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Lewis, Eddie Elections 2700 NW 87th Avenue M I AM I•DADE Miami, Florida 33172 T 305-499-8683 F 305-499-8547 TTY: 305-499-8480 miamidade.gov March 3, 2017 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 Eddie Lewis, a candidate for Council for the Miami Shores Village. A total of 65 petitions were reviewed for verification; of which 50 were certified. For purposes of signature verification, my office follows the directives given by the municipality. You are encouraged to ensure compliance with municipal charter or code requirements. Please find the certification for the petition enclosed. Should you have any questions or concerns, please feel free to contact Michelle McClain, Deputy Supervisor of Elections for Voter Services at 305-499-8302. Sincerely, >1A, 2 Christina White Supervisor of Elections Enclosure (1) Elections 2700 NW 87th Avenue M 1 A M I•DADE Miami, Florida 33172 T 305-499-8683 F 305-499-8547 TTY: 305-499-8480 miamidade.gov CERTIFICATION STATE OF FLORIDA) COUNTY OF MIAMI-DADE) 1, Christina White, Supervisor of Elections of Miami-Dade County, Florida, do hereby certify that 50 signatures submitted by Eddie Lewis for the office of Council for the Miami Shores Villaqe 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, 2017 Christina White Supervisor of Elections CANDIDA (TION We,the undersigned electors of Miami Shores Village, do hereby nominate ,��/n�� C'u• �_for a position on the Miami Shores Village Council. Printed Birth Date or Date Name Voter Ree.# Address City/County/Zip Code Si nature Signed � �Wjjj Pat] �t 0410 1050 � 0( ( TIC9 . N<<a c`S (eS, 3313,? zi, 17 (�Iovkn aw )U 10 1 7 ! enow z ,i 415.71 � II /'pp '' � 1 c- 6'P01, l7 �?� 233 N �iami �►� ►�n►i 5�►oP�s ���"' 33150 2 26 c, la !o D�aQ� / 2 X233 l� l'�,u � A� ►Gr�i ��s a 3310 IV_-._ nP Y. C=Z 74, hi Cu HAA,AG7Av0 oL qO to ° �1 % S l ✓� 2 2� 2°/ � The undersigned is the circulator of the foregoing paper-containing-Psignatures. Each appended thereto was ade in.my presence and is the genuine signature of the person whose name it purports to be. Signature of Circulator: Address: r ACCEPTANCE OF NOMINATION 1 hereby accept the nomination for-the Village Council and agree to serve if elected. A Signature of Candidate: :r_ CANDIDAi (TION We,the undersigned electors of Miami Shores Village,do hereby nominate for a position on the Miami Shores Village Council. Printed Birth Date or Date Name Voter Reg.# Address City/County/Zia Code Signature Signed 61,46010 -Q-U J I w w i oo_ " �L •I �S r^c� lrhLr4-- bauni,� G UW-4, Dou as ?-( -/957 L3 7f N /od Sf i I?Q Mo t c?6v'- C'f lnnn t �yw 5 2 ��q tLLVl C��C� �r✓L�S -=3 �"© 103�1D/19Yd a- IM,��,,.� S�areS 1-7 r7=( �� 7,� V1 IF 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 ports to be. Signature of Circulator: Address: 7o Cc/ fAve, ACCEPTANCE OF NOMINATION hereby accept the nomination for the Village Council and agree to serve if elected. Signature of Candidate: i CANDIDA' 'ITION We,the undersigned electors of Miami Shores Village,do hereby nominate for a position on the Miami Shores Village Council. Printed Birth Date or Date Name Voter Ree.# Address City/County/Zip Code Signature Signed OD -©s hwj L 3 i61 2 28 T1 3 13 Y NO Ili"4&k Kew gvf?b 3&(A bF Irl �aK �l6Sl- '1160 ,v� Z� �P« ot�'�- I A QeTa 0 CO /Cr 16 f9jav k-1 -5 Ilk ;7 The undersigned is the circulator of the foregoing u g g g paper containing�signatur`es,.. ppended thereto was-maderirkmy presen a and is the genuine signature of the person whose name ' urports to be. } Signature of Circulat Address: /ld rW ACCEPTANCE OF NOMINATION I hereby accept the nomination for the Village Council-and agree to serve if elected. Signature of Candidat . CANDIDAi ITION We,the undersigned electors of Miami Shares Village,do hereby nominate zlylu1c, 0c z, for a position on the Miami Shores Village Council. 'J q►0 Printed Birth Date or �3� Date Nam Vote r Ree.# Address City/County/Zip Code SI ture l Signed ., a4 /zi 4 A)6 103 ,j J S� t .AA.� �wv�r -z zY 5 f zt �(,o.. .G✓l f d...rOeA' � / � ,9 q.3s Nr � /4�G !� d 1+�. � aw.y J i 2 cSY�. �k I o7 (v �/� ,N���U`f•U� /`yl �G,�►'�� V (n,a,J`�d" / / �' - �S��Frvu1 i-A t.z 10 63 �3oNc g6"�s� �t,� •S 4t�s ct- � 1 Z The undersigned Is the circulator of the foregoing paper containing signatures. Each appended thereto was made in my presence and Is the genuine r signature of the person whose nam 't purports to be. Signature of Circulator: Address: tell z ACCEPTANCE OF NOMINATION I hereby accept the nomination for the Village Council and agree to serve if elected. y Signature of Candidate: CANDIDAi (TION We,the undersigned electors of Miami Shores Village,do hereby nominate ,f-Je Z 6 c:t �5 for a position on the Miami Shores Village Council. Printed Birth Date or Date Name Vote rReg.# Address CIt1+LCaunty/Zip Code Sienature Signed "-�- LZ '�r 5z.�-�r e�� n cL .11Z-d2- ' \-Tog H %tom o yCgj's-'r— "' 0 &e `I(Al.'co „6'27 �`� wL of I 33)39 3 1� LA 4 3j- %- gay 3 313 eo- The undersigned is the circulator of the foregoing paper containing signatures. Each appended thereto, made in my presence and is the genuine signature of the person whose name A urports to be. Signature of Circulator: Address: ft9t> I�Irtj ' ACCEPTANCE OF NOMINATION I hereby accept the nomination for the Village Council and agree to serve If elected. Signature of Candidate: CANDIDAi (TION We,the undersigned electors of Miami Shores Village,do hereby nominate gzZ w• ,; for a position on the Miami Shores Village Council. Printed Birth Date or Date Name Voter Reg.# Address City/County(ZipCode Signature Siened ` 147 Ll-,6A q� v a n�u S3 I- lqc> QUI yam 3 9 c"' Z LipkE LAjS W I o© TE2 M W1 Z2&�z J6)� �gcl:J, �---- vglti� b CIZ NW I OO fig.. MIUL A i $00a ,�l 3 3150 3 Y 1z, S3)D fThe undersigned is the'circulator of the foregoing paper containing signatures. Each appended thereto wa ade in my presence and Is the genuine fs(gnature of the person whose name purports ' e. Signature of Circulator: Address: ACCEPTANCE OF NOMINATION I hereby accept the nomination for the Village Council and agree to serve If elected. Signature of Candidate: f CANDIDAi 'ITION We,the undersigned electors of Miami Shores Village,do hereby nominate.Z;a41c} L fsv for a position on the Miami Shares Village Council. Printed Birth Date or Date Name Voter Ree.# Address CIty/County/zlgCode Si nat •e Siened 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 rports to be. Signature of Circulator: Address: a5�6- A1. Iii Jor— ACCEPTANCE OF NOMINATION I hereby accept the nomination for the Village Council and agree to serve if elected. Signature of Candidate: CANDIDATE OATH — NONPARTISAN OFFICE (Not for use by Judicial or School Board Candidates) OFFICE USE ONLY OATH OF CANDIDATE (Section 99.021,Florida Statutes) �l L G�Ls (PLEASE PRINT NAME AS YOU WISH IT TO APPEAR ON THE BALLOT'— NAME MAY NOT BE CHANGED AFTER THE END OF QUALIFYING) am a candidate for the nonpartisan office of ) ruri (office) (district ff) I am a qualified elector ofCounty, 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; 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; and I will support the Constitution of the United States and the Constitution of the State of Florida. X ( 300 f/L,W 65 jj,e-����js Signature of Candidate Telephone Number Email Address �L� t�:_�•�'l.I- ���� (.�i. l�.li/tl�'Ir���•kcS (�'� (t�[5•L�- �� 3fl Address City State ZIP Code Candidate's Florida Voter Registration Number(located on your voter information card): f j%c)3 -7 ! *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): Lc WfS STATE OF FLORIDA COUNTY OF YI I OS{ l e_ Sworn to(or affirmed)and subscribed before me this a.� day of Y 20 Personalty Known: v or 6,6 Signature of Notary Public Produced Identification: Print,Type,or Stamp Commissioned Name of Notary Public BARBARA A.ESTEP Type of Identification Produced: ' *. MY COMMISSION#FF 073975 p•. z EXPIRES:March 29,2018 Bonded Thru Notary Public Underwriters DS-DE 25(Rev.5111) Rule 1S-2.0001,F.A.C. ALICE BURCH `SHORES G' MAYOR V;C19,12STEVEN ZELKOWITZ .y VICE MAYOR taunt S40pej Villace �-in HERTA HOLLY ++�+ COUNCILWOMAN 4, 10050 N.E.SECOND AVENUE MAC GLINN FNTEs 1N`' MIAMI SHORES, FLORIDA 33138-2382 COUNCILMAN FZORID TELEPHONE: (305) 795-2207 FAX: (305) 756-8972 IVONNE LEDESMA COUNCILWOMAN TOM BENTON VILLAGE MANAGER BARBARA ESTEP, MMC VILLAGE CLERK RICHARD SARAFAN VILLAGE ATTORNEY March 3, 2017 Eddie Lewis 9490 N.W. 1 s`Avenue Miami Shores, FL 33150 Dear Eddie: 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: Reporting Period Due Date Account Opening — February 24, 2017 March 10, 2017 February 25— March 17, 2017 March 24, 2017 March 18 — March 31, 2017 April 7, 2017 April 1 —April 13, 2017 April 14, 2017 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 July 15, 2017 Reports shall be filed no later than 5:00 PM on the designated day, however, any report postmarked by the U.S. Postal Service prior to midnight on the designated day shall be deemed to have been filed in a timely manner. Eddie Lewis March 3, 2017 Page Two 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 is scheduled for 10:00 AM on Thursday, April 13th and will be held at the County's Division of Elections office, located at 2700 N.W. 87th Avenue, Doral, Florida. At your earliest convenience, can you please forward to me a couple of paragraphs that will tell Village residents why you are running for office. In addition, a photo that can be printed along with your write-up. I ask that you keep the statement to approximately 200 words. Your information will be put on our website and carried in our Village Newsletter prior to the election. Please have the information to me no later than Friday, March 10th 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, "a, x"A/ / Barbara A. Estep, MMC Village Clerk Candidate qualifying letter t Elections ,MIAM'I•DADE 2700 NW 87th Avenue Miami, Florida 33172 T 305-499=8683 F 305-499-8547 TTY:305-499-8480 I miamidade.gov March 3, 2017 I y Barbara A. Estep, MMC Village Clerk Miami Shores Village 10050 NE 2n'Avenue Miami Shores, FL 33138 Dear Ms. Estep: The Miami-Dade Elections Department has completed the verification of the petitions for Eddie Lewis„ a candidate for Council for the Miami Shores Village. A total of 65 petitions were reviewed for verification; of which 50 were certified. For "purposes of signature verification, my office follows the ,directives given by the municipality: `You are'encouraged to ensure compliance with municipal charter or code requirements. Please find the certification for the petition enclosed. Should you have any questions or concerns, please-feel free to contact Michelle McClain; Deputy Supervisor of Elections for Voter Services at 305=499-8302. Sincerely, I Christina White P Supervisor of.Election p s t I � 'Enclosure (1) i m g K iq' '- Elections [MIAMIDADE 2700 NW 87th Avenue Miami, Florida 33172 T 305-499-8683 F 305-499-8547 TTY:305-499-8480 I miamidade.gov r � ' CERTIFICATION 1 STATE OF FLORIDA) i COUNTY OF MIAMI-DADE) I, Christina White, Supervisor of Elections of Miami-Dade County, Florida, do hereby certify that 50 signatures submitted b Eddie Lewis:for the ` Miami Shores Village matched the signatures on the voter files. lce of Council for the E 3 WITNESS MY HAND .AND OFFICIAL SEAL, AT MIAMI, MIAMI-DADE COUNTY, FLORIDA, l ON THIS 3rd DAY OF MARCH, 2017 Y t Christina White Supervisor of Elections r - - 4 4 ( ��5,arc.u2 .p �. f!,'P t Y .� ';.t - '• I _ .,. OR -�, ,n • �` T' x . -. a.. - - +; .. ., SfEiRJe7rasnei�•.,+�acr; NINE in �Fryr 'goy 10050 N.E.SECONDAVENUE• COfF7K 711OMfM4 MIAMI SHORES,FLORIDA 3313W.2382 �ZQRjDp TELEPHONE:(305)795-2207 FAX:(305).756-8972 Ltl ag (V0JRK;E!.I[ 11 fTOM BENiCff, VILLAGE INCAMA1661 ' 'RICHARD ' VILLAGE ATiosi,,Ey ¢ March 2, 2017 A 3 N i Ms. Michelle McClain Miami-Dade County Elections Department � Dr , 2700 N.W. 871 Avenue Miami, FL 33172 Dear Ms. McClain: Enclosed are the original petition forms for Eddie Lewis. These petition forms are for a f candidate seeking to qualify for office in the Miami Shores Village Council election. The Village Charter, under Section 24, requires the verification of fifty (50) valid signatures in order for the petition to be sufficient. Please verify signatures in accordance with the Village Charter provision. Eddie Lewis filed intent to run for office on February 17, 2017. t The Village Charter, under Section 24, requires the Village Clerk to notify the candidate , i. within ten (10) days whether the required number of valid signatures was obtained. However, the candidate qualifying period expires at 5:00 PM on Friday, March 3, 2017. i l Please return the original petition forms to my office, along with a certificate certifying r the number of valid signatures. If you have any questions, please do not hesitate to contact me directly at 305-762-4851, • T i Sincerely, Barbara A. Estep, MMC Village Clerk F. 'r Enclosures (7 pages) `J CD `y1,� t ALICE BURCH MAYOR 1' le STEVEN ZELKOWITZ , ,y VICE MAYOR eou H. mum lfiiami SLreJ Villa 0? HERTA HOLLY �..,+.. — COUNCILWOMAN 10050 N.E.SECOND AVENUE MAC GLINN COR1pA MIA TELEPHONE:SHORES, (306)795 33138-2382 2 07382 COUNCILMAN FAX: (305) 756-8972 IVONNE LEDESMA COUNCILWOMAN TOM BENTON VILLAGE MANAGER BARBARA ESTEP, MMC VILLAGE CLERK RICHARD SARAFAN VILLAGE ATTORNEY March 2, 2017 Ms. Michelle McClain Miami-Dade County Elections Department 2700 N.W. 87th Avenue Miami, FL 33172 Dear Ms. McClain: Enclosed are the original petition forms for Eddie Lewis. These petition forms are for a candidate seeking to qualify for office in the Miami Shores Village Council election. The Village Charter, under Section 24, requires the verification of fifty (50) valid signatures in order for the petition to be sufficient. Please verify signatures in accordance with the Village Charter provision. Eddie Lewis filed intent to run for office on February 17, 2017. The Village Charter, under Section 24, requires the Village Clerk to notify the candidate within ten (10) days whether the required number of valid signatures was obtained. However, the candidate qualifying period expires at 5:00 PM on Friday, March 3, 2017. Please return the original petition forms to my office, along with a certificate certifying the number of valid signatures. If you have any questions, please do not hesitate to contact me directly at 305-762-4851. Sincerely, Barbara A. Estep, MMC Village Clerk Enclosures (7 pages) I�1 CANDIDAf ;ITION ' We,the undersigned electors of Miami Shores Village, do hereby nominate for a position on the Miami Shores Village Council. Printed Birth Date or Date Name Voter Ree.# Address City/County/Zip Code Si nature Signed Cl b 3 to50 t:rrl- io( ( TC¢ . isb-(`S 3313 f Zro )7 �1 �P- b (ice d� (00 IJ °f ( T 0�4a IS 337 — � -7 7 � eRaul 12 z l 1' NC9N - ST id b ' e�Nat � `13�i3� � s MAO' I AQa l �Z �Z33 N �iami �i►� iami S� 94 �Res 33�?DW2 26 I� l; 'a DrIA� dQ to < 2 9X33 /V� ►G,�vi �� IGr�i ��►4R33150 �.__ 26 1 .0 6 HAP-A G 7,motv /� l9� z q0 N•w !0 O Ali S f r/� 2 2( 20 The undersigned is the circulator of the foregoing paper-containing--psignatures. Each appended thereto was n/ade in.my presence and is the genuine signature of the person whose name it purports to be. Signature of Circulator: Address: ACCEPTANCE OF NOMINATION hereby accept the nomination fol.the Village Council and agree to serve if elected. Signature of Candidate: CANDIDA� 'TITION f We,the undersigned electors of Miami Shores Village,do hereby nominate, (-""cJJe L Q1 c, S for a position on the Miami Shores Village Council. Printed Birth Date or Date Name Voter Reg.# Address City/County/Zip Code Signature Signed l5R NAA) ` ��� 13 a -�6/ J ` 2 3i1 -b aL� , c U n 5 1 &f to loo-<Y-- (1/I cwt ka a &,6 17 t\�f t�Anh) Try'a F- f-31 ) e+ &aVp1t, 5 PTI bOL4-kQ s q-(�-�95, (3 ! NFi M �� , ' lop 10-4 IL2&st 0)tftM fes i 2 17 ��a Vt-C��Q��r✓�s 3 � 103�/D�1�a-� I��G,....� S�.or e5 - .1,--___ 2��1-� �w - --� l�;(p 7d- kgrlb4#lr�- ,ems -� �7 gy The undersigned is the circulator of the foregoing paper containing 1 signatures. Each appended thereto was made In my presence and is the genuine signature of the person whose name it ports to be. / 01 Signature of Circulator: r Address: �l`QD �� -( eye, ACCEPTANCE OF NOMINATION 1 hereby accept the nomination for the Village Council and agree to serve if elected. Signature of Candidate: CANDIDAL TITION We,the undersigned electors of Miami Shores Village, do hereby nominate_4carcc c- L QLA., �_for a position on the Miami Shores Village Council. Printed Birth Date or Date Name Voter Ree.# Address City/County/Zip Code Signature Signed t,.i 7 -7t o?fid � 7x--1 rt- Lq,c -n; I Col a v 9 /07 rt 53161 2 28 7 ube i z I //y/Vc 105 54R"4-v% i' CANDIDAi TITION We,the undersigned electors of Miami Shares Village, do hereby nominate f'c�y�1c.� [_ OL'Z �„< —for a position on the Miami Shores VIIlage Council. Printed Birth Date or Date am Vote rReg.0 Address City/CountyLip Code SI t re Signed n1 ,�,o.. •Gd ���� � / � 9.9.�s NCc' `1`f� A��, Its i+�. y aw,i 1�► �>., C., 3 � !'1�' 6 A/4/1 AAr i// /';7) 2 /1/? a4it� 17 0:� I 07 la % Jy� /U`N T /`yl �G,ti+� �G�a✓L�� 2iS �wu4 r—A'R'%-A tz ►0 63 �30IV e SO 5a 1 0-&t' txlies ..--- 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 nam t purports to be. Signature of Circulator: Address: �Y'�76 / • �f z A1,10 ACCEPTANCE OF NOMINATION I hereby accept the nomination for the Village Council and agree to serve If elected. i Signature of Candidate: CANDIDA� TITION We,the undersigned electors of Miami Shores Village,do hereby nominate_ttsL-4 !g C_ 0uw for a position on the Miami Shores Village Council. Printed Birth Date or Date Name Vote rRe . Address City/County/zip Code Signature SI ned 3 Z`' �� -1Z f--Ai-n U ` _ _ r N. . I6o �/s� _ 3 - .b w2 ! Z SZ 9 9/7/5//'� /Q-c. 3 / __ 3 i 7 /ya ri e lk �6-7� 7 DoEALco �'27�$� 13�L �E (4S s-� 3313 La 3 31g 0112_, 2-1 - �41 . AA 1 71 a, r� 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 urports to be. Signature of Circulator: Address: ftqc) ACCEPTANCE OF NOMINATION I hereby accept the nomination for the Village Council and agree to serve If elected. Signature of Candidate: CANDIDA� TITION We,the undersigned electors of Miami Shores Village, do hereby nominate_4a-be fir'c;• { —for a position on the Miami Shores Village Council. Printed Birth Date or Date Name Voter Reg.*# Address City/County1ZIp Code Signature S_ iened r o� PAA DO �5 V2 W11JOW1 Axoy_'� a nyu S3 _ 6�` Le IN ram LA C' l*,�ukE L (A[CIS (c)Q TE2 &(�o z� ,Jor (- PQ1 017-1 T NW IOD fu-. ko 15ha ,�j 33)5014e _..._._..� �3 o Y Yr 7- .z 4 The undersigned is the circulatar of the foregoing paper containingsignatures. Each appended thereto wa ade in my presence and Is the genuine signature of the person whose name purports tnAhe, Signature of Circulator: Address: ACCEPTANCE OF NOMINATION I hereby accept the nomination-for the Village Council and agree to serve if elected. Signature of Candidate: CAN DIDAi TITION We,the undersigned electors of Miami Shores Village,do hereby nominate � �.��;� c U'� S _ _for a position on the Miami Shores Village Council. ;e.,- � , Printed Birth Date or Date Name Vote rReg.4 Address City/County/Zip Code SinatUe Siened 'yam / V,1 2 v�� ir1 s � 1.� Nub ��'��-�' �iw►'u�.1� ��� 1 � ot o447 The undersigned Is the circulator of the foregoing paper containing signatures. Each appended thereto was made in my presence and is the genulne signature of the person whose name ' rports to be. Signature of Circulator: Address: A/ 6tj ACCEPTANCE OF NOMINATION I hereby accept the nomination for the Village Council and agree to serve If elected. Signature of Candidate: APPOINTMENT OF CAMPAIGN TREASURER AND DESIGNATION OF CAMPAIGN Z-17-17 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. HECK APPROPRIATE BOX(ES): Rf Initial Filing of Form Re-filing to Change: ❑ Treasurer puty (] Depository ❑ Office ❑ Party 2. Name of Candidate(in this order: First, Middle, Last) 3.Add ess(include post office box or street, city, state,zip ,E'P J rr L code) cjLt�o A, L,), 1 R ' r�.i+s 4.Telephone 55.. E-mail address (-305 ) 1Z 1 L �c�:etE+vi" ' ' C'vit/��N, t r✓► 6. Office sought(include district, circuit, group number) If a candidate for a nonpartisan office,check if ! applicable: 11,11tJ-,Y7' 40riES My intent is to run as a Write-In candidate. ��Ifq.[v� Cvu��, 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 0 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 j 11. Mailing Address 12.Telephone 13. City 14" County 15. State 16. , 'p Code 117. E-mail address 18. 1 have designated the following bank as my ❑ Primary Depository ❑ Secondary Depository 19. Name of Bank 20.Address 21. C ( 22. County 23. State 24.Zip Code 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 of Ca e i 27. ,./Treasurer's Acceptance of Appointment(fill in the blanks and check the appropriate block) I, '�z/�l J-15 , do hereby accept the appointment (Please Print or Type Name) designated ab �' Campaign Treasurer Deputy Tr l7 X17 X < Date Sign o ampalgn Tr or Deputy Treasu DS-DE 9(Rev.10110) Rule 1S-2.0001, F.A.G. 2017 Candidate Name: E44( c- Lcw�s E-Mail Address: CcUk-e Cewis -1 q C mN _ COW1 Address: g q q o U LO ls� AU Q- Telephone Numbers: 30s- o(a - leS l CANDIDATE INFORMATION REQUIRED FOR QUALIFYING FOR VILLAGE COUNCIL ELECTION V Notice of Candidacy and Residency Campaign Account &Treasurer's Appointment ✓ Form 1 Financial Disclosure ✓ Loyalty& Candidate's Oath Statement of Candidate 50 Signatures on Nominating Petition* Confirmed by Miami-Dade County Elections 5 0 t� �1 t soon, aim NOTICE OF CANDIDACY AND RESIDENCY hereby file this Notice of Candidacy this�—day of 2017,for the Village Council election of Miami Shores Village to be held on April, 11,2017. 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. rc e - ignature Print Name Address -/ j✓ Telephone Number L4�� ( tj.;j: ) i E-Mail Address STATE OF FLORIDA ) COUNTY OF MIAMI-DADE ) BEFORE ME personally a geared aS who executed this Notice of Candidacy and Residency this day of_f 2 2017. Notary Public Personally Known Produced the following Identification Seal/Commission Expires: .W w. BARBARA A ESTEP MY COMMISSION N FF 073975 EXPIRES:March 29,2018 I � Rf Ap Bonded Thru Notary Public Underwriters OFFICE USE ONLY STATEMENT OF CANDIDATE (Section 106.023, F.S.) (Please print or type) L candidate for the office of Mg., 511-44.4 fUAgE r) I A j have been provided access to 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(05111) FORM 1 STATEMENT OF 2016 Please print or type your name,mailing FINANCIAL INTERESTS FOR OFFICE USE ONLY: address,agency name,and position below: LAST NAME—FIRST NAME—MIDDLE NAME: MAILING ADDRESS: G j ` % CITY: %~ ZIP: COUNTY: NAME OF AGENCY: NAME OF OFFICE.OR POSITION HELD OR SOUGHT ,a You are not limited to the space on the linl/.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): ❑ DECEMBER 31, 2016 OR LI SPECIFY TAX YEAR IF OTHER THAN THE CALENDAR YEAR-- MANNER EARMANNER OF CALCULATING REPORTABLE INTERESTS: FILERS HAVE THE OPTION OF USING REPORTING THRESHOLDS THATARE ABSOLUTE DOLLAR VALUES,WHICH REQUIRES FEWER CALCULATIONS,OR USING COMPARATIVE THRESHOLDS,WHICH ARE USUALLY BASED ON PERCENTAGE VALUES(see instructions for further details). CHECK THE ONE YOU ARE USING(must check one): O COMPARATIVE(PERCENTAGE)THRESHOLDS OR LI DOLLAR VALUE THRESHOLDS PART A—PRIMARY SOURCES OF INCOME [Major sources of income to the reporting person-See instructions] (If you have nothing to report,write"none"or"nla") NAME OF SOURCE SOURCE'S DESCRIPTION OF THE SOURCE'S OF INCOME ADDRESS PRINCIPAL BUSINESS ACTIVITY 0-C/ntiE r l7� x>��rCev +a'la '-L 4 keJ i C-< l 0 PART B— SECONDARY SOURCES OF INCOME [Major customers,clients,and other sources of income to businesses owned by the reporting person-See instructions] (If you have nothing to report,write"none"or"nia") 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-See instructions] FILING INSTRUCTIONS for when (If you have nothing to report,write"none"or"n/a") and where to file this form are F s _ located at the bottom of page 2. qCJ D tif` t 1 " "'` r-1 SZ; INSTRUCTIONS on who must file this form and how to fill it out begin on page 3. CE FORM 1-EHedive:January t,2017 (Conned an reverse slde) PAGE 1 ir- mated by reference n Rule 34-8202(1),FAC. PART D—INTANGIBLE PERSONAL PROPERTY[Stocks,bonds,certificates of deposit,etc.-See instructions] (If you have nothing to report,write"none"or"Na") TYPE OF INTANGIBLE BUSINESS ENTITY TO WHICH THE PROPERTY RELATES PART E—LIABILITIES [Major debts-See instructions] (If you have nothing to report,write"none"or"nia") NAME OF CREDITOR ADDRESS OF CREDITOR PART F—INTERESTS IN SPECIFIED BUSINESSES [Ownership or positions in certain types of businesses-See instructions] (If you have nothing to report,write"none"or"nla') BUSINESS ENTITY#1 BUSINESS ENTITY#2 NAME OF BUSINESS ENTITY ADDRESS OF BUSINESS ENTITY PRINCIPAL BUSINESS ACTIVITY POSITION HELD WITH ENTITY 1 OWN MORE THAN A 5%INTEREST IN THE BUSINESS NATURE OF MY OWNERSHIP INTEREST PART G—TRAINING For elected municipal officers required to complete annual ethics training pursuant to section 112.3142,F.S. ❑ I CERTIFY THAT I HAVE COMPLETED THE REQUIRED TRAINING. —- IF ANY OF PARTS A THROUGH G ARE CONTINUED ON A SEPARATE SHEET, PLEASE CHECK HERE ❑ SIGNATURE OF FILER: CPA or ATTORNEY SIGNATURE ONLY If a certified public accountant licensed under Chapter 473,or attorney Signature: in good standing with the Florida Bar prepared this form for you,he or she must complete the following statement I, , prepared the CE Form 1 in accordance with Section 112.3145,Florida Statutes,and the instructions to the form.Upon my reasonable knowledge and belief,the disclosure herein is true and correct. Date Signed: w� CPA/Attorney Signature: Date Signed: 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 Intal,each local officerlemployee,state officer, signing and dating it.send back only the first on Ethics or a County Supervisor of Elections for and specified state employee must file within sheet(pages 1 and 2)for filing. your annual disclosure filing, return the form to 30 days of the date of his or her appointment that location. or of the beginning of employment. Appointees If you have nothing to report in a particular Local ofricerslemployees file with the who must be confirrrred by the Fate must file , even if that is less than section,write'none"or"n/a"in that section(s). Supervisor of Elections of the county in which they 30 d days from confirm�=date of their appointment. permanently reside. (If you do not permanently NOTE: reside in Florida, file with the Supervisor of the Candfdates must file at the same time they file MULTIPLE FILING UNNECESSARY. county where your agency has its headquarters.) theirquar64ng papers. A candidate who files a Form 1 with a qualifying State officers or specified state employees Thereafter,file by July 1 following each calendar officer is not required to file with the Commission file with the Commission on Ethics, P.O. Drawer year in which they hold their positions. or Supervisor of Elections. 15709, Tallahassee, FL 32317-5709; physical Finally, file a final disclosure form (Form 1 F) address:325 John Knox Road, Building E,Suite within 60 days of leaving office or employment. Facsimiles will not be accepted. 200,Tallahassee,FL 32303. Filing a CE Forth 1F(Final Statement of Financial Interests)does not relieve the filer of filing a CE Candidates file this form together with their Form 1 if the filer was in his or her position on qualifying papers. December 31,2016. To determine what category your position falls under,see page 3 of instructions. CE FORM 1-Etrective:Ja�ary 1,2017. PAGE 2 WArp"ated by refer===in Ride 348. 2(11.FAC. 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) 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. LEJ_' i 5 ,a candidate for the office of (( (( please print your name �(!�{r'ami )11cX t��l l7 i`4.ci P �.c�ir;.yLG t ! _ in ,.{.N�;,� 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 Signature Date COE,revised 42010 BankofAmerlca Account Summary BANK OF AMERICA,N.A.(THE"BANK") Information Thank you for allowing us to assist you with your banking needs.Here is a summary of the accounts and services we set up for you or which you applied for today. If any of this information is incorrect,please let us know.We appreciate the opportunity to serve you. EDDIE LEWIS CAMPAIGN ACCOUNT CHECKING ACCOUNT Business Fundamentals Chk Account Number 2290 5636 7060 ACH Routing Number 063100277 Title on Account EDDIE LEWIS CAMPAIGN ACCOUNT Address 9490 NW 1ST AVE MIAMI SHORES,FL 33150-2206 BUSINESS DEBIT CARD(PERMANENT DEBIT CARD) Business EDDIE LEWIS CAMPAIGN Name on Card EDDIE LEWIS Account Number 5348600006100975 Address 9490 NW 1ST AVE MIAMI SHORES,FL 33150-2206 Account(s)Linked for Access: Business Fundamentals Chk,22905 6367060 TEMPORARY DEBIT CARD Business EDDIE LEWIS CAMPAIGN Account Number 4635760029410465 Address 9490 NW 1ST AVE MIAMI SHORES,FL 33150-2206 Account(s)Linked for Access: Business Fundamentals Chk,22905 6367060 Bank Information Date 2017-02-17 Banking Center Name SHORES VILLAGE Associate's Name Christian Puello Associate's Phone Number 305-757-5511 0044-9082M 06-1999 Page I NFL CAMPAIGN TREASURER'S F:EPORT SUMMARY L e, s OFFICE USE ONLY Name (2) 5((g,6 AL v,' t - Address (number and street) City, State, Zip Code ❑ Check here if address has changed (3) ID Number: (4) Check appropriate box(es): ('Candidate Office Sought: c carte, S1.,od- 5 ❑ Political Committee(PC) ❑Electioneering Communications Org.(ECO) ❑Che ck here if PC or ECO has disbanded ❑ Party Executive Committee(PTY) ❑Chuck here if PTY has disbanded ❑ Independent Expenditure(IE)(also covers an ❑Chf ck here if no other IE or EC reports will be filed individual making electioneering communications) (5) Report Identifiers Cover Period: From /,Q. I 1361 To /��,,� I /3 / Zrf1. Report Type: F'(69) Original F-1Amendment E]Special E ection Report --- Contributions This Report (7) Expenditures This Report Mor etary Cash &Checks $ 6 Exp:nditures $ , (7 Loans $ , Trat isfers to Offii:e Account $ , Total Monetary $ Tots d Monetary $ In-Kind $ (8) Other Distributions $ , (9) TOTAL Monetary Contributions To Date (10. TOTAL Monetary ExpendituresTo ate (11)Certificztion It is a first degree misdemeanor for any person t( falsify a public record (ss.839.13, F.S.) I certify that I have examined this report and it is true,correct, End complete: / (Type name) � � Pte✓ , i Type name) z_;z C I _ ❑individual(only f Treasurer ❑Deputy Treasurer 1:1 Candidate ❑ rson(only for PC and PN) or electioneers S ature Signa -DE 12(Rev.1 ) ! SEE REVERSE FOR INSTRUCTIONS j CAMPAIGN TREASURER'S REPORT -ITEMIZED CONTRIBUTIONS (1) Name Z Cc�� L ^'' S (2) I.D. Number (3) Cover Period . -^/ 17& 7 through , , / / z /17 (4) Page of (9) (10) (11) (12) Date Full Name (6) (Last,Suf bo First,Middle) Sequence Street Address& Contributor Contribution In-kind Number Cfty,State,Zip Code Type Occupation ation T Description Ame wrrmd Amount t 1 P4-S- Sys �ON SHtio 1,1,w, 14,.e �a�l CKS # one-, 3, I%A)otie DS-DE 13(Rev.11113) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES CANT AIGN TREASURER'S REPORT-ITEMIZED EXPENDITURES (1)Name L am, z e� r C (2)I.D.Number (3)Cover Period,�f-/ / / ] through ljl,)P-1 (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 �Z � J�-.�4lq+.� CR)�S�Yyt../.-t►�f'„d-� ,mss. ./.J-v►�rJ Jh�''�f Imo/ 1 �� 7 /0. 38 i Z Z 4 C, U gee- 112-112 -f h„r-3”, Alke 39. 33 q a 45 fps �r► � 17I S G 6 Ker4Iwo,,J- 441 r, - Shur--e� Nu b CG-t � ^-ip)x:c( CAV IV D, � e AJ 64-tj Y-4, t� e he,Al W. w 7 s 7'� p�ifs ASP Ge 61,- _A41Oyl Shy5� Fl c'4falam' ,Ilql,7 .�c ow DS-DE 14(Rev.11113) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES CAMPAIGN TREASURER'S REPORT— ITEMIZED EXPENDITURES (1)Name ,1��• (2) I.D.Number (3)Cover Period 14AFJ through /3 / 17 (4) Page of (5) (7) (8) (9) (10) (11) Date Full Name Purpose (6) (Last,Suffix,First,Middle) (add office sought if - - - - - --------Street-Address-8 - ----contribution to a----_Expenditure_pendture_ Number City,State,Zip Code candidate) Type Amendment Amount Z3 Zi Do) IaKC� �►-A/ S1, C� 761 N= � .1 s-s�' �� 4,-;7/ Mi A 5 Jwmj C4 p C>4/(I JS f_7 4 �3Z/2 C u,ck V-4-S C' DZ DS-DE 14(Rev.11113) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES CAMPAIGN TREASURER'S VEPORT SUMMARY �� S OFFICE USE ONLY Name (2) 'if Address(number and street) City, State, Zip Code ❑ Check here if address has changed (3) ID Number: (4) . Check appropriate box(es): Candidate Office Sought: - ❑ Political Committee(PC) ❑ Electioneering Communications Org.(ECO) ❑Che ck here if PC or ECO has disbanded ❑ Party Executive Committee(PTY) ❑Cht ck here if PTY has disbanded ❑ Independent Expenditure(IE)(also covers an ❑Chc ck here if no other IE or EC reports will be filed individual making electioneering communications) (5) Report Identifiers Cover Period: From Atl j $ l � ) To M,�rk I _:�L / ; 1-1 Report Type: ❑Original ❑Amendment ❑Special E ection Report (6) Contributions This Report (7) Expenditures This Report Mor etary Cash & Checks $ Exp mditures $ J- 1 2/ Loans $ Trat Isfers to Offii:e Account $ , Total Monetary $ - Tot II Monetary $ In-Kind $ (8) Other Distributions $ , , (9) TOTAL Monetary Contributions To Date (10, TOTAL Monetary Expenditures To Date (11)Certification It is a first degree misdemeanor for any person tc falsify a public record (ss.839.13, F.S.) I certify that 1 have examined this report and it is true,correct,,nd complete: (Type name) G�d+ L,tf,. >-.; I Type name) ❑;e'lecfionee'®rin or reasurer ❑Deputy Treasurer 13 Candidate Chairperson(only for PC and PTY) orm.Snature -0E.12(Rev.11113) , SEE REVERSE FOR INSTRUCTIONS CAMPAIGN TREASURER'S REPORT -ITEMIZED CONTRIBUTIONS (1) Name Z(cw,, S (2) I.D. Number (3) Cover Period &RI 1&-7 through � / � / zgjrj (4) Page of (8) (9) (10) (11) (12) Date Full Name (6) (Last,Suffer,First,Middle) Sequence Street Address& Contributor Contribution In-kind Number tfty.State,Zip Code Type Occu ation Type Description ame xIrrmA Amount E DS-0E 13(Rev.11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES (1) Name J� PAIGN TREASURER'S REPORT ITEMI ED EXPENDITURES G _ /cam zG7rja; (2) I.D. Number (3)Cover Period ,4t/ /9/;20/2 through I�Aje / _/Z6/1 (4) Page / of 2j (5) (7) (8) (9) (10) (11) Date Full Name F lurpose (6) (Last,Suffix,First,Middle) (add olfi'ice sought if Sequence Street Address& contribution to a Expenditure Number City,State,Zip Code caindidate) Type Amendment Amount �1 K `f? �' -3 18711? 3127117 ID 2A- �e6 M r FI was r?-7 3 10117 Qu e- ku p 14, (3-1, S�i�L-c r-- �()-1/z) GO '? �c�`t3 NF 177 5'( C 4-n YLVJ�Ji1L 8C,k.)G=I 33`G Z 3 /W/2 -76 y /4 w 9�3 '14t,ry,l fhu01A..5 fF� 3 13011? JJ Al 046 1�414r) Is � DS-DE 14(Rev.11113) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES CgqA PAIGN TREASURER'S REPORT-ITEMIZED EXPENDITURES (1) Name :c%dle_ 1f4'(>l S (2) I.D. Number (3)Cover Period / CY' l Z61 through 1�/ Y / Zoe (4) Page Z of Z (5) (7) (8) (9) (10) (11) Date Full Name Purpose (Last,Suffix,First,Middle) (add office sought if (s) --— - - —----------Street-Address 8� --- -- --- contribution-to a- --Expenditure- sequence - ---- ---- -- - -- - --- Number City,State,Zip Code candidate) TYpe Amendment Amount 3AW7 r 'a / 6�s CAN'Vess,x 3 _V 03-3i ��v3v - - cC'� "'50 4) DS-DE 14(Rev.11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES CAMPAIGN TREASURER'S VEPORT SUMMARY (1) �W t8_ Le, S OFFICE USE ONLY Name Address (number and street) City, State, Zip Code ❑ Check here if address has changed (3) ID Number: (4) Check appropriate box(es): O'Candidate Office Sought: M c Wrn ti sl.,o,!--ZS ❑ Political Committee(PC) ❑ Electioneering Communications Org.(ECO) ❑Che ck here if PC or ECO has disbanded ❑ Party Executive Committee(PTY) ❑Che ck here if PTY has disbanded ❑ Independent Expenditure(IE)(also covers an ❑Che ck here if no other IE or EC reports will be filed individual making electioneering communications) (5) Report Identifiers Cover Period: From (� / �r� � To ©3 _ 1 $) / �J_ Report Type: )� ❑Original ❑Amendment ❑Special E ection Report (6) Contributions This Report (7) Expenditures This Report Mor etary Cash & Checks $ �/ �p- D� Exp mditures $ � Loans $ , Trat isfers to Offt:e Account $ , Total Monetary $ - Tot II Monetary $ In-Kind $ (8) Other Distributions $ , , (9) TOTAL Monetary Contributions To Date (10. TOTAL Monetary Expend'tures To Date (11)Certification It is a first degree misdemeanor for any person tt falsify a public record(ss.839.13,F.S.) I certify that I have examined this report and it is true,correct, �nd complete: (Type name) �.Q k✓ t Type name) ❑Individual(only for Treasurer Deputy Treasurer i]Candidate hairperson(only for PC and PTY) or electioneerin ) _ X K — Si ature �` r 3i ature r.. -- -- DS-0E 12(Rev.11113) SEE REVERSE FOR INSTRUCTIONS � i CAMPAIGN TREASURER'S REPORT -ITEMIZED CONTRIBUTIONS (1) Name Z�?Gt! s (2) I.D. Number (3) Cover Period Qa / / 1-7 through C3 / 11 (4) Page of (5) (7) (8) (9) (10) (11) (12) Date Full Name (6) (Last,Suffix, First,Middle) Sequence Street Address& Contributor Contribution In-kind Number City, State,Zip Code Type Occupation Type Description Amendment Amount � b1 S I 03 ,.e_ L i s 9L``ly N b 7 /U 10"/ 511 s F7 e 31 `S I I 90L Msy I I I I � I DS-DE 13(Rev.11113) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES CAMPAICqN TREASURER'S REPORT - ITEMIZED EXPENDITURES (1) Name &Lld t G'- L c L j i -S (2) I.D. Number (3) Cover Period(Q% 6 7 through 6'3 / / -2 (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 ti. 1 h^ rte► ` Sh°�zeS /� (!�i 1py �S �O� V) 5iq- 0�,7/ quvzk, 2 fS LC 051 /47 r DS-DE 14(Rev.11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES CAMPAIGN TREASURER'S VEPORT SUMMARY (1) 2�G L e, s OFFICE USE ONLY Name (2) 5'yqk A,/tf�(t , Address(number and street) City, State, Zip Code ❑ Check here if address has changed (3) ID Number: (4) Check appropriate box(es): (Candidate Office Sought: / c ca,-Y„ �L,� ,!¢S l /l k GC �•��`✓��` ` ` ❑ Political Committee(PC) r ❑ Electioneering Communications Org.(ECO) ❑ChE ck here if PC or ECO has disbanded ❑ Party Executive Committee(PTY) ❑Che ck here if PTY has disbanded ❑ Independent Expenditure(IE)(also covers an ❑Chf ck here if no other IE or EC reports will be filed individual making electioneering communications) (5) Report Ident ifiers Cover Period: From �i l f'� / To b3 / 0 / t j Report Type: Original ❑Amendment ❑Special E ection Report (6) Contributions This Report (7) Expenditures This Report Mor etary Cash &Checks $ Exp'nditures $ _ , Loans $ , , 0 Tral isfers to Offii:e Account $ , Total Monetary $ Tots il Monetary $ , In-Kind $ (8) Other Distributions (9) TOTAL Monetary Contributions To Date (10 TOTAL Monetary Expenditures To Date $ _ _ $ 3F 4,S� (11)Certifice tion It is a first degree misdemeanor for any person tc falsify a public record (ss.839.13,F.S.) I certify that I have examined this report and it is true,correct, �.nd complete: (Type name) � V- /\ -C4__ ` S l Type name) EllndMdual(only fo ZTreasurer [I Deputy Treasurer 13 Candidate [I Chairperson(only for PC and PTY) or electioneeri ) _K - atureSignature i � SEE REVERSE FOR INSTRUCTIONS DS-DE 12(Rev.11/13) CAMPAIGN TREASURER'S REPORT - ITEMIZED CONTRIBUTIONS (1) Name 6b, e 21, �� aj (2) I.D. Number (3) Cover Period D 1- / - — / through o3 / Tb / (4) Page ( of (5) (7) (8) (9) (10) (11) (12) Date Full Name (6) (Last,Suffix, First,Mddle) Sequence Street Address& Contributor Contribution In-kind Number City,State,Zip Code Type Occupation Type Description Amendment Amount `c l 'T s �� s / / DS-DE 13(Rev.11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES CAMPAIGN TREAS14RER'S REPORT — ITEMIZED EXPENDITURES (1) Name d��" tt��/ f (2) I.D. Number (3) Cover Period 0 Zl ? l j7 through 0) l ly l 7 (4) Page_�of (5) (7) (8) (9) (10) (11) Date Full Name Purpose (s) Last,Suffix, First, Middle add office sought if ( ) ( 9 —----- ----- Street Address-&— -- -- - - ---contribution-to-a-----Expenditure—_-__Se uence -- ----- _.. q City,State,Zip Code candidate) Type Amendment Amount Number DS-DE 14(Rev.11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES MIAMI SHORES 9825 NE 2ND AVE MIAMI FL 33153-9998 1158850118, 01/04/2018 (800)275-8777 4:08 PM Product Sale Final Description Qty Price Prepaid Mai 1 1--- ------- -- (Weight:¢ lbs. 0.50 oz.) (Destination:TALLAHASSEE, FL 32399 (Acceptance Date:01/04/2018 16:08 :21) (Label #:70151660000043619584) Prepaid Mail 1 (Weight:¢ lbs. 0.50 oz.) ,(Destination:MIAMI, FL 33150) (Acceptance Date:01/04/2018 16:08 :46) (Label #:70151660000043619577) r Total $0.00 A11 sales final on1stamps and postage Refunds for guaranteed services only Thank you for your bac:>iness HELP US SERVE YOU BETTER TELL US ABOUT YOUR RECENT POSTAL EXPERIENCE Go to: https://Postalexperience.com/Pos 840-5330-0063-001-00021-05474-01 n or scan frs-c*4aZi th VOLT' mob 1 e devi c � r r ,6 ■ i, Dor call 1-800-410-7420. OPINION COUNT 3 Bill #: 840-53300063-1-2105474-1 Clerk: 06 ro .• Ln Er r=1 Certified Mail Fee m $ 335 E,,x,ra��Services&Fees(check box,add a ate) �tteturn Receipt(hardcopy) $ «(A 41/ r ❑Return Receipt(electronic) $ r�POS)� C ❑Certified Mail Restricted Dellvery $ H ❑Adult Signature Required $ ❑Adult Signature Restricted Delivery$ to In Postage !� 2 Total Postage and Fees \ a7 x $ Ln Sent To _ _ rL�oR1D -- �Ip C�oNs COCri al►ss�o�( Stre( nnndgpvY�oOBox�TNo. � tS -- .--�04n5 City, 9ta_tle7,ZIP+4� �� ✓� Certified Mail service provides the following benefits: ■A receipt(this portion of the Certified Mail labeq. for an electronic return receipt,see a retail ■A unique Identifier for your mailpiece. associate for assistance.To receive a duplicate ■Electronic verification of delivery or attempted return receipt for no additional fee,present thisz delivery. USPS®-postmarked Certified Mail Wcelpt to the ■A record of delivery Qncluding the recipients retail associate. - signature)that Is retained by the Postal Service- Restricted delivery service,which provides for a specified period. delivery to the addressee specified by name,or to the addressee's authorized agent Important Reminders: Adult signature service,which requires the "L- ■You may purchase Certified Mail service with signee to be at least 21 years,of age(not �r First-Class Mail•,First-Class Package Service•, available at retaiq. or Priority Mail®service. i a' .r'Adutt signature restricted delivery service,which ■Certified Mail service is notavatiable for requires the signee to be at least 21 years of age international mall. and provides delivery to the addressee specified ■Insurance coverage is not"lable for purchase by name,or to the addressee's authorized agent3 with Certified Mail service.However,the purchase (not available at retail). of Certified Mail service does not change the ■To ensure that your Certified Mail receipt is Insurance coverage automatically included with accepted as legal proof of mailing,it should bear a' certain Priority Mail items. USPS postmark H you would like a postmark on,3 ■For an additional fee,and with a proper this Certified Mail receipt,plea§e present your endorsement on the mailpiece,you may request Certified Mail Item at a Post Office-for the following services: postmarking.H you don't peed a postmark on this Return receipt service,which provides a record, Certified Mail receipt,detach the barcoded portion 1�ofCelivery,I)n4ydingtbirecipiengs1gnajj�q).—)vyf�thislatiel,affizitto6emailplece,apply You Ban request a hardcopy return receipt or an appropriate poSfage,and depbsit the malipiece.>— •i.i<,,elect(onk;Versfori;Por ahartdcopliretumieceipt•,- I: J '�j �: y .,.� t 'f • 'complete PS Foim 3871,DOfiestic Rehm a. Recelpt•attach PS Form 381IIAD your mailpiece; IMP_ORTAM:Save this receipt for your records. Ps Form 3800.April 2015!Reverse)PSN 7530-02-000-9047 C�- u't ..n Certified Mail Fee -r 5 Extr, rvices&Fees(check box,add as date) aruSem Receipt(hardcopy) $ 3 ❑Return Receipt(electronic) $ POS ark C3 ❑Certified Mail Restricted Delivery $ O ❑Adult Signature Required $ R. ❑Adult Signature Restricted Delivery$ a _111Postage + � t Z —0 $ rq Total Postage and Fees $ l�' 5it Sent To M1 Street q A .No.,or Pb 0 oe 0. -------- mc---------------- •-------------------- Ciry,State,ZIP+4 ,nrd Shorts,L 33 s o certitiea mail service proviaes the Twowing nenents: ■A receipt(this portion of the Certified Mail label). for an electronic return receipt,see a retail ■A unique identifier for your mailpiece. associate for assistance.To receive a duplicate ■Electronic verification of delivery or attempted return receipt for no additional fee,present this""I delivery. USPS®-postmarked Certified Matlreceipt to the i ■A record of delivery Oncluding the recipient's retail associate. t I j signature)that is retained by the Postal Service- Restricted delivery service,which provides for a specified period. delivery to the addressee specified by name,or to the addressee's authorized agent. r Important Reminders. Adult signature sgrvice,which requires the ■You may purchase Certified Mail service with signee to be at lest 31*years of age(not Rrst-Class Mail®,First-Class Package Service*, available at retail). `- or Priority Mail®service. 1-i, -Adult signature restricted delivery service,,which ■Certified Mail service Is notavallable for requires the signee to be at least 21 years of age' international mail. and provides delivery to the addressee specified! ■Insurance coverage is notavailable for purchase by name,or to the addressee's authorized agent-: with Certified Mail service.However,the purchase (not available at retail). L of Certified Mail service does not change the ■To ensure that your Certified Mail receipt is insurance coverage automatically included with accepted as legal proof of mailing,It should bear a certain Priority Mail items. USPS postmark.If you wouldlilge a pgstmark on ■For an additional fee,and with a proper this Certified Mail receipt,please present your endorsement on the mailpiece,you may request Certified Mail item at a Post•Office'for t-1 the following services: postmarking.If you donUeW a postmark on this -Return receipt service,which provides a record Certified Mail receipt,detach the barcoded portion j of delivery pncluding the recipient's signature).1,I--of this lage),affix if to the itiailPiece,apply r You can request a hardcopy return receipt wan "appropriate postage,and deposlt the mailpiece.G-} electronic version.For a hardcopy return receipt, complete PS frons 3811,Domestic Return--) •t C. i Lr Receipt attach PS Eorrq 3811 to'your mailpiece;•.IMPORTAM;Save this receipt for your records. riQ1 .:�,,t; :I� Ps Forth 3800,April 2015(Reverse)PSN 753402-000-9047 Ir Ln Ir r-I OFFICIAL E —0 $ fieMW Fee m Extra Services&Fees(check box,add tee as appropriate) Q ❑Retum Receipt(hardcopy) $ �,��i); S r3 E]Retum Receipt(electronic) $ �. Postmark r3 ❑Certified Mail Restricted Delivery $ Here1 . C3 [:]Adult Signature Required $ \J(� O ❑Adult Signature Restricted Delivery$ p t i/�_ 201 PosI 7) .� $ (�� r=1 Total POstme and Fees Sent To pry] Street andApt No., r PO ox 0 q `'r ------------------- ------------ City,State,21P+4 �I `�i��CS• TL �Gi Certified Mail service provides the following benefits: ■A receipt(this portion of the Certified Mail label). for an electronic return receipt,see a retail ■A unique identifier for your mailpiece. associate for assistance.To receive a duplicate ■Electronic verification of delivery or attempted return receipt for no additional fee,present this delivery. USPS®-postmarked Certified Mail receipt to the ■A record of delivery(including the recipient's retail associate. fu signature)that is retained by the Postal Service- Restricted delivery service,which provides for a specified period. delivery to the addressee specified by name,or to the addressee's authorized agent Important Reminders. Adult signature service,which requires the — ■You may purchase Certified Mail service with signee to be at least 21 years of age(not mi Fist-Class Mail•,First-Class Package Service•, available at retail). or Priority Mail*service. Adult signature restricted delivery service,which •Certified Mail service is not available for requires the signee to be at least 21 years of age International mail. and provides delivery to the addressee specified- ■Insurance coverage Is not available for purchase by name,or to the addressee's authorized agent with Certified Mail service.However,the purchase (not available at retail). of Certified Mail service does not change the ■To ensure that your Certified Mail receipt is , Insurance coverage automatically Included with accepted as legal proof of mailing,R should bear a certain Priority Mail items. USPS postmark If you would like a postmark on ■For an additional fee,and with a proper this Certified Mall receipt,please present your s endorsement on the mailpiece,you may request Certified Mail item at a Post Office—for F" the fallowing services: postmarking.If you don't need a postmark on this -Return receipt service,which provides a record Certified Mail receipt,detach the barcoded portion of delivery(Including the recipients signature). of this label,affuc it to the mailpiece,apply You can request a hardcopy return receipt or an appropriate postage,and deposit the mailplece.— electronic version.F r a hardcopy return receipt, — complete PS Form 3811,Domestic Retum Receipt;attach PS Form 3811 to your mailptece; IMPORTANT:Save this recelpt for your records. Ps Form 3800,April 2015(Reverse)PSN 7530-02-000-9047 SENDER: COMPLETE THIS SECTION COMPLETE THIS SECTION ON DELIVERY ■ Complete items 1,2,and 3.Also complete, A. Signature item 4 if Restricted Delivery is desired. ❑Agent • Print your name and address on the reverse X ❑Addressee so that we can return the card to you. 0,:df�epeiu ��y(Printed Name) C. Date of Delivery ■ Attach this card to the back of the mailpiece, "Ii"'""Pi j Of L ' or on the front if space permits. 1. Article Addressed to: D. WeNdress iffererit tiro i&tt, y❑Yes d li ry atidrep bQ4: ❑No ON5 n71f1IiNEYGE U bm11Y11 SSS�[� �t.LAHASSEErt`j?11 n 107s+/{&d C5 5 ��' CD1k1 h5 bj&`� G� O�O�"( 3. See ice Type LTJ Certified Mail® ❑Priority Mail Express' ❑Registered ❑Return Receipt for Merchandise ❑Insured Mail ❑Collect on Delivery , 4. Restricted Delivery?(Extra Fee) ❑Yes 2. Article Number 7015 .1660 0.000 4361 9584 (Transfer from service label) `PS Form 3811,July 2013' Domestic Return Receipt 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* ( i Ce It . g `ls�bel�l ��r� o�uez 105D rn1 o,�n� S Dore S, �L �3 3 u i 1 ' SENDER: COMPLETE THIS SECTION COMPLETE THIS SECTION ON DELIVERY ■ Complete items 1,2,and 3.Also complete A. Signature item 4 if Restricted Delivery is desired. X ❑Agent ■ Print your name and address on the reverse ❑Addressee so that we can return the card to you. B. Received by(Printed Name) C. Date of Delivery ■ Attach this card to the back of the mailpiece, or on the front if space permits. i D. Is delivery address different from item 1? 13 Yes 1. Article Addressed t If YES,enter delivery address below: ❑No k 5 q�au N I -v�enNe c NA� S �Yf2s� 3. Service Type #1 l certified MWI6 ®Priority Mail Expregs' ❑ Registered ❑Return Receipt for Merchandise ❑ Insured Mail ❑Collect on Delivery tricted Delivery?(Extra Fee) ❑Yes 3 4361 9577 `PSForm 32511;July 2013 Domestic Return Receipt 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• I �V l 9CAeZ Cle(��. -��Ce -the 111a�e 10t�o N'E a►�d Aat2. \am► S�DreS��L �13$ �i Awn 'W ill i =al2Ctcf (/�e I US POSTAGE 10050 N.E.ZND AVENUE 7015 1660 0000 4361 9577 _ $06.56 `nOR�ap y F L O R 1 D A JIM 33138 First-Cass Mailed From 33138 01/04/2018 { 032A 0061803107 Mr. Ec.ie Lewis st q4qO KW 1 ,/ 12121 __ , I' `tam( RETURN .,.y O 5 NDER. U'NDELZVERABLE A5 ADDR'E'SSED UNABLE TO FORWARD i.i�• j�L J it.t i V T� V x 3�U�"V T�J-�J�.'�V i i tr :z. 1��IEI�l�t�i� ��i[Jill ir{111111111 1-I I 1 1,1 1 �jsl 11 1, MacAdam Glinn 5�►ORES MAYOR `e.y� �&Oe Sean Brady VICE MAYOR 10050 N.E. SECOND AVENUE Jonathan Meltz MIAMI SHORES, FLORIDA 33138-2382 COUNCILMAN ES�N�'°y TELEPHONE: (305)795-2207 �,ORI 0FAX: (305) 756-8972 Alice Burch COUNCILWOMAN OFFICE OF THE VILLAGE CLERH Steven Zelkowitz COUNCILMAN January 4, 2018 Mr. Eddie Lewis 9490 NW 1st Avenue Miami Shores, FL 33150 Re: Late 2017 Termination Report(Third Notice) Dear Mr. Eddie Lewis, The Termination Report was due with our office on July 18, 2017. Since this report was not filed by the appropriate filing date, a fine is being assessed for each late day pursuant to Florida Statute 106.07(8)(b). I've made various attempts at contacting you via telephone, email, and certified mail, but to no avail. Therefore, in accordance with Florida Statute 106.07(8)(d), I am required to notify the Florida Elections Commission of failure to file a termination report and pay the applicable fine. Fines are calculated $50 per day for each late day, not to exceed 25% of the total receipts or expenditures, whichever is greater, for the period covered by the late report. Said fine must be received by our office at 10050 NE 2nd Avenue, Office of the Village Clerk. Florida Statute 106.07(8)(b)goes on to say that the fine may be appealed or disputed based upon unusual circumstances surrounding the failure to file by the designated due date. A hearing before the Florida Elections Commission may be requested, which shall have the authority to waive the fine in part or whole. Any such request must be submitted in writing and must be received by the Florida Elections Commission within 20 days of your receipt of this notice. To request an appeal, please write to the Florida Elections Commission, 107 West Gaines Street, Collins Building, Suite 224,Tallahassee, FL 32399-1050. Our office must also be notified of the intent to bring this matter before the Commission. If you have any q estions regarding this matter, please contact Ysabely Rodriguez at(305) 762-4870. Sinc r ly, Ysa ly driguez, CMC Vill ge rk CC: Florida Elections Commission VISIT US www.miamishoresvillage.com