DS-DE 12 F1-07 Amended UrquizaFLORIDA DEPARTMENT OF STATE DIVISION OF ELECTIONS
CAMPAIGN TREASURER'S REPORT SUMMARY
(1) ~~~ ~ra~,2c. OFFICE USE Q1~ILY®
Name ~ `~'
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(2) ZLT ~. Q?.+o Alb ~f ,
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- rn
e~ .'~
Address (number and street) _ --- ~~ i
City, State, Zip Code =~
^ CHECK IF ADDRESS HAS CHANGED ', ~ ;~
(3) ID Number: ~: ~
(4) Ch ck appropriate box(es): -' ~
(Candidate (office sought): LAM;ss~b~n G-~o~tp~L.'
^ 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 ~~ / of / ~~. To f~ / t4 / o~ Report Type -F'I -O~
^ Original [Amendment ^ Special Election Report ^ Independent Expenditure Report
(6) CONTRIBUTIONS THIS REPORT (7) EXPENDITURES THIS REPORT
Monetary
Cash & Checks $__~?(2,p~~ Expenditures $ _ _ ~ 031 .Z
Loans ~ Transfers to Office
Account $
Total Monetary ~ ~, 42p Total
Monetary $ ~_t0~.~~~
In-Kind $
(8) Other Distributions
(9) TOTAL Monetary Contributions To Date (10) TOTAL Monetary Expenditures To Date
$ 1, 4. ~ ?4 _Q~,j $ IA , 140. 2~ _
(11) CERTIFICATION
It is a first degree misdemeanor for any pers on 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) ~ ~
vvrC~ ~.w,n ~ ~
(TYPe name) ~~ ~ ~;/-~ i/~'~ ~~c.1 > Z~~
^Individual (only for ~reasurer ^ Deputy Treasurer ^ Candidate ^ Chairperson (only for PC, PTY &
'
electioneering commun.) electio eri g commun. organization)
~/ ~
Signature Signature ;' (J
DS-DE 12 (Rev. 08/04)