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Petition Transfer of Custody Saint FleurcouMTv Jk; 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: Katia Saint Fleur GOVERMENTAL AGENCY OR COMMITTEE: Miami Shores Village COMPILED BY REGISTRATION SECTION: No. of Petitions 65 transferred No. of Boxes transferred Delivered by: (Miami -Dade Elections Dept. Staff) 2 ozi rint Name ignature Date Received by: (Governmental Agency or Committee Staff) Pri t Name Siglure Date