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Alvero, Angela
%S APPOINTMENT OF CAMPAIGN TREASURER AND DESIGNATION OF CAMPAIGN DEPOSITORY FOR CANDIDATES (Section 106.021(1), F.S.) (PLEASE PRINT OR TYPE) NOTE: This form must be on file with the qualifying officer before opening the campaign account. OFFICE USE ONLY 1. CHECK APPROPRIATE BOX(ES):, 0 Initial Filing of Form Re-filing to Change: Treasurer/Deputy ❑ Depository ❑ Office ❑ Party 2. Name of Candidate(in this order: First, Middle, Last) 3.Address (include post office box or street, city, state, zip code) a-mpayn #eady�r,e�-s A N G Ct_ �I.JER� 4. Telephone 5. E-mail address 6 A4� 4� 57�'e��_ ( '786 U 53 85?5 a a Iver o l(P Ao- lyw,I co 1ViGW% F2_ -73/ 3�-- 6. Office sought (include district, circuit, group number) 7. If a candidate for a nonpartisan office, check if applicable: V1.11ale, DunUI ❑ My intent is to run as a Write-In candidate. 8. If a candidate for a partisan office, check block and fill in name of party as applicable: My intent is to run as a ❑ Write-In ❑ No Party Affiliation ❑ Party candidate. 9. 1 have appointed the following person to act as my Campaign Treasurer Deputy Treasurer 10. Name of Treasurer or Deputy Treasurer ir-TasurCY dbsedk Oarb)lono Taasurer: jjr ter/ 11. Mailing Address 12. Telephone to IVC (o"' 5- re e l' ' 3 j3 (305 ) 5-7 7-336 Z- 13. 13. City 14. County 15. State 16. Zip Code 17. E-mail address 1\4ioml' -Dad-e r2 33132 GGIVeCo I@_ ko- mr4; I . C-0K , 18. 1 have designated the following bank as my ,& Primary Depository ❑ Secondary Depository 19. Name of Bank 20. Address �n in k o 19D R s e X31 VC) 21. City 22. County 23. State E24. Zip Code ovn% 3313ce UNDER PENALTIES OF PERJURY,I DECLARE THAT I HAVE READ THE FOREGOING FORM FOR APPOINTMENT OF CAMPAIGN TREASURER AND DESIGNATION OF CAMPAIGN DEPOSITORY AND THAT THE FACTS STATED IN IT ARE TRUE. 25. Date 26. =ofandidate �0 X 27. /Treasurer's Acceptance of Appointment(fill in the blanks and check the appropriate block) I, Jobc `u 4 la n o (_/�I1i le 7-, do hereby accept the appointment (Please Print or Type Name) designated above as: Campaign Treasure Deputy Treasurer. ! !/ X ,Llz�(T Date ignature of Campaign Treasurer Deputy Tre rer DS-DE 9(Rev. 10/10) Rule 1S-2.0001, F.A.C. LOYALTY OATH (Sections 876.05-876.10,Florida Statutes) CANDIDATE WITH NO PARTY AFFILIATION OFFICE USE ONLY i M. ve-r6 IRKt Name Middle NamelInitial Last Name a citizen of the State of Florida and of the United States of America, and being [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. Important: If elected, a candidate must retake the loyalty oath as specified in s. 876.05, Florida Statutes, and that oath shall be filed with the records of the governing official or employing governmental agency prior to the approval of payment of salary, expenses, or other compensation. OATH OF CANDIDATE (Section 99.021,Florida Statutes) L A /a 4 !verb (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 with no party affiliation for the office of U I (a tc Co o n c, , (office) (district#) I am a qualified elector of MIA m I — 0,-de County, Florida; (circuit#) (group or seat#) I am qualified under the Constitution and the Laws of Florida to hold the office to which I desire to be nominated or elected; by executing this form, I have taken the oath required by ss. 876.05-876.10, Florida Statutes; I have qualified for no other public office in the state, the term of which office or any part thereof runs concurrent with the office I seek; and I have resigned from any office from which I am required to resign pursuant to Section 99.012, Florida Statutes. 2 5-3 -BS�s' �( (<3-S) 7,T/— cZ4, a/✓erb f@�af�i/Ce Signature of Candidate Telephone Number Email Address * Please print name phonetically on the line below as you wish it to be pronounced on the audio ballot for persons with disabilities(see instructions on page 2 of this form): AN- GE -LA AL-VE-Ro STATE OF FLORIDA COUNTY OF Sworn to (or affirmed)and subscribed before me this day of 20 Personally Known: ✓ or NOTARY PUBLIC-STATE OF FLORIDA EIda M. Mirand IgnatuY�tary Public ?'k '-CGtntttission#DD725 38s Produced Identification: -Commission 1Print,Type,or Stamp Commissioned Name of Notary Public . 110NI)u THRU ATLAN nc noNDING W,MO. Type of Identification Produced: DS-DE 24B(Rev.10/10) Rule 1S-2.0001,F.A.C. i Ln MR.M. r r r O M Postage $ Ill Certified Fee rq Postmark O Return Receipt Fee Here Q (Endorsement Required) C3 Restricted Delivery Fee C3 (Endorsement Required) rq S cp Total Postage&Fees $S. n.J CO Sent To C3 sneer,apr.No.; or PO Box No. -------------------------rna ------------------------------- ON,,State,ZIP+4 Certified Mail Provides: • A malling receipt ■ A unique identifier for your mailpiece rt ■ A record of delivery kept by the Postal Service for two years Important Reminders: ■ Certified Mail may ONLY be combined with First-Class Mails or Priority Mails. ■ Certified Mail is not available for any class of international mail. ■ NO INSURANCE COVERAGE IS PROVIDED with Certified Mail. For valuables,please consider Insured or Registered Mail. ■ For an additional fee,a Retum Receipt may be requested to provide proof of delivery.To obtain Return Receipt service,please complete and attach a Return Receipt(PS Form 38112 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 USPS®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. ::'r IMPORTANT:Save this receipt and present.it when making an Inquiry. , PS Form 3800,August 2006(Reverse)PSN 7530-02-000.9047 SNoREs a a�xa CSZ� wa4, P wo owp 1pC.1932 G� logo � 01Mr W� OV -LORrpA X0050 OAT. , 11W Q2"Zae PAl - P7", COY March 4, 2011 Ms. Angela Alvero 1008 N.E. 94th Street Miami Shores, FL 33138 Dear Angela: Congratulations on becoming a qualified candidate for the upcoming Miami Shores Village Council election! 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 03/25/11 03/20/11 Second Treasurer's Report 04/07/11 04/06/11 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 07/11/11 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. �/aone: (805)995-2207 CO..- (805)966-8972 -C eafrs(CT�»timn�a/ioreavc�a�e eom Angela Alvero March 4, 2011 Page Two At 10:00 AM on April 7, 2011, 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. 87th 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, lxdaw �. Sgya,MMC Barbara A. Estep, MMC Village Clerk Certified Mail — Return Receipt Requested Candidate qualifying letter Elections 2700 NW 87th Avenue M IAM 1•DADE Miami, Florida 33172 T 305-499-VOTE F 305-499-8547 TTY:305-499-8480 miamidade.gov i CERTIFICATION STATE OF FLORIDA) COUNTY OF MIAMI-DADE) I, Lester Sola, Supervisor of Elections of Miami-Dade County, Florida, do hereby certify that 54 signatures submitted by Angela Alvero for the office of Council in the Miami Shores Village matched the signatures on the voter files. WITNESS MY HAND AND OFFICIAL SEAL, AT MIAMI, MIAMI-DADE COUNTY, FLORIDA, ON THIS 3rd DAY OF MARCH, 2011 Les r S la pervisor of E ons Miami-Dade County Please submit a check for$5.00 to our office payable to the.. "Board of County Commissioners"for the cost of verifying these signatures. Elections 2700 NW 87th Avenue MIAMI-DADE Miami,Florida 33172 T 305-499-VOTE F 305-499-8547 TTY:305-499-8480 I miamidade.gov March 3, 2011 Barbara A. Estep, MMC Village Clerk Miami Shores Village 10050 NE 2nd Avenue Miami Shores, FL 33138 Dear Ms. Estep: The Miami-Dade Elections Department has completed the verification of the petitions for Angela Alvero, a candidate for Council in the Miami Shores.Village. A total of 71 petitions were submitted and all of the petitions were reviewed for verification. Of the total 71 petitions, 54 were certified. There will be no charge for the additional petitions that were verified. For purposes of petition verification, the Code of Miami-Dade County states that petitions shall be disqualified for the following reasons:. • 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 3 However, for municipal petitions., my office does not review this information and encourages the municipality to ensure compliance with municipal charter or code requirements. y As such, please find the certification for the petition enclosed. Should you have any .questions or concerns, please feel free to contact me at 305-499-8509 or Rosy Pastrana, Deputy Supervisor of Elections for Voter Services at 305-499-8548. Sincerel , Lest Sola Supervisor of Elections Miami-Dade Elections Department Enclosure (1) ORES G<< 96a96/Aa aQ/. r�, GJ 99/#W logo Ofur WAS Svres 04 Cwalw' coy March 2, 2011 Ms. Michelle McClain Miami-Dade County Elections Department 2700 N.W. 87th Avenue Miami, FL 33172 Dear Ms. McClain: Enclosed please find Petition Forms (5) from Angela Alvero, in reference to the Miami Shores Village April 12, 2011 Council Election. The filing date for this election was February 7, 2011. 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, Ott Barbara A. Estep, MMC Village Clerk �iEone: (805)795--2207 Caa (805)7.564972 -C eats p nuumia/ioreavcYla�se� com PETITION We, the undersigned electors of Miami Shores Village, hereby nominate Q / +� /✓�Z/d for a position on the Village Council. PRINT NAME ADDRESS SIGNATURE DATE VSA A PA-7t—Z— 4ko V& 1( Z t 6LO, Lac s —� } At4z, GvOVEA �G✓� 34 tj IoISy ,A,ftw' %-'i -7'7 N& qS S�rce+ i7 f A- I LQo IAE 101 6 JOSNS: qz.Z-/ crahkim /vt �x � Ns F'- zfzz/i! 2122111 v Z LP rW ?GIO 1-57 1t�u Z erg /2! IV4 S`f 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 L,c 61.� � v;�-�� �!—� Address 7,7o N t: 9-144- 54ree J Acceptance ofNomination I hereby accept the nomination for the Village Council and agree to serve if elected. r' `� Signature of Candidate PETITION We, the undersigned electors of Miami Shores Village, hereby nominate for a position on the Village Council. PRINT NAME ADDRESS SIGNATURE DATE e u jLls q� fgS� i�/ EL IAS, 1q. EDe io41 Kke- `13 sr' 'Jf lE S`' -2j— Cc R-!( Z ��tZ ,c//� r -2��- P(310 05f Er-Afl)✓O A 3 SF MY !Z Alt- Cr'' Y\i-z & ro C(4) /f) Yu �z Y�'J y l> sVAL,lay f 7, 1 34 a, The ersi�ed is the circulator of the foregoing paper con �� LL\JignaftuVes. 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 c J& Al ye Address S Nj4M � I' Acceptance of Nomination / c I hereby accept the nomination for the Village Council and agree to serve if elected. - Signature of Candidate PETITION We,the undersigned electors of Miami Shores Village, hereby nominate for a position on the Village Council. PRINT NAME ADDRESS SIGNATURE .. D 2 �/ ATE ( >�f ala o Iv'e �.S sT l7 G Oe- "'-5 z_: r7- A, AV _21d jLyq 3 tj 1 t1 L� d 126 ��q� l _(4a C�&I Ida 1 9 760 L'11'. e// �' 7 6 011 G C� ��r r ► ,� a r� X53 JUE�'-/J-1,54 L C EC\- sfi z ��11� 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 �� �Jt� ` T �; �h✓P Acceptance of Nomination �_X3138 I hereby accept the nomination for the Village Council and agree to serve if elected. Signature of Candidate ' PETITION We, the undersigned electors of Miami Shores Village, hereby nominate �u'v for a position on the Village Council. PRINT NAME ADDRESS SIGNATURE . DATE - GtY I S� I �cc�d r►�q I 0l�-7q tl t I k Ic' RACLe,`6 o P,� 'so:?, 4F- 106 sr U,LaS l/ , cam— 3 r /j !ff3���__t�-�•t�` nb. � ov10 �5/�F� S-f- nccJ rr bV J�ec-Qd"O' W6 t-�JE. CY::)n- 31 (1, '��,LY'( Ce,6 6 1 (0(o NE 2"J b�• �� -!"l� /0) $0', 3 /� Ma��g \J � WE too S �--��- 4� 3� The undersigned is the circulator of the foregoing paper containing a sigo gnatures. 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 AG 9,? /,I,' 9 0'frP P�" Acceptance ofNomination ' I hereby accept the nomination for the Village Council and agree to serve if elected. Signature of Candidate PETITION We, the undersigned electors of Miami Shores Village, hereby nominate 4x�c���; �-% for a position on the Village Council. ' PRINTNAME ADDRESS SIGNATURE : . DATE Ch res 4zh rel--Rt) 1-73 Aif 9510 12 6 7A �-� -1 The undersigned is the circulator of the foregoing paper containing J!"` signatures. Each appended thereto was made in my presence an the genuine signature of the person whose name it purports to be. Signature of Circulato � &-/-�/ Address .,-73 rim Oi5 :�4-v--cef ISS Acceptance ofNomination _7?-731 i 5 I hereby accept the nomination for the Village Council and agree to serve if elected. Signature of Candidate S�oeEsa � 1pC.1932 ��� logo NOR iDA X0050 PA-aims 2011 Candidate Name: LOP I G MM I A h l V ,( Address: (ons �L Telephone Numbers: —( SOS) S 77 -3, COk E-Mail Address: O.Cid Vev 01 @ Yl4wxt I. com 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 V Form 1 Financial Disclosure Loyalty&Candidate's Oath Statement of Candidate 50 Signatures on Nominating Petition Confirmed by Miami-Dade County Elections �liane. x805)995-2207 CO—_ - 305,)756-8972 �P-C>ruail 4�nuamua/eoaeauclla.�e.aan FORM 1 STATEMENT OF 2010 Please print or type your name,mailing FINANCIAL INTERESTS address,agency name,and position below: LAST NAMES--FIRST NAME--MIDDLE NAME: n FOR OFFICE G () — MR Rik USE ONLY: MAILINGDDRESS. Miami, �LJI�y' ID Code 6hmes 331 g �ICtVnt- `�cid� CITY: ZIP: COUNTY: ' ID No. NAME OF AGENCY Sh o,res i Q Co U r 1 Conf.Code NAME OF F OFFICE OR POSITION HELD ORS GHT: P. Req.Code V l�a C Jr1 I WeobC You are not tmited to the space 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 YEAR. PLEASE STATE BELOW WHETHER THIS STATEMENT IS FOR THE PRECEDING TAX YEAR ENDING EITHER(must check one): A DECEMBER 31,2010 -R 0 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(must check one): 0 COMPARATIVE(PERCENTAGE)THRESHOLDS 9B DOLLAR VALUE THRESHOLDS PART A--PRIMARY SOURCES OF INCOME [Major sources of income to the reporting person] (if you have nothing to report,you must write"none"or"n/a") NAME OF SOURCE SOURCE'S DESCRIPTION OF THE SOURCE'S OF INCOME ADDRESS PRINCIPAL BUSINESS ACTIVITY r lar A I✓�t� A� Nti `'�541Zk ' rn PART B-- SECONDARY SOURCES OF INCOME[Major customers,clients,and other sources of income to businesses owned by the reporting person] (if you have nothing to report,you must write"none"or"n/a") NAME OF NAME OF MAJOR SOURCES ADDRESS PRINCIPAL BUSINESS BUSINESS ENTITY OF BUSINESS'INCOME OF SOURCE ACTIVITY OF SOURCE PART C--REAL PROPERTY [Land,buildings owned by the reporting person] FILING INSTRUCTIONS for (If you have nothing to report,you must write"none"or"n/a") when and where to file this form are located at the bottom of page 2. INSTRUCTIONS on who must file 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-Effective:January 1,2011.Refer to Rule 34-6.202(1),F.A.C. (Continued on reverse side) PAGE 1 PART D—INTANGIBLE PERSONAL PROPERTY[Stocks,bonds,certificates of deposit,etc.] (If you have nothing to report,you must write"none"or"n/a") CC TYPE OF INTANGIBLE BUSINESS ENTITY TO WHICH THE PROPERTY RELATES JkVt c y1 KGGOJ►�� D P.ISon4 Q C--oan 6 /g�✓G/� p . PART E—LIABILITIES [Major debts] (If you have nothing to report,you must write"none"or"n/a") NAME OF CREDITOR ADDRESS OF CREDITOR Aunm Loan ice 5P P-0- ADX 1-70L /1/C 6 3 3 - 170f salli-e-_ Mat-'- 5Wli`rjnj PD,W 9532,4 '1 M 477 - S3L PART F—INTERESTS IN SPECIFIED BUSINESSES [Ownership or positions in certain types of businesses] (If you have nothing to report,you must write"none"or"n/a") 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 PARTS A THROUGH F ARE CONTINUED ON A SEPARATE SHEET, PLEASE CHECK HERE ❑ SIGNATURE(required): DATE SIGNED(required): FILING INSTRUCTIONS: WHAT TO FILE: WHERE TO FILE: WHEN TO FILE: After completing all parts of this 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 Local o�cers/employees file with the Supervisor section, you must write "none" or 'n/a" in that the Senate must file prior to confirmation,even section(s). of Elections of the county in which they perma- (s) nently reside. (If you do not permanently reside if that is less than 30 days from the date of their 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. To determine what category your position Finally, at the end of office or employment, falls under, see the"Who Must File"Instructions each local officer/employee, state officer, and on page 3. specified state employee is required to file a final disclosure form(Form 1F)within 60 days of leaving office or employment. CE FORM 1-Effective:January 1,2011.Refer to Rule 34-8.202(1),F.A.C. PAGE 2 INSTRUCTIONS FOR COMPLETING FORM 1 STATEMENT OF FINANCIAL INTERESTS WHO MUST FILE FORM 1: All persons who fall within the categories of"state officers,""local officers/employees,""specified state employees,"as well as candidates for elective local office, are required to file Form 1.Positions within these categories are listed below.Persons required to file full financial disclosure(Form 6)and officers of the judicial branch do not file Form 1 (see Form 6 for a list of persons who must file that form). STATE OFFICERS include the following positions for state officials: ity,or other political subdivision;county or municipal attorney;chief county or 1) Elected public officials not serving in a political subdivision of the municipal building inspector;county or municipal water resources coordina- state and any person appointed to fill a vacancy in such office, unless tor; county or municipal pollution control director; county or municipal envi- required to file full disclosure on Form 6. ronmental control director; county or municipal administrator with power to 2) Appointed members of each board,commission,authority,or council grant or deny a land development permit;chief of police;fire chief;municipal having statewide jurisdiction, excluding members of sole advisory bodies; clerk;appointed district school superintendent;community college president; but including judicial nominating commission members; Directors of the district medical examiner; purchasing agent (regardless of title) having the 'Florida Black Business Investment Board,Enterprise Florida,Scripps Florida authority to make any purchase exceeding$20,000 for the local governmen- Funding Corporation,Workforce Florida,and Space Florida;Members of the tal unit. Florida Commission on Tourism,Florida Substance Abuse and Mental Health 5) Officers and employees of entities serving as chief administrative officer Corporation,and the Council on the Social Status of Black Men and Boys;and of a political subdivision. Governors and senior managers of Citizens Property Insurance Corporation SPECIFIED STATE EMPLOYEES include the following positions and Florida Workers'Compensation Joint Underwriting Association. for state employees: 3) The Commissioner of Education, members of the State Board of 1) Employees in the office of the Governor or of a Cabinet member who Education, the Board of Governors, and the local Boards of Trustees and are exempt from the Career Service System,excluding secretarial, clerical, Presidents of state universities. and similar positions. LOCAL OFFICERS/EMPLOYEES include the following positions 2) The following positions in each state department, commission, for officers and employees of local government: board, or council: Secretary, Assistant or Deputy Secretary, Executive 1) Persons elected to office in any political subdivision(such as munici- Director, Assistant or Deputy Executive Director, and anyone having the palities, counties, and special districts) and any person appointed to fill a power normally conferred upon such persons,regardless of title. vacancy in such office,unless required to file full disclosure on Form 6. 3) The following positions in each state department or division:Director, 2) Appointed members of the following boards,councils,commissions, Assistant or Deputy Director,Bureau Chief,Assistant Bureau Chief,and any authorities, or other bodies of any county, municipality, school district, inde- person having the power normally conferred upon such persons,regardless pendent special district, or other political subdivision: the governing body of title. of the subdivision; a community college or junior college district board of 4) Assistant State Attorneys, Assistant Public Defenders, Public trustees;a board having the power to enforce local code provisions;a board Counsel, full-time state employees serving as counsel or assistant counsel of adjustment; a planning or zoning board having the power to recommend, to a state agency,administrative law judges,and hearing officers. create, or modify land planning or zoning within the political subdivision, 5)The Superintendent or Director of a state mental health institute estab- except for citizen advisory committees, technical coordinating committees, lished for training and research in the mental health field,or any major state and similar groups who only have the power to make recommendations to institution or facility established for corrections,training,treatment, or reha- planning or zoning boards; a pension board or retirement board empowered bilitation, to invest pension or retirement funds or to determine entitlement to or amount 6) State agency Business Managers,Finance and Accounting Directors, of a pension or other retirement benefit. Personnel Officers, Grant Coordinators, and purchasing agents(regardless 3) Any other appointed member of a local government board who is of title)with power to make a purchase exceeding$15,000. required to file a statement of financial interests by the appointing authority or 7) The following positions in legislative branch agencies:each employ- the enabling legislation,ordinance,or resolution creating the board. ee(other than those employed in maintenance,clerical,secretarial,or similar 4)Persons holding any of these positions in local government: Mayor; positions and legislative assistants exempted by the presiding officer of their count or cit mana er-chief administrative em to ee of a count ,munici al- house);and each employee of the Commission on Ethics. INSTRUCTIONS FOR COMPLETING FORM 1: INTRODUCTORY INFORMATION (At Top of Form): address if you submit a written request for confidentiality Persons listed in Section 119.071(4)(d),F.S.,are encouraged to provide an address If your name, mailing address, public agency, and position are other than their home address, already printed on the form,you do not need to provide this informa- tion unless it should be changed. To change any of this information, Y write the correct information on the form,then contact your agency's year (January 1 through December 31). If that is the case for you, then financial disclosure coordinator. Your coordinator is Identified in the your financial interests should be reported for the calendar year 2009;just financial disclosure portal on the Commission on Ethics website: check the box and you do not need to add any information in this part of www.ethics.state.fl.us. the form.However,if you file your IRS tax return based on a tax year that is NAME OF AGENCY: This should be the name of the governmental unit not the calendar year,you should specify the dates of your tax year in this which you serve or served, b which you are or were employed, or for portion to the form and check the appropriate box.This is the time frame Y y yor"disclosure period"for your report. which you are a candidate. For example, "City of Tallahassee," "Leon County,"or"Department of Transportation." MANNER OF CALCULATING REPORTABLE INTERESTS: As noted in this portion of the form,the Legislature has given filers the option of report- OFFICE OR POSITION HELD OR SOUGHT Use the title of the office ing based on either thresholds that are comparative (usually, based on or position you hold,are seeking, or held during the disclosure period (in percentage values)pr thresholds that are based on absolute dollar values. some cases you may not hold that position now, but you still would be The instructions on the following pages specifically describe the different required to file to disclose your interests during the last year you held that thresholds.Simply check the box that reflects the choice you have made. position). For example, "City Council Member," "County Administrator," You must use the type of threshold you have chosen for each part of the "Purchasing Agent,"or"Bureau Chief." If you are a candidate for office or form. In other words, if you choose to report based on absolute dollar are a new employee or appointee,check the appropriate box. value thresholds, you cannot use a percentage threshold on any part of MAILING ADDRESS: If your home address appears on the form but the form. you prefer another address be shown, change the address as described above If you are an active or former officer or employee listed in Section 119.071(4)(d), F.S., whose home address is exempt from disclosure, (CONTINUED on page 4) c2p' the Commission is required to maintain the confidentiality of your home CE FORM 1-Effective:January 1,2011.Refer to Rule 34-8.202(1),F.A.C. PAGE 3 PART A - PRIMARY SOURCES OF INCOME (1) You owned (either directly or indirectly in the form of an equitable or beneficial interest)during the disclosure period more [Required by Sec. 112.3145(3)(a)1 or(b)1,Fla.Stat.] than five percent (5%) of the total assets or capital stock of a Part A is intended to require the disclosure of your principal sources of business entity (a corporation, partnership, limited partnership, income during the disclosure period.You do not have to disclose the amount proprietorship, joint venture, trust, firm, etc., doing business in of income received. The sources should be listed in descending order, Florida);and with the largest source first. Please list in this part of the form the name, (2) You received more than ten percent(10%)of your gross income address,and principal business activity of each source of your income which during the disclosure period from that business entity;and (depending on whether you have chosen to report based on percentage thresholds or on dollar value thresholds)either: business You received more than $1,500 in gross income from that business entity during the period. exceeded five percent (5%) of the gross income received by you in (b) If you are reporting based on dollar value thresholds: your own name or by any other person for your benefit or use during the disclosure period,or (1) You owned (either directly or indirectly in the form of an eequitable or beneficial interest) during the disclosure period more exceeded $2,500.00 (of gross income received during the disclosure than five percent (5%) of the total assets or capital stock of a period by you in your own name or by any other person for your use or business entity (a corporation, partnership, limited partnership, benefit). ro rietorshi p p p, joint venture, trust, firm, etc., doing business in You need not list your public salary received from serving in the Florida);and position(s) which requires you to file this form, but this amount should be (2) You received more than $5,000 of your gross income during included when calculating your gross income for the disclosure period. The the disclosure period from that business entity. income of your spouse need not be disclosed. However, if there is joint income to you and your spouse from property held by the entireties(such as If your interests and gross income exceeded the appropriate thresholds listed interest or dividends from a bank account or stocks held by the entireties), above, then for that business entity you must list every source of income to you should include all of that income when calculating your gross income and the business entity which exceeded ten percent(10%)of the business entity's disclose the source of that income if it exceeded the threshold. gross income(computed on the basis of the business entity's most recently completed fiscal year), the source's address, and the source's principal "Gross income" means the same as it does for income tax purposes, business activity. including all income from whatever source derived,such as compensation for services,gross income from business,gains from property dealings,interest, Examples: rents, dividends, pensions, social security, distributive share of partnership — You are the sole proprietor of a dry cleaning business,from which gross income,and alimony,but not child support. you received more than 10%of your gross income(an amount that was Examples: more than$1,500)(or,alternatively,more than$5,000, if you are using dollar value thresholds).If only one customer,a uniform rental company, — If you were employed by a company that manufactures computers , provided more than 10% of your dry cleaning business, you must list and received more than 5%of your gross income(salary,commissions, the name of the uniform rental company, its address, and its principal etc.) from the company(or, alternatively, $2,500), then you should list business activity(uniform rentals). the name of the company,its address,and its principal business activity (computer manufacturing). — You are a 20% partner in a partnership that owns a shopping mall and your partnership income exceeded the thresholds listed above.You — If you were a partner in a law firm and your distributive share of should list each tenant of the mall that provided more than 10%of the partnership gross income exceeded 5% of your gross income (or, partnership's gross income,the tenant's address and principal business alternatively, $2,500), then you should list the name of the firm, its activity. address,and its principal business activity(practice of law). — You own an orange grove and sell all your oranges to one marketing — If you were the sole proprietor of a retail gift business and your gross cooperative.You should list the cooperative,its address,and its principal income from the business exceeded 5%of your total gross income(or, business activity if your income met the thresholds. alternatively,$2,500),then you should list the name of the business,its address,and its principal business activity(retail gift sales). PART C - REAL PROPERTY — If you received income from investments in stocks and bonds, you [Required by Sec. 112.3145(3)(a)3 or(b)3,Fla.Stat.] are required to list only each individual company from which you derived more than 5% of your gross income (or, alternatively, $2,500), rather In this part,please list the location or description of all real property(land than aggregating all of your investment income. and buildings)in Florida in which you owned directly or indirectly at any time — If more than 5% of your gross income (or, alternatively, $2,500) during the previous tax year in excess of five percent(5%)of the property's was gain from the sale of property (not just the selling price), then value. This threshold is the same, whether you are using percentage you should list as a source of income the name of the purchaser, the thresholds or dollar thresholds.You are not required to list your residences purchaser's address, and the purchaser's principal business activity. If and vacation homes; nor are you required to state the value of the property the purchaser's identity is unknown, such as where securities listed on on the form. an exchange are sold through a brokerage firm,the source of income Indirect ownership includes situations where you are a beneficiary of should be listed simply as "sale of (name of company) stock," for a trust that owns the property, as well as situations where you are more example. than a 5%partner in a partnership or stockholder in a corporation that owns — If more than 5% of your gross income (or, alternatively, $2,500) the property. The value of the property may be determined by the most was in the form of interest from one particular financial institution recently assessed value for tax purposes, in the absence of a more current (aggregating interest from all CD's, accounts, etc., at that institution), appraisal. list the name of the institution, its address, and its principal business The location or description of the property should be sufficient to activity. enable anyone who looks at the form to identify the property. Although a legal description of the property will do, such a lengthy description is not PART B- SECONDARY SOURCES OF INCOME required. Using simpler descriptions, such as"duplex, 115 Terrace Avenue, Tallahassee"or 40 acres located at the intersection of Hwy.60 and 1-95,Lake [Required by Sec. 112.3145(3)(a)2 or(b)2, Fla.Stat.] County"is sufficient. In some cases,the property tax identification number of This part is intended to require the disclosure of major customers, the property will help in identifying it: "120 acre ranch on Hwy.902, Hendry clients, and other sources of income to businesses in which you own an County,Tax ID#131-45863." interest.You will not have anything to report unless: (CONTINUED on page 5) c:&- (a) If you are reporting based on percentage thresholds: CE FORM 1-Effective:January 1,2011.Refer to Rule 34-8.202(1),F.A.C. PAGE 4 Examples: PART E — LIABILITIES — You own 1/3 of a partnership or small corporation that owns both a [Required by Sec. 112.3145(3)(a)4 or(b)4,Fla.Stat.] vacant lot and a 12%interest in an office building.You should disclose the lot,but are not required to disclose the office building(because your In this part of the form, list the name and address of each private or 1/3 of the 12% interest—which equals 4%—does not exceed the 5% governmental creditor to whom you were indebted for a liability in any amount threshold). that,at any time during the disclosure period,exceeded: — If you are a beneficiary of a trust that owns real property and your (1) your net worth(if you are using percentage thresholds),Q interest depends on the duration of an individual's life,the value of your (2) $10,000(if you are using dollar value thresholds). interest should be determined by applying the appropriate actuarial table to the value of the property itself, regardless of the actual yield of the You are not required to list the amount of any indebtedness or your net property. worth.You do not have to disclose any of the following:credit card and retail installment accounts,taxes owed(unless reduced to a judgment), indebted- ness on a life insurance policy owed to the company of issuance,contingent liabilities, and accrued income taxes on net unrealized appreciation (an [Required by Sec. 112.3145(3)(a)3 or(b)3,Fla.Stat.] accounting concept).A"contingent liability"is one that will become an actual liability only when one or more future events occur or fail to occur,such as Provide a general description of any intangible personal property that,at where you are liable only as a guarantor,surety,or endorser on a promissory any time during the disclosure period,was worth more than: note.If you are a"co-maker"and have signed as being jointly liable or jointly (1)ten percent(10%)of your total assets(if you are using percentage and severally liable,then this is not a contingent liability;if you are using the thresholds),or $10,000 threshold and the total amount of the debt(not just the percentage (2)$10,000(if you are using dollar value thresholds), of your liability)exceeds$10,000,such debts should be reported. and state the business entity to which the property related. Intangible per- Calculations for persons using comparative(percentage)thresholds: In sonal property includes such things as money, stocks,bonds,certificates of order to decide whether the debt exceeds your net worth, you will need to deposit, interests in partnerships, beneficial interests in a trust, promissory total all of your liabilities(including promissory notes,mortgages,credit card notes owed to you, accounts receivable by you, IRA's, and bank accounts. debts,lines of credit,judgments against you,etc.).Subtract this amount from the value of all your assets as calculated above for Part D.This is your"net Such things as automobiles, houses,jewelry, and paintings are not intan- gible property. Intangibles relating to the same business entity should be worth."You must list on the form each creditor to whom your debt exceeded this amount unless it is one of the types of indebtedness listed in the para- aggregated; for example, two certificates of deposit and a savings account graph above(credit card and retail installment accounts,etc.).Joint liabilities with the same bank.Where property is owned by husband and wife as ten- with others for which you are"jointly and severally liable,"meaning that you ants by the entirety(which usually will be the case),the property should be may be liable for either your part or the whole of the obligation, should be valued at 100%. included in your calculations based upon your percentage of liability, with Calculations:In order to decide whether the intangible property exceeds the following exception:joint and several liability with your spouse for a debt 10%of your total assets,you will need to total the value of all of your assets which relates to property owned by both of you as"tenants by the entirety" (including real property, intangible property, and tangible personal property (usually the case)should be included in your calculations by valuing the asset such as automobiles,jewelry,furniture,etc.).When making this calculation, at 100%of its value and the liability at 100%of the amount owed. do not subtract any liabilities (debts) that may relate to the property—add Examples for persons using comparative(percentage)thresholds: only the fair market value of the property.Multiply the total figure by 10%to arrive at the disclosure threshold. List only the intangibles that exceed this — You owe $15,000 to a bank for student loans, $5,000 for credit threshold amount.Jointly owned property should be valued according to the card debts,and$60,000(with your spouse)to a savings and loan for a percentage of your joint ownership,with the exception of property owned by home mortgage.Your home(owned by you and your spouse) is worth husband and wife as tenants by the entirety,which should be valued at 100%. $80,000 and your other property is worth$20,000.Since your net worth None of your calculations or the value of the property have to be disclosed on is $20,000($100,000 minus $80,000), you must report only the name the form. If you are using dollar value thresholds,you do not need to make and address of the savings and loan. any of these calculations. — You and your 50%business partner have a$100,000 business loan Examples for persons using comparative(percentage)thresholds: from a bank, for which you both are jointly and severally liable. The — You own 50% of the stock of a small corporation that is worth value of the business, taking into account the loan as a liability of the $100,000, according to generally accepted methods of valuing small business, is $50,000. Your other assets are worth $25,000, and you owe$5,000 on a credit card.Your total assets will be$50,000(half of businesses. The estimated fair market value of your home and other a business worth$50,000 plus$25,000 of other assets).Your liabilities, property bank accounts, automobile, furniture, etc.) is $200,000. As for purposes of calculating your net worth,will be only$5,000,because worth over$25,000.Since the valuuee ooff the stock exceeds this threshold, your totall assets are worth $25you must disclose intangibles the full amount of the business loan already was included in valuing the t you should list"stock"and the name of the corporation.If your accounts business.Therefore,your net worth is$45,000. Since your 50%share of the$100,000 business loan exceeds this net worth figure,you must with a particular bank exceed$25,000,you should list"bank accounts" list the bank. and bank's name. — When you retired, your professional firm bought out your partner- PART F — INTERESTS IN SPECIFIED ship interest by giving you a promissory note, the present value of which is $100,000.You also have a certificate of deposit from a bank BUSINESSES worth $75,000 and an investment portfolio worth $300,000, consisting [Required by Sec. 112.3145(5), Fla.Stat.] of $100,000 of IBM bonds and a variety of other investments worth between $5,000 and $50,000 each. The fair market value of your The types of businesses covered in this disclosure are only:state and remaining assets (condominium, automobile, and other personal prop- federally chartered banks;state and federal savings and loan associations; erty)is$225,000.Since your total assets are worth$700,000,you must cemetery companies; insurance companies (including insurance agencies); list each intangible worth more than$70,000.Therefore,you would list mortgage companies;credit unions; small loan companies; alcoholic bever- "promissory note"and the name of your former partnership,"certificate age licensees; pari-mutuel wagering companies, utility companies, entities of deposit"and the name of the bank, "bonds"and "IBM,"but none of controlled by the Public Service Commission;and entities granted a franchise the rest of your investments. to operate by either a city or a county government. (CONTINUED on page 6) Cts CE FORM 1-Effective:January 1,2011.Refer to Rule 34-8.202(1),F.A.C. PAGE 5 You are required to disclose in this part of the form the fact that you disclosure period,an officer,director,partner,proprietor,or agent(other than owned during the disclosure period an interest in,or held any of certain posi- a resident agent solely for service of process). tions with, particular types of businesses listed above. You are required to If you have or held such a position or ownership interest in one of these make this disclosure if you own or owned(either directly or indirectly in the types of businesses,list(vertically for each business):the name of the busi- form of an equitable or beneficial interest)at any time during the disclosure Hess, its address and principal business activity, and the position held with period more than five percent(5%)of the total assets or capital stock of one the business e any).Also, if you own(ed) more than a 5 o interest in the of the types of business entities granted a privilege to operate in Florida that business, as described above, you must indicate that fact and describe the are listed above. You also must complete this part of the form for each of nature of your interest. these types of businesses for which you are,or were at any time during the (End of Instructions.) PENALTIES A failure to make any required disclosure constitutes grounds for and may be punished by one or more of the following: dis- qualification from being on the ballot, impeachment, removal or suspension from office or employment, demotion, reduction in salary, reprimand, or a civil penalty not exceeding$10,000. [Sec. 112.317, Florida Statutes] Also, if the annual form is not filed by September 1st,a fine of$25 for each day late will be imposed, up to a maximum penalty of$1,500.[Section 112.3145, F.S.]. OTHER FORMS YOU MAY NEED TO FILE IN ORDER TO COMPLY WITH THE ETHICS LAWS In addition to filing Form 1,you may be required to file one or more of the special purpose forms listed below,depending on your particular position, business activities,or interests.As it is your duty to obtain and file any of the special purpose forms which may be applicable to you,you should carefully read the brief description of each form to determine whether it applies. Form 1 F — Final Statement of Financial private gain (or loss) or to the special gain(or loss) of a relative, busi- Interests: Required of local officers, state officers, and speci- ness associate,or one by whom he or she is retained or employed.Each tied state employees within 60 days after leaving office or employment. appointed state officer who seeks to influence the decision on such a This form is used to report financial interests between January 1st of the measure prior to the meeting must file the form before undertaking that last year of office or employment and the last day of office or employ- action.[Sec. 112.3143,Fla.Stat.] ment.[Sec. 112.3145(2)(b),Fla.Stat.] Form 8B — Memorandum of Voting Conflict for Form 1X — Amended Statement of Financial County, Municipal, and Other local Public Interests:To be used by local officers,state officers,and speci- Officers: Required to be filed (within 15 days of abstention) by tied state employees to correct mistakes on previously filed Form 1's. each local officer who must abstain from voting on a measure which [Sec. 112.3145(9),Fla.Stat.] would inure to his or her special private gain(or loss)or the special gain (or loss)of a relative,business associate,or one by whom he or she is Form 2 — Quarterly Client Disclosure: Required retained or employed. Each appointed local official who seeks to influ- of local officers, state officers, and specified state employees to ence the decision on such a measure prior to the meeting must file the disclose the names of clients represented for compensation by them- form before undertaking that action. [Sec. 112.3143,Fla.Stat.] selves or a partner or associate before agencies at the same level of government as they serve. The form should be filed by the end of the Form 9 — Quarterly Gift Disclosure: Required of calendar quarter(March 31, June 30, Sept. 30, Dec. 31) following the local officers, state officers, specified state employees, and state calendar quarter in which a reportable representation was made. [Sec. procurement employees to report gifts over$100 in value. The form 112.3145(4),Fla.Stat.] should be filed by the end of the calendar quarter(March 31,June 30, September 30,or December 31)following the calendar quarter in which Form 3A— Statement of Interest in Competitive the gift was received.[Sec. 112.3148,Fla.Stat.] Bid for Public Business:Required of public officers and Form 10 — Annual Disclosure of Gifts from public employees prior to or at the time of submission a bid for public Governmental Entities and Direct Su ort business which otherwise would violate Sec. 112.313(33) or 112.313(7), Organizations and Honorarium Event Related Fla.Stat.[Sec. 112.313(12)(b), Fla.Stat.] g Expenses: Required of local officers, state officers, specified Form 4A—Disclosure of Business Transaction, state employees, and state procurement employees to report gifts Relationship, or Interest:Required of public officers and over $100 in value received from certain agencies and direct support employees to disclose certain business transactions, relationships, or organizations;also to be utilized by these persons to report honorarium interests which otherwise would violate Sec. 112.313(3) or 112.313(7), event-related expenses paid by certain persons and entities.The form Fla.Stat.[Sec. 112.313(12)and(12)(e),Fla.Stat.] should be filed by July 1 following the calendar year in which the gift or Form 8A — Memorandum of Voting Conflict for honorarium event-related expense was received. [Sec. 112.3148 and State Officers:Required to be filed by a state officer within 15 112.3149,Fla:Stat.] days after having voted on a measure which inured to his or her special AVAILABILITY OF FORMS; FOR MORE INFORMATION Copies of these forms are available from the Supervisor of Elections Questions about any of these forms or.the ethics laws may be n your county; from the Commission on Ethics, Post Office Drawer addressed to the Commission on Ethics, Post Office Drawer 15709, 5709, Tallahassee, Florida 32317-5709; telephone(850)488-7864; Tallahassee, Florida 32317-5709; telephone(850)488-7864. and at the Commission's web site: www.ethics.state.fl.us. CE FORM 1-Effec ive:January 1,2011.Refer to Rule 34-8.202(1),F.A.C. PAGE 6 APPOINTMENT OF CAMPAIGN TREASURER AND DESIGNATION OF CAMPAIGN DEPOSITORY FOR CANDIDATES (Section 106.021(1), F.S.) (PLEASE PRINT OR TYPE) NOTE: This form must be on file with the qualifying officer before opening the campaign account. OFFICE USE ONLY 1. CHECK APPROPRIATE BOX(ES):, Initial Filing of Form Re-filing to Change: ❑ Treasurer/Deputy ❑ Depository ❑ Office ❑ Party 2. Name of Candidate(in this order: First, Middle, Last) 3. Address (include post office box or street, city, state, zip code) 4. Telephone 5. E-mail address mi avi :Sh bCC 5� FPL 3 3 13 8 (3D5 ) `151_ al ),j 0,61Vero I e k J"I .C&O" 6. Office sought(include district, circuit, group number) \ 7. If a candidate for a nonpartisan office, check if Pr e c+n Ca'4-1 1 ) applicable: J1,`Q CDU�C I �� ❑ My intent is to run as a Write-In candidate. 1 t o +Grn+ pre,S• 8. If a candidate for a partisan office, c eck block and fill in name of party as applicable: My intent is to run as a ❑ Write-In ❑ No Party Affiliation ❑ Party candidate. 1. 1 have appointed the following person to act as my Campaign Treasurer ❑ Deputy Treasurer 10. Nam of Treasurer or Deputy Treasurer 11. Mailing Address 12. Telephone Moog NE SA-Ce_-- ( 3v5 ) 13. City 14. County 15. State 16. Zip Code 17. E-mail address I OmI kokC5 Hl arnl _ 1�je �L_ 33\3� mac_ I /e,-Ae 18. 1 have designated the following bank as my f Primary Depository ❑ Secondary Depository 19. Name of Bank 20. Address�ID R 5 ne- � ^t)d 21. Ca. 1116mi 22. County 23. State 24. Zip Code Cit MI'av�i— DAA T71 - 3313/ UNDER PENALTIES OF PERJURY,I DECLARE THAT I HAVE READ THE FOREGOING FORM FOR APPOINTMENT OF CAMPAIGN TREASURER AND DESIGNATION OF CAMPAIGN DEPOSITORY AND THAT THE FACTS STATED IN IT ARE TRUE. 25. Q/9 e 26. Signature of C ndidate X 27. Treasurer's Acceptance of Appointment(fill in the blanks and check the appropriate block) I, Ap A/ie/o , do hereby accept the appointment (Please Print or Type Name) designated above as: Campaign Treasurer Deputy Treasurer. 014400 X Date Sign ure of Campaign Treasurer or Deputy Treasurer DS-DE 9 (Rev. 10/10) Rule 1S-2.0001, F.A.C. OFFICE USE ONLY STATEMENT OF CANDIDATE (Section 106.023, F.S.) (Please Type) 141ve, candidate for the office of have received, read and understand the requirements of Chapter 106, Florida Statutes. X �-- / 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 NOT AUTOMATICALLY COVERED by the Mandatory Provisions of the Miami-Dade Ethical Campaign Practices Ordinance Miami-Dade County Code at 2-11.1.1(C)(1) The Mandatory Fair Campaign Practices Ordinance at Sec. 2-11.1.1(C)of the Miami-Dade County Code extends to— o Candidates,and their respective campaign staffs,for Miami-Dade Co. Commissioners or Mayor; • Candidates, and their respective campaign staffs,for Miami-Dade Co. Community Councils; • Candidates,and their respective campaign staffs,for any municipal elective office within Miami- Dade County; • Candidates, and their respective campaign staffs,for the Co. Property Appraiser. Other candidates for elective office with a constituency in whole or in part in Miami-Dade Co. who are not required to comply with the Mandatory Fair Campaign Practices Ordinance may at any time declare that they agree to abide by the Mandatory Fair Campaign Practices Ordinance. The Mandatory Fair Campaign Practices Ordinance states that a candidate shall not— (a) With actual malice make or cause to be made any untrue oral statement about another candidate or a member of his or her family or staff that exposes the person to hatred,contempt,or ridicule or causes the person to be shunned or avoided or injured in his of her business or occupation; (b) With actual malice publish,or cause to be published,by writing,printing,picture,effigy, sign,or otherwise than by mere speech any untrue statement about another candidate or a member of his or her family or staff that exposes the person to hatred,contempt,or ridicule or causes the person to be shunned or avoided or injured in his or her business or occupation; (c) Willfully injure,deface,or damage or cause to be injured,defaced, or damaged,by any means,any campaign poster, sign,leaflet, handbill, literature,or other campaign material of another candidate; (d) Knowingly obtain,or cause to be obtained,the campaign property of another candidate with the intent to temporarily or permanently deprive the candidate of a right to the property or its benefit; or (e) Knowingly file with the Ethics Commission a groundless or frivolous complaint against another candidate. If you are not automatically covered by the Mandatory Fair Campaign Practices Ordinance,but you have a constituency in whole or in part in Miami-Dade County and you would like to abide by the Mandatory Fair Campaign Practices Ordinance please sign and date below. Once signed,the Declaration is deemed irrevocable for the duration of the campaign. I, .,Alera , a candidate for the office of please print your name kill A 6.0 rh t.,f1l in i t /G 14 J5horeS 1. 1 la',_Ila',_ e tive office sough[ Jq county,municipality,or other jurisdiction understand that I am not automatically bound by the Mandatory Fair Campaign Practices Ordinance of Miami-Dade Co. Nevertheless, I choose to abide by the Mandatory Fair Campaign Practices Ordinance and recognize the compulsory jurisdiction of the Ethics Commission and its authority to decide whether I have violated the ordinance at Sec. 2-11.1.1(C)of the County Code. I further understand that if a violation is found,the Ethics Commission has the authority to impose the appropriate penalty,if any. Signature Date COE,revised 4/2010 SOR NES y► agog 91 .....� ��ORIDA mosso G,/V• W. GJ�2,�r,'. QWWP ,a, (gy NOTICE OF CANDIDACY AND RESIDENCY hereby file this Notice of Candidacy this 7m day of /�f , 2011, for the Village Council election of Miami Shores Village to be held on April, 12, 2011. 1 affirm that I have resided in Miami Shores Village for at least six (6) months prior to the date of qualifying for office as required by Section 23 of the Village Charter. Signature Print Name Address Telephone Number L/ / aalilewz E-Mail Address STATE OF FLORIDA ) COUNTY OF MIAMI-DADE ) BEFORE ME personally appeared 1A Ab A V who executed this Notice of Candidacy and Residency this 74k day of 2011. Barbara A. Estep Notary Public Personally Known 2 BARBARAA.ESTEP '_ Produce the following Identification Seal/Comm! i �s:MYCOMMISSION#DD 9553005; EXPIRES:March 29,2014 f�C)� I AV LV 3 LL L21 ilk far,h Bonded Thru Notary PubNc Underwriters 99,%ne: �805>795-2207 C arc 805)756-8972 C SORES iKc.1932 Gr! nn nm M F 9 too -looso P/4'p. , ORIDA 3.Y7T8 MIAMI SHORES VILLAGE COUNCIL CANDIDATE INFORMATION RECEIPT Candidate: W4, 44, This is to acknowledge receipt of the following documents relating to the 2011 Miami Shores Village Council Election to be held on Tuesday, April 12, 2011. Informational Letter from the Village Clerk Petition Forms Village Ordinances relating to Village Election Qualifying Forms Treasurer Report Forms Items and Documents available from Miami-Dade County Absentee Ballot Information Poll Watcher Information Candidate and Campaign Treasurer Handbook State Statute Chapters 97— 106 Received By: Date: �, (805)795=2207 C as (305)756-8972 @� � Elections 2700 NW 87th Avenue M I AM I•DADE 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, Lester Sola, Supervisor of Elections of Miami-Dade County, Florida, do hereby certify that 54 signatures submitted by Angela Alvero for the office of Council in the Miami Shores Village matched the signatures on the voter files. WITNESS MY HAND AND OFFICIAL SEAL, AT MIAMI, MIAMI-DADE COUNTY, FLORIDA, ON THIS 3rd DAY OF MARCH, 2011 &,�2Z 00, "O,e Les r S la pervisor of EI ons Miami-Dade County Please submit a check for$5.00 tc our office payable to the "Board of County Commissioners"for the cost of verifying these signatures. Elections 2700 NW 87th Avenue MIAMI-DADE Miami, Florida 33172 T 305-499-VOTE F 305-499-8547 fire=k TTY: 305-499-8480 miamidade.gov March 3, 2011 Barbara A. Estep, MMC Village Clerk Miami Shores Village 10050 NE 2nd Avenue Miami Shores, FL 33138 Dear Ms. Estep: The Miami-Dade Elections Department has completed the verification of the petitions for Angela Alvero, a candidate for Council in the Miami Shores Village. A total of 71 petitions were submitted and all of the petitions were reviewed for verification. Of the total 71 petitions, 54 were certified. There will be no charge for the additional petitions that were verified. For purposes of petition verification, the Code of Miami-Dade County states that petitions shall be disqualified for the following reasons: • 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 However, for municipal petitions, my office does not review this information and encourages the municipality to ensure compliance with municipal charter or code requirements. As such, please find the certification for the petition enclosed. Should you have any questions or concerns, please feel free to contact me at 305-499-8509 or Rosy Pastrana, Deputy Supervisor of Elections for Voter Services at 305-499-8548. XjLestSola , Supervisor of Elections Miami-Dade Elections Department Enclosure (1) 4y, 1y rmf- Evct tt exce E. I PETITION We, the undersigned electors of Miami Shores Village, hereby nominate , for a position on the Village Council. PRINT NAME ADDRESS SIGNATURE . DATE �GZYIS0 dIM 10 V714 n 11 6* 3-1-11 -M.ao[A-L A11 t `�>aQ x r n '5-4-41kIC RACL.C,�oRN S0� ISE. 106 Si aS C , 3 A I�Otf t �b.�OK� GbZ 4-La t 1 94Yie, 0010 J-4-,5,AJF�}�-� a Ul �P'f 6cfg b nth I Lob NE Zn! b S /nen I� bzo A/c /�/ Sa` - � ' i✓ L o 1 S 7- j6- j-1 Atlb /002 Sf �j• 3�i i/ 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 L% =L� � Address IMk Als9:�/* Acceptance ofNomination ` I hereby accept the nomination for the Village Council and agree to serve if elected. Signature of Candidate PETITION We, the undersigned electors of Miami Shores Village, hereby nominate Atlwla Ahlead for a position on the Village Council. PRINT NAME ADDRESS SIGNATURE DATE f- A Il/-( 0 /vE 9.S / r � 'ytiJ�1J\ L�tZ�'l7' il�SZtm k— -S PLA Q -S jo3 N l e' rImo. ri L d 126MEg3 ( �t 11 AJ&O�dl 9 7&O N,�".S�ke-R 1. �7 L e// � 76o 1t S"O 64LtwAa 4-1. 21si wb 1 L 0 U►� 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—540z/." A✓ Address pOs �� S�. i ��h✓vs or I Acceptance of Nomination P" 3338 I hereby accept the nomination for the Village Council and agree to serve if elected. Signature of Candidate �Z/= 4" PETITION We, the undersigned electors of Miami Shores Village, hereby nominate ,449 for a position on the Village Council. PRINT NAME ADDRESS SIGNATURE DATE air ED,& /obi PVL--X. 5� - U-[PSS 1q. E De;- 1041 Kk5 613 ST /-/f cw fv 4 /0'f tcus d� Cnl-p 101r 7/c 93 sf Pr3 )u (_15�_Elwl No �a CZ 113 51 d Z -2 Z. !/ 2 c /oyy All9,"YV C.b�111i-Q M& Y'otw /0 YU Sym orJl( o y K w_ ct q ;-4 Ao ' t-7-, ../bk) CK 1331 Al r_ /02) The ersi ed is the circulator of the foregoing paper con 'gnat es. 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 e Ja Mom)V Address j(M Nt' 90),:97&j 11iiiM i�or� )7- J3/e Acceptance of Nomination I hereby accept the nomination for the Village Council and agree to serve if elected. Signature of Candidate PETITION We, the undersigned electors of Miami`Shores Village, hereby nominate 4 Q J, 4le-, for a position on the Village Council. PRINT NAME ADDRESS SIGNA2UREDATE V J -� 6�-1 Z (?t7 —ILe I �. (aqui !� t 61 �orP� A,tA C-40UVEA ?�4 NE )01 s l- YY w Z/16 Ji L.ss 44c Corr-4 -773 N& 9'5 5+ree+ 7 1/ Co f Ar _ Loo > -101 tS r �a t/h�y� �rr��1 n, Y132 /✓ 3"/ MS �- J �- " ?Zr z/// k✓oi1 Grahr�w, rid/mac 62-N—t 3A' NS ,. 2z2/�� lgno /?Od 1 2&q NE `q Sf. N5•� 1� 2 Z2 // NOO 00oll Afelle- PIJ gL�q t'j VAS (0�6�1 -M0 N��7-1Gt 7t.�i'a ., ha u 2 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. I- Signature of Circulator I yr - ��%oL s Address 790 .N� 9`14- ►- � Acceptance of Nomination ,3Y 3 I hereby accept the nomination for the Village Council and agree to serve if elected. Signature of Candidate PETITION /�� We, the undersigned electors of Miami Shores Village, hereby nominate4/74e-1-1 �`141,-,'U for a position on the Village Council. ` PRINT NAME ADDRESS SIGNATURE p DATE v . . . L':;"Q-(cin 190 n/Y- 9-14 S�. 16 /11 O�t-cf'''n 7-7-3 Lrec /0 q09 2 �S >/ The undersigned is the circulator of the foregoing paper containing J!" signatures. Each appended thereto was made in my presence an the genuine signature of the person whose name it purports to be. Signature of Circulato Address `n3 N& 015 Acceptance of Nomination 7�-?D 13 z I hereby accept the nomination for the Village Council and agree to serve if elected. Signature of Candidate I am Angela Alvero. Raising three children and caring for my aging parents in Miami Shores has taught me that the Village is not just a collection of houses, but a tapestry of families that call those houses, and the Village, their home. We can creatively fund programs that our seniors and children thrive in without additional tax dollars. I understand the needs of businesses. As Managing Partner of our law firm, I make the tough decisions. I know that a business is more than just income. It has responsibilities to the people it employs and the community it serves. These responsibilities must be met. The revitalization of the NE 2nd Ave corridor to overcome the lingering effects of poor business decisions requires finding the tenants that will make Village Place a destination. Our Village was impacted by the real estate crash, and property owners who have become delinquent on real estate taxes. For residents who face foreclosure on their homes, the banks whose customers are Village residents must step up and provide these residents with more than an automated phone system when they seek assistance. But no such consideration should be given to commercial property owners in foreclosure who accept Village services without meeting their tax responsibilities. Barbara Estep From: angela alvero [aalvero1 @hotmail.com] Sent: Monday, March 21, 2011 9:39 PM To: Barbara Estep Subject: RE: Candidate Information Attachments: Alvero candidate statement.doc; angela1.JPG Attached, please find my candidate statement and photo. Thanks for your assistance! Subject: RE: Candidate Information Date: Mon, 21 Mar 2011 14:29:49 -0400 From: estepb@miamishoresvillage.com To: aalverol@hotmail.com Basically,the 200 word statement is anything that you, as a candidate, want to the public to know about you, i.e. who you are,where are you from, why you are running for Council. This is the type of information that other candidates supply. In addition, I will need a photo. Your picture will appear next to your narrative. Let me know if you have any other questions. Barbara From: Angela Alvero [mailto:aalverol@hotmail.com] Sent: Monday, March 21, 20112:27 PM To: Barbara Estep Subject: Re: Candidate Information Reply, I apologize for the confusion that was my mistake. please let me know what candidate statement is needed, what issues do I need to address and if u need a photograph. I was under the mistaken impression that was going to be printed in the chambers newsletter. I can make a we'd deadline no problem. Angela Alvero Managing Partner Cartolano &Alvero, P.A. On Mar 21, 2011, at 11:55 AM, "Barbara Estep" <estepb(amiamishoresvillage.com> wrote: Angela —With respect to the copies of e-mails I received between you and the Chamber, I am not sure if the e-mail below is what caused some confusion. In any event, the Village publishes (via our website) the candidate information. If you have a problem with meeting the Wednesday deadline, please let me know and I'll see what can be done to extend it by a few days. I will also need a photo to accompany the narrative. Thanks and have a good day. Barbara 1 From: Barbara Estep Sent: Wednesday, March 02, 20119:50 AM To: 'councilman pherrera@yahoo.com'; 'Coplaw@Juno.com'; 'getset@comcast.net'; 'Hunt Davis'; 'Jim McCoy'; 'angela alvero' Subject: Candidate Information A special election issue of the newsletter will be carried along with our regular April Village Newsletter on our website. Please submit a written statement letting the voters know who you are and why you are running for a Council seat. The statement should not be more than approximately 200 words in length and we will not edit the submittal. Please submit in Microsoft Word format and I will need the information no later than Wednesday, March 23rd Thanks! Barbara 2 /04, T._1 r I � l t� s= FLORIDA DEPARTMENT OF STATE DIVISION OF ELECTIONS CAMPAIGN TREASURER'S REPORT SUMMARY (1) Angela Alvero OFFICE USE ONLY Name (2) 46 NE 6th Street Address (number and street) Miami, FL 33132 City, State, Zip Code ❑ CHECK IF ADDRESS HAS CHANGED (3) ID Number: 00000 (4) Check appropriate box(es): © Candidate (office sought): village of Miami Shores 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 03 / 21 / 11 To 04 / 07 / 11 Report Type TR 0 Original ❑ Amendment ❑ Special Election Report ❑ Independent Expenditure Report (6) CONTRIBUTIONS THIS REPORT (7) EXPENDITURES THIS REPORT Monetary Cash & Checks $ 600 . 00 Expenditures $ 2, 082 . 85 Loans $ Transfers to Office Account $ Total Monetary $ 600 . 00 Total Monetary $ 2, 082 . 85 In-Kind $ (8) Other Distributions (9) TOTAL Monetary Contributions To Date (10) TOTAL Monetary Expenditures To Date $ 6, 754 . 82 $ 6, 709 . 39 (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) Julia G zalez (Type name) Angela Alvero ❑Indivi I(o y for reas er ✓ Deputy Treasurer ❑✓ Candidate ❑Chairperson(only for PC,PTY& electio ring mm electioneering commun.organization) X a - nature Signature DS-DE 12(Rev.08/04) CAMPAIGN TREASURER'S REPORT— ITEMIZED CONTRIBUTIONS (1) Name Angela Alvero (2) I.D. Number 00000 (3) Cover Period 04 07 / 2011 through 07 / 11 / 2011 (4) Page 1 of 1 (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 Tvpe Occupation T e Description Amendment Amount RMS Insurance B Insuranc CHE $500.00 04 / p7 /2011 Brokerage, LLC e Broker 1415 Kellum Place Garden City, NY 1 11530-1695 Matthew G. Krause I CHE 100.00 04 / 07 011 2 High Meadow Ct. Glen Head, NY 11545-2814 DS-DE 13(Rev.08/03) SEE REVERSE FOR INSTRUCTIONS'AND CODE VALUES CAMPAIGN TREASURER'S REPORT— ITEMIZED EXPENDITURES (1) Name Angela Alvero (2) I.D. Number 00000 (3) Cover Period 04 / 08 / 2011 through 07 / 11 / 2011 (4) Page 1 of 1 (g) (7) (8) (9) (10) (11) Date Full Name Purpose (Last,Suffix,First, Middle) (add office sought if (s) Street Address& contribution to a Expenditure Sequence Type Number City,State,Zip Code candidate) Amendment Amount Union Printing campaign MON $424 .75 04 09 11 2321 Pembroke Rd. flyers Hollywood, FL 33020 1 Publix Election day MON $543 .84 04 /11 /11 9050 Biscayne Blvd. campaining Miami Shores, FL food/beverage 33138 Metro Beauty Center Election day MON $275.00 04 /11 /11 4 Southeast 1st Street Campaining Miami, FL Target Election day MON $235.44 04 11 11 14075 Biscayne Blvd. campaining North Miami Beach,FL supplies Cartolano & Alvero, P.A. repayment of MON $603.82 05 /03 /11 46 NE 6th Street loan Miami, FL 33132 DS-DE 14(Rev.08/03) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES k FLORIDA DEPARTMENT OF STATE DIVISION OF ELECTIONS CAMPAIGN TREASURER'S REPORT SUMMARY (1) Angela Alvero OFFICE USE ONLY Name (2) 46 NE 6th Street Address (number and street) Miami, FL 33132 City, State, Zip Code ❑ CHECK IF ADDRESS HAS CHANGED (3) ID Number: 00000 (4) Check appropriate box(es): Q Candidate (office sought): village of Miami Shores Council ❑ Political Committee ❑ CHECK IF PC HAS DISBANDED ❑ Committee of Continuous Existence ❑ CHECK IF CCE HAS DISBANDED ❑ Parry Executive Committee ❑ Electioneering Communication ❑ CHECK IF NO OTHER ELECTIONEERING COMMUNICATION REPORTS WILL BE FILED (5) REPORT IDENTIFIERS Cover Period: From 03 / 21 / 11 To 04 / 07 / 11 Report Type G4 Original ❑Amendment ❑Special Election Report ❑ Independent Expenditure Report (6) CONTRIBUTIONS THIS REPORT (7) EXPENDITURES THIS REPORT Monetary Cash & Checks $ 2, 250 . 00 Expenditures $ 3 , 207 . 54 Loans $ 1, 957 . 82 Transfers to Office Account $ Total Monetary $ 41207 . 82 Total Monetary $ 3 , 207 . 54 In-Kind $ (8) Other Distributions (9) TOTAL Monetary Contributions To Date (10) TOTAL Monetary Expenditures To Date $ 6, 154 . 82 $ 4, 626 .54 (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 nam Jul' n Gonzalez (Type name) Angela Alvero ❑Ind' dual( ly fo Tre ur ❑✓ Deputy Treasurer ❑✓ Candidate ❑Chairperson (only for PC,PTY& elect' nearing m ) electioneering commun.organization) X L�Z� Si ature Signature DS-DE 12(Rev.08/04) CAMPAIGN TREASURER'S REPORT — ITEMIZED CONTRIBUTIONS (1) Name Angela Alvero (2) I.D. Number 00000 (3) Cover Period 03 / 21 / 11 through 04 / 07 / 11 (4) Page 1 of 2 (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 Michael Natiello I CHE $100.00 03 21 /11 17 Aldon Terr. Bloomfield, NJ 07003 1 Benjamin S. Waxman I Attorney CHE $150.00 03 22 /11 Gwen Wurm 131 Buttonwood Dr. Key Biscayne, FL 2 33149 Sophia Montenegro I CHE $25.00 03 23 /11 6495 SW 25th St. Miami, FL 33155 3 Edith B. Houlihan I CHE $50.00 03 23 11 3250 Allamanda St. Coconut Grove, FL 33133 4 Ellis Berger I Retired CHE $300.00 03 23 11 550 NE 53rd St. Miami, FL 33137 5 Liesbeth C. Boots I CHE $25.00 03 23 /11 1320 NW 14th St. Miami, FL 33125 6 03 24 it Royee Alcalay I CHE $100.00 233 S. Federal Hwy. Boca Raton, FL 7 33432 Carlos M. Lopez I Entrepreneur CHE $500.00 03 27 /11 3090 NW 6th St. Miami, FL 33125 8 DS-DE 13(Rev.08/03) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES CAMPAIGN TREASURER'S REPORT — ITEMIZED CONTRIBUTIONS (1) Name Angela Alvero (2) I.D. Number 00000 (3) Cover Period 03 / 21 / 11 through 04 / 07 / 11 (4) Page 2 of 2 (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 Occupation Type Description Amendment Amount Sylvia G. Laurent I Preschool CHE $300.00 03 / 27 /11 790 NE 97th St. Director/ Miami `Shores, FL Owner 33138 9 Montessori School g CHE $100.00 03 / 30 /11 of Miami Shores, Inc. 577 NE 107th St. 10 Miami, FL 33161 Virgilia M. I CHE $50.00 03 / 30 /11 Rodriguez 540 NE 53rd St. Miami, FL 33137 11 Louis M. Jepeway I Attorney CHE $500.00 03 / 31 / 11 19 W. Flagler St. Suite 407 Miami, FL 33130 12 Warren S. Schwartz I CHE $50.00 04 / 05 / 11 1320 NW 14th St. Miami, FL 33125 13 DS-DE 13(Rev.08/03) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES SENDER: COMPLETE THIS SECTION COMPLETE THIS SECTION ON DELIVERY ■ Complete items 1,2,and 3.Also complete A. Sign re item 4 if Restricted Delivery is desired. X , ❑Agent ■ Print your name and address on the reverse. ❑Addressee so that we can return the card to you. B. Re eivedd byy(PPn'nt ame) C. D of livery ■ Attach this card to the back of the mailpiece, N�/Gam, 1f!v or on the front if space permits. D. Is delivery address different-from item 1? ❑ es 1. Article Addressed to: If YES,enter delivery address below: ❑No V�k/1 eSi 33 B 4 ! 1 3. Service Type..,... ertified Mail, 0 Express Mail 0 Registered ' ❑Return Receipt for Merchandise ❑ Insured Mail ❑C.O.D. 4. Restricted Delivery?(Extra Fee) ❑Yes 2. Article Number �/q (transfer from service labeo /�g �L CJ l0 �.l lJ� 00� (��J`s ,liS Form 3811,February 2004 f i Domestic Return Receipt 102595-02-M-1540 UNITED STATES POSTAL SERVICE First-Class Mail Postage&Fees Paid USPS Permit No.G-10 • Sender: Please print your name, address, and ZIP+4 in this box • WkG U�Ilr�ge C.lexk IOOSO NE I 51nOres, CAMPAIGN LOANS REPORT ITEMIZED Page 1 of 1 (PLEASE TYPE) FULL NAME AND ADDRESS OF LENDER: FULL NAME AND ADDRESS OF LENDER: Angela Alvero Cartolano & Alvero, P.A. 1008 NE 94th St. 46 NE 6th St. Miami Shores, FL 33138 Miami, FL 33132 OCCUPATION: Attorney OCCUPATION: Law Firm AMOUNT OF LOAN: $1,354.00 AMOUNT OF LOAN: $603.82 DATE RECEIVED: 3/22/2011 DATE RECEIVED: 4/7/2011 FULL NAME AND ADDRESS OF LENDER: FULL NAME AND ADDRESS OF LENDER: OCCUPATION: OCCUPATION: AMOUNT OF LOAN: AMOUNT OF LOAN: DATE RECEIVED: DATE RECEIVED: FULL NAME AND ADDRESS OF LENDER: FULL NAME AND ADDRESS OF LENDER: OCCUPATION: OCCUPATION: AMOUNT OF LOAN: AMOUNT OF LOAN: DATE RECEIVED: DATE RECEIVED: DS-DE 73A(Rev.08/03) CAMPAIGN TREASURER'S REPORT- ITEMIZED EXPENDITURES (1) Name Angela Alvero (2)I.D. Number 00000 (3) Cover Period 03 / 20 / 11 through 04 / 07 •/ li (4) Page 1 of 1 (5) (7) (8) (9) (10) (11) Date Full Name Purpose (Last,Suffix,First,Middle) (add office sought if (8) Street Address& contribution to a Expenditure Sequence Number City,State,Zip Code candidate) Type Amendment Amount Staples Paper & MON $47.90 03 25 11 2121 Biscayne Boulevard Envelopes for Miami, FL 33137 campaign 1 mailings Alvero, Angela M. repayment of MON $400.00 03 /25/11 1008 NE 94th Street campaign loan Miami Shores, FL 33138 2 USPS Mailing MON $183.34 03 26 11 9825 NE 2nd Ave. Miami Shores, FL 33153 3 Alvero, Angela M. repayment of MON $954.00 03 /29/ 11 1008 NE 94th Street campaign loan Miami Shores, FL 33138 4 Flagler Post Office Stamps MON $18.48 04 05 11 2285 West Flagler St. Miami, FL 33135 5 Union Printing Flyers, MON a $300.00 04 05 11 2321 Pembroke Rd. Mailers Hollywood, FL 33020 6 Union Printing Flyers, MON $1,303.82 04 P7 11 2321 Pembroke Rd. Mailers Hollywood, FL 33020 7 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) Angela Alvero OFFICE USE ONLY Name (2) 46 NE 6th Street Address(number and street) Miami, FL 33132 City, State,Zip Code ❑CHECK IF ADDRESS HAS CHANGED (3) ID Number: (4) Check appropriate box(es): ✓❑Candidate (office sought): Village of Miami Shores 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 (6)REPORT IDENTIFIERS Cover Period: From 02 / 16 / 2011 To 03 / 20 / 2011 Report Type G3 ✓❑Original ❑Amendment ❑Special Election Report ❑ Independent Expenditure Report (6) CONTRIBUTIONS THIS REPORT (7) EXPENDITURES THIS REPORT Monetary Cash&Checks $1,947.00 Expenditures $ 1,419.00 Loans $ Transfers to Office Account $ Total Monetary $1,947.00 Total Monetary $ 1,419.00 In-Kind $ (8) Other Distributions (9) TOTAL Monetary Contributions To Date (10) TOTAL Monetary Expenditures To Date $ 1,947.00 $ 1,419:00 (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 have examined this report and it is true, correct,and complete. correct, and complete. (Type name) lian Gon a (Type name) Angela Alvero ❑Ind' ' al( y for T r ❑✓ Deputy Treasurer ❑✓ Candidate 4 Chairperson(only for PC,PTY e ctio ring rn ,) a ctioneering commun.organization) X !-���-- i atune Signature D84DE 12(Rev.08104) CAMPAIGN TREASURER'S REPORT—ITEMIZED CONTRIBUTIONS (1) Name Angela Alvero (2) I.D. Number 0000 3 Cover Period 02 /16 /11 through 03 / 20 / 11 4 Pae 1 of 3 (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 0==Wn Type Description Amendment Amount Angela Alvero 02 16 11 1008 NE 94th St. Miami Shores,FL 33138 1 Attorney CHE $500.00 1 Thomas Mayer 03 10 11 Mayer Realty 130 S.University Dr.,Suite A B CHE $36.00 Plantation,FL 33324 2 Jack&Wendy Weisblat 03 10 11 6526 Via Rosa Boca Raton,FL 33433 I CAS $100.00 3 Henry Bonis 03 114 11 46 NE 6th Street Miami,FL 33132 I CAS $8.00 4 Mike Walsh 03 /14 11 46 NE 6th St. Miami,FL 33132 B Attorney CHE $300.00 5 Cynthia M Atwell& 03 115 11 David V.Wanless 920 Corkwood St. I CHE $50.00 Hollywood,FL 33019 6 Gunther Geis 03 115 111 BlackPort Property Real Estate Management Div. B Investment CHE $198.00 901 SE 17th St.,#206 7 Fort Lauderdale,FL 33316 11 Matthew Troccoli 03 /16 Law Offices of Matthew Troccolli,P.A. 46 NE 6th St. I CHE $25.00 8 Miami,FL 33132 DS-DE 13(Rev.08103) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES v i CAMPAIGN TREASURER'S REPORT— ITEMIZED CONTRIBUTIONS (1) Name Angela Alvero (2) I.D. Number 0000 3 Cover Period 02 /16 /11 through 03 120 11 4 Pae 2 Of 3 (5) (7) (8) (g) (10) (11) (12) Date Full Name (6) (Last,Suffix,First,Middle) Sequence Street Address& Contributor Contribution In-kind Number City.State Zip Code Type 0ocuoation Type Description Amendment Amount Elvis Cruz 03 1 16 111 631 NE 57th St. Miami,FL 33137 I CHE $50.00 9 Tori 03 / 16 111 555 NE1ivan 50th Terr. Miami,FL 33137 1 CHE $50.00 10 Ellis Berger 03 / 16 11 550 NE 53rd St. Miami,FL 33137 1 Retired CHE $100.00 11 Julia Kefalinos 03 117 11 Law Offices of Julia Kefalinos,P.A. 2250 SW 3rd Ave.,Ste.150 B CHE $50.00 12 Miami,FL 33129 Aimone Pasqualin 03 /17 11 Law Offices of Julia Kefalinos, P.A. B CHE $50.00 2250 SW 3rd Ave.,Ste.150 13 Miami,FL 33129 Sonia Slaughter 03 17 11 Law Office of Julia Kefalinos, P.A. B CHE $50.00 ' 2250 SW 3rd Ave.,Ste.150 14 Miami,FL 33129, Joseph P.Cartolano M 03 / 17 111 1008 NE 94th St. Miami Shores,FL 33138 I CHE $30.00 t 15's Rene Palomino 03 /17 11 1111 Brickell Bay Dr., Apt.2909 Miami,FL 33131-2963 1 CHE $50.00 16 DS-DE 113(Rev.08103) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES CAMPAIGN TREASURER'S REPORT— ITEMIZED CONTRIBUTIONS (1) Name Angela Alvero (2) I.D. Number 0000 3 Cover Period 03 /21 /11 through 04 / 06 11 4 Pae 3 of 3 (5) (7) (8) (g) (10) (11) (12) Date Full Name (6) (Last,Suffix,First,Middle) Sequence Street Address& Contributor Contribution In-kind Number City,State Zip Code Type Om=tion Type Description Amendment Amount Ellis Berger 03 18 / 11 550 NE 53rd St. Miami,FL 33137 Retired CHE $100.00 17 Bryan Cohen 03 120 / 11 1314 East Las Olas Blvd., Ste. 1098 Ft.Lauderdale,FL 33301 CHE $100.00 18 Richard N.Roffman 03 120 11 1924 SE 21 st Ave. Fort Lauderdale,FL 33316 CHE $100.00 19 DS-DE 13(Rev.08M3) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES CAMPAIGN TREASURER'S REPORT- ITEMIZED EXPENDITURES (1) Name Angela Alvero (2)I.D. Number 0000 (3)Cover Period 02 / 16 / 11 through 03 / 20 / 11 (4) Page 1 Of 1 (5) (7) (8) (9) (10) (11) Date Full Name Purpose (6) (Last,Suffix,First,Middle) (add office sought if Sequence Street Address& contribution to a Expenditure Number City,State,Zip Code candidate) Type Amendment Amount Miami Dade Elections - Miami Miami Shores MON $40.00 03 09 11 Dade Board of County registerd Commissioners voter and 1 2700 NW 87th Ave. absentee Miami, FL 33172 ballot list Salon Rik Rak Photo shoot MON $130.00 03 10 11 1428 Brickell Ave. , #3 for campaign Miami, FL 33131 signs & materials 2 Forever Images Deposit for MON $100.00 03 10 11 5940 W. 16th Ave. Photo shoot Hialeah, FL 33012 3 American Political Signs Deposit for MON $200.00 03 11 11 2321 Pembroke Rd. campaign signs Hollywood, FL 33020 & materials 4 Forever Images Balance for MON $150.00 03 15 11 5940 W. 16th Ave. photo shoot Hialeah, FL 33012 5 Miami Shores Chamber of Candidates MON 03 16 11 Commerce • breakfast-3 $45.00 9701 NE 2nd Ave. attendees.$30 Miami Shores, FL 33138 reimbursed from candidates 6 person account American Political Signs Balance for MON $754.00 03 7 11 2321 Pembroke Rd. campaign signs Hollywood, FL 33020 & materials 7 DS-DE 14(Rev.08103) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES