F1 Elsa Urquiza
fl. . ql / (f!) II .' I' A~ N
IL~~Q.\ \Vd '2-~ DC,' 1fIEJ1.
FLORIDA DEPARTMENT OF STATE DIVISION OF ELECTIONS
CAMPAIGN TREASURER'S REPORT SUMMARY
(1) f.: I.so. Ulfq V\lCA OFFICE USE ONLY
Name ........
(2) V, 6 Q.~ v 0 A\~o f}r
Address (number and street)
M~CA""'~ &-Olt. '^ I F I ~ \ 5C1\
City, State, Zip Code
o CHECK IF ADDRESS HAS CHANGED (3) ID Number:
(4) ~k appropriate box(es): ~
Candidate (office sought): U;""l'o11~"aef v""o-"()
o Political Committee o CHECK IF PC HAS DISBANDED
o Committee of Continuous Existence o CHECK IF CCE HAS DISBANDED
o Party Executive Committee
o Electioneering Communication o CHECK IF NO OTHER ELECTIONEERING
COMMUNICATION REPORTS WILL BE FILED
(5) REPORT IDENTIFIERS
Cover Period: From 1 / ~l / b& To ~ / ZL / ~ Report Type f1-oc,
- -
o Original o Amendment o Special Election Report o Independent Expenditure Report
(6) CONTRIBUTIONS THIS REPORT (7) EXPENDITURES THIS REPORT
Monetary
Cash & Checks $ -~IOcO\OO Expenditures $ \1/63~ .G\Z
Loans $ Transfers to Office
Account $
Total Monetary $ Total
Monetary $ lLJb!:."q'l
In-Kind $
(8) Other Distributions
$
(9) TOTAL Monetary Contributions To Date (10) TOTAL Monetary Expenditures To Date
$ '"S,OOO,OO $ \2., b "3 {,l 0\1
(11) CERTIFICATION
It is a first degree misdemeanor for any person to falsify a public record (55. 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. Jt?~(')/~
(Type name) EJ...w r d Lolli f<? S (Type name) E I~/i IV/.
Dlndividual (only for 0Treasurer o Deputy Treasurer J2I Candidate o Chairperson (only for PC, PTY &
electioneering commun.) X tL (ctionep; Jco~mun: o:aniZatiOn)
~gn~~
Signature '--7J 0
OS-DE 12 (Rev. 08/04)
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(1) Name
CAMPAIGN TREASURER'S REPORT -ITEMIZED CONTRIBUTIONS
E/~/I l1 JlfaJi~ (2) to. Number
(3) Cover Period !2:L I Q.L I t2L- through !2:L I fdL I 0-6 (4) Page
I 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 OccuoatiOn Type Desaiotion Amendment Amount
DK I Ib lOb (draf 1?pde/
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CAMPAIGN TREASURER'S REPORT -ITEMIZED CONTRIBUTIONS
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(2) 1.0. Number
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CC7.AMPAJ<iN TAEAS~RER'S REPORT -ITEMIZED EXPENDITURES
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(3)CoverPeriod fJ7,O/ lOG through CR ,~~ (4) Page I of 3
(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
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L CAMPAIGN rREA~U. RER'S REPORT - ITEMIZED EXPENDITURES
(1) Name ~ Is,CJ f/j. VtfaLJ/ ZcL- (2) 1.0. Number
(3)CoverPeriod-2LIOI I~through~ IS I~ (4) Page ;:2 of ~3
(5) (7) (8) (9) (10) (11)
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Number City, State, Zip Code candidate) Type Amendment Amount
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(1) Name K ~A ,N'). Vl,?a.Ji~ (2) 1.0. Number
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SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES
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