Loading...
Davis, Al STATE OF FLORIDA ) MIAMI SHORES VILLAGE ) I, 1 do solemnly swear(or affirm) that I will support the Constitution and will obey the laws of the United States and of the State of Florida, that I will, in all respects, observe the provisions of the Charter and Ordinances of Miami Shores Village, and will faithfully discharge the duties of the office of Council Member. So help me God. SUBSCRIBED AND SWORN to before me: This 20th day of April, 2010. . I ) I - V� -t-4 — L Richard Sarafan Village Attorney f: NOTARY PUBMCSTATE OF FLORIDA Richard Sarafan '-:'Fi':Commission#DD787898 IV Expires: AUG.05,2012 BONDED THRU ATLANTIC BONDING CO.,ING FORM I STATEMENT OF 2008 Please print or type your name,mailing FINANCIAL INTERESTS address,agency name,and position below: LAST NAME--FIRST NAME--MIDDLE NAME: �. FOR OFFICE 1J (I�tS *j -.111AIA USE ONLY: MAILING ADDRESS: �o A.s . q l Sf ID Code �iQM�1 S�'WM'► 331�g �yr�M, �]��a CITY: ZIP: COUNTY: ID No. NAME OF AGENCY: '/ 1 ,fttAt ;k0JW(� r 6%4 �AwN�►` Conf.Code NAME OF OFFICE OR POSITION HELD OR SOUGHT: P.Req.Code You are not limited tothe ace on the lines on this form.Attach additional 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 YEJ�R. PLEASE STATE BELOW WHETHER THIS STATEMENT IS FOR THE PRECEDING TAX YEAR ENDING EITHER(check one): L1�J/ DECEMBER 31,2008 Q8 ❑ 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 REFLECTS EITHER(check one): ❑ COMPARATIVE(PERCENTAGE)THRESHOLDS Q$ ❑ DOLLAR VALUE THRESHOLDS PART A--PRIMARY SOURCES OF INCOME [Major sources of income to the reporting person] NAME OF SOURCE SOURCE'S DESCRIPTION OF THE SOURCE'S OF INCOME ADDRESS PRINCIPAL BUSINESS ACTIVITY s�A- � GL o-, �1 +,� . -�1V Ads PART B—SECONDARY SOURCES OF INCOME[Major customers,clients,and other sources of income to businesses owned by the reporting person] NAME OF NAME OF MAJOR SOURCES ADDRESS PRINCIPAL BUSINESS BUSINESS ENTITY OF BUSINESS'INCOME OF SOURCE ACTIVITY OF SOURCE �D 1A1. St 1.,r�tNook PART C--REAL PROPERTY [Land,buildings owned by the reporting person] FILING INSTRUCTIONS for when and where to file this form are locat- ,( p / S ; ed at the bottom of page 2. `� INSTRUCTIONS on who must file t this form and how to fill It out begin on page 3. OTHER FORMS you may need to file are described on page 6. CE FORM 1 Eff.1/2009 (Continued on reverse side) PAGE 1 PART D—INTANGIBLE PERSONAL PROPERTY[Stocks,bonds,certificates of deposit,etc.] TYPE OF INTANGIBLE BUSINESS ENTITY TO WHICH THE PROPERTY RELATES PART E—LIABILITIES [Major debts] n NAME OF CREDITOR ADDRESS OF CREDITOR '�k>N�i t�►� Wh��►ovin �A►"c PART F—INTERESTS IN SPECIFIED BUSINESSES [Ownership or positions in certain types of businesses] BUSINESS ENTITY#1 BUSINESS ENTITY#2 BUSINESS ENTITY#3 NAME OF BUSINESS ENTITY ADDRESS OF BUSINESS ENTITY PRINCIPAL BUSINESS ACTIVITY POSITION HELD WITH ENTITY I OWN MORE THAN A 5% INTEREST IN THE BUSINESS NATURE OF MY OWNERSHIP INTEREST IF ANY OF PART?"AHROUGH F ARE CONTINUED ON A SEPARATE SHEET, PLEASE CHECK HERE ❑ SIGNATURE(required): DATE SIGNED(required): Z– t-1_ o, FILING INSTRUCTIONS: WHAT TO FILE: WHERE TO FILE: WHEN TO FILE: After completing all parts of his 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 ment. Appointees who must be confirmed by section, you must write "none" or 'Wa" in that Local tions of the to couneesty file with the Supervisor the Senate must file prior to confirmation,even section(s). of Elections . the county t which they perms- if that is less than 30 days from the date of their nently reside. (If you do not permanently reside 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. of 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 -Eff.1/2009 PAGE 2 Elections 2700 NW 87th Avenue MIAMI-DAD-E)) 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, Tara C. Smith, Chief Deputy Supervisor of Elections of Miami-Dade County, Florida, do hereby certify that 78 signatures submitted by William "Al" Davis for the office of Village Council in Miami Shores Village matched the signatures on the voter files. WITNESS MY HAND AND OFFICIAL SEAL, AT MIAMI, MIAMI-DADE COUNTY, FLORIDA, ON THIS 23rd DAY OF A0Aa._, FEBRUARY 2009 Tara C. S 6th Chief Deputy Supervisor of Elections Miami-Dade County Please submit a check for$S.00 to our offic payable to the "Board of-County Commissioners"for the cost of verifying these signatures. PETITION t =— We,the undersigned electors of Miami Shores Village, hereby nominateW. Afor a position on the Village Council. PRINT NAME ADDRESS- .SIGNATURE--:- .DATE 41A1g7 H.R. . - _ � o� jp 1.r u c,Ll. E �► f/o�4a,j 17",0,0 I�•LC`.�4� d of, a adw ia too,* k 61 e4_�Z,4��f"41 or N6 Ave ..�; 1- 27-Qy MA Y 1421 N� IO S�. lUe-tel tr ma n 655 �G� S�� �s os s��,f�.► e. _ Cal 09 The imdersi ed is the circ r of the foregoing paper 6 "1 gn g g Pap containing signatures. Each appended.thereto was made in my presenc"WanA is the genuine signature of the person whose name it purports to be. Signature of Circulator ` Address d 0 s �j.L: 4q Sr Acceptance of Nomination I hereby accept the i nomination for the Village Council and agree to serve' lected. Signature of Candidate v� " PETITION ,Y We, the undersigned electors of Miami Shores Village, hereby nominate C for a position on the Village Council. r PRINT NAME ADDRESS -SIGNATURE :. - DATE uel Ax" yPj Ni WA76,V,' lAn/ �� N E 1�1 fit- VOOdna �. 1'1��ro�F �v� 1cif V._j ✓/"¢ s& lac f 4C /O7'sl 33«� !Zf-Of a • /CA.7013ol 09 I(A �&t- 12�/a9 ltv4� �4= ?� AI C!I Oiffth-,Ov, (e,-�'�A 6xf CR1� S� �> Com C���� Ea�c 2�• o� `�X^"`f c4S%r �,ALEKW The undersigned is the circulator of the foregoing paper containing signatures. Each appended thereto was made in my presence is the genuine signature of the person whose name it purports to be. Signature of Circulator Address 4 0-5 G , g i 5 r-- Acceptance of Nomination I hereby accept the nomination for the Village Council and agree to serve if a d. i • Signature of Candidate PETITION We, the undersigned electors of Miami Shores Village;hereby nomuiate C� Q ✓ s for a position on the Village Council. 4 f PRINT NAME ADDRESS SIGNATURE . DATE .�►`'�:�Ftrr �-�o N►- S t Cod � .t�RCirfcY m 1 a2227 10 49) �A 0 12 L'E I ESS :7 Cid' �1�/_ycL.roR ITPC(Fr-1`R A K�v g� sr �by A m 0- V ZZY-3 A 17 5 Y3 e� `7 3/ N The undersigned is the circulator of the foregoing paper containing ('1 signatures. Each appended thereto was made in my presence dLthenuine signature of the person whose name it purports to be. Signature of Circulator Address 4" Acceptance of Nomination I hereby accept the nomination for the Village Council and agree to se a ifelected. 7aSignature of Candidate r; G �♦ 44. PETITION r — We, the undersigned electors of Miami Shores Village, hereby nominate y L N4044% for a position on the Village Council. PRME INT NAADDRESS SIGNATURE :. DATE 2$a #46 1 o Y ✓ V'1'i)�Rl�er � � �/?� Q9 Oe vgr /V- — z Det! r3 -7�Il��le �e►r a s 5'�`� NC !bt �sf. 1t � 5�fa.�n i ck �'1 y N,E/0l �• , l/1j*fIq, GQ7jZgr4-z VE- 4 Z!L-Aq qIQ 4��(� W/ NA- 0? -Wit 4. � 3 6N'F�i' I-24_ c t The undersigned is the circulr of the foregoing paper containing 11 signatures. Each appended thereto was made in my presence is the genuine signature of the person whose name it purports to be. Signature of Circulator Address `�°'� �. ' R 9 Sr Acceptance of Nomination I hereby accept the nomination for the Village Council and agree to serve' d. Signature of Candidate PETITION ��Y_r We, the undersigned electors of Miami Shores Village,hereby nominate L for a position on the Village Council. PRINT NAME ' `: ADDRESS SIGNATURE.-:. DATE '✓ c� /V/,:;�� �134�-Grp•-yrl�' ,x�, ' d F t t o�Sg AIF - - 9 44 /12J1 I J11 jo. • ��' �srZ-Gc�zQ Ccvi� J � z� �' �,.. vo PzesAf , 47 T /vie s V/ ZIJ2_ �— Alf J✓ f��1'� rii4 - 2Z.7 Cl/F fo S-`'• , H The undersigned is the circulator of the foregoing paper containing signatures. Each appended Le7to. was made in my presence an s the genuine signature of the person whose name it purports to be. 4 Signature of Circulator Address - kI.6. 4 9 Q r. Acceptance of Nomination I hereby accept the nomination for the Village Council and agree to sere if el d. Signature of Candidate U!S. PostaIlServii"T�., CERTIFIED MAIO., RECEIPT 'Domy esti ail Only;No Insurance Coverage Provided) 1 For delivery information visit our website at www.usps.com" OFFICIAL a _ _ - -� • V p 1 PS F=orm 3800'A ust 2005 '?^ ��`� °'..See Reverse for instructions Certified Mail Provides: r A mailing receipt r A unique identifier for your mailpiece ■ A record of delivery kept by the Postal Service for two years Important Reminders: s Certified Mail may ONLY be combined with First-Class Mail®or Priority Mair. ■ Certified Mail is not available for any class of international mail. e NO INSURANCE COVERAGE IS PROVIDED with Certified Mail. For valuables,please consider Insured or Registered Mail. ■ 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 3811)to the article and add applicable postage to cover the fee.Endorse mailpiece"Return Receipt Requested".To receive a fee waiver for a duplicate return receipt,a USPSe postmark on your Certified Mail receipt is required. ■ 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 arti- 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 inquiry. PS Form 3800,August 2006(Reverse)PSN 7530-02-000-9047, SENDER: COMPLETE THIS SECTION COMPLETE THIS SECTION ON DELIVERY ■ Complete,items 1,2,and 3.Also complete A. Signature item 4 if Restricted Delivery is desired. ❑Agent ■ Print your name and address on the reverse X c/ l~ ❑Addressee so that we can return the card to you. g, Ry(P' ted Name) C. Date- f De-)(very ■ Attach this card to the back of the mailpiece, or on the front if space permits. 1 v!J� D. Is delivery address different from item 1 1. Article Addressed to: If YES,enter delivery address below: No 1+1 i s Los N-E- WV1 � Un'W5 W.V e—S 3. Service Type (�Certified Mail 13 Express Mail ❑Registered . ❑Return Receipt for Merchandise ❑Insured Mail ❑C.O.D. 4. Restricted Delivery?(Extra Fee) ❑Yes 2. Article Number 7 00� �Ci O r Z2O) L(03 (Transfer from service IabeQ o l (�J00 PS Form 3811',February 2004 1 Domestic Return Receipt 102595-02-M-1540 UNITED STATES POSTAL SERVICE First-Class Mail Postage&Fees Paid USPS Permit No.G-10 I • Sender. Please print your name, address, and ZIP+4 in this box • I I MIAMI SHORES VILLAGE I 10050 N. E. 2nd Avenue Shores Village, FL 33138 M VA) SINC ORES Lf� cG,/#GJ/Wfp �= t c., .o�4/ �LOR!DA X0050 C% ,2 PA� 07", coy March 2, 2009 Mr. Al Davis 405 N.E. 991h Street Miami Shores, FL 33138 Dear Al: Congratulations on becoming an announced candidate for Miami Shores Village! 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 03/25/09 03/20/09 Second Treasurer's Report 04/10/09 04/09/09 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 07/13/09 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. SPfiooee: (305)995-2809 �W.: (305)95e-8,992 cp-�i�ac` Bate @mianualeoaeavc�a�e.eo��t Mr. Al Davis March 2, 2009 Page Two At 10:00 AM on April 9, 2009, 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. 87`h 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, 4- ,, f nl9c Barbara A. Estep, MMC Village Clerk Certified Mail — Return Receipt Requested Candidate qualifying letter Elections 2700 NW 87th Avenue M I A M I•DADE Miami, Florida 33172 T 305-499-VOTE F 305-499-8547 TTY: 305-499-8480 miamidade.gov February 23, 2009 Barbara Estep, City Clerk Miami Shores Village 10050 NE 2nd Ave. Miami Shores, FL 33138 Dear Ms. Estep: The Miami-Dade County Elections Department has completed the verification of the petitions for William "Al" Davis, a candidate for Village Council. A total of 84 petitions were submitted and all were reviewed for verification. Of the total 84 petitions, 78 were certified. There will be no charge for the additional petitions that were verified. The Miami-Dade County Charter requires this process to include the following. For purposes of signature verification, however my office does not review this information, and encourages the municipality to ensure compliance with municipal charter or code requirements. • 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 As such, please find the certification for the petition enclosed. Should you have any questions or concerns, please feel free to contact me or Michelle Giles, Acting Deputy Supervisor of Elections for Voter Services at 305-499-8302. Sincerely, 0'4vt;u� Tara C. Smith Chief Deputy Supervisor of Elections Miami-Dade Elections Department Enclosure S�4cRES ..yyo _ �....� �LORIDp' -/0050 C4/w.. 2, 0A.ainu C io�ea, 3,Y738 2009 Candidate Name: IIV I S Address: L((�S aq�^ I am Telephone Numbers: 30S - ISR- 1-735 E-Mail Address: 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 Confirmed by Miami-Dade County Elections �/aone: (805)X95-220 ' CO.- (305)9'56-89 2 rp'-c3�ail @mimmia�corea,.i�a�e.eam ' 1 i StURES Ll� �36awtaxa P_Q/ �LoRi"vA X �0050 o� , QAamru pwwxea, coy February 18, 2009 Ms. Ivy Korman Miami-Dade County Elections Department 2700 N.W. 87th Avenue Miami, FL 33172 Dear Ivy: Enclosed please find Petition Forms (5) from William "Al" Davis in reference to the Miami Shores Village April 14, 2009 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, Aw,4 v, M Barbara A. Estep, MMC Village Clerk �lcane: (305)795-2209' (305)756-897.2 eate�r/i@miamcia�ox��.cam PETITION DAVii We, the undersi ed electors of Miami Shores Villa a hereb nominate �+ AL undersigned g , y for a position on the Village Council. PRINT NAME ADDRESS SIGNATtTRE :. DATE 1,, uc,L(. F �► f A/ 1720dAIX-,h2 dd, 6 17 --`�h11 Z N6 8f4 Ave Y Y Iq2( NEE I Old tr (a-) or Aaj _ e) f4 d� oan (VQ I K `P, 111 ma n 655 Al S�� 5 OS t�el s+4\ Aw e. LQ7 oq The undersigned is the circ)"r of the foregoing paper containing signatures. Each appended thereto was made in my presenc an is the genuine signature of the person whose name it purports to be. Signature of Circulator Address 4 o-Y tj,,--, `i Sr Acceptance of Nomination I hereby accept the nomination for the Village Council and agree to serve' lected. Signature of Candidate PETITION We, the undersigned electors of Miami Shores Village, hereby nominate for a position on the Village Council. LY ' pR11�TNAME ADDRESS : . -DATE SIGNATURE :. War , c LYN N s IJA-TCM 01A0 Tt:1640 L MEF v f IZZ �C 1p�f� 3:141 t Z f O f ✓ vim? �l� �t�r �/2 )tee � rr►.a..�,, �rJ1oel A/C Y& , A/ r t o C4 S 4- � � R�BE� l i utnl q N 1 MD �� o 0 -RE 16E � E The undersigned is the circulator of the foregoing paper containing�_signatures. Each appended thereto was made in my presence is the genuine signature of the person whose name it purports to be. Signature of Circulator Address 4,o-.s E. ,c , g i sr- Acceptance of Nomination I hereby accept the nomination for the Village Council and agree to serve if a d. Signature of Candidate PETITION We, the undersigned electors of Miami Shores Village, hereby nominate A ( for a position on the Village Council. PRINT NAME ADDRESS SIGNATURE .. DATE —rZ,- jZ ,,vim`I lJ�' �vs ,�% �- z� /�Cc, N�:q4 `� S� rCoy If 4 o �G. ✓ted S,s .Z2a �� 5 Si / Zlfz� jaw A DO 2 L--vE <2 3 .A `fid' S% r� • FANP, s/ 1VC00 AM we The undersigned is the circulator of the foregoing paper containing It 1 signatures. Each appended thereto was made in my presenceAd is the genuine signature of the person whose name it purports to be. Signature of Circulator Address Acceptance ofNomination I hereby accept the nomination for the Village Council and agree to se a if,elected. �► Signature of Candidate PETITION We, the undersigned electors of Miami Shores Village, hereby nominate �LAt!' �►, for a position on the Village Council. PRINT NAME ADDRESS- SIGNAT[JRE :. DAT E G � 6 P7 qd 414A�i t05' AI C5 SY ever a s �a� NC lbl ck. SIy IV F,161 SA 04A Kt, yao -7171 AO)6 4-16 r7V *4>j 'e The undersigned is the circul for of the foregoing paper containing 11 signatures. Each appended thereto was made in my presence is the genuine signature of the person whose name itpurports to be. Signature of Circulator Address °' IJ- 9 9 s r Acceptance ofNomination I hereby accept the nomination for the Village Council and agree to serve' le ed. Signature of Candidate PETITION We, the undersigned electors of Miami Shores Village, hereby nominate k+ AL Y 1r for a position on the Village Council. ' PRINT NAME ADDRESS UR SIGNATE--:. DATE V/ 5T� r 7 43 if6moo( Co -za 9 IBS-Nye Lvi.=k sk 1 � L �9 L�' ,qS_Z . GL4 '� �� :.. SST 1 /�• �- ���s'r• � . PO QV 17AX C�' 7 A/C f44 y[ The undersigned is the circulator of the foregoing paper containing signatures. Each appended eto was made in my presence an s the genuine signature of the person whose name it purports to be. Signature of Circulator Address ` iJ.G. T 9 sr—_ Acceptance of Nomination I hereby accept the nomination for the Village Council and agree to sere if el ed. Signature of Candidate PETITION We,the undersigned electors of Miami Shores Village,hereby nominate A L DAM, for a position on the Village Council. PRINT NAME ADDRESS- -SIGNATURE .. DATE � y T 2*5, i 25 ©y as nl�lol - a3 v y l �3 V2)o ) The undersigned is the circ for of the foregoing paper containing signatures. Each appended thereto was made in my presen is the genuine sigLiature of the person whose name it purports to be. Signature of Circulator Address 4 o S L(,6 . 9 9 -5 j Acceptance of Nomination I hereby accept the nomination for the Village Council and agree to serve if cted. Signature of Candidate PETITION .-cto s of Miami Shores Village, herreb nominate owl , We, the undersigned eie �- Y for a position on the Village Council. PRINTNAME _: ADDRESS SIGNA .DATA l 9 The undersigned is the circulator of the foregoing paper containing signatures. Each appended thereto was made in my presence and is the genuine signature of the person whose name it purports to be. Signature of Circulator Address Acceptance of Nomination I hereby accept the nomination for the Village Council and agree to serve if ed. .i • Signature of Candidate PETITION We, the undersigned electors of Miami Shores Village, hereby nominate_ Y;t A L DA � for a position on the Village Council. t PRINT NAME ADDRESS -SIGNATURE- DATE k C•n'1PR/LT/^( / fovNf-3) .7l ? N. C, lygSi, ✓ ,aC i nc�o�yi�1 anco -111 N G q3 S+, /-23-O AIW x,91 . ✓ Lore:lta kr?rnaA &59 McC17s't: x"49 09 MrI (7O AlE-10c `� G E2 A2 61 �y6 l0 s qq S4 4Z-.;7, 09 Pt-I Wg 4,/,/ /0010 OE 10 PL, 31� /iDDS 2 *,g.-7449204217 Z-13,1 g 1"0��I The undersigned is the circulator of the foregoing paper containing �-_j si . Each appended thereto was made in my presence d is the genuine signature of the person whose name it purports to be. Signature of Circulator Address S . `l Acceptance of Nomination I hereby accept the nomination for the Village Council and agree to se e' elected. % Signature of Candidate +. i - PETITION ` We, the undersigned electors of Miami Shor&V�illage, hereby nom_ inate , for a position on the Village Council. f PRINTNAME.. .•.: : :. ADDRESS GN - j DATE d6 E 7D 15 14Zd l4L-K (psis r_ Oq Vol". C;z I�AAO� .✓ L � o t0 z sof ✓ iPC odri'� anS tt cru.) taq Z tr o9 The undersigned is the ator of the foregoing paper containing ( signatures. Each appended thereto was made in my presen d is the genuine signature of the peon whose name it purports to be. Signature of Circulator Address 4 s tit q q Sr Acceptance of Nomination I hereby accept the nomination for the Village Council and agree to s e elected. r Signature of Candidate LOYALTY OATH OFFICE USE ONLY CANDIDATES WITH NO PARTY AFFILIATION (Sections 876.05-876.10,Florida Statutes) STATE OF FLORIDA COUNTY A � 1 r<1J►`s First Name Middle Name/Initial Last Name a citizen of the State of Florida and of the United States of America. . . . and 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. OATH OF CANDIDATE (Section 99.021,Florida Statutes) r, � L 1��►,r�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 for the office of m1A�1f J oo.µ r-Av l 6tharll� , (officq) (district) (circuit) .I am a qualified elector of els 44% �h�s County, Florida. I am qualified (group) under the Constitution and the Laws of Florida to hold the office to which I desire to be nominated or elected. I have qualified for no other public office in the state, the term of which office or any part thereof runs concurrent with th ffice I seek; and I have resigned from any office from which I am required to resign pursuant to Section 99.01 , F orida Statutes. X ( �0� ) 1{g. t�� S / Signature of Candidate Telephone Number Email Address 40S , �h&ws 331,3 t AdKress City State ZIP Code Sworn to(or affirmed)and subscribed before me this day of f&"00 Personally Known: or V Produced Identification: Type of Identification Produced: Signature of Notary Public—State of /orida Print,Type or Stamp Commissioned Name of Notary Public "ublic St:to Ot Florida 9arhar?A Es;ep uk A9y Goran,-.von DD510584 Expires G312""—,010 DS-DE 24B(Rev.05/08) STATE OF FLORIDA OFFICE USE ONLY APPOINTMENT OF CAMPAIGN TREASURER AND DESIGNATION OF CAMPAIGN DEPOSITORY FOR CANDIDATES (Section 106.021(1),F.S.) (PLEASE TYPE) CHECK APPROPRIATE BOX: Original Appointment Deputy Treasurer 0 Reappointment of Treasurer Name of Candidate 1.Address(include post office box or street,city,state,zip code) WILLIAM ALFRED DAVIS 405 NE 99 ST MIAMI SHORES FL 33138 Telephone(optional) 2. Party(Partisan candidates only) 3.Office(add district, circuit,group number) (305 ) 758-1735 r}ol 1 ire�f✓5 ��� e Cru.vci I have appointed the following person to act as my El Campaign Treasurer El Deputy Treasurer 4. Name of Treasurer or Deputy Treasurer JAMES HARWOOD DAVIS 5. Mailing Address(If post office box or drawer add street address) 6.Telephone 4-os tJ ,c, 99 Sf 20 C' lS8► t'ti� 7.City 8. County 9. State 10.Zip Code t 'r< SIgo�L+e.t �IIM+►. �na� G t, i t� I have designated the folldwing.named bank as my Primary Depository Secondary Depository 11. Name of Bank 12. Street Address TOTALBANK 12411 BISCAYNE BLVD 13. City 14. County 15.State 16.Zip Code N MIAMI DADE FL 33181 17.Signature f/Ca didate � � Date / --� 2 -110 - OC) / Campaign Treasurer's Acceptance of Appointment I, JAMES HARWOOD DAVIS do hereby accept the appointment as (Please Print or Type) Campaign Treasurer 11 Deputy Treasurer for the campaign of WILLIAM ALFRED DAVIS a who is seeking nomination or election as a candidate to the office of (Party) (7 �� oI, L1F;(.Cl1L� UNDER PENALTIES OF PERJURY,I DECLARE THAT I HAVE READ T E FOREGOING CAMPAIGN TREASURER'S ACCEPTANCE OF APPOINTMENT AND THAT�Tf4E F CTS STATED ARE TRUE. ." <-�-- Date Sig ture of Campaign Treas eputy Treasurer DS-DE 9(Rev.01/08) OFFICE USE ONLY STATEMENT OF CANDIDATE (Section 106.023, F.S.) (Please Type) I, �J►�1►n ,^, �l �f►Jtt candidate for the office of �tA µr J►�'+�d �o'�*t�' have received, read and understand the requirements of Chapter 106, Florida Statutes. X z • ►->� - meq Signature of Candidate 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(Rev.03/08) DECLARATION FOR CANDIDATES COVERED BY THE MANDATORY PROVISION OF THE ETHICAL CAMPAIGN PRACTICES ORDINANCE The mandatory practices of Ethical Campaign Practices Ordinance automatically extend to candidates and their respective campaign staffs for the Miami-Dade County Commission or Mayor;candidates and their respective campaign staffs for the Miami-Dade County and Rescue Service District Board;candidates and their respective campaign staffs for Miami-Dade Community Councils and candidates and their respective campaign staffs for any elective municipal elective office in Miami-Dade County. Furthermore,any candidate for public office in Miami-Dade County as described in the preceding sentence may at any time declare that he or she agrees to abide by theStatementof Fair Campaign Practices. a candidate for the office of %ko�4 Skos� Qo��+c.� agree to abide by the voluntary fair campaign practices as provided in Section 2-11.1.1(D)(1),of the Code of Miami-Dade County and recognize as compulsory the jurisdiction of the Ethics Commission. I further agree that the Ethics Commission will have the authority to decide whether I have violated the statement of fair campaign practices and,if a violation is found,the Ethics Commission has the authority to impose the appropriate penalty,if any. The Statement of Fair Campaign Practices is enumerated below: 1. I shall not make my race,religion,national origin,gender,physical disability or sexual orientation an issue in my campaign. 2. 1 shall not make my opponents' race,religion,national origin,gender,physical disability or sexual orientation an issue in my campaign. 3. I will condemn any appeal to prejudice based on race,creed,national origin, religion,gender,physical disability or sexual orientation. 4. I shall not without just cause attack or question my opponent's patriotism. 5. I shall not publish,display or circulate any anonymous campaign literature or political advertisement. 6. I shall not tolerate my supporters engaging in these activities which I condemn nor shall I accept their continued support if they engage in such activities. I will not permit any member of my campaign organization to engage in these activities and will immediately and publicly repudiate the support of any other individual or group,which resorts to the methods and tactics I condemn. 7. I shall run a positive campaign emphasizing my qualifications for office and position on issues of public concern. 8. I will limit my attacks on an opponent to legitimate challenges to that person's record,qualifications, and positions. 9. I will neither use nor permit the use of malicious untruths or innuendoes about an opponent's personal life,nor will I make or condone unfounded accusations discrediting that person's credibility. 10. I will take personal responsibility for approving or disavowing the substance of attacks on my opponent that may come from third parties supporting my candidacy. 11. I will not use or permit the use of campaign material that falsifies, distorts, or misrepresents facts. O e the declaration is signed it is deemed irrevocable for the duration of the campaign. -----------------------t� r S'gnature Date PLEASE FILE A COPY OF THIS FORM WITH THE MIAMI-DADE COMMISSION ON ETHICS AND PUBLIC TRUST AND THE MIAMI-DADE SUPERVISOR OF ELECTIONS. Miami-Dade Commission on Ethics Miami-Dade Supervisor of Elections 19 West Flagler Street 2700 N.W. 87th Avenue Suite 220 Doral,Florida 33172 Miami,FL 33130 Miami-Dade Supervisor of Elections Miami-Dade= 111 NW 1 Street, Suite 1910 C�W= io� Miami, FL 33128-1962 (305) 375-5553 RECEIPT Candidate: YV,11 », M �1�nL, a 1AJ► f First Name Middle Name last Name Office: i��h,�. S�o�w �,Iln�b ( ,�,►��� I This is to acknowledge my receipt of the following documents: ❑ Qualifying Handbook for Municipal Cabdidates Received by: Candidate Signature Date: t - - o 1 TAPackebV002 Packets\New MunicipalirylmuniPal 4ualffyin8 inLormatian.&C L DE Miami-Dade Supervisor of Elections MIA�{1_ 2700 NW 87th Avenue Miami, FL 33172 (305) 499-8400 RECEIPT OF HANDBOOKS AND THE ELECTION LAW BOOK Candidate: (,*�11 11**A First Name Middle Name Last Name Office: M1h•,c� s�oa�o Jr����� C(j�,uc t� This is to acknowledge my receipt of the following documents: a The Election Laws of the State of Florida August 2006 Ef 2006 Candidate and Campaign Treasurer Handbook tl'2008 Miami-Dade County Qualifying Handbook Received by: Candidate Signature Date: 1 . Phone No.: 270 �f°` ' `� �' S Fax No.: E-mail address: MD-ED 2 (Rev.03/07) FLORIDA DEPARTMENT OF STATE DIVISION OF ELECTIONS CAMPAIGN TREASURER'S REPORT SUMMARY (1) William "Al" Davis OFFICE USE ONLY Name (2) 405 NE 99th St Address (number and street) Miami Shores, FL 33138 City, State, Zip Code ❑ CHECK IF ADDRESS HAS CHANGED (3) ID Number: N/A (4) Check appropriate box(es): a Candidate (office sought): Miami Shores Village Council ❑ 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 4 / 11 / 09 To 7 / 1.3 / 09 Report Type TR 91 Original ❑ Amendment ❑ Special Election Report ❑ Independent Expenditure Report (6) CONTRIBUTIONS THIS REPORT (7) EXPENDITURES THIS REPORT Monetary Cash & Checks $ 9.09 Expenditures Loans $ Transfers to Office Account $ Total Monetary $ 0.00 Total Monetary $5,:750.00 In-Kind $ (8) Other Distributions (9) TOTAL Monetary Contributions To Date (10) TOTAL Monetary Expenditures To Date $ 6,150.00 $ 6 rs0 fin (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) (Typeme) Willi "Al" F-1 individual(only for ❑Treasurer ❑Deputy Treasurer -1 C ndidat airperson(only for PC,PTY 8 electioneering commun.) , ection ring commuFf.organization) X X Signature Sig ature DS-DE 12(Rev.08/04) CAMPAIGN TREASURER'S REPORT— ITEMIZED CONTRIBUTIONS (1) Name William "Al" Davis (2) I.D. Number (3) Cover Period 4 / 11 / 09 through 7 / 13 09 (5) /( 4) Page 1 of 1 Date Full Name (8) (9) (10) (11) (12) (6) (Last,Suffix,First, Middle) Sequence Street Address& Contributor Contribution In-kind Number Cit ,State,Zip Code T Occu tion T Descri tion Amendment Amount I / t DS-0E 13(Rev.08/03) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES CAMPAIGN TREASURER'S REPORT— ITEMIZED EXPENDITURES (1) Name William "Al" Davis (2) I.D. Number (3) Cover Period 4 / 11 / 09 through 7 / 13 / 09 (4) Page 1 of 2 (5) (7) (8) (9) (10) (��) Date Full Name Purpose (Last,Suffix,First,Middle) (add office sought if (s) Street Address& contribution to a Expenditure Sequence City,State,Zip Code candidate) Type Amendment Amount Number Football Sandwich Shop Food for party DIS 120.00 4 11 09 8484 NE 2nd Ave. Miami, FL 33138 1 Football .Sandwich Shop Food for party DIS 155.00 4 14 09 8484 NE 2nd Ave. Miami, FL 33138 25 Magnolia Outdoor Media Signs & Advert. DIS 2468.67 4 15 09 405 NE 99th St Miami Shores, FL 33138 3 Magnolia Outdoor Media Signs DIS 470.00 4 16 09 405 NE 99th St Miami Shores, FL 33138 4' Magnolia Outdoor Media Shirts, Pamphlets DIS 1500.00 4 25 09 405 _NE 99th St Miami Shores, FL 33138 5 Football Sandwich Shop Food for party DIS 120.00 8484 NE 2nd Ave. 4 /25/ 29-- Miami,,,Fb 33138 6 Miami Shores Comm. Center Tent rental DIS : 50.00 5 1 09. Park Dr. Miami Shores, FL 33138 7) DS-DE 14(Rev.08/03) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES CAMPAIGN TREASURER'S REPORT- ITEMIZED EXPENDITURES (1) Name William "Al" Davis (2) I.D. Number (3) Cover Period 4 / 11 / 09 through 7 / 13 / 09 (4) Page 2 of 2 (5) (7) (8) (9) (10) (11) Date Full Name Purpose (6) (Last,Suffix,First,Middle) (add office sought if Street Address& contribution to a Expenditure Sequence City,State,Zip Code candidate) Type Amendment Amount Number Magnolia Outdoor Media Adv. Bus Bench( s DIS 800.00 5 25 09 405 NE 99th St Miami Shores, FL 33138 8• Miami Shores Comm. Center Donation - close DIS 66.33 7 13 09 Park Drive out account Miami Shores, FL 33138 9) 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 (1) !�t�(��i..► ��L" 0-,)v� OFFICE USE ONLY Name Address (number and street) City, State,Zip Code ❑ CHECK IF ADDRESS HAS CHANGED (3) ID Number: IJ!A (4) Check appropriate box(es): Candidate (office sought): �1 � ��larc�� J, J �v►���� ❑ 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 Z Cover Period: From %� / y� / o q To 4 / 9 / vj Report Type d Original ❑Amendment ❑ Special Election Report ❑ Independent Expenditure Report (6) CONTRIBUTIONS THIS REPORT (7) EXPENDITURES THIS REPORT n o Monetary Cash & Checks $ 1 D D Expenditures $ 0 Loans $ Transfers to Office Account $ _ '0 o� Total Monetary $ Ido Total Monetary $ _ o In-Kind $ (8) Other Distributions (9) TOTAL Monetary Contributions To Date (10) TOTAL Monetary Expenditures To Date $ G/So CAMPAIGN TREASURER'S REPORT— ITEMIZED CONTRIBUTIONS (1) Name (2) I.D. Number * (3) Cover Period e 9 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,Zip Code Type I Occupation Type Description Amendment Amount E . 102i SY ! ! 90 1 ab cl � � oa RZoz $cAkCAc0- & ll cGa� C 4a cs be,f(COW""& P 'T( W ,X P GNw s 0 deA MIA C�ucww bk« ,Ft tx a _Igo ►J b��sr o�� �o DS-DE 13(Rev.08/03) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES FLORIDA DEPARTMENT OF STATE DIVISION OF ELECTIONS CAMPAIGN TREASURER'S REPORT SUMMARY (1) Al Davis OFFICE USE ONLY Name (2) 405 NE 99 St Address (number and street) Miami Shores, FL 33138 City, State, Zip Code ❑ CHECK IF ADDRESS HAS CHANGED (3) ID Number: N/A (4) Check appropriate box(es): Candidate (office sought): Miami Shares ,Village Council ❑ 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 / 1 / 09 To 3 / 20 / 09 Report Type 1 © Original ❑ Amendment ❑ Special Election Report ❑ Independent Expenditure Report (6) CONTRIBUTIONS THIS REPORT (7) EXPENDITURES THIS REPORT Monetary Cash & Checks $ 5,450.00 Expenditures $ 400.00 Loans $ Transfers to Office Account $ Total Monetary $ 5,450.00 Total Monetary $400.00 In-Kind $ (8) Other Distributions (9) TOTAL Monetary Contributions To Date (10) TOTAL Monetary Expenditures To Date $ 5,450.00 $ 400.00 (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 ha a examined this report and it is true, correct, and complete. correct, and c7Dbav`i1�s et I. (Type name Davis (Type n e) 1 . ❑Indi ' ual Z(only/rpXasurer ❑Deputy Treasurer ®Ca didate ❑Chairperson(only/or PC,PTY& electio eedng /�' electioneerin commun.organization) X X l Signatur Sign ture DS-DE 12(Rev.08/04) CAMPAIGN TREASURER'S REPORT— ITEMIZED CONTRIBUTIONS (1) Name Al Davis (2) I.D. Number N/A (3) Cover Period 3 / 1 / 09 through 3 / 20 / 09 (4) Page 1 of 6 (5) (7) (8) (9) (10) (12) Date Full Name (6) (Last, Suffix, First, Middle) Sequence Street Address& Contributor Contribution In-kind Number City,State,Zi Code Type Occupation Type Description Amendment Amount John Schmidt I Retired CHE 100.00 3 / 1 /09 1263 NE 94 St iami Shores, FL 1 33138 John Stokesberry I Retired' CHE 100.00 3 / 1 /09 934 NE 91 Ter iami Shores, FL 2 33138 hester Morris I Retired: CHE 100.00 3 / 1 /09 734 NE 119 St iscayne Park, FL 3 33161 Bill Fann I Retired CHE 100.00 3 / 1 /09 731 NE 95 St Miami Shores, FL 4 33138 Frank McCoy I Retired CHE 200.00 3 / 1 /09 85 NE 94 St Miami Shores, FL 5 33138 Gunnard Rubini I Retired' CHE 200.00 3 / 1 / 09 1420 NE 101 St Miami Shores, FL 6 33138 George Bennett I Retired' CHE 200.00 3 / 1 / 09 10007 NE 4 Ave.. Miami Shores, FL 7 33138 Bill Tenney I Realtor CHE 20.00 3 / 1 / 09 11.83 NE 99 St Miami Shores, FL 8 331.38 DS-DE 13(Rev.08/03) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES_ CAMPAIGN TREASURER'S REPORT— ITEMIZED CONTRIBUTIONS (1) Name Al Davis (2) I.D. Number N/�— (3) Cover Period 3 / 1 / 09 through 3 / 20 / 09 (4) Page 2 of 6 (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 Type Occupation Type Description Amendment Amount Bill .Rercer I Retired CHE 25.00 3 / 1 / 09 990 NE 97 St Miami Shores, FL 9 33138 Herb Spahn I Retired. CHE 50.00 3 / 1 / 09 1005 NE 95 St Miami Shores, FL 1.0 33138 Marty Mennes I FPL Exec CHE 100.00 3 / 1 / 09 307 NE 104 St Miami Shores, FL 11 33138 Carl Paxton I Retired .CHE 75.00 3/ 4 / 09 1335 NE 1.05 St #2 Miami. Shores, FL 12 33138 Pat Duffy I Realtor CHE 1,'00.,00 3 / 5 / 09 9718 NE 2 Ave. Miami Shores, FL 13 331.38 Joan Lutton I Ex .Dir. CHE 150.00 3 / 8 / 09 167, NW 109 St Cushman Miami Shores, FL School 14 33168 Melbourne Teiglan . I Retired' CHE 30..00 3 / 9 / 09 9780 NE 5 .Ave..Rd. Miami Shores, FL 15 33138 Shellace Calhoun I Teacher CHE 1;00.00 3 / 9 / 09 10610 NE 1.0 P1 Miami Shores, FL 16 33I38 DS-DE 13(Rev.08/03) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES CAMPAIGN TREASURER'S REPORT— ITEMIZED CONTRIBUTIONS (1) Name Al Davis (2) I.D. Number NIA (3) Cover Period 3 / 1 / 09 through 3 / 20 / 09 (4) Page 3 of 6 (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 Type Occupation Type Description Amendment Amount Robert Bourne I Realtor CHE 250.00 3 / 9 / 09 700 NE 90 St- Miami Shores, FL 17 33138 Bert Riney I Retired. CHE 100.00 3 / 11 / 09 150 NE 95 St Miami Shores, FL 18 33138 Cesar Sastre MD I Retired CHE 50.00 3 / 11 / 09 4000 Towerside Te Miami, FL 33138 19 Betty Hach I Retired. CHE 100.00 3 / 11. /09 987 NE 96 St Miami Shores, FL 20 33138 Chris Kelley I Attorney CHE -.7.5.00 3 / 11 / 09 11098 Biscayne Bl Miami, FL 33161 21 Charles Kluck I Broker CHE 200.00 3 / 11 /09 9701 NE 5 Ave. Miami Shores, FL 22 33138 Alice Burch I Housewifa CHE 250.00 3 / 11 /09 1440 NE 101 St Miami Shores, FL 23 331,38 Tony Tripdo I RetiredCHE 100.00 3 / 11 /09 1225 NE 95 St Miami Shores, FL 24 33138 DS-DE 13(Rev.08/03) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES CAMPAIGN TREASURER'S REPORT— ITEMIZED CONTRIBUTIONS (1) Name Al Davis (2) I.D. Number N/A (3) Cover Period 3 / 1 / 09 through 3 / 20 / 09 (4) Page 4 of 6 (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 Type I Occupation Type Description Amendment Amount Andrew McIntosh I Engineer CHE 100.0 z�- 3 / 12 / 09 434 Grand Conc. Miami Shores, FL 25 33138 Jim Hanson. MD I Doctor CHE 100.0 3 / 17 / 09 9415 NE 6 Ave. Miami Shores, FL 26 33138 Jim Davis I Sales CHE 300.0 3 / 18 / 09 405 NE 99 St Miami Shores, FL 27 33138 Jack Holly , I Sales CHE 200.0 3 / 18 / 09 9660 NE 5 Ave.Rd Miami Shores, FL 28 33138 Jan Reese I Teacher CHE 25.0 3 / 18 / 09 9655 Biscayne B1 Miami Shores, FL 29 331.38 Neal Walker I Retired CHE 50.00 3 / 19 / 09 1273 NE 95 St Miami Shores, FL 30 33138 Leonard Marinello I Executiv CHE 200.00 3 / 19 / 095000 E. 10 Ct Hialeah., FL 33013 31, Donna. Hurtak I Attorney CHE I'00.,00 3 / 19 / 09 533 Grand Conc. Miami Shores, FL 32 33138 DS-DE 13(Rev.08/03) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES • CAMPAIGN TREASURER'S REPORT— ITEMIZED CONTRIBUTIONS (1) Name Al Davis (2) I.D. Number N/A (3) Cover Period 3 / 1 ! 09 through 3 / 20 / 09 (4) Page 5 of 6 (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 Type Occu ation Type Description Amendment Amount Bob Swan I Retired CHE 1.00.00 3 19 09 770 NE 98 St Miami Shores, FL 33 33138 Ernest Hinterk6pf I Retired' CHE 100.00 3 19 09 1200 NE 102 St Miami Shores, FL 34 331'38 Donald W. Stobs I Retired' CHE 1.00.00 3 19 09 9505 NE 5 .Ave. Miami Shores, FL 35 33138 William. H. Walker I Retired: CHE 100.00 3 19 / 09 1.800 NE 11.4 St 36 . #1509 Miami, FL 33181, Alain Gonzalez I Roofer CHE 50.00 3 19 / 09 p0 Box532008 Miami Shores, FL 37 33138 Shirley S. Davis I Teacher CHE 500.,00 / go / og 405-NE 99 St Miami Shores, FL 38 331.38 Carol Sue Stobs I Builder CHE 500.;00 3 20 / 09 580 NE 92 St Miami Shores, FL 39 33138 Randy Sickelsmith I Country CAS 50.00 3 20 / 09 10000 Biscayne B1 Club Mg Miami Shores, FL 40 33138 DS-DE 13(Rev.08/03) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES • CAMPAIGN TREASURER'S REPORT— ITEMIZED CONTRIBUTIONS (1) Name Al Davis (2) I.D. Number NIA (3) Cover Period 3 / 1 / 09 through 3 / 20 / 09 (4) Page 6 of 6 (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 Type occupation Type Description Amendment Amount Vivian Decker I Retired; CHE 100.00 3 / 23 / 09 1138 NE 99 St Miami Shores, FL 41 33138 9 DS-DE 13(Rev.08/03) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES