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OATH 09/07/2001 - ~, - ~"",'- ,,_\ 0"" " .- .~ \.,. ~ ('\'"" ,.,..... \'....' \:- ''\ \' <""!... , c LOYALTY OATH CANDIDATES WITH NO PARTY AFFILIATION (Sec:ioos 876.05-876.10, F'>Cri:1a SlaMes) ,'. \\\ . - , :) STATE OF FLORIDA Miami-Dade COUNTY (P\.EASE PRINT) I, I.-OLo..""I,...... \ r1 I f,,:,<,'-T5Q"'-- Fim Name Mk1dle Namei1nltial Last Nam. 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 wHl support the Constitution of the United States and of the State of Florida. OATH OF CANDIDATE (Sec:icn 99.021, FIaida 5tautes) I, 'D 0.... "" :9 I;' _ 0.... r <) D l""-. (Pl.!.ASE PRiNT NAME M yo.; WSH IT TO APPEAR ON '1l4E 8ALJ...OT _ NAME MAY NOT BE CHNfGED A.f'nR 1'1-1..! END OF ClUAUFYlNGJ am a candidate for the office of ~""l"\lSS;i::, ,,"t.--""- ~ (oflIC8) ~ . . I am a qualified elector of Miami-Dade NJA NJA (district) (d~ult) County. Florida. (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 :EI:ER.E Signatu.. of Candidate 1330 rr'lu..-x./] l Dr_ Mailing Address (3on~-33~S- (3o~ )~("Io-~~~) Cay Phone Fax Number Stallt Zip Code 4 Cate f'\ {tA""'I~ 6~"",,c.1, City YJ ->; 3/ ~II OS-Oe:z.4B (Rev. ~9) FORM 1 STATEMENT OF 2000 ..,.:,-. .' FINANCIAL INTERESTS _.- .- LAST NAME FIRST NAME MIDDLE NAME: (f] ~. ~~ NAME OF REPORTING PERSON'S AGENCY: t7 (.D- ,.. So '"' 0.,.;"" ;:;:: I , C,'\-" ,. 0\ ~"-6-.C"J"-.. - -('f\ l tA 1""\ .. MAILING ADDRESS: ' . .....-,. ,.-- 13]D 11\,..,,,... ; l~~ 0, CHECK ~ OF THE FOLLOWING (see "Who Must File' on page 3): ~ ~CAL OFFICER 0 STATE OFFICER (Y\ ; ,..""" . ~<-""'- h n 33H I O.<-a.~ CANDIDATE 0 SPECIFIED STATE EMPLOYEE CITY: ZIP: COUNTY: LIST OFFICE OR POSITION HELD OR SOUGHT: C A)..........1""\,.:,':>:o.,<e r DISCLOSURE PERIOD: THIS STATEMENT REFLECTS YOUR FINANCIAL INTERESTS FOR THE PRECEDING TAX YEAR, WHETHER BASED ON A CALENDAR YEAR OR ON A FISC~R. PLEASE STATE BELOW WHETHER THIS STATEMENT IS FOR THE PRECEDING TAX YEAR ENDING EITHER (check one): . 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): 0 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] NAME OF SOURCE SOURCE'S DESCRIPTION OF THE SOURCE'S OF INCOME ADDRESS PRINCIPAL BUSINESs ACTIVITY C It) ~<; l\~.... L t 0'\" M r L",J>,lL.. ~ A c1....,,"" hAD 1 I v 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 ~ PART C .. REAL PROPERTY [Land, buildings owned by the reporting person) FILING INSTRUCTIONS for when and where to file this form are \)':)0 i'\~,s',,-; \\, 0" (\ lc.~ """";1' l)<...u<.L fl 3'\\~ll located at the bottom of page 2. II (A "\L <,1',.l \, \, ~ \..0'/~ H' \. ~ .k...... fA \'1)~J- INSTRUCTIONS on who must file ':J 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 - Elf. 1/2001 (Continued on reverse side) PAGE 1 PART D - INTANGIBLE PERSONAL PROPERTY [Stocks, bonds, certificates of depos~, etc.] TYPF nF INTANr.IBI F RII"INF"" F"'TITY TO WHICH THE PROPERTY RELATES S to'-- \i.... ~,,\\ ,A tI&-.,f,( c..~ riP _ 5 ~ '-' c_ V S <- '^""'_- ~<~ "'- ell 'S -1-,,-> ,_ Ie <,~ .\\ I'lL ."..."'-.'" / ') .ru /..- k (";0;''<- ~-.,,",.<~ PART E - LIABILITIES [Major debts] NAME OF CREDITOR ADDRESS OF CREDITOR ~} .. (i"\"_",, \-...,-H...,,, rtlurL " {\;<-~ "I" I" Iz j\J "I y,'fSt \.l,""G~ N ..:k>~...\ ~'-~~ r'\ ~ : \<'~~J FI \2,...."" Iz ~....,..~ \-"",...... 0\,0/-1- ,<,~"(.. j;",s rp",,- Mil '...; \J PART F -INTERESTS IN SPECIFIED BUSINESSES [Ownership or positions in certain types of businesses} . BUSINESS ENTITY # 1 BUSINESS ENTITY # 2 BUSINESS ENTITY # 3 NAME OF 6f~ /drGc.........l,0... BUSINESS ENTITY ADDRESS OF 161 ( 1/ s+ 15"~C. A I h"" K....~ BUSINESS ENTITY PRINCIPAL BUSINESS \' r~~_ \h~ ~u.. I r~~.. +" ACTIVITY POSITION HELD D...,-<.,"'t,,......V p~ rfr.~"'--- WITH ENTITY I OWN MORE THAN A 5% I:..~D'\P ",1 '\ 1/..., I "''^~c. U^t, I ~! INTEREST IN THE BUSINESS :1406 NATURE OF MY , ~..r\.....'"'c_;"J OWNERSHIP INTEREST IF ANY OF PARTS A THROUGH F ARE CONTINUED ON A SEPARATE SHEET. PLEASE CHECK HERE [J SIGNATURE.f'c:~ ~ --2-_ DATE SIGNED: ~ 1'<>: ,/ ~ ~-l-C) \ ! 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 and dating it, send back only the first on Ethics or a County Supervisor of Elections for specified state employee must file within 30 sheet (pages 1 and 2) for filing. your annual disclosure filing, return the form to days of the date of his or her appointment or of that location. the beginning of employment. Appointees who Local officers file with the Supervisor of must be confirmed by the Senate must file prior Elections of the county in which you permanentfy 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-elected 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 officers or specified state employees file lying 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 file this form together with your qual- by July 1st 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. To determine what category your position Finally, at the end of office or employment 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. sure form (Form 1 F) within 60 days of leaving office or employment. CE FORM 1 - Eft. 1/2001 PAGE 2