through 3 / 31 / 13 (4) Page 1 of 1
(5) (7) (8) (9) (10) (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
/ )bpkos Flyces
I Rl1n 4o i01 7.3.J3
N 3 P 33 1 3
1 11511.3 V '4/,N"z A cl"Am
13.333 S 0 Sq C4 e f�»fs 4 000.o0
?a4J vi-s-
3 Sa
a 1?5 %� Pk. 9RAPtt�,aS fO%
Q k got 4ecs I eva 3a io
4i v7 cu/7f i46e
5 ty. b P f 33i
3 /e 13 66 4d . cam
i a5. 3 y
DS-DE 14(Rev.08/03)
SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES 0/�G