G5 Waiver ReportWAIVER OF REPORT
(Section 106.07(7), F.S.)
(PLEASE TYPE)
OFFICE USE ONLY
Name Office Sought
Address City State Zip Code
Candidate Political Committee Party Executive Committee
NOTE: This form does not apply to an electioneering communications organization (ECO). An ECO must file a report (not a
waiver) that no reportable contributions or expenditures were made during the reporting period (s. 106.0703(6), F.S.).
Check here if address has changed since last report.Check here if PC has DISBANDED and will no longer file
reports.
TYPE OF REPORT (Check Appropriate Box and Complete Applicable Line beneath Box)
MONTHLY REPORT PRIMARY ELECTION GENERAL ELECTION OTHER REPORT TYPE
Indicate report #
M______
Indicate report #
P______
Indicate report #
G______
Indicate report type and #
as applicable:
_______________
TERMINATION REPORT SPECIAL ELECTION
NOTIFICATION OF NO ACTIVITY IN CAMPAIGN ACCOUNT FOR THE REPORTING PERIOD OF
THROUGH
X
Signature Date
X
Signature Date
REQUIRED SIGNATURES FOR: Candidates:
Candidate and Campaign Treasurer or Deputy Treasurer (s. 106.07(5), F.S.)
Political Committees:
Chairman and Campaign Treasurer or Deputy Treasurer (s. 106.07(5), F.S.)
Party Executive Committees:
Treasurer and Chairman (s. 106.29(2), F.S.)
Except as noted above for an ECO, 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. 06/15)
By City Clerk
Jonathan Meltz Council Member
157 NE 104 Street Miami Shores, FL 33138
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04/09/21
04/09/21
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04/09/21 - 09:23:04