Swan, Robert FORM 1 STATEMENT OF 2010
- Please print or type your name,mailing FINANCIAL INTERESTS
address,agency name,and position below:
LAST NAME—FIRST NAME—MIDDLE NAME
/ FOR OFFICE
,CWA-r\ O G 7 rl?-4 i 1< USE ONLY:
MAILING ADDRESS:
ID Code
CITY: ZIP: COUNTY:
ID No.
NAME OF AGENCY:
Conf.Code
NAME OF OFFICE OR POSITION HELD OR SOUGHT• P.Req.Code
'%- I -I sem+ 0LF-S vt`/-/ff s- .coo(e ekxbyCeMcNl A
You are not limited to the space on the lines on this form.Attach additional sheets,K necessary.
CHECK ONLY IF CANDIDATE OR NEW EMPLOYEE OR APPOINTEE
"BOTH PARTS OF THIS SECTION MUST BE COMPLETED'_'_
DISCLOSURE PERIODc
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(must check one):
DECEMBER 31,2010 QR 0 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(must check one):
At COMPARATIVE(PERCENTAGE)THRESHOLDS QR ❑ DOLLAR VALUE THRESHOLDS
PART A—PRIMARY SOURCES OF INCOME [Major sources of income to the reporting person]
(If you have nothing to report,you must write"none"or"n/a")
NAME OF SOURCE SOURCE'S DESCRIPTION OF THE SOURCE'S
OF INCOME ADDRESS PRINCIPAL BUSINESS ACTIVITY
S7117E Qti'Pt4"D)J'. - 7' 7 �'0
1
'3o x 3a f y3)S c 90 � &r—4 z-0,o
57 7 oY-- H le c s L. 1ZS'3 0 1J 7 Ak,•4
PART B— SECONDARY SOURCES OF INCOME[Major customers,clients,and other sources of Income to businesses owned by the reporting person]
(If you have nothing to report,you must write"none"or'Wa")
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
(If you have nothing to report,you must write"none"or"Nay when and where to file this form
are located 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 on page 6.
CE FORM 1-Effective:Jamory 1.2011.Refer to Rule 346.202(1),F.A.C. (Continued on reverse side) PAGE 1
PART D—INTANGIBLE PERSONAL PROPERTY[Stocks,bonds,certificates of deposit,etc.]
(If you have nothing to report,you must write"none"or"Na")
TYPE OF INTANGIBLE BUSINESS ENTITY TO WHICH THE PROPERTY RELATES
G:✓ot,7 t9-•t-- ..��,�s r ?' 1'?.9�-..tr� Iz�/1/ �rt- ,.,� .d, ti.c 3?J L
t
.J,�,Z < nLL �l-r— ?3/3
&1=- Af ioS-r'T A�,IF.
PART E—LIABILITIES [Major debts)
(If you have nothing to report,you must write"none"or"Na")
NAME OF CREDITOR ADDRESS OF CREDITOR
PART F—INTERESTS IN SPECIFIED BUSINESSES--[Ownership or positions in certain types of businesses]
(If you have nothing to report,you must write"none"or"Na")
BUSINESS E TITY#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 INT IN S
NATURE OF MY
OWNERSHIP INTEREST
IF ANY OF PARTS A THROUGH F ARE 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/ampioyee, 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. our annual disclosure filing,ng, return the form to file uvltlrin 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 Lowlolficerwam meet. Appointees who must be confirmed
section, you must mite "none" or "Na" in that P yeesfifewithlheSupervisor �� by
Of Elections of the in which the the Senate must file prior to confimtation,even
section(s). county tl��a-
neatly 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: Shale officers or specdw 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 CBndkbfts filo this form together with their calendar year in which they hold their posl-
of another public position must at least file a copy qualifying papers tions.
of his or her original Form 1 wfien qualifying. Final at the end of office or employment,
To determine what category your position N, p oyment,
fabs under.see the"Who Must File"Instructions each local officer/employee, state officer, and
on page 3. specified"state employee is required to file a
final disclosure form(Form 1 F)within 60 days
of leaving office or employment.
CE FORM 1-Effective:January 1,2011.Refer to Rule 348.202(1),F.A.C. PAGE 2
S-00229862
ROBERT SWAN
C/O MIAMI SHORES VILLAGE 10050 N.E. 2ND AVENUE
MIAMI SHORES, FL 33138
001604
Memorandum "®
2
To: Local Officers
From: Lester Sola
Supervisor of Electi
Subject: Financial Dis osure Filing Requirement for the 2010 Tax Year
Enclosed is a Form 1, Statement of Financial Interests, which you must complete and return to the
Elections Department to satisfy your financial disclosure filing requirement for the 2010 tax year.
Persons serving as of December 31, 2010 are required to file this year. Even if you left the position in
2011, you are required to file disclosure for 2010 on this form. Please note you may also be required to
file a Form 1F covering the portion of 2011 you served. See the instructions on Form 1 for more
information.
WHAT TO FILE: A completed, original Form 1. Please be sure to sign and date the form.
WHERE TO FILE: Miami-Dade Elections Department, 2700 NW 87 Avenue, Miami, FL 33172
A business reply envelope has been provided for your convenience, and the form
may also be hand delivered. Please do not file this form with the Florida
Commission on Ethics in Tallahassee.
WHEN TO FILE: By Friday, July 1, 2011
Please note the following:
• You can check receipt of your financial disclosure form on the Miami-Dade Elections website at
www.miamidade.gov/elections and click on the"Financial Disclosures" link.
• Persons who fail to file the disclosure form by September 1st are subject to automatic fines of
$25 for each late day.
• If your home address appears on the form and you are exempt from public records, please mark
through the address provided and insert your office or other address.
Instructions for completing.this form are included. Additional questions on how to complete this form
should be directed to the Florida Commission on Ethics at 800-262-8824. The Elections Department
serves as the records custodian for these forms. As such, if you have questions regarding the
distribution or collection of this form, please do not hesitate to contact Carmen Bofill, Financial
Disclosure Coordinator, at 305-499-8413.
If you think you have received this in error, please contact the coordinator for your agency who has
provided your name based on your official position and responsibilities. If appropriate, the local
agency's coordinator will contact the Florida Commission on Ethics to remove your name from the list.
To find your agency's coordinator, you can contact Carmen Bofill at the number above or view the list
that is provided on the Commission on Ethics'website at hfp://www.ethics.state.fl.us.
Enclosures
S-00229862
FORM 1 STATEMENT OF 2010
Please print or yyour name,mailing FINANCIAL INTERESTS
address,agency name,and position below:
LAST NAME--FIRST NAME--MIDDLE NAME: FOR OFFICE
SWAN, ROBERT 1D# 00229862 USE ONLY:
MAILING ADDRESS:
C/O MIAMI SHORES VILLAGE 10050 N.E. 2ND AVENUE II II II IIIII IIII
* S W A N
CITY: 2COUNTY:
MIAMI SHORES FL 33138 MIAMI-DADS III I IIIII IIIII II II
NAME OF AGENCY
* R O B E R T
MIAMI SHORES VILLAGE III II IIIIIIIIII II I II III II
NAME OF OFFICE OR POSITION HELD OR SOUGHT:
CODE ENFORCEMENT BOARD * 0 0 2 2 9 8 6 2
You are not limited to the space on the lines on this form.Attach additional sheets,if necessary.
CHECK ONLY IF 0 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(must check one):
❑ DECEMBER 31,2010 OR 0 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(must check one):
0 COMPARATIVE(PERCENTAGE)THRESHOLDS OR ❑ DOLLAR VALUE THRESHOLDS
PART A--PRIMARY SOURCES OF INCOME [Major sources of income to the reporting person]
(If you have nothing to report,you must write"none"or"n/a")
NAME OF SOURCE SOURCE'S DESCRIPTION OF THE SOURCE'S
OF INCOME ADDRESS, PRINCIPAL BUSINESS ACTIVITY
PART B-- SECONDARY SOURCES OF INCOME[Major customers,clients,and other sources of income to businesses owned by the reporting person]
(If you have nothing to report,you must write"none"or"n/a")
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
(If you have nothing to report,you must write"none"or'Wa")
when and where to file this form
are located 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 on page 6.
CE FORM 1-Effective:January 1,2011.Refer to Rule 34-8.202(1),F.A.C. (Continued on reverse side) PAGE 1
ROBERT SWAN S-00229862
PART D—INTANGIBLE PERSONAL PROPERTY[Stocks,bonds,certificates of deposit,etc.]
(if you have nothing to report,you must write"none"or"n/a") -
TYPE OF INTANGIBLE BUSINESS ENTITY TO WHICH THE PROPERTY RELATES
r.
PART E—LIABILITIES [Major debts] t
(If you have nothing to report,you must write"none"or"n/a") ,
NAME OF CREDITOR ADDRESS OF CREDITOR
v � F
S
PART'F—INTERESTS IN SPECIFIED BUSINESSES [Ownership or positions in certain types of businesses]
(If you have nothing to report,you must write"none"or"n/a")
BUSINESS ENTITY#1 BUSINESS ENTITY#2 ' BUSINESS ENTITY#3
t
NAME OF BUSINESS ENTITY
ADDRESS OF BUSINESS ENTITY '
PRINCIPAL BUSINESS ACTIVITY
POSITION HELD WITH ENTITY v
I OWN MORE THAN A 5% -
INTEREST IN THE BUSINESS
NATURE OF MY '.
OWNERSHIP INTEREST
IF ANY OF PARTS A THROUGH F ARE CONTINUED ON A SEPARATE SHEET, PLEASE CHECK HERE ❑
SIGNATURE(required): DATE SIGNED(required):
FILING INSTRUCTIONS:
WHAT TO FILE: WHERE TOFILE: WHEN.TO FhLE:'
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 ment. Appointees who must be confirmed by
section, you must write "none" or 'Wa" in that of Electcal ions
of the o couneesty
i le witc he Supervisor the Senate must file prior to confirmation,even
section(s). of Elections . the county in which they perms- if that is less than 30 days from the date of their
nently reside. (If you do not permanently reside
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 specified state employees must file at the same time they file their
qualifying papers.
MULTIPLE FILING UNNECESSARY: file with the Commission on Ethics,-P.O. Drawer
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. To determine what category your position Finally, at the end of office or employment,
falls under, see the 'Who Must File" Instructions each local officer/employee, state officer, and
on page 3. specified state employee is required to file a
final disclosure form(Form 1 F)within 60 days
of leaving office or employment.
CE FORM 1-Effective:January 1,2011.Refer to Rule 348.202(1),F.A.C. PAGE 2
INSTRUCTIONS FOR COMPLETING FORM 1
STATEMENT OF FINANCIAL INTERESTS
WHO MUST FILE FORM 1:
All persons who fall within the categories of"state officers,""local officers/employees,' specified state employees,"as well as candidates for elective local office,
are required to file Form 1. Positions within these categories are listed below.Persons required to file full financial disclosure(Form 6)and officers of the judicial
branch do not file Form 1 (see Form 6 for a list of persons who must file that form).
STATE OFFICERS include the following positions for state officials: ity,or other political subdivision;county or municipal attorney;chief county or
1) Elected public officials not serving in a political subdivision of the municipal building inspector; county or municipal water.resources coordina-
state and any person appointed to fill a vacancy in such office, unless tor; county or municipal pollution control director; county or municipal envi-
required to file full disclosure on Form 6. ronmental control director; county or municipal administrator with power to
2) Appointed members of each board,commission,authority,or council grant or deny a land development permit;chief of police;fire chief;municipal
having statewide jurisdiction, excluding members of sole advisory bodies; clerk;appointed district school superintendent; community college president;
but including judicial nominating commission members; Directors of the district medical examiner; purchasing agent (regardless,of title) having the
Florida Black Business Investment Board, Enterprise Florida,Scripps Florida authority to make any purchase exceeding$20,000 for the local governmen-
Funding Corporation,Workforce Florida, and Space Florida;,Members of the tal unit.
Florida Commission on Tourism, Florida Substance Abuse and Mental Health 5) Officers and employees of entities serving as chief administrative officer
Corporation,and the Council on the Social Status of Black Men and Boys;and of a political subdivision.
'.Governors and senior managers of Citizens Property Insurance Corporation SPECIFIED STATE EMPLOYEES include the following positions
I and Florida Workers'Compensation Joint Underwriting Association. for state employees:
3) The Commissioner of Education, members of the State Board of 1) Employees in the office of the Governor or of a Cabinet member who
Education, the Board of Governors, and the local Boards of Trustees and are exempt from the Career Service System, excluding secretarial, clerical,
Presidents of state universities. and similar positions.
LOCAL OFFICERVEMPLOYEES include the following positions 2) The following positions in each state department, commission,
for officers and employees of local government: board, or council: Secretary, Assistant or Deputy Secretary, Executive
1) Persons elected to office in any political subdivision(such as munici- Director, Assistant or Deputy Executive Director, and anyone.having the
palities, counties, and special districts) and any person appointed to fill a power normally conferred upon such persons, regardless of title.
vacancy in such office,unless required to file full disclosure on Form 6. 3) The following positions in each state department or division:Director,
2) Appointed members of the following boards, councils, commissions, Assistant or Deputy Director, Bureau Chief,Assistant Bureau Chief, and any
authorities, or other bodies of any county, municipality, school district, inde- person having the power normally conferred upon such persons, regardless
pendent special district, or other political,subdivision: the governing body of title.
of the subdivision; a community college or junior college district board of 4) Assistant State Attorneys, Assistant Public Defenders, Public
trustees; a board having the power to enforce local code provisions; a board Counsel, full-time state employees serving as counsel or assistant counsel
ofadjustment; a planning or zoning board having the power to recommend, to a state agency,administrative law judges,and hearing officers.
create, or modify land planning or zoning within the political subdivision, 5)The Superintendent or Director of a state mental health institute estab-
except for citizen advisory committees, technical coordinating committees, lished for training and research in the mental health field,or any major state
and similar groups who only have the power to make recommendations to institution or facility established for corrections, training, treatment, or reha-
planning or zoning boards; a pension board or retirement board empowered bilitation.
to invest pension or retirement funds or to determine entitlement to or amount 6) State agency Business Managers,Finance and Accounting Directors,
of a pension or other retirement benefit. Personnel Officers, Grant Coordinators, and purchasing agents (regardless
3) Any other appointed member of a local government board who is of title)with power to make a purchase exceeding$15,000.
required to file a statement of financial interests by the appointing authority or 7) The following positions in legislative branch agencies:each employ-
the enabling legislation,ordinance,or resolution creating the board. ee(other than those employed in maintenance,clerical,secretarial,or similar.
4)Persons holding any of these positions in local government: Mayor; positions and legislative assistants exempted by the presiding officer of their
countv or city mana er;chief administrative em Io ee of a countV,municipal- house); and each employee of the Commission on Ethics.
INSTRUCTIONS FOR COMPLETING.FORM 1:
INTRODUCTORY INFORMATION (At Top of Form): address if you submit a written request for conridentiality. Persons
listed in Section 119.071(4)(d),"F.S.,are encouraged to provide an address
If your name, mailing address, public agency, and position are other than their home address.
already printed on the form,you do not need to provide this informa-
tion unless it should be changed. To change any of this information, DISCLOSURE PERIOD:The tax year for most individuals is the calendar
write the correct information on the form,then contact your agency's year(January 1 through December 31). If that is the case for you, then
financial disclosure coordinator. Your coordinator is identified in the your financial interests should be reported for the calendar year 2009;just
financial disclosure portal on the Commission on Ethics website: check the box and you do not need to add any information in this part of
www.ethics.state.fl.us. the form.However,if you file your IRS tax return based on a tax year that is
not the calendar year,you should specify the dates of your tax year in this
NAME OF AGENCY: This should be the name of the governmental unit portion of the form and check the appropriate box.This is the time frame
which you serve or served, by which you are or were employed, or for or"disclosure period"for your report.
which you are a candidate. For example, "City of Tallahassee," "Leon MANNER OF CALCULATING REPORTABLE INTERESTS: As noted in
County,"or"Department of Transportation."
this portion of the form,the Legislature has given filers the option of report-
OFFICE OR POSITION HELD OR SOUGHT: Use the title of the office ing based on either thresholds that are comparative (usually, based on
or position you hold, are seeking, or held during the disclosure period (in percentage values)or thresholds that are based on absolute dollar values.
some cases you may not hold that position now, but you still would be The instructions on the following pages specifically describe the different
required to file to disclose your interests during the last year you held that thresholds. Simply check the box that reflects the choice you have made.
position). For example, "City.Council Member," "County Administrator," You must use the type of threshold you have chosen for each part of the
"Purchasing Agent,"or"Bureau Chief." If you are a candidate for office or form. In other words, if you choose to report based on absolute dollar
are a new employee or appointee,check the appropriate box. value thresholds, you cannot use a percentage threshold on any part of
MAILING ADDRESS: If your home address.appears on the form but the form.
you prefer another address be shown, change the address as described
above If you are an active or former officer or employee listed in Section (CONTINUED on page 4) �
119.071(4)(d), F.S., whose home address is exempt from disclosure,
the Commission is required to maintain the confidentiality of your home
CE FORM 1V-Effective:January 1,2011.Refer to Rule 34-8.202(1),F.A.C. PAGE 3
PART A - PRIMARY SOURCES OF INCOME
(1) You owned (either directly or indirectly in the form of an
equitable or beneficial interest) during the disclosure period more
[Required by Sec. 112.3145(3)(a)l or(b)1,Fla.Stat:] than five percent (5%) of the total assets or capital stock of a
Part A is intended to require the disclosure of your principal sources of ' business entity (a corporation, partnership, limited partnership,
income during the disclosure period.You do not have to disclose the amount proprietorship, joint venture, trust, firm, etc., doing business in
of income received. The sources should be listed in descending order, Florida);and
with the largest source first. Please list in this part of the form the name, (2) You received more than ten percent(10%)of your gross income
address,and principal business activity of each source of your income which during the disclosure period from that business entity;and
(depending on whether you have chosen to report based on percentage (3) You received more than $1,500 in gross income from that
thresholds or on dollar value thresholds)either:
• business entity during the period.
exceeded five percent (5%) of the gross income received by you in (b) If you are reporting based on dollar value thresholds:
your own name or by any other person for your benefit or use during the
disclosure period,or (1) You owned (either directly or indirectly in the form of an
equitable or beneficial interest) during the disclosure period'more
exceeded $2,500.00 (of gross income received during the disclosure than five percent (5%) of the total assets or capital stock of a
period by you in your own name or by any other person for your use or business entity (a corporation, partnership, limited partnership,
benefit). rproprietorship, joint venture, trust, firm, etc., doing business in
You need not'list your public salary received from serving in the Florida);and
position(s) which requires you to file this form, but this amount should be (2) You received more than $5,000 of your gross income during
included when calculating your gross income for the disclosure period. The the disclosure period from that business entity.
income of your spouse need not be disclosed. However, if there,is joint
income to you and your spouse from property held by the entireties(such as If your interests and gross income exceeded the appropriate thresholds listed
interest or dividends from a bank account or stocks held by the entireties), above,then for that business entity you must list every source of,income to
you should include all of that income when calculating your gross income and the business entity which exceeded ten percent(10%)of the business entity's
disclose the source of that income if it exceeded the threshold. gross income(computed on the basis of the business entity's most recently
completed fiscal year), the source's address,Land the source's principal
"Gross income"means the same as it does for income tax purposes, business activity.
including all income from whatever source derived,such as compensation for I
Examples:
services,gross income from business,gains from property dealings,interest,
rents, dividends, pensions, social security, distributive share of partnership — You are the sole proprietor of a dry cleaning business, from which
gross income,and alimony,but not child support. you received more than 10%of your gross income(an amount that was
Examples: more than$1,500) (or, alternatively, more than $5,000, if you are using
dollar value thresholds).If only one customer,a uniform rental company,
— If you were employed by a company that manufactures computers provided more than 10% of your dry cleaning business, you must list
and received more than 5%of your gross income(salary;commissions, the name of the uniform rental company, its address, and its principal
etc.) from the company (or, alternatively, $2,500), then you should list business activity(uniform rentals).
the name of the company,its address,and its principal business activity o
(computer manufacturing). — You area 20% partner in a partnership that owns a shopping mall
and your partnership income exceeded the thresholds listed above.You
— If you were a partner in a law firm and your distributive share of should list each tenant of the mall that provided more than 10%of the
partnership gross income exceeded 5%' of your gross income (or, partnership's gross income,the tenant's address and principal business
alternatively, $2,500), then you should list the name of the firm, its activity.
address,and its principal business activity(practice of law).
— You own an orange grove and sell all your oranges to one marketing
— If you were the sole proprietor of a retail gift business and your gross cooperative.You should list the cooperative,its address,and its principal
income from the business exceeded 5%of your total gross income(or, business activity if your income met the thresholds.
alternatively,$2,500),then you should list the name of the business, its
address, and its principal business activity(retail gift sales)., PART C — REAL PROPERTY
— If you received income from investments in stocks and bonds, you [Required by Sec. 112.3145(3)(a)3 or(b)3, Fla.Stat.]
are required to,list only each individual company from which you derived
more than 5%(of,your gross income (or, alternatively,-$2,500), rather l In this part,please list the location or-description of all real'property(land
than aggregating all of y'odinvestment income. +. and buildings)in Florida in which you owned directly or indirectly at any time
_— If more than.5% of your gross,income (or, alternatively, $2;500) during the previous tax year in excess of five percent(5%)of the property's
was,gain from the sale of property (not just the selling price), then value. `This threshold'is the same, whether you are,-using percentage
you should list as a source of income the name of the purchaser, the thresholds or dollar thresholds. You are not required to list your'residences
purchaser's address, and the purchaser's principal business activity. If and vacation homes; nor are you required to state the value'of the property
the purchaser's identity is unknown, such as where securities listed on on the form.
an exchange are sold through a brokerage firm, the source of income Indirect ownership includes situations where you are a beneficiary of
should be listed simply as "sale of (nam_a of company) stock," for a trust that owns the property, as well as situations where, you are more
example. than a 5%partner in a partnership or stockholder in a corpoation that owns
— If more than 5% of your gross income (or, alternatively, $2,500) the property. The value of the property may be determined by the most
was in the form of interest from one particular financial institution recently assessed value for tax purposes, in the absence'of a more current
(aggregating interest from all CD's, accounts, etc., at that institution), appraisal.
list the name of the institution, its address and its principal business The location or description of the property should be sufficient to
activity. enable anyone who looks at the form to identify the property. Although a
legal description of the property will do, such a lengthy description is not
PART B- SECONDARY SOURCES OF INCOME required. Using simpler descriptions, such as"duplex, 115 Terrace Avenue,
Tallahassee"or 40 acres located at the intersection,of Hwy.60 and 1-95,Lake
[Required by Sec. 112.3145(3)(a)2 or(b)2, Fla. Stat.] County"is sufficient. In some cases,the property tax identification number of
This part is intended to require the disclosure of major customers, the property will help in identifying.it: "120 acre ranch on Hwy. 902, Hendry
clients, and other sources of income to businesses in which you own an County,Tax ID#131-45863."
,(CONTINUED on page 5) coF-,
interest.You will not have anything to report unless: a
(a) If you are reporting based on percentage thresholds:
CE FORM 1-Effective:January 1,2011.Refer to Rule 34-8.202(1),F.A.C. PAGE 4
Examples: PART E — LIABILITIES
— You own 1/3 of a partnership or small corporation that owns both a [Required by Sec. 112.3145(3)(a)4 or(b)4, Fla. Stat.]
vacant lot and a 12% interest in an office building.You should disclose
the lot,but are not required to disclose the office building(because your In this part of the form, list the name and address of each private or
1/3 of the 12% interest—which equals 4%—does not exceed the 5% governmental creditor to whom you were indebted for a liability in any amount
threshold). that,at any time during the disclosure period,exceeded:
— If you are a beneficiary of a trust that owns real property and your (1) your net worth(if you are using percentage thresholds),Q
interest depends on the duration of an individual's life,the value of your (2) $10,000(if you are using dollar value thresholds).
interest should be determined by applying the appropriate actuarial table
to the value of the property itself, regardless of the actual yield of the You are not required to list the amount of any indebtedness or your net
property. worth.You do not have to disclose any of the following:credit card and retail
installment accounts,taxes owed(unless reduced to a judgment), indebted-
ness on a life insurance policy owed to the company of issuance,contingent
liabilities, and accrued income taxes on net unrealized appreciation (an
[Required by Sec. 112.3145(3)(a)3 or(b)3, Fla. Stat.] accounting'concept).A"contingent liability"is one that will become an actual
liability only when one or more future events occur or fail to occur, such as
Provide a general description of any intangible personal property that,at where you are liable only as a guarantor,surety,or endorser on a promissory
any time during the disclosure period,was worth more than: note. If you are a"co-maker"and have signed as being jointly liable or jointly
(1)ten percent(10%)of your total assets (if you are using percentage and severally liable,then this is not a contingent liability;if you are using the
thresholds),or $10,000 threshold and the total amount of the debt(not just the percentage
(2),$10,000(if you are using dollar value thresholds), of your liability)exceeds$10,000,such debts should be reported.
and.,state the business entity to which the property related. Intangible per- Calculations for persons using comparative(percentage)thresholds: In
order to decide whether the debt exceeds your net worth, you will need to
sonal property'includes such things as money, stocks, bonds, certificates of total all of your liabilities(including promissory notes, mortgages, credit card
deposit, interests in partnerships, beneficial interests in a trust, promissory debts,lines of credit,judgments against you,etc.).Subtract this amount from
notes owed to you, accounts receivable by you, IRA's, and bank accounts. the value of all your assets as calculated above for Part D.This is your"net
Such things as automobiles, houses, jewelry, and paintings are not intan- worth."You must list on the form each creditor to whom your debt exceeded
gible property. Intangibles relating to the same business entity should be this amount unless it is one of the types of indebtedness listed in the para-
aggregated; for example, two certificates of deposit and a savings account graph above(credit card and retail installment accounts,etc.).Joint liabilities
with the same bank. Where property is owned by husband and wife as ten- with others for which you are"jointly and severally liable,"meaning that you
ants by the entirety(which usually will be the case), the property should be may be liable for either your part or the whole of the obligation, should be
valued at 100%. included in your calculations based upon your percentage of liability, with
Calculations:In order to decide whether the intangible property exceeds the following exception:joint and several liability with your spouse for a debt
10%of your total assets,you will need to total the value of all of your assets which relates to property owned by both of you as"tenants by the entirety"
(including real property, intangible property, and tangible personal property (usually the case)should be included in your calculations by valuing the asset
such as automobiles,jewelry, furniture, etc.).When making this calculation, at 100%of its value and the liability at 100%of the amount owed.
do not subtract any liabilities.(debts) that may relate to the property—add Examples for persons using comparative(percentage)thresholds:
only the fair market value of the property. Multiply the total figure by 10%to p p g p (p g )
arrive at the disclosure threshold. List only the intangibles that exceed this — You owe $15,000 to a bank for student loans, $5,000 for credit
threshold amount.Jointly owned property should be valued according to the card debts,and$60,000(with your spouse)to a savings and loan for a
percentage of your joint ownership,with the exception of property owned by home mortgage. Your home (owned by you and your spouse) is worth
husband and wife as tenants by the entirety,'which should be valued at 100%. $80,000 and your other property is worth$20,000.Since your net worth
None of your calculations or the value of the property have to be disclosed on is $20,000 ($100,000 minus$80,000), you must report only the name
the form. If you are using dollar value thresholds, you do not need to make and address of the savings and loan.
any of these calculations. — You and your 50%business partner have a$100,000 business loan
Examples for persons using comparative(percentage)thresholds: from a bank, for which you both are jointly and severally liable. The
— You own 50% of the stock of a small corporation that is worth value of the business, taking into account the loan as a liability of the
$100,000, according to generally.accepted methods of valuing small business, is $50,000. Your other assets are worth.$25,000, and you
businesses. The estimated fair market value of your home and`other owe $5,000 on a credit card. Your total assets will be$50,000.(half of
property (bank accounts,•automobile, furniture; etc.) e and'o As a business worth$50,000 plus$25,000 of other assets).,Your liabilities,
your total assets are worth $250,000, you'must disclose-intangibles for purposes of calculating your net worth,will be only n v,because
worth`over$25,000.Since the value of the stock exceeds this threshold, the full amount of the business loan already was includeedd ialuing the
you should list"stock"and the name of the corporation. If your accounts business.Therefore, your net worth is$45,000. Since yourr v50share
with a particular bank exceed$25,000,you should list"bank accounts" of the$100,000 business loan exceeds this net worth figure, you must
and bank's name. list the bank.
— When you retired, your professional firm bought out your partner- PART F — INTERESTS IN SPECIFIED
ship interest by giving you a promissory note, the present value of
which is $100,000. You also have a certificate of deposit from a bank BUSINESSES
worth $75,000 and an investment portfolio worth $300,000, consisting [Required by Sec. 112.3145(5), Fla.Stat.]
of $100,000 of IBM bonds and a variety of other investments worth
between $5,000 and $50,000 each. The fair market value of your The types of businesses covered in this disclosure are only:state and
remaining assets (condominium, automobile, and other personal prop- federally chartered banks; state and federal savings and loan associations;
erty)is$225,000.Since your total assets are worth$700,000,you must cemetery companies; insurance companies(including insurance agencies);
list each intangible worth more than $70,000.Therefore, you would list mortgage companies; credit unions; small loan companies; alcoholic bever-
"promissory note"and the name of your former partnership, "certificate age licensees; pari-mutuel wagering companies, utility companies, entities
of deposit" and the name of the bank, "bonds"and "IBM," but none of controlled by the Public Service Commission;and entities granted a franchise
the rest of your investments. to operate by either a city or a county government.
(CONTINUED on page 6) C�
CE FORM 1-Effective:January 1,2011.Refer to Rule 34-8.202(1),F.A.C. PAGE 5
You are required to disclose in this part of the form the fact that you disclosure period,an officer,director, partner,proprietor,or agent(other than
owned during the disclosure period an interest in,or held any of certain posi- a resident agent solely for service of process).
tions with, particular types of businesses listed above. You are required to If you have or held such a position or ownership interest in one of these
make this disclosure o you own or owned(either directly or indirectly in the apes of businesses, list(vertically for each business):the name of the busi-
form of an equitable or beneficial interest)at any time during the disclosure Hess, its address and principal business activity,.and the position held with
period more than five percent(5%)of the total assets or capital stock'of one the business e any). Also, if you own(ed) more than a 5 o ition h t in the
of the types of business entities granted a privilege to operate in Florida that business, as described above, you must indicate that fact and describe the
are listed above. You also must complete this part of the form for each of nature of your infetest.
these types of businesses for which you are, or were at any time during the
(End of Instructions.)
PENALTIES
A failure to-make any required disclosure constitutes grounds for and may be punished by one or more of the following: dis-
qualification from being on the ballot, impeachment, removal or suspension from office or employment, demotion, reduction in
salary, reprimand, or a civil penalty not exceeding$10,000. [Sec. 112.317, Florida Statutes]
Also, if the annual form is not filed by September-1st,a fine of$25 for each day late will be imposed, up to a maximum
penalty of$1,500.(Section 112.3145, F.S.J.
OTHER FORMS YOU MAY NEED TO FILE
IN ORDER TO COMPLY WITH THE ETHICS-LAWS
In addition to filing Form 1,you may be required to file one or more of the special purpose forms listed below, depending on your'particular position,
business activities, or interests.As it is your duty to obtain and file any of the special purpose'forms which may be applicable to you, you should carefully
read the brief description of each form to determine whether it applies.
Form 1F — Final Statement of• Financial private gain (or loss) or to the special gain (or loss) of a relative, busi-
Interests: Required of local officers, state officers, and speci- ness associate;or one by whom he or she is retained or employed.Each
fled state employees within 60 days after leaving office or employment. appointed state officer'who seeks to influence the decision on such a
This form is used to report financial interests between January 1 st of the measure prior to the meeting must file the form before undertaking that
last year of office or employment and the last day of office or employ- action. [Sec. 112.3143, Fla.Stat.]
ment. [Sec. 112.3145(2)(b), Fla.Stat.] Form 8B — Memorandum of Voting Conflict for
Form 1X — Amended Statement of Financial County, Municipal, and Other local Public
Interests:,To be used by local officers,state officers,and speci- Officers:'Required to be filed (within 15 days of abstention) by
tied state employees to correct inistakes on previously filed Form 1's. each local officer who'must abstain from voting on a measure which
[Sec. 112.3145(9), Fla. Stat.] would inure to his or her special private gain(or loss)or the special gain
(or loss)of a relative, business associate, or one by whom he or she is
Form 2 — Quarterly Client Disclosure: Required retained or employed. Each appointed local official who seeks to influ-
of local officers, state officers, and specified state employees to ence the decision on such a measure prior to the meeting must file the
disclose the names of clients represented for compensation by them- form before undertaking that action. [Sec. 112.3143, Fla.Stat.]
selves or a partner or associate before agencies at the same level of
government as they serve. The form should be filed by the end of the Form 9 — Quarterly Gift Disclosure: Required of
gleridar quarter (March 31, June 30, Sept. 30, Dec. 31)following the local officers, state officers, specified state employees, and state
procurement employees to,report gifts over$100 in value. The form
calendar quarter.in which a reportable representation was made. [Sec.
112.3145(4),Fla.Stat.] should be filed by the end of the calendar quarter(March 31, June 30,
Form 3A— Statement of Interest in Com etitive September December 31)following the calendar quarter in which
p the gift was received. [Sec. 112.3148, Fla.Stat.]:
Bid for Public Business:Required of public officers and Form 10 — Annual, Disclosure of Gifts from
public employees prior to or at the time of submission of a bid for public Governmental Entities and Direct Support
business which otherwise would violate Sec. 112.313(3) or 112.313(7), Or Organizations and Honorarium Event Related
Fla.Stat.[Sec 112.313(12)(b), Fla.Stat.] g
Expenses: Required of local officers, state officers, specified
Form 4A—Disclosure of Business Transaction, state employees, and state procurement employees to report gifts
Relationship, or Interest:Required of public officers and over $100 in value received from certain agencies and direct support
employees to disclose certain business transactions, relationships, or organizations; also to be utilized by these persons to report honorarium
interests which,otherwise would violate Sec. 112.313(3) or 112.313(7), event-related expenses paid,by certain persons and entities.The form
Fla.Stat. [Sec. 112.313(12)and(12)(e), Fla.Stat.] should be filed by July 1 following the calendar year in which the gift or
Form 8A — Memorandum of Voting Conflict for honorarium event-related expense was received. [Sec. 112.3148 and
State Officers: Required to be filed by a state officer within 15 112.3149,Fla. Stat.]
days after having voted on a measure which inured to his or her special
r AVAILABILITY OF FORMS; FOR MORE INFORMATION
Copies of these forms are available from the Supervisor of Elections Questions about any of these forms or the ethics laws may be
in your county; from the Commission on Ethics, Post Office Drawer addressed to the Commission on Ethics, Post Office Drawer 15709,
15709,Tallahassee, Florida 32317-5709;telephone (850)488-7864; Tallahassee, Florida 32317-5709; telephone(850)488-7864.
and at the Commission's web site: www.ethics.state.fl.us.
a
CE FORM 1-Effective:January 1,2011.Refer to Rule 34-8.202(1),F.A.C. PAGE 6
Roy Rogers = Philip Claypool
Chair F c Executive Director
Robert J.Sniffen a
ice Chair = . Virlindia Doss
Morgan R.Bentley SOD we Deputy Executive
Cheryl Forchilli State of Florida Director
I.Martin Ford COMMISSION ON ETHICS
Jean M.Larsen P.O.Drawer 15709 (850)488-7864 Phone
Susan Horovitz Maurer Tallahassee,FL 32317-5709 (850)488-3077(FAX)
Linda McKee Robison www.ethics.state.fl.us
Edwin,Scales III 3600 Maclay Blvd.,South,Suite 201
Tallahassee,FL 32312
MEMORANDUM
TO: local Officers
FROM: Philip Claypool, Executive Director y� G "
RE: The Code of Ethics and Gifts
Gifts are an important element of the Code of Ethics for Public Officers and
Employees.' There are several sets of standards that may apply to you. Because
you serve in a position that requires filing a Form 1 financial disclosure, you are
considered to be a "reporting individual," and must comply with the Code of
Ethics' gift and honorarium standards. In addition, your agency may have more
restrictive standards that apply to you.
The Code of Ethics contains two sets of standards that apply to Form 1
filers who serve in local government.
First, like all public officers and employees, you are prohibited: from
soliciting or accepting anything of value if it is based upon the understanding
that your official action or judgment would be influenced;' and from accepting
anything of value if you know, or, with the exercise of reasonable care, should
know, that It was given to influence an action in which you were expected to
participate officially.'
Secondly, you are subject to the gift and honoraria laws in the Code of
Ethics. These, gift laws primarily address gifts4 and honoraria5 from certain
donors (a lobbyists who has tried to Influence your agency within the past 12
'Found in Part III,Chapter 112,Florida Statutes.
Z Sec. 112.313(2),Fla.Stat.
]Sec. 112.313(4),Fla.Stat.
°Defined in Sec. 112.312(12),Fla.Stat.
5 Defined in Sec. 112.3149(l),Fla.Stat.
6"Lobbyist"is defined in Sec. 112.3148(2)(b)and 112.3149(1)(d),Fla.Stat.,to include anyone who was paid to
influence the governmental decision-making of your agency,within the past 12 months. Therefore,the law applies
not just to registered"lobbyists,"but also to lawyers,salespeople,and anyone else who receives compensation for
trying to influence any decision of your agency.
i
months, the principal or employer of that lobbyist, the lobbyist's firm, and
partners of the lobbyist).7 There are two basic prohibitions: (1) you should not
solicit=any,gift for personal benefit (regardless- of value) from any of these
donors;" and (2) you should not accept a gift worth more than $100 given directly
or indirectly by any of these donors.9
3
Gifts worth more than $100 that are not prohibited (and that are not
reported elsewhere by law) should be disclosed on a quarterlybasis, using CE
Form 9.10 The only exception to this reporting requirement is for gifts from
"relatives," a group that is broadly defined under the law.11 Gifts from relatives
also are not prohibited, regardless of value.
Honoraria and honorarium-event related expenses from these donors are
limited and may be required to be disclosed.12
Many agencies also have gift policies that are more restrictive than.the
standards in the Code of Ethics. Contact the ethics officer of your agency for`
Information about whether your agency has additional gift provisions that may
apply'to you.
The laws referenced here and further information about the ethics
lawn are available on the Commission on Ethics' website:
www.ethics.state.fl.us.- If you have questions concerning Florida's gifts
laws and reporting requirements, please contact the staff of the Ethics
Commission at 850.488.7864.
- 1
r, a -+� .+ $ r• ,—
1�
i
"Political committees"and"committees of continuous existence"under the elections laws also are in this group of
rrohibited donors. w
If it is for the personal benefit of any reporting individual,State"procurement employee,"or a member of any
reporting individual's or procurement employee's immediate family. See Sec. 112.3148(3),Fla.Stat.
9 Gifts to governmental entities and charities are subject to particular standards(see Sec. 112.3148(4)and(5),Fla.
Stat).Gifts worth more than$100 having a public purpose from certain governmental entities and gifts from direct
support organizations may be accepted but must be reported,under Sec. 112.3 148(6),Fla.Stat.
10 See Sec. 112.3148(8),Fla.Stat.
" See Sec. 112.312(21),Fla.Stat.
12 See Sec. 112.3149,Fla.Stat.
LOYALTY OATH
(Sections 876.05-876.10,Florida Statutes)
CANDIDATE WITH NO PARTY AFFILIATION
OFFICE USE ONLY
First Name Middle NameAnMal Last Name
a citizen of the State of Florida and of the United States of America, and being [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.
Important: If elected, a candidate must retake the loyalty oath as specfied ins. 876.05,Florida Statutes, and that oath shag be
filed with the records of the governing official or employing governmental agency prior to the approval of payment of salary,
expenses,or other compensation.
OATH OF CANDIDATE
(Section 99.021,Florida Statutes)
.(PLEASE PRINT NAME AS YOU WISH IT TO APPEAR ON THE BALLOT t- NAME MAY NOT BE CHANGED AFTER THE END OF QUALIFYING)
am a candidate with no party affiliation for the office of /►�,q,,,.. t s V Vr
(office) (district 9)
I am a qualified elector of A-=-/q,I -4+d E, County, Florida;
(circuit#) (group or seat
I am qualified under the Constitution and the Laws of Florida to hold the office to.which I desire to be nominated or
elected; by executing this form, 1 have taken the oath required by ss. 876.05-876.10, Florida Statutes; 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 I am required to resign pursuant-to Section 99.012,
Florida Statutes.
X C., X", _7*Z'(3as'r 2.33-S�g�t/ 0.GF�rh
Signature of Candidate Telephone Number Email Address
"Please print name phonetically on the line below as you wish it to be pronounced on the audio ballot for persons
with disabilities(see instructions on page 2 of this form):
Abs—ml S inJphf,�
STATE OF FLORIDA
COUNTY OF M Q Mj- ' �
Swom to(or affirmed)and subscribed before me this a(�� day of FC, (/U 20�_.
Personally Known:�_or L
=ia s BARBARA A ESTEP re of Notary Public
_ '►: K MY COMMISSION
Produced Identification ''� , rg EXPIRES:March 29,N DD 95 20 or StampCommissioned Name of Notary Public
9otMed Thru Notary Public Underwriters
Type of Identification Produced:
DS-0E 248(Rev.10/10) Rule 1S-20001,F.A.C.
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
Amended
STATE OF FLORIDA)
COUNTY OF MIAMI-DADE)
I, Lester Sola, Supervisor of Elections of Miami-Dade County, Florida, do hereby certify
that 64 signatures submitted by Robert Swan for the office of Council in the Miami
Shores Village matched the signatures on the voter files.
WITNESS MY HAND
AND OFFICIAL SEAL,
AT MIAMI, MIAMI-DADE
COUNTY, FLORIDA,
ON THIS 1St DAY OF
MARCH, 2011
Le er Sola
Supervisor of Electio s--,
Miami-Dade County
IT y
"Ll) L E71cd Ce
Please submit a check for$5.00 to our office payable to the
"Board of County Commissioners"for the cost of verifying these signatures.
Elections
2700 NW 87th Avenue
M I AM I•DADE ' Miami, Florida 33172
WIT Mk T 305-499-VOTE F 305-499-8547
TTY: 305-499-8480
miamidade.gov
March 1, 2011
Barbara A. Estep, MMC
Village Clerk
Miami Shores Village
10050 NE 2nd Avenue
Miami Shores, FL 33138
Dear Ms. Estep:
The Miami-Dade Elections Department has amended the Certification of the petitions
for Robert Swan, a candidate for Council in the Miami Shores Village previously
submitted on February 24, 2011. A total of 68 petitions were submitted and all of the
petitions were reviewed for verification. Of the total 68 petitions, 64 were certified.
There will be no charge for the additional petitions that were verified.
For purposes of petition verification, the Code of Miami-Dade County states that
petitions shall be disqualified for the following reasons:
• 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
However, for municipal petitions, my office does not review this information and
encourages the municipality to ensure compliance with municipal charter or code
requirements.
As such, please find the certification for the petition enclosed. Should you have any
questions or concerns, please feel free to contact me at 305-499-8509 or Rosy
Pastrana, Deputy Supervisor of Elections for Voter Services at 305-499-8548.
incerely,
Les r Sola
Supervisor of Elestlans
Miami-Dade Elections Department
Enclosure (1) r"Lt�t lr ,vctZZ`xct LiAll
03/04/2011 15:10 FAX 1 800 685 7530 DATA SCAN FIELD SERVICES 0 001
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RECIPIENT ADDRESS 93055777451
DESTINATION ID
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NUMBER OF PAGES: TUU W (Including Cover Sheet)
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MESSAGE:
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�/ioyee. (305)9.95-2207 C�aa (805)756-8972 gP C�/uail l�I ntiamaliaresvc�e,com
APPOINTMENT OF CAMPAIGN TREASURER
AND DESIGNATION OF CAMPAIGN
DEPOSITORY FOR CANDIDATES
(Section 106.021(1), F.S.)
(PLEASE PRINT OR TYPE)
NOTE: This form must be on file with the qualifying
officer before opening the campaign account. OFFICE USE ONL
1. CHECK APPROPRIATE BOX(ES);,
Initial Filing of Form Re-filing to Change: ❑ Treasurer/Deputy ❑ Depository ❑ Office ❑ Pari
2. Name/o"of Candidate(in this order: First, Middle, Last) 3.Address(include post office box or street, city, state, zip
D,6�G/�-7 S:j� fie) I7D ,J—sr-
4.
J-sr4. Telephone 5. E-mail address 3 6
6. Office sought(include district, circuit, group number) 7. If a candidate for a nonpartisan office, check if
applicable:
) 4- - ,<-s �` �� F] My intent is to run as a Write-In candidate
8. If a candidate fora partisan office,check block and fill in name of party as applicable: My intent is to run as a
❑
Write-In ❑ No Party Affiliation ❑ Party candidate.
I I have appointed the following person to act as my ❑ Campaign Treasurer ❑ Deputy Treasurer
10. Name of Treasurer or Deputy Treasurer
eo&&-?-y S -tel
11. Mailing Address 12. Telephone
13. City 14. County 15.State 16.Zip Code 17. E-mail address
fhr l hr�£� /'fit, ,� 3313 ��F4� o , c®^^
18. 1 have designated the following bank as my ❑ Primary Depository ❑ Secondary Depository
19. Name of Bank 20.Address
21. City 22. County 23. State 24.Zip Code
UNDER PENALTIES OF PERJURY,I DECLARE THAT I HAVE READ THE FOREGOING FORM FOR APPOINTMENT OF CAMPAIGN TREASURER AN!
DESIGNATION OF CAMPAIGN DEPOSITORY AND THAT THE FACTS STATED IN IT ARE TRUE.
25. Date 26.Signature of Candidate
27. Treasurer's Acceptance of Appointment(fill in the blanks and check the appropriate block)
I, ��
o 14__1l-� 4 A ,do hereby accept the appointment
(Please Print or Type Name)
designated above as:
Campaign Treasurer ❑ Deputy Treasurer.
X
Date Signature of Campaign Treasurer or Deputy Treasurer
SENDER: COMPLETE THIS SECTION COMPLETE THIS SECTION ON DELIVERY
■ Complete items'l,2,and 3.'Also complete A. Sig ature
item 4 if Restricted Delivery is desired. �� ❑Agen,/
■ Print your name and address on the reverse _X dressee
so that we can return the card to you. B. Received by(Printa�wame) C. eli ery
■ Attach this card to the back of the mailpiece, •.r
or on the front if space permits. f'1� /
D. Is delivery address different from item 11 Yes
1. Article Addressed to: If YES,enter delivery address below: ❑No
770
U ��
3. Service Type ;y
ur, ltiY"b �Jl tll1 W IACertified Mail ❑Exp ;rwM
O Registered ❑Return Receipt for Merchandise
' ❑ Insured Mail ❑C.O.D.
_ d.,Rgctrirtpd nAlivarv2(Frtra Fea) ❑Yes
2. Articl 4 }
(Tran
3.
—J
PS FO12595-02-M-1540
'UNITED STATES POSTAL SER�(lCE ""�i l
}'✓A�.:"'E�.1 t.i.. ..� N, '�. 9 '^'�w"l{fRiis .:. stag8&. EE�iL' id' .
USPS
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• Sender: Please print your name, address, and ZIP+4 in this box •
BaVbaKu- ww�c
() I["e- Cleary
[U.S. Postal SePVICeTtit
CERTIFIED MAl UO RECEIPT
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PS Forth 3800,Auger 2006(Reverse)PSN 7530-02-000-9047
�SORES
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CA.anu CW aow, , COY
2011
Candidate Name: �nhPt(� oh
Address: 770 N _ L GS�
Telephone Numbers: (3aO ag�,� -4qn
E-Mail Address: C0Q[Ck t)Q_ I w), com
CANDIDATE INFORMATION REQUIRED FOR
QUALIFYING FOR VILLAGE COUNCIL ELECTION
V Confirm Address and Voter's Registration Information
y Confirm Length of Residence in Miami Shores
Campaign Account &Treasurer's Appointment
Form 1 Financial Disclosure
Loyalty&Candidate's Oath
V/ Statement of Candidate
✓ 50 Signatures on Nominating Petition
Confirmed by Miami-Dade County Elections
UCx cwnQ e+rsa 64i wik ki cke((c k c,C(Ci jK
0j- F,l4UK3, cwi(cW e qva 4k .
�lione. (5305)795-2207 CO- - 805,)756-8972 �p-C�/�acC eatr'i/��Q miccrniclio�aau�a�e�y
Elections
2700 NW 87th Avenue
M I A M I•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 63 signatures submitted by Robert Swan for the office of Council in the Miami
Shores Village matched the signatures on the voter files.
WITNESS MY HAND
AND OFFICIAL SEAL,
AT MIAMI, MIAMI-DADE
COUNTY, FLORIDA,
ON THIS 24th DAY OF
FEBRUARY, 2011
Leer Sola
Supery sor of Elections
Miami-Dade County
Please submit a check for$5.00 to our office payable to the
"Board of County Commissioners"for the cost of verifying these signatures.
Elections
2700 NW 87th Avenue
MIA M I•DADE Miami, Florida 33172
T 305-499-VOTE F 305-499-8547
TTY: 305-499-8480
ty j{, miamidade.gov
February , 2011
Barbara A. Estep, MMC
Village Clerk
Miami Shores Village
10050 NE 2nd Avenue
Miami Shores, FL 33138
Dear Ms. Estep:
The Miami-Dade Elections Department has completed the verification of the petitions for
Robert Swan, a candidate for Council in the Miami Shores Village. A total of 68
petitions were submitted and all of the petitions were reviewed for verification. Of the
total 68 petitions, 63 were certified. There will be no charge for the additional petitions
that were verified.
For purposes of petition verification, the Code of Miami-Dade County states that
petitions shall be disqualified for the following reasons:
• 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
However, for municipal petitions, my office does not review this information and
encourages the municipality to ensure compliance with municipal charter or code
requirements.
As such, please find the certification for the petition enclosed. Should you have any
questions or concerns, please feel free to contact me at 305-499-8509 or Rosy
Pastrana, Deputy Supervisor of Elections for Voter Services at 305-499-8548.
Sincerely,
Lest r Sola
Supervisor of Elections
Miami-Dade Elections Department
Enclosure (1) ,
PETITION
We, the undersigned electors of Miami Shores Village, hereby nominate •.r,-cl gy
for a position on the Village Council.
RINT NAME ADDRESSSI DATE
V41"t'
FI
en- 7 ' j�t/f/ TFC c c 7,f'a 1116 9 7
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The undersigned is the circulator of the foregoing paper containing / signatures. Each appended thereto
was made in my presence and is the genuine signature of the person whose name it purports to be.
Signature of Circulator � — s Address 77 0
[ Acceptance ofNomination .
I hereby accept the'nomination forAhe Village Council and agree to serve if elected.
91 :6 WV 83i
Signature of Candidate
PETITION
0
We, the undersigned electors of Miami Shores Village, hereby nominated
for a position on the Village Council.
P , T NAME ADDRESS /�- SIGNATURE DATE
At- /42 waa-
133 N�
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-1 r7,ILP,3 8.10CCA14M960
<<i� a►i�r 8�/� / s� e Z to 1�l
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9'800 tit
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The undersigned is the circulator of the foregoing paper con g_ signatures. Each appended thereto
was made in my presence and is the genuine signature of the person whose name it purports to be.
Signature of Circulator � �� Address 770
Acceptance of Nomination
I hereby 3accepfthe'nomination for the Village Council and agree to serve if elected.
91 :6 WV 83J I IOZ
Signature of Candidate �.
PETITION
We, the undersigned electors of Miami Shores Village, hereby nominate le'k E z s4J'q /
for a position on the Village Council.
/PRINT NAME ADDRESS - —SIGNATURE SIGNATURE�� � � � .DATE
Gin I& �nnc---Z- s7 sf "16
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7ne�j9'j►�. SO /� � 1110AJc/ �"�i
1 "70 IOS�
The undersigned is the circulator of the foregoing paper con g signatures. Each appended thereto
was made in my presence and is the genuine signature of the person whose name it purports to be.
Signature of Circulator Address 7.7 a /J s
Acceptance ofNomination
I hereby accept the,nominationtfor tho Tillage Council and agree to serve if elected.
91 :6 0 �z 83J 11OZ Signature of CandidateO 4� /V"�
PETITION
We, the undersigned electors of Miami Shores Village, hereby nominate �7-
for a position on the Village Council.
IWNT NAME ADDRESS I NATUREi. DATE
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The undersigned is the circulator of the foregoing paper containing signatures. Each appended thereto
was made in my presence and is the genuine signature of the person whose name it purports to be.
Signature of Circulator e Address '?7 O
Acceptance ofNomination
I hereby acceptl'the,nomination for the Village Council and agree to serve if elected.
911 :6 ¢
Signature of Candidate � -�-
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�10R'tDp' -/0050 Q*- ,
GA-'aims CEJ o�ea, Coy YY:f38
March 1, 2011
Mr. Robert Swan
770 N.E. 98" Street
Miami Shores, FL 33138
Dear Bob:
Congratulations on becoming a qualified candidate for the upcoming Miami Shores
Village Council election!
Please be advised that as a candidate for the Village Council, you are required to file
Campaign Treasurer's Reports on the dates shown below:
Due Date Period Ending
First Treasurer's Report 03/25/11 03/20/11
Second Treasurer's Report 04/07/11 04/06/11
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 07/11/11
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 on the designated day
shall be deemed to have been filed in a timely manner.
�iFane: 05,)795-2207 Caa 805)756-8,972 �'-Cr�ail �miamuoleaaeavilla�e.aam
r.
Robert Swan
March 1, 2011
Page Two
At 10:00 AM on April 7, 2011, 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.
I 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
5�pC.193z
PS
L, Ov�
res 10
70050
February 22, 2011
Ms. Michelle McClain
Miami-Dade County Elections Department
2700 N.W. 87th Avenue
Miami, FL 33172
Dear Ms. McClain:
Enclosed please find Petition Forms (4) from Robert Swan, in reference to the Miami
Shores Village April 12, 2011 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,
"'W y �4- 1
Barbara A. Estep, MMC
Village Clerk
�iEone: (805)995-2207 CO.- (805)756-8972 �p- ail raG�i/@mia�nio/iozra„c�a�e.,wmc
PETITION
We, the undersigned electors of Miami Shores Village, hereby nominate � '�
for a position on the Village Council.
PRINT NAME ADDRESS SIGNATURE :. DATE
2 Loh
ISO mil � �� 1,10
(VZ IUYL)- 1�
,FccvL (AL ) 6�2 St �O
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(2-L� S o t o to A i
1 -7 A/ Ff 0
SLE` �E
The undersigned is the circulator of the foregoing paper con g signatures. Each appended thereto
was made in my presence and is the genuine signature of the person whose name it purports to be.
Signature of Circulator C -'�� �1'^ Address -770
Acceptance ofNomination
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
for a position on the Village Council. '
PRINT NAME ADDRESS -SIGNATURE..... DATA
/�
- Q) / Y21 V HOf - f i C '
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The undersigned is.the circulator of the foregoing paper contaLnLZg_ signatures. Each appended thereto
was made in my presence and is the genuine signature of the person whose name it purports to be.
Signature of Circulator /'^41r, Address 7 7 0 . f.
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 nominateA7 ,Tc cl q,J
for a position on the Village Council. '
PRINT NAME ADDRESS
DATE
At
c
FrJ ►/, WkITft ty 1-2 7�`^ /✓� f S ,
_ - �-T4S 6 told'--
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The undersigned is the circulator of the foregoing paper containing 17 signatures. Each appended thereto
was made in my presence and is the genuine signature of the person whose name it purports to be.
Signature of Circulator Address 7-7o
Acceptance ofNomination
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 �� 2 7
for a position on the Village Council. '
PUNTNAME ADDRESS I NATURE ..
DATE
Lb Sl Kf V, 5� r
a a - l zh i/l
v�► � �
_LVU q ' 1057:7;0 -
Z !/
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ani �, �Y✓� ��5 SIE �j' .�.
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The undersigned is the circulator of the foregoing paper containing signatures. Each appended thereto
was made in my presence and is the genuine signature of the person whose name it purports to be.
Signature of Circulator A4,1— Z.."' Address ?7 D
Acceptance of Nomination
I hereby accept the nomination for the Village Council and agree to serve if elected.
Signature of Candidate -�
PETITION
i - We, the undersigned electors of Miami Shores Village, hereby nominate AD
for a position on the Village Council.
PRINT NAME ADDRESS SIG A A
�
1 0
AvI� �l2Ac,J� �.10/is
�cSe �
569 NE-- l0 ( 5;'. ,✓� GJ � l G �/
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ry IN
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COX 8� c,21Q-0411
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The undersigned is the circulator of the foregoing paper containing /r signatures. Each appended thereto
was made in my presence and is the genuine signature of the person whose name it purports to be.
Signature of Circulator GC% Address 7 70 rs g S
Acceptance of Nomination
I hereby accept the nomination for the Village Council and agree to serve if elected.
Signature of Candidate G�
DECLARATION FOR CANDIDATES NOT AUTOMATICALLY COVERED
by the Mandatory Provisions of the
Miami-Dade Ethical Campaign Practices Ordinance
Miami-Dade County Code at 2-1 LL (1)
The Mandatory Fair Campaign Practices Ordinance at Sec.2-11.1.1(C)of the Miami-Dade County Code
extends to—
• Candidates,and their respective campaign staffs,for Miami-Dade Co.Commissioners or Mayor;
• Candidates,and their respective campaign staffs,for Miami-Dade Co.Community Councils;
• Candidates,and their respective campaign staffs,for any municipal elective office within Miami-
Dade County;
• Candidates,and their respective campaign staffs,for the Co.Property Appraiser.
Other candidates for elective office with a constituency in whole or in part in Miami-Dade Co.who are
not required to comply with the Mandatory Fair Campaign Practices Ordinance may at any time declare
that they agree to abide by the Mandatory Fair Campaign Practices Ordinance.
The Mandatory Fair Campaign Practices Ordinance states that a candidate shall not—
(a)
ot(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 that exposes the person to hatred,contempt,or ridicule or causes
the person to be shunned or avoided or injured in his or her business or occupation;
(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 that exposes the person to hatred,contempt,or ridicule or causes the person to be
shunned or avoided or injured in his or her business or occupation;
(c) Willfully injure,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;
(d) Knowingly obtain,or cause to be obtained,the campaign property of another candidate with the intent
to temporarily or permanently deprive the candidate of a right to the property or its benefit;or
(e) Knowingly file with the Ethics Commission a groundless or frivolous complaint against another
candidate.
If you are not automatically covered by the Mandatory Fair Campaign Practices Ordinance,but you have
a constituency in whole or in part in Miami-Dade County and you would like to abide by the Mandatory
Fair Campaign Practices Ordinance,please sign and date below.Once signed,the Declaration is deemed
irrevocable for the duration of the campaign.
1, A��"t' �L�2�� ,a candidate for the office of
please print your name
in �J c er V lla-V f ,
elective office sought county,municipality,or other jurisdiction
understand that I am not automatically bound by the Mandatory Fair Campaign Practices Ordinance of
Miami-Dade Co.Nevertheless,I choose to abide by the Mandatory Fair Campaign Practices Ordinance
and recognize the compulsory jurisdiction of the Ethics Commission and its authority to decide whether I
have violated the ordinance at Sec.2-11.1.1(C)of the County Code.I further understand that if a violation
is found,the Ethics Commission has the authority to impose the appropriate penalty,if any.
X s//o
Signature Date
COE,revised 4/2010
OFFICE USE ONLY
STATEMENT OF
CANDIDATE
(Section 106.023, F.S.)
(Please Type)
candidate for the office of /n, ,
have received, read and understand the requirements of Chapter 106,
Florida Statutes.
Signature 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.03108)
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NOTICE OF CANDIDACY AND RESIDENCY
I `/C4 b-r SLJA"^) , hereby file this Notice of Candidacy this "7 day
of F-l32cc2:1�j , 2011, for the Village Council election of Miami Shores Village to be held on
April, 12, 2011. 1 affirm that I have resided in Miami Shores Village for at least six (6) months
prior to the date of qualifying for office as required by Section 23 of the Village Charter.
Signature Print Name
7 70 ..)-6 9 9 J/
Address
3OC- 7-8.3- y93
Telephone Number
E-Mail Address
STATE OF FLORIDA )
COUNTY OF MIAMI-DADE ) I^ (-
BEFORE ME personally appeared (��Q V f 5()(,n who executed this Notice of
Candidacy and Residency this ? day of C 2011.
Barbara A. Estep
Notary Public
_ Personally Known
Produced the following Identification Seal/Commission Expires:
done: 805)795-2209' r 05>7S6-8972
1pC.1932 L1�
OR
logoC
ORiDA -/005'0 P'4/w. 2,
PA". QW,0~, 6;y 33:138
MIAMI SHORES VILLAGE COUNCIL
CANDIDATE INFORMATION RECEIPT
Candidate: Robe'4 Sri an
This is to acknowledge receipt of the following documents relating to
the 2011 Miami Shores Village Council Election to be held on Tuesday,
April 12, 2011.
Informational Letter from the Village Clerk
Petition Forms
Village Ordinances relating to Village Election
Qualifying Forms
Treasurer Report Forms
Items and Documents available from Miami-Dade County
Absentee Ballot Information
Poll Watcher Information
Candidate and Campaign Treasurer Handbook
State Statute Chapters 97— 106
Received By: oeo,6 E-17- 5�0,g-
Date:
��cosre. (305)995-2207 C�a� (305)756-8972 gp'_C� ea �R miamia�ar�a�i .oasn
Bob Swan, a native Miamian who grew up in Biscayne Park, has early ties to Miami
Shores. He played on sports teams at the Miami Shores Recreation Center and then
began work at the Center at age 13. He eventually coached various sports during the
summer months.
Bob attended St. Rose of Lima Elementary School and graduated from Archbishop
Curley High School. He went on to earn a Bachelor of Science degree in Criminology
from Florida State University and a Juris Doctor degree from the University of Miami
School of Law.
Bob has been a resident of Miami Shores for the past 29 years. He worked for the
Miami-Dade Police Department for thirty-four years and retired with the rank of captain.
During his career with the Department, he served in numerous middle-management and
command level assignments.
Bob can best be described as a fiscal conservative who believes your property tax
dollars are just that....yours, and that they should be spent wisely and only in support of
the operation of the Village.
Bob thinks it is time for a changing of the guard at Village Hall. That is why he is
seeking your vote on April 12, 2011.
Barbara Estep
From: bob swan [coplaw@att.net]
Sent: Sunday, March 20,'2011 10:38 PM
To: Barbara Estep
Subject: Fw: Re: Space at the bottom
Attachments: IMG 2803.JPG
--- On Thu,3/17/11, coplaw(&Junoxom <conlaw(&aunoxom>wrote:
From: coplawgiuno.com <coplawjuno.com>
Subject: Fw: Re: Space at the bottom
To: coplaw@att.net
Date: Thursday, March 17, 2011, 9:36 PM
Please note: forwarded message attached
From: Raul Duarte <duarte1031kgmail.com>
To: Bob Spin Swan<coplaw(a�juno.com>
Subject: Re: Space at the bottom
Date: Thu, 17 Mar 201108:22:33 -0500
Hi BOB,
Here is the photo attached.
I will get an email from printing co. once it is done.
I will let you know...but, I think they should be ready by tomorrow, Friday!
Raul
On 3/16/11 11:25 PM, 'Bob Spin Swan" <coplawgiuno.com>wrote:
Raul,
Had to go to a political forum breakfast on Wed. morning. Will see you on Friday in the
morning. Do you have any of those pictures left that you took of me? If so, could you e-mail
one or more to me? Think my laminated cards mught be ready tomorrow? Please let me know.
Thanks,
Bob
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2
Barbara Estep
From: coplaw@juno.com
Sent: Sunday, March 20, 2011 10:32 PM
To: Barbara Estep
Attachments: VOTE FOR ROBERT 2.doc
Barb,
Not real good at this, so I hope this works. Picture will be sent separately, I think.
Thanks,
Bob
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1
� i I
FLORIDA DEPARTMENT OF STATE a` ISIONF ELECTIONS
CAMPAIGN TREASURER'S RE. ,ORT UMMARY li J
(1) leo b X27 SLAJ 1_3 j OFFICE USE Oh LY
Name
(2) -770 98 sYr-2,rS "
Address (number and street)
M-�► ��.,�,,( S r�zrS -�-c.. 3..3/3 �} � � I
City, State,Zip Code
❑CHECK IF ADDRESS HAS CHANGED (� ) IDN mbar: S lI
(4) Check appropriate box(es): ,
&andidate(office sought): Pyl tA-.,,, SHvIL s �i
❑ Political Committee ❑CHECKi F PC HA S_1311SBANDED
❑ Committee of Continuous Existence ❑CHECK F CCE HAS DISBANDED i
❑ Party Executive Committee
❑Electioneering Communication ❑CHECK F NO;01 HER ELECTIONEERING i
COMMUNICATI00 REPORTS WILL B FI
(5)REPORT IDENTIFIES
Cover Period: From &4f / ®8 / It To o Report Type
OriginalEl El Election Report �
❑ In Jependent Expen&ure F eport
(6) CONTRIBUTIONS THIS REPORTIT(7) E PEND RES THIS REPOT •i
Moneta } '
Cash & Checks $ Q Expendif res
Loans $ Transfersi'to office
Account
Total Monetary $ Total
Monetary
In-Kind $
(8) der Dis 'buttons
-Iii
(9) TOTAL Monetary Contributions To Date (10) TOTAL� i Moeta
$ /L 40, -- ry Ex penditures To mate
$ I ZOO,
(11)CERTIFICATIONI
It is a first degree misdemeanor for any person to fa ,,`
�fy; ' Public rcl(ss.839.13, F'S.)
[-(Type
ertify that I have examined this report and it is true, I certify th t' I have xamined this repo and i` 's true,
rrect, and complete. correct, an complete.
i
name) _RIA, .� Sc.c9<},./ (Type nal
E3 individual(only for Treasurer De i rr�
electioneering common.)
❑ poly Treasurer R,Cand' ate Chairperson(on for P
electioneering commu .orga ' tion);
X � � X .
Sig nature Signatu��
DS-DE 12(Rev.08/04) g I
i
i
I
CAMPAIGN TREASURER'S REPQRT—ITEM D EXPENDITURES
(1)Name (2)I.D. Numbar
(3)Cover P OY S / // through OS l /0 (4)page af
(s) Cr) (8) (e) i (10) (11)
Date Full Name Purpose
(g) (Last,Suffix,First,Middle) (add office so
Sequence Street Address& contribution In a Expendifun P i
j
Number City,State,Zip Code candidate) Type Amend o
d� 17 / �. tai- �o�. ,r
IC)0 0 � tVc`�_£. Zia L(
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DS-DE 14(Rev. 8103)
SEE REVERSE FOR nanait:um AND lC0 VALUES
FLORIDA DEPARTMENT OF STATE DIVISION OF ELECTIONS
CAMPAIGN TREASURER'S REPORT SUMMARY
(1) \Tose. We, (tedy OFFICE USE ONLY
Name
(2) qq b N6 6' t A,
Address (number a d street)
City, State, Zip Code
❑ CHECK IF ADDRESS HAS CHANGED (3) ID Number:
(4) Chok appropriate box(es):
Candidate (office sought): rn �m �{r< � Q
❑ Political Committee ❑ CHECK IF PC HAS DISBANDED
❑ Committee of Continuous Existence ❑ CHECK IF CCE HAS DISBANDED
❑ Party Executive Committee
❑ Electioneering Communication HECK IF NO OTHER ELECTIONEERING
COMMUNICATION REPORTS WILL BE FILED
(6) REPORT IDENTIFIERS
Cover Period: From d / g / / I To 6Y / PJ / / ( Report Type Fes(
�iginal ❑Amendment ❑ Special Election Report ❑ Independent Expenditure Report
(6) CONTRIBUTIONS THIS REPORT (7) EXPENDITURES THIS REPORT
Monetary
Cash & Checks $ Expenditures $
Loans $ Transfers to Office
Account $
Total Monetary $ Total
Monetary $ �-
In-Kind $
(8) Other Distributions
$
(9) TOTAL Monetary Contributions To Date (10) TOTAL Monetary Expenditures To Date
$ C?610-0 $ (2 5
(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. , / l correct, and complete. 1 /
(Type name) 6U�4 �U1'M�P(�l (Type me) e sse GJA ecoY
❑Individual(only for 12 Treasurer ❑Deputy Treasurer andidat ❑Chairperson(only for PC,PTY&
electione7v� '
commun. �%� /� � 97F��--
Siqt�ta're
'
X `!�
Signature
DS-DE 12(Rev.08104)
CAMPAIGN TREASURER'S REPORT- ITEMIZED EXPENDITURES
(1)Name t �4�� Li d-,, (+e-j-., (2)I.D. Number
(3)Cover Period D T / U e/ (� through 6 (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
All
DS-0E 14(Rev.08103)
SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES
JESSE WALTERS
440 NE 91st. Street
Miami Shores, FL 33138
305-758-3067 (H)
305-333-8701 (C)
getset@comcast.net
CJ Ortuno
SAVE Dade
4500 Biscayne Blvd., #340
Miami, FL 33134
April 30, 2011
Dear CJ:
Enclosed please find a personal check for $78.64. Please consider this a,donation to your
organization.
Yesterday I closed my campaign (for Miami Shores Village Council) account at Chase Bank as
required by law. I will file my final campaign expense report next week.
This check represents the entire sum remaining in my campaign account. I am using a personal
check to convey the funds to SAVE Dade as I was given cash by the bank.
Sincerely,
Jesse Walters
Enclosure
WAIVER OF REPORT
(Section 106.07(7),F.S.)
(PLEASE TYPE)
OFFICE USE ONLY
Name Office Sought
_ - 3 3
Address City State Zip Code
Candidate ❑ Committee of Continuous ❑ Electioneering Communication Organization
Existence
❑ Political Committee ❑ Party Executive Committee
❑ Check box if address has changed since last report. ❑ Check here if PC,CCE,or ECO has DISBANDED
and will no longer file reports.
TYPE OF REPORTCheck Appropriate ppropriate Box)
QUARTERLY REPORTS PRIMARY ELECTION GENERAL ELECTION
❑ January ❑ 32nd day prior ❑ 46th day prior
❑ April ❑ 18th day prior ❑ 32nd day prior
❑ July ❑ 4th day prior ❑ 18th day prior ❑TERMINATION REPORT
❑ October j 4th day prior ❑SPECIAL ELECTION
NOTIFICATION OF NO ACTIVITY IN CAMPAIGN ACCOUNT FOR THE REPORTING PERIOD OF
O 1 /2-/ /! THROUGH
X 7 Z/f
Signature Date
SIGNATURES REQUIRED FOR: Candidates
Candidate,Campaign Treasurer or Deputy Treasurer(s. 106.07(5),F.S.)
Political Committees
Chairman,Campaign Treasurer or Deputy Treasurer(s. 106.07(5), F.S.)
Committees of Continuous Existence and Electioneering Communication Organizations
Treasurer (s. 106.04(4)(c),F.S.)
Party Executive Committees
Treasurer or Chairman(s. 106.29(2),F.S.)
In any reporting period when there has been no activity in the account(no funds expended or received)the filing of the
required report is waived..However,the filing officer must be notified in writing on the prescribed reporting date that no report
is being filed.
DS-DE 87(Rev.07110)
! I i
i
II
FLORIDA DEPARTMENT OF STATE d ,ISION OF ELECTIONS
CAMPAIGN TREASURER'S RE. ;OFT UMMARY
(1 OFFICE USE Oh LY
Name i I
(2) '77® ei `8 S7 �7
Address (number and street)
/'''`► �•�•-� -Si-�-�S ISL. . �j
City, State,Zip Code
€)
❑ CHECK IF ADDRESS HAS CHANGED
IDN mbar:
(4) Check appropriate box(es): 1
Kae(office sought):,
1�r Candidtf
( j'^r1-t ri-�� S i�d-�I%9.9 : V,
❑ Political Committee ❑CHEC F PC`HAS DI I BANDED
❑Committee of Continuous Existence ❑CHECK± F CCE HAS DISBANDED
❑ Party Executive Committee
❑ Electioneering Communication ❑CHECKi F NO.OTHER ELEC71ONEE NG ,
COMMUIICATIOO REPORTS WILL BE FIL
(5)REPORT IDENTIFI S
Cover Period: From D-2 / /0 / //
To 3 / !I / / Report Type (
29 Original ❑Amendment j! " I
❑Special Election Report (] in ependent Expendi ure R4pl ort
(6) CONTRIBUTIONS THIS REPORT (7) 6i PENDITURES THIS REPO T
r b Monetary
Cash & Checks $ /Z-.�D. Expendit;l 'res S-10
;± I
Loans $ 1 )
Transfeto Office
Account I; j
Total Monetary $ Z,�Ip 010 i
Total I!
Monetary
In-Kind $ I f
±
(8) Otl der Dis 'buttons
(9) TOTAL Monetary Contributions To Date 1(10) TOi7AL Monetary Expenditur To Date
I9 0
I -
4 II
(11) CERTIFICATION I 1
It is a first degree misdemeanor for any person to falsify ii` public rd(ss.839.13, F S.) j
I certify that I have examined this report and it is true, I certify thil l I haveexamined this repo and i 's true,
correct, and complete. // correct, an comp) te. j
(Type name) �k En—? ELJ 4,jj !
(TYPe Wali )
❑Individual(only for Treasurer ❑Deputy Treasurer and*!ate
electioneering commun.) I ( ❑Chairperson(onl for P 8i
electioneering commu .orge ' tion)
X
Signature ni
Signatu j
DS-DE 12(Rev.08104) 17I
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CAMPAIGN TREASURER'S REPORT- ITEMIZED CONTRIBUTIONS
(1) Name (2) I.D. Number ss
3 Cover Period 01-/ / O / !/ through 03 / Z.V / // 4 Pae l 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
42- 3315 O /CA-?fo.vS
o 64 / // /-7/7 s �5 ' CHIC- S-00
Sit-i7c if'-1-5-0
J Gv�Jtu�7
Z �� i j-L 3:r/?-2-•
X13 b'l l lI777 A-n7iµu2 A-77o x G p i
6r o.,>r-njFy 12o46
DS-DE 13(Rev.08103) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES
CAMPAIGN TREASURER'S REPORT-ITEMIZED EXPENDITURES
(1)Name A0/3 i1.2-4t-2 (2)I.D.Number 4J—
(3)Cover Period OZ-/ i3O / /f through 03 f (4)Page of �
(5) (7) (8) (9) (10) (11)
Date Full Name Purpose
(5) (Last,Suffix,First,Middle) (add office sought If
Sequence Street Address& contribution to a Expenditure
Number City,State,Zip Code candidate) Type Amendment Amount
790 w i5F.
h1l oq_,I ti-sMkS,' 33138
r�Ot.l O�c�90q� c rJ
43 1 ( 1 w r 4- M-tio ,�qe
2 1406- Aj.!E_ q q s-rA-,e�-r
rv7�r�l,�•ti t S-c�l-��-S F�3313 8
bni a v%I SH S �}n,,,►g 147 u-��or� ca
i3 /1
d 3/i DY cNF.
C.4-'- . A.c-1-, E,r✓ 10-10,J ''yvo
3 /w�:;�-... 5:Ze�E9, 33,K?
DS-DE 14(Rev.08103) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES