DS-DE 12 Q1-11 Urquiza FLORIDA DEPARTMENT OF STATE DIVISION OF ELECTIONS
CAMPAIGN TREASURER'S REPORT SUMMARYF C F I V F fl
( u E / S / 4 - d 4 6 , t O F F I R O Y pm 4:
38
Name
( 07 /E. e i A14 CITY CLERK'S OFFICE
Address mber and street) aa
/ 4M; P f� 3-3/3g
City, State, Zip Code
❑ CHECK IF ADDRESS HAS CHANGED (3) ID Number:
(4) C ck appropriate box(es):
[ C andidate (office sought): Lo'n7>ii csier, 9 6
❑ Political Committee 111 CHEC WPC HAS DISBANDED
❑ Committee of Continuous Existence El 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 0/ / p/ / // To O. / 3/ / � Report Type q /i
Original ❑ Amendment ❑ Special Election Report ❑ Independent Expenditure Report
(6) CONTRIBUTIONS THIS REPORT (7) EXPENDITURES THIS REPORT
Monetary r? �
Cash & Checks $ Expenditures $ )
Loans $ 5;000.0o Transfers to Office
Account $
Total Monetary $ Total
Monetary $ 0
In -Kind $
(8) Other Distributions
(9) TOTAL Monetary Contributions To Date (10) TOTAL Monetary Expenditures To Date
$ 6 OOP, �n $
(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, correct, and complete.
(Type name) k C/ 4. () /s (Ty• - name) S •
❑ Individu „ . ly for Treasurer 0 Deputy Treasurer n Candida ❑ Chairperson (only for PC, PTY &
electione7 l .mmun.) electi. eering commun. organ
X / X ”- n_a ( 1c> ) • '
Signature Signature
DS -DE 12 (Rev. 08/04)
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CAMPAIGN TREASURER'S REPORT — ITEMIZED CONTRIBUTIONS
(1) Name L I , C „ -z (2) I.D. Number
(3) Cover Period / / ) ! through - / 5 / 1 (4) Page o f
(5) (7) (8) (9) (10) (11) (12)
Date Full Name
(6) (Last, Suffix, First, Middle)
Sequence Street Address & Contributor Contribution In -kind
Number C.-. ii City, State, Zip Code Type Occupation Type Description Amendment Amount
Z Z / 2z t E- (IN ,c2 AI to Pf
6r4 lie ;Yr(, LOA IS°C)
) 33140 -
(
/ /
/ /
/ /
/ /
/ /
/ /
/ /
DS -DE 13 (Rev. 08/03) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES
P et / c; 2
CAMPAIGN TREASURER'S REPORT — ITEMIZED EXPENDITURES
(1) Name (L (. v zcn (2) I.D. Number
(3) Cover Period w / k i / 11 through S/ sr / I r (4) Page of
(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
, rt.) e ism
22.7 C iz ao Mk, Dr (,�,/
�1A,U,M: t ruci� fl 33140 l2
0 0 l
/
DS -DE 14 (Rev. 08/03)
SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES
3 3