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Lewis, Eddie Elections 2700 NW 87th Avenue MIAMI•DADE Miami, Florida 33172 T 305-499-VOTE F 305-499-8547 TTY: 305-499-8480 miamidade.gov CERTIFICATION STATE OF FLORIDA) COUNTY OF MIAMI-DADE) I, Lester Sola, Supervisor of Elections of Miami-Dade County, Florida, do hereby certify that 58 signatures submitted by Eddie Lewis for the office of Village Council in Miami Shores Village matched the signatures on the voter files. WITNESS MY HAND AND OFFICIAL SEAL, AT MIAMI, MIAMI-DADE COUNTY, FLORIDA, ON THIS 13th DAY OF MARCH 2009 Lester S la upervisor of Elections Miami-Dade County Please submit a checkfor $5.'00 tolo S'00toloruri,office.p'ayable.to the `Board.tof Coun�ty,a. LOi'.cc Commissioners"fir the cost fveray /znglC se sagnaturestJ I, PETITION We, the undersigned electors ofN iami Shores Village, hereby nominate k�c E Le,,S for a position on the Village Council. PRINT NAME ADDRESS SIGNATURE DATE tt av►a Lug 5 G 10 AJEia s-h-C;*tg(" p �S kDE- 9 9 Sf rtl EcS. t g��S4- kLi ar, -- � d� a �300 ►� 71 o wb w 6-LO The undersigned is the circulator of the foregoing paper containing signatures. Each appended thereto was made in my presence and ispnume signature of the person whose name it purports to-be. Signature of Circulator Address I���l d /�.�• �' f�"`� .Acceptance.of Nomination I hereby accept the nomination for the Village Council and agree to serve if elec �° Signature of Candi PETMON We, the undersigned electors of Nfiami Shores Village, hereby nominate for a position on the Village-Council. PRINT NAME ADDRESSATURE DATE 14<--e-- 6"6q A) IV ct3 s� C� Tk� 3' 7 z� C 'C, 3 - AdzZ 57 NL 2-6k- opt G J-3 �� 7JMwil ;F Ilk i The undersigned:is.theirculator of the foregoing paper containing signatures. Each a pended thereto was made in my presence and-is the enume signature of the person whose name it purports to be. Signature of Circulator. Address Acceptance of Nomination ` I hereby-accept-the nomination for the VillageCouncil and agree to serve if elected. 1 ''�' Signature of Candidate PETITION We;the undersigned electors of Miami Shores Village, hereby nominate for a position on the Village Council. PRINT NAME ADDRESS SIGNATURE DATE fit/ Oq S� 317 d PS Nt C,111"k sf 3/7/0� t rdlZ/ AjE /3)ULo, W445-ff 107 N 9A0 0 �(,7-c J q q U D\, in Zylo 3T��t The undersigned is the circulator ofthe foregoing paper containing signatures. Each appended thereto was made in my presence-and is eine si of whose-name:it purports to be. Signature of Circulator Address q qgl d n w Acceptance of Nomination I hereby accept the nomination for the-Village Council and agree to serve if elected. �' Signature of Candidate PETITION f f We, the undersigned electors of Miami Shores Village, hereby nominate L�a l Letit for a position on the Village Council. RINT NAME ADDRESS IGNATLTRE DATE e� ►ss� l..kTv S� I�o �r c�cro� "if-3,ola o viam\-e- Nart 3 Ow tea' � � �L4) .�j-1•�/az C>0,4-e, q 2/ 6.t/�.�t� Cu . C o✓.c s.+ 7 c sfi 4) The undersigned is the circulator of the foregoing paper containing signatures. Each appended thereto was made in my presence and is thesignature of the person whose.narae it purports to be. Signature of Circulator ss. / Acceptance of Nomination I:hereby.accept the-nomination for the Village Council and agree to serve ifelected Signature of Candidate' FORM 1 STATEMENT OF 2008 Please print or type your name,mailing FINANCIAL INTERESTS address,agency name,and position below: . LAST NAME—FIRST NAME—MIDDLE NAME: FOR OFFICE Lewis Eddie USE ONLY: MAILING ADDRESS: 9490 NW 1 Ave. ID Code P.O. BOX 53-1171 CITY: ZIP: COUNTY: MIAMI SHORES 33153-2206 MIAMI-DADE ID No. NAME OF AGENCY: Conf.Code NAME OF OFFICE OR POSITION HELD OR SOUGHT: P.Req.Code MIAMI SHORES VILLAGE COUNCIL You are not limited to the space on the lines on this form.Attach additional sheets,if necessary. CHECK ONLY IF [a CANDIDATE OR NEW EMPLOYEE OR APPOINTEE "BOTH PARTS OF THIS SECTION MUST BE COMPLETED" DISCLOSURE PERIOD: THIS STATEMENT REFLECTS YOUR FINANCIAL INTERESTS FOR THE PRECEDING TAX YEAR,WHETHER BASED ON A CALENDAR YEAR OR ON A FISCAL YEAR. PLEASE STATE BELOW WHETHER THIS STATEMENT IS FOR THE PRECEDING TAX YEAR ENDING EITHER(check one): O DECEMBER 31,2008 QR ❑ SPECIFY TAX YEAR IF OTHER THAN THE CALENDAR YEAR: MANNER OF CALCULATING REPORTABLE INTERESTS: THE LEGISLATURE ALLOWS FILERS THE OPTION OF USING REPORTING THRESHOLDS THAT ARE ABSOLUTE DOLLAR VALUES, WHICH REQUIRES FEWER CALCULATIONS, OR USING COMPARATIVE THRESHOLDS, WHICH ARE USUALLY BASED ON PERCENTAGE VALUES (see instructions for further details). PLEASE STATE BELOW WHETHER THIS STATEMENT REFLECTS EITHER(check one): ❑ COMPARATIVE(PERCENTAGE)THRESHOLDS QR 0 DOLLAR VALUE THRESHOLDS PART A—PRIMARY SOURCES OF INCOME [Major sources of income to the reporting person] NAME OF SOURCE SOURCE'S DESCRIPTION OF THE SOURCE'S OF INCOME ADDRESS PRINCIPAL BUSINESS ACTIVITY NATIONWIDE RETIREMENT SOLUTIONS PO Box 182797 Columbus,Ohio 43218 20000 PART 8—SECONDARY SOURCES OF INCOME[Major customers,clients,and other sources of income to businesses owned by the reporting person] NAME OF NAME OF MAJOR SOURCES ADDRESS PRINCIPAL BUSINESS BUSINESS ENTITY OF BUSINESS'INCOME OF SOURCE ACTIVITY OF SOURCE PART C—REAL PROPERTY [Land,buildings owned by the reporting person] FILING INSTRUCTIONS for when and where to file this form are locat- 9490 NW 1 Ave Miami Shores,FL ed at the bottom of page 2. INSTRUCTIONS on who must file this form and how to fill it out begin on page 3. OTHER FORMS you may need to file are described an page 6. CE FORM 1 -Eff. 1/2009 (Continued on reverse side) PAGE 1 PART D—INTANGIBLE PERSONAL PROPERTY[Stocks,bonds,certificates of deposit,etc.] TYPE OF INTANGIBLE BUSINESS ENTITY TO WHICH THE PROPERTY RELATES PIONEER INVESTMENTS STOCKS NATIONWIDE SOLUTIONS STOCKS PART E—LIABILITIES [Major debts] NAME OF CREDITOR ADDRESS OF CREDITOR DADE COUNTY FEDERAL P.O.BOX 36631-8281 PROVIDIAN WWW:PROVIDIN.COM PART F—INTERESTS IN SPECIFIED BUSINESSES [Ownership or positions in certain types of businesses] BUSINESS ENTITY#1 BUSINESS ENTITY#2 BUSINESS ENTITY#3 NAME OF BUSINESS ENTITY ADDRESS OF BUSINESS ENTITY PRINCIPAL BUSINESS ACTIVITY POSITION HELD WITH ENTITY I OWN MORE THAN A 5% INTEREST IN THE BUSINESS NATURE OF MY OWNERSHIP INTEREST IF ANY OF PARTS A THROUGH_F RE CONTINUED ON A SEPARATE SHEET, PLEASE CHECK HERE ❑ SIGNATURE(required): `'DATE SIGNED(required): FILING INSTRUCTIONS: WHAT TO FILE: WHERE TO FILE: WHEN TO FILE: After completing all parts of this form, including If you were mailed the form by the Commission Initially, each local officer/employee, state signing and dating it, send back only the first on Ethics or a County Supervisor of Elections for officer, and specified state employee must sheet(pages 1 and 2)for filing. your annual disclosure filing, return the form to file within 30 days of the date of his or her that location. appointment or of the beginning of employ- If you have nothing to report in a particular Local oment. Appointees who must be confirmed by fi4cers/emp/ogees file with the Supervisor section, you must write "none" or "Na" in that the Senate must file prior to confirmation,even of Elections of the county in which they perma- section(s). nently reside. (If you do not permanently reside if that is less than 30 days from the date of their in Florida,file with the Supervisor of the county appointment. Facsimiles will not be accepted. where your agency has its headquarters.) Candidates for publicly-elected local office NOTE: State officers or specked state employees must file at the same time they file their MULTIPLE FILING UNNECESSARY: file with the Commission on Ethics, P.O. Drawer qualifying papers. Generally, a person who has filed Form 1 for a 15709, Tallahassee, FL 32317-5709; physical Thereafter, local officers/employees, state calendar or fiscal year is not required to file a address: 3600 Maclay Boulevard, South, Suite officers, and specified state employees are second Form 1 for the same year. However, a 201,Tallahassee,FL 32312. required to file by July 1st following each candidate who previously filed Form 1 because Candidates file this form together with their calendar year in which they hold their posi- of another public position must at least file a copy qualifying papers. tions. of his or her original Form 1 when qualifying. Finally, at the end of office or employment, To determine what category your position each local officer/employee, state officer, and falls under,see the'Who Must File"Instructions on page 3. specified state employee is required to file a final disclosure form(Form 1F)within 60 days of leaving office or employment. CE FORM 1-Eff. 1/2009 PAGE 2 SENDER: COMPLETE THIS SECTION COMPLETE THIS SECTION ON DELIVERY ■ Complete items 1,2,and 3.Also complete A. Sign item 4 if Restricted Delivery is desired. ❑Agent ■ Print your name and address on the reverse X ❑Addressee so that we can return the Card to you. . Received by(Printed Name) C. Date of Delivery ■ Attach this card to the back of the mailpiece, = ` or on the front if space permits. D. Is delivery address different from item 1? ❑Yes 1. Article Addressed to: If YES,enter delivery address below: ❑ No add►e �.W t5 �7e 94Qo N.cu. Isr eve laN - Shy2 s 331 So 3. Service Type 0 Y, C Certified Mail ❑ Express Mail ❑ Registered ❑ Return Receipt for Merchandise ❑ Insured Mail ❑C.O.D. 4. Restricted Delivery?(Extra Fee) ❑Yes 2. Article Number 7 ��'O Owl ^o[W) i'�i 0 f (Transfer from service labelabel) (�X 1� PS Form 3811,August 2001 Domestic Return Receipt 102595-02-M-1540 I 11 it 11lll ill I . 11 11I II it iI - UNITED STATES POSTAL SERVICE First-Class Mail Postage&Fees Paid USPS Permit No. G-10 • Sender: Please print your name, address, and ZIP+4 in this box • m i00 es �.t We-- [00sQ VV��aw�i S�AMP s, t a O . .- N OFFICIAL MPostage $ 143LX66£s zr Certified Fee S� r=1 Postmark O Return Receipt Fee O (Endorsement Required) 3 aL Mot H"Y � C3 Restricted Delivery Fee r3 (Endorsement Required)11-9 cD Total Postage&Fees Ls 5 �8 S3b0 ru CO Sent To Stress Apr 1�0:; .. _�_ __l.Xc1]a.ls......................... ..... ------------------- ----_.... -- ..._.._..-- City,state,ZII M . - Certified Mail Provides: ■ A mailing receipt ■ A unique Identifier for your maliplece ■ A record of delivery kept by the Postai Service for twoyears Important Reminders: ■ Certified Mail may ONLY be combined with First-Class Mail®or Priority Mails ■ Certified Mail is not available for any class of international mail. ■ NO.INSURANCE COVERAGE IS PROVIDED with Certified Mail. For Valuables,please consider Insured or Registered Mail. ■ For an additional fee,a Return Recelpt may be requested to provide proof of delivery.To obtain Return Receipt service,please complete and attach a Return Receipt(PS'Form 3811)to the article and add applicable postage to cover the fee.Endorse mailpiece'Return Receipt Requested".To receive a fee waiver for a duplicate return receipt,a USPS®postmark on your Certified Mail receipt is required._ ■For'an additiorial fee, delivery may be restricted to the addressee'or addressee's authorized agent.Advise the clerk or mark the mailpiece with the endorsement'Restricted Delivery. ■ If a postmark on the Certified Mail receipt is desired,please present the arti- cle at the post office for postmarking. If a postmark on the Certified Mail receipt is not needed,detach and affix label with postage and mail. IMPORTANT:Save this receipt and present It when making an Inquiry. "PS Form 3800,August 2006(Reverse)PSN 7530-02.001)-9047 k LOYALTY OATH FOR OFFICE USE ONLY NON-PARTISAN OFFICE (Sections 876.05-876.10,Florida Statutes) STATE OF FLORIDA MIAMI-DADE ,COUNTY j EDDIE LEWIS First Name Middle Narnaftitial Last Name a citizen of the State of Florida and of the United States of America. . . . and a candidate for public office. . . do hereby solemnly swear or affirm that I will support the Constitution of the United States and of the State of Florida. OATH OF CANDIDATE (Section 99.021,Florida Statutes) j� EDDIE LEWIS (PLEASE PRINT NAPE AS YOU WISH IT TO APPEAR ON THE BALLOT-NAME MAY NOT BE a MKiED AFTER THE END OF QUAUMM) am a candidate for the office of MIAMI SHORES VILLAGE COUNCIL (office) (district) (group) My legal residence is MIAMI - DADE County, Florida. I am qualified under the Constitution and the Laws of Florida to hold the office to which I desire to be nominated or elected. I have qualified for no other public office in the state, the term of which office or any part thereof runs concurrent with the office I seek; and I have resigned from any office from which 1 am required to resign pursuant to Section 99.012, Florida S es. 305 812-8516 EDDIELEWIS99@MSN.f Sig of Candidate Daytime Telephone Number Email Address 9490 N.W. 1s .AVE MIAMI SHORES FL 331532206 Address city State ZIP Code Swornto(or affirmed)and subscribed before me this day of 200 9 Personally Known:_�or Produced Identification: YL Type of Identification Produced: Signature of Notary Public—Stat of Florida Print,Type or Stamp Commissioned Nam of Notary Public o v mt�L idn'aro°iablic State of Florida ter;Co voni,,svi 00510584 DS-DE 26(05108) C.1932 Sa� �crixa �pefi, WWF gni Pal rirn't1! . �LQR1DA, �0050C� ,�'� March 16, 2009 "Mn Eddie Lewis 9490 N.W. ''.'Avenue'. Midmi Shores, FL 33150 Dear. Hunt: . " Congratulations on becoming an°announced candidate for Miami'Shores Village! Please be advised that:as a,candidate for the Village Council,you are required to file, Campaign T,reasurer's Reports on the dates shown below:. Due.Date Period Ending First Treasurer's Report 03/25/09 03/20/09 Second Treasurer's Report' 04/10/09 04/09/09 Within ninety (90' ) days after having been elected; eliminated, or withdrawing your candidacy, you must dispose of your`campaign fund account and file a final report. Final Treasurer's Report Due 07/1.3%09 Reports'shall be filed no later than 5:00 PM on the designated day, however, any report' postmarked by the U.S. Postal Service no`later than midnight the designated day shall be deemed to have been filed'in a timely manner. �,Goaus. (305)995--2207 Caa 805)956-8972 �P- acl ee (t�Xivaincvlcax Mr. Eddie Lewis March 16, 2009 Page Two At 10:00 AM on-April-9, 2009, in accordance with Section 101.5612, Florida Statutes, a logic and accuracy test will be conducted on the automatic tabulating equipment to be used'in the Miami Shores Village Council election. The test will be held at the County's Division of Elections office, located at 2700 N.W. 87th Avenue, Doral, Florida. If I can-be of any assistance during your campaign, please do not hesitate to contact me look forward to working with you in the coming weeks. Sincerely, Barbara A. Estep, MMC Village Clerk Certified.Mail:— Return Receipt Requested 'Candidate qualifying letter" Elections 2700 NW 87th Avenue MIAMI .,-DADE Miami, Florida 33172 T 305-499-VOTE F 305-499-8547 TTY: 305-499-8480 miamidade.gov March 13, 2009 Barbara Estep, Village Clerk Miami Shores Village 10050 NE 2"d Ave. Miami Shores, FL 33138 Dear Ms. Estep: The Miami-Dade County Elections Department has completed the verification of the petitions for Eddie Lewis, a candidate for Village Council. A total of 67 petitions were submitted and all were reviewed for verification. Of the total 67 petitions, 58 were certified. There will be no charge for the additional petitions that were verified. The Miami-Dade County Charter requires this process to include the following. For purposes of signature verification, however my office does not review this information, and encourages the municipality to ensure compliance with municipal charter or code requirements. • Title not being in English, Spanish, and Creole • Circulator was not a registered voter in Miami-Dade County • Notary did not comply with F.S. 117.05 • Notary was the same person as the circulator • Signatures of the circulator and the notary were dated earlier than any of the dates on which the electors signed the petition As such, please find the certification for the petition enclosed. Should you have any questions or concerns, please feel free to contact me or Michelle Giles, Acting Deputy Supervisor of Elections for Voter Services at 305-499-8302. Sincerely, XLester Sol Supervisor of Elections Miami-Dade Elections Department Enclosure !SROM FAX NO. Mar. 13 2009 04:02PM P2 Elections M I A M hDADE 2 700 NW 87th Avenue Miami, Florida 33172 1'105-499-V(')'Tr. r 305-499-0547 l 1 Y:.105-/i99-8480 memidade.gov CERTIFICATION STATE OF FLORIDA) COUNTY OF MIAMI-DADE) 1, Lester Sola, Supervisor of Elections of Miami-Dade County, Florida, do hereby certify that 58 signatures submitted by Eddie Lewis for the office of Village Council in Miami Shores Village matched the signatures on the voter files. WITNESS MY HAND AND OFFICIAL SEAL, AT MIAMI, MIAMI-DADE- COUNTY, FLORIDA, ON THIS 13th DAY OF MARCH 2009 Lester S .la upervisor of Elections Miami-Dade County Please submit a check for$S:00, to our.:office payable to the."13aard c fCdunty Commissioners"for the cost of verifying these signatures. 'FROM FAX NO. Mar. 13 2009 04:02PM P3 Elections 2700 NW 8711)Avenue MIAMI•DADE Miami, Florida *33,72 T 305 499-Vo)TF F 305-499-8547 T I Y- 305-499-8480 miamidade.gov March 13, 2009 Barbara Estep, Village Clerk Miami Shores Village 10050 NE 2"d Ave. Miami Shores, FL 33138 Dear Ms. Estep: The Miami-Dade County Elections Department has completed the verification of the petitions for Eddie Lewis, a candidate for Village Council. A total of 67 petitions were submitted and all were reviewed for verification. Of the total 67 petitions, 58 were certified. There will be no charge for the additional petitions that were verified. The Miami-Dade County Charter requires this process to include the following. For purposes of signature verification, however my office does not review this information, and encourages the municipality to ensure compliance with municipal charter or code requirements. • Title not being in English, Spanish, and Creole • Circulator was not a registered voter in Miami-Dade County • Notary did not comply with F.S. 117.05 • Notary was the same person as the circulator • Signatures of the circulator and the notary were dated earlier than any of the dates on which the electors signed the petition As such, please find the certification for the petition enclosed. Should you have any questions or concerns, please feel free to contact me or Michelle Giles, Acting Deputy Supervisor of Elections for Voter Services at 305-499-8302. Sincerely, Lester Sol Supervisor of Elections Miami-Dade Elections Department Enclosure -FROM FAX NO. Mar. 13 2009 04:02PM P1 2700 NW 87°i Avenue Miami,FL 33157 (305)489-8304 Elections Department Fca3x To: Barbara Este From: P Michelle Giles Fax: 305 756-8972 Pages: 3, including cover page Phone: Date: 3/13/09 Re: Eddie Lewis cc: 0 Urgent 0 For Review D Please Comment 0 Please Reply A Please Recycle • Comments: STATE OF FLORIDA OFFICE USE ONLY APPOINTMENT OF CAMPAIGN.TREASURER- AND DESIGNATION OF CAMPAIGN DEPOSITORY FOR CANDIDATES (Section 106.021(1),f.S.) (PLEASE TYPE) CHECK APPROPRIATE BOX: Original Appointment Deputy Treasurer © Reappointment of Treasurer Name of Candidate 1 Address(include post office box or street;city;state,zip code) EDDIE LEWIS 9490 N. W. 1 AVE P.O. .BOX.53-1171 Telephone(optional) 2. Party(Partisan candidates only) 3.Office(add district,circuit,group number) 305 61248516. 1 1 MIAMI SHORES VILLAGE.COUNCIL I have appointed the following person to act as my a Campaign Treasurer Deputy Treasurer d.Name of Treasurer or Do"Treasurer LEROY:BRADSHAW .5.Mailing Address-of post office box or.drawer.add.street address) 6.-Telephone 3980 N.W. 176 STREET 3057409-0040 7.City 8.County 9.State 10.Zip Code MIAMI GARDENS MIAMI-DADE FL 133056 I have designated the following named:bank as my El Primary Depository E Secondary Depository 11. Name of Bank 12.StreefiAddress BANK OF AMERICA 9499 N.E. 2 AVE 13.City 14.County 15:State 16:Zip Code MIAMI SHORES MIAMI - RADE FL 33153 17.Sig i Date 6�rIfpaign Treasurer's Acceptance of Appointment 1, LEROY BRADSHAW do hereby accept the appointment as (Please Print or Type) Campaign Treasurer [] Deputy Treasurer for the campaign of EDDIE LEWIS who is seeking nomination or election as a MIAMI SHORES VILLAGE COUNCIL candidate to the office of (Party) City Council UNDER PENALTIES OF PERJURY,I DECLARE.THAT[HAVE READ.THE FOREGOING CAMPAIGN TREASURER'S. ACCEPTANCE OF APPOINTMENT AND THAT THE.FACTS STATED ARE TRUE. Date. Signature.of paign.Treasurer or.Deputy.Treasurer DS-DE 9(Rev.01108) STATE OF FLORIDA OFFICE USE ONLY APPOINTMENT OF CAMPAIGN.TREASURER AND DESIGNATION OF CAMPAIGN DEPOSITORY FOR CANDIDATES (Section 106:021(1),F.S.) (PLEASE TYPE) CHECK APPROPRIATE BOX: Original Appointment Deputy Treasurer Reappointment of Treasurer F idate 1.Address(include.post office box or street;.city;state,zip°code) VIFIS 949:0 N. W. LAVE P.O. BOX-53-1 171 Telephone(optional) 2. Party(Partisan candidates only) 3.Office(add district,circuit,group number) 305 s121516. MIAMI.SHORES VILLAGE COUNCIL 1-have appointed the following:person to act as my Campaign Treasurer 0 Deputy Treasurer 4.Mame of Treasurer or Deputy Treasurer LEROY-BRADSF AW -5.:Mailing.Address.Of post office:box or drawer add street.address) 6.Telephone 3980 N.W. 176 STREET 305/409-0040 7.City 8.County 9.State 10.Zip Code MIAMI GARDENS MIAMI DADS FL 33056 1 have designated the following.named:bank as my. .Primary Depository Secondary Depository 11.Name of Bank 12.Street Address B ANKK OF AMERICA 19499-N.E. 2 AVE 13.City 14;County 15:State 16:Zip Code MIAMI SHORES MIAMI -DADE FL 133153 17.Signature of Candidate Date Campaign Treasurer's Acceptance of Appointment 1, LEROY BRADSH.AW do hereby accept the appointment as (Please Print or Type) "Campaign Treasurer Deputy Treasurer for the campaign of EDDIE LEWIS who is seeking nomination or election:as a MIAMI SHORES VILLAGE COUNCIL candidate to the office of (Party) City Council UNDER.PENALTIES OF PERJURY,I DECLARE.THAT I.HAVE READ.THE-FOREGOING CAMPAIGN.TREASURER'S ACCEPTANCE OF APPOINTMENT AND THAT THE.FACTS STATED ARE TRUE. 31/o/d� X LLkj &,rX"dt,tA) Data. Signature,ofGdmpaign.Treasurer or.Deputy.Treasurer DS-DE 9(Rev.01108) Stic. I ORES logo 8111. X0050 C��p. R1 2009 Candidate Name: (e Lewt Address: Telephone Numbers: 30s -Ra - Rs 16 - E-Mail Address: El.11 e(_t 1S (3q ayyy V\,C.()M CANDIDATE INFORMATION REQUIRED FOR QUALIFYING FOR VILLAGE COUNCIL ELECTION Confirm Address and Voter's Registration Information Confirm Length of Residence in Miami Shores V Campaign Account &Treasurer's Appointment Form 1 Financial Disclosure J Loyalty& Candidate's Oath JStatement of Candidate SO Signatures on Nominating Petition Confirmed by Miami-Dade County Elections J', ,8051795-2207 305)756-897.2 SgORE,S to iDA X0050 oWW , March,11; 2009 Ms. Ivy Korman Miami-Dade County Elections Department 2700 N.W. 871h-Avenue , Miami, FL 33172 Dear Ivy: Enclosed please find Petition Forms (4) from Eddie Lewis, in reference to the Miami Shores Village April 14, 2009 Council Election. Per our:Charter, prospective candidates must obtain fifty (50) signatures of qualified electors in order to qualify for our election. Please verify the signatures on the attached petitions at your earliest convenience. If you have any questions, please do not hesitate to contact me directly at 305-762- 4851. Sincerely, Barbara A. Estep, MMC Village Clerk �i�Coace: (305)795-2207 arra: r05)756-89972 `�P-C�acl eo��4@�leorea�k/lrcSe.cam PETITION We, the undersigned electors of Miami Shores Village, hereby nominate a/(e for a position on the Village Council. PRINT NAME ADDRESS SIGNATURE- DATE � ,`c LOQ �0 Ak i 3 5-tyc x- ky5 kDE 9 9 si C 1112 LO LSLO� -71 ;3 . CttoQq f h% S.7, t tif 01- i-el (_112TAVAThe undersigned is the circulator of the foregoing paper containing i signatures. Each appended thereto was made in my presence and is mine signature off the person whose name it purports to-be. Signature of Circulator Address A-1,661' Acceptance of Nomination I hereby-accept the nomination for the Village Council and agree to serve if elec .f Signature:of Candi- . f PETTTTON . We, the undersigned electors of Miami Shores Village, hereby nominate r��►� .�� , for a position on the Villagt Council. PRINT NAME ADDRESS ATURE DATE c-e- 64-eA k) �'d�,i c� Al Z- /67 1 .: 7 �I glib ,16 5-5 IV r t 4D. 9� 622 /�/O 195-j ZIA2, "7 f A ? N L02- WNW 2 N 3" 6 9 The undersigned.is the ircutator of the foregoing paper containing .signatures. Each a pend thereto was made in mypresence and is the_genuine signature of the person whose name it purports to be: Signature of Circulator. Address Acceptance of Nomination I hereby accept-the nomination for the Village Council and agree to serve if elected. Signature of Candidate PETITION We, the undersigned electors of Miami Shores Village, hereby nominate �c7� L -�✓1 for a position on the Village Council. PRINT NAIVM ADDRESS SIGNATURE : DATE ( Opt S I 3rk 17 �C lob' q1, Sfi _ Q 7/0 idlZ� L f. 100 o l L)C 102- s-f CVI;:� I Kolze_ _0012 /At loer-O:�_ 3-7- o7 —7Z7 a-y2u-' -Q _57, 3 7 7 7 zM The undersigned is the circulator of the foregoing paper containing, signatures. Each appended thereto wars made in my presence and is nuine si tore of whose-name it.purports to be. Signature of Circulator Address Acceptance of Nomination I hereby accept.the nomination for the Village Council and agree to serve if elected. Signature of Candidate PETITION We, the undersigned electors of Miami Shores Village, hereby nominate Let for a position on the Village Council. PRINT NAME ADDRESS IGNATURE DATE 0 � i IND Mark Lg cj�baL Mai,4 Lec*6- Ofw�� 5 '�6n j' 1�lAfL 300N� �� S�� 3 6G/.'Z!f t e-tet 7 2 I �g iL��E� �c.. C p•�.e.Sb VV r / The undersigned is the circulator of the foregoing paper containing signatures. Each appended thereto` was made in my presence and is.the ge a.signature of the person-whose name it purports to be. Signature of Circulator _ Adeess y'yi� Acceptance of Nommation .I hereby.accept.the.nomination.forthe Village Council and agree to serve if elected Signature of Candidate �j Miami-Dade Supervisor of Elections M1AM�•KE " 2700 NW 87th Avenue Miami, FL 33172 (305) 499-8400 RECEIPT OF HANDBOOKS AND THE ELECTION LAW BOOK Candidate: C'c7c' First Name Middle Name Last Name Office: C This is to acknowledge my receipt of the following documents: ❑ The Election Laws of the State of Florida August 2006 LJ2006 Candidate and Campaign Treasurer Handbook 2008 Miami-Dade County Qualifying Handbook Received by: Candidate Signature Date: j A'_#1-- C� 7 Phone No.: Fax No.: E-mail address: ��d`� ��`"'` 5 S ej, �''� MD-ED 2 (Rev.03/07) Miami-Dade Miami-Dade Supervisor of Elections 111 NW 1 Street, Suite 1910 ,�czro.�s Miami, FL 33128-1962 (305) 375-5553 RECEIPT Candidate: First Name Middle Name Last Name Office: This is to acknowledge my receipt of the following documents: Qualifying Handbook for Municipal Cabdidates Received by: Can date Signature Date: O/ T:TacketaO02 Packe \New Municipalirylmunipal qualif*g infw=ion.doc DECLARATION FOR CANDIDATES NOT AUTOMATICALLY COVERED BY THE MIAMI-DADE ETHICAL CAMPAIGN PRACTICES ORDINANCE The Ethical Campaign Practices Ordinance may apply to any candidate, and his or her campaign staff, for elective office with a constituency in whole or in part in Miami-Dade County who agrees to abide by the mandatory and/or voluntary fair campaign practices. I, X/rr e L ems s 4� ,a candidate for the office of CO Uyk C agree to abide by the mandatory fair campaign practices as provided in Section 2-11.1.1(C)(1)of the Code of Miami-Dade County and recognize as compulsory the jurisdiction of the Ethics Commission. I further agree that the Ethics Commission will have the authority to decide whether said candidate has violated the mandatory campaign practices and, if a violation is found,the Ethics Commission has the authority to impose the appropriate penalty, if any. By signing this declaration, I acknowledge that I will follow the mandatory campaign practices and shall not: a) with actual malice make or cause to be made any untrue oral statement about another candidate or a member of his or her family or staff which exposes said person to hatred,contempt,or ridicule, or causes said person to be shunned or avoided,or injured in his or her business or occupation;or b) with actual malice publish or cause to be published by writing,printing,picture, effigy,sign or otherwise than by mere speech any untrue statement about another candidate or a member of his or her family or staff which exposes said person to be shunned or avoided,or injured in his or her business or occupation;or c) willfully injury,deface or damage or cause to be injured,defaced or damaged by any means any campaign poster,sign,leaflet,handbill, literature or other campaign material of another candidate; or d) knowingly obtain,or cause to be obtained campaign property of another candidate with the intent to,temporarily or permanently, deprive the candidate of a right to the property or a benefit therefrom; or e) knowingly file with the Ethics Commission a groundless or frivolous complaint against another candidate; or f) knowingly fail to remove a campaign sign within thirty(30)days of the last election in which the candidate was on the ballot;or g) knowingly erect or cause to be erected a campaign sign within the right-of-way limits of any County-maintained road in Miami-Dade County. a candidate for the office of agree to abide by the Statement of Fair Campaign Practices mandatory fair campaign practices as provided in Section 2-11.1.1(C)(1)of the Code of Miami-Dade County and described on the previous page and recognize as compulsory the jurisdiction of the Ethics Commission. I further agree that the Ethics Commission will have the authority to decide whether said candidate has violated the Statement of Fair Statement Campaign Practices and, if a violation is found,the Ethics Commission has the authority to impose the appropriate penalty, if any. Once the decla s ned it is deemed irrevocable for the duration of the campaign. 3t� - <3<;' Signature Date PLEASE FILE FORM(S)WITH THE MIAMI-DADE COMMISSION ON ETHICS AND PUBLIC TRUST AND THE MIAMI-DADE SUPERVISOR OF ELECTIONS. Miami-Dade Commission on Ethics Miami-Dade Supervisor of Elections 19 West Flagler Street 2700 N.W. 87th Avenue Suite 220 Doral,Florida 33172 Miami,FL 33130 Once the declaration is signed it is deemed irrevocable for the duration of the campaign. r-- ---------------- --------------- ----------------------------- 3 /"V4-t< 07 Si ature Date In addition to abiding by the Mandatory Campaign Practices,I agree to follow the voluntary Statement of Fair Campaign Practices enumerated in Section 2-11.1(D): 1. I shall not make my race, religion, national origin, gender,physical disability or sexual orientation an issue in my campaign. 2. 1 shall not make my opponents' race,religion, national origin,gender,physical disability or sexual orientation an issue in my campaign. 3. I will condemn any appeal to prejudice based on race,creed,national origin, religion, gender,physical disability or sexual orientation. 4. I shall not without just cause attack or question my opponent's patriotism. 5. I shall not publish,display or circulate any anonymous campaign literature or political advertisement. 6. I shall not tolerate my supporters engaging in these activities which I condemn nor shall I accept their continued support if they engage in such activities. I will not permit any member of my campaign organization to engage in these activities and will immediately and publicly repudiate the support of any other individual or group,which resorts to the methods and tactics I condemn. 7. I shall run a positive campaign emphasizing my qualifications for office and positions on issues of public concern. 8. I will limit my attacks on an opponent to legitimate challenges to that person's record,qualifications,and positions. 9. I will neither use nor permit the use of malicious untruths or innuendoes about an opponent's personal life,nor will I make or condone unfounded accusations discrediting that person's credibility. 10. I will take personal responsibility for approving or disavowing the substance of attacks on my opponent that may come from third parties supporting my candidacy. 11. I will not use or permit the use of campaign material that falsifies, distorts,or misrepresents facts. OFFICE USE ONLY STATEMENT OF CANDIDATE (Section 106.023, F.S.) (Please Type) I, EDDIE LEWIS candidate for the office of City Council have received, read and understand the requirements of Chapter 106, Florida Statutes. X 21 FEB 09 Signa of Candidate Date Each candidate must file a statement with the qualifying officer within 10 days after the Appointment of Campaign Treasurer and Designation of Campaign Depository is filed. Willful failure to file this form is a first degree misdemeanor and a civil violation of the Campaign Financing Act which may result in a fine of up to $1,000, (ss. 106.19(1)(c), 106.265(1), Florida Statutes). DS-DE 84(Rev.03/08) FLORIDA DEPARTMENT OF STATE DIVISION OF ELECTIONS CAMPAIGN TREASURER'S REPORT SUMMARY (1) EDDIE LEWIS OFFICE USE ONLY Name (2) 9490 NW 1st AVENUE Address (number and street) MIAMI SHORES, FL 33153 City, State,Zip Code ❑ CHECK IF ADDRESS HAS CHANGED (3) ID Number: (4) Check appropriate box(es): © Candidate (office sought): Councilman - Miami Shores Village Council ❑ 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 IDEM TIFIERS Cover Period: From 04 / 10 / 2009 To gr' / & / 2009 Report Type [21 Original ❑Amendment ❑ Special Election Report ❑ Independent Expenditure Report (6) CONTRIBUTIONS THIS REPORT (7) EXPENDITURES THIS REPORT Monetary Cash $Checks $ 0.00 Expenditures $ 144 . 87 Loans $ 75 . 00 Transfers to Office Account $ 0. 00 Total Monetary $ 75 . 00 Total Monetary $ 144 . 87 In-Kind $ 0 . 00 (8) Other Distributions $ 0 . 00 (9) TOTAL Monetary Contributions To Date (10) TOTAL Monetary Expenditures To Date $ 1, 742 .21 $ 1, 742 .21 (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) Leroy Bradshaw (Type name) Eddie Lewis ❑Individual(only for 0 Treasurer ❑Deputy Treasurer L[ZICandidate Chairperson(only for PC,PTY& electioneering commun.) electioneering commun.organization)XI W-Z L-7 Signatureure DS-DE 12(Rev.08/04) CAMPAIGN TREASURER'S REPORT- ITEMIZED CONTRIBUTIONS (1) Name EDDIE LEWIS (2) I.D. Number (3) Cover Period 04 / 10 / 2009 through 07 / / 2009 (4) Page 1 of 1 (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 Lewis, Eddie 75.00 04 / 10 /2009 9490 NW 1st AVENUE I Entrepre LOA Miami Shores, FL nuer 33153 1 DS-DE 13(Rev.08103) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES CAMPAIGN TREASURER'S REPORT- ITEMIZED EXPENDITURES (1) Name EDDIE LEWIS (2)I.D. Number (3)Cover Period 04 / 10 / 2009 through 07 / 2009 (4)Page 1 of 1 (5) (7) (8) (9) (10) (11) Date Full Name Purpose (6) (Last,Suffix, First, Middle) (add office sought if Expenditure Sequence Street Address& contribution to a P Number City,State,Zip Code candidate) Type Amendment Amount Despinose, Jacques Count and MON $12.00 04 10 109 17745 NW 19th Ave organize signs Miami Gardens, FL 33055 & flyers 1 Lewis, Eddie close campaign MON $132.87 06 /26 /09 9490 NW 1st Avenue account. Miami Shores, FL 33153 repay loan 2 DS-DE 14(Rev.08/03) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES FLORIDA DEPARTMENT OF STATE DIVISION OF ELECTIONS CAMPAIGN TREASURER'S REPORT SUMMARY (1) EDDIE LEWIS OFFICE USE ONLY Name (2) 9490 NW 1st AVENUE Address (number and street) MIAMI SHORES, FL 33153 City, State,Zip Code ❑ CHECK IF ADDRESS HAS CHANGED (3) ID Number: (4) Check appropriate box(es): © Candidate (office sought): Councilman - Miami Shores Village Council ❑ 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 03 / 21 / 2009 To 04 / 09 / 2009 Report Type G4 ® Original ❑Amendment ❑ Special Election Report ❑ Independent Expenditure Report (6) CONTRIBUTIONS THIS REPORT (7) EXPENDITURES THIS REPORT Monetary Cash &Checks $ 100 . 00 Expenditures $ 1, 597.34 Loans $ 1,40S .00 Transfers to Office Account $ 0 .00 Total Monetary $ 1, 505 . 00 Total Monetary $ 1, 597 .34 In-Kind $ 0 . 00 (8) Other Distributions $ 0. 00 (9) TOTAL Monetary Contributions To Date (10) TOTAL Monetary Expenditures To Date $ 1, 667.21 $ 1, 597 . 34 (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) Leroy Bradshaw (Type name) Eddie Lewis ❑individual(only for [Z]Treasurer ❑Deputy Treasurer Q Candidate ❑Chairperson(only for PC,PTY& electioneering commun.) electioneering commun.organization) X AeA&J &6= X Signatureignature DS-DE 12(Rev.08104) CAMPAIGN TREASURER'S REPORT- ITEMIZED EXPENDITURES (1) Name EDDIE LEWIS (2) I.D. Number (3)Cover Period Q3 / 21 / 2009 through 04 09 / 2009 (4)Page 1 Of 1 (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 M S Greater Miami Shores Miami Shores MON $400.00 09 03 25 9701 NE 2nd Ave Chamber of Miami Shores, FL 33138 Commerce 1 Mailouts CK #: 1026 The Signs and Printing Store Print cards MON $208.65 03 /25 /09 10501 South Dixie Hwy and Signs Miami, FL 33156 CK #: 1027 2 All in One Mail Shop All in One MON $189.00 03 31 09 11950 SW 128th Street Mail Shop Miami, FL 33186 printed CK #: 1027 material 3 All in One Mail Shop All in One MON $574.50 04 /08/09 11950 SW 128th Street Mail Shop Miami, FL 33186 printed material 4 The Signs and Printing Store The Sign and MON $197.95 04 /08 /09 10501 South Dixie Hwy Print Store Miami, FL 33156 5 Greater Miami Shores Chamber of MON $27.24 04 08 09 9701 NE 2nd Ave Commerce Miami Shores, FL 33138 Candidates Breakfast 6 forum DS-DE 14(Rev.08/03) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES CAMPAIGN TREASURER'S REPORT- ITEMIZED CONTRIBUTIONS (1) Name EDDIE LEWIS (2) I.D. Number (3) Cover Period 03 / 21 / 2009 through 04 / 09 / 2009 (4) Page 1 of 1 (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 Lewis, Eddie 405.00 03 / 25 /2009 9490 NW 1st AVENUE I Entrepre LOA Miami Shores, FL nuer 33153 1 Lewis, Eddie 1000.00 03 / 31 /2009 9490 NW 1st AVENUE I Entrepre LOA Miami Shores, FL nuer 2 33153 Desulme, Alix I CHE 100.00 04 / 08 /2009 390 N. E. 125th St Apt 401 North Miami, FL 3 33161 DS-DE 13(Rev.08/03) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES FLORIDA DEPARTMENT OF STATE DIVISION OF ELECTIONS CAMPAIGN TREASURER'S REPORT SUMMARY (1) EDDIE LEWIS OFFICE USE ONLY Name (2) 9490 NW list AVENUE Address (number and street) MIAMI SHORES, FL 33153 City, State,Zip Code ❑ CHECK IF ADDRESS HAS CHANGED (3) ID Number: (4) Check appropriate box(es): © Candidate(office sought): Councilman - Miami Shores Village Council ❑ 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 03 / 11 / 2009 To 03 / 20 / 2009 Report Type G3 Original ❑Amendment ❑ Special Election Report ❑ Independent Expenditure Report (6) CONTRIBUTIONS THIS REPORT (7) EXPENDITURES THIS REPORT Monetary Cash &Checks $ 0.00 Expenditures $ 0.00 Loans $ 162 .21 Transfers to Office Account $ 0. 00 Total Monetary $ 162 .21 Total Monetary $ 0.00 In-Kind $ 0. 00 (8) Other Distributions $ 0. 00 (9) TOTAL Monetary Contributions To Date (10) TOTAL Monetary Expenditures To Date $ 162 .21 $ 0.00 (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) Leroy Bradshaw (Type name) Eddie Lewis ❑Individual(only for 0 Treasurer [:]Deputy Treasurer t[Z] didate Chairperson(only for PC,PTY& electioneering commun.) electioneering comm p,organization) `.X Signature ignature ' DS-DE 12(Rev.08/04) CAMPAIGN TREASURER'S REPORT- ITEMIZED CONTRIBUTIONS (1) Name EDDIE LEWIS (2) I.D. Number (3) Cover Period 03 / 11 / 2009 through 03 / 20 / 2009 (4) Page 1 of 1 (5) (7) (8) (9) (10) (11) (12) Date Full Name (6) (Last, Suffix, First, Middle) Sequence Street Address 8 Contributor Contribution In-kind Number City,State,Zip Code Type Occupation Type Description Amendment Amount Lewis, Eddie 162.21 03 / 11 /2009 9490 NW 1st AVENUE I Entrepre LOA Miami Shores, FL nuer 33153 1 DS-DE 13(Rev.08/03) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES CAMPAIGN TREASURER'S REPORT- ITEMIZED EXPENDITURES (1)Name EDDIE LEWIS (2)I.D. Number (3)Cover Period 03 / 11 1 2009 through 03 20 / 2009 (4)Page 1 of 1 (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 DS-DE 14(Rev.08/03) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES