DS-DE 12 TR UrquizaFLORIDA DEPARTMENT OF STATE DIVISION OF ELECTIONS
CAMPAIGN TREASURER'S REPORT SUMMARY
(1) ~~ ~ ~~ tc~ OFFICE USE ONLY
Name c:~ ' ~'
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Address (number and street) -~ ~
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City, State, Zip Coe
^ CHECK IF ADDRESS HAS CHANGED (3) ID Number: `'
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(4) Check appropriate box(es): -
[Candidate (office sought): C
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^ 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 I~ / ({, / O -~ To ~ / zQ / ~y Report Type
[~ Original Amendment ^ Special Election Report ^ Independent Expenditure Report
(6) CONTRIBUTIONS THIS REPORT (7) EXPENDITURES THIS REPORT
Monetary
Cash & Checks $ Expenditures $ 4~ 3t4, S2
Loans $ Transfers to Office
Account $
Total Monetary $ Total
Monetary $ qs 3z 4, ~~_ _, _ _
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In-Kind $
(8) Other Distributions
(9) TOTAL Monetary Contributions To Date (10) TOTAL Monetary Expenditures To Date
$ 0.~q~.UC~ $ GG
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(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.
(Type name) C:.ac~ord. l.l'rMk7rS ,Qp
(Type name) ~/S~ l'1
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^Individual (only for Treasurer ^ Deputy Treasurer -
^ Candidate Chairperson (only for PC, PTY &
electioneering commun.) ctio Bring commun. organization)
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Signature Signature
DS-DE 12 (Rev. 08/04)
(1 ~G~ I ~~
CAMPAIGN TREASURER'S REPORT -ITEMIZED EXPENDITURES
(1) Name Gls~, UrOJ12u, (2) LD. Number
(3) Cover Period tl_/~~/~_through 1 / 2O / dY (4) Page 1 of 3
(5) l7) ($) (9) (10) l11)
Date Full Name Purpose
(s)
Sequence (Last, Suffix, First, Middle)
Street Address & (add office sought if
contribution to a
Expenditure
Number City, State, Zip Code candidate) TYPe Amendment Amount
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DS-DE 14 (Rev. 08/03)
SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES
CAMPAIGN TREASURER'S REPORT -ITEMIZED EXPENDITURES
(1) Name I'sls~. V4~~2a (2) I.D. Number
(3) Cover Period ~_/~/ O'} through - / 2v / apt (4) Page Z- ~ of 3
(5) (7) (8) (9) (10) (11)
Date Full Name Purpose
(s)
Sequence (Last, Suffix, First, Middle)
Street Address & (add office sought if
contribution to a
Expenditure
Number City, State, Zip Code candidate) Type Amendment Amount
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DS-D 14 (Rev. 08/03)
SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES
CAMPAIGN TREASURER'S REPORT -ITEMIZED EXPENDITURES
(1) Name Gls, ~ ~. v;Zrn (2) I.D. Number
(3) Cover Period i1 / ~b / 0} through t / to / a~ (4) Page 3 of 3
(5)
Date (~)
Full Name l8)
Purpose l9) ho) (11)
(s)
Sequence
Number (Last, Suffix, First, Middle)
Street Address &
City, State, Zip Code (add office sought if
contribution to a
candidate)
Expenditure
Type
Amendment
Amount
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DS-DE 14 (Rev. 08/03)
SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES
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