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McCoy, Jim LOYALTY OATH (Sections 876.05-876.10,Florida Statutes) CANDIDATE WITH NO PARTY AFFILIATION OFFICE USE ONLY I CC First Na a Middle Name/Initial LName 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) I, 51 CCA'---4 (PLEASE PRINT NAME AS YO WISH IT TO APPEAR ON BALLOT'-- NAME MAY NOT BE CHANGED AFTER THE END OF QUALIFYING) am a candidate with no party affiliation for the office of MIAM I -shm cmw1v , 1 (office) (district#) I am a qualified elector of j Arj - L, A County, Florida; (circuit#) (group oi�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 loffice 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, Floridatatutes. JIM @ M CCbi?f 0%prIeS.V S xU (M IS4 -.1,110 Sig ature of Cari 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): STATE OF FLORIDA COUNTY OF M(Oft - I t Sworn to(or affirmed)and subscribed before me this a��* day of f1--( Vl✓(/1!j-,) , 20 LI Personally Known: or 0`M"' BARBARAAESTEP MY COMMISSION#DD 9553DO ,€ EXPIRES:March 29,2014 Signature of Notary Public ' Bonded Tbru Public Underxaiters Produced Identification: N0� Print,Type,or Stamp Commissioned Name of Notary Public Type of Identification Produced: DS-DE 24B(Rev.10110) Rule 1S-2.0001,F.A.C. SQ .0 1-93 ,Kc. I rag 10 -l0050 oiY. . 6", COY 2011 Candidate Name: C(0 Address: __ � �(� q,1,h g^, Telephone Numbers: �}� QS- 7 S 14 -0 C) 30S -aa -ao E-Mail Address: G eS 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 JForm 1 Financial Disclosure J Loyalty& Candidate's Oath J Statement of Candidate 7- 50 Signatures on Nominating Petition Confirmed by Miami-Dade County Elections 805)9'.95-2207 C9;.- ("805)756-8972 �p-� eat�FG@miamua�or�avcY/ge.00m Elections 2700 NW 87th Avenue MIAMI-FADE Miami,Florida 33172 i o T 305499-VOTE F 305-499-8547 TTY:305-499-8480 miamidade.gov j i CERTIFICATION i STATE OF FLORIDA) i COUNTY OF MIAMI-DADE) i I, Lester Sola, Supervisor of Elections of Miami-Dade County, Florida, do hereby certify that 55 signatures submitted by Jim McCoy for the office of Council in the Miami Shores Village matched the signatures on the voter files. , i WITNESS MY HAND i AND OFFICIAL SEAL, I AT MIAMI, MIAMI-DADE COUNTY, FLORIDA, } ON THIS 4" DAY OF MARCH, 2011 s L ster Sol Supervisor of Elections Miami-Dade County i r 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 miamidade.gov March 4, 2011 Barbara A. Estep, MMC Village Clerk Miami Shores Village 10050 NE 2"d Avenue Miami Shores, FL 33138 Dear Ms. Estep: The Miami-Dade Elections Department has completed the verification of the petitions for Jim McCoy, a candidate for Council in the Miami Shores Village. A total of 78 petitions were submitted and all of the petitions were reviewed for verification. Of the total 78 petitions, 55 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. Sincerely, Lest Sola Supervisor of EI s Miami-Dade Elections Department Enclosure (1) _ . SENDER: COMPLETE THIS SECTION COMPLETE THIS SECTION ON DELIVERY ■ Complete items 1,2,and 3.Also complete A. Sin tura 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. ReceivedPrinted Name) V Date of Deli ry ■ Attach this card to the back of the mailpiece, MAR 0 5 or on the front if space permits. D. Is delivery address different from item 1? ❑Yes 1. Article Addressed to: If YES,enter delivery address below: ❑ No /��n3. Service Type; t: I CUNAk �Y�l J�e S r. `,'ertified Mail ❑Express Mail LJ Registered ❑Return Receipt for Merchandise ❑ Insured Mail ❑C.O.D. 4: Restricted Delivery?(Extra Fee) ❑Yes 2. (Tins Number n )CO lO 100011 a3o? 0a.l (Transfer from service/abe /�-�..!�J o� �n-� PS Form 381 s1,February 2004 I I 1 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 • U I lade Gleamam L Co5o N I�U2 IM�aw�i ov�S, f- 33M U SfPostal ' e- ic,M `u _ .. r , C_ERTIREv.MAILTr,tRECEIPT� (Domestic Mail Only;No Insurance Coverage.Provided) or delivery information visit our website at www.usps.com7jRffW PS Fore 38001Au ust 2006 See Reverse for Instructions Certified Mail Provides: ' ■ A mailing receipt ■ A unique identifier for your mailpiece ■ A record of delivery kept by the Postai Service for two years Important Reminders: ■ Certified Mail may ONLY be combined with First-Class Mail®or Priority Mail®. ■ 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 Return Receipt may be requested to provide proof of delivery.To obtain Return Receipt service,please complete and attach a Retumi Receipt(PS Form 3911)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-Deliveryt ■ If a postmark on the Certified Mail receipt is desired,please present the arts- 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 SNoREs Gf` 96awwm .u. ruI __ F �ZOR1vA X0050 c/ P March 4, 2011 Mr. Jim McCoy 325 N.E. 96" Street Miami Shores, FL 33138 Dear Jim: 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. Atone. 905)y95-220y C�7 (905)756-899.2 �'p-� (C�miamaia/caxeavi/laQe� cam Jim McCoy 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, 66/01V Q 41 Iva Barbara A. Estep, MMC Village Clerk Certified Mail — Return Receipt Requested Candidate qualifying letter OFFICE USE ONLY STATEMENT OF CANDIDATE (Section 106.023, F.S.) (Please Type) I, rl Gz' , candidate for the office of have received, read and understand the requirements of Chapter 106, Florida Statutes. x 2T•� 1 igna re of Candid-V+1-1 )ate 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— • 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 or 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) Willfullyinjure,deface,or damage or cause to be injured,defaced, or damaged,by any means, any IT I 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, v I H H`'"'`� , a candidate for the office of plea`s'priintt your name e C,� `1/ 't A` f M���' St�o S Y� 1t�K. WV�`I�1 V in_M AMI-tAbC , elective office sought 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. X 2z(OII Signa a Date COE,revised 4/2010 PETITION We, the undersigned electors of Miami Shores Village, hereby nominate for a position on the Village Council. ' 6 PRINT NAME ADDRESS. SIGNATURE: DATE 1.4s M s M " • 1 ,vo .� 1 c s ,. � ,►.� ac , str 269 RAW- "CMUMA Jeyy L 'u �03 � /��� 96 �' 2G•l el f WA-kP 2-2b The undersigned is the circulator of the foregoing paper con ' g signatures. Each appended thereto was made in my presence and is the mcnuine signature of the person whose name it purports to be. Signature of Circulator Address 3Z� �� 9 b �� Ucceptance 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 for a position on the Village Council. PRINTNAME ADDRESS -SIGNATURE... DATE r ' a . �3F�TIe�L 3o AJF/43 S�- Z LZ G% 8D a7 Q -save The undersigned is the circulator of the foregoing paper containing V signatures. Each appended thereto was made in my presence and is a genuine signature of the person whose name it purports to be. Signature of Circulator Address 32'S IV e 9 6 T Acceptance of Nomination I hereby accept the nomination for the Village Council and agree to serve if elected. Signature of Candidate I PETITION I We, the undersigned electors of Miami Shores Village, hereby nominate for a position on the Village Council. ' PRINT NAME ADDRESS SIGNA DATE well 7li ,L 2 ,B � ����'/�• � ���Zoe 2 c., 2G� Aj•- et c.1 2 Z�h r�E 46 SS 3 0 do C, oc 4A Lw4POSD "s FSS Pe 'w/ ltrQ ,a.I A 550 1%316 R(V 57. • z r)JOLGO/vWCLk- S z-? Dal f gni�l(�t L GAS �'�'�-N� `���►� _ ..— � ,,�/ , The undersigned is the circulator of the foregoing paper containing signatures. Each appended thereto was made in my presence and is the mine signature of the person whose name it purports to be. Signature of Circulator Address �Jcceptance of Nomination I hereby accept the nomination for the Village Council and agree to serve if elected. a` ' Signature of Candidate PETITION We,the undersigned electors of Miami Shores Village, hereby nominate for a position on the Village Council. ' PRINT NAME ADDRESS GN : . TE Ale AEAef (5-7 AJ C' 601 S- (o In Z 2 a fl4, 6� 17,i,A to 6d-�,-T earl gmcr es AVE' loo U1 Sf ,D ia.- l� avid 2 2S o The undersigned is the circulator of the foregoing paper containing signatures. Each appended thereto was made in my presence and is the nuine signature of the person whose name it purports to be. i Signature of Circulator Address �Z� �< cceptance ofNomination I hereby accept the nomination for the Village Council and agree to serve if elected. A, Signature of Candidate PETITION We, the undersigned electors of Miami Shores a Villa hereby for a position on the Village Council. g Y nominate i PRINT NAME l . ADDRESS SIGNATURE : . DATE ���_ OVCI�' v1 ���n, ic�c3-Sn14.. `�a'.tl• ��- � I�Ms � L kA , _ rY�C3m e'�"a � � �lo(o o ►JLC J� ,d-✓c � �—, r� 3�N� - z7 The undersigned is the circulator ofAhe foregoing paper containing I signatures. Each appended thereto was made in my presence d is th e ' e signature of the person whose name it purports to be. Signature of Circulator Address 's �j S f Acceptance ofNomination I hereby accept the nomination for the Village Council and agree to serve if elected. Signature of Candidate PETITION T� We, the undersigned electors of Miami Shores Village, hereby nominate for a position on the Village Council. ' PRINT NAME ADDRESS SIGNATURE DATE M aAkt-t 4 PaILK 383 No 9(fly cot g-r I—ikk AV-A)4 KA 6© v 0.d( O/S q5 -WmiZ )1 's Rpu g !An% E.. gs sl t 4. ee 1k QA WE 95 SI I u�N ��.D �-�" �st�e• 7i�1 kD The undersigned is the circulator of the foregoing paper containing si atures. Each appended thereto was made in my presence and is th enume signature of the person whose name it purports to be. Signature of Circulator Address 32� IVG J� Acceptance of Nomination I hereby accept the nomination for the Village Council and agree to serve if elected. Signature of Candidate SgoRFs %DawGaix�z 'ttiC.I93Zuses Issue," L� �ZoRtDA X0050 ,2"d Ci��ea�nu �5�,`oxes, Cf'� .33�38 February 28, 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 (6) from Jim McCoy, 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, lac- Barbara A. Estep, MMC Village Clerk one: x805)995-2209' ('305)756-8972 g'p-� �p miamla/aresrrllage.oam 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 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 Z51 r mccoq code) 3Z5 �E 9'b sl�Cl 4. Telephone 5. E-mail addre s 1�/( h� ' ' Q16USI Ft., 33 138 (3051154 uccl 31M @1S01GS-1 6. Office sought(include district, circuit, group number) 7. If a candidate for a nonpartisan office, check if applicable: ❑ 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. have appointed the following person to act as my ❑ Campaign Treasurer ❑ Deputy Treasurer 10. Name of Treasurer or Deputy Treasurer 11. Mailing Address 12. Telephone 13. City 14. County 15. State 16. Zip Code 17. E-mail address 18. 1 have designated the following bank as my Primary Depository ❑ Secondary Depository 19. Name of Bank 20.Address r1 r 1499 NE ZIJD *4\1* 21. City 22. County 23. State 24. Zip Code M1�01 S h - poluri 3313S 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. Signature o ididate ZZ� 11 x 27. Treasurers Acceptance of Appointment(fill in the blan\j check the appropriate block) I, , do hereby accept the appointment (Please Print or Type Name) designated above as: ❑ Campaign Treasurer ❑ Deputy Treasurer. X Date Signature of Campaign Treasurer or Deputy Treasurer DS-DE 9(Rev. 10/10) Rule 1S-2.0001, F.A.C. S 193 'Scp . 932 oRiDp'full -1005'0 Q4". . 211d �u &"j C5933:a8 NOTICE OF CANDIDACY AND RESIDENCY 1 �l r1 1`1 cc.o� , hereby file this Notice of Candidacy this 14" day of 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. Signatur \1j Print Name Address Telephone Number j k M a I C61 0 S E-Mail Address STATE OF FLORIDA ) COUNTY OF MIAMI-DADE ) BEFORE ME personally appeared ( who executed this Notice of Candidacy and Residency this day of 2011. Barbara A. Estep Notary Public lry 1 BARBARA A EMP Personally Known _. MYO MMISSIONMDD95M Phui Produced the followingIdentification Seal/Commission BonWnNotwyPublcUnd mftrs �1✓!a�t6: (805)995-2209' C5r—. (805)756-8972 SgOREs Q 96aOVAO Q . txc.1932 L�` t Wp4� n.. � um t� ��TEs 1t16 �ORIDp' X0050 Q*'K 21 aq" CJiW gnu Q%mea, Coy 'Y'l7a8 MIAMI SHORES VILLAGE COUNCIL CANDIDATE INFORMATION RECEIPT Candidate: CQ 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: Z • `� SPX—: 306,)995-2209' C as 305)76-6-8972 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 55 signatures submitted by Jim McCoy 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 4th DAY OF MARCH, 2011 L ster S01 Supervisor of Elections 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 M I AM I•DADE Miami, Florida 33172 T 305-499-VOTE F 305-499-8547 we Mk TTY: 305-499-8480 miamidade.gov March 4, 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 Jim McCoy, a candidate for Council in the Miami Shores Village. A total of 78 petitions were submitted and all of the petitions were reviewed for verification. Of the total 78 petitions, 55 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. Sincerely, Lest Sola Supervisor of EI s Miami-Dade Elections Department Enclosure (1) - ` — PETITION We, the undersigned electors of Miami Shores Village, hereby nominate for a position on the Village Council. PRINT NAMEA ADDRESS SIGN TUBE : . DATE o s U �4A �c'�dS C�e'_ 9 lcllja"d�rvyno a, �-�I rl ► k C�2.3 �-srtnd c��Lu-� � a-�s - I I 1 -Z-7—(P—�f The undersigned is the circulator of a foregoing paper containing I I signatures. Each appended thereto was made in my presence d is th e e signature of the person whose name it purports to be. Signature of Circulator Address wS 1 . 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 for a position on the Village Council. ' PRINT NAME ADDRESSSIGNATURE.:. DATE 9,e ��9 -�• _ Zfo � S67_1l/E OE q4 St4A r 9 26 1A WE ek t e r L' u lo36 /J6 2 2G•1� The undersigned is the circulator of the foregoing paper contain/mg signatures. Each appended thereto was made in my presence and is thenuine signature of the person whose name it purports to be. Signature of Circulator Address 3Z 9� b S� Ucceptance 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 1 C for a position on the Village Council. ' P NAME ADDRESS ..SIGNATURE-.:. DATB IL .� r 3 q� i 5q _kl� 105ts, a 4/0V zAW ,3a X/r 43 5�- The undersigned is the circulator of the foregoing paper containingy signatures. Each appended thereto was made in my presence and is a genome signature of the person whose name it purports to be. Signature of Circulator Address �Z J 1 V 9 ST Acceptance ofNomination I hereby accept the nomination for the Village Council and agree to serve if elected. `" Signature of Candidate AkxA_ PETITION We, the undersigned electors of Miami Shores Village, hereby nominate for a position on the Village Council. P NAME ADDRESS GN TE yk) 51A64s �( Lr f N L �- �► 7157-7 AJ C' 6O1 a - �- Eitf NL` 61 /e 9tW '-01 � The undersigned is the circulator of the foregoing paper containing signatures. Each appended thereto was made in my presence and is thenuine signature of the person whose name it purports to be. Signature of Circulator Address cceptance 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 for a position on the Village Council. MINT NAME ADDRESS . .SIGNA DATE 12 z of zC d/ VV,C' tz z 4& Z9h �E46 SS 8 �7 P.�� rKGn yyy�vE t6 �!/ P0. �aS CSS ac b Z� 501%1.6 evo ST. Z 7 << L O W C"t S 70 Lem Me � Vu aL gnirin1 G G0-5 64tz-Na The undersigned is the circulator of the foregoing paper containing signatures. Each appended thereto was made in my presence and is the genume signature of the person whose name it purports-to be. ' Signature of Circulator Address ��� 1�'� 1 J 1 �Jcceptance 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 for a position on the Village Council. ,PRINT NAME ADDRESS SIGNATURE : DATE .�� M Atw Pa CK 383 No % nil c..r,� ....� L"e'0 � - -- _ F- ri 14 �- © rl SW.L�JA .�/ 10 �l L4 \& fro& q5 Sf 31x-) mss/ �• �t�, . d Gf ftL 2g C2, 575rAz)��- 21i �1 SIMOU s1tA ee- 'F-IL N 'a --1� ZSR. J 'j4 The undersigned is the circulator of the foregoing paper containing signatures Each appended thereto was made in my presence and is thiLgenume 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 serve if elected. Signature of Candidate Barbara Estep From: Vote Jim McCoy Dim@votejimmccoy.com] Sent: Wednesday, March 23, 2011 1:40 PM To: Barbara Estep Subject: candidate info Occupation: Director, commercial real estate broker, KW Commercial, Shores Office Consultant, Barry University Age: 47 Birthplace: St. Louis, Missouri Family: Wife, Anne/ Children,James and Kelly Higher Education: Trinity University Jim McCoy is a 32 year resident that lives and works in Miami Shores Village. He has been married to his wife Anne for 17 years and they have two children, James (8) and Kelly (5) that experience daily all that Miami Shores has to offer. Jim was voted into office as mayor of Miami Shores in 2003 and served on the council for four years. He has been active in nearly every initiative of consequence over the last decade and as a result, was honored last year with the Miami Shores Citizen of the Year award. In addition to his term as mayor that yielded the creation of Doctors Charter School of Miami Shores, Jim has been a two term president and a long standing vice president of the Miami Shores Chamber of Commerce. He was chairman of the downtown 2nd Avenue event that drew 5000+ people to the streets and merchants of Village Place, a community coordinator for the Miami Shores Informed Families initiative, and the vice chairman of the Planning &Zoning board that oversaw the development of quality community assets such as our state-of-the-art aquatic center and our redeveloped 51,000 square foot Publix. Jim McCoy (305)632-0200 Check out our website! jim(a_)VoteJimMcCoy.com www.Votejimmccov.com AM McCoy Proven try�tdrr,l!}rrrrJl.�hr,tYs4`I1Fr+�rE:r�rrrrer't e e i 1 '..j r', t, �., _3.x,. �\ r FLORIDA DEPARTMENT OF STATE DIVISION OF ELECTIONS CAMPAIGN TREASURER'S REPORT SUMMARY " 'Q� l OFFICE USE ONLY Name �'Zy ( J , Address numMbr and sst eel Y � City, State,Zip Code / ❑ CHECK IF ADDRESS HAS CHANGED (3) ID Number: (4) C eck appropriate box(es): ?Candidate (office sought): � s4 � ❑ Political Committee ❑ CHECK IF PC HAS DIS ANDED ❑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 / Z / 11 To 3 / / i I Report Type ❑ Original ❑Amendment ❑ Special Election Report ❑ Independent Expenditure Report (6) CONTRIBUTIONS THIS REPORT (7) EXPENDITURES THIS REPORT �� Monetary rw Cash & Checks $ , Expenditures $ Loans $ Transfers to Office Account $ Total Monetary $ zi I�J� Total Monetary $ In-Kind $ � D (8) Other Distributions (9) TOTAL Monetary Contributio Date (10) TOTAL Moneta!yExpenditure, To Date (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) ���� (T name) [:]Individual(only re s r Deputy Treasurer Candidate ❑Ch irpe on o PC,PTY& electioneering commun. o eeri o anization) X X Signature Signature MWOMMONJ DS-DE 12(Rev.08104) CAMPAIGN TREASURER'S REPORT— ITEMIZED ONTRIBUTIONS (1) Name � I 0 I 1 (2) I.D. Number 3) Cover Period 2— / 2� ! 1 through 3 / 20 / ( (4) Pae of Z (5) (7) (8) (9) (10) (11) (12) Date Full Name (6) (Last, Suffix, First, Middle) C*CV.- Sequence Street Address& Contributor Contribution In-kind Number City, State,Zip Code Type I occupation Type Description Amendment Amount M^'r. I ( 3 �33 �® o , 1 JON ( �Z tlz)l _<�- 1 200 sooa05t 3► go 5 o ► T G ?� It 3 F;14C� 2 44 -3 / 4 / o 0*�c 11b �4 9 Cr 21513 Kl� S 3 5oo W-33i 4 31,68 CPO �q C46 So uzo5tly-J110 �I�qM�S1 r3 DS-DE 13(Rev.08103) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES CAMPAIGN TREASURER'S REPORT- ITEMIZED ONTRIBUTIONS 1-7 (1) Name �� (2) I.D. Number (3) Cover Period (- / 2-15 / 1 through / 2D / l (4) Pae 7i of 2- (5) (5) (7) (8) (9) (10) (11) (12) Date Full Name L (6) (Last,Suffix, First,Middle) cite* Sequence Street Address& Contributor Contribution In-kind Number City,State Zip Code Type I Occupation Type Description Amendment Amount NW10 Y�C)D � � 41 tofop "�VAt s1�31� C� 38 4 m Y�o�sA - f3 / S , 11 kvl�C4�(1-r -�I � r 1wob t� I H� < < ' c �I foo Y 1 E . I 1 4 1 � f DS-DE 13(Rev.08103) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES, CAMP i TREA_} URER'S REPORT- ITEMIZE EXPENDITU (1)Name (2)I.D. Number (3)Cover Period Z / 26/ 1 through 3 / / (4)Page_�of (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 Number City,State,Zip Code candidate) Type Amendment Amount Z Z$ I1 41f��Nq ��O(N S T—Shtys %5►s u 35`'• kAk �rti LN o� MW fs� fire vpp-fl citj 265;3 M.z DS-DE 14(Rev.08103) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES CAMPAIGN S 'S R PORT - ITEMIZE EXPENDITURES (1) Name O (2)I.D. Number (3)Cover Period Z / / through (4)Page of (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 51 q e 610gk-s xo�klE ��cJ lit 4� �'4) s1 �S q6\4S 50utrs,. 3 ez)) 46%L � M'o 41- DS-DE 14(Rev.08103) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES CAMPA 3N T SUR R'S REPORT- ITEMIZE EXPENDITURES (1)Name I 1` 0 (2)I.D. Number (3)Cover Period / 2�/ � � through / / (4)Page�_of (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 Number City,State,Zip Code candidate) Type Amendment Amount 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) CCC) OFFICE USE ONLY Name (2) Address (number and street) MAMS 33 38 City, State, Zip C de ❑ CHECK IF ADDRESS HAS CHANGED (3) ID Number: (4) Check appropriate box(es): qt`LL46�,Candidate (office sought): r1 t�� ❑ 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 / 5 / t l To / I / i Report Type ❑ Original ❑ Amendment ❑ Special Election Report ❑ Independent Expenditure Report (6) CONTRIBUTIONS THIS REPORT (7) EXPENDITURES THIS REPORT Monetary Cash & Checks $ Expenditures $ Z Z Loans $ Transfers to Office Account $ Total Monetary $ Total Monetary $ In-Kind $ (8) Other Distributions (9) TOTAL Monetary Contributions To Date (10) TOTAL Monetary E;penturesdiTo Date $ I1 �Z3 � �� $ (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) (Type name) Individual(only for ❑Treasurer ❑Deputy kreasurer 1wCandidate ❑Chairperson(only for P&PTY& el ioneering commun.) el nearing commun.organization) X X t Signature Signature DS-DE 12(Rev.08/04) CAMPAIGN TREASURER'S REPORT— ITEMIZED ONTRIBUTIONS (1) Name �1 �� CCS (2) I.D. Number 3) Cover Period A through 7 / ( � (4) Page I of 1 (5) Date Full Name (8) (9) (10) (11) (12) (6) (Last, Suffix, First, Middle) C(f{L Sequence Street Address& Contributor Contribution In-kind Number Cit , State,Zi Code Type Occu tion T e —.,Description Amendment Amount DS-DE 13(Rev.08/03) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES CAMPAIGN TREASURER'S REPORT - ITEMIZE EXPENDITURES (1)Name (2)I.D. Number (3)Cover Period / 8 / 11 through 1 / 11 / 11 (4) Page of Z (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 Number City,State,Zip Code candidate) Type Amendment Amount 1�1 1Z5 'Zoo clqzr1oAT 3�1 ►I � N 1 /6/11 (Q COSTCO 3S 1•!4 4 /i�o�, PIPI Iq � M r cj*f --- DS-DE 14(Rev.08103) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES CA PA GN ASURER'S REPORT- ITEMIZE EXPENDITURES (1)Name 1'I`� �� (2)I.D. Number (3)Cover Period�/ through / << / (4)Page 2 of Z (5) (7) (8) (9) (10) (11) Date Full Name Purpose (6) (Last,Suffix,First,Middle) (add office sought If Street Address S contribution to a Expenditure Sequence Number City,State,Zip Code candidate) Type Amendment Amount of (I t► Ir-1 CC%"�l 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) !r ff OFFICE USE ONLY Name 7j I p (2) Address (number an(Sd tree City, State,Zip Code l� ❑ CHECK IF ADDRESS HAS CHANGED (3) ID Number: (4) C eck appropriate box(es): Candidate (office sought): "�� � 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 / Z j / 11 To 4 / I / 11 Report Type 0 Original ❑Amendment ❑ Special Election Report ❑ Independent Expenditure Report (6) CONTRIBUTIONS THIS REPORT (7) EXPENDITURES THIS REPORT b5l-3 Monetary (� —Cash & Checks $ Expenditures $ V ZI 3�, Loans $ Transfers to Office ^� Account $ Total Monetary $ �Q l Tota5 l r Monetary $ 2� , In-Kind $ (8) Other Distributions (9) TOTAL Monetary Contribut!orri To Date (10) TOTAL Monetary x enditures Lo Date $ 5� 3 : $ 2[ , 35 (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. A correct, and complete. (TyW name) �� t (Type name) Individual(only for [:]Treasurer ❑Deputy Treasurer Candidate ❑Chairperson(only for C,PTY 8 ele 'oneering commun.) lectioneering commun.organization) X X Signature Signature DS-DE 12(Rev.08/04) CAMPAIGN TREASURER'S REPORT— ITEMIZED ONTRIBUTIONS (1) Name (2) I.D. Number (3) Cover Period 3 / 2 / through 4 / 1 / 1 ) (4) Page of (5) (7) (8) (9) (10) (11) (12) Date Full Name L,,� (6) (Last,Suffix, First, Middle) n Sequence Street Address& Contributor Contribution In-kind Number City, State,Zip Code Type occupation Type Description Amendment Amount 3 , 22 , 11 C�olp9�1�I,gM� �oa 114 t�E l off► ' C46 oO � Vii, ISI 5012 �i�g11Sr1k'hl� C►�k Z5a Z �IR�II �3�3t3 3 , i,I , I t �►�� 10680 t 2s ST G C1 ' Soo 3 I�IIQMI 331�Z Wkk 140 1130 ST „ tom Z;O 3 ,23 , 1► tirzf- MAX* 1311 4Io3 ST �- 5 ms 33136 McPk, f 56 Rd S99 � m ST PrrTAC'qe 1 o o TI.S. 3313e 3 , 23 , II 44 Q" AD`�f* Wn1 Ila- 3 , Z; , 11 051whf'cc Zt�Vl M.S . 33131 DS-DE 13(Rev.08103) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES CAMPAIGN TREASURER'S REPORT— ITEMIZED ONTRIBUTIONS (1) Name 11m (2) I.D. Number 3) Cover Period J / through / / C 4 Pae Z of (5) (7) (8) (9) (10) (11) (12) Date Full Name �,,,,` (6) (Last,Suffix, First,Middle) n Sequence Street Address& Contributor Contribution In-kind Number City, State,Zip Code Type Occupation Type Description Amendment Amount 86 Oe It 2r c4< 150 °I m 33in ' A%% Jq� X45rJ�c 4$ sr Spay C1 )'OU 3 , 25 ):1 11 ,S. W38 IZ90 �� bZ Si � 2S D l2 M4 33 �3g r_ Ck 92b 6 qJz `3Mt 33136 IL" izac- 10b 100 = 69 x1411%3 1300 T91AV11 33138 5 3/ Z6, 1I 2SINA lrtr SW qto 04 9s S S � C 12'5 MS 33139 3 , 25 / p 504A I vI% 1301 NF Id�.S'�f � C� 5rjo MS !02�136 c DS-DE 13(Rev.08103) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES CAMPAIGN TREASURER'S REPORT- ITEMIZED ONTRIBUTIONS (1) Name (2) I.D. Number 3) Cover Period I I through 4 / / 1 (4) Pae of (5) (7) (8) (9) (10) (11) (12) Date Full Name LNC (6) (Last, Suffix, First, Middle) n Sequence Street Address& Contributor Contribution In-kind Number City,State,Zip Code Type Occupation Type Descri tion Amendment Amount 3 , 2 1 , Mwxto 2'S2� _T Ck foo C"�OLOCS31A 3 5 II q� C I 3311 3 / -24, 11 Wiw �wt I zv s cI ck� �,� M►A*�1 3311 b U / it v4lck�s 01 L �, 3 /Z� , �► Mrc�T2 � � Zo �s 33�3e 1415 P m !�_`21 Nowa Y s 13 02,16 3 / ZB M 1Allf0"10 WA 22 3 ' VN ' 11 ST '�b�F. r NI c S o Z3 ��s 33�3e I'SZ s Dwre 00i �s c 2-5 M1�%4-1 1 5311t I DS-DE 13(Rev.08/03) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES CAMPAIGN TREASURER'S REPORT— ITEMIZED ONTRIBUTIONS (1) Name �) 1v (2) I.D. Number (3) Cover Period / ZI / through 4 (4) Pae 4 of (5) (7) (8) (9) (10) (11) (12) Date Full Name (6) (Last,Suffix, First, Middle) nkCY-- Sequence Street Address& Contributor Contribution In-kind Number City, State,Zip Code Type occupation Type Description Amendment Amount 4 %ru poc 361 t-16- lqzz5*1 � �� � 25 M S 33►3S 1 , i► � � v1+1111-k � Z 5 C "1 1 UOD",W/y 44W) SISW49- EAU OD AIDS I �S�( 2� 1�f111`�II 31 � 3 � 41I , Ott f It; t* 20-b" 5 ra iz ) 00 2� S 33315 Cort o� i tZz R1 ST 500 2 oo ?� L OD �3 i�� 41ob 3'z, `t��g 2 r1s �3�3� DS-DE 13(Rev.08103) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES CAMPAIGN TREASURER'S REPORT— ITEMIZED ONTRIBUTIONS (1) Name �� ~� (2) I.D. Number (3) Cover Period / 2-1 4' / / I ( g/ Z� / l� throw 4 Pae of (5) (7) (8) (9) (10) (11) (12) Date Full Name LNC (6) (Last, Suffix, First, Middle) f1 Sequence Street Address& Contributor Contribution In-kind Number City, State,Zip Code Type occupation Type Description Amendment Amount *P-9h, 0� Y-a ►fig 20 g C_* 2150 � 3 �°Cs 3313 kP6 100 DS-DE 13(Rev.08/03) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES CAMPAIGN TREASURER'S REPORT- ITEMIZE EXPENDITURES (1)Name (2)I.D. Number (3)Cover Period 3 / Z / through�/ / /� (4)Page of (5) (7) (8) (9) (10) (11) Date Full Name Purpose (8) (Last,Suffix,First,Middle) (add office sought If Sequence Street Address& contribution to a Expenditure Number City,State,Zip Code candidate) Type Amendment Amount a1 715 13f �6 i M 300 l C.I,�1or(T ���I I M CCo �21Ot401 4kIS Rid- 434 ���c�o�rs 110 0 DS-DE 14(Rev.08103) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES CA�P�IGN TRE`AtSURER'S REPORT- ITEMIZE EXPENDITURES (1)Name 1 MSA 7 (2)I.D. Number (3)Cover Period 7D / 2"I / `� through 4 / 1 / I (4)Page Z of (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 -62 �44610z) sj � 0()4TIIM41 DS-DE 14(Rev.08103) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES