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OATH 9/4/01 01 SP .- L, F'C\ \2: I.; 2 LOYAL TY OATH ," '.'. ,> " ,,;~CANDIDATES WlTH NO PARTY AFFILIATION '"', ,.' '.1 1 \ l, I: (Sectioos 876.05-876.10, F1aida Statutes) STATE OF FLORlDA Miami-Dade COUNTY (Pl..EASE PRJHT) I, DAVID DERMER First Name Middle _nltlal Last Name a citizen of the State of Florida and of the United States of America, . .. and a candidate for public office. .. do hereby solemnly swear or affirm that I will support the Constitution of the United States and of the State of Florida. OATH OF CANDIDATE (Sedicn 99.1l21, F1aida S1alutes) I, DAVID DERMER. IPI..EASE PRINT NAME AS YOO 'MSH IT TO APPEAR ON TME BALLOT _ NAME MAY NOT BE ~D AFTER Tl1E END a QUAUF'nNGI am a candidate for the office of MAYOR OF THE CITY OF MIAMI (office) Miami-Dade BEACH N1A NJA (district) (circuit) County, Florida. . I am a qualified elector of (group) . . I am a qualified elector of the City of Miami Beach, Florida. I am qualified under the ordinances and Charter of said City and 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. UNDER PENALTIES OF PERJURY, I DECLARE THAT I HAVE READ THE FOREGOING LOYALTY OATH AND OATH OF CANDIDATE AND THAT THE FACTS STATED IN EACH ARE TRUE. SIGN :H:ER.E Signstuf'8 of Candidate 2525 FLAMINGO PLACE, . f 305) 532-0034 Cay Phone (305 ) 674-859..2 Fax Number Mailing Address MIAMI BEACH City FLORIDA Stal8 33140 Zip Code 09/04/01 Dote Signed os-oe 246 (Rev.llI'J9) / F.ORM 1 STATEMENT OF 2000 . FINANCIAL INTERESTC' LAST NAME FIRST NAME MIDDLE NAME: NAME OF REPORTINC 1111I~lIrnll\lIllllllllllll1ll~111111 1 . . ' 1 , 1 I DERMER DAVID David Dermer MAILING ADDRESS: City of Miami Beach 20012727 1700 Convention Center Dnfve 1/1 CHECK Q.tl.E OF THE F . " ., 20012 Dtl\'IJ Dl~",lCr laI LOCAL OFFICER 0 STATE OFFICER Miami Beach J 700 Convenlion Center Drive FL 33139 0 CANDIDATE 0 SPECIFIED STATE EMPLOYEE CITY: -ITh Floor LIST OFFICE OR POSITION HELD OR SOUGHT: ,\iiow; LJeach . FL JJ139-{)OO Mayor of Miami Beach 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 ,HIS STATEMENT IS FOR THE PRECEDING TAX YEAR ENDING EITHER (check one): n DECEMBER 31, 2000 QB 0 SPECIFY TAX YEAR IF OTHER THAN THE CALENDAR YEAR: MANNER OF CALCULATING REPORTABLE INTERESTS: PRIOR TO 2001, THE THRESHOLDS FOR REPORTING FINANCIAL INTERESTS WERE COMPARATIVE, USUALLY BASED ON PERCENTAGE VAL- UES. BEGINNING IN 2001, THE LEGISLATURE HAS ALLOWED FILERS THE OPTION OF USING REPORTING THRESHOLDS THAT ARE ABSOLUTE DOLLAR VALUES, WHICH REQUIRES FEWER CALCULATIONS (see instructions for further details). PLEASE STATE BELOW WHETHER THIS STATE. MENT REFLECTS EITHER (check one): fi COMPARATIVE (PERCENTAGE) THRESHOLDS (old method) QB 0 DOLLAR VALUE THRESHOLDS (new method) PART A - PRIMARY SOURCES OF INCOME [Major sources of income to the reporting person] Percentage of total Income NAME OF SOURCE SOURCE'S DESCRIPTION OF THE SOURCE'S OF INCOME ADDRESS PRINCIPAL BUSINESS ACTIVITY ROSE DERMER IV TRUST 2525 Flamingo Place, M.B. FL 33140 N.Y.C RENTAL PROPERTY DERMER RESIDUARY TRUST 2525 Flamingo Place, M.B.FL 33140 N.Y.C RENTAL PROPERTY ~-- PRUDENCE INVESTMENTS, INC. 2525 Flamingo Place, M.B.FL 33140 IiglJ:tX~t~J:1!l SharesMi"~i PRUDENCE DEVELOPMENT INC. 2525 Flamino:o Place .M.B. FL 33140 ~~~:~~1:1~~P~~~~~ Miami DIVIDENTS NEW YORK STOCK EXCHANGE NEW YORK 336 LEXINGTON AVE. NEW YORK, NEW YORK RENTAL PROPERTY DAVID DERMER LAW OFFICES 1111 LI LN ROAn. l-L H. l'T. PART B - SECONDARY SOURCES OF INCOME [Major customers, clients. and other sources of income to businesses owned by the reporting person] NAME OF NAME OF MAJOR SOURCES ADDRESS PRINCIPAL BUSINESS BUSINESS ENTITY OF BUSINESS'S INCOME OF SOURCE ACTIVITY OF SOURCE . (:) 0.." ;'.;J IN/A ...' (/) ~ .:...,' :.; :.~. C. .;:- ;Ii . - CJ -......:: - PART C - REAL PROPERTY (Land. buildings owned by the reporting person] FILING INSTRUCT!ONS:Iar when and where tq fiI$".lt1is form are 6700-6762 NW 72 Avenue, Miami,FL (OWNED BY PRUDENCE INVESTMENTS located at the botlbm of page 2. INC) NONE VOTING SHARES LISTED ABOVE INSTRUCTIONS on who must file this form and how to fill it out begin on page 3 of this packet. .. OTHER FORMS you may need to file are described on page 6. CE FORM 1 . Eft. 1/2001 (Continued on reverse side) . PAGE 1 PART 0 - INTANGIBLE PERSONAL PROPERTY {Stocks, bonds. certificates of deposit, eIC.) I Tt-o~ PR"'P~PTY R~I A,T~" TYP~;:;;; INTANC,IP' -~ D' , ~"TiTY T ~_._.. .. ~ -' . "In ~ ;;::, , ,,., , I '3 ,,1 , 'j i ..' PARTE - LIABILITIES [Major debts] ,-~ ~ - NAME OF CREDITOR ADDRESS OF CREDITOR ./. - . ::::: 2525 Flamingo Place, M.B. FL " i-,oJ C1 ! YAFFA DERMER -, ~ ~ ~-j N .,'.' PART F - INTERESTS IN SPECIFIED BUSINESSES [ONnership or positions in certain types of businesses] BUSINESS ENTITY # 1 BUSINESS ENTITY # 2 BUSINESS ENTITY # 3 NAME OF BUSINESS ENTITY ADDRESS OF BUSINESS ENTITY PRINCIPAL BUSINESS N/A ACTIVITY POSITION HELD WITH ENTITY I OWN MORE THAN A 5% INTEREST IN THE BUSINESS NATURE OF MY OWNERSHIP INTEREST IF A{yloF/P~RTS A THROUGH F ARE CONTINUED ON A SEPARATE SHEET, PLEASE CHECK HERE 1:1 SIGNATU~: ~- DATE SIGNED: ~/Of I '=7 FILING INSTRUCTIONS: . WHAT TO FILE: WHERE TO FILE: WHEN TO FILE: , After completing all parts of this form, including If you were mailed the form by the Commission Initially. each local officer, state officer, and signing an~ dating it, send back only the first on Ethics or a County Supervisor of Eledions for specified state employee must file within 30 sheet (pages 1 and 2) for filing. your annual disdosure filing, return the form to days ofthe date of his or her appointment or of that location: the beginning of employment. Appointeesowho Local officers file with the Supervisor of must be confirmed by the Senate must file prior Eledions of the county in which you permanently to confirmation, even if that is less than 30 reside. (If you do not permanently reside in days from the date of their appointment. NOTE: MULTIPLE FILING UNNECES- Florida, file with the Supervisor of the county Candidates for publicly-eleded local office SARY: where your agency has its headquarters.) must file at the same time they file their quali. Generally, a person who has filed Form 1 for a State offlcers or specified state employees file tying papers. calendar or fiscal year is not required to file a sec- with the Commission on Ethics, P.O. Drawer Thereafter, local officers, state officers, and ond Form 1 for the same year. However, a candi- 15709, Tallahassee, FL 32317-5709. specified state employees are required to file date who previously filed Form 1 because of Candidates tile this form together with your qual- by July 15t following each calendar year in" another publiC position must at least file a copy of which they hold their positions. his or her original Form 1 when Qualifying. ifying papers. Finally, at the end of office or employment To determine what category your position each local officer, state officer. and specified falls under, See the 'Who Must File" Instructions state employee is required to file a final disclo- on page 3. sur. form (Form 1 F) within 60 days of leaving office or employment. DAVID DERMER , CE FORM 1 . Eft. 1/2001 PAGE 2 --