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Qualifying Materials LibbinLOYALTY OATH OFFICE USE ONLY CANDIDATES WITH NO PARTY AFFILIATION ~~ ~° R.~,, ;~- ~ ~~ ~ ~~g, (Sections 876.05-876.10, Florida Statutes) STATE OF FLORIDA 2009 SEP -9 AM 9~ OS /°?,i9~'T!_/l~/l~ ,COUNTY ~1~ ~' t;I_=.,,s'~''~ u~F fl.:~. Please Print I, `-' C ~~ a L i L f r~ J L~ j i First Name Middle Name/Initial 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 (Section 99.021, Florida Statutes) I, ~J ~2/z y ~. i /~~~N (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 office of Gvnr,~:ss.'orP/L N/A N/A ~ ~ (office) (district) (circuit) % I am a qualified elector of r~.'~yr-1~'- ~~~ County, Florida. (group) I am a qualified elector of the City of Miami Beach, Fla., residing within the City at least one year before qualify- ing for the City of Miami Beach elected office, with my legal residence being: j~? ,'~'s/oec~ .D,2- ~~~ Miami Beach, Fla. I am qualified under the ordinances and Charter of said City and under the Constitution and the Laws of Florida to hold 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. X (1'U~ ) ~~5 v7i~ TP~~f~c ~c/~' tgnature of Candidate Telephone Number Email Address /l2 > y J'~v2e /,J.C~ - ~'!.' ~ BP.Qt- f-r /r/o2, ll -1'1'/x/ Address City State ZIP Code Sworn to (or affirmed) and subscribed before me this ~ ~ day of~~6~~ 200. Personally Known: V or ~~~~tttiiiiiilf~/f// H A T F j F ~ ~ ,, ~ \ \ ~ ~ ~~ ~~~ • ~ Q~ ~~ ~, SSION ~ Produced Identification: ~ ~~ ~~J F,Yp~ t8 , 2p~'9F~ ~ Z ~o ~Ja~l Type of Identification Produced: _ : ~ ,.~~ `~ :* ~_ ~~`' ~~c : ~•~ • o~ ignature of Notary P - S of Florida ; #DD 832? ~`:: o` Print, Type or Stamp Commissioned Name of Notary Public 2 o~~. /~~9 ~~~Bii iii i N~ DS-DE 246 (Rev. 05/08) FORM 1 STATEMENT. OF 2008 Plsasepirrto.typ.yournam.,maNirp FINANCIAL INTERESTS ' ~.. `~ t~ a ~~ ~ ~; sddress, agency Warta, and posltla- below: LAST NAME -FIRST NAME --MIDDLE NAME : E ~~~~ S~~ ~ 9 ~~ ~• OS USE ONLY: MAILING ADDRESS : ; ~ T ~' (~ , C; I t ", •;,, r 1' 1 , f ~ , . ._ v ~ CvtivP,~.T- v / Cc'.~ Cs2 D/1- ID Code CITY : ZIP : COUNTY ~~ ~, /7i /?~ ~ Li ID No. NAME OF AGENCY 1.,0~ ~ Conf. Code NAME OF OFFICE OR POSITION HELD OR SOUGHT : P. Req. Code You are not Ifmlbd to tfu spsce ort the Nnes on this form. Attach additbnd sheets, if necessary. CHECK ONLY IF (j~ANDIDATE OR ^ NEW EMPLOYEE OR APPOINTEE "'BOTH PARTS OF THIS SECTK3AI MUST BE COMPLETED" DISCLOSURE PERIOD: THIS STATEMENT REFLECTS YOUR FINANCIAL INTERESTS FOR THE PRECEDING TAX YEAR, WHETHER BASSO ON A CALENDAR YEAR OR ON A FISCAL YEAR. PLEASE STATE BELOW WHETHER THIS STATEMENT IS FOR THE PRECEDING TAX YEAR ENDING EITHER (check one): ^ DECEMBER 31, 2iX~ Q$ ^ SPECIFY TAX YEAR IF OTHER THAN THE CALENDAR YEAR: MANNER OF CALCULATINt3 REPORTABLE INTERESTS: THE LEGISLATURE ALLOWS FILERS THE OPTION OF USING REPORTING THRESHOLDS THAT ARE ABSOLUTE DOLLAR VALUES, WHICH REQUIRES FEWER CALCULATIONS, OR USING COMPARATIVE THRESHOLDS, WHICH ARE USUALLY BASSO ON PERCENTAGE VALUES (see instructions for further details}. PLEASE STATE BELOW WHETHER THIS STATEMENT REFLECTS EITHER (check one): ^ COMPARATIVE (PERCENTAGE) THRESHOLDS Q$ ^ DOLLAR VALUE THRESHOLDS PART A -PRIMARY SOURCES ~ INCOME [Major sources of income to the roporting person] NAME OF SOURCE SOURCE'S DESCRIPTION OF THE SOURCE'S OF INCOME ADDRESS PRINCIPAL BUSINESS ACTIVITY /- .~- :~ y.~Pr:~,~w~r~ : i~z ~ .,f a ~ ..y a. ~/ ~~iy i f~iE off ° P~ ~-~ .L~i e' C~cv ; _~ r lief • ;SAD l %,¢~ /°~u. IT.!'l:t/'~1~4P?G /' ~4~/~ ~F .rc~~R iTi'Pl F D.YiO~...~ ORC ~' f/ ~/~~ ~/~ ~OC~¢ I PART B --SECONDARY SOURCES OF INCOME [Major arstorr>ers, diems, and other sources of income to twsinesses owned by the reporting person] NAME OF NAME OF MAJOR SOURCES ADDRESS PRINCIPAL BUSINESS BUSINESS ENTITY OF BUSINESS' INCOME OF SOURCE ACTIVITY OF SOURCE PART C -REAL PROPERTY (land, buildings owned by the reporting person) FILING INSTRUCTIONS for when a d h n w ere to fife this form are locat• ~ '- _ ~~~ y / ` ed at the bottom of page 2. rr ~ n: ~~ .S~W D C- INSTRUCTIONS on who must file this form and how to fill it out begin on page 3. OTHER FORMS you may need to file are described on page 6. rtF Fr1RM ~ _ t=s ~ nnne _••• ••_--~ t~.onanuea on rovsrse side) PAGE 1 PART D -INTANGIBLE PERSONAL PROPERTY [Stocks, bonds, certficates of deposk, etc.) TYPE OF INTANGIBLE I BUSINESS ENTI a PART E -LIABILITIES [Major debts] NAME OF CREDITOR ADDRESS OF CREDITOR •N 0 P!l ~ cR- r0. Qa Z/p~ 6,r?~P.~ R C z 7y-to ~/ PART F -INTERESTS IN SPECIFIED BUSINESSES [Ownership or positions in certain types of businesses) BUSINESS ENTITY ~ 1 rrz, .y-r~va p D~ -~ ~ ~,'~~ ACTMTY fG OWNERSHIP INTEREST BUSINESS ENTITY #~ 2 BUSINESS ENTITY ~ 3 IF ANY OF PARTS A THROUGH F ARE CONTINUED ON A SEPARATE SHEET, PLEASE CHECK HERE ^ SIGNATURE WHAT TO FILE: After completing aH parts of this form, including signing and daring it, send back only tha first sheet (pages 1 and 2) for filing. If you have nothing to report in a particular section, you must write "none" or "n/a" in that section(s). Facslmlles will rwt be accepted. NOTE: MULTIPLE FILING UNNECESSARY: Generally, a person who has flied Form 1 for a calendar or fiscal year is not required to file a second Form 1 for the same year. However, a candidate who previously filed Form 1 because of another public position must at least fib a copy of his or her original Forrn 1 when qualifying. n~ enou . rs .......... DATE SIGNED FILING 1NSTRrUCTIONS: WHERE TO FILE: If you were mailed the form by the Commission on Ethics or a County Supervisor of Elections for your annual disclosure filing, return the form to that location. Local olflcsrs/amployeasflle with the Supervisor of Elections of the county in which they perma- nently reside. (If you do not permanently reside in Florida, file with the Supervisor of the county where your agency has its headquarters.) State offices or specified ataEa en-ployess fik with the Commission on Ethics, P.O. Drawer 15709, Tallahassee, FL 32317-5709; physical address: 3600 Macey Boulevard, South, Suite 201, Tallahassee, FL 32312. CanaMdatea file this form together with their qualifying papers. To determine what category your position falls under, see the "tNlmo Must File" Instructions on page 3. D WHEN TO FILE: /nldslly, each local officer/empbyee, state officer, and spektified state employee must file wld-!n 30 Jaya of the date of ha or her appointment or of the beginning of empby- ment. Appointees who must be confirmed by the Senate must file prior to confirmation, even if that is less than 30 days from the date of thefr appointment. Candidates for publicly-elekxad local office must file at the same time they file their qualifying papers. Thereafter, local officerslemployees, state officers, and specified state employees are required to file by Juty 1st folbwing each calendar year in which they hold their posi- tions. Finally, at the end of office or employment, eacm local officer/empbyee, state oifroer, and specified state empbyee is required to file a final disclosure form (FOnn 1F) within 60 days of leaving office or employment. PAGE 2 2009 SEP -9 Q~ 9~ Q6 t~ 1.. t. f ~ t :J ~~ i~ f j : ~= 1'008 <. JE~ZR~ LiB$IN °C~MP~iIGN ACGC4I7NT ea-ossrcai h-~~ DATE PAY TO THE /' .;~ 1 mc.+.c ORDER OF~~ ~~ ~~~~+C~NS .FOR ~~R~~~~~~~-] ~ / ~ fmrm~acw~