DS-DE 12 G3-13 E. Urquiza ML
FLORIDA DEPA ENT OF STATE DIVISION OF EL IONS
CAMPAIGN TREASURER'S REPORT SUMMARY
Q OFFICE USE ONLY
Nacre
/74
A dress (n ber and street)
Q
City, State, Zip Code ,
❑ CHECK IF ADDRESS HAS CHANGED (3) ID Number:
co
(4) Ch ck appropriate box(es): C• �
Candidate office sought): CO,44
❑ Political Committee ❑ CHECK IF PC HAS DISBANDED
❑ Committee of Continuous Existence ❑ CHECK IF CCE HAS DISBANDED �
❑ Party Executive Committee Ln
❑ Electioneering Communication ❑ CHECK IF NO OTHER ELECTIONEERING
COMMUNICATION REPORTS WILL BE FILED
(5) REPORT IDENTIFIERS
Cover Period: From 0 / o%� To � 20/� Report T yp e t3
❑Original ❑ Amendment ❑ Special Election Report ❑ Independent Expenditure Report
(6) CONTRIBUTIONS THIS REPORT (7) EXPENDITURES THIS REPORT
Monetary
Cash & Checks $ �, 5-00, Op Expenditures $
Loans $ Transfers to Office
Account $
Total Monetary $ Cep Total to a
Monetary $
In-Kind $ llJ
(8) Other Distributions
3
(9) TOTAL Monetary Contributions To Date (10) TOTAL Monte¢,mry Fxbenditures To Date 101
$ /_ 00 $ 3/
(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"� ,a �05 (Type name) �S/� Al. (IL)/.7.�
❑Individual(only for Treasurer ❑Deputy Treasurer Candidate ❑Chairperson(only for PC, PTY&
electioneering commun.) ctioneering commun.organization)
X X
Signatur, Signature
DS-DE 12(Rev. 08/04) ep
SCAN11p
CAMPAIGN TREASURER'S REPORT — ITEMIZED CONTRIBUTIONS
(1) Name (2) I.D. Number
(3) Cover Period o `J 1-7S /0?0/ through J 0 / I 1 /a0i3 (4) Page / of
(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 Type Description Amendment Amount
l0
�)t4 O d�
1
!ov °
/U
/0 113 n,4 rdAe-;,)
I o / o
l5 1() 61 st
l�cJ o� A')
DS-DE 13 (Rev. 08/03) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES Q
Y
AMPAIGrl'�Quize--REASURER'S REPORT — ITEMIZED EXPENDITURES
1 Name k S 1 2 I.D. Number
( ) ( )
(3)Cover Period D through /D (4) Page of /
0
(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
10 5je Me,
lo le 1-c)
y0/ s- a). // 3
7w"10 141' 33/x'3 th e 6-4 JV 0�'�0� ry
Oct IQ y 1,3 L7 lec,
Cho
/o/ 3317 �o f�� �e� .3 -3 14 q�
D 9 1.3 D 6�7.s v l�'
dp 00,
�/62 A) le
aq a
2e- co';7'ro/A
Jr' �a- �5�:'a,n,: �'/ '�a,� v-r► ,gad s: 73--3
10101113 0,or/AfOf v , c� �k
e o-n
Mo vxl�gs;
09/P f/X3
DS-DE 14(Rev.08/03) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES j