Petition Transfer of Custody MeltzM IAM I-DADE.'
Miami -Dade Elections Department
2700 NW 87' Avenue
Miami, Florida 33172
305-499-8363
Petition Transfer of Custody
(to be completed when returning processed petitions to Governmental Agency or Committee)
PETITION NAME: Jonathan Meltz
GOVERMENTAL
AGENCY OR
COMMITTEE: Miami Shores Village
C— COMPILED BY REGISTRATION SECTION:
No. of Petitions 102
transferred
No. of Boxes
transferred
Delivered by: (Miami -Dade Elections Dept. Staff)
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U Print Name Signature Date
Received by: (Governmental Agency or Committee Staff)
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PrinAame SignalVire Date