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Walters, Oesse LOYALTY OATH (Sections 876.05-876.10,Florida Statutes) CANDIDATE WITH NO PARTY AFFILIATION OFFICE USE ONLY —T Lieu(+&--'r First Name Middle Name/Initial 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 specified in s. 876.05, Florida Statutes, and that oath shall be filed with the records of the goveming official or employing govemmental agency prior to the approval of payment of salary, expenses, or other compensation. OATH OF CANDIDATE (Section 99.021,Florida Statutes) l\, We I-s (PLEASE PRINT NAME AS YOU WISH IT TO APPEAR ON THE BALLOT*-- NAME MAY NOT BE CHANGED AFTER THE END OF QUALIFYING) am a candidate with no party affiliation for the office of I�m L1 �L) l l!i%'C6 y' (office) (district#) I am a qualified elector of hA County, Florida; (circuit#) (group 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, I 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 ignatuie of Ca (date Telephone Number E ail 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): W I +1 "j � STATE OF FLORIDA COUNTY OF MiaMj- Sworn to(or affirmed)and subscribed before me this aa� day of 20 ( l •t�Y,",,,, BARBARA A.ESTEP Personally Known: or MY COMMISSION#DD 955300 a. fj& EXPIRES:March 29,2014Irgint, inature of Nota Public Bonded Th,Notary Pulft underwriteNotary Produced Identification: Type,or Stamp Commissioned Name of Notary Public Type of Identification Produced: DS-DE 24B(Rev.10/10) Rule 1S-2.0001,F.A.C. LJ LJ u LUG uuuL 1 � COMPLETE •N COMPLETE THIS SECTIONON ■ Complete items 1,2,and 3.Also complete A. ignature item 4 if Restricted Delivery is desired. `�'. 11 Agent ■ Print your name and address on the reverse X ❑Addressee so that we can return the card to you. B—BOseived by('Printed Name G Date of Delivery ■ Attach this card to the back of the mailpiece, f/.�/ s or on the front if space permits. '" 1. Article Addressed to: D. Is delivery address different from item 1? ❑Yes If YES,enter delivery address below: ❑ No ��n� 3. Service.Type rn' l�tY`r� b( ertifiedMail ❑-Express Mail ' ❑Registered O„Retum Receipt for Merchandise ❑Insured Mail ❑C.O.D. 4. Restricted Delivery?(Extra Fee) ❑Yes 2. Article Numberi (Transfer from service labeq ' 7 ' d�: O �-1.�✓( 'd 30 t b PS!Form 3811,February 2004 ;! ;Domestic Return Receipt 102595-o2-M-1540 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 • bom. muv� VI l lcge o erL tooso kdl.laimi 51nOres, � X313�" ■ ..- ��i� i"�� -�5�' x Cyt a • �� „s'.�� syr ��fda��,��,; � L .. - Er —D UAOTARMIMMM ra r,I OFFICIAL USE C3 M Postage $ ti Certified Fee a Postmark O Retum Receipt Fee Here (Endorsement Required) 0 Restricted Delivery Fee O (Endorsement ReWired)rq c cp Total Postage&Fees $ ru Sent To (`�p C3 3`tieef ApC7Vv:; ... ....... ..... .. N or PO Box No. ay,state,ZIP*a m(ChM 5110 X21 3 313 r Certified Mail Provides: ■ A mailing receipt .—" a A unique identifier for your mailpiece r. ■ A record of delivery kept by the Postal Service for two years Important Reminders: ■ Certified Mail may ONLY be combined with First-Class Mails 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. a For an additional fee,a Return Receipt may be requested to provide proof of. delivery.To obtain Return Receipt service,please complete and attach a Return Receipt(PS Form 38111 to the article and add applicable postage to cover the fee.Endorse mailpiece Return Receipt Requested".To receive a fee waiver for a duplicptte return receipt,a USP86 postmark on your Certified Mail receipt is required. L. ■ For an additional 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 ard- 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 inpiry. PS Form W,August 2006(Reverse)PSN 7530-02-000-9047 S URES �&XIAZ Q C�4�. Cp�, Q&P,W 01mr W� &" -l/mr ItivOR1Dp' 70050 PAIW. ,ol cW,. uce PA-aims &", 2011 Candidate Name: nesse- Address: q U(5 N , Telephone Numbers: (3os) 75l� - 3o6 E-Mail Address: Gek4(� cow � Y12,fr CANDIDATE INFORMATION REQUIRED FOR QUALIFYING FOR VILLAGE COUNCIL ELECTION Confirm Address and Voter's Registration Information Confirm Length of Residence in Miami Shores Campaign Account &Treasurer's Appointment Form 1 Financial Disclosure Loyalty& Candidate's Oath Statement of Candidate 50 Signatures on Nominating Petition � aS�ll - U►0. �elq( ov e_ Confirmed by Miami-Dade County Elections mt\h<),- uvi4 E(e_c tOVLS 1 �i�one. <805) 795-220 Caa (805)756-8972 �o-C ea �a nzicirtic%asc�age.00m i A KKRFS ✓ aix�a C �p�, �� 5%pc.1932 W� ITMr�� tORiDp' X0050 C/ 2"W CW,, uce COY my'no February 15, 2011 Mr. Jesse Walters 440 N.E. 91 st Street Miami Shores, FL 33138 Dear Jesse: 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. �iFone: 305 795--2207 6?-7 - 305)956-89772 �p-C� l�Q sniamiahorearic/�aSe cam J Jesse Walters February 25, 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, A'A'a a, L,� M(n L - Barbara A. Estep, MMC Village Clerk Certified Mail — Return Receipt Requested Candidate qualifying letter t 5�oREs ✓ a� �aixa C �p� i, C�� ♦ tx 193s GI Qir" 1ldof 0 FLORIDA 0,0050 Qw. uce PAa�nu �, .3'n"Y8 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 Jesse Walters, 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, &4V Barbara A. Estep, MMC Village Clerk 9iEaxe: (805)y95-2�Oy C •{a �05)X56-89y2 �o-C' r �U mia�nia�Oreavcl/dSe.aam PETITION 1 We, the undersigned electors of Miami Shores Village, hereby nominate �5� ��ra for a position on the Village Council. PRINT NAME ADDRESS SIGNATURE . DATE �cl v 12,E ffil AS}- z 7 3 - 2—A) GtF464-4D 4A Irene 4e y)A �Z. 853 NE 96, S r I)TrIv ZZ040-119A.) 2( sT a�s 4e Pi VP-t440 A s PSC A-U— ,�"7,� �/ qdz 5- tivh(it q a .fro k �`")C7 ie-14,46 5 3 3 7 .-YV k(L lr-3k Ulu 'A�L- The undersigned is the circulator of the foregoing paper containing signatures. Each appended thereto was made in my presence genuine ature of the person whose name it purports to be. Signature of Circulator Address Y;P1`ft /'/ Acceptance of Nomination I hereby accept the nomination for the Village Council and agree to serve if elected. Signature of Candidate T PETITION We, the undersigned electors of Miami Shores Village, hereby nominate kd-'-� for a position on the Village Council. PRINT NAME ADDRESS . . IgNATURF.. DATE qqo W qt 1i Ir c� ✓�o�rr)r)J ySv NFSti�I. St .0 r4 I Dg :�fil DL hu 21011 li� Liza1��, 2 =es The undersigned is the circulator of the foregoing paper containing signatures. Each appended thereto was made in my presence en ' signature of the person whose name it purports to be. Signature of Circulator Address lt4 /J6 T/> V Acceptance of Nomination I hereby accept the nomination for the Village Council and agree to serve if elected. Signature of Candidate PETITION l the undersigned signedltf electors oMiami Village, hereby i Shg � y nominatedeS for a position on the Village Council. PRINT NAME ADDRESS SIGNATURE DATE SS► �qn l q0 too 2: 5;4- A� S Mi Ana ,a.l /✓w ,�2..SS, i 7 0 ilyl� �� ' • Sly A-*1 Jl� 7�D n1.-� .�� S l _ ' Ir 1V nil 1 W D L 9,6 S- T- The undersigned is the circulator of the forego' g paper containing signatures. Each appended thereto was made in my presence gen ' e gn e of the person whose name it purports to be. Signature of Circulator Address 17yd /_L/t5' '�7/ 'V�A 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 VSA WQ ` c° for a position on the Village Council. PRINT NAME ADDRESS SIGNATURE . DATE Icc-_it- �Q) u. %.1 A-)ti is ne�� a v�S T N n E S4- ' If usv Sc hw►,'�� Fav 2 �� - - ��L 411� Ted: -s( ) �!;r%< '5�/e Z)F i /lit- s lK;►�1 LA2xuL,;� 111 The undersigned is the circulator of the foregoing paper containing signatures. Each appended thereto -was made in my presenc Ggen ' e s' ature of the person whose name it purports to be. Signature of Circulator f�' Address Z yD/(J6, Acceptance ofNomination I hereby accept the nomination for the Village Council and agree to serve if elected. r. Signature of Candidate PETITION I l r We, the undersigned electors of Miami Shores Village, hereby nominate for a position on the Village Council. PRINT NAME ADDRESS SIGN TURE : DATE GtS-�a✓o �arr,a" YlZ/ NE " A V6 gD�3ia� UES $�1 N�t-1 A 3� bM 2.�� Vit✓ g�'� �. 33►3� �/��1 a 50 77-Z.,C'T/<4- P e NL 9 TA The undersigned is the circulator of the foregoing paper containing signatures. Each appended thereto was made in my presence the genuine si tore of the person whose name it purports to be.. Signature of Circulator Address a !`� 271 1� v Acceptance of Nomination I hereby accept the nomination for the Village Council and agree to serve if elected. Signature of Candidate OFFICE USE ONLY STATEMENT OF CANDIDATE (Section 106.023, F.S.) (Please Type) I, candidate for the office of 1 ��►"� h ate (� CGS have received, read and understand the requirements of Chapter 106, Florida Statutes. X � J. h l� Si nature of Candidate Dat 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) 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 ONLY 1. CJ4ECK APPROPRIATE BOX(ES):, 0/ Initial Filing of Form Re-filing to Change: ❑ Treasurer/Deputy ❑ Depository ❑ Office ❑ Party 2. Name �of�"Candidate(in this order: First, Middle, Last) 3. Address (include post office box or street, city, state, zip `..J-P, Oa,(+t a code) 4. Telephone 5. E-mail address 6. Office sought(include district, circuit, group number) 7. If a candidate for a nonpartisan office, check if applicable: V ) I off � � Id,v��.�,t�J �S�hl�4 au E] My intent is to run as a Write-In candidate. 8. If a candidate four a 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. have appointed the following person to act as my Campaign Treasurer ❑ Deputy Treasurer 10. Name of Treasurer or Deputy Treasurer j 11. Mailing Address 12. Telephone /doa rl 9/s4 7-na Q,,c ('N-6 ) 36 Z 13. City14. County 15. State 16. Zip Code 17. E-mail address ILct^'k S l�,re S C k b w%l�Dote, f L �`?J�� s� o;, 4 c� (4 o s+,�r. co w 18. 1 have designated the following bank as my LK Primary Depository ❑ Secondary Depository 19. Name of Bank 20. Address 21. City 22.�unt t�` J�� 23. Stae 24. Zip Code UNDER PENALTIES OF PERJURY,I DECLARE THAT I HAVE READ THE FOREGOING FORM FOR APPOINTMENT OF CAMPAIGN TREASURER AND DESIGNATION OF CAMPAIGN DEPOSITORY AND THAT THE FACTS STATED IN IT ARE TRUE. 25. Date 26. Signatur idate X . 1 �� F, ' Trea u'r`er's Acceptance of Appointtment(fill in the blanks and check the appropriate block) UA bw � do herebythe accept p appointment (Please Print or Type Name) designated above as: Campaign Treasurer ❑ Deputy Treasurer. D X D to nature o C ign Treasurer or Deputy Treasurer DS-DE 9(Rev. 10/10) Rule 1S-2.0001, F.A.C. FORM 1 STATEMENT OF 2010 Please print or type your name,mailing FINANCIAL INTERESTS address,agency name,and position below: LAST NAME--FIRST PAME--MIDDLE NAME: FOR OFFICE wa,(4� ,� ��, USE ONLY: MAILING ADDRESS: � L10 IVB f� ID Code CITY: < ZI / COUNTY ( kAk t R4 r"9 Fly � v ID No. NAME OF AGENCY: Conf.Code NAME OF OFFICE OR POSITION LD OR SOUGHT: I P. Req.Code You are not limited to the space on the lines on this form.Attach ad itional sheets,if necessary. CHECK ONLY IF 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 EAR. 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 R LECTS EITHER(must check one): 0 COMPARATIVE(PERCENTAGE)THRESHOLDS 4$ 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 I A1rG 1-,1, I/4 Irnot Sk4) 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"Na") 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 Q. 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 PART D—INTANGIBLE PERSONAL PROPERTY[Stocks,bonds,certificates of deposit,etc.] (If you have nothing to report,you must write"none"or'Wa") TYPE OF INTANGIBLE BUSINESS ENTITY TO WHICH THE PROPERTY RELATES PART E—LIABILITIES (Major debts] (if you have nothing to report,you must write"none"or"n/a") NAME OF CREDITOR ADDRESS OF CREDITOR L Coe l 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 NAME OF BUSINESS ENTITY ADDRESS OF BUSINESS ENTITY PRINCIPAL BUSINESS ACTIVITY POSITION HELD WITH ENTITY VX 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(requir d): 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 officers/emp/oyeesfile with the Supervisor ment. Appointees who must be confirmed by section, you must write "none" or 'Wa" in that of Elections of the county in which they perma- the Senate must file prior to confirmation,even 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 specified 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. f 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 specified state employee is required to file a on page 3. final disclosure form(Form 1F)within 60 days of leaving office or employment. CE FORM 1-Effective:January 1,2011.Refer to Rule 346.202(1),F.A.C. PAGE 2 DECLARATION FOR CANDIDATES NOT AUTOMATICALLY COVERED by the Mandatory Provisions of the Miami-Dade Ethical Campaign Practices Ordinance Miami-Dade County Code at 2-11.1.1(C)(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) 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, 3�`rt' wa"I , a candidate for the office of please print your name i 1 6l�^ �,r J t 1 fi C�JAG, ( in 1 O�A l �I1arC,1c— 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. Signature Date COE,revised 4/2010 OR LN tt1C.1981 �Boom �� & gfarw 60eAR X0050 Q*W. , s NOTICE OF CANDIDACY AND RESIDENCY SSe, U),t,(�-ecc hereby file this Notice of Candidacy this day of ,rvG 2011, for the Village Council election of Miami Shores Village to be held on April, 12, 2011. 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. Signa ure Print Name Ad d re?M i Gc�►� (r�i o, r p(, 3 J l e Telephone Number E-M ' Address STATE OF FLORIDA ) COUNTY OF MIAMI-DADE ) BEFORE ME personally appeared G�S� who executed this Notice of Candidacy and Residency this -7 day of 2011. 6' L62 Barbara A. Estep Notary Public Personally Known Produced the following Identification Seal/Commissio ; •t¢ � BARBARA A.ES1EP MY COMMISSION N DD 955300 ~' #` (PIRES:March 2 U2014 ��Af��h�``` Bonded Thru Notary Publndervrrltere 9Olco . (305)995-2207 CO—_ - (305)756-8972 W-Q ail.• eatr,FG@miav�ua/eoreavi�a�e.com SCU-1-932 RFSevil e44 rtic mw—. C��azm.� C��o�xea• �Yu�� oRIDp' X0050 P'A�u COY m-ay MIAMI SHORES VILLAGE COUNCIL CANDIDATE INFORMATION RECEIPT Candidate: 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: Date: -/one: (305)9955-2209' Caa (305)756-8972 g'p-� rates�p muamcia/cox�avvre.com Elections 2700 NW 87th Avenue M I AM 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 59 signatures submitted by Jesse Walters 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 2nd DAY OF MARCH, 2011 Aster Sola Supervisor of Elections Miami-Dade County Please submit a check for$5.00 0 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 T 305-499-VOTE F 305-499-8547 TTY: 305-499-8480 miamidade.gov March 2, 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 Jesse Walters, a candidate for Council in the Miami Shores Village. A total of 61 petitions were submitted and all of the petitions were reviewed for verification. Of the total 61 petitions, 59 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, Les r Sola Supervisor of Elec ions Miami-Dade Elections Department Enclosure (1) PETITION We, the undersigned electors of Miami Shores Village, hereby nominate �� G�f for a position on the Village Council. PRINT NAME ADDRESS SIGNATURE DATE An IA614 U VV �Icv Z&V `JJ r( 1 / z2o (-TF . 31'eAle-laZ— 51' Irene �e-rna r�.Z 853 ►�E 9� sr 2 -ls-i/ D-) I Sr P� A 7-V A/ F E sq -- 3? s� .St— `�z%� ii `5l 1&k, �� 211d1 The undersigned is the circulator of the foregoing paper containing signatures. Each appended thereto was made in my presence genuine ' ature of the person whose name it purports to be. Signature of Circulator Address �}`ttr Acceptance of Nomination I hereby accept the nomination for the Village Council and agree to serve if elected. a, Signature of Candidate FT PETITION We, the undersigned electors of Miami Shores Village, hereby nominate for a position on the Village Council. r. PRINT NAME ADDRESS SjqNA DATE d� qqo q ,/ 2 a� ✓�cxo r 45-o IU&ri ii L St 6nnJ �H o Buz.g� <e 6tax 44c) AX j tk6 T o p j/n!l 54-_ a I /, (t , C I �ff Le�ff IN-D (X i Ulf 1/ - 3Nr' CjI � i� LAI z nz4D Z-5 N P J ✓ 2' dz es �r /m. ` A IVE -1f a s / 2 12 �i37"t' . -The undersigned is the circulator of the foregoing paper containing signatures. Each appended thereto was made in my presen=�" e n ' signature of the person whose name it purports to be. J Signature of CirculatorK Address `t`to 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, here Q v`�� 4u- for g , by nominate W a position on the Village Council. PRINT NAME ADDRESS SIGNATURE DATE SS► Vb1� qD ry,Lj c JW&W tpZ S' �Ayt D 5 MrrWEV- tM)AJ �7D /VW 1m.-ST, Oa47 l) &&&Al- W7 l� N too vt- - �� v fn- :2-:j*: 1 `')V pL ALJ ' x'2-3 CF The undersigned is the circulator of the forego'Ln g paper containing signatures. Each appended thereto was made in my presence gen ' e gn a of the person whose name it purports to be. Signature of Circulator Address -17y0 Acceptance of Nomination I hereby accept the nomination for the Village Council and agree to serve if elected. Signature of Candidate PETITION ( e4 We, the undersigned electors of Miami Shores Village, hereby nominate � W� for a position on the Village Council. ' PRINT NAME ADDRESS SIGNATURE : DATE f2Ay(r? ('1Z.�hJ/�M; D f4E R(.r r tir NU( (Sl( 7 1�- �� &( d et ran2� av►rt� 11�- nE q- S4-Arin 61 dd� -M J1 �'cus4iv Schvh,Vs �, 9ts< Tyr: Q-I i( r6 1(o �-�- 7 &9 0(27 1111 � � i o dTJ /U T 6e�"Z- &1-3 si�'fff AmiA LK U ' 7 / J-(6 1 �A) 09U rr-1 eAd1 'Lf! 6"]rbc 15D Jf- A Al �. The undersigned is the circulator of the foregoing paper containing signatures. Each appended thereto was made in my presenc gen#e e s' ature of the person whose name it purports to be. r Signature of Circulator Gf/ Address Z /D/�-(6 Acceptance ofNomination I hereby accept the nomination for the Village Council and agree to serve if elected. Signature of Candidate r;. _� r �M h �'` 9 y �, I ii�. 1\ ��'�.,` � t STATEMENT OF CANDIDACY: JESSE WALTERS I am Jesse Walters and am excited to be a candidate for Miami Shores Village Council. For many years I was the CEO of a convention and visitors bureau, and I have an extensive business back ground in hotels and tourism. Now, I am a stay-at-home Dad, taking care of our daughter Faith, who is fourteen months old. My partner David Traupman and I have been together for 23 years. We feel very fortunate to live in Miami Shores. It is an extra special place, and I want to encourage more citizens to become involved in aspects of our civic life. We are stewards of the incredible wealth of institutions we have inherited here and we need residents to embrace them and cherish them. am especially interested in revitalizing our downtown and have several specific ideas I look forward to sharing with you in the candidate's forums. I believe we can enhance the way we communicate with residents, and I believe Doctors Charter School and the Country Club need attention. I look forward to meeting you and hearing your concerns as well as joining our excellent village council! Barbara Estep From: getset@comcast.net Sent: Wednesday, March 02, 2011 7:19 PM To: Barbara Estep Subject: Re: Candidate Information Attachments: STATEMENT OF CANDIDACY.doc Hope this works. What are the latest filing and certification numbers, if you don't mind (smile)? Jesse Walters 440 NE 91st. Street Miami Shores, FL 33138 305-333-8701 ----- Original Message ----- From: "Barbara Estep" <estepb@miamishoresvillage.com> To: "councilman pherrera" <councilman_pherrera@yahoo.com>, Coplaw@Juno.com, getset@com cast.net, "Hunt Davis" <huntdavismsv@gmail.com>, "Jim McCoy" <jimmccoy@mccoyproperties.us>, "angela alvero" <aalvero1 @hotmail.com> Sent: Wednesday, March 2, 2011 9:49:38 AM Subject: Candidate Information A special election issue of the newsletter will be carried along with our regular April Village Newsletter on our website. Please submit a written statement letting the voters know who you are and why you are running for a Council seat. The statement should not be more than approximately 200 words in length and we will not edit the submittal. Please submit in Microsoft Word format and I will need the information no later than Wednesday, March 23rd Thanks! Barbara 1 FLORIDA DEPARTMENT OF STATE DIVISION OF ELECTIONS CAMPAIGN TREASURER'S REPORT SUMMARY (1) �e1'.re �(.w C-few OFFICE USE ONLY Name (2) y 4�6 /�� j /d_7� �S_X_dCy Address (number and street) City, State, Zip Code ❑ CHECK IF ADDRESS HAS CHANGED (3) ID Number: (4) Chec appropriate box(es): [g'Candidate (office sought): /y &W, �l-�Sl� U�� Cwl--C ❑ 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 3 / / 11 To q / r / tl Report Type Original ❑Amendment ❑ Special Election Report ❑ Independent Expenditure Report (6) CONTRIBUTIONS THIS REPORT (7) EXPENDITURES THIS REPORT rj Monetary Cash & Checks $ / '� J AD Expenditures $ ` Loans $ --� Transfers to Office � c Account $ Total Monetary $ I � 'r ' D3 Total Monetary $ In-Kind $ (8) Other Distributions $ (9) TOTAL Monetary Contributions To Date (10) TOTAL Monetary Expenditures To Date (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. C� ) (Type name) etxt , Cel t d.i' (Type name) Individual(only for Treasurer ❑Deputy Treasurer andidate E]Chairper on only for PC,PTY& elleectioneering commun. elect* neeri ommun.organization) X Sign re Signature DS-DE 12(Rev.08/04) CAMPAIGN TREASURER'S REPORT— ITEMIZED CONTRIBUTIONS __A � (1) Name � �ei U l�w_ (2) I.D. Number (3) Cover Period 2 / / C( through 411 / l (4) Page of (5) (7) (8) (9) (10) (11) (12) Date Full Name (6) (Last, Suffix, First, Middle) Sequence Street Address& Contributor Contribution In-kind Number City, State,Zip Code Type Occupation T e Descri tion Amendment Amount AA �Y.f l G SD 01 co pl- 209 44 �r NL,) DS-DE 13(Rev.08/03) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES CAMPAIGN TREASURER'S REPORT— ITEMIZED CONTRIBUTIONS (1) Name �� w (2) I.D. Number (3) Cover Period / through y / / / (4) Page of (5) (7) (8) (9) (10) (11) (12) Date Full Name (6) (Last, Suffix, First, Middle) Sequence Street Address& Contributor Contribution In-kind Number City, State,Zip Code Type Occupation Type Description Amendment Amount rQh� C,0411 ly ale 3 shy N�' ACV DS-DE 13(Rev.08103) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES ��D CAMPAIGN TREASURER'S REPORT— ITEMIZED CONTRIBUTIONS (1) Name \ ��(� W� ` � (2) I.D. Number (3) Cover Period / / through / / ( (4) Page of (5) (7) (8) (9) (10) (11) (12) Date Full Name (6) (Last, Suffix, First, Middle) Sequence Street Address& Contributor Contribution In-kind Number City, State, jZip Code Type occupation T e Descri tion Amendment Amount 0/ 10 l 4 JPA 11 w.7 / 0-0 5 f� niAr rol- om Tev4 q1 q or a2jt4j'-rj VL DS-DE 13(Rev.08/03) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES / �Cj 4 t � . � �� ... - � { R e C .. j \4 V , ��-�--- � � f- , � dk' � k b } e , {' { 1 � ��. .f� 1 1 1 .F CAMPAIGN TREASURER'S REPORT—ITEMIZED CONTRIBUTIONS (1) Name �J �l" (2) I.D. Number (3) Cover Period �1 / / through (4) Pae 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 Tvpe Occupation Type Description Amendment Amount /OV DS-DE 13(Rev.08/03) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES �� CAMPAIGN TREASURER'S REPORT- ITEMIZED EXPENDITURES (1)Name O-Q-cc-e-' W (+Pf.i (2)I.D. Number (3)Cover Period / / ( � through / / (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) Tyle Amendment Amount Ix Jr AG:7 J� DS-0E 14(Rev.08/03) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES I� FLORIDA DEPARTMENT OF STATE DIVISION OF ELECTIONS CAMPAIGN TREASURER'S REPORT SUMMARY 'C 4—L, 606r- OFFICE USE ONLY Name AddresA, (number and street) l 4.-c A oveG-i ft- City, State, Zip Code ❑ CHECK IF ADDRESS HAS CHANGED (3) ID Number: (4) Check appropriate box(es): _ N16andidate (office sought): j71 wt,C, Y ❑ 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 61 / b l( / ( To 031 V/ ( Report Type Original ❑Amendment ❑ Special Election Report ❑ Independent Expenditure Report (6) CONTRIBUTIONS THIS REPORT (7) EXPENDITURES THIS REPORT Monetary Cash & Checks $ (h G, Expenditures $ Loans $ oTransfers to Office Account $ Total Monetary $ CJ Total Monetary $ In-Kind $ (8) Other Distributions (9) TOTAL Monetary Contributions To Date (10) TOTAL Monetary Expenditures To Date $ $ a Vis,i (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) �� G!-.w► (Type arae) (4_�_ Individual(only for reasurer [:]Deputy Treasurer Candidat Chairpers n(only for PC,PTY& electioneering co un.) e ioneenn commun.organization) X X S ature Signature DS-DE 12(Rev.08/04) FLORIDA DEPARTMENT OF STATE DIVISION OF ELECTIONS CAMPAIGN TREASURER'S REPORT SUMMARY OFFICE USE ONLY Name (2) Addres (number and street) 1 AoveT' City, State,Zip Code ❑ CHECK IF ADDRESS HAS CHANGED (3) ID Number: (4) Check appropriate box(es): _ �07 5a,6andidate(office sought): `yl i c��ac v LLQ:fir U< 11.-_;e11.-_;e 'i,� ❑ 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 Ol / b ( / I ( TOy 3/ / ( Report Type Original ❑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 $ cJ Total Monetary $ In-Kind $ ,� (8) Other Distributions $ (9) TOTAL Monetary Contributions To Date (10) TOTAL Monetary Expenditures To Date $ =�'S �%t� $ ,�,1 ate, / -) (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) orf s �1�.., ��—� (Type ame) �. Individual(onlyfor rea urer ❑Deputy Treasurer Candidat Chairpers n(only for PC.PTY& electioneering comm ele 'oneerin mmun.organization) X X Signat re Signature DS-DE 12(Rev.08/04) CAMPAIGN TREASURER'S REPORT ITEMIZED CONTRIBUTIONS AND FUND TRANSFERS (1) Name re-fslel Wei-(teya- (2) I.D. Number (3)Co er Period 01 / / 1 ! through / / if (4) Page of ontributions (Use separate sheets for Contributions and Fund Transfers.Do not combine sequence numbers with Fund Transfers) ❑Fund Transfers (Use separate sheets for Contributions and Fund Transfers. Do not combine sequence numbers with Contributions) (5) (7) (8) (9) (10) (11) (12) Date at Contributor- (6) Full Name(L,Suffix,F,M) Contribution In-kind Descrip Seq Num Full Street Address& Type Occupation or Transfer or City,State,Zip Code Type Nature of Acct. Amended Amount 6/ , l 8 l It iF6111e,e, 7s � ej&3CC 611 I r, G kdx-e, ioYa, dw� cis /gid' a 'e,r<<te 8 17 �qv ,►-� yin -LI— �F fid' a'b ,art- n 1,0�-r, 4,F- �i t) oar I 1/1 ,�,►, ate. DS-DE 13A(Rev.02108) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES CAMPAIGN TREASURER'S REPORT ITEMIZED CONTRIBUTIONS AND FUND TRANSFERS (1) Name (2) I.D. Number (3)Co er Period 01 / / � ( through / / � � (4) Page of - ontributions (Use separate sheets for Contributions and Fund Transfeia.'.Do not combine sequence numbers with Fund Transfers) [❑Fund Transfers (Use separate sheets for Contributions and Fund Transfers. Do not combine sequence numbers with Contributions) (5) (7) (8) Tcontribution ) (10) (11) (12) Date Contributor (6) Full Name(L, Suffix,F,M) in-kind Descrip Full Street Address& ansfer or Seq Num Type Occupation Ci ,State,ZiD Code Tvpe Nature of Acct. Amended Amount tom` -avJr 1 C'!� Ye iv t17 IV 6.4 1 P►t,i (', W 'ct 1/ tv ef `� /� ..� �, t:�l. P�e Oa, a� '� G✓� l it AIIIJA G'ap �/C )3 irz , e ?AL336)3 U I tU'�"a-Aa --,") C� DS-DE 13A(Rev.02108) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES CAMPAIGN TREASURER'S REPORT ITEMIZED CONTRIBUTIONS AND FUND TRANSFERS (1) Name SS �.VGZ ltt!°� (2) I.D. Number 1 A=(3) Co er Period 01 / l l 1 through / / 1 / (4) Page of ontributions (Use separate sheets for Contributions and Fund Transfers,.Do not combine sequence numbers with Fund Transfers) Fund Transfers (Use separate sheets for Contributions and Fund Transfers- Do-not combine sequence numbers with Contributions) (5) (7) (8) (9) .. (10) (11) (12) Date Contributor (6) Full Name(L, Suffix, F, M) Contribution In-kind Descrip Seq Num Full Street Address 8� or Transfer or city, State,Zi Code Type Occupation Type Nature of Acct Amended Amount td XIU t (o s` fir• � Ole 1 � A 6 ti f > b4wrc At e I r-L CJAS 1A lb Iy p G 'Z -j/ / / , L►at+4e 00 DS-DE 13A(Rev.02108) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES CAMPAIGN TREASURER'S REPORT ITEMIZED CONTRIBUTIONS AND FUND TRANSFERS (1) Name (2) I.D. Number eSS� L� .t )(_(_eJ� =ibutions r Period 01 / l f through / I j (4) Page of (use separate sheets for Contributions and Fund Transfers..Do not combine sequence numbers with Fund Transfers) FjFund Transfers (use separate sheets for Contributions and Fund Transfers. Do not combine sequence numbers with Contributions) (5) (7) (8) (9) (10) (11) (12) Date Contributor (6) Full Name(L,Suffix,F,M) Contribution In-kind Descrip Seq Num Full Street Address& or Transfer or City- State,Zi Code Type Occupation T Nature of Acct. Amended Amount 11-1 TV a T'` s1P�o t J?is jP rrvi y7t nc• nr+e w io.... mm�oa .cee oaseoce eno r►�crn��nr�nwrc wwtn rnno aiw� �� CAMPAIGN TREASURER'S REPORT— ITEMIZED CONTRIBUTIONS (1) Name �� CTC/ (2) I.D. Number (3) Cover Period 1 I �� / // through L�,l / y/ �/ (4) Page j 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 I DS-DE 13(Rev.08/03) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES / �� CAMPAIGN TREASURER'S REPORT-ITEMIZED EXPENDITURES (1)Name Li (2)I.D. Number (3)Cover Period 19 / / ( i through (4)Page of (5) (7) (8) (9) (10) (11) Date Full Name Pu'''pose (Last,Suffix,First,Middle) (add office sought if (6) Street Address& contribution to a Expenditure Sequence City,State,Zip Code candidate) Type Amendment Amount Number r vei- TL 40� el a A wu- 4 AA - A, /l�►v, yGj j/6 v ,6 _ J) f3' Y`z (o /tn ems- P ' , db D�-DE 14(Rev.08/03) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES CAMPAIGN TREASURER'S REPORT - ITEMIZED EXPENDITURES (1)Name �-Q-�� W 6� (-des-.f (2)I.D. Number (3)Cover Period D / J through l I �� (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) Ype Amendment Amount 113 7,I 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 (�) �G,lf� (!✓mac( .�� OFFICE USE ONLY Name (2) 400 Address (number and stre City, State,Zip Code ❑CHECK IF ADDRESS HAS CHANGED (3) ID Number: (4) Cheqk appropriate box(es): / Candidate(office sought): ��^+-� ✓ /�cs (Jc Qr'G5e C_bu;�c 1 ❑ 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 N / 6 1 / it To / / // Report Type .6ri 9�Inal [R-A-mendment ❑ Special Election Report p El independent Expenditure Report (6) CONTRIBUTIONS THIS REPORT (7) EXPENDITURES THIS REPORT Monetary Cash & Checks $ � Expenditures $ Loans $ Transfers to Office Account $ Total Monetary $ Total Monetary $ 7' In-Kind $ (8) Other Distributions (9) TOTAL Monetary Contributions To Date (10) TOTAL Monetary Expenditures To Date $ CL) ov $ �a �� - (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. y I L correct, and complete. ) / (Type name) ��7(,� �C!��x c l�`� (Type n e) �_jkllics ❑Individual(only forreasurer ❑Deputy Treasurer andidate tE],Chha'rpe on only for PC,PTY& elleectioneering commun.) nee' commun.organization) X nature Signature DS-DE 12(Rev.08/04) CAMPAIGN TREASURER'S REPORT ITEMIZED CONTRIBUTIONS AND FUND TRANSFERS (1) Name Tezf;e, WeL l+ems (2) I.D. Number (3) Co er Period 01 / 6 ) / l I through / d / It (4) Page of ontributions (Use separate sheets for Contributions and Fund Transfers.Do not combine sequence numbers with Fund Transfers) E]Fund Transfers (Use separate sheets for Contributions and Fund Transfers. Do not combine sequence numbers with Contributions) (5) (7) (8) (9) (10) (11) (12) Date (g) Contributor Full Name(L, Suffix, F, M) Contribution In-kind Descrip Seq Num Full Street Address& or Transfer or City, State,Zi Code Type Occupation Type Nature of Acct. Amended Amount d?D� 1E CAS a e i lA-. m� � ei, ,?Z71J 3? 17 i2o_/ 61 / it di/ D y / �! % tel DA L44,t �l C.K>E /pro DS-DE 13A(Rev.02/08) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES Q CAMPAIGN TREASURER'S REPORT ITEMIZED CONTRIBUTIONS AND FUND TRANSFERS (1) Name ��(S,� ��fie - (2) I.D. Number (3)C er Period 01 / D( / I through 03 / �Y/ It (4) Page of ontributions (Use separate sheets for Contributions and Fund Transfers.Do not combine sequence numbers with Fund Transfers) f7 Fund Transfers (Use separate sheets for Contributions and Fund Transfers. Do not combine sequence numbers with Contributions) (5) (7) (8) (9) (10) (11) (12) Date (6) Contributor Full Name(L,Suffix,F, M) Contribution In-kind Descrip Seq Num Full Street Address& or Transfer or City, State,Zi Code Type Occupation Type Nature of Acct. Amended Amount p4 ,Z� ,�.4 �j 1,60 lie r 1' CSE c', Ft4 lets tin -j / ! /n1331Zo d5' 11f �� b le, DS-DE 13A(Rev.02108) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES / CAMPAIGN TREASURER'S REPORT ITEMIZED CONTRIBUTIONS AND FUND TRANSFERS (1) Name ��5� ��( 'ems- (2) I.D. Number (3)C er Period 0 1 through Y/ 11 (4) Page of J ontributions (Use separate sheets for Contributions and Fund Transfers..Do not combine sequence numbers with Fund Transfers) rl Fund Transfers (Use separate sheets for Contributions and Fund Transfers. Do not combine sequence numbers with Contributions) (5) (7) (8) (9) (10) (11) (12) Date (s) Contributor Full Name(L, Suffix,F, M) Contribution In-kind Descrip Seq Num Full Street Address& Type Occupation or Transfer or City,State,Zip Code Type Nature of Acct. Amended Amount I— la 6' G/1 a IT X4/,4e�,j�� T 641 i DO lfl �- a K pk.a- 1( Ido lkKr �� } 'ff� AWM. �b 29 07 a� i►"Vvc, tw jmv CAS hr► I�wG� 6 (Z)aa N_ r DS-DE 13A(Rev.02/08) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES CAMPAIGN TREASURER'S REPORT ITEMIZED CONTRIBUTIONS AND FUND TRANSFERS (1) Name ��S'� Wim,(+ev — (2) I.D. Number (3)Co er Period 01 / 0/ / l I through OSI a Y l It (4) Page of If— butions (Use separate sheets for Contributions and Fund Transfers..Do not combine sequence numbers with Fund Transfers) - rj Fund Transfers (Use separate sheets for Contributions and Fund Transfers. Do not combine sequence numbers with Contributions) (5) (7) (8) (9) (10) (11) (72) Date (s) Contributor Full Name(L,Suffix, F, M) Contribution In-kind Descrip Seq Num Full Street Address& or Transfer or City,State,Zi Code Type Occupation Type Nature of Acct. Amended Amount �Gyre�x Q Cl( , - �A M i .J �� DS-DE 13A(Rev.02108) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES CAMPAIGN TREASURER'S REPORT— ITEMIZED CONTRIBUTIONS (1) Name V ��l " (2) I.D. Number (3) Cover Period through (4) Pae of =� (5) (7) (8) (9) (10) (12) Date Full Name (6) (Last, Suffix, First, Middle) Sequence Street Address& Contributor Contribution In-kind Number City, State,Zip Code Tvpe Occupation Type Description Amendment Amount D► DS-DE 13(Rev.08/03) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES / t r D t CAMPAIGN TREASURER'S REPORT — ITEMIZED EXPENDITURES (1) Name �2Sr� LJ ,,F, (+e,(--f (2)I.D. Number (3)Cover Period / / ( / through / / �� (4) Page of (5) (7) (8) (9) (10) (11) Date Full Name Purpose (8) (Last,Suffix, First,Middle) (add office sought if Sequence Street Address& contribution to a Expenditure Number City,State,Zip Code candidate) Type Amendment Amount 3 c3 63 arl vl�. �l PEJO w dam.. �T hyo J � � ��-J�i r/Jar /y'f Ve'f pix J'✓r r 33� r4 444' >e -> . �s DS-DE 14(Rev.08/03) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES