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STATEMENT OF CANDIDATE-ULVERTOFFICE USE ONLY STATEMENT OF CANDIDATE (Section 106.023, F.S.) (Please print or type) Christian Ulvert candidate for the office of Miami Shores Village Council 02-19-19 1 :54 RC V[? have been provided access to read and understand the requirements of Chapter 106, Florida Statutes. X Signature of Candidate February 18, 2019 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 (05111)